Archive for the ‘Diseases And Conditions’ Category
Apurva Shree asked:
If you have been facing persistent back pain symptoms and have been ignoring them so far, then it is now time to give it a serious thought. Pain in the back which is usually severe or gives out a burning sensation can be termed as Chronic Back Pain. chronic pain symptoms are usually faced due to inflammation of the spinal tissues and they last over weeks or even months.
Five Stages from Acute to Chronic Back Pain
In most of the cases back pain progresses from being acute pain to chronic pain. Following are the stages through which you would undergo incase of a back pain:
Stage 1: In this stage, the back pain is at a preliminary phase. Most of us would ignore this back pain considering it to be a usual pain and take rest or maybe catch up on some extra hours of sleep! This stage lasts for maximum 2 -3 days.
Stage 2: The pain refuses to subside and gets stronger. This time you decide to take a pain killer or apply some external ointment to kill the pain. The pain is as severe as stage 1, however still bearable.
Stage 3: You face acute pain in the back and the pain subsides due to pain killers but reappears. However the pain is faced only in one particular area of the back. This is a critical stage. Most of the times, appropriate actions are not taken by the victim to curb these pains. Till this stage 3, you are only facing acute back pain. These pains could last for a week or two.
Stage 4: Many a times, you would see a gap between stage 3 and 4. In this stage you face a severe burning sensation in your back. These pains slowly get unbearable.
Stage 5: In this stage, you observe that the pain is moving from the spinal cord to the hips and into the legs at times and now your pain can be termed as chronic back pain. It is vital to go through a back pain diagnosis and eventually undergo treatments if your pain has lasted not only days but weeks.
All through these stages you will observe that back pain can be self controlled, however only at early stages. Taking pain killers is also only a temporary solution. Rather indulge in some simple stretching back pain exercises at home which could eventually prove to be beneficial. If not totally, surely 50% is in your hands on how you control your chronic pain symptoms and not let them turn into chronic pain symptoms. Also at every stage of back pain it is important to carefully do back pain diagnosis at every stage to be able to provide the right observations to the doctor when needed.
Whittier Chiropractor
If you have been facing persistent back pain symptoms and have been ignoring them so far, then it is now time to give it a serious thought. Pain in the back which is usually severe or gives out a burning sensation can be termed as Chronic Back Pain. chronic pain symptoms are usually faced due to inflammation of the spinal tissues and they last over weeks or even months.
Five Stages from Acute to Chronic Back Pain
In most of the cases back pain progresses from being acute pain to chronic pain. Following are the stages through which you would undergo incase of a back pain:
Stage 1: In this stage, the back pain is at a preliminary phase. Most of us would ignore this back pain considering it to be a usual pain and take rest or maybe catch up on some extra hours of sleep! This stage lasts for maximum 2 -3 days.
Stage 2: The pain refuses to subside and gets stronger. This time you decide to take a pain killer or apply some external ointment to kill the pain. The pain is as severe as stage 1, however still bearable.
Stage 3: You face acute pain in the back and the pain subsides due to pain killers but reappears. However the pain is faced only in one particular area of the back. This is a critical stage. Most of the times, appropriate actions are not taken by the victim to curb these pains. Till this stage 3, you are only facing acute back pain. These pains could last for a week or two.
Stage 4: Many a times, you would see a gap between stage 3 and 4. In this stage you face a severe burning sensation in your back. These pains slowly get unbearable.
Stage 5: In this stage, you observe that the pain is moving from the spinal cord to the hips and into the legs at times and now your pain can be termed as chronic back pain. It is vital to go through a back pain diagnosis and eventually undergo treatments if your pain has lasted not only days but weeks.
All through these stages you will observe that back pain can be self controlled, however only at early stages. Taking pain killers is also only a temporary solution. Rather indulge in some simple stretching back pain exercises at home which could eventually prove to be beneficial. If not totally, surely 50% is in your hands on how you control your chronic pain symptoms and not let them turn into chronic pain symptoms. Also at every stage of back pain it is important to carefully do back pain diagnosis at every stage to be able to provide the right observations to the doctor when needed.
Whittier Chiropractor
Marc Warren asked:
Millions of individuals all around the world suffer from some sort of back pain or anther. Like you, they all do their best to find the solution for relieving their pain. Back pain can interrupt your daily life whether you suffer from the type of back pain that may come from improper lifting and strains to your back.
These types of pain can generally find relief by taking over the counter pain medication and deep tissue massage. However, when you suffer from chronic back pain the story can be much different. It can be challenging to find the solution for relieving this type of back pain, since everyone is different and various methods of pain relief works or does not work, according the individuals condition.
In order to relief your back pain, you will need to do a bit of research on your personal condition to find out about the various choices of treatment. Get into a regular exercise routine, while protecting you body, by paying attention to its pain signals. It is in your best interest not to continually concentrate on the pain you feel, while learning to change any pain habits you may have. Since changing these habits aid in uplifting your feelings about yourself and your pain.
You should also consider seeking support, while creating your own pain management plan of tracking the progress of the methods you use, to find out which gives you the relief you seek. Most importantly, you should stay positive in your attitude, by thinking positively, keeping your sense of humor about you. You should be eating a well balanced diet and exercising daily and enjoying your daily activities when you are with others or alone.
There are natural body controls, such as intense concern for others and outside controls such as medications, physical therapy, heat and cold methods, exercise and relaxation as well as massage techniques that aid in controlling the signals of pain our body feels when dealing with back pain symptoms. When you suffer from back pain, there are several methods you can choose from to aid your relief, these include, limiting and moderating as little medication for pain as you can handle.
Increasing your social and physical activities and enjoying an active lifestyle, changing any habit of pain you have that may be interrupting your life, such as consuming alcohol or staying in bed all day for relief, as well as eagerly learning new methods of reducing your pain. Of course, you must understand that different methods work better for some individuals, than they do for others. You will be working to find and practice the right methods for reducing your own personal pain.
One solution for relieving you pain is to visit your family physician and talking with him or her concerning your condition, while being enthusiastic about working as a team to find the best pain relief for your particular condition. You can help your physician understand your pain by being able to explain the location, the frequency and severity of your symptoms as well as letting the physician know what make the pain feel worse or better. After doing so, your physician will be able to help you figure out the best solution for relieving you pain.
Some of things you may be counseled to do is:
Use heat and cold treatments for relief
Heat treatments may include soaking in warm water or using a hot water bottle or heat packs, using a heating pad for a limited amount of time, as well as using an electric blanket and flannel sheets for warmth as well as warming your clothing in a dryer before putting them on. Or try dipping you hand in a paraffin bath to relieve your pain symptoms. You may also find relief by alternating heat and cold water bath treatments. Cold treatments would include using ice packs or frozen vegetables on the area of your pain. However, you should always practice safety first when working with heat and cold treatments, for the best results.
Wisely using your joints and exercising
Wisely using your joints include, being aware of your body position, avoiding activities that cause you pain, while planning ahead to simplify your daily tasks, using most often your strongest and largest muscles and joints. You should always practice proper lifting techniques, not staying in one position for extended periods of time, learning to balance your times of activity and rest as well as having a healthy respect for your pain.
Relaxation
Relaxation techniques may include, guided imagery to help you focus on images that bring pleasure, prayer, hypnosis, which aids by focusing attention internally, rather than persisting with concentration on your other thoughts or anxieties. You may consider using biofeedback, which involves very sensitive electrical equipment that measures the reactions of your body, as well as the use of audio tapes for relaxation guidance.
Counseling, Support and Pain Clinics
Counseling and support involve working with others, such as your physician, nurse or even a physical or occupational therapist as well as a counselor, psychologist, social worker and your pharmacist, depending upon your condition and the type of support you need. Counseling, support groups and pain clinics, involves being unafraid to seek out help when you need someone to talk with about the pain and stress you encounter with back pain. You can always ask your physician for his recommendations of these types of pain relief options to find out where to find them.
Other techniques for pain management
These pain management techniques for pain relief may include such things as, using splints to reduce pain and swelling, getting a good restful nights sleep, which aids by restoring your spirits and energy daily. Or you may use of topical deep heating lotions and massage techniques. You may even consider transcutaneous electrical nerve stimulation or TENS, which is a small electrical device that uses mild pulses of electricity to stimulate the nerves influenced in painful areas.
When you suffer from upper or lower back pain, with or without arthritis, you should know that you are not alone in your fight to be pain-free or to at least decrease the amount of pain you feel. There are others who are able to help you deal with and control your pain, as well as some really inspiring methods and techniques you can try when searching for just the right type of solution for your pain.
Whittier Chiropractor
Millions of individuals all around the world suffer from some sort of back pain or anther. Like you, they all do their best to find the solution for relieving their pain. Back pain can interrupt your daily life whether you suffer from the type of back pain that may come from improper lifting and strains to your back.
These types of pain can generally find relief by taking over the counter pain medication and deep tissue massage. However, when you suffer from chronic back pain the story can be much different. It can be challenging to find the solution for relieving this type of back pain, since everyone is different and various methods of pain relief works or does not work, according the individuals condition.
In order to relief your back pain, you will need to do a bit of research on your personal condition to find out about the various choices of treatment. Get into a regular exercise routine, while protecting you body, by paying attention to its pain signals. It is in your best interest not to continually concentrate on the pain you feel, while learning to change any pain habits you may have. Since changing these habits aid in uplifting your feelings about yourself and your pain.
You should also consider seeking support, while creating your own pain management plan of tracking the progress of the methods you use, to find out which gives you the relief you seek. Most importantly, you should stay positive in your attitude, by thinking positively, keeping your sense of humor about you. You should be eating a well balanced diet and exercising daily and enjoying your daily activities when you are with others or alone.
There are natural body controls, such as intense concern for others and outside controls such as medications, physical therapy, heat and cold methods, exercise and relaxation as well as massage techniques that aid in controlling the signals of pain our body feels when dealing with back pain symptoms. When you suffer from back pain, there are several methods you can choose from to aid your relief, these include, limiting and moderating as little medication for pain as you can handle.
Increasing your social and physical activities and enjoying an active lifestyle, changing any habit of pain you have that may be interrupting your life, such as consuming alcohol or staying in bed all day for relief, as well as eagerly learning new methods of reducing your pain. Of course, you must understand that different methods work better for some individuals, than they do for others. You will be working to find and practice the right methods for reducing your own personal pain.
One solution for relieving you pain is to visit your family physician and talking with him or her concerning your condition, while being enthusiastic about working as a team to find the best pain relief for your particular condition. You can help your physician understand your pain by being able to explain the location, the frequency and severity of your symptoms as well as letting the physician know what make the pain feel worse or better. After doing so, your physician will be able to help you figure out the best solution for relieving you pain.
Some of things you may be counseled to do is:
Use heat and cold treatments for relief
Heat treatments may include soaking in warm water or using a hot water bottle or heat packs, using a heating pad for a limited amount of time, as well as using an electric blanket and flannel sheets for warmth as well as warming your clothing in a dryer before putting them on. Or try dipping you hand in a paraffin bath to relieve your pain symptoms. You may also find relief by alternating heat and cold water bath treatments. Cold treatments would include using ice packs or frozen vegetables on the area of your pain. However, you should always practice safety first when working with heat and cold treatments, for the best results.
Wisely using your joints and exercising
Wisely using your joints include, being aware of your body position, avoiding activities that cause you pain, while planning ahead to simplify your daily tasks, using most often your strongest and largest muscles and joints. You should always practice proper lifting techniques, not staying in one position for extended periods of time, learning to balance your times of activity and rest as well as having a healthy respect for your pain.
Relaxation
Relaxation techniques may include, guided imagery to help you focus on images that bring pleasure, prayer, hypnosis, which aids by focusing attention internally, rather than persisting with concentration on your other thoughts or anxieties. You may consider using biofeedback, which involves very sensitive electrical equipment that measures the reactions of your body, as well as the use of audio tapes for relaxation guidance.
Counseling, Support and Pain Clinics
Counseling and support involve working with others, such as your physician, nurse or even a physical or occupational therapist as well as a counselor, psychologist, social worker and your pharmacist, depending upon your condition and the type of support you need. Counseling, support groups and pain clinics, involves being unafraid to seek out help when you need someone to talk with about the pain and stress you encounter with back pain. You can always ask your physician for his recommendations of these types of pain relief options to find out where to find them.
Other techniques for pain management
These pain management techniques for pain relief may include such things as, using splints to reduce pain and swelling, getting a good restful nights sleep, which aids by restoring your spirits and energy daily. Or you may use of topical deep heating lotions and massage techniques. You may even consider transcutaneous electrical nerve stimulation or TENS, which is a small electrical device that uses mild pulses of electricity to stimulate the nerves influenced in painful areas.
When you suffer from upper or lower back pain, with or without arthritis, you should know that you are not alone in your fight to be pain-free or to at least decrease the amount of pain you feel. There are others who are able to help you deal with and control your pain, as well as some really inspiring methods and techniques you can try when searching for just the right type of solution for your pain.
Whittier Chiropractor
Keith George asked:
You can really eliminate pain with hypnosis. The saying “no pain, no gain” is really not true. Do you remember all of the times pain has hindered you from taking part in activities that you enjoy? Partaking in sports and even sitting can be unbearable when you are in pain.
However, to say that “pain is all in your head” can really be true. If that is the case then the cure should be all in your head too! With help of self-hypnosis, pain can completely disappear. Despite what most people think, hypnosis is simply a mental state where messages can connect with the unconscious easier. The state of hypnosis is characterized by very deep relaxation. With regular practice of a hypnosis pain elimination regimen, you will feel more peaceful over all.
Pain signals that something in your body is amiss so pain is technically a good thing. Make sure a doctor check you out to ensure that the pain is not indicating a harmful condition. Then it’s time to manage and even eliminate the pain.
There is really no danger in a self-hypnosis pain relief program. It is not true that you can “get stuck” in a hypnotic state. The worst that might happen when you use hypnosis for upper pain reduction is that you could fall into a natural state of sleep for half an hour. Compare to all of the nights that discomfort has prevented you from sleep!
One can’t say that a hypnosis pain management system is the same as sleep though. That is probably the biggest misconception about hypnosis. When you are asleep, you are unconscious, and if you are unconscious you cannot hear anything. If you can’t hear anything, the hypnotist cannot help you. On the contrary, hypnosis is actually a state of keen awareness.
Being consciously aware of everything, a hypnosis pain management program can help both physical and mental causes and lead to many successful avenues to do away with pain. As you know, medications merely block the reception of the physical symptoms of pain on a temporary basis. Hypnosis pain regimens can in fact lessen the amount and strength of pain signals that you perceive. You can actually reprogram your body to send less pain-inducing chemicals to your receptors. This means that you can use fewer pain killing drugs, often no medications at all.
You have probably heard of endorphins, the opiate-like chemicals that are generated in our brains. Endorphins are the chemicals that cause people who train to get a high when they workout hard. Using hypnosis, you can also learn how to program your brain to create pain-relieving endorphins on demand! And send them to the painful part of your body where they are required.
With help of endorphins, the brain is capable of inducing analgesia, which is a mild anesthesia, as well as full anesthesia (numbness). Medical journals are full of accounts both in modern times, as well as in pre-anesthesia days, when invasive surgery has been done under hypnoanesthesia.
Hypnosis can also work to program the mind to direct your attention away from pain. In this way you will perceive far less discomfort. Also, hypnosis pain management programs can help our mind realize and understand that the pain is there, but not to let us suffer from it. A certified hypnotherapist will be familiar with how to fully address additional hypnotic suggestions that will aid in your recovery.
A really effective hypnosis pain remedy lies in neuro linguistic programming, NLP. No doubt that after living with chronic pain or left side pain, you may be cynical that a hypnosis pain program will help. In many cases, NLP methods really work far better for modern thinkers than traditional hypnosis does. It was actually developed for people like you who are brought up to analyze and question everything. Analyzing can mean that we tend to put up barriers to the acceptance of hypnotic suggestions.
Whittier Chiropractor
You can really eliminate pain with hypnosis. The saying “no pain, no gain” is really not true. Do you remember all of the times pain has hindered you from taking part in activities that you enjoy? Partaking in sports and even sitting can be unbearable when you are in pain.
However, to say that “pain is all in your head” can really be true. If that is the case then the cure should be all in your head too! With help of self-hypnosis, pain can completely disappear. Despite what most people think, hypnosis is simply a mental state where messages can connect with the unconscious easier. The state of hypnosis is characterized by very deep relaxation. With regular practice of a hypnosis pain elimination regimen, you will feel more peaceful over all.
Pain signals that something in your body is amiss so pain is technically a good thing. Make sure a doctor check you out to ensure that the pain is not indicating a harmful condition. Then it’s time to manage and even eliminate the pain.
There is really no danger in a self-hypnosis pain relief program. It is not true that you can “get stuck” in a hypnotic state. The worst that might happen when you use hypnosis for upper pain reduction is that you could fall into a natural state of sleep for half an hour. Compare to all of the nights that discomfort has prevented you from sleep!
One can’t say that a hypnosis pain management system is the same as sleep though. That is probably the biggest misconception about hypnosis. When you are asleep, you are unconscious, and if you are unconscious you cannot hear anything. If you can’t hear anything, the hypnotist cannot help you. On the contrary, hypnosis is actually a state of keen awareness.
Being consciously aware of everything, a hypnosis pain management program can help both physical and mental causes and lead to many successful avenues to do away with pain. As you know, medications merely block the reception of the physical symptoms of pain on a temporary basis. Hypnosis pain regimens can in fact lessen the amount and strength of pain signals that you perceive. You can actually reprogram your body to send less pain-inducing chemicals to your receptors. This means that you can use fewer pain killing drugs, often no medications at all.
You have probably heard of endorphins, the opiate-like chemicals that are generated in our brains. Endorphins are the chemicals that cause people who train to get a high when they workout hard. Using hypnosis, you can also learn how to program your brain to create pain-relieving endorphins on demand! And send them to the painful part of your body where they are required.
With help of endorphins, the brain is capable of inducing analgesia, which is a mild anesthesia, as well as full anesthesia (numbness). Medical journals are full of accounts both in modern times, as well as in pre-anesthesia days, when invasive surgery has been done under hypnoanesthesia.
Hypnosis can also work to program the mind to direct your attention away from pain. In this way you will perceive far less discomfort. Also, hypnosis pain management programs can help our mind realize and understand that the pain is there, but not to let us suffer from it. A certified hypnotherapist will be familiar with how to fully address additional hypnotic suggestions that will aid in your recovery.
A really effective hypnosis pain remedy lies in neuro linguistic programming, NLP. No doubt that after living with chronic pain or left side pain, you may be cynical that a hypnosis pain program will help. In many cases, NLP methods really work far better for modern thinkers than traditional hypnosis does. It was actually developed for people like you who are brought up to analyze and question everything. Analyzing can mean that we tend to put up barriers to the acceptance of hypnotic suggestions.
Whittier Chiropractor
Jesse Cannone asked:
One of the most common questions I get is…..
“Please help with my back pain”
If you’ve never needed back pain help before, chances are 8 out of 10 you will. Getting help for your back pain is second only to the common cold when it comes to healthcare provider visits in the United States. And it’s right at the top of the list of occupational health hazards.
Although help for your back pain is readily available, terminology and methods used can be confusing at first. Here we’ll demystify some of the common back pain terms and diagnosis methods you’ll run into along the way as you seek help for your back pain.
Getting back pain help: Types of back pain
All back pain is classified as either acute or chronic back pain.
Acute back pain – Indicates a sudden onset of pain, typically with severe lower back pain and limited mobility
Chronic back pain – Chronic back pain refers to lower back pain or acute back pain episodes recurring for more than three months
Getting back pain help: Common back pain terms
You’ll likely hear one or more of these terms used as you seek back pain help at your healthcare provider.
Onset – How the pain begins: either acute (sudden) or insidious (gradually increasing pain over a longer period of time – days or longer)
Frequency / Duration – How often the pain happens and how long it lasts
Recurrence – Back pain with intervals of no pain in between episodes
Persistence – Back pain with pain always present
Location – Where it hurts – the spot on your body where pain is felt
Intensity – Your estimate of how bad the pain is on a scale of 0 (no pain) to 10 (worst pain of your life)
Getting back pain help: Steps to diagnosis
During your search for help with your back pain, when you ask almost any healthcare provider to “help with my back pain,” they will start with one or more of these diagnostic methods to better enable them to provide accurate help for your back pain.
Medical history – You’ll usually need to answer a number of questions related to your personal and family medical histories in addition to questions specific to your back pain
Physical examination – A physical evaluation to assess various postures and movements ranges and related back pain symptoms
Neurological testing – Testing with particular attention to reflexes, muscle strength, and general nervous system and circulatory system conditions
Diagnostic testing – Internal examinations including x-rays, MRIs, CAT scans, etc.
Getting Treatment – You should first research what might be causing your pain and once you have identified the causes you can treat them. In the meanwhile check out this video on how to eliminate back pain at work
If you suffer from back pain and would like to learn how to get relief, check out some of our back pain videos now.
Jesse Cannone
Whittier Chiropractor
One of the most common questions I get is…..
“Please help with my back pain”
If you’ve never needed back pain help before, chances are 8 out of 10 you will. Getting help for your back pain is second only to the common cold when it comes to healthcare provider visits in the United States. And it’s right at the top of the list of occupational health hazards.
Although help for your back pain is readily available, terminology and methods used can be confusing at first. Here we’ll demystify some of the common back pain terms and diagnosis methods you’ll run into along the way as you seek help for your back pain.
Getting back pain help: Types of back pain
All back pain is classified as either acute or chronic back pain.
Acute back pain – Indicates a sudden onset of pain, typically with severe lower back pain and limited mobility
Chronic back pain – Chronic back pain refers to lower back pain or acute back pain episodes recurring for more than three months
Getting back pain help: Common back pain terms
You’ll likely hear one or more of these terms used as you seek back pain help at your healthcare provider.
Onset – How the pain begins: either acute (sudden) or insidious (gradually increasing pain over a longer period of time – days or longer)
Frequency / Duration – How often the pain happens and how long it lasts
Recurrence – Back pain with intervals of no pain in between episodes
Persistence – Back pain with pain always present
Location – Where it hurts – the spot on your body where pain is felt
Intensity – Your estimate of how bad the pain is on a scale of 0 (no pain) to 10 (worst pain of your life)
Getting back pain help: Steps to diagnosis
During your search for help with your back pain, when you ask almost any healthcare provider to “help with my back pain,” they will start with one or more of these diagnostic methods to better enable them to provide accurate help for your back pain.
Medical history – You’ll usually need to answer a number of questions related to your personal and family medical histories in addition to questions specific to your back pain
Physical examination – A physical evaluation to assess various postures and movements ranges and related back pain symptoms
Neurological testing – Testing with particular attention to reflexes, muscle strength, and general nervous system and circulatory system conditions
Diagnostic testing – Internal examinations including x-rays, MRIs, CAT scans, etc.
Getting Treatment – You should first research what might be causing your pain and once you have identified the causes you can treat them. In the meanwhile check out this video on how to eliminate back pain at work
If you suffer from back pain and would like to learn how to get relief, check out some of our back pain videos now.
Jesse Cannone
Whittier Chiropractor
Bella Mclaine asked:
Chronic pain has plugged into thousands and millions of people in this fast developing world. There are number of cases found suffering from chronic pain conditions and takes a long period of time to recover. People tempt to get chronic pain relief through some natural ways. Around 50 to 80 millions of Americans are suffering form chronic pain condition. The chronic pain if treated at an earlier stage can be well treated but if it sustains for a longer period than the situation can become worse. Chronic pain relives the flow of harmful hormones, such as cortisol which plays a major role in adversely affecting the immune system and kidney function.
Chronic pain relief has now emerged with new and great techniques and treatments. The researchers and surgeons are now enhanced with effective drugs to implant and electrical stimulation. The birth of chronic pain can be due to various reasons like from an accident affecting much too sensitive veins and muscles, back injuries, an injury caused while playing sport, and chronic pain can also be occur from health conditions like migraines, diabetes, arthritis, shingles, and cancer. It is not important that a person will be suffering from chronic pain only; he may suffer from acute pain too. The acute pain causes are also the same as chronic pain but the difference lies as the acute pain easily and quickly subside after treatment. The foremost distinguish feature between acute pain and chronic pain is the duration of time. Chronic pain can be for a longer period of time and severe and unbearable. While acute pain subside the pain gradually and swiftly within a short period of time.
One should be smart enough to take precise care of his/her health in a pragmatic way. A patient can opt to treat in a natural or surgical way. Acupuncture, acupressure, massage therapy or if any alternative therapy are some natural ways which can be best suited for your health. In acupuncture you just need to locate the pressure points to heal the body pain and feel relax and comfortable. Acupuncture is done by way of needles and acupressure is done by way of hands. This therapy gives the relaxation to our muscles helps to keep your mind calm. Even doing medication acts as assistance to cure your chronic back pain relief. Pain relief supplements can provide only temporary relief.
Thus, to deal with chronic pain relief you can even join a support group of patients suffering from same pain. You need to be habituated of taking healthy diet including some fruits and fresh juices which plays a vital role in curing the unbearable pain. A patient suffering from chronic pain needs to develop positive mental attitude to strengthen his/her mind.
Whittier Chiropractor
Chronic pain has plugged into thousands and millions of people in this fast developing world. There are number of cases found suffering from chronic pain conditions and takes a long period of time to recover. People tempt to get chronic pain relief through some natural ways. Around 50 to 80 millions of Americans are suffering form chronic pain condition. The chronic pain if treated at an earlier stage can be well treated but if it sustains for a longer period than the situation can become worse. Chronic pain relives the flow of harmful hormones, such as cortisol which plays a major role in adversely affecting the immune system and kidney function.
Chronic pain relief has now emerged with new and great techniques and treatments. The researchers and surgeons are now enhanced with effective drugs to implant and electrical stimulation. The birth of chronic pain can be due to various reasons like from an accident affecting much too sensitive veins and muscles, back injuries, an injury caused while playing sport, and chronic pain can also be occur from health conditions like migraines, diabetes, arthritis, shingles, and cancer. It is not important that a person will be suffering from chronic pain only; he may suffer from acute pain too. The acute pain causes are also the same as chronic pain but the difference lies as the acute pain easily and quickly subside after treatment. The foremost distinguish feature between acute pain and chronic pain is the duration of time. Chronic pain can be for a longer period of time and severe and unbearable. While acute pain subside the pain gradually and swiftly within a short period of time.
One should be smart enough to take precise care of his/her health in a pragmatic way. A patient can opt to treat in a natural or surgical way. Acupuncture, acupressure, massage therapy or if any alternative therapy are some natural ways which can be best suited for your health. In acupuncture you just need to locate the pressure points to heal the body pain and feel relax and comfortable. Acupuncture is done by way of needles and acupressure is done by way of hands. This therapy gives the relaxation to our muscles helps to keep your mind calm. Even doing medication acts as assistance to cure your chronic back pain relief. Pain relief supplements can provide only temporary relief.
Thus, to deal with chronic pain relief you can even join a support group of patients suffering from same pain. You need to be habituated of taking healthy diet including some fruits and fresh juices which plays a vital role in curing the unbearable pain. A patient suffering from chronic pain needs to develop positive mental attitude to strengthen his/her mind.
Whittier Chiropractor
Bella Mclaine asked:
Abdominal Pain is also known by other name “Bellyache”. It can be defined in a simple way as pain in the belly. The abdomen extends from below your chest to your groin. You may feel abdominal pain anywhere between your chest and groin. Abdominal pain is a common problem. Due to the many organ systems in the abdomen the pain may arise in any of the organ from chest to groin. These organs include the stomach, small intestine, colon, liver, gall bladder, and pancreas. However, pain can be mild or serious which may put you into health dilemma. Abdomen pain can be classified into two categories namely acute abdomen pain and chronic abdomen pain. The causes of abdominal pain also rely on sex and age of the patient. An abdominal pain can be easily caused to small children and adults too. The abdominal pain usually is used to explain pain originating from organs within the abdominal cavity.
The pain caused by the abdomen may be mild or serious. It is said in abdominal pain that the pain can be minor which may lead to threatening condition, such as colon cancer or appendicitis. Severe abdominal pain can be from light situations, such as gastric problem or viral gastroenteritis.
Causes of Abdominal Pain:
While seeking medical care you are advice for regular check ups to doctor so that your health condition is in control. Some of the feasible causes include.
* Gastric problem
* Constipation problem
* Viral gastroenteritis
* Indigestion or Heartburn
* Food poisoning
* Food allergy
* Hernia
* Kidney stones
* Urinary tract infection
* Pelvic inflammatory disease
* Lactose intolerance (milk intolerance)
* Crohn’s disease
* Muscle strain or trauma
* Inflammation of the gall bladder
* Pancreatitis
* Parasite infections
* Gastro esophageal reflux disease (GERD)
* Endometriosis
* Irritable bowel syndrome
Acute abdomen can be defined as stern, constant abdominal pain of sudden start that is probable to involve surgical intervention to treat its cause. Often the lower abdominal pain can be linked with nausea and vomiting, abdominal distention, fever and signs of shock. Even a small child or an adolescent are prone to abdominal pain. It is difficult to apportion the ratio of abdominal pain in accordance to the age of a person.
Consult your doctor immediately if feeling mild or severe pain. Medical aid should be taken if the abdominal pain is sudden and sharp, having pain in the chest, neck or shoulder, and if you are eliminating blood from your body.
Thus, abdominal pain should be taken care of within time. Don’t take the stomach ache or belly ache to lightly as then it can invite serious health problems. Make a habit to enhance a healthy eating lifestyle blending with fruits or juice in good of your healthy abdomen.
Whittier Chiropractor
Abdominal Pain is also known by other name “Bellyache”. It can be defined in a simple way as pain in the belly. The abdomen extends from below your chest to your groin. You may feel abdominal pain anywhere between your chest and groin. Abdominal pain is a common problem. Due to the many organ systems in the abdomen the pain may arise in any of the organ from chest to groin. These organs include the stomach, small intestine, colon, liver, gall bladder, and pancreas. However, pain can be mild or serious which may put you into health dilemma. Abdomen pain can be classified into two categories namely acute abdomen pain and chronic abdomen pain. The causes of abdominal pain also rely on sex and age of the patient. An abdominal pain can be easily caused to small children and adults too. The abdominal pain usually is used to explain pain originating from organs within the abdominal cavity.
The pain caused by the abdomen may be mild or serious. It is said in abdominal pain that the pain can be minor which may lead to threatening condition, such as colon cancer or appendicitis. Severe abdominal pain can be from light situations, such as gastric problem or viral gastroenteritis.
Causes of Abdominal Pain:
While seeking medical care you are advice for regular check ups to doctor so that your health condition is in control. Some of the feasible causes include.
* Gastric problem
* Constipation problem
* Viral gastroenteritis
* Indigestion or Heartburn
* Food poisoning
* Food allergy
* Hernia
* Kidney stones
* Urinary tract infection
* Pelvic inflammatory disease
* Lactose intolerance (milk intolerance)
* Crohn’s disease
* Muscle strain or trauma
* Inflammation of the gall bladder
* Pancreatitis
* Parasite infections
* Gastro esophageal reflux disease (GERD)
* Endometriosis
* Irritable bowel syndrome
Acute abdomen can be defined as stern, constant abdominal pain of sudden start that is probable to involve surgical intervention to treat its cause. Often the lower abdominal pain can be linked with nausea and vomiting, abdominal distention, fever and signs of shock. Even a small child or an adolescent are prone to abdominal pain. It is difficult to apportion the ratio of abdominal pain in accordance to the age of a person.
Consult your doctor immediately if feeling mild or severe pain. Medical aid should be taken if the abdominal pain is sudden and sharp, having pain in the chest, neck or shoulder, and if you are eliminating blood from your body.
Thus, abdominal pain should be taken care of within time. Don’t take the stomach ache or belly ache to lightly as then it can invite serious health problems. Make a habit to enhance a healthy eating lifestyle blending with fruits or juice in good of your healthy abdomen.
Whittier Chiropractor
herbalremedies asked:
More people call out sick from work because of chronic pain than call out sick because of the common cold. Chances are you or someone you know suffers from chronic pain. Pain is a necessary part of life. It alerts us when something is wrong with our bodies. It’s normal to experience pain with an illness or injury. Normally, this pain fades as the injury heals or the sickness goes away. This is referred to as acute pain.
Pain becomes chronic when it continues after the healing time of the injury. This pain can hang on for months or even years and often causes depression in its sufferers. Chronic pain can also occur as the result of an ongoing condition, like fibromyalgia, arthritis, or cancer. Back injuries, carpal tunnel syndrome, and migraine headaches are some other examples of conditions that cause chronic pain. Some pain can result from injury to the nerves causing them send false signals to the brain. How massage affects your pain is partly dependent on its source.
If your pain is caused by a muscle injury massage can not only help ease the pain but also help speed the healing process. Acute or chronic – these are the two words that describe pain. Acute goes away easily and rarely lasts long. Chronic is its exact opposite. Chronic pain can last for six months and is expected to recur at anytime. The main cause of it is very hard to pinpoint. And it doesn’t help if doctors were more interested in addressing the pains rather than knowing what is actually causing it. As such, chronic pain relief can be elusive to patients.
But then again, there are certain medicines and therapies that are deemed effective for chronic pain. There are also a lot of medicines sold over-the-counter, which can truly help. While chronic pain is a major problem, patients do have options to treat it. Doctors normally prescribe medicines, antidepressants, and anticonvulsants, to address chronic pain. Chronic pain relief is also possible with physical therapy. Physical therapy corresponds to the low-impact exercises like swimming, walking, and stretching. If done regularly, these simple exercises can help your body a lot. It can help lower the intensity of the pain you’re going through.
However, these exercises are best performed along a trained physical therapist. Both occupational and behavioral therapies could also help. In occupational therapy, patients are thought how to pace and condition themselves when doing everyday tasks. Don’t get discouraged if you are one of the chronic pain sufferers for which a cause cannot be found. An unknown source doesn’t make the pain any less real. Fibromyalgia, for example, causes widespread pain in muscles and joints.
Yet, a person with fibromyalgia may not know the cause of the pain A healthcare provider may be able to link fibromyalgia to an injury or virus; but in other cases, a specific cause may go unidentified. Irritable bowel syndrome is another example of chronic pain for which the specific cause may not be known. Chronic pain may be related to changes in your nerve signals after a healed injury. Chronic pain may also be related to heightened pain sensitivity when your body produces lower than normal levels of painkilling endorphins. If you suffer from chronic pain do not ignore the warning signals. If you try to tough it out, the disease, illness, or injury may get worse. Left untreated, chronic pain can also mentally wear you down. Making massage therapy part of your treatment routine could help ease your pain and lessen your dependence on pain killing drugs. In the long run this will lead to less drug side effects and better health.
Whittier Chiropractor
More people call out sick from work because of chronic pain than call out sick because of the common cold. Chances are you or someone you know suffers from chronic pain. Pain is a necessary part of life. It alerts us when something is wrong with our bodies. It’s normal to experience pain with an illness or injury. Normally, this pain fades as the injury heals or the sickness goes away. This is referred to as acute pain.
Pain becomes chronic when it continues after the healing time of the injury. This pain can hang on for months or even years and often causes depression in its sufferers. Chronic pain can also occur as the result of an ongoing condition, like fibromyalgia, arthritis, or cancer. Back injuries, carpal tunnel syndrome, and migraine headaches are some other examples of conditions that cause chronic pain. Some pain can result from injury to the nerves causing them send false signals to the brain. How massage affects your pain is partly dependent on its source.
If your pain is caused by a muscle injury massage can not only help ease the pain but also help speed the healing process. Acute or chronic – these are the two words that describe pain. Acute goes away easily and rarely lasts long. Chronic is its exact opposite. Chronic pain can last for six months and is expected to recur at anytime. The main cause of it is very hard to pinpoint. And it doesn’t help if doctors were more interested in addressing the pains rather than knowing what is actually causing it. As such, chronic pain relief can be elusive to patients.
But then again, there are certain medicines and therapies that are deemed effective for chronic pain. There are also a lot of medicines sold over-the-counter, which can truly help. While chronic pain is a major problem, patients do have options to treat it. Doctors normally prescribe medicines, antidepressants, and anticonvulsants, to address chronic pain. Chronic pain relief is also possible with physical therapy. Physical therapy corresponds to the low-impact exercises like swimming, walking, and stretching. If done regularly, these simple exercises can help your body a lot. It can help lower the intensity of the pain you’re going through.
However, these exercises are best performed along a trained physical therapist. Both occupational and behavioral therapies could also help. In occupational therapy, patients are thought how to pace and condition themselves when doing everyday tasks. Don’t get discouraged if you are one of the chronic pain sufferers for which a cause cannot be found. An unknown source doesn’t make the pain any less real. Fibromyalgia, for example, causes widespread pain in muscles and joints.
Yet, a person with fibromyalgia may not know the cause of the pain A healthcare provider may be able to link fibromyalgia to an injury or virus; but in other cases, a specific cause may go unidentified. Irritable bowel syndrome is another example of chronic pain for which the specific cause may not be known. Chronic pain may be related to changes in your nerve signals after a healed injury. Chronic pain may also be related to heightened pain sensitivity when your body produces lower than normal levels of painkilling endorphins. If you suffer from chronic pain do not ignore the warning signals. If you try to tough it out, the disease, illness, or injury may get worse. Left untreated, chronic pain can also mentally wear you down. Making massage therapy part of your treatment routine could help ease your pain and lessen your dependence on pain killing drugs. In the long run this will lead to less drug side effects and better health.
Whittier Chiropractor
Mark Janiga MD asked:
Sacroiliac joint pain
Sacroiliac (SI) joint pain has gained a lot of attention in the last ten years as an underappreciated cause of back pain with some studies indicating it is responsible for 15% to 40% of low back pain. The increased attention is due to the increasing knowledge of the SI joints intimate role in pelvic stability. I hope more physicians consider SI joint pain in their differential after reading this article.
Pathophysiology
SI joint dysfunction due to inflammation within the joint itself is called sacroilitis. Pain from within the SI joint is common in rheumatoid patients and spondyloarthropathies.
The other cause of SI joint dysfunction stems from instability of the SI joint. Many experts feel that SI joint pain is a component of a larger problem of pelvic instability (1). Pelvic instability has traditionally been underappreciated as a cause of low back pain, buttock pain, groin pain, and leg pain. Physical therapists and doctors of osteopathic medicine have been teaching these concepts for years but only relatively recently has this dissemination of knowledge trended towards mainstream thinking among medical doctors.
The SI joint complex (the SI joint and its associated ligaments) is the major support structure of the pelvic ring and is the strongest ligament complex in the body. The complex consists of interosseous sacroiliac ligaments, iliolumbar ligaments, posterior sacroiliac ligaments, and the sacrotuberous and sacrospinous ligaments. The SI joints are two of the three joints involved in the stability of the pelvic ring. The pelvic ring is the meeting place of the force vectors from the upper body and the lower extremities. The third joint in the pelvic ring is the pubis symphysis. Pelvic instability causes pelvic rotation which can also cause twisting of the pubis symphysis. Coupling this with its anterior location appears to provide an explanation as to why patients with SI joint instability can also experience anterior groin pain. Anecdotal evidence for this is seen when patients undergo a successful SI joint intra-articular injection relieving all of their posterior back, buttock, and leg symptoms but the patient still has groin pain. Groin pain is almost never eliminated by SI joint injections unless pelvic symmetry is corrected.
If the SI joints are unstable, it can lead to significant pain and discomfort over the SI joints as well as numerous referred areas. If an individual affected by SI joint pain has pain only over his or her SI joint, he/she should be considered lucky. Most often SI joint instability causes unnatural strain on the entire low back and pelvic region causing a sometimes confusing clinical picture. Pain referral patterns of SI joint pain are often confused with L5 or S1 radiculitis or radiculopathies.
Referral patterns of SI joint dysfunction (2)
SI joint dysfunction often presents with a confusing clinical presentation.
1. Buttock pain 94%
2. Lower lumbar pain 74%,
3. Lower extremity pain 50%, with 28% of these lower extremity pains going distal to the knee
4. Pain goes all the way into the foot 13%. Younger patients are more likely to refer pain distal to the knee.
5. Groin pain 14%.
Most patients with SI joint instability also experience pain over the buttock region due to secondary muscle spasm of the gluteus muscles and piriformis complex. Lower extremity symptoms are explained by the piriformis muscles natural tendency to spasm or tighten over the sciatic nerve whenever the SI joint is out of alignment. This spasm of gluteus and piriformis muscles can cause a mechanical crowding or impingement of the sciatic nerve as it exits just below the SI joint (see figure 1. note the intimate association of the piriformis muscle, SI joint, and sciatic nerve). Patients often complain of buttock pain and radiation of pain down to the knee and even down to the foot. Not all back pain and leg pains are due to a pinched a nerve from an intervertebral disk herniation. SI joint dysfunction very closely mimics S1 or L5 radiculitis’ or radiculopathies because of the above described sciatic nerve irritation or impingement.
Groin pain and abdominal pain are not uncommon with SI joint instability. Often times the groin pain is mistaken as a urologic problem like pudendal neuralgia, prostatitis, genitofemoral neuralgia, or sterile epidydymitis(1). This is likely either due to unnatural tension on the nerves and ligaments around the pubis symphysis or actual impingement of the pudendal nerve which lies between the sacrospinous ligament and sacrotuberous ligament. The distance between these two ligaments abruptly narrows when the Ilium and sacrum are out of alignment i.e. SI joint instability.
The typical history of SI joint dysfunction consists of lateral or bilateral low back pain almost always below the pelvic rim. Pain can also radiate into the hip, groin, pelvis, leg, and foot. The most common location of pain is in the buttock with pain extending down to the knee. Females are much more affected than males though the ratio is unclear. The mechanism of injury is a continuum from completely atraumatic events to more obvious trauma like motor vehicle accidents, childbirth, or falls. A little over one third of failed back surgery patients suffer from SI joint dysfunction. In my practice, I often see patients who lose a substantial amount of weight and then develop SI joint dysfunction. The etiology of this is unclear. Women who have had multiple births also seem to have a higher incidence of SI joint dysfunction. The symptoms may be acute or may present as a remote or cumulative injury with chronic waxing and waning of symptoms with slow progression over time. Patients often experience some degree of temporary relief with manipulation. Patients must change positions frequently to avoid pain. This is called “Theater Party Cocktail Syndrome”. Patient’s legs can also feel like they’re going to give out, but with objective testing of motor strength, no dysfunction is found. This is called a “Slipping Crutch syndrome”. Patients usually have a difficult time sleeping and getting out of bed in the morning can be excruciatingly painful. Continued movement after waking up tends to improve the pain.
There are many provocative physical exam maneuvers used to help establish the diagnosis of SI joint dysfunction. Going through each one of these provocative maneuvers is beyond the scope of this article. It is important to note that the predictive value of provocative SI joint maneuvers in determining SI joint dysfunction is only 60%(4). The conclusion of a recent study by Slipman et al(5), was that physical exam techniques can at best enter SI joint dysfunction into the differential diagnosis of a patient’s low back pain. Of the alleged signs of sacroiliac joint pain, maximum pain below L5 coupled with pointing to the PSIS or local tenderness just medial to the PSIS (sacral sulcus) has the highest positive predictive value (PPD) at 60%(4).
Diagnosis
The gold standard for making a diagnosis of SI joint dysfunction is a fluoroscopically guided SI joint injection. Fluoroscopy is needed to accurately and consistently inject the sacroiliac joint. Only 12% of patients had intra-articular SI joint injections when fluoroscopy was not utilized (3). Also important is to anesthetize the entire SI joint complex. In my experience as an interventional pain physician this cannot be consistently done by palpation alone, especially in obese patients. It is humbling to see anatomy change under fluoroscopic guidance. What you perceive with palpation is sometimes markedly different than the actual location of the structure that you palpate. Also vitally important is that these diagnostic injections are followed up with another physical exam while the patient is in the recovery room. Sending a patient home, having them follow up in several weeks, and then determining if this “diagnostic” injection was successful has consistently been shown to be an inaccurate way of establishing a pathoanatomic diagnosis.
Treatments
There is no one specific treatment for SI joint dysfunction which helps all patients. The treatment varies if the dysfunction is intra-articular (inflammatory), or if it’s a lack of stability. Conservative treatment should first be tried including the manipulation by a qualified physical therapist or osteopathic physician to restore normal motion and balance, home self-correction exercises, a walking program (avoid heavy axial loading maneuvers), and core strengthening exercises (Pilates, Yoga, or guided physical therapy). Some patients also benefit from a quality SI joint support belt. If conservative therapy is not helpful then I recommend a diagnostic SI joint complex injection. The injection should include the SI joint ( intra-articularly) and the supporting ligaments with pain relief lasting for the duration of the local anesthetic and achieving greater than 75% pain relief. If there is any question about the positivity of this diagnostic test, it should be repeated.
Radiofrequency Denervation
If the diagnosis has been established by an intra-articular SI joint injection and pain relief using conservative therapy affords no long-term pain relief, then consideration for other treatments can be made. Radiofrequency denervation of an SI joint carries about a 65% success rate for patients who have failed other conservative therapies and only mild instability around the joint. The procedure involves the neurotomy of the lateral branch nerves that lay over the sacrum and innervate the posterior SI joint. The advantage of SI joint radiofrequency is that it is a very safe procedure with almost no documented morbidity.
Prolotherapy
Another treatment for SI joint pain is Prolotherapy. Prolotherapy works by stimulating an inflammatory cascade which leads to fibroblastic activity thereby strengthening the entheses of ligaments and tendons. Prolotherapy on SI joints usually requires very strong Prolotherapy solutions. In my experience, hypertonic Dextrose Prolotherapy only relieves 20 to 30% of most patients’ pain. More aggressive prolotherapy usually reduces pain by 50% or greater in roughly 75% of patients. The greatest advantage of Prolotherapy is that it is provides a level of permanent relief.
SI joint Fusion
If the patient fails radiofrequency and prolotherapy, the last treatment option would be consideration for an SI joint fusion. The outcome data on SI joint fusions is not highly favorable. However, there are new minimally invasive SI joint fusions that have recently been approved by the FDA that appear promising. Patients with very diffuse pelvic pain and leg pains are not good candidates for fusion surgery.
Whittier Chiropractor
Sacroiliac joint pain
Sacroiliac (SI) joint pain has gained a lot of attention in the last ten years as an underappreciated cause of back pain with some studies indicating it is responsible for 15% to 40% of low back pain. The increased attention is due to the increasing knowledge of the SI joints intimate role in pelvic stability. I hope more physicians consider SI joint pain in their differential after reading this article.
Pathophysiology
SI joint dysfunction due to inflammation within the joint itself is called sacroilitis. Pain from within the SI joint is common in rheumatoid patients and spondyloarthropathies.
The other cause of SI joint dysfunction stems from instability of the SI joint. Many experts feel that SI joint pain is a component of a larger problem of pelvic instability (1). Pelvic instability has traditionally been underappreciated as a cause of low back pain, buttock pain, groin pain, and leg pain. Physical therapists and doctors of osteopathic medicine have been teaching these concepts for years but only relatively recently has this dissemination of knowledge trended towards mainstream thinking among medical doctors.
The SI joint complex (the SI joint and its associated ligaments) is the major support structure of the pelvic ring and is the strongest ligament complex in the body. The complex consists of interosseous sacroiliac ligaments, iliolumbar ligaments, posterior sacroiliac ligaments, and the sacrotuberous and sacrospinous ligaments. The SI joints are two of the three joints involved in the stability of the pelvic ring. The pelvic ring is the meeting place of the force vectors from the upper body and the lower extremities. The third joint in the pelvic ring is the pubis symphysis. Pelvic instability causes pelvic rotation which can also cause twisting of the pubis symphysis. Coupling this with its anterior location appears to provide an explanation as to why patients with SI joint instability can also experience anterior groin pain. Anecdotal evidence for this is seen when patients undergo a successful SI joint intra-articular injection relieving all of their posterior back, buttock, and leg symptoms but the patient still has groin pain. Groin pain is almost never eliminated by SI joint injections unless pelvic symmetry is corrected.
If the SI joints are unstable, it can lead to significant pain and discomfort over the SI joints as well as numerous referred areas. If an individual affected by SI joint pain has pain only over his or her SI joint, he/she should be considered lucky. Most often SI joint instability causes unnatural strain on the entire low back and pelvic region causing a sometimes confusing clinical picture. Pain referral patterns of SI joint pain are often confused with L5 or S1 radiculitis or radiculopathies.
Referral patterns of SI joint dysfunction (2)
SI joint dysfunction often presents with a confusing clinical presentation.
1. Buttock pain 94%
2. Lower lumbar pain 74%,
3. Lower extremity pain 50%, with 28% of these lower extremity pains going distal to the knee
4. Pain goes all the way into the foot 13%. Younger patients are more likely to refer pain distal to the knee.
5. Groin pain 14%.
Most patients with SI joint instability also experience pain over the buttock region due to secondary muscle spasm of the gluteus muscles and piriformis complex. Lower extremity symptoms are explained by the piriformis muscles natural tendency to spasm or tighten over the sciatic nerve whenever the SI joint is out of alignment. This spasm of gluteus and piriformis muscles can cause a mechanical crowding or impingement of the sciatic nerve as it exits just below the SI joint (see figure 1. note the intimate association of the piriformis muscle, SI joint, and sciatic nerve). Patients often complain of buttock pain and radiation of pain down to the knee and even down to the foot. Not all back pain and leg pains are due to a pinched a nerve from an intervertebral disk herniation. SI joint dysfunction very closely mimics S1 or L5 radiculitis’ or radiculopathies because of the above described sciatic nerve irritation or impingement.
Groin pain and abdominal pain are not uncommon with SI joint instability. Often times the groin pain is mistaken as a urologic problem like pudendal neuralgia, prostatitis, genitofemoral neuralgia, or sterile epidydymitis(1). This is likely either due to unnatural tension on the nerves and ligaments around the pubis symphysis or actual impingement of the pudendal nerve which lies between the sacrospinous ligament and sacrotuberous ligament. The distance between these two ligaments abruptly narrows when the Ilium and sacrum are out of alignment i.e. SI joint instability.
The typical history of SI joint dysfunction consists of lateral or bilateral low back pain almost always below the pelvic rim. Pain can also radiate into the hip, groin, pelvis, leg, and foot. The most common location of pain is in the buttock with pain extending down to the knee. Females are much more affected than males though the ratio is unclear. The mechanism of injury is a continuum from completely atraumatic events to more obvious trauma like motor vehicle accidents, childbirth, or falls. A little over one third of failed back surgery patients suffer from SI joint dysfunction. In my practice, I often see patients who lose a substantial amount of weight and then develop SI joint dysfunction. The etiology of this is unclear. Women who have had multiple births also seem to have a higher incidence of SI joint dysfunction. The symptoms may be acute or may present as a remote or cumulative injury with chronic waxing and waning of symptoms with slow progression over time. Patients often experience some degree of temporary relief with manipulation. Patients must change positions frequently to avoid pain. This is called “Theater Party Cocktail Syndrome”. Patient’s legs can also feel like they’re going to give out, but with objective testing of motor strength, no dysfunction is found. This is called a “Slipping Crutch syndrome”. Patients usually have a difficult time sleeping and getting out of bed in the morning can be excruciatingly painful. Continued movement after waking up tends to improve the pain.
There are many provocative physical exam maneuvers used to help establish the diagnosis of SI joint dysfunction. Going through each one of these provocative maneuvers is beyond the scope of this article. It is important to note that the predictive value of provocative SI joint maneuvers in determining SI joint dysfunction is only 60%(4). The conclusion of a recent study by Slipman et al(5), was that physical exam techniques can at best enter SI joint dysfunction into the differential diagnosis of a patient’s low back pain. Of the alleged signs of sacroiliac joint pain, maximum pain below L5 coupled with pointing to the PSIS or local tenderness just medial to the PSIS (sacral sulcus) has the highest positive predictive value (PPD) at 60%(4).
Diagnosis
The gold standard for making a diagnosis of SI joint dysfunction is a fluoroscopically guided SI joint injection. Fluoroscopy is needed to accurately and consistently inject the sacroiliac joint. Only 12% of patients had intra-articular SI joint injections when fluoroscopy was not utilized (3). Also important is to anesthetize the entire SI joint complex. In my experience as an interventional pain physician this cannot be consistently done by palpation alone, especially in obese patients. It is humbling to see anatomy change under fluoroscopic guidance. What you perceive with palpation is sometimes markedly different than the actual location of the structure that you palpate. Also vitally important is that these diagnostic injections are followed up with another physical exam while the patient is in the recovery room. Sending a patient home, having them follow up in several weeks, and then determining if this “diagnostic” injection was successful has consistently been shown to be an inaccurate way of establishing a pathoanatomic diagnosis.
Treatments
There is no one specific treatment for SI joint dysfunction which helps all patients. The treatment varies if the dysfunction is intra-articular (inflammatory), or if it’s a lack of stability. Conservative treatment should first be tried including the manipulation by a qualified physical therapist or osteopathic physician to restore normal motion and balance, home self-correction exercises, a walking program (avoid heavy axial loading maneuvers), and core strengthening exercises (Pilates, Yoga, or guided physical therapy). Some patients also benefit from a quality SI joint support belt. If conservative therapy is not helpful then I recommend a diagnostic SI joint complex injection. The injection should include the SI joint ( intra-articularly) and the supporting ligaments with pain relief lasting for the duration of the local anesthetic and achieving greater than 75% pain relief. If there is any question about the positivity of this diagnostic test, it should be repeated.
Radiofrequency Denervation
If the diagnosis has been established by an intra-articular SI joint injection and pain relief using conservative therapy affords no long-term pain relief, then consideration for other treatments can be made. Radiofrequency denervation of an SI joint carries about a 65% success rate for patients who have failed other conservative therapies and only mild instability around the joint. The procedure involves the neurotomy of the lateral branch nerves that lay over the sacrum and innervate the posterior SI joint. The advantage of SI joint radiofrequency is that it is a very safe procedure with almost no documented morbidity.
Prolotherapy
Another treatment for SI joint pain is Prolotherapy. Prolotherapy works by stimulating an inflammatory cascade which leads to fibroblastic activity thereby strengthening the entheses of ligaments and tendons. Prolotherapy on SI joints usually requires very strong Prolotherapy solutions. In my experience, hypertonic Dextrose Prolotherapy only relieves 20 to 30% of most patients’ pain. More aggressive prolotherapy usually reduces pain by 50% or greater in roughly 75% of patients. The greatest advantage of Prolotherapy is that it is provides a level of permanent relief.
SI joint Fusion
If the patient fails radiofrequency and prolotherapy, the last treatment option would be consideration for an SI joint fusion. The outcome data on SI joint fusions is not highly favorable. However, there are new minimally invasive SI joint fusions that have recently been approved by the FDA that appear promising. Patients with very diffuse pelvic pain and leg pains are not good candidates for fusion surgery.
Whittier Chiropractor
Hemant Yagnick, M.D. asked:
Patients with advanced cancer often have pain as their chief complaint. Although advances in cancer treatment have lengthened survival among cancer patients, cancer pain remains under treated in patients. It has been estimated that 25% of all cancer patients who die, do so without adequate pain relief, despite the fact that the tools for adequate pain control are available. With advanced disease, 90% of patients with cancer require strong opiates to control their pain. However, many physicians remain concerned about inadvertently making a patient an addict if they prescribe narcotics to treat pain. Cultural and attitudinal barriers, knowledge deficits among health care professionals, and the influence of state and federal drug regulatory agencies also contribute to the fact that the pain experienced by cancer patients, all too often, is under-treated.
Cancer pain is classified according to pain duration and quality. Duration of pain can denote the acute or chronic nature of pain. It is common to experience anxiety, apprehension and depression in patients with cancer pain. The types of pain most commonly experienced by cancer patients are:
- Acute cancer related pain
- Chronic cancer related pain
- Pain unrelated to cancer
- Pain in opiod tolerant cancer patients
- End of life pain
After an appropriate medical history review and a physical, a pain physician will tailor a suitable pain treatment program. Because everyone has a different response to medications and therapies, the other types of drugs with pain relievers. They include anti-inflammatory steroids, anticonvulsants, and antidepressants. These drugs may be effective treatments for specific types of pain or pain with specific causes. For example, the doctor may prescribe antidepressants to help relieve certain types of pain. However, it doesn’t necessarily mean that the patient is suffering from depression. Similarly, steroids often are effective in relieving pain associated with inflammation.
Cancer pain can be controlled effectively through therapies already available today. Pain treatments range from mild, nonprescription pain relievers, to stronger prescription medications, to neurological surgery, to alternative therapies such as relaxation, biofeedback, guided imagery, and acupuncture.
Oncologists and pain specialists can devise a treatment plan based on the type and severity of pain, side effects, and how the patient responds to the treatment. Some common approaches to treat cancer pain include:
1. Oral Medicines- Aspirin & NSAIDs, Opiods, Adjuvants
2. Intravenous drugs
3. Transdermal drug delivery systems
4. Nerve blocks
5. Interthecal drug pumps
6. Neuroablstive procedures
Although they have cancer pain, many patients are afraid of getting addicted to pain medicines. When cancer pain medicines are given and taken in the right way, patients rarely become addicted to them. To be sure, they should talk to the doctor, nurse, or pharmacist about how to use pain medications safely. Many patients only need pain medicines for a time, until the cause of the pain goes away due to other treatments like chemotherapy, radiotherapy or surgery. When they are ready to stop taking the medicine, the doctor gradually lowers the amount of medicine they take. By the time they stop using it completely, the body has had time to adjust. Some patients will need to take pain medicines for the long-term. Taking medicines regularly should not make patients feel like an “addict.”
Physical dependence, tolerance to medication and addiction are three different issues in people treated with strong pain medications. The patient’s physician can explain the subtle but important difference between them. It’s often easier to control pain in its early stages, because it becomes severe. Therefore, it is better for cancer pain patients to ask for adequate pain relief.
A primary care physician or oncologist can help explain the possible options for pain relief and can make a referral, when necessary, to a pain medicine specialist for optimal pain management.
About Walton Rehabilitation Health System:
Walton Rehabilitation Health Systems (WRHS) is a leading not-for-profit comprehensive, multi-specialty, dedicated provider of physical medicine and rehabilitation. Our mission is to be an advocate for wellness by providing a continuum of services to treat the whole person. WRHS, whose reputation extends throughout the south, is a trusted partner with just the right expertise and treatments to help people with disabling injuries and illnesses return to work and to a fulfilling life. By pursuing its mission, WRHS has grown to include Walton Pain and Headache Centers, Walton Community Services, Walton Options for Independent Living, Walton Foundation for Independence, and Walton Technologies. We are located at: 1355 Independence Drive, Augusta, GA 30901-1037. For more information visit www.wrh.org or call 866-4-WALTON.
Whittier Chiropractor
Patients with advanced cancer often have pain as their chief complaint. Although advances in cancer treatment have lengthened survival among cancer patients, cancer pain remains under treated in patients. It has been estimated that 25% of all cancer patients who die, do so without adequate pain relief, despite the fact that the tools for adequate pain control are available. With advanced disease, 90% of patients with cancer require strong opiates to control their pain. However, many physicians remain concerned about inadvertently making a patient an addict if they prescribe narcotics to treat pain. Cultural and attitudinal barriers, knowledge deficits among health care professionals, and the influence of state and federal drug regulatory agencies also contribute to the fact that the pain experienced by cancer patients, all too often, is under-treated.
Cancer pain is classified according to pain duration and quality. Duration of pain can denote the acute or chronic nature of pain. It is common to experience anxiety, apprehension and depression in patients with cancer pain. The types of pain most commonly experienced by cancer patients are:
- Acute cancer related pain
- Chronic cancer related pain
- Pain unrelated to cancer
- Pain in opiod tolerant cancer patients
- End of life pain
After an appropriate medical history review and a physical, a pain physician will tailor a suitable pain treatment program. Because everyone has a different response to medications and therapies, the other types of drugs with pain relievers. They include anti-inflammatory steroids, anticonvulsants, and antidepressants. These drugs may be effective treatments for specific types of pain or pain with specific causes. For example, the doctor may prescribe antidepressants to help relieve certain types of pain. However, it doesn’t necessarily mean that the patient is suffering from depression. Similarly, steroids often are effective in relieving pain associated with inflammation.
Cancer pain can be controlled effectively through therapies already available today. Pain treatments range from mild, nonprescription pain relievers, to stronger prescription medications, to neurological surgery, to alternative therapies such as relaxation, biofeedback, guided imagery, and acupuncture.
Oncologists and pain specialists can devise a treatment plan based on the type and severity of pain, side effects, and how the patient responds to the treatment. Some common approaches to treat cancer pain include:
1. Oral Medicines- Aspirin & NSAIDs, Opiods, Adjuvants
2. Intravenous drugs
3. Transdermal drug delivery systems
4. Nerve blocks
5. Interthecal drug pumps
6. Neuroablstive procedures
Although they have cancer pain, many patients are afraid of getting addicted to pain medicines. When cancer pain medicines are given and taken in the right way, patients rarely become addicted to them. To be sure, they should talk to the doctor, nurse, or pharmacist about how to use pain medications safely. Many patients only need pain medicines for a time, until the cause of the pain goes away due to other treatments like chemotherapy, radiotherapy or surgery. When they are ready to stop taking the medicine, the doctor gradually lowers the amount of medicine they take. By the time they stop using it completely, the body has had time to adjust. Some patients will need to take pain medicines for the long-term. Taking medicines regularly should not make patients feel like an “addict.”
Physical dependence, tolerance to medication and addiction are three different issues in people treated with strong pain medications. The patient’s physician can explain the subtle but important difference between them. It’s often easier to control pain in its early stages, because it becomes severe. Therefore, it is better for cancer pain patients to ask for adequate pain relief.
A primary care physician or oncologist can help explain the possible options for pain relief and can make a referral, when necessary, to a pain medicine specialist for optimal pain management.
About Walton Rehabilitation Health System:
Walton Rehabilitation Health Systems (WRHS) is a leading not-for-profit comprehensive, multi-specialty, dedicated provider of physical medicine and rehabilitation. Our mission is to be an advocate for wellness by providing a continuum of services to treat the whole person. WRHS, whose reputation extends throughout the south, is a trusted partner with just the right expertise and treatments to help people with disabling injuries and illnesses return to work and to a fulfilling life. By pursuing its mission, WRHS has grown to include Walton Pain and Headache Centers, Walton Community Services, Walton Options for Independent Living, Walton Foundation for Independence, and Walton Technologies. We are located at: 1355 Independence Drive, Augusta, GA 30901-1037. For more information visit www.wrh.org or call 866-4-WALTON.
Whittier Chiropractor