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10 Myths about Chronic Pain

Today I am sharing a graphic that I found while researching for this sure is an eye-opener!

(Originally posted in 2014)

Ankle Replacement: The latest in joint replacement surgery

By now, most of us know one person or another who has had a knee or hip replacement.  What you might not know, is, as these procedures become more common, the frontier of joint replacement has expanded to include shoulder replacements.  And even more recently, ankle joint replacements have become available.

Up until this point, ankle fusion, or ankle arthrodesis has been the surgery of choice for those who suffer from debilitating ankle pain due to arthritis or prior ankle injury. The downfall of this procedure has been that the bones of the ankle are fused using metal plates and screws.  The end product is a joint that is less flexible than the normal ankle.  In turn, this puts pressure on other joints of the foot, leading to the possibility that arthritis will develop in those joints.

Ankle replacement joints were approved by the FDA in 2012.  The advantage to using them is that the post operative ankle function is more like a normal ankle, allowing the patient improved function r…

Quantum Mechanics Offers New Hope For Patients With Peripheral Neuropathy

As previously mentioned, one of the most painful consequences of type II diabetes is a condition known as peripheral neuropathy. This condition is essentially nerve damage caused by elevated blood sugar levels over extended periods of time.

There are also other forms of peripheral neuropathy--due to nerve damage from other causes. According to Peter Carney, MD, there are approximately 23 million persons in America who suffer from this problem.  Dr. Carney is the lead author of a study that offers a novel approach to treatment of this condition...and perhaps the answer to a prayer for sufferers.

Dr. Carney's study involves using a technique known as Combined Electrochemical Therapy (CET).
This technique uses a combination of local anesthetic and electrical current. Forty-one patients with peripheral neuropathy were studied. After twice weekly treatments (up to 24 total treatments per patient), 73% showed regrowth of nerves. Reduction in pain (as per visual analog scale) was marke…

Increased Mindfulness ---> Better Glucose Control

Mindfulness is defined as "the quality or state of being conscious or aware of something." This concept has become a hot topic in the past couple of decades. The roots of this idea are ancient—martial arts, yoga, meditation and Buddhism are all closely related to it.

Mindfulness is a very powerful tool. There are reports that Buddhist monks who sleep in freezing conditions in the mountains of Tibet are able to control their body temperature using this technique!  You have to ask yourself...what things could be possible in your own life if you were able to master this practice?
Four hundred participants in a study at Brown University recently gave us a hint at what is possible.  Using the Mindful Attention Awareness Scale (MAAS), researchers found a significant association between dispositional mindfulness and glucose control. After evaluating their findings, the authors hypothesize that being aware of the present moment can lead to reduced likelihood of obesity and a greater s…

iovera® Device: For Treatment of Breakthrough Pain?

The marketplace for pain management products is changing...and many devices have come onto the market for this purpose.  The early generation products, such as spinal cord stimulators and TENS units are still in use today..but more and more new devices have entered the scene.

One such device is undergoing clinical trials right now.  It's called iovera®and it's  already FDA approved for breakthrough pain.  The current trials are focused on post-surgical management of pain in knee replacement patients. There is a lot of interest in this product--according to Myoscience, the California based product developer, enrollment for the study filled up ahead of schedule!

This device is a little different from some of the earlier devices because of its use for breakthrough pain.  The earlier products I am most familiar with deliver a constant baseline level of pain relief--if breakthrough pain should occur while using these earlier products, it is managed using medication or some other p…

Biopsychosocial Program: A Method That Provides Long-Term Pain Relief to Patients Not Responding to Opioids

Okay, so sometimes pain management with opioids fails for one reason or another.  Maybe the side effects are just too much for an individual...or maybe an individual becomes addicted and wants to find and alternative way to manage pain going forward.  If that sounds like you, or someone you know...there is hope.

Research findings presented at this year's American Academy of Pain Management describe a study of this very thing.  A study of patients at the Chronic Pain and Recovery Center in New Canaan, Connecticut followed 154 patients who came to the center due to opioid failure/addiction.  Following a 28 day residential treatment program, these patients learned self management techniques,and participated in group therapy, physical therapy,substance abuse and nutrition counseling, 63 percent of these folks were no longer on opioids and still reported a reduction in their pain scores!

These findings are preliminary, but they are indeed good news! You can read the original story by …

Pain Medications Can Hurt You, Too...

A very traditional part of medicine follows the logic that medication is the first resort for pretty much every medical condition known to man.  This was a widely accepted practice for many years. For patients, it became pretty much expected that a visit to the doctor entailed a brief exam to evaluate the patient's complaint, followed by a prescription for some medication to treat said medical condition.

In more recent years, the medical community has learned from the flaws in this logic.  For example, after treating patient after patient with antibiotics for minor infection, we have fallen victim to "super bugs"--strains of bacteria that are resistant to most, if not all, antibiotics.  We have learned that it's better to find other approaches to the more minor infections, allowing the body to heal itself and develop a stronger immune system.
In that same vein, chronic pain conditions fell into the same logic process.  Long acting opioid products used over long peri…

When Pain Medication Fails You...

This topic is important...and has not yet been addressed in this blog, so today is the day!

Modern medications are a true marvel.  There are more drugs for more indications on the market now than we ever could have imagined even a decade ago.  As the science of drug development evolves, the newer drugs seem to be more effective than their predecessors. At the same time, more is known about drug metabolism and the interactions drugs have with foods and other drugs. This has made medicinal therapy become increasingly more complex as the years pass.
At the same time, there are occasions when therapy with medication fails.  Chemotherapy for cancer is one example; while much progress has been made, there are still many treatment failures.  This is also the case in the realm of pain management.  There are many medications out there--some new and some old standbys. But not every drug or drug combination for pain is successful 100% of the time in 100% of patients.
For this reason, it is very…

Prevent Chronic Pain--Prevent Type II Diabetes!

One of the best defenses we have against chronic pain, or any illness for that matter--is to know what the risk factors are and to do our best to eliminate as many risks as possible. There are some risk factors we really can't control--such as genetics. The good news is, there are many risk factors that can be controlled or eliminated.

Type II diabetes is one example of the health conditions I am talking about here.  While diabetes is not a painful condition in and of itself, it can lead to the development of diabetic neuropathy. This condition leads to nerve damage due to elevated blood glucose levels over extended periods.

There is a period of time prior to development of type II diabetes that is known as pre-diabetes. During the pre-diabetes period, timely management of risk factors such as hypertension, weight management, dietary modifications, etc. can halt the further development of this form of diabetes.

For that reason, today I am sharing a link to a quiz that will help d…

Spirituality: A Holistic Health Practice

One subject we have not broached too much in this blog is is one of the elements of holistic health care...but does not always get the "air time" that it deserves.

Spirituality is defined as "being concerned with religion or religious matters; of or relating to a person's spirit."  One approach to spirituality is the practice of organized religion, but spirituality is actually more encompassing than that...

Organized religion is certainly a great way to address a person's spiritual needs.  Most religions have a system of beliefs that set them apart from other religious practices. Those who embrace these practices can find much solace in their respective system of belief. Beyond Christianity, Judaism, Islam and other practices, spirituality also encompasses a sort of "sixth sense." Each person's idea of spirituality is as unique as a fingerprint.  As previously stated, this may be firmly rooted in organized religion..but for …

Chronic Pain? Think Holistically!

Holistic medicine is defined as medical practice that seeks to treat an individual as a whole--body, mind, emotions, and spirit--as opposed to treatment that is focused on a specific malady.  The holistic approach to medicine emerged in the 1970s. Traditional western medicine scoffed at what we now know as complementary or alternative practices; since that time these practices have become more widely accepted and integrated into modern medical practice.

The principles of holistic medicine embrace a team approach to patient care. Holistic practitioners believe that every individual possesses an innate ability to heal themselves. They see the patient as a person rather than a disease state. In an attempt to treat the patient, holistic practitioners are members of a team that strives to correct the underlying cause of the patients condition as opposed to simply alleviating symptoms.
There are many types of treatments that come under the auspices of holistic medicine. These include traditio…

Microglia: A New Discovery And Its Role in Fibromyalgia

Fibromyalgia is still a poorly understood disorder..but fear not, the push is on to learn more about it so it can be better managed and treated. Ask anyone who has this disorder--it's certainly no walk in the park, and the need for remediation is obvious.

One of the more recent discoveries in this effort is the existence of microglia.  Unique to the central nervous system, these tiny cells travel about to areas of injury or infection. Once there, they send out an SOS to other parts of the immune system. Microglia also attempt to begin the healing process. Inflammation is part of this process. While this is a normal part of the healing process, chronic inflammation is problematic.
It's thought that microglial activation is part of the problem experienced by patients with fibromyalgia...perhaps with respect to brain fog and issues with hyperalgesia (pain amplification) and mechanical allodynia (pain experience from something that doesn't usually cause pain, such as brushing…

Fibromyalgia & Pelvic Pain--It's Not That Unusual

In recent news, it's been reported that women with fibromyalgia commonly suffer from pelvic pain....

An Oregon Health & Science University is looking to expand a preliminary study of 177 females average age approximately 52 years who responded to three different questionnaires regarding these topics: Fibromyalgia Impact Questionnaire (FIQ), Pelvic Floor Distress Inventory 20 (PFDI-20), and the Pelvic Pain Urgency, and Frequency Questionnaire (PUF).  When the results were analyzed, a positive correlation between fibromyalgia and the other two conditions was found.
At this point in time, study authors recommend that patients with fibromyalgia be routinely offered all three of these questionnaires to screen for these conditions. 
Sources:HCPLive; Pixabay

Why aren't chronic opioids prescribed for fibromyalgia?

Given that fibromyalgia is such a painful condition, it may seem logical to think that treatment should include chronic opioids. After all, the "tender points" that are the hallmark for diagnosing this condition are so excruciatingly painful to the slightest touch. That leads us to question why the practice of prescribing Oxycontin and similar products for round the clock relief...right?

If the truth be told, the American College of Rheumatology treatment guidelines for fibromyalgia specifically state the following in this regard:

"Doctors do not recommend opioid narcotics for treating fibromyalgia. The reason for this is that research evidence suggests these drugs are not of great benefit to most people with fibromyalgia. In fact, they may cause greater pain sensitivity or make pain persist."

There are currently three drugs on the market that have FDA approval for chronic treatment of fibromyalgia--and all three of them are antidepressants.  Whether or not to use the…

Just Breathe!

Have you ever noticed that your body tends to "tense up" in response to discomfort?  If not, maybe it's worth paying attention to.  Many of us actually hold our breath during those difficult moments...

I recently read a column written by Sarah Anne Shockley about this very topic.  Ms. Shockley suffers from thoracic outlet syndrome, a condition in which nerves, muscles and blood vessels are compressed in her thorax, making something as simple as breathing very difficult to do without pain. After years of attempts to treat the condition with physical therapy, medications, meditation, exercise and such, she found little to no relief. With a little thought and some experimentation, Ms. Shockley came to discover a whole new approach to her condition. Her breathing awareness technique evolved; this has done much to help her cope with her condition. 
I have often stated in this blog that it takes some trial and error on the part of the patient to find what is optimal for a giv…

Parkinson's Disease Possibly Linked to Migraine

An observational study of older Taiwanese adults with migraine suggests that there is a link between migraine headache and the development of Parkinson's disease.  While the study has its shortcomings, it does suggest the possibility that older persons who endure these very debilitating headaches should be monitored for the development of Parkinson's. The exact relationship between these two conditions is unclear; further study is needed determine the connection.

Parkinson's disease is a progressive neurological disorder that develops slowly over time.  Early symptoms may include slurred speech, and/or a lack of facial expressions.  Eventually, the patient may develop a tremor, slowed movement, changes in speech and/ or handwriting, and impaired posture or balance.

While there is no cure for Parkinson's disease, there are many medications available in the present day that can help control symptoms.  An active lifestyle, including aerobic exercise and a healthy diet c…

Endomorphin...pain relief without side effects?

Researchers at Tulane University School of Medicine are working on a genetically engineered version of endorphin.  For those of you who don't know, endorphins are the feel-good, pain killing substance that the human body produces as a way of relieving pain.

The genetically engineered version, known as endomorphin, seems to work at least as well as morphine in preliminary studies.  The best part is, the risks of morphine usage--such as respiratory depression and impaired motor skills--do not seem to occur when endomorphin is used.  In addition, endomorphin does not appear to be addictive in nature.

According to lead researcher James Zadina,  it's unprecedented to that a peptide such as endomorphin can fight pain so well without the side effects of the opioid drugs currently in use.  Clinical trials are expected to begin within a couple of years.

Source: PainWeek; Wikimedia

Never Ignore Pain...

Today I am sharing a link to WebMD's slide show on chronic pain. Many Americans suffer from various forms of chronic pain:  arthritis, migraine headaches, post herpetic neuralgia, back pain, etc. etc.

I would encourage you to have a look at the slide show.  There's a lot of good advice in this short presentation about pain relieving solutions that just might be of help.  If you take nothing else from this post, here is the main thing to remember:

If you suffer from pain on a regular basis--even if it's mild pain--it's worth your while to seek medical attention.  You might just be able to prevent a potentially serious condition from becoming disabling or even fatal.

Your body talks to please listen carefully!

Sources: WebMD; Pixabay

Rules for Success: You ARE What You EAT!

Did you know...that for individuals with chronic pain, forty percent of the problem can be traced to their diet?

Well, it's true. And sadly, the foods that are the most problematic are the very foods we love oh so much.  Eating these foods, especially when we know they are triggers, can mess us up for weeks on end.  Doctors and other health care providers are not always in the loop about this.  They do need to become more knowledgeable so they can help patients to help themselves.  In the end, those same patients will feel better more of the time and rely on medications much less.  That's a winning combination!

So, which foods should be avoided?  Start with bread, flour, sugars, artificial sweeteners, fruit juices, potatoes, and hydrogenated fats.  Those seem to affect most everyone.  Read the ingredients on all the foods you eat.  You'd be surprised how many wheats, fats, etc. you are consuming without even thinking about it.  This kind of diet is not about losing weigh…

Chronic Pain And The Loves of Our Lives...or the Lack Thereof

According to a 2015 NIH study, nearly 50 million Americans suffer from some form of chronic or severe pain. That number is alarming. And if that isn't bad enough, chronic pain not only affects an individual, but all family, friends, husbands, wives, and others connected to that individual.

Maybe those not affected by chronic pain don't stop to think about the impact of this statistic.  For one thing, chronic pain affects the most intimate relationships because it can impact the ability to be physically intimate.  Consider fibromyalgia as an example... even the slightest touch can be excruciating. That's only one example--many other possibilities exist. At some point, someone with chronic pain may even "opt out" of physical love completely, just because it hurts too much.

Pain management medications take their toll on these relationships as well.  In as much as they benefit the patient, side effects such as decreased libido and fatigue can be a problem. Communica…