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11 Oct

Cervical Spinal Stenosis: Causes, Symptoms, Treatment

Written by Joshua M. Ammerman, MD

Most people who have cervical spinal stenosis are adults in their 50s and 60s who may have had neck pain for several years.

What Causes Cervical Spinal Stenosis?

A common cause of cervical spinal stenosis is degeneration, or wear and tear affecting the anatomical structures in your neck due to aging. That’s why most people who have cervical spinal stenosis are adults in their 50s and 60s who may have had neck pain for several years. Injury or trauma may also cause or contribute to the development of spinal stenosis.

Whether degeneration is natural (ie, age-related) or helped along by the long-term effects of previous injury, smoking or poor posture—structural changes develop altering spinal function. The intervertebral disc is a good example. One or more discs may lose elasticity, resiliency to handle loads and forces created during everyday activities (eg, walking, lifting), disc shape may change, discs may become thin and flatten (loss of disc height), bulge or herniate. These changes can affect the amount of space between two vertebral bodies, potentially narrowing nerve passageways (neural foramen) leading to nerve compression.

Degeneration can also affect the spine’s facet joints, often caused by spondylosis, or spinal osteoarthritis. People with osteoarthritis may develop bone spurs, or osteophytes, which is your body’s attempt to stop or remedy joint dysfunction. Bone spurs can form around your discs, facet joints, and spinal nerves, causing spinal stenosis.

Symptoms of Cervical Spinal Stenosis

When spinal nerves are compressed or pinched in your neck, symptoms and severity varies—pain, weakness, tingling, and other neurological symptoms may travel into your shoulders, arms, and legs. Cervical radiculopathy is the medical term for nerve-related symptoms that travel from your neck into your arms.

Cervical radiculopathy can affect sensation and function in different areas of your upper body based on the nerve or nerve(s) that are compressed. For example, radiculopathy at the C6 (the sixth pair of nerve roots in your cervical spine) is associated with bicep weakness and reduced bicep reflex. On the other hand, C7 radiculopathy is associated with triceps weakness.

While spinal stenosis can impact select nerves or groups of nerves in your neck, more advanced cases involve a narrowing of the spinal canal that compresses your spinal cord. Spinal cord compression in your neck is called cervical myelopathy, and it can be a serious condition causing significant symptoms such as problems with balance and difficulty walking.

How Your Doctor Diagnoses Cervical Spinal Stenosis

After reviewing your medical history and symptoms, your doctor performs a physical and neurological examination. For diagnostic purposes, you may be asked to bend or twist your neck (Spurling’s maneuver) to replicate your symptoms. Your doctor will test your muscle strength, reflexes, and observe you walking to assess balance and gait. There are many different types of tests to evaluate function, sensation, and balance.

Plain x-rays are a first-line imaging test that can reveal structural changes, such as loss of disc height, bone spurs and spondylosis. Other imaging studies may be necessary, such as a magnetic resonance imaging (MRI) scan to evaluate your spinal cord, nerves and other soft tissues. Imaging studies help your doctor to confirm spinal stenosis and pinpoint its cause.

Treatment Options for Cervical Spinal Stenosis

Most people with spinal stenosis do not need surgery. For many patients, nonsurgical treatments—and there are many options—effectively reduce and manage pain and symptoms. Your doctor may recommend one therapy or combine it with different types of treatment. There are various types of drugs and medications, passive and active physical therapies, and spinal injections—some patients find acupuncture is helpful.

Spine surgery may be considered if nonoperative treatments are ineffective and/or symptoms worsen, which may happen quickly or progressively over time. There are cases when surgery is the first treatment, such as acute disc herniation, fracture or severe neurological deficit develops (cervical myelopathy).

Surgical Treatment of Cervical Spinal Stenosis

The goal of surgery is to take pressure off the spinal cord and/or nerves—this is called decompression. There are different types of decompression procedures to treat spinal stenosis affecting the spinal canal (spinal cord; central spinal stenosis) and/or neural foramen (nerves; lateral spinal stenosis). Sometimes instrumentation and fusion are performed after spinal decompression to stabilize the cervical spine. Alternatively, certain patients may be candidates for motion preserving spinal implants, so-called cervical arthroplasty.

Typical surgical procedures performed to treat spinal stenosis affecting the neck include:

Anterior cervical discectomy and fusion (ACDF)
Laminectomy or laminotomy
Foraminotomy
Cervical arthroplasty (ie, artificial disc)

Advances in spine surgery have made it possible to perform some procedures using minimally invasive techniques and sometimes on an outpatient basis. Minimally invasive spine surgery has many benefits for you as a patient, including smaller incisions and faster recovery times. If you are a candidate for surgical treatment of your spinal stenosis, your doctor will discuss his recommendations and why with you.

Updated on: 07/26/19

Article Provided By: spineuniverse

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21 Sep

Peripheral Neuropathy

Peripheral neuropathy, a result of damage to the nerves located outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in the hands and feet. It can also affect other areas and body functions including digestion, urination and circulation.

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, perspiration, heart rate, digestion and bladder function

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
Drops 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.

Causes

Peripheral neuropathy is nerve damage caused by a number of different 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. This is the most common cause. Among people with diabetes, more than halfwill 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 on 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.
Injury or pressure on the nerve. Injuries, 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).

Risk factors

Peripheral neuropathy risk factors include:

Diabetes, especially if your sugar levels are poorly controlled
Alcohol misuse
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 injuries. 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: mayo clinic

Photo by Sangga Rima Roman Selia on Unsplash

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9 Sep

Causes and Treatment of a Pinched Nerve In The Back

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Causes and treatment of a pinched nerve in the back

An injury, a herniated disc, or an underlying medical condition can cause a pinched nerve in the back — resulting in pain, numbness, or tingling sensations.

The symptoms of a pinched nerve in the back sometimes also affect surrounding areas.

Below, we investigate what a pinched nerve in the back is, what it may feel like, and when to see a doctor. We also explore the causes and treatments, as well as exercises that may help.

What is a pinched nerve?

A doctor reviews an x-ray showing a pinched nerve in the back. — The severity and cause of a pinched nerve in the back will determine the best treatment option.

Nerves in the spine can be compressed by surrounding bone or tissue. If this happens, a person has a pinched nerve in their back.

Nerves are responsible for sending signals to the brain. When a nerve is compressed, the pressure disrupts the signals, resulting in symptoms.

Symptoms

A pinched nerve often causes pain, numbness, and tingling. The location of these symptoms depends on that of the compressed nerve.

If a pinched nerve is at the top of the spine, symptoms may affect the neck or arms. Doctors call this issue cervical radiculopathy.

Symptoms of a pinched nerve in the upper back can include:

pain that starts in the neck and may travel down the arm
tingling sensations in the hand, or specifically the fingers
weakness in the arm, shoulder, or hand
numbness

Nerves in the lower back can also become compressed. Doctors refer to this as lumbar radiculopathy. This condition often manifests as sciatica.

Symptoms of a pinched nerve in the lower back can include:

pain that radiates from the lower back to the legs or feet
numbness and tingling in the legs or feet
muscle spasms or weakness

If a person does not experience tingling or numbness, they may have a different type of back pain, such as muscle pain. This can occur due to wear and tear, sprains, or weakness.

Causes

An injury can damage tissues in the spine or cause them to become inflamed. In either case, it can put pressure on the nerves.

Other causes of a pinched nerve in the back can include:

A herniated disk: The disks between the vertebrae in the spine can become compressed and bulge, putting pressure on nearby nerves.
Spinal stenosis: This refers to a narrowing of the spinal column, which puts excess pressure on the nerves around the spinal cord.
Arthritis: This causes inflammation around joints and bones, which can increase pressure on nerves in the spine.
Bone spurs: A bone spur is an extra growth of bone, which can form on the spine and compress surrounding nerves, causing reoccurring episodes of pain.
Spondylolisthesis: This involves a vertebra in the lower spine dislodging and pinching nerves.
Infection: The vertebrae or disks of the spine can become infected, leading to inflammation and nerve pain.

Risk factors

Certain factors make developing back pain more likely. They include:

Aging: The disks between the vertebrae lose their ability to cushion with age, increasing a person’s risk of a pinched nerve. Spinal stenosis also becomes more likely with age.
Physical fitness: People who do little exercise or who have weaker abdominal muscles are more likely to develop back pain, possibly from an injury. The same is true for people who are generally inactive but then try intense physical exercise.
Overweight or obesity: Both place extra strain on the back, making back pain more likely.
Uneven posture: If the neck, shoulders, spinal column, or hips are out of alignment for prolonged periods, it can place pressure on nerves in the back.

Diagnosis

A doctor may be able to diagnose a pinched nerve with only a physical examination. They may also perform tests to check the person’s reflexes and muscle movement.

The doctor may ask the person to demonstrate their range of motion, such as by lifting a leg while keeping it straight. This can also indicate which movements trigger pain. All of this information can help with a diagnosis.

In some cases, the doctor may need further tests to determine the exact location and cause of a pinched nerve. Tests may include:

an X-ray, which can show structural problems, such as bone spurs
an MRI, which can show the condition of the spinal cord, disks, and nerves
a CT scan to examine the spinal structures
electromyography, which shows the electrical impulses of muscles

Treatment

The right treatment depends on the severity and cause of a pinched nerve.

Some people can treat a pinched nerve in the back at home, while others require professional treatment. Recovery may take days or weeks.

Plenty of rest and gentle movements can help the body repair. Avoiding strenuous exercise and heavy lifting is key to supporting recovery and preventing further damage.

Over-the-counter pain relief medication, such as nonsteroidal anti-inflammatory drugs, may help relieve pain and reduce inflammation.

If a person has pain in the top of the spine, a cervical collar may help. This is a soft, padded support structure that wraps around the neck, helping the neck muscles rest and relieving nerve pressure caused by neck movement.

When pressure on a nerve is severe or chronic, a doctor may suggest oral or injected steroids to reduce swelling and pain, particularly any that radiates to the lower body.

Some people require surgery to correct the cause of pressure and stabilize the spine.

People with numbness, tingling, weakness, or pain should contact a doctor before trying any exercises, as some can make pinched nerve symptoms worse.

Once the pain improves, certain exercises can support recovery, help restore movement, and prevent the issue from returning.

When looking for exercises to help with back pain, it is best to seek professional advice.

The following exercises may help. But — as always — if pain, numbness, or tingling worsen, stop the exercise right away.

To try an exercise for the neck and top of the spine:

Sit or stand upright, facing forward.
Place the fingers of one hand on your chin and gently push the head back, keeping the shoulders in place and the head facing forward.
A person should feel a stretch in the back of the neck and a contraction in the front of the neck.
Hold the position for 1–2 seconds, then gently release it.
Repeat 8–10 times, three to four times per day.
Continue for 2 weeks after the symptoms resolve to help prevent them from returning.

Lumbar rotation

To try an exercise for the lower back:

A woman does a lower back exercise, which may help a pinched nerve in the back.

Lie on the back, with the legs bent and the feet flat on the floor.
Gently rock the knees from side to side, allowing the back to rotate slightly.
Only move within a range that is pain-free.
Repeat this 10–15 times per session.

Back extensions

A woman completes a sciatica exercise, which may help a pinched nerve in the back.

To try an exercise for sciatica:

Lie flat facing downward.
Bend the elbows and rest the forearms flat on the floor.
Look straight down at the floor, keeping the neck straight.
Gently arch the back upward, keeping the hips and forearms pressed into the floor.
Keep the neck straight, without bending it back.
Hold the position for 5–10 seconds, remembering to breathe.
Gently lower the back to the floor.
Repeat the stretch 8–10 times per session.

Proper alignment of the head, neck, and spine is also important for reducing back pain; an uneven posture can put extra pressure on the nerves.

To put less strain on the neck and back, be sure to sit and stand with the shoulders back and the ears aligned with the shoulders.

When to see a doctor

Anyone with the following symptoms should seek immediate medical care.

sudden, severe, or continuous numbness, weakness, or paralysis in an arm or leg
loss of control of bladder or bowel function
loss of sensation in the genital or anal area
severe pain or weakness in the legs, making it difficult to walk or rise from sitting

These symptoms may indicate compression of the spinal cord, which is a medical emergency.

Also, see a doctor if back pain continues without improvement for a few weeks or symptoms are severe or getting worse.

Summary

Most people make a full recovery from a pinched nerve in the back.

Some find that symptoms resolve with home care. Getting plenty of rest, avoiding strenuous activity, and taking pain medication can help.

Certain gentle exercises may also help, but check with a doctor first, and stop any exercise that causes or worsens symptoms.

More severe or chronic pain may require steroid injections or surgery.

If a person experiences sudden paralysis, loss of bowel or bladder control, or severe weakness, they should receive emergency care.

Article Provided By: medicalnewstoday

Feature Photo by Gabe Pierce on Unsplash

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23 Aug

Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

Carpal tunnel syndrome is when the median nerve is compressed as it passes through the carpal tunnel. The carpal tunnel is an opening in your wrist that is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. The median nerve provides sensory and motor functions to the thumb and 3 middle fingers. If it gets compressed or irritated, you may have symptoms.

WHAT YOU NEED TO KNOW

Carpal tunnel release is one of the most common hand conditions requiring surgery.
Symptoms may include tingling, pain, numbness or weakness in the thumb through ring fingers of the affected hand.
Women get carpal tunnel syndrome three times more often than men.
Carpal tunnel syndrome is a progressive condition that can worsen without proper care.
Symptoms of carpal tunnel syndrome often occur during pregnancy and can be alleviated with nonsurgical treatments. Symptoms often improve after delivery, but such patients are at higher risk of developing carpal tunnel syndrome later in life.

What causes carpal tunnel syndrome?

Most cases of carpal tunnel syndrome have no specific cause, although any or all of the following may be a contributing factor:

Frequent, repetitive, small movements with the hands (such as with typing or using a keyboard)
Frequent, repetitive, grasping movements with the hands (such as with sports and certain physical activities)
Joint or bone disease (for example, arthritis, osteoarthritis, or rheumatoid arthritis)
Hormonal or metabolic changes (for example, menopause, pregnancy, or thyroid imbalance)
Changes in blood sugar levels (may be seen with type 2 diabetes)
Other conditions or injuries of the wrist (for example, strain, sprain, dislocation, break, or swelling and inflammation)
Family history of carpal tunnel syndrome

What are the symptoms of carpal tunnel syndrome?

These are the most common symptoms:

Weakness when gripping objects with one or both hands
Pain or numbness in one or both hands
“Pins and needles” feeling in the fingers
Swollen feeling in the fingers
Burning or tingling in the fingers, especially the thumb and the index and middle fingers
Pain or numbness that is worse at night, interrupting sleep

The symptoms of carpal tunnel syndrome may be similar to other medical conditions or problems. Always see your health care provider for a diagnosis.

How is carpal tunnel syndrome diagnosed?

Your provider will check your medical history and give you a physical exam. He or she may recommend that you have electrodiagnostic tests on your nerves. These tests are the best way to diagnose carpal tunnel syndrome. Electrodiagnostic tests stimulate the muscles and nerves in your hand to see how well they work.

Treatment of carpal tunnel syndrome

Your health care provider will figure out the best treatment for you based on:

Your age
Your overall health and medical history
How bad your wrist is right now
How well you tolerate specific medications, procedures, or therapies
How bad the disease is expected to get
Your opinion or preference

Treatment may include:

Splinting your hand. This helps keep your wrist from moving. It also eases the compression of the nerves inside the tunnel.
Anti-inflammatory medication. These may be oral or injected into the carpal tunnel space. These reduce the swelling.
Surgery. This eases compression on the nerves in the carpal tunnel.
Worksite changes. Changing position of your computer keyboard or making other ergonomic changes can help ease symptoms.
Exercise. Stretching and strengthening exercises can be helpful in people whose symptoms have gotten better. These exercises may be supervised by a physical or occupational therapist.

Article Provided By: hopkinsmedicine
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18 Aug

Postherpetic Neuralgia

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Postherpetic neuralgia

Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.

The chickenpox (herpes zoster) virus causes shingles. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time.

Symptoms

The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred — most commonly in a band around your trunk, usually on one side of your body.

Signs and symptoms might include:

Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching.
Sensitivity to light touch. People with the condition often can’t bear even the touch of clothing on the affected skin (allodynia).
Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

When to see a doctor

See a doctor at the first sign of shingles. Often the pain starts before you notice a rash. Your risk of developing postherpetic neuralgia is lessened if you begin taking antiviral medications within 72 hours of developing the shingles rash.

Causes

Once you’ve had chickenpox, the virus remains in your body for the rest of your life. As you age or if your immune system is suppressed, such as from medications or chemotherapy, the virus can reactivate, causing shingles.

Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles. Damaged fibers can’t send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic, often excruciating pain that can last months — or even years.

Risk factors

When you have shingles, you might be at greater risk of developing postherpetic neuralgia as a result of:

Age. You’re older than 50.
Severity of shingles. You had a severe rash and severe pain.
Other illness. You have a chronic disease, such as diabetes.
Shingles location. You had shingles on your face or torso.
Your shingles antiviral treatment was delayed for more than 72 hours after your rash appeared.

Complications

Depending on how long postherpetic neuralgia lasts and how painful it is, people with the condition can develop other symptoms that are common with chronic pain such as:

Depression
Fatigue
Difficulty sleeping
Lack of appetite
Difficulty concentrating

Prevention

The Centers for Disease Control and Prevention (CDC) recommends that adults 50 and older get a Shingrix vaccine to prevent shingles, even if they’ve had shingles or the older vaccine Zostavax. Shingrix is given in two doses, two to six months apart.

The CDC says two doses of Shingrix is more than 90 percent effective in preventing shingles and postherpetic neuralgia. Shingrix is preferred over Zostavax. The effectiveness may be sustained for a longer period of time than Zostavax. Zostavax may still be used sometimes for healthy adults age 60 and older who aren’t allergic to Zostavax and who don’t take immune-suppressing medications.

By Mayo Clinic Staff

Article Provided By: mayo clinic
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10 Aug

The Lowdown on Living with Neuropathy

May 7 to 13 is National Neuropathy Awareness Week. The week highlights the national effort to educate the public on neuropathy’s causes, treatments, and prevention strategies. If you or someone you care for is living with neuropathy, the week presents an excellent opportunity to learn more about this condition and help others.

What Is Neuropathy?

Approximately 20 million Americans are living with peripheral neuropathy. While the term “neuropathy” simply means “nerve damage,” peripheral neuropathy is the impairment of the nerves in the body’s outer extremities — such as the hands and feet. While the explanation for an individual’s neuropathy is sometimes unknown, a wide range of factors can cause it. Here are some causes of this chronic neurological disease.

Trauma from injury and repetitive stress is the most common cause, and medical treatments, like certain types of chemotherapy and surgeries, can damage nerves.
Nearly 70 percent of people with diabetes live with some level of neuropathy.
Inflammation from autoimmune diseases like lupus and rheumatoid arthritis can destroy nerve fibers.
The majority of people on dialysis for kidney disease develop neuropathy because excess toxic chemicals accumulate and damage nerves.
Infections, both bacterial and viral, are a major cause of neuropathy.
Heavy drinking can cause irreversible nerve damage.

Diagnosing Neuropathy

Symptoms of neuropathy depend on the type of nerve damaged. Associated with muscle weakness, motor nerve damage symptoms include decreased reflexes, twitching, and cramping. Sensory nerve damage leads to loss of sensation and is a leading cause of falls among older adults. It also causes difficult-to-treat neuropathic pain. Common symptoms of neuropathy include:

Tingling, burning, or numb sensations
Hypersensitive to touch
Stabbing or shooting pains
Muscle cramps and loss of muscle mass
Dizziness and balance issues
Weakness

To diagnose neuropathy, health care professionals begin with a physical and neurological exam, and gather your medical history. They may order any number of tests and screenings to expand their search or confirm suspicions. Tests might include skin and nerve biopsies and magnetic resonance imaging (MRI) scans. Nerve conduction velocity tests — used to determine damage to large nerve fibers — and those that measure muscles’ electrical activity help pinpoint neuropathy’s physical effects.

Treating Neuropathy

The good news for those living with neuropathy is that it is sometimes reversible. Peripheral nerves do regenerate. Simply by addressing contributing causes such as underlying infections, exposure to toxins, or vitamin and hormonal deficiencies, neuropathy symptoms frequently resolve themselves.

In most cases, however, neuropathy is not curable, and the focus for treatment is managing symptoms. Assistive devices, pain management, and physical therapy make a tremendous difference for those living with neuropathy. Technologies — from specialized footwear to electrical nerve stimulation devices — offer hope for the future.

Preventing Neuropathy

Whether you have to quit smoking, control blood sugar levels, avoid alcohol, or implement aggressive self-care, you can likely manage symptoms and stall neuropathy’s progression. Some people even make changes to their routine to greatly reduce their risk of ever acquiring it. Eating a healthy diet, exercising regularly, and avoiding bad habits are major steps in that direction.

Help make National Neuropathy Awareness Week a success by becoming a part of the effort. Learn what you can and share your experiences. If you’re living with neuropathy or caring for someone who is, know that your voice matters.

Article Provided By: dignityhealth

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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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20 Jul

Responding to Weather Changes When Caring for Neuropathy Patients

by Ezekiel Lim | September 11, 2019

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

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

Cold weather and neuropathy

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

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

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

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

Managing symptoms in heat

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

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

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

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

Article Provided By: fapnewstoday
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, 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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14 Jul

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SI Joint and Sciatica Definitions

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

What Is Sciatica?

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

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

What Is SI Joint Dysfunction?

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

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

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

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

Underlying Causes of Sciatica Pain and SI Joint Pain

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

Spine Problems that Can Result in Sciatica

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

SI Joint Dysfunction: Potential Causes

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

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

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

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

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

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

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

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

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

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

Treatments to Relieve the Pain

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

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

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

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

Article Provided By: SI-Bone.com

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Cervical Spinal Stenosis: Causes, Symptoms, Treatment

What Causes Cervical Spinal Stenosis?

Symptoms of Cervical Spinal Stenosis

How Your Doctor Diagnoses Cervical Spinal Stenosis

Treatment Options for Cervical Spinal Stenosis

Surgical Treatment of Cervical Spinal Stenosis

Symptoms

When to see a doctor

Causes

Risk factors

Complications

Prevention

Manage underlying conditions

Make healthy lifestyle choices

Causes and treatment of a pinched nerve in the back

Risk factors

Lumbar rotation

Back extensions

Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

WHAT YOU NEED TO KNOW

What are the symptoms of carpal tunnel syndrome?

How is carpal tunnel syndrome diagnosed?

Treatment of carpal tunnel syndrome

When to see a doctor

Causes

Risk factors

Complications

Prevention

The Lowdown on Living with Neuropathy

Neuropathy basics

Neuropathy and COVID-19

Be aware of your condition

Know the risk

Contracting COVID-19

Responding to Weather Changes When Caring for Neuropathy Patients

Cold weather and neuropathy

Managing symptoms in heat

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

Sciatica and other symptoms

from Nerve Compression in the Spine

Sciatica and other symptoms

from the SI Joint

SI Joint and Sciatica Definitions

Underlying Causes of Sciatica Pain and SI Joint Pain

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

Treatments to Relieve the Pain