Do You Suffer From Fibromyalgia?
It is thought that nearly 1 in 20 people are affected by fibromyalgia. Of these, a considerable 80-90% of those affected are women. This complex condition can rear its head suddenly and be tricky to diagnose. Patients can be misdiagnosed and consequently improperly treated for diseases that are similar to fibromyalgia.
A huge step forward in the treatment of this debilitating illness is being able to put a name to it. This is important not only with regards to assigning strategic treatment but also for patients being able to validate the pain that they feel.
Causes: Fibromyalgia a chronic condition characterized by pain in the soft tissue surrounding the muscles. Fibromyalgia syndrome can vary in severity and may affect one muscle or an entire group.
Symptoms: Patients report certain tender points or triggers that cause pain. Patients may also report other symptoms such as fatigue, depression and other psychological issues.
Treatments: Physical therapy is considered as the best option for Fibromyalgia syndrome. Interventional procedures include trigger point injections, spray and stretch techniques, and dry needling.
If you are dealing with fibromyalgia contact a local pain management specialist for help.
Pain In the Lower Back, Hips Or Buttocks?
SI Joint Injections May Help
A sacroiliac (SI) joint injection is a treatment to help patients with pain in the buttocks, lower back and hips. These joints connect the bottom of your spine to your pelvis and provide support for the lower part of your body and your back.
If the SI joint is confirmed as your source of pain, an anti-inflammatory medication (corticosteroid) is included with the injection to provide pain relief by reducing inflammation within the joint.
If the patient experiences prolonged pain relief after a therapeutic sacroiliac joint injection, he or she can begin a physical therapy and rehabilitation program to further reduce pain and return the patient to normal activity levels.
If the therapeutic sacroiliac joint injection is successful in reducing or eliminating the patient's pain for a longer duration, it may be repeated up to three times per year, in conjunction with physical therapy and rehabilitation program, to help the patient maintain normal function.
What Will Happen During the Procedure?
You will lie on your stomach on a table. Then the area to be treated will be cleaned and covered with a special sheet. Before the procedure starts, a doctor will inject you with a local anesthetic. This will numb the skin over the area that will be treated. Then your doctor will inject the numbing medication and the steroid medication in the joint(s). You may feel some pressure when the medications will be injected. The entire procedure should take about 10 minutes.
About 20-30 minutes after the procedure, you will be asked to move your back to try to provoke your usual pain. You may or may not obtain improvement in the first few hours after the injection, depending on if the sacroiliac joint is your main pain source.
You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit them for the first 4-6 hours after the procedure, so that the diagnostic information obtained from the procedure is accurate. You may be referred for physical or manual therapy after the injection while the numbing medicine is effective and/or over the next several weeks while the cortisone is working.
Risks and Side Effects
A SI joint injection is generally considered safe. The most common side effect is soreness in the injected area. The soreness will go away once the steroid starts to work.
Complex Regional Pain Syndrome (CRPS)
Telltale Signs and Symptoms
Complex Regional Pain Syndrome (CRPS) is a chronic pain syndrome that involves a region of the body, often one arm or leg, usually following trauma or injury. CRPS is rare, but can be very disabling, and is not considered normal. CRPS symptoms are much worse than the pain caused from the initial trauma or injury.
Most people with CRPS have constant, severe, burning pain in one part of the body. In severe cases, even the slightest touch can cause significant pain. Symptoms include swelling, changes in skin blood flow and temperature in the body part. Abnormal excessive sweating as changing in growth patterns for hair and nails may also occur.
CRPS is so painful that many people are not able to move the affected body part, which often leads to muscle stiffness, weakness, or atrophy. The less the person moves the limb, the worse the symptoms can become.
We do not know the full cause of CRPS, though it may be caused by changes in the nerves after injury. There is no certain cure for CRPS.
Once you have been diagnosed with CRPS, your doctor will work with you on a treatment plan to reduce pain, regain movement, and restore use of the affected limb.
Intensive physical therapy earlier in the course of the problem helps. Also, interventional procedures, such as stellate ganglion blocks, lumbar sympathetic blocks, or spinal cord stimulation, are performed by an interventional pain physician.
Because living with chronic pain can be hard both physically and mentally, psychosocial support is very important. Counseling, support groups, relaxation training, and other activities can help you cope better with pain even as you undergo treatment.
You and your interventional pain physician can work to reduce your pain, restore your movement, and improve your life.
Suffering From Neck Pain?
Neck pain is the second most common complaint among patients second only to lower back pain. Most people will experience neck pain at some point in their lives.
Neck pain can be acute, meaning it lasts a few hours to a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain. If your neck pain is so severe that you can't touch your chin to your chest despite a few days of self-care, seek immediate medical attention.
Causes of Neck Pain
There are myriad reasons that pain in the neck can occur, but usually the causes of neck pain are not serious. Sometimes the cause is obvious, a patient has had an accident or injury resulting a physical trauma that causes pain in the neck or cervical region. However, other times you may not be able to pin point a specific incident or don’t understand what happened to actually cause the pain you are experiencing.
Poor posture at work, such as leaning into your computer, and during hobbies, such as hunching over your workbench, are common causes of neck pain. Acute strain may also occur after sleeping in an awkward position.
Symptoms of Neck Pain
You may hear or feel clicking or grating (called “crepitus”) as you move your head. This is caused by roughened bony surfaces moving against each other or by ligaments rubbing against bone.
Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and gland swelling.
Treatments for Neck Pain
Applying ice massages for 5-10 minutes at a time to a painful area within the first 48 hours of pain onset can help relieve pain as can heat, which relaxes the muscles. Heat should be applied for pains lasting greater than 48 hours.
Rest – lie down from time to time during the day to give your neck a rest from holding up your head. Avoid prolonged rest, since too much inactivity can cause increased stiffness in your neck muscles.
Your doctor may recommend that you work with a physical therapist to learn neck exercises and stretches. A physical therapist can guide you through these exercises and stretches.
Acetaminophen (Tylenol) with or without an anti-inflammatory medicine such as ibuprofen (Advil) or naproxen (Aleve) may help relieve your neck pain. It may take several days to settle the pain down. Stronger narcotic-containing medicines are usually not necessary, but your doctor may provide these for the first few days.
If severe neck pain occurs following an injury (motor vehicle accident, diving accident, or fall) medical care should be sought immediately. If there has not been an injury, you should seek medical care when neck pain is continuous and persistent, severe, accompanied by pain that radiates down the arms or legs, or by headaches, numbness, tingling, or weakness.
Are You Suffering From Hip Pain?
The hip joint is a large ball and socket joint and is designed to withstand repeated motion and allow for fluid movement. Hip pain is a common complaint with a number of possible causes. The most common causes of hip pain are arthritis, bursitis, muscle strain, and nerve irritation. Treatment and management of hip pain is dependent on the diagnosis and any underlying illness that may be present.
Treatment Of Hip Pain
Below are some of the common treatment options that are pursued in the management of hip pain:
Medication Management: Over-the-counter pain medications such as acetaminophen (Tylenol), non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are often sufficient in managing hip pain. There are also other prescription NSAIDs including Diclofenac, Naprosyn, Celebrex that have been proven to relieve hip pain. Opioids, or narcotic medications may be considered in the management of hip pain, if the pain is severe and if alternative pain management options fail to offer relief.
Physical Therapy: Physical therapy is an excellent treatment for managing hip pain. Therapy is directed to maintain the strength and range of motion of the hip through various stretches and strengthening exercises. Other techniques used in physical therapy include ultrasound therapy, heat therapy, and massage.
Joint Injections: Depending on the diagnosis, joint injections can be offered to help with pain relief. This is particularly useful in patients who have moderate to severe osteoarthritis of the hip. Arthritis of the hip can present as pain in the groin, and can also be felt in the thigh. Injecting a solution of local anesthetic and steroid can help reduce inflammation caused by arthritis and the results can be instantaneous.
In some cases, if the patient responds favorably to nerve blocks of the articular branches to the hip from the femoral and obturator nerves, radiofrequency ablation can be used to extend the duration of pain relief. This can be applied even in post-hip replacement pain.
PRP Therapy: Platelet-rich plasma (PRP) is a concentrate of plasma that has higher amount of growth factors. It is used to help regenerate soft tissue and healing. Platelet-rich plasma can treat sports injuries, including torn ligaments and tendons, skeletal fractures, strained muscles, sprained knees and chronic tendon injuries.
Joint Replacement Surgery: In the event that the above treatments do not help joint replacement surgery is available. The classic indication for joint replacement surgery is some form of destructive osteoarthritis where the entire hip joint’s normal architecture is damaged.
Sciatica Treatment Options
The sciatic nerve is the largest single nerve in the human body; it runs from each side of the lower spine through deep in the buttock into the back of the thigh and all the way down to the foot. It serves a vital role in connecting the spinal cord with the leg and foot muscles.
Sciatica is nerve pain from irritation of the sciatic nerve. Sciatica pain is typically felt from the low back to behind the thigh and radiating down below the knee. Treatments for sciatica depend on the underlying cause and the severity of the pain.
For severe or ongoing flare-ups of sciatic nerve pain, the condition may need to be treated so it does not get worse over time.
Readily available non-surgical remedies and regular exercise will go a long way toward relieving the pain most people experience.
For others, when the pain is severe or does not get better on its own, a more structured treatment approach, and possibly surgery, may be the best option for finding pain relief and preventing or minimizing future pain and/or dysfunction.
Non-surgical Treatment for Sciatica
The goals of non-surgical sciatica treatments are to relieve pain and any neurological symptoms caused by a compressed nerve root. There is a broad range of options available for sciatica treatment. One or more of the treatments below are usually recommended in conjunction with specific exercises.
For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some find more relief with heat. The two may be alternated. It is best to apply ice with a cloth or towel placed between the ice and skin to avoid an ice burn.
Over-the-counter or prescription medications are often effective in reducing or relieving sciatica pain. Nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen), or oral steroids can reduce the inflammation that is usually part of the cause of pain. Muscle relaxants or narcotic medications may also be prescribed for the short term (a few days and up to two weeks) to alleviate pain.
Epidural Steroid Injections
If the pain is severe, an epidural steroid injection can reduce inflammation. Unlike oral medications, an injection goes directly into the painful area around the sciatic nerve to address the inflammation that may be causing pain.
While the effects tend to be temporary (providing pain relief for as little as one week or up to a year), and it does not work for everyone, an epidural steroid injection can be effective in relieving acute sciatic pain. Importantly, it can provide sufficient relief to allow a patient to progress with a conditioning and exercise program.
It is always advisable to have a qualified medical professional oversee any type of sciatica treatment.
Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head. Typically, the pain of occipital neuralgia begins in the neck and then spreads upwards.
Some individuals will also experience pain in the scalp, forehead, and behind the eyes. Their scalp may also be tender to the touch, and their eyes especially sensitive to light.
The location of pain is related to the areas supplied by the greater and lesser occipital nerves, which run from the area where the spinal column meets the neck, up to the scalp at the back of the head. The pain is caused by irritation or injury to the nerves, which can be the result of trauma to the back of the head, pinching of the nerves by overly tight neck muscles, compression of the nerve as it leaves the spine due to osteoarthritis, or tumors or other types of lesions in the neck.
Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), and frequent lengthy periods of keeping the head in a downward and forward position are also associated with occipital neuralgia. In many cases, however, no cause can be found. A positive response (relief from pain) after an anesthetic nerve block will confirm the diagnosis.
Treatment is generally symptomatic and includes massage and rest. In some cases, antidepressants may be used when the pain is particularly severe. Other treatments may include local nerve blocks and injections of steroids directly into the affected area. Occipital neuralgia is not a life-threatening condition. Many individuals will improve with therapy involving heat, rest, anti-inflammatory medications, and muscle relaxants. Recovery is usually complete after the bout of pain has ended and the nerve damage repaired or lessened.
Information provided by NIH
Could You Have a Herniated Disc?
Disk herniation is usually caused by a gradual, aging-related wear and tear called disk degeneration. Also, spinal disk’s tissues lose some amount of water content with aging. Therefore, they become less flexible and more predisposed to tearing or rupturing.
Factors that increase the risk of disk herniation may include:
- Excess body weight that can cause extra pressure on the disks.
- Physically demanding jobs. Repetitive lifting, pushing, bending sideways and twisting may increase the risk of a herniated disk
- Predisposition to developing a herniated disk can be inherited.
The most common symptoms of a herniated disk are:
- Arm or leg pain - If the herniated disk occurs in the lower back, you will typically feel the intense pain in buttocks, thigh, and calf. The foot also can be involved. If the herniated disk is in the neck, the pain will typically be most intense in the shoulder and arm.
- Numbness or tingling - Patients with a herniated disk often feel numbness or tingling in the body region served by the affected nerves.
- Weakness - Muscles served by the affected nerves tend to weaken.
A small number of people end up needing surgery to treat a herniated disc. However, most patients do well with simpler treatments, such as:
- Pain medicines.
- Drugs originally designed to control seizures also may be helpful in the treatment of the radiating nerve pain associated with a herniated disk.
- Cortisone injections. Inflammation-suppressing corticosteroids may be given by injection directly into the area around the spinal nerves.
- Medicines to relax the muscles (called muscle relaxants).
- Injections of medicines that numb the back or reduce swelling.
- Physical therapy to teach you special exercises and stretches.
In some cases, people with herniated disks need surgery. Your physician can suggest this when conservative treatments fail to reduce pain after six weeks. Moreover, surgery is indicated for patients who continue to experience:
- Numbness or weakness
- Difficulty standing or walking
- Loss of bladder or bowel control
In most cases, surgeons can remove just the protruding portion of the disk. However, in some cases, the entire disk must be removed and after that, the vertebrae may need to be fused together with metal hardware.