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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

 

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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
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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

 

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Femoral Neuropathy

Femoral Neuropathy

Femoral neuropathy, or femoral nerve dysfunction, occurs when you can’t move or feel part of your leg because of damaged nerves, specifically the femoral nerve. This can result from an injury, prolonged pressure on the nerve, or damage from disease. In most cases, this condition will go away without treatment. However, medications and physical therapy may be necessary if symptoms don’t improve.

What causes femoral neuropathy?

The femoral nerve is one of the largest nerves in your leg. It’s located near the groin and controls the muscles that help straighten your leg and move your hips. It also provides feeling in the lower part of your leg and the front of your thigh. Because of where it’s located, damage to the femoral nerve is uncommon relative to neuropathies caused by damage to other nerves. When the femoral nerve is damaged, it affects your ability to walk and may cause problems with sensation in your leg and foot. View the femoral nerve on this BodyMap of the femur.

Damage to the femoral nerve can be the result of:

  • a direct injury
  • a tumor or other growth blocking or trapping part of your nerve
  • prolonged pressure on the nerve, such as from prolonged immobilization
  • a pelvic fracture
  • radiation to the pelvis
  • hemorrhage or bleeding into the space behind the abdomen, which is called the retroperitoneal space
  • a catheter placed into the femoral artery, which is necessary for certain surgical procedures

Diabetes may cause femoral neuropathy. Diabetes can cause widespread nerve damage due to fluctuations in blood sugar and blood pressure. Nerve damage that affects your legs, feet, toes, hands, and arms is known as peripheral neuropathy. There is currently some debate about whether femoral neuropathy is truly a peripheral neuropathy or a form of diabetic amyotrophy.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), diabetes is the most common reason for peripheral neuropathy in people who’ve had diabetes for at least 25 years.

Signs of femoral neuropathy

This nerve condition can lead to difficulties moving around. Your leg or knee might feel weak, and you may be unable to put pressure on the affected leg.

You might also feel unusual sensations in your legs. They include:

  • numbness in any part of the leg (typically the front and inside of the thigh, but potentially all the way down to the feet)
  • tingling in any part of the leg
  • dull aching pain in the genital region
  • lower extremity muscle weakness
  • difficulty extending the knee due to quadriceps weakness
  • feeling like your leg or knee is going to give out (buckle) on you
How serious is it?

Prolonged pressure placed on the femoral nerve can prevent blood from flowing in the affected area. The decreased blood flow can result in tissue damage.

If your nerve damage is the result of an injury, it may be possible that your femoral vein or artery is also damaged. This could cause dangerous internal bleeding. The femoral artery is a very large artery that lies close to the femoral nerve. Trauma often damages both at the same time. Injury to the artery or bleeding from the artery can cause compression on the nerve.

Additionally, the femoral nerve provides sensation to a major portion of the leg. This loss of sensation can lead to injuries. Having weak leg muscles can make you more prone to falling. Falls are of particular concern in older adults because they can cause hip fractures, which are very serious injuries.

Diagnosing femoral neuropathy

Initial tests

To diagnose femoral neuropathy and its cause, your doctor will perform a comprehensive physical exam and ask questions about recent injuries or surgeries, as well as questions about your medical history.

To look for weakness, they will test specific muscles that receive sensation from the femoral nerve. Your doctor will probably check your knee reflexes and ask about changes in feeling in the front part of the thigh and the middle part of the leg. The goal of the evaluation is to determine whether the weakness involves only the femoral nerve or if other nerves also contribute.

Additional testing might include:

Nerve conduction

Nerve conduction checks the speed of electrical impulses in your nerves. An abnormal response, such as a slow time for electrical signals to travel through your nerves, usually indicates damage to the nerve in question.

Electromyography (EMG)

Electromyography (EMG) should be performed after the nerve conduction test to see how well your muscles and nerves are working. This test records the electrical activity present in your muscles when the nerves that lead to them are active. The EMG will determine whether the muscle responds appropriately to stimulation. Certain medical conditions cause muscles to fire on their own, which is an abnormality that an EMG can reveal. Because nerves stimulate and control your muscles, the test can identify problems with both muscles and nerves.

MRI and CT scans

An MRI scan can look for tumors, growths, or any other masses in the area of the femoral nerve that could cause compression on the nerve. MRI scans use radio waves and magnets to produce a detailed image of the part of your body that is being scanned.

A CT scan can also look for vascular or bone growths.

The first step in treating femoral neuropathy is dealing with the underlying condition or cause. If compression on the nerve is the cause, the goal will be to relieve the compression. Occasionally in mild injuries, such as mild compression or a stretch injury, the problem may resolve spontaneously. For people with diabetes, bringing blood sugar levels back to normal may alleviate nerve dysfunction. If your nerve doesn’t improve on its own, you’ll need treatment. This usually involves medications and physical therapy.

Medications

You might have corticosteroid injections in your leg to reduce inflammation and get rid of any swelling that occurs. Pain medications can help relieve any pain and discomfort. For neuropathic pain, your doctor may prescribe medications, such as gabapentin, pregabalin, or amitriptyline.

Therapy

Physical therapy can help build up the strength in your leg muscles again. A physical therapist will teach you exercises to strengthen and stretch your muscles. Undergoing physical therapy helps to reduce pain and promote mobility.

You might need to use an orthopedic device, such as a brace, to assist you with walking. Usually, a knee brace is helpful in preventing knee buckling.

Depending on how severe the nerve damage is and how much trouble you’re having moving around, you might also need occupational therapy. This type of therapy helps you learn to do regular tasks like bathing and other self-care activities. These are called “activities of daily living.” Your doctor might also recommend vocational counseling if your condition forces you to find another line of work.

Surgery

Your doctor might recommend surgery if you have a growth blocking your femoral nerve. Removing the growth will relieve the pressure on your nerve.

Long-term outlook after treatment

You might be able to heal fully after you treat the underlying condition. If the treatment isn’t successful or if the femoral nerve damage is severe, you might permanently lose feeling in that part of your leg or the ability to move it.

Tips to prevent nerve damage

You can lower your risk of femoral neuropathy caused by diabetes by keeping your blood sugar levels under control. This helps protect your nerves from damage caused by this disease. Preventive measures would be directed at each cause. Talk to your doctor for advice about what preventive measures would be the best for you.

Maintaining an active lifestyle helps to keep your leg muscles strong and improve stability.

Last medically reviewed on September 13, 2017

 

Article Provided By: healthline

Photo by Arnel Hasanovic on Unsplash

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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
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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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
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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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Carpal Tunnel Syndrome

Carpal tunnel syndrome

Carpal tunnel syndrome is caused by pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. When the median nerve is compressed, the symptoms can include numbness, tingling and weakness in the hand and arm.

The anatomy of your wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome.
Proper treatment usually relieves the tingling and numbness and restores wrist and hand function.

Symptoms
Carpal tunnel syndrome symptoms usually start gradually and include:
Tingling or numbness. You may notice tingling and numbness in your fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not your little finger. You might feel a sensation like an electric shock in these fingers.
The sensation may travel from your wrist up your arm. These symptoms often occur while holding a steering wheel, phone or newspaper, or may wake you from sleep.
Many people “shake out” their hands to try to relieve their symptoms. The numb feeling may become constant over time.
Weakness. You may experience weakness in your hand and drop objects. This may be due to the numbness in your hand or weakness of the thumb’s pinching muscles, which are also controlled by the median nerve.
When to see a doctor
See your doctor if you have signs and symptoms of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Permanent nerve and muscle damage can occur without treatment.

Causes
Carpal tunnel syndrome is caused by pressure on the median nerve.
The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).
Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation caused by rheumatoid arthritis.
Many times, there is no single cause of carpal tunnel syndrome. It may be that a combination of risk factors contributes to the development of the condition.
Risk factors
A number of factors have been associated with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the median nerve. These include:
Anatomic factors. A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve.
People who have smaller carpal tunnels may be more likely to have carpal tunnel syndrome. Carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller in women than in men.
Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don’t have the condition.
Nerve-damaging conditions. Some chronic illnesses, such as diabetes, increase your risk of nerve damage, including damage to your median nerve.
Inflammatory conditions. Rheumatoid arthritis and other conditions that have an inflammatory component can affect the lining around the tendons in your wrist and put pressure on your median nerve.
Medications. Some studies have shown a link between carpal tunnel syndrome and the use of anastrozole (Arimidex), a drug used to treat breast cancer.
Obesity. Being obese is a risk factor for carpal tunnel syndrome.
Body fluid changes. Fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve. This is common during pregnancy and menopause. Carpal tunnel syndrome associated with pregnancy generally gets better on its own after pregnancy.
Other medical conditions. Certain conditions, such as menopause, thyroid disorders, kidney failure and lymphedema, may increase your chances of carpal tunnel syndrome.
Workplace factors. Working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve or worsen existing nerve damage, especially if the work is done in a cold environment.
However, the scientific evidence is conflicting and these factors haven’t been established work as direct causes of carpal tunnel syndrome.
Several studies have evaluated whether there is an association between computer use and carpal tunnel syndrome. Some evidence suggests that it is mouse use, and not the use of a keyboard, that may be the problem. However, there has not been enough quality and consistent evidence to support extensive computer use as a risk factor for carpal tunnel syndrome, although it may cause a different form of hand pain.
Prevention
There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists with these methods:
Reduce your force and relax your grip. If your work involves a cash register or keyboard, for instance, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink.
Take short, frequent breaks. Gently stretch and bend hands and wrists periodically. Alternate tasks when possible. This is especially important if you use equipment that vibrates or that requires you to exert a great amount of force. Even a few minutes each hour can make a difference.
Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. Keep your keyboard at elbow height or slightly lower.
Improve your posture. Incorrect posture rolls shoulders forward, shortening your neck and shoulder muscles and compressing nerves in your neck. This can affect your wrists, fingers and hands, and can cause neck pain.
Change your computer mouse. Make sure that your computer mouse is comfortable and doesn’t strain your wrist.
Keep your hands warm. You’re more likely to develop hand pain and stiffness if you work in a cold environment. If you can’t control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.

Article Provided By: mayoclinic.org
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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Nerve Pain in the Leg

Nerve Pain in the Leg

By Grant Cooper, MD

Nerves in the leg may become inflamed, compressed, or degenerated as a result of mechanical or chemical irritants. Nerves may also become damaged due to associated conditions such as diabetes or nutritional deficiencies. Depending on the cause of nerve damage, the specific leg symptoms may differ.
Nerve pain is typically described as sharp, shooting, electric-like, or searing pain. It may also produce a sensation of hot or warm water running down the thigh and/or leg. In some individuals, a dull ache may occur. The pain may be intermittent or constant.

The most common types of nerve pain in the leg are described below.

Sciatica is radicular nerve pain that occurs when the sciatic nerve roots in the lower back are irritated or compressed.
Radiculopathy
The medical term for leg pain that originates from a problem in the nerve roots of the lumbar and/or sacral spine is radiculopathy (the lay term is sciatica). This pain may be caused when the nerve roots are inflamed, irritated, or compressed. The characteristics of this pain depend on the specific nerve root(s) affected.

Research indicates 95% of radiculopathy in the lumbosacral spine occurs at the L4-L5 and L5-S1 levels. The pain from these nerve roots is characterized by:
Pain that originates in the lower back or buttock and travels down the thigh, calf, and foot.
Numbness in the calf, foot, and/or toes.
Weakness in the hip, thigh, and/or foot muscles.
Depending on the individual, additional sensations may occur, such as a feeling of pins-and-needles in the leg, warm water running down the thigh, or the foot immersed in hot water. Radiculopathy typically affects one leg.

Peripheral Neuropathy
Damage to one or more nerves in the peripheral nervous system (outside the brain and spinal cord) is called peripheral neuropathy. This form of neuropathy in the leg most commonly occurs due to diabetes.
Pain that originates in the toes and gradually spreads toward the knee (also called stocking-glove pattern; the action of putting on a stocking)
Numbness in the legs and feet
Weakness in the toes and ankles during the later stages of the condition
Peripheral neuropathy pain typically affects both legs.

Lumbosacral Radiculoplexus Neuropathy
This condition occurs due to inflammation of small blood vessels in the legs leading to reduced blood supply to the nerves, resulting in nerve damage. This condition is commonly seen in diabetic individuals and may also be caused by other issues. Common symptoms include:
Pain that usually begins in a specific location, such as the buttock, hip, thigh, leg, or foot and gradually spreads to other areas of the leg
Numbness and a prickling feeling in the affected areas
Weakness in the leg muscles
Loss of balance, which may cause falls.
Typically, several nerves are affected together. The condition may develop in one leg and over time involve both legs.

Peroneal Neuropathy
Compression of the peroneal nerve near the knee may cause symptoms in the leg. Typical symptoms include:
Foot drop, characterized by the inability to lift the foot, or a catch in the toes while walking
Numbness along the side of the leg, the upper part of the foot, and/or the first toe web space
Pain is not a typical feature of this condition but may be present when peroneal neuropathy occurs as a result of trauma.

Meralgia Paresthetica
Compression of the lateral femoral cutaneous nerve in the thigh may cause a condition called meralgia paresthetica. Symptoms typically include:
Burning or achy pain in the outer side and/or front of the thigh
Coldness in the affected areas
Buzzing or vibrations (such as from a cell phone) in the thigh region
Meralgia paresthetica pain typically increases while standing or walking and alleviates while sitting.

Tarsal Tunnel Syndrome
Dysfunction of the tibial nerve due to nerve compression within the foot’s tarsal tunnel causes this syndrome. Common symptoms include:
Sharp, shooting pain in the inner ankle joint and along the sole of the foot
Numbness in the sole of the foot
Tingling and/or burning sensation in the foot
The symptoms typically worsen at night, with walking or standing, and/or after physical activity; and get better with rest.

Neurogenic Claudication
This type of leg pain occurs due to narrowing of the spinal canal (spinal stenosis) causing compression of the spinal cord. This compression may occur due to bone spurs (abnormal bone growth), lumbar disc herniation, or spondylolisthesis (forward slippage of a vertebra).
The symptoms of neurogenic claudication typically occur in both legs and include:
Pain and numbness while walking, standing, or performing upright exercises
Weakness during leg movements
Neurogenic claudication pain typically increases while bending the spine backward and decreases while bending forward at the waist, sitting, or lying down.

A qualified medical professional can help diagnose the exact cause of nerve pain in the leg based on the type of presenting symptoms, medical history, and by performing certain clinical tests.

Article Provided By: spine-helath.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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How to Approach Allergy Season with Chronic Pain

How to Approach Allergy Season with Chronic Pain

Seasonal allergies are one of the leading causes of chronic illness in the United States, affecting millions every year. However, for people who suffer from other forms of chronic pain such as rheumatoid arthritis, back and muscle pain, or fibromyalgia, seasonal allergies can prove an even bigger challenge to overcome.

By
Zachary Pottle
Monday, March 1, 2021

As winter begins to subside in many states across America, spring brings about long-awaited warm weather, outdoor activities, and a break from the dreary winter months. However, rising temperatures bring about one of the most notorious markers of spring: seasonal allergies. Cars everywhere begin to don an unmistakable yellow hue. Eyes start to itch, noses start to run, and the novelty of springtime is soon ruined for millions.
Allergy season can be extremely tough for the more than 50 million Americans that experience some type of seasonal allergy each year, according to the Asthma and Allergy Foundation of America. Yet, for people who suffer from chronic pain or illness, allergy season can prove to be an even bigger challenge.
What are seasonal allergies?
Seasonal allergies are most commonly caused by pollen, a powdery substance consisting of pollen grains used to fertilize plants of the same species. Pollen is typically released by trees, grasses, and weeds anywhere from spring into summer and late fall respectively. The light, dry substance is released by the plants and carried by the wind, which makes it almost impossible to avoid; some pine pollen has reportedly traveled up to 1800 miles away from its source tree.
For most, the culprit of their seasonal allergies is grasses and weeds. Thought to be the most common type of allergen across the United States is a weed species named ragweed, which flowers in late August to early September. While ragweed only lives for one single season out of the year, its ability to release over one billion pollen grains, some of which have been reported to travel over 400 miles, proves it to be a fierce allergen.
When is allergy season?
Allergy season can range anywhere from early spring (February to March), to late fall (September to October). The type of pollen being released into the air differs with the seasons, which can be a very important tidbit of knowledge for those who know which type of pollen they are sensitive to. Three major groups of allergens can be attributed to seasonal allergies: trees, grasses, and weeds, each of which peaks at different times of the year.
Trees are among the first to release their pollen each year, starting as early as February, with a peak in pollen counts around April and May. Some of the most common tree pollen allergies are to trees such as birch, ash, cedar, elm, and oak.
Grasses tend to begin their pollination in early spring (March or April typically), and often coincide their peak pollen counts, unfortunately for many, with that of trees, and often carry those high levels into June and July. Popular grass allergens are johnsongrass, ryegrass, orchard grass, and bermudagrass to name a few.
Unfortunately, weeds tend to start their pollination just as grass pollen levels begin to subside. Around the peak of summer, July and August, weed pollen levels begin to rise drastically, and by September they are at their highest. Other weed allergens that prove troublesome for many are pigweed, tumbleweed, and sagebrush.
How do allergies affect people with chronic pain?
The link between allergies and chronic pain or illness is often overlooked. It’s easy to dismiss the two as being related, but they go more hand in hand than many may understand. Allergies are a direct result of the immune system’s accidental response to foreign bodies like pollen that are otherwise harmless. When the immune system combats these allergens, it releases antibodies into the bloodstream, which in turn produces the symptoms of an allergic reaction. For those who suffer from chronic pain or illness, allergies can prove to be challenging, as many of the symptoms are easily confused for one another. Understanding how seasonal allergies can affect chronic pain and illness can be a useful tool in combating allergy season and alleviating unwanted added stress on one’s body.
For those who may suffer from chronic pain related to rheumatoid arthritis or other muscle or joint pain, immune responses to allergies can add unwanted stress to an already strained immune system. Some of the most common symptoms of seasonal allergies are inflammation and joint pain. This “doubling down” of inflammation can often make symptoms feel worse than they otherwise would be, making it hard to determine the root cause.Seasonal allergies also bring with them the addition of symptoms such as coughing and sneezing. These symptoms, whilst easy to attribute to allergies, are extremely challenging for those with chronic pain in their back, neck, and spine. Coughing and sneezing produce violent, quick movements in both the neck and back, which for many may already be a cause of debilitating pain. Coughing can also add to this pain, and in some cases cause it. People with recent injuries to their back, neck, or spine, are at an increased risk of injuries such as herniated disks and muscle strain, which can be triggered by the sudden, abrupt movement of the back.
The added fatigue that can come with seasonal allergies can also be troublesome for those with chronic pain or illness. Symptoms of fibromyalgia can include chronic fatigue and tiredness, the inability to sleep, headaches and migraines, and problems with memory and concentration. All of these symptoms can be worsened with the addition of seasonal allergies, which can cause all of the above symptoms. The addition of any added symptom or ailment can be difficult to overcome for many, especially when one can suffer from more than one type of pollen allergy, which can lead to months of suffering.
What can you do?
While avoiding seasonal allergies can seem impossible, in many cases avoiding any kind of pollen would mean simply staying indoors for months at a time. Still, there are steps one can take to enjoy the outdoors and avoid serious allergic reactions.
Shower After Being Outdoors: This may seem obvious to many, but showering immediately after being outdoors can greatly reduce the amount of pollen that is not only on the body but also in the home. It is also important to wash the clothes that have been outdoors immediately after returning and to refrain from wearing them again until they have been washed.
Regularly Change Air Filters in Home: One of the most effective ways to prevent pollen from entering the house is to change air filters frequently. The Environmental Protection Agency (EPA) recommends that households use a HEPA filter (high-efficiency particulate air) when choosing an air filter replacement. These air filters can prevent 99.97% of all dust, pollen, mold, bacteria, and airborne particles and should be changed with regards to the manufacturer’s instructions.
Wash Bedding at Least Once a Week: While showering, washing clothes, and changing air filters can all help reduce pollen in the house, some pollen, especially from plants with stickier pollen like that of the dandelion or other insect-pollinated plants and flowers, can stick to the body and make their way past all of these defenses. Washing bed sheets at least once a week can be a great way to reduce stubborn pollen in the house.
Consult an Allergist: It’s important to understand one’s body and its sensitivity to pollen. Consulting an allergy specialist can be an effective way to combat seasonal allergies, as it can give individuals insight into what specifically is the cause of their allergies. Allergists are typically a good solution for those who may suffer from more severe, recurring seasonal allergies.
Understand Pollen Levels: Finally, it is important to understand that there may be some days in which outdoor activities may not be a reasonable undertaking. Monitor pollen levels in the local area and plan accordingly. Along with local news stations and online sites, there are numerous phone apps dedicated to monitoring pollen levels that will give real-time data in a specific area. On days where pollen levels are forecasted to be high, avoid outdoor activities to reduce the risk of an allergic reaction.

Article Provided By: painresource.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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