Tag: chronic pain

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

  • What you should know about depression and back pain?

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

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    How many people are affected by depression and back pain? 

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

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

    Why do they occur together? 

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

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

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

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

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

    Medication use

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

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

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    Recent research 

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

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

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

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

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

    Treating depression and back pain

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

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

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

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

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

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

    How to diagnose depression

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

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    What to watch for 

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

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

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

    Talk about it

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

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

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

    Don’t ignore it

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

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

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  • The power of positive thinking for pain patients

    The power of positive thinking for pain patients

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

    What are the benefits of positive thinking?

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

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

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    More receptive to health changes and advice

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

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

    Alter unhealthy habits

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

    Increase regular medical screenings

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

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

    Improve task performance 

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

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

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

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

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    The power of positive thinking for chronic pain patients

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

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

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

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

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

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

    How to practice more positive thinking

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

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

    Practice self-affirmations

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

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

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

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

    Take a few deep breaths

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

    Remember that the worst thing rarely happens

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

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

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

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

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

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

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

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

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

    How many people suffer from hip and leg pain?

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

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

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

    How does the hip work?

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

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

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

    What are the major causes of hip and leg pain?

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

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

    Leg pain from sports injuries

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

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

    What are muscle cramps?

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

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

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

    What are sprains and strains?

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

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

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

    What are shin splints?

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

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

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

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

    What about more serious injuries, like fractures? 

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

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

    There are several categories of fractures, including:

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

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    How will my hip and leg pain be diagnosed?

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

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

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

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

    Diagnostic tools

    Common imaging techniques to evaluate hip and leg pain include:

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

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

    Treatments for hip and leg pain

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

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

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

    Physical therapy 

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

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

    Hip and leg injections

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

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

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

    How to avoid common sleep deprivation effects with chronic pain?

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

    What are common sleep deprivation effects? 

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

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

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

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

    1. Minor sleep loss can be just like drinking alcohol

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

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

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

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

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

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

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

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

    3. Increased risk of serious cardiovascular health problems

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

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

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    4. Risk of increased weight gain

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

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

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

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

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

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

    6. Reduces the effectiveness of your immune system

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

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

    How to get better sleep for pain management

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

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

    1. Stick to a sleep schedule

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

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

    2. Get comfortable and control your sleeping environment

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

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

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    3. Avoid sleeping in or long naps

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

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

    4. Be mindful of light exposure

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

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

    5. Look at your eating habits and diet 

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

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

    6. Try cognitive behavioral therapy (CBT) 

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

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

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

    7. Eliminate the clutter in your bedroom

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

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

    8. Get moving and exercise!

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

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  • How can active release technique manage pain?

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

    What is active release technique therapy?

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

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

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

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

    Active release technique benefits

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

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

    History of ART

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

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

    How is active release techniques different than other therapies?

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

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

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

    When should I try ART? 

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

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

    This chain of reaction leads to:

    How does active release technique work?

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

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

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

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

    What can I expect during a session?

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

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

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

    Are there active release techniques risks? 

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

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

    How to find an active release technique provider

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

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

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

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

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

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

    At-home exercises for sore muscles include:

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

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

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

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    Major plantar fasciitis symptoms are:

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

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

    What are major plantar fasciitis causes?

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

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

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

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

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

    Who is at risk?

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

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

    1. Obesity

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

    2. Genetics

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

    3. Metabolic issues

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

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    4. Lifestyle

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

    5. Age and gender

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

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

    How is this condition diagnosed?

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

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

    How to prevent plantar fasciitis

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

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

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

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

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

    How do you treat plantar fasciitis?

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

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

    Orthotics

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

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    Traditional physical therapy

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

    High-load strength training

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

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

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

    Interventional radiology

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

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

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

    Interventional treatments

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

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  • Why pain patients suffer from more anxiety (and how to treat it)?

    If you suffer from anxiety, you’re not alone. If you’re a pain patient, you should know that anxiety and pain are often interrelated. Anxiety itself is the most common mental health issue, according to the Anxiety and Depression Association of America (ADAA). About 18% of all U.S. adults suffer from an anxiety disorder, and about one-third of people don’t receive treatment. Even more difficult, up to 45% of pain patients may suffer from anxiety. Although difficult to live with, anxiety is one of the most treatable mental illnesses with the right help. Successful treatment is especially important for people living with chronic pain. Anxiety can worsen or even cause some types of pain, including headaches or back pain. Anxiety may also worsen or cause fatigue, intensifying symptoms of conditions like fibromyalgia.

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    What is anxiety?

    Anxiety is essentially amplified fear that often develops while anticipating events or situations. It’s a normal human emotion that may precede scary or celebratory happenings, like surgery or weddings. But sometimes feelings of anxiousness grow larger and interfere with daily living.

    When anxiety makes it difficult to carry out the basic tasks of living, mental health experts consider it a mental illness. Even people without full-blown anxiety disorders may find fear, tension, and worry decreasing quality of life or exacerbating chronic pain symptoms.

    Although treatable, anxiety is complex. Let’s take a look at the different types.

    Panic disorder

    This type of anxiety may lead to sudden feelings of terror with no overt cause or warning sign. Panic attacks may develop. These involve:

    • Chest pain
    • Sweating
    • Heart palpitations
    • General feelings that one is about to lose their mind

    Some symptoms may be confused with the onset of a heart attack. This can cause even more anxiety if the person experiencing panic believes they may have a serious health problem.

    Anxiety is usually not related to an underlying health problem, but can sometimes be a symptom of heart disease, diabetes, or thyroid problem, according to Mayo Clinic.

    Social anxiety disorder

    In some people, anxiety may manifest as a fear of interacting with people, entering social situations, or in severe cases, even leaving the house.

    People experiencing social anxiety disorder may worry about being judged by others or feel so much tension over what to say, wear, or act that the entire interaction becomes a stressful situation they believe is better avoided.

    Generalized anxiety disorder

    One of the more common anxiety conditions, generalized anxiety disorder involves tension and worry about everyday living concerns.

    People with generalized anxiety may always expect the worst to happen, and because of that, experience uncontrollable thoughts racing through their heads playing out various scenarios of impending doom. Areas of concern may range from work, family, money, or school, but this type of anxiety usually involves circular thinking about worst-case scenarios.

    Symptoms may include muscle tension, headaches, fatigue, and nausea.

    What are common anxiety symptoms? 

    While anxiety may result in various conditions, underlying symptoms include:

    However, these physical symptoms barely touch the surface of this condition. People with anxiety may become so overwrought by the things on their to-do list, for example, that they’re unable to move, instead just sitting and thinking about all the things they have to do and how little time there is to do them.

    Anxiety may involve laying in bed at night, worrying about a mistake at work, which turns into mental scenes preparing for a clash with your boss that will probably never happen. As it escalates, your mind may blank as it succumbs to feelings of sheer terror or panic, and you may not be able to think, only feel nervous of what’s to come.

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    This underlying tension or nervousness is what people refer to with the term “anxiety.” With all the pressures we face day-to-day, increasing numbers of people are suffering from anxiety. While medications are sometimes used to help manage it, more and more people are turning to holistic methods of controlling stress and changing the thought patterns that lead to anxiety.

    What causes anxiety?

    Researchers are investigating the potential for a biological cause of anxiety. While no clear answers have been found, scientists point to a cocktail of genes, stress, diet, and pollution, according to Healthline. Some people are more likely than others to develop anxiety, including:

    • Women
    • People who suffer from other mental health conditions, like depression
    • Those who abuse drugs
    • People who have experienced a life trauma such as abuse, violence, or a serious health scare
    • Patients with chronic illnesses, like chronic pain

    The pressure of living with chronic pain could very well lead to anxiety, making it important to seek help if you’re feeling tense, nervous, or restless.

    Fear is a natural reaction to life’s difficult times, but sometimes that fear spirals out of control, resulting in anxiety. When learning to combat anxiety, a goal is to learn to manage fear and develop healthy ways of responding to triggers. Without tools to manage fear and nervous thoughts, those thoughts take over the mind, repeating obsessively and creating tension.

    What is the link between anxiety and pain?

    Many people with chronic pain experience anxiety, and people with anxiety sometimes develop chronic pain, according to ADAA. Headaches are a good example of anxiety leading to pain. Anxiety may lower a person’s tolerance for pain, intensifying discomfort from arthritis or fibromyalgia.

    Feeling fear related to chronic pain is understandable since it impacts your quality of life. You may not be able to care for yourself as completely as you wish, or need help with tasks like cooking or walking.

    The long-term nature of chronic conditions also creates uncertainty. You don’t know when, or if, your condition will improve. Fear and anxiety is natural, but learning how to manage it is important to reduce pain.

    The link between anxiety and pain is so strong that some doctors believe pain patients should automatically be screened for a related disorder, according to research published in the journal General Hospital Psychiatry. Researchers say that while the link between pain and depression is well known, pain’s connection to anxiety is not.

    Scientists surveyed 250 patients and found 45% of them reported at least one anxiety disorder. Those with anxiety experienced more severe pain and worse quality of life, underscoring the imperative for pain patients to receive treatment for their anxiety.

    Researchers said it’s important for patients to receive cognitive behavioral therapy to learn new ways of thinking. Dr. Roger Chou, who participated in the study, says:

    “Just throwing pain medications at someone like this (with anxiety) doesn’t tend to be very effective since you’re not dealing with an important driver of the pain.”

    How can you treat anxiety?

    Anxiety is a horrific feeling, but fortunately, many remedies are available to help relieve tension and find peace. Treatments for tension range from meditation to medication, from completely natural to pharmacological and everything in between. Not only will these help with your anxiety, many of these treatments are appropriate for anxiety and pain symptoms.

    Here are six treatments for anxiety you may find helpful.

    1. Meditation

    Meditation is the practice of sitting still, breathing, and focusing on the breath while observing thoughts that arise, not following them. So, for example, if you think, “I’m really bored,” while meditating, you would just let that thought go and return your attention to the breath instead of following it up with thoughts of, “am I doing this right?” Or “does this really work?”

    The practice may sound overly simple or complex depending on your point of view, and it may seem strange at first that sitting in a quiet place and breathing may help calm anxiety. However, an increasing number of studies demonstrate the powerful effects.

    A review of 47 studies published in JAMA Internal Medicine found that meditation helps lessen anxiety, as well as depression and pain. People meditating for as little as 2.5 hours each week saw a benefit. That’s an average of 21 minutes per day.

    The power of meditation lies in its ability to teach people to stay in the present moment. Anxiety typically involves concerns about the future, so staying in the present moment and learning to watch thoughts, instead of identify with them, helps practitioners distance themselves from feelings of fear.

    For optimal results, meditation should be practiced daily, but you don’t need to start with 20-minute intervals. Try sitting for five minutes and work your way up to an amount of time that works for you. For a primer with meditation instructions, click here.

    2. Therapy

    Therapy is a commonly used treatment for anxiety, and it’s important. A frequently used type known as cognitive behavioral therapy is wonderful for teaching people how to develop new ways of thinking about ongoing problems.

    Psychiatrists can help you learn to change your thoughts about daily struggles that cause anxiety. These new thinking patterns, either alone or in conjunction with other therapies, can reduce the amount of worry you feel.

    If, for example, you go into certain situations thinking, “I always mess up,” talk therapy can help you identify those patterns and help you change the inner dialogue to something more supportive.

    Talk therapy is one of the most effective treatments for anxiety because it targets the cause of the problem, and not just the symptoms like medication does, according to helpguide.org. Research from Johns Hopkins found therapy even more beneficial than medication for treating social anxiety disorder, and therapy lasts for a long time, unlike medication that stops working after the body processes it.

    3. Exercise

    Scientists have long known that exercise benefits physical health, but studies increasingly show fitness benefits mental health, too. Researchers still aren’t sure exactly how exercise works in the brain as a treatment for anxiety, but the link is strong enough to consider working out a proven, effective way to reduce tension, according to Mayo Clinic.

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    Exercise triggers the brain to release happiness-inducing chemicals known as endorphins and elevates body temperature, which Mayo Clinic says may reduce anxiety. Meanwhile, it gives you something outside yourself to focus on. This takes your mind off your worries and onto those weights you’re lifting or stairs you’re climbing.

    4. Acupuncture

    Acupuncture, a centuries-old Chinese medical practice of inserting thin needles into specific points along the body, is gaining recognition as a treatment for anxiety.

    In Chinese medicine, practitioners believe life energy, known as qi but pronounced “chee,” runs through the body in invisible lines known as meridians. When energy becomes stuck or stagnant, disease may follow. With anxiety, the kidney or spleen meridians may have deficiencies of this life energy, according to the University of Maryland.

    Inserting the acupuncture needles into places along either of those meridians helps to clear these areas of stuck qi and promote health.

    5. Herbs

    Herbs are an ancient, time-tested method of helping to relieve anxiety. One caveat is that some types of herbs may interact with medications you’re taking so it’s always best to consult with your healthcare provider before using them.

    One helpful herbal treatment for anxiety is a root herb called kava. Sold as a tea, this powerful beverage helps to soothe frayed nerves and promote restful sleep, according to Healthline. Kava has been long used by Pacific Island indigenous cultures that have passed their traditions down through the centuries.

    Chamomile, which comes from a flower, is also sold commercially in tea form and may help anxiety, according to webmd. The supplement Ginkgo, which many use to improve memory, may also work as a treatment for anxiety, webmd reports.

    6. Medication

    The number of anti-anxiety medications is vast and ever growing. Many people turn to medication to help combat severe cases of anxiety and panic attacks. They can also be a useful supplement to talk therapy or other, less-intensive forms of treatment.

    While medication provides relief, it doesn’t help solve the root cause of tension, which are the thoughts creating fear, according to helpguide.org. Some anti-anxiety drugs like Xanax and Valium are also addictive. This could lead to a substance abuse problem on top of the anxiety. These strong drugs are benzodiazepines, a category that also includes Ativan and Klonopin.

    The drugs work by quieting activity in the brain, also leading to drowsiness and diminished coordination. While many people find these medications are useful for managing anxiety, they should be taken with caution.

    Other medications used for treating anxiety include some types of antidepressants, including Prozac, Paxil, and Lexapro. While these drugs have less potential for abuse, they may also take up to six weeks to begin working. Antidepressants work by regulating the neurotransmitter serotonin, and the process takes several weeks before patients feel the effects.

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  • How can I remember to take my medication?

    If you’ve ever had any sort of health issues, you probably know what it’s like to be handed a thick stack of prescriptions with no idea what each medication does, why you should take them, or how often to take them. It can be easy to become overwhelmed, which can quickly lead to refusing to take all medications. However, with some careful planning and organizations, managing your medications can be simplified.

    How to remember to take your medications

    While it may be true that a spoonful of sugar helps the medicine go down, something sweet may not be the only (or best) way to manage your medications. Managing medications safely is an important part of successful treatment of any condition, and chronic pain is no exception. Here are some of the best ways to remember, organize, and keep track of your medications.

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    Know that it’s important and ask questions

    The first step to remembering to take your medications regularly is realizing that it’s important to do so.

    Sometimes physicians hand over prescriptions without a full explanation, so don’t be afraid to ask questions, such as:

    • What does this medication do?
    • Why do you think it will help me?
    • Are there any potential side effects I should watch for?
    • Does it interact with any other medications, foods, or drinks?
    • Should I take this medication with food?
    • Is there a certain time of day that it’s more effective?

    Before you leave the office, make sure you have a clear understanding of the following:

    • Dose: How much of each medication should you be taking? Ask about the amount of medicine in each pill (milligrams) as well as the number of pills. If you are not sure you will remember everything, write it down or take someone with you to your appointment.
    • Restrictions: Ask about which medicines need to be taken with food, which need to be taken without, and which should not be taken at certain times of day.
    • Side effects: Your pharmacist can discuss these with you as well, but talk to your doctor about potential side effects or drug interactions. It is crucial that you disclose any other medications – prescription, over-the-counter (OTC), or naturopathic – you may be taking so that your doctor can identify potential adverse drug interactions. If you aren’t sure if a particular supplement or OTC medication will interact, ask anyway.

    Knowing why a medication is important can make you a lot more likely to take it. If you take multiple medications, consider taking notes. This way, if you lose the inspiration to take them later on, you can revisit your notes and remind yourself why it’s important.

    Discuss your current medications

    Open communication with your healthcare provider and all of his or her office staff is crucial to managing medications. Many issues with prescriptions begin at the doctor’s office, even with prescribing that is mostly electronic. Make sure you tell your physician about all of your medications, including over-the-counter.

    Studies have shown that a lot of patients hold back from their physicians, but it’s extremely important to be honest about all the medications you take. They can interact with each other, sometimes dangerously. For example, non-steroidal anti-inflammatory drugs(nsaids) like Aleve or Advil are safe in small to moderate doses on their own. When combined with some prescription drugs, though, they can increase the risk of gastrointestinal bleeding. If your physician tells you that one of your prescription medications shouldn’t be taken with certain over-the-counter pain medications, ask what you should take instead.

    In addition to drug interactions, some medications can react with foods. For example, some diabetes medications interact very dangerously with grapefruit. The effectiveness of certain blood thinners can be unintentionally reduced by vitamin K. Others can’t be taken with anything that’s been fermented, such as alcohol or certain cheeses. Also consider asking your physician how severe the interactions are, so you know how strictly you have to avoid them.

    Use other resources, if needed

    If you realize after leaving your doctor’s office that you forgot a question or two, don’t panic. Call the doctor’s office and ask them to have your physician call you back by the end of the day. You can also take advantage of pharmacists.

    For example, most Walgreens pharmacies have a window just for consultations or questions. A pharmacist won’t be able to alter your prescriptions at all, but he or she will be able to give you a lot of information. Also, lots of pharmacies are open 24 hours a day, so you can call any time of the day or night with questions.

    When you fill your prescriptions, read each label carefully and make sure that the prescription matches what your doctor told you. If you have any concerns, don’t hesitate to call your doctor or ask the pharmacist to double check.

    Check your phone’s medication apps

    Technology makes managing medications easier than ever. A study from Queen Mary University of London found that a simple text message helped one in six patients remember to take their medication. This may not seem like a large number, but when some research indicates that only half of patients take their prescriptions properly, that added patient is a step in the right direction. The lead author of the study believes that:

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    “[a]n important and overlooked problem in medicine is the failure to take prescribed medication. The results of this trial show that text message reminders help prevent this in a simple and effective way. More than just a reminder, the texts provided the link to identify patients who needed help.”

    There are tools beyond a text that can help patients remember to take medications. Apps for smartphones can be easily downloaded to do the reminding. These include the following apps.

    Rxmindme 

    This app allows users to customize it with all prescription information, including doctor and dosage. You can add or remove medications easily, and the app offers a custom alarm to remind you to take your pills. You can also program a reminder for when your prescription is running low. The app has a list of medications, making common prescriptions easy to add, but not all herbal supplements or over-the-counter meds are listed. These must be listed manually. This app is only available for iPhone 4 or later.

    Dosecast 

    Dosecast offers similar features to rxmindme but is available for Android, Apple, and Blackberry phones. This app has similar features to rxmindme but also tracks medical adherence (whether or not you are taking your medications properly). This app also allows you to skip or postpone a dose and sends reminders that you program.

    Drugs.com reminder apps 

    Drugs.com offers several different apps to help with not only medication reminders but also pill identifiers and apps for information on each drug. Their pill reminder app is free for iphones only and installs directly onto your phone. You can track prescriptions and set medication or refill reminders. Other features include drug interactions and warnings and precautions.

    Prepare and organize your doses

    Especially for those who are taking multiple medications multiple times a day, a weekly pill sorter can help you organize and plan ahead. These can be purchased in the pharmacy section of drug and grocery stores and can be as simple or elaborate as you like.

    You can get small boxes or containers and label each one with a time of day (such as “Breakfast pills”). Then take each of them in that box at its assigned time. Alternatively, you can use colored markers, colored rubber bands, or colored stickers to denote the time of day. You can even put colored stickers on your chart (blue stickers for lunch pills, red stickers for bedtime pills, etc.) And coordinate the colors you mark your pill bottles with.

    Pill organizers also work well for this. A pill organizer is a box with compartments for your medication times each day. Some have just one compartment, but others have as many as four. These are great for anyone who tends to forget if they’ve taken their medications yet. You can look at your pill organizer and easily see whether or not you’ve taken your “Dinner” pills on Thursday. You can even find pill organizers that release medications on a timer, have alarms, or come apart so you can bring a day’s medications with you.

    Make organizing your medications part of your weekly Sunday night rituals. Or, if you’re on many, ask another family member to help out.

    A note of caution: if you have small children in your house, pill sorters may not be a good idea. They are not childproof, and many medications can cause serious injury to children. Use common sense when deciding if this is a good plan for you, or make sure to store it in a secure place.

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    Make a medication chart

    The key to taking your medications regularly is organization and one of the best ways to do that is with a medication chart.

    These are a lifesaver when you’ve got a lot of medications to keep track of. A chart gives you a place to record the name, dosage, time of day, and any other notes for each medication you take. You can print off and fill out this chart from the FDA or this chart from the North Carolina Program on Health Literacy. If you have allergies to any medications, consider writing them in across the top or bottom and labeling them clearly as allergies. Then make copies: one for home, one to carry with you, and one to give to a friend or family member.

    Make sure you have your medication chart with when you see doctors. Your physician might even want a copy of it; if not, he or she will likely copy yours for his or her own records. Make sure you let your physician know if anything on your chart is incorrect. A bottle of white-out at home can help you correct your master chart so you can make updated copies.

    Take your medications on your schedule

    In other words, use your everyday activities as reminders.

    Get into the habit of taking your medications with breakfast or just before you go to bed. If you take a lot of medications, you can use your chart to help you break them up throughout the day, perhaps taking a few with each meal and a few at bedtime.

    Have a plan in place for eating out or traveling

    If you have a pill organizer that comes apart into one-day sections, bringing along your medications for a day out is very easy.

    If you’re only planning to be away from home for one meal, you can get a pill box. For medications that need to be kept at a certain temperature, have a small cooler on hand.

    Bring in other technologies

    You can also use a little technology to help you remember to take your medications, beyond those in your medication apps.

    Research has shown that text alerts can help people remember to take their medications. There are several online services (like this or this) that you can sign up with to receive text or email alerts. You can even set reminders to help you remember to refill your prescriptions before you run out.

    Additionally, if you’re on a lot of medications or have a serious medical condition, get a medical alert bracelet or necklace. These can list your condition, note that you have a medication chart in your wallet or purse, or even give an 800-number that can be called for more information.

    Don’t forget to dispose of medications properly

    The ideas above will help you remember to take your medications in proper doses, but what should you do if you switch medications and have pills remaining? The old standby used to be simply flush the medication down the toilet, but with drugs showing up in our drinking water this is no longer recommended. There are safer ways to dispose of expired or unnecessary medications.

    The U.S. Food and Drug Administration offers these guidelines for safe disposal of medication:

    • Do not flush down the toilet or wash down the drain unless the label specifically instructs you to do so.
    • Find a local drug take-back program.
    • If no take-back program is available, follow these steps: remove medications from original containers and mix with old kitty litter or used coffee grounds to make them unrecognizable and undesirable, then seal trash bags tightly or place in a sealable container and put out with your regular trash.
    • Do not give old medication to friends. This is illegal and unsafe.
    • If all of these methods sound unappealing or you are unable to safely dispose of your medications, bring them to your pharmacist for further instructions.

    When you throw away empty prescription bottles, make sure to scratch out or black out all personal identifying information.

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  • How chiropractic works and can help you find pain relief?

    Chiropractors may best be associated with spinal adjustments and the popping sound that many people’s bodies make as their musculoskeletal systems click back into proper alignment. That noise is actually the sound of pockets of gas released by the joints as they fall back into place. But the science of chiropractic dates back to the earliest days of civilization, making appearances in texts discovered from ancient Chinese and Greek civilizations. Today, chiropractic care ranks as the third largest health profession, surpassed only by medicine and dentistry. Here’s how chiropractic works and how it can help you.

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    How chiropractic works — the beginning

    With 77,000 chiropractors practicing across the country, this rapidly expanding field offers thousands of patients hope for pain relief. Increasing numbers of everyday people are turning to this time-honored tradition, the same one used by every team in the National Football League to help its players recuperate from whiplash, muscles strains, and neck and low back pain, according to the American Chiropractic Association (ACA).

    But, chiropractic care itself has existed since ancient times. Too many ignore these historic, effective traditions as fancy treatments and pharmaceutical interventions captured the public imagination over the past century.

    Writings dating from 2700 B.C. and 1500 B.C. were uncovered in Greece and China that reference the use of chiropractic care. Later, Hippocrates, the famous Greek physician whose eponymous Hippocratic Oath all doctors take, famously wrote:

    “Get knowledge of the spine, for this is the requisite for many diseases.”

    Starting in the late 1800s, chiropractic care emerged in the U.S., pioneered by an Iowa doctor named Daniel David Palmer. Palmer founded the Palmer School of Chiropractic. This school lives on to today, steeping young doctors in the rich traditions of the practice.

    During chiropractic school, students undergo four to five years of training. They spend at least 4,200 hours spent in the laboratory, classroom, and medical clinic. Before practicing, chiropractic doctors must pass a national board test along with any tests required on the state level. Each state also has its own licensing requirements. The depth and breadth of training confers chiropractors the ability to act as primary care providers, according to ACA.

    Today, the harsh effects of harmful drugs and the reality that wellness comes from a healthy skeleton and lifestyle—not costly and dangerous drugs—is again taking hold. With it, the momentum builds for more natural, holistic, and effective treatments.

    How chiropractic works — the approach

    Chiropractors focus on the health and proper alignment of the musculoskeletal system. Many muscle and joint pains result when some component in this intricate system of muscles, joints, bones, tendons, and ligaments falls out of place. Whether you’re a sports star or desk jockey, anybody’s musculoskeletal system may experience a disturbance resulting from daily activity.

    Chiropractic medicine is based on the idea that a person’s overall health is linked to spinal alignment. The spine is not just a column of bones. It also houses the central nervous system. And, this affects the way a person processes pain.

    All body parts are intricately connected. A misalignment in one area can influence misalignments, or even pain, in other, seemingly non-related parts of the body. Through spinal adjustments and manipulations, chiropractors help patients ensure their bodies are in optimal alignment, which encourages the free flow of muscles and bones. Without restriction in the musculoskeletal system, most patients experience a reduction in pain.

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    Benefits of chiropractic care

    The chiropractic approach is medicine-free, minimally invasive, and holistic. The most common techniques used are spinal adjustments or manipulations, but chiropractors treat the whole person. They examine lifestyle choices like diet, stress, sleep, and physical activity levels. These factors influence a person’s experience of pain and the degree of healing that’s possible.

    A spinal manipulation may reduce a patient’s pain, but helping that patient possibly lose weight or reduce stress, for example, will support continued health.

    Studies show that patients who actively participate in their treatment experience better outcomes and reduced pain. Many patients with low back pain find chiropractic care is an effective way to manage discomfort and find improved quality of life.

    Another benefit is that the practice is minimally invasive. Injured workers are 28% less to undergo spinal surgery if they visit a chiropractor before an MD, ACA reports.

    With prescription drug abuse skyrocketing and the dangers of opioids increasingly well known, more patients are gravitating toward chiropractors and their minimally invasive, effective methods of treatment.

    Chiropractic care for back pain

    Back pain is a pervasive and serious issue, affecting up to 80% of people at some time during their lives, according to the ACA. At any given time, about 31 million U.S. adults experience back pain.

    While back pain has many lifestyle risk factors, such as poor posture and sedentary living, studies have shown that chronic back pain is related to changes in pain processing, according to research published in The Journal of Pain. The study found that patients receiving spinal manipulation therapy experienced less sensitivity to pain, and researchers said the procedure holds promise as a clinical treatment.

    Another study published in The Spine Journal examined the benefits of spinal manipulation in patients with acute back pain and found the chiropractic technique outperformed other treatment methods like medication or exercise.

    Back pain is one of the leading causes of disability and costs associated with treating it are estimated at $194 billion annually, according to the American Academy of Orthopaedic Surgeons. Studies show that chiropractors can alleviate some of that cost burden, with patients spending up to 20% less when they visit a chiropractor first instead of an MD, according to ACA.

    Chiropractors, instead of prescribing drugs or invasive procedures, seek to understand pain conditions from musculoskeletal origins.

    The origin of pain

    Often times, pain results from tissue injuries that lead to hypermobile or restricted joints. Injuries sometimes develop from accidents, but may also result from daily repetitive stress, such as poor posture.

    When tissues become injured, they become inflamed and painful, limiting muscle and joint mobility and often causing seemingly unrelated pain.

    Chiropractors are able to uncover the musculoskeletal issues underlying many painful conditions and perform the necessary adjustments. In addition to approaching pain from this alignment perspective, chiropractors also frequently suggest rehabilitation techniques and lifestyle changes such as diet, exercise, and stress management to support a path to healing.

    What happens during a chiropractic appointment?

    Chiropractors use a whole-body approach with patients. The doctors are trained in specific diagnostic techniques that range from skeletal imaging to observing how patients’ bodies move to identify areas needing adjustment.

    During a chiropractor appointment, patients may undergo an examination, receive hands-on treatment to correct misalignments, or receive information about possible lifestyle modifications to help reduce pain.

    Is chiropractic care safe?

    The short answer is yes, but let’s dive a little deeper.

    First, one of the most commonly used methods of treating back and other types of musculoskeletal pain is painkillers. However, even over-the-counter medications like Advil and Tylenol are not without danger when taken over long periods of time.

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    These medicines are intended for short-term issues, like healing a headache or acute injury. When taken continually, these medications may cause gastrointestinal problems such as ulcers or bleeding. Other risks include high blood pressure, kidney problems, or even heart issues.

    With many medical treatments emphasizing invasive methods, chiropractic care offers a refreshingly non-invasive approach. And even among non-invasive therapies, chiropractic care ranks among the safest there is.

    No treatment is 100% safe, and there are risks, however those risks are very small. Some patients experience feelings of soreness or achiness following treatment, but that discomfort usually disappears within 24 hours.

    Some claims have linked a specific type of neck manipulation with a stroke known as vertebral artery dissection. However more complete evidence suggests that this stroke may take place spontaneously, and chiropractic care is not a trigger.

    Other reports have connected the stroke to normal activities like turning the head while driving or even getting shampooed in a hair salon. These patients have specific symptoms involving neck pain and a headache for which they seek treatment. Only one in 5.85 million patients will experience this type of stroke connected to a high-velocity upper neck manipulation, making this an extremely rare occurrence.

    Patient satisfaction for chiropractors is extremely high, with low-back pain patients giving the doctors high marks, above even physical therapists, surgeons, or primary care physicians.

    Conservative care starts with chiropractic

    Chiropractors believe in conservative care first. They believe that non-invasive treatments should come before more drastic measures. Further, medications should be used sparingly, and not as the first line of defense. As the American Chiropractic Association (ACA) says:

    “For years, many patients would find relief through conservative forms of care such as chiropractic services only after unsuccessfully trying a range of other, more complex, and riskier treatments. Today, that approach has been reversed.”

    Chiropractic care promotes non-invasive, drug-free treatments when possible to support patient health.

    Over the past few years, increasing awareness about the dangers associated with opioid drugs, which are frequently used to treat back pain, has led to a resurging interest in methods such as chiropractic and associated treatments, including acupuncture.

    Opioids are dangerous because they can lead to addiction, and even overdose or death. Meanwhile, these powerful drugs don’t address pain’s root cause. Instead, they leave patients reliant on these pills, which aren’t 100% effective, for the rest of their lives. As these ill effects become better known, alternative therapies such as chiropractic are growing more popular.

    Chiropractic doctors focus on the body’s musculoskeletal and nervous systems. These specially trained physicians perform treatments including spinal manipulations, also known as adjustments. These work to increase mobility of a patient’s spinal vertebrae and ensure they’re in the proper alignment.

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  • What undiagnosed pain patients can do to find answers?

    If you’re still traveling from doctor to doctor, hoping for a diagnosis, take heart: you’re not alone. Unfortunately, too many undiagnosed pain patients go years without figuring out what’s causing their condition or symptoms. If you’re one of these patients, there are things you can do to improve your chances.

    Why are there so many undiagnosed pain patients? 

    Consider the story of one 50-year-old Oregon woman who landed in the hospital 60 times over the course of 15 years because of her mysterious symptoms that included stomach pain, dizziness, and nausea. All those hospital visits, rounds of testing, and a never-ending parade of doctors, and still no diagnosis, reports Everyday Health.

    While chronic pain is considered a disorder in itself, it’s also an umbrella term for the numerous conditions associated with it. Back pain, leg pain, pain from cancer or diabetes, fibromyalgia—each of these conditions are worlds within themselves, with different causes and responses to treatments.

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    Even if someone receives a diagnosis, sometimes that’s the starting point and not the end. Think of the wide world of often-painful autoimmune disorders, which are typically difficult to diagnose and highly individualized. One patient might find a special type of diet works wonders while another may need specialized treatments like acupuncture.

    Even conditions that sound specific, like irritable bowel syndrome, can be catch-all disorders. IBS is characterized by digestive troubles, but patients often develop these troubles for various reasons, necessitating different treatments. Dr. David Clarke, author of the book They Can’t Find Anything Wrong! Tells Everyday Health:

    “It is enormously frustrating for a patient with real pain not to know the cause, and they may even question their own sanity.”

    Should I visit a pain doctor or family doctor?

    For many people with chronic pain, the family doctor is the first stop on the journey to find answers. About 63% of people with ongoing pain have visited their family doctor at some point for answers, according to the American Academy of Pain Medicine.

    And while 45% of chronic pain patients have visited some type of specialist, only 15% have sought the advice of a pain doctor.

    Family doctors frequently prescribe medication, whether over-the-counter or prescription. This approach may work for those with mild or moderate pain that you can’t manage on your own, according to webmd. However, pain medication doesn’t always work and even if it does, it’s only a bandage. Medication doesn’t fix any underlying issues that may be causing the pain.

    People with moderate to severe pain that is constant should consider visiting either a pain specialist or doctor specializing in the area of the body causing pain, such as a chiropractor for back pain. Pain doctors have the expertise to dive deeper into the underlying causes, and even begin to ferret out some of the lesser-known causes of chronic pain that are often invisible and difficult to detect.

    For instance, lifestyle factors such as stress, weight, and physical activity can dramatically influence your experience of pain. The relentless suffering experienced by the Oregon woman from earlier in this article turned out to be caused by stress, says Clarke. He adds:

    “In some patients, stress is responsible for 100% of the pain. In others, it is only a minor contributing factor.”

    After Clarke worked with the Oregon woman, he soon learned the pain resulted from stress she felt from interacting with her emotionally abusive mother. Once the patient discussed the stress and figured out the dramatic impact it had upon her health, the symptoms stopped, Clarke said.

    What you can do to get diagnosed

    Unexpressed emotions and related stress are to blame for some cases of un-diagnosable chronic pain. Other times, the pain is from a very physical cause that just needs the right type of testing.

    Public relations specialist Alyssa B. Suffered from extreme neck pain that wouldn’t relent, no matter how many painkillers her doctors gave her, reports Everyday Health. Finally, after insisting to her doctors, she received an MRI and discovered four herniated discs. Doctors recommended surgery. Alyssa has opted to forgo that option for now and do the best she can with medication and physical therapy.

    Alyssa’s story underscores the importance of finding the right doctor, being your own advocate, and not stopping until you find the answers you seek. The journey of all undiagnosed pain patients are different, but there are a few things you can do to increase the likelihood of finding answers.

    1. Visit a pain specialist

    Family doctors are excellent at what they do, but pain specialists offer a wealth of knowledge outside the scope of family medicine, Everyday Health says. Many family doctors receive only a few hours of education in pain, while pain specialists focus on the topic in school and in practice.

    Experienced pain doctors have years of patient case studies to draw information from, increasing the likelihood that you’ll finally find the answers you’re looking for.

    2. Keep a pain journal

    A pain journal could be a critical resource in helping you and your medical team understand the condition you’re facing and identify the most helpful treatment options.

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    Track when you feel pain along with your daily stress levels, exercise activities, and food intake. Over time, you’ll be able to analyze this information and potentially identify pain triggers. Maybe you realize that the pain is stress-related after all. Or perhaps you see that a certain food sets it off.

    With this information, you’ll develop the ability to tailor your lifestyle to reduce triggers and feel less pain.

    3. Participate in your treatment

    Studies show that patients who actively participate in feeling better, whether that’s by exercising or researching potential new treatments, have better health outcomes. The web offers an infinite source of information and also the ability to connect with others who, like you, may be having trouble finding a diagnosis or effective treatment.

    Multiple applications for your cell phone also help with everything from developing mindfulness—which is beneficial for reducing pain regardless of source—to helping you sleep better.

    In the search for answers, you’ll also need to be your own advocate. Demand advanced testing like an MRI if you feel you need one. Switch doctors if you feel yours doesn’t listen or have the time to fully investigate your health condition.

    Become the boss of your health, patiently and persistently searching for answers, or at the very least, solutions. Because even if you aren’t able to fully understand your condition, you can still find ways to manage the pain it causes.

    4. Become an informed patient online

    This tip is among the most important. The amount of health information available to patients has never been greater, thanks to the Internet. Demand is equally high; one in 20 Google searches seeks health information, according to Google. Everyone from independent doctors’ offices to huge medical systems is making authoritative information readily available. That said, the Internet is still the Internet, and not all information is credible. Knowing the difference can help you avoid sites that make unsubstantiated claims.

    Learning how to sort through online information is important for optimal health. Patients without high health literacy generally experience worse outcomes than more informed patients, according to the U.S. Department of Health and Human Services.

    Here are a few ways you can become a more empowered patient.

    Look for new partnerships that improve online health content for patients

    At the other end are search engines like Google. These filter through the glut of information posted online to rate its usefulness, which includes measures like credibility. Google uses those usefulness ratings to order search engine results.

    Now, these two sides are coming together to help a patient get better information. Mayo Clinic recently announced a partnership with Google that has already changed how web viewers see health information online.

    When a patient searches for a medical condition in Google, a knowledge box appears on the right side of the screen. Mayo doctors are working with Google to review the information and ensure accuracy.

    Searching for “low back pain,” for example, yields a box with an overview of the condition, prevalence rates to let patients know if it’s common or not, symptoms, and possible treatments. Mayo medical editor Dr. Phillip Hagen says:

    “I certainly am sensitive to the need for accurate information, so if you take a site like Google, which is a first stop for a lot of people, I’d love it if they can get good, reliable information when they start.”

    Credibility is key

    Anyone with access to a computer can post information online, making it important for a patient to assess the credibility of information they’re reading.

    One easy way to assess authoritativeness is to check out the URL of the website. Sites ending in .gov are great because that information is coming straight from a government agency, and is probably backed by the best experts around. If you’re accessing non-government based websites, make sure that they clearly link their information back to an authoritative source like a government site.

    Extensions related to schools, such as .edu, are also generally good. However, be careful because sometimes students will write papers on topics that are posted on a school’s website, leaving the URL sounding official even though the information is not from a doctor or other health care professional.

    Avoid this by looking at the URL a little more closely. Information published by individuals will often have a tilde (~) in it. These pages are generally less authoritative than content posted on a clearly branded university page. Also, some schools are not as credible as others, so try to stick to well-known institutions like Harvard or New York University.

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    Also take care when looking at non-profit sites with urls ending in .org. Anybody can purchase a .org URL, so that alone does not mean the site is credible. Try to find well-known organizations with boards consisting of doctors. Sometimes smaller groups aren’t as credible or have ulterior motives that aren’t immediately apparent.

    And if the information is coming from a person or business, make sure the person has appropriate degrees, like a medical degree or, for example, a registered dietician credential for information related to food.

    Find simple information—it exists!

    When searching for the latest information about whatever ails you, it’s easy to get sucked into the world of medical jargon. This somehow makes everything sound really scary and complicated.

    And while some medical issues truly are complicated, they can always be distilled into easy-to-understand terms. Increasing numbers of health websites are taking it upon themselves to simplify health information for that very reason.

    The effort is an important one. A study published in the Australian and New Zealand Journal of Public Health found that most Australians don’t find the information they need because the existing content is too complex.

    Even on the simplest issues, like obesity, researchers found that 17 sites formally discussing the condition were difficult to understand. Difficult information makes ideas not only harder to comprehend. It also increases the likelihood that a patient will misinterpret key information, leading to health choices that aren’t in their best interest.

    Researchers urged medical health websites to focus on simplicity to continue empowering patients in making good health choices. Mayo’s recently announced partnership with Google is a huge step in that direction.

    The bottom line is, if you feel confused or overwhelmed, seek out another source of information. Plenty exists, so find the source that speaks to you.

    Look for dates

    New medical studies come out every day, and new information sometimes proves old information wrong or incomplete. Check for dates to make sure the information is as accurate as possible.

    Ways to verify the date include looking at the bottom of the article or webpage. Many credible, online resources will post a “last updated” date at the bottom of their post or list a copyright date in the footer bar of the webpage.

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    References:

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    Fibromyalgia Stores

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