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Why Is Neuropathy Worse at Night?

January 3, 2020 / Brain & Spine
Why Is Neuropathy Worse at Night?
Reasons why nerve pain is more painful at night
Peripheral neuropathy is when a nerve or group of nerves outside of the brain and spinal cord is injured or dysfunctions. It could be because of an injury to a single nerve, like carpal tunnel syndrome, or because a group of nerves have become defective, like with peripheral neuropathy of the feet.
“Across the board we know that neuropathy can cause pain depending on what type of nerves are involved,” says neurologist Benjamin Claytor, MD. “When people describe worsening symptoms at night they’re describing discomfort – pins and needles, tingling and burning pain.”
Here Dr. Claytor discusses what might be causing this nightly pain and how to find relief.
Distraction
Our attention level can influence how we perceive pain. So during the day when we’re at work or taking care of the kids – we’re distracted and busy. Although there hasn’t been much research around it, the idea is that we aren’t focusing on the pain during the day because we’re busy, we pay less attention to it and perceive less pain.
“Many patients will tell me that after they get home from work, have dinner and sit down to watch TV for the night that their pain flares up,” says Dr. Claytor. “This could be because the daytime distractions are now gone and you’re starting to unwind for the night.”
Temperature and sleep
Another thought behind nightly neuropathy has to do with temperature. At night our body temperature fluctuates and goes down a bit. Most people tend to sleep in a cooler room as well. The thought is that damaged nerves might interpret the temperature change as pain or tingling, which can heighten the sense of neuropathy.
Also consider poor sleep quality. If you’re not sleeping very well to begin with, either due to poor sleep habits or sleep related disorders, this could lead to increased pain perception.
Emotions and stress
Our emotional state can also influence how we perceive pain. Stress and anxiety can feed in to and amplify pain signaling. Living in a chronic state of stress wreaks havoc on your physical and mental health.
Medication
Sometimes medication dosing and timing might need to be adjusted, which could be particularly true for some short acting medications used for neuropathy pain.
How to stop neuropathy pain at night
“There are options we can explore if your neuropathy pain seems to be worsening at night,” explains Dr. Claytor. “There might be oral or topical medications we can prescribe, or maybe it’s getting your stress under control and being more mindful.”
Cognitive behavioral therapy, physical therapy and meditation may be complementary tools to reduce pain as well.
Dr. Claytor stresses the importance of talking to your doctor sooner rather than later. Often time’s people will wait so long to see their physician that there’s permanent nerve damage that might have been avoided.
“I think one of the most important things I can discuss with a patient who comes in with neuropathy pain at night is getting to the root cause of what is actually driving it,” says Dr. Claytor. “Depending on what the underlying cause is, treating that first and foremost can usually help reduce the pain overall – especially at night.”

 

Article Provided By: health.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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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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Complex Regional Pain Syndrome

 

What is complex regional pain syndrome?
Complex regional pain syndrome (CRPS) is a chronic (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. The central nervous system is composed of the brain and spinal cord; the peripheral nervous system involves nerve signaling from the brain and spinal cord to the rest of the body. CRPS is characterized by prolonged or excessive pain and changes in skin color, temperature, and/or swelling in the affected area.
CRPS is divided into two types: CRPS-I and CRPS-II. Individuals without a confirmed nerve injury are classified as having CRPS-I (previously known as reflex sympathetic dystrophy syndrome). CRPS-II (previously known as causalgia) is when there is an associated, confirmed nerve injury. As some research has identified evidence of nerve injury in CRPS-I, it is unclear if this disorders will always be divided into two types. Nonetheless, the treatment is similar.
CRPS symptoms vary in severity and duration, although some cases are mild and eventually go away. In more severe cases, individuals may not recover and may have long-term disability.

Who can get CRPS?
Although it is more common in women, CRPS can occur in anyone at any age, with a peak at age 40. CRPS is rare in the elderly. Very few children under age 10 and almost no children under age 5 are affected.

What are the symptoms of CRPS?
The key symptom is prolonged severe pain that may be constant. It has been described as “burning,” “pins and needles” sensation, or as if someone were squeezing the affected limb. The pain may spread to the entire arm or leg, even though the injury might have only involved a finger or toe. In rare cases, pain can sometimes even travel to the opposite extremity. There is often increased sensitivity in the affected area, known as allodynia, in which normal contact with the skin is experienced as very painful.
People with CRPS also experience changes in skin temperature, skin color, or swelling of the affected limb. This is due to abnormal microcirculation caused by damage to the nerves controlling blood flow and temperature. As a result, an affected arm or leg may feel warmer or cooler compared to the opposite limb. The skin on the affected limb may change color, becoming blotchy, blue, purple, pale, or red.
Other common features of CRPS include:
changes in skin texture on the affected area; it may appear shiny and thin
abnormal sweating pattern in the affected area or surrounding areas
changes in nail and hair growth patterns
stiffness in affected joints
problems coordinating muscle movement, with decreased ability to move the affected body part
abnormal movement in the affected limb, most often fixed abnormal posture (called dystonia) but also tremors in or jerking of the limb.

What causes CRPS?
It is unclear why some individuals develop CRPS while others with similar trauma do not. In more than 90 percent of cases, the condition is triggered by a clear history of trauma or injury. The most common triggers are fractures, sprains/strains, soft tissue injury (such as burns, cuts, or bruises), limb immobilization (such as being in a cast), surgery, or even minor medical procedures such as needle stick. CRPS represents an abnormal response that magnifies the effects of the injury. Some people respond excessively to a trigger that causes no problem for other people, such as what is observed in people who have food allergies.
Peripheral nerve abnormalities found in individuals with CRPS usually involve the small unmyelinated and thinly myelinated sensory nerve fibers (axons) that carry pain messages and signals to blood vessels. (Myelin is a mixture of proteins and fat-like substances that surround and insulate some nerve fibers.) Because small fibers in the nerves communicate with blood vessels, injuries to the fibers may trigger the many different symptoms of CRPS. Molecules secreted from the ends of hyperactive small nerve fibers are thought to contribute to inflammation and blood vessel abnormalities. These peripheral nerve abnormalities trigger abnormal neurological function in the spinal cord and brain.
Blood vessels in the affected limb may dilate (open wider) or leak fluid into the surrounding tissue, causing red, swollen skin. The dilation and constriction of small blood vessels is controlled by small nerve fiber axons as well as chemical messengers in the blood. The underlying muscles and deeper tissues can become starved of oxygen and nutrients, which causes muscle and joint pain as well as damage. The blood vessels may over-constrict (clamp down), causing old, white, or bluish skin.
CRPS also affects the immune system. High levels of inflammatory chemicals (cytokines) have been found in the tissues of people with CRPS. These contribute to the redness, swelling, and warmth reported by many patients. CRPS is more common in individuals with other inflammatory and autoimmune conditions such as asthma.
Limited data suggest that CRPS also may be influenced by genetics. Rare family clusters of CRPS have been reported. Familial CRPS may be more severe with earlier onset, greater dystonia, and more than one limb being affected.
Occasionally CRPS develops without any known injury. In these cases, an infection, a blood vessel problem, or entrapment of the nerves may have caused an internal injury. A physician will perform a thorough examination in order to identify a cause.
In many cases, CRPS results from a variety of causes. In such instances, treatments are directed at all of the contributing factors.

How is CRPS diagnosed?
Currently there is no specific test that can confirm CRPS. Its diagnosis is based on a person’s medical history, and signs and symptoms that match the definition. Since other conditions can cause similar symptoms, careful examination is important. As most people improve gradually over time, the diagnosis may be more difficult later in the course of the disorder.
Testing also may be used to help rule out other conditions, such as arthritis, Lyme disease, generalized muscle diseases, a clotted vein, or small fiber polyneuropathies, because these require different treatment. The distinguishing feature of CRPS is that of an injury to the affected area. Such individuals should be carefully assessed so that an alternative treatable disorder is not overlooked.
Magnetic resonance imaging or triple-phase bone scans may be requested to help confirm a diagnosis. While CRPS is often associated with excess bone resorption, a process in which certain cells break down the bone and release calcium into the blood, this finding may be observed in other illnesses as well.

What is the prognosis?
The outcome of CRPS is highly variable. Younger persons, children, and teenagers tend to have better outcomes. While older people can have good outcomes, there are some individuals who experience severe pain and disability despite treatment. Anecdotal evidence suggests early treatment, particularly rehabilitation, is helpful in limiting the disorder, a concept that has not yet been proven in clinical studies. More research is needed to understand the causes of CRPS, how it progresses, and the role of early treatment.

How is CRPS treated?
The following therapies are often used:
Rehabilitation and physical therapy. An exercise program to keep the painful limb or body part moving can improve blood flow and lessen the circulatory symptoms. Additionally, exercise can help improve the affected limb’s flexibility, strength, and function. Rehabilitating the affected limb also can help to prevent or reverse the secondary brain changes that are associated with chronic pain. Occupational therapy can help the individual learn new ways to work and perform daily tasks.
Psychotherapy. CRPS and other painful and disabling conditions often are associated with profound psychological symptoms for affected individuals and their families. People with CRPS may develop depression, anxiety, or post-traumatic stress disorder, all of which heighten the perception of pain and make rehabilitation efforts more difficult. Treating these secondary conditions is important for helping people cope and recover from CRPS.
Medications. Several different classes of medication have been reported to be effective for CRPS, particularly when used early in the course of the disease. However, no drug is approved by the U.S. Food and Drug Administration specifically for CRPS, and no single drug or combination of drugs is guaranteed to be effective in every person. Drugs to treat CRPS include:
bisphosphonates, such as high dose alendronate or intravenous pamidronate
non-steroidal anti-inflammatory drugs to treat moderate pain, including over-the-counter aspirin, ibuprofen, and naproxen
corticosteroids that treat inflammation/swelling and edema, such as prednisolone and methylprednisolone (used mostly in the early stages of CRPS)
drugs initially developed to treat seizures or depression but now shown to be effective for neuropathic pain, such as gabapentin, pregabalin, amitriptyline, nortriptyline, and duloxetine
botulinum toxin injections
opioids such as oxycodone, morphine, hydrocodone, and fentanyl. These drugs must be prescribed and monitored under close supervision of a physician, as these drugs may be addictive.
N-methyl-D-aspartate (NMDA) receptor antagonists such as dextromethorphan and ketamine, and
topical local anesthetic creams and patches such as lidocaine.
All drugs or combination of drugs can have various side effects such as drowsiness, dizziness, increased heartbeat, and impaired memory. Inform a healthcare professional of any changes once drug therapy begins.
Sympathetic nerve block. Some individuals report temporary pain relief from sympathetic nerve blocks, but there is no published evidence of long-term benefit. Sympathetic blocks involve injecting an anesthetic next to the spine to directly block the activity of sympathetic nerves and improve blood flow.
Surgical sympathectomy. The use of this operation that destroys some of the nerves is controversial. Some experts think it is unwarranted and makes CRPS worse, whereas others report a favorable outcome. Sympathectomy should be used only in individuals whose pain is dramatically relieved (although temporarily) by sympathetic nerve blocks.
Spinal cord stimulation. Placing stimulating electrodes through a needle into the spine near the spinal cord provides a tingling sensation in the painful area. Electrodes may be placed temporarily for a few days in order to assess whether stimulation is likely to be helpful. Minor surgery is required to implant all the parts of the stimulator, battery, and electrodes under the skin on the torso. Once implanted, the stimulator can be turned on and off, and adjusted using an external controller. Approximately 25 percent of individuals develop equipment problems that may require additional surgeries.
Other types of neural stimulation. Neurostimulation can be delivered at other locations along the pain pathway, not only at the spinal cord. These include near injured nerves (peripheral nerve stimulators), outside the membranes of the brain (motor cortex stimulation with dural electrodes), and within the parts of the brain that control pain (deep brain stimulation). A recent option involves the use of magnetic currents applied externally to the brain (known as repetitive Transcranial Magnetic Stimulation, or rTMS). A similar method that uses transcranial direct electrical stimulation is also being investigated. These stimulation methods have the advantage of being non-invasive, with the disadvantage that repeated treatment sessions are needed.
Intrathecal drug pumps. These devices pump pain-relieving medications directly into the fluid that bathes the spinal cord, typically opioids, local anesthetic agents, clonidine, and baclofen. The advantage is that pain-signaling targets in the spinal cord can be reached using doses far lower than those required for oral administration, which decreases side effects and increases drug effectiveness. There are no studies that show benefit specifically for CRPS.
Emerging treatments for CRPS include:
Intravenous immunoglobulin (IVIG). Researchers in Great Britain report low-dose IVIG reduced pain intensity in a small trial of 13 patients with CRPS for 6 to 30 months who did not respond well to other treatments. Those who received IVIG had a greater decrease in pain scores than those receiving saline during the following 14 days after infusion.
Ketamine. Investigators are using low doses of ketamine—a strong anesthetic—given intravenously for several days to either reduce substantially or eliminate the chronic pain of CRPS. In certain clinical settings, ketamine has been shown to be useful in treating pain that does not respond well to other treatments.
Graded Motor imagery. Several studies have demonstrated the benefits of graded motor imagery therapy for CRPS pain. Individuals do mental exercises including identifying left and right painful body parts while looking into a mirror and visualizing moving those painful body parts without actually moving them.
Several alternative therapies have been used to treat other painful conditions. Options include behavior modification, acupuncture, relaxation techniques (such as biofeedback, progressive muscle relaxation, and guided motion therapy), and chiropractic treatment.

What research is currently being done on CRPS?
The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is part of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.
NINDS-supported scientists are studying new approaches to treat CRPS and to intervene more aggressively to limit the symptoms and disability associated with the syndrome. Other NIH institutes also support research on CRPS and other painful conditions.
Previous research has shown that CRPS-related inflammation is caused by the body’s own immune response. Researchers hope to better understand how CRPS develops by studying immune system activation and peripheral nerve signaling using an animal model of the disorder. The animal model was developed to mimic certain CRPS-like features following fracture or limb surgery, by activating certain molecules involved in the immune system process.
Limb trauma, such as a fracture, followed by immobilization in a cast, is the most common cause of CRPS. By studying an animal model, researchers hope to better understand the neuroinflammatory basis of CRPS in order to identify the relevant inflammatory signaling pathways that lead to the development of post-traumatic CRPS. They also will examine inflammatory effects of cast immobilization and exercise on the development of pain behaviors and CRPS symptoms.
Peripheral nerve injury and subsequent regeneration often lead to a variety of sensory changes. Researchers hope to identify specific cellular and molecular changes in sensory neurons following peripheral nerve injury to better understand the processes that underlie neuroplasticity (the brain’s ability to reorganize or form new nerve connections and pathways following injury or death of nerve cells). Identifying these mechanisms could provide targets for new drug therapies that could improve recovery following regeneration.
Children and adolescents with CRPS generally have a better prognosis than adults, which may provide insights into mechanisms that can prevent chronic pain. Scientists are studying children with CRPS given that their brains are more adaptable through a mechanism known as neuroplasticity. Scientists hope to use these discoveries in order to develop more effective therapies for CRPS.
NINDS-funded scientists continue to investigate how inflammation and the release of adenosine triphosphate (ATP) may induce abnormal connections and signaling between sympathetic and sensory nerve cells in chronic pain conditions such as CRPS. (ATP is a molecule involved with energy production within cells that can also act as a neurotransmitter. Neurotransmitters are chemicals used by nervous system cells to communicate with one another.) A better understanding of changes in nerve connections following peripheral nerve injury may offer greater insight to pain and lead to new treatments.

Article Provided By: ninds
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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Pinched Nerve In Shoulder

What happens with a pinched nerve in the shoulder?

A pinched nerve in the shoulder occurs when a nearby structure irritates or presses on a nerve coming from the neck. This can lead to shoulder pain and numbness of the arm and hand.
Doctors may also refer to a pinched nerve in the shoulder arising from the neck as cervical radiculopathy.
An acute injury or changes to the body over time can cause a pinched nerve in the shoulder. This article will identify common symptoms, causes, and treatments for the condition.
Signs and symptoms

Disk degeneration or herniation can cause a pinched nerve in the shoulder.
A pinched nerve in the shoulder will typically cause pain, numbness, or discomfort in the shoulder region.
A person may also have other symptoms, which include:

changes in feeling on the same side as the shoulder that hurts
muscle weakness in the arm, hand, or shoulder
neck pain, especially when turning the head from side to side
numbness and tingling in the fingers or hand
Causes
A pinched nerve in the shoulder occurs when material, such as bone, disk protrusions, or swollen tissue, puts pressure on the nerves extending from the spinal column toward the neck and shoulder.
The spinal column consists of 24 bones called vertebrae that sit atop each other with protective, cushion-like disks between each one.
Doctors divide the spinal column into three regions based on the area of the body and the appearance of the spinal bones. These include:
Cervical spine: Consisting of the first seven vertebrae.
Thoracic spine: Made up of the middle 12 vertebrae.
Lumbar spine: Consisting of the last five vertebrae.
A pinched nerve in the shoulder affects the cervical spine specifically. Extending from the cervical spine are nerves that transmit signals to and from the brain to other areas of the body.
Some common causes of a pinched nerve in the shoulder include:
Disk degeneration: Over time, the gel-like disks between the cervical vertebrae can start to wear down. As a result, the bones can get closer together and potentially rub against each other and the nerves. Sometimes, a person will develop bony growths on their vertebrae called bone spurs. These can also press on shoulder nerves.
Herniated disk: Sometimes a disk can stick out and press on nerves where they exit the spinal column. A person will tend to notice this pain more with activities, such as twisting, bending, or lifting.
Acute injury: A person can experience an injury, such as from a car accident or sports activity, that causes a herniated disk or tissue inflammation in the body that presses on the nerves.
A doctor can usually identify the cause of a pinched nerve in the shoulder by taking a medical history, doing a physical exam, and requesting imaging studies.

 

How does a doctor diagnose shoulder pain?

A doctor can use an X-ray to diagnose a pinched nerve.
Doctors will start to diagnose a person’s shoulder pain by taking a history and doing a physical examination.
They will ask a person about the symptoms they are experiencing, such as when they first noticed these, and what makes them worse or better. A doctor will also examine the shoulder, neck, and surrounding areas to try to identify any noticeable problems.
A doctor will often order further tests to confirm a diagnosis or rule out other causes. Examples of these tests include:
X-ray or computed tomography (CT) scan: These tests provide details of spinal bones to help identify changes to the bones that may be pressing on a nerve.
Magnetic resonance imaging (MRI): This test provides greater detail of soft tissue and nerves that a CT scan or X-ray cannot.
Electrodiagnostic studies: These tests use special needles that send electrical signals to different areas of the neck and shoulder. They can test the nerve functions in the body to work out where one is compressed.
These tests can help a doctor identify a pinched nerve in the shoulder or another condition that may also cause shoulder pain. Examples of other conditions include:
a tendon tear
arthritis or inflammation of the joints
bursitis or inflammation of the fluid-filled sacs that cushion the joints
shoulder fracture

Treatment options
Most people with a pinched nerve in the shoulder will get better over time and do not require any treatment.
When necessary to make treatment recommendations, a doctor will consider:
what is causing the pinched nerve
how severe the pain is
how the pinched nerve affects daily activities
A doctor will usually recommend nonsurgical treatments first. If a person’s pain does not respond to these treatments or gets worse, the doctor may then recommend surgery.
Nonsurgical treatments for a pinched nerve include:
taking nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
taking oral corticosteroids to relieve inflammation
injecting corticosteroids to reduce swelling and inflammation
wearing a soft, cervical collar to limit movement in the neck to allow the nerves to heal
undertaking physical therapy and exercises to reduce stiffness and improve range of motion
taking pain-relieving medication for a short time to reduce the most immediate effects of shoulder pain
Sometimes pain due to a pinched nerve in the shoulder will come and go. But if a person’s pain is the result of degenerative changes, their pain may worsen with time.
If the above treatments no longer relieve pain, a doctor may recommend surgery. Types of surgery can include:
Anterior cervical discectomy and fusion (ACDF): In this procedure, a surgeon accesses the neck bones from the front of the neck. They will remove the area of disk or bone that is causing pain before fusing areas of the spine together to reduce pain.
Artificial disk replacement: This procedure involves replacing a diseased or damaged disk with an artificial one made from metal, plastic, or a combination of both. As with an ACDF, a surgeon will access the spinal column from the front of the neck.
Posterior cervical laminoforaminotomy: This procedure involves making a 1- to 2-inch cut on the back of the neck and removing portions of the spine that may be pressing on the nerves in the back.
Decompression of the suprascapular nerve: This means the surgeon tries to free up the nerve in the region of the scapular notch if this nerve is compressed.
The surgical approach will depend on a person’s symptoms and what area of the spine or tissue is pressing on the nerves.

Managing a pinched nerve in the shoulder

An ice pack can help to manage intense symptoms of a pinched nerve.
The pain from a pinched nerve in the shoulder often comes and goes. When a person is experiencing intense symptoms, they may wish to try the following:
Apply cloth-covered ice packs to the neck and shoulder blade area over a period of up to 48 hours after the pain began. After this time, they can use warm, moist heat to relieve pain.
Sleep with a pillow designed to support the neck. These pillows are available to purchase online.
Take anti-inflammatory or pain-relieving medications.
When a person’s symptoms start to get better, they may want to try doing the following to help prevent further episodes of pain:
Focusing on proper postures when sleeping and sitting at a desk. People can use devices, such as a hands-free phone, to avoid having to strain or move the neck repetitively. Adjusting chair and keyboard height may also reduce strain on the back.
Engaging in regular exercise to reduce stiffness and help maintain a healthy weight.
Having massages that can boost circulation to inflamed areas, which can aid healing. Massages can also relieve muscle tension.
A physical or occupational therapist can be helpful in recommending exercises and giving advice on how to improve posture at home and at work.

Outlook
A pinched nerve in the shoulder can be a painful problem that can lead to weakness, tingling, and numbness in the hand and arm.
Over-the-counter measures can usually help to reduce symptoms. If these methods do not work, surgical options are available.
People should always talk to their doctor when they have shoulder pain that lasts beyond a few days.

Last medically reviewed on January 14, 2020

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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Hyperalgesia

Hyperalgesia: It Hurts Everywhere!!

Christina Lasich, MD
Health Professional
March 2, 2013

Imagine if a paper cut felt like a red, hot poker stabbed you. Imagine if a small bruise felt like a sledge hammer hit you. If you are able to imagine these examples or maybe have even felt this way, then you know what it is like to have hyperalgesia. This term means that the tissue involved has an increased sensitivity to painful stimuli. The small hurts hurt even worse. The minor injuries feel ten times worse. And it seems to hurt everywhere.

Where does hyperalgesia come from? And why does it happen? Increased sensitivity to pain can occur in damaged or undamaged tissue. Remember, pain does not necessarily mean that something is damaged. But pain does mean that the brain is interpreting signals from the body that seem threatening. Sometimes those signals are amplified because of the superactivation of the pain pathways. And sometimes those signals are amplified because of the suppression natural pain-relieving pathways in the body. Whether you have over-activity of pain pathways or suppression of pain-relieving pathways or both, all these roads can lead to an increased sensitivity to pain.

A classic example of hyperalgesia is felt when someone is experiencing opioid withdrawals. The sudden discontinuation of pain medications leaves a person with a non-functioning natural-pain relieving system while at the same time, the pain pathways deep within the nervous system become extremely active. This perfect storm of hyperalgesia causes a person to feel achy and sensitive everywhere. (1)

 

Another example of an increased sensitivity to pain is getting more and more notoriety because of the overuse of short-acting opioid medications for the treatment of chronic pain. This condition is called opioid-induced hyperalgesia. Pain medication can cause more pain if the user is experiencing a frequent cycle of withdrawals. As already mentioned, opioid withdrawals are well known to cause hyperalgesia. Furthermore, the frequent cycle of withdrawals sensitizes the nervous system. (2)

Nervous system sensitization is probably the most common reason for someone to experience an increased sensitivity to pain. Common conditions like fibromyalgia, headaches and sciatica are all conditions that typically have a component of hyperalgesia associated with that experience. Furthermore, each of those conditions is also related to a nervous system that has been altered in some way to be overactive and wound-up. The nervous system is your alarm system. When your alarm system overreacts to painful stimuli, all the little hurts feel HUGE.

And that might be the reason why you hurt everywhere. Hyperalgesia is not only an increased sensitivity to pain; it is also an indicator that someone’s alarm system might be dysfunctional because of the sudden withdrawal of medications, the overuse of medications or the sensitization of the nervous system. The hyperalgesia process can be reversed. It’s a matter of resetting the alarm. Allowing the body’s natural pain-relieving system to turn back on, eliminating the frequent cycles of withdrawals and desensitizing the nervous system are all ways to treat the increased sensitivity to pain. Unfortunately, resetting your alarm system is easier said than done.

Pain. 2013 Jan 11. pii: S0304-3959(13)00011-0

Cephalalgia. 2013 Jan;33(1):52-64

 

Article Provided By: Healthcentral

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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Allodynia

What to know about allodynia

Someone who has allodynia feels pain from non-painful stimuli. For example, a person may feel pain from a light touch or when brushing their hair.
Allodynia can be a symptom of several different nerve conditions, or it can occur on its own.
Allodynia is not the same thing as an increased response to painful stimuli.
Some people feel extreme pain from something minor, such as a paper cut. Feeling increased pain or being hypersensitive to mild pain is called hyperalgesia.
Individuals with allodynia, however, feel pain when something is ordinarily painless.

Symptoms

Allodynia is characterized by intense feelings of pain with no clear cause.
Pain is one of the body’s protective mechanisms. It tells a person to stop doing something that is harmful.
For instance, a pain response causes a person to pull their hand away from a hot stove, preventing a severe burn. But people with allodynia perceive pain even though there is nothing harmful causing the pain.
The main symptom of allodynia is pain from non-painful stimuli.
Some people with allodynia may experience severe pain even from a few hairs brushing against their skin.
Symptoms can vary from mild to severe. Some people may feel a burning sensation while others feel an ache or squeezing pain.
Allodynia can limit the activities a person is able to do and decrease their quality of life. Common complications of allodynia include:
depression
anxiety
sleep disturbances
fatigue

Types of allodynia
There are three main types of allodynia, which are classified according to what causes the pain.
Regardless of the type of allodynia, pain is still the main symptom. Some people may only have one type of allodynia. Others may have all three types of the condition.
Types of allodynia include:
Thermal allodynia: Thermal allodynia causes temperature-related pain. Pain occurs due to a mild change of temperature on the skin. For example, a few drops of cold water on the skin may be painful.
Mechanical allodynia: Movement across the skin causes mechanical allodynia. For instance, bedsheets pulled across a person’s skin may be painful.
Tactile allodynia: Tactile allodynia, also called static allodynia, occurs due to light touch or pressure on the skin. For example, a tap on the shoulder may cause pain for someone with tactile allodynia.

Causes and risk factors

Something as simple as hair being brushed may cause intense pain to someone with allodynia.
The exact cause of allodynia is not known.
Allodynia may occur due to increased responsiveness or malfunction of nociceptors, which are a particular type of nerve.
Having one of the following medical conditions may also increase a person’s risk of developing allodynia.
Migraines: Migraines can cause debilitating head pain, but a headache is often not the only symptom. Migraines can also cause additional symptoms, such as nausea and sensitivity to sound and light. According to the American Migraine Foundation, up to 80 percent of people experience symptoms of allodynia during a migraine.
Postherpetic neuralgia: Postherpetic neuralgia is a complication of shingles, which is caused by the same virus that causes chicken pox. Shingles can cause damage to the nerve fibers, which leads to persistent nerve pain and is associated with allodynia.
Fibromyalgia: Fibromyalgia is a medical condition that causes widespread pain in the body. The cause of fibromyalgia is not known, but there does appear to be a genetic link in some instances. There also seems to be a connection between allodynia and fibromyalgia.
Diabetes: Over time, diabetes can cause damage to nerves, increasing the likelihood that a person will develop allodynia. Nerve growth factor (NGF) is essential to the nervous system, and some experts have suggested that diabetes can lower NGF levels. A recent study in rodents showed that low levels of NGF led to both hyperalgesia and allodynia.
Complex regional pain syndrome: Complex regional pain syndrome (CRPS) is a long-term pain condition that tends to affect one limb, typically after the person injures the area. People believe CRPS occurs due to problems with the nervous systems.

Diagnosis and when to see a doctor
There is not one specific medical test to diagnose allodynia. Instead, a doctor will perform a physical exam, take a medical history, and review a person’s symptoms.
Many common conditions can cause chronic pain, so doctors may need to rule out certain medical conditions before they can make a diagnosis of allodynia.
Various nerve sensitivity tests may also be performed to help make a diagnosis.
Anyone who experiences pain from non-painful stimuli, such as light touch, should see their doctor.
Dealing with chronic pain that develops after even the mildest touch can be frustrating and upsetting. Receiving an accurate diagnosis can help someone start the treatment and management process.

Treatment

Topical creams may help to treat the symptoms of allodynia. Recommended treatment will be based on the cause of the condition.
Currently, there is no cure for allodynia. Treatment is aimed at decreasing pain, using medications and lifestyle changes.
Pregabalin is a medication used to treat nerve pain associated with conditions, such as spinal cord injuries, diabetes, fibromyalgia, and shingles. It may also decrease pain in some people with allodynia.
Topical pain medications, such as creams and ointments containing lidocaine, may be helpful in some cases. Over-the-counter, non-steroidal medicines may also be effective.
Complementary approaches to pain management, such as acupuncture and massage, may not be tolerated as they involve touch and can lead to discomfort for a person with allodynia.
Treating an underlying condition that is causing allodynia may also help. For example, preventing migraines or treating migraines straightaway can help reduce the risk of allodynia symptoms. Getting diabetes under good control can also be helpful.
Some people might find that lifestyle changes, such as light exercise, a healthful diet, and getting enough sleep might help.
Research shows that smokers experience more chronic pain than nonsmokers. Quitting smoking can be beneficial on many levels, from improving circulation to decreasing inflammation.
Although living a healthful lifestyle will not cure allodynia, it can enhance overall health and help people with the condition cope more efficiently.
Identifying and decreasing pain triggers as much as possible may also reduce symptoms. It may not be possible to limit all the things that cause discomfort, but some changes may help.
For example, it might not be reasonable for someone to shave their head if brushing their hair hurts. But switching to a different type of brush or brushing it less frequently may be possible.
Similarly, if certain fabrics hurt the skin, a person can try clothing made of a different, less irritating material.
Stress may make the pain worse in some people. So, learning stress management techniques may also help.
Although stress reduction may not improve allodynia in every case, developing better stress management techniques can help a person cope with their condition.

Outlook
Allodynia is not life-threatening, but it can make daily life difficult and cause frustrating limitations. It can also lead to anxiety and other mental health conditions.
The outlook for people with allodynia varies depending on the severity of the condition. Taking a comprehensive approach to treatment can improve the outlook.
Using a combination of pain management techniques along with lifestyle changes may decrease symptoms of allodynia.
A holistic approach can also help someone feel more in control of their condition and improve their overall quality of life.

Last medically reviewed on August 10, 2017

Article Provided By: Medical News Today

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Paresthesia

What Is Paresthesia?

If you’ve ever felt as though your skin was crawling, or had numbness or itching for no apparent reason, you may have experienced paresthesia.
Almost everyone has experienced paresthesia on occasion. One of the most common times people get that familiar feeling of pins and needles is when their arms or legs “fall asleep.” This sensation usually occurs because you’ve inadvertently put pressure on a nerve. It resolves once you change your position to remove the pressure from the affected nerve. This type of paresthesia is temporary and usually resolves without treatment. If the paresthesia persists, you may have an underlying medical disorder that requires treatment.
What are the symptoms of paresthesia?
Paresthesia can affect any part of the body, but it commonly affects the:
hands
arms
legs
feet
It can be temporary or chronic. The symptoms can include feelings of:
numbness
weakness
tingling
burning
cold
Chronic paresthesia may cause a stabbing pain. That may lead to clumsiness of the affected limb. When paresthesia occurs in your legs and feet, it can make it difficult to walk.
See your doctor if you have symptoms of paresthesia that persist or affect with your quality of life. It could be a sign that you have an underlying medical condition that needs treatment.

What causes paresthesia?
It’s not always possible to determine the cause of paresthesia. Temporary paresthesia is often due to pressure on a nerve or brief periods of poor circulation. This can happen when you fall asleep on your hand or sit with your legs crossed for too long. Chronic paresthesia may be a sign of nerve damage. Two types of nerve damage are radiculopathy and neuropathy.
Radiculopathy
Radiculopathy is a condition in which nerve roots become compressed, irritated, or inflamed. This can occur when you have:
a herniated disk that presses on a nerve
a narrowing of the canal that transmits the nerve from your spinal cord to your extremity
any mass that compresses the nerve as it exits the spinal column
Radiculopathy that affects your lower back is called lumbar radiculopathy. Lumbar radiculopathy can cause paresthesia in your leg or foot. In more severe cases, compression of the sciatic nerve can occur and may lead to weakness in your legs. The sciatic nerve is a large nerve that starts in your lower spinal cord.
Cervical radiculopathy involves the nerves that provide sensation and strength to your arms. If you have cervical radiculopathy, you may experience:
chronic neck pain
paresthesia of the upper extremities
arm weakness
hand weakness
Neuropathy
Neuropathy occurs due to chronic nerve damage. The most common cause of neuropathy is hyperglycemia, or high blood sugar.
Other possible causes of neuropathy include:
trauma
repetitive movement injuries
autoimmune diseases, such as rheumatoid arthritis
neurological diseases, such as MS
kidney diseases
liver diseases
stroke
tumors in the brain or near nerves
bone marrow or connective tissue disorders
hypothyroidism
deficiencies in vitamin B-1, B-6, B-12, E, or niacin
getting too much vitamin D
infections, such as Lyme disease, shingles, or HIV
certain medications, such as chemotherapy drugs
exposure to toxic substances, such as chemicals or heavy metals
Nerve damage can eventually lead to permanent numbness or paralysis.

Who is at risk for paresthesia?
Anyone can experience temporary paresthesia. Your risk of radiculopathy increases with age. You also may be more prone to it if you:
perform repetitive movements that repeatedly compress your nerves, such as typing, playing an instrument, or playing a sport such as tennis
drink heavily and eat a poor diet that leads to vitamin deficiencies, specifically vitamin B-12 and folate
have type 1 or 2 diabetes
have an autoimmune condition
have a neurological condition, such as MS

 

How is paresthesia diagnosed?
See your doctor if you have persistent paresthesia with no obvious cause.
Be prepared to give your medical history. Mention any activities you participate in that involve repetitive movement. You should also list any over-the-counter or prescription medications that you take.
Your doctor will consider your known health conditions to help them make a diagnosis. If you have diabetes, for example, your doctor will want to determine if you have nerve damage, or neuropathy.
Your doctor will probably perform a full physical exam. This will likely include a neurological exam as well. Blood work and other laboratory tests, such as a spinal tap, may help them rule out certain diseases.
If your doctor suspects there’s a problem with your neck or spine, they may recommend imaging tests, such as X-rays, CT scans, or MRI scans.
Depending on the results, they may refer you to a specialist, such as a neurologist, orthopedist, or endocrinologist.

What is the treatment for paresthesia?
Treatment depends on the cause of your paresthesia. It may be possible to treat your condition by eliminating the cause in some cases. For example, if you have a repetitive movement injury, a few lifestyle adjustments or physical therapy may solve the problem.
If your paresthesia is due to an underlying disease, getting treatment for that disease can potentially ease the symptoms of paresthesia.
Your individual circumstances will determine whether your symptoms will improve. Some types of nerve damage are irreversible.

What is the outlook for people with paresthesia?
Temporary paresthesia usually resolves within a few minutes.
You may have a case of chronic paresthesia if those strange sensations don’t go away or they come back far too often. It can complicate your daily life if the symptoms are severe. That’s why it’s so important to try to find the cause. Don’t hesitate to seek a second opinion or see a specialist if necessary.
The severity of chronic paresthesia and how long it will last largely depends on the cause. In some cases, treating the underlying condition solves the problem.
Be sure to tell your doctor if your treatment isn’t working so they can adjust your treatment plan.
How can you prevent paresthesia?
Paresthesia isn’t always preventable. For instance, you probably can’t help it if you tend to fall asleep on your arms. You can take steps to reduce the occurrence or severity of paresthesia, though. For example, using wrist splints at night may alleviate the compression of the nerves of your hand and help resolve the symptoms of paresthesia you experience at night.
Follow these tips for preventing chronic paresthesia:
Avoid repetitive movement if possible.
Rest often if you need to perform repetitive movements.
Get up and move around as often as possible if you have to sit for long periods.
If you have diabetes or any other chronic disease, careful monitoring and disease management will help lower your chances of having paresthesia.

Article Provided By: healthline

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Neuropathic Pain Management

Neuropathic Pain Management

Neuropathic pain is often described as a shooting or burning pain. It can go away on its own but is often chronic. Sometimes it is unrelenting and severe, and sometimes it comes and goes. It often is the result of nerve damage or a malfunctioning nervous system. The impact of nerve damage is a change in nerve function both at the site of the injury and areas around it.
One example of neuropathic pain is called phantom limb syndrome. This rare condition occurs when an arm or a leg has been removed because of illness or injury, but the brain still gets pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.
Causes of Neuropathic Pain
Neuropathic pain often seems to have no obvious cause. But some common causes of neuropathic pain include:
Alcoholism
Amputation
Chemotherapy
Diabetes
Facial nerve problems
HIV infection or AIDS
Multiple myeloma
Multiple sclerosis
Nerve or spinal cord compression from herniated discs or from arthritis in the spine
Shingles
Spine surgery
Syphilis
Thyroid problems
Symptoms of Neuropathic Pain
Neuropathic pain symptoms may include:

Shooting and burning pain
Tingling and numbness

Diagnosing Neuropathic Pain
To diagnose neuropathic pain, a doctor will conduct an interview and physical exam. He or she may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain. The doctor will also ask about your risk factors for neuropathic pain and may also request both blood and nerve tests.
Neuropathic Pain Treatment
Anticonvulsant and antidepressant drugs are often the first line of treatment. Some neuropathic pain studies suggest the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Aleve or Motrin, may ease pain. Some people may require a stronger painkiller. Be sure to discuss the pros and cons of the medicine you take with your doctor.

If another condition, such as diabetes, is involved, better management of that disorder may alleviate the pain. Effective management of the condition can also help prevent further nerve damage.
In cases that are difficult to treat, a pain specialist may use an invasive or implantable device to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain may significantly control the pain symptoms.
Other kinds of treatments can also help with neuropathic pain. Some of these include:
Physical therapy
Working with a counselor
Relaxation therapy
Massage therapy
Acupuncture
Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability. A multidisciplinary approach that combines therapies, however, can be a very effective way to provide relief from neuropathic pain.

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on August 11, 2019

Article Provided By: Webmd

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RSD

Reflex Sympathetic Dystrophy

Reflex sympathetic dystrophy (RSD) is a type of complex regional pain syndrome (CRPS). This condition occurs because of malfunctions in your sympathetic nervous system and immune system. RSD causes severe pain in one or more limbs that lasts months or longer.
In general, the condition develops after an injury or other medical condition. RSD can lead to many physical and emotional symptoms. A variety of treatments are available for RSD, and it’s important to get treated early to prevent worsening of your symptoms.

Symptoms
RSD occurs in the extremities. It most commonly affects the upper limbs, but it’s possible to get it in your lower limbs as well. Specifically, you may experience RSD in your:
hands
fingers
arms
shoulders
legs
hips
knees
Symptoms include:
stiffness
discomfort
pain or burning sensation
swelling
sensitivity to heat or cold
weakness
feeling warm to the touch
skin redness
skin paleness with a blue tone
tenderness
sweating around the affected area
changes to the skin in the affected area
muscle weakness
muscle spasms
muscle atrophy
joint pain and stiffness
nail and hair changes
Most symptoms begin at the site of the condition but may spread as RSD progresses. You may have symptoms on one side but notice them in your opposite limb as the condition worsens. Symptoms may begin as mild and then become more severe, interfering with your daily life.
Your mental health can also be affected with RSD. You may experience anxiety, depression, or post-traumatic stress disorder related to the condition.

Causes
RSD occurs when your sympathetic nervous system and immune system malfunction because of nerve damage. It affects up to 200,000 Americans annually. The damaged nerves misfire, sending your brain excessive signals of pain from the affected area.
According to the National Institute of Neurological Disorders and Stroke, 90 percent of people with CRPS can point to their medical history to determine what caused the condition. Many underlying conditions and factors can lead to RSD, including:
trauma, such as fractures, broken bones, or amputation
infection
soft tissue injuries such as burns and bruises
sprains
radiation therapy
cancer
surgery
paralysis of one side of the body
heart attack
emotional stress
nerve pressure
stroke
You may also experience RSD with no prior medical condition. Your doctor will try to determine the cause of the RSD if this is the case.

Factors that may put you at risk
You may be more susceptible to RSD if you:
are between the ages of 40 and 60 years
are a woman
have other inflammatory or autoimmune conditions

How it’s diagnosed
There isn’t a definitive test for RSD. Your doctor will need to take your medical history, conduct several tests, and perform a thorough physical examination. It’s important to diagnose the condition early to prevent it from getting worse, though diagnosis isn’t always straightforward. You may wait for many months or even longer before your doctor diagnoses RSD.
Tests your doctor may perform include:
bone scans
MRI scans
X-rays
sympathetic nervous system tests
skin temperature readings
Your doctor may check for other medical conditions before diagnosing RSD. These conditions are treated differently than RSD. They include:
arthritis
Lyme disease
muscle diseases
blood clots in your veins
small fiber polyneuropathies

Treatment
Early treatment is imperative to stop RSD from worsening or spreading. However, early treatment can be difficult if it takes time to diagnose the condition.
Treatments for RSD vary. Certain interventions and medications may help relieve and treat symptoms. You may also seek physical therapy and psychotherapy to reduce the effects of RSD. You may find that your condition improves dramatically with treatment, but some people have to learn how to manage their symptoms.
Medical procedures
Interventions for RSD include:
transcutaneous electrical nerve simulation
biofeedback
peripheral nerve blocks
spinal cord stimulation
pump implantation
sympathectomy, either chemical or surgical, which destroys some of your sympathetic nerves
deep brain stimulation
intrathecal (in the spine) drug pumps
electroacupuncture
Medication
A variety of medications are available for RSD, ranging from over-the-counter pain relievers and topical creams to prescription drugs from your doctor. These medications include:
anticonvulsants
antidepressants
beta-blockers
benzodiazepines
bisphosphonates
guanethidine
membrane stabilizers
muscle relaxers
nonsteroidal anti-inflammatory drugs
opioids
systemic steroids
topical anesthetics
vasodilators
Therapies
Physical therapy may help you rehabilitate the affected limb. This type of therapy will ensure that you continue to move the limb to retain its abilities. It also improves your blood flow and reduces symptoms related to circulation problems. Regular physical therapy may be needed to reduce symptoms.
Seeing a health professional for psychotherapy may also be necessary with RSD. You may develop a psychological condition from the chronic pain associated with the condition. Psychotherapy will help you manage your mental health.
You may also find that complementary alternative therapies like acupuncture or relaxation methods work for treating your RSD.

About prevention
While some research discusses the prevention of RSD for specific cases, there is no conclusive evidence that a person can avoid RSD completely.
People who’ve had a stroke should be mobilized soon afterward to avoid developing RSD. If you’re taking care of a loved one with a stroke, help them get up and walking around. This movement may also be useful to people who’ve had heart attacks.
Read more: What to expect when recovering from a stroke »
Taking daily vitamin C after a fracture may also decrease your chances of CRPS.
Outlook
RSD can result in a variety of outcomes. You may find that early intervention and treatment minimizes your symptoms and allows you to return to life as usual. On the other hand, your symptoms may get worse and may not be diagnosed in a timely fashion. In these cases, it’s necessary to learn how to best manage your symptoms for the fullest life possible.

Article Provided By: healthline

 

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CRPS, Complex Regional Pain Syndrome, Pain Relief, Chronic Pain, Pain Therapy, Pain Management, Carolina Pain Scrambler Center, Greenville South Carolina

Telltale Signs of CRPS/RSD

You are likely researching CRPS/RSD because you or a loved one are experiencing unexplained moderate-to-severe pain and are trying to find the cause. Perhaps a Google search of the symptoms got you to this page. You may have already visited one or more physicians.

A physician may have suggested that your symptoms could possibly be CRPSComplex Regional Pain Syndrome – or, RSD – Reflex Sympathetic Dystrophy, but that they do not specialize in this condition. You are on a journey for a concrete diagnosis.

First of all, you may or may not have CRPS/RSD. There are a number of conditions that have serious, chronic pain as a symptom, along with others that are also present in CRPS/RSD. Here you can learn more about this condition and its symptoms to help you and your doctor rule it in — or rule it out.

What is CRPS/RSD?

CRPS/RSD is a chronic neuro-inflammatory disorder. It is classified as a rare disorder by the United States Food and Drug Administration. However, up to 200,000 individuals experience this condition in the United States, alone, in any given year.

CRPS occurs when the nervous system and the immune system malfunction as they respond to tissue damage from trauma. The nerves misfire, sending constant pain signals to the brain. The level of pain is measured as one of the most severe on the McGill University Pain Scale.

CRPS generally follows a musculoskeletal injury, a nerve injury, surgery or immobilization.

The persistent pain and disability associated with CRPS/RSD require coordinated, interdisciplinary, patient-centered care to achieve pain reduction/cessation and better function.

It has been shown that early diagnosis is generally the key to better outcomes. However diagnosing CRPS/RSD is not a simple matter and many patients search for months or years for a definitive diagnosis.

It is important to know that research has proven that CRPS/RSD is a physical disorder. Unfortunately, it has not been unusual for medical professionals to suggest that people with CRPS/RSD exaggerate their pain for psychological reasons. Trust your body and continue to seek a diagnosis. If it’s CRPS/RSD, the pain is not in your mind!

Making the Diagnosis

There is no single diagnostic tool for CRPS/RSD. Physicians diagnose it based on patient history, clinical examination, and laboratory results. Physicians must rule out any other condition that would otherwise account for the degree of pain and dysfunction before considering CRPS/RSD.

Early diagnosis and appropriate treatment offer the highest probability of effective treatment and possible remission of CRPS/RSD.

CRPS/RSD Signs and Symptoms Checklist

There is no gold standard for diagnosing CRPS/RSD. If the pain is getting worse, not better, and if the pain is more severe than one would expect from the original injury, it might be CRPS/RSD.

Look for these telltale signs and symptoms:

  • Pain that is described as deep, aching, cold, burning, and/or increased skin sensitivity
  • An initiating injury or traumatic event, such as a sprain, fracture, minor surgery, etc., that should not cause as severe pain as being experienced or where the pain does not subside with healing
  • Pain (moderate-to-severe) associated with allodynia, that is, pain from something that should not cause pain, such as the touch of clothing or a shower
  • Continuing pain (moderate-to-severe) associated with hyperalgesia, that is, heightened sensitivity to painful stimulation)
  • Abnormal swelling in the affected area
  • Abnormal hair or nail growth
  • Abnormal skin color changes
  • Abnormal skin temperature, that is, one side of the body is warmer or colder than the other by more than 1°C
  • Abnormal sweating of the affected area
  • Limited range of motion, weakness, or other motor disorders such as paralysis or dystonia
  • Symptoms and signs can wax and wane
  • Can affect anyone, but is more common in women, with a recent increase in the number of children and adolescents who are diagnosed

Please keep in mind that this information is not intended as medical advice, nor is it a substitute for a diagnosis by a qualified, medical professional. Please feel free to share the information with your doctor or doctors.

Article Provided By: RSDSA

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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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