Learning to live with chronic pain

Chronic pain is a formidable foe. It’s invisible and can’t be measured by an X-ray or a blood test. Sometimes it has no identifiable cause and yet it can ruin lives, affecting everything from employment to family relationships.

“Pain Matters,” a new documentary airing on the Discovery Channel, illuminates what it’s like to be one of the millions of Americans suffering with chronic pain, often defined as recurrent pain that lasts more than three months.

In the documentary, we hear from six people living with the condition, including a Navy veteran who sustained debilitating injuries in Iraq, and a mother of two who is still hurting from a car accident more than 20 years ago. Their testimony will surely strike a chord with anyone who has struggled with a bad back, arthritis, carpal tunnel syndrome or recurrent headaches.

Clinicians also provide insight on the timely subject of pain management. Last month, the Food and Drug Administration recommended tighter controls on how physicians prescribe the most commonly used narcotic painkillers, such as Vicodin.

For more on this topic, we turned to Penney Cowan, 65, founder and executive director of the American Chronic Pain Association, one of the experts featured in the documentary. Here is an edited transcript of our interview:

Q: What is your personal connection to pain?

Full story of living with chronic pain at the Chicago Tribune

Is Chronic Pain Keeping You Awake? Help Is On the Way

According to some studies, more than 100 million people in North America live with—or perhaps more accurately, don’t find it easy to live with—days and nights filled with chronic pain. They know that persistent pain does more than make one achy and perhaps a bit cranky. Chronic pain has been associated with a significant increase in the rate of depression and anxiety. Most of those who have to endure chronic pain may also have problems with attention, memory, high blood pressure and related heart problems, along with sleep issues. Common causes of pain include degenerative spine disease, lower back pain, rheumatoid arthritis, osteoarthritis, fibromyalgia, HIV, migraine, neuropathy and complications of shingles.

This population includes approximately five million people with Type 2 diabetes who experience chronic pain, a condition called painful diabetic neuropathy (PDN). It is estimated that about half of them suffer pain that keeps them from getting to sleep, or when they do, staying asleep.

Neuropathy in Type 2 diabetes can frustrate both patients and their doctors and other health providers. Although there is a range of treatments, including pharmaceutical painkillers, antidepressants, anticonvulsants, steroid and cortisone injections, analgesic patches, vitamin B shots and hot/cold packs, relief is often elusive or sporadic. People with chronic pain may need a deep, restorative night’s rest to fully function.

Full story of chronic pain and sleep at the Sacramento Bee

Treating Chronic Pain With Ketamine

Treating Chronic Pain with KetamineAs human beings, we instinctively avoid pain—the sting of nettles, the burn of a hotplate, the pinching of door hinges. Pain is useful because it communicates immediate danger and helps us keep out of it. However, some pain is chronic, as neuropathic pain often is.

Neuropathic pain derives from the central nervous system or peripheral nervous system. It is pain that comes from the nerves, as opposed to common muscular aches and arthritic pain. Sometimes it is triggered by traumatic accidents.

In support forums, patients suffering from neuropathic pain describe their symptoms as “burning all over,” “shooting pains in the arms and legs,” “agony,” and “unbearable.” Many of them recount their experiences in seeking relief “frustrating,” that they’ve “tried everything,” or that “not one doctor can give me an answer.”

Neuropathic pain, as a broad category of conditions that include neuralgia, phantom limb syndrome, complex regional pain syndrome (CRPS), and central pain syndrome, is a little-understood realm in medicine. We don’t always know its causes. And current treatment methods are mediocre at best.

Full story of ketamine for chronic pain at Epoch Times

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New Treatment Available for Chronic Heel Pain

Treatment for Chronic Heel PainThere are 3.85 million cases of chronic heel pain in the United States, costing healthcare 2.29 billion dollars. Now, a new twenty minute non-surgical procedure can alleviate chronic heel pain (Plantar Facsiitis) and Dr. Charles Birk offers it. Dr. Birk has offices in Cape May Court House and in Beesleys Point and is specially trained to offer this treatment for heel pain.

Plantar Facsiitis (heel pain) results from inflammation of the connective tissue that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel. Typically pain is the worst with the first few steps in the morning. It is sometimes associated with a heel spur, in which case it is called “heel spur syndrome.”

The condition can usually be successfully treated with conservative therapies such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, night splints, cortisone injections and physical therapy. If the condition does not clear up, ESWT or Shockwave Therapy may be considered.

Full story of chronic heel pain treatment at Cape May County Herald

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What Works For Knee Pain? Don’t Waste Your Money On Bad Medicine

What Medicines Works for Knee PainKnee pain is a very common problem, affecting young and old alike.  Among athletes, knees take a beating, particularly in sports that involve running and twisting.  Among older people, the cartilage that provides a cushion in our knees often just wears out, producing chronic stiffness and pain.

I’ve had knee problems myself, so I was interested to see an article posted on CNN, with content from Harvard Medical School called “Alternative Treatments for Knee Pain.”  Would it describe “alternative” medicine, as in “complementary and alternative medicine,” or would it present real medicine for knee pain?

A little of both, as it turns out.  But it does more: it inadvertently illustrates one of the major flaws with the U.S. health system.  We don’t discriminate between effective and ineffective treatments, and some doctors seem content to let patients try anything, regardless of efficacy or cost.

The article describes several treatments for knee pain, and for each one it turns to Eric Berkson, M.D., for an opinion on how well the treatment works.  Berkson is an orthopaedic surgeon at Massachusetts General Hospital and an Instructor in Orthopaedic Surgery at Harvard Medical School.

Full story of knee pain medications at Forbes

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Mayo Clinic: Teens with chronic pain should not use medical marijuana

Teens Treating Chronic Pain with Marijuana UseTeens with chronic pain should not be prescribed medical marijuana, according to the Mayo Clinic.

Due to a lack of information on the risks and benefits of medical marijuana for adolescents, the Mayo Clinic is not recommending that youth be given pot for pain conditions. While the drug may help alleviate some of their other conditions or symptoms, marijuana can lead to some negative short-term side effects including fatigue, impaired concentration and slower reaction times.

“The consequences may be very, very severe, particularly for adolescents who may get rid of their pain — or not — at the expense of the rest of their life,” commentary co-author Dr. J. Michael Bostwick, a Mayo Clinic psychiatrist, said in a press release.

The commentary will be published in the July issue of Mayo Clinic Proceedings.

Marijuana is the most commonly used illegal drug in the U.S. according to the2008 National Survey on Drug Use and Health. About 15.2 million users used marijuana in the month before they completed the questionnaire.

Full story teens treating chronic pain at CBS News

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Challenge chronic pain with physical therapy

Challenge Pain with Physical TherapyPhysical therapy is just one essential part of any comprehensive pain management plan. A multidisciplinary approach to pain management utilizes the strengths of several different techniques to complement each other and provide the most effective treatment for those suffering from chronic pain.

Using only one method to manage pain (such as chiropractic adjustments or acupuncture) will often fail to resolve problems, or leave the patient with insufficient skills to manage pain. There are many different ways to approach pain management, and a balanced program is more effective than a singular approach. By consulting with a licensed pain physician to create a multidisciplinary program, the patient can take control of their body and learn to manage chronic pain in a healthy, effective way.

Physical therapy can find solutions to improve a patient’s quality of life through pain management strategies, and, in many cases, reduce pain. Therapy treatments may include:

Strengthening Exercises

Physical therapists can prescribe a program of graded exercises — movement that are gradually increased according to your abilities. They help improve conditioning and movement, reducing the stress and strain on the body.

Full story of chronic pain and physical therapy at Komo News

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Medical Edge: Daily routine a good first step for teen with chronic pain

Teen Deals with Chronic PainDEAR MAYO CLINIC: As the result of a sports injury, my 16-year-old daughter has chronic pain that has lasted for more than a year. It’s really taking a toll on her. The pain makes it hard for her to go to school and participate in the activities she enjoys. Medication doesn’t make much difference. What can we do? Is there a chance the pain will go away with time?

Your daughter’s pain may fade over time. While she has pain, though, it’s important for her to find ways to manage it. A cure may not be possible, but there are many strategies that can help her get back into life.

Pain usually comes from illness, injury or surgery, and it goes away as our bodies heal. This type of pain is called acute pain. Chronic pain is different. It is generally defined as daily pain that lasts more than three months. Chronic pain may continue after an injury or illness has passed. It may come from a medical condition that’s hard to treat. Sometimes chronic pain may not have any clear source.

Full story of teen with chronic pain at Post Bulletin

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Chronic Back Pain Cure Using Antibiotics May Help 40% Of Sufferers

Antibiotics Help Back PainChronic back pain is a condition that nobody would wish on even their worst enemy. Doctors and scientists have struggled to narrow down the root cause of many cases, prescribing dangerous surgery or pain killers that offer only fleeting relief.

Now two new studies out of Denmark and the UK are turning common conceptions about the causes of back pain on their heads.

Back pain specialists have known that bacterial infections could cause back pain, but the findings indicate that as much as 20 to 40 percent of all back pain could be cured with a course of antibiotics.

The first research paper analyzed the presence of bacteria in the slipped discs of patients who had suffered from intense pain and inflammation and thus undergone surgery. The researchers found that close to half of all samples tested positive for infection and, of all those with bacterial infections, 80 percent carried a specific bacterial species called Propionibacterium acnes.

Full story of chronic back pain at Medical Daily

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Chronic pain after trauma may be genetic

Chronic Pain After Trauma May be GeneticPersistent pain after a traumatic event like a car accident or sexual assault may have a neurological basis, new research suggests.

“Our study findings indicate that mechanisms influencing chronic pain development may be related to the stress response, rather than any specific injury caused by the traumatic event,” says Samuel McLean, assistant professor of anesthesiology at the University of North Carolina School of Medicine.

“In other words, our results suggest that in some individuals something goes wrong with the body’s ‘fight or flight’ response or the body’s recovery from this response, and persistent pain results.”

Published in the journal Pain, the study assessed the role of the hypothalamic-pituitary adrenal (HPA) axis, a physiologic system of central importance to the body’s response to stressful events.

Full story of chronic pain and trauma at Futurity

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