Tag: chronic pain

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

  • Pain Relief for Achy Joints

    Getting older certainly has its perks, but the reality is that aging can take its toll on many of us, despite our efforts to get out there and stay active—especially as the cold weather sets in.

    No, it wasn’t an exaggeration when your mother/father/grandmother or someone else rubbed their knee/elbow/back, winced and muttered, “I can feel a storm coming on.”

    Yes, there is evidence that shows a link between weather changes and chronic pain, especially joint pain and migraines. A 2007 Tufts University study showed that for every 10-degree drop in temperature, there was an incremental increase in arthritis pain. Low barometric pressure, low temperatures and precipitation can all increase pain. The theory is that these conditions increase swelling in the joint capsule, says the Arthritis Foundation.

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    It all adds up to giving your body an opportunity to heal itself by reducing its creation of pain-driving substances and stimulating mitochondria, the “energy packs” that drive cellular function and repair.

    Here are a few of the more common causes of joint pain and ways to ease your discomfort.

    1. Injury
    You slip and fall. Overdo it at the gym. Get rear-ended in your car. Sleep in the wrong position. Sit cramped on a plane for too many hours. Have poor posture. There are a zillion ways to injure your body, whether quite innocently and unknowingly from an everyday cause or overuse from repetitive motions over time.

    That pain can lead to stiffness, sleep disturbances, a burning sensation in your muscles, achiness or acute pain running from mild to severe.

    What to do to relieve muscle tension and soreness? Well, you can complain, call a doctor, take a pain reliever or rest—but don’t underestimate the power of massage in delivering a significant reduction in pain and soreness.

    2. Osteoarthritis
    This chronic condition of the joints is sometimes referred to as degenerative joint disease or “wear and tear” arthritis. It gets its name from the way it develops: cartilage, the cushion between our joints, breaks down over time and with use. What comes next? Pain, stiffness and swelling.

    If your knees, hips, lower back and neck hurt, you’re in good company with the 27 million other Americans who feel the pain. Also affected could be the small joints in your fingers and the bases of your big toe and thumb.

    Although physical activity might be the furthest thing from your mind when you’re feeling this way, it pays to be active. Studies show that simple exercise, like walking, can help manage or even reduce the pain from osteoarthritis. Weight management, stretching and anti-inflammatory medications can help, too, as can alternative approaches like massage, acupuncture and hydrotherapy.

    3. Bursitis
    We all have bursae—small sacs filled with fluid that cushion the bones, tendons and muscles near and around the joints of the shoulders, elbows and hips. When these become inflamed from repetitive movements, you’ve got bursitis, which can also affect the knees, heels and base of the big toe. Sometimes you can get bursitis from putting pressure on a joint for too long—like kneeling or leaning on your knees or elbows, for instance.

    The pain from bursitis can make you feel achy or stiff and can hurt when you move or press on the joint, which might also appear swollen or red.

    While you can’t prevent all types of bursitis, there are some things you can do to reduce the likelihood you’ll get it. If you do a lot of things that require kneeling, take stress off your knees by using a kneeling pad; warm up and stretch prior to strenuous activity; maintain a healthy weight to take stress off your joints and strengthen the muscles around them; use your knees, rather than your back, to lift heavy loads.

    Bursitis usually improves on its own, but you can help it along by resting, icing and taking a pain reliever. More aggressive treatment, if necessary, might include physical therapy, prescription medications and steroid injections.

    4. Gout
    This inflammatory form of arthritis affects about 4 percent of American adults.

    Many people think of gout as a “rich man’s disease,” a result of a lavish and expensive diet. That’s only a very small part of the picture. Most of the uric acid—actually about two-thirds of it—is produced naturally by your body. The rest comes from diet, in the form of purines, found in animal and plant foods. In fact, one of the great myths of gout is that it is caused by or can be controlled by diet. The reality of it is that gout is mainly a metabolic disease with genetic origins.

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    Gout occurs when there’s too much uric acid in your body and your kidneys can’t flush it out. It builds in the bloodstream and forms needle-like crystals in a joint. Those crystals, in turn, bring on sudden and severe attacks of pain, tenderness, redness and swelling. It commonly affects the big toe but can also occur in your feet, ankles, knees, hands and wrists. It can make the joint feel like it’s on fire. The pain can get so severe that even the weight of a sheet can be impossible to tolerate.

    Don’t think that you don’t have control over gout. You might not be able to change your genetics, but you can change factors like being overweight, which contributes to things like high blood pressure, high cholesterol and high blood sugar—all linked to gout.

    Experts say that although eating a low-purine diet won’t cure gout, it’s important to eat well and maintain a healthy weight. And, it’s wise to limit foods that increase uric acid levels, such as red meat, shellfish like shrimp and lobster, beer, liquor and high-fructose corn syrup.

    To help ease the pain from acute attacks and prevent future ones, gout is usually treated with medication like nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen and others), colchicine (a pain reliever used for gout pain) and corticosteroids (like prednisone).

    5. Lyme Disease
    Achy knees and Lyme disease often go together, and that’s because the bacteria transmitted by the tick bite can spread to your joints. This stiffness could also develop in your neck, hands and feet. Aside from joint pain, Lyme’s usual symptoms are fever, headache, fatigue and a skin rash characterized by a bulls-eye red circle that usually appears about seven days following the bite.

    Left untreated, Lyme can also spread to the heart and nervous system.

    Each year, approximately 30,000 people get bitten by a tick and develop Lyme disease. The first way to prevent it is to reduce your exposure by avoiding wooded and brush areas with high grass and leaf litter. Also, use insect and tick repellent, and inspect your body thoroughly for ticks after you’ve been outdoors. Putting your clothing in a hot dryer for 10 minutes can kill off any ticks that hitched a ride.

    Caught early, Lyme can be successfully treated with a variety of oral, and sometimes, intravenous antibiotics or penicillin.

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  • Diabetic Nerve Pain Treatment

    Diabetics are more prone to developing skin diseases and vision problems – and the list goes on. Many of these conditions lead to pain, but one condition that puts the patient at risk of developing chronic pain is neuropathy, which is a condition that is inclusive of nerve damage. Since there are nerves all over the body, there is no telling where the pain will be.

    Research suggests that neuropathy occurs most often in diabetics who have a hard time controlling their blood glucose levels. People over 40 years old and smokers are also at increased risk of developing diabetic neuropathy.

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    Chronicillness.co-Site of United States works with people suffering from diabetes to manage both pain and neuropathy so that it does not become a chronic condition. The first step is to keep the blood glucose levels at a target range. Levels that are out of whack are dangerous because extreme blood sugar levels damage nerves and reduce circulation.

    Drug therapy is a route a patient can go if their neuropathy causes too much pain. Medication may include anti-seizure medication (often used for nerve pain as well as seizure control) or antidepressants. Antidepressants work by changing the way the brain perceives pain by altering the chemical process.

    Steroid injections and nerve blocks are diabetic neuropathy treatments that target specific areas of pain instead of taking medication that goes through the whole body. Since they generally last a few months, repeat injections may be necessary. These injections work by stopping the pain signal from the nerve from going to your brain. That way, your brain won’t look at those areas as painful anymore since it is not receiving any pain signals. The injections are not very painful because the patient is given a numbing shot near the area before the medication is injected. Steroid injections and nerve blocks do not usually come with any side effects other than some irritation around the injection site.

    There are a few at-home treatments a diabetic patient may want to try alongside treatment at Chronicillness.co Site of United States and between visits. These include eating a better diet with less junk food and exercising. Exercise, even though it may be painful at first, strengthens the muscles around the nerve so that less pressure is being put on the damaged nerve. Our physicians can help the patient find a safe exercise routine that works specific muscles near the nerve as well.

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  • Sciatica Leg Pain: Can It Be Cured?

    If you’ve had sciatica leg pain, you know it can be miserable—shooting pain in your leg and sometimes tingling, weakness, or numbness.

    Sciatica pain starts when something in your body, often a herniated disk, is pressing on the sciatic nerve, which runs from the lower back down the back of your legs.

    The good news is that most people with sciatica start to feel better within a few weeks.  For some, though, the pain continues for a year or longer.

    Fortunately, there are many strategies you can try for sciatica leg pain relief.

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    Exercises: Building up the muscles that support your spine and stretching the leg muscles involved in sciatica leg pain can help. A physical therapist can make sure you’re doing the exercises correctly so that you get the most out of them and don’t hurt yourself. If you’re in too much pain for exercise, steroid injections may bring you enough relief to get started.

    Medication. Over-the-counter acetaminophen or nonsteroidal inflammatory drugs such as naproxen and ibuprofen are enough to get many people through the pain. Other patients may need muscle relaxants, antidepressants, or opiate pain relievers, although medications must be taken with care to avoid becoming dependent on them.

    Alternative therapies. Chiropractic treatment, acupuncture, and massage therapy are sometimes used either alone or in combination with other treatments to treat sciatica leg pain.

    Epidural steroid injections. Some patients are able to get relief lasting three to four months from steroid injections.

    Nerve blocks. Injection of nerve-numbing medication into the area that is the source of the pain may be recommended for some patients.

    Radiofrequency ablation. In this minimally invasive procedure, nerve fibers in the back that carry pain signals are destroyed to block the pain.

    Spinal cord stimulation. If other options aren’t working, your doctor may recommend spinal cord stimulation, in which a device that delivers mild electrical pulses is implanted near the spinal cord to block pain signals.

    Surgery. Most patients with sciatica will not need surgery, but it can be an option if disabling pain isn’t responding to other treatments.

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  • New Chronic Pain Treatments Help the Whole Person

    New Chronic Pain Treatments Help the Whole Person

    Women who live with chronic pain seek relief through all kinds of treatments, from acupuncture to physical therapy, medication to psychology.

    But in recent years, researchers have proven a multidisciplinary approach to chronic pain management can offer substantial and sustained pain relief.

    Even if you have explored multiple treatment modalities, you likely haven’t experienced a true multidisciplinary pain management program. That’s because they are few and far between. These complex team-driven programs require resources typically found only at large medical institutions. Some patients travel from far away to receive care because the potential life-changing effects are worth it.

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    What is a multidisciplinary pain management program?

    In a multidisciplinary approach, a team of clinicians collaborates to create custom treatment programs for each patient, using a variety of modalities. Patients often spend many days a week, sometimes for multiple weeks, in a program.

    “It’s more of a patient-centered, goal-oriented, holistic approach,” said Tim J. Lamer, MD, pain management specialist at Mayo Clinic and president of the American Academy of Pain Medicine. Lamer explained that multidisciplinary pain management is like a puzzle where every piece matters—and they all fit together.

    Institutions like the Shirley Ryan AbilityLab Pain Management Center in Chicago provide a model for multidisciplinary care, according to attending physician Shana Margolis, MD. There, most patients have previously tried one discipline at a time but not an approach that combines them all. The Shirley Ryan AbilityLab uses a biopsychosocial approach, meaning its team treats biological, psychological, and social drivers of pain, both as individual forces and as forces that intersect with one another.

    Multidisciplinary pain management programs may include:

    • Pain psychology: Teaching patients how mood affects pain and how pain affects mood, often using cognitive behavioral therapy. “When you’re in pain, it can make you more irritable, anxious, and depressed, which then can make it harder to manage your pain, and you can get stuck in a vicious cycle,” said Margolis.
    • Biofeedback therapy: Providing a variety of relaxation techniques that employ monitoring technology that gives patients instant feedback on their efforts.
    • Physical therapy: Including time spent on strengthening, range of motion, biomechanics, and pacing.
    • Occupational therapy: Focusing on ergonomics and improving a patient’s ability to perform everyday tasks with less pain.
    • Vocational therapy: Helping patients learn to reclaim their working life through a variety of strategies.
    • Art therapy: Using creativity to cope with pain, express emotions, and even reduce symptoms.
    • Interventional therapies: Employing techniques like nerve blocks, injections, or electrical stimulator devices to treat the neurological aspect of pain.
    • Physician and nurse monitoring: Ensuring patients are using medications properly, that comorbid conditions are also well-managed, and more.

    Margolis said a key aspect of a multidisciplinary approach is that the patient is at the center of the program, playing an active role in their own care, as opposed to simply receiving treatment. “We’re trying to give patients tools in their toolbox so they can learn to self-manage their pain,” she said.

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    Research shows results

    Lamer said most patients in a multidisciplinary approach experience improved function, mental health and management of pain in their busy lives. And there’s research to prove it, he said, including at least one study that followed patients for as long as 13 years who experienced long-term benefits.

    More research by Shirley Ryan Ability Lab Pain Management Center and the Department of Physical Medicine & Rehabilitation at the Northwestern University Feinberg School of Medicine in Chicago showed patients experienced improvement in pain, pain-related anxiety, ability to cope, and depression, among others.

    Margolis said that while many people can benefit from a multidisciplinary pain management approach, patients with widespread pain conditions like complex regional pain syndrome and fibromyalgia are likely to experience the greatest benefit. “Any kind of chronic pain condition that’s really affecting the patient’s lifestyle is where we excel,” she said. Emphasis on the mind-body connection and mindfulness plays a significant role in a patient’s success.

    Ready to take action?

    If you’re looking for a multidisciplinary pain management program, ask at your nearest large medical center. If there isn’t one in your immediate area, reach out to reputable programs and ask if they can recommend a provider in your area.

    The American Chronic Pain Association offers an extensive overview of pain management programs.

    The Alliance for Balanced Pain Management offers resources for patients seeking to understand their treatment options.

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  • Coping with Whole Body Pain

    It’s bad enough to have a headache or backache. But when literally everything seems to hurt, you’re truly miserable. You can have trouble getting through simple daily activities and may find it hard to get a good night’s sleep. That can make the pain even worse.

    The good news is that whole-body pain relief is possible. The first step is finding out what is causing your pain. There are at least 20 different issues that can cause total body pain. Here’s a quick look at a few of them:

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    • Infections: The flu, pneumonia, or similar illnesses can make you ache all over. Luckily, the pain goes away when the illness does, although you may need medical help to recover from an infection.
    • Arthritis: The inflammation from some types of arthritis, particularly rheumatoid arthritis, can cause achy joints throughout your body, which may be accompanied by fatigue as well.
    • Statins. Although effective at treating high cholesterol, about 20-30 percent of those who use statins develop muscle and joint aches.
    • Lupus. In this autoimmune disorder, your immune system mistakenly attacks your own healthy tissue. The resulting damage and inflammation can cause pain throughout your body.
    • Lyme disease. Ticks spread the bacteria that cause Lyme disease. If you’ve been in tick country and your aches come with a rash, see your doctor right away. If left untreated, Lyme disease can lead to arthritis, heart palpitations, and other serious problems.
    • Fibromyalgia. This condition, which is not well understood, can cause muscles and bones throughout your body to feel tired, tender, and achy. It can also cause insomnia, stiffness, and numb hands and feet.
    • Hypothyroidism. When your body doesn’t produce enough thyroid, one of the symptoms can be muscle cramping and stiff joints.
    • Opioidinduced hyperalgesia: In some people who have used opioid drugs for a long time to treat pain, the drug can eventually produce the opposite effect, making your body more sensitive to pain.
    • Poor circulation. Burning, cramping or other pain during exercise, particularly in the legs or arms, can be a sign that the vessels providing blood to your limbs have narrowed and you’re not getting enough oxygen.

    There are probably a dozen other conditions that could cause you to feel widespread pain, so it’s critical to work with a doctor to get to the root of the problem. The most effective treatment will depend on what’s causing your pain. For instance, for a Lyme disease infection, you’ll be given antibiotics, while for rheumatoid arthritis or lupus, you may be prescribed medicine to calm an overactive immune system.

    A variety of treatments can help with the pain itself, ranging from ice packs and simple over-the-counter pain relievers to procedures such as steroid injections, nerve blocks, and neuromodulation. Alternative treatments such as acupuncture, meditation, and cognitive behavioral therapy can often help as well.

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  • Why I’m Talking About My Chronic Pain and Why You Should Too

    As a physical therapist, my job is to assist my patients to move better, get stronger, and most often to reduce their pain. This is an important, gratifying, and yet often challenging profession. This is in part due to my own daily chronic pain that is primarily in my low back and tailbone. I have been in some level of pain constantly for the past ten years.

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    While there are times that I share my experience with my patients, I usually smile, persevere and act as if everything is fine. I think many others with chronic pain can relate to this alternate persona—the brave mask so many chronic pain warriors put on daily.

    This is one of the tricky things about living with chronic pain. Most of the time I just want to feel normal. I want to go about my day-to-day tasks as if everything was not a monumental challenge and a huge energy expense. I want to pretend that my chronic pain has not affected my job satisfaction, my relationships and my feelings of self-worth.

    There are other times when I want to scream. I want to wear a sign across my chest that says, “Please be gentle with me, I have chronic pain.” I want everyone around me know what I’m going through, why I am the way I am. I want my struggles heard, to know that it’s not easy. It is not pity I seek, but rather compassionate recognition of the daily challenges of living with chronic pain.

    I’m often afraid to talk about my struggles with chronic pain. This would mean ripping up the mask––that brave face that I have worked so hard to maintain. My hope is that if I am true and open about my experiences more, a few people might feel less alone. A few people may push aside the fear of stigmatization and feel comfortable to be open and honest about what they are going through.

    Early in my clinical training, a patient taught me an important lesson. She told me to never tell someone, “I know how you feel.” Her statement took me aback, but her explanation has really stuck with me. It is true. I could never really know what someone is feeling. It is impossible to know just from their explanations, my own examination and my pre-conceived beliefs and education.

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    I cannot innately tell how past experiences have affected someone. I cannot exactly grasp the psychological impacts that their illness or pain has had on them. I do not know all other aspects of their life that this has affected. I can’t ever fully understand what someone else is going through, but I can listen. I can respect someone’s experience and I can do my best to validate their concerns. I can call on my past experiences of others discrediting my own feelings and I can work hard to not allow this to happen to another person—at least when they are working with me.

    I learned that opening up about my pain did lead to judgment from a few—one family member told someone that I write about my chronic pain, as a way to complain and vent. Many more have provided support and encouragement. I also learned that ignoring your pain and suffering in silence does not make it go away. I have found that by acknowledging my pain it encourages me to seek more treatment and work harder toward finding relief.

    Most importantly, talking about my pain has allowed me to maintain the healthy human connection that we all crave and need so badly in this life. It is so much easier to genuinely connect with the people in your life when you are raw and honest. It is never easy, but eventually you will have to take the mask off and let the person see the real you.

    I hope that you will find that by talking about your experiences with chronic pain and acknowledging its presence will lessen the power it has over your life. By ignoring my pain, I felt helpless. I let my chronic pain determine what kind of day I was going to have, how long a relationship could last, and how many hours I could stand to work in a week.

    While the process is ongoing, I am happy to be taking steps to regain control and be honest about my experiences. I am in far less discomfort than I used to be and now I have something even more important—the hope that one day I might actually be pain-free.

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  • What to Look for in a Pain Management Clinic

    If you’re in pain, you’re not alone.

    About 1 in 4 Americans suffer from pain that lasts more than 24 hours. In fact, more people suffer from pain than from cancer, heart disease, and diabetes combined.

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    Where can you get relief? An increasing number of people with chronic pain are turning to pain management clinics, and for good reason. They can make a real difference in lessening their patients’ pain and helping them live more productive lives. But not all pain clinics are created equal.

    Ask these five questions when you’re choosing a pain treatment clinic.

    1. Are the doctor board certified in pain management?

    Pain treatment is complicated, and the research is continually evolving. Specialized pain doctors have in-depth knowledge of the physiology of pain, the diagnostic tests used to pinpoint the cause, the most appropriate medications to treat it, and how to perform pain-relieving procedures such as nerve blocks or spinal injections.

    To be certified as a pain specialist, a doctor must complete a fellowship—that’s a level of training beyond the residency all doctors must complete. Only three organizations offer pain management certification in the United States— the American Board of Anesthesiology, the American Board of Psychiatry and Neurology, and the American Board of Physical Medicine and Rehabilitation. Before you make an appointment, find out if your doctor is certified by one of those organizations.

    2. Does the clinic have experience treating your particular type of pain?

    Rheumatoid arthritis pain is different from cancer pain, which is different from migraines. Make sure the clinic you’re considering has doctors with experience treating your ailment. Find out how many years of experience they have and what kind of methods they recommend.

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    3. Does the clinic offer a range of treatment options?

    We all experience pain differently and respond differently to treatments. One patient may feel fine after a steroid injection, while another will need spinal cord stimulation to get relief. And although opioid medications have their place in pain treatment, they also pose serious risks. If a clinic focuses mainly on opioid prescriptions, you may want to look elsewhere.

    4. Are you comfortable with your doctor?

    To get good results, you and your doctor need to be on the same team. You need to feel like your doctor respects you, understands your pain and can help solve your problem.

    5. Does the clinic support a comprehensive treatment program involving multiple professionals?

    Sometimes you need lots of players on your team to get relief. You may need physical therapy to strengthen muscles so you can move with less pain, or you may benefit from acupuncture or chiropractic care. Your pain may be causing depression or anxiety, which a counselor can help you address.

    Make sure the pain clinic understands the importance of involving experts from multiple specialties to treat you as a whole person. They should be willing to refer you to outside professionals in complementary fields. Some may even have those experts available at the clinic.

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  • Smart Steps for Healthy Feet

    Are your feet something you think about only when they hurt? Simple steps can protect them from common problems, some of which are hard to get rid of.

    READ: The Ways to Treat Your Feet Right

    The first step is to wear shoes, such as water slip-ons, in moist environments like indoor swimming pools and communal showers at the gym. Damp areas allow bacteria and viruses to thrive, and walking barefoot makes you more susceptible to common infections like nail fungus, athlete’s foot and warts.

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    You don’t have to give up style, but skip shoes that don’t feel comfortable from the moment you try them on. Calluses, corns, blisters and irritations can all result from or get worse from shoes that pinch and don’t fit well. It’s a mistake to expect that the shoes will “give” and feel better over time.

    Choose hosiery with care. That means buying socks and tights made from breathable fabrics. It’s not always possible to wear cotton, so if your feet get sweaty when you wear hosiery made of synthetics like nylon, take these steps: Carefully wash and dry feet when you get home, hand-wash the hosiery every night and let shoes dry out before you wear them again — you may need to wait 48 hours.

    A pedicure might be a great treat for your feet, but beware of harmful practices, both at salons and at home. It’s OK to gently slough off dead skin cells with a pumice stone after soaking your feet, but tools with razor blades are dangerous.

    Cutting cuticles is also unsafe. Gently push them back with an orange wood stick. To prevent ingrown toenails, clip straight across, not in a curve. The edges should be just a few millimeters shy of the toe tips. Use an emery board to smooth any ragged spots straight across.

    If you’re concerned about any changes in your feet, promptly contact your doctor or a podiatrist for an evaluation.

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  • The 7 Most Common Types of Neck Injury

    If your car was rear-ended two days ago, and you wake up with neck pain, the cause is obvious: you’re likely suffering from whiplash. Other times the cause of your neck injury can be more mysterious. Sometimes you wake up with a “crick” in your neck and have no idea why.

    Understanding the cause of your neck pain is the first step in figuring out how to treat it. Here are some of the most common causes:

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    1. Car accidents. When you are hit from behind in a car, your head is thrown forward and backward quickly, which can damage muscles, ligaments, and sometimes nerves in the neck.
    2. Athletic injury or fall. Football players are especially prone to neck injuries, but a mishap that damages the muscles, tendons, and ligaments of the neck can happen to anyone.
    3. Overuse injuries, stress, and poor posture. If you’re doing repetitive tasks that involve the upper body and arms, you may find yourself with a stiff neck. Sitting hunched over your computer too long while stressing about a tight deadline can also be a culprit.
    4. Poor sleeping position. Sleeping with your neck twisted at an odd angle (perhaps while on your stomach) or using pillows that are either too full or too flat may cause you to wake up achy.
    5. Arthritis. Over time the cartilage that helps cushion the bones in your neck may wear down, causing pain.
    6. Pinched nerves. Sometimes bone spurs or herniated disks will put pressure on nerves in your neck, causing pain and sometimes numbness or tingling in your arms or hand.
    7. Illnesses. Some serious illnesses, such as meningitis or cancer, can cause neck pain.

    Important: If you or someone you are with has severe neck pain or loss of movement or feeling after an accident, get emergency help immediately. They could have a broken or dislocated spine, which could injure the spinal cord and cause permanent paralysis.

    Neck Injury Symptoms

    The symptoms you’re suffering can sometimes help a neck injury doctor identify the cause.

    • Aches and stiffness, sometimes spreading to your back or arms, can be a sign of a sprain or strain in the muscles or ligaments.
    • Shooting pain that includes a burning or stinging sensation and sometimes numbness or tingling can indicate a pinched nerve.
    • Neck pain accompanied by the shoulder and arm pain and sometimes headache, dizziness, or nausea can mean you have a torn or ruptured disc.
    • A stiff neck accompanied by fever, headache, and sometimes vomiting can be a sign of meningitis.

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    To diagnose the source of your pain, a neck injury doctor will ask you questions about your health and history and do a physical examination. He or she may also use X-rays, MRI scans, CT scans, and blood tests to help figure out what’s causing your pain.

    How to Treat Neck Injury Pain

    Often a neck injury will resolve by itself with rest and over-the-counter medications. If your pain continues for a week or more, though, you may want to see a doctor. In some cases, your general practice physician will refer you to a pain specialist or a doctor who specializes in neck injuries.

    Neck injury treatment can involve the following:

    • Ice, rest, muscle relaxants, and over-the-counter pain medication.
    • Physical therapy, including stretching and other exercises.
    • Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) or other prescription medications.
    • Chiropractic care, massage therapy, or acupuncture.
    • Epidural steroid injections can provide pain relief for three to four months.
    • Nerve blocks, which contain local pain medications to control acute pain.
    • Radiofrequency ablation, or rhizotomy, which is a minimally invasive procedure that destroys the nerve fibers in the neck that carry pain signals.
    • Spinal cord stimulation involves implanting devices in the spine that deliver mild electrical pulses to block the transmission of pain.
    • Surgery. While seldom necessary, surgery can be an option if other treatments aren’t providing enough relief.

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  • Nerve Block Technique Might Help Chronic Back Pain

    A procedure that uses radio waves to treat chronic low back pain provided long-lasting relief to a small group of patients, researchers report.

    Called intradiscal biacuplasty (IDB), the procedure uses two water-cooled needles to blast radiofrequency energy at the nerve fibers within and around a spinal disc that’s begun to degenerate but has not ruptured, explained lead researcher Dr. Michael Gofeld.

    “Basically you’re destroying the nerve fibers, which will lead to the elimination of pain,” he said. Gofeld is a chronic pain management specialist at St. Michael’s Hospital and Women’s College Hospital in Toronto.

    A year out from treatment, half of the patients who received IDB in the study said they still were experiencing significant pain reduction, Gofeld and his colleagues reported.

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    The treatment is specifically to help people with discogenic back pain, Gofeld said — pain related to discs that are deteriorating but have not ruptured.

    Prior studies have found that discogenic back pain accounts for 39 percent of cases of chronic lower back pain, he said.

    The idea of using radio waves to treat back pain has been around for a quarter-century, Gofeld said. But recent breakthroughs using water-cooled needles have made the technology potentially more effective.

    “If the needle gets too hot, the energy will not spread efficiently enough,” Gofeld said.

    The procedure takes about a half hour, followed by six weeks of physical therapy, he said. Ideal patients have lower back pain that doesn’t shoot down the legs and limited disc degeneration, with no significant tears or ruptures.

    Dr. John Mafi, an internist and assistant professor at UCLA’s David Geffen School of Medicine, in Los Angeles, pointed out that the U.S. Food and Drug Administration approved IDB for use in 2007. But the technology has not been widely adopted in the United States, he said.

    “It’s not widely used,” Mafi said. “Insurance doesn’t seem to cover it yet, and that may be because they want to see more evidence.”

    For example, the U.S. Centers for Medicare and Medicaid Services (CMS) ruled in September 2008 that the government insurance plans would not cover any radiofrequency treatments for low back pain. The CMS decision memo concluded that there wasn’t enough evidence to prove that the procedures would improve health outcomes.

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    Gofeld’s study, which was funded by device manufacturer Kimberly-Clark Corp., focused on 22 patients who received IDB treatment alongside typical medical care for back pain.

    These patients originally showed less pain at six months following treatment, and now a one-year follow-up found that their pain reduction and improved function had continued, Gofeld said.

    The one-year report also included 25 members of the initial control group for the study, who at first only received typical medical care that included physical therapy and exercises.

    These patients were allowed to “cross over” after six months and receive IDB. They also experienced some pain relief and improved function, the Canadian researchers reported.

    However, their pain reduction was not as strong as that experienced by the original treatment group, Gofeld said.

    “We can infer from this result that the sooner we do the procedure and get the patient into rehabilitation treatment, the better will be the result,” he said.

    Researchers also found no significant side effects associated with IDB.

    The findings were presented Feb. 19 at the American Academy of Pain Medicine’s annual meeting in Palm Springs, Calif. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

    Mafi said the small number of patients involved makes this more of a “pilot study.”

    “I wouldn’t jump to any changes in policy based on this study,” Mafi said. “This is a promising start, but now it’s time to do a rigorous clinical trial from this pilot data.”

    Dr. Nathaniel Tindel, an orthopedic spine surgeon at Lenox Hill Hospital in New York City, also sounded a cautious note, based on both the small number of participants and the fact that numerous prior radiofrequency treatments have failed to help people with low back pain.

    “Whenever there are a plethora of procedures offered to treat a condition which is known to heal best when left alone, those procedures are either all very effective or equally ineffective,” Tindel said. “Unfortunately, medical research has already shown us that intradiscal therapy falls into the latter category, and to date has not been shown to have long-term effect on back pain and disc disease.”

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