Posts Tagged ‘pregnancy’

Simple in Home Remedy to Backpain

April 20th, 2010

Back­ache is defined as mild to severe pain or dis­com­fort in the area of the lower back. The pain can be acute (sud­den and severe) or chronic if it has lasted more than three months. It often occurs in younger peo­ple whose work involves phys­i­cal effort and in peo­ple of retire­ment age. It is one of the most com­mon ail­ments of mankind. It can also be defined as a degen­er­a­tive dis­or­der in which the ver­te­bral bone or the inter ver­te­bral disc becomes soft and loses shape. As a result the spine loses its flex­i­bil­ity caus­ing acute pain in the back. Women are very vul­ner­a­ble to back pain dur­ing preg­nancy. This is because dur­ing preg­nancy there is stretch­ing of the lig­a­ments around the uterus and pres­sure on the lower back.

Nature Cre­ation is offer­ing many options to min­i­mize your pains with­out side effects. Nature Cre­ation back/ abdomen pack is a per­fect choice for peo­ple who pre­fer sim­ple and con­ve­nience nat­ural ther­apy at home. This pack con­tains 9 essen­tial nat­ural herbs, which are known to have nat­ural heal­ing for­mula built-in the essence. Just heat the pack for approx­i­mately 1 1/2 to 2 min­utes in microwave and apply it to the pain area. The heat may last 15 min­utes or so to pen­e­trate deep into the mus­cles. The users will instantly feel the rem­edy and soak in great relief of pain.

If you like big­ger or wider design, there is Nature Cre­ation Spine/ Back pack. They lay­out of this prod­uct is sim­i­lar to Nature Cre­ation Back/ Abdomen pack. How­ever, it has 5 lay­ers of tub­ing, instead of 3 tub­ing in the back/ abdomen pack. These extra tub­ing extend the cov­er­age up to 4 1/2 inches. It is per­fect for peo­ple who have wide body or like to extend the treat­ments to the spine back area.

There are five dif­fer­ent col­ors to choose from, which include black, blue, green, pur­ple and red. Every Nature Cre­ation prod­uct is cov­ered by 1-year crafts­man­ship war­ranty. If you find any defects or imper­fec­tion on the sewing or mate­ri­als, just con­tact our cus­tomer ser­vice hot-line at 1–888-250‑2010.

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Frequently Asked Questions — Mammogram

February 12th, 2010
mammogram

mam­mo­gram


What is a mammogram?

A mam­mo­gram is a safe, low-dose x-ray exam of the breasts to look for changes that are not nor­mal. The results are recorded on x-ray film or directly into a com­puter for a doc­tor called a radi­ol­o­gist to examine.

A mam­mo­gram allows the doc­tor to have a closer look for changes in breast tis­sue that can­not be felt dur­ing a breast exam. It is used for women who have no breast com­plaints and for women who have breast symp­toms, such as a change in the shape or size of a breast, a lump, nip­ple dis­charge, or pain. Breast changes occur in almost all women. In fact, most of these changes are not can­cer and are called “benign,” but only a doc­tor can know for sure. Breast changes can also hap­pen monthly, due to your men­strual period.

What is the best method of detect­ing breast can­cer as early as possible?

A mam­mo­gram plus a clin­i­cal breast exam, an exam done by your doc­tor, is the most effec­tive way to detect breast can­cer early. Find­ing breast can­cer early greatly improves a woman’s chances for suc­cess­ful treatment.

Like any test, mam­mo­grams have both ben­e­fits and lim­i­ta­tions. For exam­ple, some can­cers can’t be found by a mam­mo­gram, but they may be found in a clin­i­cal breast exam.

Check­ing your own breasts for lumps or other changes is called a breast self-exam (BSE). Stud­ies so far have not shown that BSE alone helps reduce the num­ber of deaths from breast can­cer. BSE should not take the place of rou­tine clin­i­cal breast exams and mammograms.

If you choose to do BSE, remem­ber that breast changes can occur because of preg­nancy, aging, menopause, men­strual cycles, or from tak­ing birth con­trol pills or other hor­mones. It is nor­mal for breasts to feel a lit­tle lumpy and uneven. Also, it is com­mon for breasts to be swollen and ten­der right before or dur­ing a men­strual period. If you notice any unusual changes in your breasts, con­tact your doctor.

How is a mam­mo­gram done?

You stand in front of a spe­cial x-ray machine. The per­son who takes the x-rays, called a radi­o­logic tech­ni­cian, places your breasts, one at a time, between an x-ray plate and a plas­tic plate. These plates are attached to the mam­mo­gram machine and com­press the breasts to flat­ten them. This spreads the breast tis­sue out to obtain a clearer pic­ture. You will feel pres­sure on your breast for a few sec­onds. It may cause you some dis­com­fort; you might feel squeezed or pinched. This feel­ing only lasts for a few sec­onds, and the flat­ter your breast, the bet­ter the pic­ture. Most often, two pic­tures are taken of each breast — one from the side and one from above. A screen­ing mam­mo­gram takes about 20 min­utes from start to finish.

Are there dif­fer­ent types of mammograms?

  • Screen­ing mam­mo­grams are done for women who have no symp­toms of breast can­cer. It usu­ally involves two x-rays of each breast. Screen­ing mam­mo­grams can detect lumps or tumors that can­not be felt. They can also find micro­cal­ci­fi­ca­tions (my-kro-kal-si-fi-KAY-shuns) or tiny deposits of cal­cium in the breast, which some­times mean that breast can­cer is present.
  • Diag­nos­tic mam­mo­grams are used to check for breast can­cer after a lump or other symp­tom or sign of breast can­cer has been found. Signs of breast can­cer may include pain, thick­ened skin on the breast, nip­ple dis­charge, or a change in breast size or shape. This type of mam­mo­gram also can be used to find out more about breast changes found on a screen­ing mam­mo­gram, or to view breast tis­sue that is hard to see on a screen­ing mam­mo­gram. A diag­nos­tic mam­mo­gram takes longer than a screen­ing mam­mo­gram because it involves more x-rays in order to obtain views of the breast from sev­eral angles. The tech­ni­cian can mag­nify a prob­lem area to make a more detailed pic­ture, which helps the doc­tor make a cor­rect diagnosis.

A dig­i­tal mam­mo­gram also uses x-ray radi­a­tion to pro­duce an image of the breast, but instead of stor­ing the image directly on film, it stores the image of the breast directly on a com­puter. This allows the recorded data to be mag­ni­fied for the doc­tor to take a closer look. Cur­rent research has not shown that dig­i­tal images are bet­ter at show­ing can­cer than x-ray film images in gen­eral. But, women with dense breasts who are pre– or per­i­menopausal, or who are younger than age 50, may ben­e­fit from hav­ing a dig­i­tal rather than a film mam­mo­gram. Dig­i­tal mam­mog­ra­phy may offer these benefits:

  • Long-distance con­sults with other doc­tors may be eas­ier because the images can be shared by computer.
  • Slight dif­fer­ences between nor­mal and abnor­mal tis­sues may be eas­ily noted.
  • The num­ber of follow-up tests needed may be fewer.
  • Fewer repeat images may be needed, reduc­ing expo­sure to radiation.

How often should I get a mammogram?

  • Women 40 years and older should get a mam­mo­gram every 1–2 years.
  • Women who have had breast can­cer or other breast prob­lems or who have a fam­ily his­tory of breast can­cer might need to start get­ting mam­mo­grams before age 40, or they might need to get them more often. Talk to your doc­tor about when to start and how often you should have a mammogram.

What can mam­mo­grams show?

The radi­ol­o­gist will look at your x-rays for breast changes that do not look nor­mal and for dif­fer­ences in each breast. He or she will com­pare your past mam­mo­grams with your most recent one to check for changes. The doc­tor will also look for lumps and calcifications.

  • Lump or mass. The size, shape, and edges of a lump some­times can give doc­tors infor­ma­tion about whether or not it may be can­cer. On a mam­mo­gram, a growth that is benign often looks smooth and round with a clear, defined edge. Breast can­cer often has a jagged out­line and an irreg­u­lar shape.
  • Cal­ci­fi­ca­tion. A cal­ci­fi­ca­tion is a deposit of the min­eral cal­cium in the breast tis­sue. Cal­ci­fi­ca­tions appear as small white spots on a mam­mo­gram. There are two types:
    • Macro­cal­ci­fi­ca­tions are large cal­cium deposits often caused by aging. These usu­ally are not a sign of cancer.
    • Micro­cal­ci­fi­ca­tions are tiny specks of cal­cium that may be found in an area of rapidly divid­ing cells.

If cal­ci­fi­ca­tions are grouped together in a cer­tain way, it may be a sign of can­cer. Depend­ing on how many cal­cium specks you have, how big they are, and what they look like, your doc­tor may sug­gest that you have other tests. Cal­cium in the diet does not cre­ate cal­cium deposits, or cal­ci­fi­ca­tions, in the breast.

What if my screen­ing mam­mo­gram shows a problem?

If you have a screen­ing test result that sug­gests can­cer, your doc­tor must find out whether it is due to can­cer or to some other cause. Your doc­tor may ask about your per­sonal and fam­ily med­ical his­tory. You may have a phys­i­cal exam. Your doc­tor also may order some of these tests:

  • Diag­nos­tic mam­mo­gram, to focus on a spe­cific area of the breast
  • Ultra­sound, or imag­ing test that uses a device with sound waves to cre­ate a pic­ture of your breast. The pic­tures may show whether a lump is solid or filled with fluid. A cyst is a fluid-filled sac. Cysts are not can­cer. But a solid mass may be can­cer. After the test, your doc­tor can store the pic­tures on video or print them out. This exam may be used along with a mammogram.
  • Mag­netic res­o­nance imag­ing (MRI), which uses a pow­er­ful mag­net linked to a com­puter. MRI makes detailed pic­tures of breast tis­sue. Your doc­tor can view these pic­tures on a mon­i­tor or print them on film. MRI may be used along with a mammogram.
  • Biopsy, a test in which fluid or tis­sue is removed from your breast to help find out if there is can­cer. Your doc­tor may refer you to a sur­geon or to a doc­tor who is an expert in breast dis­ease for a biopsy.

Where can I get a high-quality mammogram?

Women can get high qual­ity mam­mo­grams in breast clin­ics, hos­pi­tal radi­ol­ogy depart­ments, mobile vans, pri­vate radi­ol­ogy offices, and doc­tors’ offices. The Food and Drug Admin­is­tra­tion (FDA) cer­ti­fies mam­mog­ra­phy facil­i­ties that meet strict qual­ity stan­dards for their x-ray machines and staff and are inspected every year. You can ask your doc­tor or the staff at the mam­mog­ra­phy cen­ter about FDA cer­ti­fi­ca­tion before mak­ing your appoint­ment. A list of FDA-certified facil­i­ties can be found on the Inter­net at: http://www.fda.gov/cdrh/mammography/certified.html.

Your doc­tor, local med­ical clinic, or local or state health depart­ment can tell you where to get no-cost or low-cost mam­mo­grams. You can also call the National Can­cer Institute’s Can­cer Infor­ma­tion Ser­vice toll free at 1–800-422‑6237 (TTY: 1–800-332‑8615). Visit them online at http://www.cancer.gov.

What if I have breast implants?

Women with breast implants should con­tinue to have mam­mo­grams. A woman who had an implant after breast can­cer surgery should ask her doc­tor whether she needs a mam­mo­gram of the recon­structed breast.

If you have breast implants, be sure to tell your mam­mog­ra­phy facil­ity that you have them when you make your appoint­ment. The tech­ni­cian and radi­ol­o­gist must be expe­ri­enced in x-raying patients with breast implants. Implants can hide some breast tis­sue, mak­ing it harder for the radi­ol­o­gist to see a prob­lem when look­ing at your mam­mo­gram. To see as much breast tis­sue as pos­si­ble, the x-ray tech­ni­cian will gen­tly lift the breast tis­sue slightly away from the implant and take extra pic­tures of the breasts.

How do I get ready for my mammogram?

First, check with the place you are hav­ing the mam­mo­gram for any spe­cial instruc­tions you may need to fol­low before you go. Here are some gen­eral guide­lines to follow:

  • If you are still hav­ing men­strual peri­ods, try to avoid mak­ing your mam­mo­gram appoint­ment dur­ing the week before your period. Your breasts will be less ten­der and swollen. The mam­mo­gram will hurt less and the pic­ture will be better. 
  • If you have breast implants, be sure to tell your mam­mog­ra­phy facil­ity that you have them when you make your appointment.
  • Wear a shirt with shorts, pants, or a skirt. This way, you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.
  • Don’t wear any deodor­ant, per­fume, lotion, or pow­der under your arms or on your breasts on the day of your mam­mo­gram appoint­ment. These things can make shad­ows show up on your mammogram.
  • If you have had mam­mo­grams at another facil­ity, have those x-ray films sent to the new facil­ity so that they can be com­pared to the new films.

Are there any prob­lems with mammograms?

Although they are not per­fect, mam­mo­grams are the best method to find breast changes. If your mam­mo­gram shows a breast change, some­times other tests are needed to bet­ter under­stand it. Even if the doc­tor sees some­thing on the mam­mo­gram, it does not mean it is cancer.

As with any med­ical test, mam­mo­grams have lim­its. These lim­its include:

  • They are only part of a com­plete breast exam. Your doc­tor also should do a clin­i­cal breast exam. If your mam­mo­gram finds some­thing abnor­mal, your doc­tor will order other tests.
  • Find­ing can­cer does not always mean sav­ing lives. Even though mam­mog­ra­phy can detect tumors that can­not be felt, find­ing a small tumor does not always mean that a woman’s life will be saved. Mam­mog­ra­phy may not help a woman with a fast grow­ing can­cer that has already spread to other parts of her body before being found.
  • False neg­a­tives can hap­pen. This means every­thing may look nor­mal, but can­cer is actu­ally present. False neg­a­tives don’t hap­pen often. Younger women are more likely to have a false neg­a­tive mam­mo­gram than are older women. The dense breasts of younger women make breast can­cers harder to find in mammograms.
  • False pos­i­tives can hap­pen. This is when the mam­mo­gram results look like can­cer is present, even though it is not. False pos­i­tives are more com­mon in younger women, women who have had breast biop­sies, women with a fam­ily his­tory of breast can­cer, and women who are tak­ing estro­gen, such as hor­mone replace­ment therapy.
  • Mam­mo­grams (as well as den­tal x-rays and other rou­tine x-rays) use very small doses of radi­a­tion. The risk of any harm is very slight, but repeated x-rays could cause prob­lems. The ben­e­fits nearly always out­weigh the risk. Talk to your doc­tor about the need for each x-ray. Ask about shield­ing to pro­tect parts of the body that are not in the pic­ture. You should always let your doc­tor and the tech­ni­cian know if there is any chance that you are pregnant.

mammogram-picture

mammogram-picture

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Migraine… What is it?

September 2nd, 2009

migraineMigraines are chronic headaches that can cause sig­nif­i­cant pain for hours or even days. Symp­toms can be so severe that all you can think about is find­ing a dark, quiet place to lie down.

Some migraines are pre­ceded or accom­pa­nied by sen­sory warn­ing symp­toms or signs (auras), such as flashes of light, blind spots or tin­gling in your arm or leg. A migraine is often accom­pa­nied by nau­sea, vom­it­ing, and extreme sen­si­tiv­ity to light and sound.

Although there’s no cure, med­ica­tions can help reduce the fre­quency and sever­ity of migraines. If treat­ment hasn’t worked for you in the past, it’s worth talk­ing to your doc­tor about try­ing a dif­fer­ent migraine med­ica­tion. The right med­i­cines com­bined with self-help reme­dies and lifestyle changes may make a tremen­dous dif­fer­ence.
Migraines usu­ally begin in child­hood, ado­les­cence or early adult­hood. A typ­i­cal migraine attack pro­duces some or all of these signs and symptoms:

* Mod­er­ate to severe pain, which may be con­fined to one side of the head or may affect both sides
* Head pain with a pul­sat­ing or throb­bing qual­ity
* Pain that wors­ens with phys­i­cal activ­ity
* Pain that inter­feres with your reg­u­lar activ­i­ties
* Nau­sea with or with­out vom­it­ing
* Sen­si­tiv­ity to light and sound

When untreated, a migraine typ­i­cally lasts from four to 72 hours, but the fre­quency with which headaches occur varies from per­son to per­son. You may have migraines sev­eral times a month or much less frequently.

Not all migraines are the same. Most peo­ple expe­ri­ence migraines with­out auras, which were pre­vi­ously called com­mon migraines. Some peo­ple have migraines with auras, which were pre­vi­ously called clas­sic migraines. Auras can include changes to your vision, such as see­ing flashes of light, and feel­ing pins and nee­dles in an arm or leg.

Whether or not you have auras, you may have one or more sen­sa­tions of pre­mo­ni­tion (pro­drome) sev­eral hours or a day or so before your headache actu­ally strikes, including:

* Feel­ings of ela­tion or intense energy
* Crav­ings for sweets
* Thirst
* Drowsi­ness
* Irri­tabil­ity or depression

Although much about the cause of migraines isn’t under­stood, genet­ics and envi­ron­men­tal fac­tors seem to both play a role.

Migraines may be caused by changes in the trigem­i­nal nerve, a major pain path­way. Imbal­ances in brain chem­i­cals, includ­ing sero­tonin — which helps reg­u­late pain in your ner­vous sys­tem — also may be involved.

Sero­tonin lev­els drop dur­ing migraines. This may trig­ger your trigem­i­nal sys­tem to release sub­stances called neu­ropep­tides, which travel to your brain’s outer cov­er­ing (meninges). The result is headache pain.

Migraine trig­gers
What­ever the exact mech­a­nism of the headaches, a num­ber of things may trig­ger them. Com­mon migraine trig­gers include:

* Hor­monal changes in women. Fluc­tu­a­tions in estro­gen seem to trig­ger headaches in many women with known migraines. Women with a his­tory of migraines often report headaches imme­di­ately before or dur­ing their peri­ods, when they have a major drop in estro­gen. Oth­ers have an increased ten­dency to develop migraines dur­ing preg­nancy or menopause. Hor­monal med­ica­tions — such as oral con­tra­cep­tives and hor­mone replace­ment ther­apy — also may worsen migraines, though some women find it’s ben­e­fi­cial to take them.
* Foods. Some migraines appear to be trig­gered by cer­tain foods. Com­mon offend­ers include alco­hol, espe­cially beer and red wine; aged cheeses; choco­late; aspar­tame; overuse of caf­feine; monosodium glu­ta­mate — a key ingre­di­ent in some Asian foods; salty foods; and processed foods. Skip­ping meals or fast­ing also can trig­ger migraines.
* Stress. Stress at work or home can insti­gate migraines.
* Sen­sory stim­uli. Bright lights and sun glare can pro­duce migraines, as can loud sounds. Unusual smells — includ­ing pleas­ant scents, such as per­fume, and unpleas­ant odors, such as paint thin­ner and sec­ond­hand smoke, can also trig­ger migraines.
* Changes in wake-sleep pat­tern. Either miss­ing sleep or get­ting too much sleep may serve as a trig­ger for migraine attacks in some indi­vid­u­als, as can jet lag.
* Phys­i­cal fac­tors. Intense phys­i­cal exer­tion, includ­ing sex­ual activ­ity, may pro­voke migraines.
* Changes in the envi­ron­ment. A change of weather or baro­met­ric pres­sure can prompt a migraine.
* Med­ica­tions. Cer­tain med­ica­tions can aggra­vate migraines.
Sev­eral fac­tors make you more prone to hav­ing migraines.

* Hav­ing a fam­ily his­tory. Many peo­ple with migraines have a fam­ily his­tory of migraine. If one or both of your par­ents have migraines, there’s a good chance you will too.
* Being younger than 40. Half the peo­ple who suf­fer from migraines started get­ting them before they were 20 and migraines are most com­mon in peo­ple who are between 30 and 39 years old.
* Being female. Women are three times as likely to have migraines as men are. Headaches tend to affect boys more than girls dur­ing child­hood, but by the time of puberty, more girls are affected.
* Expe­ri­enc­ing hor­monal changes. If you’re a woman with migraines, you may find that your headaches begin just before or shortly after onset of men­stru­a­tion. They may also change dur­ing preg­nancy or menopause. Some women report that their migraines got worse dur­ing the first trimester of a preg­nancy. Though for many, the migraines improved dur­ing later stages in the preg­nancy.
Some­times your efforts to con­trol your pain cause problems.

* Abdom­i­nal prob­lems. Non­s­teroidal anti-inflammatory drugs (NSAIDs), such as ibupro­fen (Advil, Motrin, oth­ers) and aspirin, may cause abdom­i­nal pain, bleed­ing and ulcers — espe­cially if taken in large doses or for a long period of time.
* Rebound headaches. In addi­tion, if you take over-the-counter or pre­scrip­tion headache med­ica­tions more than nine days per month or in high doses, you may be set­ting your­self up for a seri­ous com­pli­ca­tion known as rebound headaches. Rebound headaches occur when med­ica­tions not only stop reliev­ing pain, but actu­ally begin to cause headaches. You then use more pain med­ica­tion, which traps you in a vicious cycle.
* Sero­tonin syn­drome. This poten­tially life-threatening drug inter­ac­tion can occur if you take migraine med­i­cines called trip­tans, such as suma­trip­tan (Imitrex) or zolmitrip­tan (Zomig), along with anti­de­pres­sants known as selec­tive sero­tonin reup­take inhibitors (SSRIs) or sero­tonin and nor­ep­i­neph­rine reup­take inhibitors (SNRIs). Some com­mon SSRIs include Zoloft, Prozac and Paxil. SNRIs include Cym­balta and Effexor. For­tu­nately, sero­tonin syn­drome is rare.

Non­tra­di­tional ther­a­pies may be help­ful if you have chronic headache pain:

* Acupunc­ture. In this treat­ment, a prac­ti­tioner inserts many thin, dis­pos­able nee­dles into sev­eral areas of your skin at defined points. A num­ber of clin­i­cal tri­als have found that acupunc­ture may be help­ful for headache pain.
* Biofeed­back. Biofeed­back appears to be espe­cially effec­tive in reliev­ing migraine pain. This relax­ation tech­nique uses spe­cial equip­ment to teach you how to mon­i­tor and con­trol cer­tain phys­i­cal responses related to stress, such as mus­cle ten­sion.
* Mas­sage. Mas­sage may help reduce the fre­quency of migraines. And it can improve the qual­ity of your sleep, which can, in turn, help pre­vent migraines.
* Herbs, vit­a­mins and min­er­als. There is some evi­dence that the herbs fever­few and but­ter­bur may pre­vent migraines or reduce their sever­ity. A high dose of riboflavin (vit­a­min B-2) also may pre­vent migraines by cor­rect­ing tiny defi­cien­cies in the brain cells. Coen­zyme Q10 sup­ple­ments may be help­ful in some indi­vid­u­als. Oral mag­ne­sium sul­fate sup­ple­ments may reduce the fre­quency of headaches in some peo­ple, although stud­ies don’t all agree on this issue. Mag­ne­sium taken intra­venously seems to help some peo­ple dur­ing an acute headache, par­tic­u­larly peo­ple with mag­ne­sium defi­cien­cies. Ask your doc­tor if these treat­ments are right for you. Don’t use fever­few or but­ter­bur if you’re preg­nant.
Whether or not you take pre­ven­tive med­ica­tions, you may ben­e­fit from lifestyle changes that can help reduce the num­ber and sever­ity of migraines. One or more of these sug­ges­tions may be help­ful for you:

* Avoid trig­gers. If cer­tain foods seem to have trig­gered your headaches in the past, avoid those foods. If cer­tain scents are a prob­lem, try to avoid them. In gen­eral, estab­lish a daily rou­tine with reg­u­lar sleep pat­terns and reg­u­lar meals. In addi­tion, try to con­trol stress.
* Exer­cise reg­u­larly. Reg­u­lar aer­o­bic exer­cise reduces ten­sion and can help pre­vent migraines. If your doc­tor agrees, choose any aer­o­bic exer­cise you enjoy, includ­ing walk­ing, swim­ming and cycling. Warm up slowly, how­ever, because sud­den, intense exer­cise can cause headaches. Obe­sity is also thought to be a fac­tor in migraines, and reg­u­lar exer­cise can help you keep your weight down.
* Reduce the effects of estro­gen. If you’re a woman with migraines and estro­gen seems to trig­ger or make your headaches worse, you may want to avoid or reduce the amount of med­ica­tions you take that con­tain estro­gen. These med­ica­tions include birth con­trol pills and hor­mone replace­ment ther­apy. Talk with your doc­tor about the best alter­na­tives or dosages for you.

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Back Pain during Pregnancy

August 17th, 2009

bpp2976Back pain or dis­com­fort is com­mon dur­ing preg­nancy and should be expected to some degree by most women. Back pain may be expe­ri­enced dur­ing any point of your preg­nancy; how­ever, it most com­monly occurs later in the preg­nancy as the weight of the baby increases. Back pain can dis­rupt your daily rou­tine or inter­fere with a good night of sleep. The good news is there are steps you can take to man­age the back pain that you expe­ri­ence.
How com­mon is back pain dur­ing pregnancy?

You are not alone if you are expe­ri­enc­ing back pain dur­ing your preg­nancy. The preva­lence varies with reports, show­ing between 50 to 70 per­cent of all preg­nant women hav­ing back pain.
What causes back pain dur­ing pregnancy?

Back pain dur­ing preg­nancy is related to a num­ber of fac­tors. Some women begin to expe­ri­ence lower back pain with the onset of preg­nancy. Women who are most at risk for back pain are those who are over­weight or had back pain prior to preg­nancy. Here is a list of poten­tial causes of back pain or dis­com­fort dur­ing pregnancy:

* Increase of hor­mones – hor­mones released dur­ing preg­nancy allow lig­a­ments in the pelvic area to soften and the joints to become looser in prepa­ra­tion for the birthing process of your baby; this shift in joints and loos­en­ing of lig­a­ments may affect the sup­port your back nor­mally expe­ri­ences
* Cen­ter of grav­ity – your cen­ter of grav­ity will grad­u­ally move for­ward as your uterus and baby grow, which causes your pos­ture to change
* Addi­tional weight – your devel­op­ing preg­nancy and baby cre­ate addi­tional weight that your back must sup­port
* Pos­ture or posi­tion – poor pos­ture, exces­sive stand­ing, and bend­ing over can trig­ger or esca­late the pain you expe­ri­ence in your back
* Stress – stress usu­ally finds the weak spot in the body, and because of the changes in your pelvic area, you may expe­ri­ence an increase in back pain dur­ing stress­ful peri­ods of your pregnancy

How can you pre­vent or min­i­mize back pain dur­ing pregnancy?

Back pain may not be pre­vented com­pletely, but there are things that you can do to reduce the sever­ity or fre­quency. Here are a few steps you can take to help reduce the back pain you are experiencing:

* Use exer­cises approved by your health care provider that sup­port and help strengthen the back and abdomen

* Squat to pick up some­thing ver­sus bend­ing over
* Avoid high heels and other shoes that do not pro­vide ade­quate sup­port
* Avoid sleep­ing on your back
* Wear a sup­port belt under your lower abdomen
* Make sure your back is aligned using a chi­ro­prac­tor
* Get plenty of rest. Ele­vat­ing your feet is also good for your back

How can you treat back pain dur­ing pregnancy?

There are a num­ber of things you can do to treat back pain dur­ing preg­nancy. Some of the steps you take to avoid back pain may also be used to treat cur­rent back pain. Here are some other com­mon interventions:

* Ice or heat
* Braces or sup­port devices
* Sleep on your left side and use a sup­port pil­low under your knees
* Med­ica­tions used to treat inflam­ma­tion
* Use a licensed health care pro­fes­sional such as a chi­ro­prac­tor or mas­sage therapist

When to con­tact your health care provider?

Expe­ri­enc­ing back pain itself is usu­ally not a rea­son to con­tact your health care provider, but there are sit­u­a­tions where con­tact­ing your provider is nec­es­sary. You want to con­tact your health care provider if you are expe­ri­enc­ing any of the following:

* Severe back pain
* Increas­ingly severe or abrupt-onset of back pain
* Rhyth­mic cramp­ing pains; this could be a sign of preterm labor

Severe back pain may be related to pregnancy-associated osteo­poro­sis, ver­te­bral pregnancy-back-pain-suffererosteoarthri­tis, or sep­tic arthri­tis. These are not com­mon, but it is some­thing your health care provider will exam­ine if you are expe­ri­enc­ing severe back pain.
Your Next Steps:

* Begin an approved exer­cise pro­gram to sup­port your back and abdomen
* Set aside a cou­ple of times a day where you can take a nap or get off your feet
* Find a Chi­ro­prac­tor in your area
* Pur­chase a sup­port belt
* Pur­chase a sleep aid pillow

Com­piled using infor­ma­tion from the fol­low­ing sources:

Dan­forth Obstet­rics and Gyne­col­ogy Ninth Ed. Scott, James. Gibbs, et al, Ch. 1

Williams’s Obstet­rics Twenty-Second Ed. Cun­ning­ham, F. Gary, et al, Ch. 8

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Alternative Solution to Back Pain

July 28th, 2009

1) Acupunc­ture
A study con­ducted at Sheffield Uni­ver­sity in the United King­dom looked at the long-term symp­tom reduc­tion and eco­nomic ben­e­fits of acupunc­ture for per­sis­tent low back pain. An aver­age of 8 acupunc­ture treat­ments were given to 159 peo­ple, while 80 peo­ple received usual care instead.

After one year, peo­ple receiv­ing acupunc­ture had reduced pain and reported a sig­nif­i­cant reduc­tion in worry about their pain com­pared to the usual care group. After two years, the acupunc­ture group was sig­nif­i­cantly more likely to report that the past year had been pain-free. They were less likely to use med­ica­tion for pain relief.

How does acupunc­ture work? Accord­ing to tra­di­tional Chi­nese med­i­cine, pain results from blocked energy along energy path­ways of the body, which are unblocked when acupunc­ture nee­dles are inserted along these invis­i­ble pathways.

A sci­en­tific expla­na­tion is that acupunc­ture releases nat­ural pain-relieving opi­oids, sends sig­nals that calm the sym­pa­thetic ner­vous sys­tem, and releases neu­ro­chem­i­cals and hormones.

An acupunc­ture treat­ment gen­er­ally costs between $60 and $120. Acupunc­ture is tax-deductible (it’s con­sid­ered a med­ical expense) and some insur­ance plans pay for acupuncture.

If you want to try acupunc­ture, plan on going one to three times a week for sev­eral weeks initially.

2) Cap­saicin Cream
Although you may not have heard of cap­saicin (pro­nounced cap-SAY-sin) before, if you’ve ever eaten a chili pep­per and felt your mouth burn, you know exactly what cap­saicin does. Cap­saicin is the active ingre­di­ent in chili peppers.

When it is applied to the skin, cap­saicin has been found to deplete sub­stance P–a neu­ro­chem­i­cal that trans­mits pain–causing an anal­gesic effect.

In one double-blind study, 160 peo­ple were treated with cap­saicin for 3 weeks, while another 160 peo­ple used a placebo. After 3 weeks, pain was reduced by 42% in the cap­saicin group com­pared to 31% in the placebo group. Inves­ti­ga­tors rated cap­saicin sig­nif­i­cantly more effec­tive than placebo.

Cap­saicin cream, also called cap­sicum cream, is avail­able in drug stores, health food stores, and online. A typ­i­cal dosage is 0.025% cap­saicin cream applied four times a day. The most com­mon side effect is a sting­ing or burn­ing sen­sa­tion in the area.

If pos­si­ble, wear dis­pos­able gloves (avail­able at drug­stores) before apply­ing the cream. Be care­ful not to touch the eye area or open skin. A tube or jar of cap­saicin cream typ­i­cally costs between $8 and $25.

3) Vit­a­min D
Chronic mus­cle pain can be a symp­tom of vit­a­min D defi­ciency. Vit­a­min D is found in fish with small bones, for­ti­fied milk and cereal, and expo­sure to sunlight.

Risk fac­tors for vit­a­min D defi­ciency are:

•darker pig­mented skin (e.g. His­panic, African Amer­i­can, Asian) does not con­vert UV rays effi­ciently to vit­a­min D

•diges­tive dis­or­ders, such as celiac disease

•use of glu­co­cor­ti­coid med­ica­tions for con­di­tions such as lung dis­eases and allergies

•min­i­mal sun expo­sure (elderly, insti­tu­tion­al­ized, home­bound, veiled or heavily-clothed individuals)

•lat­i­tude and sea­son — for exam­ple, peo­ple in Boston do not pro­duce vit­a­min D from sun expo­sure between Novem­ber and February

A study by the Uni­ver­sity of Min­nesota looked at the preva­lence of vit­a­min D defi­ciency in 150 peo­ple with chronic mus­cu­loskele­tal pain. Researchers found that 93% of patients had vit­a­min D defi­ciency. All peo­ple with darker pig­mented skin (African Amer­i­can, East African, His­panic, and Native Amer­i­can ori­gin) had vit­a­min D deficiency.

Another inter­est­ing find­ing was that the major­ity of peo­ple with severe vit­a­min D defi­ciency were under 30 years of age. Sea­son was not a sig­nif­i­cant factor.

The researchers con­cluded that all peo­ple with per­sis­tent, non-specific mus­cu­loskele­tal pain should be screened for vit­a­min D deficiency.

4) Music Ther­apy
Music ther­apy is a low-cost nat­ural ther­apy that has been found to reduce the dis­abil­ity, anx­i­ety, and depres­sion asso­ci­ated with chronic pain.

A study eval­u­ated the influ­ence of music ther­apy in hos­pi­tal­ized patients with chronic back pain. Researchers ran­dom­ized 65 patients to receive, on alter­nate months, phys­i­cal ther­apy plus 4 music ther­apy ses­sions or phys­i­cal ther­apy alone.

Music ther­apy sig­nif­i­cantly reduced dis­abil­ity, anx­i­ety, and depres­sion. Music had an imme­di­ate effect on reduc­ing pain, although the results were not sta­tis­ti­cally significant.

5) Vit­a­min B12
Vit­a­min B12 has been found to relieve low back pain. A double-blind Ital­ian study exam­ined the safety and effec­tive­ness of vit­a­min B12 for low back pain. Peo­ple who received vit­a­min B12 showed a sta­tis­ti­cally sig­nif­i­cant reduc­tion in pain and dis­abil­ity. They also used less pain med­ica­tion than the placebo group.

Besides pain, other symp­toms of vit­a­min B12 defi­ciency are numb­ness and tin­gling, irri­tabil­ity, mild mem­ory impair­ment, and depression.

Risk fac­tors for vit­a­min B12 defi­ciency are :

•per­ni­cious anemia

•med­ica­tions (stom­ach acid-blocking medications)

•inad­e­quate intake of meat or dairy products

•infec­tion (small intes­tine bac­te­r­ial over­growth, parasites)

•Diges­tive dis­eases (stom­ach removal surgery, celiac dis­ease, Crohn’s disease

Vit­a­min B12 mus­cle injec­tions are the stan­dard treat­ment for vit­a­min B12 defi­ciency. Stud­ies have found vit­a­min B12 sub­lin­gual tablets (placed under the tongue for absorp­tion) and nasal gel are also effective.

6) Mag­ne­sium
Mag­ne­sium is the fourth most abun­dant min­eral in the body. It’s involved in over 300 bio­chem­i­cal reac­tions in the body.

Mag­ne­sium helps main­tain nor­mal mus­cle and nerve func­tion, keeps heart rhythm steady, sup­ports a healthy immune sys­tem, and keeps bones strong. Mag­ne­sium also helps reg­u­late blood sugar lev­els, pro­motes nor­mal blood pres­sure, and is known to be involved in energy metab­o­lism and pro­tein synthesis.

Symp­toms of mag­ne­sium defi­ciency include mus­cle spasms and pain, pre­men­strual syn­drome, irri­tabil­ity, depres­sion, insulin resis­tance, high blood pres­sure, irreg­u­lar heart rhythms, and heart disease.

A Ger­man study found that min­eral sup­ple­ments increased intra­cel­lu­lar mag­ne­sium lev­els by 11% and was asso­ci­ated with a reduc­tion in pain symp­toms in 76 out of 82 peo­ple with chronic low back pain.

7) Wil­low Bark
The bark of the white wil­low tree (Salix alba) has pain-relieving prop­er­ties sim­i­lar to aspirin. An ingre­di­ent in white wil­low bark, called salicin, is con­verted in the body to sal­i­cylic acid (aspirin is also con­verted to sal­i­cylic acid once in the body). Sal­i­cylic acid is believed to be the active com­pound that relieves pain and inflammtion.

A num­ber of stud­ies have com­pared white wil­low to med­ica­tion or placebo:

•A Uni­ver­sity of Syd­ney study com­pared the effects of wil­low bark extract to refe­coxib, a Cox-2 inhibitor pain med­ica­tion. In the study, 114 patients received a herbal extract con­tain­ing 240 mg of salicin and 114 received 12.5 mg of refe­coxib every day. After four weeks, both groups had a com­pa­ra­ble reduc­tion in pain.

•A study in the Amer­i­can Jour­nal of Med­i­cine exam­ined 191 patients with an exac­er­ba­tion of chronic low back pain. They were ran­domly assigned to receive a wil­low bark extract with either 120 mg (low-dose) or 240 mg (high-dose) of salicin, or placebo. In the fourth week of treat­ment, 39% of peo­ple receiv­ing the high-dose extract were pain-free, 21% receiv­ing the low-dose were pain-free, and 6% of peo­ple receiv­ing the placebo were pain-free. Peo­ple in the high-dose group improved after the first week. Sig­nif­i­cantly more peo­ple in the placebo group required pain medication.

8) Yoga for Back Pain
Yoga cre­ates bal­ance in the body through var­i­ous poses that develop flex­i­bil­ity and strength. A study of peo­ple with chronic mild low back pain com­pared Iyen­gar yoga to back edu­ca­tion. After 16 weeks, there was a sig­nif­i­cant reduc­tion in pain inten­sity, dis­abil­ity, and reliance on pain med­ica­tion in the yoga group. Ben­e­fits were also seen at three month fol­low up assessments.

Another study com­pared yoga, con­ven­tional exer­cise, and a self care book for peo­ple with chronic low back pain. Back func­tion in the yoga group was supe­rior to the book and exer­cise groups at 12 weeks. Although there was no dif­fer­ence in symp­toms at 12 weeks, at 26 weeks, the yoga group was supe­rior to the book group.

9) Bowen Ther­apy
Bowen ther­apy is a type of gen­tle body­work that was devel­oped in Aus­tralia by osteopath Tom Bowen (1916–1982). Bowen ther­apy is more widely used in Aus­tralia and Europe, but it has been grow­ing in pop­u­lar­ity in North America.

Bowen ther­a­pists use a series of spe­cial­ized “moves” using their fin­gers and thumbs. The moves typ­i­cally involve the ther­a­pist pulling the skin slack away from the mus­cle, apply­ing pres­sure, and then quickly releas­ing the tension.

These moves are per­formed on pre­cise areas of mus­cles where spe­cial recep­tors are located. Nerve impulses are sent to the brain, result­ing in mus­cle relax­ation and reduc­tion of pain.

The moves are not con­tin­u­ous — the ther­a­pist allows the client to rest for a few min­utes between each move. A typ­i­cal treat­ment is between 30 to 40 minutes.

10) Breath­ing Tech­niques
Breath­ing tech­niques that make use of the mind-body con­nec­tion have been found to reduce pain. These tech­niques inte­grate body aware­ness, breath­ing, move­ment, and med­i­ta­tion. What’s great about breath­ing tech­niques is that you can do them your­self at home at no cost.

One study com­pared 6–8 weeks (12 ses­sions) of breath ther­apy to phys­i­cal ther­apy. Patients improved sig­nif­i­cantly with breath ther­apy. Changes in stan­dard low back pain mea­sures of pain and dis­abil­ity were com­pa­ra­ble to those result­ing from high qual­ity, extended phys­i­cal ther­apy. Breath ther­apy was found to be safe. Other ben­e­fits of breath ther­apy were improved cop­ing skills and new insight into the effect of stress on the body.

11) Mas­sage Ther­apy
When many peo­ple have back aches and pain, the first thing they think of is mas­sage. Stud­ies have found that mas­sage may be effec­tive for sub­a­cute and chronic pain. It has also been found to reduce anx­i­ety and depres­sion asso­ci­ated with chronic pain. Mas­sage ther­apy is the most pop­u­lar ther­apy for low back pain dur­ing pregnancy.

12) Chi­ro­prac­tic
Back pain is one of most com­mon rea­sons peo­ple see a chi­ro­prac­tor. Doc­tors of chi­ro­prac­tic use chi­ro­prac­tic spinal manip­u­la­tion to restore joint mobil­ity. They man­u­ally apply a con­trolled force to joints that have become restricted by mus­cle injury, strain, inflam­ma­tion, and pain. Manip­u­la­tion is believed to relieve pain and mus­cle tight­ness and encour­age healing.

A study pub­lished in the Spine Jour­nal exam­ined manip­u­la­tions com­pared to sim­u­lated manip­u­la­tions in 102 peo­ple with back pain and/or radi­at­ing pain. The researchers found that active manip­u­la­tions were more effec­tive at reduc­ing acute back pain and sci­at­ica with disc protrusion.

13) Alexan­der Tech­nique
Alexan­der tech­nique teaches peo­ple to improve their pos­ture and elim­i­nate bad habits such as slouch­ing, which can lead to pain, mus­cle ten­sion, and decreased mobil­ity. This tech­nique was cre­ated by Fred­er­ick Matthias Alexan­der (1869–1955), an Aus­tralian actor who learned how to cor­rect hoarse­ness in his voice by improv­ing his posture.

You can learn Alexan­der tech­nique in pri­vate ses­sions or group classes. A typ­i­cal ses­sion lasts about 45 min­utes. Dur­ing that time, the instruc­tor notes the way you carry your­self and coaches you with ver­bal instruc­tion and gen­tle touch.

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(Con­tin­ued from Page 2)
10) Breath­ing Tech­niques
Breath­ing tech­niques that make use of the mind-body con­nec­tion have been found to reduce pain. These tech­niques inte­grate body aware­ness, breath­ing, move­ment, and med­i­ta­tion. What’s great about breath­ing tech­niques is that you can do them your­self at home at no cost.

One study com­pared 6–8 weeks (12 ses­sions) of breath ther­apy to phys­i­cal ther­apy. Patients improved sig­nif­i­cantly with breath ther­apy. Changes in stan­dard low back pain mea­sures of pain and dis­abil­ity were com­pa­ra­ble to those result­ing from high qual­ity, extended phys­i­cal ther­apy. Breath ther­apy was found to be safe. Other ben­e­fits of breath ther­apy were improved cop­ing skills and new insight into the effect of stress on the body.
•Breath­ing tech­nique — How to breathe with your belly
11) Mas­sage Ther­apy
When many peo­ple have back aches and pain, the first thing they think of is mas­sage. Stud­ies have found that mas­sage may be effec­tive for sub­a­cute and chronic pain. It has also been found to reduce anx­i­ety and depres­sion asso­ci­ated with chronic pain. Mas­sage ther­apy is the most pop­u­lar ther­apy for low back pain dur­ing preg­nancy.
•Find a mas­sage ther­a­pist
12) Chi­ro­prac­tic
Back pain is one of most com­mon rea­sons peo­ple see a chi­ro­prac­tor. Doc­tors of chi­ro­prac­tic use chi­ro­prac­tic spinal manip­u­la­tion to restore joint mobil­ity. They man­u­ally apply a con­trolled force to joints that have become restricted by mus­cle injury, strain, inflam­ma­tion, and pain. Manip­u­la­tion is believed to relieve pain and mus­cle tight­ness and encour­age healing.

A study pub­lished in the Spine Jour­nal exam­ined manip­u­la­tions com­pared to sim­u­lated manip­u­la­tions in 102 peo­ple with back pain and/or radi­at­ing pain. The researchers found that active manip­u­la­tions were more effec­tive at reduc­ing acute back pain and sci­at­ica with disc pro­tru­sion.
•Find a doc­tor of chi­ro­prac­tic
13) Alexan­der Tech­nique
Alexan­der tech­nique teaches peo­ple to improve their pos­ture and elim­i­nate bad habits such as slouch­ing, which can lead to pain, mus­cle ten­sion, and decreased mobil­ity. This tech­nique was cre­ated by Fred­er­ick Matthias Alexan­der (1869–1955), an Aus­tralian actor who learned how to cor­rect hoarse­ness in his voice by improv­ing his posture.

You can learn Alexan­der tech­nique in pri­vate ses­sions or group classes. A typ­i­cal ses­sion lasts about 45 min­utes. Dur­ing that time, the instruc­tor notes the way you carry your­self and coaches you with ver­bal instruc­tion and gen­tle touch.
•More about Alexan­der tech­nique
14) Pro­lother­apy
Pro­lother­apy addresses dam­aged lig­a­ments (bands of con­nec­tive tis­sue that help keep bones attached to each other) to relieve chronic mus­cu­loskele­tal pain.

How does it work? Ten­dons and lig­a­ments in the back often do not heal com­pletely after injury. Bones of the spine become less sta­ble, which can lead to chronic pain.

Pro­lother­apy involves the injec­tion of a liq­uid solu­tion into soft tis­sues such as lig­a­ments and ten­dons. This trig­gers local inflam­ma­tion and trig­gers the body’s nat­ural heal­ing response which repairs the weak­ened soft tis­sues and relieves pain. Unlike drugs, pro­lother­apy is thought to address the under­ly­ing problem.

After locat­ing the areas that require treat­ment, the doc­tor inserts a thin nee­dle with the solu­tion into the area. There is often mild pain, but it can be reduced by using a local anaes­thetic. A typ­i­cal course of treat­ment is 10 to 25 ses­sions for back pain. Since it is believed to repair the joint, no other treat­ment is necessary.

Pre­lim­i­nary stud­ies have found that back pain, which often involves lig­a­ment injury, responds par­tic­u­larly well to pro­lother­apy. It is the posi­tion of the Amer­i­can Asso­ci­a­tion of Orthopaedic Med­i­cine that pro­lother­apy is a safe and effec­tive ther­apy for the treat­ment of selected cases of low back pain and other chronic myofas­cial pain syn­dromes. Pro­lother­apy injec­tions must be admin­is­tered by a med­ical doc­tor (M.D.), osteopath (D.O.) or by a state-licensed natur­o­pathic doc­tor (N.D.) in cer­tain states.

15) Bal­neother­apy
Bal­neother­apy is one of the old­est ther­a­pies for pain relief. The term “bal­neo” comes from the Latin word, bal­neum, mean­ing bath. Bal­neother­apy is a form of hydrother­apy that involves bathing in min­eral water or warm water.
•A study com­pared bathing in min­eral water to plain tap water in 60 peo­ple with low back pain. They found that min­eral water con­tain­ing sul­phur was supe­rior in reduc­ing pain and improv­ing mobil­ity com­pared with tap water.

•A sys­tem­atic review and meta-analysis pub­lished in the jour­nal Rheuma­tol­ogy assessed spa ther­apy and bal­neother­apy for low back pain. The researchers found that the data sug­gest ben­e­fi­cial effects com­pared to con­trol groups. They con­cluded that the results were encour­ag­ing and that large-scale tri­als were war­ranted.
Dead Sea salts and other sulphur-containing bath salts can be found in spas, health food stores, and online.

Peo­ple with heart con­di­tions should not use bal­neother­apy unless under the super­vi­sion of their pri­mary care provider.

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Carpal Tunnel Syndrome, What is that?

July 23rd, 2009

tunnel

What is carpal tun­nel syn­drome?
Carpal tun­nel syn­drome is a painful dis­or­der of the wrist and hand. The carpal tun­nel is a nar­row tun­nel formed by the bones and other tis­sues of your wrist. This tun­nel pro­tects your median nerve. The median nerve gives you feel­ing in your thumb, and index, mid­dle and ring fin­gers. But when other tis­sues in the carpal tun­nel, such as lig­a­ments and ten­dons, get swollen or inflamed, they press against the median nerve. That pres­sure can make part of your hand hurt or feel numb.

What causes carpal tun­nel syn­drome?
Doing the same hand move­ments over and over can lead to carpal tun­nel syn­drome. It’s most com­mon in peo­ple whose jobs require pinch­ing or grip­ping with the wrist held bent. Peo­ple at risk include peo­ple who use com­put­ers, car­pen­ters, gro­cery check­ers, assembly-line work­ers, meat pack­ers, musi­cians and mechan­ics. Hob­bies such as gar­den­ing, needle­work, golf­ing and canoe­ing can some­times bring on the symptoms.

Carpal tun­nel syn­drome is linked to other things too. It may be caused by an injury to the wrist, such as a frac­ture. Or it may be caused by a dis­ease such as dia­betes, rheuma­toid arthri­tis or thy­roid dis­ease. Carpal tun­nel syn­drome is also com­mon dur­ing the last few months of pregnancy.

Symp­toms of carpal tun­nel syndrome

* Numb­ness or tin­gling in your hand and fin­gers, espe­cially the thumb and index and mid­dle fingers.

* Pain in your wrist, palm or forearm.

* More numb­ness or pain at night than dur­ing the day. The pain may be so bad it wakes you up. You may shake or rub your hand to get relief.

* More pain when you use your hand or wrist more.

* Trou­ble grip­ping objects.

* Weak­ness in your thumb.

How is carpal tun­nel syn­drome diag­nosed?
Your doc­tor will prob­a­bly ask you about your symp­toms. He or she may exam­ine you and ask you how you use your hands. Your doc­tor may also do these tests:

* Your doc­tor may tap the inside of your wrist. You may feel pain or a sen­sa­tion like an elec­tric shock.
* Your doc­tor may ask you to bend your wrist down for 1 minute to see if this causes symp­toms.
* Your doc­tor may have you get a nerve con­duc­tion test or an elec­tromyo­g­ra­phy (EMG) test to see whether the nerves and mus­cles in your arm and hand show the typ­i­cal effects of carpal tun­nel syndrome.

How seri­ous is carpal tun­nel syn­drome?
Carpal tun­nel syn­drome usu­ally isn’t seri­ous. With treat­ment, the pain will usu­ally go away and you’ll have no last­ing dam­age to your hand or wrist.

How is carpal tun­nel syn­drome treated?
If carpal tun­nel syn­drome is caused by a med­ical prob­lem, your doc­tor will prob­a­bly first treat that problem.

Your doc­tor may ask you to rest your wrist or change how you use your hand. Your CARPTUNdoc­tor may also ask you to wear a splint on your wrist. The splint keeps your wrist from mov­ing but lets your hand do most of what it nor­mally does. A splint can help ease the pain of carpal tun­nel syn­drome, espe­cially at night.

Putting ice on your wrist, mas­sag­ing the area and doing stretch­ing exer­cises may help too.

Tips on reliev­ing carpal tun­nel syndrome

* Prop up your arm with pil­lows when you lie down.
* Avoid using your hand too much.
* Find a new way to use your hand by using a dif­fer­ent tool.
* Try to use the other hand more often.
* Avoid bend­ing your wrists down for long periods.

Can I pre­vent carpal tun­nel syn­drome?
Yes. See the box below for some tips on pre­vent­ing carpal tun­nel syndrome.

Many prod­ucts you can buy–such as wrist rests–are sup­posed to ease symp­toms of carpal tun­nel syn­drome. No one has proven that these prod­ucts really pre­vent wrist prob­lems. Some peo­ple may have less pain and numb­ness after using these prod­ucts, but other peo­ple may have increased pain and numbness.

Things that may help pre­vent carpal tun­nel syndrome

* Lose weight if you’re over­weight.
* Get treat­ment for any dis­ease you have that may cause carpal tun­nel syn­drome.
* If you do the same tasks with your hands over and over, try not to bend, extend or twist your hands for long peri­ods.
* Don’t work with your arms too close or too far from your body.
* Don’t rest your wrists on hard sur­faces for long peri­ods.
* Switch hands dur­ing work tasks.
* Make sure your tools aren’t too big for your hands.
* Take reg­u­lar breaks from repeated hand move­ments to give your hands and wrists time to rest.
* Don’t sit or stand in the same posi­tion all day.
* If you use a key­board a lot, adjust the height of your chair so that your fore­arms are level with your key­board and you don’t have to flex your wrists to type.

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Hypertension or High Blood Pressure…? Why…?

July 22nd, 2009

What is high blood pres­sure? What causes high blood pressure?

Blood pres­sure is the force of blood push­ing against blood ves­sel walls. The heart pumps blood into the arter­ies (blood ves­sels), which carry the blood through­out the body. High blood pres­sure, also called hyper­ten­sion, is dan­ger­ous because it makes the heart work harder to pump blood to the body and it con­tributes to hard­en­ing of the arter­ies or ath­er­o­scle­ro­sis and the devel­op­ment of heart failure.

What Is “Nor­mal” Blood Pressure?

There are sev­eral cat­e­gories of blood pres­sure, including:

* Nor­mal: Less than 120/80
* Pre­hy­per­ten­sion: 120–139/80–89
* Stage 1 high blood pres­sure: 140–159/90–99
* Stage 2 high blood pres­sure: 160 and above/100 and above

Peo­ple whose blood pres­sure is above the nor­mal range should con­sult their doc­tor about meth­ods for low­er­ing it.
What Causes High Blood Pressure?

The exact causes of high blood pres­sure are not known. Sev­eral fac­tors and con­di­tions may play a role in its devel­op­ment, including:

* Smok­ing
* Being over­weight or obese
* Lack of phys­i­cal activ­ity
* Too much salt in the diet
* Too much alco­hol con­sump­tion (more than 1 to 2 drinks per day)
* Stress
* Older age
* Genet­ics
* Fam­ily his­tory of high blood pres­sure
* Chronic kid­ney dis­ease
* Adrenal and thy­roid disorders

Essen­tial Hypertension

In as many as 95% of reported high blood pres­sure cases in the United States, the under­ly­ing cause can­not be deter­mined. This type of high blood pres­sure is called essen­tial hypertension.

Though essen­tial hyper­ten­sion remains some­what mys­te­ri­ous, it has been linked to cer­tain risk fac­tors. High blood pres­sure tends to run in fam­i­lies and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pres­sure, although the gap begins to nar­row around age 44. After age 65, black women have the high­est inci­dence of high blood pressure.

Essen­tial hyper­ten­sion is also greatly influ­enced by diet and lifestyle. The link between salt and high blood pres­sure is espe­cially com­pelling. Peo­ple liv­ing on the north­ern islands of Japan eat more salt per capita than any­one else in the world and have the high­est inci­dence of essen­tial hyper­ten­sion. By con­trast, peo­ple who add no salt to their food show vir­tu­ally no traces of essen­tial hypertension.

The major­ity of all peo­ple with high blood pres­sure are “salt sen­si­tive,” mean­ing that any­thing more than the min­i­mal bod­ily need for salt is too much for them and increases their blood pres­sure. Other fac­tors that have been asso­ci­ated with essen­tial hyper­ten­sion include obe­sity; dia­betes; stress; insuf­fi­cient intake of potas­sium, cal­cium, and mag­ne­sium; lack of phys­i­cal activ­ity; and chronic alco­hol consumption.

Sec­ondary Hypertension

When a direct cause for high blood pres­sure can be iden­ti­fied, the con­di­tion is described as sec­ondary hyper­ten­sion. Among the known causes of sec­ondary hyper­ten­sion, kid­ney dis­ease ranks high­est. Hyper­ten­sion can also be trig­gered by tumors or other abnor­mal­i­ties that cause the adrenal glands (small glands that sit atop the kid­neys) to secrete excess amounts of the hor­mones that ele­vate blood pres­sure. Birth con­trol pills — specif­i­cally those con­tain­ing estro­gen — and preg­nancy can boost blood pres­sure, as can med­ica­tions that con­strict blood ves­sels.
Who Is More Likely to Develop High Blood Pressure?

* Peo­ple with fam­ily mem­bers who have high blood pres­sure.
* Peo­ple who smoke.
* African-Americans.
* Women who are preg­nant.
* Women who take birth con­trol pills.
* Peo­ple over the age of 35.
* Peo­ple who are over­weight or obese.
* Peo­ple who are not active.
* Peo­ple who drink alco­hol exces­sively.
* Peo­ple who eat too many fatty foods or foods with too much salt.

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Being Tired…? Why…

July 10th, 2009

tired1Some days you’re so low on energy that you’re drowsy by lunchtime and in need of a nap by mid after­noon. What’s mak­ing you so tired all the time? Stress, poor eat­ing habits, over­work, even med­ical treat­ments can wear you down and cause fatigue.

Fatigue isn’t the same thing as sleepi­ness, although it’s often accom­pa­nied by a desire to sleep — and a lack of moti­va­tion to do any­thing else.

In some cases, fatigue is a symp­tom of an under­ly­ing med­ical prob­lem that requires med­ical treat­ment. Most of the time, how­ever, fatigue can be traced to one or more of your habits or rou­tines. Chances are you know what’s caus­ing your fatigue. And with a few sim­ple lifestyle changes, it’s likely that you have the power to put the vital­ity back in your life.

Tak­ing a quick inven­tory of the things that might be respon­si­ble for your fatigue is the first step toward relief. Three gen­eral areas cause most cases of fatigue:

  • Lifestyle prob­lems. Feel­ings of fatigue often have an obvi­ous cause, such as sleep tired2depri­va­tion, over­work or unhealthy habits.
  • Psy­cho­log­i­cal prob­lems. Fatigue is a com­mon symp­tom of men­tal health prob­lems, such as depres­sion and grief, and may be accom­pa­nied by other signs and symp­toms, includ­ing irri­tabil­ity and lack of motivation.
  • Med­ical prob­lems. Unre­lent­ing exhaus­tion may be a sign of an under­ly­ing ill­ness, such as a thy­roid dis­or­der, heart dis­ease or diabetes.

Com­mon causes of fatigue include:

  • Acute liver failure
  • Alco­hol use or abuse
  • Ane­mia
  • Anx­i­ety
  • Caf­feine use
  • Can­cer
  • Chronic fatigue syndrome
  • COPD
  • Depres­sion (major depression)
  • Emphy­sema
  • Exces­sive phys­i­cal activity
  • Grief
  • Heart dis­ease
  • Hyper­thy­roidism (over­ac­tive thyroid)
  • Hypothy­roidism (under­ac­tive thyroid)
  • Inac­tiv­ity
  • Kid­ney fail­ure, chronic
  • Lack of sleep
  • Med­ica­tions, such as anti­his­t­a­mines, cough and cold reme­dies, pre­scrip­tion pain med­ica­tions, heart med­ica­tions, blood pres­sure med­ica­tions, and some antidepressants
  • Obe­sity
  • Preg­nancy
  • Recov­ery from major surgery
  • Rest­less legs syndrome
  • Sleep apnea
  • Stress
  • Type 1 diabetes
  • Type 2 diabetes
  • Unhealthy eat­ing habits
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What is Stress?

May 11th, 2009

We are all famil­iar with the word “stress”. Stress is when you are wor­ried about get­ting laid off your job, or wor­ried about hav­ing enough money to pay your bills, or wor­ried about your mother when the doc­tor says she may need an oper­a­tion. In fact, to most of us, stress is syn­ony­mous with worry. If it is some­thing that makes you worry, then it is stress.

Your body, how­ever, has a much broader def­i­n­i­tion of stress. TO YOUR BODY, STRESS IS SYNONYMOUS WITH CHANGE. Any­thing that causes a change in your life causes stress. It doesn’t mat­ter if it is a “good” change, or a “bad” change, they are both stress. When you find your dream apart­ment and get ready to move, that is stress. If you break your leg, that is stress. Good or bad, if it is a CHANGE in your life, it is stress as far as your body is concerned.

Even IMAGINED CHANGE is stress. (Imag­in­ing changes is what we call “wor­ry­ing”.) If you fear that you will not have enough money to pay your rent, that is stress. If you worry that you may get fired, that is stress. If you think that you may receive a pro­mo­tion at work, that is also stress (even though this would be a good change). Whether the event is good or bad, imag­in­ing changes in your life is stressful.

Any­thing that causes CHANGE IN YOUR DAILY ROUTINE is stressful.

Any­thing that causes CHANGE IN YOUR BODY HEALTH is stressful.

IMAGINED CHANGES are just as stress­ful as real changes.

Let us look at sev­eral types of stress — ones that are so com­mon­place that you might not even real­ize that they are stressful.……

Emo­tional Stress

When argu­ments, dis­agree­ments, and con­flicts cause CHANGES in your per­sonal life — that is stress.

Emotional Stress

Ill­ness

Catch­ing a cold, break­ing an arm, a skin infec­tion, a sore back, are all CHANGES in your body condition.

illness

Push­ing Your Body Too Hard

A major source of stress is over dri­ving your­self. If you are work­ing (or par­ty­ing) 16 hours a day, you will have reduced your avail­able time for rest. Sooner or later, the energy drain on your sys­tem will cause the body to fall behind in its repair work. There will not be enough time or energy for the body to fix bro­ken cells, or replace used up brain neu­ro­trans­mit­ters. CHANGES will occur in your body’s inter­nal envi­ron­ment. You will “hit the wall,” “run out of gas”. If you con­tinue, per­ma­nent dam­age may be done. The body’s fight to stay healthy in the face of the increased energy that your are expend­ing is major stress.

Envi­ron­men­tal Factors

Very hot or very cold cli­mates can be stress­ful. Very high alti­tude may be a stress. Tox­ins or poi­sons are a stress. Each of these fac­tors threat­ens to cause CHANGES in your body’s inter­nal environment.

environmental toxins

The Spe­cial Case of Tobacco Use

Tobacco is a pow­er­ful toxin!! Smok­ing destroys cells that clean your tra­chea, bronchi, and lungs. Smok­ing causes emphy­sema and chronic bron­chi­tis, which progress to slow suf­fo­ca­tion. The car­bon monox­ide from cig­a­rette smok­ing causes chronic car­bon monox­ide poi­son­ing. Tobacco use dam­ages the arter­ies in your body, caus­ing insuf­fi­cient blood sup­ply to the brain, heart, and vital organs. Cig­a­rette smok­ing increases the risk of can­cer 50 fold.

Chew­ing tobacco or snuff is no safe haven. It also dam­ages your arter­ies, and it car­ries the same can­cer risk. (Can­cers of the head and neck are par­tic­u­larly vicious, dis­fig­ur­ing, and deadly).

Poi­son­ing the body with car­bon monox­ide, and caus­ing the phys­i­cal ill­nesses of emphy­sema, chronic bron­chi­tis, can­cer, and arte­r­ial dam­age, tobacco is a pow­er­ful source of added stress to one’s life.

Hor­monal Factors

PUBERTY

The vast hor­monal changes of puberty are severe stres­sors. A person’s body actu­ally CHANGES shape, sex­ual organs begin to func­tion, new hor­mones are released in large quan­ti­ties. Puberty, as we all know, is very stressful.

PRE-MENSTRUAL SYNDROME

Once a woman passes puberty, her body is designed to func­tion best in the pres­ence of female hor­mones. For women past puberty, a lack of female hor­mones is a major stress on the body. Once a month, just prior to men­stru­a­tion, a woman’s hor­mone lev­els drop sharply. In many women, the stress of sharply falling hor­mones is enough to cre­ate a tem­po­rary OVERSTRESS. This tem­po­rary OVERSTRESS is pop­u­larly known as Pre Men­stru­al­Syn­drome (PMS).

POST-PARTUM

Fol­low­ing a preg­nancy, hor­mone lev­els CHANGE dra­mat­i­cally. After a nor­mal child­birth, or a mis­car­riage, some women may be thrown into OVERSTRESS by loss of the hor­mones of pregnancy.

MENOPAUSE

There is another time in a woman’s life when hor­mone lev­els decline. This is the menopause. The decline in hor­mones dur­ing menopause is slow and steady. Nev­er­the­less, this menopausal decline causes enough stress on the body to pro­duce OVERSTRESS in many women.

Tak­ing Respon­si­bil­ity for Another Person’s Actions

When you take respon­si­bil­ity for another person’s actions, CHANGES occur in your life over which you have lit­tle or no con­trol. Tak­ing respon­si­bil­ity for another person’s actions is a major stressor.

Aller­gic Stress

Aller­gic reac­tions are a part of your body’s nat­ural defense mech­a­nism. When con­fronted with a sub­stance which your body con­sid­ers toxic, your body will try to get rid of it, attack it, or some­how neu­tral­ize it. If it is some­thing that lands in your nose, you might get a runny, sneezy nose. If it lands on your skin, you might get blis­tery skin. If you inhale it, you’ll get wheezy lungs. If you eat it, you may break out in itchy red hives all over your body. Allergy is a def­i­nite stress, requir­ing large changes in energy expen­di­ture on the part of your body’s defense sys­tem to fight off what the body per­ceives as a dan­ger­ous attack by an out­side toxin.

On a typ­i­cal day in the brain, tril­lions of mes­sages are sent and received. The mes­sages that are happy, up beat mes­sages are car­ried by the brain’s “HAPPY MESSENGERS” (tech­ni­cally known as Bio­genic Amine/Endorphin Sys­tem). Other mes­sages are somber and qui­et­ing. They are car­ried by the brain’s “SAD MESSENGERS”. Most nerve cen­ters receive input from both types of mes­sen­gers. As long as this input is bal­anced, every­thing runs along on an even keel.

Stress, how­ever, causes prob­lems with the brain’s Happy Mes­sen­gers. When life is smooth, the happy mes­sages keep up with demand. But when too much stress is placed on the brain, the Happy Mes­sen­gers begin to fall behind on their deliv­er­ies. As the stress con­tin­ues, the happy mes­sages begin to fail. Impor­tant nerve cen­ters then receive mostly SAD MESSAGES, and the whole brain becomes dis­tressed. The per­son enters a state of brain chem­i­cal imbal­ance known as — OVERSTRESS.

OVERSTRESS makes peo­ple feel ter­ri­ble. With SAD MESSAGES over­whelm­ing the happy mes­sages, a per­son feels “over­whelmed” by life. Peo­ple com­plain of being tired, unable to fall asleep or to obtain a rest­ful night’s sleep. They have plagues of aches and pains, lack of energy, lack of enjoy­ment of life. They feel depressed, anx­ious, or just unable to cope with life.

Too many sad messages

Low Stress Tol­er­ance — The Inher­ited Factor

Every­one inher­its a cer­tain abil­ity to make and use Happy Mes­sen­gers in the brain. As long as you can make enough Happy Mes­sen­gers to keep up with the stress in your life, you will find stress to be fun, excit­ing, enjoy­able, chal­leng­ing. In fact, with­out it you would be bored.

How­ever, when the amount of stress in your life is so great that you begin to run out of Happy Mes­sen­gers, then bad things begin to hap­pen. You may have sleep dis­tur­bances, aches and pains, lack of enjoy­ment of life and even panic attacks.

The amount of stress that you can tol­er­ate before your Happy Mes­sen­gers mal­func­tion is referred to as your “Stress Tol­er­ance”. Your Stress Tol­er­ance is set by your genetic inher­i­tance. Most of us have inher­ited suf­fi­cient Stress Tol­er­ance to allow us to weather the stresses of daily liv­ing. We still feel well and enjoy life. Yet, each of us, at some time has expe­ri­enced short peri­ods of brain chem­i­cal imbalance.

The night you couldn’t sleep before your big test at school, or your impor­tant job inter­view, or your “fab­u­lous date”…

The sad­ness and cry­ing you may have felt when a friend or rel­a­tive passed away, or a girl­friend or boyfriend left…

The chest pains or the headaches that you may have thought were heart prob­lems or migraine, but your doc­tor said came from too much stress and strain…

WE HAVE ALL EXPERIENCED SUCH BRIEF EPISODES OF HAPPY MESSENGER MALFUNCTION. BUT, FULLY 10% OF OUR POPULATION FEELS LIKE THIS ALL OF THE TIME!

You see, one in ten per­sons has inher­ited a LOW STRESS TOLERANCE. This means that his/her Happy Mes­sen­gers “poop out” at stress lev­els which the rest of us would con­sider “nor­mal, every­day stress.” The result of inher­it­ing such a Low Stress Tol­er­ance may be a dis­as­ter. Such a per­son will be oper­at­ing his or her life in prac­ti­cally per­ma­nent OVERSTRESS. Sleep dis­tur­bances, aches and pains, fatigue, depres­sions, mood swings, anx­i­ety attacks, and even drug addic­tion can become life long problems.

Since one in ten per­sons have inher­ited a Low Stress Tol­er­ance, we are describ­ing an enor­mous num­ber of people.

Ten per­cent of your friends, your acquain­tances, your employ­ees, your co-workers, your employ­ers… every­where around you there are per­sons who are not able to cope with the stress of daily life.

One in ten is OVERSTRESSED

To under­stand how stress results in this dis­as­trous con­di­tion for so many peo­ple, let us begin by exam­in­ing the brain’s HAPPY MESSENGERS.

There are three Happy Mes­sen­gers: SEROTONIN, NORADRENALIN, and DOPAMINE. These are the brain chem­i­cals that begin to mal­func­tion when stress lev­els become more than a per­son can handle.

Sero­tonin

SEROTONIN LETS YOU SLEEP

The Happy Mes­sen­ger, Sero­tonin, must work prop­erly in order for you to sleep well. Sero­tonin is respon­si­ble for mak­ing sure that your body’s phys­i­ol­ogy is set for sleep­ing. If Sero­tonin does not do its job prop­erly, you will not be able to obtain a rest­ful sleep, no mat­ter how hard you try.

SEROTONIN SETS YOUR BODY CLOCK

Inside every one of our brains is a very accu­rate “Clock”. This time keep­ing appa­ra­tus func­tions like the con­duc­tor of a sym­phony orches­tra. Just as the con­duc­tor of the orches­tra keeps all the var­i­ous instru­ments play­ing in rhythm, so the Body Clock keeps all the var­i­ous func­tions of your body coor­di­nated, and mov­ing to the same rhythm.

The Body Clock is located deep in the cen­ter of the brain, in a lit­tle group of cells known as the Pineal Gland. Within the Pineal Gland is a store-house of the mes­sen­ger Sero­tonin, which is the chem­i­cal “main­spring” of the Clock. Each day the Sero­tonin is chem­i­cally con­verted to a related com­pound, Mela­tonin; and then the Mela­tonin is con­verted right back to Sero­tonin. The whole cycle from Sero­tonin to Mela­tonin and back to Sero­tonin takes exactly 25 hours — and this forms your Body’s Clock.

Twenty five hours? Yes, under exper­i­men­tal con­di­tions of an unchang­ing envi­ron­ment, such as in a cave kept at a con­stant level of illu­mi­na­tion for weeks on end, this Body Clock cycles every 25 hours. If, how­ever, a per­son is exposed to a nat­ural out­door cycle of day­light and dark­ness, the Pineal Gland will auto­mat­i­cally set itself to a 24 hour day. That is, the Pineal Gland will auto­mat­i­cally match its cycle to the length of one Earth’s day. That way, noon in the Pineal Gland is always noon on Earth. If exposed to day­light, the Pineal Gland will nei­ther gain nor lose time, but will always cycle exactly in con­cert with the Earth as our planet twirls through space. The whole process of set­ting the Body Clock to Earth time takes about three weeks.

The 24 hour cycling of the Body Clock is impor­tant. It adjusts your body chem­istry for sleep­ing and for wak­ing. Every evening your Body Clock will set your phys­i­ol­ogy for sleep­ing; then you feel drowsy and sleep soundly. After a while, your Body Clock adjusts your phys­i­ol­ogy for wak­ing. You then wake up and feel refreshed.

We men­tioned that the Body Clock is the coor­di­na­tor of your phys­i­o­logic orches­tra. Three impor­tant play­ers in that orches­tra are your body tem­per­a­ture, stress fight­ing hor­mone, and sleep cycles. Each of these must be prop­erly coor­di­nated by the Body Clock in order for you to sleep soundly, and awake feel­ing rested.

THE BODY CLOCK AND YOUR BODY TEMPERATURE

Every 24 hours, your body tem­per­a­ture cycles from high to low, vary­ing by as much as one degree. When it is time to wake up and be active, your body tem­per­a­ture rises slightly. When it is time to fall asleep, your body tem­per­a­ture dips slightly. Most of us have felt how dif­fi­cult it is to fall asleep on a very warm night, when you toss and turn and wish you could cool off. Con­trast this with the rel­a­tive com­fort when one is tucked in a nice bed in a room that is slightly cool, or even down­right cold. To achieve the best sleep, the body ther­mo­stat is sup­posed to lower slightly at night, a tim­ing which is coor­di­nated by your Body Clock.

THE BODY CLOCK AND YOUR STRESS FIGHTING HORMONE

The body has a vital hor­mone called Cor­ti­sol, which is the body’s chief stress fight­ing hor­mone. When Cor­ti­sol secre­tion is high, the body shifts to a “war foot­ing”. It is pre­pared for stress con­di­tions such as hunger, trauma, hem­or­rhage, fight­ing, or run­ning. Ordi­nar­ily, one’s Cor­ti­sol drops sub­stan­tially in the evening, as one relaxes, set­tles down, and pre­pares for sleep.

As with body tem­per­a­ture, the ups and downs of your stress fight­ing hor­mone must cycle prop­erly dur­ing a 24 hour day for you to achieve a rest­ful night’s sleep and awake refreshed. Any dis­rup­tion of your Cor­ti­sol cycle, and rest­ful sleep will become very difficult.

THE BODY CLOCK AND YOUR SLEEP CYCLES

After falling asleep, one nor­mally goes DEEPER and DEEPER into sleep, finally reach­ing a state of deep restora­tive sleep. Then sleep becomes LIGHTER and LIGHTER until one enters dream­ing sleep. Then the whole cycle begins over again. About every 90 min­utes one goes through this cycle. In the early part of the evening the cycle pauses a rel­a­tively long time in the deep­est restora­tive phase. As the evening pro­gresses, the amount of time spent in deep restora­tive sleep lessens, and one spends more and more time dream­ing. In order for one to feel rested, this sleep pat­tern must be cycling prop­erly. And, of course, the cycle is reg­u­lated by your inter­nal Body Clock.

STRESS DESTROYS YOUR SLEEP

The Body Clock is essen­tial for the proper har­mony of your body tem­per­a­ture, stress fight­ing hor­mone, and sleep cycles. In order to fall asleep eas­ily, sleep soundly, and awake refreshed, your Body Clock must be func­tion­ing prop­erly. The Happy Mes­sen­ger, Sero­tonin, is the “main­spring” of the Body Clock. If stress causes Sero­tonin to fail, the Body Clock will stop work­ing. You will not be able to obtain a rest­ful sleep, no mat­ter how hard you try.

SINCE SEROTONIN IS USUALLY THE FIRST HAPPY MESSENGER TO FAIL UNDER STRESS, THE FIRST SIGN OF OVERSTRESS WILL USUALLY BE INABILITY TO OBTAIN A RESTFUL SLEEP.

Nora­dren­a­lin: Giv­ing Us Energy

I am sure you have all heard of “Adren­a­lin”. When you are fright­ened, Adren­a­lin is released into your blood stream by your adrenal glands. Your heart beats faster, blood flow is shunted away from your skin and intestines and towards your mus­cles. Per­spi­ra­tion appears on your palms and fore­head. You are ready for “fight or flight”. A cousin of Adren­a­lin, named Nora­dren­a­lin is one of the Happy Mes­sen­gers. Nora­dren­a­lin has many impor­tant func­tions in the body’s ner­vous sys­tem. The one that most con­cerns us here, how­ever, is the role of Nora­dren­a­lin in set­ting your energy lev­els. Proper func­tion­ing of Nora­dren­a­lin in the brain is essen­tial for you to feel ener­gized. With­out enough brain Nora­dren­a­lin you feel exhausted, tired, droopy and with­out energy. You just don’t feel like doing any­thing. You just wantto sit.

Peo­ple with Nora­dren­a­lin fail­ure become pro­gres­sively more and more lethar­gic. They do not seem to have any energy to do any­thing. Run­ning your brain with low Nora­dren­a­lin is akin to run­ning your car with a fail­ing bat­tery. Sooner or later, it just won’t start.

Dopamine: Your Plea­sure and Your Pain

As you prob­a­bly know, mor­phine and heroin are the most potent pain reliev­ing and plea­sure pro­duc­ing med­ica­tions known to man. They are so potent in fact, that they were long believed to mimic some unknown, but nat­u­rally occur­ring, body chem­i­cal. A recent tech­no­log­i­cal advance has led to the remark­able uncov­er­ing of nat­ural morphine-like mol­e­cules that are, indeed, made in each of our brains. Col­lec­tively, these sub­stances are known as ENDORPHINS, and they are respon­si­ble for reg­u­lat­ing our moment to moment aware­ness of pain.

It appears that in the dis­cov­ery of Endor­phins we have found our body’s nat­u­rally occur­ring mech­a­nism for reg­u­lat­ing pain. It is likely that a cer­tain base­line secre­tion of Endor­phin occurs at all times in the body. Under cer­tain con­di­tions, this Endor­phin secre­tion may rise, mak­ing the per­son rel­a­tively insen­si­tive to pain. Under other con­di­tions, the Endor­phin lev­els may drop, mak­ing a per­son more sen­si­tive than usual to pain.

Indi­vid­ual vari­a­tions of Endor­phin level would explain the obser­va­tion that peo­ple may react with dif­fer­ing lev­els of per­ceived pain when suf­fer­ing the same painful stim­u­lus. In med­ical prac­tice it is quite com­mon to see one per­son with an injury have very lit­tle dis­com­fort, while another per­son with a very sim­i­lar injury has ter­ri­ble dis­com­fort. In the past we have said that such unusual suf­fer­ing was “all in the person’s head”.

Now we may spec­u­late that what is dif­fer­ent in that person’s head is the Endor­phin level. Hence, the per­son who seems to have an unusual amount of dis­com­fort from what appears to be a triv­ial injury, prob­a­bly is feel­ing more pain. For some rea­son, his body’s own pain con­trol mech­a­nism has been depleted of Endorphins.

Now, our third Happy Mes­sen­ger, Dopamine, seems to be con­cen­trated in areas of the brain imme­di­ately adja­cent to where the major Endor­phin releas­ing mech­a­nisms lie. When Dopamine func­tion declines, Endor­phin func­tion also declines. Hence, when too much stress causes fail­ure of Dopamine func­tion, it also causes loss of your body’s nat­ural “pain killer”.

Dopamine also runs your body’s “Plea­sure Cen­ter”. This is the area of your brain that allows you to enjoy life. When stress inter­feres with your Dopamine func­tion, the Plea­sure Cen­ter becomes inop­er­a­tive. Nor­mally plea­sure­ful activ­i­ties no longer give any plea­sure. With severe Dopamine/Endorphin mal­func­tion, life becomes painful and devoid of any pleasure.

WHAT OVERSTRESS FEELS LIKE

When your stress level is high enough to cause fail­ure of your Happy Mes­sen­gers, what is going to hap­pen to you? What will you feel like?

If your total stress load is high enough to inter­fere with your brain’s Happy Mes­sen­gers, then your Body Clock is going to stop work­ing. You will find your­self hav­ing dif­fi­culty falling asleep, and fre­quent awak­en­ings dur­ing the night, per­haps with vivid dreams. When morn­ing rolls around, you will not feel at all rested.

Next, you will note lack of energy, lack of desire to get out and do things, lack of inter­est in the out­side world.

Next, you will have aches and pains. Par­tic­u­larly com­mon are chest, shoul­der, back and neck pains. But, it will seem like you are aware of vague, uncom­fort­able feel­ings from all over your body. Along with increased sen­si­tiv­ity to aches and pains, there is a decreased sense of plea­sure in life. Things that used to be fun or plea­sur­able do not seem enjoy­able anymore.

When all of these symp­toms coincide–lack of sleep, fatigue, aches and pains–you feel that life is not enjoy­able any­more. You feel over­whelmed by life. Now you may cry eas­ily, and feelthat you are “depressed”.

You may also feel quite anx­ious. All these strange changes in your body. Why can’t I sleep? Why do I ache all the time? Am I hav­ing a heart attack? What is hap­pen­ing to me? It is not uncom­mon for per­sons who are expe­ri­enc­ing the strange changes in their body caused by Happy Mes­sen­ger fail­ure to have peri­ods of panic. It is dur­ing these so-called “panic attacks” that you feel as if you can not catch your breath. The heart races in panic, the mus­cles ache and pain all over the chest. You may even get light-headed. You may have stom­ach upset and diar­rhea. Stress has caused your body to behave in strange and dif­fi­cult ways. Under these cir­cum­stances, anx­i­ety and fear are not at all unexpected.

All of us have expe­ri­enced some peri­ods of OVERSTRESS in our lives. Usu­ally they will be of short dura­tion. We live in such a high stress soci­ety, how­ever, that at least TEN PERCENT OF OUR POPULATION IS IN OVERSTRESS ALL THE TIME! These peo­ple, who have inher­ited a Low Stress Tol­er­ance, are fight­ing against Happy Mes­sen­ger fail­ure every day of their lives. It rarely stops; and they are sorely afflicted.

In the past, we did not know the cause of this suf­fer­ing. Such per­sons were often said to have a “men­tal ill­ness”. The med­ical world now rec­og­nizes these symp­toms to arise from a brain Happy Mes­sen­ger mal­func­tion. THIS MALFUNCTION IS CAUSED BY TOO MUCH STRESS.

What was once regarded as a men­tal ill­ness has emerged from that shad­owy realm to reside in the world of bio­chem­istry and phys­i­cal illness.

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What are the common causes of Lower Back Pain

May 7th, 2009

Com­mon causes of low back pain include lum­bar strain, nerve irri­ta­tion, lum­bar radicu­lopa­thy, bony encroach­ment, and con­di­tions of the bone and joints. Each of these is reviewed below.

  1. Lum­bar strain (acute, chronic)
    A lum­bar strain is a stretch­ing injury to the lig­a­ments, ten­dons, and/or mus­cles of the low back. The stretch­ing inci­dent results in micro­scopic tears of vary­ing degrees in these tis­sues. Lum­bar strain is con­sid­ered one of the most com­mon causes of low back pain. The injury can occur because of overuse, improper use, or trauma. Soft-tissue injury is com­monly clas­si­fied as “acute” if it has been present for days to weeks. If the strain lasts longer than three months, it is referred to as “chronic.”

    Lum­bar strain most often occurs in peo­ple in their for­ties, but it can hap­pen at any age. The con­di­tion is char­ac­ter­ized by local­ized dis­com­fort in the low back area with onset after an event that mechan­i­cally stressed the lum­bar tis­sues. The sever­ity of the injury ranges from mild to severe, depend­ing on the degree of strain and result­ing spasm of the mus­cles of the low back.

    The diag­no­sis of lum­bar strain is based on the his­tory of injury, the loca­tion of the pain, and exclu­sion of ner­vous sys­tem injury. Usu­ally, x-ray test­ing is only help­ful to exclude bone abnormalities.

    The treat­ment of lum­bar strain con­sists of rest­ing the back (to avoid re-injury), med­ica­tions to relieve pain and mus­cle spasm, local heat appli­ca­tions, mas­sage, and even­tual (after the acute episode resolves) recon­di­tion­ing exer­cises to strengthen the low back and abdom­i­nal mus­cles. Long peri­ods of inac­tiv­ity in bed are no longer pro­moted, as this treat­ment may actu­ally slow recov­ery. Spinal manip­u­la­tion for peri­ods of up to one month has been found help­ful in some patients that do not have signs of nerve irri­ta­tion. Future injury is avoided by using back-protection tech­niques dur­ing activ­i­ties and sup­port devices as needed at home or work.

  2. Nerve irri­ta­tion
    The nerves of the lum­bar spine can be irri­tated by mechan­i­cal impinge­ment or dis­ease any where along their paths—from their roots at the spinal cord to the skin sur­face. These con­di­tions include lum­bar disc dis­ease (radicu­lopa­thy), bony encroach­ment, and inflam­ma­tion of the nerves caused by a viral infec­tion (shin­gles). See dis­cus­sions of these con­di­tions below.
  3. Lum­bar radicu­lopa­thy
    Lum­bar radicu­lopa­thy is nerve irri­ta­tion that is caused by dam­age to the discs between the ver­te­brae. Dam­age to the disc occurs because of degen­er­a­tion (“wear and tear”) of the outer ring of the disc, trau­matic injury, or both. As a result, the cen­tral softer por­tion of the disc can rup­ture (her­ni­ate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal col­umn. This rup­ture is what causes the com­monly rec­og­nized “sci­at­ica” pain that shoots down the leg. Sci­at­ica can be pre­ceded by a his­tory of local­ized low-back aching or it can fol­low a “pop­ping” sen­sa­tion and be accom­pa­nied by numb­ness and tin­gling. The pain com­monly increases with move­ments at the waist and can increase with cough­ing or sneez­ing. In more severe instances, sci­at­ica can be accom­pa­nied by incon­ti­nence of the blad­der and/or bow­els.
    Lum­bar radicu­lopa­thy is sus­pected based on the above symp­toms. Increased radi­at­ing pain when the lower extrem­ity is lifted sup­ports the diag­no­sis. Nerve test­ing (EMG/electromyogram and NCV/nerve con­duc­tion veloc­ity) of the lower extrem­i­ties can be used to detect nerve irri­ta­tion. The actual disc her­ni­a­tion can be detected with radi­ol­ogy test­ing, such as CAT or MRI scan­ning.
    Treat­ment of lum­bar radicu­lopa­thy ranges from med­ical man­age­ment to surgery. Med­ical man­age­ment includes patient edu­ca­tion, med­ica­tions to relieve pain and mus­cles spasm, cor­ti­sone injec­tion around the spinal cord (epidural injec­tion), phys­i­cal ther­apy (heat, mas­sage, ultra­sound, elec­tri­cal stim­u­la­tion), and rest (not strict bed rest, but avoid­ing re-injury). With unre­lent­ing pain, severe impair­ment of func­tion, or incon­ti­nence (which can indi­cate spinal cord irri­ta­tion), surgery may be nec­es­sary. The oper­a­tion per­formed depends on the over­all sta­tus of the spine, and the age and health of the patient. Pro­ce­dures include removal of the her­ni­ated disc with lamino­tomy (a small hole in the bone of the lum­bar spine sur­round­ing the spinal cord), laminec­tomy (removal of the bony wall), by nee­dle tech­nique (per­cu­ta­neous dis­cec­tomy), disc-dissolving pro­ce­dures (chemonu­cle­ol­y­sis), and others.

Pic­ture of her­ni­ated disc between L4 and L5
Picture of herniated disc between L4 and L5

Cross-section pic­ture of her­ni­ated disc between L4 and L5
Cross-section picture of herniated disc between L4 and L5

  1. Bony encroach­ment
    Any con­di­tion that results in move­ment or growth of the ver­te­brae of the lum­bar spine can limit the space (encroach­ment) for the adja­cent spinal cord and nerves. Causes of bony encroach­ment of the spinal nerves include foram­i­nal nar­row­ing (nar­row­ing of the por­tal through which the spinal nerve passes from the spinal col­umn, out of the spinal canal to the body), spondy­lolis­the­sis (slip­page of one ver­te­bra rel­a­tive to another), and spinal steno­sis (com­pres­sion of the nerve roots or spinal cord by bony spurs or other soft tis­sues in the spinal canal). Spinal-nerve com­pres­sion in these con­di­tions can lead to sci­at­ica pain that radi­ates down the lower extrem­i­ties. Spinal steno­sis can cause lower-extremity pains that worsen with walk­ing and are relieved by rest­ing (mim­ic­k­ing poor cir­cu­la­tion). Treat­ment of these afflic­tions varies, depend­ing on their sever­ity, and range from rest to sur­gi­cal decom­pres­sion by remov­ing the bone that is com­press­ing the ner­vous tissue.
  2. Bone and joint con­di­tions
    Bone and joint con­di­tions that lead to low back pain include those exist­ing from birth (con­gen­i­tal), those that result from wear and tear (degen­er­a­tive) or injury, and those that are from inflam­ma­tion of the joints (arthritis).

      Con­gen­i­tal bone con­di­tions—Con­gen­i­tal causes (exist­ing from birth) of low back pain include sco­l­io­sis and spina bifida. Sco­l­io­sis is a side­ways (lat­eral) cur­va­ture of the spine that can be caused when one lower extrem­ity is shorter than the other (func­tional sco­l­io­sis) or because of an abnor­mal design of the spine (struc­tural sco­l­io­sis). Chil­dren who are sig­nif­i­cantly affected by struc­tural sco­l­io­sis may require treat­ment with brac­ing and/or surgery to the spine. Adults infre­quently are treated sur­gi­cally but often ben­e­fit by sup­port bracing.

      Spina bifida is a birth defect in the bony ver­te­bral arch over the spinal canal, often with absence of the spin­ous process. This birth defect most com­monly affects the low­est lum­bar ver­te­bra and the top of the sacrum. Occa­sion­ally, there are abnor­mal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnor­mal­ity with­out symp­toms. How­ever, the con­di­tion can also be accom­pa­nied by seri­ous ner­vous abnor­mal­i­ties of the lower extremities.

      Degen­er­a­tive bone and joint con­di­tions—As we age, the water and pro­tein con­tent of the body’s car­ti­lage changes. This change results in weaker, thin­ner, and more frag­ile car­ti­lage. Because both the discs and the joints that stack the ver­te­brae (facet joints) are partly com­posed of car­ti­lage, these areas are sub­ject to wear and tear over time (degen­er­a­tive changes). Degen­er­a­tion of the disc is called spondy­lo­sis. Spondy­lo­sis can be noted on x-rays of the spine as a nar­row­ing of the nor­mal “disc space” between the ver­te­brae. It is the dete­ri­o­ra­tion of the disc tis­sue that pre­dis­poses the disc to her­ni­a­tion and local­ized lum­bar pain (“lum­bago”) in older patients. Degen­er­a­tive arthri­tis (osteoarthri­tis) of the facet joints is also a cause of local­ized lum­bar pain that can be detected with plain x-ray test­ing. These causes of degen­er­a­tive back pain are usu­ally treated con­ser­v­a­tively with inter­mit­tent heat, rest, reha­bil­i­ta­tive exer­cises, and med­ica­tions to relieve pain, mus­cle spasm, and inflammation.

      Injury to the bones and joints—Frac­tures (break­age of bone) of the lum­bar spine and sacrum bone most com­monly affect elderly peo­ple with osteo­poro­sis, espe­cially those who have taken long-term cor­ti­sone med­ica­tion. For these indi­vid­u­als, occa­sion­ally even min­i­mal stresses on the spine (such as bend­ing to tie shoes) can lead to bone frac­ture. In this set­ting, the ver­te­bra can col­lapse (ver­te­bral com­pres­sion frac­ture). The frac­ture causes an imme­di­ate onset of severe local­ized pain that can radi­ate around the waist in a band-like fash­ion and is made intensely worse with body motions. This pain gen­er­ally does not radi­ate down the lower extrem­i­ties. Ver­te­bral frac­tures in younger patients occur only after severe trauma, such as from motor-vehicle acci­dents or a con­vul­sive seizure.In both younger and older patients, ver­te­bral frac­tures take weeks to heal with rest and pain reliev­ers. Com­pres­sion frac­tures of ver­te­brae asso­ci­ated with osteo­poro­sis can also be treated with a pro­ce­dure called ver­te­bro­plasty, which can help to reduce pain. In this pro­ce­dure, a bal­loon is inflated in the com­pressed ver­te­bra, often return­ing some of its lost height. Sub­se­quently, a “cement” (methymethacry­late) is injected into the bal­loon and remains to retain the structure.

      Arthri­tis—The spondy­loarthropathies are inflam­ma­tory types of arthri­tis that can affect the lower back and sacroil­iac joints. Exam­ples of spondy­loarthropathies include reac­tive arthri­tis (Reiter’s dis­ease), anky­los­ing spondyli­tis, pso­ri­atic arthri­tis, and the arthri­tis of inflam­ma­tory bowel dis­ease. Each of these dis­eases can lead to low back pain and stiff­ness, which is typ­i­cally worse in the morn­ing. These con­di­tions usu­ally begin in the sec­ond and third decades of life. They are treated with med­ica­tions directed toward decreas­ing the inflam­ma­tion. Newer bio­logic med­ica­tions have been greatly suc­cess­ful in both qui­et­ing the dis­ease and stop­ping the progression.

What are other causes of low back pain?

Other causes of low back pain include kid­ney prob­lems, preg­nancy, ovary prob­lems, and tumors.

  1. Kid­ney prob­lems: Kid­ney infec­tions, stones, and trau­matic bleed­ing of the kid­ney (hematoma) are fre­quently asso­ci­ated with low back pain. Diag­no­sis can involve urine analy­sis, sound­wave tests, or radi­o­log­i­cal scan­ning of the abdomen.
  2. Preg­nancy: Preg­nancy com­monly leads to low back pain by mechan­i­cally stress­ing the lum­bar spine (chang­ing the nor­mal lum­bar cur­va­ture) and by the posi­tion­ing of the baby inside of the abdomen. Addi­tion­ally, the effects of the female hor­mone estro­gen and the ligament-loosening hor­mone relaxin may con­tribute to loos­en­ing of the lig­a­ments and struc­tures of the back. Pelvic-tilt exer­cises are often rec­om­mended for this pain. Women are also rec­om­mended to main­tain phys­i­cal con­di­tion­ing dur­ing preg­nancy accord­ing to their doc­tors’ advice.
  3. Ovary prob­lems: Ovar­ian cysts, uter­ine fibroids, and endometrio­sis not infre­quently cause low back pain. Pre­cise diag­no­sis can require gyne­co­logic exam­i­na­tion and testing.
  4. Tumors: Low back pain can be caused by tumors, either benign or malig­nant, that orig­i­nate in the bone of the spine or pelvis and spinal cord (pri­mary tumors) and those which orig­i­nate else­where and spread to these areas (metas­ta­size). Symp­toms range from local­ized pain to radi­at­ing severe pain and loss of nerve and mus­cle func­tion (even incon­ti­nence of urine and stool) depend­ing on whether or not the tumors affect the ner­vous tis­sue. Tumors of these areas are detected using radi­o­log­i­cal tests, such as plain x-rays, nuclear bone scan­ning, and CAT and MRI scanning.

What are uncom­mon causes of low back pain?

Uncom­mon causes of low back pain include Paget’s dis­ease of bone, bleed­ing or infec­tion in the pelvis, infec­tion of the car­ti­lage and/or bone of the spine, aneurysm of the aorta, and shingles.

  1. Paget’s dis­ease of bone: Paget’s dis­ease of the bone is a con­di­tion of unknown cause in which the bone for­ma­tion is out of syn­chrony with nor­mal bone remod­el­ing. This con­di­tion results in abnor­mally weak­ened bone and defor­mity and can cause local­ized bone pain. Paget’s dis­ease is more com­mon in peo­ple over the age of 50. Hered­ity (genetic back­ground) and cer­tain unusual virus infec­tions have been sug­gested as causes. Thick­en­ing of involved bony areas of the lum­bar spine can cause the radi­at­ing lower extrem­ity pain of sci­at­ica.
    Paget’s dis­ease can be diag­nosed on plain x-rays. How­ever, a bone biopsy is occa­sion­ally nec­es­sary to ensure the accu­racy of the diag­no­sis. Bone scan­ning is help­ful to deter­mine the extent of the dis­ease, which can involve more than one bone area. A blood test, alka­line phos­phatase, is use­ful for diag­no­sis and mon­i­tor­ing response to ther­apy. Treat­ment options include aspirin, other anti-inflammatory med­i­cines, pain med­ica­tions, and med­ica­tions that slow the rate of bone turnover, such as cal­ci­tonin (Cal­ci­mar, Mia­cal­cin), etidronate (Didronel), alen­dronate (Fos­amax), rise­dronate (Actonel), and pamidronate (Aredia).
  2. Bleed­ing or infec­tion in the pelvis: Bleed­ing in the pelvis is rare with­out sig­nif­i­cant trauma and is usu­ally seen in patients who are tak­ing blood-thinning med­ica­tions, such as warfarin(Coumadin). In these patients, a rapid-onset sci­at­ica pain can be a sign of bleed­ing in the back of the pelvis and abdomen that is com­press­ing the spinal nerves as they exit to the lower extrem­i­ties. Infec­tion of the pelvis is infre­quent but can be a com­pli­ca­tion of con­di­tions such as diver­tic­u­lo­sis, Crohn’s dis­ease, ulcer­a­tive col­i­tis, infec­tion of the tubes or uterus, and even appen­dici­tis. This is a seri­ous com­pli­ca­tion of these con­di­tions and is often asso­ci­ated with fever, low­er­ing of blood pres­sure, and a life-threatening state.
  3. Infec­tion of the car­ti­lage and/or bone of the spine: Infec­tion of the discs (sep­tic disci­tis) and bone (osteomyelitis) is extremely rare. These con­di­tions lead to local­ized pain asso­ci­ated with fever. The bac­te­ria found when these tis­sues are tested with lab­o­ra­tory cul­tures include Staphy­lo­coc­cus aureus and Mycobac­terium tuber­cu­lo­sis (TB bac­te­ria). TB infec­tion in the spine is called Pott’s dis­ease. These are each very seri­ous con­di­tions requir­ing long courses of antibi­otics. The sacroil­iac joints rarely become infected with bac­te­ria. Bru­cel­losis is a bac­te­r­ial infec­tion that can involve the sacroil­iac joints and is usu­ally trans­mit­ted in goat’s milk.
  4. Aneurysm of the aorta: In the elderly, ath­er­o­scle­ro­sis can cause weak­en­ing of the wall of the large arte­r­ial blood ves­sel (aorta) in the abdomen. This weak­en­ing can lead to a bulging (aneurysm) of the aorta wall. While most aneurysms cause no symp­toms, some cause a pul­sat­ing low back pain. Aneurysms of cer­tain size, espe­cially when enlarg­ing over time, can require sur­gi­cal repair with a graft­ing pro­ce­dure to repair the abnor­mal por­tion of the artery.
  5. Shin­gles: Shin­gles (Her­pes zoster) is an acute infec­tion of the nerves that sup­ply sen­sa­tion to the skin, gen­er­ally at one or sev­eral spinal lev­els and on one side of the body (right or left). Patients with shin­gles usu­ally have had chick­en­pox ear­lier in life. The Her­pes virus that causes chick­en­pox is believed to exist in a dor­mant state within the spinal nerve roots long after the chick­en­pox resolves. In peo­ple with shin­gles, this virus reac­ti­vates to cause infec­tion along the sen­sory nerve, lead­ing to nerve pain and usu­ally an out­break of shin­gles (tiny blis­ters on the same side of the body and at the same nerve level). The back pain in patients with shin­gles of the lum­bar area can pre­cede the skin rash by days. Suc­ces­sive crops of tiny blis­ters can appear for sev­eral days and clear with crusty inflam­ma­tion in one to two weeks. Patients occa­sion­ally are left with a more chronic nerve pain (pos­ther­petic neu­ral­gia). Treat­ment can involve symp­to­matic relief with lotions, such as calamine, or med­ica­tions, such as acy­clovir (Zovi­rax) for the infec­tion and pre­ga­balin (Lyrica) for the pain.
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