A back spasm is a painful contraction of a muscle. It can be felt anywhere along the spinal cord, but is commonly experienced in the lower back. Backspasms are often a symptom of more serious conditions. They can be either acute or chronic and may persist if treatment is not sought at Chronicillness.co Site of United States. The spasm often occurs when the patient is twisting or exerting their back muscles in any way. However, the pain can sometimes be spontaneous and cause lower back pain to become worse.
People experience back spasms as a result of muscle or tendon damage, but these painful contractions could also be a result of an arthritic or spinal condition. However, in most cases, back spasms are caused by over-exertion from heavy lifting or excess strain. Diagnostic imaging could be used to see if arthritis or spinal discs are the cause of the back pain and an MRI machine can detect muscle issues. Be sure to bring in all images or have your doctor send them to Chronicillness.co Site of United States before your next appointment.
In order to prevent back spasms, our physicians recommend that patients warm up and stretch their backs before working out or lifting heavy objects. Lifting abnormally shaped objects (like furniture) puts people at risk of developing back pain and muscle spasms. In order to prevent straining the back in a position that is uncomfortable, we highly encourage using another person to lessen the burden on the weight. If patients regularly work out their back muscles, it is important to spend a few days resting in between. Muscles that are in spasm are often irritated and inflamed, so rest days allow muscles to recover so they do not result in spasms.
The board-certified pain management physicians at Chronicillness.co Site of the United States has treatment options for just about every cause of back spasm. They can prescribe muscle relaxants to soothe the muscles, but if the medication does not work, the back spasms could be a result of a more serious condition. Injections are a great way to find out where the back pain is coming from and treat back spasms at the source. For example, if a patient has facet joint arthritis, a physician can administer a facet joint block. Our physicians will work with the patient until they find a treatment that works best for them.
We urge patients to come to Chronicillness.co Site of the United States if they are experiencing back spasms. They can start as a sharp, sudden pain that goes away, but if left untreated, back spasms could become chronic. Our physicians can determine the cause and put you back on track toward a pain-free life again.
Stem cell clinics are charging big money for knee arthritis “cures” and making extravagant claims about their therapies, a new study contends.
A same-day injection for one knee costs thousands of dollars at these centers, according to a consumer survey taken of clinics across the United States.
People are paying that kind of cash because two-thirds of stem cell clinics promise that their treatments work 80 to 100 percent of the time, researchers report.
But there’s no medical evidence suggesting that any stem cell therapy can provide a lasting cure for knee arthritis, said study lead researcher Dr. George Muschler, an orthopedic surgeon with the Cleveland Clinic.
“There are claims made about efficacy [effectiveness] that aren’t supported by the literature,” Muschler said. “There’s a risk of charlatanism, and patients should be aware.”
Stem cells have gained a reputation as a miracle treatment and potential cure for many ailments. The cells have the potential to provide replacement cells for any part of the body—blood, brain, bones or organs.
As a result, a wave of stem cell centers have opened up around the country, offering cures for a variety of diseases, Muschler said.
“It’s very sexy to market yourself as a stem cell center, so there’s been a boom of centers, probably close to 600 now in the United States offering this therapy,” Muschler said. “But the truth is that the medical literature hasn’t quite caught up to the enthusiasm in the marketplace.”
The U.S. Food and Drug Administration has expressed extreme skepticism over these centers, and in November the agency announced that it would crack down on clinics offering dangerous stem cell treatments.
The “pie-in-the-sky” dream for knee arthritis patients is that a stem cell injection will produce fresh new protective cartilage in their joint, said Dr. Scott Rodeo, an orthopedic surgeon with the Hospital for Special Surgery in New York City.
“The reality is they don’t do that. There is zero data to suggest that,” said Rodeo, who wasn’t involved with the study. “The idea these cells are going to regenerate cartilage––there’s zero data.”
At best, these injections might temporarily reduce pain and inflammation by prompting the release of soothing chemicals in the knee, Rodeo and Muschler said.
To get an idea what stem cell centers are promising customers, Muschler and his colleagues called 273 U.S. clinics posing as a 57-year-old man with knee arthritis.
The clinics were asked about same-day stem cell injections, how well they work and how much they cost.
Of the 65 centers that provided pricing information, the average cost for a knee injection was $5,156, with prices ranging from $1,150 to $12,000, the researchers found. Fourteen centers charged less than $3,000 for a single injection, while 10 centers charged more than $8,000.
The 36 centers that provided information on effectiveness claimed an average effectiveness of 82 percent, the researchers said. Of them, 10 claimed that the injection worked 9 out of 10 times, and another 15 claimed 80 to 90 percent effectiveness.
The findings were presented Tuesday at the American Academy of Orthopaedic Surgeons‘ annual meeting, in New Orleans. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
“Patients are being told there’s an 80 percent likelihood of improvement, which is only 10 to 20 percent better than you’d expect from a placebo effect,” Muschler said.
In fact, he suspects that the placebo effect is responsible for much of the improvement patients feel following a knee injection.
“People always show up to the doctor when they hurt,” Muschler said. “If I see a patient who has arthritis in their knee and I do nothing, there’s a very good chance they’re going to get better over the coming months, anyway. There’s this natural cycle of increasing and decreasing pain that’s present in the life of someone who has arthritis.”
That’s compounded by the fact that people expect to feel better after shelling out a load of cash, Muschler added.
These centers generally provide three different types of treatment, only one of which actually has live stem cells involved, Muschler said.
One treatment injects the knee with platelet-rich plasma drawn from the patient’s own blood, while another uses a slurry produced from fetal tissue and fluid gathered after birth. Neither of these contains stem cells, but they are marketed as stem cell therapies, Muschler said.
A third option involves bone marrow taken from the patient and injected into the knee. This does contain a mixture of three types of stem cells, but “the evidence that you’re doing [your knees] a favor is still pretty weak in the literature,” Muschler said.
People aren’t likely to be harmed by these injections, Rodeo said, but there’s not a lot of evidence that they’ll be helped.
“Patients should go into it eyes wide open,” Rodeo said. “They’re paying a lot of money out of pocket, because these are not covered by insurers.”
Knee arthritis sufferers would be better off trying many of the established options for reducing knee pain, Muschler and Rodeo said.
Losing weight is a “key factor,” Muschler said.
“There’s very good evidence that if you are at a 5 on the pain scale and you lose 10 percent of your body weight, your pain will drop 2 points,” Muschler said.
Patients also can use NSAIDs like aspirin or ibuprofen to reduce pain and swelling, get a steroid injection, or perform weight training to strengthen the muscles that support the knee, Muschler and Rodeo said.
Sure, an over-the-counter painkiller like Tylenol or Advil can help ease aches and pains, but could it mess with your thoughts and emotions, too?
That’s the finding from a new review of recently published studies. The studies focused on how nonprescription painkillers might temporarily alter emotions such as empathy or even a person’s reasoning skills.
“In many ways, the reviewed findings are alarming,” said a team led by Kyle Ratner, a psychology and brain science researcher at the University of California, Santa Barbara.
“Consumers assume that when they take an over-the-counter pain medication, it will relieve their physical symptoms, but they do not anticipate broader psychological effects,” the study group said.
One clinical psychiatrist who reviewed the findings said they aren’t far-fetched.
“Intuitively, this makes sense, as physical and emotional senses can overlap in the brain,” said Dr. Alan Manevitz of Lenox Hill Hospital in New York City.
“While physical pain can be locally ‘felt’ at the site of a physical injury, the main source and registration of physical pain is in the brain,” he explained. “The same is true of hurtful, emotional and painful feelings. We say our ‘heart is breaking,’ but emotions are felt in the brain.”
The new study reviewed findings from studies focused on common over-the-counter painkillers such as ibuprofen (Advil and Motrin) or acetaminophen (Tylenol).
The experiments suggest that a regular dose of the pills might affect a person’s sensitivity to painful emotional experiences. For example, in one study, women who took ibuprofen reported less hurt feelings from emotionally painful experiences, such as being excluded by others or writing about being betrayed.
However, men had the opposite pattern—they became more sensitive to these types of scenarios if they had just taken the painkiller.
Ratner’s team suggested that these medicines might also reduce a person’s ability to empathize with the pain of others. For example, one experiment found that people who took acetaminophen were less emotionally distressed while reading about a person suffering physical or emotional pain and felt less regard for the person, compared with people who did not take acetaminophen.
People also seemed more willing to part with possessions after taking an over-the-counter painkiller in one study: Their asking price for a possession was lower if they had recently taken such a drug.
Nonprescription painkillers might even impair “information processing,” the researchers said. In one study, people who took acetaminophen made more errors of omission during a task than those who did not take the drug, for example.
Dr. Michael Ketteringham, a psychiatrist at Staten Island University Hospital in New York City, reviewed the findings. He stressed that—given an ongoing epidemic of opioid abuse—people shouldn’t be too concerned about the new report.
“Over-the-counter pain medications play an important role as alternative medication to opioids in the treatment of pain,” Ketteringham said.
But the study team wondered if, sometime in the future, it might be possible that the medicines could be used to help people deal with hurt feelings.
Still, both Ratner’s team and Manevitz stressed that it’s far too early to turn over-the-counter painkillers into psychological treatments.
“Clinically, we are a far cry away from the doctor saying, ‘Heartbreak? Take two Tylenol and call me in the morning,’” Manevitz said.
A new treatment that aims electrical pulses at irritated nerves around the spinal cord appears effective at relieving chronic lower back pain and sciatica, a preliminary study suggests.
The minimally invasive procedure, called image-guided pulsed radiofrequency, eased lingering pain in 80 percent of 10 patients after a single 10-minute treatment. Ninety percent were able to avoid surgery.
“Given the very low risk profile of this technique, patients suffering herniated disc and nerve root compression symptoms may undergo a safe and fast recovery, going back to normal activities within days,” said study author Dr. Alessandro Napoli, an interventional radiologist at Sapienza University in Rome, Italy.
“In fact,” he added, “one of the dramatic advantages of this technology is that we can perform it in a day-surgery setting, without anesthesia, and [patients] go home the same day.”
Napoli’s study was scheduled for presentation Wednesday at the Radiological Society of North America’s annual meeting in Chicago. Studies presented at scientific conferences typically haven’t been peer-reviewed or published, and results are considered preliminary.
About 8 in 10 people suffer from lower back pain at some point in their lives, according to study documents. This pain can be due to a herniated disc in the lower spine. Sciatica is radiating leg pain caused by a pinched nerve in the lower spine, which also may be due to a herniated disc.
Also called a slipped or ruptured disc, a herniated disc occurs when the spongy material inside a spinal disc squeezes through its tough outer shell because of aging or injury. This material can press on surrounding nerves, causing pain and numbness or tingling in the legs, according to the American Academy of Orthopaedic Surgeons (AAOS).
Conservative, nonsurgical approaches typically ease symptoms of a herniated disc over time, according to the AAOS. These treatments include rest, gentle exercise, pain relievers, anti-inflammatory drugs, cold or hot compresses, physical therapy and massage therapy.
However, about 20 percent of those with acute low back pain don’t find relief through these measures. That leads some to decide on surgery to remove disc material pressing on their spinal nerves. For these people, Napoli said, image-guided pulsed radiofrequency treatment may become a viable option if larger studies reinforce his findings.
Napoli’s research included 80 people who had experienced at least three months of low back pain from a herniated disc that hadn’t responded to conservative treatments.
Image-guided pulsed radiofrequency treatment uses computed tomography—a CT scan—to help physicians insert a needle to the location of the herniated disc and surrounding nerves. A probe that’s inserted through the needle tip delivers pulsed radiofrequency energy to the area over a 10-minute period, resolving the herniation without touching the disc, Napoli explained.
More than 80 percent of the 80 study participants were pain-free a year after a single treatment. Six people required a second treatment session.
Pulsed radiofrequency has been widely used in pain medicine for other types of chronic pain, Napoli noted.
He said the treatment works by “eliminating the inflammation process” in nerves surrounding the herniated disc, hindering painful muscle contractions. “The aim was to interrupt this cycle and give the body the chance to restore a natural healing,” he added.
Dr. Scott Roberts, a physiatrist with Christiana Care Health System in Wilmington, Del., said the new findings showed “an impressive drop in pain and improvement in function.” However, he noted that the research didn’t include a control group for comparison with people not given the treatment.
“With no control group, we don’t know how much of the improvement we’re seeing would have happened anyway,” Roberts said. “I was very encouraged by [the study] because its results are significant, but it’s far from conclusive without a control group.”
Getting older certainly has its perks, but the reality is that aging can take its toll on many of us, despite our efforts to get out there and stay active—especially as the cold weather sets in.
No, it wasn’t an exaggeration when your mother/father/grandmother or someone else rubbed their knee/elbow/back, winced and muttered, “I can feel a storm coming on.”
Yes, there is evidence that shows a link between weather changes and chronic pain, especially joint pain and migraines. A 2007 Tufts University study showed that for every 10-degree drop in temperature, there was an incremental increase in arthritis pain. Low barometric pressure, low temperatures and precipitation can all increase pain. The theory is that these conditions increase swelling in the joint capsule, says the Arthritis Foundation.
It all adds up to giving your body an opportunity to heal itself by reducing its creation of pain-driving substances and stimulating mitochondria, the “energypacks” that drive cellular function and repair.
Here are a few of the more common causes of joint pain and ways to ease your discomfort.
1. Injury You slip and fall. Overdo it at the gym. Get rear-ended in your car. Sleep in the wrong position. Sit cramped on a plane for too many hours. Have poor posture. There are a zillion ways to injure your body, whether quite innocently and unknowingly from an everyday cause or overuse from repetitive motions over time.
That pain can lead to stiffness, sleep disturbances, a burning sensation in your muscles, achiness or acute pain running from mild to severe.
What to do to relieve muscle tension and soreness? Well, you can complain, call a doctor, take a pain reliever or rest—but don’t underestimate the power of massage in delivering a significant reduction in pain and soreness.
2. Osteoarthritis This chronic condition of the joints is sometimes referred to as degenerative joint disease or “wear and tear” arthritis. It gets its name from the way it develops: cartilage, the cushion between our joints, breaks down over time and with use. What comes next? Pain, stiffness and swelling.
If your knees, hips, lower back and neck hurt, you’re in good company with the 27 million other Americans who feel the pain. Also affected could be the small joints in your fingers and the bases of your big toe and thumb.
Although physical activity might be the furthest thing from your mind when you’re feeling this way, it pays to be active. Studies show that simple exercise, like walking, can help manage or even reduce the pain from osteoarthritis. Weight management, stretching and anti-inflammatory medications can help, too, as can alternative approaches like massage, acupuncture and hydrotherapy.
3. Bursitis We all have bursae—small sacs filled with fluid that cushion the bones, tendons and muscles near and around the joints of the shoulders, elbows and hips. When these become inflamed from repetitive movements, you’ve got bursitis, which can also affect the knees, heels and base of the big toe. Sometimes you can get bursitis from putting pressure on a joint for too long—like kneeling or leaning on your knees or elbows, for instance.
The pain from bursitis can make you feel achy or stiff and can hurt when you move or press on the joint, which might also appear swollen or red.
While you can’t prevent all types of bursitis, there are some things you can do to reduce the likelihood you’ll get it. If you do a lot of things that require kneeling, take stress off your knees by using a kneeling pad; warm up and stretch prior to strenuous activity; maintain a healthy weight to take stress off your joints and strengthen the muscles around them; use your knees, rather than your back, to lift heavy loads.
Bursitis usually improves on its own, but you can help it along by resting, icing and taking a pain reliever. More aggressive treatment, if necessary, might include physical therapy, prescription medications and steroid injections.
4. Gout This inflammatory form of arthritis affects about 4 percent of American adults.
Many people think of gout as a “rich man’s disease,” a result of a lavish and expensive diet. That’s only a very small part of the picture. Most of the uric acid—actually about two-thirds of it—is produced naturally by your body. The rest comes from diet, in the form of purines, found in animal and plant foods. In fact, one of the great myths of gout is that it is caused by or can be controlled by diet. The reality of it is that gout is mainly a metabolic disease with genetic origins.
Gout occurs when there’s too much uric acid in your body and your kidneys can’t flush it out. It builds in the bloodstream and forms needle-like crystals in a joint. Those crystals, in turn, bring on sudden and severe attacks of pain, tenderness, redness and swelling. It commonly affects the big toe but can also occur in your feet, ankles, knees, hands and wrists. It can make the joint feel like it’s on fire. The pain can get so severe that even the weight of a sheet can be impossible to tolerate.
Don’t think that you don’t have control over gout. You might not be able to change your genetics, but you can change factors like being overweight, which contributes to things like high blood pressure, high cholesterol and high blood sugar—all linked to gout.
Experts say that although eating a low-purine diet won’t cure gout, it’s important to eat well and maintain a healthy weight. And, it’s wise to limit foods that increase uric acid levels, such as red meat, shellfish like shrimp and lobster, beer, liquor and high-fructose corn syrup.
To help ease the pain from acute attacks and prevent future ones, gout is usually treated with medication like nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen and others), colchicine (a pain reliever used for gout pain) and corticosteroids (like prednisone).
5. Lyme Disease Achy knees and Lyme disease often go together, and that’s because the bacteria transmitted by the tick bite can spread to your joints. This stiffness could also develop in your neck, hands and feet. Aside from joint pain, Lyme’s usual symptoms are fever, headache, fatigue and a skin rash characterized by a bulls-eye red circle that usually appears about seven days following the bite.
Left untreated, Lyme can also spread to the heart and nervous system.
Each year, approximately 30,000 people get bitten by a tick and develop Lyme disease. The first way to prevent it is to reduce your exposure by avoiding wooded and brush areas with high grass and leaf litter. Also, use insect and tick repellent, and inspect your body thoroughly for ticks after you’ve been outdoors. Putting your clothing in a hot dryer for 10 minutes can kill off any ticks that hitched a ride.
Caught early, Lyme can be successfully treated with a variety of oral, and sometimes, intravenous antibiotics or penicillin.
Earlier this month, superstar Lady Gaga took to social media to announce that she has long struggled with fibromyalgia.
The news has put the painful and poorly understood illness center stage.
Just this week, the singer announced on Twitter that she’s postponing the European leg of her 2017 “Joanne” concert tour due to what she described as fibromyalgia-related “trauma and chronic pain.”
Gaga hasn’t offered up details of her condition, although it comes just before a new TV documentary about the singer—set to premiere Friday on Netflix—that will reportedly highlight some of her health concerns.
But one thing is already clear: the disease does, at times, pull the rug out from under the performer’s best-laid plans.
“The pain and disability seen in fibromyalgia is typically worse than almost any other chronic pain condition,” explained Dr. Daniel Clauw. He is a professor of anesthesiology, medicine/rheumatology and psychiatry at the University of Michigan.
“[The pain] doesn’t just affect one area of the body you can avoid moving, and often is accompanied by severe fatigue, sleep, memory and other issues,” Clauw noted.
Dr. Marco Loggia added that “it can be extremely debilitating.” Loggia is associate director of the Center for Integrative Pain NeuroImaging at Massachusetts General Hospital in Charlestown, Mass.
“Most of the patients we encounter in our research studies are significantly impacted by the disorder,” Loggia noted, “which sometimes prevents them from having normal work and social lives.”
Fibromyalgia was first recognized by the American Medical Association as a distinct disease back in 1987, and is “a relatively common chronic pain disorder,” Loggia said.
How common? The National Fibromyalgia & Chronic Pain Association (NFMCPA) indicates that the illness affects up to 4 percent of the world’s population, and anywhere from 5 million to 10 million Americans. It is much more common among women, who account for 80 percent of patients. Although it can affect children, it is most often diagnosed during middle age.
According to Loggia, the disorder is characterized “by persistent, widespread pain, fatigue, un-refreshing sleep, memory loss, poor concentration and other symptoms.”
The NFMCPA adds that it can also give rise to sensitivity to light and sound, as well as to a degree of psychological distress in the form of anxiety and depression.
But what exactly is it, and how does it develop?
The picture is murky, with the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases flatly acknowledging that “the causes of fibromyalgia are unknown.”
But experts suggest that the disorder is likely driven by several factors, including exposure to a traumatic event (like a car crash) and/or exposure to repetitive injuries. Central nervous system disturbances may also play a role, as might a genetic predisposition to feel pain in reaction to stimuli that most people perceive as benign.
Struggling to find more in-depth answers, Loggia noted that American and German researchers have recently identified a subset of fibromyalgia patients who appear to have abnormalities in some of their peripheral small nerve fibers.
His own research suggests that some degree of brain inflammation may be at play, given that brain inflammation is common among chronic back pain sufferers and most fibromyalgia patients suffer from chronic back pain.
Unfortunately, Clauw cautioned that the failure to identify a clear cause for fibromyalgia has given rise to the myth “that it is not real.” That, he said, is decidedly not the case.
Loggia agreed.
“Traditionally, patients with fibromyalgia have been met with a great deal of skepticism, stigma and even condescension, including by many physicians that are supposed to take care of them,” Loggia said. “Even today, their pain is often dismissed as ‘all in their head,’ not real,” he added.
“However, many studies—and particularly those using brain imaging techniques such as functional magnetic resonance imaging—have now provided substantial support to the notion that the excessive sensitivity to pain that these patients demonstrate is genuine. I think that it is time to stop dismissing these patients,” Loggia said.
What these patients need now are “better drug and non-drug treatments,” Clauw said.
“We’ve only begun to take this condition seriously from a research standpoint for about 20 to 30 years,” he noted, adding that there are no “really effective” drugs for fibromyalgia.
Loggia said that means a lot of the focus has been placed on pain management, with patients turning to interventions such as painkillers (opioids) as well as yoga and cognitive behavioral therapy. “But these interventions are rarely ‘completely curative,’” he added.
As for Lady Gaga, she likely faces a better prognosis than most. “That this was diagnosed when she was younger is good, because many people go years or decades undiagnosed,” Clauw said. “But she also almost certainly got better recognition and treatment for her condition given who she is. Others in similar medical—but different social—situations would struggle to even find a doctor to see them and take them seriously.”
Diabetics are more prone to developing skin diseases and vision problems – and the list goes on. Many of these conditions lead to pain, but one condition that puts the patient at risk of developing chronic pain is neuropathy, which is a condition that is inclusive of nerve damage. Since there are nerves all over the body, there is no telling where the pain will be.
Research suggests that neuropathy occurs most often in diabetics who have a hard time controlling their blood glucose levels. People over 40 years old and smokers are also at increased risk of developing diabetic neuropathy.
Chronicillness.co-Site of United States works with people suffering from diabetes to manage both pain and neuropathy so that it does not become a chronic condition. The first step is to keep the blood glucose levels at a target range. Levels that are out of whack are dangerous because extreme blood sugar levels damage nerves and reduce circulation.
Drug therapy is a route a patient can go if their neuropathy causes too much pain. Medication may include anti-seizure medication (often used for nerve pain as well as seizure control) or antidepressants. Antidepressants work by changing the way the brain perceives pain by altering the chemical process.
Steroid injections and nerve blocks are diabetic neuropathy treatments that target specific areas of pain instead of taking medication that goes through the whole body. Since they generally last a few months, repeat injections may be necessary. These injections work by stopping the pain signal from the nerve from going to your brain. That way, your brain won’t look at those areas as painful anymore since it is not receiving any pain signals. The injections are not very painful because the patient is given a numbing shot near the area before the medication is injected. Steroid injections and nerve blocks do not usually come with any side effects other than some irritation around the injection site.
There are a few at-home treatments a diabetic patient may want to try alongside treatment at Chronicillness.co Site of United States and between visits. These include eating a better diet with less junk food and exercising. Exercise, even though it may be painful at first, strengthens the muscles around the nerve so that less pressure is being put on the damaged nerve. Our physicians can help the patient find a safe exercise routine that works specific muscles near the nerve as well.
If you’ve had sciaticaleg pain, you know it can be miserable—shooting pain in your leg and sometimes tingling, weakness, or numbness.
Sciatica pain starts when something in your body, often a herniated disk, is pressing on the sciatic nerve, which runs from the lower back down the back of your legs.
The good news is that most people with sciatica start to feel better within a few weeks. For some, though, the pain continues for a year or longer.
Fortunately, there are many strategies you can try for sciatica leg pain relief.
Exercises: Building up the muscles that support your spine and stretching the leg muscles involved in sciatica leg pain can help. A physical therapist can make sure you’re doing the exercises correctly so that you get the most out of them and don’t hurt yourself. If you’re in too much pain for exercise, steroid injections may bring you enough relief to get started.
Medication. Over-the-counter acetaminophen or nonsteroidal inflammatory drugs such as naproxen and ibuprofen are enough to get many people through the pain. Other patients may need muscle relaxants, antidepressants, or opiate pain relievers, although medications must be taken with care to avoid becoming dependent on them.
Alternative therapies. Chiropractic treatment, acupuncture, and massage therapy are sometimes used either alone or in combination with other treatments to treat sciatica leg pain.
Epidural steroid injections. Some patients are able to get relief lasting three to four months from steroid injections.
Nerve blocks. Injection of nerve-numbing medication into the area that is the source of the pain may be recommended for some patients.
Radiofrequency ablation. In this minimally invasive procedure, nerve fibers in the back that carry pain signals are destroyed to block the pain.
Spinal cord stimulation. If other options aren’t working, your doctor may recommend spinal cord stimulation, in which a device that delivers mild electrical pulses is implanted near the spinal cord to block pain signals.
Surgery. Most patients with sciatica will not need surgery, but it can be an option if disabling pain isn’t responding to other treatments.
Women who live with chronic pain seek relief through all kinds of treatments, from acupuncture to physical therapy, medication to psychology.
But in recent years, researchers have proven a multidisciplinary approach to chronic pain management can offer substantial and sustained pain relief.
Even if you have explored multiple treatment modalities, you likely haven’t experienced a true multidisciplinary pain management program. That’s because they are few and far between. These complex team-driven programs require resources typically found only at large medical institutions. Some patients travel from far away to receive care because the potential life-changing effects are worth it.
In a multidisciplinary approach, a team of clinicians collaborates to create custom treatment programs for each patient, using a variety of modalities. Patients often spend many days a week, sometimes for multiple weeks, in a program.
“It’s more of a patient-centered, goal-oriented, holistic approach,” said Tim J. Lamer, MD, pain management specialist at Mayo Clinic and president of the American Academy of Pain Medicine. Lamer explained that multidisciplinary pain management is like a puzzle where every piece matters—and they all fit together.
Institutions like the Shirley Ryan AbilityLab Pain Management Center in Chicago provide a model for multidisciplinary care, according to attending physician Shana Margolis, MD. There, most patients have previously tried one discipline at a time but not an approach that combines them all. The Shirley Ryan AbilityLab uses a biopsychosocial approach, meaning its team treats biological, psychological, and social drivers of pain, both as individual forces and as forces that intersect with one another.
Multidisciplinary pain management programs may include:
Pain psychology: Teaching patients how mood affects pain and how pain affects mood, often using cognitive behavioral therapy. “When you’re in pain, it can make you more irritable, anxious, and depressed, which then can make it harder to manage your pain, and you can get stuck in a vicious cycle,” said Margolis.
Biofeedback therapy: Providing a variety of relaxation techniques that employ monitoring technology that gives patients instant feedback on their efforts.
Physical therapy: Including time spent on strengthening, range of motion, biomechanics, and pacing.
Occupational therapy: Focusing on ergonomics and improving a patient’s ability to perform everyday tasks with less pain.
Vocational therapy: Helping patients learn to reclaim their working life through a variety of strategies.
Art therapy: Using creativity to cope with pain, express emotions, and even reduce symptoms.
Interventional therapies: Employing techniques like nerve blocks, injections, or electrical stimulator devices to treat the neurological aspect of pain.
Physician and nurse monitoring: Ensuring patients are using medications properly, that comorbid conditions are also well-managed, and more.
Margolis said a key aspect of a multidisciplinary approach is that the patient is at the center of the program, playing an active role in their own care, as opposed to simply receiving treatment. “We’re trying to give patients tools in their toolbox so they can learn to self-manage their pain,” she said.
Lamer said most patients in a multidisciplinary approach experience improved function, mental health and management of pain in their busy lives. And there’s research to prove it, he said, including at least one study that followed patients for as long as 13 years who experienced long-term benefits.
More research by Shirley Ryan Ability Lab Pain Management Center and the Department of Physical Medicine & Rehabilitation at the Northwestern University Feinberg School of Medicine in Chicago showed patients experienced improvement in pain, pain-related anxiety, ability to cope, and depression, among others.
Margolis said that while many people can benefit from a multidisciplinary pain management approach, patients with widespread pain conditions like complex regional pain syndrome and fibromyalgia are likely to experience the greatest benefit. “Any kind of chronic pain condition that’s really affecting the patient’s lifestyle is where we excel,” she said. Emphasis on the mind-body connection and mindfulness plays a significant role in a patient’s success.
If you’re looking for a multidisciplinary pain management program, ask at your nearest large medical center. If there isn’t one in your immediate area, reach out to reputable programs and ask if they can recommend a provider in your area.
It’s bad enough to have a headache or backache. But when literally everything seems to hurt, you’re truly miserable. You can have trouble getting through simple daily activities and may find it hard to get a good night’s sleep. That can make the pain even worse.
The good news is that whole-body pain relief is possible. The first step is finding out what is causing your pain. There are at least 20 different issues that can cause total body pain. Here’s a quick look at a few of them:
Infections: The flu, pneumonia, or similar illnesses can make you ache all over. Luckily, the pain goes away when the illness does, although you may need medical help to recover from an infection.
Arthritis: The inflammation from some types of arthritis, particularly rheumatoid arthritis, can cause achy joints throughout your body, which may be accompanied by fatigue as well.
Statins. Although effective at treating high cholesterol, about 20-30 percent of those who use statins develop muscle and joint aches.
Lupus. In this autoimmune disorder, your immune system mistakenly attacks your own healthy tissue. The resulting damage and inflammation can cause pain throughout your body.
Lyme disease. Ticks spread the bacteria that cause Lyme disease. If you’ve been in tick country and your aches come with a rash, see your doctor right away. If left untreated, Lyme disease can lead to arthritis, heart palpitations, and other serious problems.
Fibromyalgia. This condition, which is not well understood, can cause muscles and bones throughout your body to feel tired, tender, and achy. It can also cause insomnia, stiffness, and numb hands and feet.
Hypothyroidism. When your body doesn’t produce enough thyroid, one of the symptoms can be muscle cramping and stiff joints.
Opioid–induced hyperalgesia: In some people who have used opioid drugs for a long time to treat pain, the drug can eventually produce the opposite effect, making your body more sensitive to pain.
Poor circulation. Burning, cramping or other pain during exercise, particularly in the legs or arms, can be a sign that the vessels providing blood to your limbs have narrowed and you’re not getting enough oxygen.
There are probably a dozen other conditions that could cause you to feel widespread pain, so it’s critical to work with a doctor to get to the root of the problem. The most effective treatment will depend on what’s causing your pain. For instance, for a Lyme disease infection, you’ll be given antibiotics, while for rheumatoid arthritis or lupus, you may be prescribed medicine to calm an overactive immune system.
A variety of treatments can help with the pain itself, ranging from ice packs and simple over-the-counter pain relievers to procedures such as steroid injections, nerve blocks, and neuromodulation. Alternative treatments such as acupuncture, meditation, and cognitive behavioral therapy can often help as well.
