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The Ideal Diet For Reducing Neuropathy Symptoms

The Ideal Diet For Reducing Neuropathy Symptoms

Written by Marriane Sokolowska
Last updated: September 11th, 2019 06:27 pm

If you suffer from neuropathy, then you will probably have considered many different remedies and medicine.
However, it is also likely that you haven’t yet considered the importance of a good diet to help you manage your symptoms and perhaps even reverse some of the damage.
There is, however, more and more research to demonstrate that there is a direct link between the foods we eat and our nervous system, both positive and negative.

Importance of Good Nutrition for Preventing Neuropathy
In fact, the first line of defense when it comes to preventative medicine is good nutrition, and the same is true for peripheral neuropathy.
Once you have developed it, diet continues to be important in terms of managing and reducing your symptoms, and even healing your nerves.
Neuropathy is often caused by other conditions, most notably diabetes, so it is very important that you control your blood sugar level in order to avoid neuropathy. Similarly, excessive alcohol consumption can lead to certain vitamin B deficiencies, again leading to neuropathy.
Regardless of whether you have neuropathy, cancer, diabetes, an addiction disorder, or any other problem, it is important that you should eat a diet rich in lean protein, whole grains, vegetables, and fruits.

Keep A Food Diary
You may also want to consider keeping a food diary, particularly if you have neuropathy, as this will help you to identify which foods make you feel better, or worse.
Neuropathy can be improved or worsened depending on what you eat. There are foods that can cause further damage to the nerves, weakening them even more. It is important, therefore, to know not just what to eat, but also what to avoid in order to stop your tingling, numbness, and/or nerve pain from getting worse.
At the same time, you can consume foods that make your nerves stronger, thereby improving your existing condition and avoiding it from getting any worse.
In fact, there are even foods that can help to repair any nerves that have been damaged, which means you could get full relief of your symptoms. So what are the foods you really should include, and what should you avoid?
Foods to Include for Reducing Symptoms of Neuropathy
Ginger

This is surprising to many people but ginger is a strong, natural, pain reliever. This means that it can help you feel a lot better. Added to that, it contains gingerols, which have anti-inflammatory properties, thereby increasing mobility in people with serious and chronic pain and helping them to become more mobile.
Water

Water has to be a standard component of any healthy diet. It isn’t a miraculous healer in terms of neuropathy, but what it can do is provide relief from inflammation. This means that the pain you experience as part of neuropathy does not get any worse.
When you start to get dehydrated, your blood starts to thicken and your muscles go into spasm. As a result, inflammation occurs and affects areas where pain receptors and nerves are located. If you ensure that you are always hydrated, your overall bodily functions are better able to function as well, thereby increasing your overall well being.
Fruits and vegetables

Fruits and vegetables are filled with various minerals, vitamins, antioxidants, and dietary fibers. Put together, these help to create a strong immune system while at the same time preventing and fighting disease and illness.
People who have neuropathy should increase their intake of fruits and vegetables immediately. Many people who have neuropathy also have diabetes, and eating plenty of fruits and vegetables means that you will also be better able to control the symptoms of diabetes.
You should try to eat at least five portions of different fruits and vegetables every day in order to see some real results. Try to choose those that have very high levels of antioxidants, including berries, cherries, grapefruit, oranges, Brussels sprouts, onions, and bell peppers.
Another great benefit of fruits and vegetables is that you can purchase them ready to eat. As a result, you don’t have to do a lot of work in the kitchen, which means you will feel much less stressed as well.
Lean protein

Lean protein is necessary for your body to be able to build and repair new tissue. It is important to stick to lean protein, however, so that you don’t eat too many animal fats. Good sources include low fat dairy and poultry, and people with peripheral or diabetic neuropathy should consider increasing their level of consumption.
Avoid eating processed foods, as well as foods with high trans and saturated fats, including deep fried foods, cheese, butter, whole milk, and fatty meat. Not only can these make your neuropathy worse, they can also lead to heart disease, high cholesterol, and diabetes.
You should try to add things like fish, tofu, yogurt, low fat milk, legumes, and skinless poultry to your diet, for balanced nutrition, for the best results. Lean protein is not just important to combat neuropathy, it is also has a positive influence on your blood sugar level.
Foods to Avoid
Peripheral and diabetic neuropathy can be caused or worsened by vitamin deficiencies, diabetes, traumatic injuries, alcoholism, and more. To treat it, you will often have to find a way to manage that underlying cause, which includes medication and therapy, but you should also take a close look to your diet as there are foods that can make it worse. These include:
Gluten

Avoid gluten, particularly, if you have celiac disease. If you are allergic to gluten, consuming it can trigger neuropathy or make symptoms much worse. Gluten can be found in any product made with baking, cake, wheat, or white flower. Hence, switch to gluten free if necessary.
Refined grains

These have a high glycemic level. This means that they significantly impact your blood sugar. You must be able to control your insulin and glucose levels if you are to control diabetic neuropathy in particular. In order to have a better glycemic impact on your diet, you should consume whole grains instead of refined grains
Sugar

This adds a lot of flavor to foods, but little to no nutrients. When you have a nutritional deficiency, it is much easier to experience neuropathy. You should eat lots of whole grains and vegetables and for that occasional sweet treat, fresh fruits.
Saturated fats

These are found mainly in whole fat dairy products and fatty meats. They can lead to inflammation, as well as increasing your chance of having type 2 diabetes.
Final Thoughts
Due to a number of factors, including the amount of toxins in our environment and the poor mineral quality of our soil, the foods we eat are becoming less nutrient dense than in previous generations.
Therefore, it is vital to not only eat organic fruits and vegetables like those listed above, but to also take supplements with your diet to get the proper vitamins, minerals, and nutrients that support optimal nerve health.
You may, for even better effects, also want to consider supplementing your diet with a product like Nerve Renew which is designed for supporting healthy nerves and reducing pain.

 

Article Provided By: nervepaintreatment
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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CRPS

Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome, is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems.
CRPS is most common in people ages 20-35. The syndrome also can occur in children; it affects women more often than men.
There is no cure for CRPS.

What Causes Complex Regional Pain Syndrome?
CRPS most likely does not have a single cause; rather, it results from multiple causes that produce similar symptoms. Some theories suggest that pain receptors in the affected part of the body become responsive to catecholamines, a group of nervous system messengers. In cases of injury-related CRPS, the syndrome may be caused by a triggering of the immune response, which may lead to the inflammatory symptoms of redness, warmth, and swelling in the affected area. For this reason, it is believed that CRPS may represent a disruption of the healing process.
What Are the Symptoms of Complex Regional Pain Syndrome?
The symptoms of CRPS vary in their severity and length. One symptom of CRPS is continuous, intense pain that gets worse rather than better over time. If CRPS occurs after an injury, it may seem out of proportion to the severity of the injury. Even in cases involving an injury only to a finger or toe, pain can spread to include the entire arm or leg. In some cases, pain can even travel to the opposite extremity. Other symptoms of CRPS include:
“Burning” pain
Swelling and stiffness in affected joints
Motor disability, with decreased ability to move the affected body part
Changes in nail and hair growth pattern; there may be rapid hair growth or no hair growth.
Skin changes; CRPS can involve changes in skin temperature — skin on one extremity can feel warmer or cooler compared to the opposite extremity. Skin color may become blotchy, pale, purple or red. The texture of skin also can change, becoming shiny and thin. People with CRPS may have skin that sometimes is excessively sweaty.
CRPS may be heightened by emotional stress.
How Is Complex Regional Pain Syndrome Diagnosed?
There is no specific diagnostic test for CRPS, but some testing can rule out other conditions. Triple-phase bone scans can be used to identify changes in the bone and in blood circulation. Some health care providers may apply a stimulus (for example, heat, touch, cold) to determine whether there is pain in a specific area.
Making a firm diagnosis of CRPS may be difficult early in the course of the disorder when symptoms are few or mild. CRPS is diagnosed primarily through observation of the following symptoms:
The presence of an initial injury
A higher-than-expected amount of pain from an injury
A change in appearance of an affected area
No other cause of pain or altered appearance

How Is Complex Regional Pain Syndrome Treated?
Because there is no cure for CRPS, the goal of treatment is to relieve painful symptoms associated with the disorder. Therapies used include psychotherapy, physical therapy, and drug treatment, such as topical analgesics, narcotics, corticosteroids, osteoporosis medication, antidepressants, osteoporosis medicines, and antiseizure drugs.
Other treatments include:
Sympathetic nerve blocks: These blocks, which are done in a variety of ways, can provide significant pain relief for some people. One kind of block involves placing an anesthetic next to the spine to directly block the sympathetic nerves.
Surgical sympathectomy: This controversial technique destroys the nerves involved in CRPS. Some experts believe it has a favorable outcome, while others feel it makes CRPS worse. The technique should be considered only for people whose pain is dramatically but temporarily relieved by selective sympathetic blocks.
Intrathecal drug pumps: Pumps and implanted catheters are used to send pain-relieving medication into the spinal fluid.
Spinal cord stimulation: This technique, in which electrodes are placed next to the spinal cord, offers relief for many people with the condition.

WebMD Medical Reference Reviewed by Carol DerSarkissian on April 27, 2019
Sources
SOURCES:
National Institute of Neurological Disorders and Stroke: ”Complex Regional Pain Syndrome Fact Sheet.”
UpToDate.
© 2019 WebMD, LLC. All rights reserved.

Article Provided By: webmd
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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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
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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Trigeminal Neuralgia

Trigeminal Neuralgia

Trigeminal Neuralgia
Trigeminal neuralgia is a condition characterized by pain coming from the trigeminal nerve, which affects the face — most commonly one side of the jaw or cheek.
The pain of trigeminal neuralgia is unlike facial pain caused by other problems. It is often described as stabbing, lancinating or electrical in sensation and so severe that the affected person cannot eat or drink.
Trigeminal neuralgia is sometimes known as tic douloureux, which means “painful tic.”

What You Need to Know
Trigeminal neuralgia most frequently affects people older than 50, and the condition is more common in women than men.
Trigeminal neuralgia is the most common cause of facial pain and is diagnosed in approximately 15,000 people per year in the United States.
Trigeminal neuralgia pain is exceptionally severe. Although the condition is not life-threatening, the intensity of the pain can be debilitating.
Trigeminal neuralgia relief is possible: Medical and surgical treatments can bring the pain under control, especially when managed by an expert physician and surgeon.
Causes of Trigeminal Neuralgia
Trigeminal neuralgia may be caused by a blood vessel pressing against the trigeminal nerve. Over time, the pulse of an artery rubbing against the nerve can wear away the insulation, which is called myelin, leaving the nerve exposed and highly sensitive.
These symptoms can be similar to those caused by dental problems, and sometimes people with undiagnosed trigeminal neuralgia explore multiple dental procedures in an effort to control the pain.
Multiple sclerosis or rarely a tumor can cause trigeminal neuralgia. Researchers are exploring whether or not postherpetic neuralgia (caused by shingles) can be related to this condition.

Trigeminal Neuralgia Symptoms
Episodes of sharp, stabbing pain in the cheek or jaw that may feel like an electric shock
Pain episodes that may be triggered by anything touching the face or teeth, including shaving, applying makeup, brushing teeth, eating, drinking or talking — or even a light breeze
Periods of relief between episodes
Anxiety from the thought of the pain returning
A flare-up of trigeminal neuralgia may begin with tingling or numbness in the face. Pain occurs in intermittent bursts that last anywhere from a few seconds to two minutes, becoming more and more frequent until the pain is almost continuous.
Flare-ups may continue for a few weeks or months followed by a pain-free period that can last a year or more.
Trigeminal Neuralgia Diagnosis
Diagnosing trigeminal neuralgia involves a physical exam and a detailed medical history to rule out other causes of facial pain. The health care provider will ask what the pain is like, what seems to set it off and what makes it feel better or worse.
The provider may recommend imaging or laboratory tests to determine if the pain is caused by a tumor or blood vessel abnormality or by undiagnosed multiple sclerosis. Certain advanced MRI techniques may help the doctor see where a blood vessel is pressing against a branch of the trigeminal nerve.
Treatment for Trigeminal Neuralgia
Most common over-the-counter and prescription pain medicines don’t work for people with trigeminal neuralgia, but many modern treatments can reduce or eliminate the pain. The doctor may recommend one or more of these approaches:
Medications: Seizure drugs like carbamazepine, gabapentin or other agents can be helpful. It is important to work closely with a neurologist or primary care provider to monitor dosages and side effects.
Surgery: Several procedures can often help bring trigeminal neuralgia pain under control.
Rhizotomy
There are several kinds of rhizotomies, which are all outpatient procedures performed under general anesthesia in the operating room. The surgeon inserts a long needle through the cheek on the affected side and uses an electrical current or a chemical to deaden the pain fibers of the trigeminal nerve.
Stereotactic Radiosurgery
Stereotactic radiosurgery, sometimes known as CyberKnife treatment, is another outpatient procedure that involves a very concentrated and precise beam of radiation that is directed at the trigeminal nerve to relieve the pain.
Microvascular Decompression (MVD) Surgery
This procedure is currently regarded as the most long-lasting treatment for trigeminal neuralgia and may be suitable for people in good health who can tolerate surgery and general anesthesia and whose lifestyles can accommodate a recovery period of four to six weeks.
The surgeon makes an incision behind the ear and removes a small piece of the skull to gain access to the nerve and blood vessels. Then, the surgeon places a cushion of insulation around the blood vessel so it no longer compresses or rubs against the nerve.
In about one third of people treated with MVD surgeries, trigeminal neuralgia pain returns, possibly due to the blood vessels growing back. The doctor will help individuals with recurring pain choose other options or may recommend repeating procedures.
Managing Trigeminal Neuralgia
Although not fatal, trigeminal neuralgia pain and the anxiety it causes can erode a person’s quality of life. It is essential to work closely with experienced and compassionate health care providers who can help find the best therapeutic approach for each individual.
The surgery for trigeminal neuralgia is delicate and precise since the involved area is very small. Look for experienced neurosurgeons who see and treat a large number of people with trigeminal neuralgia.

 

Article Provided By: hopkinsmedicine
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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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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Finger Nerve Pain

Finger Nerve Pain Causes, Symptoms, and Treatments For Relief

The nerves of the body are like telephone wires that transmit messages between the brain, spinal cord, and other parts of the body. Some of these nerves carry signals of pressure, pain, or temperature from the body and transports them to the brain.

Quite a number of these nerve fibers are located in the fingers, where they are protected and insulated by tissues. Like with the wrist, damage to the nerves in the finger area can be excruciating. Nerve pain in the finger is a form of peripheral neuropathy which usually occurs periodically or constantly but typically felt in both hands.
Our hands are tactile organs which we use to carry out a multitude of tasks which include brushing our teeth, typing, washing, buttoning our clothes and tying our shoelaces. Our hands are hardly ever at rest, so it is not uncommon to experience uncomfortable sensations like throbbing, stabbing pains, or numbness.
Often, these feelings are mild and temporary. However, some people might experience symptoms that are extreme and episodic, which may be a marker for nerve damage from the wrist to the fingers.
The main nerves that control the fingers are the median nerves, the ulnar nerves, and the radial nerves. The median nerve which travels through the carpal tunnel controls impulses in the middle finger, one side of the ring finger, the index finger, and the thumb. The largest unprotected nerve in the body popularly called the ulnar nerve, branches off the adjoining side of the ring finger and the little finger.
This nerve facilitates grasping of objects while creating sensations on the palm. The radial nerve takes an active part in controlling the position of the hands. It provides signals from the bordering half of the ring finger and the posterior of the little finger.
According to WebMD, it is believed that 40 million Americans are saddled with nerve pain. Nerve pain in the fingers may be acute or progress slowly over the years.

Symptoms
The symptoms of nerve pain in the fingers usually begin with a pricking, burning, or tingling sensation in the fingers. Following are the frequent forms of nerve pains in the fingers:
Chronic, intense pain
A pinched nerve
Hypersensitivity to touch and temperature
Burning sensation
The feeling of wearing an invisible sock
Loss of coordination
Irregularities in heart rate and blood pressure
Cramping of muscles
Inability to sleep
Loss of balance
Causes
Quite a number of factors can cause nerve damage in the fingers. They include:
Infections
Exposure to toxins
Diabetic neuropathy
Repetitive stress
Trauma
Types of Nerve Damage
Motor Nerve Damage
Damage to the motor nerves can cause stabbing pains in the fingers. Motor nerves help to transmit impulses from the central nervous system to the muscles of the hands and other parts of the body. Motor nerves partake in activities like catching a ball or writing. Destruction to the motor nerves leads to spasms, cramps, and difficulty in moving the arms.
Sensory Nerve Damage
Sensory nerves in the hands help to direct signals from the muscles to the central nervous system. These nerves help individuals to decipher if a particular object is sharp or blunt, cold, or hot and if it’s stagnant or dynamic. Extreme damage to these sensory nerves of the fingers, causes pain, numbness, burning sensation, tingling, and heightened sensitivity to external stimuli.
Autonomic Nerve Damage
The autonomic nerves oversee semi-voluntary and involuntary functions in the body like sweating, digestion, heart rate, and blood pressure. Injury to the autonomic nerves can result in uncontrolled sweating, vomiting, constipation, irregular heart rate, abnormal blood pressure, nausea, constipation, and sexual dysfunction.
Conditions Which Causes Nerve Pain in the Finger
Any injury to the hand will greatly affect your quality of life and there are quite a number of health conditions which predispose the fingers to nerve pain. They include:
Hand nerve entrapment – hand nerve entrapment occurs in two forms: Carpal Tunnel syndrome and Cubital tunnel syndrome
Ulnar nerve compression
Numbness and tingling
Trigger finger
Goalkeeper’s thumb
Mallet finger
Nail bed injuries
Hand cysts and tumors
Arthritis
Fractures

How to Relieve Nerve Pain in a Finger
Some nerve pain in the finger can heal without any form of intervention while a host of others require early detection and special care to speed up recovery.
Prior to the commencement of treatment, it is crucial to look out for any underlying reason that is causing nerve pain in the hand. The severity of nerve pain has a direct link to how severe an underlying disease condition is. The following ways have been proven to alleviate nerve pains in the finger.
Painkillers
Over-the-counter pain relievers like Ibuprofen usually reduce pain after a short while. If the pain persists after taking painkillers, contact your physician.

Topical treatment
Prescription topical treatment like lotions, ointments, balms, gels, and creams can reduce nerve pains in the fingers. Go for a formula that has the active ingredient, capsaicin. Capsaicin is a biological substance extracted from chili pepper that serves as an anesthetic, which helps significantly reduce the pain.

Dietary Supplementation
Depletion in the nutrient stores may not cause nerve pain directly, but they can interfere with processes that aid the smooth function of the nerves. This is why it is important to use dietary supplements for neuropathy to boost the health of your nerves. One of the best brands of dietary supplements that have proven to help is Nerve Renew. The product is rich in vitamins and minerals like vitamin B2, B6, copper, and manganese. This pain-free approach uses natural sources to help reduce discomfort associated with neuropathy. It also helps to reduce symptoms.
Alternative approaches
Acupuncture and massages help in relieving pain.
Lifestyle modification habits
Lifestyle changes are typically preventive measures, but they can also help to improve cure. Exercise and good dietary habit help maintain the integrity of nerves in your fingers. Smoking, too much alcohol, and a poor diet generally aggravate nerve pain, so avoid them at all costs.
In certain cases, a surgical procedure might be required to correct the damage which causes the pain. Only a professional can handle this.

Article Provided By: nervepainguide

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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Pudendal Neuralgia

What Is Pudendal Neuralgia?
Pudendal neuralgia is a condition that causes pain, discomfort, or numbness in your pelvis or genitals. It happens when a major nerve in the lower body is damaged or irritated, and it can make it hard to use the bathroom, have sex, or sit down. The pain comes and goes.
It’s not clear exactly how many people have this condition, but experts believe it’s rare.
The pudendal nerve runs from the back of the pelvis to near the base of your penis or vagina, where it branches off into other nerves.
It sends messages to the brain from your genitals, anus, and other nearby body parts. It controls the sphincter muscles that open and close when you use the bathroom.
Causes
There are several things that can damage your pudendal nerve.
It can happen when you’re injured, have surgery, or give birth. A tumor or an infection can squeeze or irritate it. And sometimes, certain types of exercise, like spending a lot of time on a bicycle, can cause the problem.
Symptoms
You usually feel pudendal neuralgia symptoms in your lower body, genitals, or perineum (the area between your genitals and anus). These may include:

A sharp or burning pain
More sensitivity
Numbness or a pins-and-needles feeling, like when your leg falls asleep
A swollen feeling
These feelings might be worse when you sit down. Or you may have symptoms on both sides of your body, and they might go into your belly, buttocks, or legs.
You also may have problems such as:
A sudden or frequent need to go to the bathroom
Trouble or pain during sex
For men, problems getting an erection

Diagnosis
If you have pelvic pain, tell your doctor. At your appointment, you’ll answer questions about your symptoms and get a physical examination. Your doctor will put a finger into your vagina or rectum and put pressure on the nerve to check on it.
You might also get an imaging test with an MRI machine. It uses powerful magnets and radio waves to take a picture of your body’s internal organs.
Your doctor may also give you a pudendal nerve block. This is a shot you get in your pelvis to numb the nerve and see if your symptoms go away.
Treatment
Most people with pudendal neuralgia get treatment with a combination of physical therapy, lifestyle changes, and medicines.
Sit up straight or stand more often to help with nerve pain. This can take pressure off the pudendal nerve.
Don’t do squats or cycle. Certain exercises can make pudendal neuralgia worse.
Go for physical therapy. It relaxes and stretches the muscles at the lower end of your pelvis, known as the pelvic floor. This can ease pressure that may irritate the pudendal nerve. If pudendal neuralgia makes it hard to control your bladder or bowels, physical therapy can help with that, too.
Try prescription medication. Muscle relaxants may help relieve symptoms of pudendal neuralgia. Drugs used to treat other conditions, like depression or epilepsy, might also help.
If these don’t work, your doctor may give you a shot of medications that numb the nerve or lower inflammation, which lessens pressure. These may take several weeks to fully take effect.
In rare cases, your doctor may recommend surgery to remove anything that presses on the nerve. You may also get a small electrical device put under your skin to stimulate the nerve and interrupt the pain signals it sends to the brain.
WebMD Medical Reference Reviewed by Tyler Wheeler, MD on January 27, 2020
Sources
SOURCES:
National Institutes of Health, Genetic and Rare Diseases Information Center: “Pudendal Neuralgia.”
Health Organization for Pudendal Education: “Anatomy of the pudendal nerve.”
Obstetrical and Gynecological Survey: “Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria).”
U.K. National Health Service: “Pudendal neuralgia.”
University of Rochester Medical Center: “Pudendal neuralgia,” “Pudendal nerve block.”
Women’s Health Research Institute of Australia: “Pudendal Neuralgia.”
© 2020 WebMD, LLC. All rights reserved.

Article Provided By: webmd
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Managing and Coping with Neuropathy

Managing & Coping with Neuropathy

 

What predicts depression and anxiety among people with PN? Not necessarily the severity of the PN symptoms! The predictors are the psychological variables (i.e.: How do you feel? Hopeless, optimistic, anxious, etc.); social variables (i.e.: Are you active? Do you have support?) All of these variables can be changed!
Dwelling on what might have been if you were not diagnosed, self-pitying, ruminating about better times, and think of yourself primarily as a “PN patient” does not provide the escape from stress of the illness. These coping strategies are ineffective and can make your neuropathy symptoms worse.
Below are effective Self-Care and Coping Skills:
Managing Peripheral Neuropathy
The following suggestions can help you manage peripheral neuropathy:
Take care of your feet, especially if you have diabetes. Check your feet daily for signs of blisters, cuts or calluses. Tight shoes and socks can worsen pain and tingling and may lead to sores that won’t heal. Wear soft, loose cotton socks and padded shoes. You can use a semicircular hoop, which is available in medical supply stores, to keep bed covers off hot or sensitive feet.
Quit smoking. Cigarette smoking can affect circulation, increasing the risk of foot problems and possibly amputation.
Eat healthy meals. If you’re at high risk of neuropathy or have a chronic medical condition, healthy eating is especially important. Emphasize low-fat meats and dairy products and include lots of fruits, vegetables and whole grains in your diet. Drink alcohol in moderation.
Massage. Massage your hands and feet, or have someone massage them for you. Massage helps improve circulation, stimulates nerves and may temporarily relieve pain.
Avoid prolonged pressure. Don’t keep your knees crossed or lean on your elbows for long periods of time. Doing so may cause new nerve damage.
Skills for Coping With Peripheral Neuropathy
Living with chronic pain or disability presents daily challenges. Some of these suggestions may make it easier for you to cope:
Set priorities. Decide which tasks you need to do on a given day, such as paying bills or shopping for groceries, and which can wait until another time. Stay active, but don’t overdo.
Acceptance & Acknowledgement. Accept and acknowledge the negative aspects of the illness, but then move forward to become more positive to find what works best for you.
Find the positive aspects of the disorder. Of course you are thinking there is nothing positive about PN. Perhaps your outlook can help increase empathy, encourage you to maintain a balanced schedule or maintaining a healthier lifestyle.
Get out of the house. When you have severe pain, it’s natural to want to be alone. But this only makes it easier to focus on your pain. Instead, visit a friend, go to a movie or take a walk.
Get moving. Develop an exercise program that works for you to maintain your optimum fitness. It gives you something you can control, and provides so many benefits to your physical and emotional well-being.
Seek and accept support. It isn’t a sign of weakness to ask for or accept help when you need it. In addition to support from family and friends, consider joining a chronic pain support group. Although support groups aren’t for everyone, they can be good places to hear about coping techniques or treatments that have worked for others. You’ll also meet people who understand what you’re going through. To find a support group in your community, check with your doctor, a nurse or the county health department.
Prepare for challenging situations. If something especially stressful is coming up in your life, such as a move or a new job, knowing what you have to do ahead of time can help you cope.
Talk to a counselor or therapist. Insomnia, depression and impotence are possible complications of peripheral neuropathy. If you experience any of these, you may find it helpful to talk to a counselor or therapist in addition to your primary care doctor. There are treatments that can help.
How to Sleep With Neuropathy
Sleep is an essential part of living—sleep helps us avoid major health problems and it is essential to our mental and physical performance. It affects our mood and stress and anxiety levels. Unfortunately, sleep disturbance or insomnia is often a side effect of neuropathy pain. It is a common complaint among people with living with chronic pain.
It’s no surprise that about 70 percent of pain patients, including those suffering from PN, back pain, headaches, arthritis and fibromyalgia, report they have trouble sleeping according to the Journal of Pain Medicine.
Pain can interfere with sleep due to a combination of issues. The list includes discomfort, reduced activity levels, anxiety, worry, depression and use of medications such as codeine that relieve pain but disturb sleep.
Most experts recommend a range of seven to nine hours of sleep per night for adults, regardless of age or gender. This may seem impossible to people with chronic pain, but there are steps you can take to improve your sleep, which may lead to less pain and lower levels of depression and anxiety. First, talk with your doctor to see if there are medications that may lessen your sleep disturbance. You should also check with your doctor to make sure your current medications aren’t causing some of your sleep disturbance.
Beyond medication, there are several things you can do yourself to improve your sleep. Here are some methods to try and help you fall asleep more quickly, help you sleep more deeply, help you stay asleep, and ultimately help keep you healthy.
Following are tips for improving your sleep:
Reduce your caffeine intake, especially in the afternoons
Quit smoking
Limit and/or omit alcohol consumption
Limit naps to less than one hour, preferably less
Don’t stay in bed too long—spending time in bed without sleeping leads to more shallow sleep
Adhere to a regular daily schedule including going to bed and getting up at the same time
Maintain a regular exercise program. Be sure to complete exercise several hours before bedtime
Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more support
Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.
Turn off your TV and Computer, many people use the television to fall asleep or relax at the end of the day. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it.
Don’t watch the clock – turn your alarm clock around so that it is not facing you
Keep a note pad and pencil by your bed to write down any thoughts that may wake you up at night so you can put them to rest
Refrain from taking a hot bath or shower right before bed; the body needs to cool a degree before getting into deep sleep
Try listening to relaxing soft music or audio books instead, or practicing relaxation exercises.
Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.
Some patients find comfort from a pillow between their legs that keeps their knees from touching. And there’s an added benefit: A pillow between your legs at night will prevent your upper leg from pulling your spine out of alignment and reduces stress on your hips and lower back.
It may take three to four weeks of trying these techniques before you begin to see an improvement in your sleep. During the first two weeks, your sleep may actually worsen before it improves, but improved sleep may lead to less pain intensity and improved mood.

 

Article Provided By: foundationforpn

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Exercises For A Pinched Nerve In Your Hip

Exercises for a pinched nerve in your hip

A pinched nerve in the hip can be very painful. Certain home remedies and exercises can help relieve the pain.
In this article, we look at how to identify a pinched nerve, what home remedies can help, and exercises for this condition.
What is a pinched nerve?

A pinched nerve in the hip may cause sharp pain in the thigh, hip, or groin.
Nerves transmit pain signals. This means that when something goes wrong with a nerve, the symptoms can be very uncomfortable.
A common problem is when a nerve becomes pressed or pinched by nearby tendons, ligaments, or bone.

When a pinched nerve occurs, the nerve signals become aggravated, emphasized, or interrupted by pressure, irritation, or rubbing. This is known medically as radiculopathy.
In the hip, a pinched nerve can cause a:
sharp, searing, or burning pain in the hip, thigh, or groin
dull, achy pain in the hips and buttocks
tingling, “pins and needles” feeling, or numbness in the hip or down the leg
weakness or loss of movement in the affected hip and leg
Usually, the pain or numbness will worsen when a person moves. The nerve gets further irritated and aggravated by the structure that is pinching it.
Causes
A pinched nerve can be caused by a minor incident, such as sleeping in an improper position, or a major event, such as an accident.
Some of the more common causes of a pinched nerve in the hip include:
repetitive stress on the hips, back, and nearby joints, such as walking, standing, or sitting in a particular position for long periods
falls, car accidents, or sports injuries, which can throw the muscles and joints out of alignment
sleeping in a position that puts stress on the hips and back
hip flexors that are too tight, which may be caused by exercising without stretching before and after the activity

 

Home remedies
Minor pinched nerves can usually be treated at home.
Useful home remedies for a pinched nerve in the hip include:
Rest. Avoiding any activities that make the pain worse can reduce irritation and stress on the nerve, allowing it to heal.
Anti-inflammatories. These can reduce swelling, which may take pressure off of the nerve. Common brands include ibuprofen and naproxen.
Heat pads and cold pads. Alternate between the two, or use the one that brings the most relief. Both heat pads and cool packs are available for purchase online.
Gentle stretches. This can relieve pressure on muscles or tendons that may be too tight.

Stretches
Certain stretches can be very beneficial for a person with a pinched nerve in their hip. Stretching the following muscle areas may be helpful:

The piriformis stretch may help with a pinched nerve in the hip.
The piriformis is a muscle in the buttock area. When it is too tight, it can aggravate a pinched nerve and worsen hip pain.
This muscle gets tight when a person spends too long sitting down. It can also become overly tense if a person fails to stretch before and after strenuous exercise, such as running.
A person can use these three exercises to stretch the piriformis:
Piriformis stretch
Lie down on a flat surface.
Clasp the knee of the affected leg with both hands.
Slowly pull the knee upwards towards the head.
A person can deepen the stretch by holding the ankle and pulling the foot gently towards the opposite hip.
Hold for 10 seconds.
Repeat 3 times with both legs.
The bridge
Lie down on a flat surface, such as a carpeted floor.
Place feet flat on the ground, shoulder-width apart. Bend the knees about 45 degrees.
Put arms straight out to the side, flat on the floor.
Draw in the tummy and squeeze the buttocks.
Slowly push up through the heels and lift the buttocks and lower back off the floor, leaving the head and shoulders on the floor. Over time, the back will be completely off the floor, and the knees, hips, and shoulders will form a straight line.
Hold this pose for 10–30 seconds and slowly lower the back and buttocks down.
Rest for 15 seconds and repeat.
Floor slides
Lie on the floor, face up.
Bend the knees, placing the feet flat on the floor.
Gently draw the belly button in toward the spine, tightening the abdominal muscles. Breathe slowly and gently while holding the belly in.
Without moving the belly or spine, slowly extend one leg out straight until it is flat on the floor.
Hold the leg straight for up to 15 seconds and slowly slide it back up to a bent position.
Repeat with the other leg.
Glutes stretch
The glutes or gluteal muscles are muscles in the buttock area. They are closely connected to many causes of hip pain. Any tension in these muscles can also aggravate lower back pain.
Use the following exercises to stretch the glutes:
Sit and twist
Sit on the floor with legs straight out in front.
Bend the right knee and cross the right foot over the left knee.
Move the right heel up close to the left buttock, keeping the right foot flat on the floor. Reach the right arm behind the back and allow the fingers to touch the floor behind the back.
Put the left hand on top of the right knee. Slowly and gently pull the right knee towards the left until feeling a stretch in the buttock and hip area.
Hold for 15 to 30 seconds. Slowly release and repeat on the other side.
Lying down crossover
Lie flat on the floor, face up, with legs out straight.
Lift the left leg and hip, crossing it over the right. Keep shoulders and back flat on the floor.
Keep stretching until a stretch is felt in the glute and hips.
Hold for up to 30 seconds and slowly release. Repeat on the other side.
Full body stretches
Because all of the body’s muscles work together, having good flexibility in all muscle groups can help avoid a pinched nerve and muscle-related pain.
Try these relaxing and invigorating moves to stretch the various muscles in the body:
Classic bend and stretch
Stand up straight with feet hip-width apart. Knees should be slightly bent, not locked.
Breathe out and slowly bend forward at the hips. Gently lower the head toward the floor and focus on keeping the upper body relaxed.
Grab the back of the lower legs with hands.
Hold for 30 seconds while breathing deeply, and slowly rise to standing again.
Repeat.
The Sphinx

The Sphinx yoga pose can help to stretch the lower back.
This yoga pose helps stretch the lower back and strengthens the abdominals, both of which are related to the hips.
Lie face down on the floor with legs straight. Tuck elbows in under the shoulders and put forearms flat on the floor.
Lift the chest off the floor and press hips and thighs downward into the floor. Keep lifting the chest until a stretch is felt in the lower back. Focus on relaxing the shoulders and stretching the spine.
Go only far enough to feel a stretch, and stop if it is painful.
As with any stretches, some are better for certain body types and fitness levels. The best way to adopt a full stretching program is with the help of a certified personal trainer, sports medicine physician, or physical therapist.

When to see a doctor
Anyone who experiences a hip pain that lasts more than a few days and does not get better with rest and over-the-counter pain medicines should consult a doctor.
Severely pinched nerves can lead to scarring in the affected area or permanent nerve damage if not treated. Also, other medical causes for the pain should be ruled out.
In more severe cases, a doctor may recommend specific treatments for a pinched nerve. They include:
physical therapy
steroid injections given directly at the site of the pinched nerve
oral steroid medicines

Outlook
A pinched nerve in the hip is rarely serious, but the painful symptoms can interfere with daily life.
Home remedies and exercises can usually solve the issue, but it is best to see a doctor if symptoms persist beyond a few days.

Article Provided By: Medicalnewstoday

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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
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