Tag Archives: pain disorder

Resolve Inter-Vertebral Back Pain Once and For All

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If you have back pain from an inter-vertebral disc injury, there are pain alleviation treatments that can be applied to heal sooner than later. Unfortunately, too many who suffer inter-vertebral disc injuries believe the only way to alleviate the pain is through pharmaceuticals and surgery. I’m here to tell you, long term drug use and surgery is not the only solution. There are other treatment options under a doctor’s care that may avoid surgery.

If you have compromised a vertebral disc space, one way to alleviate the pain may be surgical intervention. However, to understand the inter-vertebral compromise and severity of internal damage and best treatment course, It is first necessary to define and differentiate between a torn, herniated, slipped or ruptured disc or some other insidious cause of pain. Through this understanding it is easier to decide on a pain management and medical treatment plan that is right for you.

A torn disc is defined as a rupture in the exterior layer of an inter-vertebral disc between the vertebrae. Rupturing means the jellylike interior of a disc seeps through the tear and enters the spinal canal. A herniated, or ruptured disc is often referred to as a slipped disc, whereas the discs in the back have been compromised between articulating vertebrae. The disc function is to act as a soft and spongy cushion between each vertebra to protect the bone as movement occurs. If a disc happens to herniate beyond a bulge and ruptures, surgery often follows. A slipped disc is a very painful event and difficult to pain manage without proper treatment. In many cases, if treated appropriately – natural healing occurs and surgery is not needed.

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How does a vertebra disc slip? If enough pressure is applied to the center of the disc it can cause disc trauma by way of slipping one way or the other off center of vertebral alignment. When this happens, pressure is then pushed against one or more spinal nerves that become pinched and swell underlying tissue which cause varying levels of pain. Other painful conditions and symptoms that often result from a slipped disc: weakness, tingling or numbness in the neck and arms and/or legs, etc.

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There is multiple back pain alleviation treatment applications that include non-invasive back pain relief products and techniques and don’t further aggravate compromised nerve endings. If you now experience a chronic back pain condition and all non-surgical treatment applications have failed – surgery may be necessary… which may or may not make you pain free… because of post-surgery soft tissue damage that aggravates nerve endings. Therefore surgery should be the last option to resolve back pain. If you’re having a tough time making a decision on how to manage your back pain or determine if surgery is right for you… ask your primary physician to refer you to a physiatrist [doctor that specializes in pain management], concurrent with an orthopedic back surgeon.

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Physiatrists are medical doctors that specialize in the whole-body, mind and spirit [encompassing being] and offer other holistic and alternative pain alleviation treatment and therapy options to remove acute and chronic pain, whereas surgery may not be needed.

It must be recognized each person has a varying level of pain threshold and/or pain tolerance. Meaning one pain management program may be tolerated by one client but not the other – even when injuries are similar. For example, patient 1 may be able to tolerate a higher level of pain when beginning a pain management program compared to patient 2 – Even when both patience shares a similar pain and lifestyle story. But patient 2 ends up opting for surgery because of intolerable chronic pain before and after therapy. Pain sensitivities and threshold and treatment therapy options in my opinion are best managed by a referring physiatrist to other pain management specialists.

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If a physiatrist recommends acupuncture at any juncture within the pain management process, I do have personal experience with this treatment. Japanese and Chinese acupuncture removed 75% of my pain – whereas nothing else worked for me outside of medication.

I have multiple intravertebral disc injuries that have resulted in more than one referral to surgery over the last 30 years. To date, I have not had one back surgery and am nearly pain free. I can only share my personal experience and how acupuncture worked for me and may work for you.

I’ve experienced both Japanese and Chinese acupuncture [yes, they are different in technique]. It was the Chinese acupuncture that worked best for me. The Japanese acupuncture was a painful process because of my pain intolerance to it… . Regardless, I tolerated 12 sessions. The treatment was highly successful at rerouting nerve pain and eliminating it. After 6 months of Japanense acupuncture treatment, I opted for Chinese acupuncture [less pain aggravation during needle insert] to finish off the total treatment course. It is more likely than not your health insurance covers this form of pain therapy treatment.

I must state upfront, I did not have a ruptured disc. I have had herniated, bulging and slipped discs. I have also suffered a broken back through military service and have degenerative disc disease. The degenerative process causes a slow ooze of the inner gel out of disc through time. This gel loss puts pressure on spinal nerves by way of narrowing of disc thickness, or space between vertebrae (cushion narrowing) as well as bulging disc pain that flares up occasionally. Although my back condition is aggravating and varies in pain acutely, it is manageable through exercise. I am free of pain killers and only use anti-inflammatories when necessary.

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Acupuncture did wonders for me in terms of rerouting compromised disc and nerve pain. When I do slip and/or aggravate those discs infrequently… , the pain is less severe and can be managed without pain killing medication. Typically, I rest for a day should this occur and then continue walking daily and perform strength building exercises on alternate days. If pain increases beyond an acceptable pain threshold and becomes chronic, I would seek another course of Chinese acupuncture to alleviate the pain. My goal is to avoid surgery. To date, I have been successful at achieving that goal.

For the remainder of my life, I’ll have to manage back pain through a combination of exercise and other noninvasive therapy strategies after back aggravation. Fortunately, my pain is manageable with little physician intervention. Does this mean I will never need back surgery? No, it does not. Currently, I am managing an acceptable level of pain and sustain good physical fitness and functionality and I’m thankful for my good fortune.

Inter-vertebra disc pain may heal “substantially” on its own if you isolate and tolerate a minimal amount of pain during physical therapy and other pain alleviation treatment practises. If you have chronic and unrelenting pain, you may need surgery as a corrective healing course. Your physicians can help you determine what medical and pain management treatment course is right for you.

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If your back pain is more acute than chronic… and your physician recommends physical therapy and medication – take that advise and accept and work through the treatment course. However, requesting referrals for pain killers as a long-term or permanent solution to alleviate pain does not address the real problem… especially if there is a treatment course you can take without more pills and surgery.

If surgery cannot be avoided, I would only accept the advisement of a physiatrist working with an orthopedic back specialist where both recommend surgical intervention as the best course of action to live the lifestyle you need, want and deserve.

Marc T. Woodard, MBA, BS Exercise Science, ARNG, CPT, RET2021 Copyright.  All rights reserved, Mirror Athlete Publishing @: www.mirrorathlete.org,  Sign up for your Free eNewsletter.

Learn to Embrace the Pain, Exercise and Get Fit

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Walking is the best exercise activity to connect healthy mind, body and spirit with environment

The mindset change required to work around your pain is most important in order to meet your fitness goals; especially if your challenge is to manage acute and chronic pain.  The mind must learn to embrace and adapt to a specific ill-health pain condition(s) and/or physical-mental limitations in order to increase fitness levels.  And it is important to understand your medical condition and limitations before applying exercise.  Without this knowledge you may further injure yourself during activity.

The only true way to understand your limitations brought about by pain is to work with your medical providers.  By working with medical pain specialists you can then better understand what triggers and aggravates your pain when working through Range-Of-Motion (ROM) activities.   By becoming knowledgeable about your body and ill-health pain condition, you “can” prevent further aggravation or injury and alleviate your pain with customized exercise programming.  A fitness goal of yours should be to “find a way” to continue some form of movement activity no matter the mobility status (bed ridden, wheel chair, walker, cane, or other ambulatory challenges, e.g., prosthetics).

Exercise activities are important because body movement provides oxygenated-enriched blood, while strengthening and providing nutrients to muscles, tendons, ligaments and vital organs no matter how “limiting” the movement may seem to the patient.

Always thinking, how can we each do our part for a better tomorrow.

Author: Always thinking, how can we each do our part for a better tomorrow and live life to the fullest

Exercise movement activities also activate natural feel good pain reducing endorphins.  These hormones are necessary to provide a feeling of overall wellbeing and thwart depression.  Physical activity is also a metabolic booster:  Weight control, immune deficiency exciter, repairs tissue as a mending facilitator, tones muscle, improves cognitive brain function, realigns and strengthens posture, improves cardiovascular health and promotes good skin, hair, nails etc., with many more benefits too numerous to mention.

It also must be understood that not all preexisting, or recent injuries to the body you experience may ever be 100% pain free.  This is because once there is internal-external, or injury breach to the bodies postural integrity, it is most likely this damage will be felt with some frequently after the mend and throughout life.  And as you age, and if activity exercise is not continued this pain can become more problematic.

Most first experience acute (infrequent) pain after injury, or surgery, and then with age, these infrequent (acute) trigger pain sights can become a chronic pain condition.  If movement is limited for too long because of pain, this can/does become more aggravating if ignored.  If you experience unacceptable pain after injury or surgery, ensure you follow up with your medical specialists.  Don’t just ignore the pain for years.  Learn to properly manage an ill-health and/or alleviate a painful condition by working with the right referred medical resources in a timely manner.

My personal experience when managing pain, whether acute, or chronic; pain is less severe if exercise and activity are applied daily.  And when adequate movement is not applied, frequency and intensity of pain episodes at damaged tissue sites tend to increase.

This then translates from the mind to the body an unacceptable pain experience.  With unacceptable pain, the mind tells the body to “guard” the pain.  Guarding simply means the mind instructs the muscles to tense up and become rigid at the pain sight to prevent full ROM within a body segment to reduce the pain.  Another way to explain this is the body becomes less flexible and unwilling to use a full ROM to accomplish work.  And this guarded reflex if allowed to continue, “will” create more radiating pain while reducing your ability to accomplish physical activity.  Guarding can also damage other tissue in the surrounding trigger pain site; because now other muscle tissue becomes conditioned to guard peripherally around a pain center.

When the mind tells the body to guard a segment of body, it becomes isolated to varying degrees during movement activity.  And since body segments within a specific range remain guarded, then the circulatory systems that provide oxygenated enriched blood to areas on the mend are less efficient metabolically and don’t receive healing nutrients to the full extent.

Internal tissue damage requires a constant supply of oxygenated-enriched blood and nutrient lubrication through good circulation to heal optimally.  With movement activity, damaged tissues, i.e., nerves, muscle, and joints can be relieved of stiffening, tightening and alleviation of pain.

Keeping pain within a tolerable pain threshold  while exercising requires one to be more in tune with the body’s pain trigger mechanisms.  In other words, movement that causes intolerable pain can be modulated to reduce extreme  guarding effect that would severely limit range of motion.  While working with your physician and pain specialists, you must listen and apply their exercise instruction to improve overall muscular endurance, circulation and flexibility when customizing your fit-healthy pain management program.   And to do this will require you tolerate an “acceptable” amount of pain to improve range of motion and mend as best as possible.

No gym membership, no problem. Development in nature can serve all exercise activity needs.

By working closely with your primary care physician(s):  Advocate and self-refer to a pain management specialist through your primary physician (i.e., immunologist, rheumatologist, generalist-holistic pain specialist, physical therapy, physiatrist, sports medicine, certified pain management fitness trainers, orthopedic specialists, etc.).  You can activate many needed referred services to help you better manage your chronic condition.  In this way, you begin to build a customized activity exercise program that will help to alleviate your pain and increase your overall fitness levels (Cardiovascular endurance, flexibility, strength, muscular endurance, improved posture, reduced body fat, encompassing being mending, neural conductivity repair etc.).

You also may be taking a cocktail of pharmaceuticals, causing you to lose productivity and gain weight only to find out years later, your pain disease has progressed to the point you need surgery!   Again, my point is to learn as much as possible about your medical ondition “while in the early stages of development” and advocate through primary physicians and self refer to the medical specialists you need.  Don’t just accept years of pharmaceuticals to bandage your underlying pain problems and medical condition(s).

If your pain management program is just about pill management, this will likely create many other secondary health risks that will complicate your pain story and make it more difficult to focus on exercise activity to alleviate your pain.  Why is this?  Because your body & mind can’t feel the natural healing effects (biofeedback mechanisms are broke due to the numbing effect of opiates) from exercise.  Especially if overusing medications that also have mind altering effects.  Note:  I’m not saying to stop taking your prescribed medications.  I’m saying you may need help in “balancing” your prescription use with exercise activity.

Fortunately, I now live a lifestyle with managed pain tolerance.  Although I must admit, to get to this point was not easy.   I understand, my pain will always be with me and I do have to manage it daily.  Nobody else can mentally, physically or spiritually do this for me.  It would be easy to become depressed about daily pain, but pain and depression once managed can be very tolerable.  And the only way to do this is through pain management and customized exercise activity approved by medical doctors.

Explore and Live in a World Without Pain

Explore and Live in a World Without Pain

It is also understood one can have pain in a specific, or multiple areas throughout the body.  It is my experience after going through many medical consultations and conversations with other pain patients and clients as a fitness consultant; most are not educated on how to work around pain and prioritize activity risk and benefit.  I believe this has mostly to do when a physiatrist, sports medicine, exercise physiology or physical therapist is not involved in a pain patient’s therapy.

The next thing you should think about when identifying your fitness goals while working around pain, what do you enjoy doing?  Do you enjoy exercising in a gym, walking, biking, swimming, gardening, shopping, arts and crafts, reading, computer work, etc?  Why do I ask?  Because a patient activity of interest, it is hard to know what the right motivational activities are to therapeutically modify and prescribe for the chronic pain patient.

When I list activities, it also should be understood that mental exercises that appear to be more sedentary then physically active do not “activate optimally” your body’s metabolism.  But any activity can improve an overall ill-health condition whereby depression, anxiety and stress is minimized, hence an overall health benefit is gained.  For example, if bed ridden, a mental activity stimulus can transfer a portion of that benefit to the physical body.  This is due to the psycho-somatic Neurochemical transmitter connection (mind-body).

Once you identify your physical and mental limitations to include fitness goals that may interest you, pay close attention to the prescribed pharmaceutical(s) you ingest.  When you pursue fitness activity, as mentioned previously; medications can reduce pain sensation (numbing effect) with a false sense of security while increasing physical effort.  Also, there are many medications used that regulate blood pressure, balance hormones, control cholesterol, regulate body weight, alleviate depression, the list goes on.

I do not claim to be an expert in pharmaceuticals or their prescribed use.  However, it is well known your health risk(s) will increase when pursuing an exercise program while on certain medications.   Therefore you need to consult with your medical provider.   Ask about prescribed drug use and if those risks increase during exercise.

For those that are using more pharmaceuticals and moving less, you must find some way to become less dependent on pain killers if using them.  If not, fitness levels and overall health issues tend to get worse through time.  I’m not advocating you quit using your medications!  I’m advocating increasing your daily activity levels while balancing pain medications to reduce your overall pain experience.  I know through fitness activity you’ll become less dependent on the opiates.  Of course, you need to work through this process with your pain management specialist to help you reach this balance.

I believe if patients are armed with safe exercise fitness activity, pain management information and treatment options, they enjoy a better quality of life, especially if they suffer with chronic pain and disease.

By reading MirrorAthlete Articles you can learn how to customize a fitness-pain management program that works well for you (subscribe to our free monthly eNewsletter and be sure to stay up-to-date on all hard to find fitness secrets information).

Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2011 Copyright, All rights reserved, MirrorAthlete Publishing @: http://www.mirrorathlete.org,  Sign up for your Free eNewsletter.

Cramp Facilitation, The Same as Restless Leg Syndrome?

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See the World While You are Able

The patient Restless Leg Syndrome (RLS) experience is a creepy crawly, twitching, involuntary underlying skin movement sensation and also may be associated with aching mostly in the knee down to the foot.  The symptoms can also occur in the arms with a feeling as if you are in a constant state of a flexing sensation.  This experience also induces insomnia for many that experience restless nights because of involuntary muscle movement.  There are now several potential causes identified with restless leg syndrome.  These causes are mostly to do within diet.  And the other causes could be something of concern that could stay undiagnosed for years until a neurological specialist rules out one thing or the other.

Caffeine and low levels of blood glucose have a known cause-effect associated with RLS.   It is recommended if you have RLS like symptoms, to rule out specific causes possibly through diet and that you seek a referral from your primary care physician to see a neurologist.  Until you get this referral try eliminating coffee, tea, sodas and cocoa from the diet.  This will provide some feedback to your neurologist when you get the consult.  By eliminating these potential causes from diet, either RLS symptoms are relieved, not relieved, or in remission.  If symptoms disappear, don’t cancel your neurology appointment.   The remission of symptoms could simply be due to infrequent muscle facilitation caused by something else.  And when you see your neurologist asks the following questions:  Can I also be evaluated for functional “hypoglycemia (low blood sugar),” and/or deficiencies of folic acid, iron or magnesium.

And if the lab results rule out these diet deficiencies, also ask if consideration of vitamin E and L-tryptophan trials would be worthwhile to assist in determining treatment.  It has been proven in clinical trials that vitamin and mineral deficiencies can and do cause hyper excitable muscle sensations (RLS) and that supplementation in clinical studies have proven to remove, or substantially reduce the symptoms associated with RLS.  But it is important to note while anyone can supplement their diet, using proper dosages under a physicians care is very important for the safety and success of such treatment.

Now let’s take a look at RLS syndrome’s close cousin [Cramp Facilitation Syndrome].  Why do I say cousin?  Because there are many close symptomatic similarities that could confuse the necessity to look further into your condition and unknowingly push off identification and treatment of a more severe and insidious disease.

What is cramp facilitation syndrome and how do you know you have it?  It is a rare condition characterized by muscle pain, twitching, cramps, creepy crawly sensations typically felt within the legs and arms.  These symptoms have also been characterized and confused by patients as restless leg syndrome at the onset.

It is also not common knowledge that there is a whole host of diseases that can cause these symptoms.  Other disease pathology mimics less serious diagnosis than others.  For a piece of mind, if you experience any of these symptoms [RLS, or Cramp Facilitation Syndrome] to seek a referral from your primary care physician to see a neurological to rule out other potential serious disease (Parkinson’s, MS, Cancer, etc.).  I recommend being adamant in pursuing this referral if you have RLS like symptoms.

I’ve become very familiar with RLS through commercialization of this conditional diagnosis as seen on infomercials.  But have never heard of “Cramp Facilitation Syndrome, and in some cases known as Isaac’s syndrome.”  These syndromes also mimic [although typically more pronounced and severe symptoms] very similar conditions, I only knew to be RLS.  Cramp Facilitation Syndrome is also medically transcribed and known as Neuromyotonia (NMT).

NMT or Isaac’s syndrome is a form of peripheral nerve hyperexcitabilty and is very rare.  There are no known cures for Isaac’s syndrome.  And from all I’m reading about it and as discussed with a neurologist, there are a lot of unknowns about the origins of these syndromes.  The 3 causes of spontaneous repetitive muscular activity “throughout” the body triggered by muscle fiber action potential with regard to NMT are: 1) Acquired  2) Paraneoplastic  3) Hereditary.

1)      The Acquired is the most common form of NMT and is thought to be caused by antibodies against the neuromuscular junctions; suspected to be an immune deficiency [80% of all cases).  If the immune system suspects foreign bodies at these neuromuscular junctions, they attempt to neutralize the foreign matter.  These antibodies are produced by our white blood cells and promote various antibodies to deal with perceived invasion of our internal body.  By binding to a perceived internal threat our defense mechanisms cause muscle fasciculation to occur.

2)   What is Paraneoplastic cause of muscle fasciculation – The immune or hormonal response from a tumor sends chemical signal to cause an antibody reaction at neuromuscular junctions within muscle cells.  The cause of this action is the presence of cancer in the body; excreted by tumor cells that trigger the body’s hormones or immune system.  And the muscle hyperexcitability can be triggered before a tumor is diagnosed as malignant!  Tumor cells usually present themselves within the lung, breast, ovaries or lymphatic system.

3)   Hereditary – Genetic predisposition to have NMT symptoms with like biological pathogen source passed down through family genes.

In many cases, cramp facilitation syndrome is treatable.  In rare occasions, those with more severe conditions where antibodies work against voltage-gated potassium channels [a chemical action necessary for muscle movement] impact the central nervous system and could be fatal (e.g., Morvan’s Syndrome).  Rest assured RLS and NMT is not fatal [exception: Paraneoplastic cause appears to have statistical probability associated with fatalities].

NMT does mimic other serious disease that could be fatal.  Most NMT cases are autoimmune and not associated with cancer [80 percent of all cases and is suspected to be autoimmune mediated, which is usually caused by antibodies].  For a piece of mind, having the correct diagnosis allows one to seek appropriate and applicable treatment as soon as possible, which also helps to reduce anxiety and mitigate outcome of insidious disease through early diagnosis and proper treatment.

World Wide Internet References,

http://www.tldp.com/issue/179/restless_legs_syndrome.htm

http://en.wikipedia.org/wiki/Isaac’s_Syndrome

http://www.wrongdiagnosis.com/c/cramp_fasciculations_syndrome/intro.htm

Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET. 2011 Copyright, All rights reserved, Mirror Athlete Publishing @: www.mirrorathlete.org,  Sign up for your Free eNewsletter.