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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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Exercises for Peripheral Neuropathy

Exercises for Peripheral Neuropathy

Alternative treatments for peripheral neuropathy
About 20 million people across the country live with a form of peripheral neuropathy. Peripheral neuropathy is nerve damage disorder that typically causes pain in your hands and feet. Other common symptoms of this disorder include:
muscle weakness
numbness
tingling
poor balance
inability to feel pain or temperature
Treatment options typically focus on pain relief and treating the underlying cause. However, studies show that exercise can effectively preserve nerve function and promote nerve regeneration.
Exercise techniques for peripheral neuropathy
There are three main types of exercises ideal for people with peripheral neuropathy: aerobic, balance, and stretching.
Before you start exercises, warm up your muscles with dynamic stretching like arm circles. This promotes flexibility and increases blood flow. It will boost your energy, too, and activate your nerve signals.
Aerobic exercises
Aerobic exercises move large muscles and cause you to breathe deeply. This increases blood flow and releases endorphins that act as the body’s natural painkillers.
Best practices for aerobic exercising include routine activity for about 30 minutes a day, at least three days a week. If you’re just starting out, try exercising for 10 minutes a day to start.
Some examples of aerobic exercises are:
brisk walking
swimming
bicycling
Balance training
Peripheral neuropathy can leave your muscles and joints feeling stiff and sometimes weak. Balance training can build your strength and reduce feelings of tightness. Improved balance also prevents falls.
Beginning balance training exercises include leg and calf raises.
Side leg raise
Using a chair or counter, steady your balance with one hand.
Stand straight with feet slightly apart.
Slowly lift one leg to the side and hold for 5–10 seconds.
Lower your leg at the same pace.
Repeat with the other leg.
As you improve balance, try this exercise without holding onto the counter.
Calf raise
Using a chair or counter, steady your balance.
Lift the heels of both feet off the ground so you’re standing on your toes.
Slowly lower yourself down.
Repeat for 10–15 reps.
Stretching exercises
Stretching increases your flexibility and warms up your body for other physical activity. Routine stretching can also reduce your risk of developing an injury while exercising. Common techniques are calf stretches and seated hamstring stretches.
Calf stretch
Place one leg behind you with your toe pointing forward.
Take a step forward with the opposite foot and slightly bend the knee.
Lean forward with the front leg while keeping the heel on your back leg planted on the floor.
Hold this stretch for 15 seconds.
Repeat three times per leg.
Seated hamstring stretch
Sit on the edge of a chair.
Extend one leg in front of you with your toe pointed upward.
Bend the opposite knee with your foot flat on the floor.
Position your chest over your straight leg, and straighten your back until you feel a muscle stretch.
Hold this position for 15 – 20 seconds.
Repeat three times per leg.

Outlook
Exercise can reduce pain symptoms from peripheral neuropathy. Be sure to stretch after any workout to increase your flexibility and reduce pain from muscle tightness.
Mild pain is normal after stretching and regular activity. However, if your pain worsens or if you develop joint swelling, visit your doctor.

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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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