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Showing posts from June, 2014

Non Drug Pain Management Ideas: Coping with Lupus in the mornings

A few months ago, I wrote a blog post about Lupus Disease;  it is an autoimmune disorder that is related to Rheumatoid Arthritis.  While I took the time to describe the disorder and the various problems that arise from the disease, there was not much about the pain management aspect in that post.



At this point, there is more information to share --and here it is!
People with lupus disease often feel stiff and exhausted in the morning.  It has been suggested that moist heatcan help provide some relief.  Try a bath or a long hot shower in the mornings; if that is not possible try using a moist heating pad for about thirty minutes prior to wake up time. Another option is to purchase an electric blanket with a timer, and set it to come on one half hour before you need to wake up for the day.

If you think ahead, you could set things up for morning in the kitchen before you go to bed.  If the table is set and the coffee pot is ready to go, life is good!


It's important to face the day kn…

The Gout Diet

If you've been following this series on gout, you know that there are dietary modifications that can be made to prevent recurrence of gout flare-ups. Yesterday, it was mentioned that coffee, vitamin C supplementation, and cherries and other dark colored fruits seem to help keep uric acid levels in check.
I know it's hard to believe--but there are even more dietary measures that can be used to help control gout.  There is actually a gout diet, and here are some highlights as suggested by the Mayo Clinic:




To follow the diet:
~Restrict intake of meat, poultry and fish. Animal proteins are high in purine. Avoid or severely limit high-purine foods, such as organ meats, herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all meat, poultry and fish contain purines, limit your intake to 4 to 6 ounces (113 to 170 grams) daily.

~Cut back on fat. Saturated fat lowe…

Gouty Arthritis Part III: Non Drug Treatments

If you've been diagnosed with gout and are taking medication to control the condition, you might be surprised to know that there are more things that you can do to stay ahead of the curve.  Here are some non pharmacological lifestyle modifications/alternative medicine suggestions from the Mayo Clinic:
Drink 8 to 16 cups (about 2 to 4 liters) of fluid each day, with at least half being water.Avoid alcohol.Eat a moderate amount of protein, preferably from healthy sources, such as low-fat or fat-free dairy, tofu, eggs, and nut butters.Limit your daily intake of meat, fish and poultry to 4 to 6 ounces (113 to 170 grams).Some foods may actually help prevent recurrence of gout attacks; one simply needs to include these items in their diet.  Interestingly, coffee (decaf or regular) has been shown to lower uric acid levels, although the mechanism is not understood.  A reasonable intake of vitamin C through food sources and supplements is also beneficial, but caution is in order: Mega doses…

Gouty Arthritis Part II: Medical Management

In all likelihood, the diagnosis of gout means treatment with medication will be involved.  In this post, we'll look at some of the medications used to treat gout and how they work.  Part III of this series will
focus on non-drug measures to help relieve the pain of gout and prevent recurrent attacks.



Pharmaceutical treatment of gout falls into two basic categories: the first category consists of medications that would be used for a gouty attack, while the second category of drugs are utilized to help prevent future attacks.

Drugs for treatment of gout attacks are agents that help to reduce the pain and inflammation associated with the condition.  Many years ago, the primary agents for gout attack were butazolidin (one of the first NSAIDs on the market) and colchicine.  Butazolidin was removed from the US market many years ago over safety concerns, and has largely been replaced by more modern day agents such as ibuprofen or naproxen.  Colchicine is still in use--but usually only…

Gouty Arthritis Part I: What is Gout?

What is gout?







Gout is actually a form of arthritis.  It can occur in either gender, but is more common in men. The incidence of gout in women increases in frequency after menopause.  Episodes of gout can be sudden and may occur as an episode of pain, redness and/or tenderness in a joint. The base of the great toe is a common site for gout attacks. The affected joint may feel as if it is on fire; redness and tenderness can be so severe that even the weight of a bed sheet may be intolerable.
The symptoms of gout, as mentioned can occur suddenly without warning. They include intense joint pain, commonly in the big toe. Other joints can be affected by this as well, including the feet, ankles, knees, hands or wrists.  The pain is most likely to be severe during the first twelve to twenty four hours from onset. Some discomfort may linger, anywhere from a few weeks to a few months.  Swelling, redness and tenderness may persist.
The good news is--the cause of gout has been determined!  Uric …

Fibromaylgia and Sensitivity to Noise

The pain and fatigue of fibromyalgia are difficult to deal with; these are the most well known symptoms and are being studied extensively.  Other aspects of this condition are just becoming realized--one of these being an enhanced sensitivity to a noises.

Current thinking about the sensitivity to pain in fibromyalgia occurs because there is an  inability to "tune out" painful sensations.  This same faulty filtration mechanism may also explain the problems with decreased tolerance to noise.

In the meantime, there are several things one can do to help control the noise issue:

--First and foremost, try to avoid  noisy environments as much as possible. An ounce of prevention is worth a pound of cure!

--It might also be a good idea to be familiar with meditative techniques, such as deep breathing techniques.

--If it is possible to leave premises in search of a quieter environment, it would be wise to do so.

--Last but not least, it might be a good idea to have some quiet time afte…

Non Drug Pain Management Ideas: Chronic Pain Self-Management Workshops

Do you know anyone who has been diagnosed with diabetes?  If so, chances are that they have been to classes with a Certified Diabetes Educator. In these classes, they learn a lot about how to self-manage their condition.  Diabetes educators share information with patients about managing their blood glucose levels, nutrition, and diabetes-related health conditions.

In recent years, these self-management programs have expanded into other areas of medicine. At the time of this writing,they are still in their infancy. Hopefully in this era of pain medication shortages and excessive regulations, this avenue of approach will help those with chronic disease, especially those with chronic pain. The workshop for chronic pain, for instance, addresses the following:

1) techniques to deal with problems such as frustration, fatigue, isolation, and poor sleep  2) appropriate exercise for maintaining and improving strength, flexibility, and endurance,  3) appropriate use of medications,  4) communicati…

The Zohydro Controversy: The Future (Part III)

In my opinion, the future of pain management with any of the long acting opioids is uncertain. Zohydro is no exception.  Some of this depends on where you live. As I mentioned in part II, It's not just a question of the DEA or FDA or State Health Boards of Health calling the shots now.  Regulation seems to be expanding in various states/cities/localities.  This is a new twist, and a new challenge in the world of pain management.

That being said, it is clear that new roads to pain management are emerging.  I have posted information about new devices on the marketplace for treatment of chronic pain, anxiety, and migraine headache. These are new relatively new ideas, and where they fit into the scheme of things remains to be seen. They may be more cost effective than medication...and provided that they successfully treat conditions as claimed, without problems, there is hope. Clinical investigation of drugs not initially marketed for pain management is underway- oxytocin and HCG ar…

The Zohydro Controversy: Modern Day (Part II)

In modern day pain medicine, many of the same historic controversies exist.


Addiction is a prevalent problem in society; sometimes it emerges when a patient is ordered pain medication for a legitimate purpose, only to fall victim to a bigger problem  Other times, people who are somehow predisposed to substance abuse find themselves drawn to it for recreation purposes.  In either case, once addicted, the problem is the same for all of these individuals.

Modern addiction medicine does not employ withdrawal or detoxification as part of treatment; it seems more common to send these persons to day programs or inpatient treatment and prescribe suboxone or some similar agent for maintenance purposes. My biggest problem with this approach is that the problem is not really fixed--it's only patched. You see, suboxone and its nearest relatives merely trick the body's opiate receptors into thinking that all is well.

In my work career, I witnessed this problem many times over.  The sadde…

The Zohydro Controversy: Background (Part I)

The use of opioid medications is certainly not a new, or novel approach to pain management. Some of the properties of opium, produced from poppies and a predecessor to modern day opioids, were recognized as long before the time of Christ.  Historical records indicate knowledge/use of opium in Europe around 4200 BC. In these early times, the use of opium was primarily ritualistic or medicinal. Some of the ancient Greek and Egyptian myths mention opium, indicating that is was known to civilizations of those times.




Around the time of the fall of the Roman Empire, opium became known to Islamic society for its medicinal properties; its utility in pain management and anesthesia was now being recognized. Writings from this time indicate its use in the treatment of melancholy, migraine, and sciatica by the time of the Ottoman Empire (14th Century).
Between 400-1200 AD, Arab traders introduced the Chinese to opium, .  By the 15th century, the Chinese were using opium in a recreational sense a…

A Patient's Guide to Fibromyalgia

A quick guide to Fibromyalgia from PainMedicineNews.com If you want to save or print a copy, click here!

Disruption Of Brain Signals May Play A Role in Fibromyalgia Pain

The term 'hyperalgesia" comes from the Greek language. It is defined as "an increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves."  





  .........New research findings published in Arthritis & Rheumatism suggest that a disruption in brain signals for reward and punishment...contributing to hyperalgesia in patients with fibromyalgia. 


"In patients with fibromyalgia there is an alteration in the central nervous system pain processingand a poor response to topical pain treatments, trigger point injections and opioids," said lead author Dr.Marco Loggia from Massachusetts General Hospital and Harvard Medical School in Boston. "Our study examines the disruption of brain function involved in the individual experience of pain anticipation and pain relief."
This study consisted of 45 subjects: 31 of these had fibromyalgia, while the other 14 were identified as healthy. All subjects were subject to cuff pressure o…

Does Chronic Pain Impact Your Life? Take my poll..

To answer this question, you can take my poll on Facebook. I will share the results in the near future.
You might just be the one to inspire my next blog post, or help me to "pay it forward" in helping another person learn from your experience with chronic pain!


You can take the poll by following this link.

Source: Facebook, Wikipedia

A bit about me...

I have been posting to this blog since October of last year on many approaches to chronic pain management. I came to realize that many of you know that I have some professional credentials, so I know a bit about pain management in that regard. But you might not know that I have personal experience in dealing with chronic pain as well. So, this post is all about me and the various pain issues I deal with in life.



Ever since I was a young teen, I have been plagued with migraine headaches.  Most of my issues in this regard seemed to be worsened by hormonal cycles.  Now that I have past that part of my life, I still get an occasional migraine, but for the most part life is good in this regard.  That being said, I can't even begin to tell you how many days I spent sick in bed because of a migraine headache.  Many times I could not even eat or drink for hours on end because of this.  I am ever so grateful that this is in the past!
I was diagnosed with osteoarthritis in my mid-thirties.…

Drink Up! The importance of staying hydrated---

Now that summer weather has arrived, I don't know about you...but I drink a lot more water.  It might seem obvious at first, but have you ever considered why staying hydrated...all year round...is important?  Here are some good reasons to consider drinking more water, if you are not one of those who are already working at increasing water intake.

Staying well hydrated, believe it or not, plays a role in pain management. For one thing, it can improve your mood. Many people with chronic pain suffer from anxiety and/or depression.  So, in a manner of speaking, water is a natural antidepressant.

When the human body is well hydrated, so is the cartilage of all the skeletal joints. By serving as a lubricant, there is less joint pain when lubrication is sufficient.

Headaches can be caused by dehydration.  Maintaining adequate hydration will increase the odds that these types of headaches will stay out of your life!

Water plays many other roles in human life and survival. Did you know th…

Post Herpetic Neuralgia

Following an outbreak of shingles, there is a risk of developing a chronic pain condition known as post-herpetic neuralgia.  The risk is greater for those who are over 50, or who have a severe shingles outbreak.  If the original outbreak occurs on the face, the risk of post herpetic neuralgia is also greater.



You can read more about shingles in two of my earlier posts:
1 )The Hearbreak of Shingles
2) New Drug Treatment on Horizon for Chronic Pain from Shingles


Post herpetic neuralgia occurs if the pain of the original shingles outbreak lingers after the rash and blisters have disappeared.  It is commonly described as a burning or tingling sensation; it often interferes with normal daily body functions, such as sleep or appetite.

It is important to see a doctor at the earliest signs of a shingles outbreak; getting a head start with antiviral medications is a good way to stay ahead of possible post herpetic neuralgia. (Note:The risk of developing this condition is reduced by half if an…

Think you have fibromyalgia? Here's a self-assessment to help you and your doctor

Fibromyalgia is difficult to diagnose; many times it's a process of elimination. Weeks, months, and years of suffering go by before those who are afflicted ever know what's happening to them.





If you think you have fibromyalgia and have been struggling to confirm the diagnosis, this self-assessment toolmight help you and your physician to come to a conclusion.

This might also be worth sharing with friends or family members who might find it useful.



Source: WebMD, gvarc.org,wikimedia

Oxytocin and HCG : New weapons in the future of pain management?

Have you ever heard of oxytocin?  It is a naturally occurring hormone/neurotransmitter.  If you have heard of it, you probably know that it has a role in pregnancy, childbirth, and lactation. It is also a powerful neurotransmitter, and has a role in pair bonding.  Human chorionic gonadotropin is another hormone produced in pregnancy; its usual role is in the production of progesterone in the first trimester. These two substances have recently been under investigation for a possible role in pain management. Although studies are very early on, there is some excitement about the possibilities!

A recent small scale study by PAINWeek faculty member Forest Tennant, MD, DrPH, indicated that  administration of oxytocin and human chorionic gonadotropin (HCG) to 9 patients resulted in a 30-40% decrease in pain in 7 of the 9 patients studied. In addition, these patients reported longer pain free periods between flares, and the need for pain medication was reduced by 30-40 percent.  Although this i…

Drugs for Fibromyalgia: How Good Are They?

In all the months I have been writing posts for this blog, I have observed that people with fibromyalgia are eager for relief.  The current recommendation for fibromyalgia treatment is multi modal--that is to say, it includes approaching the condition from multiple angles--medication, exercise, improvements in sleep duration and quality, etc.  

For today's post, I am sharing recent article from National Pain Report that discusses the medication aspect of fibromyalgia treatment.  After reading it, you will see why medications alone won't help most people.  







Drugs for Fibromyalgia: How Good Are They?
March 5th, 2014 by Dr. John Quintner
Most fibromyalgia sufferers will at some stage be offered a prescription for one or more the  officially approved drugs – Lyrica, Cymbalta, and Savella.
Many will ask their doctors two important questions: How good are these drugs and what harm can they cause me?
Many would be surprised by the answers they get – if the doctor is willing and able to pro…