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Carpal Tunnel Pain

 

Carpal Tunnel Syndrome

Carpal tunnel syndrome, also called median nerve compression, is a condition that causes numbness, tingling, or weakness in your hand.It happens because of pressure on your median nerve, which runs the length of your arm, goes through a passage in your wrist called the carpal tunnel, and ends in your hand. The median controls the movement and feeling of your thumb and the movement of all your fingers except your pinky. 

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Symptoms

Symptoms of carpal tunnel include:

  • Burning, tingling, or itching numbness in your palm and thumb or your index and middle fingers
  • Weakness in your hand and trouble holding things
  • Shock-like feelings that move into your fingers
  • Tingling that moves up into your arm

You might first notice that your fingers “fall asleep” and become numb at night. It usually happens because of how you hold your hand while you sleep.

In the morning, you may wake up with numbness and tingling in your hands that may run all the way to your shoulder. During the day, your symptoms might flare up while you’re holding something with your wrist bent, like when you’re driving or reading a book.

As carpal tunnel syndrome gets worse, you may have less grip strength because the muscles in your hand shrink. You’ll also have more pain and muscle cramping.

Your median nerve can’t work the way it should because of the irritation or pressure around it. This leads to:

  • Slower nerve impulses
  • Less feeling in your fingers
  • Less strength and coordination, especially the ability to use your thumb to pinch

Carpal Tunnel Syndrome Causes

Often, people don’t know what brought on their carpal tunnel syndrome. It can be due to:

Carpal Tunnel Syndrome Risk Factors

You might have a higher risk of getting carpal tunnel syndrome if you:

  • Are a woman. Women are three times more likely than men to get it. This might be because they tend to have smaller carpal tunnels.
  • Have a family member with small carpal tunnels
  • Have a job in which you make the same motions with your arm, hand, or wrist over and over, such as an assembly line worker, sewer or knitter, baker, cashier, hairstylist, or musician
  • Fracture or dislocate your wrist

Carpal Tunnel Syndrome Diagnosis and Tests

Your doctor may tap the palm side of your wrist, a test called Tinel sign, or fully flex your wrist with your arms extended. They might also do tests including:

  • Imaging tests. X-rays, ultrasounds, or MRI exams can let your doctor look at your bones and tissues.
  • Electromyogram. Your doctor puts a thin electrode into a muscle to measure its electrical activity.
  • Nerve conduction studies. Your doctor tapes electrodes to your skin to measure the signals in the nerves of your hand and arm.

 

Carpal Tunnel Syndrome Treatment

Your treatment will depend on your symptoms and how far your condition has progressed. You might need:

  • Lifestyle changes. If repetitive motion is causing your symptoms, take breaks more often or do a bit less of the activity that’s causing you pain.
  • Exercises. Stretching or strengthening moves can make you feel better. Nerve gliding exercises can help the nerve move better within your carpal tunnel.
  • Immobilization. Your doctor may tell you to wear a splint to keep your wrist from moving and to lessen pressure on your nerves. You may wear one at night to help get rid of that numbness or tingling feeling. This can help you sleep better and rest your median nerve.
  • Medication. Your doctor may give you anti-inflammatory drugs or steroid shots to curb swelling.
  • Surgery. If none of those treatments works, you might have an operation called carpal tunnel release that increases the size of the tunnel and eases the pressure on your nerve.

 

Carpal Tunnel Syndrome Complications

If you have carpal tunnel syndrome and don’t treat it, the symptoms can last a long time and get worse. They could also go away and then come back. When you get a diagnosis early, the condition is easier to treat. You can avoid permanent muscle damage and keep your hand working the way it should.

Carpal Tunnel Syndrome Prevention

To avoid carpal tunnel syndrome, try to:

  • Keep your wrists straight.
  • Use a splint or brace that helps keep your wrist in a neutral position.
  • Avoid flexing and extending your wrists over and over again.
  • Keep your hands warm.
  • Take breaks whenever you can.
  • Put your hands and wrists in the right position while you work.

 

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on November 25, 2019

Sources

SOURCES:

American Academy of Orthopaedic Surgeons: “Carpal Tunnel Syndrome.”

National Institute of Neurological Disorders and Stroke.

National Institutes of Health.

Mayo Clinic Proceedings: “The Many Faces of Carpal Tunnel Syndrome.”

Cleveland Clinic: “Carpal Tunnel Syndrome.”

Mayo Clinic: “Carpel tunnel syndrome.”

Johns Hopkins Medicine: “Carpal Tunnel Syndrome.”

© 2019 WebMD, LLC. All rights reserved.

Article Provided By: Webmd

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If 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

 

CRPS, Complex Regional Pain Syndrome, Pain Relief, Pain Therapy, Carolina Pain Scrambler, Greenville South Carolina, Peripheral Neuropathy

CRPS Facts and Information

CRPS

A Chronic, Progressive, Painful Condition Affecting the Skin, Muscles, Joints, and Bones

Chronic arm or leg pain developing after injury, surgery, stroke, or heart attack.

CRPS Facts & Information

Potential causes of CRPS range from minor injuries, such as a sprain, to severe injuries, such as damage to a nerve. Even relatively long periods of immobility, such as would occur with a broken leg, can result in CRPS.

The symptoms of CRPS frequently include severe burning pain and extreme sensitivity to touch in the area of the injury. Swelling, excessive sweating, and changes in the bone and skin tissue may also occur. If you’re experiencing these symptoms, it’s important to seek early intervention.

The nation’s leader in pain management, National Spine & Pain Centers has board-certified doctors who are highly skilled in accurately diagnosing CRPS and customizing non-surgical treatment plans that offer lasting relief.

How & Why Does CRPS Develop?

CRPS, also referred to as Reflex Sympathetic Dystrophy (RSD) and Causalgia, is usually caused by an injury to the bones, joints, tissue, or nerves. The original injury can be severe, such as a broken bone, or minor, such as a sprain. In the case of an injury, CRPS symptoms may not appear right away. As described above, these symptoms can result in extreme discomfort. Stress often increases the severity of pain. As with any injury or condition, paying attention to the messages your body sends you and seeking treatment from knowledgeable medical professionals is critical.

It most often occurs in adults between the ages 20-40 and generally affects women more than men.

CRPS can result from several different causes. Research suggests that the symptoms may result from an injured nerve or nerves. The nerves send normal pain signals that pass through the spinal cord and are then transmitted to the brain. The problems occur because the spinal cord begins to send confusing signals to the brain, as well as to the injured area itself.

These confused signals interfere with normal blood flow and sensory signals resulting in extreme pain. In some cases, an immune response is triggered causing sweating, redness, inflammation, warmth, and/or muscle spasms.

Symptoms

Symptoms may spread upward from the initial injury site (e.g. hand to shoulder) and may be heightened by emotional stress. The unrelenting pain causes many people extreme emotional and physical duress and, left untreated, can lead to permanent changes in muscle and bone. Early detection and treatment are very much needed. Common symptoms include:

  • Swelling
  • Muscle spasms
  • Loss of motion
  • Abnormal sweating
  • Tenderness and stiffness in joints
  • Extreme sensitivity to even mild stimuli, such as clothing or a light touch
  • Warm, red-looking skin at the injured area initially, changing to cool, bluish-looking skin later

Diagnosis

Proper diagnosis starts with an experienced pain management doctor. The type of pain that you may have with CRPS can be similar to the symptoms of several types of disorders. Accurately determining the correct source of your pain is critical to successful treatment. Diagnosis involves the following:

  • Begins with a thorough clinical evaluation
  • Including a complete medical history, analysis of your symptoms, and physical examination
  • Testing may include x-rays, MRI and/or CT scans, and electro-diagnosis (EMG)
  • These advanced diagnostic techniques definitively pinpoint the source of pain

Article Provided By: Advanced Medical Group

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Coping with Chronic Pain

A little pain usually is a good thing. It’s our alarm system. It’s our body’s way of saying, “Hey, that’s hot … get away before it hurts you!” But when the pain lingers on and on, it’s no longer helpful. Chronic pain can disrupt your normal lifestyle.

If you suffer from chronic pain, you should know that there are ways to cope. Chronic pain does not need to run, or ruin, your life.

The first step is to learn all you can about your condition. Talk to your doctor and read up on it. Understanding your pain is the first step to reducing it.

Next, take an active role in your recovery. Talk with your doctor about medical treatments that might reduce your pain. But if these treatments can’t completely heal you, don’t give up hope. You can use basic lifestyle choices to control your pain and regain a normal life.

Manage Stress and Your Emotions

Our bodies and minds are connected. Stress, tension and stirred emotions can aggravate pain. Find ways to reduce the stress in your life; deal with your troubling emotions and your pain likely will decrease. Deep breathing, visualization and other relaxation techniques can help you calm your mind and reduce your pain.

Exercise

Exercise leads to a healthier body, and a healthier body feels less pain. Strong, toned muscles feel less pain than unused muscles. Also, exercise will give you more of the energy you need to overcome the pain. Less tangible is the fact that when you’re more fit, you’ll feel better about yourself — more in control — and that can mean a lot. Be sure to talk to your doctor about exercise that is safe for you.

Control Your Physical Activity

Specific activities or body movements may aggravate your pain more than others. Excluding those movements from your day can reduce your pain a great deal. If the painful movements involve important household, personal or work activities, consider using adaptive equipment that will let you perform the same activity without using the same painful motion.

Find Support

Chronic pain can make you feel isolated and afraid. You may feel like you’re all alone. That couldn’t be further from the truth. But it’s estimated that one in three people suffer from chronic pain. Contact others who also suffer chronic pain to share what you know, and to learn from them. You’ll learn ways to cope. You’ll learn that the pain you feel, and the emotions that come with it, are not unusual. Chronic pain support groups can be a great way to get this important human contact.

Finally, look beyond the pain. Don’t let your pain consume your life. There are more important things in your life to focus on, such as friends, family, work, and hobbies. Talk to your doctor about the ideas mentioned above, and start taking back control of your life. As you begin to refocus, the pain will decrease, and you will begin to believe more strongly that you can lead a normal life despite the pain.

Article Provided By: Psych Central

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Nerve Pain Treatment, Pain Relief, Chronic Pain, Chronic Pain Therapy, Pain Therpy, Neuropathic Pain Therapy, Greenville SC

Managing Peripheral Neuropathy

There is no sure way to prevent chemo-induced peripheral neuropathy (CIPN), but there are things you can do to manage your symptoms. During treatment, your cancer care team will ask you about your symptoms and watch you to see if the CIPN is getting worse. Your team may need to delay your treatment, use smaller doses of the chemo drugs, or stop treatment with the drug that is causing the CIPN until your symptoms get better. These actions must be started right away to prevent long-term damage that won’t get better.

Can CIPN be treated?

Treatment can often help ease some of the symptoms of CIPN. Sometimes these symptoms go away a short time after treatment is done. But sometimes they last much longer and need long-term treatment. Severe CIPN may never go away.

Treatment is mostly given to relieve the pain that can come with CIPN. Some of the drugs used include:

  • Steroids for a short time until a long-term treatment plan is in place
  • Patches or creams of numbing medicine that can be put right on the painful area (for example, lidocaine patches or capsaicin cream)
  • Antidepressant medicines, often in smaller doses than are used to treat depression
  • Anti-seizure medicines, which are used to help many types of nerve pain
  • Opioids or narcotics, for when pain is severe

Researchers are looking at which drugs work best to relieve this kind of pain. It may take more than one try to find out what works best for you.

Other treatments that can be tried to ease nerve pain and its effects on your life include:

  • Electrical nerve stimulation
  • Occupational therapy
  • Physical therapy
  • Relaxation therapy
  • Guided imagery
  • Distraction
  • Acupuncture
  • Biofeedback

What can I do to deal with CIPN?

There are some things you can do to better manage the symptoms of CIPN, such as:

  • Talk to your doctor or nurse about the problems you are having in daily life. They might be able to suggest ways to make you feel better or function better.
  • If you are taking pain medicines, use them as your doctor prescribes them. Most pain medicines work best if they are taken before the pain gets bad. See Cancer Pain to learn more about pain, how to talk about it, and how to manage it.
  • Avoid things that seem to make your CIPN worse, such as hot or cold temperatures, or snug clothes or shoes.
  • Give yourself extra time to do things. Ask friends for help with tasks you find hard to do.
  • Don’t drink alcohol. It can cause nerve damage on its own, and might make CIPN worse.
  • If you have diabetes, control your blood sugar. High blood sugar levels can damage nerves.
  • If constipation is a problem, follow your doctor’s recommendations about laxatives and exercise. Drink plenty of water and eat fruits, vegetables, and whole grains to get enough fiber.
  • If the neuropathy is in your feet, sit down as much as possible, even while brushing your teeth or cooking.
  • If your neuropathy is permanent, your doctor may refer you to an occupational therapist (OT). They are experts who help people lead more normal lives despite physical limits.

What should I do to avoid injury?

When your sense of feeling is affected by CIPN, you might be more likely to injure yourself by accident. Here are some things you can do to stay safe:

  • If you have neuropathy in your hands, be very careful when using knives, scissors, box cutters, and other sharp objects. Use them only when you can give your full attention to your task.
  • Protect your hands by wearing gloves when you clean, work outdoors, or do repairs.
  • Take care of your feet. Look at them once a day to see if you have any injuries or open sores.
  • Always wear shoes that cover your whole foot when walking, even at home. Talk to your doctor about shoes or special inserts that can help protect your feet.
  • Be sure that you have ways to support yourself if you have problems with stumbling while walking. Hand rails in hallways and bathrooms may help you keep your balance. A walker or cane can give you extra support.
  • Use night lights or flashlights when getting up in the dark.
  • Protect yourself from heat injuries. Set hot water heaters between 105° to 120°F to reduce scalding risk while washing your hands. Use oven gloves and hot pads when handling hot dishes, racks, or pans. Check bath water with a thermometer.
  • Keep your hands and feet warm and well covered in cold weather. For example, consider keeping a pair of gloves in your car. Avoid extreme temperatures.

What questions should I ask about CIPN?

Here are some questions you might want to ask your health care team:

  • Is the chemo I’m getting likely to cause CIPN?
  • Am I at high risk for CIPN?
  • What symptoms do I need to watch for and report to you?
  • Have you treated CIPN in other patients? How? Did it work?
  • If my CIPN gets bad and is very painful, will it change my treatment plan?
  • Is it likely that my CIPN will get better or go away after treatment is over?

Talk to your health care team

It’s important to work closely with your doctor or nurse to manage peripheral neuropathy caused by chemotherapy. Talk to your doctor about any changes in how you feel, and any trouble you have walking or holding things. Tell the doctor how your symptoms affect the things you do every day.

If you get medicines to help CIPN, be sure to keep your doctor posted on whether the drugs are helping and if new problems start up. You might also want to talk with your doctor about whether you can get into a clinical trial to help deal with your CIPN.

If you are concerned about how future treatment might affect your quality of life, talk with your doctor about what’s most important to you. Remember that only you can decide whether you want to get, or keep getting, a certain treatment.

Article Provided By: American Cancer Society

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Chemotherapy, Chronic Pain, Pain Therapy, Chronic Pain Therapy, Neuropathic Pain Therapy, Greenville SC

Symptoms of DPN

What is diabetic peripheral neuropathy?

Diabetic peripheral neuropathy is a condition caused by long-term high blood sugar levels, which causes nerve damage. Some people will not have any symptoms. But for others symptoms may be debilitating.

Between 60 and 70 percent of people with diabetes have some form of neuropathy, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Peripheral neuropathy, the most common form of diabetic neuropathy, affects the legs, feet, toes, hands, and arms.

Many people do not know that they have diabetes. People unaware of their diabetes may not know what’s causing some of the unusual sensations they’re experiencing.

What causes nerve damage?

Nerve damage is the result of high levels of blood glucose over long periods of time. It isn’t entirely clear why high glucose levels damage nerves.

A number of factors may play a role in nerve fiber damage. One possible component is the intricate interplay between the blood vessels and nerves, according to the Mayo Clinic.

Other factors include high blood pressure and cholesterol levels and nerve inflammation.

Diabetic peripheral neuropathy usually first appears in the feet and legs, and may occur in the hands and arms later.

Feeling numbness

A common symptom of diabetic peripheral neuropathy is numbness. Sometimes you may be unable to feel your feet while walking.

Other times, your hands or feet will tingle or burn. Or it may feel like you’re wearing a sock or glove when you’re not.

Shooting pain

Sometimes you may experience sudden, sharp pains that feel like an electrical current. Other times, you may feel cramping, like when you’re grasping something like a piece of silverware.

You also may sometimes unintentionally drop items you’re holding as a result of diabetic peripheral neuropathy.

Loss of balance

Walking with a wobbly motion or even losing your balance can result from diabetic peripheral neuropathy. Wearing orthopedic shoes often helps with this.

Loss of coordination is a common sign of diabetic peripheral neuropathy. Often, muscle weakness affects the ankle, which can affect your gait. Numbness in the feet can also contribute to loss of balance.

Neuropathy Treatment, Pain Relief, Treatments, South Carolina

Peripheral Neuropathy Fact Sheet

What is peripheral neuropathy?

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. Peripheral nerves send many types of sensory information to the central nervous system (CNS), such as a message that the feet are cold. They also carry signals from the CNS to the rest of the body. Best known are the signals to the muscles that tell them to contract, which is how we move, but there are different types of signals that help control everything from our heart and blood vessels, digestion, urination, sexual function, to our bones and immune system. The peripheral nerves are like the cables that connect the different parts of a computer or connect the Internet. When they malfunction, complex functions can grind to a halt.

Nerve signaling in neuropathy is disrupted in three ways:

  • loss of signals normally sent (like a broken wire)
  • inappropriate signaling when there shouldn’t be any (like static on a telephone line)
  • errors that distort the messages being sent (like a wavy television picture)

Symptoms can range from mild to disabling and are rarely life-threatening. The symptoms depend on the type of nerve fibers affected and the type and severity of damage. Symptoms may develop over days, weeks, or years. In some cases, the symptoms improve on their own and may not require advanced care. Unlike nerve cells in the central nervous system, peripheral nerve cells continue to grow throughout life.

Some forms of neuropathy involve damage to only one nerve (called mononeuropathy). Neuropathy affecting two or more nerves in different areas is called multiple mononeuropathy or mononeuropathy multiplex. More often, many or most of the nerves are affected (called polyneuropathy).

More than 20 million people in the United States have been estimated to have some form of peripheral neuropathy, but this figure may be significantly higher—not all people with symptoms of neuropathy are tested for the disease and tests currently don’t look for all forms of neuropathy. Neuropathy is often misdiagnosed due to its complex array of symptoms.

How are the peripheral neuropathies classified?

More than 100 types of peripheral neuropathy have been identified, each with its own symptoms and prognosis. Symptoms vary depending on the type of nerves—motor, sensory, or autonomic—that are damaged.

  • Motor nerves control the movement of all muscles under conscious control, such as those used for walking, grasping things, or talking.
  • Sensory nerves transmit information such as the feeling of a light touch, temperature, or the pain from a cut.
  • Autonomic nerves control organs to regulate activities that people do not control consciously, such as breathing, digesting food, and heart and gland functions.

Most neuropathies affect all three types of nerve fibers to varying degrees; others primarily affect one or two types. Doctors use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe different conditions.

About three-fourths of polyneuropathies are “length-dependent,” meaning the farthest nerve endings in the feet are where symptoms develop first or are worse.  In severe cases, such neuropathies can spread upwards toward the central parts of the body. In non-length dependent polyneuropathies, the symptoms can start more toward the torso, or are patchy.

What are the symptoms of peripheral nerve damage?

Symptoms are related to the type of nerves affected.

Motor nerve damage is most commonly associated with muscle weakness. Other symptoms include painful cramps, fasciculations (uncontrolled muscle twitching visible under the skin) and muscle shrinking.

Sensory nerve damage causes various symptoms because sensory nerves have a broad range of functions.

  • Damage to large sensory fibers harms the ability to feel vibrations and touch, especially in the hands and feet. You may feel as if you are wearing gloves and stockings even when you are not. This damage may contribute to the loss of reflexes (as can motor nerve damage). Loss of position sense often makes people unable to coordinate complex movements like walking or fastening buttons or maintaining their balance when their eyes are shut.
  • The “small fibers” without myelin sheaths (protective coating, like insulation that normally surrounds a wire) include fiber extensions called axons that transmit pain and temperature sensations. Small-fiber polyneuropathy can interfere with the ability to feel pain or changes in temperature.  It is often difficult for medical caregivers to control, which can seriously affect a patient’s emotional well-being and overall quality of life. Neuropathic pain is sometimes worse at night, disrupting sleep. It can be caused by pain receptors firing spontaneously without any known trigger, or by difficulties with signal processing in the spinal cord that may cause you to feel severe pain (allodynia) from a light touch that is normally painless. For example, you might experience pain from the touch of your bedsheets, even when draped lightly over the body.

Autonomic nerve damage affects the axons in small-fiber neuropathies. Common symptoms include excess sweating, heat intolerance, inability to expand and contract the small blood vessels that regulate blood pressure, and gastrointestinal symptoms. Although rare, some people develop problems eating or swallowing if the nerves that control the esophagus are affected.

There are several types of peripheral neuropathies, the most common of which is linked to diabetes. Another serious polyneuropathy is Guillain-Barre syndrome, which occurs when the body’s immune system mistakenly attacks the nerves in the body.  Common types of focal (located to just one part of the body) mononeuropathy include carpal tunnel syndrome, which affects the hand and the wrist, and meralgia paresthetica, which causes numbness and tingling on one thigh.  Complex regional pain syndrome is a class of lingering neuropathies where small-fibers are mostly damaged.

What are the causes of peripheral neuropathy?

Most instances of neuropathy are either acquired, meaning the neuropathy or the inevitability of getting it isn’t present from the beginning of life, or genetic.  Acquired neuropathies are either symptomatic (the result of another disorder or condition; see below) or idiopathic (meaning it has no known cause).

Causes of symptomatic acquired peripheral neuropathy include:

  • Physical injury (trauma) is the most common cause of acquired single-nerve injury. Injury from automobile accidents, falls, sports, and medical procedures can stretch, crush, or compress nerves, or detach them from the spinal cord. Less severe traumas also can cause serious nerve damage. Broken or dislocated bones can exert damaging pressure on neighboring nerves and slipped disks between vertebrae can compress nerve fibers where they emerge from the spinal cord. Arthritis, prolonged pressure on a nerve (such as by a cast) or repetitive, forceful activities can cause ligaments or tendons to swell, which narrows slender nerve pathways. Ulnar neuropathy and carpal tunnel syndrome are common types of neuropathy from trapped or compressed nerves at the elbow or wrist. In some cases, there are underlying medical causes (such as diabetes) that prevent the nerves from tolerating the stresses of everyday living.
  • Diabetes is the leading cause of polyneuropathy in the United States. About 60 – 70 percent of people with diabetes have mild to severe forms of damage to sensory, motor, and autonomic nerves that cause such symptoms as numb, tingling, or burning feet, one-sided bands or pain, and numbness and weakness on the trunk or pelvis.
  • Vascular and blood problems that decrease oxygen supply to the peripheral nerves can lead to nerve tissue damage. Diabetes, smoking, and narrowing of the arteries from high blood pressure or atherosclerosis (fatty deposits on the inside of blood vessel walls) can lead to neuropathy. Blood vessel wall thickening and scarring from vasculitis can impede blood flow and cause patchy nerve damage in which isolated nerves in different areas are damaged—called mononeuropathy multiplex or multifocal mononeuropathy.
  • Systemic (body-wide) autoimmune diseases, in which the immune system mistakenly attacks a number of the body’s own tissues, can directly target nerves or cause problems when surrounding tissues compress or entrap nerves.  Sjögren’s syndrome, lupus, and rheumatoid arthritis are some systemic autoimmune diseases that cause neuropathic pain.
  • Autoimmune diseases that attack nerves only are often triggered by recent infections. They can develop quickly or slowly, while others become chronic and fluctuate in severity. Damage to the motor fibers that go to the muscle includes visible weakness and muscle shrinking seen in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. Multifocal motor neuropathy is a form of inflammatory neuropathy that affects motor nerves exclusively. In other autoimmune neuropathies the small fibers are attacked, leaving people with unexplained chronic pain and autonomic symptoms.
  • Hormonal imbalances can disturb normal metabolic processes, leading to swollen tissues that can press on peripheral nerves.
  • Kidney and liver disorders can lead to abnormally high amounts of toxic substances in the blood that can damage nerve tissue. Most individuals on dialysis because of kidney failure develop varying levels of polyneuropathy.
  • Nutritional or vitamin imbalances, alcoholism, and exposure to toxins can damage nerves and cause neuropathy. Vitamin B12 deficiency and excess vitamin B6 are the best known vitamin-related causes. Several medications have been shown to occasionally cause neuropathy.    
  • Certain cancers and benign tumors cause neuropathy in various ways. Tumors sometimes infiltrate or press on nerve fibers. Paraneoplastic syndromes, a group of rare degenerative disorders that are triggered by a person’s immune system response to a cancer, can indirectly cause widespread nerve damage.
  • Chemotherapy drugs used to treat cancer cause polyneuropathy in an estimated 30 to 40 percent of users. Only certain chemotherapy drugs cause neuropathy and not all people get it. Chemotherapy-induced peripheral neuropathy may continue long after stopping chemotherapy. Radiation therapy also can cause nerve damage, sometimes starting months or years later.
  • Infections can attack nerve tissues and cause neuropathy. Viruses such as varicella-zoster virus (which causes chicken pox and shingles), West Nile virus, cytomegalovirus, and herpes simplex target sensory fibers, causing attacks of sharp, lightning-like pain. Lyme disease, carried by tick bites, can cause a range of neuropathic symptoms, often within a few weeks of being infected. The human immunodeficiency virus (HIV), which causes AIDS, can extensively damage the central and peripheral nervous systems.  An estimated 30 percent of people who are HIV-positive develop peripheral neuropathy; 20 percent develop distal (away from the center of the body) neuropathic pain.

Genetically-caused polyneuropathies are rare.  Genetic mutations can either be inherited or arise de novo, meaning they are completely new mutations to an individual and are not present in either parent. Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood. Charcot-Marie-Tooth disease, also known as hereditary motor and sensory neuropathy, is one of the most common inherited neurological disorders.

The small-fiber neuropathies that present with pain, itch, and autonomic symptoms also can be genetic. As our understanding of genetic disorders increases, many new genes are being associated with peripheral neuropathy.

How is peripheral neuropathy diagnosed?

The bewildering array and variability of symptoms that neuropathies can cause often makes diagnosis difficult.  A diagnosis of neuropathy typically includes:

  • Medical history.  A doctor will ask questions about symptoms and any triggers or relieving factors throughout the day, work environment, social habits, exposure to toxins, alcohol use, risk of infectious diseases, and family history of neurological diseases.
  • Physical and neurological exams. A doctor will look for any evidence of body-wide diseases that can cause nerve damage, such as diabetes. A neurological exam includes tests that may identify the cause of the neuropathic disorder as well as the extent and type of nerve damage.
  • Body fluid tests. Various blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, infections and signs of abnormal immune system activity. Less often other body fluids are tested for abnormal proteins or the abnormal presence of immune cells or proteins associated with some immune-mediated neuropathies.
  • Genetic tests. Gene tests are available for some inherited neuropathies.

Additional tests may be ordered to help determine the nature and extent of the neuropathy.

Physiologic tests of nerve function

  • Nerve conduction velocity (NCV) tests measure signal strength and speed along specific large motor and sensory nerves. They can reveal nerves and nerve types affected and whether symptoms are caused by degeneration of the myelin sheath or the axon. During this test, a probe electrically stimulates a nerve fiber, which responds by generating its own electrical impulse. An electrode placed further along the nerve’s pathway measures the speed of signal transmission along the axon. Slow transmission rates tend to indicate damage to the myelin sheath, while a reduction in the strength of impulses at normal speeds is a sign of axonal degeneration. Inability to elicit signals can indicate severe problems with either.
  • Electromyography (EMG) involves inserting very fine needles into specific muscles to record their electrical activity at rest and during contraction. EMG tests irritability and responsiveness, detects abnormal muscular electrical activity in motor neuropathy, and can help differentiate between muscle and nerve disorders.

Neuropathology tests of nerve appearance

  • Nerve biopsy involves removing and examining a sample of nerve tissue, usually a sensory nerve from the lower leg (called a sural nerve biopsy). Although a nerve biopsy can provide the most detailed information about the exact types of nerve cells and cell parts affected, it can further damage the nerve and leave chronic neuropathic pain and sensory loss.
  • Neurodiagnostic skin biopsy allows specialists to examine nerve fiber endings following removal of only a tiny piece of skin (usually 3 mm diameter) under local anesthesia. Skin biopsies have become the gold standard for diagnosing small fiber neuropathies that don’t affect standard nerve conduction studies and electromyography.

Autonomic testing

  • Several different types of autonomic testing can evaluate peripheral neuropathies, one of which is a QSART test that measures the ability to sweat in several sites in the arm and leg. Abnormalities in QSART are associated with small fiber polyneuropathies

Radiology imaging tests

  • Magnetic resonance imaging (MRI) of the spine can reveal nerve root compression (“pinched nerve), tumors, or other internal problems. MRI of the nerve (neurography) can show nerve compression.
  • Computed tomography (CT) scans of the back can show herniated disks, spinal stenosis (narrowing of the spinal canal), tumors, bone and vascular irregularities that may affect nerves.

Muscle and nerve ultrasound is a noninvasive experimental technique for imaging nerves and muscles for injury such as a severed nerve or a compressed nerve. Ultrasound imaging of the muscles can detect abnormalities that may be related to a muscle or nerve disorder. Certain inherited muscle disorders have characteristic patterns on muscle ultrasound.

What treatments are available?

Treatments depend entirely on the type of nerve damage, symptoms, and location. Your doctor will explain how nerve damage is causing specific symptoms and how to minimize and manage them. With proper education, some people may be able to reduce their medication dose or manage their neuropathy without medications. Definitive treatment can permit functional recovery over time, as long as the nerve cell itself has not died.

Addressing neuropathy’s causes. Correcting underlying causes can result in the neuropathy resolving on its own as the nerves recover or regenerate. Nerve health and resistance can be improved by healthy lifestyle habits such as maintaining optimal weight, avoiding toxic exposures, eating a balanced diet, and correcting vitamin deficiencies. Smoking cessation is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms. Exercise can deliver more blood, oxygen, and nutrients to far-off nerve endings, improve muscle strength, and limit muscle atrophy. Self-care skills in people with diabetes and others who have an impaired ability to feel pain can alleviate symptoms and often create conditions that encourage nerve regeneration. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.

Inflammatory and autoimmune conditions leading to neuropathy can be controlled using immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine. Plasmapheresis—a procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the body—can help reduce inflammation or suppress immune system activity. Agents such as rituximab that target specific inflammatory cells, large intravenously administered doses of immunoglobulins, and antibodies that alter the immune system, also can suppress abnormal immune system activity.

Specific symptoms can usually be improved

  • For motor symptoms, mechanical aids such as hand or foot braces can help reduce physical disability and pain. Orthopedic shoes can improve gait disturbances and help prevent foot injuries. Splints for carpal tunnel problems can help position the wrist to reduce pressure of the compressed nerve and allow it to heal. Some people with severe weakness benefit from tendon transfers or bone fusions to hold their limbs in better position, or to release a nerve compression.
  • Autonomic symptoms require detailed management depending on what they are. For example, people with orthostatic hypotension (significant drop in blood pressure when standing quickly) can learn to prevent drops by standing up slowly and taking medications to improve blood pressure swings. Many people use complementary methods and techniques such as acupuncture, massage, herbal medications, and cognitive behavioral or other psychotherapy approaches to cope with neuropathic pain.
  • Sensory symptoms, such as neuropathic pain or itching caused by injury to a nerve or nerves, are more difficult to control without medication.  Some people use behavioral strategies to cope with chronic pain as well as depression and anxiety that many may feel following nerve injury.

Medications recommended for chronic neuropathic pain are also used for other medical conditions. Among the most effective are a class of drugs first marketed to treat depression.  Nortriptyline and newer serotonin-norepinephrine reuptake inhibitors such as duloxetine hydrochloride modulate pain by increasing the brain’s ability to inhibit incoming pain signals. Another class of medications that quiets nerve cell electrical signaling is also used for epilepsy. Common drugs include gabapentin, pregabalin, and less often topiramate and lamotrigine. Carbamazepine and oxcarbazepine are particularly effective for trigeminal neuralgia, a focal neuropathy of the face.

Local anesthetics and related drugs that block nerve conduction may help when other medications are ineffective or poorly tolerated.  Medications put on the skin (topically administered) are generally appealing because they stay near the skin and have fewer unwanted side effects.

Lidocaine patches or creams applied to the skin can be helpful for small painful areas, such as localized chronic pain from mononeuropathies such as shingles.  Another topical cream is capsaicin, a substance found in hot peppers that can desensitize peripheral pain nerve endings.  Doctor-applied patches that contain higher concentrations of capsaicin offer longer term relief from neuropathic pain and itching, but they worsen small-fiber nerve damage.  Weak over-the-counter formulations also are available. Lidocaine or longer acting bupivicaine are sometimes given using implanted pumps that deliver tiny quantities to the fluid that bathes the spinal cord, where they can quiet excess firing of pain cells without affecting the rest of the body. Other drugs treat chronic painful neuropathies by calming excess signaling.

Narcotics (opioids) can be used for pain that doesn’t respond to other pain-control medications and if disease-improving treatments aren’t fully effective. Because pain relievers that contain opioids can lead to dependence and addiction, their use must be closely monitored by a physician.  One of the newest drugs approved for treating diabetic neuropathy is tapentadol, which has both opioid activity and norepinephrine-reuptake inhibition activity of an antidepressant.

Surgery is the recommended treatment for some types of neuropathies. Protruding disks (“pinched nerve”) in the back or neck that compress nerve roots are commonly treated surgically to free the affected nerve root and allow it to heal. Trigeminal neuralgia on the face is also often treated with neurosurgical decompression. Injuries to a single nerve (mononeuropathy) caused by compression, entrapment, or rarely tumors or infections may require surgery to release the nerve compression. Polyneuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not helped by surgical intervention. Surgeries or interventional procedures that attempt to reduce pain by cutting or injuring nerves are not often effective as they worsen nerve damage and the parts of the peripheral and central nervous system above the cut often continue to generate pain signals (“phantom pain”). More sophisticated and less damaging procedures such as electrically stimulating remaining peripheral nerve fibers or pain-processing areas of the spinal cord or brain have largely replaced these surgeries.

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive intervention used for pain relief in a range of conditions. TENS involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, in some studies TENS has been shown to improve neuropathic symptoms associated with diabetes.

How can I prevent neuropathy?

The best treatment is prevention, and strategies for reducing injuries are highly effective and well tested. Since medical procedures ranging from casting fractures to injuries from needles and surgery are another cause, unnecessary procedures should be avoided. The new adjuvanted vaccine against shingles prevents more than 95 percent of cases and is widely recommended for people over 50, including those who have had previous shingles or vaccination with the older, less effective vaccine. Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize use of medications that are known to cause or worsen neuropathy where alternatives exist. Some families with very severe genetic neuropathies use in vitro fertilization to prevent transmission to future generations.

What research is being done?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

NINDS-funded research ranges from clinical studies of the genetics and the natural history of hereditary neuropathies to discoveries of new cause and treatments for neuropathy, to basic science investigations of the biological mechanisms responsible for chronic neuropathic pain. Together, these diverse research areas will advance the development of new therapeutic and preventive strategies for peripheral neuropathies. Understanding the causes of neuropathy provides the foundation for finding effective prevention and treatment strategies.

Genetic mutations have been identified in more than 80 distinct hereditary neuropathies. NINDS supports studies to understand the disease mechanisms of these conditions and to identify other genetic defects that may play roles in causing or modifying the course of disease. The Inherited Neuropathies Consortium (INC)—a group of academic medical centers, patient support organizations, and clinical research resources dedicated to conducting clinical research in Charcot-Marie-Tooth disease and improving the care of people with the disease—seeks to better characterize the natural history of several different forms of neuropathy and to identify genes that modify clinical features in these disorders. Knowing which genes are mutated, and what their normal function is, permits precise diagnosis and leads to new therapies that prevent or reduce nerve damage. INC is also developing and testing biomarkers (signs that can indicate the diagnosis or progression of a disease) and clinical outcome measures that will be needed in future clinical trials to determine whether individuals respond to candidate treatments.

Rapid communication between the peripheral nervous system and the central nervous system often depends on myelination, a process through which special cells called Schwann cells create an insulating coating around axons. Several NINDS-funded studies focus on understanding how myelin protein and membrane production and maintenance in Schwann cells is regulated and how mutations in genes involved in these processes cause peripheral neuropathies. Schwann cells play a critical role in the regeneration of nerve cell axons in the peripheral nervous system. By better understanding myelination and Schwann cell function, researchers hope to find targets for new therapies to treat or prevent nerve damage associated with neuropathy.

Other efforts focus on immune system peripheral nerve damage. In inflammatory peripheral neuropathies such as Guillain-Barre Syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP), the body’s immune system mistakenly attacks peripheral nerves, damaging myelin and weakening signaling along affected nerves. NINDS-supported researchers hope to better understand how antibodies to cell membrane components cause peripheral nerve damage and how the effects of these antibodies can be blocked. Researchers are also studying how mutations in the Autoimmune Regulator (AIRE) gene in a mouse model of CIDP cause the immune system to attack peripheral nerves. NINDS research has helped discover that some types of small-fiber polyneuropathy appear to be immune-caused, particularly in women and children.

NINDS-supported researchers are also exploring the use of tissue engineered from the cells of humans with peripheral neuropathy as models to identify specific defects in the transport of cellular components along axons and the interactions of nerves with muscles. Such tissue engineering approaches may eventually lead to new therapeutics for peripheral neuropathies.

In addition to efforts to treat or prevent underlying nerve damage, other NINDS-supported studies are informing new strategies for relieving neuropathic pain, fatigue, and other neuropathy symptoms. Researchers are investigating the pathways that carry pain signals to the brain and are working to identify substances that will block this signaling.

Article Provided By: NIH

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Top Pain Management Techniques

Bodily pain that lasts more than 12 weeks is defined as chronic pain. This differs from recurring pain, wherein an individual suffers shorter bouts of pain on a consistent basis. Both chronic pain and recurring pain can be life-altering and have an adverse effect on mood, happiness, and general quality of life. While diagnosing and treating the underlying condition is a good step toward reducing pain, other pain management techniques may offer relief. From exercise to biofeedback, people should know there are options for managing their pain.

1. Cold and heat

Heat therapy and cold therapy are two of the best simple and inexpensive pain management options. Heat therapy involves applying heat to the affected area; this improves circulation and blood flow. Depending on the condition, dry heat, such as heating pads, or moist heat, such as a steamed towel, may prove more beneficial. Conversely, cold therapy reduces inflammation and swelling by reducing blood flow to the target area.

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2. Yoga

Yoga is an ancient physical, mental, and spiritual practice that combines mindfulness with breathing exercises and gentle motions. Gently raising the heart rate can release endorphins that help moderate pain, as does the increase in oxygen, which also enhances mood. Physically, stretching helps reduce pain held in the muscles and joints.

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3. Exercise

Gentle exercise such as taking a brisk walk, going for a swim, or riding a bicycle can ease pain. Exercising releases endorphins that elevate mood and block pain on a molecular level. These practices also strengthen the muscles, which reduces pain and prevents re-injury in the long run.

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4. Meditation

Meditation is a mindfulness activity that requires the individual to calm and center him or herself through deep breathing and focus. The practice can elevate mood, increase energy, and help ground oneself. Studies also show that meditation and deep breathing have a positive effect on pain. Meditation releases unconscious tension and tightness that are common sources of pain.

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5. Physical therapy

Regular sessions with a licensed physical therapist can greatly reduce pain. Physical therapists will aim to treat the pain as well as the underlying source. Physical therapy sessions consist of light aerobic exercise, stretching, and strength training. Therapists may also utilize tools such as heating pads, ice packs, and massage.

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6. Massage

While many people think of a massage as part of a trip to the spa, therapeutic massage can be a useful tool for pain management in addition to relaxation. Massage releases mental stress and eases muscle tension. Although massage typically targets neck and back pain, evidence suggests it is beneficial to all types of pain, and therapists are often well-versed in treating the whole body.

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7. Avoid alcohol and smoking

Pain often makes falling asleep and staying asleep difficult. A lack of sleep can contribute to pain, creating a vicious cycle. While alcohol is a depressant and may help you fall asleep faster, it does nothing to improve the quality of your sleep, and you’ll often feel exhausted the next day; this is because alcohol blocks the deep, restorative REM sleep we need. Smoking worsens circulation, which can contribute to chronic pain.

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8. Occupational therapy

Different from physical therapy, occupational therapy involves learning and applying daily behaviors that will not aggravate the chronic pain. For example, if a person suffers from neck pain that makes it difficult to sit in front of a computer all day, an occupational therapist can suggest modifications and exercises to improve the situation. Occupational therapy is often used in conjunction with physical therapy to get the best results.

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9. Acupuncture

Acupuncture is the ancient practice of stimulating pressure points on the body to achieve specific results. While scientific inquiry into the health benefits of acupuncture is ongoing, much of the evidence suggests acupuncture is an efficient way to treat pain. Acupuncture works by activating the body’s self-healing mechanisms and can be useful in treating lower back pain, neck pain, knee pain, and osteoarthritis. It may also help with chronic migraines.

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10. Biofeedback

Biofeedback is a therapy that helps control the body’s involuntary responses to pain. Electrodes take various readings such as heart and breathing rate, blood pressure, and skin temperature. The biofeedback therapist then takes the patient through relaxation exercises that help regulate these functions and ultimately positively affect pain.

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Article Provided By: FactyHealth

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Symptoms of Carpal Tunnel Syndrome

Pressure on the median nerve – the central nerve that connects to the hand – causes carpal tunnel syndrome. In carpal tunnel patients, it causes pain and lack of function in the hand when squeezed. People whose work requires repetitive hand movements often experience this disorder. For example, people who work on computers and hair stylists commonly experience carpal tunnel syndrome. Pregnant women are also highly susceptible. A wrist splint or exercises can ease symptoms in the early days, however, in advanced cases surgery is necessary.

1. Pins and Needles

Everyone recognizes the tingling sensation known as pins and needles. This easily happens to someone who stays in an awkward position without moving hands and legs over a period. In these cases, the feeling is no more than a slight irritant, but with carpal tunnel syndrome, the sensation is far more intense and unpleasant. Usually, it only affects the thumb and fingers, but it can also spread to other areas.

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2. Pain

Even in the early stages, carpal tunnel syndrome can be extremely painful. The pain is usually in the hands and fingers, however, in severe cases it may travel through the arm to the shoulder. Pain patterns vary from patient to patient. Doctors are continuously researching to understand more about carpal tunnel syndrome.

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3. Numbness in the fingertips

Carpal tunnel syndrome may cause loss of feeling in the fingers. The fingers may feel very little to no sensation at all. As a result, patients may be unable to complete normal day to day tasks. Surgical treatment is usually necessary to restore sensation and function. However, exercise and home treatment may be enough in some cases.

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4. Sensation of swelling

Quite regularly people with carpal tunnel syndrome feel as though their hands or fingers have become swollen. When the doctor checks them, they find no evidence of swelling, but patients continue to feel that sensation. Minor swelling may occur above the wrist at times in carpal tunnel syndrome. However, most patients report the feeling in the fingers, localized to where the numbness occurs.

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5. Hands feel weak

One of the most common carpal tunnel syndrome feelings is a sense of hands that have lost their power. In particular, people claim that they find it harder to grip small objects and this causes many breakages in the kitchen. Medical tests do not reveal any marked loss of hand power in these cases, so doctors remain uncertain why so many patients feel this way. However, some slight deterioration in grip control may happen after surgical treatment.

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6. Responds to changes in wrist movements

People with carpal tunnel syndrome often find that they can get relief by moving their hand into a different position. Symptoms are usually worse at night – presumably because of fewer hand movements. In the most severe cases, the symptoms might be so intense that they disturb sleep and cause night waking.

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7. A condition that worsens over time

Carpel tunnel syndrome worsens with time, especially if symptoms go ignored and untreated. Surgery is usually necessary for the later stages of the condition. Early detection is best, as treatment is quite simple in the early stages. Wrist splints and exercise are usually enough to relieve symptoms in the early stages.

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8. Skin color changes

A certain number of people might notice changes in the color of the skin of their hand as a consequence of this condition. Sometimes the skin could become dry. Tingling and numbness feelings in their hand is also a good indication that they might have carpal tunnel syndrome. This is especially likely to be the case if they also feel that their fingertips have become frigid.

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9. Stiffness of the fingers

Some carpal tunnel syndrome patients complain that they feel as though their fingers are very stiff. However, when the doctor examines them, they fail to find any evidence to support this feeling. If the patient’s fingers actually have become stiff, it’s likely they are experiencing rheumatic or arthritic condition.

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10. Like the twang of a rubber band

One of the strangest feelings associated with carpal tunnel syndrome is in response to a certain hand movement. People say they sense something comparable to the twang of a released rubber band in their hand and fingers. Nobody is sure what exactly causes them to have this feeling. In particular, patients report this happening after they have had surgery performed.

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Article Provided By: FactyHealth

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Peripheral Neuropathy and Diabetes

Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, or hands. It is the most common complication of diabetes.

About 60% to 70% of all people with diabetes will eventually develop peripheral neuropathy, although not all suffer pain. Yet this nerve damage is not inevitable. Studies have shown that people with diabetes can reduce their risk of developing nerve damage by keeping their blood sugar levels as close to normal as possible.

What causes peripheral neuropathy? Chronically high blood sugar levels damage nerves not only in your extremities but also in other parts of your body. These damaged nerves cannot effectively carry messages between the brain and other parts of the body.

This means you may not feel heat, cold, or pain in your feet, legs, or hands. If you get a cut or sore on your foot, you may not know it, which is why it’s so important to inspect your feet daily. If a shoe doesn’t fit properly, you could even develop a foot ulcer and not know it.

The consequences can be life-threatening. An infection that won’t heal because of poor blood flow causes risk for developing ulcers and can lead to amputation, even death.

This nerve damage shows itself differently in each person. Some people feel tingling, then later feel pain. Other people lose the feeling in fingers and toes; they have numbness. These changes happen slowly over a period of years, so you might not even notice it.

Because the changes are subtle and happen as people get older, people tend to ignore the signs of nerve damage, thinking it’s just part of getting older.

But there are treatments that can help slow the progression of this condition and limit the damage. Talk to your doctors about what your options are, and don’t ignore the signs because with time, it can get worse.

Symptoms of Nerve Damage From Diabetes

Numbness is the most common, troubling symptom of nerve damage due to diabetes. The loss of sensation is a special concern. People who lose sensation are the ones most likely to get ulcers on their feet and to end up needing amputations.

People describe the early symptoms of peripheral neuropathy in many ways:

  • Numbness
  • Tingling
  • Pins and needles
  • Prickling
  • Burning
  • Cold
  • Pinching
  • Buzzing
  • Sharp
  • Deep stabs

Others describe sharp pain, cramps, tingling, prickling, a burning sensation. Still others have exaggerated sensitivity to touch.

The symptoms are often worse at night. Be on the look out for these changes in how you feel:

  • Touch sensitivity. You may experience heightened sensitivity to touch, or a tingling or numbness in your toes, feet, legs, or hands.
  • Muscle weakness. Chronically elevated blood sugars can also damage nerves that tell muscles how to move. This can lead to muscle weakness. You may have difficulty walking or getting up from a chair. You may have difficulty grabbing things or carrying things with your hands.
  • Balance problems. You may feel more unsteady than usual and uncoordinated when you walk. This occurs when the body adapts to changes brought on by muscle damage.

Because people with type 2 diabetes may have multiple health problems, doctors don’t always diagnose peripheral neuropathy when symptoms first appear. You need to be aware that your pain may be confused with other problems.

Make sure your pain is taken seriously.

Article Provided By: WebMD

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What to Say to Someone in Chronic Pain

Helpful Things to Say to Someone in Chronic Pain

Supporting someone in chronic pain can be difficult.  There is nothing that can be done to ease someone’s pain and sometimes, it leaves friends and family at a loss for words. There are no magic words or actions, but there are suggestions for things to say that could possibly help your loved one feel better.

Here is a list I have compiled from personal experience and research of helpful things to say to someone in chronic pain:

1-     “You look well today/good, but how are you feeling?”  Many times people with chronic pain feel like people see how they look on the outside, not how they feel on the inside.  This statement is helpful because you are stating something positive about the person, but asking how they are feeling despite looking good.  Additionally, asking “how are you holding up?” is a similar and helpful comment that lets the person in pain know that you acknowledge they are in pain and you wish to know how they are handling it.

2-     “I am going to be going to the store. Can I get you something?” After my second surgery my best friend would often call on weekends and tell me she was at the store and did I need anything.  The way she asked didn’t hit my pride, because I felt like she was already there and I wouldn’t bother her if I said, “sure, can you get me bread?”

3-     “I can’t imagine how hard this is for you, but you seem to be handling it well and I think you are so strong.” I often feel weakened by pain, but statements like these make me feel stronger and supported.

4-     “You are in my thoughts and prayers” As opposed to telling someone to ‘pray’ or ‘have faith,’ this statement expresses a good intention and lets us know you care.

5-     Mirror back what is being said.  If the person says “my back is really hurting me” Tell them, “Your back hurts, that must be difficult for you.”  By mirroring their statement, the person feels their pain was heard, even though there is nothing you can really say or do to help, they know you listened/heard their pain.

6-     “This must be so difficult for you, I can’t imagine.”  There are no magic words, and unless you are living with chronic pain, it’s difficult to understand what we are going through.  Comments like this show support without pretending you know how we feel.

7-     “I wish I had something to say that would help/take away the pain, but I don’t.  But I am here to listen.”  Sometimes, the best thing to say is nothing at all.  Sometimes it is best to just listen, without judgment, and just be there for someone.  Admitting you are at a loss and offering an ear is one of the most helpful things a loved one can do.

8-     “Please don’t feel bad if you have to cancel, I understand and I hope I can see you when you feel well.” This statement expresses concern without making the person feel bad about their limitations.

9-     “I hope that you feel as well as possible.”  Since we are talking about chronic pain, ‘feel better’ can be frustrating because many people don’t have ‘better’ days.  This statement is more genuine, in a way.

10- “I heard about _______(fill in miracle cure of the say).  I know every case is different, but would you like to hear about it?”  We have a lot of advice thrown at us by well-meaning people, but much of it is unwanted because it can make us feel as though others think we are not trying to help ourselves.  We also do a lot of research and see a lot of doctors, so we have probably heard it already.  By asking if the person would be interested in receiving advice shows respect for our situation and gives us the option to say ‘not right now’ or ‘sure.”

Actions speak louder than words so, remember, it can be very helpful to DO something nice for that person, like bring a meal, offer to do a load of laundry or make the bed.  Help.  But don’t make a big deal out of it.  Many times people who need help have a sense of pride and don’t like to feel they are being a burden, so by doing something and making it seem as if it’s “no big deal,” you are helping us without making us feel guilty.

Something I encounter a lot is that friends omit telling me things that have happened with their own health.  They say, “it was no big deal, it’s nothing compared to what you are going through.”  If you are supporting someone with chronic pain and you care about them, chances are they care about you and your health problems, so share what’s going on with your health as well.  It will help the person in pain feel the friendship is not one-sided.  Just because we are in pain doesn’t mean we forgot how to listen and care and, if your health issues involve pain, we can certainly sympathize better than anyone.

And, please don’t turn your back on those of us living with chronic pain just because you feel like you can’t help us.  This lifestyle carries with it so much isolation, depression and loneliness.  We count on our support system to help us.  We know we are not always the easiest of people to deal with, but please remember, we did not ask for this and we would love to have our “old lives” back.

Remember, sometimes the best thing you can say is the simplest: “I love you.”

Article Provided By: PsychCentral

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