The Working Definition Of Neuropathic Pain
Neuropathic pain is a subcategory of the larger group of pain syndromes and is characterized by chronic pain, various heterogeneous diagnoses , and differing etiologies. In addition, within a specific diagnosis, there is notable variability in the presentation as well as the characteristics of the experienced pain.
Safe Effective Ways To Relieve Pain Without Meds
Approaches such as acupuncture, massage and tai chi may ease discomfort
“For many Americans who suffer from chronic pain, medications may not completely relieve pain and can produce unwanted side effects. As a result, many people may turn to nondrug approaches to help manage their pain,” study lead author Richard Nahin said in a U.S. government news release.
“Our goal for this study was to provide relevant, high-quality information for primary care providers and for patients who suffer from chronic pain,” Nahin added. He is lead epidemiologist at the U.S. National Center for Complementary and Integrative Health .
Researchers reviewed 105 U.S.-based clinical trials from the past 50 years.
Several alternative approaches showed promise for providing safe and effective pain relief. They included acupuncture and yoga for back pain acupuncture and tai chi for osteoarthritis of the knee and relaxation techniques for severe headaches and migraine. Results of massage therapy for short-term relief of neck pain were also promising.
Choosing The Right Pain Medicine
The right choice of medicine for you will depend on:
- the location, intensity, duration and type of pain
- any activities that ease the pain or make it worse
- the impact your pain has on your lifestyle, such as how it affects your appetite or quality of sleep
- your other medical conditions
- other medicines you take.
Discuss these with your doctor or other health professional, so that you choose the safest and most effective pain relief option.
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A Civil War Over Painkillers Rips Apart The Medical Community And Leaves Patients In Fear
These days, Whites baseline pain stays at a 4 meaning, its always there, but its manageable. On the bad days, he considers small things, like getting out of bed in the morning, to be victories. Instead of lying in bed, I gotta get my butt out of bed otherwise it becomes a tomb, and the stinkin thinkin comes back, White said.
Hes now working at the Minnesota Adult and Teen Challenge, a faith-based addiction therapy program in Rochester. And hes working on launching a pain management program for his clients.
Your Role In Pain Control
Your main role as a patient is to make sure you tell your surgical team or health care provider if you have pain. Also, make sure to take your medication at the scheduled time and dont wait until you are in pain to take your medication.
Donna Wagner, a double bypass patient, made the mistake of not taking her medications regularly. She said it was a lesson she had to learn the hard way.
When I came home , I thought, I am not going to take as much pain medicine. So I cut back on the pain medicine, Wagner told Drugwatch. The second night I was home I was sitting, and I just didnt feel well, and my whole left arm and shoulder got really sore and heavy. It scared me a little.
Make sure you understand how to wean off stronger medications and dont just stop taking them.
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What To Expect With Pregabalin
Pregabalin is prescribed for people whose nerve pain has not responded to other medicines. Nerve pain medicines do not work for everyone and often they do not relieve pain completely when they do work.
Pregabalin helps lessen the pain you are feeling so that you are able to perform your daily activities and have a better quality of life.
Precautions When Taking Pain Medicines
Treat over-the-counter pain medicines with caution, just like any other medicines. Its always good to discuss any medicines with your doctor or pharmacist.
General suggestions include:
- Dont self-medicate with pain medicines during pregnancy some can reach the fetus through the placenta and potentially cause harm.
- Take care if you are elderly or caring for an older person. Older people have an increased risk of side effects. For example, taking aspirin regularly for chronic pain can cause a dangerous bleeding stomach ulcer.
- When buying over-the-counter pain medicines, speak with a pharmacist about any prescription and complementary medicines you are taking so they can help you choose a pain medicine that is safe for you.
- Dont take more than one over-the-counter medicine at a time without consulting your doctor or pharmacist. It is easier than you think to unintentionally take an overdose. For example, many cold and flu medicines contain paracetamol, so it is important not to take any other paracetamol-containing medicine at the same time.
- See your doctor or healthcare professional for proper treatment for sport injuries.
- Dont use pain medicines to tough it out.
- Consult your doctor or pharmacist before using any over-the-counter medicine if you have a chronic physical condition, such as heart disease or diabetes.
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Could An Injected Electrode Control Your Pain Without Drugs
THURSDAY, May 28, 2020 — An injectable electrode could prove a better way to ease chronic nerve pain than opioid painkillers or bulky and expensive implants, animal research suggests.
It’s called an “injectrode.” It appears easier and cheaper than spinal implants for debilitating back pain, and safer than long-term use of opioids like OxyContin , a recent paper suggests.
A liquid silicone gel filled with small metal particles is injected around the nerve that’s causing the pain, said researcher Kip Ludwig, a professor of biomedical engineering and neurological surgery at the University of Wisconsin-Madison.
“It cures , and it becomes a conductible electrode” that surrounds the nerve, Ludwig said.
Doctors then inject an outer sheath of insulation around the newly formed electrode, and use the same gel to craft a wire running from the injectrode to the surface of the skin.
“You now have a direct connection to stimulate a deep nerve from the surface of the skin, without affecting any nerves on the surface of the skin,” Ludwig said. “We’re trying to get this to the point where it’s like getting a tattoo, in terms of invasiveness.”
The use of electrical pulses to alter nerve activity, a technique called neuromodulation, has been shown to effectively treat chronic nerve pain, Ludwig said.
“When you feel pain, those nerves are sending an electrical signal that goes to your brain and tells you that you’re feeling pain,” Ludwig said. “This interrupts that signal.”
Pain Relief With Diet
Here’s extra incentive if you’ve been thinking about losing weight: Shedding excess pounds could help reduce the risk of pain.
“If you’re overweight and de-conditioned, your joints take a major hit, because of the increased poundage that your joints have to carry,” says Elton Strauss, MD, chief of orthopaedic trauma and adult reconstruction at Mount Sinai Hospital in New York City.
There are plenty of weight loss programs available, but keep in mind that regular physical activity and a nutritious, well-balanced diet are proven methods for weight loss.
On the other extreme, being underweight or weight loss with a poor diet and inactivity can exacerbate pain. “Your hormone levels are off,” explains Lisa Dorfman, MSRD, a sports nutritionist and spokeswoman for the American Dietetic Association . Normal flow of hormones can help the body combat aches, and activate the body’s own healing systems.
Dorfman says people need not become vegetarians for pain relief. She suggests limiting intake of animal protein and saturated fat, and beefing up on foods rich in omega-3 fatty acids, antioxidants, vitamins, and minerals.
Christine Gerbstadt, MD, RD, another spokesperson for the ADA, agrees. She also suggests eating more whole grains and organically produced foods. She says steroid hormones and preservatives may negatively stimulate the immune system.
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A Renewed Interest In Alternative Treatments
Such results, and anecdotal reports from patients like White, have spurred renewed interest in biopsychosocial pain management.
Insurance coverage is still a battle: Many plans will pay for medical treatments such as surgeries, pills, and steroid injections that can run $2,000 apiece. Theyre not as keen to cover therapy, massage, and meditation. Its much more efficient for insurers to pay for a pill in a 15-minute office visit, Twillman said, instead of a pill, plus a psychologist, plus a chiropractor, plus acupuncture, plus yoga and massage.
Slowly though, thats changing, in large part because of the opioid crisis.
Reduce Pain With Exercise
Dont let pain stop you from exercising. Gentle exercise is one of the best ways to manage pain. It promotes circulation, stimulates endorphin release, strengthens muscles and tendons and enhances mood and sense of well-being. But it needs to be done wisely. I recommend either simple walking in nature, yoga, qigong or tai chi practices, or swimming. Many communities have a public pool, often with water aerobics classes designed for people who need a bit of guidance in their routine.
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Neuropathic Pain And Depression
One common comorbid psychiatric diagnosis encountered in patients with neuropathic pain is depression, which affects the majority of individuals . Studies indicate that patients with pain have a substantially increased risk for depression, anywhere from 2 to 5 times that of the general population. Given that these syndromes are commonly comorbid, the assessment of depression in the presence of pain is typically complicated by the presence of shared features between the two syndromes . In addition, the format for assessment may affect findings. Specifically, prevalence rates of depression among pain patients are seemingly higher when assessed through self-report measures compared with standardized diagnostic approaches.
Investigators have also found that the prevalence rate of depression among pain patients may vary as a function of the clinical setting. In a review of the literature, Bair et al found that the prevalence of depression among pain patients in psychiatry clinics was 35 percent, in pain clinics 38 percent, in rheumatology clinics 52 percent, and in dental clinics 78 percent. Surprisingly, despite the frequent comorbidity of pain and depression, Jackson and St. Onge indicate that both remain under-recognized and under-treated in this clinical population.
Causes Of Pinched Nerves
A pinched nerve typically happens when a nerve is damaged and cannot send regular signals to the brain, which may cause feelings of numbness and tingling.
Also, certain activities and habits can cause a pinched nerve. Sitting, standing, or walking with poor posture may contribute to a pinched nerve.
Injuries from sports or repetitive actions may compress a nerve. Extra pressure and weight caused by obesity may also lead to pinched nerves.
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Additional Treatments For Stopping Pain Pills And Controlling Dependence
Detox and medications are only part of the answer for stopping pain pills and staying off them. They can be great tools to help process these drugs out of the body and reach a safe physical balance however, the emotional aspects of drug dependence and addiction need to be handled too.
Relapse is common and can be particularly dangerous after detox and a period of abstinence. For this reason, counseling and therapies are essential in helping to prevent and minimize relapse. Behavioral therapies help individuals learn how to control cravings, recognize and manage potential triggers for relapse, and form healthy coping mechanisms for handling stress. Therapy and counseling sessions typically include both individual and group formats.
A residential addiction treatment program is often recommended in cases of severe or long-term painkiller abuse. These programs can promote overall healing and wellness by attending to both physical and emotional needs. For example, therapy and counseling improve self-reliance and emotional balance while physical health is improved with nutritious and balanced meals, regular physical activity, and structured sleep schedules. Malnutrition is often a side effect of chronic drug use, and healthy sleep, exercise, and eating habits can promote healing. The brain will need time to restore its balance without drugs, and a comprehensive addiction treatment program can provide the time and space for this to take place.
Plumbing Psychology To Deal With Pain
There used to be hundreds of integrated pain management centers all across the country. But in the 90s, the insurance market shifted more patients joined managed care plans that limited them to a narrow network of doctors. Then in 1996, the powerful opioid OxyContin hit the market. It quickly became the tool of choice for controlling pain.
Soon, there were just four major integrated pain management centers left: Mayo Clinic, Johns Hopkins University, Cleveland Clinic, and Stanford University.
The Mayo Clinics outpatient pain program runs for three weeks, and keeps patients busy from 8 a.m. and 5 p.m.
They do physical and occupational therapy learning, for instance, how to go shopping or do yard work in ways that wont aggregate their pain. And the program includes four to five hours of lessons each day on how to understand pain. Patients learn to relax, breathe slowly, and meditate to mitigate some of the anxiety-related pain flare-ups. Entire sessions are dedicated to understanding the psychological underpinnings of their own pain.
By the time people get here, they have a lot of functional disability, said Sperry, who helps run the program. Theyre fearful, because theyre getting such strong signals in the brain so we offer a very structured increase in activity, where were retraining the brain to soothe the central nervous system to not process these signals as danger.
Jeannie Sperry, Mayo Clinic
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Strategies For Easing Nerve Pain
In addition to relieving pain, many self-care and home treatments can help prevent more serious problems and protect overall health. Some of these strategies may even trigger the body’s natural painkillers, having the added benefit of making you feel good.
Walk it off.Exercise releases natural painkillers called endorphins. Exercise also promotes blood flow to the nerves in the legs and feet. Researchers believe that regular exercise may create a long-lasting expansion in blood vessels in the feet, nourishing damaged nerves back to health. Start with a daily walk, gradually increasing pace and distance.
Pamper your feet. If the feet are affected by nerve pain, it’s time to focus on good foot care. Nerve pain usually means impaired sensation, making injuries and infections more likely. Reduce the risk by examining your feet daily, wearing comfortable shoes, and seeing a podiatrist regularly. No wound or injury to your feet is too minor for a consultation with a doctor.
Soak it away. A warm bath might be the easiest — and least expensive — home treatment for nerve pain. Warm water temporarily increases blood flow to the legs and can help ease stress as well. Avoid burns by measuring water temperature with your arm before stepping in.
What Causes Nerve Pain
Neuropathic pain comes from nerve damage. Most commonly, this is caused by medical conditions such as diabetes, side effects from drugs or chemotherapy, or injuries.
Damaged nerves are more likely to misfire, sending pain signals when there is no cause for pain. They can also put you at risk for more serious problems such as foot infections.
All the causes of nerve pain are still largely a medical mystery. Researchers have identified several different ways nerves can misfire, and this has led to treatments that help many people.
Still, in surveys of people with nerve pain, most say they still have pain despite the best efforts of doctors. If you’re one of them, you may want to look beyond conventional medicine for relief. Almost half of those with nerve pain report trying complementary or alternative approaches to improve their pain.
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Medications: Opioids Vs Non
Non-opioid medications may be beneficial in helping to control chronic pain. Some examples of non-opioid pain medications include over the counter medications such as Tylenol , Motrin , and Aleve . Some prescription medications may also be used to manage pain. Neurontin is often prescribed to manage nerve pain. Corticosteroids may be used to decrease pain caused by inflammation, and some types of antidepressants may also be effective in treating chronic pain. Sometimes, your doctor may recommend a topical pain medication such as lidocaine or capsaicin.
It is important to discuss the use of these medications with your doctor as they may have dangerous interactions with other prescription medications or cause dangerous side effects for some people.
Opioids are medications used to relieve severe pain. They reduce the intensity of pain signals from your body and change how your brain perceives pain. Typically, opioids are prescribed to people who are injured, are recovering from surgery, or are suffering from chronic pain.
Some examples of common opioids include:
- Norco, Vicodin, or Percocet
- Morphine, Dilaudid, or Fentanyl
Opioids are rarely a permanent solution to chronic pain. They can reduce some types of pain, but not all types, and can even make some pain worse. It is impossible for your doctor to know how much your pain may decrease from taking opioids or how much your quality of life will improve.