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Causalgia

Complex Regional Pain Syndrome Type II (Causalgia)

What is causalgia?
Causalgia is technically known as complex regional pain syndrome type II (CRPS II). It’s a neurological disorder that can produce long-lasting, intense pain.
CRPS II arises after an injury or trauma to a peripheral nerve. Peripheral nerves run from your spine and brain to your extremities. The most common site of CRPS II pain is in what’s called the “brachial plexus.” This is the bunch of nerves that run from your neck to your arm. CRPS II is rare, affecting slightly fewer than 1 person out of 100,000
.
Symptoms of causalgia
Unlike CRPS I (formerly known as reflexive sympathetic dystrophy), CRPS II pain is generally localized to the area around the injured nerve. If the injury occurred to a nerve in your leg, for example, then pain settles in your leg. Conversely, with CRPS I, which doesn’t involve an apparent nerve injury, pain from a hurt finger can radiate throughout your body.
CRPS II can occur wherever there’s a peripheral nerve injury. Peripheral nerves run from your spine to your extremities, which means CRPS II is usually found in your:
arms
legs
hands
feet
Regardless of what peripheral nerve is injured, symptoms of CRPS II tend to remain the same and include:
burning, aching, excruciating pain that lasts six months or longer and seems disproportionate to the injury that brought it on
pins and needles sensation
hypersensitivity around the area of injury, in which being touched or even wearing clothes can trigger sensitivity
swelling or stiffness of the affected limb
abnormal sweating around the injured site
skin color or temperature changes around the injured area, such as skin that looks pale and feels cold and then red and warm and back again

Causes of causalgia
At the root of CRPS II is peripheral nerve injury. That injury can result from a fracture, sprain, or surgery. In fact, according to one investigation, 1.8 percent
of nearly 400 elective foot and ankle surgery patients developed CRPS II after surgery. Other causes of CRPS II include:
soft-tissue trauma, such as a burn
crushing injury, such as slamming your finger in a car door
amputation
However, it’s still unknown why some people respond so dramatically to these events and others don’t.
It’s possible that people with CRPS (either I or II) have abnormalities in the linings of their nerve fibers, making them hypersensitive to pain signals. These abnormalities can also initiate an inflammatory response and induce changes to blood vessels. This is why so many people with CRPS II can have swelling and skin discoloration at the site of the injury.

How causalgia is diagnosed
There is no one test that can definitively diagnose CRPS II. Your doctor will perform a physical exam, record your medical history, and then order tests that may include:
an X-ray to check for broken bones and loss of bone minerals
an MRI to look at soft tissues
thermography to test skin temperature and blood flow between injured and noninjured limbs
Once other more common conditions such as fibromyalgia are eliminated, your doctor can make a CRPS II diagnosis more confidently.

Treatment options for causalgia
CRPS II treatment generally consists of medications and certain types of physical and nerve-stimulating therapies.
If over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) aren’t providing relief, your doctor may prescribe stronger drugs. These can include:
steroids to reduce inflammation
certain antidepressants and anticonvulsants, such as Neurontin, that have pain-relieving effects
nerve blocks, which involve injecting an anesthetic directly into the affected nerve
opioids and pumps that inject drugs directly into your spine to block pain signals from nerves
Physical therapy, used to sustain or improve range of motion in painful limbs, is also often used. Your physical therapist may also try what’s called transcutaneous electrical nerve stimulation (TENS), which sends electrical impulses through fibers in your body to block pain signals. In research studying people with CRPS I, those receiving TENS therapy reported more pain relief than those not receiving it. Battery-operated TENS machines are available for at-home use.
Some people have found that heat therapy — using a heating pad periodically throughout the day — can also help. Here’s how you can make your own heating pad.

The outlook
Whenever you experience prolonged pain that interferes with your life and isn’t relieved by over-the-counter medications, you should see your doctor.
CRPS II is a complex syndrome that may need a variety of specialists to treat it. These specialists may include experts in orthopedics, pain management, and even psychiatry, as chronic pain can take a toll on your mental health.
While CRPS II is a serious condition, there are effective treatments. The sooner it’s diagnosed and treated, the better your chances are for a positive outcome.

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

 

 

 

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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.

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

 

 

 

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CRPS

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

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

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

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

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

 

 

 

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Paresthesia

What Is Paresthesia?

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

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

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

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

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

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

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

 

 

 

 

 

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Why Is Neuropathy Worse at Night?

January 3, 2020 / Brain & Spine
Why Is Neuropathy Worse at Night?
Reasons why nerve pain is more painful at night
Peripheral neuropathy is when a nerve or group of nerves outside of the brain and spinal cord is injured or dysfunctions. It could be because of an injury to a single nerve, like carpal tunnel syndrome, or because a group of nerves have become defective, like with peripheral neuropathy of the feet.
“Across the board we know that neuropathy can cause pain depending on what type of nerves are involved,” says neurologist Benjamin Claytor, MD. “When people describe worsening symptoms at night they’re describing discomfort – pins and needles, tingling and burning pain.”
Here Dr. Claytor discusses what might be causing this nightly pain and how to find relief.
Distraction
Our attention level can influence how we perceive pain. So during the day when we’re at work or taking care of the kids – we’re distracted and busy. Although there hasn’t been much research around it, the idea is that we aren’t focusing on the pain during the day because we’re busy, we pay less attention to it and perceive less pain.
“Many patients will tell me that after they get home from work, have dinner and sit down to watch TV for the night that their pain flares up,” says Dr. Claytor. “This could be because the daytime distractions are now gone and you’re starting to unwind for the night.”
Temperature and sleep
Another thought behind nightly neuropathy has to do with temperature. At night our body temperature fluctuates and goes down a bit. Most people tend to sleep in a cooler room as well. The thought is that damaged nerves might interpret the temperature change as pain or tingling, which can heighten the sense of neuropathy.
Also consider poor sleep quality. If you’re not sleeping very well to begin with, either due to poor sleep habits or sleep related disorders, this could lead to increased pain perception.
Emotions and stress
Our emotional state can also influence how we perceive pain. Stress and anxiety can feed in to and amplify pain signaling. Living in a chronic state of stress wreaks havoc on your physical and mental health.
Medication
Sometimes medication dosing and timing might need to be adjusted, which could be particularly true for some short acting medications used for neuropathy pain.
How to stop neuropathy pain at night
“There are options we can explore if your neuropathy pain seems to be worsening at night,” explains Dr. Claytor. “There might be oral or topical medications we can prescribe, or maybe it’s getting your stress under control and being more mindful.”
Cognitive behavioral therapy, physical therapy and meditation may be complementary tools to reduce pain as well.
Dr. Claytor stresses the importance of talking to your doctor sooner rather than later. Often time’s people will wait so long to see their physician that there’s permanent nerve damage that might have been avoided.
“I think one of the most important things I can discuss with a patient who comes in with neuropathy pain at night is getting to the root cause of what is actually driving it,” says Dr. Claytor. “Depending on what the underlying cause is, treating that first and foremost can usually help reduce the pain overall – especially at night.”

 

Article Provided By: health.clevelandclinic
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Neuropathic Pain

Neuropathic Pain

What is neuropathic pain?
Neuropathic pain can result after damage or dysfunction of the nervous system. Pain can rise from any level of the nervous system. These levels are the peripheral nerves, spinal cord, and brain. Pain centers receive the wrong signals from the damaged nerve fibers. Nerve function may change at the site of the nerve damage, as well as areas in the central nervous system (central sensitization).
Neuropathy is a disturbance of function or a change in one or several nerves. About 30% of neuropathy cases is caused by diabetes. It is not always easy to tell the source of the neuropathic pain. There are hundreds of diseases that are linked to this kind of pain.
What are some of the sources of neuropathic pain?
Alcoholism
Amputation (results in phantom pain)
Chemotherapy drugs (Cisplatin®, Paclitaxel®, Vincristine®, etc.)
Radiation therapy
Complex regional pain syndrome
Diabetes
Facial nerve problems
HIV infection or AIDS
Shingles
Spinal nerve compression or inflammation
Trauma or surgeries with resulting nerve damage
Nerve compression or infiltration by tumors
Central nervous system disorders (stroke, Parkinson’s disease, multiple sclerosis, etc.)
What are the symptoms of neuropathic pain?
Many symptoms may be present in the case of neuropathic pain. These symptoms include:
Spontaneous pain (pain that comes without stimulation): Shooting, burning, stabbing, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling
Evoked pain: Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc. This is called allodynia. Evoked pain also may mean the increase of pain by normally painful stimuli such as pinpricks and heat. This type of pain is called hyperalgesia.
An unpleasant, abnormal sensation whether spontaneous or evoked (dysesthesia)
Trouble sleeping
Emotional problems due to disturbed sleep and pain
Pain that may be lessened in response to a normally painful stimulus (hypoalgesia)
Diagnosis and Tests
How is neuropathic pain diagnosed?
Your doctor will take a medical history and do a physical exam. Neuropathic pain is suggested by its typical symptoms when nerve injury is known or suspected. Your doctor will then try to find the underlying cause of the neuropathy and then trace the symptoms.
Management and Treatment
How is neuropathic pain treated?
The goals of treatment are to:
Treat the underlying disease (for example, radiation or surgery to shrink a tumor that is pressing on a nerve)
Provide pain relief
Maintain functionality
Improve quality of life
Multimodal therapy (including medicines, physical therapy, psychological treatment, and sometimes surgery) is usually required to treat neuropathic pain.
Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as Neurontin®, Lyrica®, Topamax®, Tegretol®, and Lamictal®. Doctors also prescribe antidepressants such as Elavil®, Pamelor®, Effexor®, and Cymbalta®. A doctor’s prescription for anti-seizure drugs or antidepressants does not mean you have seizures or are depressed.
A topical patch (Lidocaine® or Capsaicin®) or a cream or ointment can be used on the painful area. Opioid analgesics can provide some relief. However, they generally are less effective in treating neuropathic pain. Negative effects may prevent their long-term use.
The pain can also be treated with nerve blocks given by pain specialists, including injections of steroids, local anesthetics, or other medicines into the affected nerves.
Neuropathic pain that has not responded to the therapies mentioned above can be treated with spinal cord stimulation, peripheral nerve stimulation, and brain stimulation.
Outlook / Prognosis
What is the outlook for people with neuropathic pain?
Neuropathic pain is difficult to get rid of, but is not life-threatening. Without rehabilitation and sometimes psychosocial support, treatment has a limited chance of success. With help from a pain specialist using the multimodal approaches listed above, your neuropathic pain can be managed to a level that improves your quality of life.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.

Article Provided By: clevelandclinic
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Pudendal Neuralgia

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

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

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

Article Provided By: webmd
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Exercises For A Pinched Nerve In Your Hip

Exercises for a pinched nerve in your hip

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

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

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

 

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

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

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

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

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

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

Article Provided By: Medicalnewstoday

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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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Sciatica

Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.
Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.

Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that’s associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.

Symptoms
Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You might feel the discomfort almost anywhere along the nerve pathway, but it’s especially likely to follow a path from your low back to your buttock and the back of your thigh and calf.
The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.
Some people also have numbness, tingling or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part.
When to see a doctor
Mild sciatica usually goes away over time. Call your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than a week, is severe or becomes progressively worse. Get immediate medical care if:
You have sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg
The pain follows a violent injury, such as a traffic accident
You have trouble controlling your bowels or bladder

Causes
Herniated disk
Bone spurs on spine
Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.

Risk factors
Risk factors for sciatica include:
Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
Obesity. By increasing the stress on your spine, excess body weight can contribute to the spinal changes that trigger sciatica.
Occupation. A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods might play a role in sciatica, but there’s no conclusive evidence of this link.
Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

Complications
Although most people recover fully from sciatica, often without treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you have:
Loss of feeling in the affected leg
Weakness in the affected leg
Loss of bowel or bladder function

Prevention
It’s not always possible to prevent sciatica, and the condition may recur. The following can play a key role in protecting your back:
Exercise regularly. To keep your back strong, pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment. Ask your doctor to recommend specific activities.
Maintain proper posture when you sit. Choose a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.
Use good body mechanics. If you stand for long periods, rest one foot on a stool or small box from time to time. When you lift something heavy, let your lower extremities do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward.

Diagnosis
During the physical exam, your doctor may check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position and, while lying on your back, lift your legs one at a time. Pain that results from sciatica will usually worsen during these activities.

Imaging tests
Many people have herniated disks or bone spurs that will show up on X-rays and other imaging tests but have no symptoms. So doctors don’t typically order these tests unless your pain is severe, or it doesn’t improve within a few weeks.
X-ray. An X-ray of your spine may reveal an overgrowth of bone (bone spur) that may be pressing on a nerve.
MRI. This procedure uses a powerful magnet and radio waves to produce cross-sectional images of your back. An MRI produces detailed images of bone and soft tissues such as herniated disks. During the test, you lie on a table that moves into the MRI machine.
CT scan. When a CT is used to image the spine, you may have a contrast dye injected into your spinal canal before the X-rays are taken — a procedure called a CT myelogram. The dye then circulates around your spinal cord and spinal nerves, which appear white on the scan.
Electromyography (EMG). This test measures the electrical impulses produced by the nerves and the responses of your muscles. This test can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).
More Information
CT scan
MRI
X-ray

Treatment
If your pain doesn’t improve with self-care measures, your doctor might suggest some of the following treatments.
Medications
The types of drugs that might be prescribed for sciatica pain include:
Anti-inflammatories
Muscle relaxants
Narcotics
Tricyclic antidepressants
Anti-seizure medications
Physical therapy
Once your acute pain improves, your doctor or a physical therapist can design a rehabilitation program to help you prevent future injuries. This typically includes exercises to correct your posture, strengthen the muscles supporting your back and improve your flexibility.
Steroid injections
In some cases, your doctor might recommend injection of a corticosteroid medication into the area around the involved nerve root. Corticosteroids help reduce pain by suppressing inflammation around the irritated nerve. The effects usually wear off in a few months. The number of steroid injections you can receive is limited because the risk of serious side effects increases when the injections occur too frequently.
Surgery
This option is usually reserved for when the compressed nerve causes significant weakness, loss of bowel or bladder control, or when you have pain that progressively worsens or doesn’t improve with other therapies. Surgeons can remove the bone spur or the portion of the herniated disk that’s pressing on the pinched nerve.

Lifestyle and home remedies
For most people, sciatica responds to self-care measures. Although resting for a day or so may provide some relief, prolonged inactivity will make your signs and symptoms worse.
Other self-care treatments that might help include:
Cold packs. Initially, you might get relief from a cold pack placed on the painful area for up to 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel.
Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.
Stretching. Stretching exercises for your low back can help you feel better and might help relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch, and try to hold the stretch for at least 30 seconds.
Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) are sometimes helpful for sciatica.
Alternative medicine
Alternative therapies commonly used for low back pain include:
Acupuncture. In acupuncture, the practitioner inserts hair-thin needles into your skin at specific points on your body. Some studies have suggested that acupuncture can help back pain, while others have found no benefit. If you decide to try acupuncture, choose a licensed practitioner to ensure that he or she has had extensive training.
Chiropractic. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain. Spinal manipulation appears to be as effective and safe as standard treatments for low back pain, but might not be appropriate for radiating pain.

Preparing for your appointment
Not everyone who has sciatica needs medical care. If your symptoms are severe or persist for more than a month, though, make an appointment with your primary care doctor.
What you can do
Write down your symptoms and when they began.
List key medical information, including other conditions you have and the names of medications, vitamins or supplements you take.
Note recent accidents or injuries that might have damaged your back.
Take a family member or friend along, if possible. Someone who accompanies you can help you remember what your doctor tells you.
Write down questions to ask your doctor to make the most of your appointment time.
For radiating low back pain, some basic questions to ask your doctor include:
What’s the most likely cause of my back pain?
Are there other possible causes?
Do I need diagnostic tests?
What treatment do you recommend?
If you’re recommending medications, what are the possible side effects?
For how long will I need to take medication?
Am I a candidate for surgery? Why or why not?
Are there restrictions I need to follow?
What self-care measures should I take?
What can I do to prevent my symptoms from recurring?
Don’t hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
Do you have numbness or weakness in your legs?
Do certain body positions or activities make your pain better or worse?
How limiting is your pain?
Do you do heavy physical work?
Do you exercise regularly? If yes, with what types of activities?
What treatments or self-care measures have you tried? Has anything helped?

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

 

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