Back Pain



Back pain is categorized in two ways -- acute and chronic. Acute back pain typically involves an injury or an illness. Chronic back pain is usually diagnosed when the pain lasts more three months. Chronic back pain can be caused by many factors including incorrect posture, muscle strain, accidents, sports injuries, and nerve injuries. Back pain may also indicate an underlying medical condition. Back pain is one of the most common chronic pain conditions.

Loss of muscle bulk or a particular fine twitching of muscles may be seen in neuropathy.

The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can radiate pain to the extremities.

Those who suffer chronic back pain are often limited in their daily activities. These limitations may cause depression, anxiety, anger, stress, and fatigue. The emotions caused by chronic back pain can actually exacerbate the pain. Insomnia can also make back pain worse. Sadly, the pain and the stress become a vicious cycle.

The management goal when treating back pain is to attain maximum reduction in pain as rapidly as possible. Not all treatments work for all conditions or for all individuals. Treatment for back pain is tailored to the individual.



Fibromyalgia



Fibromyalgia is a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.

Carpal tunnel syndrome is a condition related to inflammation around and compression of the median nerve.

The cause of fibromyalgia is unknown. Possible causes and/or triggers include physical or emotional trauma, sleep disturbance, infection, and abnormal pain response. People who suffer from fibromyalgia usually have tender spots. The pain may feel like a deep ache or a shooting pain. Fibromyalgia affects almost every aspect of a person's life. Symptoms of fibromyalgia include, but are not limited to, memory loss, IBS, numbness, sleep disturbances, anxiety, depression, muscle pain, headaches, and exhaustion.

Physical therapy, exercise, and stress-relief methods can help treat fibromyalgia. Medications can also be prescribed to help ease symptoms. Physical therapy is often recommended to help ease fibromyalgia pain and teach self-management skills.



Rheumatoid Arthritis



Rheumatoid arthritis, or RA, is a form of inflammatory arthritis and an autoimmune disease. The cause of RA is unknown. Autoimmune disease means the body's immune system mistakenly attacks healthy tissue that is designed to protect our health by attacking foreign cells. RA is a long-term disease. RA can occur at any age but is more common in middle age. Rheumatoid arthritis is a chronic disease, meaning it cannot be cured.

Rheumatoid arthritis is symmetrical, meaning if a joint on one side of the body is affected, the corresponding joint on the other side of the body is also involved. For instance, both hands, both knees, or both feet will swell causing excruciating pain. People with RA have more problems in the waking hours as joints appear to be stiffer. Fall and winter seasons may also cause one to suffer a great deal more. This disease usually starts slowly with minor joint pain or stiffness. As RA advances, joints will swell, disfigure, and curl. Toes and fingers are especially known to curl over each other leaving the sufferer unable to perform every day tasks. Range of motion of limbs and joints are limited.

"Although the world is full of suffering, it is also full of the overcoming of it. "
- Helen Keller

Rheumatoid arthritis can affect nearly every part of the body. Complications can include damage of lungs (rheumatoid lung), increased hardening of the arteries, spinal injury, inflammation of blood vessels (rheumatoid vasculitis causing skin, nerve, heart, and brain problems), and swelling of the outer lining of the heart. It can cause damage to cartilage, tendons, and ligaments; it can even wear away the ends of your bones. Some people with RA develop nodules (lumps of tissue that form under the skin over bony areas exposed to pressure). They most often occur around the elbows but can be found anywhere on the body.

There is no known prevention for RA. Proper treatment can help prevent further joint damage. Without proper treatment, permanent joint damage can occur. Early treatment with many of the newer medicines have decreased joint pain and damage. How well one responds to treatment depends on the severity of symptoms.

It is imperative to get treatment for RA as soon as possible. Doctors believe there is an early window of opportunity to treat rheumatoid arthritis before the onset of irreparable joint damage. RA requires lifelong treatment, including medications, physical therapy, exercise, education, and possibly surgery. RA treatment usually involves disease modifying anti-rheumatic drugs (DMARDs), in addition to rest, strengthening exercises, and anti-inflammatory drugs.



Temporomandibular Joint Disorder & Temporomandibular Disorder



Temporomandibular joint disorder, or TMJ, occurs as a result of problems with the jaw, jaw joint, and surrounding facial muscles that control chewing and moving the jaw. Causes may include injury, grinding the teeth, dislocation of the soft cushion between the ball and socket, or even osteoarthritis or rheumatoid arthritis. TMJ can be very painful. People with TMJ usually experience pain in the face, jaw, neck, and/or shoulders. There may also be a clicking sound when the jaw opens or closes. TMJ can cause headaches, toothaches, neckaches, and tinnitus.

With MS, the nerves of the brain and spinal cord are damaged by one's own immune system. Thus, the condition is called an autoimmune disease.

Treatment for TMJ may include wearing a mouth guard at night, using muscle relaxants, and low-level laser therapy to reduce inflammation

Temporomandibular (TM) is a disorder in which a person feels pain and discomfort in the muscles and joints that connect the lower jaw bone to the skull. These muscles are needed to talk, chew, swallow, and yawn. TN is a characterized by episodes of pain the face, originating from the trigeminal nerve. Individual attacks of TN usually affect one side of the face at a time, lasting from several seconds to a few minutes and may repeat may times throughout the day. The pain also tends to occur in cycles with remissions lasting months or even years.

TN is not easily controlled but can be managed with a variety of treatment options.



Chronic Nerve Pain



Chronic nerve pain encompasses various diagnoses. Types of chronic nerve pain include arthritis, neuropathy, carpel tunnel syndrome, shingles, phantom limb pain, facial pain, nerve entrapment, etc. Pain and discomfort caused by irritated nerves can be displaced to other areas of the body that are controlled by or connected to the damaged area.

In 10% to 20% of cases of RSD/CRPS, no direct cause can be found.

Nerve pain can be confusing to doctors and health professionals. The pain may be in a place that has no feeling. It may also be in an unusual area when it involves more than one nerve. When joints deteriorate, nerves may get caught and cause more pain. Swelling can also entrap nerves causing chronic nerve pain. Nerves can also be torn, severed, or pinched.

Chronic nerve pain can be severe causing anxiety, sleep deprivation, and excruciating pain. Exercise under a doctor's direction can sometimes help with nerve pain. Treatment varies and is customized to the specific diagnosis and individual patient.



Complex Regional Pain Syndrome (CRPS)



Complex regional pain syndrome (CRPS), also referred to as reflex sympathetic dystrophy syndrome (RSD), is a chronic pain condition that is believed to be the result of dysfunction in the central or peripheral nervous systems.

"I am only one, but still I am one. I cannot do everything, but still I can do something; and because I cannot do everything, I will not refuse to do something that I can do. "
- Helen Keller

There are two types of CRPS:
  • Type I, formerly known as reflex sympathetic dystrophy (RSD), Sudeck's atrophy, reflex neurovascular dystrophy (RND) or algoneurodystrophy, does not have demonstrable nerve lesions.
  • Type II, formerly known as causalgia, has evidence of obvious nerve damage.


CRPS can strike at any age and affects both men and women although it seems to be more common in women.

CRPS often affects one of the extremities (arms, legs, hands or feet). Oftentimes, the pain spreads to include the entire arm or leg even though the initial injury was to a finger, shoulder or toe. There have also been cases where CRPS spreads to an opposite limb and even the entire body.

The cause of this syndrome is currently unknown. Precipitating factors include injury and surgery although there are documented cases that have no demonstrable injury to the original site.

Symptoms of CRPS



The key symptom of CRPS is a continuous, intense pain out of proportion to the severity of the injury (if one in fact has occurred) which gets worse rather than better over time.

CRPS is often accompanied by:
  • “Burning” pain
  • Electrical sensations described to be like "shooting pains"
  • Increased skin sensitivity
  • Swelling and stiffness in affected joint
  • Motor disability with decreased range of motion and decreased ability to move the affected body part
  • Changes in skin temperature (warmer or cooler compared to opposite extremity)
  • Changes in skin color -- often blotchy, purple, pale, or red
  • Changes in skin texture -- shiny and thin and sometimes excessively sweaty
  • Softening and thinning of bones
  • Changes in nail and hair growth patterns
  • Depression and/or anxiety
  • Insomnia


Prognosis:



There is no cure for CRPS. The prognosis varies from person to person. In certain people, spontaneous remission has occurred, while others can have unremitting pain and crippling, irreversible changes. Most doctors believe early treatment is helpful in limiting the disorder although no clinical evidence from clinical trials supports this.

For more information regarding CRPS/RSD please visit the following sites:

//www.rsdhope.org/

//www.hopeoverpain.org/

//www.rsdcanada.org/



Lupus



Lupus is an autoimmune disease --the body's immune system also attacks healthy tissues (rather than just fighting foreign invaders). This causes inflammation, swelling, pain, and tissue damage. Severe lupus may cause kidney, heart, lung, blood, or nervous system problems. The severity of symptoms ranges from mild to severe. Lupus is life long.

Nerve pain can cause numbness to the hands and feet.

While the exact cause of lupus is not known, many experts believe that some people are born with genes that may affect how the immune system works. Many things can trigger lupus attacks such as viruses and even sunlight. Some symptoms of lupus may include, but are not limited to, fatigue, muscle pain, headaches, skin rashes, fever, heart problems, lung problems, nervous system issues, mental problems, hair loss, weight gain, and swollen glands.

Many people can control their symptoms and prevent damage to their organs. You can do this by seeing your physician for checkups, exercising, resting, and taking medication. Reducing your daily stress levels can also help with your symptoms. Being diagnosed with lupus affects you not only physically, but also emotionally and mentally. Be sure and discuss with your physician any problems you may be having in dealing with lupus.



Multiple Sclerosis



Multiple Sclerosis, or MS, is a chronic disease of the central nervous system. Symptoms of MS can be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The severity of MS is unpredictable and usually varies from one person to another. Approximately 2.5 million people worldwide have been diagnosed with MS; it is most prevalent in northern Europe, North America, southeast Australia and New Zealand. The odds of being diagnosed with multiple sclerosis are 1 in 750.

More than 26 million Americans between the ages of 20-64 experience frequent back pain.

Multiple sclerosis is commonly diagnosed between the ages of 20 and 50. MS is 2-3 times more common in women than in men. Diagnosing MS is complex and usually involves various tests. Symptoms of MS may include fatigue, numbness, pain, problems with balance, vision changes, depression, poor muscle coordination, slurred speech, bladder or bowel problems, etc.

Keeping a journal of your illness can help your physician. Physical exams as well a MRI can help with diagnosis. You may need additional tests to determine if you have MS.



Chronic Headaches



The term "headache" covers a broad spectrum of diagnoses. In fact, 150 headache diagnostic categories have been established. Headaches are classified as chronic when they occur frequently. There are various causes of chronic headaches including, but not limited to, stress, anemia, food allergies, oral contraceptives, brain tumors, and excessive caffeine. Causes of chronic headaches may be hard to diagnose, but the pain is very real.

"All the world is full of suffering. It is also full of overcome. "
- Helen Keller

According to the National Headache Foundation, over 45 million Americans suffer from chronic, recurring headaches and of these, 28 million suffer from migraines. About 20% of children and adolescents also have significant headaches.

The exact cause of migraines is unknown. Migraines are usually related to blood vessel contractions and other changes in the brain. Migraine pain is moderate to severe, often described as pounding, throbbing pain. They can last from four hours to days and usually occur one to four times per month. Migraines symptoms include sensitivity to light, noise, or odors; nausea or vomiting; loss of appetite; blurred vision; dizziness; and stomach upset or abdominal pain. When a child suffers with a migraine, he/she often looks pale, and the migraine can be accompanied by a fever.

Keeping a journal of your chronic headaches is a helpful practice not only to document your pain but also to provide specific information for your physican. Sharing your journal with your physician helps to customize your treatment plan . Finding the right medication and treatment option usually takes time. Reducing stress can be helpful in dealing with chronic headaches.



Caregivers for those who suffer Chronic Pain



It is very difficult to watch someone you love suffer with chronic pain. Caregiving can easily lead to feelings of depression, anxiety, guilt, hopelessness, and frustration. It is very important for caretakers to take care of themselves as well as their loved one. If you are a caretaker, please know that you are not alone. Connecting with other caregivers can provide hope and emotional support.

With neck pain, 85% of the time the pain is mechanical coming from either the muscles, joints or ligaments.

As you care for a person in pain, there are several important things to keep in mind -- believe in your loved one's pain levels, pay attention to signs that indicate his/her level of pain, observe facial expressions, notice unusual body movements, and be aware of bouts of crying or irritability. Many caregivers also attend physician's visits. Prepare questions in advance and keep a pain diary to share with the doctor. Keep a current list of both prescribed and over-the-counter medications. If your loved one is dealing with sleep deprivation due to the pain, be sure to discuss this with the physician also. Encourage your loved one to follow his/her treatment plan including diet, medication schedules, physical activities, and rest.

When people offer to help, accept the offer and suggest certain things they may be able to do to help you. Value yourself. You have a demanding job and deserve some quality time for you. Join pain-advocacy groups to help raise awareness for those who suffer from chronic pain. Watch out for signs of depression in yourself and don't wait to get professional help should you need it. Be open to ideas that may help your loved one become more independent.