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Trigeminal Neuralgia

Trigeminal Neuralgia

Trigeminal Neuralgia
Trigeminal neuralgia is a condition characterized by pain coming from the trigeminal nerve, which affects the face — most commonly one side of the jaw or cheek.
The pain of trigeminal neuralgia is unlike facial pain caused by other problems. It is often described as stabbing, lancinating or electrical in sensation and so severe that the affected person cannot eat or drink.
Trigeminal neuralgia is sometimes known as tic douloureux, which means “painful tic.”

What You Need to Know
Trigeminal neuralgia most frequently affects people older than 50, and the condition is more common in women than men.
Trigeminal neuralgia is the most common cause of facial pain and is diagnosed in approximately 15,000 people per year in the United States.
Trigeminal neuralgia pain is exceptionally severe. Although the condition is not life-threatening, the intensity of the pain can be debilitating.
Trigeminal neuralgia relief is possible: Medical and surgical treatments can bring the pain under control, especially when managed by an expert physician and surgeon.
Causes of Trigeminal Neuralgia
Trigeminal neuralgia may be caused by a blood vessel pressing against the trigeminal nerve. Over time, the pulse of an artery rubbing against the nerve can wear away the insulation, which is called myelin, leaving the nerve exposed and highly sensitive.
These symptoms can be similar to those caused by dental problems, and sometimes people with undiagnosed trigeminal neuralgia explore multiple dental procedures in an effort to control the pain.
Multiple sclerosis or rarely a tumor can cause trigeminal neuralgia. Researchers are exploring whether or not postherpetic neuralgia (caused by shingles) can be related to this condition.

Trigeminal Neuralgia Symptoms
Episodes of sharp, stabbing pain in the cheek or jaw that may feel like an electric shock
Pain episodes that may be triggered by anything touching the face or teeth, including shaving, applying makeup, brushing teeth, eating, drinking or talking — or even a light breeze
Periods of relief between episodes
Anxiety from the thought of the pain returning
A flare-up of trigeminal neuralgia may begin with tingling or numbness in the face. Pain occurs in intermittent bursts that last anywhere from a few seconds to two minutes, becoming more and more frequent until the pain is almost continuous.
Flare-ups may continue for a few weeks or months followed by a pain-free period that can last a year or more.
Trigeminal Neuralgia Diagnosis
Diagnosing trigeminal neuralgia involves a physical exam and a detailed medical history to rule out other causes of facial pain. The health care provider will ask what the pain is like, what seems to set it off and what makes it feel better or worse.
The provider may recommend imaging or laboratory tests to determine if the pain is caused by a tumor or blood vessel abnormality or by undiagnosed multiple sclerosis. Certain advanced MRI techniques may help the doctor see where a blood vessel is pressing against a branch of the trigeminal nerve.
Treatment for Trigeminal Neuralgia
Most common over-the-counter and prescription pain medicines don’t work for people with trigeminal neuralgia, but many modern treatments can reduce or eliminate the pain. The doctor may recommend one or more of these approaches:
Medications: Seizure drugs like carbamazepine, gabapentin or other agents can be helpful. It is important to work closely with a neurologist or primary care provider to monitor dosages and side effects.
Surgery: Several procedures can often help bring trigeminal neuralgia pain under control.
Rhizotomy
There are several kinds of rhizotomies, which are all outpatient procedures performed under general anesthesia in the operating room. The surgeon inserts a long needle through the cheek on the affected side and uses an electrical current or a chemical to deaden the pain fibers of the trigeminal nerve.
Stereotactic Radiosurgery
Stereotactic radiosurgery, sometimes known as CyberKnife treatment, is another outpatient procedure that involves a very concentrated and precise beam of radiation that is directed at the trigeminal nerve to relieve the pain.
Microvascular Decompression (MVD) Surgery
This procedure is currently regarded as the most long-lasting treatment for trigeminal neuralgia and may be suitable for people in good health who can tolerate surgery and general anesthesia and whose lifestyles can accommodate a recovery period of four to six weeks.
The surgeon makes an incision behind the ear and removes a small piece of the skull to gain access to the nerve and blood vessels. Then, the surgeon places a cushion of insulation around the blood vessel so it no longer compresses or rubs against the nerve.
In about one third of people treated with MVD surgeries, trigeminal neuralgia pain returns, possibly due to the blood vessels growing back. The doctor will help individuals with recurring pain choose other options or may recommend repeating procedures.
Managing Trigeminal Neuralgia
Although not fatal, trigeminal neuralgia pain and the anxiety it causes can erode a person’s quality of life. It is essential to work closely with experienced and compassionate health care providers who can help find the best therapeutic approach for each individual.
The surgery for trigeminal neuralgia is delicate and precise since the involved area is very small. Look for experienced neurosurgeons who see and treat a large number of people with trigeminal neuralgia.

 

Article Provided By: hopkinsmedicine
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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Why Is Neuropathy Worse at Night?

January 3, 2020 / Brain & Spine
Why Is Neuropathy Worse at Night?
Reasons why nerve pain is more painful at night
Peripheral neuropathy is when a nerve or group of nerves outside of the brain and spinal cord is injured or dysfunctions. It could be because of an injury to a single nerve, like carpal tunnel syndrome, or because a group of nerves have become defective, like with peripheral neuropathy of the feet.
“Across the board we know that neuropathy can cause pain depending on what type of nerves are involved,” says neurologist Benjamin Claytor, MD. “When people describe worsening symptoms at night they’re describing discomfort – pins and needles, tingling and burning pain.”
Here Dr. Claytor discusses what might be causing this nightly pain and how to find relief.
Distraction
Our attention level can influence how we perceive pain. So during the day when we’re at work or taking care of the kids – we’re distracted and busy. Although there hasn’t been much research around it, the idea is that we aren’t focusing on the pain during the day because we’re busy, we pay less attention to it and perceive less pain.
“Many patients will tell me that after they get home from work, have dinner and sit down to watch TV for the night that their pain flares up,” says Dr. Claytor. “This could be because the daytime distractions are now gone and you’re starting to unwind for the night.”
Temperature and sleep
Another thought behind nightly neuropathy has to do with temperature. At night our body temperature fluctuates and goes down a bit. Most people tend to sleep in a cooler room as well. The thought is that damaged nerves might interpret the temperature change as pain or tingling, which can heighten the sense of neuropathy.
Also consider poor sleep quality. If you’re not sleeping very well to begin with, either due to poor sleep habits or sleep related disorders, this could lead to increased pain perception.
Emotions and stress
Our emotional state can also influence how we perceive pain. Stress and anxiety can feed in to and amplify pain signaling. Living in a chronic state of stress wreaks havoc on your physical and mental health.
Medication
Sometimes medication dosing and timing might need to be adjusted, which could be particularly true for some short acting medications used for neuropathy pain.
How to stop neuropathy pain at night
“There are options we can explore if your neuropathy pain seems to be worsening at night,” explains Dr. Claytor. “There might be oral or topical medications we can prescribe, or maybe it’s getting your stress under control and being more mindful.”
Cognitive behavioral therapy, physical therapy and meditation may be complementary tools to reduce pain as well.
Dr. Claytor stresses the importance of talking to your doctor sooner rather than later. Often time’s people will wait so long to see their physician that there’s permanent nerve damage that might have been avoided.
“I think one of the most important things I can discuss with a patient who comes in with neuropathy pain at night is getting to the root cause of what is actually driving it,” says Dr. Claytor. “Depending on what the underlying cause is, treating that first and foremost can usually help reduce the pain overall – especially at night.”

 

Article Provided By: health.clevelandclinic
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

 

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Finger Nerve Pain

Finger Nerve Pain Causes, Symptoms, and Treatments For Relief

The nerves of the body are like telephone wires that transmit messages between the brain, spinal cord, and other parts of the body. Some of these nerves carry signals of pressure, pain, or temperature from the body and transports them to the brain.

Quite a number of these nerve fibers are located in the fingers, where they are protected and insulated by tissues. Like with the wrist, damage to the nerves in the finger area can be excruciating. Nerve pain in the finger is a form of peripheral neuropathy which usually occurs periodically or constantly but typically felt in both hands.
Our hands are tactile organs which we use to carry out a multitude of tasks which include brushing our teeth, typing, washing, buttoning our clothes and tying our shoelaces. Our hands are hardly ever at rest, so it is not uncommon to experience uncomfortable sensations like throbbing, stabbing pains, or numbness.
Often, these feelings are mild and temporary. However, some people might experience symptoms that are extreme and episodic, which may be a marker for nerve damage from the wrist to the fingers.
The main nerves that control the fingers are the median nerves, the ulnar nerves, and the radial nerves. The median nerve which travels through the carpal tunnel controls impulses in the middle finger, one side of the ring finger, the index finger, and the thumb. The largest unprotected nerve in the body popularly called the ulnar nerve, branches off the adjoining side of the ring finger and the little finger.
This nerve facilitates grasping of objects while creating sensations on the palm. The radial nerve takes an active part in controlling the position of the hands. It provides signals from the bordering half of the ring finger and the posterior of the little finger.
According to WebMD, it is believed that 40 million Americans are saddled with nerve pain. Nerve pain in the fingers may be acute or progress slowly over the years.

Symptoms
The symptoms of nerve pain in the fingers usually begin with a pricking, burning, or tingling sensation in the fingers. Following are the frequent forms of nerve pains in the fingers:
Chronic, intense pain
A pinched nerve
Hypersensitivity to touch and temperature
Burning sensation
The feeling of wearing an invisible sock
Loss of coordination
Irregularities in heart rate and blood pressure
Cramping of muscles
Inability to sleep
Loss of balance
Causes
Quite a number of factors can cause nerve damage in the fingers. They include:
Infections
Exposure to toxins
Diabetic neuropathy
Repetitive stress
Trauma
Types of Nerve Damage
Motor Nerve Damage
Damage to the motor nerves can cause stabbing pains in the fingers. Motor nerves help to transmit impulses from the central nervous system to the muscles of the hands and other parts of the body. Motor nerves partake in activities like catching a ball or writing. Destruction to the motor nerves leads to spasms, cramps, and difficulty in moving the arms.
Sensory Nerve Damage
Sensory nerves in the hands help to direct signals from the muscles to the central nervous system. These nerves help individuals to decipher if a particular object is sharp or blunt, cold, or hot and if it’s stagnant or dynamic. Extreme damage to these sensory nerves of the fingers, causes pain, numbness, burning sensation, tingling, and heightened sensitivity to external stimuli.
Autonomic Nerve Damage
The autonomic nerves oversee semi-voluntary and involuntary functions in the body like sweating, digestion, heart rate, and blood pressure. Injury to the autonomic nerves can result in uncontrolled sweating, vomiting, constipation, irregular heart rate, abnormal blood pressure, nausea, constipation, and sexual dysfunction.
Conditions Which Causes Nerve Pain in the Finger
Any injury to the hand will greatly affect your quality of life and there are quite a number of health conditions which predispose the fingers to nerve pain. They include:
Hand nerve entrapment – hand nerve entrapment occurs in two forms: Carpal Tunnel syndrome and Cubital tunnel syndrome
Ulnar nerve compression
Numbness and tingling
Trigger finger
Goalkeeper’s thumb
Mallet finger
Nail bed injuries
Hand cysts and tumors
Arthritis
Fractures

How to Relieve Nerve Pain in a Finger
Some nerve pain in the finger can heal without any form of intervention while a host of others require early detection and special care to speed up recovery.
Prior to the commencement of treatment, it is crucial to look out for any underlying reason that is causing nerve pain in the hand. The severity of nerve pain has a direct link to how severe an underlying disease condition is. The following ways have been proven to alleviate nerve pains in the finger.
Painkillers
Over-the-counter pain relievers like Ibuprofen usually reduce pain after a short while. If the pain persists after taking painkillers, contact your physician.

Topical treatment
Prescription topical treatment like lotions, ointments, balms, gels, and creams can reduce nerve pains in the fingers. Go for a formula that has the active ingredient, capsaicin. Capsaicin is a biological substance extracted from chili pepper that serves as an anesthetic, which helps significantly reduce the pain.

Dietary Supplementation
Depletion in the nutrient stores may not cause nerve pain directly, but they can interfere with processes that aid the smooth function of the nerves. This is why it is important to use dietary supplements for neuropathy to boost the health of your nerves. One of the best brands of dietary supplements that have proven to help is Nerve Renew. The product is rich in vitamins and minerals like vitamin B2, B6, copper, and manganese. This pain-free approach uses natural sources to help reduce discomfort associated with neuropathy. It also helps to reduce symptoms.
Alternative approaches
Acupuncture and massages help in relieving pain.
Lifestyle modification habits
Lifestyle changes are typically preventive measures, but they can also help to improve cure. Exercise and good dietary habit help maintain the integrity of nerves in your fingers. Smoking, too much alcohol, and a poor diet generally aggravate nerve pain, so avoid them at all costs.
In certain cases, a surgical procedure might be required to correct the damage which causes the pain. Only a professional can handle this.

Article Provided By: nervepainguide

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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Neuropathic Pain

Neuropathic Pain

What is neuropathic pain?
Neuropathic pain can result after damage or dysfunction of the nervous system. Pain can rise from any level of the nervous system. These levels are the peripheral nerves, spinal cord, and brain. Pain centers receive the wrong signals from the damaged nerve fibers. Nerve function may change at the site of the nerve damage, as well as areas in the central nervous system (central sensitization).
Neuropathy is a disturbance of function or a change in one or several nerves. About 30% of neuropathy cases is caused by diabetes. It is not always easy to tell the source of the neuropathic pain. There are hundreds of diseases that are linked to this kind of pain.
What are some of the sources of neuropathic pain?
Alcoholism
Amputation (results in phantom pain)
Chemotherapy drugs (Cisplatin®, Paclitaxel®, Vincristine®, etc.)
Radiation therapy
Complex regional pain syndrome
Diabetes
Facial nerve problems
HIV infection or AIDS
Shingles
Spinal nerve compression or inflammation
Trauma or surgeries with resulting nerve damage
Nerve compression or infiltration by tumors
Central nervous system disorders (stroke, Parkinson’s disease, multiple sclerosis, etc.)
What are the symptoms of neuropathic pain?
Many symptoms may be present in the case of neuropathic pain. These symptoms include:
Spontaneous pain (pain that comes without stimulation): Shooting, burning, stabbing, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling
Evoked pain: Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc. This is called allodynia. Evoked pain also may mean the increase of pain by normally painful stimuli such as pinpricks and heat. This type of pain is called hyperalgesia.
An unpleasant, abnormal sensation whether spontaneous or evoked (dysesthesia)
Trouble sleeping
Emotional problems due to disturbed sleep and pain
Pain that may be lessened in response to a normally painful stimulus (hypoalgesia)
Diagnosis and Tests
How is neuropathic pain diagnosed?
Your doctor will take a medical history and do a physical exam. Neuropathic pain is suggested by its typical symptoms when nerve injury is known or suspected. Your doctor will then try to find the underlying cause of the neuropathy and then trace the symptoms.
Management and Treatment
How is neuropathic pain treated?
The goals of treatment are to:
Treat the underlying disease (for example, radiation or surgery to shrink a tumor that is pressing on a nerve)
Provide pain relief
Maintain functionality
Improve quality of life
Multimodal therapy (including medicines, physical therapy, psychological treatment, and sometimes surgery) is usually required to treat neuropathic pain.
Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as Neurontin®, Lyrica®, Topamax®, Tegretol®, and Lamictal®. Doctors also prescribe antidepressants such as Elavil®, Pamelor®, Effexor®, and Cymbalta®. A doctor’s prescription for anti-seizure drugs or antidepressants does not mean you have seizures or are depressed.
A topical patch (Lidocaine® or Capsaicin®) or a cream or ointment can be used on the painful area. Opioid analgesics can provide some relief. However, they generally are less effective in treating neuropathic pain. Negative effects may prevent their long-term use.
The pain can also be treated with nerve blocks given by pain specialists, including injections of steroids, local anesthetics, or other medicines into the affected nerves.
Neuropathic pain that has not responded to the therapies mentioned above can be treated with spinal cord stimulation, peripheral nerve stimulation, and brain stimulation.
Outlook / Prognosis
What is the outlook for people with neuropathic pain?
Neuropathic pain is difficult to get rid of, but is not life-threatening. Without rehabilitation and sometimes psychosocial support, treatment has a limited chance of success. With help from a pain specialist using the multimodal approaches listed above, your neuropathic pain can be managed to a level that improves your quality of life.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.

Article Provided By: clevelandclinic
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

 

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Pudendal Neuralgia

What Is Pudendal Neuralgia?
Pudendal neuralgia is a condition that causes pain, discomfort, or numbness in your pelvis or genitals. It happens when a major nerve in the lower body is damaged or irritated, and it can make it hard to use the bathroom, have sex, or sit down. The pain comes and goes.
It’s not clear exactly how many people have this condition, but experts believe it’s rare.
The pudendal nerve runs from the back of the pelvis to near the base of your penis or vagina, where it branches off into other nerves.
It sends messages to the brain from your genitals, anus, and other nearby body parts. It controls the sphincter muscles that open and close when you use the bathroom.
Causes
There are several things that can damage your pudendal nerve.
It can happen when you’re injured, have surgery, or give birth. A tumor or an infection can squeeze or irritate it. And sometimes, certain types of exercise, like spending a lot of time on a bicycle, can cause the problem.
Symptoms
You usually feel pudendal neuralgia symptoms in your lower body, genitals, or perineum (the area between your genitals and anus). These may include:

A sharp or burning pain
More sensitivity
Numbness or a pins-and-needles feeling, like when your leg falls asleep
A swollen feeling
These feelings might be worse when you sit down. Or you may have symptoms on both sides of your body, and they might go into your belly, buttocks, or legs.
You also may have problems such as:
A sudden or frequent need to go to the bathroom
Trouble or pain during sex
For men, problems getting an erection

Diagnosis
If you have pelvic pain, tell your doctor. At your appointment, you’ll answer questions about your symptoms and get a physical examination. Your doctor will put a finger into your vagina or rectum and put pressure on the nerve to check on it.
You might also get an imaging test with an MRI machine. It uses powerful magnets and radio waves to take a picture of your body’s internal organs.
Your doctor may also give you a pudendal nerve block. This is a shot you get in your pelvis to numb the nerve and see if your symptoms go away.
Treatment
Most people with pudendal neuralgia get treatment with a combination of physical therapy, lifestyle changes, and medicines.
Sit up straight or stand more often to help with nerve pain. This can take pressure off the pudendal nerve.
Don’t do squats or cycle. Certain exercises can make pudendal neuralgia worse.
Go for physical therapy. It relaxes and stretches the muscles at the lower end of your pelvis, known as the pelvic floor. This can ease pressure that may irritate the pudendal nerve. If pudendal neuralgia makes it hard to control your bladder or bowels, physical therapy can help with that, too.
Try prescription medication. Muscle relaxants may help relieve symptoms of pudendal neuralgia. Drugs used to treat other conditions, like depression or epilepsy, might also help.
If these don’t work, your doctor may give you a shot of medications that numb the nerve or lower inflammation, which lessens pressure. These may take several weeks to fully take effect.
In rare cases, your doctor may recommend surgery to remove anything that presses on the nerve. You may also get a small electrical device put under your skin to stimulate the nerve and interrupt the pain signals it sends to the brain.
WebMD Medical Reference Reviewed by Tyler Wheeler, MD on January 27, 2020
Sources
SOURCES:
National Institutes of Health, Genetic and Rare Diseases Information Center: “Pudendal Neuralgia.”
Health Organization for Pudendal Education: “Anatomy of the pudendal nerve.”
Obstetrical and Gynecological Survey: “Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria).”
U.K. National Health Service: “Pudendal neuralgia.”
University of Rochester Medical Center: “Pudendal neuralgia,” “Pudendal nerve block.”
Women’s Health Research Institute of Australia: “Pudendal Neuralgia.”
© 2020 WebMD, LLC. All rights reserved.

Article Provided By: webmd
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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Managing and Coping with Neuropathy

Managing & Coping with Neuropathy

 

What predicts depression and anxiety among people with PN? Not necessarily the severity of the PN symptoms! The predictors are the psychological variables (i.e.: How do you feel? Hopeless, optimistic, anxious, etc.); social variables (i.e.: Are you active? Do you have support?) All of these variables can be changed!
Dwelling on what might have been if you were not diagnosed, self-pitying, ruminating about better times, and think of yourself primarily as a “PN patient” does not provide the escape from stress of the illness. These coping strategies are ineffective and can make your neuropathy symptoms worse.
Below are effective Self-Care and Coping Skills:
Managing Peripheral Neuropathy
The following suggestions can help you manage peripheral neuropathy:
Take care of your feet, especially if you have diabetes. Check your feet daily for signs of blisters, cuts or calluses. Tight shoes and socks can worsen pain and tingling and may lead to sores that won’t heal. Wear soft, loose cotton socks and padded shoes. You can use a semicircular hoop, which is available in medical supply stores, to keep bed covers off hot or sensitive feet.
Quit smoking. Cigarette smoking can affect circulation, increasing the risk of foot problems and possibly amputation.
Eat healthy meals. If you’re at high risk of neuropathy or have a chronic medical condition, healthy eating is especially important. Emphasize low-fat meats and dairy products and include lots of fruits, vegetables and whole grains in your diet. Drink alcohol in moderation.
Massage. Massage your hands and feet, or have someone massage them for you. Massage helps improve circulation, stimulates nerves and may temporarily relieve pain.
Avoid prolonged pressure. Don’t keep your knees crossed or lean on your elbows for long periods of time. Doing so may cause new nerve damage.
Skills for Coping With Peripheral Neuropathy
Living with chronic pain or disability presents daily challenges. Some of these suggestions may make it easier for you to cope:
Set priorities. Decide which tasks you need to do on a given day, such as paying bills or shopping for groceries, and which can wait until another time. Stay active, but don’t overdo.
Acceptance & Acknowledgement. Accept and acknowledge the negative aspects of the illness, but then move forward to become more positive to find what works best for you.
Find the positive aspects of the disorder. Of course you are thinking there is nothing positive about PN. Perhaps your outlook can help increase empathy, encourage you to maintain a balanced schedule or maintaining a healthier lifestyle.
Get out of the house. When you have severe pain, it’s natural to want to be alone. But this only makes it easier to focus on your pain. Instead, visit a friend, go to a movie or take a walk.
Get moving. Develop an exercise program that works for you to maintain your optimum fitness. It gives you something you can control, and provides so many benefits to your physical and emotional well-being.
Seek and accept support. It isn’t a sign of weakness to ask for or accept help when you need it. In addition to support from family and friends, consider joining a chronic pain support group. Although support groups aren’t for everyone, they can be good places to hear about coping techniques or treatments that have worked for others. You’ll also meet people who understand what you’re going through. To find a support group in your community, check with your doctor, a nurse or the county health department.
Prepare for challenging situations. If something especially stressful is coming up in your life, such as a move or a new job, knowing what you have to do ahead of time can help you cope.
Talk to a counselor or therapist. Insomnia, depression and impotence are possible complications of peripheral neuropathy. If you experience any of these, you may find it helpful to talk to a counselor or therapist in addition to your primary care doctor. There are treatments that can help.
How to Sleep With Neuropathy
Sleep is an essential part of living—sleep helps us avoid major health problems and it is essential to our mental and physical performance. It affects our mood and stress and anxiety levels. Unfortunately, sleep disturbance or insomnia is often a side effect of neuropathy pain. It is a common complaint among people with living with chronic pain.
It’s no surprise that about 70 percent of pain patients, including those suffering from PN, back pain, headaches, arthritis and fibromyalgia, report they have trouble sleeping according to the Journal of Pain Medicine.
Pain can interfere with sleep due to a combination of issues. The list includes discomfort, reduced activity levels, anxiety, worry, depression and use of medications such as codeine that relieve pain but disturb sleep.
Most experts recommend a range of seven to nine hours of sleep per night for adults, regardless of age or gender. This may seem impossible to people with chronic pain, but there are steps you can take to improve your sleep, which may lead to less pain and lower levels of depression and anxiety. First, talk with your doctor to see if there are medications that may lessen your sleep disturbance. You should also check with your doctor to make sure your current medications aren’t causing some of your sleep disturbance.
Beyond medication, there are several things you can do yourself to improve your sleep. Here are some methods to try and help you fall asleep more quickly, help you sleep more deeply, help you stay asleep, and ultimately help keep you healthy.
Following are tips for improving your sleep:
Reduce your caffeine intake, especially in the afternoons
Quit smoking
Limit and/or omit alcohol consumption
Limit naps to less than one hour, preferably less
Don’t stay in bed too long—spending time in bed without sleeping leads to more shallow sleep
Adhere to a regular daily schedule including going to bed and getting up at the same time
Maintain a regular exercise program. Be sure to complete exercise several hours before bedtime
Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more support
Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.
Turn off your TV and Computer, many people use the television to fall asleep or relax at the end of the day. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it.
Don’t watch the clock – turn your alarm clock around so that it is not facing you
Keep a note pad and pencil by your bed to write down any thoughts that may wake you up at night so you can put them to rest
Refrain from taking a hot bath or shower right before bed; the body needs to cool a degree before getting into deep sleep
Try listening to relaxing soft music or audio books instead, or practicing relaxation exercises.
Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.
Some patients find comfort from a pillow between their legs that keeps their knees from touching. And there’s an added benefit: A pillow between your legs at night will prevent your upper leg from pulling your spine out of alignment and reduces stress on your hips and lower back.
It may take three to four weeks of trying these techniques before you begin to see an improvement in your sleep. During the first two weeks, your sleep may actually worsen before it improves, but improved sleep may lead to less pain intensity and improved mood.

 

Article Provided By: foundationforpn

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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Exercises For A Pinched Nerve In Your Hip

Exercises for a pinched nerve in your hip

A pinched nerve in the hip can be very painful. Certain home remedies and exercises can help relieve the pain.
In this article, we look at how to identify a pinched nerve, what home remedies can help, and exercises for this condition.
What is a pinched nerve?

A pinched nerve in the hip may cause sharp pain in the thigh, hip, or groin.
Nerves transmit pain signals. This means that when something goes wrong with a nerve, the symptoms can be very uncomfortable.
A common problem is when a nerve becomes pressed or pinched by nearby tendons, ligaments, or bone.

When a pinched nerve occurs, the nerve signals become aggravated, emphasized, or interrupted by pressure, irritation, or rubbing. This is known medically as radiculopathy.
In the hip, a pinched nerve can cause a:
sharp, searing, or burning pain in the hip, thigh, or groin
dull, achy pain in the hips and buttocks
tingling, “pins and needles” feeling, or numbness in the hip or down the leg
weakness or loss of movement in the affected hip and leg
Usually, the pain or numbness will worsen when a person moves. The nerve gets further irritated and aggravated by the structure that is pinching it.
Causes
A pinched nerve can be caused by a minor incident, such as sleeping in an improper position, or a major event, such as an accident.
Some of the more common causes of a pinched nerve in the hip include:
repetitive stress on the hips, back, and nearby joints, such as walking, standing, or sitting in a particular position for long periods
falls, car accidents, or sports injuries, which can throw the muscles and joints out of alignment
sleeping in a position that puts stress on the hips and back
hip flexors that are too tight, which may be caused by exercising without stretching before and after the activity

 

Home remedies
Minor pinched nerves can usually be treated at home.
Useful home remedies for a pinched nerve in the hip include:
Rest. Avoiding any activities that make the pain worse can reduce irritation and stress on the nerve, allowing it to heal.
Anti-inflammatories. These can reduce swelling, which may take pressure off of the nerve. Common brands include ibuprofen and naproxen.
Heat pads and cold pads. Alternate between the two, or use the one that brings the most relief. Both heat pads and cool packs are available for purchase online.
Gentle stretches. This can relieve pressure on muscles or tendons that may be too tight.

Stretches
Certain stretches can be very beneficial for a person with a pinched nerve in their hip. Stretching the following muscle areas may be helpful:

The piriformis stretch may help with a pinched nerve in the hip.
The piriformis is a muscle in the buttock area. When it is too tight, it can aggravate a pinched nerve and worsen hip pain.
This muscle gets tight when a person spends too long sitting down. It can also become overly tense if a person fails to stretch before and after strenuous exercise, such as running.
A person can use these three exercises to stretch the piriformis:
Piriformis stretch
Lie down on a flat surface.
Clasp the knee of the affected leg with both hands.
Slowly pull the knee upwards towards the head.
A person can deepen the stretch by holding the ankle and pulling the foot gently towards the opposite hip.
Hold for 10 seconds.
Repeat 3 times with both legs.
The bridge
Lie down on a flat surface, such as a carpeted floor.
Place feet flat on the ground, shoulder-width apart. Bend the knees about 45 degrees.
Put arms straight out to the side, flat on the floor.
Draw in the tummy and squeeze the buttocks.
Slowly push up through the heels and lift the buttocks and lower back off the floor, leaving the head and shoulders on the floor. Over time, the back will be completely off the floor, and the knees, hips, and shoulders will form a straight line.
Hold this pose for 10–30 seconds and slowly lower the back and buttocks down.
Rest for 15 seconds and repeat.
Floor slides
Lie on the floor, face up.
Bend the knees, placing the feet flat on the floor.
Gently draw the belly button in toward the spine, tightening the abdominal muscles. Breathe slowly and gently while holding the belly in.
Without moving the belly or spine, slowly extend one leg out straight until it is flat on the floor.
Hold the leg straight for up to 15 seconds and slowly slide it back up to a bent position.
Repeat with the other leg.
Glutes stretch
The glutes or gluteal muscles are muscles in the buttock area. They are closely connected to many causes of hip pain. Any tension in these muscles can also aggravate lower back pain.
Use the following exercises to stretch the glutes:
Sit and twist
Sit on the floor with legs straight out in front.
Bend the right knee and cross the right foot over the left knee.
Move the right heel up close to the left buttock, keeping the right foot flat on the floor. Reach the right arm behind the back and allow the fingers to touch the floor behind the back.
Put the left hand on top of the right knee. Slowly and gently pull the right knee towards the left until feeling a stretch in the buttock and hip area.
Hold for 15 to 30 seconds. Slowly release and repeat on the other side.
Lying down crossover
Lie flat on the floor, face up, with legs out straight.
Lift the left leg and hip, crossing it over the right. Keep shoulders and back flat on the floor.
Keep stretching until a stretch is felt in the glute and hips.
Hold for up to 30 seconds and slowly release. Repeat on the other side.
Full body stretches
Because all of the body’s muscles work together, having good flexibility in all muscle groups can help avoid a pinched nerve and muscle-related pain.
Try these relaxing and invigorating moves to stretch the various muscles in the body:
Classic bend and stretch
Stand up straight with feet hip-width apart. Knees should be slightly bent, not locked.
Breathe out and slowly bend forward at the hips. Gently lower the head toward the floor and focus on keeping the upper body relaxed.
Grab the back of the lower legs with hands.
Hold for 30 seconds while breathing deeply, and slowly rise to standing again.
Repeat.
The Sphinx

The Sphinx yoga pose can help to stretch the lower back.
This yoga pose helps stretch the lower back and strengthens the abdominals, both of which are related to the hips.
Lie face down on the floor with legs straight. Tuck elbows in under the shoulders and put forearms flat on the floor.
Lift the chest off the floor and press hips and thighs downward into the floor. Keep lifting the chest until a stretch is felt in the lower back. Focus on relaxing the shoulders and stretching the spine.
Go only far enough to feel a stretch, and stop if it is painful.
As with any stretches, some are better for certain body types and fitness levels. The best way to adopt a full stretching program is with the help of a certified personal trainer, sports medicine physician, or physical therapist.

When to see a doctor
Anyone who experiences a hip pain that lasts more than a few days and does not get better with rest and over-the-counter pain medicines should consult a doctor.
Severely pinched nerves can lead to scarring in the affected area or permanent nerve damage if not treated. Also, other medical causes for the pain should be ruled out.
In more severe cases, a doctor may recommend specific treatments for a pinched nerve. They include:
physical therapy
steroid injections given directly at the site of the pinched nerve
oral steroid medicines

Outlook
A pinched nerve in the hip is rarely serious, but the painful symptoms can interfere with daily life.
Home remedies and exercises can usually solve the issue, but it is best to see a doctor if symptoms persist beyond a few days.

Article Provided By: Medicalnewstoday

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Peripheral Neuropathy Diet Guide

Peripheral Neuropathy Diet: Best Foods That Heal Nerve Damage (And 4 Foods to Avoid With Neuropathy)
October 23, 2018 by Kelly

If you suffer from peripheral neuropathy, your first line of defense should be diet and lifestyle. (1) Good nutrition can help to slow nerve damage and even reverse nerve pain.
Peripheral neuropathy is a painful and disruptive condition that many with diabetes experience. Symptoms tend to start small, with numbness or tingling in the extremities, however this discomfort increases over time if no steps are taken to fight it. Eventually, the pain from peripheral neuropathy can be so severe that normal activities, like walking or putting on gloves, can become unbearable.
Fortunately, with the correct diet, you can calm nerves and help relieve nerve pain. There are foods that have been shown to help alleviate neuropathic pain and help to heal nerves, avoiding future complications.
Neuropathy is not an inevitable consequence of diabetes. If you want to stop this disease in its tracks and begin to feel relief, you must take steps to optimize your nutrition.
Nerve Regeneration Foods That Stimulate Nerve Growth, Heal Nerve Damage, and Help Pain Relief
The pain and other symptoms of peripheral neuropathy are due to damage to neurons, which are the cells that make up your nervous system. By improving the health of your nervous system and providing your body with the nutrients that it needs to regenerate nerves, you can protect yourself from further pain.
The regeneration of nerves has been tied to improved quality of life and reduced symptoms for those with neuropathy. (1,2) There are numerous foods that have been found to encourage the growth of new neurons.
Spinach
Leafy greens, such as spinach, kale, dandelion greens, cilantro, and parsley, are packed full of phytonutrients that are known to boost human health. Two of these nutrients that have been shown to help neuropathy are folate and magnesium.
Folate
Folate, also known as folic acid, is another name for vitamin B9. Folate is commonly found in plant foods, and is important for cell growth.
Metformin is a prescription drug often used to treat those with type 2 diabetes. (3) With long-term use, it helps to lower blood sugar levels. While metformin is effective at lowering blood sugar levels, it does not do so without side effects.
One of the side effects is a reduction in serum levels of folic acid and cobalamin, with an increase in Hcy. This alteration of serum makeup has been implicated in the pathogenesis of peripheral neuropathy, suggesting that metformin may lead to this complication.
In order to counteract these effects and protect your peripheral neurons, it may be helpful to increase your intake of folic acid to counteract these effects. (4) In an animal study it was found that folic acid supplementation resulted in higher expression of nerve growth factor (NGF) in rats with a condition similar to diabetic peripheral neuropathy. This research suggests that folic acid may play a protective role for nerve health and function in those with diabetes.
Spinach is one of the foods richest in folate, leading to benefits in nerve regeneration and a possible role in protecting against the pathogenesis of diabetic neuropathy.
Magnesium
Human studies on those with type 2 diabetes have found that lower blood levels of magnesium are associated with dampened peripheral nerve function. (6) Other studies have found that supplementing with magnesium may help to improve blood glucose levels, blood pressure, and cholesterol levels in those with type 2 diabetes. (7)
Studies suggest that higher magnesium levels are tied to improved functioning of the peripheral nerves, helping to reduce the likelihood of peripheral diabetic neuropathy progression.
As spinach is second only to almonds as a dietary source of magnesium, adding spinach to your daily diet can help to protect peripheral nerve function. (8)
Almonds, Cashews, and Peanuts
When it comes to quality sources of dietary magnesium, only almonds have higher quantities than spinach. (8) In one ounce of dry roasted almonds, you can acquire 20% of the recommended daily allotment of magnesium.
Cashews and peanuts are two other sources high in magnesium. As outlined above, type 2 diabetes patients who have higher blood levels of magnesium tend to have better peripheral nerve function, as well as other parameters associated with diabetes and diabetic neuropathy progression, such as blood glucose levels. (6,7)
By consuming more magnesium-rich foods, you may be able to protect the health and function of your peripheral nerves.
Black Beans, Edamame, and Kidney Beans
Three other healthful foods that are high in magnesium are black beans, edamame, and kidney beans. Thanks to rich levels of this mineral, these foods may help to protect against damage to peripheral nerves.
Broccoli
Broccoli is a cruciferous vegetable that is rich in a wide array of nutrients, including chromium, an essential element that has been found to protect nerves from damage and improve insulin sensitivity.
Chromium
Chromium deficiency has been tied to impaired glucose tolerance and nerve dysfunction. Animal studies suggest that chromium supplementation can help in managing glucose levels in diabetes, which may also help to protect nerve function. (9)
In one case study, a 40 year old female who suddenly developed neuropathy was found to have a chromium deficiency. Supplementing with chromium reversed this neuropathy and the associated symptoms. (10)
While chromium deficiency is rare, adding in broccoli, the richest dietary source of chromium, may help those who are unknowingly deficient in this trace mineral. (11)
Foods That Calm Nerves and Relieve Pain
There are some foods that are known to help with the pain caused by peripheral neuropathy, calming nerves and thereby helping those with neuropathy find relief.
Flax Seeds, Chia Seeds, and Walnuts
Flax seeds, chia seed, and walnuts are three of the richest plant sources of omega-3 fatty acids. The type of omega-3 fatty acid that they are rich in is ALA, or alpha-lipoic acid. It is this fatty acid in particular that has been shown in studies to help those suffering from neuropathy.
Alpha-Lipoic Acid
ALA, which is an antioxidant with potential for lowering blood glucose levels, has been shown in studies to offer an additional benefit of reducing diabetic neuropathic pain. (12)
In a human study on peripheral neuropathy, 600 mg of ALA supplemented for 90 days was found to decrease neuropathy symptoms in some, and fully resolve them in others. Pain, pressure, and sensation were improved.
It is easy to obtain 600 mg/day ALA with dietary sources only. You can get far more than 600 mg/day through 1 tablespoon of either flaxseed oil, chia seeds, walnuts or flaxseeds.
Seafood: Wild Caught Salmon and Other Fatty Fish
Wild-caught, cold-water fish, such as salmon, trout, tuna, and sardines, are rich sources of omega-3 fatty acids and vitamin B12. Research suggests that these two nutrients may help to encourage nerve growth, protect nerves from damage, and reduce the feelings of pain associated with neuropathy.
Omega-3 Fatty Acids: EPA and DHA
While nuts and seeds are high in the omega-3 fatty acid APA, coldwater fish are high in EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Research examining the effect of fish oil and these fatty acids on neuropathy are limited, but this limited research suggests that these fatty acids may help to encourage nerve growth and act as neuroprotectants. (14)
Vitamin B12
Earlier in this article, we discussed how the diabetes medication metformin has been shown to lead to deficiencies in folate. The same study showed that those who take metformin also often suffer from a vitamin B12 deficiency. (3) These changes in serum makeup are thought to be the reason why it often leads to diabetic neuropathy in patients.
Vitamin B12 is critical for proper neurological function, with deficient levels implicated in nerve damage. (15) Some studies have found that supplementation with vitamin B12 may help to relieve the pain caused by neuropathy.
Seafood and fish are the primary sources of vitamin B12 in the human diet. It is primarily coldwater fish that are the highest in vitamin B12. In order to increase your intake of this vitamin and omega-3 fatty acids, it is recommended to consume 2-3 servings of coldwater fish each week.
Two of your best options for both are wild-caught salmon and trout. Other contenders are sardines, anchovies, and herring.
Turmeric
Turmeric is a spice most well-known for its role in the Indian dish curry, where it is the primary spice. Its health benefits have been touted for thousands of years in an ancient form of holistic medicine in India known as Ayurveda.
Research has found that the primary compound in turmeric that provides its powerful health benefits is curcumin. Studies have found that curcumin may be beneficial for those with diabetes and diabetic neuropathy.
Curcumin
The health benefits of curcumin are largely thanks to its anti-inflammatory and antioxidant capacity. (16) It has demonstrated benefits in lowering blood glucose levels and protecting against diabetic neuropathy. Animal studies found reduced pain behavior and increased pain threshold in those treated with curcumin.
Foods To Avoid That Make Neuropathy Worse
Additionally, it is important not to eat foods that exacerbate your underlying diabetes. Elevated blood sugar levels are implicated in the pathogenesis of diabetic neuropathy, meaning that elevated blood sugar levels are likely to lead to disease progression and increased pain.There are numerous foods that have been implicated in the progression of diabetes and diabetic neuropathy. These foods are often to thank for oxidative damage and inflammation that contribute to nerve pain.
With these things in mind, you should avoid the following foods: (17)
Refined Carbohydrates
Refined carbs are those that have had the healthful portions of the grains removed. Examples include white flour and white rice. Common foods that include refined carbs are white bread, bagels, baked goods, pancakes, crackers, and more.
Not only do these foods lack fiber and nutrients, but they are known to cause a spike in blood glucose levels. This glucose is involved in damaging nerves and thus the progression of diabetic neuropathy.
Foods with Added Sugars
Another common example of foods that have had any beneficial nutrients removed are white sugar and high fructose corn syrup. Unfortunately, nearly every fast food item and the vast majority of processed and packaged food at the supermarket include these ingredients.
Common examples of some of the worst offenders are sodas, candy, ice cream, baked goods, and fast food. These foods cause the biggest spike in blood sugar of any food out there, so it is important to avoid these as much as possible.
Saturated and Trans Fats
Fats are a complicated and often confusing category of food for those with diabetes and other health concerns. There are some fats that are good for your health, some that are bad, and some that are alright in moderation.
Generally, you want to stay away from saturated fats, which are those that tend to be solid at room temperature, and trans fats. Examples of foods high in saturated fats include lard, cream, butter, processed meats, and red meats. Those high in trans fats include margarine, shortening, and fast food.
Click here for a complete guide on “good” and “bad” fats.
Alcohol
When consumed in moderation, alcohol may not cause much damage when it comes to neuropathy, but when consumed in excess, alcohol can cause damage to nerves. In fact, there is such thing as alcoholic neuropathy, where excess alcohol consumption causes nerve damage similar to that of diabetic neuropathy.
Additionally, alcoholism is associated with difficulties absorbing important nutrients whose deficiencies have been found to correlate with diabetic neuropathy. These include folate and vitamin B12.
Neuropathy Diet Tips
When it comes to what type of diet to follow, a low-fat, vegetarian diet appears to have benefits for those with diabetic neuropathy. (17,18) This type of diet is associated with improvements in blood glucose levels, blood pressure, and blood lipid concentration, all three factors which are thought to play a role in the pathogenesis of both diabetes and diabetic neuropathy.
Even if you are unable to fully make the switch to a low-fat, vegetarian diet, you can use this diet as a kind of template for best practices. By cutting down on meat and dairy, particularly high-fat meat and dairy, and increasing your consumption of nutrient-rich plant foods, you can improve your health and your symptoms of diabetic neuropathy.
Additionally, you may want to work with a doctor if you suspect that you may have trouble digesting gluten. Celiac disease and neuropathy are related. It has been found that 2.5% of those with neuropathy have celiac disease, in comparison to only 1% of the normal population. (19) Because of this, you want to be sure that you do not have an underlying allergy to gluten that could be making your symptoms worse.

Article Provided By: Neuropathyreliefguide

 

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Sciatica

Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.
Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.

Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that’s associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.

Symptoms
Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You might feel the discomfort almost anywhere along the nerve pathway, but it’s especially likely to follow a path from your low back to your buttock and the back of your thigh and calf.
The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.
Some people also have numbness, tingling or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part.
When to see a doctor
Mild sciatica usually goes away over time. Call your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than a week, is severe or becomes progressively worse. Get immediate medical care if:
You have sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg
The pain follows a violent injury, such as a traffic accident
You have trouble controlling your bowels or bladder

Causes
Herniated disk
Bone spurs on spine
Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.

Risk factors
Risk factors for sciatica include:
Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
Obesity. By increasing the stress on your spine, excess body weight can contribute to the spinal changes that trigger sciatica.
Occupation. A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods might play a role in sciatica, but there’s no conclusive evidence of this link.
Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

Complications
Although most people recover fully from sciatica, often without treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you have:
Loss of feeling in the affected leg
Weakness in the affected leg
Loss of bowel or bladder function

Prevention
It’s not always possible to prevent sciatica, and the condition may recur. The following can play a key role in protecting your back:
Exercise regularly. To keep your back strong, pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment. Ask your doctor to recommend specific activities.
Maintain proper posture when you sit. Choose a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.
Use good body mechanics. If you stand for long periods, rest one foot on a stool or small box from time to time. When you lift something heavy, let your lower extremities do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward.

Diagnosis
During the physical exam, your doctor may check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position and, while lying on your back, lift your legs one at a time. Pain that results from sciatica will usually worsen during these activities.

Imaging tests
Many people have herniated disks or bone spurs that will show up on X-rays and other imaging tests but have no symptoms. So doctors don’t typically order these tests unless your pain is severe, or it doesn’t improve within a few weeks.
X-ray. An X-ray of your spine may reveal an overgrowth of bone (bone spur) that may be pressing on a nerve.
MRI. This procedure uses a powerful magnet and radio waves to produce cross-sectional images of your back. An MRI produces detailed images of bone and soft tissues such as herniated disks. During the test, you lie on a table that moves into the MRI machine.
CT scan. When a CT is used to image the spine, you may have a contrast dye injected into your spinal canal before the X-rays are taken — a procedure called a CT myelogram. The dye then circulates around your spinal cord and spinal nerves, which appear white on the scan.
Electromyography (EMG). This test measures the electrical impulses produced by the nerves and the responses of your muscles. This test can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).
More Information
CT scan
MRI
X-ray

Treatment
If your pain doesn’t improve with self-care measures, your doctor might suggest some of the following treatments.
Medications
The types of drugs that might be prescribed for sciatica pain include:
Anti-inflammatories
Muscle relaxants
Narcotics
Tricyclic antidepressants
Anti-seizure medications
Physical therapy
Once your acute pain improves, your doctor or a physical therapist can design a rehabilitation program to help you prevent future injuries. This typically includes exercises to correct your posture, strengthen the muscles supporting your back and improve your flexibility.
Steroid injections
In some cases, your doctor might recommend injection of a corticosteroid medication into the area around the involved nerve root. Corticosteroids help reduce pain by suppressing inflammation around the irritated nerve. The effects usually wear off in a few months. The number of steroid injections you can receive is limited because the risk of serious side effects increases when the injections occur too frequently.
Surgery
This option is usually reserved for when the compressed nerve causes significant weakness, loss of bowel or bladder control, or when you have pain that progressively worsens or doesn’t improve with other therapies. Surgeons can remove the bone spur or the portion of the herniated disk that’s pressing on the pinched nerve.

Lifestyle and home remedies
For most people, sciatica responds to self-care measures. Although resting for a day or so may provide some relief, prolonged inactivity will make your signs and symptoms worse.
Other self-care treatments that might help include:
Cold packs. Initially, you might get relief from a cold pack placed on the painful area for up to 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel.
Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.
Stretching. Stretching exercises for your low back can help you feel better and might help relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch, and try to hold the stretch for at least 30 seconds.
Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) are sometimes helpful for sciatica.
Alternative medicine
Alternative therapies commonly used for low back pain include:
Acupuncture. In acupuncture, the practitioner inserts hair-thin needles into your skin at specific points on your body. Some studies have suggested that acupuncture can help back pain, while others have found no benefit. If you decide to try acupuncture, choose a licensed practitioner to ensure that he or she has had extensive training.
Chiropractic. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain. Spinal manipulation appears to be as effective and safe as standard treatments for low back pain, but might not be appropriate for radiating pain.

Preparing for your appointment
Not everyone who has sciatica needs medical care. If your symptoms are severe or persist for more than a month, though, make an appointment with your primary care doctor.
What you can do
Write down your symptoms and when they began.
List key medical information, including other conditions you have and the names of medications, vitamins or supplements you take.
Note recent accidents or injuries that might have damaged your back.
Take a family member or friend along, if possible. Someone who accompanies you can help you remember what your doctor tells you.
Write down questions to ask your doctor to make the most of your appointment time.
For radiating low back pain, some basic questions to ask your doctor include:
What’s the most likely cause of my back pain?
Are there other possible causes?
Do I need diagnostic tests?
What treatment do you recommend?
If you’re recommending medications, what are the possible side effects?
For how long will I need to take medication?
Am I a candidate for surgery? Why or why not?
Are there restrictions I need to follow?
What self-care measures should I take?
What can I do to prevent my symptoms from recurring?
Don’t hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
Do you have numbness or weakness in your legs?
Do certain body positions or activities make your pain better or worse?
How limiting is your pain?
Do you do heavy physical work?
Do you exercise regularly? If yes, with what types of activities?
What treatments or self-care measures have you tried? Has anything helped?

Article Provided By: Mayoclinic
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

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Complex Regional Pain Syndrome

 

What is complex regional pain syndrome?
Complex regional pain syndrome (CRPS) is a chronic (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. The central nervous system is composed of the brain and spinal cord; the peripheral nervous system involves nerve signaling from the brain and spinal cord to the rest of the body. CRPS is characterized by prolonged or excessive pain and changes in skin color, temperature, and/or swelling in the affected area.
CRPS is divided into two types: CRPS-I and CRPS-II. Individuals without a confirmed nerve injury are classified as having CRPS-I (previously known as reflex sympathetic dystrophy syndrome). CRPS-II (previously known as causalgia) is when there is an associated, confirmed nerve injury. As some research has identified evidence of nerve injury in CRPS-I, it is unclear if this disorders will always be divided into two types. Nonetheless, the treatment is similar.
CRPS symptoms vary in severity and duration, although some cases are mild and eventually go away. In more severe cases, individuals may not recover and may have long-term disability.

Who can get CRPS?
Although it is more common in women, CRPS can occur in anyone at any age, with a peak at age 40. CRPS is rare in the elderly. Very few children under age 10 and almost no children under age 5 are affected.

What are the symptoms of CRPS?
The key symptom is prolonged severe pain that may be constant. It has been described as “burning,” “pins and needles” sensation, or as if someone were squeezing the affected limb. The pain may spread to the entire arm or leg, even though the injury might have only involved a finger or toe. In rare cases, pain can sometimes even travel to the opposite extremity. There is often increased sensitivity in the affected area, known as allodynia, in which normal contact with the skin is experienced as very painful.
People with CRPS also experience changes in skin temperature, skin color, or swelling of the affected limb. This is due to abnormal microcirculation caused by damage to the nerves controlling blood flow and temperature. As a result, an affected arm or leg may feel warmer or cooler compared to the opposite limb. The skin on the affected limb may change color, becoming blotchy, blue, purple, pale, or red.
Other common features of CRPS include:
changes in skin texture on the affected area; it may appear shiny and thin
abnormal sweating pattern in the affected area or surrounding areas
changes in nail and hair growth patterns
stiffness in affected joints
problems coordinating muscle movement, with decreased ability to move the affected body part
abnormal movement in the affected limb, most often fixed abnormal posture (called dystonia) but also tremors in or jerking of the limb.

What causes CRPS?
It is unclear why some individuals develop CRPS while others with similar trauma do not. In more than 90 percent of cases, the condition is triggered by a clear history of trauma or injury. The most common triggers are fractures, sprains/strains, soft tissue injury (such as burns, cuts, or bruises), limb immobilization (such as being in a cast), surgery, or even minor medical procedures such as needle stick. CRPS represents an abnormal response that magnifies the effects of the injury. Some people respond excessively to a trigger that causes no problem for other people, such as what is observed in people who have food allergies.
Peripheral nerve abnormalities found in individuals with CRPS usually involve the small unmyelinated and thinly myelinated sensory nerve fibers (axons) that carry pain messages and signals to blood vessels. (Myelin is a mixture of proteins and fat-like substances that surround and insulate some nerve fibers.) Because small fibers in the nerves communicate with blood vessels, injuries to the fibers may trigger the many different symptoms of CRPS. Molecules secreted from the ends of hyperactive small nerve fibers are thought to contribute to inflammation and blood vessel abnormalities. These peripheral nerve abnormalities trigger abnormal neurological function in the spinal cord and brain.
Blood vessels in the affected limb may dilate (open wider) or leak fluid into the surrounding tissue, causing red, swollen skin. The dilation and constriction of small blood vessels is controlled by small nerve fiber axons as well as chemical messengers in the blood. The underlying muscles and deeper tissues can become starved of oxygen and nutrients, which causes muscle and joint pain as well as damage. The blood vessels may over-constrict (clamp down), causing old, white, or bluish skin.
CRPS also affects the immune system. High levels of inflammatory chemicals (cytokines) have been found in the tissues of people with CRPS. These contribute to the redness, swelling, and warmth reported by many patients. CRPS is more common in individuals with other inflammatory and autoimmune conditions such as asthma.
Limited data suggest that CRPS also may be influenced by genetics. Rare family clusters of CRPS have been reported. Familial CRPS may be more severe with earlier onset, greater dystonia, and more than one limb being affected.
Occasionally CRPS develops without any known injury. In these cases, an infection, a blood vessel problem, or entrapment of the nerves may have caused an internal injury. A physician will perform a thorough examination in order to identify a cause.
In many cases, CRPS results from a variety of causes. In such instances, treatments are directed at all of the contributing factors.

How is CRPS diagnosed?
Currently there is no specific test that can confirm CRPS. Its diagnosis is based on a person’s medical history, and signs and symptoms that match the definition. Since other conditions can cause similar symptoms, careful examination is important. As most people improve gradually over time, the diagnosis may be more difficult later in the course of the disorder.
Testing also may be used to help rule out other conditions, such as arthritis, Lyme disease, generalized muscle diseases, a clotted vein, or small fiber polyneuropathies, because these require different treatment. The distinguishing feature of CRPS is that of an injury to the affected area. Such individuals should be carefully assessed so that an alternative treatable disorder is not overlooked.
Magnetic resonance imaging or triple-phase bone scans may be requested to help confirm a diagnosis. While CRPS is often associated with excess bone resorption, a process in which certain cells break down the bone and release calcium into the blood, this finding may be observed in other illnesses as well.

What is the prognosis?
The outcome of CRPS is highly variable. Younger persons, children, and teenagers tend to have better outcomes. While older people can have good outcomes, there are some individuals who experience severe pain and disability despite treatment. Anecdotal evidence suggests early treatment, particularly rehabilitation, is helpful in limiting the disorder, a concept that has not yet been proven in clinical studies. More research is needed to understand the causes of CRPS, how it progresses, and the role of early treatment.

How is CRPS treated?
The following therapies are often used:
Rehabilitation and physical therapy. An exercise program to keep the painful limb or body part moving can improve blood flow and lessen the circulatory symptoms. Additionally, exercise can help improve the affected limb’s flexibility, strength, and function. Rehabilitating the affected limb also can help to prevent or reverse the secondary brain changes that are associated with chronic pain. Occupational therapy can help the individual learn new ways to work and perform daily tasks.
Psychotherapy. CRPS and other painful and disabling conditions often are associated with profound psychological symptoms for affected individuals and their families. People with CRPS may develop depression, anxiety, or post-traumatic stress disorder, all of which heighten the perception of pain and make rehabilitation efforts more difficult. Treating these secondary conditions is important for helping people cope and recover from CRPS.
Medications. Several different classes of medication have been reported to be effective for CRPS, particularly when used early in the course of the disease. However, no drug is approved by the U.S. Food and Drug Administration specifically for CRPS, and no single drug or combination of drugs is guaranteed to be effective in every person. Drugs to treat CRPS include:
bisphosphonates, such as high dose alendronate or intravenous pamidronate
non-steroidal anti-inflammatory drugs to treat moderate pain, including over-the-counter aspirin, ibuprofen, and naproxen
corticosteroids that treat inflammation/swelling and edema, such as prednisolone and methylprednisolone (used mostly in the early stages of CRPS)
drugs initially developed to treat seizures or depression but now shown to be effective for neuropathic pain, such as gabapentin, pregabalin, amitriptyline, nortriptyline, and duloxetine
botulinum toxin injections
opioids such as oxycodone, morphine, hydrocodone, and fentanyl. These drugs must be prescribed and monitored under close supervision of a physician, as these drugs may be addictive.
N-methyl-D-aspartate (NMDA) receptor antagonists such as dextromethorphan and ketamine, and
topical local anesthetic creams and patches such as lidocaine.
All drugs or combination of drugs can have various side effects such as drowsiness, dizziness, increased heartbeat, and impaired memory. Inform a healthcare professional of any changes once drug therapy begins.
Sympathetic nerve block. Some individuals report temporary pain relief from sympathetic nerve blocks, but there is no published evidence of long-term benefit. Sympathetic blocks involve injecting an anesthetic next to the spine to directly block the activity of sympathetic nerves and improve blood flow.
Surgical sympathectomy. The use of this operation that destroys some of the nerves is controversial. Some experts think it is unwarranted and makes CRPS worse, whereas others report a favorable outcome. Sympathectomy should be used only in individuals whose pain is dramatically relieved (although temporarily) by sympathetic nerve blocks.
Spinal cord stimulation. Placing stimulating electrodes through a needle into the spine near the spinal cord provides a tingling sensation in the painful area. Electrodes may be placed temporarily for a few days in order to assess whether stimulation is likely to be helpful. Minor surgery is required to implant all the parts of the stimulator, battery, and electrodes under the skin on the torso. Once implanted, the stimulator can be turned on and off, and adjusted using an external controller. Approximately 25 percent of individuals develop equipment problems that may require additional surgeries.
Other types of neural stimulation. Neurostimulation can be delivered at other locations along the pain pathway, not only at the spinal cord. These include near injured nerves (peripheral nerve stimulators), outside the membranes of the brain (motor cortex stimulation with dural electrodes), and within the parts of the brain that control pain (deep brain stimulation). A recent option involves the use of magnetic currents applied externally to the brain (known as repetitive Transcranial Magnetic Stimulation, or rTMS). A similar method that uses transcranial direct electrical stimulation is also being investigated. These stimulation methods have the advantage of being non-invasive, with the disadvantage that repeated treatment sessions are needed.
Intrathecal drug pumps. These devices pump pain-relieving medications directly into the fluid that bathes the spinal cord, typically opioids, local anesthetic agents, clonidine, and baclofen. The advantage is that pain-signaling targets in the spinal cord can be reached using doses far lower than those required for oral administration, which decreases side effects and increases drug effectiveness. There are no studies that show benefit specifically for CRPS.
Emerging treatments for CRPS include:
Intravenous immunoglobulin (IVIG). Researchers in Great Britain report low-dose IVIG reduced pain intensity in a small trial of 13 patients with CRPS for 6 to 30 months who did not respond well to other treatments. Those who received IVIG had a greater decrease in pain scores than those receiving saline during the following 14 days after infusion.
Ketamine. Investigators are using low doses of ketamine—a strong anesthetic—given intravenously for several days to either reduce substantially or eliminate the chronic pain of CRPS. In certain clinical settings, ketamine has been shown to be useful in treating pain that does not respond well to other treatments.
Graded Motor imagery. Several studies have demonstrated the benefits of graded motor imagery therapy for CRPS pain. Individuals do mental exercises including identifying left and right painful body parts while looking into a mirror and visualizing moving those painful body parts without actually moving them.
Several alternative therapies have been used to treat other painful conditions. Options include behavior modification, acupuncture, relaxation techniques (such as biofeedback, progressive muscle relaxation, and guided motion therapy), and chiropractic treatment.

What research is currently being done on CRPS?
The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is part of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.
NINDS-supported scientists are studying new approaches to treat CRPS and to intervene more aggressively to limit the symptoms and disability associated with the syndrome. Other NIH institutes also support research on CRPS and other painful conditions.
Previous research has shown that CRPS-related inflammation is caused by the body’s own immune response. Researchers hope to better understand how CRPS develops by studying immune system activation and peripheral nerve signaling using an animal model of the disorder. The animal model was developed to mimic certain CRPS-like features following fracture or limb surgery, by activating certain molecules involved in the immune system process.
Limb trauma, such as a fracture, followed by immobilization in a cast, is the most common cause of CRPS. By studying an animal model, researchers hope to better understand the neuroinflammatory basis of CRPS in order to identify the relevant inflammatory signaling pathways that lead to the development of post-traumatic CRPS. They also will examine inflammatory effects of cast immobilization and exercise on the development of pain behaviors and CRPS symptoms.
Peripheral nerve injury and subsequent regeneration often lead to a variety of sensory changes. Researchers hope to identify specific cellular and molecular changes in sensory neurons following peripheral nerve injury to better understand the processes that underlie neuroplasticity (the brain’s ability to reorganize or form new nerve connections and pathways following injury or death of nerve cells). Identifying these mechanisms could provide targets for new drug therapies that could improve recovery following regeneration.
Children and adolescents with CRPS generally have a better prognosis than adults, which may provide insights into mechanisms that can prevent chronic pain. Scientists are studying children with CRPS given that their brains are more adaptable through a mechanism known as neuroplasticity. Scientists hope to use these discoveries in order to develop more effective therapies for CRPS.
NINDS-funded scientists continue to investigate how inflammation and the release of adenosine triphosphate (ATP) may induce abnormal connections and signaling between sympathetic and sensory nerve cells in chronic pain conditions such as CRPS. (ATP is a molecule involved with energy production within cells that can also act as a neurotransmitter. Neurotransmitters are chemicals used by nervous system cells to communicate with one another.) A better understanding of changes in nerve connections following peripheral nerve injury may offer greater insight to pain and lead to new treatments.

Article Provided By: ninds
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