Diseases That Cause Pain – Michigan Spine & Pain

5 Common Causes of Hip Pain in Women

As with other types of chronic pain, women tend to experience hip pain more often than men. Yet, hip pain can have a number of different causes and determining the correct one is the key to getting the best treatment.

Getting a Hip Pain Diagnosis

When you tell your doctor your hip hurts, the first thing he should do is confirm that your hip is actually the problem. Women might say they have hip pain, but what they may mean is they’re having pain in the side of the upper thigh or upper buttock, or they may be experiencing lower back pain. Hip pain is often felt in the groin or on the outside of the hip, directly over where the hip joint (a ball-and-socket joint) is located.

Hip Pain Causes in Women

When a female patient comes to Michigan Spine and Pain complaining of hip pain, our clinicians and physiatrists consider the patient’s age, build and activity level. Depending on the patient’s weight, general physical fitness and health as well as age and other factors, the possibilities will be different.

Some of the most common causes of hip pain in women include:

Arthritis.

The most common cause of chronic hip pain in women is arthritis, particularly osteoarthritis — the wear-and-tear kind that affects many people as they age. The ball-and-socket joint starts to wear out. Arthritis pain is often felt in the front of your thigh or in the groin, due to stiffness or swelling in the joint.

Hip fractures.

Hip fractures are common in older women, especially those with osteoporosis (decreased bone density). Symptoms of a hip fracture include pain when you straighten, lift or stand on your leg. Also, the toes on your injured side will appear to turn out, a sign that can aid our preliminary diagnosis.

Tendinitis and Bursitis.

Many tendons around the hip connect the muscles to the joint. These tendons can easily become inflamed if you overuse them or participate in strenuous activities. One of the most common causes of tendinitis at the hip joint, especially in runners, is iliotibial band syndrome — the iliotibial band is the thick span of tissue that runs from the outer rim of your pelvis to the outside of your knee.

Hernia.

In the groin area, femoral and inguinal hernias — sometimes referred to as sports hernias — can cause anterior (frontal) hip pain in women. Pregnant women can be susceptible to inguinal hernias because of the added pressure on the wall of their abdomen.

Gynecological and Back Issues.

Hip pain in women can have gynecological causes and it’s important not to just assume the pain is caused by arthritis, bursitis or tendinitis. Depending on one’s age and other health issues, the pain in your hip could be coming from some other system.”

Treatment for hip pain depends on the diagnosis, but pain caused by overuse or sports injury is often treated with heat, rest and over-the-counter anti-inflammatory medication. To prevent injuries, it’s important to stretch before exercising and wear appropriate clothing, especially good shoes when running. Some causes of hip pain, such as fractures or hernias, may need surgical repairs. If your hip pain persists, come in and let’s discuss the possible causes and treatment options.

Panacea Alert: Glucosamine, Chondroitin and Fish Oil

The scientific research, however, isn’t as effusive as the marketing copy on the back of the bottles. Here, we look at the evidence for when these supplements might help — and other pain management strategies to consider.

Omega-3 Supplements

Research suggests that high doses of fish oil, or other sources of omega-3 fatty acids, may help for one particular type of joint pain: rheumatoid arthritis. But its effect on most other types of joint pain, including osteoarthritis, is unclear.

For example, Consumer Reports cited analysis in The Journal of Pain that looked at 17 randomized controlled clinical trials which concluded that people with rheumatoid arthritis who took 1.7 to 9.6 grams of fish oil a day reported less joint pain, tenderness and stiffness. The investigation also found that people who took more than 2.7 g per day reported a greater improvement in morning stiffness and painful or tender joints than those who took lower doses.

But taking fish oil isn’t risk-free. “Even at doses below three grams per day, fish oil can cause side effects, including upset stomach, diarrhea, and a tendency to burp,” writes Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser, adding that with every incremental increase in dosage taken “…the more likely [one is] to experience gastrointestinal problems.”

Another sticking point that is often acknowledged but also given short shrift: dietary supplements aren’t regulated by the Food and Drug Administration the same way prescription or over-the-counter medications are — so there’s no guarantee the fish oil listed on the label is what’s actually in the bottle, or that it’s high quality, or even that it’s safe to take. According to the American College of Rheumatology: “Some fish oil supplements may contain high levels of mercury or vitamin A, which could be toxic.”

Glucosamine and Chondroitin Supplements

A 2010 trial of 662 people with knee osteoarthritis published in the Annals of the Rheumatic Diseases did find that these supplements relieved pain for some people — but over time were no more effective than a placebo. More recently, a study of 1,625 people published in the journal Arthritis & Rheumatology in 2015 found that using glucosamine and chondroitin over a four year period did not relieve knee pain or prevent cartilage loss in people with osteoarthritis any better than a placebo. In addition, The American Academy of Orthopaedic Surgeons does not recommend either of these supplements for osteoarthritis of the knee.

Got Knee Pain? What to Do Instead…

One step is to lose weight. Research suggests that for every pound of excess weight you shed, it can take approximately 4 lbs. of pressure off the knees when walking. Additionally, strength training can help build up the muscles that support the affected joint. As well, gentle, low-impact exercise such as swimming and walking can relieve dull knee pain by keeping the joints flexible and lubricated. And, for flare-ups, try over-the-counter anti-inflammatory medications like ibuprofen or naproxen, if your medical provider agrees that this is safe and recommended for you.

If you are experiencing joint pain, we suggest a thorough for proper diagnosis. To schedule an appointment, contact Michigan Spine and Pain online or by calling (800) 586-7992.

The Sleep-Pain Paradox

It’s a problem.

People who suffer pain need restorative sleep, more than the general population. Yet, people in pain tend not to get enough restorative sleep. The 2015 Sleep Poll conducted by the National Sleep Foundation says that 23% of chronic pain sufferers say they have been diagnosed with a sleep disorder.

It’s important for pain sufferers to take control of their sleep as if it were a high priority project. Pain sufferers need sleep in order to function in their already somewhat compromised state. So, here are some reminders:

Try to sleep for at least eight hours per night, not too much more and not too much less. If it takes you a long time to fall asleep, you need to create a sleep schedule that gets you into bed for more than eight hours to allow for that extra “sleep prep” time.
Regarding too much sleep: it is a real thing. Pain sufferers benefit greatly from daily physical activity and too much bedrest contributes to poor circulation, weight control issues, and even more pain.
Some people find naps restorative. If you must take a nap, limit the nap to 30 minutes. Make sure your nap is at least six hours prior to your scheduled bedtime.
In addition to scheduling your sleep, schedule your physical activity with a goal of 30 minutes of stretching, cardiovascular or weight-bearing exercises daily. Avoid exercising just before bedtime.
All days are equal. You need to have a sleep routine on Tuesday night and on Saturday night that allows for eight hours of sleep. Weekends are a great opportunity to catch up on sleep, but overdoing socializing or overscheduling is a missed opportunity. In addition, oversleeping is a mistake, too.
Eat dinner at least two to three hours before bedtime.
If caffeine affects your sleep, avoid it after 12:00 noon. If you can, wean yourself from caffeine altogether.
Avoid alcohol use or limit your intake to one drink in the evening.
Remove all screens from the bedroom. From the TV to your smartphone, the temptation is too great to keep watching, keep reading or keep texting. Better to read in bed or do crosswords than have a screen to stimulate your brain and visual cortex and prevent deep sleep.
See a sleep specialist if you consistently cannot obtain restorative sleep to rule out sleep apnea and other sleep disturbances.

Getting enough sleep is as important as pain treatment. It is a lifestyle decision that only you can control.

September is Pain Awareness Month

If you are reading this, you may already be WELL AWARE of pain.

Pain Awareness Month, truthfully, is directed at the general public and all of the health care providers, as well as family members of those who suffer from pain.

The messages of Pain Awareness Month:

The Cost of Pain:

Did you know that chronic pain affects 100 million Americans, more than cancer and heart disease combined?
Chronic pain is a leading cause of employee absenteeism.

The Impact of Pain on Quality of Life:

Pain can adversely impact a person, and limit their ability to work, to socialize and to form and maintain good relationships with family and friends.
Pain sufferers also report poor sleep, which exacerbates their pain and ability to function.
Pain and depression often co-exist.
Pain and anxiety can also co-exist.

Not Everybody Understands Pain:

Many health care providers “don’t get” pain, underestimating its intensity or impact.
Prescription pain management and proper use of prescription medication complicates the treatment of pain.

Ways to celebrate this month:

Share your pain story with others. Tell those who don’t understand pain how you cope, what works and what your struggles are. Your goal is to educate those around you about this seemingly invisible illness. Make it visible!
Take time to take care of yourself. Lead your friends and neighbors in a restorative walk. Host a healthy potluck. Get together with pain sufferers and non-pain sufferers to share how you get through tough times.
Take time to learn, taking advantage of resources on our website as well as with our knowledgeable staff. We can recommend lots of websites, books and magazines that we trust.

You are more than your pain. But your pain deserves to be acknowledged and treated.

Not Tonight, I Have a Headache

Your headache is truly a pain. Perhaps your head is throbbing, or maybe there is a sharp pain. Maybe your headache improves when you lie down

Knowing what kind of headache you have matters.

Different headaches respond to different treatments.

The first question about your headache is, “Do I have a primary or a secondary headache?”

Secondary headaches are headaches that are caused by other disease processes, some relatively minor (dehydration, sinus infection, ear infection, flu); some quite serious (encephalitis, aneurysm, stroke). Your health care provider would need to evaluate your symptoms and examine you in person to rule out more serious ailments.

Primary headaches are headaches where the major illness is the headache. For some reason, there is overstimulation of the pain-sensitive structures in your head.

The most common primary headaches are:

Cluster Headaches (can involve any part of the head, usually consists of sharp, stabbing pain, can be debilitating)
Migraine Headaches (typically starts as a dull pain, but then worsens, can involve any part of the head, often includes light sensitivity and nausea)
Tension Headaches (typically a dull ache or pain, most often in the front of the head)

Primary headaches can be caused or exacerbated by the following:

Poor or insufficient sleep
Insufficient hydration
Hunger
Eating certain trigger foods
Alcohol use or abuse
Extended periods of discomfort, including poor positioning, strain, excessive work or exercise
Stress

Primary headaches can be treated with over the counter medications, a variety of prescription medications, biofeedback, physical therapy, complementary medicine, and relaxation techniques.

In order to get relief from your headache, it is critical to narrow down the type of headache you are experiencing.

Why is Fibromyalgia So Hard to Diagnose?

Fibromyalgia is a complex, chronic health problem. Its chief symptoms are pain or tenderness, especially a tenderness or soreness that is made worse when touched. Fibromyalgia is also indicated when fatigue, poor sleep, memory and cognition issues (often called “Fibro-Fog”) and severe moods are present.

Other symptoms can include headaches (tension and migraine), digestive issues, pelvic pain, jaw or face pain as well as depression and anxiety.

Fibromyalgia can be tricky to diagnose.

Typically, patients who experience fibromyalgia have symptoms that can have multiple causes. To make things even trickier, there is no fibromyalgia test. Frequently, diagnostic tests will be ordered to ensure that other diseases or injuries are not the cause of the symptoms. These could include x-rays and scans such as MRI and CT scans.

In addition, there is not even a single “cause” of fibromyalgia. It has not been found in gene studies, but it may run in families. For many patients, there are triggers to fibromyalgia. These can include injuries or other diseases, or even stress. For other patients, there appear to be no significant triggers.

Doctors will ask you where you are feeling pain, will ask you to describe the pain’s intensity and will often touch or palpate parts of your body to see how your body responds to slight pressure and touching. Doctors will also want to know how long you have been experiencing the major symptoms (pain, fatigue, mood disorders and cognitive issues); typically a 3 months’ duration is necessary before a fibromyalgia diagnosis can be reached.

Fibromyalgia pain needs to occur on both the left side and the right side of the body and should also not be isolated to one small area.

Physicians have to rule out a whole host of other diseases before definitively diagnosing fibromyalgia. As a result, many physicians are still hesitant to diagnose fibromyalgia.

Leg Cramps in the Middle of the Night: Causes and Cures

If you’ve ever experienced painful leg cramps in the middle of the night, you know they hurt! Waking up with shooting pains, typically in the calf, sometimes in the feet or even thighs can be scary and certainly interrupts needed sleep. Most of the time leg cramps are not a major cause for concern. But leg cramps that cause significant sleep disruption or cause lasting pain warrant a trip to the doctor. Consult your health care provider regarding your leg cramps and follow their advice.

What causes nocturnal leg cramps?

One answer (not so popular) is that we do not always know, but here are a few major culprits of nocturnal leg cramps:

Long periods of inactivity
Muscle tiredness or overexertion
Adults over age 50 are at highest risk for leg cramps.
Pregnancy
Dehydration
Diabetes (especially for those who have diabetic neuropathy)
A variety of diseases: Parkinson’s Disease, multiple sclerosis, kidney diseases, thyroid abnormalities
Exposure to cold temperatures, especially cold water
Certain medications are implicated including medications for COPD, blood pressure, coronary artery disease, congestive heart failure, high cholesterol, anti-psychotic medication, birth control, migraine headache treatments and diuretics.
Insufficient potassium and/or calcium
Sleeping in certain positions

What can you do when spasms occur?

Sometimes, in the middle of a leg cramp, it’s hard to keep your wits about you, but try these:

Stretch the muscle right away: walk it off, flex your toes or do gentle knee bends.
Warm showers or baths can provide relief if the area is still achy.
Massaging the area of the cramp can also provide relief.
Applying a heating pad to the affected area can also help.

What can you do to try to prevent nocturnal leg cramps?

Stretch your legs before you go to sleep. Avoid pointing the toes, but do flex the feet gently several times.
If you happen to own a stationary bike, 5-10 minutes of gentle biking just before bedtime appear to stave off cramps.
Before you go bed, untuck all of the bedclothes, so they are nice and loose.
Drink plenty of water (more than you think you need) throughout the day. Dehydration is a fairly common cause of leg cramps.
Some health care providers also recommend supplementing with sports drinks that contain potassium.

MRI’s and the Origins of Physical and Emotional Pain

Most of us, having made it to this point in our lives, have experienced both physical and emotional pain. Pain hurts. No big news bulletin there…Doctors of physical pain medicine as well as neurologists, psychiatrists and psychologists have long wondered about the similarities and differences between physical and emotional pain and how the human body copes with both types of pain.

Current research suggests that physical pain and emotional pain from, for example, rejection share common neural mechanisms. This means that emotional pain can actually be quantified and characterized along with actual physical pain. These commonalities can actually be visualized through the use of magnetic resonance imaging (MRI) technology. Some of these theories are beginning to be challenged and investigated more thoroughly. Luckily for all of us, researchers are engaged in discovering how our brains process and react to pain.

Here are a few articles to look at if you are interested in learning more about this subject in depth:

Separate Neural Representations for Physical Pain and Social Rejection: www.nature.com/ncomms/2014/141117/ncomms6380/full/ncomms6380.html
*Response of the μ-opioid System to Social Rejection and Acceptance: www.nature.com/mp/journal/v18/n11/full/mp201396a.html#close
*The Pain of Social Disconnection: Examining the Shared Neural Underpinnings of Physical and Social pain: www.nature.com/nrn/journal/v13/n6/full/nrn3231.html

*There is a small cost associated with downloading and/or printing these two articles if you are not already a registered subscriber to the journals Nature Reviews Neuroscience, or Molecular Psychiatry.

Osteoporosis: What Women AND MEN Need to Know, Part I

Lots of people assume that as you age, your bones have to deteriorate. In fact, this isn’t the case. You can do a lot to prevent the onset of osteoporosis. Even after diagnosis, you can take positive steps to improve your bone health.

A note for men: A recent study out of Beth Israel Deaconess Medical Center indicates that men are not screened adequately for bone loss and osteoporosis. As a result, there are lots of older men with significant risk for fractures who are not aware of their high risk.

The best ways to combat osteoporosis include dietary management, exercise, and reducing harmful behavior. Today, we are going to focus on dietary intake of vitamins and minerals.

Getting enough Calcium: Calcium, an essential mineral, is a builder of bones and its presence also keeps our bones in optimum condition. Our body does not naturally replace calcium, so we have to replenish our calcium supply daily. Do you get enough calcium? Women need more than men, and everybody has to increase their calcium intake as we age. You should attempt to get most of your calcium from the food you eat, and only use a supplement to make up the shortfall. There are no risks to eating the required amount of calcium, but there are some side effects from calcium supplements. Consult with your health care provider regarding your recommended calcium intake.

Daily Calcium Needs

Women 50 years and younger: 1,000 mg/day

Women 51 years and older: 1,200 mg/day

Men 70 years and younger: 1,000 mg/day

Men 71 years and older: 1,200 mg/day

Getting enough Vitamin D: Vitamin D allows your body to absorb calcium. Some of the foods which contain calcium also contain Vitamin D, but it is difficult to get all of the required Vitamin D through food alone. Sunlight also aids in production of Vitamin D, but those who live in cloudy locales or who apply sunscreen to prevent skin cancer don’t get the Vitamin D through the sunlight. For most people, a Vitamin D supplement is necessary. You should take a supplement that covers the shortfall of Vitamin D that you don’t take in with food. Consult with your health care provider regarding your appropriate Vitamin D requirement.

Daily Vitamin D Requirements

Women and Men under Age 50: 400-800 International Units/Day

Women and Men, Age 51 and Older: 800-1,000 International Units/Day

What A Pain! Changes in the Weather and Your Arthritis

For those who suffer from arthritis, the variable fall temperatures bring beautiful skies, gorgeous leaves…and sometimes pain.

You might be surprised to know that scientists are extremely skeptical about what changes the weather actually brings to those who deal with pain. We all know arthritic patients who swear that they “feel it in their bones” when there are changes in the humidity or drops in temperature. Yet, there is no concrete evidence that changes in the weather truly create measurable physical changes in our bodies.

But, if a person sees those looming storm clouds or watches the Weather Channel’s forecasts for dipping temperatures, there may be a psychological component to their experiences of low temperature weather pain. If a person has previously felt increased arthritic symptoms in the cold weather, then the brain may be sending a message to their body to prepare for more pain. This could, in turn, “excite” the pain nerve receptors, thereby activating them.

Even if we can’t find a reason for more symptoms during cold weather months, we still have to treat the pain. So, all pain patients should be aware of the following steps that can lessen pain:

Changes in medication might be necessary. This might mean actually changing the class of medication that is being used to treat your pain or it could mean changing the dosage.

Staying warm is also key, so that your mind and your body don’t feel exposed to cold. Make preparations before you hit the outside morning air. Be sure you are fully bundled up; don’t wait to zip up after you’ve already walked out the door. Try to warm up the car ahead of time (or get somebody else to start the car for you), if your car is kept outside. Dress in layers so that you feel toasty, but not sweaty. You can always remove layers if you warm up throughout the day.

Concentrate on reducing swelling in affected joints. Osteoarthritis is essentially swelling in the joints. Anything you can do to decrease the swelling will decrease the pain. Unfortunately, heat does not decrease swelling. But there are other methods: gloves and splints worn on swollen hands can bring down the swelling.

Exercise and movement are essential. It may seem counterintuitive; if you are feeling pain, you may want to go back to bed or to become totally sedentary. In fact, this is absolutely the wrong way to go. Regular, gentle, fluid motion does keep arthritis pain at bay. Water aerobics, light walking, stretching, yoga and other activities can be helpful. Activities that have a social component also can combat the depression that may accompany chronic pain.

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