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Category: Chronic Pain

A comprehensive guide on chronic pain, its causes, symptoms, and effective management strategies to improve your quality of life.

  • How to relieve middle back pain while sleeping?middle back painHow to relieve middle back pain while sleeping?

    How to relieve middle back pain while sleeping?middle back painHow to relieve middle back pain while sleeping?

    Sleep is critical to your health and overall sense of wellbeing. But getting enough sleep may be easier said than done if you are experiencing nocturnal back pain. Chronic middle back pain while sleeping can disrupt your sleep enough to affect not just your nights, but yfour days as well. Keep reading for tips on how to manage or even eliminate middle back pain while sleeping.

    What causes middle back pain while sleeping?

    Your middle back is also referred to as the thoracic region. It roughly encompasses the area from the base of your neck to just below your ribcage, and includes the space between your shoulder blades.

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    Middle back pain at night is sometimes caused by something simple, such as bad posture or twisting too quickly. In these cases, the pain is usually temporary and you’ll find relief fairly easily with proper care and patience. In other cases, however, back pain has a more serious cause that will require professional intervention.

    Middle back pain while sleeping may not be as widely discussed as other kinds of nocturnal back pain, but it can be just as distressing and must be taken just as seriously. Here are the major causes of middle back pain while sleeping.

    Poor posture during the day

    Much has been made about the amount of time people spend sitting — whether in the car, at work, or in front of a screen — and the effects this can have on your health and lifespan. But it’s not just sitting itself that can impact your life; it’s also the way you sit.

    Spending prolonged periods of time leaning forward or hunching over can strain your back, leading to pain throughout your neck, shoulders, and back.

    Arthritis

    Arthritis is a very common cause of joint pain. Mostly affecting older individuals, it is characterized by:

    In addition to the pain and discomfort caused by the arthritis itself, arthritis can make you more susceptible to injury as well.

    Injury

    Back injuries run the gamut from minor to life-changing.

    In cases of minor injuries, such as those caused by improper lifting technique or turning the wrong way, your pain will likely go away by itself within days or weeks. But if the injury is serious enough, it can lead to long-term problems, including chronic pain.

    Herniated or bulging disc

    You have discs all along your spine in between each pair of vertebrae. Each disc is filled with a jelly-like substance that keeps your backbones from grinding against each other when you move.

    A herniated disc occurs when one of the discs breaks open. A bulging disc is a similar condition, but instead of breaking open, the disc slips out of place and the inner substance “bulges” outwards but doesn’t rupture. Both conditions may be asymptomatic, or they may cause symptoms like pain, numbness, and weakness.

    Herniated and bulging discs affect both the surrounding vertebrae and, often, the nearby nerves. These injuries are most common in the lower back, but they can also occur in the middle and upper back and even in the neck.

    Vertebral compression fracture

    A vertebral compression fracture, when one of your vertebrae cracks or collapses, is usually the result of osteoporosis or a traumatic injury, like a fall or an accident.

    Vertebral compression fractures don’t always cause symptoms. When they do, the symptoms tend to vary widely, but there are some commonalities. These include pain and a permanent curve of the spine (kyphosis). The severity of symptoms will depend on the severity of the fracture and may worsen over time.

    Tumor

    In rare cases, a tumor may cause middle back pain by pressing against the body parts (e.g. The nerves) near the spine.

    Tumors can also trigger a vertebral compression fracture.

    When is middle back pain while sleeping serious?

    Most cases of middle back pain while sleeping are not serious. It is certainly disruptive, annoying, and even upsetting, but the underlying causes do not pose an immediate health risk. The symptoms can be safely treated with more conservative remedies.

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    However, as mentioned earlier, some middle back pain causes are more serious than others. If your middle back pain is accompanied by numbness and/or tingling, there may be underlying nerve damage. This can be caused by multiple conditions, some potentially dangerous, so it’s important to visit your doctor as soon as possible.

    Further, any middle back pain that occurs with loss of feeling in your limbs or loss of bowel control is an emergency condition. Contact your doctor immediately if this occurs.

    In addition, if you’ve tried some basic at-home remedies and your symptoms are still so severe that you can’t sleep well, make an appointment with your doctor as soon as you can. Without proper rest, your body and mind will quickly become exhausted. Any and all medical issues that prevent you from sleeping properly should be taken care of as quickly as possible.

    How to sleep with middle back pain: 5 tips

    Sleeping with middle back pain can be a challenge, but it isn’t impossible. Some remedies require making a purchase, while you can test out others tonight for no cost.

    Below are some tips on how to sleep with middle back pain.

    Rearrange your pillows

    Most people use pillows to provide support for their head and neck while they sleep. But you can also use pillows to support your back and minimize pain while sleeping.

    No matter which sleeping position you favor, there is a way to arrange your pillows to ease your middle back pain and get a better night’s rest. Try pillows between the knees if you’re a side sleeper or a small one under your knees if you sleep on your back. Try a different pillow to manage your neck pain if it’s leading to back issues.

    Not working? Talk to your doctor for suggestions that could work for you.

    Stretches

    Your nighttime routine can make a difference in how well you sleep at night.

    Try performing gentle stretches before going to bed. This can strengthen and stretch your back to relieve pain and discomfort.

    Change your sleeping position

    When it comes to managing back pain at night, not all sleeping positions are created equal. For example, sleeping on your stomach forces your neck to rest in unnatural positions, straining your back.

    The Cleveland Clinic offers this guide to evaluate your sleeping position(s) and to figure out whether it might be necessary for you to try some new ones. Our earlier post also discusses at length how certain sleeping positions can cause back pain and which ones may be better for you.

    Buy a new mattress

    Back pain can be exacerbated by an old, uncomfortable, or unsupportive mattress. One study suggests that medium-firm mattresses provide the best sleep quality. But don’t think of this as a hard and fast rule. You know your body better than anyone, and you are the only one who can choose the best mattress for you.

    While mattress shopping, there are several things you can do to make sure you pick the right one. Before making a purchase, do some research on which mattress brand, style, and firmness might work for you. Some of this work can be done online, but it’s also important to go to the store, ask questions of the sales rep, and test out the mattress you’re considering. A mattress is a big investment, so take your time and do your homework before making a final decision. See if you can find options with a good return policy or risk-free trial period.

    If a new mattress just isn’t in the budget at the moment, try a foam mattress topper. These are generally much cheaper than a full mattress, but they can still provide additional support if you need it.

    Change how you get out of bed

    Even after the night is over and you’re ready to start the day, you still have to get out of bed. As with choosing a sleeping position, there is a right way and a wrong way to do this.

    Verywell Health provides a step-by-step guide on how to get out of bed without hurting your back.

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    How to relieve middle back pain while sleeping

    If you’ve tried the tips above and still can’t sleep, then it’s time to move away from coping with middle back pain while sleeping and start actively treating it.

    Fortunately, there are a multitude of ways to treat back pain. However, not all of them may work for you, and some may even be harmful, depending on your back pain cause or underlying medical conditions. Because of this, it’s always important to consult with your doctor before beginning any new treatment regimens.

    Adjust your posture

    Because poor posture is such a common cause of back pain that no matter who you are, it’s probably a good idea to pay more attention to how you sit and stand throughout the day.

    Do you hunch your shoulders for hours as you work on the computer? Do you slouch when you walk? Get into the habit of assessing your posture regularly and adjusting it as necessary. Here’s some tips for improving your posture.

    Rest and exercise

    One of the simplest yet most useful ways to combat middle back pain is a combination of rest and gentle exercise.

    Using your back muscles on a regular basis keeps them strong and helps them recover more quickly. That said, don’t push yourself too hard. If you feel any pain or discomfort while exercising, stop, rest, and modify the exercise if you try it again.

    Heat/cold therapy

    Heat and/or cold therapy is a time-honored method of pain relief. While many stores and pharmacies carry products such as heating pads to provide this treatment, you don’t need to buy anything if you don’t want to. Ice wrapped in a towel or a hot shower can also work.

    These treatments are best done before or as you’re settling into bed. Do not use heat or cold therapy while sleeping.

    Medication

    Pain of all kinds is often treated with medication. Over-the-counter medicines like ibuprofen or acetaminophen are often enough to help you find relief for pain flare-ups.

    If your pain is severe, you may need to get a prescription for a stronger medication. Regardless of which kind of medicine you take, be sure to follow all instructions and to never take more than the recommended dose. Talk to your doctor about any risks or side effects.

    Physical therapy

    A physical therapist can help you reduce your pain and increase your range of motion.

    When you go in for a visit, your physical therapist will examine you and determine what treatment or combination of treatments will help your back heal. You’ll work with them closely as they show you correct form for these exercises and lead you through exercise routines.

    Brace

    If you have suffered from an injury, you may need to wear a back brace for several weeks. This can help minimize pain and prevent re-injury. On the other hand, using a brace for a long time may weaken your back muscles.

    As with all treatments, discuss the pros and cons with your doctor before you try it.

    Surgery

    In some rare cases, more drastic solutions are needed to resolve middle back pain while sleeping. For chronic pain that doesn’t respond to more conservative treatments, you may need to consider surgical options with your doctor.

    The type of surgery you undergo will depend on your middle back pain cause. For example, herniated disc pain may be treated by removing part or all of the affected disc in a procedure called a discectomy. A vertebral compression fracture sometimes requires a vertebroplasty, during which bone cement is injected into the spine to strengthen the damaged vertebra.

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  • What Is Spondylolisthesis? Its causes and treatments

    Lower back pain can take a toll on your entire body. This particular health concern is reported among men and women equally, affecting about 80% of people at some point in their lives. While there are many factors that can lead to lower back pain, a condition called spondylolisthesis is one of the most common causes. This article will cover what you should know about the condition and how to find relief.

    What is spondylolisthesis?

    Spondylolisthesis is a spinal condition that can lead to pain and discomfort in the lower back. It occurs when one of the bones (vertebrae) in the spine moves out of place and onto the bone below it. If the bone slips too much, it can even press on surrounding nerves.

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    This can occur for many reasons. In children and young adults, it is usually due to a birth defect or periods of rapid growth, also known as growth spurts. It’s also more likely to occur in athletes who frequently overstretch the lower back. This may include gymnasts, football players, and weight lifters.

    Doctors believe there is also a genetic component to spondylolisthesis. Some people are born with thin vertebral bones that are more susceptible to fractures. These fractures can lead to the slippage associated with spondylolisthesis.

    Types of spondylolisthesis

    There are several different ways to classify spondylolisthesis. The following types are based on the initial cause of the condition.

    • Degenerative spondylolisthesis: This is the most common form of spondylolisthesis, which is simply due to aging. As the years go on, discs between your bones lose water and become less effective in cushioning each vertebral bone. This occurs from basic wear and tear on your body.
    • Congenital spondylolisthesis: By definition, congenital means “present at birth.” Abnormal bone formation can put a person at greater risk for developing this condition.
    • Isthmic spondylolisthesis: As we’ll discuss later in this article, spondylolisthesis can occur as a result of spondylolysis. This is when stress fractures weaken the bone, causing it to slip out of place.
    • Traumatic spondylolisthesis: This is when an injury leads to fractures and subsequent slipping. This may be the result of athletic activity or a fall.
    • Pathological spondylolisthesis: The spine can weaken from diseases like osteoporosis or even a temporary infection. Pathological spondylolisthesis takes place after this type of health event.
    • Post–surgical spondylolisthesis: Slippage that occurs or becomes worse after spinal surgery.

    Spondylolysis is also divided up into several different grades based on severity. This helps doctors determine the best course of treatment for a specific case. Slippage is graded on a scale of one to five.

    1. 25% or less of the vertebral body has slipped forward
    2. Between 26-50% of the vertebral body has slipped forward
    3. Between 51-75% of the vertebral body has slipped forward
    4. Up to 76-100% of the vertebral body has slipped forward
    5. The vertebral body has completely slipped off and looks detached

    Your doctor will determine the best type of treatment based on your personal situation. However, Grade 1 and grade 2 slips generally don’t require surgery. In many cases, these patients respond well to conservative and non-invasive methods of treatment.

    Slips that are rated above grades 1 and 2 may require surgery if significant pain persists.

    Spondylolisthesis vs. Spondylolysis

    As previously mentioned, a condition called spondylolysis often leads to spondylolisthesis. It occurs when there is a fracture in the bone, but it hasn’t yet fallen onto a lower bone in your spine. In most cases, patients with spondylolysis will also have some degree of spondylolisthesis.

    The two conditions are so similar that they come with the same set of symptoms. For this reason, your doctor will need to conduct imaging tests, such as X-rays, computerized tomography (CT) scans, or magnetic resonance imaging (MRI) scans. This is the best way to look at what is happening in the spinal area and confirm a diagnosis.

    Do I have it? 4 common spondylolisthesis symptoms

    In some cases, patients with spondylolisthesis don’t have symptoms and aren’t aware of the condition. This is generally true for mild forms. On the other hand, those with severe cases may not be able to go about simple activities.

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    Here are four common spondylolisthesis symptoms.

    1. Lower back pain

    Persistent lower back pain is the most common symptom of this condition. It will feel much like a muscle strain that worsens with activity.

    This pain can also radiate down to the buttocks and back of the thighs.

    2. Stiffness

    Tenderness associated with spondylolisthesis can lead to stiffness in the lower back and legs.

    This usually makes it difficult for patients to walk or stand for long periods of time.

    3. Muscle spasms

    Spasms can lead to tight hamstrings (the muscles in the back of the thigh).

    As this type of pain progresses, tingling and numbness can travel all the way down to the feet. This is a result of pressure on the spinal nerve root as it exits the spinal canal near the fracture.

    4. Weakness

    Weakness in one or both legs can occur in many cases of spondylolisthesis.

    Like muscle spasms, this is due to pinching of the spinal nerve root and can lead to changes in posture and gait.

    How do you fix spondylolisthesis?

    If you believe you may be suffering from spondylolisthesis, it’s important to talk to your doctor. After a thorough review of your symptoms and medical history, various tests will help your doctor confirm a diagnosis.

    Luckily, there are a wide variety of spondylolisthesis treatment options. Your doctor will start with conservative methods of pain relief before suggesting more invasive procedures.

    These are some of the more common ways patients find relief from their pain and other symptoms.

    Spondylolisthesis exercises

    Lower back pain can make exercising feel impossible, but it’s one of the best ways to minimize spondylolisthesis symptoms. With a gentle routine, you can maintain a healthy weight and increase your flexibility.

    Some exercises focus on stretching and lengthening, while others are meant for strengthening the muscles of the spine and abdomen for better support. This is a prescription for both treatment and prevention of future lower back pain.

    Once your doctor clears you for exercise, try a few simple stretches each day. Concerned about whether you’re doing them correctly? Work with a physical therapist or qualified personal trainer. They can teach you how to perform each exercise in a way that will prevent further injury.

    Yoga for spondylolisthesis

    Yoga is a form of exercise that focuses specifically on stretching, lengthening, and strengthening. In fact, many of the best exercises for lower back pain are poses commonly found in yoga classes. Find a reputable studio that offers private lessons or classes that are designed to be gentle on those with injuries.

    Experts advise anyone with spondylolisthesis to approach poses slowly and gently. If you feel pain, stop immediately. Back bends and poses that require twisting and bending forward aren’t recommended. A professional yoga instructor or physical therapist can help you determine the best poses for your condition. Before trying a class, be sure to inform the instructor of your condition.

    Back brace for spondylolisthesis

    A back brace is an affordable and effective tool that can help you perform basic activities during a mild and short-term pain flare-up. They also limit your range of motion to promote healing and prevent further injury.

    Other benefits of back braces for lower back pain can include:

    Back braces work best in combination with other forms of treatment like physical therapy and medications. Talk to your doctor about whether this may be a promising form of treatment for your lower back pain, and take a look at our list of back braces.

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    Spondylolisthesis physical therapy

    Physical therapy is a great way to treat a range of lower back pain causes. Even better, most insurance companies cover this type of treatment.

    A professional physical therapist develops a routine to help you build up core muscles in the midsection of your body, including your back. You will also practice targeted stretching to improve your flexibility and relieve muscle pain. Physical therapy can strengthen the muscles that support your spine, helping you prevent further injury.

    You are usually assigned a number of exercises to perform each day on your own. This will help you maximize the benefits of your time in physical therapy.

    Chiropractic care for spondylolisthesis

    Chiropractic care is a form of complementary and alternative medicine. It continues to grow in popularity as a cost-effective and successful way of relieving lower back pain.

    A chiropractor will use various manipulation techniques to adjust and correct your alignment. They believe that a natural balance needs to be maintained in order for the body to function optimally. Targeted and controlled forces will be applied to specific joint areas that are limiting movement. Patients often report relief from muscle tightness and pain, as well as better range of motion.

    Spondylolisthesis medications

    A wide range of medications can be helpful in reducing the lower back pain associated with spondylolisthesis.

    Your doctor may first recommend nsaids because of their anti-inflammatory properties. Basic over-the-counter nsaids include drugs like aspirin and ibuprofen. In general, these medications are best for short-term relief to avoid side effects of prolonged use.

    In severe cases of spondylolisthesis, your doctor may prescribe something stronger for pain management. However, prolonged use of pain medications is associated with a number of side effects and concerns in regarding misuse and addiction. Always talk with your healthcare team about your pain level and health concerns to determine the best medications for your specific case.

    Interventional injections

    If conservative treatment options aren’t giving you the pain relief you need, but you aren’t ready to consider surgery, your doctor may recommend injections. This is a minimally invasive procedure that can have significant benefits.

    Epidural steroid injections are the most common type of injection for lower back pain with spondylolisthesis. These injections involve a combination of a corticosteroid and numbing agent delivered into the epidural space of the spine. The drugs work to reduce inflammation and pain. This relief can last for weeks or years, depending on the case. Most patients can resume normal activities the following day.

    You can learn more about this procedure in the following video.

    Surgery

    Non-invasive treatment for mild cases of spondylolisthesis is successful in about 80% of cases. Unfortunately, if you are still experiencing pain that disrupts your everyday routine, your doctor may suggest surgery. In severe cases where the bones of your spine are pressing on your nerves, this may be the only way to fix the issue.

    A spinal fusion is one of the most common operations to help patients suffering from spondylolisthesis. In this surgery, bone grafts are placed between vertebrae to help them fuse together. Your doctor will also use screws and rods to hold the vertebrae together as they heal. It will typically take four to eight months for the bones to fully fuse together, but spinal fusion success rates are typically high.

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  • How to prevent a headache from computer use?

    When we switch our computer on in the morning, we are usually greeted by a beautiful screensaver. Maybe it is a vacation snapshot, a picture of the kids, or a beautiful scene out of nature. Try as we might, those beautiful screensavers cannot cover up the fact that our computer screens may be causing us headache pain. Headache from computer use is a growing issue. Here’s what you should know about preventing it, along with more innovative treatments that can help.

    Why do I have a headache from computer use? 

    Screens are ubiquitous, and our use of them has increased as technology advances. The average adult spends up to nine hours a day looking at a screen (and checking a cell phone 150 times a day), and that may not count all of the hours logged in front of a computer at work.

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    Kids are not much better. Their screen time averages clock in at seven hours and 38 minutes a day. If you consider that many kids spend their time “media multitasking” (using more than one screen at a time), that amount jumps to a total of ten hours and 45 minutes of daily screen time.

    All of this can lead to headache from computer (and mobile and tablet) use. It’s commonly referred to as “computer vision syndrome” or “computer eye strain.”

    What is computer vision syndrome?

    Computer vision syndrome (CVS) is being increasingly diagnosed for those of us with 24/7 access to the world of technology. The particular nature of a computer screen and prolonged viewing of it can lead to computer vision syndrome.

    It’s a temporary but uncomfortable condition that can include the following symptoms:

    The National Institute for Occupational Safety and Health (NIOSH) estimates that approximately 90% of adults who spend three or more consecutive hours looking at a computer will experience some or all of these symptoms, with headache from computer use and eye strain being the most common.

    How to prevent headache from computer use

    With so much work being performed on computers these days, CVS may seem inevitable, but here are nine simple ways to prevent it.

    1. Take breaks

    Not only is sitting devastatingly bad for your health, but short breaks are actually very good for you in terms of both health and productivity.

    Every hour, stand, stretch, and take a stroll around the office. (And, don’t use this time to check your text messages!)

    2. Move away from the light

    Glare from windows makes your eyes work harder to see and is the leading cause of eye strain. If you prefer a desk by the window (and you are lucky enough to have that), use blinds or shades and keep them lowered when you are working.

    Anti-glare screens are also available and can help reduce glare even further. Make sure you are not facing an unshaded window, as that could cause you to squint and further strain your eyes. Also, use programs like f.lux to reduce blue light from screens, especially in the evening.

    3. Contact lens wearers, blink

    When we are focusing on a digital screen, we blink up to three times less than when looking at a book or something else 3-D.

    Ask your eye doctor about breathable lenses, and keep eye-wetting drops close by. Use them when taking a break.

    4. Adjust your monitor height

    You should be able to look up and just over the top of your screen. Your monitor or laptop should sit five to nine inches below your horizontal line of vision.

    5. Adjust the distance between your eyes and your monitor

    Sit back in your chair. If you can touch the screen at this distance, you are sitting too close. To adjust, open a document of a type you would use every day and move back until it becomes blurry. Divide this distance by three, then place your monitor at that distance.

    6. Adjust your lighting

    In addition to making you look terrible, overhead fluorescent lights are very taxing to the eyes. If you can, use indirect lighting from a desk lamp or floor lighting.

    7. Back away from the cell phone

    Studies have shown that we hold digital devices much closer to our eyes than we do printed material, and this can cause eye strain and headache.

    Hold your mobile devices as far away as you can while still being able to read. These devices also have the ability to make print larger, so take advantage of that feature.

    8. If you are transcribing or doing research, place paper documents in line with your screen

    The movement of looking frequently down and to the side can place strain on the eyes, head, and neck and cause repetitive motion injuries. Take a tip from secretaries in the 50s and invest in a spring-loaded clip that attaches your paper documents to your screen. You can also use a document stand that sits next to your monitor or laptop.

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    9. Finally, have an annual eye exam

    Many health insurance plans may include an annual vision exam. Take advantage of this provision and have your vision checked by an eye care professional. Let them know how many hours you spend in front of a screen.

    If you have any concerns about your eyes, or you have been having symptoms of CVS that include headaches and dizziness, an annual exam is a great time to share them. You are also establishing a relationship with a doctor who can follow changes in your vision over the years, noting if there is anything that might be of concern.

    Treating headaches from computer use

    Unfortunately, headaches as a whole are one of the most common pain problems. Almost everyone has experienced an acute headache in their lives. About 15% of the population has experienced recurring headaches that can lead to debilitating pain. Sometimes the pain is generalized but often it is centered on a specific area of the head. This can be indicative of the type of headache the individual is experiencing.

    Commonly-recommended treatments for managing headaches include:

    • Drinking enough water and eating a balanced, healthy diet
    • Using over-the-counter medications, like aspirin or ibuprofen
    • Resting in a quiet and dark room
    • Using hot or cold compresses on your neck
    • For severe cases, talking to your doctor about preventative medications or other interventional treatments

    Innovative headache treatments

    New treatment and pain relieving techniques are being discovered all the time and what can’t help one person could help another. While the common treatments work for many, these treatments may help for others whose pain hasn’t resolved. Here are eight innovative treatments for headaches.

    1. Acupuncture

    Acupuncture is performed by trained practitioners who insert fine needles in specific points along the body’s meridians which then corrects the flow of the body’s natural energy known as qi.

    This is a relatively low risk treatment so it is often recommended as an exploratory option for people looking to reduce their pain or their dependence on medications. Acupuncture is fairly accessible anywhere in the country.

    2. Biofeedback

    This method is a way to retrain the brain to react to painful stimuli.

    In a session, the patient is able to observe their vital signs and brain activity as a headache occurs. These tools help them visualize the effects of stress on their bodies and they are able to learn relaxation techniques that can help control the triggers that lead to these headaches. Patients work directly with specialists for this process.

    3. Neuromodulation

    This method is a way of inhibiting or disrupting the pain signals that are being communicated by the nerves to the brain. Impulses to the nerves can lessen the signals and help relieve pain. Some patients experience headache relief from deep brain stimulation where electrodes are implanted directly in the brain which override the body’s natural inclination to transmit pain to the brain.

    It has been most successful in treating cluster and tension headaches. There have also been observable relationships between the quality of sleep and these types of pain signals. Neuromodulation is still experimental and will require additional testing before it is recommended as a standard treatment for certain types of headaches.

    4. Transcranial stimulation

    For a non-invasive option, transcranial stimulation has several similarities to neuromodulation. Electrodes are applied to the head on a cap that stimulates the appropriate nerves through the skull. One form of this treatment, TENS, is already commonly used for a variety of pain conditions. There are very few side effects and the worst reported seem to be mild pain and muscle cramps. It has been proven effective for cluster and migraine headaches.

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    5. Botox

    The use of pharmacological treatments can land fully on both ends of the medical spectrum. Some specialists feel like medication is over-prescribed while others feel it provides the best pain relief for their patients. However, many headaches don’t respond well to the types of drugs that are currently on the market and the final step is often opioids that come attached with a very high risk of dependency or addiction.

    Some doctors are seeing success using the popular cosmetic injections known as Botox. Ultimately, patients are injecting a powerful neurotoxin into their skin but, when supervised by a medical professional, it can be used to relax muscles that are strained during a headache. It has been approved for treating tension headaches and chronic migraines.

    6. Triptans

    For patients suffering from the pain of cluster headaches, which can be tricky to diagnose and treat, inhaled triptans have had some success. However, they are best if used against specific headache pain and are not considered a cure. They have limited side effects if used correctly. Though this treatment will not stop headaches from reoccurring, it can help restore normalcy when life is interrupted by head pain.

    7. Massage therapy

    Because tension is at the heart of several types of headaches, many patients have success with massage therapy. Stress can be a major cause of head pain but that can also make it difficult to treat in an effective way. Since stress can be caused by both major and minor life events the head pain can come and go frequently and at inconvenient times. Many doctors recommend massage therapy for patients dealing with the effects of stress causing head pain. Some insurance companies will even pay for massage therapy with a licensed practitioner if it is prescribed by a doctor.

    8. Radiofrequency ablation

    Of course, for some people suffering from debilitating chronic migraines the final solution needs to be invasive. For the least invasive of the surgical procedures, some patients turn to radiofrequency ablation. In the procedure, your doctor will insert a needle-like probe into the back of your neck near nerves in the upper spine. The probe then uses radio waves to create an electric current that heats the nerve endings.

    This incapacitates the nerves so they no longer transmit the incorrect pain data to the brain. This can be a permanent solution for chronic head pain.

    Get help for headache from computer use

    To find out if you might be at risk for CVS, or if you are experiencing headaches or other symptoms, talk to your doctor to reduce your chances of screen-related conditions.

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  • Chronic fatigue treatments and complementary therapies that can help

    Chronic fatigue syndrome (CFS) is a complex condition that goes by many names, such as chronic fatigue immune dysfunction and myalgic encephalomyelitis. It is characterized by extreme fatigue or tiredness that does not go away with bed rest. Chronic fatigue syndrome also has no discernible medical cause and can worsen when a person undergoes physical or mental activity. Symptoms can limit the everyday activities someone can enjoy as well as affect other parts of their life including work, family, and friends. In this post, we talk about some chronic fatigue treatments you can try to resolve symptoms and get back to your life.

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    Symptoms of chronic fatigue syndrome

    Chronic fatigue syndrome is a disorder that is often misdiagnosed because its symptoms are common in other illnesses. The central symptom that defines CFS is extreme fatigue that lasts for more than six months, but there are many others that come along with this condition as well. According to the Centers for Disease Control, the following are symptoms that are used to diagnose chronic fatigue syndrome. A person must suffer from at least four of these to be diagnosed with chronic fatigue syndrome:

    • Malaise: The onset of extreme exhaustion and sickness following physical or mental exertion that lasts more than 24 hours
    • Cognitive issues: Lapse in memory, concentration, or complex information processing
    • Headaches
    • Sore throat
    • Persistent muscle pain
    • Joint pain that migrates without swelling
    • Tender lymph nodes
    • Unrefreshing sleep

    These are not the only things you have to worry about, though. On top of those symptoms, the following have also been commonly reported:

    • Brain fog, such as feeling hazy and disoriented
    • Difficulty with balance
    • Sensitivity to foods, odors, chemicals, medications, light, or noise
    • Irritable bowel
    • Depression, anxiety, or panic attacks

    Those who have chronic fatigue syndrome will notice a drastically lower level of energy than before they had this condition. This disorder also tends to occur alongside other illnesses such as fibromyalgia, irritable bowel syndrome, multiple chemical sensitivity, and orthostatic intolerance. If you believe you have chronic fatigue syndrome or any other illness, make sure to tell your healthcare professional.

    Common causes and risk factors

    Even with the current wave of research, it is still not known what exactly causes chronic fatigue syndrome. It is possible that it is caused by multiple factors at once. Many different factors have been studied in an attempt to find the cause. The following may be linked with a patient developing chronic fatigue syndrome:

    Viral infections

    Many different viruses have been researched, but none of them have been exclusively linked to the disorder. Some research has shown that the Epstein-Barr, Ross River, Human Herpesvirus 6, and Coxiella burnetti virus may create conditions that meet the criteria for CFS.

    Hormonal imbalance

    Many patients with chronic fatigue syndrome produce lower levels of cortisol and other hormones, which can greatly affect many other parts of the body. This underproduction is usually prompted by an emotional or physical stress event and is known to be a common pre-onset trigger. However, these production levels are still within a normal acceptable range and seem to happen in other illnesses.

    Immune system problems

    People who develop chronic fatigue syndrome often have abnormal immune responses, such as particular T-cell activation markers and intolerance to some foods or medications.

    Causes are still being explored, but scientists have discovered various risk factors that can increase your chance of developing chronic fatigue syndrome.

    1. Sex: Women tend to be two to four times more likely to develop this condition versus men.
    2. Age: It most commonly affects people in their 40s and 50s.
    3. Family history: Sometimes, chronic fatigue syndrome is developed by members within the same family. This indicates a possible genetic link, although one has yet to be discovered.

    Overall, adults are more likely to develop this condition than children and its incidence seems to be found in all races equally.

    Diagnosing chronic fatigue syndrome

    Of the up to the four million people in the U.S. who have chronic fatigue syndrome, only about 20% have actually received a proper diagnosis. This is because diagnosing this condition is a difficult process. Currently no one diagnostic test or sign can conclusively point to this disorder.

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    The process to be diagnosed is complicated further as it requires a variety of tests to rule out other similar conditions that may cause the same symptoms. This can be a problem as chronic fatigue syndrome can vary in severity and the symptoms can wax and wane, so a discernable pattern is not always easy to pin down.

    Three critera have to be met if a diagnosis of chronic fatigue syndrome is to be determined:

    1. Unexplained and persistent fatigue for six months that cannot be relieved by rest
    2. This fatigue must greatly interfere with everyday activities
    3. Four of the eight symptoms listed above must be present

    The basic process that is used in the diagnosis process is laid out as follows:

    • A doctor will take a detailed medical history of the patient
    • The patient will undergo a thorough physical and metal examination
    • A multitude of tests will be required while trying to rule out other conditions

    The CDC provides a more in-depth explanation of the diagnosis steps and the numerous tests that you might need.

    Chronic fatigue treatments and complementary approaches

    This syndrome can be debilitating to the person suffering but also devastating to loved ones and caregivers. While researchers continue to study potential treatments, here are some current treatment options for chronic fatigue syndrome. There is no specific process or drug that can treat chronic fatigue syndrome. Managing this condition requires a team of professionals to help develop a personalized treatment plan that is best suited to each individualized patient.

    Lifestyle approaches

    Beyond that, there are a few lifestyle changes that can be made to help relieve and prevent some of the symptoms. These include:

    • Develop a sleep routine: Sleep hygiene is key for good health. Set a schedule and keep to it. Make sure to avoid problem products like caffeine and alcohol. Keeping a clean and clutter-free bedside table (and room in general) also helps promote sleep, as does going to bed at the same time and shutting off all screens (TV and computer) at least two hours before bedtime.
    • Try to reduce stress: Try meditation or yoga or whatever works for you. The point is to make time every day to relax and burn off some emotional stress.
    • Don’t overdo it: Make sure you don’t push yourself too hard even on the best days. A great way to have all of those symptoms come crashing back is to overexert yourself.

    Lack of vital nutrients can contribute to fatigue and lack of energy. It is important to eat whole foods that are a vital source of iron and magnesium to keep iron levels in the blood high and increase oxygen levels in the blood and muscles. Many people do not get their recommended daily dose of eight to 18 milligrams of iron and 310 to 420 milligrams of magnesium daily.

    Although supplements are an option, reach first for leafy greens, white beans, oatmeal, grass-fed beef, pumpkin seeds, and spinach to concentrate on upping levels of both vital nutrients naturally. Add vitamin C to increase absorption of iron in the blood and help build up your immune system at the same time!

    Vitamins and minerals for rest and energy

    One of chronic fatigue syndrome’s primary symptoms is the inability to have restful sleep. Although prescription sleeping medication is an option, long-term use can be dangerous and habit forming. Several supplements may help promote quality sleep without a prescription.

    • Melatonin: The body produces melatonin on its own to signal the brain that it is time for rest, but sometimes it does not produce enough. You can prompt your brain to begin melatonin production by keeping lights in the bedroom dark when it is time for bed. If this does not help, start with a low dose of a melatonin supplement (500 mg) and see if that helps improve your rest.
    • Theanine: Theanine is an amino acid that improves the quality of sleep. The tricky part is that it is found naturally in green and black teas, both of which contain caffeine. You could try decaf versions of those teas, or try a supplement. Take 100-200 milligrams 30 to 60 minutes before bedtime.

    Unfortunately, sometimes sleep is elusive, and you may still have things to do the following day. There are natural supplements that can improve energy too:

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    • L-Ornithine: A body suffering from chronic fatigue syndrome often has too much ammonia in the blood. This ammonia can make the brain foggy and less alert. L-Ornithine can help with that foggy-brain feeling and increased alertness and mental acuity during the day. The dosage is two to six milligrams.
    • Glycine: After a poor night’s sleep, glycine is an amino acid that may help improve cognitive performance the next day. Three daily grams can help clear up your thinking and sharpen your mind.

    Medications

    Coping with a chronic condition can be mentally taxing, and many with chronic fatigue syndrome also battle depression and anxiety. Antidepressants can help ameliorate the effects of depression, some of which contribute to even more fatigue and a deeper sense of malaise.

    Used carefully and under a doctor’s supervision, prescription sleeping medication can also help provide a full, restful night of sleep when it is desperately needed. A person’s outlook can change drastically with a good night’s rest, and this may enable them to work with other treatments during the day.

    Graded exercise therapy (GET)

    This type of exercise therapy is designed by a physiotherapist for each individual patient.

    The therapist will evaluate the chronic pain patient. Then, they’ll design an exercise program that gradually increases in duration and intensity as needed. Exercise can improve mood and quality of life, but chronic fatigue patients often feel as if they can’t muster the energy to do anything. This type of exercise takes that into account.

    Cognitive behavioral therapy (CBT)

    When combined with graded exercise therapy, CBT helps patients change their mindset surrounding their chronic fatigue. This does not tell them that it’s all in their head. Instead, it helps them to reframe their challenges and focus more on improvements and steps forward.

    Complementary and alternative chronic fatigue treatments

    Many chronic fatigue syndrome patients report success with alternative treatments such as acupuncture, yoga, meditation, and t’ai chi. Using these treatments can be helpful when a patient does not want to add prescription medications, or they feel as if they need to incorporate more holistic approaches to their treatment plan.

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  • What you should know about depression and back pain?

    Chronic pain and mood disorders can often go hand-in-hand. In fact, as many as 50% of people with chronic pain also have depression. It seems that one particular pair of conditions – depression and back pain – may be particularly widespread. Considering how often chronic pain and mood disorders can co-occur, this isn’t very surprising. After all, back pain is one of the most commonly-reported pain conditions, and depression is one of the most common mood disorders.

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    How many people are affected by depression and back pain? 

    Both depression and back pain afflict a large number of people. Over 26 million people in the United States suffer from back pain, making it the leading cause of disability among people in the U.S. under the age of 45. People who have low back pain are commonly in poorer physical and mental health than people without low back pain.

    Around 20.9 million people in the United States suffer from some sort of mood disorder. Out of these people, a whopping 14.8 million have depression. Depression can (and often does) co-occur with other mood disorders, as well as with illnesses, pain, and medical conditions.

    Why do they occur together? 

    Back pain and depression often co-occur, largely because it’s possible for each condition to cause (or worsen) the other.

    Dealing with chronic back pain can cause a lot of stress. Back pain can even affect a person’s ability to work, interfere with relationships, and chip away at self-esteem. Sleep can be disrupted by back pain, and the ensuing fatigue can further decrease quality of life.

    Back pain can also make physical activity difficult or unappealing. Even if, in the long run, physical activity might help with back pain, it can initially be hard to get started or cause some aches and pains. Lessened physical fitness can further reduce self-esteem and interfere with relationships.

    Aside from the effects of back pain, the pain itself can increase the risk of depression. It’s easy to focus on pain, which can magnify its effects. The higher the perception of pain is, the more likely it is to cause depression. Once depression has set in, it can cause emotional interpretations of pain, which lead to increased perception of pain. In other words, pain worsens depression, and depression worsens pain, which further worsens pain. As is obvious, the cycle can go around and around, worsening steadily over time if there is no intervention.

    Just as back pain can lead to depression, depression can lead to back pain. Sleep disturbance, social withdrawal, difficulty at work, lowered self-esteem, and withdrawal from activities can all occur with depression. Additionally, many people experience physical symptoms, like pain, as a result of depression. Indeed, for some people, physical pain may be the primary symptom of their depression.

    Medication use

    Also, some overuse or abuse of some medications can lead to depression. Opioids, for instance, are a pain medication, but they carry a high risk of abuse, addiction, and depression. Unfortunately, when depression is causing or contributing to back pain, treating the back pain is unlikely to work unless paired with treatment for depression.

    This can lead to feelings of hopelessness about ineffective treatment, which can further exacerbate depression and the risk for overuse of pain medications.

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    Recent research 

    Recent research suggests there may be deeper reasons for the common co-occurrence of back pain and depression.

    A study carried out by researchers at UC Irvine and UCLA examined the brains of rodents with chronic pain. They found that chronic pain can cause brain inflammation. This pain-derived brain inflammation causes faster growth and activation of a type of immune cell, called microglia. Microglia cells trigger chemical signals that restrict dopamine release. Dopamine aids in controlling the reward and pleasure centers of the brain, but it’s also involved in pain responses. As noted on Scientific American’s blog, it’s also involved in depressive behavior:

    “[D]opamine could also be important in major depressive disorder. People with depression often exhibit reduced motivation, anhedonia (a decrease in pleasure from usually enjoyed things), sometimes motor decreases as well. All of these are linked with dopamine.”

    Opioid pain medications also work by triggering the release of dopamine. However, the pain-derived brain inflammation and its resultant increased microglia cells mean that opioids can fail to trigger a dopamine response. This explains why opioids are often ineffective in treating chronic pain. If further research can continue to explain the mechanisms behind the relationship between chronic pain and depression, a targeted, more effective therapy can be developed.

    Researchers are also considering the possibility of genetics playing a role. Data concerning over 2,000 twins was analyzed to look for genetic factors relating to both back pain and depression. Interestingly, the group with the strongest association between back pain and depression was the non-identical twin group. When identical pairs of twins were considered, the association disappeared.

    Treating depression and back pain

    Just as the development of back pain and depression can go hand-in-hand, treatment for these conditions can work together, too.

    Treating a person’s pain while ignoring his or her depression can prove ineffective, and treating his or her depression while ignoring his or her pain can be ineffective, too. However, just because treating one or the other may not solve both issues completely doesn’t mean it can’t help, as explained at Everyday Health:

    “What’s interesting about back pain and depression is that they seem to be so closely tied that getting depression relief may actually lead to back pain relief… On the flip side of the coin, getting back pain relief can also help the depression improve.”

    Therefore, treating one or the other is much better than treating neither.

    The best case scenario, though, is undergoing treatment for both back pain and depression. The first step in getting treatment is discussing all issues, physical, mental, and emotional, with a primary care physician. From there, the physician should be able to suggest specialists and coordinate treatment for both conditions.

    But, one of the first steps to treating it is actually knowing if you have depression to begin with. Here’s how to diagnose this condition.

    How to diagnose depression

    You find yourself snapping at your kids. Maybe your temper flares more often in traffic. You don’t seem to have as much patience as you normally do, or small things get under your skin more than they used to. On top of that, your back has started hurting right around your shoulders, so much so that it can be hard to fall asleep at night. The signs of depression don’t always show up on a billboard; you may be suffering from depression and not realize it. One in four people suffer from some form of mental illness in their lives, but we still have a hard time bringing this “hidden illness” into light. Here are a few ways to do that.

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    What to watch for 

    Depression can manifest itself in sometimes hidden ways. The most common signs of depression are:

    Some people may experience these common signs in uncommon ways, such as:

    Some of these may be triggered by traumatic events. Some may be as a result of treatment for another condition. Regardless, it is important to talk to your doctor if these symptoms persist. Consider this first meeting a fact-finding session more than a diagnosis, and go in with an open mind (and heart).

    Talk about it

    If you have suffered from periods of depression or anxiety, it can be helpful to others going through a similar experience to know they are not alone. Depression can be socially isolating. The depressed person often feels alone and may question if anyone cares about them. Remind them that they are loved, you get it, and you are here for them. Often a person suffering from depression is plagued with the idea that they are their illness.

    National Institue of Mental Health director Thomas Insel believes we should discuss mental illness in the same way we discuss things like cardiovascular disease, noting:

    “We need to talk about mental disorders the way we talk about other medical disorders. We generally don’t let having a medical illness define a person’s identity, yet we are very cautious about revealing mental illness because it will somehow define a person’s competence or even suggest dangerousness.”

    Don’t ignore it

    Ninety percent of people who commit suicide suffer from mental illness, often undiagnosed. If you or someone you love is showing signs of depression that are persistent and lasting longer than two months, it is important to not ignore it.

    There are ways to ease into conversations about sadness and depression, but sometimes we feel awkward and uneasy, especially when the depression may be related to grief or a traumatic event. When someone has died, we may hesitate to bring up that person for fear of “triggering” depression, but chances are good that talking about it may be just the thing that encourages someone to seek help.

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  • The power of positive thinking for pain patients

    The power of positive thinking for pain patients

    Self-affirmation is the practice of expressing positivity about yourself. It can be stated aloud, said in your head, or written down. While some may scoff or assume that it’s pointless, science is proving that self-affirmation and positive thinking can have measurably positive effects on people.

    What are the benefits of positive thinking?

    So far, the clearest benefit to self-affirmation is its ability to encourage changes in health behavior.

    When you’re told by a physician (or friend or family member) that you must make a life change, it’s not uncommon to become defensive. For instance, when your doctor tries to convince you to stop smoking, you stop listening or get irritated. If your aunt tells you that you need to lose weight, you might respond by getting upset or even binge-eating.

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    More receptive to health changes and advice

    Self-affirmation and positive thinking, however, can make you more receptive to health advice. A team of researchers set out to get sedentary adults to be more active by utilizing self–affirmation. First they examined the brains of participants with imaging equipment while the participants were given health advice. In people who did a self-affirmation exercise prior to receiving health advice, a key part of the brain was more active. This part of the brain, called the ventromedial prefrontal cortex (VMPFC), is believed to be involved in processing self-relevance.

    Additionally, the people who did self-affirmation did a better job of following the health advice and were more active in the next few months. In another experiment, text messages were sent to sedentary adults, encouraging them to stand up or do some sort of activity. When the health advice was paired with some form of affirmation, the people receiving the text message were more active.

    Alter unhealthy habits

    Self-affirmation, used in conjunction with health advice, can help facilitate changes in other areas, in addition to activity level. All of the following has a better chance of changing with positive thinking:

    Increase regular medical screenings

    People may also be more willing to follow through on medical screening and treatment if they participate in self-affirmation. This may be due to self-affirmation’s ability to help the brain accept changes more easily.

    However, it may also be due to the simple fact that refocusing someone onto a positive topic (such as positive thinking) rather than a negative one (like the possibility of undesirable test results) can make him or her less likely to avoid threatening or scary information.

    Improve task performance 

    You might also be able to perform some tasks better by doing self-affirmation.

    Researchers at Carnegie Mellon University conducted a study on how well college students could perform problem-solving tasks. Unsurprisingly, since chronic stress can have serious negative impacts on mental and physical health, students who’d been suffering from chronic stress didn’t perform as well as those without stress.

    Doing a self-affirmation exercise prior to the problem-solving tasks, though, made quite a difference. After some self-affirmation, the chronically stressed students were able to perform at the same level as the students without chronic stress.

    In another study, two groups of people performed a simple, quick-response task. One group had done self-affirmation beforehand, but the other had not. When they got a task right, both groups had the same level of brain response. However, when they got the task wrong, the self-affirmation group had notably higher levels of brain response. According to the study’s authors, this suggests that doing self-affirmation may make people more aware of their own mistakes and able to correct those mistakes.

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    The power of positive thinking for chronic pain patients

    Self-affirmation may also help people with chronic pain control their discomfort.

    The many benefits associated with positive thinking, such as increased receptivity to health advice and more willingness to undergo medical tests or treatments, could have a serious benefit on pain levels. Increased receptivity to physicians’ advice might mean better adherence to medication instructions or more willingness to try an anti-inflammatory diet. More willingness to undergo tests or treatments could lead to better diagnoses and treatment.

    Also, in the mentioned study with the college students, self-affirmation was able to reverse the effects of chronic stress on problem solving. Stress and pain are tightly connected and can have a strong influence on each other. Therefore, if positive thinking is able to counter some of the effects of chronic stress, it could also help lower pain levels.

    Self-affirmation can also offer some potential relief during serious pain flares. In her blog Chronic Pain Life, Stephanie offers resources and suggestions to help people live with chronic pain. Many of her suggested pain-management techniques utilize mindfulness, meditation, or artistic outlets (such as photography or journaling).

    In one blog post, she describes the affirmations she uses when suffering from intense pain, stating:

    “I seriously couldn’t function without them. In a pain flare-up they prevent me from entering a spiral of negative thoughts that in the past led to depression and even suicidal thoughts. Sometimes I only have to repeat the affirmations a couple of times, while other times I have to read them over and over throughout the day. They have helped me make it through another moment, another hour, another day.”

    How to practice more positive thinking

    The last time you encountered a hectic workweek, opened yet another expensive repair bill, or suffered through a day of chronic pain, what did you think about? Although everyone experiences stress, not everyone handles it the same way.

    Changing your thought process related to these events can reduce associated stress. Additionally, changing your perception can help uncover positive solutions and maybe even bring a little peace. This process of positive thinking takes time, so be patient with yourself. Here’s some ways to get started.

    Practice self-affirmations

    Practicing self-affirmations can be done in any way you want, as long as you end up feeling better. In many of the studies surrounding self-affirmation, the exercises involve arranging different topics into order of personal importance. Some of these topics might include:

    • Family
    • Friends
    • Art
    • Accomplishments
    • Hobbies
    • Job

    Once you’ve figured out which topic is most important in your life, write (or simply think about) a couple sentences describing why it’s so important to you, as well as how you demonstrate this. For example, if family is most important in your life, you might write, “My family is important to me because I know they’re always there to support me. I demonstrate how important my family is to me by spending as much time as I can with them, even when I’m tired or hurting.”

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    If there’s something specific you’re unhappy about, write down a list of ways to change it. For example, you may wish you had a better connection with your colleagues, write down a list of present-tense sentences about what you can do to accomplish that – such as “I am courteous and patient to my coworkers,” or “When I ask how someone’s doing, I really listen to their answer.” You can repeat your affirmations to yourself as often as you want. If you practice meditation or breathing exercises, you can even incorporate your affirmations into your routine.

    Take a few deep breaths

    Life sometimes looks rosier after inhaling more oxygen. Deep, long breathing calms the body’s stress response, lowers the heart rate, and gives you something to focus on besides the stressor.

    Remember that the worst thing rarely happens

    A lot of stress comes not from what’s actually happening, but worries about what could happen, including worst-case scenarios. Think back over your life. How many times has the worst-case scenario actually happened?

    If you find yourself ruminating on all of the potential disasters that could befall you should you fail to complete all the tasks on your list, take a deep breath. Pick one thing, the most important thing, and do that. When you feel overwhelmed, take a walk, listen to music, or engage in some other healthy outlet. Unless it’s life or death, it can wait.

    Review the situation and analyze the things you can control and those you can’t

    Has your boss completely overloaded you with work? Is your husband not helping with housework? Are tight finances stressing you out? Ask for help. Let the people affected know you’re overwhelmed, ask for a deadline extension, get help with washing dishes, or find a financial counselor. Asking for help can seem scary, but your mental well-being is more important.

    With chronic stress, like any illness or disease, sometimes it helps to focus on what you do have. You’re alive, you have a beautiful beating heart, and you probably have family members and friends who love you. If you can walk, walk and feel your legs moving and enjoy the air on your skin.

    Even under more serious stress, think about what you can control. Maybe you can exercise or eat better or try meditation. Nobody has complete control over their life, but everyone has some small step they can take right now to improve their circumstances and reduce stress.

    And what you can’t control? Try to accept it and let go. Although easier said than done, greater acceptance brings peace, further lessening stress.

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  • What are the major causes of hip and leg pain?

    Hip and leg pain is a broad category of conditions that can range from acute soreness due to a minor injury to long-term chronic pain that can be the result of a disease or disorder. Because of the varying causes of hip and leg pain, there are a number of possible treatments as well, all dependent on the cause and severity of the condition.

    How many people suffer from hip and leg pain?

    It is estimated that nearly two million people in the United States seek emergency room treatments for sports injuries each year. Sports injuries are most often associated to injuries to the legs.

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    Basketball injuries top the list, with over 90% of individuals seeking treatment after an injury in this sport being men. Bicycling, football, and baseball were the next three most common sports causing injuries on the list. Children between the ages of six and 19 made up 20% of all sports injury related emergency room visits.

    However, not all sports injuries are treatable by emergency room visits and some more minor injuries can be treated with rest and at-home care. There are also other conditions that can lead to hip and leg pain. Many of these are related to the hip itself.

    How does the hip work?

    The hip joint is a ball and socket joint, where the femur connects to the pelvis. The top of the femur is a round ball, which fits into the socket (acetabulum) formed by the pelvic bone.

    The ball is allowed to glide and rotate within the acetabulum because a group of ligaments and muscles support the joint and inhibit over extension or malrotation from occurring. Also, within the joint is a synovial lining, which provides lubricating fluid to decrease friction, produced when the joint is in motion.

    Any condition that irritates or inflames this joint, like arthritis, can also lead to pain.

    What are the major causes of hip and leg pain?

    The hip joint is a large weight-bearing joint attaching the leg bone to the pelvis. It allows the body to walk, run, and sit. The most common causes of pain in the hip and leg include:

    • Sports-related injuries
    • Motor vehicle accidents (MVA)
    • Falls in the elderly
    • Arthritis

    Leg pain from sports injuries

    The most common hip and leg pain issues are caused by minor sports injuries for most of the population. This can lead to:

    Each of these conditions can be treated at home with rest and a few simple at-home remedies.

    What are muscle cramps?

    Muscle cramps are a common condition that can be persistent and painful. They are often referred to as a “Charley Horse” when felt in the calf muscles. Caused by an involuntary contraction of the muscle, the sensation of a muscle cramp is a muscle that will not relax. You may even feel spasms in the affected area. Muscle cramps can occur after a sports injury and they are often related to nutrition and hydration.

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    When exercising, running, or playing sports, it is important to stretch the muscles properly before beginning and stay hydrated throughout the activity. To relieve a muscle cramp as it is happening, you may want to stretch the muscle, apply heat, drink more water, or take an over-the-counter pain reliever.

    Typically a muscle cramp will go away on its own, but if the pain persists, there may be some concern about nerve damage or another malfunction that is causing the muscle cramps. If the cramps reoccur frequently, you should talk with a doctor about them.

    What are sprains and strains?

    The diagnoses of sprains and strains are among the most common sports injuries, but what do these terms really mean?

    A sprain is the stretching or tearing of the ligaments that connect our bones. It is generally caused by some trauma, directly or indirectly, that stretches or ruptures these ligaments. This can be the result of a fall, a blow to the body from another player, or overstretching the leg during the game. Sprains will usually heal with rest and self-care. This may include compression, ice, and elevation as well as the use of over-the-counter pain medications. If an injury is more severe, surgical correction may be necessary.

    A strain is an injury of the muscle or the tendons that connect the muscles to bones. Strains are more commonly caused by a repetitive motion or overuse of the muscles in the leg. To prevent a strain, athletes and individuals exercising are advised to take the proper breaks. Strains can also be caused by falls and contact with other players. Strains are treated similarly to sprains with compression, ice, and elevation.

    What are shin splints?

    The primary sign of a shin splint is an aching or throbbing in the shin, the front area of the lower leg just above your foot. They can be caused by swollen and irritated muscles, a stress fracture, or flat feet. They are most common for runners or dancers.

    In general, shin splints will heal on their own. You can treat them at home with:

    • Rest
    • Ice
    • Non-steroidal anti-inflammatory medications (nsaids)
    • Compression
    • Arch supports for your shoes

    If the pain persists, you may want to talk to a doctor and have them do a complete physical examination of the area to determine if there any additional underlying problems. They may also recommend physical therapy.

    What about more serious injuries, like fractures? 

    A leg breaks when a force great enough to break the bone is applied to the limb. It is a common sports injury, but can also occur due to a car accident or a fall. The treatment for a broken leg will depend entirely on the severity of the break.

    A leg fracture can occur in the femur, located in the thigh, or the tibia and fibula which are the two bones that make up your leg from the knee to the foot.

    There are several categories of fractures, including:

    Stress and hairline fractures will generally heal on their own without the use of a cast. For more severe breaks, medical intervention is required to set the bone and allow it to heal properly. Some broken legs will require surgery if the break is extreme.

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    How will my hip and leg pain be diagnosed?

    Diagnosing patients with hip and leg pain is never straight forward and is often difficult, as many of the symptoms are similar to other conditions. The first step is taking a comprehensive history and physical exam.

    Several aspects will be covered in the history and some of the most common questions your doctor will ask you are:

    • Where is the pain located?
    • How long has the pain been there?
    • What were you doing when you first noticed the pain?
    • Is there anything you can do that alleviates the pain?
    • Are you currently taking any medications for the pain? Do they work?
    • Is there any family history of arthritis or other autoimmune diseases?

    After conducting a full history and physical exam your doctor may want additional studies, including radiological films and blood work. Imaging techniques are useful because your doctor is often able to see pathology inside the affected joint.

    Diagnostic tools

    Common imaging techniques to evaluate hip and leg pain include:

    • X-rays: A diagnostic test using an electromagnetic energy ray to produce images of internal tissues.
    • CT scans: A diagnostic test that combines X-rays with computer technology to produce cross sectional views of the body. This is helpful because it helps to visualize detailed images of the body, including the bones, muscles, and organs.
    • MRI scans: A diagnostic image that uses large magnets and a computer to produce detailed images of the structures within the body. This is even more detailed than the CT scan or an X-ray.

    Your physician may also request a blood test, and may need to evaluate the consistency of the fluid accumulation in the joint.

    Treatments for hip and leg pain

    Most of these leg injuries fall under the category of acute pain. These conditions will heal on their own without lingering, long-term effects. Acute pain can be treated at home, as discussed previously, or with medical intervention.

    Once the injury heals, you can normally resume full activity. However, if any pain from an injury continues for longer than three months it has crossed classification from acute to chronic pain. Patients dealing with chronic leg pain after an injury may need to seek more advanced treatment to stop or alleviate the pain long-term.

    If you have experienced a sports-related injury, such as a muscle strain or a shin splint, talk with your doctor about the best care for your situation. If home care and rest doesn’t improve the condition, discuss more advanced treatment plans.

    Physical therapy 

    The most common and recommended methods for treating arthritis are conservative alternative therapy provided by a pain specialist. Staying active and physical therapy have also proven to be beneficial.

    Physical therapy has been noted to significantly improve postural stability in patients suffering from hip osteoarthritis.

    Hip and leg injections

    Intra-articular joint injections are also rapidly gaining popularity and use in the treatment for arthritis because of their success, minimally invasive nature, and long-acting effects.

    Speak with your pain physician today to determine the best way to improve your hip and leg pain. After conducting a full history and physical exam your physician may want additional studies, including radiological films and blood work.

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  • How to avoid common sleep deprivation effects with chronic pain?

    How to avoid common sleep deprivation effects with chronic pain?

    How many times have you rolled around in bed wondering why you are still awake? It is never fun to go through the next day exhausted, but that could be the least of your problems—your body can suffer in many different ways from sleep deprivation effects. This is doubly true if you also suffer from chronic pain, with 65% of patients reporting sleep issues.

    What are common sleep deprivation effects? 

    We spend one-third of our life sleeping. It’s essential for a sharp mind and a healthy body. This is doubly true for those who suffer from chronic pain conditions as adequate rest can have a huge impact on pain levels.

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    How much sleep should you get? According to the CDC, the average adult should get seven to nine hours of sleep a night and children should get ten to 11 hours. These are usually broken into 90-minute cycles, and the quality of sleep is also very important. If you are not entering REM sleep, you aren’t getting the true benefits of sleep, so you have to be mindful of your sleeping patterns. It is estimated that 50 – 70 million adults in the U.S. have sleep difficulties.

    This number is even higher in those patients who are afflicted with chronic pain as 65% report having a sleeping disorder, such as non-restorative or disruptive sleep. A major issue with sleep deprivation is that it can increase a person’s sensitivity to pain, among other things, which perpetuates a vicious cycle of sleepless nights and worsening pain. Managing your pain and your sleeping habits can greatly affect your overall mental and physical health.

    Once you understand the full sleep deprivation effects, we bet you’ll be motivated to try and change your sleeping habits for good!

    1. Minor sleep loss can be just like drinking alcohol

    Not getting enough sleep can have some big effects on your brain and every other organ in your body. According to Jeffrey P. Barasch, M.D., Medical Director of The Valley Hospital Center for Sleep Medicine, a two hours loss of sleep can have effects similar to alcohol intoxication.

    Sleep deprivation leads to a reduction in judgement, response speed, motor skills, and accuracy, some of which are even greater than alcohol consumption. Some tests showed response speeds were 50% worse than drinking, so think twice about getting behind the wheel next time you have a sleepless night.

    2. Lack of sleep can lead to emotional vulnerability and negative thinking

    Various sleep studies have shown that not getting enough rest can wreak havoc on your mental state. It can impair thinking and emotional regulation in the brain. Specifically, it changes your mindset to one that is more vulnerable to further degradation. It can include symptoms such as:

    • Irritability
    • Hallucinations
    • Impaired decision-making abilities
    • Mood swings

    Sleep problems can also have long-term effects on the mind. It can:

    • Impair creative thinking
    • Reduce focus
    • Lower work or school productivity
    • Greatly increase your chances of developing depression and anxiety

    It is believed that patients with untreated insomnia are between two and ten times more likely to have or develop major depression episodes. It can also exacerbate preexisting conditions such as bipolar disorder and ADHD.

    3. Increased risk of serious cardiovascular health problems

    Sleep is critical to the body’s repair and recovery process. People who routinely do not get enough sleep are at a much higher risk for developing numerous other diseases as the body does not have time to effectively carry out this procedure. These diseases include:

    In a Harvard Medical School study, it was found that people with hypertension, who did not get adequate sleep, will have elevated blood pressure all throughout the following day. Another study found that those with insomnia had a 45% increase of developing or dying from a cardiovascular disease.

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    4. Risk of increased weight gain

    New research by the University of Chicago Medical Center shows that a decrease in sleep leads to more cravings of higher fat snacks. This sleep deprivation effects study showed that when offered food, sleep deprived participants reported higher scores for hunger and desire to eat and ate twice as much fat than when they had eight hours of sleep.

    The reason this leads to weight gain is that the additional hours awake do not expend the extra calories that are consumed. In the study, the average person burned an additional 70 calories from losing four hours of sleep, but binged an additional 300 calories. Erin Hanlon, phd, a research associate in endocrinology, diabetes, and metabolism at the University of Chicago stated that:

    “If you’re sleep deprived, your hedonic drive for certain foods gets stronger, and your ability to resist them may be impaired. So you are more likely to eat it. Do that again and again, and you pack on the pounds.”

    5. Insomnia can lead to more sleepless nights and chronic pain

    A major issue with insomnia and pain is that you can be caught in a destructive loop. Chronic pain conditions can harm a quality sleep cycle and poor sleep can lower a patient’s pain threshold and pain tolerance, which makes existing pain feel even more severe.

    While sleeping pills are an option to get more sleep, they can interact poorly with other medications. Furthermore, a study showed that lack of sleep can also counteract the effectiveness of medication for many conditions.

    6. Reduces the effectiveness of your immune system

    The effects of sleep deprivation can really do a number on your immune system. The Mayo Clinic states that lack of quality sleep can raise the risk of infection as well as increase the recovery time from being ill.

    The reason for this is that certain proteins (cytokines) are released when the body is fighting infections and inflammation and their production is decreased when you are low on sleep.

    How to get better sleep for pain management

    We have all had nights where we toss and turn without getting any sleep. There are a lot of things that can interfere with a person’s sleep cycle, from stress at work to family responsibilities to chronic pain. With all the stress of our daily lives, it’s a true challenge to figure out how to get better sleep.

    Sleep can be a wonderful relief to a long day regardless if it was filled with work or play, but only if it is quality sleep. Here are a handful of tricks and tips that will show you how to get better sleep, so you can fill your night with the sleeps you need and avoid these sleep deprivation effects.

    1. Stick to a sleep schedule

    Getting your body in the habit of going to sleep and waking up the same time each day will improve the quality of your sleep quite a bit.

    A consistent sleep schedule allows you to match up with your body’s natural sleep cycle (AKA circadian rhythm) and will leave you more refreshed and energized than sticking to an erratic sleeping pattern.

    2. Get comfortable and control your sleeping environment

    Creating a nighttime ritual to wind down before bed will also improve sleep quality. This can include breathing and visualization techniques to calm the mind. You can also try reading a book, listening to music, or taking a relaxing bath or shower.

    Make sure your bedroom is cool, quiet, and relaxing for you. It is also smart to make sure your bed and pillows adequately meet your needs as they can greatly influence your sleep quality.

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    3. Avoid sleeping in or long naps

    Trying to figure out how to get better sleep, but your weekends and weekdays are completely different? It is easy to sleep in after a busy week or a long night out, but even a change of an hour in your natural sleep schedule can cause sleep problems.

    Your best bet to more quality sleep is to avoid sleeping in on weekends and instead take short naps in the early afternoon to avoid throwing off your internal clock. Otherwise, this extra sleep could mess up your sleep schedule for days! Also important to note, if you are fighting bouts of insomnia at night, consider eliminating napping or heavily limiting it to 15 minutes.

    4. Be mindful of light exposure

    Sunlight plays a large role in how our bodies regulate a variety of functions, but most certainly our sleep patterns. Try to get as much light (preferably natural) as you can in the mornings and afternoons.

    When night rolls around, avoid heavy light (i.e. Tvs, computers, etc.) At least an hour before you go to bed as overexposure reduces melatonin production, the hormone that signals the brain that it is time for sleep. It is also a good idea to make sure that you are sleeping in a dark room and away from technology like blinking cell phones or bright digital clocks.

    5. Look at your eating habits and diet 

    The food you eat during the day can definitely affect how you sleep. This is doubly true for food and beverages ingested a few hours before bed. Heavy meals can be tough on the stomach and, while alcohol can relax the body, it also has disruptive effects on your sleep cycle.

    Instead, try to keep late night snacks to something healthy like granola or a banana. It is also best to cut out nicotine and caffeine after lunchtime as these substances can take up to ten hours to wear off and can be a main culprit of poor quality sleep.

    6. Try cognitive behavioral therapy (CBT) 

    New research out of the University of Warwick shows that CBT has moderate to strong effectiveness at reducing insomnia, specifically for patients with chronic pain conditions. This is particularly important as long-term pharmaceutical options for insomnia are not viable and can interact poorly with pain management medications.

    According to Dr Nicole Tang, from the University’s Department of Psychology:

    “This study is particularly important because the use of drugs to treat insomnia is not recommended over a long period of time therefore the condition needs to be addressed using a non-pharmacological treatment. We believe that our results will be of particular interest to primary care physicians and allied health professionals who are taking up an increasingly important role in preventing and managing long-term conditions.”

    7. Eliminate the clutter in your bedroom

    Today, many bedrooms are multifunctional rather than just being somewhere we sleep. More and more people use their bedroom as an office or entertainment room, which can affect your sleep patterns.

    Try to simplify the room by removing these distractions and it might just help you relax when you lay down for bed.

    8. Get moving and exercise!

    Exercise in the mornings or afternoons can be quite energizing. It is also vital to keeping the body’s natural rhythm on check while promoting healthy sleep. Various studies have shown that moderate aerobic exercise can reduce the time it takes to fall asleep and increase the length of sleep of those who suffer from sleeping disorders.

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  • How can active release technique manage pain?

    A powerful hands-on therapy known as Active Release Techniques (ART) works deep within the body to reduce pain resulting from injury or overuse. Here’s how active release technique works, how it helps, and what you can expect during a session.

    What is active release technique therapy?

    Healthy movement of the body relies on the free-flow and correct alignment of muscles, tendons, bones, and other tissues. But through life—whether a sedentary or active one—our bodies may become misaligned and experience an increased risk for injury or pain. Other times, acute injuries result in scar tissue and subsequent pain.

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    Active release techniques are a type of therapeutic massage that uses hands-on therapy to lengthen muscles and release these adhesions and scar tissue, which develop when tissues contract in response to injury or inflammation. Adhesions can:

    • Develop in tissues and nerves
    • Interfere with proper movement
    • Cause pain
    • Create the conditions for injuries to develop

    During treatment, a skilled practitioner will apply precisely directed tension while the patient performs specific movements intended to shorten and lengthen muscles at the right time. You will work with a practitioner who applies directed tension to the areas that need it the most. They will also direct you to perform specific motions to help with muscular shortening and lengthening.

    Active release technique benefits

    Active release technique therapy is a safe method for correcting soft tissue injuries and other muscle related problems. It can be used for a variety of pain conditions including:

    Active release techniques can help you relieve pain from these conditions quickly and even permanently.

    History of ART

    A doctor named Michael Leahy created this system of treatments after noticing that he could feel changes in his patients’ soft tissue that seemed to correlate to their symptoms of pain. He carefully observed how different parts of the body responded to the techniques he used, from the muscles and fascia to tendons and ligaments, and says the protocols helped more than 90% of his patients.

    Leahy systematized ART and now he trains health care practitioners worldwide how to treat others with the technique.

    How is active release techniques different than other therapies?

    On the surface, active release techniques may seem similar to other hands-on techniques, such as trigger point release. However, ART is unique in that it’s highly specialized, requiring a great deal of training to learn all 500-plus specific protocols. This ensures the complete dedication of the practitioner.

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    ART also emphasizes developing the ability to feel, through the skin, nerves, and tissues and cultivating a sense of how those parts respond to the different techniques. This is an essential component of active release techniques because the practitioner must be able to select the most beneficial protocol for the patient out of the vast number of options.

    While training in active release techniques, practitioners learn how to find tissues under the skin by touch and make that all-important selection of which technique to use.

    When should I try ART? 

    Muscles generally sustain damage in a few ways, according to ART’s official website. Acute conditions include pulls or tears that develop after blunt trauma. Sometimes multiple small tears accumulate, in a condition known as micro-trauma. The third way damage results from overuse is through hypoxia, when muscles don’t receive enough oxygen.

    These conditions have a common result, which is the body’s production of dense, tough scar tissue that ensnares surrounding tissues, restricting their movement. The scar tissue continues to build, and the muscles eventually grow shorter and weaken. Tendons trying to work despite the restrictions may develop tendinitis, and nerves sometimes become trapped.

    This chain of reaction leads to:

    How does active release technique work?

    As muscles in the body become overused, the related tissues can become adhered to other tissues and nerves. In order to increase range of motion and relieve pain they need to be restored to their intended state. These adhesions cause muscles to become shorter and weaker and can lead to tendinitis or painful trapped nerves. The adhesions can be caused by improper posture, incorrect use of muscles, sprains, or strains.

    Active release techniques are a physical therapy option that helps to lengthen the muscles and separate adhesions to restore better motion.

    Active release techniques practitioners use more than 500 specific treatment protocols, selecting those that best fit the patient’s needs. Multiple treatments are often needed, but it’s common for patients to see significant results after just a few treatment sessions.

    There are many similarities between active release techniques and chiropractic care and, in fact, the two are often performed in conjunction.

    What can I expect during a session?

    Before receiving active release technique therapy, patients will undergo a physical examination to identify the exact muscles, ligaments, and nerves that are implicated in causing pain.

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    During a session, the problem areas are identified and the proper technique is determined. The therapist will direct the patient to perform specific movements to shorten and lengthen these muscles, tendons, and ligaments while they make contact with the affected area with their hands to apply pressure and help the adhesions break up. It will also release the nerves from entrapment. Patients can direct their level of comfort and if the treatment becomes too painful, it can stop. Significant results are typically felt within just the first few treatments.

    Although this deep, powerful work may cause some pain, it’s only done to the patient’s tolerance. It’s all natural and highly effective, making it a wonderful choice for those patients whose pain conditions warrant the treatment.

    Are there active release techniques risks? 

    It is critical that active release techniques are only used on muscles that have been overused or have sustained a use-related injury such as a sprain. It should never be used to treat traumatic injuries or an area that is experiencing active inflammation.

    Do not do treatments every day but keep it to every other day or less depending on the severity of your pain. Otherwise, there are few adverse side effects with this form of treatment and it is considered generally safe.

    How to find an active release technique provider

    Active release techniques are part of a specialization where physical therapists or chiropractors are trained in the specific practice. Since there are active release technique certifications, look for someone who is knowledgeable about the ART process and trained professionally. ART’s official website offers a directory of qualified providers.

    Talk to your doctor or chiropractor for a referral and always let them know about any alternative treatments and techniques you’re considering before making a decision.

    Because active release techniques do carry some risks if performed incorrectly or with the wrong kind of injury, it is imperative that you fully understand how the process works and have a comfort level with your practitioner.

    Are there at-home active release technique therapies I can do?

    Because this technique is based entirely on soft tissue and muscle movement it can be done at home without a trained practitioner as long as it is performed safely and with a few modifications.

    If your muscles are suffering from fatigue rather than soft tissue injury this may be a great way to remain limber and keep pain at bay. Always be sure to use proper stretching techniques. Don’t overdo it or you could exacerbate the injury.

    At-home exercises for sore muscles include:

    • Shoulders: Extend your arm in front of your body. Use your other hand to press the muscles between your neck and shoulder. Move your free hand to your lower back. Tilt your head away from the hand pressing on the muscles. Straighten your head and extend your arm. Continue as you move the pressure along the area between your shoulder and neck to release tension all across the muscle.
    • Achilles tendon: Sit down extending one leg in front of you with the toes pointed. Bend the other leg at the knee and grasp it with your fingers on your mid-calf and thumb on your shin. Press and pull up slightly with your hand as you flex your toes.
    • Hamstrings: Lie down on your back with both of your legs bent at the knee. Grasp one leg at the hamstring with both hands and raise your foot toward the ceiling and hold for a few seconds. Repeat across the hamstring and on your opposite leg.
    • Calf: Sit down with one leg bent like you did for the Achilles tendon. Grasp your calf with fingers on the lower area and straighten your leg. Flex your toes. Continue to the middle and top of your calf muscle.

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  • What is plantar fasciitis? Symptoms, prevention, and treatment

    Plantar fasciitis affects one in ten adults in their lifetime. The plantar fascia is a thick tissue that connects the ball of the foot to the heel and also supports the arch of the foot. When this muscle becomes strained or compressed, severe pain can result and become chronic. Heels can actually develop new bone and create painful heel spurs—bony projections that cause intense pain. This chronic pain condition can impact life every day, and if left untreated can become severe and require surgery.

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    Major plantar fasciitis symptoms are:

    • Stiffness or soreness in the whole foot, especially in the morning
    • Swelling and redness
    • Pain in the heel and the arch
    • Flat feet or high arches
    • Burning or tenderness in the soles of the feet
    • Difficulty going up or down stairs

    Left untreated, the heels can develop painful bony spurs, a growth of bone in the heel that presses painfully into the soles.

    What are major plantar fasciitis causes?

    Plantar fasciitis is caused mainly by one or more of the following:

    • Poorly fitting or unsupportive footwear
    • Excessive exercise on hard surfaces
    • Improper or non-existent warm-up
    • Not enough rest of the feet

    The leading cause of plantar fasciitis is stress or strain on the plantar fascia that causes tiny tears in the ligament. These tears cause inflammation and pain, which makes walking or other activities difficult, especially in the morning. Not warming up or using proper conditioning techniques are other causes of plantar fasciitis, as is starting a new physical activity after long periods of rest or inactivity. These activities may cause microscopic tears that are only found once a diagnosis of plantar fasciitis is made.

    People with very flat feet or very high arches are prone to plantar fasciitis due to the shortening or lengthening of the tissue and the strain that causes.

    For athletes, training repetitively on hard surfaces with improper footwear can cause plantar fasciitis. A rapid increase in the intensity of a workout, or the length of a workout can also trigger painful symptoms.  Some patients report that symptoms worsen over time, but others say that their symptoms occurred suddenly.

    Who is at risk?

    Men between the ages of 40 and 70 are most likely to experience the pain of plantar fasciitis, but people of all ages can develop this condition. Some behaviors can increase the risk. A genetic history or family record of plantar fasciitis is a primary risk, as is simply getting older.

    Although everyone who walks on the planet is capable of developing plantar fasciitis, there are a few specific risk factors that can increase your chances of developing it.

    1. Obesity

    Increased weight means increased daily pressure on the feet. This additional daily strain can cause all kinds of problem in the lower extremities, including swelling and pain in the feet.

    2. Genetics

    Those with first-degree relatives (parents or siblings) who develop plantar fasciitis are more likely to develop the condition themselves.

    3. Metabolic issues

    A person with liver disease, diabetes, or thyroid issues may have issues with their circulatory systems that put them at risk for plantar fasciitis. These metabolic conditions may result in not enough blood and oxygen to the feet, which can cause pain in the plantar fascia.

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    4. Lifestyle

    Smokers and those who have a history of overuse of alcohol may be more at risk for developing plantar fasciitis. This may be closely linked to inactivity, and obesity may be a contributing factor as well.

    5. Age and gender

    Getting older is a primary risk factor for plantar fasciitis. Men between 40 and 70 years of age are the demographic most likely to be diagnosed with this condition.

    Many of these risk factors deal with metabolic issues and may be related to the circulation of blood in the feet. There are some physicians who believe that this condition is a result of high acidity in the body, and they point to the variety of those affected as proof. Patients with plantar fasciitis can be marathon runners or couch potatoes. They can be in good health otherwise or be obese with an unhealthy diet. There are multiple risk factors that have not been explored deeply at this point, but there are also a variety of treatment options.

    How is this condition diagnosed?

    Physicians diagnose plantar fasciitis with a combination of patient interviews and examination. Doctors will especially focus on onset and any activities that may have caused the pain.

    If bone spurs are suspected, doctors may order X-rays to confirm that diagnosis.

    How to prevent plantar fasciitis

    Prevention is key for this condition. Patient education can help with this. Some of the best ways to prevent this condition include:

    • Finding proper footwear
    • Utilizing orthotics when needed
    • Properly warming up

    To prevent plantar fasciitis, a warm-up is essential. Beyond shoes, many athletes ignore their feet when they begin to workout. Here are a few stretches that can be done to get the blood flowing in the feet before beginning.

    • With feet bare, grasp toes with one hand and the heel with the other. Bend the toes back with one hand as the other hand pulls the heel back. Hold for 30 seconds.
    • Still with bare feet, start in a squat with your toes spread wide. Lean forward slowly and bring your knees to the ground so that your toes are still flexed underneath you. Sit back on your heels as far as you can. This is a very intense stretch, so go slowly and back off if it becomes painful. Hold for at least one minute.
    • Place hands on a wall, shoulder height. Step the left foot straight back so there is about two or three feet between your left toe and right heel. Move your hips forward, keeping your left heel down, until you feel a stretch in the calf. Don’t bounce, just hold for 30 seconds. Release, and do the same with the right foot.

    You can also use a tennis ball to massage the arch of your foot. Add pressure as you can, but go slowly. This should relieve pressure and feel good. You can roll the tennis ball all over the foot, putting weight onto it to increase the depth of massage. If you need a deeper massage, switch to a harder ball with less “give.”

    How do you treat plantar fasciitis?

    The initial treatment options are easy to comply with and generally non-invasive. A period of rest and icing to the affected area can help with pain and inflammation, as can over-the-counter non-steroidal anti-inflammatory drugs (nsaids). If the plantar fasciitis is due to injury or repetitive motion, then rest is essential, with as little strain put on the foot as possible.

    Depending on the extent of your pain, you may also need to try some other treatment options. These are discussed below.

    Orthotics

    For severe cases, doctors may recommend a boot or other immobilizing support, but in milder cases, shoes with orthotic insoles or firm arch support will be adequate.

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    Traditional physical therapy

    Patients will be instructed on specific stretches and movements to loosen and condition the plantar fascia. Plantar stretches may include placing the foot on the opposite knee while seated and flexing the feet strongly while pulling back on the toes.

    High-load strength training

    While working the plantar fascia like a muscle may seem odd, new research has found that doing so can actually improve recovery times. A recent study published in the Scandinavian Journal of Medicine and Science in Sports found that plantar fascia has a job that is similar to the Achilles tendon in both load bearing and function. Researchers studied the effect of this specific tendon in a randomized group of 48 patients with plantar fasciitis. They wanted to see if high-load strength training, typically utilized to develop muscles and stretch tendons in the lower leg, would offer superior results to traditional plantar stretches.

    One study group completed plantar stretches ten times for ten seconds, three times per day, and the other group completed unilateral heel raises using a towel under the toes. Study participants stood on a raised platform and placed their toes on a rolled-up towel. Patients took three seconds to raise up on tiptoe, paused for two seconds, then took three seconds to slowly lower down. Patients performed the activity with one foot at a time, starting with three sets of 12 repetitions. They gradually added weight by filling a backpack with books. The repetitions were decreased but the number of sets was increased as weight was added to the backpack.

    The result? The high-load strength-training group achieved short-term pain relief more quickly than the group that completed traditional plantar fasciitis stretches. While both groups had similar levels of pain at the six and 12-month mark, the pain-relieving effects of high-load strength training were immediate.

    Interventional radiology

    Research presented at the Society of Interventional Radiology’s Annual Scientific Meeting has indicated that ultrasound imaging and targeted ultrasonic energy is an effective way to not only break up and remove tissue damaged by plantar fasciitis but to also allow healthy tissue to regenerate in its place. One hundred patients treated with this therapy starting in 2013 have reported positive, long-lasting relief.

    Rahul Razdan, M.D., one of the study’s researchers and an interventional radiologist at Advanced Medical Imaging in Lincoln, Nebraska, noted that this is the first treatment option that goes beyond short-term solutions:

    “While standard treatments, such as pain medication and physical therapy, can offer some relief, there have been no permanent answers. It is important for patients suffering from chronic plantar fasciitis to know that they have treatment options. We have patients who are in so much pain they can’t even play with their kids or take their dog for a walk. This ultrasonic treatment can give patients their lives back and let them enjoy their lives.”

    Interventional treatments

    For inflammation that persists, doctors may prescribe corticosteroids for short periods of time. If pain persists, and a cast or a boot does not help with the pain and inflammation, then doctors may prescribe steroid injections. For the most severe cases that are not responding to treatments, doctors may try plantar fascia release where they cut into the connective tissue to ease the tension and stress that is causing the pain.

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