Cold Feet

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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.

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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26 Aug

Peripheral Neuropathy

Neuropathy (Peripheral Neuropathy)

Diabetes is a leading cause of neuropathy in the United States, although there are many other causes too. Some cases of neuropathy can be easily treated and sometimes cured. If neuropathy can’t be cured, treatment is aimed at controlling and managing symptoms and preventing further nerve damage.

Your peripheral nervous system is made up of the nerves outside your central nervous system. Sensory nerves carry messages to your brain. Motor nerves carry messages to your muscles.
What is neuropathy?
Neuropathy is damage or dysfunction of one or more nerves that typically results in numbness, tingling, muscle weakness and pain in the affected area. Neuropathies frequently start in your hands and feet, but other parts of your body can be affected too.
Neuropathy, often called peripheral neuropathy, indicates a problem within the peripheral nervous system. Your peripheral nervous system is the network of nerves outside your brain and spinal cord. Your brain and spinal cord make up your central nervous system. Think of the two systems working together this way: Your central nervous system is the central station. It is the control center, the hub from which all trains come and go. Your peripheral nervous system are the tracks that connect to the central station. The tracks (the network of nerves) allow the trains (information signals) to travel to and from the central station (your brain and spinal cord).
Neuropathy results when nerve cells, called neurons, are damaged or destroyed. This disrupts the way the neurons communicate with each other and with the brain. Neuropathy can affect one nerve (mononeuropathy) or nerve type, a combination of nerves in a limited area (multifocal neuropathy) or many peripheral nerves throughout the body (polyneuropathy).

What types of peripheral nerves are there and what do they do?
The peripheral nervous system is made up of three types of nerves, each with an important role in keeping your body healthy and functioning properly.
Sensory nerves carry messages from your five senses (sight, hearing, smell, taste, touch) through your spinal cord to your brain. For example, a sensory nerve would communicate to your brain information about objects you hold in your hand, like pain, temperature, and texture.
Motor nerves travel in the opposite direction of sensory nerves. They carry messages from your brain to your muscles. They tell your muscles how and when to contract to produce movement. For example, to move your hand away from something hot.
Autonomic nerves are responsible for body functions that occur outside of your direct control, such as breathing, digestion, heart rate, blood pressure, sweating, bladder control and sexual arousal. The autonomic nerves are constantly monitoring and responding to external stresses and bodily needs. For instance, when you exercise, your body temperatures increases. The autonomic nervous system triggers sweating to prevent your body’s temperature from rising too high.
The type of symptoms you feel depend on the type of nerve that is damaged.
What does neuropathy feel like?
If you have neuropathy, the most commonly described feelings are sensations of numbness, tingling (“pins and needles”), and weakness in the area of the body affected. Other sensations include sharp, lightening-like pain; or a burning, throbbing or stabbing pain.
How common is neuropathy? Who gets neuropathy?
Neuropathy is very common. It is estimated that about 25% to 30% of Americans will be affected by neuropathy. The condition affects people of all ages; however, older people are at increased risk. About 8% of adults over 65 years of age report some degree of neuropathy. Other than age, in the United States some of the more common risk factors for neuropathy include diabetes, metabolic syndrome (high blood pressure, high cholesterol, obesity, diabetes), and heavy alcohol use. People in certain professions, such as those that require repetitive motions, have a greater chance of developing mononeuropathies from trauma or compression of nerves.
Among other commonly cited statistics, neuropathy is present in:
60% to 70% of people with diabetes.
30% to 40% of people who receive chemotherapy to treat cancer.
30% of people who have human immunodeficiency virus (HIV).
How quickly does neuropathy develop?
Some peripheral neuropathies develop slowly – over months to years – while others develop more rapidly and continue to get worse. There are over 100 types of neuropathies and each type can develop differently. The way your condition progresses and how quickly your symptoms start can vary greatly depending on the type of nerve or nerves damaged, and the underlying cause of the condition.

There are many causes of neuropathy. Diabetes is the number one cause in the United States. Other common causes include trauma, chemotherapy, alcoholism and autoimmune diseases.
What causes neuropathy?
Neuropathy is not caused by a single disease. Many conditions and events that impact health can cause neuropathy, including:
Diabetes: This is a leading cause of neuropathy in the United States. Some 60% to 70% of people with diabetes experience neuropathy. Diabetes is the most common cause of small fiber neuropathy, a condition that causes painful burning sensations in the hands and feet.
Trauma: Injuries from falls, car accidents, fractures or sports activities can result in neuropathy. Compression of the nerves due to repetitive stress or narrowing of the space through which nerves run are other causes.
Autoimmune disorders and infections: Guillain-Barré syndrome, lupus, rheumatoid arthritis, Sjogren’s syndrome and chronic inflammatory demyelinating polyneuropathy are autoimmune disorders that can cause neuropathy. Infections including chickenpox, shingles, human immunodeficiency virus (HIV), herpes, syphilis, Lyme disease, leprosy, West Nile virus, Epstein-Barr virus and hepatitis C can also cause neuropathy.
Other health conditions: Neuropathy can result from kidney disorders, liver disorders, hypothyroidism, tumors (cancer-causing or benign) that press on nerves or invade their space, myeloma, lymphoma and monoclonal gammopathy.
Medications and poisons: Some antibiotics, some anti-seizures medications and some HIV medications among others can cause neuropathy. Some treatments, including cancer chemotherapy and radiation, can damage peripheral nerves. Exposure to toxic substances such as heavy metals (including lead and mercury) and industrial chemicals, especially solvents, can also affect nerve function.
Vascular disorders: Neuropathy can occur when blood flow to the arms and legs is decreased or slowed by inflammation, blood clots, or other blood vessel disorders. Decreased blood flow deprives the nerve cells of oxygen, causing nerve damage or nerve cell death. Vascular problems can be caused by vasculitis, smoking and diabetes.
Abnormal vitamin levels and alcoholism: Proper levels of vitamins E, B1, B6, B12, and niacin are important for healthy nerve function. Chronic alcoholism, which typically results in lack of a well-rounded diet, robs the body of thiamine and other essential nutrients needed for nerve function. Alcohol may also be directly toxic to peripheral nerves.
Inherited disorders: Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy. CMT causes weakness in the foot and lower leg muscles and can also affect the muscles in the hands. Familial amyloidosis, Fabry disease and metachromatic leukodystrophy are other examples of inherited disorders that can cause neuropathy.
No known cause: Some cases of neuropathy have no known cause.
What are the symptoms of neuropathy?
Symptoms of neuropathy vary depending on the type and location of the nerves involved. Symptoms can appear suddenly, which is called acute neuropathy, or develop slowly over time, called chronic neuropathy.
Common signs and symptoms of neuropathy include:
Tingling (“pins and needles”) or numbness, especially in the hands and feet. Sensations can spread to the arms and legs.
Sharp, burning, throbbing, stabbing or electric-like pain.
Changes in sensation. Severe pain, especially at night. Inability to feel pain, pressure, temperature or touch. Extreme sensitivity to touch.
Falling, loss of coordination.
Not being able to feel things in your feet and hands – feeling like you’re wearing socks or gloves when you’re not.
Muscle weakness, difficulty walking or moving your arms or legs.
Muscle twitching, cramps and/or spasms.
Inability to move a part of the body (paralysis). Loss of muscle control, loss of muscle tone or dropping things out of your hand.
Low blood pressure or abnormal heart rate, which causes dizziness when standing up, fainting or lightheadedness.
Sweating too much or not enough in relation to the temperature or degree or exertion.
Problems with bladder (urination), digestion (including bloating, nausea/vomiting) and bowels (including diarrhea, constipation).
Sexual function problems.
Weight loss (unintentional).

Neuropathy (Peripheral Neuropathy): Diagnosis and Tests

Common symptoms of neuropathy include numbness and tingling, frequent falls, muscle weakness and difficulty walking, and low blood pressure.
How is neuropathy diagnosed?
History and physical exam: First, your doctor will conduct a thorough history and physical exam. You doctor will review your symptoms and ask questions including your current and past medications, exposure to toxic substances, your history of trauma, your line of work or social habits (looking for repetitive motions), family history of diseases of the nervous system, your diet and alcohol use.

Neurologic exam: During a neurologic exam, your doctor will check your reflexes, your coordination and balance, your muscle strength and tone, and your ability to feel sensations (such as light touch or cold).
Blood work and imaging tests: Your doctor may also order blood work and imaging tests. Blood work can reveal vitamin and mineral imbalances, electrolyte imbalances (indicator of kidney problems, diabetes, other health issues), thyroid problems, toxic substances, antibodies to certain viruses or autoimmune diseases. Magnetic resonance imaging (MRI) can detect tumors, pinched nerves and nerve compression.
Genetic testing: A genetic test may be ordered if your doctor suspects a genetic condition is causing your neuropathy.
Electrodiagnostic assessment (EDX): Your doctor might send you to a nerve specialist for an EDX to find the location and degree of nerve damage. EDX includes two tests:
Nerve conduction study (NCS): During this test, small patches – called electrodes – are placed on the skin over nerves and muscles on different parts of your body, usually your arms or legs. A brief pulse of electricity is applied to the patch over a nerve to be studied. The test measures the size of the response and how quickly the nerve is carrying the electrical signal. Both motor and sensory nerves can be studied in this way.
Needle electromyography (EMG): An EMG can determine the health of a muscle, and determine if there is any disconnection between the nerve and muscle by measuring the electrical activity within the muscle while it is in use. During an EMG, a very thin needle electrode is inserted through the skin into the muscle. The muscle is then used for a specific movement and the electrical activity of the muscle is recorded on a graph called an electromyogram.
Tissue biopsies: In some cases, a nerve, muscle or skin biopsy is needed to confirm the diagnosis. During a biopsy, a small sample of your tissue is removed for examination under a microscope.
Other tests: Other tests include a test to measure your body’s ability to sweat (called a QSART test) and other tests to check the sensitivity of your senses (touch, heat/cold, pain, vibration).

Neuropathy (Peripheral Neuropathy): Management and Treatment

How is neuropathy treated?
Treatment begins by identifying and treating any underlying medical problem, such as diabetes or infections.

Some cases of neuropathy can be easily treated and sometimes cured. Not all neuropathies can be cured, however. In these cases, treatment is aimed at controlling and managing symptoms and preventing further nerve damage. Treatment options include the following:
Medicines can be used to control pain. A number of different medications contain chemicals that help control pain by adjusting pain signaling pathways within the central and peripheral nervous system. These medications include:
Antidepressants such as duloxetine or nortripyline.
Antiseizure medicines such as gabapentin (Neurontin®, Gralise®) and pregabalin (Lyrica®).
Topical (on the skin) patches and creams containing lidocaine (Lidoderm®, Xylocaine®) or capsaicin (Capsin®, Zostrix®).
Narcotic medications are not usually used for neuropathy pain due to limited evidence that they are helpful for this condition.
Physical therapy uses a combination of focused exercise, massage and other treatments to help you increase your strength, balance and range of motion.
Occupational therapy can help you cope with the pain and loss of function, and teach you skills to make up for that loss.
Surgery is available for patients with compression-related neuropathy caused by such things as herniated disc in back or neck, tumors, infections, or nerve entrapment disorders, such as carpal tunnel syndrome.
Mechanical aids, such as braces and specially designed shoes, casts and splints can help reduce pain by providing support or keeping the affected nerves in proper alignment.
Proper nutrition involves eating a healthier diet and making sure to get the right balance of vitamins and other nutrients.
Adopting healthy living habits, including exercising to improve muscle strength, quitting smoking, maintaining a healthy weight, and limiting alcohol intake.
Other treatments
Transcutaneous electrical nerve stimulation (TENS): This treatment involves placing electrodes on the skin at or near the nerves causing your pain. A gentle, low-level electrical current is delivered through the electrodes to your skin. Treatment schedule (how many minutes and how often) is determined by your therapist. The goal of TENS therapy is to disrupt pain signals so they don’t reach the brain
Immune suppressing or immune modulating treatments: Various treatments are used for individuals whose neuropathy is due to an autoimmune disease. These include oral medications, IV infusion treatments, or even procedures like plasmapheresis where antibodies and other immune system cells are removed from your blood and the blood is then returned to your body. The goal of these therapies is to stop the immune system from attacking the nerves.
Complementary treatments: Acupuncture, massage, alpha-lipoic acid, herbal products, meditation/yoga, behavioral therapy and psychotherapy are other methods that could be tried to help relieve neuropathic pain. Ask your doctor if any of these therapies might be helpful for treating the cause of your neuropathy.

Neuropathy (Peripheral Neuropathy): Prevention

Can neuropathy be prevented?
You can reduce your risk of neuropathy by treating existing medical problems and adopting healthy living habits. Here are some tips:
Manage your diabetes: If you have diabetes, keep your blood glucose level within the range recommended by your doctor.
Take care of your feet: If you have diabetes or poor blood flow, it’s important to check your feet every day. Look for sores, blisters, redness, calluses, or dry or cracking skin. Keep your toenails clipped (clip straight across the nail); apply lotion to clean, dry feet; and wear closed-toe, well-fitting shoes. Protect your feet from heat and cold. Don’t walk barefoot.
Declutter your floors. Keep your floors free of items that could cause you to trip and fall. Make sure all electrical cords are tucked away along the baseboards of walls and rooms are well lit.
Stop smoking: Smoking constricts blood vessels that supply nutrients to nerves. Without proper nutrition, neuropathy symptoms can worsen.
Maintain a healthy lifestyle: Eat a balanced diet, stay within your ideal weight range, exercise several times a week and keep alcoholic drinks to a minimum. These healthy living tips keep your muscles strong and supply your nerves with the oxygen and nutrients they need to remain healthy.
Review your medications: Talk with your doctor or pharmacist about all the medications and over-the-counter products you take. Ask if any are known to cause or worsen neuropathy. If so, ask if a different medication can be tried.

Neuropathy (Peripheral Neuropathy): Outlook / Prognosis

Can neuropathy be stopped?
Your long-term outcome depends on what is causing your neuropathy. If your neuropathy is caused by a treatable condition, managing the condition might result in stopping the neuropathy or preventing it from getting worse. If the underlying cause of the neuropathy can’t be treated, then the goal is to manage the symptoms of neuropathy and improve your quality of life.
Neuropathy rarely leads to death if the cause is determined and controlled. The sooner the diagnosis is made and treatment is started, the greater the chance that nerve damage can be slowed or repaired. Recovery, if it’s possible, usually takes a very long time — from months to even years. Some people live with a degree of neuropathy for the rest of their lives.

Can neuropathy be reversed?
If the underlying cause of the neuropathy can be treated and cured (such as neuropathy caused by a vitamin deficiency), it’s possible that the neuropathy can be reversed too. However, frequently by the time individuals are diagnosed with a neuropathy, there is some degree of permanent damage that can’t be fixed.
Even though this is the general belief of today, it’s not the hope of tomorrow. Nerve damage may be reversible someday. Researchers are already seeing positive results – the regrowth of nerve fibers – in a drug study in mice with diabetes. Ongoing research combined with living a healthy lifestyle so the body can repair itself will likely be needed. Stay tuned.

Neuropathy (Peripheral Neuropathy): Living With

Can neuropathy lead to amputation?
Yes, neuropathy – especially diabetic neuropathy – can lead to limb amputation. Each year about 86,000 Americans with diabetes lose a limb. The sequence of events leading up to amputation is typically this: the high glucose levels seen in diabetes cause nerve damage. The nerve damage reduces sensation in the limbs (usually the feet), which can lead to unnoticed injuries turning into skin ulcers or infections. Reduced blood flow to the feet, another effect of diabetes, prevents the wound from healing properly. The wounds cause the tissue in the foot or leg to break down, requiring amputation.
You can, however, reduce your chance of an amputation by keeping your diabetes under control and carefully caring for your skin and feet.

What should I do if I think I have neuropathy?
See your healthcare provider immediately as soon as you notice symptoms. Neuropathy can also be a symptom of a serious disorder. If left untreated, peripheral neuropathy can lead to permanent nerve damage.

Article Provided By: ClevelandClinic
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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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

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 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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7 Aug

Diabetic Neuropathy, Pain Relief, Peripheral Neuropathy, Pain Management, Nerve Pain Treatment, Carolina Pain Scrambler, Greenville South Carolina

Idiopathic Neuropathy

What is idiopathic neuropathy?
Neuropathy is when nerve damage interferes with the functioning of the peripheral nervous system (PNS). When the cause can’t be determined, it’s called idiopathic neuropathy.
The PNS carries information from the central nervous system (CNS), or brain and spinal cord, to the rest of the body.
There are three kinds of nerves within the PNS. Sensory nerves relay messages from the senses to the brain. This allows sensations of temperature and touch. Motor nerves transmit signals from the brain to the muscles. This helps the brain control the muscles. Autonomic nerves control body functions like heart rate, breathing, and digestion.
Damage to nerve cells can affect how the PNS communicates with the rest of the body. Symptoms can include numbness, pain, and balance issues.
It’s called acute neuropathy when symptoms develop suddenly. Alternately, it’s called chronic neuropathy when symptoms start slowly and increase over time.
Diagnosis involves physical examination and review of medical history. Diagnostic testing may include blood tests, nerve testing, and imaging tests.
There is no cure for idiopathic neuropathy. Treatments including medication, physical therapy, and lifestyle modifications can help you function and feel better.
What are the symptoms of neuropathy?
Symptoms can be vague at onset and are similar to those of other conditions. Symptoms vary depending on which nerves are damaged.
Symptoms of sensory neuropathy may include:
numbness, tingling, and burning sensation, particularly in hands and feet
vague or strange sensations (paresthesias)
pain, or inability to feel pain, touch, or temperature
lack of coordination or loss of reflexes
Symptoms of motor neuropathy may include:
muscle weakness or loss of muscle control
trouble with balance and coordination
muscle twitching, cramping, or spasms
difficulty walking or moving limbs
Symptoms of autonomic neuropathy may include:
dizziness, or fainting
sweating abnormalities
nausea, vomiting, or diarrhea
abnormal heart rate or blood pressure
sexual dysfunction
Symptoms may progress quickly and then slowly get better over time in some forms of acute neuropathy. Some chronic neuropathies cause periods of relapse followed by periods of remission.
What are the causes of neuropathy?
Some conditions that cause neuropathy are hereditary. Other things that can cause it include:
injury or infection
nutritional or hormonal imbalances
chemotherapy or exposure to toxic substances
autoimmune diseases such as Lyme disease, lupus, and rheumatoid arthritis (RA)
systemic diseases like diabetes, kidney disorders, and certain cancers
vascular disorders
tumors
Approximately 30 percent of neuropathy cases are due to diabetes, according to the Cleveland Clinic. Between 30 and 40 percent of the remaining cases are idiopathic.

Who is at risk for neuropathy?
The National Institute of Neurological Disorders and Stroke estimates that approximately 20 million Americans have peripheral neuropathy. Anyone can develop neuropathy, but risk increases with age.

How is neuropathy diagnosed?
There is no one definitive test for neuropathy. Testing begins with a physical examination and a complete medical history. Tell your doctor about any symptoms you’re experiencing. Be sure to let them know about over-the-counter and prescription medications you’re taking. It’s also important to mention if you’ve been exposed to toxins on the job or at home.
Diagnostic testing may include:
blood work
urinalysis
nerve conduction studies (NCS)
electromyography (EMG)
skin, nerve, and muscle biopsies
Imaging tests may include a CT scan, X-rays, or magnetic resonance imaging (MRI).

How is neuropathy treated?
Peripheral neuropathy can cause permanent damage to nerves if untreated. Treatment will target the cause if it can be determined.
Treatment of idiopathic neuropathy revolves around symptom management. Options include over-the-counter and prescription medications, physical therapy, and occupational therapy.
Mobility aids can help you move around safely if you’re having trouble with balance or walking. These may include special shoes, braces, and canes.
Lifestyle choices can help to improve day-to-day functioning. It’s important to maintain a healthy weight through a balanced diet rich in vitamins and nutrients. It’s also important to get plenty of rest and exercise to tone and strengthen your muscles. Quitting smoking and keeping alcohol consumption to a minimum is healthy and may also help with your neuropathy.
Living with a chronic illness can lead to anxiety and stress. It can be helpful to talk with someone who lives with the same condition. Your doctor can refer you to a local neuropathy support group for additional support.

What is the long-term outlook for neuropathy?
The general prognosis for idiopathic neuropathy is good, even if your symptoms are permanent. There are many effective treatments available for keeping your symptoms in check and helping you lead a comfortable, happy life. Working with your doctor to treat any underlying condition you may have, along with your symptoms, is the ticket to your best outcome in the short and long term.

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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3 Aug

Neuopathy Flares

What Makes Neuropathy Flare up? Here Are 4 Common Causes and The Top 3 Solutions
Last Updated on April 16, 2019

Neuropathy can make life far more difficult than it has to be. Of course, there will always be some struggle when it comes managing the pain and the uncomfortable feelings that come with the condition.

For the most part, treatment is straightforward: manage the symptoms that are able to be managed and find ways to cope with the ones that aren’t.
Sadly, there are times when neuropathy can flare up, making management significantly more troublesome.
Being able to understand why neuropathy is flaring up is one of the first steps to preparing, coping, and managing with the condition.
Sometimes, they are even caused by things that are relatively easy to change and fix, meaning that there are some ways that a person can make it easier to deal with neuropathy.
What Causes Neuropathy To Get Worse?
Because neuropathy is a disease that focuses on the nerves of the body, nearly anything can make it flare up. Flare ups are generally classified as an intensifying of the chronic pain that a person is used to, although it often goes back down to its typical level given time.
As neuropathy is a disease concerned with the nerves, anything that affects the nerves can cause a flare up. This can range from the food that a person eats in a day, to the temperature outside, to the way that person lives his or her life. There are many things that can cause a flare up but many of these things are somewhat preventable.
The things that a person physically cannot change, such as the temperature outside, are things that the person can remedy in other ways. This means that once a person knows what common triggers are, it will be easier to avoid them in the future, leading to an easier and more comfortable life.

The Wrong Foods
The food that a person intakes plays a significant role in neuropathy symptoms. As many people have come to learn, the kinds of foods that can affect it are generally grains, sugars, gluten, and fat. In particular, refined grains have a high glycemic content in them.
This will greatly affect a person’s blood sugar. Diabetic neuropathy is one of the most common forms of neuropathy, meaning that it is crucial that a person keeps his or her blood sugar at an appropriate level whether or not he or she is diabetic.
If a person eats a lot of refined grains, it is best to replace them with whole grains to prevent this issue with blood sugar.

Likewise, sugar directly correlates to a person’s blood sugar levels. Added sugars are even worse as they are only there for flavor and nothing more.
Especially if a person is diabetic, it is best to avoid foods with added sugar. Too much sugar can cause a flare up as it will cause the blood sugar to fluctuate.
This is one of the most common triggers, especially in people who have diabetic neuropathy. Nutritional deficiencies caused by relying too much on the flavor that added sugars provide can not only worsen neuropathy but they can also cause symptoms in someone who does not have it.
If a person has a gluten allergy, it is common sense that he or she stays away from food with gluten. Managing neuropathy symptoms is all the more reason to stay away from gluten. If a person’s body cannot process gluten, then it can severely worsen the symptoms of neuropathy, causing a flare up. This means that these people should search for gluten-free products to avoid these symptoms.
Lastly, saturated fats can cause inflammation, which is definitely a trigger for a neuropathy flare up. If a person does not already have type 2 diabetes, too much saturated fat can put this person on the road to developing diabetes.
To prevent this, the best thing that a person can do is find foods that don’t have a lot of saturated fats in them. Ultimately, the best thing that a person can do to alter any food-related triggers for neuropathy is to avoid sugars, refined grains, gluten, and saturated fat. This will take care of some of the triggers for flare ups.
Poor Physical Health
Since neuropathy is focused on the nerves in the body, the physical health of a person’s body will of course play a big role in how often neuropathy flare ups happen. Some major triggers for a flare up could be smoking, injuries, and illnesses. For instance, it is a well-known fact that smoking is very bad for the human body.

Smoking is one of the many triggers, because smoking constricts the blood vessels in the body, which constricts the blood that goes to the extremities.
This can quickly and easily worsen the symptoms of neuropathy, ultimately resulting in a flare up that nobody wants to deal with.
In addition to this, it should be relatively obvious that injuries to the body can cause a flare up as they can open many nerve endings to more pain that a person typically experiences.
On the chance that a person’s extremities have become so numb that the person is not aware of an injury, it is imperative that this person regularly checks to ensure that there are no injuries on the feet or hands. An injury can put a lot of physical stress on the body, which can lead to a neuropathic nightmare.
As the health of a person’s body plays a large role in whether or not the person is nearing a flare up, another thing that is important to pay attention to is health. Being sick puts quite a bit of stress on the body and thus the nerves. The stress on the nerves can translate into a neuropathic flare up, which can only make dealing with the sickness even worse.
In some cases, underlying issues can even be the cause of the neuropathy in the first place. If a person has any reason to suspect being sick, it would be a good idea to visit the doctor. Besides visiting the doctor, a person should take the appropriate measures to stay as healthy as possible both physically and mentally, to avoid worsening conditions.
Poor Mental and Emotional Health
Just as physical stress plays an enormous role in whether or not a person’s body is at risk for a flare up, mental stress and temperature also play a role. Emotional stress, while people might not think about it much, can be extremely hard on the nerves. This can make emotional stress a trigger for a neuropathic flare up.

One of the ways that a person could alleviate and remove this trigger is to make sure that there isn’t really anything stressful going on.
If there is something stressful, measures should be taken to remove that stressor, whether that means taking care of a particular task or ignoring some people for a period of time.

The temperature of a room or location also plays into the idea of triggers both emotional and physical.
After all, temperature is signaled to the brain through the nerves. Depending on the type of neuropathy a person has, temperature can quickly become a trigger for a flare up.
Typically, cooler temperatures are better, although the change should be gradual so as not to jolt the nerves too much. Cooler temperatures are best as they cause a slower heart rate and slow blood flow a little bit, slightly numbing any pain that a person might be feeling.

Contradicting Medications

Anything that is ingested into the body is going to affect the health of nerves and this especially goes for medication.
Medication can bring about worse side effects that can trigger a neuropathic flare up that nobody wants to deal with.
This can be difficult to deal with as finding the medication that is causing the flare up can be tough. Sometimes, that medication is something that a person needs.
When this happens, it might be worth talking to a doctor about alternatives to reduce the chances that a person’s own medication is causing symptoms to get worse.
How Can They Be Prevented?
Out of the many things that cause flare ups, there are several that can easily be changed. With time, diet and nutrition can change to a more suitable situation for a person’s needs. Stress will come and go with time and managing that stress will be important in regulating flare ups.
Know Your Triggers
Making sure that a person knows what his or her triggers are is essential in preventing flare ups from happening. This means that one of the best things a person can do is keep track of what came before a flare up so that he or she can get a good idea of what triggers neuropathic flare ups. Once the person understands what causes the flare ups, the hard work is halfway done.
Optimize Your Lifestyle
All that needs to be done now is changes in lifestyle to create a life where a person doesn’t have to worry nearly as much about triggering a neuropathic flare up. By having a journal that logs what triggers are and what can be done to avoid them, a person can begin taking the steps needed to live a life without neuropathic flare ups.
Take Supplements
Nutritional supplementation is a safe, low cost way to provide your nerves with the right herbs, vitamins, and nutrition they need for proper functioning. Many people are deficient in key vitamins like thiamine and methyl b12 due to lower nutrient density in today’s foods. People can either take multiple nerve health supplements individually or use a pre-formulated solution like Nerve Renew, which consists of proven ingredients in the optimal dosages according to clinical studies.

Article Provided By: Nerve Pain Guide

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29 Jul

Allodynia

What to know about allodynia

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

Symptoms

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

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

Causes and risk factors

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

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

Treatment

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

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

Last medically reviewed on August 10, 2017

Article Provided By: Medical News Today

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27 Jul

Paresthesia

What Is Paresthesia?

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

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

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

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

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

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

Article Provided By: healthline

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22 Jul

Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-Induced Peripheral Neuropathy
Timothy J Brown, MD; Ramy Sedhom, MD; Arjun Gupta, MD
Article Information
JAMA Oncol. 2019;5(5):750. doi:10.1001/jamaoncol.2018.6771

Peripheral neuropathy refers to symptoms arising from damage to peripheral nerves. These nerves carry sensation, control movements of the arms and legs, and control the bladder and bowel. Chemotherapy and other drugs used to treat cancer can cause peripheral neuropathy. This is termed chemotherapy-induced peripheral neuropathy (or CIPN).

What Increases the Risk of Developing CIPN?
Certain chemotherapy drugs are more likely to cause neuropathy. These include: platinum drugs, such as oxaliplatin; taxanes, such as docetaxel; vinca alkaloids, such as vincristine; and myeloma treatments, such as bortezomib.
Other chemotherapy drugs can also cause neuropathy. The risk of developing CIPN is higher with higher doses, multiple courses, and combination chemotherapy. Patients are more likely to develop CIPN if they are older or have diabetes, vitamin deficiencies, or preexisting peripheral neuropathy.
How Can I Reduce My Risk of Developing CIPN?
No medication or supplement has been shown to definitively prevent CIPN. Regular exercise, reducing alcohol use, and treating preexisting medical conditions (vitamin B12 deficiency) may reduce the risk of CIPN.
What Are the Symptoms and Complications of CIPN?
Depending on the nerves affected, symptoms include:

Tingling (“pins and needles”)
Pain, which may be severe and constant, may come and go, or may feel like burning
Decreased sensation (“legs feel like jelly”)
Increased sensitivity to touch, temperature, pressure, pain
Muscle weakness

Symptoms can appear hours to days after chemotherapy and may reduce in intensity with time. Commonly, symptoms occur weeks to months after chemotherapy. They can get worse with additional cycles of chemotherapy.
What Should I Do If I Develop Symptoms?
You should notify your care team. Symptoms are likely to worsen if not addressed. Your oncologist can diagnose CIPN based on symptoms and by examining you. Specialized testing is rarely needed.
I Have CIPN—What Now?
One should avoid injury by paying attention to home safety, such as by using handrails on stairs to prevent falls and potholders in the kitchen to avoid burns. Your oncologist may choose to discontinue or reduce the dose of a chemotherapy drug. Your oncologist may recommend over-the-counter pain medications, lidocaine patches, menthol creams, or a medication called duloxetine. Physical therapy, occupational therapy, and rehabilitation may be helpful to regain function. Studies are researching how novel therapies (biofeedback or scrambler therapy) can help. Improvements in function may be gradual. In some cases, nerve damage may be permanent.

Article Provided By: JAMA

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

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Neuropathic Pain Therapy Center

Cold Feet

Peripheral Neuropathy

Pinched Nerve In Shoulder

Tarsal Tunnel Syndrome

Hyperalgesia

Idiopathic Neuropathy

Neuopathy Flares

Allodynia

Paresthesia

Chemotherapy-Induced Peripheral Neuropathy

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