Everyday pain management ideas

Today, I am sharing some thoughts about what causes fibromyalgia.  Current understanding of this debilitating disorder suggests that central pain processing in fibromyalgia patients is altered.  Somehow, the central nervous system (CNS)  has some faulty wiring problems, resulting in an amplified physical pain. In the adult population, it seems that more women are affected by fibromyalgia than are men.  In children and adolescents the gender ratio is 1:1. There are a few theories out there as to the root cause of fibromyalgia.  Some ideas: 1) Genetic Basis -- it seems that fibromyalgia "runs in families", suggesting that there is a specific gene  that may be involved in the perception of pain. 2) Biochemical Imbalances --Some findings in fibromyalgia show that these patients have very low levels of serotonin,which has been linked to problems with sleep,pain perception,headaches, and mood disorders. Other studies have shown that people with fibromyalgia have eleva

Tender points...click caption for WebMD animation Tender points are a unique feature of fibromaylgia.  There are 18 such points on the human body (9 pairs as shown).  Using special technique by hand or a dolorimeter, a fibromyalgia patient will experience pain in at least 11 points, and there will be at least one painful tender point in each quadrant of the body! One study found that up to 96% of fibromyalgia patients suffer from sleep disorders. It is believed that this is responsible for a deprivation of delta sleep, during which human growth hormone is produced. This hormone is essential to tissue repair. Other common problems in fibromyalgia are fatigue, concentration/memory ("fibro fog"), and depression.  There is no doubt in my mind that just enabling the patient to sleep well on a regular basis would be of great benefit! It is not uncommon for fibromyalgia patients to have coexisting conditions--some of these are lupus, disease, irritable bowel syndrome, l

I have been watching the statistics on this blog since I started it, and I could not help but notice that some of the most popular posts pertained to fibromyalgia.  So, I thought,  why not devote a whole week to the subject?  So, without further ado, on this first day of Fibromyalgia Week, I shall begin with an overview. The American Medical Association  gave official recognition to fibromyalgia back in 1987. Before that time, this disorder was considered a "wastebasket" diagnosis, but in more recent years it is being recognized as a true illness. Here are some interesting facts about fibromyalgia: The characteristic feature of fibromyalgia is chronic, widespread musculoskeletal pain, associated wit symptoms of fatigue, insomnia, and other symptoms such as stiffness, headache, and chest pain. An interesting and unique feature of fibromyalgia is "tender points"--which are specific targeted areas where people with this disorder feel an amplified pain

Thinking about osteoporosis, I think about those who have the highest number of these risk factors-- small frame female Caucasian or Asian post-menopausal or post-hysterectomy family history Osteoporosis in and of itself is not painful, but it increases the risk of fracture. If a fracture does occur, it can be disabling or perhaps even fatal.  In the last few years I have seen a few women with known osteoporosis suffer fractures that laid them up for months on end. And it never seems to be the same after the fact, even after the bones have healed, and many physical therapy sessions have been attended. With that in mind, we must also keep in mind that other persons can suffer from osteoporosis as well. Men, for example, can develop this condition, and it's sometimes overlooked because the focus is on women with known risk factors.  Sadly, this group can suffer the same risk of fracture, and when it happens, they can be laid up for months on just like their fema

While we await a final autopsy findings on Prince's cause of death, People   magazine reports that he was being treated for addiction just prior to his demise.  Sadly, bad things happen to good people..and whether or not Prince's death is related to this issue, it brings the topic of addiction front and center. The Washington Post recently reported that there were 52 deaths per day in 2014 due to opioids.  If you do the math, that amounts to almost 190,000 deaths per year!  The federal government has recently shown some movement in response to this issue...last month, the CDC released its recommendations for prescribers with respect to opioid usage and prescribing.  In the last couple of weeks, the FDA has chimed in. An FDA advisory panel has voted in favor of mandatory opioid prescribing training for physicians. It's about time something is done. This problem has been ongoing for the last twenty years. There have been many deaths that could have been prevented.

As we ponder the opioid crisis and the rise in heroin usage, and death from drug overdoses, we must wonder what the future holds.  We've seen the development of many types of pain management devices-- Alpha Stim ®, Sensus ®, Cefaly ®, Quell ®, iovera ®, and Oska Pulse  ® are a few of these. Due to fears of addiction, and shifting medical opinions on the management of chronic pain, these devices are potential options for pain sufferers everywhere. These devices have many advantages for potential users: Drug free pain relief--reduced risk of drug interactions and/or side effects of drugs Unlike prescription refills, many offer a free trial period to see if the product is effective. After initial expense, maintenance costs are relatively low. Can lead to more cost effective pain relief! May help to postpone or completely eliminate the need for surgery or use of medications altogether It's really up to the patient to decide whether or not to pursue this avenue. It

Some new thoughts on the dangers of long term use of popular NSAID drugs are emerging from a study out of UC Davis.  According to study author Aldrin Gomes, PhD. , we already knew that prolonged use of these medications could lead to increased risk of heart disease and stroke...but now we are beginning to understand why. The study examined the use of prolonged administration of NSAIDs in mice, and discovered the following: a reduced ability of cardiac cells to produce energy generation of a stress-inducing reactive oxygen species interference with production of proteasome ...all of which leads to a toxic buildup and eventual cell death. Another finding of note--the study compared naproxen, which is available over the counter, with a more potent prescription product, meclonfenamate sodium.  It appears that the prescription drug was more likely to have detrimental effects than its OTC counterpart.  In addition, the authors note that vitamin C, an antioxidant, along wit

It has been speculated that our "clean living" is sometimes too clean... Whipworm--an intestinal parasite Consider Inflammatory Bowel Disease, for instance.  It is thought that the absence of exposure to parasitic worms is a root cause of some oversensitive, gut-based immune system cases of IBD.  These worms are thought to help promote a balance of microorganisms in the GI tract...but it appears that the most developed nations on the earth have the highest cases of Crohn's Disease and ulcerative colitis. A study team at NYU Langone Medical Center is looking into this very issue. They observed that the incidence of IBD in Malaysia ( a more underdeveloped country) is very low, while persons of this region have a high rate of worm infections.  In experiments conducted thus far, they intentionally infected mice with intestinal worms and observed a significant change in the  gut microbiome of these mice.  This is one of the first studies linking parasitic worms, nor

Given the large number of knee an hip replacement surgeries that are performed on a daily basis, it's safe to say that hip and knee pain are common problems.  It seems that low back pain could also be added to the list as well.  I know lots of people who have a "bad back." Perhaps you could say the same. If you or someone you know is dealing with one of these problems, and surgery is not on the radar just yet, here are some pain management methods that might just do the trick.  The best thing about this list is that you can use any or all of these methods together without risk of side effects! 1) Weight Loss Being overweight puts stress on the back and the joints.  Weight loss can help to reduce the stress and delay or perhaps eliminate the need for surgery down the road. 2) Exercise Osteoarthritis is one big contributor to back, knee and hip pain.  One of the very best ways to preserve joint function is exercise! This does not mean it's time to r

Have you ever laughed so hard you started to cry--or maybe experienced being tickled until it hurts? Over the centuries it's been proposed that pain and pleasure are at opposite ends of a continuum... It has been established scientifically that these pain and pleasure neural pathways may at least overlap. From the standpoint of evolution, it would be important to be able to discern pain from pleasure for the ability to survive.  Some who have studied this topic say that having pain and pleasure on a continuum is the most efficient way to accomplish this.  As diametric opponents, when you feel true pleasure you really don't feel much in the way of pain, and vice versa. Truthfully, there's been a lot of thinking on this topic, but there are no clear answers as of yet. In the realm of pain management, we look at this continuum as a model for methods that can be used to remediate pain.  For instance, a chronic pain sufferer may dwell emotionally on the "pain&q

So, have you seen television ads for Quell® ?  It's a newer pain relief device, FDA approved...a TENS unit-- with a twist. Quell® is a wearable pain management device that can be used for many types of chronic pain. While the actual device sits in an adjustable band that is worn just below the knee, it can deliver pain relief to other body sites when in use.  It has a smart phone app that can be used to make adjustments to pain relief program as needed. The product web site says that the device itself is responsive to the body's changing needs for pain relief and can adjust itself to accommodate as needed. And if that's not enough, it's a drug-free method of pain relief! The product is available on line through the manufacturer from about $249.00. There are also some retailers who have this product available, including Amazon, QVC, and Target.  There is more information available at the product web site which you can access here.     The Quell® website is ac

Yet another pain management device has entered the marketplace..it's called the Oska Pulse. Using pulsed electromagnetic field therapeutic technology, this small portable device is intended to relieve minor aches and pains, reduce stiffness, and help to increase mobility. Leslie Cross, chairman of the board at Oska Wellness, says that she uses the product for chronic hip pain. After trying the product for several days, she joined the team because she was impressed by the product.  Best of all, it's drug free and can be used several times a day. A person can stay active--go for long walks, golf, etc...in spite of chronic pain! And now the product is available to the public. Suggested retail is around $399. You can see it for yourself by visiting the Oska Wellness website . Sources: Oska.com; Drugstore News; Wikimedia

Over a year ago, I shared some interesting news about acetaminophen.  It's not unusual think of this common household medication as benign. Overdosing or taking too much over an extended period is liver toxic, but aside from that it seems pretty safe all in all. Fast forward to 2015...I shared this post .  A study at Ohio State University reported findings that suggest that this drug tended to dull the emotions in study subjects.  The authors reported their findings to be "subtle but reliable."At the time it was thought that further study was needed to get a better idea of this phenomenon. Now, a first of its kind study reported in Social Cognitive and Affective Neuroscience reports that acetaminophen may impair the brain's ability to detect errors. According to postdoctoral fellow Dan Randles, lead author of the study... “It looks like acetaminophen makes it harder to recognize an error, which may have implications for cognitive control in daily life. So

It's long been known that small fiber neuropathy (nerve damage) is positively associated with diabetes.  Most commonly the first sign of this problem are is a burning sensation in the feet. Diabetics are well aware of this problem, but it can also be caused by several other disorders including celiac disease, Lyme disease, HIV, lupus and alcoholism. Small fiber neuropathy: Microscopic view A small scale study of this disorder conducted at the prestigious Johns Hopkins University was recently published in JAMA Neurology . Surprisingly they discovered a new cause of small fiber neuropathy--prediabetes.  This may suggest that screening for the disorder should begin when a person diagnosed with prediabetes rather then waiting until the diagnoses of type II diabetes is confirmed. You can read more about this topic by clicking here. Sources: Pain Week.org; Wiki media

Some people say that the massage experience is the ultimate in pampering.  In truth, it can be much more than that.  There is a form of massage known as medical massage. With proper training, any license massage therapist can provide this therapy for any number of conditions, including seizures, fibromyalgia, migraines, nerve pain, joint pain, and many others. Medical massage is a bit different from the spa experience that you might be visualizing right now.  A given patient may go to see his/her therapist weekly, for anywhere from four to sixteen visits.  The number of treatments varies so widely because it is outcome based, so depending on the condition being treated and the goals of therapy.  The therapist will  likely follow up with clients after treatment to ensure that everything is going well and determine whether or not future sessions are necessary. Sadly, health care insurance providers do not always see the benefit of this form of therapy so they do not alwa

A new device in the chronic pain marketplace may be "just what the doctor ordered" in future pain management. Researchers at the University of Texas at Arlington are studying a device that wirelessly sends electrical stimulation to sites deep within the brain to relieve long-term pain. Other stimulation devices currently on the marketplace are designed to send electrical stimulation to a body site where chronic pain originates. The new device is different because it acts at a site deep within the brain--and wireless. It could be used to treat any number of pain conditions and allows the user to go about his/her usual business while it is working! According to the researchers, “There are several other commercial companies making FDA-approved stimulation devices for neurological and psychiatric disorders, such as Parkinson’s disease, depression and dystonia, so many safety issues have already been investigated and addressed,” he said. “We hope to see this move forward

Osteoporosis is very common in older persons. Usually it is the result of aging, but it can also be caused by a medical condition known as hyperparathyroidism . While osteoporosis is not painful, the potential for debilitating or life threatening related conditions is great.  Read below for clarification of this point... Fracture of the hip Here are some facts and figures from The International Osteoporosis Foundation: It is estimated that over 200 million women have osteoporosis. That’s more than the combined populations of the Germany, the United Kingdom and France! In fact, every three seconds a bone will break, somewhere in the world, because of this disease. Many people won’t know they have osteoporosis until their first fracture, which is why it’s called the ‘ silent disease ’. Even after a break, it often goes untreated. Worldwide, one in three women and one in five men over the age of fifty will experience an osteoporotic fracture. Fractures are

What comes first..the chicken, or the egg?  This riddle has been pondered by generations.  And is there really an answer? Maybe...or maybe not.   In the world of pain management, there is a similar question, and that is the basis for today's post. It has long been apparent that living with chronic pain can be disruptive to sleep patterns. This has a negative effect on the quality of life for chronic pain patients.   Have you ever thought about the reverse situation...that is to say, how does a disruptive sleep pattern affect chronic pain? A study of this topic, conducting in the Netherlands, gives us an idea that there is a relationship.  "Emerging adults" (age 19-22) looked at followed subjects over several years; half of those who had sleep problems in the first year of study continued to be plagued with sleep issues in the third year of the study.  The subjects who had sleep problems at the outset were more likely to have chronic pain, and m

As medical research advances, there are many new and interesting findings all the time.  Some of them are revolutionary, result in new and better treatments of health issues. Still others do not help us to find cure or treatment, but instead help us to find connections or to better understand disease process. One most interesting finding of late is that there appears to be a connection between tinnitus (constant ringing of the ears) and chronic pain.  Jose Rauschecker, lead author of a study at Georgetown University reports that these two phenomenon may coexist because of changes that occur in two areas of the brain. According to study findings, two areas in the frontal area of the brain serve as "gatekeepers" of sensory stimuli.  These regions of the brain appear to have less grey matter in persons with chronic pain and/or tinnitus as compared to normal test subjects. This Georgetown study proposes that these areas of the brain tend to filter out signals that a

A recent small scale study conducted by scientists in the US and Australia showed that patients who took opioids for as little as one month demonstrated changes in the gray matter of the brain, confirmed by MRI.  At present, the authors of the study note that it is preliminary to say exactly what these changes mean... Grey Matter of the Human Brain “It’s disturbing to learn that in as little as one month, daily use of opioids can alter brain morphology. And it’s even more disturbing to learn that despite the harm caused to the subjects in the morphine arm, their pain wasn’t any better controlled than the patients receiving placebo,” commented Andrew Kolodny, MD, chief medical officer, Phoenix House; executive director, Physicians for Responsible Opioid Prescribing; and senior scientist, Heller School for Social Policy and Management, Brandeis University, Waltham, Mass. “This is strong evidence that for many patients, the risks of long-term opioids clearly outweigh potenti