Tag: Chronic Pain

Low-impact exercises for pain

Patients struggling with chronic pain find it difficult to engage in exercises. Yet research shows that physical activities is one of the most effective treatments for many pain conditions. It is important for patients to be strategic about exercise, & invest the limited time & energy on sustainable, beneficial forms of exercises. Walking & Nordic walking…

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Sleep & pain

Sleep is a key contributor to chronic pain. Impaired sleep worsens pain, which in turn prevents patients from getting restful sleep. When pursuing treatment for chronic pain, it is important to not overlook simple, non-drug strategies that can markedly improve sleep. During the day Develop a regular energizing morning routine. Start the day with 3 minutes…

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Pelvic pain

Pain around the vagina, penis, anus, & buttock are often experienced by patients but seldom reported. Patients should know that this is a common problem that can often respond to comprehensive pain treatments by pelvic pain specialists. Pelvic pain Pelvic pain is experienced around the vagina, penis, scrotum, anus, & buttock. It can be worsened…

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Drug-herb-gene CYP3A4 interactions

The liver enzyme CYP3A4 is the key body mechanism for metabolizing pain medications. Patients who take pain medications must be aware that drugs, herbs, & genes can complexly alter CYP3A4 activity. Ask your doctor before making changes. Drugs metabolized by CYP3A4 Fentanyl Buprenorphine Oxycodone Methadone Diazepam Midazolam Alprazolam Metoprolol Losartan Amlodipine Rivaroxaban Dabigatran Apixaban Tacrolimus CYP3A4…

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Stylohyoid (Eagle’s) syndrome

Entrapment of nerves by the “stylohyoid complex” is an uncommon cause of neuropathic jaw & neck pain. This can be due to congenitally long styloid processes, or scarring after surgery or traumatic injury. The stylohyoid complex connects the hyoid bone — important in swallowing & tongue movement — to the head. Made of tough cartilage & bone, the complex…

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Activating the brainstem to treat pain

Pain signals converge in the core of the brainstem where they deeply influence behavior. For checks & balances, the brainstem uses “descending inhibition” as a volume control to reduce pain. Pain physicians leverage this for treatment, via antidepressants, acupuncture, & meditation. Descending inhibition systems To keep pain signals from running out of control, the brainstem…

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Medication overuse headache

Headache medications taken too regularly can paradoxically cause a new headache, called medication overuse headache (MOH), that is constant, over & above the primary headache. The treatment is to stop the medications & treat the primary headache. Central sensitization Using rescue headache medications every day changes the balance of neurochemistry (in particular serotonin) in the…

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Sympathetic blocks for pain

The sympathetic nervous system lets the brain control the organs to maintain overall balance of body systems. In many chronic pain conditions, it worsens inflammation & pain; in some, they even become pathologic. Sympathetic blocks help reduce these effects. Sympathetically Maintained Pain Sympathetic nerves release norepinephrine and: Sensitize painful nerve endings Widen arteries causing redness…

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Chronic pain cycle

Unlike acute pain (pain after surgery or injury), chronic pain is a disease driven by a self-reinforcing cyclic process between the nerves, the brain, & the muscles, Injury, Surgery, & Inflammation Initial tissue injury triggers the chronic pain cycle. In the setting of chronic pain, the initial injury may resolve while the chronic pain cycle…

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