Managing and Coping with Neuropathy

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6 Oct

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

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

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28 Sep

Peripheral Neuropathy Diet Guide

Peripheral Neuropathy Diet: Best Foods That Heal Nerve Damage (And 4 Foods to Avoid With Neuropathy)
October 23, 2018 by Kelly

If you suffer from peripheral neuropathy, your first line of defense should be diet and lifestyle. (1) Good nutrition can help to slow nerve damage and even reverse nerve pain.
Peripheral neuropathy is a painful and disruptive condition that many with diabetes experience. Symptoms tend to start small, with numbness or tingling in the extremities, however this discomfort increases over time if no steps are taken to fight it. Eventually, the pain from peripheral neuropathy can be so severe that normal activities, like walking or putting on gloves, can become unbearable.
Fortunately, with the correct diet, you can calm nerves and help relieve nerve pain. There are foods that have been shown to help alleviate neuropathic pain and help to heal nerves, avoiding future complications.
Neuropathy is not an inevitable consequence of diabetes. If you want to stop this disease in its tracks and begin to feel relief, you must take steps to optimize your nutrition.
Nerve Regeneration Foods That Stimulate Nerve Growth, Heal Nerve Damage, and Help Pain Relief
The pain and other symptoms of peripheral neuropathy are due to damage to neurons, which are the cells that make up your nervous system. By improving the health of your nervous system and providing your body with the nutrients that it needs to regenerate nerves, you can protect yourself from further pain.
The regeneration of nerves has been tied to improved quality of life and reduced symptoms for those with neuropathy. (1,2) There are numerous foods that have been found to encourage the growth of new neurons.
Spinach
Leafy greens, such as spinach, kale, dandelion greens, cilantro, and parsley, are packed full of phytonutrients that are known to boost human health. Two of these nutrients that have been shown to help neuropathy are folate and magnesium.
Folate
Folate, also known as folic acid, is another name for vitamin B9. Folate is commonly found in plant foods, and is important for cell growth.
Metformin is a prescription drug often used to treat those with type 2 diabetes. (3) With long-term use, it helps to lower blood sugar levels. While metformin is effective at lowering blood sugar levels, it does not do so without side effects.
One of the side effects is a reduction in serum levels of folic acid and cobalamin, with an increase in Hcy. This alteration of serum makeup has been implicated in the pathogenesis of peripheral neuropathy, suggesting that metformin may lead to this complication.
In order to counteract these effects and protect your peripheral neurons, it may be helpful to increase your intake of folic acid to counteract these effects. (4) In an animal study it was found that folic acid supplementation resulted in higher expression of nerve growth factor (NGF) in rats with a condition similar to diabetic peripheral neuropathy. This research suggests that folic acid may play a protective role for nerve health and function in those with diabetes.
Spinach is one of the foods richest in folate, leading to benefits in nerve regeneration and a possible role in protecting against the pathogenesis of diabetic neuropathy.
Magnesium
Human studies on those with type 2 diabetes have found that lower blood levels of magnesium are associated with dampened peripheral nerve function. (6) Other studies have found that supplementing with magnesium may help to improve blood glucose levels, blood pressure, and cholesterol levels in those with type 2 diabetes. (7)
Studies suggest that higher magnesium levels are tied to improved functioning of the peripheral nerves, helping to reduce the likelihood of peripheral diabetic neuropathy progression.
As spinach is second only to almonds as a dietary source of magnesium, adding spinach to your daily diet can help to protect peripheral nerve function. (8)
Almonds, Cashews, and Peanuts
When it comes to quality sources of dietary magnesium, only almonds have higher quantities than spinach. (8) In one ounce of dry roasted almonds, you can acquire 20% of the recommended daily allotment of magnesium.
Cashews and peanuts are two other sources high in magnesium. As outlined above, type 2 diabetes patients who have higher blood levels of magnesium tend to have better peripheral nerve function, as well as other parameters associated with diabetes and diabetic neuropathy progression, such as blood glucose levels. (6,7)
By consuming more magnesium-rich foods, you may be able to protect the health and function of your peripheral nerves.
Black Beans, Edamame, and Kidney Beans
Three other healthful foods that are high in magnesium are black beans, edamame, and kidney beans. Thanks to rich levels of this mineral, these foods may help to protect against damage to peripheral nerves.
Broccoli
Broccoli is a cruciferous vegetable that is rich in a wide array of nutrients, including chromium, an essential element that has been found to protect nerves from damage and improve insulin sensitivity.
Chromium
Chromium deficiency has been tied to impaired glucose tolerance and nerve dysfunction. Animal studies suggest that chromium supplementation can help in managing glucose levels in diabetes, which may also help to protect nerve function. (9)
In one case study, a 40 year old female who suddenly developed neuropathy was found to have a chromium deficiency. Supplementing with chromium reversed this neuropathy and the associated symptoms. (10)
While chromium deficiency is rare, adding in broccoli, the richest dietary source of chromium, may help those who are unknowingly deficient in this trace mineral. (11)
Foods That Calm Nerves and Relieve Pain
There are some foods that are known to help with the pain caused by peripheral neuropathy, calming nerves and thereby helping those with neuropathy find relief.
Flax Seeds, Chia Seeds, and Walnuts
Flax seeds, chia seed, and walnuts are three of the richest plant sources of omega-3 fatty acids. The type of omega-3 fatty acid that they are rich in is ALA, or alpha-lipoic acid. It is this fatty acid in particular that has been shown in studies to help those suffering from neuropathy.
Alpha-Lipoic Acid
ALA, which is an antioxidant with potential for lowering blood glucose levels, has been shown in studies to offer an additional benefit of reducing diabetic neuropathic pain. (12)
In a human study on peripheral neuropathy, 600 mg of ALA supplemented for 90 days was found to decrease neuropathy symptoms in some, and fully resolve them in others. Pain, pressure, and sensation were improved.
It is easy to obtain 600 mg/day ALA with dietary sources only. You can get far more than 600 mg/day through 1 tablespoon of either flaxseed oil, chia seeds, walnuts or flaxseeds.
Seafood: Wild Caught Salmon and Other Fatty Fish
Wild-caught, cold-water fish, such as salmon, trout, tuna, and sardines, are rich sources of omega-3 fatty acids and vitamin B12. Research suggests that these two nutrients may help to encourage nerve growth, protect nerves from damage, and reduce the feelings of pain associated with neuropathy.
Omega-3 Fatty Acids: EPA and DHA
While nuts and seeds are high in the omega-3 fatty acid APA, coldwater fish are high in EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Research examining the effect of fish oil and these fatty acids on neuropathy are limited, but this limited research suggests that these fatty acids may help to encourage nerve growth and act as neuroprotectants. (14)
Vitamin B12
Earlier in this article, we discussed how the diabetes medication metformin has been shown to lead to deficiencies in folate. The same study showed that those who take metformin also often suffer from a vitamin B12 deficiency. (3) These changes in serum makeup are thought to be the reason why it often leads to diabetic neuropathy in patients.
Vitamin B12 is critical for proper neurological function, with deficient levels implicated in nerve damage. (15) Some studies have found that supplementation with vitamin B12 may help to relieve the pain caused by neuropathy.
Seafood and fish are the primary sources of vitamin B12 in the human diet. It is primarily coldwater fish that are the highest in vitamin B12. In order to increase your intake of this vitamin and omega-3 fatty acids, it is recommended to consume 2-3 servings of coldwater fish each week.
Two of your best options for both are wild-caught salmon and trout. Other contenders are sardines, anchovies, and herring.
Turmeric
Turmeric is a spice most well-known for its role in the Indian dish curry, where it is the primary spice. Its health benefits have been touted for thousands of years in an ancient form of holistic medicine in India known as Ayurveda.
Research has found that the primary compound in turmeric that provides its powerful health benefits is curcumin. Studies have found that curcumin may be beneficial for those with diabetes and diabetic neuropathy.
Curcumin
The health benefits of curcumin are largely thanks to its anti-inflammatory and antioxidant capacity. (16) It has demonstrated benefits in lowering blood glucose levels and protecting against diabetic neuropathy. Animal studies found reduced pain behavior and increased pain threshold in those treated with curcumin.
Foods To Avoid That Make Neuropathy Worse
Additionally, it is important not to eat foods that exacerbate your underlying diabetes. Elevated blood sugar levels are implicated in the pathogenesis of diabetic neuropathy, meaning that elevated blood sugar levels are likely to lead to disease progression and increased pain.There are numerous foods that have been implicated in the progression of diabetes and diabetic neuropathy. These foods are often to thank for oxidative damage and inflammation that contribute to nerve pain.
With these things in mind, you should avoid the following foods: (17)
Refined Carbohydrates
Refined carbs are those that have had the healthful portions of the grains removed. Examples include white flour and white rice. Common foods that include refined carbs are white bread, bagels, baked goods, pancakes, crackers, and more.
Not only do these foods lack fiber and nutrients, but they are known to cause a spike in blood glucose levels. This glucose is involved in damaging nerves and thus the progression of diabetic neuropathy.
Foods with Added Sugars
Another common example of foods that have had any beneficial nutrients removed are white sugar and high fructose corn syrup. Unfortunately, nearly every fast food item and the vast majority of processed and packaged food at the supermarket include these ingredients.
Common examples of some of the worst offenders are sodas, candy, ice cream, baked goods, and fast food. These foods cause the biggest spike in blood sugar of any food out there, so it is important to avoid these as much as possible.
Saturated and Trans Fats
Fats are a complicated and often confusing category of food for those with diabetes and other health concerns. There are some fats that are good for your health, some that are bad, and some that are alright in moderation.
Generally, you want to stay away from saturated fats, which are those that tend to be solid at room temperature, and trans fats. Examples of foods high in saturated fats include lard, cream, butter, processed meats, and red meats. Those high in trans fats include margarine, shortening, and fast food.
Click here for a complete guide on “good” and “bad” fats.
Alcohol
When consumed in moderation, alcohol may not cause much damage when it comes to neuropathy, but when consumed in excess, alcohol can cause damage to nerves. In fact, there is such thing as alcoholic neuropathy, where excess alcohol consumption causes nerve damage similar to that of diabetic neuropathy.
Additionally, alcoholism is associated with difficulties absorbing important nutrients whose deficiencies have been found to correlate with diabetic neuropathy. These include folate and vitamin B12.
Neuropathy Diet Tips
When it comes to what type of diet to follow, a low-fat, vegetarian diet appears to have benefits for those with diabetic neuropathy. (17,18) This type of diet is associated with improvements in blood glucose levels, blood pressure, and blood lipid concentration, all three factors which are thought to play a role in the pathogenesis of both diabetes and diabetic neuropathy.
Even if you are unable to fully make the switch to a low-fat, vegetarian diet, you can use this diet as a kind of template for best practices. By cutting down on meat and dairy, particularly high-fat meat and dairy, and increasing your consumption of nutrient-rich plant foods, you can improve your health and your symptoms of diabetic neuropathy.
Additionally, you may want to work with a doctor if you suspect that you may have trouble digesting gluten. Celiac disease and neuropathy are related. It has been found that 2.5% of those with neuropathy have celiac disease, in comparison to only 1% of the normal population. (19) Because of this, you want to be sure that you do not have an underlying allergy to gluten that could be making your symptoms worse.

Article Provided By: Neuropathyreliefguide

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21 Sep

Complex Regional Pain Syndrome

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

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

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

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

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

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

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

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

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

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17 Sep

Responding to Weather Changes When Caring for Neuropathy Patients

September 11, 2019 by Ezekiel Lim In Columns, Rumination and Response – a Column by Ezekiel Lim.

Patients with familial amyloid polyneuropathy may find that changes in seasons increase discomfort. Colder temperatures require layers of clothing that may bother someone with peripheral neuropathy symptoms. A change to hotter temperatures may cause increased discomfort to someone already experiencing burning sensations due to nerve damage.
Caregivers can take steps to help manage the impact of weather changes on neuropathy patients.

Cold weather and neuropathy
Patients with peripheral neuropathy symptoms experience a slowing of blood flow to nerve endings, causing numbness and tingling. Colder temperatures may make it difficult for patients to measure their bodies’ response to the climate.
My family lives in an area known for weather extremes. When spending time with my mother-in-law during the winter months, it is important for us not only to make sure she has adequate layers of clothing, but also to know when the bundled clothing is causing her discomfort.
Following are some tips for caregivers who are managing the daily care of a loved one during a change to colder weather:

Make sure the patient is wearing warm, comfortable clothing that isn’t too heavy.
Protect the patient’s hands and feet with warm gloves and neuropathy socks.
Massage areas where circulation may be lacking.
Limit the time spent outside in the cold.
Limit caffeine and alcohol intake as they may respectively narrow blood cells and cause vitamin deficiency.
Managing symptoms in heat
Hotter temperatures may exacerbate the tingling and burning sensations that neuropathy patients experience. During a transition from cold winters to mild or hot months, caregivers must gauge their loved one’s peripheral symptoms. Just as in winter months, patients may have difficulty measuring their bodily responses to temperature.
For caregivers managing responses to hotter temperatures, following are some tips for ensuring patient comfort:
Keep time spent outside to a minimum and, if needed, stay indoors all day.
Make sure air conditioning is adjusted to a comfortable level to avoid interacting with symptoms of numbness.
Make sure your loved one is adequately fed and hydrated.
Understand the patient’s comfort level and make sure they are wearing lighter layers of clothing.
Try using topical treatments and cooling products when the patient begins to feel too hot.
The pain caused by humidity and summer heat may cause increased discomfort in those suffering from peripheral neuropathy symptoms. By ensuring the patient has a comfortable indoor environment, the change in temperature will not exacerbate chronic pain.

***
Note: FAP News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of FAP News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to familial amyloid polyneuropathy.

Article Provided By: fapnewstoday

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14 Sep

Exercises for Peripheral Neuropathy

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

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

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

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31 Aug

Burning Feet

Burning feet

By Mayo Clinic Staff

Burning feet — the sensation that your feet are painfully hot — can be mild or severe. In some cases, your burning feet may be so painful that the pain interferes with your sleep. With certain conditions, burning feet may also be accompanied by a pins and needles sensation (paresthesia) or numbness, or both.

Burning feet may also be referred to as tingling feet or paresthesia.

Causes

While fatigue or a skin infection can cause temporarily burning or inflamed feet, burning feet are most often a sign of nerve damage (peripheral neuropathy). Nerve damage has many different causes, including diabetes, chronic alcohol use, exposure to certain toxins, certain B vitamin deficiencies or HIV infection.

Possible causes of burning feet:
Alcohol use disorder
Athlete’s foot
Charcot-Marie-Tooth disease (a group of hereditary disorders that affects the nerves in your arms and legs)
Chemotherapy
Chronic kidney disease
Complex regional pain syndrome (chronic pain due to a dysfunctional nervous system)
Diabetic neuropathy (nerve damage caused by diabetes)
HIV/AIDS
Hypothyroidism (underactive thyroid) (underactive thyroid)
Tarsal tunnel syndrome
Vitamin deficiency anemia

When to see a doctor

Seek emergency medical care if:
The burning sensation in your feet came on suddenly, particularly if you may have been exposed to some type of toxin
An open wound on your foot appears to be infected, especially if you have diabetes
Schedule an office visit if you:
Continue to experience burning feet, despite several weeks of self-care
Notice that the symptom is becoming more intense and painful
Feel the burning sensation has started to spread up into your legs
Start losing the feeling in your toes or feet

If your burning feet persist or if there is no apparent cause, then your doctor will need to do tests to determine if any of the various conditions that cause peripheral neuropathy are to blame.

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

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28 Aug

Cold Feet

By Shawn Bishop

Cold Feet That Aren’t Cold to the Touch May Indicate Neurologic Problem
April 1, 2011
Dear Mayo Clinic:
Lately my feet always seem cold but are not cold to the touch. Could this be an early symptom of something to come?
Answer:
Pinpointing the exact source of this symptom requires a physical exam and diagnostic tests. But when feet feel cold but are not cold to the touch, a possible cause is a neurologic problem, such as peripheral neuropathy.
Of course, feet can get cold for many reasons. The most obvious is a cold environment, along with a lack of proper shoes or socks. Frequent or constant sweating (hyperhidrosis) can also make feet feel cold, especially when evaporation cools the feet quickly. This can often be caused by nervousness, literally “getting cold feet.” Lack of adequate blood flow to the feet through the arteries can also make the feet cold. But in all these situations, the feet feel cold to the touch.
Often the sensation of cold feet is benign and there is no serious underlying cause. However, experiencing the sensation of cold feet that don’t feel cold to the touch may be a sign of a nerve problem. For example, peripheral neuropathy can cause this symptom. Peripheral neuropathy occurs as a result of nerve damage caused by injury or an underlying medical disorder. Diabetes is one of the most common causes of peripheral neuropathy, but the condition may also result from vitamin deficiencies, metabolic problems, liver or kidney diseases, infections, or exposure to toxins. The condition can also be inherited. Sometimes the cause of peripheral neuropathy is never found.
The peripheral nerves are all of the nerves in the body that are outside of the brain and spinal cord (central nervous system). Peripheral neuropathy frequently begins in the body’s longest nerves, which reach to the toes. So symptoms often appear in the feet first and then the lower legs. Other potential symptoms caused by peripheral neuropathy include numbness; a tingling, burning or prickling feeling in the feet and legs that may spread to the hands and arms; sharp or burning pain; and sensitivity to touch. As peripheral neuropathy progresses, loss of feeling, lack of coordination, and muscle weakness may develop.
You should see your doctor to have your situation evaluated. If your doctor suspects peripheral neuropathy or other nerve damage, a variety of tests may be used to uncover the underlying source of the problem. To help in the diagnosis, your doctor will likely talk with you about your medical history and perform a physical and neurological exam that may include checking your reflexes, muscle strength and tone, ability to feel certain sensations, and posture and coordination.
In addition, blood tests may be used to check vitamin levels, thyroid function, blood sugar levels, liver function and kidney function, as all these can affect your nerves. Your doctor also may suggest electrophysiologic testing known as electromyography (EMG) and nerve conduction studies (NCS). These tests measure the electrical signals in the peripheral nerves and how well the nerves transfer signals to your muscles.
In some cases, a nerve biopsy — a procedure in which a small portion of a sensory nerve near the ankle is removed and examined for abnormalities — and imaging tests, such as an MRI or CT scan, may also be needed to help determine the cause of nerve damage.
It’s important to have your situation assessed by your doctor soon. If peripheral neuropathy is the source of the problem, and the cold sensation in your feet is the only symptom, you may be in the early stages of the disorder. In that case, finding and treating the underlying cause of the nerve damage may be all that’s necessary. Nerve damage that progresses can lead to pain and other symptoms which can be more difficult to successfully treat.
— John Jones, M.D., Vascular Center, Mayo Clinic, Rochester, Minn.

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24 Aug

Pinched Nerve In Shoulder

What happens with a pinched nerve in the shoulder?

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

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

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

How does a doctor diagnose shoulder pain?

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

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

Managing a pinched nerve in the shoulder

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

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

Last medically reviewed on January 14, 2020

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

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19 Aug

Tarsal Tunnel Syndrome

Recognizing and Treating Tarsal Tunnel Syndrome

What is tarsal tunnel syndrome?
Tarsal tunnel syndrome is a condition caused by repeated pressure that results in damage on the posterior tibial nerve. Your tibial nerve branches off of the sciatic nerve and is found near your ankle.
The tibial nerve runs through the tarsal tunnel, which is a narrow passageway inside your ankle that is bound by bone and soft tissue. Damage of the tibial nerve typically occurs when the nerve is compressed as a result of consistent pressure.

What are the symptoms of tarsal tunnel syndrome?
People with tarsal tunnel syndrome may experience pain, numbness, or tingling. This pain can be felt anywhere along the tibial nerve, but it’s also common to feel pain in the sole of the foot or inside the ankle. This can feel like:
sharp, shooting pains
pins and needles
an electric shock
a burning sensation
Symptoms vary greatly depending on each individual. Some people experience symptoms that progress gradually, and some experience symptoms that begin very suddenly.
Pain and other symptoms are often aggravated by physical activity. But if the condition is long-standing, some people even experience pain or tingling at night or when resting.
What causes tarsal tunnel syndrome?
Tarsal tunnel syndrome results from compression of the tibial nerve, and it’s often caused by other conditions.
Causes can include:
severely flat feet, because flattened feet can stretch the tibial nerve
benign bony growths in the tarsal tunnel
varicose veins in the membrane surrounding the tibial nerve, which cause compression on the nerve
inflammation from arthritis
lesions and masses like tumors or lipomas near the tibial nerve
injuries or trauma, like an ankle sprain or fracture — inflammation and swelling from which lead to tarsal tunnel syndrome
diabetes, which makes the nerve more vulnerable to compression

How is tarsal tunnel syndrome diagnosed?
If you think you have tarsal tunnel syndrome, you should see your doctor so they can help you identify the cause and create a treatment plan so that the condition doesn’t get worse. Your general practitioner can refer you to an orthopedic surgeon or podiatrist.
At your appointment, your doctor will ask about the progression of your symptoms and about medical history like trauma to the area. They’ll examine your foot and ankle, looking for physical characteristics that could indicate tarsal tunnel syndrome. They’ll likely perform a Tinel’s test, which involves gently tapping the tibial nerve. If you experience a tingling sensation or pain as a result of that pressure, this indicates tarsal tunnel syndrome.
Your doctor may also order additional tests to look for an underlying cause, including an electromyography, which is a test that can detect nerve dysfunction. MRIs may also be ordered if your doctor suspects that a mass or bony growth could be causing the tarsal tunnel syndrome.

Can tarsal tunnel syndrome cause any complications?
If tarsal tunnel syndrome is left untreated, it can result in permanent and irreversible nerve damage. Because this nerve damage affects your foot, it could be painful or difficult to walk or resume normal activities.

How is tarsal tunnel syndrome treated?
Treating tarsal tunnel syndrome depends on your symptoms and the underlying cause of your pain.
At-home treatments
You can take anti-inflammatory medications (including nonsteroidal anti-inflammatory drugs) to reduce inflammation, which may alleviate compression of the nerve. Resting, icing, compression, and elevation, known as the RICE treatment, may also help reduce swelling and inflammation.
Doctor-prescribed treatments
Steroid injections may also be applied to the affected area to reduce swelling. In some cases, braces and splits may be used to immobilize the foot and limit movement that could compress the nerve. If you have naturally flat feet, you may want to have custom shoes made that support the arches of your feet.
Surgery
In severe, long-term cases, your doctor may recommend a surgery called the tarsal tunnel release. During this procedure, your surgeon will make an incision from behind your ankle down to the arch of your foot. They will release the ligament, relieving the nerve.
A minimally invasive surgery is also used by some surgeons, in which much smaller incisions are made inside your ankle. The surgeon uses tiny instruments to stretch out the ligament. Because there’s less trauma sustained by the tissues, the risk of complications and recovery time are both reduced.

Article Provided By: healthline

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17 Aug

Hyperalgesia

Hyperalgesia: It Hurts Everywhere!!

Christina Lasich, MD
Health Professional
March 2, 2013

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

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

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

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

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

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

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

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

Article Provided By: Healthcentral

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Neuropathic Pain Therapy Center

Managing and Coping with Neuropathy

Peripheral Neuropathy Diet Guide

Complex Regional Pain Syndrome

Responding to Weather Changes When Caring for Neuropathy Patients

Exercises for Peripheral Neuropathy

Burning Feet

Cold Feet

Pinched Nerve In Shoulder

Tarsal Tunnel Syndrome

Hyperalgesia

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