Treatments for pain Archives - Page 2 of 2

Which Pain Reliever Should You Take?

If you are like us, you have a variety of over the counter (OTC) pain relievers stashed in a variety of places: your medicine cabinet, your purse, your office desk, and even in your car. You may rely on your favorite OTC to knock out that impending headache or that recurring muscle pain.

These OTC’s include aspirin, acetaminophen (Tyelonol), ibuprofen or naproxen. Naproxen and ibuprofen are part of a class of drugs called NSAIDs (non-steroidal anti-inflammatory drugs).

The question you need to ask yourself (and your health care team!) is this:

What is the safest OTC pain reliever?

The answer is: It depends.

We know you might hate answers like that, but it’s true. So what are the factors in determining the safest pain reliever?

Your overall health condition. If you have diabetes or impaired kidney function, the NSAIDs may not the best choice. The same is true if you have digestive disorders, as NSAIDs can upset the stomach or even cause ulcers. And the most recent research indicates that NSAIDs are not recommended following heart bypass surgery. On the other hand, acetaminophen should be avoided if you have any liver diseases.
What ails you? In general, acetaminophen is the “gentlest” of the OTC’s, and it can be effective for lowering fevers and for general aches. Because acetaminophen combines effectiveness with lower risks, it is typically recommended for both children and the elderly who are running a fever. However, most people prefer NSAIDs for menstrual cramps or muscular aches.
What other drugs do you take? OTC’s interact in a variety of ways with other drugs, sometimes adversely. Your doctor and pharmacist are your best resources for devising a regimen to deal with a whole host of pain incidents.

Always follow the dosing instructions exactly when taking OTC pain relievers and take the smallest dosage that is effective for you. Always take medication under the guidance of your physician and be sure your health care team is aware of your entire health history, including your current diagnoses and medications.

You may want to refer to our earlier blog which includes an OTC comparison chart.

The Balancing Act

Having good balance is critical. You need good balance to function efficiently and safely. Sometimes injury and disease processes can impair balance.

There are two kinds of balance: static balance and dynamic balance. Static balance is your ability to stay upright and in good position while staying still. Dynamic balance is your ability to maintain proper balance and form while moving around (walking, exercising, transitioning from sitting to standing).

All adults, young and old, can benefit from exercises that work on strengthening and improving balance. Older adults, in particular, should tackle balance-increasing activities as they can help to prevent falls, which can be harmful or even fatal for seniors, and can lead to loss of independence and mobility. Balance issues can also impair athletic performance and daily living skills for all people, regardless of age.

Consider incorporating exercises into your routine that address endurance, strength, balance and coordination. Here are a few suggestions:

Sitting down and standing up without using your hands for support
Standing on one foot (you can do this holding on to something or not)
Walking on a line (or if advanced, a balance beam). To do this, you need to walk with one foot directly in front of another. You can hold on to a friend or a wall for support, if necessary, but try to progress to doing it unaided.
Leg Raises: Stand alone or behind a chair. Lift one leg at a time, first to the side and then to the back. Switch legs. (You can even do this while standing in line…ignore the stares of the other people, they are imbalanced.)
Tai chi is a slow, deliberate series of movies that emphasizes balance and gentle stretching.
Certain beginning yoga and Pilates moves also incorporate balance, but they often require strength. Your pain level may or may not allow these more involved calisthenics.

Please check with your health care team before embarking on any exercise program.

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.

Meditation and its Health Benefits

We admit that we are guilty of not taking time away from our busy days to be intentionally quiet, what many would call “meditating”. Call it what you will; approach it religiously or secularly. The data is in and it is irrefutable: regular quiet meditation is beneficial to your physical and mental well being. We love this infographic, courtesy of Huffington Post:

Test Anxiety: What are all these Scans?

There are so many medical procedures to help evaluate all kinds of acute and chronic conditions. What exactly are these scans and how do they differ? We help break it down for you:

X-Ray: The x-ray has been around for a long time. Other than exposing you to a bit of radiation, the x-ray procedure is non-invasive and should not produce much pain, other than perhaps having to get into a certain position and hold still. X-rays are typically used to show bones and therefore fractures. Chest x-rays, however, also can show diseases of the lungs.

CT Scan (also known as CAT Scan) which stands for computed tomography works very much like an x-ray in terms of emitting beams of energy at the body. However the CT scan takes these “slices” of images while moving around the body. Then, using computer technology, these slices are assembled, creating a more detailed 3D image on a computer monitor. CT scans should be relatively painless, other than having to remain still. CT scans are quite effective in diagnosing serious injuries to the head, chest, spine and abdomen as well as discovering tumors. CT scans are also useful in diagnosing kidney stones.

CT Scan with Contrast: There are times when a physician needs to examine a particular organ or tissue area and will order a CT scan with contrast. This test requires the patient to either ingest by mouth or be injected intravenously with a dye. As the dye moves through the tissue or organ, the radiologist can often see blockages and other issues. Sometimes these scans require that the patient fast ahead of time. Some patients have an allergy to the contrast dye. CT scans with contrast are also not suitable for patients with kidney disease. In addition, diabetics who take metformin or Glucophage have to stop taking the medication after the dye has been introduced for a few days. Some patients experience unpleasant side effects after taking in the contrast dye, including nausea, a metallic taste, headache and flushing.

MRI: Magnetic Resonance Imaging, unlike X-rays and CT scans, utilizes radio waves and powerful magnets to create a three dimensional image. MRI scans take a little longer than CT scans. MRI’s are quite effective in diagnosing issues in soft tissue, joints, tendons, muscles and ligaments. MRI’s are often utilized to evaluate the spine, neck, brain, breast and abdomen. MRI’s are more enclosed than CT machines and may induce a type of claustrophobia. There are open MRI’s which can be utilized if your insurance covers that. In addition, sedatives or anti-anxiety medications may lessen the closed-in feeling. Patients should avoid eating or drinking prior to the exam, particularly any food or drink that contains caffeine.

PET Scan: Positron Emission Tomography utilizes a radioactive substance that has been administered to the patient. The PET scan then looks for the particles emitted from the substance within the body. PET scans are used to look for the location of cancerous areas as well as to track any spread of cancer. A PET scan is also useful in cardiac care as well as in neurologic diagnoses. Patients need to drink water prior to a PET scan, but cannot eat for four hours prior to the scan. The radioactive substance will be administered through an intravenous line. PET scans take longer than both CT and MRI scans as you will have to remain relatively quiet and still after the IV starts, but before the scan can begin. The major discomforts of the PET scan include the administration of the IV, having to stay still and being in a closed machine.

It’s a Matter of Trust: Responsible Use of Pain Relief Medication

One of the tools in our arsenal for combating pain issues is a large variety of pain medications.

We prescribe medication to our patients as part of a comprehensive pain management approach, along with other therapeutic treatment, like physical therapy, chiropractic treatment, massage therapy, social and psychological services and acupuncture.

Many times our patients’ pain level is reduced significantly with over-the-counter pain relievers. Over-the-counter drugs are a great option, as they tend to be inexpensive and widely available. However, even over-the-counter pain relief needs management as they are not without side effects.

When over-the-counter analgesics are not effective, we often turn to different classes of prescription pain medications. Unfortunately, certain pain medications can become addictive. Addiction to pain medication ultimately negates the positive aspects of pain relief.

At Michigan Spine & Pain, we are committed to responsible medication use. The way to accomplish this is through honest partnership with our patients as well as the pharmacists in our community.

Our goals are simple:

We want our patients to have access to effective medication which relieves acute and chronic pain.
We want to be responsible members of the health care community, ensuring that our patients utilize the medications in the manner they are prescribed and only in the prescribed amounts.

We are conservative in prescribing pain relief medication, working first to make sure other modalities aren’t effective on their own. We also rely on our patients’ truthful input, telling us how much pain they are in, how effective various pain relief treatments are as well as what side effects, if any, they are experiencing.

There is no one size-fits all solution for pain. All pain relief requires a team approach. An integral component of that team approach is the relationship between the patients and the members of the health care providers.

Results of New Pain Study are Alarming

Chronic pain patients, in order to manage their pain, use a combination of therapies and medications. Opioids are a class of drugs often utilized by chronic pain patients.

Opioids are synthetic narcotics that bind to opioid receptors in the body, causing a reduction in the sending of pain messages and subsequently reducing pain. Opioids are often prescribed when other pain medications do not adequately control moderate or severe pain.

Different types of opioid medications include forms of codeine, hydrocodone, morphine, fentanyl, hydromorphone, miperidine, methadone, oxycodone and naloxone.

The majority of pain patients take prescribed opioids appropriately and do not become addicted or misuse the drugs. But many chronic pain patients also struggle with opioid addiction (and subsequent withdrawal) as well as improper usage of opioid medication.

The April issue of the journal Pain, which is published by the International Association for the Study of Pain, determined two significant and disturbing statistics:

20-30% of opioids prescribed for chronic pain are being misused.
10% of chronic pain sufferers are addicted to opioid medication.

The study defined “misuse” as utilization of the medication in a way that was contrary to the prescribed use, including to cause a euphoria or high sensation, altering one’s consciousness in order to sleep or zone out, as well as abusive usage like taking more than the prescribed amount of medication or crushing and snorting the drugs.

The study did not address the issue of opioid tolerance, which occurs when a patient needs higher and higher dosages of opioids in order to continue to manage pain effectively.

Opioid abuse and addiction can be fatal. In 2013, there were 16,235 deaths involving prescription opioids in the United States, according to the Centers for Disease Control. This was an increase over the previous year.

Physicians, patients, patients’ families and state and federal government are all concerned about these statistics. Doctors are working to monitor prescriptions and to look out for patterns of abuse and addiction. Michigan requires tracking of prescriptions for controlled substances, which is why many doctors and pharmacists will not use electronic prescriptions for these classes of drugs.

For the majority of pain patients who use opioids responsibly and appropriately, they may feel the pressure of increased surveillance by pharmacists and doctors. This should not be perceived as intrusive, but as protective.

Honest communication between doctors and patients about medication usage, continued monitoring of opioid use and effectiveness and an openness among patients who wish to be pain-free but are aware of the dangers of opioid addiction and abuse are helpful in managing pain relief without the unwanted consequences of opioid abuse.

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Which Pain Reliever Should You Take?

The Balancing Act

Not Tonight, I Have a Headache

Meditation and its Health Benefits

Test Anxiety: What are all these Scans?

It’s a Matter of Trust: Responsible Use of Pain Relief Medication

Results of New Pain Study are Alarming

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