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

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

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

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

 

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

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

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

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

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

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

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

 

Sciatic anterior

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

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

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

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

SI Joint and Sciatica Definitions

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

What Is Sciatica?

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

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

What Is SI Joint Dysfunction?

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

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

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

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

Underlying Causes of Sciatica Pain and SI Joint Pain

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

 

Spine Problems that Can Result in Sciatica

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

SI Joint Dysfunction: Potential Causes

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

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

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

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

Sciatic posterior

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

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

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

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

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

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

Treatments to Relieve the Pain

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

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

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

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

 

Article Provided By: SI-Bone.com

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

 

 

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Four Types of Sciatic Nerve Pain

Four Types of Sciatic Nerve Pain

By April Mayer
Last Updated On January 25th, 2021

 

Sciatica is a form of radiculopathy—a mild to severe pain caused by the compression or pinching of a spinal nerve root. Sciatica radiates pain down the legs and feet, away from the source, and is a sign of nerve irritation or inflammation. It causes an electric shock sensation and numbness in the legs and feet.

While “sciatica” is often used to describe a sharp pain in the lower back and legs, not all sciatic nerve pain is sciatica. While the symptoms are similar from case-to-case, minor details signal different causes, such as whether your pain begins in your back versus your legs. Knowing the root of the issue is vital to treating sciatic nerve pain, as certain diagnoses require different treatments.

We discuss the most common types of sciatic nerve pain and an overview of what sciatic nerve pain is, its potential causes and risk factors, and various treatment options to give you a stronger understanding of the issue.

Neurogenic

Neurogenic sciatica is when the sciatic nerve is compressed or pinched, leading to pressure along the spine. The symptoms generally include sharp, shooting pain down the legs and weakened legs and feet. While the issue is rooted in the spine, the pain is usually worse in your legs than in your back.

Along with physical pain, neurogenic sciatica causes abnormal neurological changes. Individuals may suffer from a loss of reflexes, sensory issues, muscle weakness, and paresthesia (“pins-and-needles”) due to improper nerve conduction.

Referred

Referred sciatica is not a true form of sciatica, but mirrors the pain and symptoms. Rather than being a spinal issue, referred sciatica is pain related to a muscle or joint problem. Referred pain is one of the main reasons why a diagnosis for sciatica is vital, as it may need further evaluation treatment beyond home remedies.

As opposed to shooting pains, people with referred sciatica may feel dull and achy and their pain may be worse in their back than in their legs. Referred pain also does not cause abnormal neurological changes, either, such as worsened reflexes, sensory issues, or tingling.

Alternating Sciatica

Sciatica typically only affects one leg as the sciatic nerve is only pinched on one side of the body. However, alternating sciatica affects both legs successively. It may be a result of degenerative issues in the sacroiliac joint, the joint connecting the spine to the hips, or sacroiliac arthritis.

Bilateral Sciatica

Bilateral sciatica is when both ends of the sciatic nerve are pinched. This results in pain and symptoms occurring in both legs and buttocks at once. It’s a rarer form of sciatica, and the pain in one leg can be worse than in the other. Bilateral sciatica may be the result of multiple herniated discs or disc degeneration.

Sources of Sciatic Pain

There are 33 individual bones in your spine known as vertebrae. Each vertebra is divided into regions and classified according to the number of vertebra per region. The vertebrae are then labeled by a number and letter based on their placement, such as C1 for the first vertebra in the cervical spine. There are five regions of the spine: cervical, thoracic, lumbar spine, sacrum, and coccyx.

The most common regions associated with sciatica are the lumbar spine and sacrum, and the source of your sciatic pain slightly alters your symptoms.

L4 Nerve Root

Irritation to the L4 nerve root causes pain to the hips, thighs, inner knees, calf, and foot. Thigh and hips muscles may feel weak, and calves numb. When sciatica is in the L4 level, a person may be unable to flex their foot or walk on their heels, and they may have a reduced knee-jerk reflex.

L5 Nerve Root

Individuals with sciatica from the L5 nerve root typically experience pain in the buttocks, outer, thigh, and leg, as well as difficulty flexing their ankle or lifting their big toe. Sciatica from the L5 level might also cause numbness, mainly on the top of the foot and between the big toe and second toe.

S1 Nerve Root

Sciatica from the S1 nerve root is also known as classic sciatica as it’s most commonly rooted in the sacrum. Sciatica from the S1 level specifically causes pain and weakness in the buttocks, back of the calf, and outside of the foot. Individuals with sciatica from the S1 level may have numbness or tingling in their third, fourth, and fifth toes, and have difficulty walking on their tiptoes or raising their heels off of the ground. Individuals may also find they have a weakened ankle-jerk reflex.

Duration of Sciatic Pain

Sciatica and sciatic pain are categorized based on how long the symptoms and pain have occurred. The duration of your pain may be a signifier for the necessary treatment options you need.

Acute Sciatica

Acute sciatica lasts between a few days to a few weeks. Typically, it does not require medical attention from a doctor, and home remedies are usually enough to treat the pain. However, acute sciatica can be severe during the brief period of time it is present.

Chronic Sciatica

Chronic sciatica is characterized by symptoms lasting longer than 12 weeks. It’s often less severe than acute pain, but it may not respond well to self-management nor does it pass on its own. Chronic sciatica may require surgical or non-surgical treatment to improve.

Common Causes of Sciatic Pain

Sciatic pain is a result of different conditions or diseases aggravating the sciatic nerve. Not all the conditions listed are guaranteed to cause sciatic pain, but sciatic pain is a frequent symptom.

Herniated or Bulging Discs

Herniated or bulging discs occur when the spongy discs between your spinal vertebrae are compressed and bulge out of place. They can occur at any age, but become more common as you grow older or if you have degenerative disc disease, a condition where the discs lose fluid and wear down. Herniated discs are most common in the lumbar spine and near the sciatic nerve, so they can cause sciatic pain.

Bone Spurs

Bone spurs are small bone growths appearing near joints and are increasingly common with age. Bone spurs are the result of joint damage and linked to osteoarthritis, rheumatoid arthritis, and degenerative joint disease. After an injury or damage has occurred, your body attempts to heal the area by growing extra bone.

Typically, bone spurs cause no symptoms at all, though depending on where they’ve developed, a growth can compress your sciatic nerve and lead to pain.

Spinal Stenosis

The spinal canal is the spinal cord’s pathway down the back. With spinal stenosis, the spinal canal becomes narrower, placing pressure on the spinal cord. There are two types of spinal stenosis: lumbar and cervical stenosis. Cervical spinal stenosis affects the neck, while lumbar spinal stenosis affects the lower back and may cause sciatica.

Lumbar spinal stenosis can be the result of arthritis, spinal degeneration with age, tumors, or cysts.

Spondylolisthesis

Spondylolisthesis is a condition where one vertebra in the spine slips over the one below it, particularly in the lumbar spine region. The condition is typically a result of disc degeneration, arthritis, certain cancers, and certain surgeries.

Stress fractures are another common cause of spondylolisthesis, especially in young people and athletes, though they can happen to anybody. Repeated stress to the vertebra,  injuries from motor vehicle accidents, or heavy lifting, can cause the vertebrae to fracture, leading to spondylolisthesis and sciatica.

Piriformis Syndrome

Piriformis syndrome is a neuromuscular disorder where the piriformis muscle (located where the femur and pelvis meet) compresses the sciatic nerve, resulting in spasms and pain in the buttocks and legs.

While the pain mimics sciatic pain, with tingling and numbness from the leg to the foot, it’s not sciatica since it’s not caused by spinal issues. Instead, it’s a referred pain beginning from the buttocks as opposed to the lower back.

Risk Factors

Sciatic Nerve Pain

Roughly 40 percent of people experience sciatica at some point in time, and while it’s most common for people 40 to 50 years old, it can happen at any age.

  • Pre-existing spinal condition(s): Conditions such as degenerative disc disease or spinal stenosis, while they may not initially trigger sciatic pain, can eventually progress and cause sciatica.
  • Diabetes: As a diabetic, your body becomes more vulnerable to nerve damage, increasing the possibility of sciatic nerve damage and sciatica.
  • A sedentary lifestyle: Sitting for long periods of time, such as at work or school, can weaken your muscles and cause them to become stiff over time. A weak back and core puts pressure on your lumbar spine and leaves you at risk for sciatica.
  • Heavy lifting: Heavy lifting such as at work, at the gym, or when gardening, can strain your back and lead to lower back issues, especially if you have improper form. When lifting heavy objects, carry the brunt of the weight with your legs as opposed to your back.
  • Age: As you age, your spinal discs and tissues wear down, leaving you at risk for herniated discs. You also are more prone to physical health conditions, such as spinal stenosis or arthritis, resulting in sciatic pain.
  • Weight: If you are overweight or obese, the extra weight in your midsection puts pressure and stress on your spine, leading to back strains and sciatica.

How to Treat Sciatic Pain

In some instances, simple home remedies are enough to ease and treat mild-to-moderate sciatic pain. However, if your sciatic pain is chronic or severe, receiving medical attention is the best step to take for proper treatment. Nearly all treatments—with a doctor or otherwise—are nonsurgical.

Massage Therapy

Massages improve blood circulation, relax muscles, reduce muscle tightness, and release endorphins, all of which are natural pain-relievers and can ease irritation. You can self-massage at home or visit a massage therapist for treatment.

Topical Treatments

A simple way to reduce this pain is to use topical treatments such as analgesic (pain-relief) ointments or hot and cold therapies. They provide temporary relief for localized pain and can be used throughout the day as needed.

For hot and cold therapies, use ice packs (wrapped in a towel to prevent ice burns), heat pads, or hot towels for twenty-minute intervals. Hot and cold ointments are another simple treatment and can be used on the go if needed.

Exercise

Physical activity can strengthen your back and core muscles and relieve pressure on your lower spine. Stretching and light aerobic exercises increase your body’s flexibility and potentially alleviate symptoms. However, avoid strenuous or heavy exercises and be sure your form is correct at all times so as not to worsen your pain.

Medications

While medications don’t directly treat sciatica, they can relieve pain temporarily and make daily activities easier. You can use over-the-counter (OTC) anti-inflammatory medications such as ibuprofen or aspirin, or your doctor might prescribe muscle relaxants, antidepressants, or higher doses of anti-inflammatory drugs. For more severe pain, your doctor may inject corticosteroids or epidural steroid injections in your lumbar spine to relieve inflammation for one to two months.

Chiropractic or Physical Therapy

Your doctor might refer you to a chiropractor or physical therapist for physical rehabilitation.

With a physical therapist, you learn techniques and exercises to strengthen your back and core, improve your posture, and how to avoid aggravating your sciatic nerve. Your physical therapist makes a home exercise routine for you to follow to reduce symptoms.

Chiropractors have an excellent understanding of the body’s musculoskeletal system and how to manipulate it to ease any pain. They complete different treatments to take the pressure off your sciatic nerve, including massage, hot and cold therapy, and spinal adjustments.

Surgery

It’s rare for sciatica patients to need surgery and is typically the final step if other nonsurgical treatment options have not shown improvement. If you have severe pain lasting beyond 6 to 12 weeks or you are debilitated by your pain, your doctor may suggest surgery.

The most common surgeries to treat sciatic pain are microdiscectomy, laminectomy, a spinal fusion, or disc replacement, and the surgery you are referred to is based on your diagnosis.

FAQs

When is sciatic pain a medical emergency?

Sciatic pain is rarely an emergency, but if your sciatic pain is paired with incontinence, fever, loss of appetite, worsening numbness and tingling, swollen legs or lower back, or it began after an accident, seek immediate medical care.

What causes sciatica to flare up?

Some potential triggers for sciatica flare-ups include:

  • Stress and anxiety: Sciatica can be exacerbated by anxious thoughts as, when stressed, the brain deprives the nerves of needed oxygen and can result in weakness and tingling in the legs.
  • Wallet sciatica: Wallet sciatica is a term used to describe sciatica aggravated by sitting on your wallet, keys, or cellphone. When an item is in your back pocket, it directly presses up against the sciatica nerve and causes a flare-up.
  • High heels: When wearing high heels, your center of gravity shifts and stretches your hamstring and sciatic nerve. Walking on your toes, as you do in heels, might also irritate your sciatica.
  • Poor posture: Having poor posture when sitting or standing puts stress on your lower back and spine, resulting in a flare-up.
  • Tight clothing: Some clothing may be just tight enough to press against your sciatic nerve and trigger your sciatica pain.

Why is sciatica so painful at night?

Sciatica pain can be aggravated when lying down, making it difficult to sleep and find a comfortable position. In some instances, sciatic pain can be severe to the point of waking you up at night. Adjusting your sleep position, as well as using a supportive mattress, can ease your pain.

Side sleeping may place pressure directly onto the nerve roots and tilt your hips out of alignment with your spine. It’s best to lay on your unaffected side and use a pillow between your knees to keep your spine aligned and prevent pain.

Lying on your back emphasizes the lumbar spine’s curve, potentially pinching the sciatic nerve’s roots and causing pain. Elevate your legs using a pillow under your knees or an adjustable base to reduce the pressure and relieve your symptoms.

Stomach sleeping can overextend your lower back and irritate your sciatica, so it’s best to try a different sleeping position. However, if it’s too difficult to switch positions, temporarily use a pillow under your hips to protect your back.

Can sciatica be caused by a bad mattress?

While it’s unlikely a bad mattress is the cause of your sciatica, your mattress can definitely worsen pain if it’s unsupportive. Older mattresses tend to be rather unsupportive and lumpy, but even new mattresses can aggravate your sciatica if they’re not suited for your sleeping position.

It’s best to use a high-quality mattress built for your sleeping position and body weight to keep your spine aligned and minimize your pain as much as possible.

Should I push through sciatic pain?

If you’re experiencing any sciatic pain while exercising or completing any daily activities, don’t ignore it. Instead, take a few minutes to rest and allow your pain to pass. However, if your sciatic pain makes it difficult to complete daily activities as normal, speak with your doctor for treatment options.

Conclusion

If you’re experiencing sciatic nerve pain, it’s best to get diagnosed and figure out what type of sciatic pain it truly is, as it can be a sign of a larger underlying condition. Although what you’re experiencing may feel like sciatica, it can be caused by an unrelated issue such as piriformis syndrome. In order to protect your body and prevent worsening the issue, always get a doctor’s opinion if you are unsure.

 

This article is for informational purposes and should not replace advice from your doctor or other medical professional.

 

Article Provided By: amerisleep

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

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Postherpetic Neuralgia

Postherpetic Neuralgia

 

Postherpetic neuralgia is a painful condition that affects your nerves and skin. It’s a complication of herpes zoster, commonly called shingles.

Shingles is a painful, blistering skin rash caused by a reactivation of the varicella-zoster virus.

People usually contract this virus in childhood or adolescence as chickenpox. The virus can remain dormant in the body’s nerve cells after childhood and reactivate decades later.

When the pain caused by shingles doesn’t go away after the rash and blisters clear up, the condition is called postherpetic neuralgia.

Postherpetic neuralgia is the most common shingles complication. It occurs when a shingles outbreak damages the nerves.

The damaged nerves can’t send messages from the skin to the brain, and the messages become confused. This results in chronic, severe pain that can last for months.

According to a 2017 review, about 20 percent of people who get shingles also develop postherpetic neuralgia. Additionally, this condition is more likely to occur in people over the age of 50.

What are the symptoms of postherpetic neuralgia?

Shingles typically causes a painful, blistering rash. Postherpetic neuralgia is a complication that only occurs in people who have already had shingles.

Common signs and symptoms of postherpetic neuralgia include:

  • severe pain that continues for more than 1 to 3 months in the same place that the shingles occurred, even after the rash goes away
  • burning sensation on the skin, even from the slightest pressure
  • sensitivity to touch or temperature changes
What are the risk factors for postherpetic neuralgia?

Age is a major risk factor for getting both shingles and postherpetic neuralgia. Risk begins to increase at age 50 and rises exponentially the older you get.

People who have acute pain and severe rash during shingles also have a higher risk for developing postherpetic neuralgia.

People with lowered immunity due to conditions like HIV or Hodgkin’s lymphoma have an increased risk for developing shingles. The risk of shingles is 20 to 100 greater in this group.

How is postherpetic neuralgia diagnosed and treated?

Most of the time, your doctor is able to make a diagnosis of postherpetic neuralgia based on how long you’ve experienced pain following shingles. Tests are unnecessary in confirming a diagnosis.

Treatment for postherpetic neuralgia aims to manage and reduce the pain until the condition goes away.

How can postherpetic neuralgia be prevented?

Two doses of a herpes zoster vaccine called Shingrix reduce the risk of shingles by more than 90 percentTrusted Source. The vaccine also protects against postherpetic neuralgia.

The Centers for Disease Control and Prevention (CDC)Trusted Source recommends healthy people ages 50 and up get the Shingrix vaccine.

Postherpetic neuralgia is treatable and preventable. Most cases disappear in 1 to 2 months. In rare cases, it can last longer than a year.

If you’re older than 50, it’s wise to get vaccinated against shingles and postherpetic neuralgia.

If you do develop postherpetic neuralgia, you have many treatment options to manage the pain. Talk with your doctor to find the best treatment for you.

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

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

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

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

 

 

 

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Failed Back and Failed Fusion Syndrome

Failed Back and Failed Fusion Syndrome

After any spine surgery, a percentage of patients may still experience pain. This is called failed back or failed fusion syndrome, which is characterized by intractable pain and an inability to return to normal activities. Surgery may be able to fix the condition but not eliminate the pain.

Symptoms
The main symptom is pain following back surgery. Additionally, the patient’s ability to complete activities of daily living may be altered.

Causes and Risk Factors
Smoking
Formation of scar tissue
Recurring or persistent disc disease at adjacent levels
Continued pressure from spinal stenosis
Instability or abnormal movement
Pseudoarthrosis or failure of the fusion
Nerve damage within the nerve, arachnoiditis

Diagnosis
A diagnosis will be based on the patient’s symptoms and medical history.
Additional tests that may be useful include:
Magnetic resonance imaging (MRI)
Computed tomography (CT scans)

Treatment
Treatment of these conditions, once they have occurred, will vary depending on the nature of the condition and what caused prior surgery to fail.
Some patients fail to improve even after the best surgical intervention. In spite of careful diagnosis and a successful operation, patients may continue to experience pain or limitations in performing daily activities. This continuation of symptoms is known as “failed back syndrome.” A spinal fusion occurs after the surgeon creates the conditions for the bones of the spine to unite into an immobile block. The union of the fusion mass occurs over time. When the time for healing is extended or the fusion fails to unite, this is a called a “failed fusion” or pseudoarthrosis.

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

 

 

 

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How to Approach Allergy Season with Chronic Pain

How to Approach Allergy Season with Chronic Pain

Seasonal allergies are one of the leading causes of chronic illness in the United States, affecting millions every year. However, for people who suffer from other forms of chronic pain such as rheumatoid arthritis, back and muscle pain, or fibromyalgia, seasonal allergies can prove an even bigger challenge to overcome.

By
Zachary Pottle
Monday, March 1, 2021

As winter begins to subside in many states across America, spring brings about long-awaited warm weather, outdoor activities, and a break from the dreary winter months. However, rising temperatures bring about one of the most notorious markers of spring: seasonal allergies. Cars everywhere begin to don an unmistakable yellow hue. Eyes start to itch, noses start to run, and the novelty of springtime is soon ruined for millions.
Allergy season can be extremely tough for the more than 50 million Americans that experience some type of seasonal allergy each year, according to the Asthma and Allergy Foundation of America. Yet, for people who suffer from chronic pain or illness, allergy season can prove to be an even bigger challenge.
What are seasonal allergies?
Seasonal allergies are most commonly caused by pollen, a powdery substance consisting of pollen grains used to fertilize plants of the same species. Pollen is typically released by trees, grasses, and weeds anywhere from spring into summer and late fall respectively. The light, dry substance is released by the plants and carried by the wind, which makes it almost impossible to avoid; some pine pollen has reportedly traveled up to 1800 miles away from its source tree.
For most, the culprit of their seasonal allergies is grasses and weeds. Thought to be the most common type of allergen across the United States is a weed species named ragweed, which flowers in late August to early September. While ragweed only lives for one single season out of the year, its ability to release over one billion pollen grains, some of which have been reported to travel over 400 miles, proves it to be a fierce allergen.
When is allergy season?
Allergy season can range anywhere from early spring (February to March), to late fall (September to October). The type of pollen being released into the air differs with the seasons, which can be a very important tidbit of knowledge for those who know which type of pollen they are sensitive to. Three major groups of allergens can be attributed to seasonal allergies: trees, grasses, and weeds, each of which peaks at different times of the year.
Trees are among the first to release their pollen each year, starting as early as February, with a peak in pollen counts around April and May. Some of the most common tree pollen allergies are to trees such as birch, ash, cedar, elm, and oak.
Grasses tend to begin their pollination in early spring (March or April typically), and often coincide their peak pollen counts, unfortunately for many, with that of trees, and often carry those high levels into June and July. Popular grass allergens are johnsongrass, ryegrass, orchard grass, and bermudagrass to name a few.
Unfortunately, weeds tend to start their pollination just as grass pollen levels begin to subside. Around the peak of summer, July and August, weed pollen levels begin to rise drastically, and by September they are at their highest. Other weed allergens that prove troublesome for many are pigweed, tumbleweed, and sagebrush.
How do allergies affect people with chronic pain?
The link between allergies and chronic pain or illness is often overlooked. It’s easy to dismiss the two as being related, but they go more hand in hand than many may understand. Allergies are a direct result of the immune system’s accidental response to foreign bodies like pollen that are otherwise harmless. When the immune system combats these allergens, it releases antibodies into the bloodstream, which in turn produces the symptoms of an allergic reaction. For those who suffer from chronic pain or illness, allergies can prove to be challenging, as many of the symptoms are easily confused for one another. Understanding how seasonal allergies can affect chronic pain and illness can be a useful tool in combating allergy season and alleviating unwanted added stress on one’s body.
For those who may suffer from chronic pain related to rheumatoid arthritis or other muscle or joint pain, immune responses to allergies can add unwanted stress to an already strained immune system. Some of the most common symptoms of seasonal allergies are inflammation and joint pain. This “doubling down” of inflammation can often make symptoms feel worse than they otherwise would be, making it hard to determine the root cause.Seasonal allergies also bring with them the addition of symptoms such as coughing and sneezing. These symptoms, whilst easy to attribute to allergies, are extremely challenging for those with chronic pain in their back, neck, and spine. Coughing and sneezing produce violent, quick movements in both the neck and back, which for many may already be a cause of debilitating pain. Coughing can also add to this pain, and in some cases cause it. People with recent injuries to their back, neck, or spine, are at an increased risk of injuries such as herniated disks and muscle strain, which can be triggered by the sudden, abrupt movement of the back.
The added fatigue that can come with seasonal allergies can also be troublesome for those with chronic pain or illness. Symptoms of fibromyalgia can include chronic fatigue and tiredness, the inability to sleep, headaches and migraines, and problems with memory and concentration. All of these symptoms can be worsened with the addition of seasonal allergies, which can cause all of the above symptoms. The addition of any added symptom or ailment can be difficult to overcome for many, especially when one can suffer from more than one type of pollen allergy, which can lead to months of suffering.
What can you do?
While avoiding seasonal allergies can seem impossible, in many cases avoiding any kind of pollen would mean simply staying indoors for months at a time. Still, there are steps one can take to enjoy the outdoors and avoid serious allergic reactions.
Shower After Being Outdoors: This may seem obvious to many, but showering immediately after being outdoors can greatly reduce the amount of pollen that is not only on the body but also in the home. It is also important to wash the clothes that have been outdoors immediately after returning and to refrain from wearing them again until they have been washed.
Regularly Change Air Filters in Home: One of the most effective ways to prevent pollen from entering the house is to change air filters frequently. The Environmental Protection Agency (EPA) recommends that households use a HEPA filter (high-efficiency particulate air) when choosing an air filter replacement. These air filters can prevent 99.97% of all dust, pollen, mold, bacteria, and airborne particles and should be changed with regards to the manufacturer’s instructions.
Wash Bedding at Least Once a Week: While showering, washing clothes, and changing air filters can all help reduce pollen in the house, some pollen, especially from plants with stickier pollen like that of the dandelion or other insect-pollinated plants and flowers, can stick to the body and make their way past all of these defenses. Washing bed sheets at least once a week can be a great way to reduce stubborn pollen in the house.
Consult an Allergist: It’s important to understand one’s body and its sensitivity to pollen. Consulting an allergy specialist can be an effective way to combat seasonal allergies, as it can give individuals insight into what specifically is the cause of their allergies. Allergists are typically a good solution for those who may suffer from more severe, recurring seasonal allergies.
Understand Pollen Levels: Finally, it is important to understand that there may be some days in which outdoor activities may not be a reasonable undertaking. Monitor pollen levels in the local area and plan accordingly. Along with local news stations and online sites, there are numerous phone apps dedicated to monitoring pollen levels that will give real-time data in a specific area. On days where pollen levels are forecasted to be high, avoid outdoor activities to reduce the risk of an allergic reaction.

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

 

 

 

 

 

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Chronic Pain During the Holidays

Chronic Pain During the Holidays
No matter what holiday you celebrate, this time of year can be a lot. There are elaborate dinners to prepare, parties to host and attend, presents to find, decorations to hang, families to visit, traditions to respect, and very little time for self-care. But your body doesn’t know that, and chronic pain is, if anything, exacerbated by stress and busy schedules.
Here are some tips to help you survive the holidays, pain or no pain:
1. BE REALISTIC
Tempering the holiday madness may not sound like much fun, but if you start off with unrealistic expectations, then no matter how hard you try, you’ll never quite manage. If your physical ability is less than it was last year, adjust your schedule and chores accordingly. Don’t take on more than you know you can manage – that’s just setting yourself up for failure. Consider what’s practical, and use that as your starting point for all your holiday plans.
2. SHARE THE LOAD
A lot of people try to do it all themselves, but the holidays are meant to be a family affair! So don’t be afraid to share the workload. For parties, consider going potluck. For the main event, share cooking responsibilities by assigning someone to each dish. This ensures that even if you have a bad day, there will still be a good meal for everyone. Ask others to help you decorate, ask the kids to pitch in, or pay the neighbor’s kid to shovel your porch. You do not have to do everything yourself.
3. SHOP ONLINE
Online shopping is a godsend, especially for those who struggle to fight their way around malls at this busy time of year. And it’s not just for gifts. You can order groceries, alcohol, decorations, and even cards online. This helps streamline your chores and minimizes energy spent.
4. PLAN FOR DOWNTIME
When everything feels like a rush, it can be hard to shoehorn in time for yourself. So don’t rely on doing this in the moment – plan for it. Deliberately set aside some time each day to rest and recuperate. Avoid scheduling multiple energy-intensive activities on back-to-back days, and arrange to have a day off after big events. You have to be proactive here, as otherwise your time will fill up without you even realizing!
5. KEEP TO NORMAL ROUTINES
Keeping a routine is tough during the holidays, as many of the touchstones are gone. You may be off work, the kids are home, there could be family staying with you – everything is all over the place! But sticking to your usual, tried-and-tested routines will never matter more. Keep your medication schedule, your sleep schedule, and your exercise routine. This helps you feel as well as you can, each and every day, no matter what else is going on.
6. BE ORGANIZED
No matter how much you scale back, there is still a laundry list of things to do over the holidays. You can get a lot done, even with chronic pain, if you remain organized. Make a list of all of your tasks, and prioritize them. Know in advance what you can let slide and what has to be done. Set a schedule and stick to it. It’s incredibly tempting to get caught up in holiday cheer and ignore warning signals, so set a hard “out” time for events in advance. This ensures you take care of your body, no matter what your heart may be telling you!
“YOU ARE IN CONTROL OF WHAT YOU CHOOSE TO CARE ABOUT AND WHERE YOU SPEND YOUR ENERGY; DON’T LET OTHER PEOPLE’S ABILITIES, SUCCESSES, OR EFFORTS IMPACT HOW YOU FEEL ABOUT WHAT YOU CAN DO.”7. DRIVE TWO CARS TO EVENTS
Guilt for dampening loved ones’ merriment can be a big issue, so plan ahead to avoid it. Driving two cars to an event means that you can leave when you need to, without hindering anyone else’s fun. It gives you and your loved ones maximum flexibility. Difficulty driving? Plan in advance to take a taxi or Uber home early.
8. COMMUNICATE
You are not the only person who will be stressed over the holidays. It’s pretty much guaranteed that everyone else is feeling rushed and a little overwhelmed. This may mean that usually sensitive or helpful friends and family suddenly seem less caring, or too busy for what you need. It’s important to understand that this isn’t about you. Remember to cut them some slack for any thoughtlessness, and be clear when stating what you need and what you can and can’t do.
9. ENJOY YOURSELF
With all this talk about “coping” and “managing” and “chores,” it can be easy to forget the holidays are supposed to be a time of fun. So don’t forget to have some! Make time for yourself and what you enjoy, even if it means saying no to someone else. You don’t have unlimited energy or strength, and you can’t do everything. Be kind to yourself, and choose one or two special activities that are just for you.
10. REMEMBER: IT’S NOT A COMPETITION
This time of year can sometimes feel like a never-ending exercise in living up to (or failing) other people’s expectations. But it doesn’t have to be. It doesn’t matter how amazing your neighbor’s decorations are, or the face your mother-in-law makes when she sees your store-bought holiday spread. You are in control of what you choose to care about and where you spend your energy; don’t let other people’s abilities, successes, or efforts impact how you feel about what you can do. Being in chronic pain is hard enough without all of the judgement, so let it go. It doesn’t matter what anyone else has done.
Shared from the US Pain Foundation.

Article Provided By: chicagoneuropain
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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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

Image By: David Dewitt
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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