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Posture Treatment: New Hope For An Old Problem?

With the opioid crisis looming over our heads, we need to look for new ways to treat some of the problems that could potentially lead to future opioid use.  One of the most common causes of chronic pain is low back pain that stems from degenerative changes, sciatica, etc. As mentioned in past posts, there is no panacea for any of these conditions, but there are many options out there.

I recently read a story in the New India Express about a new treatment that is offering hope to patients with these types of maladies. According to the article, our body posture can easily end up in misalignment when we try to compromise for things like physical trauma, or develop poor posture habits in the workplace. We often overlook the effects of these postural abnormalities as part of "the big picture."  Using the latest technology, medical science can now detect and treat such abnormalities with great precision. Medical procedures of this sort are non-invasive and are virtually painless…

Strange But True: Burning Mouth Syndrome

Believe it or not, there really is a painful disorder known as "Burning Mouth Syndrome!" While it does not occur commonly, it can affect an individual for weeks, months or years.  This syndrome, as its name implies, causes a burning sensation in the oral cavity.  The primary symptoms is a sensation in the mouth that has been described as burning, scalding, or even tingling. It is difficult to diagnose because there is no visible abnormality for a doctor, dentist, or other health care provider to see upon exam.

Burning Mouth Syndrome is considered "Primary BMS" if no underlying medical condition can be associated with it.  In this case, damage to nerves seems to be the underlying cause of the problem.

"Secondary BMS" can be associated with an existing medical problem such as diabetes, thyroid disorders, allergies, Sjorgren's syndrome, certain medications or nutritional deficiencies, an oral infection or even gastroesophogeal reflux disease GERD).


Shared Reading: A New Approach To Chronic Pain?

One of the traditional strategies in the treatment of chronic pain is cognitive based therapy(CBT)--that is, using the help of a psychologist to help build up coping skills and keep a positive perspective in spite of the hardships. A recent study based in the United Kingdom suggests an alternative approach: shared reading.  Shared reading is an activity in which a small group of individuals gather to read aloud. The study involved reading poetry, short stories, and other literature that helped participants to recall memories and experiences of life, especially those that pertain to childhood, family, work, and other lifetime memories.  The idea for this study stems from the use of this strategy for other chronic conditions such as dementia. It is thought that prompting these memories helps patients to address painful emotions that may contribute to their respective conditions.

While the results of the study are encouraging, the team who conducted the study says a larger scale study w…

New Saliva Test Helps Clinician Monitor Pain Patients

A Denver-based company has developed a test that can help physicians monitor opioid usage in patients--using saliva instead of urine samples.  The test is known as CORE (Comprehensive Oral fluid Rx Evaluation). Cordant Health Solutions, the developer of this test, says that it is more accurate than the widely used urine tests currently in use.  A sample is easily collected simply by swabbing the inside of a patient's mouth. The test can detect if patient is taking the right amount of medication, while urine tests only detect the presence or absence of a drug.  Urine tests also give false results sometimes.  As an example, the decongestant component in common cold remedies can trigger as a positive for amphetamines.

While it has its positives, the company admits that the test is not foolproof. Drug levels found in saliva do not correspond with blood test results about 25 percent of the time. Another drawback is that the result of a saliva test is not available for 48 to 72 hours, wh…

Living With Psoriatic Arthritis

While it might seem overwhelming at first, it is possible to have a somewhat normal life when you are diagnosed with psoriatic arthritis.  If you are new to exercise, it will probably be very challenging in the beginning, but it can be done!  It's important to start low, go're not training for a marathon when you first start out!

Gentle forms of exercise, such as walking or swimming are great exercises for beginners. It might be necessary to get some help from a physical therapist or a personal trainer to get yourself going! Cycling, yoga and tai chi are other possible activities.  Do not hesitate to talk to your health care team if you are unsure about an activity; it's better to be safe than sorry.

Pain is an unfortunate consequence of psoriatic arthritis.  Medications are necessary to combat pain and also the inflammation caused by this condition.  Most likely prescription NSAIDs or biologics such as Humira® will be a component of your treatment.  Some pati…

Psoriatic Arthritis: Complementary Therapies

While the mainstay of therapy for psoriatic arthritis is the medical management of inflammation, there are a number of things that complement the efforts of their health care team.  First and foremost, diet and nutrition play a big role in this regard.

Their are several facets to consider in this effort:

--Anti-inflammatory foods help to reduce the inflammation caused by psoriatic arthritis and psoriasis.
   See my earlier post: The Painful Truth About Psoriasis: Dietary Considerations
--A heart-healthy diet, including elimination of alcohol, processed foods, and fatty foods and instead opting for lean meats, fish, fresh fruits and vegetables, and healthy oils.
--Inclusion of omega-3 oils in the diet through supplements, nuts, fish oil, eggs and other foods
--Up to 25 percent of those who have psoriasis have gluten sensitivity, so a gluten-free diet is worth considering.

--Weight loss is important, especially since obesity is a risk factor for psoriasis and the other risks a psoriasi…

Psoriatic Arthritis: Are You At Risk?

Psoriasis is a chronic disorder, and those who suffer from it are at higher risk than most for other disorders.

One such problem is psoriatic arthritis.  About 10 to 20 percent of all psoriasis patients will go on to develop psoriatic arthritis.  Symptoms include joint pain, stiffness, and swelling are the hallmarks of psoriatic arthritis. Any part of the body can be affected by it, and the symptoms can range in intensity from mild to severe.  There is no cure for this disorder, so the focus of treatment is on managing inflammation to prevent joint pain and disability.

That being said, psoriasis is not the only risk factor for psoriatic arthritis; as a matter of fact some people develop psoriatic arthritis even though they do not have psoriasis! Knowing these risk factors and doing your best to control the controllable are the keys to prevention.

So, here is a list of these risk factors.

1) As already mentioned, having psoriasis is a big risk factor for development of psoriatic arthr…

The Painful Truth About Psoriasis--Dietary Considerations

Just as with many other chronic health conditions, diet plays a role in disease management.  Here is a quick overview of dietary considerations for people with psoriasis:

First off, if you are a psoriasis patient you may notice that some foods tend to trigger flare-ups more than other foods.  To this point, it's good to be observant and do what your body tells you to do. As long as you follow a healthy diet, this is good!
It has been suggested that people with celiac disease may be at higher risk for psoriasis than other persons. A gluten free-diet is the mainstay of treatment for celiac disease,and it may help keep psoriasis flares at bay as well. But the relationship between gluten intolerance, yeast exposure and psoriasis is not well understood at this point in time. You can try eliminating gluten or yeast if you suspect it to be a problem and see what happens.
Fatty red meats are known to increase heart health risks...and people with psoriasis have an increased risk of heart …

The Painful Truth About Psoriasis--Traditional Medical Treatments

As previously posted, psoriasis is a chronic immune mediated disorder that causes raised red scaly patches to appear on the skin.  You might not think of it as a chronic pain disorder, but it's not exactly comfortable to be living with this condition all the time. If left untreated, psoriasis can develop into psoriatic arthritis. Other possible complications include eye issues, type 2 diabetes, obesity, hypertension, heart disease and more.  So it makes sense to manage and treat it, because it certainly is much more than a simple skin condition.

There are several methods that are used to manage psoriasis in traditional medical practice. Here are some examples:

Biologics--usually administered via IV infusion, these drugs are usually used for more severe cases or cases in which other treatments have been ineffective.

Systemics--these are for moderate to severe cases of psoriasis.  Some are injectable and some are oral medications. They include drugs such as cyclosporine and methotrex…

The Painful Truth About Psoriasis--In A Nutshell

The National Psoriasis Foundation defines psoriasis as "an immune-mediated disease that causes raised, red scaly patches to appear on the skin." The exact cause of this disorder in not known, but genetics and the immune system play a big role in its development. Men and women are affected equally, but Caucasians are more susceptible than African Americans. Most people are initially diagnosed somewhere between 10 and 15 years of age. Psoriasis is not a contagious disease!

There are five basic types of psoriasis:

Plaque psoriasis is the most common form of psoriasis. It appears as raised red patches with a silver to white buildup of dead skin cells on top.  It looks something like this:

Guttate psoriasis appears as small dot like lesions on the skin.  This form usually starts in childhood, and is the second most common form of the disorder.  Here is an example:

Very red patches that appear in body folds, such as armpits, back of the knee, or groin might be a form of psoriasis k…

A Picture Says It All: Back Pain

A Picture Says It All: Headache or Migraine?

A Picture Says It All: Fibromyalgia

Pain and Pregnancy, Part Three

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.
Pregnancy category X
Both human and an…

Pain and Pregnancy, Part Two

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 improving mood. An…

Pain and Pregnancy, Part One

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 medication of any…

All About Feet: Neuromas

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 can help you to …

All About Feet: Bunions

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 heelsSteer away from ill-fitting shoes, especially if the toe box is too tightHeredity 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 bursitis and hamme…

All About Feet: Plantar Fascitis

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 important to seek…

Beyond Lung Cancer: Smoking And Chronic Pain

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--did you know th…