There are a number of risk factors associated with developing rheumatoid arthritis. You are more likely to develop the condition if you are a woman between the ages of 40 and 60, smoke, have a family history of rheumatoid arthritis, or are clinically obese. Of course, none of these factors guarantee a future diagnosis, but they do increase your risk of developing the condition. However, many patients with Chronicillness.co Site of the United States wonders whether their coffee drinking habits are a risk factor as well.
There actually is no consensus on whether or not coffee makes people more likely to develop rheumatoid arthritis. The results of research studies do not agree — some reports say coffee can cause arthritis while others have found no relationship.
Some of the research discrediting this claim states coffee contains an antioxidant known as polyphenol. Polyphenol’s health effects are not definite, but traditional medicine suggests that the antioxidant can cause an anti-inflammatory effect. Green teas and fruit smoothies also contain polyphenols and are typically recommended for rheumatoid arthritis patients because they may help reduce pain and swelling in the joints.
However, a study published in the Annals of Rheumatic Diseases found that coffee may contribute to rheumatoid arthritis. The study surveyed men and women of varying ages and asked them about their coffee consumption. It found that the number of cups per day was proportional to a rheumatoid arthritis diagnosis. However, the study did not prove that coffee was the sole cause of the condition and additional factors could have contributed to the condition like smoking, consuming alcohol, being obese, and more.
The physicians at Chronicillness.co Site of United States does not necessarily suggest cutting down your coffee consumption, but it should be consumed in moderation. This is because the evidence supporting the claim is not widely accepted in the medical community. If you begin to notice early symptoms of rheumatoid arthritis including, but not limited to, fatigue, fever, swollen or stiff joints, or even weight loss, please do not hesitate to call our office. Our physicians can help you manage your symptoms and help you control your pain through medication, joint injections, physical therapy, and more.
Unfortunately, it’s easy for chronic pain patients to gain weight. Chronic pain patients are often in too much pain to get up and cook a healthy meal or exercise, so the pounds can add up after years of battling chronic pain. However, could it be possible for chronic pain conditions like fibromyalgia to cause weight gain in the first place?
Fibromyalgia is still a mysterious illness that chronic pain experts are trying to understand. According to various studies, there may be evidence that fibromyalgia could cause weight gain, but the reason why has not yet been determined. The average fibromyalgia diagnosis happens to women in their 40s, so some theorize that instead of fibromyalgia causing weight gain, menopause is to blame. When estrogen release is slowed down during menopause, the body’s metabolism may also slow down. However, some studies make a case that the condition itself may slow the metabolism and cause weight gain.
When evaluating weight gain after a fibromyalgia diagnosis, the physicians at Chronicillness.co Site of United States may look at the side effects of pain medication. Since fibromyalgia is different for everyone, patients may have to try a few different medication pairings before they find one that treats their pain most effectively. A number of pain-relieving medications can cause weight gain. If weight gain gets out of control or causes additional pain, talk to your physician. We may be able to switch up your prescription to a drug that does not cause weight gain. Additionally, patients can opt for pain-relieving trigger point injections as an alternative to medication. These injections can cause longer-lasting relief with little to no side effects.
Aside from pain medication alternatives, patients can take measures to control their weight while managing their fibromyalgia. Our physicians recommend eating a healthy diet full of essential vitamins and minerals. However, we’ve found that it may be easier for patients to gradually get away from sweets starting out by only switching out a few foods for healthier alternatives and gradually adopting a healthy diet. Finally, our physicians can recommend simple exercises for patients who are just starting out. It may be difficult to exercise when dealing with fibromyalgia pain, but it’s important to note that when following an exercise routine, it gets much easier the more you do it. Many patients have found success doing gentle flow yoga and moving up towards low-impact activities like walking and doing weight-bearing exercises.
Exercise is extremely vital to our health. It keeps our hearts healthy, lowers our risk of diseases, and can even release pain-relieving endorphins that can help patients suffering from chronic pain. However, instead of feeling pain relief, some people may get headaches after working out, commonly after running or lifting weights, although some people have reported getting a headache during their exercise session as well.
Exercise headaches, also known as exertion headaches, are usually described as pounding or throbbing and occurring on both sides of the head. Patients may find relief if they avoid movement or changes in blood pressure. Exercise headaches may also cause nausea, a symptom shared with migraine headaches. However, exercise headaches should not be confused with migraines and do not share other symptoms like light sensitivity.
Causes:
We are not exactly sure what causes exercise headaches, but pain specialists have a few well-researched theories. The number one cause to look for is dehydration. Many people will drink plenty of water during the workout, but it is equally as important to drink copious amounts of water before and after the exercise. However, water is not the only thing you should be fueling your body with before exercise. Patients should not exercise on an empty stomach, so a light, healthy snack is advised beforehand, as blood sugar may be a factor causing headaches. Other theories suggest that exercise headaches could be caused by changes in the amount of blood going to the brain or an underlying condition inside the brain.
Exercising should not leave people in pain, so if you are frequently experiencing an exercise headache after drinking more water and trying to eat something light prior to your workout, we encourage you to come to see the physicians at Chronicillness.co Site of United States. Our offices are equipped with state-of-the-art equipment and headache experts who can get to the bottom of your headaches. We will work with you to find a treatment plan that is right for you. In addition to pain medication, we offer injection therapy that is specifically targeted to treat chronic headaches. The injections may provide relief for many months and can be repeated if necessary. If an underlying condition does exist, our staff will make sure you are in the right hands to effectively treat your condition and get back into life.
A procedure that uses radio waves to treat chronic low back pain provided long-lasting relief to a small group of patients, researchers report.
Called intradiscal biacuplasty (IDB), the procedure uses two water-cooled needles to blast radiofrequency energy at the nerve fibers within and around a spinal disc that’s begun to degenerate but has not ruptured, explained lead researcher Dr. Michael Gofeld.
“Basically you’re destroying the nerve fibers, which will lead to the elimination of pain,” he said. Gofeld is a chronic pain management specialist at St. Michael’s Hospital and Women’s College Hospital in Toronto.
A year out from treatment, half of the patients who received IDB in the study said they still were experiencing significant pain reduction, Gofeld and his colleagues reported.
The treatment is specifically to help people with discogenic back pain, Gofeld said — pain related to discs that are deteriorating but have not ruptured.
Prior studies have found that discogenic back pain accounts for 39 percent of cases of chronic lower back pain, he said.
The idea of using radio waves to treat back pain has been around for a quarter-century, Gofeld said. But recent breakthroughs using water-cooled needles have made the technology potentially more effective.
“If the needle gets too hot, the energy will not spread efficiently enough,” Gofeld said.
The procedure takes about a half hour, followed by six weeks of physical therapy, he said. Ideal patients have lower back pain that doesn’t shoot down the legs and limited disc degeneration, with no significant tears or ruptures.
Dr. John Mafi, an internist and assistant professor at UCLA’s David Geffen School of Medicine, in Los Angeles, pointed out that the U.S. Food and Drug Administration approved IDB for use in 2007. But the technology has not been widely adopted in the United States, he said.
“It’s not widely used,” Mafi said. “Insurance doesn’t seem to cover it yet, and that may be because they want to see more evidence.”
For example, the U.S. Centers for Medicare and Medicaid Services (CMS) ruled in September 2008 that the government insurance plans would not cover any radiofrequency treatments for low back pain. The CMS decision memo concluded that there wasn’t enough evidence to prove that the procedures would improve health outcomes.
Gofeld’s study, which was funded by device manufacturer Kimberly-Clark Corp., focused on 22 patients who received IDB treatment alongside typical medical care for back pain.
These patients originally showed less pain at six months following treatment, and now a one-year follow-up found that their pain reduction and improved function had continued, Gofeld said.
The one-year report also included 25 members of the initial control group for the study, who at first only received typical medical care that included physical therapy and exercises.
These patients were allowed to “cross over” after six months and receive IDB. They also experienced some pain relief and improved function, the Canadian researchers reported.
However, their pain reduction was not as strong as that experienced by the original treatment group, Gofeld said.
“We can infer from this result that the sooner we do the procedure and get the patient into rehabilitation treatment, the better will be the result,” he said.
Researchers also found no significant side effects associated with IDB.
The findings were presented Feb. 19 at the American Academy of Pain Medicine’s annual meeting in Palm Springs, Calif. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.
Mafi said the small number of patients involved makes this more of a “pilot study.”
“I wouldn’t jump to any changes in policy based on this study,” Mafi said. “This is a promising start, but now it’s time to do a rigorous clinical trial from this pilot data.”
Dr. Nathaniel Tindel, an orthopedic spine surgeon at Lenox Hill Hospital in New York City, also sounded a cautious note, based on both the small number of participants and the fact that numerous prior radiofrequency treatments have failed to help people with low back pain.
“Whenever there are a plethora of procedures offered to treat a condition which is known to heal best when left alone, those procedures are either all very effective or equally ineffective,” Tindel said. “Unfortunately, medical research has already shown us that intradiscal therapy falls into the latter category, and to date has not been shown to have long-term effect on back pain and disc disease.”
Chronicillness.co Site of United States values innovation, so when a new FDA-approved device comes out, we want our patients to be the first to learn about the possible benefits. You may have heard of a TENS unit, a device our patients have been using for years. A TENS unit is a small device that sends electrical stimulation to the nerves to correct any misfiring nerves and stop them from sending pain signals to the brain. A Quell device is similar to this.
A Quell device looks a little bit like the armbands you wear to the gym that holds your iPod or phone. However, this device is worn on your calf. While it doesn’t hold any iPods, it can actually be controlled from your smartphone! Instead of coming to appointments to have your electrical impulse levels adjusted by a physician, you can control the level you need.
So how does it work? The band is equipped with an electrode or a conductor that sends electricity into the body. By stimulating the nerves in the calf, signals can be sent to the spine and then the brain, so it works for pain in all areas of the body.
After strong evidence that it can help people suffering from chronic pain, it received FDA approval and is available at Chronicillness.co Site of United States. The device offers a nighttime mode and can be worn 24 hours per day, but some people may find it uncomfortable to sleep with, or that they are unable to wear tight-fitting pants while using the device. The nighttime mode can be programmed to go off every other hour to avoid disturbing sleep patterns.
While we believe Quell can be available to patients at a lower cost than some of our implantable electrical devices, the electrodes do need to be replaced about every two weeks, although the battery can be charged and work for up to 30 hours. Our physicians do not see Quell as a permanent fix for chronic pain. Pain relief stops when the device comes off, so we recommend pursuing other treatment options at the same time.
One of the best ways to ease anxiety about a major event, like surgery, is to plan ahead. Conversations about postsurgical pain management need to happen before your procedure, so you can focus on your recovery after surgery is complete.
Here are9 questions you should ask your attending health care professional before having surgery.
Make sure you understand your health care provider’s instructions about eating and drinking. Anesthesia administered during surgery may require you to have an empty stomach.
Preemptive or preventive pain relievers may be given, in addition to general anesthesia or other sedatives before surgery. Local anesthetics may be used during surgery to numb the area and help control pain. These may be placed directly into the surgical site, into or around a nerve (“nerve block“) or close to the spinal cord (“epidural”). Ask your health care provider to walk you through the pain management plan so there are no surprises.
This will depend on the type of procedure you’re having and the pain medications used before, during and after your surgery. Be sure and talk with your health care provider so you will know what to expect and be familiar with all of your options for pain management.
Depending on the type of procedure you’re having, a combination of medications may be used before, during and after surgery to block the various sources and pathways of pain. Essentially, these drugs may work in different areas or in different ways to better address your specific needs. Ask your health care provider about the risks and benefits of each medication being used along the way.
One of the best signs of proper pain management is being able to start moving and resume normal activities. You may also be periodically asked to measure your pain on a scale from 1 to 10 (with 10 being the worst pain and anything above 7 being severe). If you’re taking pain medication, it’s important to stay ahead of your pain and not let your pain levels get out of control.
Sharing information about yourself and your medical history will help your surgeon better understand your treatment needs and tailor a pain management plan that’s right for you. Let your health care provider know if you are:
There are a variety of products your surgeon may give you before and during surgery to minimize your need for narcotics after surgery, including local anesthetics. Local anesthetics are numbing medications that can be used to numb the area where you had surgery from anywhere between a few hours to a few days. These may be placed directly into the surgical site, into or around a nerve (“nerve block”) or close to the spinal cord (epidural). If long-lasting local anesthetics are used during your procedure to numb the surgical site, you may require less narcotic pain medication afterwards.
After surgery, there are several non-narcotic options that may be appropriate for you, including common over-the-counter (OTC) pain relievers like acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen. These may be prescribed in higher doses than the OTC dosages. All can help control mild to moderate pain. Aspirin may also help prevent blood clots, while NSAIDs may help reduce swelling and inflammation. Once you’re in the recovery room, your pain medication may be given orally (by mouth) or through an IV (a tube feeding into a vein).
Here is more information about postsurgical pain management options.
The kinds of side effects you may experience will depend on the type of medications used before, during and after your surgery. For example, narcotics may cause constipation, nausea and vomiting, while nerve blocks can cause muscle weakness. Ask your health care provider about the side effects that can be expected with all the pain medications you will receive.
Before you leave the hospital, make sure you feel 100 percent comfortable about how your pain will be managed at home. In most cases, you will be given a prescription for pain medication before or after surgery. You may be able to fill the prescription at the hospital pharmacy or it may be sent in to your local pharmacy for pickup on your way home. Making sure you have your pain medication in hand when you reach home, will help you stay ahead of your pain and not let it get out of control. Before you take your medication, be sure to read the enclosed instructions about how often to take the medication and what side effects to look for. If you have any questions about your pain medication, ask your local pharmacist or your health care professional.
As summer approaches, more families are heading to the pool to cool off. It is also a time when many who suffer from a wide range of pain conditions take advantage of the pool to help ease their pain. But does swimming actually help reduce degenerative disc disease pain? There is a bit of a debate within the chronic pain community about this exact question. Some argue swimming can worsen back pain, while others say swimming is a safe form of exercise for degenerative disc disease.
Our pain management doctors often recommend exercise to help relieve degenerative disc pain. Light and low-impact exercise can help increase blood flow to the spine, strengthen the muscles that support the spine, and even help patients keep off additional weight. High-impact exercises, like running or jumping, may cause a great deal of pain because damaged discs cannot absorb shock as well on hard surfaces. Swimming solves this problem because our spines don’t have to work as hard to support our bodies. The buoyancy of water eliminates the stress that is usually absorbed by the joints during exercise.
For this reason, patients with degenerative disc disease may find pain relief from doing light stretches or exercises in the pool. Backstroke is often recommended because it promotes a neutral spine, and reduces the risk of hyperextension associated with other swim strokes. Those who are not ready for swimming may opt to try water aerobics, which can help strengthen the core and lower back muscles.
In some cases, however, swimming may be harmful to degenerative disc disease and other back or spine conditions. Patients unfamiliar with the breaststroke may accidentally throw the head back too far, and those doing a front stroke requiring them to look to the side for breath may hurt their necks as well. Patients who want to try swimming for degenerative disc pain should first consult with their doctor, and consider working with a certified trainer or physical therapist before trying any of the exercises on their own.
If you are cleared to swim, start with spine-friendly swim techniques and stretches that you are already familiar with – and go slow. Take care to use proper technique, and try to keep your body straight and avoid twisting the spine. Floatation devices can be used to help avoid hyperextension in your back or neck, as you are less tempted to move into an irregular position to stay afloat.
Through activities like swimming and aqua therapy, you can beat the heat and feel better too. If you are experiencing degenerative disc disease pain or other back pain, talk to your physician or a board-certified pain management specialist for more tips to relieve your back pain.
This Mother’s Day, take pity on the woman who cooks, cleans, shops, fusses and worries over you.
Before you overwhelm her with breakfast in bed, let her sleep in.
It’s no secret that women are chronically sleep deprived, and moms, especially working moms, are at the top of that list.
According to a survey conducted by the National Sleep Foundation, almost three out of four American women between the ages of 30 and 60 don’t get the recommended eight hours of sleep a night during the week. The average weeknight’s sleep for women is only about six-and-a-half hours.
“Sleep deprivation is epidemic in the United States,” says Gary Zammit, director of the Sleep Disorders Institute at St. Luke’s-Roosevelt Hospital in New York City. “Most of us need eight hours or more in order to feel refreshed and fully functional during the day. The majority of us are getting less than that.”
“It’s part of the achievement orientation that’s become unbalanced in our society, which results in a lack of respect and attention to rest and relaxation, not to mention play,” adds Dr. Suzanne Griffin, a clinical assistant professor of psychiatry at Georgetown University Medical Center in Washington, D.C.
What are the reasons for the lack of sleep and lack of quality sleep? They can run the gamut from hormonal fluctuations to depression and anxiety to just being a vigilant mom, the experts say.
“The most obvious one is hormonal fluctuations, which, to some extent, defines femaleness, and there are several different times in life when we encounter this,” Griffin says. Menopausal, perimenopausal and postpartum women are most likely to have disturbances in sleep continuity. Also, one quarter to one third of women will experience some sleep disturbance while they have premenstrual syndrome (PMS) at least half the time, Griffin adds.
Women are also more likely to suffer from certain diseases that are associated with sleep disturbances, such as fibromyalgia and depression.
Moms have additional difficulties.
“For many mothers, their brain is set to a level of vigilance and awareness even during sleep that allows them to wake up to small changes in the environment — whimpers, coughs, kids getting up and padding around,” Griffin says. “What happens in particularly sensitive people, once they get that level of arousal going, their brain is trained to wake up, and then they develop a more chronic sleep disturbance.”
There’s also a social aspect related to the increasing number of roles that women are taking on in society.
“As women have occupied more important roles in the workplace, they haven’t necessarily relieved themselves of their traditional roles in the home,” Zammit says. “For women, particularly mothers, they go out and work and then they come home and for the most part they bear the greatest burden in the family of caring for their spouse, cooking, laundry, children and so on. Most of them fit it in by cheating on their sleep.”
“Even a small amount of sleep deprivation — say an hour a night when it occurs chronically over an extended period [of] one or two weeks — that can have an impact that is as significant as staying awake all night long and then trying to function,” Zammit says.
People who don’t get enough sleep are often not at peak performance. Their memory, concentration, cognitive functioning, attention and mood all suffer.
Fatigued people are also at greater risk for accidents and injury, especially motor vehicle accidents. The National Transportation Safety Board reports that 100,000 police-reported crashes each year are the direct result of drowsy driving, resulting in more than 1,550 deaths, 71,000 injuries and $12.5 billion in economic costs.
But don’t lose hope. There are several common-sense things moms and all women can do to try to get their sleep and life back on track. Try these steps:
“The most important thing is learning to say ‘no,’ and the second most important is delegating,” Griffin says. Try setting limits on the amount of time you are willing to devote to particular activities, and determine what your most important priorities are. For Griffin, mothering her children was the clear priority that led her to change her schedule and professional commitments.
Stay away from alcohol and caffeine, both of which can alter your sleep for the worse.
Dedicate the bedroom to sleep and love only, Griffin suggests. If you have trouble sleeping or getting to sleep, don’t read, talk on the phone, watch TV or make lists in bed.
Go to bed and get up at the same time every day.
Relax for an hour before going to bed, Griffin advises. “If you have been busy, busy, busy until the minute you get into bed, it’s going to be difficult to turn off your head,” she explains.
Turn the clock around so, if you are awake, you’re not watching the time.
Try a light snack before you go to bed so your blood sugar doesn’t drop and wake you up in the middle of the night. Avoid snacks with a heavy sugar content, Griffin advises, and go for cheese and crackers or cheese and fruit instead. Don’t have any heavy meals within three hours of going to bed.
Stay away from herbal remedies because in the United States, it’s hard to know what the potency of a compound is. Opt instead for herbal teas such as peppermint, Sleepy Time and chamomile, Griffin says.
“Exercising is really important for promoting good sleep, but it needs to occur more than three hours before bedtime, otherwise it will interfere with getting to sleep,” Griffin says.
If you find you can’t sleep after 15 minutes in bed, get out of bed and go to a quiet, dimly lit place where you can relax until you fall asleep. Don’t get up to do the laundry.
If your sleep disorder persists, visit a sleep-disorders center, but make sure it’s accredited by the American Academy of Sleep Medicine, Zammit says.
“It’s important to realize that better living does not necessarily mean more living. It might mean better quality living,” Zammit says.
“As people think about what life experiences are like going through life fatigued, they’re not really getting the most out of their lives and they’re probably not delivering the most to their families,” he adds. “So, actually saying that, ‘yes, sleep is an essential for me,’ is part of setting the foundation for a good life.”
When you drop something on your foot or slam your finger in a drawer, you know that pain will usually follow. Did you ever wonder why you feel that pain? Feeling pain in response to an injury is a signal that your body has been damaged in some way. Or, if you have an illness, headache, or another type of pain, it’s a signal to your brain that something is not right.
Our nervous system is made up of the brain and the spinal cord, which combine to form the central nervous system; and our sensory and motor nerves, which form the peripheral nervous system. Nerves send information about what is happening in our environment to the brain via the spinal cord. The brain then sends information back to our nerves, helping us to perform actions in response.
There are two major categories of pain: acute pain (short-term) and chronic pain (long-term).
Acute pain is a severe or sudden pain that resolves within an expected amount of time. You might feel acute pain when you experience an injury, have surgery, or are sick. An example of acute pain is when you twist your ankle. The sensory nerves in your ankle respond by firing off, letting the spinal cord instantly know that something is wrong. Your spinal cord delivers the message to the brain. Finally, the brain decides how bad the injury is and what to do next. Your brain is a massive database stored with every incident like this in your life, and it reverts back to other situations when this kind of injury has happened. Then your brain decides whether to invoke tears, increase your heart rate, release adrenaline, or any one of a billion other possible responses.
With chronic pain, however, the initial pain receptors continue to fire after the injury. Chronic pain is defined as pain that lasts three months or more, or longer than the expected healing time for an illness or trauma. Chronic pain can be caused by a disease or condition that continuously causes damage. For example, with arthritis, the joint is in a constant state of disrepair, causing pain signals to travel to the brain with little downtime. Sometimes, there is no longer a physical cause of pain, but the pain response is the same. In these cases, it is difficult to pin down the cause of the chronic pain, and difficult to treat.
Response to pain is individual, and what may be painful to one person can be only slightly uncomfortable to another. Because pain messages pass through the emotional and thinking regions of your brain, your experience of pain is shaped not just by the physical damage or sensation, but by psychological, emotional, and social factors as well. Your memories of past painful experiences, genetics, long-term health problems, coping strategies, and attitude toward pain can all contribute to how you feel pain.
Lower back pain is a common reason for visits to the doctor, affecting people of all ages and activity levels. An estimated 8 in 10 people experience this musculoskeletal disorder at some point in their lives. It accounts for more sick leave and disability than any other medical condition. It is easy to write off low back pain; however, when the pain becomes a chronic condition, it can significantly impact the quality of life.
Low back pain can begin suddenly. It can result from an accident or from lifting something heavy. It can also develop over time due to age-related changes to the spine, disease, or as a result of a sedentary lifestyle. Thus, it is not always possible to identify a specific back injury or condition which might be causing lower back pain. However, this should not prevent lower back pain from being managed or treated.
The most common cause of low back pain is an injury or overuse of muscles, ligaments, or joints. This is prevalent for people playing sports where there is a repetition of movement. Pain can be worsened by pressure on nerve roots in the spinal canal. This compression can be caused by a herniated disc, which can be a result of a sudden movement or brought on by repeated vibration or motion. These types of injuries are frequently found in weight lifters, as well as people whose professions require assembly-line types of repetitive behavior.
As people age, osteoarthritis can develop. When osteoarthritis affects the small facet joints in the spine, it can lead to back pain. Osteoarthritis in other joints, such as the hips, can cause you to limp or change the way you walk. This can also lead to low back pain. Other conditions that can contribute to low back pain include spinal stenosis, ankylosing spondylitis, compression fractures, and spondylolisthesis.
Diagnosing the cause of lower back pain
Kidney problems, ovary problems, tumors, infection, or even pregnancy can cause lower back pain. It is important to see a physician rule out these conditions – especially if you are unable to point to a specific injury as the cause of your low back pain. In addition to completing a physical examination, your pain doctor will want to run tests to determine exactly where the pain is stemming from. These tests might include spinal x-rays, MRI or CT scans, or nerve studies. He or she may ask you about any personal history of arthritis or spine injuries, your family history of back pain, and your daily routines and movements.
Managing lower back pain
After a thorough examination, your pain doctor will talk with you about your goals and recommend options for lower back pain management. Treatment plans may include medication, specialized stretches for back pain, or lower back strength training with a physical therapist. In complex cases, nerve stimulators or minimally invasive procedures may be recommended. Ongoing treatments could include heat/ice therapy, massage therapy, and other alternative therapies. And because chronic pain often affects mood, cognitive-behavioral therapy may be recommended to help teach patients appropriate coping skills for dealing with anxiety, depression, and irritability.
