Neuropathy and COVID-19, What You Should Know

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4 Aug

Neuropathy and COVID-19, What You Should Know

COVID-19 has been dominating the news and has been a constant worry for people with preexisting conditions. If you’re one of these people and are living with neuropathy, the best thing you can do is to arm yourself with the best information available.

At US Neuropathy Centers, our team of experienced doctors is dedicated not only to treating your neuropathy but helping you safely manage and navigate your way through the COVID-19 crisis.

Neuropathy basics

To understand COVID-19’s effect on neuropathy, you need to understand the condition itself. Here’s some information we put together on the basics of neuropathy.

Your body is made up of many complex systems including your central nervous system. The nervous system consists of your brain, your spine, and a network of nerves called peripheral nerves.

These nerves extend into the other areas of your body, controlling movement and carrying information between your brain and muscles.

Neuropathy, often known as peripheral neuropathy because it affects the peripheral nerves outside your spine and brain, refers to weakened or damaged nerves. There are many reasons you may be experiencing peripheral neuropathy.

For example, chemotherapy treatment, diseases like HIV and shingles, some autoimmune diseases, and exposure to certain toxins can result in loss of sensation. But the most common cause of neuropathy is diabetes.

The nerve damage leaves you with numbness or tingling in your affected extremities. You may even completely lose sensation and reflexes. Managing these symptoms and monitoring your condition is especially important in the middle of the pandemic.

Neuropathy and COVID-19

While there’s no direct link between neuropathy and COVID-19, there are certain circumstances that put you at risk for contracting the virus and experiencing worsened symptoms. Here are a few things you should know about living with neuropathy during this pandemic:

Be aware of your condition

Neuropathy typically indicates the presence of an underlying condition. Diabetes, autoimmune diseases, cancer, and other infections are all causes of neuropathy and all reasons to be extra vigilant with COVID-19 spreading.

Because your immune system is compromised, you’re at a much higher risk of contracting the virus. We recommend that you observe social distancing guidelines and possibly quarantine yourself to prevent the risk of infection.

Know the risk

Because your extremities have lost most or all of their sensation, you might not be aware that you’ve injured yourself and developed an infection.

For example, if you have diabetic neuropathy, it’s now even more important that you control your blood sugar and constantly monitor your feet for signs of ulcers and infections.

If you suffer from neuropathy caused by an autoimmune disease and need regular blood infusions, be aware that most blood donors have not been tested for COVID-19 antibodies. If you’re aware of the risks related to your neuropathy, you can adjust and protect yourself.

Contracting COVID-19

If you do become infected with the virus, you’re not likely to experience any new damage to your cells, but you may have flare-ups of your neuropathic symptoms.

The flu-like effects of COVID-19 may exacerbate the tingling and numbness you normally feel. While this may be uncomfortable, it’s no need to panic. Follow your doctor’s care orders closely until the infection runs its course.

Article Provided By: usneuropathycenters
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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26 Jul

How do I Exercise with Neuropathy?

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.

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.

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.

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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7 Jul

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

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24 Jun

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.

Treatment options

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

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SC

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14 Jun

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, 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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3 Jun

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.

RSD is a little more typical in women than in men. Children can get it, too, but usually it shows up between ages 30 and 60.

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.

RSD can also affect your immune system. This can cause:

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.

There’s no single test that can tell your doctor whether you have RSD. Instead, they’ll rely on a physical exam and your medical history information. There are also a few tests that can provide clues to see if you have certain signs of the condition. These include:

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, 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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26 Apr

The Common Symptoms of Neuralgia

Erica Jacques

Medically reviewed by

Scott Zashin, MD

on July 05, 2020

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 neuropathy, neuropathic 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, 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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13 Apr

Peripheral Neuropathy

Peripheral neuropathy

Peripheral neuropathy, a result of damage to the nerves outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body.
Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. The peripheral nerves also send sensory information to the central nervous system.

Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes.
People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy.

Symptoms
Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Nerves are classified into:
Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin
Motor nerves that control muscle movement
Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder
Signs and symptoms of peripheral neuropathy might include:
Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms
Sharp, jabbing, throbbing or burning pain
Extreme sensitivity to touch
Pain during activities that shouldn’t cause pain, such as pain in your feet when putting weight on them or when they’re under a blanket
Lack of coordination and falling
Muscle weakness
Feeling as if you’re wearing gloves or socks when you’re not
Paralysis if motor nerves are affected
If autonomic nerves are affected, signs and symptoms might include:
Heat intolerance
Excessive sweating or not being able to sweat
Bowel, bladder or digestive problems
Changes in blood pressure, causing dizziness or lightheadedness
Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy) or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy.
When to see a doctor
Seek medical care right away if you notice unusual tingling, weakness or pain in your hands or feet. Early diagnosis and treatment offer the best chance for controlling your symptoms and preventing further damage to your peripheral nerves.

Not a single disease, peripheral neuropathy is nerve damage caused by a number of conditions. Health conditions that can cause peripheral neuropathy include:
Autoimmune diseases. These include Sjogren’s syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and vasculitis.
Diabetes. More than half the people with diabetes develop some type of neuropathy.
Infections. These include certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis B and C, leprosy, diphtheria, and HIV.
Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy.
Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press nerves. Also, polyneuropathy can arise as a result of some cancers related to the body’s immune response. These are a form of a degenerative disorder called paraneoplastic syndrome.
Bone marrow disorders. These include an abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (myeloma), lymphoma and the rare disease amyloidosis.
Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism).
Other causes of neuropathies include:
Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies.
Exposure to poisons. Toxic substances include industrial chemicals and heavy metals such as lead and mercury.
Medications. Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy.
Trauma or pressure on the nerve. Traumas, such as from motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from having a cast or using crutches or repeating a motion such as typing many times.
Vitamin deficiencies. B vitamins — including B-1, B-6 and B-12 — vitamin E and niacin are crucial to nerve health.
In a number of cases, no cause can be identified (idiopathic).
More Information
Peripheral neuropathy care at Mayo Clinic
Hypothyroidism: Can it cause peripheral neuropathy?
Risk factors
Peripheral neuropathy risk factors include:
Diabetes, especially if your sugar levels are poorly controlled
Alcohol abuse
Vitamin deficiencies, particularly B vitamins
Infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis B and C, and HIV
Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues
Kidney, liver or thyroid disorders
Exposure to toxins
Repetitive motion, such as those performed for certain jobs
Family history of neuropathy
Complications
Complications of peripheral neuropathy can include:
Burns and skin trauma. You might not feel temperature changes or pain on parts of your body that are numb.
Infection. Your feet and other areas lacking sensation can become injured without your knowing. Check these areas regularly and treat minor injuries before they become infected, especially if you have diabetes.
Falls. Weakness and loss of sensation may be associated with lack of balance and falling.
Prevention
Manage underlying conditions
The best way to prevent peripheral neuropathy is to manage medical conditions that put you at risk, such as diabetes, alcoholism or rheumatoid arthritis.
Make healthy lifestyle choices
These habits support your nerve health:
Eat a diet rich in fruits, vegetables, whole grains and lean protein to keep nerves healthy. Protect against vitamin B-12 deficiency by eating meats, fish, eggs, low-fat dairy foods and fortified cereals. If you’re vegetarian or vegan, fortified cereals are a good source of vitamin B-12, but talk to your doctor about B-12 supplements.
Exercise regularly. With your doctor’s OK, try to get at least 30 minutes to one hour of exercise at least three times a week.
Avoid factors that may cause nerve damage, including repetitive motions, cramped positions that put pressure on nerves, exposure to toxic chemicals, smoking and overindulging in alcohol.

By Mayo Clinic Staff

Article Provided By: mayoclinic
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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6 Apr

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, 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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23 Mar

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, 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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