Archive for April, 2009
Thursday, April 30th, 2009
Pain is a reaction to signals that are being communicated somewhere in your body that there is a problem. The signals come from wherever there is pain and move through the nerves in your spinal cord and to their final destination, the brain. Back Pain Treatments vary.
Types of Pain
Pain can be broken down into two categories- neuropathic and nociceptive. Understanding the type of pain you have is important because the course of treatment can then be determined based upon it. It is important to note that some individuals suffer from mixed pain which is a combination of the two types of pain.
Neuropathic Pain- This type of pain is the result of damage that occurred to nerve tissue. The manifestation of neuropathic pain is often a sharp pain that feels like a burning or a stabbing. A perfect example is that of a pinched nerve.
Nociceptive Pain- This type of pain comes about as a result of a disease or injury that does not involve the central nervous system. Most often it manifests itself as pressure or a dull ache. Arthritis pain is an example of this kind of pain.
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Wednesday, April 29th, 2009
Pitchers suffer an inordinate number of arm injuries in large part because the human body wasn’t designed to fling baseballs 90 or more miles per hour. And, for that matter, the human body may not have been designed for us to even walk upright, surmises Houston pain specialist Dr. Uday Doctor, because of the world of hurt our spines can cause us.
Doctor is chief of pain management at the Texas Orthopedic Hospital. He stays busy because of the inherent design flaws in our backbones vis-à-vis how we use our bodies in jogging, lifting heavy objects and whacking golf balls.
Doctor, who is board-certified to practice interventional spine care, is hardly alone in his field. There are more than 150 physicians in the area who are pain management specialists. And who knows how many chiropractors, acupuncturists and physical therapists also earn a living off our agony?
As we reach a certain age, most of us start to hurt, which wreaks havoc on the quality of our lives, affecting mood, motor functions and concentration.
Doctor suggests that there are two kinds of chronic pain, that which is caused by cancer and that which emanates from diseased and damaged nerves.
The former, he said, is treated by throwing the book at it with little regard for the consequences. Side effects and the risk of addiction are secondary concerns.
“You’re just trying to relieve suffering,” Doctor said, “and that’s especially true if the patient is terminal. All you’re trying to do is make them more comfortable.”
For those coping with nerve pain, however, it’s trickier because addiction issues and side effects of the most potent painkillers do matter. We don’t want to spend every waking moment groaning and grimacing, but we certainly don’t want to turn into junkies, either.
Attacking the problem with surgery is no black-and-white solution. Spinal operations, in particular, remain a dicey proposition, and it’s the spine — particularly the disks separating the vertebrae — that’s often the source of pain. For example, while a stabbing ache in the shoulder could be a torn rotator cuff, it’s more likely to be the byproduct of a herniated disk between the C6 and C7 vertebra, “pinching” the nerve leading to the shoulder.
Dr. Tom Blair, a retired pulmonary specialist at St. Joseph’s Hospital, has battled back problems for 40 years. He takes Naprosyn, a prescription-strength anti-
inflammatory drug, and stays as active as he deems prudent. He thinks shutting down completely because you’re hurting inflicts psychological damage that exacerbates physical discomfort.
Blair’s advice? Educate yourself. Make every effort to know your body — so you’ll know why you’re hurting — before deciding what to do about it. And, he adds, “Don’t turn yourself over to somebody you don’t have good references on or who won’t explain what they’re doing, and why they’re doing it.”
The old-school way of thinking about pain offered two options, sucking up and living with it or swallowing hard and going under the knife. Fortunately, there are other options. For example, Doctor and his partners at SpineCare Consultants (www.spinecare1.com) are practitioners of the nerve root block, which attacks pain without major invasive surgery.
Yes, they will stick a needle or two in your neck or lower back. But that’s a far cry from having an epidural, never mind fusing vertebrae.
And most insurance plans cover it even without a referral from a primary-care physician.
“We find the nerve that’s inflamed and we put (anti-inflammatory) medication directly on it,” Doctor said. “It’s critical to isolate the source of the pain. Say your shoulder hurts. In the old days, we’d probably scope it. If that didn’t work, then we’d operate on your neck.”
Michael Cokinos, president of Cokinos Energy Corp., says the nerve block ended his searing back, arm and hand pain. But, ever fearful of a stress-induced relapse, Cokinos regularly visits a chiropractor, Dr. Ron Grabowski, who Doctor recommended. Grabowski’s mission is to keep Cokinos’ C7 vertebrae from re-settling on the nerve.
“I thought I was going to have to live with (the pain) the rest of my life,” Cokinos said. “But I feel like I’m 150 percent of my old self. I’m working out again and feeling great. What a relief.”
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Monday, April 27th, 2009
Is your back bothering you to the point that it hinders your daily routine or worse, your job? Back pain is becoming more and more common nowadays, mainly because of two reasons: the alarming rise of obesity, and wrong sleeping positions.
Still, treating back pain is relatively easy:
The market offers a vast array of choices when it comes to our sleeping materials; soft mattresses are very much in demand, yet many people fail to realize that their sleeping positions are being affected when they lie down on these, as soft mattresses do not help maintain the normal curve of a spine.
This makes the veins in between the spinal bones pinched, thus causing back pain. Though many do not choose firm mattresses as they feel it is uncomfortable to sleep in, it actually helps support your back more as you sleep.
Avoiding obesity can help treat back pain. It is not the fat that causes back pain; it is the weight, which puts a strain on your back that actually causes it. And not only does your spine or back suffer; extra weight also strains your knees and ankles, for instance. Losing weight plays an important role in treating back pain.
Doing these will help you avoid and treat back pain, but aside from these, heat therapy can help immediately.
Doing it daily for half an hour will do wonders, as the heat increases blood flow to the inflamed tissues, taking away things which inflame bones and muscles, such as pain medications.
Muscle rubbing and stretching will also help a lot, though the latter should be done gently. Massaging, stretching and rubbing will help the muscles to relax, thus avoiding pain.
If all these do not help, pain medications prescribed by a doctor may also be taken. These are usually Ibuprofen, Naproxen, Meloxicam, and others. Keep in mind that these medicines must be taken only after you consult with a physician.
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Sunday, April 26th, 2009
Ever wondered why so many people suffer from foot pain? There are 26 bones located in your foot and 39 muscles. These bones and muscles are designed to withstand movement and to support your weight. The foot can also adjust to most terrains and take us just about anywhere we ask them to take us. There are many causes of foot pain. Some of the common causes of foot pain are:
* Arthritis
* Injury
* Overuse
* Back, Hip, or Knee injury
Pain is a significant signal that the body uses to communicate a need. Pain is a stimulus that we must respond to. It can be important to know what is causing the foot pain in order to discover the correct pain relief. Listen to your pain and make every effort to describe it to your doctor.
One common type of foot pain is caused when you sprain your ankle. These accidents are attributed to high heels, being overweight, or sports. Should a painful foot appear deformed it may be broken and should not be moved. In this case the person needs to be seen immediately by a doctor or through an emergency room.
An important thing to remember is not to walk on a sprained foot until it has a chance to heal. Do not place weight on your injured foot.
Use ice/hot compresses, bed rest, and be sure that you elevate your foot to avoid further swelling.
Another common cause of foot pain is arthritis. Arthritis can cause both pain and swelling of the foot. Elevate the foot and follow any instructions your doctor may have given you in advance.
There are many over-the-counter medications that can be taken to relieve foot pain. Brand name medications include: Advil, Aleve and Tylenol.
When you suffer from foot pain, it can affect you in many ways. It can affect your ability to move around, get to school or work, and can be the cause of missed work and school days.
Chronic foot pain can be frustrating as you try to design an appropriate pain management plan. Your doctor may do want to take an x-ray of your foot in order to see what is happening with your foot. One way to help your doctor understand your chronic foot pain is to keep a journal of when, how, and where the pain occurs. These may be important clues to diagnose the cause of your chronic foot pain.
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Saturday, April 25th, 2009
Q: Do you have any information on natural treatments for a sore ganglion cyst on the wrist? I have been using a wrap-around brace on my wrist and would prefer to handle this without medication or surgery.
A: A ganglion cyst is a fluid-filled sac that forms on joints such as the wrist, ankles, feet or fingers. If the sac presses on a nerve, it may be painful. Such cysts often disappear on their own, so “watch and wait” is the first choice for treatment. The American Academy of Orthopedic Surgeons also recommends wearing a brace to immobilize the joint. If the cyst is persistent and painful, it should be checked by a doctor, who might opt to puncture and drain it.
We did hear about an unusual treatment for ganglion cysts from a young woman who applied frankincense oil to hers. It disappeared.
Another reader tried this: “I had cysts on my knees that made it excruciating to kneel. Frankincense oil on them twice a day cleared them up in only four days. I would never have believed this could work so quickly!”
Frankincense is resin from Boswellia trees. Boswellia extract has anti-inflammatory activity.
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Friday, April 24th, 2009
Spring is a dangerous time of year. Household hermits come out of their winter hibernation for outdoor activities.
Digging, weeding and slinging mulch in the garden, spring-cleaning in the attic or garage, and weekend running, tennis or softball all can contribute to strained muscles and aching backs.
For relief, most people turn to over-the-counter pain relievers. They are readily available and affordable, and seem like an easy solution for stiff joints and soreness. Surveys by Roper and the National Consumers League estimate that more than 20 million Americans swallow a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen every day.
Some long-distance runners, bikers and hikers refer to ibuprofen as “vitamin I.” That’s because it is such a common part of their daily regimen. They don’t even think of this NSAID as a powerful medicine, and they hardly ever heed the warning to take OTC pain relievers for no more than 10 days without medical supervision.
Only about one person out of five reads the directions on the pain-reliever label (Journal of Rheumatology, November 2005). Fewer than one in three checks out dosing instructions. About one-quarter take more than the recommended dose.
About half of those surveyed did not realize that OTC pain relievers could cause any harm.
But swallowing pain pills without reading the labels can land you in a world of hurt. The most obvious complication from NSAIDs
like Advil, Aleve or aspirin is stomach upset. This can turn into a lot more than a bad bellyache, though.
Bleeding ulcers can occur even at relatively low doses and may produce no warning symptoms. Thousands die each year as a consequence.
Other NSAID complications include high blood pressure, kidney problems, allergic reactions, skin rash and liver damage.
Interactions with other medicines such as blood pressure pills or blood thinners like Coumadin (warfarin) or Plavix can be quite dangerous.
Even savvy consumers who would like to read labels carefully may find it difficult to locate important information. Fine print and poor design make it hard to locate some important safety information (Proceedings of the National Academy of Sciences online, March 30, 2009).
Many people use OTC pain relievers for short periods of time with no complications. But folks with arthritis or athletes who need pain relief for the long term may want to look beyond ibuprofen and naproxen.
Avoiding aches and pains during the first several weeks of beautiful spring weather also may involve some common sense.
Pacing oneself and being careful to avoid overexertion can be very helpful in getting back into shape. If pain pills become necessary, the lowest dose for the shortest period of time is the safest approach.
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Thursday, April 23rd, 2009
Open the medicine cabinet of almost any home and you’ll find at least one pain reliever on the shelf. Depending on the age and health conditions of the family members, you may find more than one. Although it’s a good idea to have some sort of pain relief medicine around, many people don’t realize how dangerous some of these can be. Aspirin and NSAIDs, also known as nonsteroidal anti-inflammatory drugs, should be taken with great care.
Watch out for these side effects.
1. Ulcers
Unless you’ve been hiding under a rock, you’ve heard the word “ulcer” before. You probably thought it was related to someone experiencing excessive stress in their life. What you may not realize is that NSAIDs are one of the major causes of ulcer development. Using these medications for an extended period of time can lead to serious cases of gastrointestinal bleeding which may require surgery or hospitalization.
Aspirin, in particular, can be very irritating to the stomach lining and this often causes bleeding to occur. Taking aspirin while also ingesting alcohol or caffeine can put you at an increased risk of developing problems. You should consult your doctor immediately if you begin to experience dark stools because this is usually a sign of internal bleeding, a very serious condition.
2. Kidney Problems
Aspirin can also cause problems with your kidneys and make them have increased levels of fluid.
3. Blood Thinning
Aspirin and NSAIDS thin the blood when you take them. Before you have any type of surgical procedure, your doctor will advise that you discontinue any of this type of pain relief medicine for about two weeks prior to the procedure. If you continue to take these drugs, you can experience excessive bleeding after the surgery which could result in serious complications.
4. Risk of Overdose
As with most drugs, there is always the risk of overdosing when you take a pain relief medicine. It’s easy to think you need more just because your pain has not subsided enough yet. If you suspect that you or someone you know has overdosed on something like aspirin, call your physician right way.
5. Increased Gastrointestinal Problems
Sometimes when you take NSAIDs you experience increased gastrointestinal symptoms such as heartburn, nausea, or vomiting. Be sure to let your doctor know about this before it becomes a serious issue.
Many people choose to avoid pain relief medicine such as aspirin and NSAIDs because of the side effects mentioned above. You may want to consider herbal remedies and alternate methods of pain control such as stress management and exercise. The more options you have when treating your pain the better you can handle the situation.
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Wednesday, April 22nd, 2009
What are the alternatives when pain strikes. This varies on how severe the pain is, and where in the body the pain is occurring . If the pain is only a mild headache, toothache or a pain where you know the cause, such as a fall or graze, then an ordinary pain killer will usually be enough. For toothache pain medication containing Ibuprofen is the correct choice, toothache is often accompanied by inflammation, Ibuprofen is an anti inflammatory and therefore helps to decrease the inflammation. If the pain persists you should get medical advice, as the pain could be the symptom of a more chronic underlying medical problem. Pain is your body letting you know that something is amiss, do not ignore this message if pain persists.
Pain can be separated into two types, chronic and acute pain. Acute pain is usually a short term pain that recedes without further treatment, it has no serious underlying medical problems associated with it and normally needs nothing more than simple over the counter pain medication. Chronic pain though is much more serious, it generally persists and is often associated with a more serious underlying condition or injury. It can often begin from something as simple as a sprain or an infection that eventually becomes more serious, or it can be caused by a developing disease or cancer. Chronic pain can persist for months, or even years. As well as a requirement to treat the main cause, pain killers that are stronger than normal pain killers is usually required. Among the most prescribed pain medications include tramadol, ultram and ultracet, with tramadol being the most common prescribed. These pain medications aren’t scheduled as controlled substances, it is therefore possible to order tramadol online. In many cases pain killers are prescribed with other treatments to treat the cause of the problem.
Probably the commonest type of pain we all experience is a headache. A headache may well disappear without requiring any treatment, simple over the counter pain medication will usually be enough to lessen the pain. Migraine is a much more severe type of headache and can be caused by various underlying conditions. A migraine can be accompanied by several other conditions, such as mood changes, sensitivity to light, one sided headaches and nausea or vomiting. A migraine can last for a few hours, but might continue for several days. Anyone experiencing a migraine should get medical attention as soon as possible.
For pain associated with muscles and joints, physiotherapy is often used as a treatment, and can in many cases result in the complete removal of the underlying problem. Electrical stimulation is a technique sometimes used, often as a last resort. Electrical stimulation interrupts pain signals in the spinal cord. Acupuncture may also be used to try and reduce pain, fine needles are entered at key points on the skin, the theory being that these disturb the flow of spasms through the body. Fine needles may be used in areas removed from the source of the pain.
The main point to observe, is that if a pain becomes serious, especially if it persists, get medical advice without delay, it could be down to a more serious problem.
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Monday, April 20th, 2009
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about pain:
1. What are the most common conditions that may cause me to experience acute pain?
2. What are the most common conditions that may cause me to experience chronic pain?
3. How can I tell the difference between acute and chronic pain? At what point would my acute condition be considered chronic if it is not resolved?
4. What is a pain diagram? When might I use one?
5. What other types of pain assessment might be used with me?
6. How might my condition be diagnosed?
7. Does my medical history reveal anything significant about my pain or risk of certain complications?
8. What is the difference between an x-ray, CAT scan, MRI and other imaging tests? Why is one test recommended for me over another?
9. How can I tell when I can treat my pain myself and when I need medical attention?
10. Which medications can treat my pain?
11. Should I take acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) to treat my pain at home?
12. Are there ways to treat my pain that do not involve medications? Do you recommend physical therapy, occupational therapy or other therapy for me?
13. Are complementary and alternative methods such as acupuncture or biofeedback effective ways to treat my pain?
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Sunday, April 19th, 2009
According to the American Pain Foundation, more than 50 million people in the United States experience chronic pain that interferes with daily life. But most pain is untreated, undertreated or improperly treated.
Many patients, particularly men and elders, underreport pain for a variety of reasons. Some patients fear complaints will not be taken seriously, whereas others believe relief is not available. Some physicians do not treat pain sufficiently because they fear that patients using opioids will develop a dependency or addiction.
There are a number of ways that patients can address this issue, including getting a correct diagnosis, being an advocate for pain needs, making a commitment to pain reduction and carrying out lifestyle improvements that may help, such as exercise and weight loss.
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