Everyday pain management ideas

As the gluten free marketplace expands, and more and more people are following the gluten free trend, many of us are unaware of the most important reason to follow a gluten free diet: celiac disease. This condition affects approximately 1 in 100 persons worldwide.  If a parent or sibling has been given this diagnosis, there is a 1 in 10 risk that children, brothers, and sisters will also be diagnosed. If you know something about Celiac disease, you might know that it's an autoimmune disorder. The gastrointestinal effects of the condition are well known, including cramping, constipation, diarrhea, vomiting and such. There are many other signs and symptoms that you can read about here .  But there are additional problems that can and do occur with this diagnosis, including a rash known as dermatitis herpetiformis, migraines, nutritional deficiencies, seizures and osteoporosis.  Some persons with Celiac disease also develop other serious conditions such as type I diabetes and

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

Have you ever seen the scale below? Or been asked by a health care provider to rate your pain on a scale of 1 to 10?  I would bet most people would answer yes to at least one of those questions. Now, a new kind of pain scale has emerged. ..instead of focusing on the intensity of the pain, the emphasis is on the quality/nature of the pain . " Mypainfeelslike.. ." is a new campaign initiated in Ireland by a German pharmaceutical company.  (You can visit the web site yourself by clicking the link above!) The project was designed was to help patients and their doctors to better understand more about a given patients pain...there is a graphic to help patients discern between stabbing pain, burning, piercing, stabbing and other pain sensations...and a questionnaire to that the patient can complete if they so desire.  Initially, this web site developed for patients  with neuropathic pain, but it can be used by other chronic pain sufferers as well. If this sounds helpful

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

Breathing--the process by which the human body moves air in and out of the lungs. It's the essence of life itself.  No one teaches us how to breathe; it's instinctive. Or, is it? Breathing is something every living person does day in, day out, asleep or awake.  This life force, when used in its fullest capacity is also a very powerful means by which an individual can take some control over anxiety, pain, and healing. It is also essential to optimal brain activity and overall good health. Sadly, this very powerful life force is often overlooked as a pain management tool.  Through a complex mechanism, the practise of basic relaxation breath can calm nerves, reduce anxiety, and improve gastrointestinal and immune system function. If you've ever given birth or observed someone giving birth (a pretty painful process, isn't it?), you will notice that breathing is a very important part of the process...doesn't that tell us something? There are many resources onli

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

News reports out of Sydney, Australia are sharing promising results for patients with osteoarthritis. In a couple of studies going on there, patients with hip or joint osteoarthritis, a new technique involving stem cells is undergoing clinical trials. Human Stem Cells According to reports, patients in these studies first undergo liposuction to harvest the stem cells needed for the procedure.  The stem cells are then processed in a laboratory, and when ready (about four weeks later), they are injected into the same patient's affected joint. This is the first time that a treatment of this type is being tried...and while still incomplete, the early results are quite remarkable. Interestingly, the patients with most severe joint damage seem to be the ones who benefit the most! The results are yet unpublished...but it's exciting to thing that this could revolutionize treatment of osteoarthritis in future.  Maybe joint replacement therapy will become less common, or eve

The preliminary results of a University of Toledo (Ohio) suggest that emotional abuse in childhood is linked to the development of migraine headaches in adults, particularly in men. All varieties of child abuse (sexual, physical, and emotional) increase the chances of developing migraine later in life, but according to study author Gretchen Tietjen, MD and colleagues, emotional abuse alone increases the risk of developing migraine by a whopping 52%. The authors go on to say that the relationship between emotional abuse, depression, and migraine are worthy of further investigation. Emotional abuse of children is not uncommon...when physical or sexual abuse is added to the mix,the relationship between the abuse and migraine seems to be more strongly connected.  Interestingly, the authors note, when children are emotionally abused, data suggests that it helps to build resilience to a point, but beyond that point the problems begin. The authors go on to suggest their theory as

Most people know about some of the problems with opioid usage: sedation, risk of addiction, impaired motor skills, to name a few.  In truth, there are more problems to add to that list. One of them is the risk of hypotension (low blood pressure)...and perhaps the most deadly side effect of all is the risk of respiratory depression, which can lead to death. CPAP--a common treatment for sleep apnea A review of literature conducted by Frances Chung, MBBS, and her coauthors reports that the overall prevalence of sleep apnea in chronic opioid users is 24%. The rate of sleep disordered breathing in this population is reported as high as 85%;  those who use higher doses (morphine equivalent daily doses of 200 mg or more) show a 92% rate of ataxic periodic breathing. This reiterates the need for primary care and pain management physicians to be aware of this very serious problem.  In this way, the CDC guidelines helps to bring this issue front and center,  and that's exactly

I'm sure after reading parts one and two of this series, chronic pain patients might feel a little anxious...and that is certainly understandable.  Sometimes change is good, but sometimes, it's difficult. Image Source: Wikimedia It's hard to know exactly how these guidelines will affect health care delivery of pain management going forward. First of all, remember that these guidelines are non-binding. No practitioner, regardless of specialty, is being forced to comply. For those patients who are doing well on established regimens, I do not expect much to change. The biggest changes, in my humble opinion, will affect those who are newly diagnosed with chronic pain conditions.  The guidelines emphasize that more conservative measures be the first approach to treatment.  Opioids should reserved for those who fail more conservative treatments, cancer patients, or those who are in palliative or end of life care. There are also provisions in the guidelines for monit

Needless to say, the opioid epidemic has caused a major clash of government agencies, drug companies, pain care advocates and other medical organizations.  Some US states have passed legislation in response to the crisis. In the last few weeks, the CDC--a governmental agency that oversees public health matters--released its own guidelines for pain management.  The guidelines are non-binding but represent a sweeping change to the way pain is addressed in the American medical community.  Some highlights from this policy change include: opioid medications should not be considered "first line therapy" three days or less of opioid medication should be sufficient for most cases, excluding cancer patients, or those under palliative or end of life care dosage and prescribing limitations for prescribers review of dosages and patient goals and outcomes of therapy during patient care visits prescriber monitoring of patient history/pattern of drug usage through established

Even if you don't pay particular attention to the news, stories about the opioid crisis are everywhere. You just can't miss it. Opium has been in use for centuries. According to Wikipedia, opium was in use during the Neolithic Age- (10,200 BC to around 4,500 BC). So, the question is...how did this crisis emerge? Fast forward to the modern century...about fifteen years ago, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) reported that pain was vastly under treated here in the United States. Pain was deemed the "Fifth Vital Sign" and JCAHO stressed that pain assessments be a part of every patient/physician visit.  It was suggested that opioids could safely and effectively be used liberally, without fear of addiction. In the meantime, Purdue Pharmaceuticals launched Oxycontin®, an opioid product that offers continuous pain relief over 12 to 24 hours. As such, this product contained higher amounts of opioid than other immediate rel