Everyday pain management ideas

No one should have to live their life in pain. That's a given.  But no one should lose their life to "Pain Killers", such as the opioids. Using these medications has landed us all in a tough spot.  Scores of people have died from opioid addiction, still more have moved beyond opioids to heroin. Heroin deaths have quadrupled in number in the last decade or so. One of the safest approaches to pain management is physical therapy.  While chronic pain patients will likely need to employ multiple approaches of pain management, physical therapy is always a safe and effective pain management tool.  The American Physical Therapy Association has recently launched a campaign to promote this idea. Known as " #Choose PT ", its aim is to make people aware of the safety and effectiveness of this form of treatment. In 2008, a study that followed 20,000 people over a period of 11 years found that people who exercised experienced less pain than those who did not exerci

I remember working in retail pharmacy in the 1980s and 1990s when NSAIDs were all the rage. This class of drugs was one of the most commonly prescribed.  As the years went on, we all became aware of the problems associated with this class of drugs.  The first problem that became obvious was that patients who used these drugs on a regular basis were developing gastric ulcers and GI bleeding. For that reason, it was advised that these medications be taken with food.  One company even developed an NSAID product that contained an additional drug that was purported to protect the lining of the GI tract from injury. After this era, a new sub-class of these drugs--known as "COX-2" inhibitors came onto the US marketplace. This class of drugs possesses all the benefits of the original NSAID drugs--but did not have the GI side effects of the original NSAID drugs.  Three COX-2 Inhibitors (Bextra®, Vioxx®, and Celebrex®) were launched in the US market in the late 1990s-early 2000

New research into a group of compounds known as endomorphins may offer hope to chronic pain patients of the future.  These compounds are based on endorphins, which are the human body's naturally occurring pain relievers.  Researchers say that these compounds appear to be superior to morphine in terms of analgesia, and have fewer side effects as well.  The other big advantage to these compounds is that there appears to be no risk of addiction, respiratory depression, constipation, and some of the other problems that develop with the use of opioids.  This would be a most wonderful development in the world of pain management! Endorphin molecule In the meantime, one of the best ways to help your body deal with chronic pain is to practice activities that help to increase natural endorphin levels.  According to Reader's Digest , here are eight ways to reach this goal: The scent of vanilla and lavender are said to increase endorphin levels.  Try adding some vanill

Today I am sharing an article about one multi-modal approach to chronic pain that makes a lot of sense to me... I don't want to elaborate too much because I think it's worth it for you to read for yourself.  All I can say in advance is that this article makes me think of a three-legged stool.  If you only rely on one leg of the stool, it's certainly not going to be very useful. So without further ado, here is a link to the article I am speaking of.  Read and contemplate...comments are appreciated! Sources: statnews.com; wikimedia

Pain management is a complicated field.  For one thing, there is an objective goal--that is to say, to determine what is causing pain in the first place, and what to do about it. But we also have to consider subjective aspect of pain management.  One of the tenets of pain management is this: If a person says they are in pain, we cannot deny that the pain exists.  But sometimes it's hard to determine why that person is experiencing this discomfort, or why it seems to be as severe as they claim. In recent years the genetic aspect of pain management is under closer study.  One example of this is a group from Touro College of Pharmacy in New York City.  Dr. Priyank Kumar and his associates are looking at a specific human gene--namely, 118G. They are finding that variations in this particular gene help to predict a patient's response to opioids, and also the risk of respiratory depression, opioid misuse and even addiction. Genetic testing of this sort may become commonpl

Thankfully, arachnoiditis is a rare disorder...I say that because it is a source of chronic pain for those diagnosed, and it's also a difficult disorder to treat.  Let me begin by explaining that arachnoiditis is a condition in which the arachnoid membrane (which protects the nerves of the spinal cord) becomes inflamed because of infection, injury, chemical exposure, etc.  As a result, there is compression of the affected area of the spinal cord. Scar tissue can form, and this entire process can impair the nervous system transmissions that pass through the spinal column. Any number of symptoms can develop, including numbness, burning, stinging, cramps, or twitching.  The resulting nerve damage can affect body functions such as urination, defecation, and sexual functions.  Paralysis of the lower limbs may also be a result of arachnoiditis. Cross section showing the location of the arachnoid matter  of the spine The course of this condition is not predictable, and treatme

The opioid crisis came about largely because of routine use of opioids for chronic pain conditions. Opioids are used to control post operative (acute) pain as well; and even though short term use of these drugs generally does not lead to addiction, more and more advances are being made to reduce or eliminate their usage save for very rare circumstances. Here are a couple of examples-- 1) There is a product line known as On-Q ®..you can click the link to see specifics about this if you wish.  These products are drug delivery systems that can be used in some types of surgery, such as knee replacements to reduce or eliminate the need for opioids. On-Q® devices can be filled with a local anesthetic. The device has tubing with a catheter like tip that is placed in the operative site, allowing the anesthetic to be delivered directly to the affected area via the On-Q® pump.  These have been around for several years, and the results are dramatic! 2) A new technique devised by Dr.

Two recent studies have brought a not-so-novel concept into the limelight-the concept being that people who present with knee pain often develop pain in other parts of their bodies.  These studies, known as the Multicenter Osteoarthritis Study ( MOST ) and the Osteoarthritis Initiative ( OAI ), were assessed by a Clinical Epidemiology Team as Boston University School of Medicine in an effort to find preventive strategies to combat this trend. The authors suggest that knee pain may cause individuals to alter their gait in an effort to compensate for their discomfort. In doing so, the alignment of other body joints is altered, and this may be the cause of secondary joint pain, especially hips and ankles. The authors go on to say that the pain in these secondary sites is not necessarily osteoarthritis--perhaps bursitis or some other injury. Osteoarthritis is a result of wear and tear in the joints.  We may not be able to completely eliminate osteoarthritis from occurring, but

Lately I've seen a lot of television spots for prescription medications...for products that treat diabetes, psoriasis, and of course, chronic pain. While think it's generally good for patients to know about pharmaceutical options available to them, sometimes I wonder if patients consider all the pros and cons of each medication before visiting their doctors asking for prescriptions for this or that. Case in point--one product I see quite often is a prescription product known as Lyrica®. The generic name is pregabalin and it's indicated for chronic pain. The general mechanism of action for this drug is that it dampens the nervous impulses (including pain signals from body to brain) as they travel along the neurons in the human bodies.  While this drug is categorized as a controlled substance, it's not really habit forming and does not pose risk of addiction like the opioids do. This product is widely used and does offer some relief to patients...but there are new

The topic for today is NSAIDS.  I hope you know what this acronym stands for, and I hope you know even more about the topic after you read this post! First off, NSAID is an acronym that stands for Non Steroidal Anti-Inflammatory Drug.  This class of drugs has flooded the marketplace in the last twenty or thirty years.  If you don't know the term NSAID, you might be aware of some of the brand or generic names of these drugs, including Aleve®, Naprosyn®, Motrin®, naproxen, and ibuprofen.  But there are many more. These drugs are very effective at reducing fever, pain and inflammation.  But there is more to the story... I came across a survey in recent news...in a poster session at the recent PAINWEEK conference in Las Vegas, authors cited survey results that were truly shocking.  Forty-seven percent of a responders to a small online survey did not know what an NSAID was, including forty percent of responders who reported that they had taken pain medication in the last twelv

Most of us know someone who has osteoarthritis, if we don't have it ourselves.  Joint replacement surgery is a pretty common remedy when the joint becomes severely damaged and the patient is in a lot of pain.  With risk of complications from such a surgery, perhaps an alternative treatment should be tried first. One such remedy is the injection of a synthetic version of collagen(e.g. Synvisc®) into the affected joint.  This procedure restores the cushioning to a joint that has degenerated over the years. It can diminish the pain substantially and help put off joint replacement surgery for months to years.  The biggest drawback is that these products are expensive.   GoodRX , a web site that can be used to estimate the cost of medications, estimates the cost of these products to be over $1,000 each. Here's another example--and I am not sure how widely accepted this protocol has become since study authors introduced it in November 2015.  Are you ready for this? Inject

In the wake of opioid and heroin addiction, you may be hearing more about patient/provider agreements when it's determined that opioid therapy is in the patient's best interest.  Today's post will provide you with a brief overview of what a patient/provider agreement is, and what you might see in one if opioid therapy is in your future A patient/provider agreement is simply a contract that these two parties make with each other at the onset of treatment.  This type of contract spells out in detail all of the responsibilities of the health care provider as well as those of the patient.  The contract also spells out what will happen if the terms of the contract are violated by either party. What are some of the things you might see in a patient/provider agreement? Each provider may be a little bit different, but in general you can expect to see at least some of the following: Patient Responsibilities: Patient agrees to take medication only as prescribed. Patie

My message for today is simple but very important.  My message today is that a positive attitude about ANY situation--chronic pain being a prime example--is the most important weapon you can have.  Case in point: Barby Ingle.  Click here for a link to a column she wrote for her the Pain News Network.  Her story is not unusual; her attitude is priceless! Sources: Flickr; Pain News Network

One of the most baffling pain conditions women experience is chronic pelvic pain. This unfortunate problem is not only uncomfortable, but can be a cause of infertility in women. Some of the usual causes are fibroids, endometriosis and pelvic adhesions. Typically, these problems are addressed by standard modalities--surgery, medications, psychotherapy, and physical therapy among them. Recently, I came across a newer idea for treatment of pelvic pain caused by adhesions.  It's known as the Wurn Technique, and it's really a quite interesting approach.  Similar to a deep tissue massage, this method can be used to break the adhesions in the pelvic area.  This helps to reduce the pelvic pain and can even restore fertility in some cases!  The best part is that it's all drug free! For more information about the Wurn Technique, you can click here to reach the ClearPassages website. This site explains in more detail about how the technique is used and also the story of how

Piercing is a form of self expression these days, along with tattoos of every shape and size. I try not to judge--and here is one good reason why. Have you ever seen someone with a piercing like the one above?  This is known as Daith piercing .  It is not just someone trying to be stylish! This is actually an acupuncture practice that has been in existence for thousands of years.  There is no scientific evidence to support this practice, but many migraine sufferers who have this piercing report a reduced frequency in migraine attacks. Migraine headaches are a complex neurological event. More than 3 million persons in the US experience a migraine attack every year. The pain can be so severe as to cause nausea and vomiting, and can incapacitate a person for hours to days.  If you experience severe headache, typically a throbbing on one side of the head, accompanied by sensitivity to light and/or nausea/vomiting, it just might be a migraine.  There are many pharmacological and no

Do you know anyone who is extremely flexible--in the physical sense?  As it turns out, a small number of these individuals actually have a connective tissue disorder.  Known as Ehlers-Danlos syndrome, this inherited disorder of connective tissue results in overly flexible joints and stretchy, fragile skin.  A more severe version of this disorder also affects the walls of the blood vessels. How does one know this might be a problem? Firstly, the joints are much more flexible than the average person because the connective tissue that holds the joints together is very loose.  Secondly, the skin of affected individuals is very "stretchy...it can be pulled away from the body more than normal, but goes right back into place when released.  The skin is also very fragile, to the point where wounds do not heal well. Those who have the vascular form of this disorder have distinctive facial features( thin nose and upper lip, small earlobes, and prominent eyes), and the heart can be aff

Back in March 2015 I wrote a post about pain catastrophizing .  You can read that post by clicking this link , but I will try to explain it to you briefly: Pain catastrophizing simply means that physical pain that is amplified by negative emotions that coincide with the physical pain.  Many people might think that this is just part of a personality, that it cannot be changed, etc. etc. But today I am here to share some good news--that is to say, that some of that factors associated with pain catastrophizing CAN be controlled.  In the next paragraph or two, you'll get my drift. First, let me tell you about an article I read about this topic that was completed at Emory University. The study authors investigated 300 chronic pain patients at clinics in rural Alabama. The study revealed that a very key factor common to pain catastrophe is low health literacy. These patients simply did not understand much about health and/or medicine, so they had very poor understanding of thei

A new study published in JAMA ( Journal of American Pediatrics) tells us that pregnant women who took Tylenol® (or its active ingredient--acetaminophen)--had an increased risk of delivering a child with hyperactivity issues. This drug is still relatively safe to take...the researchers say that using acetaminophen products during gestation may ward off more significant problems--for example, if it is being used to reduce fever! So the bottom line here is simply this: There's no reason to avoid these products altogether during pregnancy, but it doesn't hurt to err on the side of caution! You can see the ABC news report on this topic by clicking here . Sources: ABCNews; Flickr

The American Eye Institute reports that approximately 3 million Americans suffer from chronic dry eye.  As such, it's a fairly common condition.  The usual treatment for this malady is the use of artificial tears. This is important, because without lubrication the cornea can be damaged, and it can be very uncomfortable as well. New research about chronic dry eye is shedding light on another aspect of the condition.  As reported in the Journal of Pain, some patients with dry eye have a neuropathic pain condition.  Patients reported having higher levels of ocular pain as well as a number of coexisting chronic pain syndromes.  They also reported a higher incidence of depression and a lower quality of life. This research sheds light on the complexities of what we might otherwise think of as a simple everyday problem.  More research is needed to explore more fully the link between dry eyes and chronic pain syndromes, and a more permanent treatment for those affected by this com

There's been a lot of discussion in pain management circles about the psychological aspects of chronic pain. Patients with dementia are a hot topic in this area; now more information is coming out about these persons, and those with other cognitive deficits including those with attention deficit and/or impaired executive functions. A study published in January 2014 edition of Brain helps to illustrate how and why this is the case.This study looked at 189 subjects who ranged in age from 18 to 85 years.  Study subjects were all about to undergo knee replacement (for osteoarthritis) or breast cancer surgery. And here's where it becomes interesting--in the knee replacement group, 84% of the patients had "clinically meaningful" pain levels prior to procedure.  Six to twelve months after surgery, 38-39% of these subjects were still reporting significant pain.  In the breast cancer group, none of the subjects complained of significant pain before surgery, but six to