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Cervical Spinal Stenosis: Causes, Symptoms, Treatment

Cervical Spinal Stenosis: Causes, Symptoms, Treatment

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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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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The Lowdown on Living with Neuropathy

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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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, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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How do I Exercise with Neuropathy?

How do I Exercise with Neuropathy?

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

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

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

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

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

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

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

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

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

 

Article Provided By: thehealthboard

Olympic Photo by Alex Smith on Unsplash

 

If you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

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Responding to Weather Changes When Caring for Neuropathy Patients

Responding to Weather Changes When Caring for Neuropathy Patients

Ezekiel Lim avatar

by Ezekiel Lim | 

weather changes

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

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

Cold weather and neuropathy

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

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

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

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

Managing symptoms in heat

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

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

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

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

Article Provided By: fapnewstoday
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

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

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

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

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

 

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

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

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

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

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

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

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

 

Sciatic anterior

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

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

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

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

SI Joint and Sciatica Definitions

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

What Is Sciatica?

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

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

What Is SI Joint Dysfunction?

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

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

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

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

Underlying Causes of Sciatica Pain and SI Joint Pain

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

 

Spine Problems that Can Result in Sciatica

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

SI Joint Dysfunction: Potential Causes

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

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

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

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

Sciatic posterior

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

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

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

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

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

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

Treatments to Relieve the Pain

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

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

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

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

 

Article Provided By: SI-Bone.com

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

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

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

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

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

Understanding ‘electric pain’

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

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

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

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

How is the cause of nerve pain found?

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

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

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

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

This article originally appeared in Cleveland Clinic Arthritis Advisor.

 

Article Provided By: clevelandclinic

 

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If you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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Femoral Neuropathy

Femoral Neuropathy

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

What causes femoral neuropathy?

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

Damage to the femoral nerve can be the result of:

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

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

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

Signs of femoral neuropathy

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

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

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

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

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

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

Diagnosing femoral neuropathy

Initial tests

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

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

Additional testing might include:

Nerve conduction

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

Electromyography (EMG)

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

MRI and CT scans

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

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

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

Medications

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

Therapy

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

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

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

Surgery

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

Long-term outlook after treatment

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

Tips to prevent nerve damage

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

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

Last medically reviewed on September 13, 2017

 

Article Provided By: healthline

Photo by Arnel Hasanovic on Unsplash

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If you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

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Managing & Coping with Neuropathy

Managing & Coping with Neuropathy

What predicts depression and anxiety among people with PN? Not necessarily the severity of the PN symptoms! The predictors are the psychological variables (i.e.: How do you feel? Hopeless, optimistic, anxious, etc.); social variables (i.e.: Are you active? Do you have support?) All of these variables can be changed!

Dwelling on what might have been if you were not diagnosed, self-pitying, ruminating about better times, and think of yourself primarily as a “PN patient” does not provide the escape from stress of the illness. These coping strategies are ineffective and can make your neuropathy symptoms worse.

Below are effective Self-Care and Coping Skills:

Managing Peripheral Neuropathy

The following suggestions can help you manage peripheral neuropathy:

Take care of your feet, especially if you have diabetes. Check your feet daily for signs of blisters, cuts or calluses. Tight shoes and socks can worsen pain and tingling and may lead to sores that won’t heal. Wear soft, loose cotton socks and padded shoes. You can use a semicircular hoop, which is available in medical supply stores, to keep bed covers off hot or sensitive feet.

Quit smoking. Cigarette smoking can affect circulation, increasing the risk of foot problems and possibly amputation.

Eat healthy meals. If you’re at high risk of neuropathy or have a chronic medical condition, healthy eating is especially important. Emphasize low-fat meats and dairy products and include lots of fruits, vegetables and whole grains in your diet. Drink alcohol in moderation.

Massage. Massage your hands and feet, or have someone massage them for you. Massage helps improve circulation, stimulates nerves and may temporarily relieve pain.

Avoid prolonged pressure. Don’t keep your knees crossed or lean on your elbows for long periods of time. Doing so may cause new nerve damage.

Skills for Coping With Peripheral Neuropathy

Living with chronic pain or disability presents daily challenges. Some of these suggestions may make it easier for you to cope:

Set priorities. Decide which tasks you need to do on a given day, such as paying bills or shopping for groceries, and which can wait until another time. Stay active, but don’t overdo.

Acceptance & Acknowledgement. Accept and acknowledge the negative aspects of the illness, but then move forward to become more positive to find what works best for you.

Find the positive aspects of the disorder. Of course you are thinking there is nothing positive about PN. Perhaps your outlook can help increase empathy, encourage you to maintain a balanced schedule or maintaining a healthier lifestyle.

Get out of the house. When you have severe pain, it’s natural to want to be alone. But this only makes it easier to focus on your pain. Instead, visit a friend, go to a movie or take a walk.

Get moving.  Develop an exercise program that works for you to maintain your optimum fitness.   It gives you something you can control, and provides so many benefits to your physical and emotional well-being

Seek and accept support. It isn’t a sign of weakness to ask for or accept help when you need it. In addition to support from family and friends, consider joining a chronic pain support group. Although support groups aren’t for everyone, they can be good places to hear about coping techniques or treatments that have worked for others. You’ll also meet people who understand what you’re going through. To find a support group in your community, check with your doctor, a nurse or the county health department.

Prepare for challenging situations. If something especially stressful is coming up in your life, such as a move or a new job, knowing what you have to do ahead of time can help you cope.

Talk to a counselor or therapist. Insomnia, depression and impotence are possible complications of peripheral neuropathy. If you experience any of these, you may find it helpful to talk to a counselor or therapist in addition to your primary care doctor. There are treatments that can help.

How to Sleep With Neuropathy

Sleep is an essential part of living—sleep helps us avoid major health problems and it is essential to our mental and physical performance.  It affects our mood and stress and anxiety levels. Unfortunately, sleep disturbance or insomnia is often a side effect of neuropathy pain. It is a common complaint among people with living with chronic pain.

It’s no surprise that about 70 percent of pain patients, including those suffering from PN, back pain, headaches, arthritis and fibromyalgia, report they have trouble sleeping according to the Journal of Pain Medicine.

Pain can interfere with sleep due to a combination of issues. The list includes discomfort, reduced activity levels, anxiety, worry, depression and use of medications such as codeine that relieve pain but disturb sleep.

Most experts recommend a range of seven to nine hours of sleep per night for adults, regardless of age or gender. This may seem impossible to people with chronic pain, but there are steps you can take to improve your sleep, which may lead to less pain and lower levels of depression and anxiety. First, talk with your doctor to see if there are medications that may lessen your sleep disturbance. You should also check with your doctor to make sure your current medications aren’t causing some of your sleep disturbance.

Beyond medication, there are several things you can do yourself to improve your sleep. Here are some methods to try and help you fall asleep more quickly, help you sleep more deeply, help you stay asleep, and ultimately help keep you healthy.

Following are tips for improving your sleep:

  • Reduce your caffeine intake, especially in the afternoons
  • Quit smoking
  • Limit and/or omit alcohol consumption
  • Limit naps to less than one hour, preferably less
  • Don’t stay in bed too long—spending time in bed without sleeping leads to more shallow sleep
  • Adhere to a regular daily schedule including going to bed and getting up at the same time
  • Maintain a regular exercise program. Be sure to complete exercise several hours before bedtime
  • Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more support
  • Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.
  • Turn off your TV and Computer, many people use the television to fall asleep or relax at the end of the day. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it.
  • Don’t watch the clock – turn your alarm clock around so that it is not facing you
  • Keep a note pad and pencil by your bed to write down any thoughts that may wake you up at night so you can put them to rest
  • Refrain from taking a hot bath or shower right before bed; the body needs to cool a degree before getting into deep sleep
  • Try listening to relaxing soft music or audio books instead, or practicing relaxation exercises.

Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.

Some patients find comfort from a pillow between their legs that keeps their knees from touching.  And there’s an added benefit:  A pillow between your legs at night will prevent your upper leg from pulling your spine out of alignment and reduces stress on your hips and lower back.

It may take three to four weeks of trying these techniques before you begin to see an improvement in your sleep. During the first two weeks, your sleep may actually worsen before it improves, but improved sleep may lead to less pain intensity and improved mood.

Article Provided By: foundationforPN

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

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