Dear Fibromyalgia

Tag: Fibromyalgia

An in-depth guide on Fibromyalgia, covering its symptoms, causes, treatments, and tips for managing this chronic condition effectively.

A Numb Arm Led to My Rheumatoid Arthritis Diagnosis

Have you ever slept in an odd position and when you woke up, your arm felt numb and you couldn’t lift it? Well that’s what happened to me a little more than five years ago. I went to bed feeling fine and when I woke up, I couldn’t lift my arm. Except for me, the feeling didn’t go away. My first thought was it must have something to do with the surgery I had years ago on my spine.

Six years before the morning with my arm, I had been lifting boxes and woke up with a stiff neck. For more than a year, I felt pain on and off. I ended up getting an MRI and once I did, I was told I needed immediate surgery to remove herniated discs in my neck. So it made sense to me that maybe my arm numbness was related to my neck issue from years earlier.

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I called my spine doctor and after completing a thorough exam, he told me that it was unrelated to my surgery and he thought I may have rheumatoid arthritis. I was in disbelief. I had felt fine the day before and I didn’t even feel bad the day of the appointment, other than the fact that I couldn’t lift my arm! My doctor drew all the bloodwork so he could verify the diagnosis and sent me home.

A few days later, he called and told me my rheumatoid factor, an antibody found in the blood of most patients with rheumatoid arthritis, was off the charts. Normal is considered between 10 and 20 and mine was greater than 600! He suggested I visit a rheumatologist right away to get started on treatment.

At this point, I was starting to feel more and more uncomfortable and experiencing some pain. Feeling fortunate that I live in an area with great access to many specialists, I called around to get an appointment. Every doctor’s office I spoke with said they could see me in August or September. It was March! How was I going to live with this pain? How was I going to work? I am a single mom with a full-time job. I couldn’t wait 5 months! This was the beginning of realizing that I needed to advocate for myself and my care. I called my spine doctor back and he was able to get me in for an appointment. The rheumatologist started me on a disease-modifying anti-rheumatic drug (DMARD) and after a few adjustments, I began managing the medical aspect of my condition.

What may have been even more difficult for me, however, was managing the emotional and mental aspects of being diagnosed with an autoimmune disease at the age of 49. I started out doing exactly what you shouldn’t do—googling my condition. Everything I read made me feel hopeless. On top of that, I found that every thought I had focused on my condition. I would constantly question—should I be eating this? Should I be doing different exercises? Should I try this new vitamin or supplement? Every thought I had was about rheumatoid arthritis. I remember saying to my mom that I can’t wait for the day that I can say this disease is something I have, not something I am.

I looked for a support group with people to connect but found nothing in my area. I found an organization called Arthritis Introspective (who have since merged with the Arthritis Foundation) and went through training to become a facilitator of my own support group. It started with me sitting in Wegman’s (my local grocery store) hoping for one person to show up and now, three years later, we have more than 100 people in our group. The connections within the group help me take power and control back into my own hands, while educating and learning to advocate for myself.

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You wouldn’t be able to tell by looking at me that I have rheumatoid arthritis. I work full-time, volunteer with the Arthritis Foundation, and am involved in my church. I spend time with family and friends and stay busy. Because of this, people often forget that I struggle at times. Some days I hurt more than others. Stress is a big factor in how I feel. And my flares tend to be different than other people. Rather than redness and pain in my joints, I feel extremely exhausted, like I’m coming down with the flu. If I’m very busy during the week, I need to take the weekend to recharge my battery. I no longer feel guilty if I stay in my pajamas or cancel plans. I’m constantly learning how to manage my time and my energy reserves.

In the autoimmune world, you often hear about the spoon theory. You start out with a certain amount of spoons each morning and you have to think about how you’ll use your spoons. If you have 15 spoons, it may take one spoon to get out of bed, two spoons to take a shower, another spoon to dry your hair, four spoons to go to work, and so on. My spoons are not endless like maybe someone who is healthy. I’ve learned to manage my spoons. If I work late two nights in one week, I know that I will have no spoons left for the weekend to socialize. It’s a daily struggle to balance what I can and can’t do.

I decided early on that I was not going to let this disease take over. I changed my diet, I found exercise that worked for me, and I found support. I am a platinum ambassador for the Arthritis Foundation, the leader of a top fundraising team for the Walk to Cure Arthritis, and the incoming board chair for our local leadership board. I tell people that the number one thing they need to do is to find their tribe and get connected. Not everyone in your tribe has to have arthritis, but they all have to understand that you are going to have bad days and good days. And your tribe should support you when you are struggling AND when you are celebrating!

After five years, I can finally say that rheumatoid arthritis is something I have, not something I am.

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02/08/2023
What You Need to Know About Acetaminophen Use during Pregnancy?

Two-thirds of American women take acetaminophen for pregnancy’s aches and pains. But the medication might not be as harmless as previously thought.

Research published in October online in JAMA Psychiatry shows that women who took acetaminophen (Tylenol) at the end of their pregnancies were much more likely to have a child with attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). After testing blood from the mother and the umbilical cord soon after birth, the odds of these developmental disorders were more than twice as high in children exposed to acetaminophen near the time of birth. The association was strongest between exposure to acetaminophen and ADHD in the child.

Researchers analyzed data from the Boston Birth Cohort, a long-term study of factors influencing pregnancy and child development. They collected umbilical cord blood from 996 births and measured the amount of acetaminophen and two of its byproducts in each sample. Participants‘ average age was 10 and slightly more than half were boys. When the children were an average of 8.9 years, 25.8 percent had been diagnosed with ADHD only, 6.6 percent with ASD only and 4.2 percent with ADHD and ASD. Just over 30 percent had another developmental disability. Almost 33 percent had no developmental concerns.

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Researchers classified the amount of acetaminophen and its byproducts in the samples into thirds, from lowest to highest. Compared to the lowest third, the middle third of exposure was associated with about 2.26 times the risk for ADHD. The highest third of exposure was associated with 2.86 times the risk. Similarly, ASD risk was higher for those in the middle third (2.14 times) and highest third (3.62 times).

Authors found that their results support earlier studies linking acetaminophen exposure in the womb with ADHD and ASD. While the study found an association between an expectant mother’s use of acetaminophen and the development of ADHD and possibly autism in her child, it can’t prove a definitive cause-and-effect link.

Doctors Weigh In

Don’t panic if you’ve taken acetaminophen during pregnancy. “I wouldn’t worry if you’ve already taken acetaminophen purely based on the results of this study,” says Rashmi Kudesia, MD, M.Sc., a reproductive endocrinologist and infertility specialist who practices at CCRM Fertility Houston in Houston and is Assistant Clinical Professor of Obstetrics & Gynecology at Houston Methodist Hospital. She is on the Women’s Health Advisory Council. “This study only looked at umbilical cord blood, reflective of the time right around delivery. What, if anything, that means for earlier acetaminophen use, is unknown.”

Talk about medication use with your doctor. If you’ve already taken acetaminophen, don’t worry. “As for this study, since the genetics and environmental etiologies of autism and ADHD remain poorly understood, I would advise caution in linking Tylenol to causation or increased fetal risk,” says Dr. DaCarla M. Albright, MD, Associate Professor of Clinical Obstetrics and Gynecology at the University of Pennsylvania School of Medicine and an Assistant Dean for Diversity and Inclusion, with a focus on Wellness, at the Perelman School of Medicine at the Univeristy of Pennsylvania in Philadelphia. She is on the HealthyWomen’s Women’s Health Advisory Council. “We have more to learn.”

Most doctors have a ‘safe-during-pregnancy’ list of medications they’ll provide early in pregnancy, Dr. Kudesia says. “Even with this study, acetaminophen remains among the safest drugs for pain during pregnancy,” she says. NSAIDs like ibuprofen aren’t recommended, and neither are narcotics. If your pain is chronic, develop a long-term pain management plan ahead of time to avoid or reduce repetitive use of acetaminophen. “This latter recommendation is one I’ve always made, and it’s unchanged by the findings of the current study,” she says. For certain conditions, like migraines, there may be specialized prescription medications that work best. “But out of over-the-counter options, acetaminophen remains the best alternative,” she says.

If you get a fever during pregnancy, talk with your obstetrician before medicating; it may be a sign of pregnancy complications and may need further evaluation. Tylenol is your safest medication for fever management, says Dr. Albright. Non-medication alternatives, like ice packs or warm compresses (don’t apply heat directly to your abdomen in pregnancy), or alternative approaches such as massage or acupuncture, depending on the type of pain you’re experiencing. “Discuss the desire to take any medication in pregnancy with your physician,” she says. “It allows your physician the opportunity to appropriately triage the condition and make the best recommendations for you.”

The study was funded by the National Institutes of Health and the Agency for Health Care Research and Quality. The study was conducted by Xiaobing Wang, M.D., of the Johns Hopkins University Bloomberg School of Public Health, Baltimore, and colleagues.

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02/07/2023
4 Tips for Pain Relief Quick

When you’re in pain, you have one thing on your mind – please make it stop. Luckily there are many pain management options out there, some work faster than others, and some even have an immediate effect. And while opioids can serve an important function, my advice for patients is to try a non-medication approach first. The following pain-relief tips are sustainable and most importantly they’re often times effective for many types of pain conditions when combined with a comprehensive treatment plan.

1. Go for a walk:

Being active is great for your health as seen in many studies. It can help strengthen muscles and extend your life, when combined with a comprehensive pain management routine. Any physical activity should first be discussed with your doctor, and be adjusted based on your ability to tolerate your symptoms and function; however, there are plenty of low-impact exercises that can have a positive impact on your pain. Walking is one of them. It can be done anytime and almost anywhere, and the simple act of moving can work wonders on relieving certain symptoms, especially chronic back pain. Some ideas on how to incorporate walking into your daily routine could include: take your dog for a quick stroll first thing in the morning when you may be feeling especially stiff, choose the farthest parking space, use the office restroom or the walking route that’s out of your way at work.

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2. Take massage into your own hands:

Massage is a popular pain-relief option due to its many pain-relieving benefits; however, making an appointment at the spa can be prohibitive due to time and cost. So if you are one of the many individuals whose day is filled with work, errands and other responsibilities, a handheld at-home massager can be a much needed relief. For example, the Wahl Deep Tissue Massager is one of the most powerful massagers currently available. It offers customized relief through a combination of interchangeable heads and variable intensity control.

One of the biggest advantages of incorporating at-home massage into a comprehensive pain-management regimen is convenience and the fact that it provides relief fast. Massage relieves muscle tension by enhancing blood flow, which causes muscles to relax. It also decreases inflammation by activating genes that can naturally reduce swelling, it reduces pain intensity by diminishing bodily substances that create and prolong pain and it improves recovery by stimulating mitochondria, the “energy packs” driving cellular function and repair.

3. Stay hydrated:

Water can be an easy way to stem pain at the source. Keeping water nearby and making sure you drink at least eight 8-ounce glasses daily can make all the difference when trying to combat pain. In general, your body needs water to work properly, to lubricate and cushion your joints, to protect your tissues, to keep your temperature normal and to get rid of wastes. A lack of water can lead to dehydration and drain your energy even further, leading to exhaustion and more painful symptoms. Water is a key element in keeping balance in your body and overall health.

4. Take a dip.

I already covered the miraculous effect water can have on your body from the inside, but it has soothing powers from the outside too. Depending on the source or your chronic pain, a warm bath can offer respite from your discomfort. Being submerged in water reduces the stress of body weight and gives all-over support, easing pressure on your joints. What’s more, the warm and even temperature stimulates blood flow throughout your body helping to loosen stiff, painful muscles.

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02/06/2023
Suffering From Chronic Pain as a Black Woman

Every time Jaime Sanders visits an urgent care clinic, she makes sure she brings the three-ring binder that details her comprehensive medical care plan, including lists of medications, allergies and records of past doctors’ visits.

Sanders knows she’s never guaranteed to find doctors who will take her migraine pain seriously and carries the binder as proof of her diagnosis. Still, Sanders remembers how one doctor she saw regularly groaned and said, “Oh, it’s the binder,” when she saw Sanders. The doctor followed by asking if Sanders was doing everything she could for her migraine pain.

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“These situations keep me from wanting to seek the treatment I need,” Sanders said. “It’s traumatizing, and who wants to keep being retraumatized? Sometimes I feel like turning around and just going home. It seems like it offends some people that I know so much about my illness.”

An estimated 50 million Americans suffer from chronic pain daily or almost daily, according to a 2018 Centers for Disease Control and Prevention study, and 19.6 million experience high-impact chronic pain. The study found that women, older adults, adults living in poverty and adults without health insurance were more likely to have from chronic pain, but race was not directly associated with chronic pain prevalence.

Racial bias

It’s possible, however, that Black women’s pain is underdiagnosed. A New York University study examining bias in pain management found that white health care professionals were less likely to perceive pain on the faces of Black patients compared to white patients, which contributed to different treatment decisions.

In an Association of American Medical Colleges editorial, Dr. Janice Sabin highlighted research where significant percentages of white medical students believed Black patients had thicker skin or less sensitive nerve endings, making them less likely to suffer from pain. Another study she cited found that white pediatricians were less likely to prescribe pain medication for a Black teenager after surgery than a white teenager.

Even a CDC paper issuing guidance on prescribing opioids for chronic pain noted that members of racial and ethnic minority groups could be at risk for inadequate pain treatment.

Sanders, who is Black, has been blogging at The Migraine Diva about her chronic pain due to migraine, fibromyalgia, depression and anxiety since 2011. She has a family history of migraine headaches and received her diagnosis at the age of eight. She received compassionate care as a child, but as an adult she’s faced microaggressions in health care facilities, from the mocking of her health binder to being refused a doctor-prescribed treatment from another doctor who told her it was unsafe — despite research showing otherwise. Sanders remembered the latter doctor telling her he was able to manage his own migraine headaches, and that 90% of his patients were able to control their headaches with lifestyle changes.

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“It’s like he was blaming me for my pain,” said Sanders. “I worry about so many layers to my health care — how I speak, how I dress when I arrive at the doctor’s office — it’s exhausting and mentally draining.”

Tiffani Stokley suffered from joint pain and headaches for 10 years before being diagnosed with lupus in 2006. The path to her diagnosis wasn’t direct — she said doctors failed to dig deeper into the issues causing her pain until a blood test finally provided clues that led to the lupus diagnosis. Black women are three times more likely than white women to develop lupus, a chronic autoimmune disease that can damage any part of the body, and as many as one in 250 Black women will be diagnosed with lupus.

Applying the biopsychosocial model of disease developed by George Engel in the 1970s could help improve outcomes for Black women experiencing chronic pain. This model encourages doctors to look at a continuum of biological, psychological and social factors that could affect a patient’s health, instead of focusing on the pain alone. One’s mental health or work environment could exacerbate physical pain, for example, and, under this model, a health care professional would look at every factor in a particular woman’s life to address and treat the pain.

Earlier this year, Stokley experienced yet another dismissal of her pain. She went to the emergency room after having complications from a kidney stone removal procedure and, during recovery, an emergency room nurse questioned her need for pain medication. Eventually, an attending doctor noticed the pain on Stokley’s face and got her the medication she needed.

“Some instances, I feel like I’m dismissed because I’m a woman, and a Black woman in particular, or it can just be a lack of compassion that doctor or nurse has in general,” Stokley said. “You don’t know sometimes how to get them to take you seriously. I’ve seen people be really dramatic and not be heard, but even if you speak to the doctor in a reasonable way, that doesn’t guarantee they’ll pay attention either.”

A purpose to the pain

Stokley’s observation echoes Sanders’ point about the fine line Black women walk when trying to manage their pain. When Sanders began blogging, she hoped to create a support system and talk with others about her life as a wife and mother of three children, managing a household while dealing with chronic pain. She later began receiving invitations to speak on health panels, launching her into her current role as a patient advocate.

“This gave my pain a purpose, and I found empowerment from that,” Sanders said. “It allowed me to come to terms with my pain and recognize that it doesn’t define me.”

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02/04/2023
Avoiding Pain While Doing Laundry and Making the Bed
Coping with chronic pain can be difficult. You have to alter practically all facets of your life to cater to your treatment needs. The spring season is quickly approaching, pushing a lot of us to clean out hoarded closets and re-organize messy rooms, while simultaneously making sure our pain is managed.

At Chronicillness.co Site of United States, our providers know the burden that household chores can put on people living with chronic pain. Whether you have neuropathy, fibromyalgia, or back pain, spring cleaning can be a pain. We encourage people to seek medical advice from professionals at any of Chronicillness.co Site locations and get back into life, today!

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Laundry and housecleaning are inevitable parts of human life. People who have pain from strenuous movement and heavy lifting should follow the following tips while cleaning laundry:
- Avoid heavy lifting. Separate your clothes into different piles to prevent strenuous pressure on your back. When bending, use your knees and your feet; not your back!
- Avoid twisting. Some household laundry rooms have cabinets above their washers and dryers. Use a step stool when reaching for the detergent or fabric softener. If you are required to reach for something low, kneel down slowly.
- Stand to sort, fold, and iron clothes.
- Don’t overindulge. Do one major cleaning task each day.
You will likely have to transfer your laundry from the dryer into the bedroom. Chances are, some of that laundry will include bed sheets, which poses another hurdle for pain sufferers. Take a look over these tips for making the bed using proper pain management techniques:
- Wear loose clothing, giving your arms room to stretch.
- Make one side of the bed at a time.
- Do the farthest corner first.
- Do not lean across the bed to tuck in the corners. Instead, rest on your knees on the bed in the area where you need to tuck the sheets.
- When tucking in the sheeting, keep your back straight. Avoid twisting and turning.
Spring cleaning requires a lot of work. Don’t be afraid to ask a loved one or friend for help during your chores. For more information on cleaning tips to avoid pain, contact a Pain Care physician, today! Keep an eye out for more tips to avoid pain while spring cleaning.

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02/04/2023
In a World of Pain

When Marin Hinkle tells you about her work, family and friends, you can hear the excitement and love in her voice. But behind that serene smile you see on television, in her roles on shows such as “The Marvelous Mrs. Maisel”and “Two and a Half Men,” is a woman who struggles daily with agonizing chronic pain.

“My pain originated in my pelvis, and it’s around my pelvic girdle on the left side of my body,” explains Hinkle. The pain began in 2015 and took a long time for doctors to identify. “It’s one of the most difficult areas to diagnose, and it’s one of the most painful areas a human can experience pain.”

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Hinkle had a history of kidney stones, so when the pain began, that’s what she thought it was. Because she was shooting a television pilot, she tried her best to ignore it. That didn’t last.

“I was in excruciating pain, and I didn’t understand why it was lasting so long,” she recalls.

When the pain just wouldn’t stop, Hinkle ended up in a pain program at Cedars-Sinai Hospital. Doctors initially tried to break her pain cycle by giving her an epidural injection, which numbed her pain for six hours. For some patients, that’s enough. Unfortunately, it wasn’t for her.

“After it wore off, the pain came racing back,” Hinkle says.

Hinkle was temporarily prescribed opioids to help her get through work. But she didn’t like how they made her feel — sleepy and drugged. When the pilot project finished, she stopped taking them.

The pain returned.

“I began a journey that took about two years. [I had] to figure out how I was going to live with this kind of pain,” says Hinkle.

For four months after the pain returned, she was bedridden and for a year and a half after that, she didn’t work. “I didn’t even want to get into cars to go places because every time I sat, I had pain in my pelvis.”

Hinkle saw specialist after specialist, and each one seemed to think her pain was caused by something different.

“I had seven different diagnoses,” says Hinkle. One of those was interstitial cystitis, which resulted in her trying everything from changing her diet to having her bladder numbed. Nothing worked.

Searching for an answer

“I was my own advocate,” Hinkle says. “I basically had to crusade to figure out what was wrong. I would often meet with doctors who weren’t sensitive, and some thought I was being overly emotional because I’m an actor. One neurologist actually said to me, ‘You’re too smart for all this.’ I started to think I had become crazy. I remember weeping in doctors‘ offices.”

Six months later, having seen doctor after doctor and undergone test after test, Hinkle found a female physician who took her seriously. “She was kind and thoughtful. She started writing letters to get me seen at the Mayo Clinic in Minnesota for a week and then in the chronic pain program at Cleveland Clinic for a month,” says Hinkle.

At the Cleveland Clinic, during a pelvic pain workup, Hinkle was given a diagnosis of pudendal neuralgia, which occurs when a major nerve is damaged in the lower body and can cause everything from pain and discomfort to numbness in the genital region. Doctors aren’t sure how she damaged the nerve; it could have been the result of a gynecological procedure where a nerve was pinched, along with her exercise of choice, which had been cycling.

Although she finally had a diagnosis, the pain remained. The pain program, however, taught her how to live with it. “They taught me that I can still do all the physical stuff I used to. I’m just going to be doing it in pain,” says Hinkle.

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A couple of months after she completed the pain program, Hinkle went on her first audition in a long time. She was cast as Dr. Miller in the sitcom ” Speechless.” “That reignited my career and allowed me to prove to myself that I could work with the pain,” Hinkle says. In fact, she based the optimistic character in the sitcom on a woman who is in pain and has decided she won’t let it get to her.

Hinkle’s next audition was for the role of Rose Weissman in “The Marvelous Mrs. Maisel.” Landing that part changed her life; in 2019 it earned her her first Emmy Award nomination for outstanding supporting actress in a comedy series.

Hinkle as Rose Weissman in “The Marvelous Mrs. Maisel,” Courtesy of Amazon Prime Video

“Through this, I was able to show that I’m back working. At the end of the day, when the work is finished, the pain surges again. So that’s not to say I don’t feel it when I’m working, but the work is so much more than the pain.”

During her search for the source of her pain, Hinkle says that the intimacy in all her relationships — with her husband, son, mom, and her friends — was altered and stressed. Nevertheless, they all supported her. “I thank God that I had love in my family because the isolation of pain is so difficult. I see why people crumble. You feel like you’re in a nightmare, and no one understands,” she says.

Friends helped her too. A women’s group she belongs to called The Hyphenates — they’re all actors who are also writers, directors, teachers and the like — sent her books, tea, cups, handmade bookmarks in beautiful fabric and letters in which they expressed their compassion and love for her. “That buoyed me and kept me going,” she says.

At the time, her son was in middle school. Before the pain, Hinkle had been the fun mom who would clown around with her son and attend all of his school events. But when she was in so much pain, that stopped.

While writing an essay to get into a private high school, her son was asked, “What’s the greatest challenge that you’ve faced?” His answer, Hinkle says, broke her heart: “When my mom wasn’t able to do all the fun things that she used to.”

Today, Hinkle says she’s still in pain all the time. In the morning, it’s less, but by nightfall, it fires up. She takes an anti-seizure medicine and a low-dose antidepressant to help with the pain. Although Hinkle can’t exercise like she used to, as even yoga hurts, she finds gentle movement on an elliptical machine helps. “The only other thing I let myself do is walk, and I walk as much as possible,” she says.

For other women with chronic pain or other chronic health problems, Hinkle suggests they look at what they loved doing before their issues began. “Let yourself indulge in them in a way that’s even more enhanced … Rely on loved ones for support, take in the outdoors when you can, and take in the little details of life, like making a pie or taking a shower.”

Hinkle says another thing that helped her was adopting a rescue dog, and she highly recommends having the gentle love of an animal.

During the 12 years she acted on “Two and a Half Men,” Hinkle always performed in a play each year as well. But with her pain at night, she stopped. “My dream,” she says, “is to get back on the stage.”

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02/03/2023
Minimizing Back Pain While Doing Dishes and Cleaning the Floor
17 Expert-Backed Ways to Dramatically Minimize Back Pain While Doing Dishes and Cleaning the Floor

Back pain is one of the most common complaints among adults, and surprisingly, everyday household chores like washing dishes and cleaning the floor can be significant contributors. These tasks, though simple on the surface, require repetitive motions, bending, and prolonged standing, all of which can strain the lower back. The good news is that by making small changes to your daily routine and technique, you can dramatically reduce your risk of discomfort or long-term injury.

This article explores practical, expert-backed strategies for minimizing back pain while doing dishes and cleaning the floor. By implementing these techniques, you can keep your spine supported and your muscles relaxed, ensuring your home stays clean without taking a toll on your body.

Understanding the Root Causes of Back Pain During Chores

The human spine is designed for movement, but it thrives on proper alignment and balanced activity. When you bend forward at the waist, twist repetitively, or remain in one position too long, you stress your lumbar spine and surrounding muscles. Dishwashing often involves leaning forward over a sink, while floor cleaning requires bending and twisting—especially when using traditional mops or cleaning on hands and knees. These positions lead to muscle fatigue, poor posture, and increased pressure on spinal discs.

Ergonomic Positioning at the Sink

Standing at a sink for long periods while doing dishes can cause a slight but continuous forward lean, which puts pressure on the lower back. To counter this:
- Elevate one foot on a small stool or open cabinet base while you stand. This shifts weight and eases spinal pressure.
- Lean slightly forward by hinging at your hips, not curving your back. Maintain a straight spine.
- Stand close to the sink, so you’re not stretching your arms out for too long. This reduces upper back and neck tension.
You can also place a thick anti-fatigue mat under your feet to cushion your stance and encourage better posture.

Choosing the Right Tools for Floor Cleaning

Floor cleaning often leads to discomfort because of repetitive bending, kneeling, or twisting. Consider these tool upgrades:
- Use a long-handled mop or broom that allows you to stand upright. Avoid hunching over.
- Choose lightweight cleaning tools to reduce strain on your back, arms, and shoulders.
- Opt for a microfiber mop that glides easily across surfaces, requiring less physical effort.
If you’re cleaning manually, such as scrubbing a floor by hand, consider using knee pads and placing one hand on a surface for support while the other scrubs.

How to Bend Safely

Incorrect bending is one of the fastest ways to trigger or worsen back pain. The key is using the hips and knees, not the spine.
- Always bend at the hips and knees, not your waist.
- Keep your back straight when lowering yourself.
- Engage your core muscles for additional support during movement.
- When picking something off the floor, use a squatting technique instead of bending forward.
Pacing Yourself with Breaks and Movement

Even when practicing good posture, prolonged periods of dishwashing or floor cleaning can still cause fatigue. It’s important to introduce frequent breaks:
- Take a break every 20 to 30 minutes. Walk around, stretch gently, or shift tasks.
- Alternate between tasks that require standing and those that allow you to sit.
- Perform light back stretches before and after chores to keep your muscles flexible and warm.
Keeping a small timer or reminder can help ensure you don’t forget to pause and reset your body.

Engaging the Core and Improving Strength

One of the most effective ways to minimize back pain during chores is to strengthen the muscles that support your spine, particularly the core. A strong core stabilizes the lower back and reduces the chance of injury.

Incorporate these habits into your routine:
- Practice light core exercises such as planks, bridges, or abdominal tightening routines.
- Engage your abs gently while doing chores, particularly when bending or twisting.
- Focus on posture throughout the day, even when not cleaning.
Over time, stronger muscles will make household tasks feel less tiring and risky.

Wearing Supportive Footwear

Many people do chores barefoot or in soft slippers, which may not provide adequate support. The result is misalignment through the legs, hips, and back.
- Choose firm-soled, supportive shoes when standing or walking for extended periods.
- Avoid flip-flops or completely flat footwear.
- If you’re working on tile or hardwood floors, proper shoes can prevent slipping and help with posture.
Designing a Back-Friendly Cleaning Routine

Smart planning can reduce the physical toll of housework.
- Break large cleaning jobs into shorter sessions over several days.
- Use tools like robot vacuums or automatic scrubbers for basic cleaning.
- Store cleaning supplies at a mid-level height to avoid bending or reaching.
This proactive approach helps reduce cumulative strain on your back while still keeping your home in top shape.

Using Temperature and Relaxation Techniques

After cleaning, your muscles might feel tight or sore. Taking care of your body post-task is just as important.
- Apply a warm compress or heating pad to your lower back to soothe tense muscles.
- Try gentle yoga or stretching to increase blood flow and flexibility.
- A short warm bath or shower can relax overworked muscles and reset your posture.
When to Seek Help

While mild back pain is common, recurring or severe discomfort may signal an underlying issue. If your pain persists:
- Consult a physical therapist for personalized ergonomic advice.
- Speak to your doctor if you notice pain radiating to the legs or worsening over time.
- Consider a chiropractic evaluation for alignment issues.
Early attention to symptoms can prevent chronic issues and help you return to pain-free living faster.

Frequently Asked Questions

1. Can dishwashing really cause back pain?
Yes, standing in one position for extended periods and leaning forward over the sink can strain the lower back, especially without proper posture.

2. What’s the best posture for mopping or sweeping?
Keep your back straight, bend slightly at the hips, and use long, sweeping motions with minimal twisting. Switch hands regularly to balance the strain.

3. Should I wear shoes while doing chores?
Yes, supportive footwear can reduce the impact on your spine by aligning your feet, knees, and hips correctly during movement.

4. Is it better to use a mop or scrub on my hands and knees?
Using a mop is generally better for your back. If you must clean by hand, use a cushion under your knees and keep your back as straight as possible.

5. How can I strengthen my back to prevent pain during cleaning?
Incorporate core-strengthening exercises like planks and pelvic tilts into your weekly routine. This builds support for your spine during physical activity.

6. Are ergonomic tools really worth the investment?
Yes. Long-handled, lightweight, and well-designed tools can drastically reduce the need to bend or twist, preventing fatigue and injury.

Conclusion

Minimizing back pain while doing dishes and cleaning the floor isn’t just about avoiding discomfort—it’s about protecting your long-term health. By applying ergonomic principles, using proper tools, and staying mindful of posture and movement, you can transform your daily cleaning routine into a safer, more comfortable experience. These small adjustments may take time to adopt, but they offer lasting benefits for your spine and overall well-being.

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02/03/2023
Resilience and Other Tools for Overcoming Barriers to Care for Women with Chronic Pain
We can all build resilience, but our circumstances are not all the same. Some women face more barriers than others. The common barriers we all face include:
- Poor reimbursement by health insurance for many pain treatments
- A society where pain is undertreated, and the conditions causing it are often misdiagnosed
- Stigma associated with chronic pain
- The lack of medical education about pain
- The lack of pain specialists in the U.S.
- The lack of research funding compared with pain’s prevalence and its impact, especially on women, among so many other obstacles
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I discovered this world of barriers in 1994 after a surgical injury to my spine caused severe pain, and I was unable to sit, stand or walk more than a couple of feet with a walker for the next 15 years. I basically had to navigate the world lying down.

“Resilience” is often defined as the capacity to recover from difficulties—having a certain toughness. When you have chronic pain, it is less about recovering and more about adapting to new circumstances, because the pain persists; it is ongoing or continuous. Perhaps the definition of resilience as “springing back into shape” or “elasticity” is a better fit. All of us have the capacity for resilience, and tapping this resilience can help us move forward.

To me, resilience is the ability to adapt and thrive despite ongoing and difficult circumstances. For example, figuring out how to continue to do my job when I could only lie down enabled me to continue to pursue my interests and have an income, although I couldn’t do things in the same way or participate in work that required travel.

It’s a fact that resilience in our society is mostly about resources. Women with good medical care, a job that offers a living wage and access to sick leave fare better—whether the difficulty is coping with an inadequate health care system or recovering from the impact of a natural disaster, for example. This matters because resilience is partly about our inner reserves and partly about what comes to us from the outside in terms of both resources and difficult experiences.

Trauma occurs when difficult experiences overwhelm our inner reserves. If we have more resources, the difficult experience may not overwhelm us. Regardless of our circumstances, cultivating resilience can help us buttress those inner reserves.

How can I harness resilience?

First, focus on those things you can control. Chronic pain is difficult because it endures; it can feel like it has always been and will never end. Taking things a day or even a moment or an hour at a time can really help because the pain intensity is rarely exactly the same at every moment. Seize moments that give you an opening to do something that feels useful; often, those moments can accumulate. If you are having an especially grueling period, give yourself permission not to be productive and be kind and gentle with yourself.

Second, use any social and cultural resources available to you. They provide emotional buffers. Pain is an assault on intimacy. You may not be able to participate in shared social activities, and your family and friends can’t see or experience what you do. Chronic pain can separate us from others. But we have to find ways to cultivate this needed connection. Early in my pain experience, I found it helpful for my friends to sit with me and describe their vibrant hiking and camping experiences—the activities that once were such a big part of my life. When I was bedridden, I would sometimes virtually accompany friends to dinner or small parties or even join via cell phone while my friends ran errands or went through the ordinary tasks of their days.

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I’ve tried numerous techniques over the years that helped, including meditation and relaxation therapy, journaling, drawing and deeply taking in fine art. Resilience can show up unexpectedly. For example, when I started to draw, I barely had the energy to put pen to paper. Then, I noticed that sketching helped me focus outside of myself and awakened different parts of my brain. An entirely new reserve of energy surfaced. Looking at art on the thousands of museum websites that have their collections online opened up new worlds to me, while not requiring the focus of reading an entire novel or watching a play.

Third, don’t expect too much of yourself. The only way to be resilient is to accept the new normal and your current capabilities. We can’t expect to do all the same things in the same ways that we did before chronic pain. If your work life is challenging, consider asking your employer for accommodations. Under the Americans with Disability Act, employers are required to make appropriate accommodations for you. You can ask to telework or request projects that are less deadline-intensive when you are in a flare-up. If you can afford it, consider a part-time or flexible schedule when things are especially difficult. Whether these accommodations will be provided will depend on your employer’s circumstances too—such as how large and well-resourced they are.

I was fortunate because I worked in the Civil Rights Division at the Department of Justice when my pain began—the office that enforces the Americans with Disabilities Act—so they were especially accommodating to me.

And, reach out: Ask for help. Resilience isn’t about going it alone. When things get rough, I try and focus on these five concepts:
1. Pleasure. Find what makes you feel good and hold on to it.
2. Patience. Pain is an endurance test, so it is really important to be patient with yourself.
3. Perseverance. Find a way to reach out to others, to make and sustain social contacts.
4. Pause. Take time out when you need to rest, and try and find those things that give you a sense of relaxation and stillness.
5. Perspective. Even with the most intractable chronic condition, there are always ebbs and flows. Holding on to the times that are better and remembering them is important, so you don’t feel like you’re just stuck in an unrelenting rut.
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02/02/2023
3 Easy Desk-side Stretches to Keep Muscle Pain at Bay

If you’re not taking regular breaks to move around during your workday, your muscles may rebel after being scrunched in your desk chair hour after hour.

The rebellion might be felt in your neck, shoulders, back, hips and legs when you do finally stand up. Stop the insurrection with these three simple stretching exercises you can do without even leaving your workstation or office.

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Start with the lateral lean. Stand up straight and clasp your hands behind your head. Turn your head toward your left elbow and then lean your torso in the same plane to the right — don’t bend forward or backward. Hold the stretch for 30 seconds and then repeat the stretch to the opposite side.

Next move to the standing hip flexor. Despite its name, it helps the legs as well. Lightly place your left hand on your desk for balance and bend your right knee, bringing your right foot behind you toward your right glute. Grip the right ankle with your right hand to gently press the heel toward your butt. Contract both sides of your glutes and keep your knees close together and your spine straight. Hold for 30 seconds and then repeat with the left leg.

Finish with the open and closed upper body stretch. It helps prevent both lower back and shoulder pain. From a standing position, hinge forward from the waist, letting your arms hang toward the floor. Take a few deep breaths and then slowly stand up straight as you move your arms out to the sides in line with your shoulders. Rotate your thumbs backwards with your palms facing the ceiling. Think of bringing your thumbs together behind you as you open your upper chest toward the ceiling. Hold for 30 seconds and repeat up to four times in total.

Take three minutes every two or three hours — more often if you can — to do these simple moves. Your body will thank you.

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02/01/2023
Chronic Pain Is a Disease and It Should Be Treated Like One

More than 20 years ago, a heavy filing cabinet fell on Cindy Steinberg at her office and caused nerve and ligament damage to her back. The pain never went away. In the years after, she became an advocate for people who experience chronic pain and is currently the national director of policy & advocacy for the U.S. Pain Foundation.

In 2011, a landmark report titled “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research,” made the case for the National Institutes of Health (NIH) to define chronic pain as a brain and nervous system disease. However, the change has not been implemented, in part because awareness among other organizations and practitioners is still lacking.

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“The problem is that [chronic pain being a disease] is not widely understood by the public or even (healthcare) providers because pain and advances in pain neuroscience [are] rarely if ever taught in medical school or other professional schools and the public is completely in the dark about this … until it happens to them or a loved one,” Steinberg wrote in an email.

If chronic pain was better understood as a disease, those who live with chronic pain as well as those who research it would benefit immensely. The classification could unlock research funding as well as open the door to drug approvals, and help change attitudes in medical communities. Most important, for consumers, it could pave the way for chronic pain to be covered under health insurance.

According to Monica Mallampalli, Ph.D., senior advisor, scientific & strategic initiatives at chronicillness.co, classifying chronic pain as a disease could create a structure for how pain can be addressed. She emphasized the need for advocacy and education to make that happen.

“Advocacy can help Congress to mandate [chronic pain] as a disease and ask for funding to be allocated to study it as a disease,” Mallampalli, who is also a member of Chronic Pain Advisory Council, wrote in an email. “If that happens, NIH will be asked to put a budget on how to address this.”

“The problem is chronic pain is so complex and includes many diseases and conditions,” she added. “I think it will take time and effort to break those silos.”

What is chronic pain?

There are two types of pain: chronic and acute. Acute pain is usually the result of a specific cause — think broken bone or a burn — and goes away once that injury heals. Chronic pain lasts for longer than six months after an injury heals or an illness ends.

There’s also high-impact chronic pain, which NIH defines as pain that has lasted at least three months and restricts someone’s ability to work, go to school, or accomplish household tasks.

“It robs your life of any quality,” said Steinberg, who cannot sit or stand for more than an hour at a time.

How many people have chronic pain?

Fifty million people in the U.S. — 1 in 5 Americans — live with chronic pain, according to a 2018 study from the Centers for Disease Control and Prevention (CDC).

Additionally, of the nearly 50 million Americans with chronic pain, about 20 million have high-impact chronic pain, and 11.3 million of those are women, according to the CDC.

How is chronic pain treated?

“The historical view of chronic pain and pain in general has been that pain is a symptom of some other derangement in the body, and the pain is important only in that it’s a signal of something else that is wrong,” said Dr. Roger Fillingim, a professor at the University of Florida who has spent more than 25 years researching chronic pain.

Under the traditional mindset, healthcare providers (HCPs) would then follow a basic biomedical method: Find the source of the pain, treat it, and the pain goes away.

“Frankly that would be just fine if that perspective worked, but for the tens of millions who currently have high-impact pain and have sought many treatments to try to get rid of whatever the derangement that physicians think is causing it, that approach to chronic pain hasn’t been very effective,” Fillingim said.

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When part of your body suffers harm, it sends signals to your brain — known as neurotransmitters — that cause you to feel pain. But with some forms of chronic pain, those neurotransmitters don’t turn off, causing a type of feedback loop where the pain continues even though the initial injury has already healed.

“Increasingly, it’s clear that the brain seems to change significantly in people with chronic pain,” Fillingim said. “Regardless of where pain starts, it’s only pain if it’s in the nervous system. No brain, no pain.”

Instead, researchers including Fillingim are studying how to treat the nervous system and how it processes pain. Rather than searching for a source outside the brain, they’re focusing on the brain itself.

How does chronic pain affect women in particular?

Numerous studies have shown that HCPs are less likely to take women’s pain seriously, especially when it comes to chronic pain, than they are for men. Antidepressants may be prescribed to treat chronic pain, and women are more likely to end up with a referral to a mental health provider than have their pain taken seriously.

This is where it gets complicated because chronic pain is a risk factor for people to develop anxiety and depression, and vice versa. As a result, medical providers may dismiss patients’ pain as part of their mental health disorder.

“The concern is that people with chronic pain conditions will have their pain minimized and perceived as just another symptom of their psychological condition,” Fillingam said.

How can classifying chronic pain as a disease help chronic pain sufferers?

Recognizing chronic pain as a disease would be a game changer in terms of how insurance companies address treatment options. A 2017 review of state-based health insurance plans found that the majority did not cover nonpharmaceutical treatment options for people with chronic low back pain, for example.

“Acknowledging the burden of pain and how this disease has affected so many millions of people should lead to pressure on insurers to approve coverage for more treatment,” Steinberg said.

Maria Willson, senior policy advisor at chronicilness.co, said getting the condition classified as a disease is a concept that has value because insurers pay medical bills based on CPT codes for disease evaluation, diagnosis and treatment submitted by providers. This can give insurers control over which treatment doctors can give a patient so that they will be reimbursed and not have to pay out of pocket for costly care that they may not be able to afford otherwise.

“While I think this is changing slightly, it is more likely HCPs have figured out ways to bill,” Nolan wrote in an email. “With the bias toward treating something recognized as a disease as opposed to something unidentifiable or harder to classify, making the change could help with coverage as well as people with chronic pain not being dismissed by doctors.”

By increasing chronic pain research and training, experts hope that HCPs will be better informed when speaking to patients about their pain and that if HCPs understand that this is disease like any other disease, patients will in turn receive better treatment.

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01/31/2023