Everyday pain management ideas

Image source: Wikimedia

The FDA has clearly established guidelines for safe usage of medications during pregnancy. Generally speaking, there are five categories of drugs:  Pregnancy category A Adequate research has been done with the conclusion that drugs in this category are not likely to cause any harm to the fetus in the first trimester as well as later in pregnancy. Pregnancy Category B Studies carried out on animals have shown no adverse effects on the fetus; however, there is a lack of controlled studies on human pregnancy. Pregnancy category C Animal studies have shown evidence of harmful effects on the fetus; however, no controlled study has been done on a human pregnancy. The medicines may be prescribed in cases where the potential benefits outweigh the possible adverse effects. Pregnancy category D Studies done on human pregnancy have shown positive risks to the fetus. However, doctors might prescribe them in certain cases where the potential benefits outweigh the risks

Fibromyalgia was not recognized as a clinical disorder until sometime in the 1990s, but it has probably existed for a lot longer than that.  People of almost any age can be affected by fibromyalgia, but many people are first diagnosed in their twenties. According to the National Fibromyalgia and Chronic Pain Association, 75-90% of persons affected by fibromyalgia are women . For these reasons, it's important to share a few thoughts about the management of fibromyalgia in women during the childbearing years. There are medications for fibromyalgia, but at the present time, these drugs are not recommended for use during pregnancy.  Therefore, alternative methods of fibromyalgia management are very important. These methods include exercise, yoga, meditation,  massage and rest.  Exercise is key, because it keeps you fit and improves mood due to an increase in serotonin levels. Serotonin seems to be a key player in helping one to manage stress, in calming anxiety, and improvin

Pregnancy is such an exciting time in a woman's life (usually)...but it does not come without its pains or discomforts!  Additionally, some women have pre-existing conditions that they must endure in addition to being pregnant. Sadly, many chronic pain conditions are among the possibilities. In terms of medications, there are guidelines that physicians follow with respect to pain management in pregnancy.  Tylenol (acetaminophen) is generally regarded as a safe and effective treatment for most pregnant women, but it has been reported that babies born to women who used it had an increased risk of developing hyperactivity issues.  The FDA has established a system for categorizing drugs as to risk in pregnancy.  There are some medical reference books available to pharmacists and other health care workers to help pregnant and nursing mothers to assess risks of specific drugs to both developing and nursing babies. For the most part, great caution is advised when using med

 Have you ever tried to walk with a stone in your shoe? This sensation is similar to the discomfort one experiences when they have a neuroma --a benign tumor made up of nerve tissue that causes pain between the toes. Often times a person with neuroma will stop in the middle of an activity, such as walking, remove their shoe and rub the painful area to obtain relief. No one really knows what causes neuroma, but it's been attributed to bio mechanical deformities, high arches, flat feet, improper footwear, and/or repeated stress or injury to the foot. Symptoms of neuroma include pain in the front of the foot, or between the toes, pain in the ball of the foot when body bearing weight, numbness, tingling, or perhaps swelling.  You can try to help yourself if you experience these problems by wearing shoes that are well fitted. Avoid high heels; rest and massage your feet in the painful area. Ice packs can be helpful. Typically neuromas are treated by a podiatrist. He/she c

Here is another common foot problem--bunions. A bunion is essentially a bony bump that begins to form at the base of the big toe.  The exact cause has yet to be determined, but it's thought that genetics may play a role in their formation.  Some experts say that wearing high heels--which forces the front of the foot into the small toe box of the shoe--is another potential cause. Foot injuries or deformities, and some forms of arthritis may also precede bunion formation. The image above is a good illustration of bunion formation, and how they can become a severe deformity if left unaddressed. Here are some tips that may help to prevent this problem from the get-go: Avoid wearing high heels Steer away from ill-fitting shoes, especially if the toe box is too tight Heredity and/or rheumatoid arthritis may predispose one to bunions; if that's the case, be extra vigilant about the first two tips given here! Other complications aside from those pictured above include bu

Nothing feels good when your feet hurt.  I haven't talked much about foot pain in this blog, so I thought this week I would discuss some common causes of foot pain and the remedies that usually work for them. One of the most common causes of foot pain is plantar fascitis.  The plantar fascia is a thick band of tissue that runs across the bottom of the foot; it connects the bones of the toes to the heel bone. It's not uncommon for someone with plantar fascitis to have a stabbing pain in the bottom of the foot, near the heel. This pain can be at its worst one takes their first steps out of bed in the morning. What a way to start the day, right? As with any condition, certain situations or activities put a person at increased risk for plantar fascitis. These risk factors include obesity, spending long periods of time standing up on our feet, some forms of exercise and dance, and issues regarding foot mechanics, such as a high arch or being flat-footed. It's

Smoking has been on the decline for decades. However, there are still a good number of smokers out there--despite all the health warnings!  I suppose the biggest fear in this group is the fear that they might develop lung cancer.  And that certainly is a possibility. What they might not consider is that smoking cessation has many other benefits. For one thing, the risk of heart attack, stroke and other vascular diseases is reduced greatly when one decides to kick the habit. Chronic obstructive pulmonary disease (COPD) is another health issue that can improve or be completely prevented if a smoker decides to quit. Women of childbearing age who smoke can experience infertility issues-; this is less of an issue if a woman does not smoke.  If a woman is pregnant, the baby is less likely to experience health issues if the mother is not a smoker. Expectant mothers who stop smoking during the pregnancy are less likely to have a baby with low birthweight. Last, but not least--

In the US, more than 46 million people suffer from Rheumatoid Arthritis (RA). Even though the incidence of RA has been on the decline over the last several decades, it's painful and debilitating to those who suffer from it. The modern mainstay of arthritis treatment is the use of a class of drugs known as DMARDs (disease-modifying anti rheumatic drugs).  This class of drugs has done much for affected patients in terms of improving quality of life and slowing progression of disease. That being said, complementary treatments are still an important part of therapy for those affected by this condition. What are these "complementary treatments" you ask?  Here are some examples: Anti-Inflammatory diets, such as the Mediterranean diet, are helpful in controlling inflammation. Some of the important elements of these diets include fish, vegetables, and olive oil. Heat and cold therapies are effective for acute pain. For joint stiffness, heat seems to have best effect,

The elderly population is probably at greater risk for chronic pain than their younger peers.  The wear and tear on knees, hips and other joints over the years is one big source of this problem, combined with the likelihood of other health issues such as diabetes, restless leg syndrome, Parkinson's disease, cancer, stroke, etc. Those with dementia may also suffer from pain--but their ability to effectively communicate this to caregivers is often diminished. Due to the fact that multiple problems often coexist in this population, pain management can be problematic.  It's certainly not a good idea to ignore their pain; that would be inhumane  and could lead to a whole host of new problems including anxiety, depression, and insomnia.  But often times medication options are more limited due to an individual's prescription regimen for their current comorbidities. Fear not!  There are still ways to manage this issue. Less severe pain can be managed using ice packs and/or

An emerging form of treatment, known as "scrambler therapy" was introduced to the 2016 meeting of the American Pain Society.  This type of therapy, also known as Calmare Pain Therapy Treatment , seems to be useful for various forms or neuropathic pain, including neuropathic pain following cancer chemotherapy. This form of treatment involves using electrical stimulation to block nerve pain.  Treatments are given in cycles.  One cycle of treatment can produce remission for 10 days, 2 months, or even longer. If a patient's pain begins to re-emerge, another cycle of treatment can be initiated.  Study authors are also studying the possibility that other forms of chronic pain treatment may complement or enhance this new pain therapy. You can read more about scrambler therapy and the Calmare Pain Therapy Treatment by clicking here . Sources:  Calmarett.com; Pain Medicine News; Wikimedia

As a young pharmacist, I remember the popularity of codeine containing products--Tylenol® With Codeine, Empirin® with Codeine, and many formulations of cough syrups with codeine.  But as the years have gone by,  the rationale for using these products has fallen by the wayside. First of all, codeine in and of itself is a prodrug. It does not have any pharmacological effect until it is converted by bodily enzymes into morphine, its active form.  Due to genetic variability some people do not possess the enzyme that is responsible for this conversion. When these persons are ordered codeine containing products for pain, or for cough, it does not provide analgesia or cough suppression. Conversely, there are also " ultra-rapid metabolizers " of codeine--in this group, codeine is very quickly converted to morphine, so quickly in fact, that the effect can result in toxicity. Since the medical field does not genetically test people routinely to see who can or can't metabolize co

Web MD has a great slide presentation about home remedies for Restless Leg Syndrome--they're all simple things most anyone can do to help manage this condition. Here is a quick list of ten of the suggestions they present~~ keep a regular bedtime-- helps combat fatigue and keeps symptoms in check stretch before you sleep~ leg stretches may help just before bed or following prolonged sitting eliminate caffeine~ may worsen symptoms for some RLS sufferers warm bath before sleep~ a classic way to wind down and relax before sleep exercise habit~ one study found that exercise resulted in reduced leg movement/deeper sleep exercise your brain~ crossword puzzles, knitting, etc. are good distraction techniques leg massage~ calf massage can help one to fall asleep more quickly yoga~ stretching, breathing and relaxation of can relieve mild RLS symptoms avoid alcohol and cigarettes~ nicotine and alcohol can exaggerate RLS symptoms medication review~ some cold and allergy med

Hot off the presses!!! We're all aware the of the existing opioid and heroin epidemics going on in the world...and that the need to use more alternative and complementary practices to manage chronic pain is urgent. Sadly, we're also aware that chronic use of opioids has led many into addiction, and ultimately death. But perhaps new hope is in store! An exciting study at the University of Calgary reveals that an existing anti-gout medication can help to ease the symptoms of opioid withdrawal.  Their findings reveal the cellular mechanism of withdrawal and can--and hopefully will--lead to new ways to approach the problem of opioid addiction. Keep in mind that this study is still at the preclinical levels. Let's hope at a future date there is more good news in store. This cannot come soon enough! You can read more about this very exciting news by clicking here! Sources: EurekaAlert; Wikipedia

After my last post, I realized that the terms complementary, alternative, or integrative medicine may seem to confusing to some readers. It is my hope that after reading today's post these terms will be better understood. So, without further ado, here is my attempt to explain-- Alternative medicine  refers to practices outside the scope of traditional medicine. Yoga practice, meditation, chiropractic medicine,  and nutritional supplements or herbal medicines are some examples of these practices.  The term "alternative medicine" implies that one ore more of these non-traditional methods is being used in place of traditional medicine for a given condition. Complementary medicine  refers to using a combination of traditional and alternative medicine to treat a given condition. As an example, a migraine sufferer finds that attending yoga classes regularly helps to reduce the frequency of migraine headaches. But this same individual is also under care of a physic

Modern pain management practice is looking for alternatives to opioid prescribing...and as such, they are looking toward some very new approaches--such as the pain management devices that are coming onto the marketplace--and some very old methods--such as yoga, acupuncture, reiki, and nutritional supplementation. The question is-- how can a patient tell what is safe and effective from what is not ? One good resource is the NIH--the National Institutes of Health.  If you go to the Pain Management Section of the site, you can find information on many of the topics in this field. The Cleveland Clinic and Mayo Clinic , two prestigious medical institutions, also offer online health libraries that you can access if you have a computer, laptop. or smartphone. WebMD is another good resource.  Many products--such as the devices on the marketplace--may have their own individual informational sites, and you can visit them for information. A discussion with you medical care team ma

I've previously mentioned that having a hobby can do much to distract someone from chronic pain...and I've previously mentioned that knitting and /or crochet are helpful to those with stress and anxiety--two common problems in the chronic pain population. Recently, I came across a post in "The Little Things" citing many reasons why knit and crochet are good for your health.  You can read the post in entirety here , but here is the short list of the benefits! 1) Knitting (or crochet) can reduce heart rate and blood pressure. This leads to reduced levels of cortisol, a stress hormone that can damage the circulatory system and the heart. 2) Knit/crochet help keep fingers nimble. Just as walking or other exercise is good for arthritic knees and hips, knitting and crochet serve to exercise muscles in the fingers and hands, which helps to keep them from becoming stiff and dysfunctional. 3) Math skills are improved in people who knit/crochet. Following patterns

Last summer, TIME magazine ran a very thoughtful article about the Opioid Crisis. The piece was written by Andre Machado, Chairman of the Neurological Institute of the prestigious Cleveland Clinic. In this short editorial, he brilliantly lays out how we have arrived at such a critical juncture in the world of pain management, and how we can move forward to a better approach toward the treatment of chronic pain. You can read this very timely article (no pun intended) by clicking here . Sources: Time Magazine; Flickr

In one of the first studies of its kind, the FAIR Health group released some very interesting information last fall.  This group used claims data from privately insured persons to illustrate some obvious, but very shocking conclusions about privately insured persons who are regular opioid users. The data from this study looked at (non-identifying) data from insurers who cover upwards of 150 million patients. They noticed the following observations: From 2007-2014, medical services for people with opioid dependence diagnoses skyrocketed more than 3,000% Much of the increase in opioid dependence occurred since 2011, even though this period was marked by increased attention to the problem and a growing concern amongst advocates as they called on doctors to reduce the number of opioid prescriptions. Younger patients (19-35 years) were most likely to be diagnosed as “opioid dependent” relative to other age groups. (Dependence is defined by symptoms such as increased

Today I am sharing an article from PhillyVoice . I don't want to paraphrase it because if I did,something would be lost in translation.  All I want to say about it is that we often wonder about these aspects of  the human body and pain...but no one really addresses these things. That is, until now. You can read this short but informative article by clicking here . Sources: PhillyVoice; Pixabay