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How do I Exercise with Neuropathy?

How do I Exercise with Neuropathy?

Water aerobics is an exercise performed in a pool.
Water aerobics is an exercise performed in a pool.

To exercise with neuropathy, or nerve damage, you should aim for a moderate workout schedule rather than overdoing it. It’s important to have regular exercise sessions though, because it may lessen the extent or intensity of neuropathy over time. In general, exercises that don’t put a lot of pressure on the skeleton, especially the feet, are good for people with neuropathy.

Exercising in the water puts little stress on the joints and bones, and may be recommended for those with neuropathy.
Exercising in the water puts little stress on the joints and bones, and may be recommended for those with neuropathy.

Running, jogging, hiking, walking and step aerobics may be too much when exercising with nerve damage. If you have moderate to severe neuropathy in the feet or legs, overdoing or even moderately doing these activities may cause foot ulcers or joint damage. If the feet or legs aren’t swollen, sore or have a “pins and needles” feeling, then a limited amount of these types of exercises may be able to be done.

Running, jogging, hiking, and walking may be too much when exercising with nerve damage.
Running, jogging, hiking, and walking may be too much when exercising with nerve damage.

Aqua aerobics in the shallow end of a swimming pool may be fine in moderation, as the water helps cushion the feet and joints. However, as there is still contact with the feet on the pool floor, deep water aerobics can offer even more cushioning exercises. Swimming is often an excellent physical activity for those who exercise with neuropathy. Since it involves whole body movement, swimming can provide overall toning as well as cardiovascular benefits when done at a brisk pace.

While regular exercise is especially important for diabetics with neuropathy, as it can help lower blood sugar, proper fitting shoes and checks of the feet after workouts is important. Yoga can be an extremely beneficial exercise with neuropathy, as it’s gentle on the body, but if it’s done in bare feet, diabetics must be sure to take caution in not getting any scrapes or even a tiny pebble on either foot. Something as minor as a scratch on the foot may go unnoticed by those with neuropathy, as their feet are typically numb. If untreated, a foot infection may become so severe that amputation is necessary.

Individuals suffering from neuropathy may not notice scratches on their feet.
Individuals suffering from neuropathy may not notice scratches on their feet.

If you begin the type of exercise that best suits your degree of neuropathy, you should aim for about 30 minutes three to five times a week, depending on your fitness level and physician’s recommendations. In addition to water exercises, cycling may be another activity that you find you can do with neuropathy. It’s important to begin any type of exercise with neuropathy slowly and build up your time spent on it gradually.

 

Article Provided By: thehealthboard

Olympic Photo by Alex Smith on Unsplash

 

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

 

 

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Responding to Weather Changes When Caring for Neuropathy Patients

Responding to Weather Changes When Caring for Neuropathy Patients

Ezekiel Lim avatar

by Ezekiel Lim | 

weather changes

Patients with familial amyloid polyneuropathy may find that changes in seasons increase discomfort. Colder temperatures require layers of clothing that may bother someone with peripheral neuropathy symptoms. A change to hotter temperatures may cause increased discomfort to someone already experiencing burning sensations due to nerve damage.

Caregivers can take steps to help manage the impact of weather changes on neuropathy patients.

Cold weather and neuropathy

Patients with peripheral neuropathy symptoms experience a slowing of blood flow to nerve endings, causing numbness and tingling. Colder temperatures may make it difficult for patients to measure their bodies’ response to the climate.

My family lives in an area known for weather extremes. When spending time with my mother-in-law during the winter months, it is important for us not only to make sure she has adequate layers of clothing, but also to know when the bundled clothing is causing her discomfort.

Following are some tips for caregivers who are managing the daily care of a loved one during a change to colder weather:

  • Make sure the patient is wearing warm, comfortable clothing that isn’t too heavy.
  • Protect the patient’s hands and feet with warm gloves and neuropathy socks.
  • Massage areas where circulation may be lacking.
  • Limit the time spent outside in the cold.
  • Limit caffeine and alcohol intake as they may respectively narrow blood cells and cause vitamin deficiency.

Managing symptoms in heat

Hotter temperatures may exacerbate the tingling and burning sensations that neuropathy patients experience. During a transition from cold winters to mild or hot months, caregivers must gauge their loved one’s peripheral symptoms. Just as in winter months, patients may have difficulty measuring their bodily responses to temperature.

For caregivers managing responses to hotter temperatures, following are some tips for ensuring patient comfort:

  • Keep time spent outside to a minimum and, if needed, stay indoors all day.
  • Make sure air conditioning is adjusted to a comfortable level to avoid interacting with symptoms of numbness.
  • Make sure your loved one is adequately fed and hydrated.
  • Understand the patient’s comfort level and make sure they are wearing lighter layers of clothing.
  • Try using topical treatments and cooling products when the patient begins to feel too hot.

The pain caused by humidity and summer heat may cause increased discomfort in those suffering from peripheral neuropathy symptoms. By ensuring the patient has a comfortable indoor environment, the change in temperature will not exacerbate chronic pain.

Article Provided By: fapnewstoday
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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Is Your Sciatica Coming From Your Spine or Your SI Joint?

Is Your Sciatica Coming From Your Spine or Your SI Joint?

If you have pain radiating down your leg, you may immediately think: “I have a pinched nerve in my back.” But sacroiliac (SI) joint dysfunction can also cause pain that radiates down the leg. So, how do you tell the difference?

First, it’s important to understand that sciatica is not a diagnosis: it’s a symptom related to an underlying condition. Sciatica is the sensation of pain, tingling, weakness, and/or numbness in the lower extremities that is typically caused by compression or irritation of a spinal nerve(s) or of the sciatic nerve itself (see diagram). Usually, the nerve compression or irritation occurs in the lumbar spine.

 

The tricky thing is, the real source of the pain might be something else: your SI joint.

Start here to better understand your symptoms and what to do about them:

  • Nerve Compression or Irritation from the Spine Versus Nerve Irritation Related to the SI Joint:
  • SI Joint and Sciatica: Understand the Definitions
  • View Causes of Sciatica
  • Tests that Determine the Source of Your Leg or Lower Back Pain
  • Potential Treatments to Relieve the Pain

Nerve Compression or Irritation from the Spine Versus Nerve Irritation Related to the SI joint:

Even if you’ve determined that you have sciatica, the cause could be nerve irritation or compression in the spine OR you may have an SI joint problem OR a combination of both. The L5 and S1 spinal nerves are located very close to the SI joint, and SI joint dysfunction could result in irritation of those nearby nerves.

How can you be certain what’s causing the pain?

The only way to truly know what’s going on is to see your doctor and describe what you are feeling and experiencing. Your doctor will likely ask many questions, ask you to point to the source of your pain, and perform a physical exam.

 

Sciatic anterior

Here are a few subtle differences that he or she may be looking for:

Sciatica and other symptoms
from Nerve Compression in the Spine
Sciatica and other symptoms
from the SI Joint
  • Pain that starts in the lower back and goes down one leg (the leg pain is usually greater than the low back pain)
  • Lower back pain (below L5) that is off to one side that you can typically point to
  • Pelvis/buttock pain
  • Hip/groin pain
  • Pain, weakness, and/or numbness or a tingling sensation radiating to the calf, foot, or toes along the back of your buttock, thigh, and calf. You may have actual weakness and/or numbness as a result of compressed nerves.
  • Pain can be mild to excruciating; it may feel like an “electric shock”
  • Sensation in lower extremity: pain, numbness, tingling, weakness. Upon exam, patients do not usually have true weakness or numbness.
  • Typically, the pain stays above the knee, but can radiate down the leg to the calf or foot.
  • Severe cases may result in significant leg weakness
  • (Weakness, numbness, and reflex changes are called radiculopathy.)
  • Feeling of pain and leg instability (buckling, giving way) when standing.
  • The leg isn’t actually weak; the leg gives way because of the severe pain you may experience when the SI joint is loaded.
  • Sitting for a long time can make symptoms worse.
  • Pain going from sitting to standing. Unable to sit for long periods of time or sitting or sleeping on one side due to the pain. (Disturbed sitting and sleeping patterns.)
  • Typically felt on one side.
  • Can be on one or both sides, although typically on one side.

It’s rare for someone with sciatica from an SI joint problem to have real numbness, weakness, or reflex changes. This is because there is rarely a physical compression of the nerve. The L5 and/or S1 nerves are irritated (called radiculitis) when they cross near the SI joint, but these nerves are not compressed.

Your radiating leg pain (sciatica) can be from your spine or from your SI joint. However, it is possible to be diagnosed with problems in both areas. That’s why it’s so important to visit your doctor to truly determine what is causing your low back or leg pain.

SI Joint and Sciatica Definitions

Let’s back up a step and make sure we fully understand the definitions of sciatica and SI joint dysfunction.

What Is Sciatica?

Sciatica is a symptom (radiating leg pain) caused by a problem with the spinal nerve(s) or sciatic nerve, such as compression or irritation, which sends signals of pain, numbness, tingling, or weakness. The sciatic nerve is a made up of several nerves from your lower spine; it extends down the back of your leg to the bottom of your foot. You have one on each side. Sometimes, the compression in the spine affects nerves on both the left and right sides of the body.

The sciatic nerve carries nerve signals down to the muscles and sensation signals up to the spinal cord. These signals tell your muscles to move; when these signals are disrupted, this is why you might sometimes feel weakness or buckling in the knee.

What Is SI Joint Dysfunction?

Sacroiliac (SI) joint dysfunction is caused by trauma or degeneration of the SI joint. The SI joint is where your iliac bone (pelvis) connects to the sacrum (lowest part of the spine above the tailbone).

The SI joint is responsible for transferring the weight from your upper body to your pelvis and legs. Pain caused by SI joint dysfunction can be felt in the lower back or spine, buttocks, pelvis, groin, and sometimes in the legs, which makes it seem like the cause could be nerve compression in the spine.

The L5 and S1 nerves are near the SI joint and studies have shown that SI joint dysfunction can cause pain and other symptoms in the distribution of these nerves.

The SI joint is separate from the sciatic or spinal nerve(s); however, the SI joint can cause sciatica-like symptoms.

Underlying Causes of Sciatica Pain and SI Joint Pain

Oftentimes, it’s difficult to pinpoint the exact cause of pain. Nerve compression in the spine and SI joint dysfunction are two areas that often cause pain running down the back of the leg.

 

Spine Problems that Can Result in Sciatica

  • A bulging, ruptured, or herniated disc in the spine
  • Central spinal stenosis or when your central spinal canal is constricted
  • Foraminal stenosis, when the openings where the nerves leave the spine become tight
  • Spondylolisthesis (or segmental instability), when one vertebra slips forward in the lower back
  • Facet arthropathy, a wearing down of the cartilage between the facet joints in the back of the spine
  • Injury or infection
  • Nutritional deficiencies and genetic problems (less common)

SI Joint Dysfunction: Potential Causes

  • Trauma to the SI joint from a fall, car accident, or giving birth
  • Degeneration of the SI joint

Both situations can be acute (lasting a couple weeks and resolving on its own) or chronic (lasting a very long time).

People with chronic SI joint dysfunction can suffer with the pain for years before they receive the correct diagnosis and treatment.

If your pain has lasted more than a couple weeks or is impacting your daily life, see a doctor right away.

Sciatic posterior

Testing to Determine the Source of Your Leg or Lower Back Pain

Your doctor will likely ask many questions, such as when the pain started, how long it lasts, and what causes it to get worse or better. Answers to these questions will provide clues to which tests you should get first.

For example, if your pain started after a fall on the buttocks or if it extends to the groin area, that might be a clue that it’s SI-joint-related, and you may require physical examination including provocative tests.

Provocative tests help determine whether the pain is caused by the SI joint. A diagnostic injection can help confirm diagnosis. If you are experiencing true muscle weakness, this could indicate that you have a pinched nerve in the spine. When nerves are compressed/irritated in the spine, patients will frequently have a positive passive straight leg raising test.

Your doctor will also likely rule out potential causes of nerve compression in the spine, such as a bulging disc, with an MRI of the spine and other radiological and laboratory testing.

Sometimes patients are misdiagnosed, like in the case of Keith, who was diagnosed with a pinched nerve in the spine but in reality, had SI joint dysfunction. The pain was coming from his SI joint. See Keith’s Sciatica from SI Joint Pain Story.

Treatments to Relieve the Pain

Conservative therapies to treat sciatica from both the spine or the SI joint may include therapeutic injections of steroids, which may offer temporary relief. For sciatica related to the spine, the injection will be targeted in the lumbar spine at the site of the nerve compression. For sciatica related to SI joint dysfunction, the injection will be targeted in the SI joint.

Treatment of spinal conditions may include medications, physical therapy (including exercises specific for sciatic pain), and in extreme cases, surgery to remove the pressure from the pinched nerve(s) in the spine.

SI joint dysfunction treatments also include medications, physical therapy and other non-surgical treatments, and if non-surgical treatments no longer work, minimally invasive SI joint fusion may be an option.

If you suspect your lower back and leg pain is caused by your sacroiliac joint or your spine, visit your doctor with a list of symptoms, including when the pain started, and what makes it worse. If it turns out you need an SI joint specialist, you can find one in your area here.

 

Article Provided By: SI-Bone.com

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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What Is Nerve Pain (and How Does It Differ From Other Kinds of Pain?)

What Is Nerve Pain (and How Does It Differ From Other Kinds of Pain?)

“Can you describe your pain?” This will likely be one of the first questions your doctor asks if you complain of chronic pain. Unless there’s an obvious reason for pain, your doctor needs a lot of information to identify the underlying cause. This includes the location, type, intensity and frequency of pain. The doctor is partly trying to determine whether the pain is nociceptive or neuropathic (also called nerve pain), or possibly both.

“This can be tricky because all pain is experienced through the nerves,” says sports medicine specialist Dominic King, DO. Damage to bodily tissues, such as muscles, tendons, ligaments or the capsules around joints, causes nociceptive pain. Nerve receptors adjacent to the damaged tissue, called nociceptors, transmit a pain signal to the brain. This type of pain tends to feel sharp, achy, dull or throbbing.

Understanding ‘electric pain’

If you’re experiencing something that feels more like burning, stabbing, or shooting pain ― especially if there also is numbness or tingling ― it’s likely to be neuropathic pain. This means there is direct damage or irritation to a nerve. “It can cause a lightning strike type of electric pain,” says Dr. King.

Nerve pain can arise from a variety of causes, including diabetes, infections (such as shingles), multiple sclerosis, the effects of chemotherapy or trauma. When it comes to orthopeadic issues, nerve pain often stems from a nerve being pinched by nearby bones, ligaments and other structures.

For example, a herniated disk in the spine or a narrowing of the spinal canal (stenosis) can press on a nerve as it leaves the spinal canal. This can cause pain along the path of the nerve. When nerves that originate in the lower spine are affected, symptoms might be felt in the buttocks or down a leg. If the compressed nerve is in the upper spine, the pain and other symptoms can shoot down the arm. Numbness or tingling may also occur because the brain is not receiving a consistent signal due to the compression.

Another common cause of nerve pain is carpal tunnel syndrome. A nerve and several tendons travel through a passageway in the wrist (the carpal tunnel) to the hand. Inflammation in the tunnel can press on the nerve, causing numbness and tingling in the thumb and fingers.

How is the cause of nerve pain found?

“There are so many orthopaedic conditions that overlap between pain stemming from problems with tendons, muscles, joints and nerves that you need a very discerning physician to do a good physical exam to figure out the cause,” says Dr. King. “I make my determination based on when the patient experiences pain, where the pain is located and what the pain feels like.”

Pain related to joints, such as from arthritis, will feel more like stiffness when going from sitting to standing. With tendon pain, it will feel sore when you push on the affected area. “Nerve pain is more of a burning, fiery pain,” says Dr. King. And it tends to come and go.

“Nerve pain typically gets worse with more and more use and can be associated with numbness,” says Dr. King.

Ultimately, getting the right treatment depends on getting the right diagnosis. For many bone and joint conditions, nondrug treatment will be tried first. Sometimes pain medication is needed. However, neuropathic pain does not respond to drugs commonly used for nociceptive pain, such as nonsteroidal anti-inflammatory drugs.

This article originally appeared in Cleveland Clinic Arthritis Advisor.

 

Article Provided By: clevelandclinic

 

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SC

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

 

 

 

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Managing & 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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What Is Reflex Sympathetic Dystrophy Syndrome?

What Is Reflex Sympathetic Dystrophy Syndrome?

Medically Reviewed by Melinda Ratini, DO, MS on September 16, 2020

Reflex sympathetic dystrophy syndrome (RSD) is a disorder that causes lasting pain, usually in an arm or leg, and it shows up after an injury, stroke, or even heart attack. But the severity of pain is typically worse than the original injury itself. Doctors don’t know exactly what causes it, but they are able to treat many cases.The term reflex sympathetic dystrophy syndrome is actually not a name that doctors use anymore. It’s an older term used to describe one form of Complex Regional Pain Syndrome (CRPS). RSD is sometimes called Type I CRPS, and it’s caused by injury to tissue with no related nerve damage.

What Causes RSD?

Doctors think the pain caused by RSD comes from problems in your sympathetic nervous system. Your sympathetic nervous system controls blood flow movements that help regulate your heart rate and blood pressure.

When you get hurt, your sympathetic nervous system tells your blood vessels to get smaller so you don’t lose too much blood at your injury site. Later, it tells them to open back up so blood can get to damaged tissue and repair it.

When you have RSD, your sympathetic nervous system gets mixed signals. It turns on after an injury, but doesn’t turn back off. This causes a lot of pain and swelling at your injury site.Sometimes, you can get RSD even if you haven’t had an injury, although it’s not as common.

Symptoms

When you get RSD, your symptoms may show up slowly. You may have pain first, and then it may get worse over time. You may not realize your pain is abnormal at first.

The types of injuries that can cause RSD include:

  • Amputation
  • Bruises
  • Burns
  • Cuts
  • Fractures
  • Minor surgery
  • Needle sticks
  • Radiation therapy
  • Sprains

It’s most common to get RSD in your arm, shoulder, leg, or hip. Usually the pain spreads beyond your injury site. In some cases, symptoms can spread to other parts of your body, too.

  • Redness
  • Skin that’s warm to the touch around the injury
  • Swelling

The pain you get with RSD is usually constant and severe. Many people describe RSD pain as:

  • Aching
  • Burning
  • Cold
  • Deep
  • Throbbing

Your skin may also feel sensitive when you do things that don’t normally hurt it, like taking a shower. Or it might hurt just to wear your clothes.

Other symptoms of RSD include:

  • Changes in your hair or nail growth, or skin’s texture
  • Excess sweat in certain areas of your body
  • Muscle weakness or spasms
  • Stiff joints
  • Trouble moving the injured area
  • White, mottled, red, or blue skin

Diagnosis

Often, doctors don’t know your pain is being caused by RSD until you’ve had it for some time. When pain doesn’t go away, or is more severe than it should be for your type of injury, it can be the first clue that it could be RSD.

Bone scan. This test can detect if any of your bones are wearing away at the ends or whether there are issues with regular blood flow.

MRI. Your doctor might order an MRI to look inside your body, specifically at your tissues, for noticeable changes.

Sweat test. This test can tell your doctor if you sweat more on one side of your body than the other.

Thermography test. This sympathetic nervous system test checks to see if the temperature or blood flow is different at your injury site than in other parts of your body.

X-rays. These are typically ordered if your syndrome is in later stages to look for mineral loss in your bones.

Treatment

Early detection is key in RSD treatment. The earlier you’re able to catch it, the better your treatment will work. Some cases of RSD don’t respond to treatment. RSD doesn’t have a cure, but it’s possible to recover from many of the symptoms.

  • Anesthetic creams like lidocaine
  • Antidepressants
  • Anti-inflammatory drugs, called NSAIDs
  • Anti-seizure medications that may help treat pain
  • Nasal spray that treats bone loss
  • Nerve blocking injections
  • Over-the-counter options like aspirin, ibuprofen, or naproxen for pain

Other ways to treat symptoms include:

  • Electrodes on your spinal cord that send small electric shocks to relieve pain
  • Physical therapy to help you move around more easily and take away pain
  • Psychotherapy that can teach you relaxation methods
  • Splints to help with hand pain

 

 

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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Hyperalgesia: What you need to know

Hyperalgesia: What you need to know

Hyperalgesia is a condition where a person develops an increased sensitivity to pain. What may not hurt most people can cause significant pain in an individual with hyperalgesia.

Although there are many potential causes associated with hyperalgesia, the condition is thought to be the result of changes to nerve pathways, which cause a person’s nerves to have an overactive response to pain.

Medications are available to prevent a person’s symptoms from worsening.

Fast facts on hyperalgesia:

  • Hyperalgesia can be very difficult for a doctor to diagnose.
  • Different types of hyperalgesia exist, and doctors have a variety of theories regarding why people experience hyperalgesia.
  • Researchers are also studying a potential genetic link to hyperalgesia
  • The condition closely resembles both drug tolerance and drug withdrawals.
Causes
Hyperalgesia is an extreme reaction to painful stimuli.

There are several nerve or “pain” pathways in the body where signals can start to miscommunicate with each other, resulting in hyperalgesia.

Some scientists think that hyperalgesia occurs when chemicals known to reduce pain are disrupted.

Others propose that hyperalgesia happens when “crossed wires” in the nervous system prevent pain signals from transmitting accurately.

Nociceptive and neuropathic pain

Nociceptive and neuropathic are two different types of pain. Nociceptive pain is acute and it usually has a specific cause, such as an injury.

Neuropathic pain results from damage to the nervous system. It can happen even when there is no injury or outside stimulus.

Hyperalgesia is considered a form of neuropathic pain.

Types

Doctors usually divide hyperalgesia into primary and secondary categories. Both of these conditions are due to initial tissue trauma and inflammation.

Primary hyperalgesia

This type of hyperalgesia is when the increased pain occurs in the tissue where the injury took place. An example would be when a person has surgery on their elbow, and the pain starts to worsen over time instead of improving.

Secondary hyperalgesia

This type occurs when the pain seems to spread to non-injured tissue or tissues.

Other types of hyperalgesia

Another kind of hyperalgesia is opioid-induced hyperalgesia (OIH). OIH occurs when a person experiences worsening or new pain as a result of taking opioids, such as morphine, hydrocodone, or fentanyl for pain relief.

Symptoms

The chief symptom of hyperalgesia is an increasingly extreme reaction to painful stimuli without any new injuries or worsening of a medical condition. An example would be a surgical incision that becomes more painful over time, yet the wound is not infected, and a person has not experienced any further injury.

Hyperalgesia is different from tolerance to medications although the two processes are similar.

If a person develops a tolerance to a particular drug, it usually means that their body has become accustomed to the presence of the drug at the current dosage, and the drug is no longer working properly. When a person has developed a tolerance to a drug, increasing the dosage will usually decrease a person’s pain.

Drug tolerance is different from hyperalgesia, where increasing pain medication will not reduce the amount of pain a person feels. Sometimes, increasing the pain medication makes the person’s pain worse.

Another similar medical condition is allodynia. This condition is where a person develops a significant pain response to non-painful stimuli. Even brushing against a person’s skin can cause pain.

In hyperalgesia, a person has experienced a painful stimulus, such as cancer pain or pain following surgery, but their response to the pain is greater than the expected level of pain.

How do doctors diagnose hyperalgesia?

doctor checking notes on a tablet
Diagnosing hyperalgesia may be difficult for a doctor.

Hyperalgesia can present difficulties for a doctor to treat because a person may have developed OIH.

To make a diagnosis, a doctor will take a medical history and review a person’s medication.

They may also ask them questions about the nature of their pain.

Some of the signs that could indicate hyperalgesia include:

  • Pain extends beyond the area where a person experienced an initial injury or previously felt pain. Examples could include headaches, neck pain, leg pain, or back pain.
  • Some people describe the pain as “diffuse” or spreading. Some may report all-over body pain and aches.
  • The quality or experience of the pain is different than it used to be. The pain may become sharp, aching, or stabbing where previously the person felt the pain differently.

Currently, there are no definitive diagnostic tests for hyperalgesia.

Article Provided By: medicalnewstoday

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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The Common Symptoms of Neuralgia

The Common Symptoms of Neuralgia

Neuralgia is nerve pain that may be caused by many different things, including nerve damage, nerve irritation, infection, or other diseases. It is caused by irritation or damage to a nerve and is a sharp and very intense pain that follows the path of the nerve.

Neuralgia is also sometimes called neuropathyneuropathic pain, or neurogenic pain. It is most common in older adults but can affect people of all ages.

The nerves of the lower body
MedicalRF.com / Getty Images

 

Symptoms

How can you tell if the pain you are experiencing is neuralgia or some other type of pain? Neuralgia is typically more severe and has some distinct symptoms:

  • Increased sensitivity: The skin along the path of the damaged nerve will be very sensitive, and any touch or pressure, even gentle, is painful.
  • Sharp or stabbing pain: Pain will occur along the path or the damaged nerve and will be felt in the same location each time. It often comes and goes but can also be constant and burning and may feel more intense when you move that area of your body.
  • Weakness: Muscles supplied by the damaged nerve may feel very weak or become completely paralyzed.

 

Types

Certain painful conditions are classified as neuralgia because they are caused by nerve damage and lead to nerve pain. You can also experience neuralgia as a side effect of surgery. The pain can range in severity based on the extent of nerve damage and what nerves are affected.

Some common types of neuralgia include:

 

Treatment

Unfortunately, treating neuralgia is not an easy task and treatment will vary depending on the cause, location, and severity of your pain. The first step your doctor will likely take will be to identify the cause of the nerve problem and work to reverse or control it. He or she will also likely recommend pain medications to control your symptoms, including:1

  • Antidepressant medications
  • Antiseizure medications
  • Over-the-counter pain medications, such as aspirin, acetaminophen or ibuprofen
  • Narcotic analgesics for short-term pain
  • Lidocaine patch
  • Capsaicin or lidocaine medicated skin creams

Other treatment options may include anesthetic shots, nerve blocks, physical therapy, surgery, nerve ablation, or complementary and alternative therapies. Talk to your doctor to discover the source of your pain and find out what treatments may work for you.

 

Article Provided By:verywellhealth
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Neuralgia

Neuralgia

Neuralgia is a stabbing, burning, and often severe pain due to an irritated or damaged nerve. The nerve may be anywhere in the body, and the damage may be caused by several things, including:

  • aging
  • diseases such as diabetes or multiple sclerosis
  • an infection, such as shingles

Treatment for the pain of neuralgia depends on the cause.

Types of neuralgia

Postherpetic neuralgia

This type of neuralgia occurs as a complication of shingles and may be anywhere on the body. Shingles is a viral infection characterized by a painful rash and blisters. Neuralgia can occur wherever the outbreak of shingles was. The pain can be mild or severe and persistent or intermittent. It can also last for months or years. In some cases, the pain may occur before the rash. It will always occur along the path of a nerve, so it’s usually isolated to one side of the body.

Trigeminal neuralgia

This type of neuralgia is associated with pain from the trigeminal nerve, which travels from the brain and branches to different parts of the face. The pain can be caused by a blood vessel pressing down on the nerve where it meets with the brainstem. It can also be caused by multiple sclerosis, injury to the nerve, or other causes.

Trigeminal neuralgia causes severe, recurrent pain in the face, usually on one side. It’s most common in people who are older than 50 years.

Glossopharyngeal neuralgia

Pain from the glossopharyngeal nerve, which is in the throat, is not very common. This type of neuralgia produces pain in the neck and throat.

Causes of neuralgia

The cause of some types of nerve pain is not completely understood. You may feel nerve pain from damage or injury to a nerve, pressure on a nerve, or changes in the way the nerves function. The cause may also be unknown.

Infection

An infection can affect your nerves. For example, the cause of postherpetic neuralgia is shingles, an infection caused by the chickenpox virus. The likelihood of having this infection increases with age. An infection in a specific part of the body may also affect a nearby nerve. For example, if you have an infection in a tooth, it may affect the nerve and cause pain.

Multiple sclerosis

Multiple sclerosis (MS) is a disease caused by the deterioration of myelin, the covering of nerves. Trigeminal neuralgia may occur in someone with MS.

Pressure on nerves

Pressure or compression of nerves may cause neuralgia. The pressure may come from a:

  • bone
  • ligament
  • blood vessel
  • tumor

The pressure of a swollen blood vessel is a common cause of trigeminal neuralgia.

Diabetes

Many people with diabetes have problems with their nerves, including neuralgia. The excess glucose in the bloodstream may damage nerves. This damage is most common in the hands, arms, feet, and legs.

Less common causes

If the cause of neuralgia isn’t infection, MS, diabetes, or pressure on the nerves, it may be from one of many less-common factors. These include:

  • chronic kidney disease
  • medications prescribed for cancer
  • fluoroquinolone antibiotics, used to treat some infections
  • trauma, such as from surgery
  • chemical irritation
When to seek medical help

The pain of neuralgia is usually severe and sometimes debilitating. If you have it, you should see your doctor as soon as possible.

You should also see your doctor if you suspect you have shingles. Besides neuralgia, shingles also causes a red, blistering rash. It’s usually on the back or the abdomen, but it may also be on the neck and face. Shingles should be treated as soon as possible to prevent complications. These can include postherpetic neuralgia, which can cause debilitating and lifelong pain.

What to expect at a doctor’s appointment

When you see your doctor for neuralgia, you can expect to be asked a series of questions about your symptoms. Your doctor will want you to describe the pain and to tell them how long the pain has been a problem. You will also need to inform them of any medications you take and any other medical issues you have. This is because neuralgia may be a symptom of another disorder, such as diabetes, MS, or shingles.

Your doctor will also perform a physical exam to pinpoint the location of the pain and the nerve that’s causing it, if possible. You may also need to have a dental exam. For example, if the pain is in your face, your doctor may want to rule out other possible dental causes, such as an abscess.

To find an underlying cause of your pain, your doctor may order certain tests. You may need to have blood drawn to check your blood sugar levels and kidney function. A magnetic resonance imaging (MRI) test can help your doctor determine if you have MS. A nerve conduction velocity test can determine nerve damage. It shows how fast signals are moving through your nerves.

Treatment of neuralgia

If your doctor can pinpoint the cause of your neuralgia, your treatment will focus on treating the underlying cause. If the cause is not found, treatment will focus on relieving your pain.

Potential treatments may include:

  • surgery to relieve the pressure on the nerve
  • better control of blood sugar levels in people with diabetes-caused neuralgia
  • physical therapy
  • nerve block, which is an injection directed at a particular nerve or nerve group and that is intended to “turn off” pain signals and reduce inflammation
  • medications to relieve the pain

Medications prescribed may include:

  • antidepressants such as amitriptyline or nortriptyline, which are effective in treating nerve pain
  • antiseizure medications such as carbamazepine, which is effective for trigeminal neuralgia
  • short-term narcotic pain medications, such as codeine
  • topical creams with capsaicin

There is no cure for neuralgia, but treatment can help improve your symptoms. Some types of neuralgia improve over time. More research is being done to develop better treatments for neuralgia.

 

Article Provided By: healthline
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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Calmare Scrambler, Pain Therapy, Carolina Pain Scrambler, Greenville South Carolina

Mayo Clinic Researchers Test Scrambler Therapy For Pain

Mayo Clinic researchers test scrambler therapy for pain

Scrambler therapy is a pain management approach that uses a machine to block the transmission of pain signals by providing non-pain information to nerve fibers that have been receiving pain messages.
The first study on scrambler therapy was published in 2003 by a team of researchers led by Giuseppe Marineo, professor in delta research and development at University of Rome Tor Vergata in Italy. He and colleagues reported that scrambler therapy was effective at reducing pain symptoms in patients with severe, drug-resistant pain from terminal cancer.

 

Charles L. Loprinzi

The Calmare scrambler therapy device has since received FDA clearance in the United States for use in patients experiencing pain from cancer and chemotherapy, pain as a result of chronic diseases such as diabetes, multiple sclerosis and arthritis, back and neck pain, failed back surgery syndrome, and phantom limb pain among others.
HemOnc Today asked Charles L. Loprinzi, MD, Regis professor of breast cancer research at Mayo Clinic in Rochester, Minnesota, about the safety and efficacy of scrambler therapy, as well as his ongoing research efforts.
Question: Can you describe scrambler therapy and how it came about?
Answer: Scrambler therapy is an electro-cutaneous treatment. Although people may think of it as being similar to transcutaneous electrical nerve stimulation (TENS) therapy, scrambler therapy is felt to work through a different mechanism. TENS is thought to work through the gateway theory of pain relief, whereby normal touch sensations blocks pain sensations. Scrambler therapy, on the other hand, is proposed to provide normal-self, non-pain electrical information via nerves that have been transmitting chronic pain information. Through a process termed plasticity, this is able to retrain the brain so that it does not ascribe pain to the chronic pain area. Scrambler therapy consists of a machine, which looks somewhat like an electrocardiogram machine. Leads are placed on patients, around the areas of chronic pain. Scrambled electrical signals are then sent to the brain that perceives them as normal, non-pain signals. Via this process, the brain is retrained to think that there really is not pain in the area that is being treated.
Q: How and when did you become involved with this treatment approach?
A: I was introduced to scrambler therapy in 2010 by Thomas J. Smith, MD, now at Johns Hopkins University, who had heard about scrambler therapy and decided to try it in patients with chemotherapy-induced peripheral neuropathy (CIPN). He subsequently published a pilot trial that supported that scrambler therapy was an effective approach for treating established CIPN. After some internal debate as to whether I should look further into this treatment approach, which sounded quite strange to me, I did agree to study it. Having now treated more than 200 patients at Mayo, we published a paper on the use of this treatment for chemotherapy neuropathy, which concurred with Dr. Smith’s report, further supporting that this therapy was helpful for CIPN.
Q: What other published data support the value of scrambler therapy?
A: I am aware of 19 published reports regarding scrambler therapy, involving more than 800 patients. Seventeen of these are published manuscripts, whereas two are only published as meeting abstracts. These reports include clinical practice summaries, prospective non-randomized clinical trials and randomized controlled trials, including two trials that sought to double blind patients and investigators. The authors of 18 of the 19 reports concluded that scrambler therapy was a beneficial treatment approach, whereas one report — published only as a meeting abstract and only involving 14 patients — concluded that this was not an effective treatment. Of note, one relatively large randomized trial, with a non-blinded control arm consisting of optimizing medical management of pain, reported substantially more benefit from scrambler therapy than was observed in the control arm. Additionally, a relatively small placebo-controlled, patient-blinded trial reported a statistically significantly beneficial effect for scrambler therapy in a small number of patients with chronic low back pain. Thus, there are substantial data that support the value of scrambler therapy. Having said this, I readily admit that scrambler therapy has not yet been clearly proven to be beneficial. Ideally, additional randomized clinical trials will be reported to provide for more substantial clinical data regarding the true value of scrambler therapy. Dr. Smith is conducting one trial at Johns Hopkins and we, at Mayo, are gearing up for another one. This all takes time, energy and funds.
Q: Can you briefly discuss the findings from the clinical study you reported regarding the use of scrambler therapy in patients with established CIPN?
A: When we received the scrambler therapy machine, we decided to treat patients on a clinical trial as opposed to just using it for routine clinical practice. For this, we developed an open-label clinical trial to document our results and to learn how to provide this therapy. Prior to treating patients on this trial, we went to Rome for training. We then treated patients on this clinical trial, who had chronic pain or neuropathy with a pain and/or tingling score of at least 4 out of 10. In order to report data on a series of these patients, we took the first 37 patients who entered on this clinical trial who had CIPN as their designated clinical problem. We prospectively collected patient-reported outcome data on each of 10 days of treatment and then weekly for 10 weeks following that. Results, reported in Supportive Care in Cancer, illustrated that, during the treatment days, there was approximately a 50% reduction from baseline for pain, tingling and numbness scores. When we then followed the patients weekly, after the 10 days of therapy, the benefit, on the whole, persisted.
Q: Can you describe the treatment process and when beneficial results appear?
A: The area of pain/neuropathy is first defined and a set of leads is placed in normal sensation skin sites, close to the area of pain/neuropathy. The electrodes are then turned on with a gradual increase in intensity to a point where the patient is able to feel sensations, short of pain. When successful, the patient reports that the buzzing sensation has replaced an area of pain/neuropathy. This generally occurs within a minute or two. At times, electrodes need to be moved to obtain this sort of success. Sometimes, several sets of electrodes are needed to cover the area of discomfort. The scrambler machine stays on for about 30 minutes following successful electrode placements. The electricity is then turned off and the patient commonly reports that the pain/tingling is still markedly improved. After one treatment, the benefit is often relatively short-lived, lasting for minutes to hours. With repetitive days of treatment (standardly up to 10 treatments, although stopped earlier if the problem goes away completely and lasts overnight), the period of benefit increases until it lasts for a couple days. The benefit largely persists for weeks to months. Some patients relapse and can be successfully retreated, oftentimes only needing an additional few doses.
Q: Is this therapy routinely offered at Mayo Clinic?
A: Mayo recently began offering scrambler therapy as part of clinical practice. As with many new practice approaches, there are many questions that arise: How effective is the therapy? Who should be treated and for which conditions? How well is this approach covered by different insurance carriers? Admittedly, we do not have ideal answers for these and many other questions, but we are cautiously proceeding forward. There is considerable demand for scrambler therapy along with concerns that efficacy has not been proven and that the reported results from it sound too good to be true. But, these concerns are not too surprising, as there is often a wariness when a new therapy is initiated.
Q: Is this therapy routinely offered at places other than Mayo Clinic?
A: Yes, it is available at other select places. I understand there are more than 30 institutions in Italy and even more institutions in South Korea that provide scrambler therapy as a part of clinical practice. Multiple United States military institutions also offer scrambler therapy. In the United States, I estimate that there are between 15 and 30 sites that are actively offering this treatment. It should be noted that there is a learning curve in terms of making this therapy work. For example, in our paper where we looked at CIPN, even though we had reasonably good experience which included visiting the inventor in Rome and being trained by him, we did a whole lot better with the later patients we treated than we did the first 25% we treated.
Q: What type of feedback have you received on the therapy?
A: There are patient testimonials, which can be found on the Internet, whereby patients swear by this therapy. In line with this, I have seen some phenomenal results in patients. We have clinical trial data that asked patients, daily while they were receiving 2 weeks of outpatient therapy and then weekly for 10 weeks of follow-up, whether they would recommend this treatment to others. Approximately 80% of the replies noted that they would recommend it, 1% said that they would not and the rest said that they were unsure. There, admittedly, are some people who say this therapy did not work for them.
Q: How much of an issue is cost?
A: There are the issues regarding the cost of the machine, the cost of training and whether insurance companies cover this therapy. There are some insurance companies that cover the therapy, having realized that it is a lot cheaper than alternative therapies that might be employed for the same patient problem. This is certainly an evolving process. The cost can run anywhere between $200 and $500 per session, and up to 10 sessions may be recommended. This is less expensive than some other procedures and therapies employed for chronic pain, such as spinal cord stimulators. There are some patients who choose to pay for the treatments on their own, if not covered by insurance.
Q: Are there any side effects associated with this therapy? Do they outweigh the benefit, in your opinion?
A: There have not been many documented side effects with this therapy. People feel a buzzing sensation when the machine is working and sometimes this can be uncomfortable. If pain happens during the procedure, the signal intensity should be turned down and/or off. At times the electrode leads can be moved to an alternative site, sometimes by just a couple centimeters. Occasionally, patients may develop some skin irritation or bruising under the sites of the leads. There have been some patients who report more pain in the day or days following the treatment, but it is not apparent that this is more than the normal process of a waxing and waning of the baseline pain. Overall, the reports in the literature have been largely free of side effects.
Q: Is there anything else you would like to add?
A: Although if I consider myself to be a fairly conservative clinician and have not been shy about publishing negative results from many clinical trials, I do believe that scrambler therapy works. This contention is based on the knowledge that the majority of the reports in the literature are positive an also the personal experience I have observed in many patients, including seeing dramatic reductions of symptoms in some patients that did not derive similar benefit from previous treatment approaches. – by Jennifer Southal

Article Provided By:healio.com
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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