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Tag: chronic illness

Raise awareness about chronic illnesses by understanding their impact, symptoms, and the importance of support and education.

  • Does medication for lower back pain actually work?

    In the fight against lower back pain, many people and their doctors reach for the same weapons: common over-the-counter (OTC) and prescription medications. New research on commonly recommended and prescribed lower back pain medications has found that many may actually be virtually ineffective for treating lower back pain and that medication for lower back pain may actually do more harm than good.

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    Over-the-counter medication for lower back pain

    Nsaids are a standard go-to medication for lower back pain, but their effectiveness is being called into question. The common over-the-counter pain medications Tylenol, Advil, and Aleve are all types of nsaids. More powerful nsaids are also available by prescription from your physician. For many people with chronic back pain, it’s not unusual to keep a bottle of over-the-counter nsaids on hand to treat pain as needed.

    A great many medications fall into the classification of nsaids, but all of them function in a similar way. Nsaids block an enzyme called cyclooxygenase (COX), which in turn inhibits the production of certain inflammatory responses like fever, swelling, and pain. Since many instances of pain are caused by inflammation or swelling, inhibiting inflammatory responses should reduce pain.

    However, COX enzymes also aid in protecting the stomach lining, which is why using nsaids can sometimes lead to ulcers or bleeding in the stomach. Potential side effects of nsaids include digestive symptoms like heartburn, diarrhea, vomiting, or stomach pain.

    Research on Tylenol

    Tylenol in particular has been widely advertised all over the world as a catch-all OTC medication for aches and pains of every variety. From acute back pain to achy knees and chronic pain, advertisements would have you believe that Tylenol is effective and safe for pain. A study from the BMJ (formerly the British Medical Journal) found that Tylenol’s claims of efficacy in the treatment of both back and knee pain were false.

    A meta-analysis of randomized controlled studies focusing on Tylenol’s ability to relieve spinal pain and pain due to osteoarthritis found that for spinal pain, Tylenol showed no effect on pain in either short- or intermediate-term follow-ups. For osteoarthritis, the short-term efficacy of Tylenol for spinal pain was more pronounced than for intermediate use, but pain reduction was still rated as moderate. Any pain relief reported was clinically insignificant and similar to the placebo group. The studies included in the meta-analysis focused on just over 5,300 patients with lower back pain and knee pain and excluded any patients with previous surgeries for either condition.

    Side effects of non-steroidal anti-inflammatory drugs

    While some patients suffering from chronic and acute back pain may find that any minor reduction in pain is worth the risk, the side effects may not be worth it. Since 2011, the Food & Drug Administration has required medications that use acetaminophen to carry a “black box” warning that highlights its risk for liver failure.

    Many who take Tylenol for pain do not realize that other medications (e.g. Cold medicines) also contain acetaminophen. Exceeding the maximum daily dose by even a small amount can cause serious side effects and may even cause death. For anything other than acute, short-term pain, taking Tylenol is not recommended as a medication for lower back pain.

    Opioid medications

    Opioids are a narcotic pain reliever. Previously used primarily for short-term relief of acute pain, or for pain relief in patients with a chronic condition like cancer, opioids have become part of mainstream pain management over the last two decades. The number of prescriptions written for oral opioid medications, such as hydrocodone, oxycodone, or hydromorphone, has more than tripled over the last 20 years. Despite the risks associated with opioid medications, they are becoming increasingly widespread as a prescribed medication for lower back pain, even though new research suggests opioids aren’t very effective for this type of pain.

    Opioids and spinal surgery risks

    While the risks of opioids have been well-documented, a study by the American Academy of Pediatrics found that the use of prescription opioids is linked to fewer positive outcomes after spinal surgery. The study of just over 500 patients used patient reporting to measure health preoperatively and at three, six, and 12 months post-operatively. Differences in recovery, mental health, and decreased pain was significantly influenced by opioid use in the following ways:

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    • Patients who increased opioid use before spinal surgery did significantly worse post-operatively at three and 12 months
    • For every ten milligrams of increase in opioid use, the study found a significant decrease in mental and physical health scores
    • Patients who also suffered from comorbid conditions such as depression and anxiety were more likely to take opioids

    Lead study author Clinton J. Devin, MD, assistant professor of orthopedic surgery and neurosurgery at the Vanderbilt Spine Center had this to say about the treatment implications of study’s findings:

    “Our work highlights the importance of careful preoperative counseling with patients on high doses of preoperative opioids, pointing out the potential impact on long term outcome and working toward narcotic reduction prior to undergoing surgery.”

    Even for those patients who choose not to undergo surgery, opioids have very little effect on chronic low back pain. While there seems to be some short-term analgesic benefit, the risk of dependence and other side effects likely outweighs the minimal benefit in intermediate- and long-term use for this medication for lower back pain.

    Opioids for chronic pain

    Researchers have also been reevaluating the trials and evidence that support the effectiveness of opioid pain medications, and the evidence doesn’t hold up. The National Institutes of Health (NIH) convened a seven-member panel to examine the evidence for opioid medications. An article by the University of Connecticut summed up the results, noting:

    “A National Institutes of Health white paper that was released today finds little to no evidence for the effectiveness of opioid drugs in the treatment of long-term chronic pain, despite the explosive recent growth in the use of the drugs.”

    Additionally, a University of Colorado Boulder study showed that opioid use (specifically morphine) actually prolonged neuropathic pain in rats, suggesting that it could have the same effect on humans.

    Opioids for lower back pain

    Finally, the BMJ published a clinical review of the efficacy of opioids as a medication for lower back pain. The conclusions in this article include:

    • Opioids don’t speed injured workers’ return to work
    • Opioids don’t improve functional outcomes of acute back pain in primary care
    • There is little evidence of opioid efficacy for chronic back pain

    It was also pointed out that controlled trials of opioids for back pain tend to experience a high dropout rate among participants. The trials also have a short duration (generally four months or less) and have highly selected patients. This all suggests that the controlled trials that do support opioid efficacy for back pain are perhaps not reliable, or at least are not thorough enough.

    Opioids also have a high risk of abuse and dependence. Using opioids before spinal surgery has been linked to a higher risk of negative surgical outcome. Slow-acting opioids, which have been assumed to be safer than fast-acting opioids, have been shown to make men five times as likely to develop low testosterone. More and more evidence continues to point to the fact that opioids are not a suitable medication for lower back pain, unless used for highly-controlled, acute cases.

    Oral steroids

    Steroids are commonly used to treat inflammation associated with back pain, but they may not be as effective as previously believed. Steroids, also called corticosteroids, are a synthetic (man-made) version of a hormone naturally found in the body. Steroids are used to treat many different conditions, largely because they are cost-effective and can be applied in many different forms (oral, injected, inhaled, topically, etc.). Long-term or illicit use of steroids is associated with several potentially-serious side effects, but when used as directed, steroids are generally considered safe.

    In a randomized controlled trial of 267 people with herniated disc, researchers found that there was no significant difference in pain relief between the group receiving oral steroids (prednisone) and the group receiving a placebo. Both groups saw improvement, but even after a year, there was no difference between the two (except in rate of disability, which was slightly lower in the prednisone group).

    Likewise, a study originally published in the Journal of the American Medical Association (JAMA) looked at the efficacy of the oral steroid prednisone in treating sciatica-related back pain. In this study, half the participants were given a 15-day course of prednisone to treat sciatica resulting from a herniated disc, while the other half were given placebos to treat the same condition. Although both groups’ symptoms improved, there were no statistically significant differences in pain or disability by the end of six weeks.

    Again, this is a case of the side effects outweighing the negligible benefits. In addition to headache, mood swings, and irregular heartbeat, long-term use of prednisone is a risk factor for osteoporosis, which may increase the risk of spinal injury leading to pain. Steroid injections, on the other hand, provide a targeted approach to using these medications which may work more powerfully for lower back pain patients.

    What are non-medication options for lower back pain? 

    With these common back pain medications increasingly debunked in the research, there are other treatment options to consider.

    First, don’t stop your medication for lower back pain

    Even with this research, this does not mean that you should stop your medication for lower back pain, especially if they’ve been prescribed by a physician.

    If you’re taking a medication that relieves your symptoms of back pain, that’s great. Keep taking it. If your current medication doesn’t seem to be doing the job, keep taking it until you’re able to talk to your pain doctor and get an alternative medication or treatment (or are given the go-ahead to stop taking it). Stopping a medication prescribed by your doctor could be unsafe if you haven’t discussed it with them before.

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    And keep in mind that pursuing alternative, complementary, or interventional pain management techniques – either in conjunction with or (with your physician’s permission) instead of medication – might help you control your pain much more effectively than medication for lower back pain alone.

    Exercise

    Staying physically active is an important treatment option for lower back pain. While it may seem counterintuitive to move when you are in pain, keeping your muscles strong and engaged can be the key to a healthy back. Focus on stretches and core work, but don’t forget low-impact cardiovascular exercise such as biking, swimming, and hiking.

    Dietary changes

    Although it may not work as quickly as medication for lower back pain, eating a healthy diet full of anti-inflammatory foods can make a tremendous difference in treating chronic back pain. Adding these foods while eliminating common inflammation-causing foods like sugar, wheat, and dairy can help you manage pain.

    Weight management

    The more weight we carry on our bodies, the more stress there is on our joints. Maintaining a healthy weight with diet and exercise can be an important part of treatment for back pain, especially in cases where back pain is due to compression injuries such as herniated discs or inflammation caused by spinal stenosis.

    Complementary medicine

    Acupuncture is gaining traction as an effective treatment for low back pain. Chiropractic care can also be an excellent first-line treatment that minimizes the chance of spinal surgery in the future. Mindfulness meditation and biofeedback have both been shown to diminish the perception of pain. All of these treatments are nearly side-effect free, and many are now covered by insurance.

    Interventional pain management

    Finally, if your pain doesn’t respond to medication for lower back pain or these complementary approaches, you could try more targeted therapies for resolving your back pain. This will involve identifying the underlying causes of your back pain and finding a therapy that can work to resolve or treat the symptoms of your pain. Once a correct diagnosis is made, your doctor may recommend any of the following therapies:

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    For More Information Related to Fibromyalgia Visit below sites:

    References:

    Fibromyalgia Contact Us Directly

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    Official Fibromyalgia Blogs

    Click here to Get the latest Chronic illness Updates

    Fibromyalgia Stores

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  • My personal top 10 favorite posts on pain doctor

    It’s been about a year since we became Pain Doctor and began sharing information with you about everything pain- and health-related. In that time, we’ve covered a lot of information, but we’ve tried to make sure that all of it is centered around the topics that you, as a health–conscious pain patient, might care about the most. It was tough, but we narrowed down a year’s worth of information into our top ten favorite posts from Pain Doctor, covering everything from resources to lifestyle changes.

    In no particular order, here are our top ten favorite posts on Pain Doctor.

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    1. Exercising With Pain 

    It can be hard to start a new exercise routine, especially if you’re in pain, but the payoff will be worth it. In this post, we touched on a few studies that looked at the benefits of exercise for people with chronic pain, noting:

    “Several studies have looked at the effects of exercise on chronic pain conditions. The results are often very similar: decreased pain and a better quality of life.”

    We also gave you some suggested types of exercise, along with a few tips, to get you started on your fitness journey.

    2. The Importance of Self-Care: Why You Should Pamper Yourself

    We’ve mentioned several times on Pain Doctor that stress is bad for you, particularly if you live with chronic pain. Self-care is one of the absolute best ways to combat chronic stress and, by extension, improve your health and reduce your pain. Also, the more often you allow yourself a few minutes of self-care, the better, because your body will eventually come to associate a certain activity or routine (like the motions of brewing a pot of tea for an afternoon break) with relaxation. Once your body has built up this association, you’ll begin to experience the physiological signs of relaxation more quickly. If you need ideas for self-care or relaxation, look no further: this post has plenty.

    3. Health Literacy Online: Finding Good Resources

    Health literacy is all about knowing how to find and understand health information so you can make informed decisions about your own healthcare. Pain conditions, like lots of medical conditions, can get confusing and overwhelming very quickly, so having the health literacy skills to do research, find information, and know what questions to ask your physician is vital. This post breaks down how to judge the reliability of an online resource by asking five simple questions:

    1. Who is in charge of this website?
    2. What is being said?
    3. When was it published or updated?
    4. Where is the information coming from?
    5. Why does this website exist?

    4. How To Manage Your Medications

    After you’ve been dealing with a chronic pain condition or medical condition for long enough, managing your medications will become almost automatic. If you’re newly diagnosed, or if your medication regime has changed recently, it can be scary trying to keep all those pills (and maybe even injected medications) straight. Here we gave you some tips and tricks about medication management, like using a medication sheet and letting your everyday activities (such as meals or bedtime) act as reminders. The bottom line is to make sure you talk about your medications with your physician and then take them as directed.

    5. Snoozing Your Way To Health 

    Sleep might not seem like that much of a deal, but it is. Getting enough sleep can have big benefits on your health, just as being chronically sleep deprived carries some serious risks. If you deal with pain on a regular basis, sleep can be a struggle. Hopefully this post convinced you that, if your pain is interfering with your sleep, you should talk to your physician about it. After all, as we noted:

    “Sleep deprivation lowers the pain threshold. This means that the more tired an individual is, the more likely he or she is to experience sensations as painful. The increased pain can make falling asleep and staying asleep difficult, which often leads to more sleep deprivation. This becomes a repeating cycle, until it’s difficult to tell which came first – the sleep deprivation or the pain.”

    6. Untangling Connections Between Chronic Pain And Depression

    There are a lot of surface similarities between chronic pain and depression. For instance, people suffering from these conditions often face similar misconceptions, like the problem being “all in your head” or that you can “just get over it.” With both chronic pain and depression, though, this is certainly not the case. Both conditions are serious, diagnosable medical conditions that need attention from a physician. And the similarities go even deeper, right down to some of the same centers of the brain being involved in both chronic pain and mood disorders.

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    7. How Do Opioids Work?

    This post is a must-read for anyone who takes opioids (or who has a family member or friend who takes opioids). It covers all the nuts and bolts of opioids, from how they work to the different types to what they treat best to the risks involved.

    8. New Opioid Restrictions: Part Of The Solution To Opioid Abuse?

    A common opioid painkiller, hydrocodone, was reclassified last year, along with hydrocodone-based painkillers. We know that for a lot of people with chronic pain, opioids are commonly used for as-needed or breakthrough pain relief, until a less risky pain management technique can be found. In this post we delved into why hydrocodone-based painkillers have been reclassified and how it might impact you.

    9. Celebrating Dogs On National Dog Day

    Dogs are good for your health in lots of ways, and they can even help you manage your pain. For some people, it’s only thanks to their assistive or service dogs that they’re able to function independently. Therapy dogs can make a huge difference to people who are hospitalized or living in assisted care. What it boils down to, though, is that no matter the breed, age, size, or training, your canine best friend does more for you than you realize.

    10. Disease-Sniffing Dogs: The Next Stage Of Diagnostic Medicine?

    Hopefully this post was as interesting to read as it was to write. Dogs’ super-sensitive noses have been used for jobs like search and rescue or bomb-sniffing for years, but now they’re being trained and put to work in the medical field. Some of these amazing dogs can detect oncoming seizures, allergic reactions, or blood sugar fluctuations in their owners. Others are taught to identify infections or cancers. The really amazing thing is that oftentimes, the dogs are more sensitive than modern medical equipment.

    At Pain Doctor, we try to help you live your best life possible, and we truly think that part of that is arming you with all the knowledge you need to make the best decisions about your lifestyle and healthcare. We hope we’ve accomplished that for you, and we hope that we can continue to help you control your pain and enjoy your life to the fullest.

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    For More Information Related to Fibromyalgia Visit below sites:

    References:

    Fibromyalgia Contact Us Directly

    Click here to Contact us Directly on Inbox

    Official Fibromyalgia Blogs

    Click here to Get the latest Chronic illness Updates

    Fibromyalgia Stores

    Click here to Visit Fibromyalgia Store

  • How to prevent knee pain in old age?

    How to prevent knee pain in old age?

    If you’re wondering how to prevent knee pain in old age, the answer often comes down to taking steps today to reduce your risk. By reducing your risk for the nine most common causes and risk factors for knee pain, you can prevent a large possibility of knee pain in your future.

    How does anatomy prevent knee pain, and cause it? 

    The knee is a joint made of four bones: the femur, tibia, fibula and patella. There are a series of muscles that also support the knee, including the quadriceps and hamstrings. Finally, these are all joined together by a carefully woven set of ligaments, meniscus, and tendons. Precious cartilage provides necessary cushioning for comfortable movement.

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    The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are perhaps most critical for proper knee movement. The knee is also surrounded by fluid filled sacs called bursae that provide additional cushioning.

    Since it’s such a complex joint, it can sustain most of the demands we place on it every day. However, these same joints and tendons can become inflamed, leading to pain. Likewise, the delicate structures of the knee can become injured leading to pain. We’ll talk about some of the risk factors you can work to reduce today to prevent knee pain in the future from these causes.

    What are the most common types of knee pain?

    The knee moves in two ways: bending (flexion) and straightening (extension). However, the knee can also twist, which is the common cause of many injuries to ligaments. Those who have ligament injuries to the knee often report hearing a popping, followed by the inability to place weight on the knee.

    Such twisting-related injuries can also cause damage to the knee’s tendons and meniscus. These injuries will likely cause pain, swelling, and limited movement. Often surgery is required. However, the knee is a major joint that takes the weight of the body daily; with time, wear and tear injuries may occur that leads to knee pain as people get older. Also known as degeneration injuries, these include osteoarthritis and chondromalacia patella. Both are the result of degeneration of cartilage, causing bone-on-bone rubbing and pain.

    What are the most common risk factors for knee pain? 

    One of the largest risk factors for knee pain is age. Age increases the risk for a variety of conditions leading to knee pain, including osteoarthritis. Older people are also more likely to have weakened muscles. They are also more vulnerable to injury while playing sports or participating in normal daily activities.

    A study in the journal Osteoarthritis and Cartilage found that the risk factors for knee pain and osteoarthritis are essentially the same: age, extra weight, history of knee injury, and having a job that places extra stress on the knee. Increased age and unhappiness with a person’s job had a greater impact on the incidence of knee pain than the other factors.

    However, the best way how to prevent knee pain in old age is to avoid risk factors when you’re younger. Knee pain often results from osteoarthritis or sports injuries. These other nine risk factors for knee pain involve lifestyle choices that can you can manage to reduce or prevent knee pain in the future.

    1. Extra weight

    Extra weight is one of the largest risk factors for knee pain. The knee supports much of the body’s weight, and too much weight taxes the joint and increases the likelihood of pain. Anterior knee pain, which develops at the front and center, is one of the more common types of knee pain associated with carrying extra weight. Inactivity or muscle weakness, both associated with being overweight, can exacerbate the condition.

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    Obesity stresses the structure of the knee, including the patella—the medical term for the kneecap. The patella already supports forces that are equivalent to as much as five times the body’s weight, according to the University of Michigan, Ann Arbor’s school of Orthopaedic Surgery. A combination of weight loss and muscle strengthening can alleviate chronic pain related to obesity, although surgery is sometimes needed.

    2. Muscle weakness

    The knee connects the thighbone—also known as the femur—to the shinbone—also known as the tibia. Having strong quadriceps muscles helps to stabilize the knee joint and keep it healthy.

    And improving muscular fitness can be one of the best ways how to prevent knee pain, even if you’re older. A study in the journal Osteoarthritis and Cartilage studied a group of people aged 50 to 79 with osteoarthritis in the knee or risk factors for developing the disease. Women who had weak quadriceps were found to experience worse knee pain over the 5 years of the study, even when accounting for weight, level of exercise, and any history of knee surgery. Women with the weakest quadriceps experienced a 28% greater risk that their knee pain would worsen.

    The connection between strength of the quadriceps and knee pain did not hold true for men.

    Developing the right muscles can also help protect against one of the more serious knee injuries—a torn anterior cruciate ligament (ACL). Athletes involved in sports where they jump and quickly accelerate and decelerate are particularly susceptible to torn acls. However, strong quadriceps and hamstring muscles can help insulate the knee from stress.

    3. Inactivity

    A cause of muscle weakness and obesity—inactivity—is also another factor for knee pain. People who are inactive are less strong, less flexible, and more sedentary. When the time comes to move and exercise, there is a greater risk of injury.

    Inactivity has also been found to make knee pain from arthritis worse, according to webmd. Being sedentary results in muscle deterioration that weakens the knee and increases pain.

    4. Not resting after injury

    Injured people who don’t rest their knees for a long enough period of time increase their risk of re-injury, according to webmd. Although recovery periods can last anywhere from several weeks to several months, taking the time to allow the body to adequately repair and heal is critical for allowing the knee to regain its strength.

    Resting is particularly difficult for athletes and other active people, but spending some quality time on the couch will go a long way to keeping the knees healthy and protecting against future injury.

    5. Smoking

    Smoking increases the risk of a host of health problems, and knee pain can be added to the list. Quitting smoking is one of the best ways how to prevent knee pain when you get older. A study published in Annals of the Rheumatic Diseases found that smoking increased the risk for both cartilage loss and knee pain in men who had developed osteoarthritis in the knee. Because smoking affected the amount of cartilage the men had in their knees, it increased the amount of pain they experienced.

    6. Genes

    Much of knee health is related to the underlying structure of the leg. And that structure is due to genetics, according to a study published in the British Journal of Sports Medicine. Researchers recruited a set of female twins and videotaped them while watching them land from jumps and execute cutting maneuvers. Scientists examined the angles of the women’s knees and the structure of the joints themselves.

    At the time of the videotaping, the girls were healthy. Over the next year, however, both women tore their acls, giving the scientists and opportunity to gauge the impact of genetics, the New York Times reported. Researchers found that the twins had excessively flexible knee joints and narrow notches in the knee where the ACL connects to the bone. Another study published in the American Journal of Sports Medicine identified a gene that affects the composition of collagen and increases the risk of torn acls.

    Unfortunately, there’s no way to reduce your genetic risk. But, you can be informed. If family members suffer from knee pain, take even more precautions now.

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    7. Occupation

    People who work in intense, manual-labor jobs are more likely to develop knee pain, according to research published in Osteoarthritis and Cartilage.

    Occupations associated with increased risk factors for knee pain included carpenters, miners, and construction workers. Carpenters and miners are at the highest risk. These jobs involve frequent knee bending, sitting, or standing for long periods of time in unnatural positions, along with heavy lifting. Of those individuals studied, 28% reported knee pain.

    If you are in one of these fields, make sure you talk to your doctor about ways to prevent your risk. These may include physical therapy or the use of braces.

    8. Depression

    People who are depressed report worse knee pain related to osteoarthritis, according to research published in The Journal of Bone and Joint Surgery. The effect was most pronounced in people with mild or moderate osteoarthritis, who reported severe pain despite less significant cartilage damage. Simultaneous emotional and physical pain feed off each other, exacerbating the effects of each, researchers say. Talk to your doctor about therapy options for reducing both your knee pain and depression.

    9. Overuse and injuries

    Many knee injuries, from tendinitis to iliotibial band syndrome, also known as runner’s knee, result from overuse. Repetitive motions involved in sports, such as running, often lead to inflammation. They can also cause structures in the leg and knee to rub against each other and cause pain. Although sports are a frequent contributor to knee pain, gardening, hobbies, or repetitive motions occurring during household activities can also be to blame. Injuries are the most common cause of knee problems, according to webmd.

    If you’ve suffered from any injury, make sure to rest and wear a brace or other supportive device when you do take up activity again.

    Other than surgery, what are some knee pain treatment options?

    If you’re already suffering from knee pain, there are non-surgical options for reducing your pain. The first lies with the basics tenets of how to prevent knee pain in the first place: exercise, consistently and with low-impact activities to reduce inflammation and reduce tension.

    From there, initial knee pain may respond to ice and anti–inflammatory non-steroidal medications. Additionally, neuropathic medications, such as gabapentin or lyrica, may help those reporting burning, numbness, or pins and needles. For those who have ongoing issues, perhaps the best tool for treating knee pain is an MRI. An appropriate diagnosis is absolutely critical to create a plan to effectively reduce your pain.

    Interventional treatments

    Once a pain physician has the MRI results and can make a diagnosis, treatment options may include corticosteroid injections directly into the joint. These injections immediately reduce inflammation, which can effectively reduce pain. Watch one of these injections take place in the following video.

    Other treatments include visco-supplementation. This is used for those who may need additional lubrication to the knee joint as a result of osteoarthritis. Nerve blocks are an additional treatment option.

    A saphenous nerve block may provide those with chronic knee pain – at times present after knee replacement – relief. Additionally, chiropractic therapy, gait analysis, bracing and TENS Unit may provide relief. A comprehensive knee pain treatment may also include physical therapy. This can help those with knee pain strengthen muscles surrounding the knee to improve stability.

    Finally, neuromodulation via a spinal cord stimulator may be an option for those patients who otherwise fail to respond to more conservative treatment options. Spinal cord stimulation includes the implantation of small electrodes in the epidural space of the spine. Through this device, large nerve fibers are stimulated to inhibit small nerve fibers, thereby blocking the sensation of pain.

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    For More Information Related to Fibromyalgia Visit below sites:

    References:

    Fibromyalgia Contact Us Directly

    Click here to Contact us Directly on Inbox

    Official Fibromyalgia Blogs

    Click here to Get the latest Chronic illness Updates

    Fibromyalgia Stores

    Click here to Visit Fibromyalgia Store

  • Breaking out of pain-induced isolation: faces of pain

    Chronic pain is usually defined as pain that’s lasted for more than three months. This may not seem like a terribly long time–unless you’re the one in pain. When something hurts for so long, it can easily eat away at every aspect of a person’s life, from mood to friendships.

    The loss of a social life can have significant negative effects on a person’s chronic pain and general health.

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    Not only can constant pain affect an individual’s ability to perform household chores or go to work, but it can create feelings of isolation and loneliness. A person with chronic pain may feel alone or as though no one understands what he or she goes through. He or she might become resentful of those who don’t have to deal with pain on a regular basis. His or her loved ones might become frustrated by their inability to help. These feelings can multiply and eventually damage friendships and relationships.

    Patient.co.uk defines “passive coping” as giving up one’s social life and relying entirely on doctors and medications for pain relief. While having a team of doctors and some carefully-chosen medications is certainly important, it’s not recommended to depend so heavily on them that the rest of a person’s social life is abandoned. In fact, passive coping is associated with increased pain, increased disability, and depression.

    On the flip side, a strong support system can have big benefits.

    According to one study, chronic pain patients who reported having a supportive family did significantly better than those who described their families as unsupportive. Those with a supportive family reported less pain intensity, had greater activity levels, and were less reliant on medications. They also were more likely to be able to continue working.

    Support from loved ones, like family and friends, can make a big difference. Even having a loving pet at home can be helpful. However, connecting with others who have chronic pain is just as important.

    Everydayhealth.com gives a few reasons for this:

    • Learn from others about ways to cope
    • Help others learn the same
    • Share advice
    • Find that pain and its accompanying emotions aren’t unusual

    Being part of a chronic pain support group can provide an outlet for rough days and a place to celebrate successful pain management techniques. It can give people with chronic pain a place to say, “It’s one of those days,” and know that others understand what that means.

    Many people don’t realize how many others suffer with pain on a daily basis. A chronic pain support group can make it easier to talk about chronic pain, even with those who don’t have it. This can increase awareness of chronic pain and, by extension, increase support from family, friends, and coworkers.

    It’s for these reasons and more that the Faces of Pain support group exists.

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    The Faces of Pain support group allows people to load a picture and a little information about themselves. The simple act of sharing really can help. Additionally, for anyone having a rough day, reading through the many stories at Faces of Pain will inevitably inspire and encourage. Some of the entries are short and to the point, such as Lisa’s: “The way I cope with Chronic Pain is to just trying to fake it ’til I make it…”

    Some entries really drive home why support groups are vital, such as Ivy’s:

    “My primary goal is to rejoin life again. I’m afraid to go out anymore because I never know when my back will go out or my Meniere’s disease will hit. I’m so out of touch with people and afraid they’ll judge me for my health issues. So my goal is to move past that and learn to enjoy life again despite my health issues. I need strength and courage to move past it.”

    Without groups like Faces of Pain, it would be much more difficult for people in situations like Ivy’s to reach out for support. In addition to posts that allow people to share their pain, there are posts that share people’s goals and inspiration. Many people recount their dependence on faith as a source of strength. Many others list their goals, such as traveling, writing, or animal rescue. A significant number of people at Faces of Pain describe their desires to cope with pain by helping others.

    Some people also share their successes, which can serve as inspiration for others. One of these is Jess’s. Below a picture of Jess with her young son next to her, she writes:

    “On the right, that was as close as my son and I could get from January til May. Now we don’t have limitations in that way and get super close. Love my little guy.”

    In addition to the Faces of Pain site, the Fibromyalgia Support Group on Facebook provides a way for those with chronic pain to interact with each other.

    The Fibromyalgia Support Group currently has 15,000 members. People in this group sometimes reach out for support while experiencing pain. For example, in a recent post, a woman described the pain that was keeping her from sleep. Several people commented, commiserating with and comforting her. Other posts are jokes and jabs to encourage laughter, which can often reduce pain. Also often posted at the Chronic Pain Support Group are requests for advice. Because the group is so large and varied, there’s almost always someone able to provide suggestions.

    Chronic pain doesn’t have to be suffered through in silence and isolation.

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  • Why do we feel pain?

    To most people, pain is usually nothing more than an annoyance–a twinge of back pain or a prickle of pain from a hangnail. For those who suffer from a chronic pain condition, however, it’s much more than an annoyance. When traditional treatment methods have failed and the pain persists, it might beg the question: why do we feel pain?

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    Pain is an extremely important genetic adaptation.

    At its core, pain is a survival mechanism. It’s the body’s way of forcing an immediate response to prevent further injury. For example, if a person sets his or her hand on a hot stove, nerves will transmit a pain response and trigger the person to pull the hand away, almost before he or she has realized that it hurts. By pulling the hand away so quickly, further damage to deeper tissue is prevented.

    In addition to preventing severe injuries, pain can help with the healing process by acting as a reminder. George Dvorsky at io9 explains:

    “Given that a traumatic event (like stubbing your toe) set the injury response into action, the pain receptors will continue to sense that an injury has occurred and that you need to be reminded about it until it heals. Consequently, the nerve fibres are specialized enough to recognize an ongoing injury that’s in the healing process.”

    However, no matter how useful pain is, it’s still unpleasant. To appreciate why pain is important enough that it’s worth the unpleasantness, though, consider those who feel no pain at all.

    A rare genetic condition renders some individuals unable to experience physical pain.

    A condition, commonly referred to as congenital insensitivity to pain or congenital analgesia, leaves certain individuals unable to feel pain. At 1st this sounds great, but think of tripping over a pet, fracturing a bone, and not knowing that an injury has occurred because there was no pain. Consider a parent attempting to raise a child who cannot experience pain.

    2 individuals with this condition recalled the lengths their parents went to in an effort to prevent injuries:

    • Socks over their hands, to prevent finger-chewing or face-scratching
    • Goggles, to protect the eyes from scratches
    • Helmets, to prevent concussions

    Despite these safety measures, both still managed to injure themselves regularly. 1 individual recounts his most frequent childhood injuries:

    “Jumping down the stairs was the most common injury I had. I would also injure myself by pushing a swingset away from me and having it slam into my face. At the time I enjoyed the reaction I received from others and the time I would spend in the hospital. Touching hot objects was another one of the most frequent injuries I had. I loved to hear the sizzling of my skin. Broken legs were a very common injury for me.”

    Strangely enough, this condition is considered a type of peripheral neuropathy, which can also be a cause of chronic pain. This is because congenital insensitivity to pain is a result of malfunctioning peripheral nerves. Chronic pain from peripheral neuropathy occurs when those same nerves are damaged and, instead of going silent, send an overload of pain signals.

    Current researchers are delving into the evolutionary properties of pain.

    It’s understood that pain is a survival mechanism, but the individual gene receptors that control pain responses are still being studied. For example, a recent study conducted by Shigeru Saito, et. Al. Isolated a specific gene for pain receptors in chickens, called TRPA1. By examining the receptor’s function with different stimuli, the researchers found that heat stimulated the TRPA1 gene in chickens.

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    The researchers also found that a chemical bird repellant stimulated the same pain receptor as heat, the TRPA1 gene, but the responses to the same repellant by other vertebrate species were varied. Additionally, researchers were able to identify 3 amino acid residues involved in the activation of TRPA1 by the chemical repellant.

    Although this study involved pain receptors in chickens, and a chicken’s TRPA1 is more similar to that of a cold blooded animal than that of a human, this is still a significant step in the study of pain. It has added to scientists’ understanding of the functional, biological evolution of pain receptors, and might help answer the question: why do we feel pain?

    Another field of evolutionary study, evolutionary psychology, gives a potential explanation for chronic pain.

    Evolutionary psychology suggests that the pressure to survive and reproduce throughout human history has shaped the human mind. This field of study attempts to identify imprinted, evolutionary traits to explain why people do or experience what they do. For example, close relatives like children or spouses are jealously guarded because of an evolutionary urge to reproduce and pass on genes.

    A school of thought in evolutionary psychology suggests that humans have learned that pain can sometimes help them obtain attention, emotional rewards, and sometimes even economic rewards from others and this is why we feel pain. For example, if an individual complains of pain, he or she is the recipient of sympathy. This might suggest that chronic pain is an evolutionary adaptation of sorts.

    However, this idea fails to explain the people who suffer from chronic pain without complaint. Many of these people never even pursue treatment for their pain. Some of those who study evolutionary psychology suggest that the way people handle pain–whether they complain or not, and whether they pursue treatment or not–is dependent on personality and cultural influences.

    Even if pain–perhaps even chronic pain–is an important evolutionary trait, it shouldn’t be ignored.

    Most pain is evidence of an injury or condition that needs time to heal, possibly even a physician’s attention. Chronic pain, or pain that lasts for 3 months or more, can sometimes potentially be accompanied by psychiatric conditions like depression or anxiety. Because of these risks, it’s advisable to always pursue treatment for chronic pain.

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  • Leg spasms relieved by muscle relaxants

    Almost everyone will experience a painful leg spasm at some point. These spasms, sometimes called “Charley horses,” are a painful contraction that can last from a few seconds to several minutes. Residual pain can linger for days. Spasms most often occur during intense activity, such as while running, or when a person is just dozing off or waking up. The muscles of the hands, arms, abdomen, or along the rib cage are all prone to spasms, but most muscle spasms occur in the foot, calf, or thigh muscles. Sometimes, especially after an injury of some sort, these spasms can become chronic.

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    No single cause has been identified for muscle spasms, but there are several potential causes, such as:

    The occasional muscle spasm isn’t cause for great alarm. A multivitamin, increased fluid intake, and proper warm-ups before exercise can often prevent more spasms. Avoiding overexertion from too much exercise can also prevent spasms.

    Although most muscle spasms aren’t serious, some might call for medical intervention.

    Sometimes, muscle spasms can have deeper causes that make them more difficult to treat. Injuries to the head or spinal cord can sometimes lead to frequent muscle spasms. Additionally, some medical conditions, such as cerebral palsy or multiple sclerosis, can be accompanied by regular spasms. When muscle spasms occur frequently despite efforts to prevent them, or begin to interfere with daily life, it might be time to speak to a physician.

    Because a muscle spasm in the leg is a painfully strong contraction of the muscle, it makes sense that a muscle relaxant might help by relaxing the muscle. However, the name muscle relaxant is somewhat misleading, because this group of drugs doesn’t act directly on muscles. Instead, most muscle relaxants act on the central nervous system, which includes the brain and spinal cord. As a result of the way they function, muscle relaxants can almost be thought of as entire-body relaxants. Indeed, the most common side effect of muscle relaxants is drowsiness or sedation.

    According to some sources, stress might actually contribute to or worsen muscle spasms. If this is the case, the sedative-like qualities of muscle relaxants may also contribute to their effectiveness. As stated on the healthline website:

    “The sedative effect that most muscle relaxants cause may also be important. Many experts think that much of the benefit of these drugs may come from the sedation they induce in people.”

    However they work, muscle relaxants have been proven to provide relief from painful spasms in the legs.

    There are 2 types of muscle relaxants that can relieve leg pain from spasms.

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    The 1st type of muscle relaxant is classified as an antispastic. These medications decrease spasticity, which happens when there is increased muscular tone and exaggerated tendon reflexes. Chronic spasticity is often an effect of neurological disorders, such as multiple sclerosis or a spinal cord injury. As a result, antispastic muscle relaxants are generally prescribed for individuals whose muscle spasms are neurologically caused. Baclofen and dantrolene are both antispastic medications. Some research suggests that antispastic muscle relaxants’ effectiveness may be limited as compared to antispasmodic muscle relaxants.

    Antispasmodic muscle relaxants, on the other hand, work by reducing the number of spasms experienced, which in turn reduces the pain caused by spasms. Although it’s not clear exactly how antispasmodic muscle relaxants work, they have been proven successful at treating chronic pain from frequent muscle spasms. Spasms that are caused by musculoskeletal issues often respond well to antispasmodic muscle relaxants. Non-benzodiazepines and benzodiazepines are both classified as antispasmodic muscle relaxants.

    The most common side effect of both antispastic and antispasmodic muscle relaxants is drowsiness.

    Because of this, physicians might not prescribe muscle relaxants to people with jobs that require the use of potentially dangerous equipment, like pilots or construction workers. It’s also recommended that a person taking a muscle relaxant for the 1st time do so at home, so he or she can see if the muscle relaxant will cause a serious sedative effect.

    In some cases, individuals with a leg pain condition that could benefit from traditional oral pain medications, such as non-steroidal anti-inflammatory drugs (nsaids), might have another condition that makes the use of nsaids impossible or unwise. For example, nsaids can cause bleeding or damage to the liver in some cases. Someone with liver disease or a history of ulcers should avoid nsaids. For these individuals, muscle relaxants can provide a viable alternative.

    Another surprising treatment option for muscle spasms is Botox injections.

    Clostridium botulinum bacteria produce enzymes called botulinum neurotoxins. The word Botox is a shortened version of this enzyme’s name: Bo from botulinum and tox from neurotoxins. Botox enzymes attach to nerve endings, preventing the release of chemical transmitters that tell a muscle to move. This causes temporary paralysis of the injected muscle, which prevents muscle spasms. It is thought that this temporary paralysis also disrupts neurotransmitters that send pain messages. Therefore, not only can Botox prevent further painful muscle spasms, it can also potentially relieve pain from previous spasms.

    After a Botox injection is delivered to the affected muscle, it usually takes 2 to 4 weeks to take full effect. Data regarding the use of Botox to treat painful muscle spasms is somewhat limited. However, findings have indicated that it can, indeed, relieve pain. Botox’s effects aren’t permanent, but injections can be repeated every 3 months. Because it treats the symptoms rather than the cause of pain, many physicians also recommend some form of therapy along with Botox injections.

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  • Living with osteoarthritis of the knees and hips

    Living with osteoarthritis of the knees and hips

    In 2007, arthritis and conditions related to it cost the U.S. economy almost $128 billion in medical care and indirect expenses. The most widespread form of arthritis is osteoarthritis, which is sometimes called “wear and tear” arthritis.

    Osteoarthritis is characterized by the chronic degeneration of the cartilage that cushions our joints. This cartilage allows for easy, smooth movement. When cartilage is worn away, bone rubs directly on bone, causing pain, stiffness, inflammation, and tenderness. Weight-bearing joints like the hips and knees are often most affected by osteoarthritis.

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    Although osteoarthritis of the knees and hips can affect nearly anyone, certain populations are more at risk than others.

    The 2 largest risk factors for osteoarthritis are age and gender. Women are much more likely to suffer from osteoarthritis, and they are more apt to develop this disease after age 45. However, before age 45, men are more likely than women to have osteoarthritis. Other risk factors include obesity, past injuries, or a job with repetitive actions or a lot of lifting.

    Early warning signs of osteoarthritis of the knees or hips include stiffness or swelling. Among those whose X-rays show osteoarthritic degeneration, only about 1 in 3 report feeling pain. Those who do experience pain might only feel it after physical activity, and pain might fade during rest. Patients might also experience the sensation of bone rubbing on bone or hear a crunching or popping sound during movement. In extreme cases, the sound of bone rubbing across bone can even be audible to the people surrounding the patient.

    If the knee joints have degenerated as a result of osteoarthritis, it may become difficult to walk, climb stairs, or get in and out of chairs, cars, or bathtubs. When the hips are affected by osteoarthritis, movement can be even more severely limited. Bending may become difficult, and everyday activities like dressing or putting on shoes can become a challenge. Osteoarthritis pain from the hip joints might even be experienced in the inner thigh, buttocks, groin, or knees.

    If osteoarthritis of the knees and hips is significantly advanced and causing a serious decline in a patient’s quality of life, joint replacement surgery is sometimes suggested. Both knee and hip joints can be partially replaced or, if the degeneration is significant enough, completely replaced. During this surgery, the damaged joint will be cut away and a prosthetic joint made of plastic, metal, or ceramic will be installed. Although highly invasive, joint replacement is successful at reducing pain in 90% of patients. However, there is a risk that the artificial joint might eventually become loose or worn out.

    There are several non-invasive treatments to consider for osteoarthritis pain before pursuing a more invasive joint replacement.

    Often, actions as simple as resting the affected joint can provide relief. Weight loss can be extremely helpful, especially with knee osteoarthritis, since every pound of weight lost removes approximately 3 to 6 pounds of pressure from the knee joints.

    Stiffness from osteoarthritis can be relieved by the application of heat, while pain or muscle spasms from osteoarthritis can be alleviated by cold. Over-the-counter pain creams can also be helpful. Assistive devices, such as a cane or walker, can help remove some of the burden from degenerated joints.

    Though exercising while suffering from osteoarthritis may seem counterintuitive, it can be very beneficial.

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    Exercises for people with osteoarthritis should be gentle and low-impact. For example, easy stretches can relieve stiffness. Aerobic exercises like walking can help keep off excess weight, which will reduce strain on joints affected by osteoarthritis. Strong muscles from strengthening exercises can help support and protect joints.

    However, overexertion during exercise can exacerbate osteoarthritis pain. Therefore, osteoarthritis sufferers should introduce activity gradually and pay attention to the body’s fatigue signals.

    If a person is still experiencing osteoarthritis pain, medications can be helpful.

    Oral opioids can block pain signals, but extended use carries the risk of dependency. Non-steroidal anti-inflammatory medications (nsaids) work by reducing inflammation around the joints, which can be very effective for reducing discomfort and alleviating pain.

    Some injected medications also reduce osteoarthritis pain. Nerve block injections are injected into the nerves of the painful area. These injections include a local anesthetic, such as lidocaine, and often include a corticosteroid to reduce inflammation as well. Another treatment designed to benefit the nerves is radiofrequency ablation (RFA). During RFA, radiofrequency heat is applied to the nerves to cause the formation of a lesion that can stop pain signals.

    Other non-invasive treatments for osteoarthritis of the knees and hips include acupuncture or transcutaneous electrical nerve stimulation (TENS). Acupuncture is the insertion of small needles to block the transmission of pain signals along the nerves. TENS includes the placement of a cap or small pads on the body, through which a slight electrical charge is transmitted to interfere with pain signals.

    Bio-medical products can provide more non-surgical options for treating osteoarthritis of the knees and hips. The loss of cartilage in osteoarthritis is often accompanied by the loss of synovial fluid, which is the fluid that encapsulates joints. During a procedure called visco-supplementation, hyaluronate bio-medical fluid is injected into the joint to replace lost synovial fluid. This procedure has proved effective in relieving osteoarthritis pain in the knee joint, but no studies have been carried out to test the potential benefits of visco-supplementation for treatment of osteoarthritic hip pain.

    If non-surgical methods fail to alleviate osteoarthritis pain, the patient should discuss the possibility of joint replacement with his or her physician. If the surgery is performed, the person should be sure to take his or her physician’s advice after the procedure. Physical therapy is necessary to help the person regain full mobility and avoid pain. Additionally, lifestyle changes like weight loss or abstinence from alcohol or tobacco use can benefit the recovery process.

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  • Innovative Treatment for Phantom Limb Pain

    Did you know that the majority of people who have had a limb amputated still report feeling some sensation in the removed limb, such as itching or tingling? As many as 80% of amputees experience a type of this phantom limb pain. This can manifest as almost any sort of pain, such as stabbing, throbbing, or burning. Pain can last anywhere from minutes to hours to days, with some amputees in constant pain for decades.

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    While no one is quite sure what causes phantom limb pain, many experts suspect damaged nerves or scar tissue. Some also blame the mixed signals sent to the brain when an entire limb suddenly stops sending information. When the brain stops receiving input from a limb, it emits the most basic message it can to convey that something’s wrong: pain.

    Because no one is certain of the cause of phantom limb pain, no single treatment has been proven to work without fail.

    Medications and noninvasive therapies are often a doctor’s first suggestion. Oral drugs, like antidepressants, anticonvulsants, or narcotics, are sometimes effective. Injected pain medications or steroids have also shown some success. Noninvasive techniques like acupuncture or transcutaneous electrical nerve stimulation (TENS) can be helpful, too.

    Spinal cord stimulation, during which the doctor inserts small electrodes into the spinal column, might also reduce pain. An electrical current is transmitted through the electrodes, hopefully blocking pain signals. Similar to spinal cord stimulation, deep brain stimulation employs electrical currents to block pain signals, but the currents are instead delivered directly into the patient’s brain. If all else fails, surgery might be suggested to remove scar tissue or damaged nerves. However, this risks worsening the pain if the surgery is unsuccessful or other complications arise.

    Other therapies used for phantom limb pain are meant to trick the brain into thinking that the amputated limb still exists.

    For example, if a patient only has 1 remaining leg, a mirror box is used to make it appear that the missing leg is still there. Patients perform symmetrical exercises with the remaining limb while imagining that the phantom limb is performing the exercises simultaneously.

    Recently, virtual reality (VR) programs have taken the place of traditional mirror therapy. Patients wear VR goggles while performing tasks with their remaining limb, but the goggles show the same tasks being performed by the missing limb instead. Alternatively, a patient can perform tasks in front of a screen equipped with motion tracking equipment and the screen shows the tasks being performed by the phantom limb.

    These methods have had mixed results. Some patients report no difference in their phantom limb pain at all.  Additionally, these therapies are useless for patients who have lost both arms or both legs, because there’s nothing for the mirrors to reflect or for the VR programs to mimic.

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    A new treatment for phantom limb pain takes this idea to new heights, while also providing a novel option for double amputee patients.

    Max Ortiz-Catalan, a researcher at Chalmers University of Technology, recently carried out a case study with a patient who suffered from constant phantom limb pain for 48 years. The patient, who lost his arm below the elbow after a traumatic accident, had attempted drug therapy, acupuncture, traditional mirror therapy, and even hypnosis, but his pain remained. Researchers attempted a new treatment method with the patient that was detailed in a recent article in Frontiers in Neuroscience.

    For the study, electrodes were attached to the patient’s arm stump. The patient was instructed to attempt 8 different movements with his phantom arm and hand, such as opening and closing his hand or flexing his wrist. These attempted movements “trained” the researchers’ computer program to translate myoelectric muscle signals in the stump and allowed the patient to control a superimposed arm on a screen. The superimposed arm responded in real time, fooling the brain into thinking it was controlling a real arm.

    Not only does this method allow a patient to visualize the amputated limb, as in existing mirror and VR therapy, but it also engages the areas of the brain that control the limb’s movement. This, suggests Max Ortiz-Catalan, is the reason that this method is more effective at treating phantom limb pain. Even when the superimposed arm wasn’t visible, such as while playing a racing video game, the patient was able to achieve the same control over the arm and experienced the same benefits. Additionally, this therapy method’s function is based on muscle signals in the stump, rather than the reflection of a remaining limb, so it will work just as well for double amputees.

    So far, the results are promising.

    After 48 years of continuous phantom limb pain, the patient in Ortiz-Catalan’s case study reported being pain-free for 15-60 minutes after each therapy session. He experienced lessened pain at home between therapy sessions, and eventually reported experiencing periods of time at home with no pain at all for the 1st time since losing his arm. He also no longer experiences such severe pain at night that he’s woken up by it. When asked about the perceived position of his missing hand, the patient stated that it was relaxed and semi-open, as opposed to the strongly clenched fist he’s experienced until now.

    This therapy is similar in function to myoelectric prosthetics. Indeed, a myoelectric prosthetic utilizes electrodes on a patient’s skin to control movement of the prosthetic arm, just as electrodes allow patients control of the superimposed arm in Ortiz-Catalan’s study. While data is somewhat unclear, there is some suggestion that use of a myoelectric prosthesis could relieve phantom limb pain to some degree. However, these sorts of prosthetics are not very common. A great deal of training is involved, both for the doctor and for the patient. Also, a myoelectric prosthesis is extremely expensive, with prices ranging up to $100,000.

    Ortiz-Catalan’s therapy method could provide a much more accessible, cost-effective means of treating phantom limb pain, especially if patients are able to carry out this therapy at home. An at-home system has already been developed and is awaiting approval. The patient in the case study is using it regularly.

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  • The invisible pain of neuralgia

    The invisible pain of neuralgia

    Neuralgia is sharp, and often severe, pain that runs along the path of a nerve. The basic cause of neuralgia pain is damage or irritation of a nerve. This damage or irritation can be caused by several different conditions, from disease to trauma.

    Causes of neuralgia

    To understand the cause of neuralgia, it’s first necessary to understand how nerves work.

    The nervous system is responsible for carrying information back and forth from the brain to the rest of the body. Nerves are the long bundles of fibers that connect sensitive nerve endings to the rest of the nervous system.

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    Nerves are protected by a layer of protein and fatty substances called the myelin sheath. If the myelin, or the nerve that’s insulated by it, is damaged, the impulses sent along the nerve can be slowed or interrupted. This can lead to problems like neuralgia or neuropathy.

    Both neuralgia and neuropathy are nerve-related and caused by damage to the nerves. However, by breaking down the origins of each word, it’s possible to see how the two conditions are different. Neuro- (or neura-) means nerve. –algia means pain, while –pathy means disease. Therefore, while neuropathy can be accompanied by pain, it’s also characterized by tingling, numbness, weakness, or other symptoms. Neuralgia, however, refers only to nerve pain.

    Neuralgia pain is usually a side effect or symptom of something else.

    According to the Better Health Channel:

    “Generally, neuralgia isn’t an illness in its own right, but a symptom of injury or a particular disorder. In many cases, the cause of the pain is not known. Older people are most susceptible, but people of any age can be affected.”

    Sometimes simple old age can be blamed for neuralgia. Other times, a disease might cause damage to the nerves, as in diabetes or multiple sclerosis. Infections like HIV, Lyme disease, or syphilis can also sometimes cause nerve damage. Even a bacterial infection, such as an abscessed tooth, can irritate nearby nerves and cause neuralgia. Pressure on a nerve might cause neuralgia pain, too; bone, tissue, or tumors that press on a nerve can cause painful irritation.

    Unfortunately, some medications—including the medications used to treat cancerous tumors—might also lead to neuralgia. Sometimes even trauma, whether from an injury or from a surgical procedure, can cause neuralgia pain. Essentially, anything that can damage the myelin sheath can potentially cause neuralgia.

    Types of neuralgia

    The different types of neuralgia are generally characterized by the cause or the location of the pain.

    For example, the two most common types of neuralgia are post herpetic neuralgia and trigeminal neuralgia. Post herpetic neuralgia is characterized by its cause. It is the result of nerve damage from the herpes zoster virus, commonly called shingles.

    Trigeminal neuralgia is diagnosed according to which nerve is affected and where the pain is felt. In this type of neuralgia, the trigeminal nerve is damaged or has painful pressure exerted on it. Trigeminal neuralgia pain affects the face. In addition to pain, there might also be such intense hypersensitivity that even brushing the teeth or feeling a breeze on the cheek can cause severe pain. The pain may begin in just one area or on one side of the face, but it can spread as the condition worsens.

    Another type of nerve pain is glossopharyngeal neuralgia, which is somewhat uncommon. This occurs when the glossopharyngeal nerve is irritated or damaged, which produces pain in the neck and throat. Sometimes the pain can also extend to the tongue, back of the throat, tonsils, or ears.

    Occipital neuralgia occurs when the occipital nerves, or the nerves that run from the top of the spinal cord up to the scalp, are injured or inflamed. This often causes pain that starts at the back of the head and radiates forward, but it can also cause pain on one or both sides of the head or behind the eye. Sensitivity to light or a tender scalp may also occur. This condition can sometimes go undiagnosed because its symptoms are easy to mistake for headaches or migraines.

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    Conditions related to neuralgia

    There is a host of conditions that can cause or be accompanied by neuralgia pain.

    Multiple sclerosis is well-known as a nerve-related disease, and it can indeed cause neuralgia pain. In fact, nerve pain is one of the best-known symptoms of multiple sclerosis. However, it’s not the only disease that can cause neuralgia pain.

    Other conditions that might be accompanied by neuralgia include:

    • Diabetes
    • Porphyria
    • Chronic kidney disease (also called chronic renal disease or insufficiency)
    • Lupus
    • Hypothyroidism
    • Complex regional pain syndrome
    • Stroke
    • Spinal stenosis
    • Fibromyalgia
    • Sciatica

    Neuralgia treatment options

    People with neuralgia pain have a lot of treatment options.

    Each individual’s treatment for neuralgia pain might be different, depending on what caused the pain. For example, since the high blood sugar levels associated with diabetes are responsible for damaging nerves, someone with diabetes-related neuralgia pain might benefit from stricter control of diet (and possibly diabetes medications) to keep blood sugar levels at heathier levels. Treating the underlying condition causing the neuralgia is often a good way to treat the pain.

    If treating the condition doesn’t relieve neuralgia pain—or if the cause of the pain can’t be identified—there are many other non-surgical treatment options. In some cases, over-the-counter pain medications may be sufficient. Heat therapy, massage, or rest might also do the trick. If not, a physician might be able to prescribe stronger medications, such as antidepressants, antiseizure drugs, or narcotics. Skin patches or creams that contain pain-relieving medications might also help. Physical therapy can sometimes be indicated, as well.

    If the pain still persists, the physician may suggest injections of pain medications, such as an occipital nerve block injection for occipital neuralgia. He or she might also suggest radiofrequency ablation, which is focused heat that damages a painful nerve in order to cut off pain signals before they’re sent to the brain.

    If non-surgical methods have failed to alleviate neuralgia pain, there are surgical ways that can treat it. The most common surgical procedures to correct neuralgia attempt to relieve the pressure on a painful nerve, perhaps by moving the blood vessel that’s pressing on the nerve. Other surgical procedures have a similar goal as radiofrequency ablation: the interruption of the nerve to stop pain signal transmission.

    Unfortunately, some people are unable to find relief from neuralgia pain despite attempting all available treatments. However, most neuralgia pain is relatively minor and responds well to treatment.

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  • Pain without a reason: complex regional pain syndrome

    Imagine waking up with intense, burning pain for no reason, or undergoing surgery only to find that the accompanying pain increases and spreads until it forces the use of a wheelchair. Worse still, imagine spending months—or even years—going to physicians who are unable to diagnose the condition. This is the grim reality for people with complex regional pain syndrome.

    The symptoms of complex regional pain syndrome can be very different from person to person.

    Once called reflex sympathetic dystrophy (RDS), complex regional pain syndrome (CRPS) is characterized by pain. According to the National Institute of Neurological Disorders and Stroke, “CRPS represents an abnormal response that magnifies the effects of the injury.” In other words, a small injury becomes a big pain.

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    The pain associated with this syndrome may be constant and severe. It may begin in one small, localized area, such as a finger, and spread to include a much larger area, such as the entire arm. It may also spread to the opposite extremity. Painfully-increased sensitivity, called allodynia, may also occur, so that even a light touch on the affected area can cause severe pain.

    In addition to pain, other potential symptoms of complex regional pain syndrome include:

    • Changes in temperature of affected body part (warmer or cooler than rest of body)
    • Blotchy, blue, red, or pale skin coloration
    • Sweating, including an abnormal sweating pattern
    • Changes in hair or nail growth
    • Inflammation
    • Stiffness
    • Tremors or jerking
    • Difficulty with muscle movement and decreased ability to move the affected body part
    • Abnormal movement or fixed abnormal position of the affected body part

    All of these symptoms are confined to the affected area of the body, so one leg might be swollen, blotchy, extremely painful, and difficult to move, while the opposite leg is completely fine. Sometimes, though, symptoms can spread, so both of an individual’s legs might be affected.

    Cases of complex regional pain syndrome are divided into two types, although some sources list a third type, as well. Type one (CRPS I) is characterized by severe, burning pain at the injury site, accompanied by muscle spasms, joint stiffness, and rapid hair and nail growth. Type two (CRPS II) is more intense pain, accompanied by swelling, slowed hair growth, unhealthy nail growth, and atrophied muscles. When differentiated, type three (CRPS III) is accompanied by unyielding, wider-spread pain, irreversible skin and bone changes, and severely limited mobility.

    There is no known cause for complex regional pain syndrome.

    Some people develop complex regional pain syndrome at random, with no identifiable triggers. These people may simply wake up one day in agonizing, unrelenting pain. However, many people afflicted with complex regional pain syndrome develop it after an injury or surgery. Even something as simple as a soft tissue injury, like a cut or bruise, can trigger complex regional pain syndrome.

    In the case of photographer, blogger, and author Micaela Bensko, her complex regional pain syndrome developed as a result of a concussion and damage to her cervical spine after a tailgate hit her on the head.

    As stated in her blog:

    “Along with the mechanical injuries to my spine, after about a year symptoms began to develop that leaned toward a Motor Neuron Disease such as ALS or MS but with unrelenting pain unlike anything I had ever experienced in my life. After extensive neurological testing, and a multitude of doctors, I was diagnosed with Complex Regional Pain Syndrome in my spine after one of my procedures.”

    As pointed out here, the diagnosis of complex regional pain syndrome can be difficult. The symptoms can vary from person to person. There is often no clear-cut cause. In some cases, the condition can improve without treatment, which might end all attempts at diagnosis until the symptoms flare up again and make it necessary to start the diagnostic process all over.

    Additionally, there is no single test to confirm complex regional pain syndrome. A diagnosis relies on observation of symptoms and the combined results of several different diagnostic tests to rule out other conditions.

    A recent study brings researchers closer to understanding the cause of complex regional pain syndrome.

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    The researchers from the University of Liverpool’s Institute of Translational Medicine, alongside researchers from the University of Pecs in Hungary, carried out a study on the autoantibodies in people with complex regional pain syndrome. Autoantibodies are naturally-produced but harmful antibodies that attack and damage bodily tissue. Usually, the body self-regulates autoantibodies, but sometimes—particularly in autoimmune disorders—the body fails to do this, allowing autoantibodies to multiply.

    In this study, researchers took autoantibody serum from healthy people and from people with complex regional pain syndrome. The serums were injected into mice. Mice injected with serum from people with complex regional pain syndrome began to show symptoms of the syndrome. As stated on the University of Liverpool’s website:

    “Although it had previously been thought, that the cause of CRPS is exclusively an abnormal brain activity after injury, more recent results, including from the Liverpool group have pointed to an immune dysfunction.”

    If the cause of complex regional pain syndrome can be pinned down by more studies like this one, there may someday be a cure for it.

    For now, although there is no cure, there are several treatments that show promise at treating the symptoms of complex regional pain syndrome.

    Traditional treatments for complex regional pain syndrome symptoms include rehabilitation therapy, neural stimulation, or medication. Some alternative treatments, such as biofeedback, acupuncture, or chiropractic care, have also had some success.

    One newer treatment for complex regional pain syndrome symptoms is the use of hyperbaric oxygen (HBO) therapy. This involves the afflicted individual spending time in a pressurized, high-oxygen hyperbaric chamber. One study found that after regular HBO treatments, pain and swelling from complex regional pain syndrome were reduced, while the range of motion was increased.

    Another potential treatment for complex regional pain syndrome symptoms is the anesthetic drug ketamine. A study in Australia found that 76% of patients experienced full, although temporary, relief from pain after receiving regular infusions of ketamine. Eventually, this treatment was brought to the United States, where it has shown real success.

    A previous study at the University of Liverpool examined the effectiveness of intravenous immunoglobulin (IVIG). Patients in this study showed an average drop in pain of 1.55 on an 11-point pain scale. While this study wasn’t as thorough or as promising as others, it was noted that IVIG is significantly more cost-effective than some treatments, such as ketamine therapy.

    In Italy, researchers recently found that a bisphosphonate called neridronate can have very profound effects on type one complex regional pain syndrome symptoms. Bisphosphonates are typically used to treat bone-related conditions like osteoporosis. However, this study found that regular applications of the bisphosphonate neridronate caused significant reduction of pain and hypersensitivity when given intravenously.

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