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Trigeminal Neuralgia

Trigeminal Neuralgia
Trigeminal neuralgia (TN), also known as tic douloureux, is sometimes described as the most excruciating pain known to humanity. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve, which sends branches to the forehead, cheek and lower jaw. It usually is limited to one side of the face. The pain can be triggered by an action as routine and minor as brushing your teeth, eating or the wind. Attacks may begin mild and short, but if left untreated, trigeminal neuralgia can progressively worsen.

Although trigeminal neuralgia cannot always be cured, there are treatments available to alleviate the debilitating pain. Normally, anticonvulsive medications are the first treatment choice. Surgery can be an effective option for those who become unresponsive to medications or for those who suffer serious side effects from the medications.
The Trigeminal Nerve
The trigeminal nerve is one set of the cranial nerves in the head. It is the nerve responsible for providing sensation to the face. One trigeminal nerve runs to the right side of the head, while the other runs to the left. Each of these nerves has three distinct branches. “Trigeminal” derives from the Latin word “tria,” which means three, and “geminus,” which means twin. After the trigeminal nerve leaves the brain and travels inside the skull, it divides into three smaller branches, controlling sensations throughout the face:
Ophthalmic Nerve (V1): The first branch controls sensation in a person’s eye, upper eyelid and forehead.
Maxillary Nerve (V2): The second branch controls sensation in the lower eyelid, cheek, nostril, upper lip and upper gum.
Mandibular Nerve (V3): The third branch controls sensations in the jaw, lower lip, lower gum and some of the muscles used for chewing.
Prevalence and Incidence
It is reported that 150,000 people are diagnosed with trigeminal neuralgia (TN) every year. While the disorder can occur at any age, it is most common in people over the age of 50. The National Institute of Neurological Disorders and Stroke (NINDS) notes that TN is twice as common in women than in men. A form of TN is associated with multiple sclerosis (MS).
Causes
There are two types of TN — primary and secondary. The exact cause of TN is still unknown, but the pain associated with it represents an irritation of the nerve. Primary trigeminal neuralgia has been linked to the compression of the nerve, typically in the base of the head where the brain meets the spinal cord. This is usually due to contact between a healthy artery or vein and the trigeminal nerve at the base of the brain. This places pressure on the nerve as it enters the brain and causes the nerve to misfire. Secondary TN is caused by pressure on the nerve from a tumor, MS, a cyst, facial injury or another medical condition that damages the myelin sheaths.
Symptoms
Most patients report that their pain begins spontaneously and seemingly out of nowhere. Other patients say their pain follows a car accident, a blow to the face or dental work. In the cases of dental work, it is more likely that the disorder was already developing and then caused the initial symptoms to be triggered. Pain often is first experienced along the upper or lower jaw, so many patients assume they have a dental abscess. Some patients see their dentists and actually have a root canal performed, which inevitably brings no relief. When the pain persists, patients realize the problem is not dental-related.
The pain of TN is defined as either type 1 (TN1) or type 2 (TN2). TN1 is characterized by intensely sharp, throbbing, sporadic, burning or shock-like pain around the eyes, lips, nose, jaw, forehead and scalp. TN1 can get worse resulting in more pain spells that last longer. TN2 pain often is present as a constant, burning, aching and may also have stabbing less intense than TN1.
TN tends to run in cycles. Patients often suffer long stretches of frequent attacks, followed by weeks, months or even years of little or no pain. The usual pattern, however, is for the attacks to intensify over time with shorter pain-free periods. Some patients suffer less than one attack a day, while others experience a dozen or more every hour. The pain typically begins with a sensation of electrical shocks that culminates in an excruciating stabbing pain within less than 20 seconds. The pain often leaves patients with uncontrollable facial twitching, which is why the disorder is also known as tic douloureux.
Pain can be focused in one spot or it can spread throughout the face. Typically, it is only on one side of the face; however, in rare occasions and sometimes when associated with multiple sclerosis, patients may feel pain in both sides of their face. Pain areas include the cheeks, jaw, teeth, gums, lips, eyes and forehead.
Attacks of TN may be triggered by the following:
Touching the skin lightly
Washing
Shaving
Brushing teeth
Blowing the nose
Drinking hot or cold beverages
Encountering a light breeze
Applying makeup
Smiling
Talking
The symptoms of several pain disorders are similar to those of trigeminal neuralgia. The most common mimicker of TN is trigeminal neuropathic pain (TNP). TNP results from an injury or damage to the trigeminal nerve. TNP pain is generally described as being constant, dull and burning. Attacks of sharp pain can also occur, commonly triggered by touch. Additional mimickers include:
Temporal tendinitis
Ernest syndrome (injury of the stylomandibular ligament
Occipital neuralgia
Cluster headaches/ migraines
Giant cell arteritis
Dental pain
Post-herpetic neuralgia
Glossopharyngeal neuralgia
Sinus infection
Ear infection
Temporomandibular joint syndrome (TMJ)
Diagnosis
TN can be very difficult to diagnose, because there are no specific diagnostic tests and symptoms are very similar to other facial pain disorders. Therefore, it is important to seek medical care when feeling unusual, sharp pain around the eyes, lips, nose, jaw, forehead and scalp, especially if you have not had dental or other facial surgery recently. The patient should begin by addressing the problem with their primary care physician. They may refer the patient to a specialist later.
Testing

Magnetic resonance imaging (MRI) can detect if a tumor or MS is affecting the trigeminal nerve. A high-resolution, thin-slice or three-dimensional MRI can reveal if there is compression caused by a blood vessel. Newer scanning techniques can show if a vessel is pressing on the nerve and may even show the degree of compression. Compression due to veins is not as easily identified on these scans. Tests can help rule out other causes of facial disorders. TN usually is diagnosed based on the description of the symptoms provided by the patient, detailed patient history and clinical evaluation. There are no specific diagnostic tests for TN, so physicians must rely heavily on symptoms and history. Physicians base their diagnosis on the type pain (sudden, quick and shock-like), the location of the pain and things that trigger the pain. Physical and neurological examinations may also be done in which the doctor will touch and examine parts of your face to better understand where the pain is located.
Treatment
Non-Surgical Treatments
There are several effective ways to alleviate the pain, including a variety of medications. Medications are generally started at low doses and increased gradually based on patient’s response to the drug.
Carbamazepine, an anticonvulsant drug, is the most common medication that doctors use to treat TN. In the early stages of the disease, carbamazepine controls pain for most people. When a patient shows no relief from this medication, a physician has cause to doubt whether TN is present. However, the effectiveness of carbamazepine decreases over time. Possible side effects include dizziness, double vision, drowsiness and nausea.
Gabapentin, an anticonvulsant drug, which is most commonly used to treat epilepsy or migraines can also treat TN. Side effects of this drug are minor and include dizziness and/or drowsiness which go away on their own.
Oxcarbazepine, a newer medication, has been used more recently as the first line of treatment. It is structurally related to carbamazepine and may be preferred, because it generally has fewer side effects. Possible side effects include dizziness and double vision.
Other medications include: baclofen, amitriptyline, nortriptyline, pregabalin, phenytoin, valproic acid, clonazepam, sodium valporate, lamotrigine, topiramate, phenytoin and opioids.
There are drawbacks to these medications, other than side effects. Some patients may need relatively high doses to alleviate the pain, and the side effects can become more pronounced at higher doses. Anticonvulsant drugs may lose their effectiveness over time. Some patients may need a higher dose to reduce the pain or a second anticonvulsant, which can lead to adverse drug reactions. Many of these drugs can have a toxic effect on some patients, particularly people with a history of bone marrow suppression and kidney and liver toxicity. These patients must have their blood monitored to ensure their safety.
Surgery
If medications have proven ineffective in treating TN, several surgical procedures may help control the pain. Surgical treatment is divided into two categories: 1) open cranial surgery or 2) lesioning procedures. In general, open surgery is performed for patients found to have pressure on the trigeminal nerve from a nearby blood vessel, which can be diagnosed with imaging of the brain, such as a special MRI. This surgery is thought to take away the underlying problem causing the TN. In contrast, lesioning procedures include interventions that injure the trigeminal nerve on purpose, in order to prevent the nerve from delivering pain to the face. The effects of lesioning may be shorter lasting and in some keys may result in numbness to the face.
Open Surgery
Microvascular decompression involves microsurgical exposure of the trigeminal nerve root, identification of a blood vessel that may be compressing the nerve and gentle movement of the blood vessel away from the point of compression. Decompression may reduce sensitivity and allow the trigeminal nerve to recover and return to a more normal, pain-free condition. While this generally is the most effective surgery, it also is the most invasive, because it requires opening the skull through a craniotomy. There is a small risk of decreased hearing, facial weakness, facial numbness, double vision, stroke or death.
Lesioning Procedures
Percutaneous radiofrequency rhizotomy treats TN through the use of electrocoagulation (heat). It can relieve nerve pain by destroying the part of the nerve that causes pain and suppressing the pain signal to the brain. The surgeon passes a hollow needle through the cheek into the trigeminal nerve. A heating current, which is passed through an electrode, destroys some of the nerve fibers.
Percutaneous balloon compression utilizes a needle that is passed through the cheek to the trigeminal nerve. The neurosurgeon places a balloon in the trigeminal nerve through a catheter. The balloon is inflated where fibers produce pain. The balloon compresses the nerve, injuring the pain-causing fibers, and is then removed.
Percutaneous glycerol rhizotomy utilizes glycerol injected through a needle into the area where the nerve divides into three main branches. The goal is to damage the nerve selectively in order to interfere with the transmission of the pain signals to the brain.
Stereotactic radiosurgery (through such procedures as Gamma Knife, Cyberknife, Linear Accelerator (LINAC) delivers a single highly concentrated dose of ionizing radiation to a small, precise target at the trigeminal nerve root. This treatment is noninvasive and avoids many of the risks and complications of open surgery and other treatments. Over a period of time and as a result of radiation exposure, the slow formation of a lesion in the nerve interrupts transmission of pain signals to the brain.
Overall, the benefits of surgery or lesioning techniques should always be weighed carefully against its risks. Although a large percentage of TN patients report pain relief after procedures, there is no guarantee that they will help every individual.
Neuromodulation
For patients with TNP, another surgical procedure can be done that includes placement of one or more electrodes in the soft tissue near the nerves, under the skull on the covering of the brain and sometimes deeper into the brain, to deliver electrical stimulation to the part of the brain responsible for sensation of the face. In peripheral nerve stimulation, the leads are placed under the skin on branches of the trigeminal nerve. In motor cortex stimulation (MCS), the area which innervates the face is stimulated. In deep brain stimulation (DBS), regions that affect sensation pathways to the face may be stimulated.
How to Prepare for a Neurosurgical Appointment
Write down symptoms. This should include: What the pain feels like (for example, is it sharp, shooting, aching, burning or other), where exactly the pain is located (lower jaw, cheek, eye/forehead), if it is accompanied by other symptoms (headache, numbness, facial spasms), duration of pain (weeks, months, years), pain-free intervals (longest period of time without pain or in between episodes), severity of pain (0=no pain, 10=worst pain)
Note any triggers of pain (e.g. brushing teeth, touching face, cold air)
Make a list of medications and surgeries related to the face pain (prior medications, did they work, were there side effects), current medications (duration and dose)
Write down questions in advance
Understand that the diagnosis and treatment process for TN is not simple. Having realistic expectations can greatly improve overall outcomes.
Follow-up
Patients should follow-up with their primary care providers and specialists regularly to maintain their treatment. Typically, neuromodulation surgical patients are asked to return to the clinic every few months in the year following the surgery. During these visits, they may adjust the stimulation settings and assess the patient’s recovery from surgery. Routinely following-up with a doctor ensures that the care is correct and effective. Patients who undergo any form of neurostimulation surgery will also follow-up with a device representative who will adjust the device settings and parameters as needed alongside their doctors.

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

 

 

 

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Carpal Tunnel Syndrome

Carpal tunnel syndrome

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

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

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

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

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

 

 

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How Pets Can Help Your Chronic Pain Symptoms

How Pets Can Help Your Chronic Pain Symptoms

By Jeanne Faulkner
Reviewed by QualityHealth’s Medical Advisory Board

Pet owners love their companions for a variety of reasons. But can having a pet relieve your chronic pain? In fact, studies have found that, yes, pets can help relieve many of the symptoms associated with chronic pain conditions and help patients live better lives. Here are five ways that pets can help patients with chronic pain:
1. Provide distraction. It’s hard to focus on pain when you’re watching a kitten chase her tail or when a dog is cuddled up next to you. Animals give patients opportunities to enjoy life through simple moments and events, like throwing your dog a ball, playing with your cat or listening to your bird sing. Plus, being a responsible pet owner requires that you feed, water, walk, care for and clean up after your animal, which gives you something to focus on outside of your diagnosis.
2. Increase activity. Even if all you do is walk to the pantry to open a can, owning a pet makes you get up and move. Dogs are particularly effective pets for bumping up your physical activity level because they require walking and demand playful interaction. Cats, on the other hand, are more independent, which might provide a better pet-match for patients with mobility issues.
3. Improve your mood. Studies show that the very act of petting an animal reduces anxiety, symptoms of depression, and stress. Pets provide companionship, opportunities to connect with others and reduce feelings of isolation. What’s more, dogs are effective at sensing and absorbing people’s moods. Often they’re used in hospitals, schools, and other care facilities to provide therapy and personal services. That’s not just a benefit for dog owners, however. Cats, horses, birds, chickens, and other animals can provide companionship and services that help people experience a better sense of wellbeing.
4. Improve your heart health. According to the American Pain Foundation, pet owners who suffer heart attacks have higher one-year survival rates than patients who are not pet owners. Animal owners also have lower triglyceride and cholesterol levels, fewer minor health problems such as headaches and injuries, and are able to cope better with stressful life events. Petting a dog has been proven to reduce blood pressure dramatically in some patients.
5. Provide unconditional love. Animals don’t care what you look like, how much you complain, or how exhausted you are. They love you regardless of the circumstances. Through their eyes, you’re perfect. Their inexhaustible patience and ability to stay present in the moment provides their owners valuable lessons in how to be better humans.
Want to Reap the Benefits of Owning a Pet?
Contact a veterinarian and find out what types of pets would work for your home, family and health condition. Visit the Humane Society or local animal shelter and consider adopting an animal that needs you as much as you need him. If owning your own pet doesn’t work for you, contact the Delta Society and find out about pet therapy dogs in your area.

Article Provided By: qualityhealth
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 And Where Are Dermatomes?

What and where are dermatomes?

Dermatomes are areas of skin that send signals to the brain through the spinal nerves. These signals give rise to sensations involving temperature, pressure, and pain.
The part of a nerve that exits the spinal cord is called the nerve root. Damage to a nerve root can trigger symptoms in the nerve’s corresponding dermatome.
Below, we show the locations of the dermatomes throughout the body. We also describe health conditions that can damage the spinal nerves and affect their dermatomes.

What are they?

A dermatome is an area of skin that sends information to the brain via a single spinal nerve.
Spinal nerves exit the spine in pairs. There are 31 pairs in total, and 30 of these have corresponding dermatomes.
The exception is the C1 spinal nerve, which does not have a corresponding dermatome.
The spinal nerves are classified into five groups, according to the region of the spine from which they exit.
The five groups and their points of exit from the spine are:
Cervical nerves: These exit the neck region and are labeled C1–C8.
Thoracic nerves: These exit the torso region and are labeled T1–T12.
Lumbar nerves: These exit the lower back region and are labeled L1–L5.
Sacral nerves: These exit the base of the spine and are labeled S1–S5.
A coccygeal nerve pair: These exit the tailbone, or coccyx.

Locations of the dermatomes
Each dermatome shares the label of its corresponding spinal nerve.
Some dermatomes overlap to a certain extent, and the precise layout of the dermatomes can vary slightly from one person to the next.
Below, we list the locations of the dermatomes that correspond to the spinal nerves in each group.
Cervical nerves and their dermatomes
C2: the base of the skull, behind the ear
C3: the back of the head and the upper neck
C4: the lower neck and upper shoulders
C5: the upper shoulders and the two collarbones
C6: the upper forearms and the thumbs and index fingers
C7: the upper back, backs of the arms, and middle fingers
C8: the upper back, inner arms, and ring and pinky fingers
Thoracic nerves and their dermatomes
T1: the upper chest and back and upper forearm
T2, T3, and T4: the upper chest and back
T5, T6, and T7: the mid-chest and back
T8 and T9: the upper abdomen and mid-back
T10: the midline of the abdomen and the mid-back
T11 and T12: the lower abdomen and mid-back
Lumbar nerves and their dermatomes
L1: the groin, upper hips, and lower back
L2: the lower back, hips, and tops of the inner thighs
L3: the lower back, inner thighs, and inner legs just below the knees
L4: the backs of the knees, inner sections of the lower legs, and the heels
L5: the tops of the feet and the fronts of the lower legs
Sacral nerves and their dermatomes
S1: the lower back, buttocks, backs of the legs, and outer toes
S2: the buttocks, genitals, backs of the legs, and heels
S3: the buttocks and genitals
S4 and S5: the buttocks
The coccygeal nerves and their dermatome
The dermatome corresponding with the coccygeal nerves is located on the buttocks, in the area directly around the tailbone, or coccyx.

Associated health conditions
Symptoms that occur within a dermatome sometimes indicate damage or disruption to the dermatome’s corresponding nerve. The location of these symptoms can, therefore, help doctors diagnose certain underlying medical conditions.
Some conditions that can affect the nerves and their corresponding dermatomes are:
Shingles
Shingles, or herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus. This is the same virus that causes chickenpox.
After the body recovers from chickenpox, the virus can lie dormant and eventually reactivate as shingles.
In adults, shingles typically causes a rash to form on the trunk, along one of the thoracic dermatomes. The rash may be preceded by pain, itching, or tingling in the area.
Some other symptoms of shingles can include:
a headache
sensitivity to bright light
a general feeling of being unwell
A person with a weakened immune system may develop a more widespread shingles rash that covers three or more dermatomes. Doctors refer to this as disseminated zoster.
Pinched nerves
A pinched nerve occurs when a nerve root has become compressed by a bone, disc, tendon, or ligament. This compression can occur anywhere along the spine, but it usually occurs in the lower, or lumbar, region.
A pinched nerve can cause pain, tingling, or numbness in its corresponding dermatome. As such, the location of the symptoms can help a doctor identify the affected nerve.

The doctor then diagnoses and treats the underlying cause of the pinched nerve and recommends ways to relieve the symptoms.
Traumatic injury
A traumatic injury to the nerves may result from an accident or surgery.
The severity of symptoms can help doctors determine the extent of the nerve injury.

Summary
Dermatomes are areas of skin, each of which is connected to a single spinal nerve. Together, these areas create a surface map of the body.
Dysfunction or damage to a spinal nerve can trigger symptoms in the corresponding dermatome. Nerves damage or dysfunction may result from infection, compression, or traumatic injury.
Doctors can sometimes use the severity of symptoms in a dermatome to determine the extent and location of nerve damage. They then work to diagnose and treat the underlying cause of the damage.

Article Provided By: medicalnewstoday

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

 

 

 

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Everything You Should Know About Allodynia

Everything You Should Know About Allodynia

What is allodynia?
Allodynia is an unusual symptom that can result from several nerve-related conditions. When you’re experiencing it, you feel pain from stimuli that don’t normally cause pain. For example, lightly touching your skin or brushing your hair might feel painful.
To ease allodynia, your doctor will try to treat the underlying cause.
What are the symptoms of allodynia?
The main symptom of allodynia is pain from stimuli that don’t usually cause pain. In some cases, you might find hot or cold temperatures painful. You might find gentle pressure on your skin painful. You might feel pain in response to a brushing sensation or other movement along your skin or hair.
Depending on the underlying cause of your allodynia, you might experience other symptoms too.
For example, if it’s caused by fibromyalgia, you might also experience:
anxiety
depression
trouble concentrating
trouble sleeping
fatigue
If it’s linked to migraines, you might also experience:
painful headaches
increased sensitivity to light or sounds
changes in your vision
nausea
What causes allodynia?
Some underlying conditions can cause allodynia. It’s most commonly linked to fibromyalgia and migraine headaches. Postherpetic neuralgia or peripheral neuropathy can also cause it.
Fibromyalgia
Fibromyalgia is a disorder in which you feel muscle and joint pain throughout your body. But it’s not related to an injury or a condition such as arthritis. Instead, it seems to be linked to the way your brain processes pain signals from your body. It’s still something of a medical mystery. Scientists don’t quite understand its roots, but it tends to run in families. Certain viruses, stress, or trauma might also trigger fibromyalgia.
Migraine headaches
Migraine is a type of headache that causes intense pain. Changes in nerve signals and chemical activity in your brain trigger this type of headache. In some cases, these changes can cause allodynia.
Peripheral neuropathy
Peripheral neuropathy happens when the nerves that connect your body to your spinal cord and brain become damaged or destroyed. It can result from several serious medical conditions. For example, it’s a potential complication of diabetes.
Postherpetic neuralgia
Postherpetic neuralgia is the most common complication of shingles. This is a disease caused by the varicella zoster virus, which also causes chicken pox. It can damage your nerves and lead to postherpetic neuralgia. Heightened sensitivity to touch is a potential symptom of postherpetic neuralgia.

 

What are the risk factors for allodynia?
If you have a parent who has fibromyalgia, you’re at higher risk of developing it and allodynia. Experiencing migraines, developing peripheral neuropathy, or getting shingles or chickenpox also raises your risk of developing allodynia.

How is allodynia diagnosed?
If you notice your skin has become more sensitive to touch than normal, you can start to diagnose yourself. You can do this by testing your nerve sensitivity. For example, try brushing a dry cotton pad on your skin. Next, apply a hot or cold compress on your skin. If you experience a painful tingling feeling in response to any of these stimuli, you might have allodynia. Make an appointment with your doctor to get a formal diagnosis.
Your doctor may conduct a variety of tests to assess your nerve sensitivity. They will also ask about your medical history and other symptoms that you might have. This can help them start to identify the cause of your allodynia. Be sure to answer their questions as honestly and completely as possible. Tell them about any pain in your extremities, headaches, poor wound healing, or other changes that you’ve noticed.
If they suspect you might have diabetes, your doctor will likely order blood tests to measure the level of glucose in your bloodstream. They might also order blood tests to check for other possible causes of your symptoms, such as thyroid disease or infection.

How is allodynia treated?
Depending on the underlying cause of your allodynia, your doctor might recommend medications, lifestyle changes, or other treatments.
For example, your doctor might prescribe medications such as lidocaine (Xylocaine) or pregabalin (Lyrica) to help ease your pain. They might also recommend taking a nonsteroidal anti-inflammatory drug, such as naproxen (Alleve). In some cases, your doctor might recommend treatment with electrical stimulation, hypnotherapy, or other complementary approaches.
It’s also important for your doctor to address the underlying condition that’s causing your allodynia. For instance, successful diabetes treatment can help improve diabetic neuropathy. This can help lower your risk of allodynia.
Lifestyle changes
Identifying triggers that make your allodynia worse can help you manage your condition.
If you experience migraine headaches, certain foods, beverages, or environments might trigger your symptoms. Consider using a journal to track your lifestyle habits and symptoms. Once you’ve identified your triggers, take steps to limit your exposure to them.
Managing stress is also important if you’re living with migraine headaches or fibromyalgia. Stress can bring on symptoms in both of these conditions. Practicing meditation or other relaxation techniques might help you reduce your stress levels.
Wearing clothes made of light fabrics and going sleeveless may also help, if your allodynia is triggered by the touch of clothing.
Social and emotional support
If treatment doesn’t relieve your pain, ask your doctor about mental health counseling. These services might help you learn to adjust to your changing physical health. For example, cognitive behavior therapy can help you change how you think about and react to difficult situations.
It might also help to seek the advice of other people with allodynia. For example, look for support groups in your community or online. In addition to sharing strategies to manage your symptoms, it might help to connect with others who understand your pain.

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

 

 

 

 

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Neuropathic Pain

Neuropathic Pain

What is neuropathic pain?
Neuropathic pain can result after damage or dysfunction of the nervous system. Pain can rise from any level of the nervous system. These levels are the peripheral nerves, spinal cord, and brain. Pain centers receive the wrong signals from the damaged nerve fibers. Nerve function may change at the site of the nerve damage, as well as areas in the central nervous system (central sensitization).
Neuropathy is a disturbance of function or a change in one or several nerves. About 30% of neuropathy cases is caused by diabetes. It is not always easy to tell the source of the neuropathic pain. There are hundreds of diseases that are linked to this kind of pain.
What are some of the sources of neuropathic pain?
Alcoholism
Amputation (results in phantom pain)
Chemotherapy drugs (Cisplatin®, Paclitaxel®, Vincristine®, etc.)
Radiation therapy
Complex regional pain syndrome
Diabetes
Facial nerve problems
HIV infection or AIDS
Shingles
Spinal nerve compression or inflammation
Trauma or surgeries with resulting nerve damage
Nerve compression or infiltration by tumors
Central nervous system disorders (stroke, Parkinson’s disease, multiple sclerosis, etc.)
What are the symptoms of neuropathic pain?
Many symptoms may be present in the case of neuropathic pain. These symptoms include:
Spontaneous pain (pain that comes without stimulation): Shooting, burning, stabbing, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling
Evoked pain: Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc. This is called allodynia. Evoked pain also may mean the increase of pain by normally painful stimuli such as pinpricks and heat. This type of pain is called hyperalgesia.
An unpleasant, abnormal sensation whether spontaneous or evoked (dysesthesia)
Trouble sleeping
Emotional problems due to disturbed sleep and pain
Pain that may be lessened in response to a normally painful stimulus (hypoalgesia)
Diagnosis and Tests
How is neuropathic pain diagnosed?
Your doctor will take a medical history and do a physical exam. Neuropathic pain is suggested by its typical symptoms when nerve injury is known or suspected. Your doctor will then try to find the underlying cause of the neuropathy and then trace the symptoms.
Management and Treatment
How is neuropathic pain treated?
The goals of treatment are to:
Treat the underlying disease (for example, radiation or surgery to shrink a tumor that is pressing on a nerve)
Provide pain relief
Maintain functionality
Improve quality of life
Multimodal therapy (including medicines, physical therapy, psychological treatment, and sometimes surgery) is usually required to treat neuropathic pain.
Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as Neurontin®, Lyrica®, Topamax®, Tegretol®, and Lamictal®. Doctors also prescribe antidepressants such as Elavil®, Pamelor®, Effexor®, and Cymbalta®. A doctor’s prescription for anti-seizure drugs or antidepressants does not mean you have seizures or are depressed.
A topical patch (Lidocaine® or Capsaicin®) or a cream or ointment can be used on the painful area. Opioid analgesics can provide some relief. However, they generally are less effective in treating neuropathic pain. Negative effects may prevent their long-term use.
The pain can also be treated with nerve blocks given by pain specialists, including injections of steroids, local anesthetics, or other medicines into the affected nerves.
Neuropathic pain that has not responded to the therapies mentioned above can be treated with spinal cord stimulation, peripheral nerve stimulation, and brain stimulation.
Outlook / Prognosis
What is the outlook for people with neuropathic pain?
Neuropathic pain is difficult to get rid of, but is not life-threatening. Without rehabilitation and sometimes psychosocial support, treatment has a limited chance of success. With help from a pain specialist using the multimodal approaches listed above, your neuropathic pain can be managed to a level that improves your quality of life.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.

Article Provided By: clevelandclinic
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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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

Shingles affects the nerves

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: Mayoclinic
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