by admin | Jan 26, 2015 | Uncategorized
One of Americans’ most common medical complaints is chronic pain. According to Institute of Medicine of The National Academies, over 100 million Americans suffer from chronic pain. Furthermore, it is one of the most common causes of disability in America — for example back pain is one of the leading causes of disability in Americans who are younger than the age of 45, and more than 26 million Americans have frequent back pain.
According to data gathered by the National Center for Health Statistics, about 76.2 million Americans have had pain that lasts longer than a day, and millions more live with acute pain — one of the common culprits responsible for chronic pain. Here’s what you need to know.
1. What is CRPS?
Complex regional pain syndrome is a medical condition that causes chronic pain. It usually affects a limb after the area suffers an injury or a trauma. The condition is believed to be an issue with the nervous system, which transmits pain information through the body. The nervous system is comprised of the brain, spinal cord, and nerves, and in some cases nerves fire pain signals more frequently than they need to. This is the cause of the chronic pain.
2. What are the symptoms of complex regional pain syndrome?
Symptoms of chronic pain are not limited to experiencing pain itself. Common symptoms of chronic pain include things like skin texture changing near the pain, abnormal hair or nail growth, stiff joints, changes in sweating patterns, and abnormal movements and reflexes in the affected area. Studies have shown that migraine pain could be connected to CRPS, and in the United States, every 10 seconds someone goes to the emergency room because of a migraine or a headache.
3. What are the treatments?
There are a few different types of treatment for CRPS. Rehabilitation and physical therapy exercises are sometimes used, which help improve blood flow. In some cases, chronic pain patients are prescribed medications to help them manage their pain. In others, relief of pain can come from minimally invasive procedures like nerve block injections which can help stop the nerve from firing pain signals.
Do you have any other questions about CRPS? Feel free to ask us in the comments section below.
by admin | Jan 21, 2015 | Uncategorized
By: Diane Wedner.
Hispanics and African-Americans have worse symptoms of arthritis than the general population and face greater disability and work limitations. Lifescript’s Health Detective explains why, and what minorities with arthritis can do to take care of themselves…
Aching, swollen knees hobbled Kimberly Felder for nine years.
“I could barely move,” says Felder, 41, a New York City educator. “It took 10 minutes to walk to the bathroom. My knee was the size of a grapefruit.”
Her doctor’s diagnosis: rheumatoid arthritis (RA), an inflammatory disease that causes joint pain and inflammation.
Felder, who’s African-American, is one of 7.7 million minorities with arthritis. The disease hits minorities harder than the general population. They develop more crippling arthritic conditions, such as rheumatoid arthritis (RA) and lupus. They also face more disability, according to a 2010 study by the Centers for Disease Control and Prevention (CDC).
Minorities also are twice as likely as whites to have severe joint pain and lose work days because of the disease, according to the study.
Doctors aren’t sure why – but there are clues, says Patience White, M.D., a professor of medicine at George Washington University School of Medicine and Health Sciences.
“Many patients in [the minority] community don’t go to the doctor early enough” in the disease’s course, Dr. White says. “By the time they’re diagnosed, they have worse disability.”
They also have higher rates of obesity, which worsens symptoms of arthritis.
Here are the main reasons why African-Americans and Hispanics may suffer greater arthritis disability, along with arthritis remedies to help reduce the risk.
1. Obesity
African-Americans and Hispanics have higher rates of obesity in the U.S. than Caucasians, putting them at greater risk for arthritis and other conditions that worsen arthritis symptoms, according to the CDC report. About 44% of African-Americans are obese, while 38% of Hispanics are, compared with about 33% of whites.
Chronic conditions associated with obesity, such as heart disease and diabetes, make it more difficult for arthritis patients to exercise, worsening their arthritis symptoms and making them more dependent on others, doctors say.
Obesity is the biggest factor in disabling symptoms of arthritis, says Melvyn Harrington, M.D., an orthopedic surgeon and associate professor at Baylor College of Medicine in Houston, Texas.
“I talk more about weight loss with my arthritis patients than joint replacements,” he says.
Here’s why: If you’re overweight, every step puts eight times that weight’s force on your knees and hips, says rheumatologist Eric P. Gall, M.D., professor of clinical medicine and interim director of the Arizona Arthritis Center at the University of Arizona College of Medicine.
“If you’re 10 pounds overweight, you’re adding 80 pounds to that joint with every step,” Dr. Gall explains.
-Shedding pounds is the best way to avoid the worst symptoms of arthritis, doctors contend. “Losing just 10% of your weight decreases your pain by 50%,” Dr. White says.
-Walking, swimming and tai chi are gentle ways to lose weight and keep pounds off, Dr. White says. Strengthening and stretching exercises toughen the muscles around joints, delaying wear and tear on knees and hips, she adds.
2. Family history
Minorities face more pain and disability from arthritis because they often experience the most severe, systemic forms of the condition, such as RA and lupus, which attack many organs and the whole body, says Jennifer Hootman, Ph.D., a CDC epidemiologist and co-author of the study.
Sometimes those conditions are passed down genetically. Lupus patients, for example, may inherit a susceptibility to the condition from their parents, according to the Lupus Foundation of America.
Although there are no genetic tests to determine whether you’re at risk, researchers are conducting “linkage studies,” in which they evaluate families with more than one member who has lupus.
RA isn’t hereditary, but certain genes may increase your risk of developing the disease.
You have up to a 4% chance of developing RA if your mother, father, sister or brother has it, according to Harvard Medical School. In the general population, 1% runs that risk.
Arthritis remedies:
-Get as complete a family medical history as possible.
-Consult with a rheumatologist if one or more members of your family have lupus or RA.
3. Ignoring symptoms
-Minority women are more likely to ignore their aching joints and inflammation. One reason: cultural attitudes.
“If you ask people with arthritis what their No.1 issue is, it’s pain,” Dr. Gall says.
But in some ethnic communities, “they’re told by family members … that you just get arthritis when you’re old and there’s nothing you can do about it,” Dr. Gall says. “So they don’t seek help.”
Many also are more worried about having bigger health problems, such as heart disease, hypertension or diabetes, three of the leading co-conditions of arthritis.
“When you get [minorities] with all the co-conditions, arthritis is way down on their list of complaints for their primary care physicians to address,” Dr. Harrington says. “They’re worried about heart disease and blood pressure, so they don’t even mention achy joints.”
That delay carries a high price. Hispanic and African-American patients typically have worse preoperative hip and knee function before surgery than white patients, according to a 2010 report published in The Journal of Arthroplasty.
Ignoring symptoms of arthritis leads to more severe conditions later, doctors say.
By the time patients do seek help, the remedies aren’t as effective or are more invasive. And at these later stages, the outcome may not be as beneficial.
For example, a white male with 75% joint erosion will enjoy a 90% improvement after surgery, Dr. Harrington says, while an African-American woman’s joint will improve only 80%.
“There’s no catch-up phenomenon when you’re advanced,” he says. “It’s too late for less-invasive tools.”
Arthritis remedies:
-Visit a doctor if any symptoms of arthritis flare, such as painful, swollen joints, rashes, fatigue and fevers. The earlier the diagnosis and treatment by a rheumatologist, the better the result.
-Even if you have heart disease, diabetes or other serious health conditions, speak up about your symptoms of arthritis to your doctor. Don’t assume that aching joints are a minor problem.
-Educate yourself and others.
“It’s vital to get the word out about arthritis,” Dr. Harrington says. “Minority patients – and everyone, for that matter – need to know the effects of this condition” and the damage it causes.
4. Lack of health insurance, and other impediments
Even when African-American and Hispanic arthritis patients want care, they may not be able to get it, doctors say.
“Some minority patients don’t have health insurance,” Dr. Harrington says. “They also may not have access to an orthopedist for surgery.”
If African-American patients do have access, “often they want to see African-American orthopedists,” Dr. White says, because they place their trust in black doctors more readily than white ones.
But, depending on the geography, they may not be easily available.
About 75% of physicians identified themselves as white, while 4% were African-American and 5.3% Hispanic, in a 2008 Health Tracking Physician Survey by the Center for Studying Health System Change.
Meanwhile, some patients with insurance don’t know that orthopedic surgeries are covered, so they don’t consider that option, Dr. White says. Undergoing the surgery without insurance coverage would be prohibitively expensive.
“Access and health insurance are the two biggest obstacles to arthritis treatment,” Dr. White says.
With undocumented Hispanics, immigration fears may prevent them from seeking a doctor’s care at county facilities, making them especially at risk for advanced disease, doctors say. Family responsibilities keep them away from doctors too.
“Women who are the mainstays of their family units don’t have time for surgery,” Dr. White says.
For example, knee surgery is a “major operation,” with full recovery taking 6-12 months, Dr. Harrington says. Patients must be healthy enough to undergo physical therapy before and after the operation, and be able to undergo anesthesia. Patients return to most activities in 2-3 months.
Arthritis patients who also have diabetes and heart disease may be poor candidates for surgery, even if they have insurance. And those who wait too long before seeking relief may be out of luck.
Arthritis remedies:
-Get informed. Hispanics and African-Americans seeking safe, affordable care for arthritis may find information at local churches and schools.
-Know your options. Patients should ask their primary care physicians about surgical options under their health insurance policies, and seek detailed information from doctors about the disease.
While many challenges exist for African-American and Hispanic patients with symptoms of arthritis, they can manage the condition.
It takes the right information and attitude, says Felder, the New York schoolteacher.
“The best way to do that is to not just take care of yourself through exercise and diet, but by getting the medical attention you need,” Felder says. “That’s what I did. And it worked.”
How Much Do You Know About the Types of Arthritis?
About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030. Do you or someone close to you have arthritis? Take this quiz to see how much you know about this disease.
by admin | Jan 21, 2015 | Uncategorized
It’s been a hard day, and Joe’s back is killing him.
His wife has some Percocet left over from a trip to the dentist, and there’s that big bottle of Tylenol under the sink, so Joe grabs a couple of each and washes them down with a slug of beer.
Luckily for Joe, he’s a fictional character invented for this article. But there are a lot of real-life Joes out there making big mistakes with over-the-counter and prescription pain pills.
Can you spot Joe’s mistakes? Joe didn’t make every mistake in the book. But he made quite a few.
Here’s WebMD’s list of common pain pill mistakes, compiled with the help of pharmacist Kristen A. Binaso, RPh, spokeswoman for the American Pharmacists Association; and pain specialist Eric R. Haynes, MD, founder of Comprehensive Pain Management Partners in Trinity, Fla.
Pain Medications Mistake No.1:
If 1 Is Good, 2 Must Be Better
Doctors prescribe pain pills at the doses they believe will offer the greatest benefit at the least risk. Doubling or tripling that dose won’t speed relief. But it can easily speed the onset of harmful side effects.
“The first dose of a pain medication may not work in five minutes the way you want. But this does not mean you should take five more,” Binaso says. “With some pain drugs, if you take additional doses, it makes the first dose not work as well. And with others, you end up in the emergency room.”
If you’ve given your pain medication time to work, and it still does not control your pain, don’t double down. See your doctor about why you’re still hurting.
“This ‘one is good so two must be better’ thing is a common problem,” Haynes says. “Patients should follow the instructions their doctor gives. Ask before leaving the office: Can I take an extra pill if I still hurt? What is the upper limit for this medication?”
Another bad idea is trying to boost the effect of one kind of pain pill by taking another.
“There may be ibuprofen, acetaminophen, and naproxen in the house, and a person may take them all,” Binaso says.
This can escalate into a very bad situation, Haynes says.
Pain Medications Mistake No. 2:
Duplication Overdose
People often take over-the-counter pain drugs — and even prescription pain drugs — without reading the label. That means they often don’t know which drugs they’re taking. That’s never a good idea.
And if they take another over-the-counter drug — either for extra pain relief or for other reasons — they may be getting an overdose. That’s because many OTC drugs are combination pills that carry a full dose of pain pill ingredients.
In Joe’s case, he’s taken a prescription pain pill that contains acetaminophen along with a second full dose of acetaminophen from Tylenol, putting him at risk of injury.
Pain Medications Mistake No. 3:
Drinking While Taking Pain Drugs
Pain medications and alcohol generally enhance each other’s effect. That’s why many of these prescription medications carry a “no alcohol” sticker.
That sticker shows a martini glass covered by the international “No” sign of a circle with a slash. But it applies to wine and beer just as much as it does to spirits.
“A common misperception is people see that sticker and think, ‘I’m OK as long as I don’t drink liquor — I can have a beer.’ But no alcohol means no alcohol,” Binaso says.
“The patient should heed that alcohol warning, because it can be a major problem if they do not,” Haynes says. “Alcohol can make you inebriated, and some pain medications can make you have that feeling as well. You can easily get yourself into trouble.”
Drinking alcohol can be a problem even with over-the-counter pain drugs.
Pain Medications Mistake No. 4:
Drug Interactions
Before taking any pain pill, think about what other medicines, herbal remedies, and supplements you are taking. Some of these drugs and supplements may interact with pain medications or increase the risk of side effects.
For example, aspirin can affect the action of some non-insulin diabetes drugs; codeine and oxycodone can interfere with antidepressants.
You should give your doctor a complete list of all the drugs, herbs, and supplements you take — before getting any prescription.
If buying over-the-counter medications, Binaso recommends showing a list of everything else you’re taking to the pharmacist.
Pain Medications Mistake No. 5:
Drugged Driving
Pain medications can make you drowsy. Different people react differently to different drugs.
“How I react to a pain medication is different from how you react,” Binaso says. “It may not make me drowsy, but may make you drowsy. So I recommend trying it at home first, and see how you feel. Don’t take two pills and go out driving.”
Pain Medications Mistake No. 6:
Sharing Prescription Medicines
Unfortunately, it’s very common for people to share prescription medications with friends, relatives, and co-workers. Not smart, Haynes and Binaso say — particularly when it comes to pain medications.
“If a fairly healthy person is taking a medicine because she is in pain, and wants to give some pills to Uncle Joe because he is hurting — well, this is a potential problem,” Haynes says. “Uncle Joe may have a problem that keeps his body from eliminating the drug, or he may have an allergic reaction, or the drug may interact with a medication he is taking, with life-threatening results.”
Pain Medications Mistake No. 7:
Not Talking to the Pharmacist
It’s not easy to read drug labels, even if you can make out the small print. If you have a question about either a prescription or OTC drug, ask the pharmacist.
“That’s why I’m in the store,” Binaso says. “You may have to wait a couple of minutes for me to finish what I’m doing. But you’ll get the information you need to take the right medicine the right way. Just say, ‘Tell me about this medicine; what should I be on the lookout for?'”
Pain Medications Mistake No. 8:
Hoarding Dead Drugs
Joe’s wife is actually to blame for one of his mistakes. She should have disposed of those extra pain pills once she was over her dental pain.
Why? One reason is that pills stored at home start breaking down soon after their expiration date. That’s especially true of drugs kept in the moist environment of the bathroom medicine cabinet.
“People say, “That drug is only a year past its expiration date; isn’t it good?” But if you take a pill that’s broken down, it may not work — or you may end up in the emergency room because of reaction to a breakdown product. That is really common,” Binaso says.
Another reason that it’s dangerous to hoard is that the drugs may tempt someone else into making a very bad choice.
“Teen drug abuse is really up, especially with pain medications,” Binaso says. “It is not uncommon for kids to go to their parents’ or grandparents’ medicine cabinet and then go to a party and put the drugs in a bowl.”
Pain Medications Mistake No. 9:
Breaking Unbreakable Pills
Pills are actually little drug-delivery machines. They don’t work the way they’re supposed to when taken apart the wrong way.
Scored pills should be cut only across the line, Binaso says. Those without scoring should not be cut at all, unless you’re specifically instructed to do so.
“When you start chopping up pills like that, the pill may not work,” she says. “We find more and more people are doing this. And then they say, “Oh, that pill had a really bad taste. That is because they cut away the coating.”
Source: Web MD
By Daniel J. DeNoon
Reviewed By David T. Derrer, MD
by admin | Jan 20, 2015 | Uncategorized
Sitting is one of the worst positions for the body to maintain. After just 20 minutes hunched over in a chair, blood pools in the legs and immense pressure builds on the spine. Now, imagine the effects of sedentary workdays long term.
For employees at and tech companies, our jobs are desk-bound (that is, until treadmill desks are affordable in bulk). So, it’s a good thing that expert’s tips to prevent serious injury are rather simple — take frequent breaks and stand as often as possible.
Prolonged sitting causes discomfort, numbness and spine misalignment. Holding the body upright also increases tension in major muscles and joints. All that means stationary time at work can lead to cardiovascular disease (because of less blood flow), tightened hip flexors, shortened hamstrings, pinched nerves and many physical injuries in the long run.
Why Is Sitting So Unnatural?
New York City chiropractor Dr. Jan Lefkowitz treats pinched nerves, spilled discs, carpal tunnel, back pain and stiff necks full time. His chiropractic office resides in the corporate heart of Midtown NYC. The majority of his clients work 50 to 80 hours weekly.
Body pain, herniated discs, nerve problems and painful joints are direct results of long office hours, says Dr. Lefkowitz. When you’re sitting, the spine is under a lot of pressure. Our bodies were made to stand, so maintaining the seated position is physically stressful.
“The weight is distributed in a standing position,” says Kelly McGonigal, Ph. D., a health psychologist at Stanford University and a leading expert in neck and back pain.
That’s not the case with sitting. McGonigal explains, “When you sit, you distort the natural curve of the spine, which means your back muscles have to do something to hold your back in shape because you’re no longer using the natural curves of the spine to lift yourself up against gravity.”
Around 80% of Americans will experience chronic pain in their lifetime as a result, she says. Desk work is putting a huge mental and physical stress on our bodies.
Bad posture makes the sitting disease even worse. Slipped discs is a direct result.
“When the posture breaks down, it causes a lot of spinal problems,” Lefkowitz says. “If you are sitting down with bad posture and you’re slouching, you can only handle 20 minutes of that before it deforms your ligaments.”
How to Prevent Back and Neck Injuries
Good posture when sitting maintains the three natural curves of a healthy spine. The neck is forward, the upper back has an outward curve and the lower back is inward. Elbows are at the sides of the body and shoulders are relaxed — holding shoulders upright for a long time will strain the area.
“The main point is avoid slouching, you have to sit up straight and sit all the way back in your chair,” Lefkowitz says. “The chair should be tucked in close to desk. And, you need lumbar (lower back) support.”
Inexpensive remedies are available. Either roll up a thick sweater or use a small pillow behind your back to allow your lower back to curve inward. Aim to insert it in between the small of your back and the chair.
Another recommendation to avoid pulling muscles or causing pain is simply standing every 20 minutes or so. It’s the most important thing desk workers can do to give the body a break from a long held position.
“That will push the blood out of your legs and will prevent ligaments from getting strained,” Lefkowitz says. “It starts to stretch out your ligaments.”
Simple stretches at your desk such as twisting, turning the head from side-to-side and chin tucks upward towards the ceiling will also help.
“Those movements, doing them very regularly, at least once an hour, for 60 seconds will do more to relieve chronic pain than going to a yoga class once a week,” McGonigal says.
General Tips
- Stand at least every hour at your desk.
- Do simple stretches throughout the day such as placing your hands on your lower back and stretching backwards.
- Get moving! Make conference calls on your feet or suggest a moving meeting — walk up and down the hall.
- When seated, make sure you maintain good posture with your butt all the way back to the chair, feet flat on the floor, head straight and with lower back naturally arched inward.
by admin | Jan 15, 2015 | Uncategorized
If you have been injured at work or in an auto accident, Dr. Hanna provides EXPERT pain management treatment.
As an industrial medicine and personal injury practice, Dr. Hanna not only treats state injured workers and accident victims, but also federal injured workers. Patients are seen from Florida as well as Washington state..
