Scrambler Therapy For Chemotherapy Neuropathy

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18 Dec

Pain Therapy, Carolina Pain Scrambler Center, Greenville South Carolina

Scrambler Therapy For Chemotherapy Neuropathy

Clinical Trial
Support Care Cancer
. 2020 Mar;28(3):1183-1197. doi: 10.1007/s00520-019-04881-3. Epub 2019 Jun 17.
Scrambler therapy for chemotherapy neuropathy: a randomized phase II pilot trial
Charles Loprinzi 1 , Jennifer G Le-Rademacher 2 , Neil Majithia 2 , Ryan P McMurray 2 , Carrie R O’Neill 2 , Markus A Bendel 2 , Andreas Beutler 2 , Daniel H Lachance 2 , Andrea Cheville 2 , David M Strick 2 , David F Black 2 , Jon C Tilburt 2 , Thomas J Smith 2
Affiliations Expand
PMID: 31209630 DOI: 10.1007/s00520-019-04881-3
Abstract
Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a prominent clinical problem, with limited effective therapies. Preliminary non-randomized clinical trial data support that Scrambler Therapy is helpful in this situation.
Methods: Patients were eligible if they had CIPN symptoms for at least 3 months and CIPN-related tingling or pain at least 4/10 in severity during the week prior to registration. They were randomized to receive Scrambler Therapy versus transcutaneous electrical nerve stimulation (TENS) for 2 weeks. Patient-reported outcomes (PROs) were utilized to measure efficacy and toxicity daily for 2 weeks during therapy and then weekly for 8 additional weeks.
Results: This study accrued 50 patients, 25 to each of the 2 study arms; 46 patients were evaluable. There were twice as many Scrambler-treated patients who had at least a 50% documented improvement during the 2 treatment weeks, from their baseline pain, tingling, and numbness scores, when compared with the TENS-treated patients (from 36 to 56% compared with 16-28% for each symptom). Global Impression of Change scores for “neuropathy symptoms,” pain, and quality of life were similarly improved during the treatment weeks. Patients in the Scrambler group were more likely than those in the TENS group to recommend their treatment to other patients, during both the 2-week treatment period and the 8-week follow-up period (p < 0.0001). Minimal toxicity was observed.
Conclusions: The results from this pilot trial were positive, supporting the conduct of further investigations regarding the use of Scrambler Therapy for treating CIPN.
Keywords: Chemotherapy-induced peripheral neuropathy; Scrambler; TENS.

Article Provided By: pubmed
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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4 Dec

Top Twenty Symptoms of Peripheral Neuropathy

Top Twenty Symptoms of Peripheral Neuropathy
By LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS14 Comments

Each person’s experience varies depending on their type of Neuropathy, but in general following are the most common Symptoms of Peripheral Neuropathy:
1) Severe strange pains in your feet, legs, hands and other parts of the body; including “crawling insects” under your skin;
2) Balance is difficult when walking, getting dressed, getting out of bed or whenever you close your eyes;
3) Numbness / heavy / cardboard / heavy cement feeling/ Novocain feeling in your feet and legs;
4) Tingling or “vibration” like feelings in your feet and hands;
5) Electric shocks starting at the bottom of your feet/foot that shoot up your leg(s) and on almost any part of the body;
6) Bone pain especially in the feet on walking or standing;
7) Painful muscle spasms/cramps;
8) Skin may become painful to touch or loss of the feeling of touch; with Agent Orange skin rash;
9) Burning sensations in your feet and hands;
10) Loss, or lessening, of sensation for hot and cold;
11) Feeling like you are wearing socks when you are not;
12) The feeling you are walking on crumpled socks or stones;
13) Feet feel swollen or large;
14) Difficulty moving your hands or feet;
15) A feeling of clumsiness, tripping (foot drop) or dropping things;
16) Attacks of daily severe exhaustion with strange fatigue;
In more severe case of Peripheral Neuropathy you may also experience the following:
17) Problems with not sweating in lower body with excessive sweating in upper body;
18) Digestive (fullness; alternating diarrhea / constipation) and/or urinary problems (overflow incontinence);
19) Sexual problems (loss of sensation/feeling/moisture);
20) A tightening of your chest with an increased difficulty in breathing and/or swallowing; uncorrectable vision problems.

Article Provided By: neuropathyjournal
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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30 Nov

What You Should Know About Neuropathic Pain

Neuropathic pain is a pain condition that’s usually chronic. It’s usually caused by chronic, progressive nerve disease, and it can also occur as the result of injury or infection.
If you have chronic neuropathic pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well.
Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits.
With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted.
People with this pain condition may experience shooting, burning pain. The pain may be constant, or may occur intermittently. A feeling of numbness or a loss of sensation is common, too.
Neuropathic pain tends to get worse over time.
About 1 in 3 Americans experience chronic pain. Of those, 1 in 5 experience neuropathic pain.
A 2014 study estimated that as many as 10 percent of Americans experience some form of neuropathic pain.
Understanding the possible causes can help you find better treatments and ways to prevent the pain from getting worse over time.
What causes neuropathic pain?
The most common causes for neuropathic pain can be divided into four main categories: disease, injury, infection, and loss of limb.
Disease
Neuropathic pain can be a symptom or complication of several diseases and conditions. These include multiple sclerosis, multiple myeloma, and other types of cancer.
Not everyone with these conditions will experience neuropathic pain, but it can be an issue for some.
Diabetes is responsible for 30 percent of neuropathic cases, according to the Cleveland Clinic. Chronic diabetes can impact how your nerves work.
People with diabetes commonly experience loss of feeling and numbness, following by pain, burning, and stinging, in their limbs and digits.
Long-term excessive alcohol intake can cause many complications, including chronic neuropathic pain. Damage to nerves from chronic alcohol use can have long-lasting and painful effects.
Trigeminal neuralgia is a painful condition with severe neuropathic pain of one side of the face. It’s one of the more common types of neuropathic pain and it can occur without a known reason.
Lastly, cancer treatment may cause neuropathic pain. Chemotherapy and radiation can both impact the nervous system and cause unusual pain signals.
Injuries
Injuries to tissue, muscles, or joints are an uncommon cause of neuropathic pain. Likewise, back, leg, and hip problems or injuries can cause lasting damage to nerves.
While the injury may heal, the damage to the nervous system may not. As a result, you may experience persistent pain for many years after the accident.
Accidents or injuries that affect the spine can cause neuropathic pain, too. Herniated discs and spinal cord compression can damage the nerve fibers around your spine.
Infection
Infections rarely cause neuropathic pain.
Shingles, which is caused by reactivation of the chicken pox virus, can trigger several weeks of neuropathic pain along a nerve. Postherpetic neuralgia is a rare complication of shingles, involving persistent neuropathic pain.
A syphilis infection can also lead to the burning, stinging unexplained pain. People with HIV may experience this unexplained pain.
Limb loss
An uncommon form of neuropathic pain called phantom limb syndrome can occur when an arm or leg has been amputated. Despite the loss of that limb, your brain still thinks it’s receiving pain signals from the removed body part.
What’s actually happening, however, is that the nerves near the amputation are misfiring and sending faulty signals to your brain.
In addition to arms or legs, phantom pain may be felt in the fingers, toes, penis, ears, and other body parts.
Other causes
Other causes of neuropathic pain include:
vitamin B deficiency
carpal tunnel syndrome
thyroid problems
facial nerve problems
arthritis in the spine

What are the symptoms?
Each person’s symptoms of neuropathic pain may vary slightly, but these symptoms are common:
shooting, burning, or stabbing pain
tingling and numbness, or a “pins and needles” feeling
spontaneous pain, or pain that occurs without a trigger
evoked pain, or pain that’s caused by events that are typically not painful — such as rubbing against something, being in cold temperatures, or brushing your hair
a chronic sensation of feeling unpleasant or abnormal
difficulty sleeping or resting
emotional problems as a result of chronic pain, loss of sleep, and difficulty expressing how you’re feeling

How’s it treated?
A goal of neuropathic pain treatment is to identify the underlying disease or condition that’s responsible for the pain, and treat it, if possible.
An important goal is that your doctor will aim to provide pain relief, help you maintain typical capabilities despite the pain, and improve your quality of life.
The most common treatments for neuropathic pain include:
Over-the-counter pain medication
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve and Motrin, are sometimes used to treat neuropathic pain.
However, many people find these medicines aren’t effective for neuropathic pain because they don’t target the source of the pain.
Prescription medication
Opioid pain medications don’t usually reduce neuropathic pain as well as they reduce other types of pain. Plus, doctors may hesitate to prescribe them for fear that a person may become dependent.
Topical pain relievers can be used, too. These include lidocaine patches, capsaicin patches, and prescription-strength ointments and creams.
Antidepressant drugs
Antidepressant medications have shown great promise in treating symptoms of neuropathic pain.
Two common types of antidepressant drugs are prescribed to people with this condition:
tricyclic antidepressants
serotonin-norepinephrine reuptake inhibitors
These may treat both the pain and symptoms of depression or anxiety caused by chronic pain.
Anticonvulsants
Anti-seizure medications and anticonvulsants are often used to treat neuropathic pain. Gabapentinoids are most commonly prescribed for neuropathic pain.
It’s not clear why anti-seizure drugs work for this condition, but researchers believe the medications interfere with pain signals and stop faulty transmissions.
Nerve blocks
Your doctor may inject steroids, local anesthetics, or other pain medications into the nerves that are thought to be responsible for the wayward pain signals. These blocks are temporary, so they must be repeated in order to keep working.
Implantable device
This invasive procedure requires a surgeon to implant a device in your body. Some devices are used in the brain and some are used in the spine.
Once a device is in place, it can send electrical impulses into the brain, spinal cord, or nerves. The impulses may stop the irregular nerve signals and control symptoms.
These devices are typically used only in individuals who haven’t responded well to other treatment options.
Lifestyle treatments
Physical, relaxation, and massage therapies are all used to relieve symptoms of neuropathic pain. These forms of treatment can help ease muscles.
Your healthcare provider can also teach you ways to cope with your pain.
For example, some people with neuropathic pain may experience increased symptoms after sitting for several hours. This might make desk jobs difficult to perform.
A physical therapist or occupational therapist can teach you techniques for sitting, stretching, standing, and moving to prevent pain.

How can this pain be managed?
If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain.
For example, diabetes is a common cause of neuropathic pain. Proper diabetes care — which includes a healthy diet and regular exercise — may eliminate or reduce neuropathic pain.
Taking care of blood sugar levels can also prevent worsening pain and numbness.
Multimodal therapy
A multipronged approach can be an effective way to manage the condition.
A combination of medications, physical therapy, psychological treatment, and even surgery or implants may be used to bring about the best results.

Outlook
Neuropathic pain can negatively impact your life if you don’t take steps to treat it and prevent worsening symptoms.
Over time, this can lead to serious disability and complications, including depression, problems sleeping, anxiety, and more.
Fortunately, researchers are learning more about why this condition develops and what can be done to effectively treat it. That’s leading to better treatment options.
Finding the correct treatment options for you can take time, but you and your doctor can work together to find relief from the symptoms of this painful condition.

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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12 Nov

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.

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9 Nov

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, 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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4 Nov

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, 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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29 Oct

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.

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22 Oct

Why Is Neuropathy Worse at Night?

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

Article Provided By: health.clevelandclinic
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, 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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15 Oct

Neuropathic Pain

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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
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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9 Oct

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.

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Neuropathic Pain Therapy Center

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Causalgia

Allodynia

CRPS

Paresthesia

Why Is Neuropathy Worse at Night?

Neuropathic Pain

Pudendal Neuralgia

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