Information on chronic pain and addicton

Christopher Frandrup, M.D., DABPM, FIPP

Category: Chronic Pain (Page 1 of 6)

Ketamine Therapy

Ketamine infusions may be effective for various pain conditions such as neuropathic pain, complex regional pain syndrome (CRPS), migraines, fibromyalgia, post-herpetic neuralgia and spinal cord injury. Ketamine was first used in 1966 as an anesthetic and recently interest in its properties has been growing.  Ketamine is what is known as an N-methyl-D-aspartic acid (NMDA) receptor antagonist.  The activity of this receptor can be altered in various conditions such as chronic pain, depression and PTSD. 

Ketamine is a potent anesthetic, but the anesthetic effects are short-lived. In low doses it is tremendously effective in reducing pain.  In high doses, ketamine can cause euphoria and hallucinations which has popularized its recreational use. The long-term benefits from ketamine derive from the way it changes activity in the spinal cord and brain to reduce nerve activity activated by disease states.  Chronic pain and depression are often interlinked.  Individuals suffering from chronic pain often become depressed.  On the other hand, we know if you suffer from depression, you are more prone to chronic pain as well.  It is estimated that between 50-75% of chronic pain patients have depression.  Ketamine is one of a few treatments targeting both aspects of this problem.  When used for depression, it is recommend the diagnosis of depression be confirmed by a physician.  In addition, you should first try antidepressant medication before resorting to ketamine infusions.  Antidepressants generally take weeks to work for depression.  What is remarkable about ketamine is the immediacy of the antidepressant effects.  When it works, it takes only hours instead of weeks!  Ketamine works differently than traditional antidepressants and can therefore be especially beneficial to those who have not responded to antidepressants. 

Ketamine is widely used to treat acute pain, especially following surgery.  In low doses, ketamine can reduce post operative pain and reduce the need for strong narcotics by 40% with very little side effects.  We now know uncontrolled acute pain can lead to chronic pain.    If you have had a major operation recently, you may have been given ketamine as part of your anesthetic.   The successful use of ketamine in the operating room has lead to surge in use for chronic pain as well. 

Ketamine can be administered through many different routes. Most commonly, ketamine is delivered through an intravenous (IV) pump. Sometimes, patients will ingest ketamine orally as a pill. Ketamine can also be applied directly to the skin as a topical gel or cream, inhaled through the nose, or injected into a muscle or bone.

Patients with chronic pain have been successfully treated with intravenous or intranasal ketamine.   Those responding to treatment have seen the following results:

▪ reduced pain

▪ improved depression

▪ more hopeful

▪ improved interpersonal relationships

▪ more relaxed

At Allpria Healthcare, we use ketamine a possible treatment option to treat various chronic pain disorders and depression.  Therapy is individually tailored to your needs and our professional office staff provides a safe and comfortable experience for the infusion.  The success rates for ketamine therapy vary based on the condition, but more that 70% of patients has a beneficial response.   At low dose the side effects are minimal but may include dizziness, abnormal muscle movements, changes in blood pressure or heart rate, increased salivation, disorientation, nausea, redness or swelling at the IV site, and allergic reactions. These side effects will subside once the infusion stops. Schedule an appointment to discuss if this treatment is right for you.

Is Pain Hereditary?

Is Pain Hereditary? | Allpria.com

Is Pain Hereditary?

Chronic pain is a complex medical condition with no easy answers. While acute pain can often be traced to one particular injury or illness, why acute pain turns into chronic pain long after the accident occurs remains a mystery. This mystery is the focus of a new study that attempted to answer the question: is pain hereditary?

Is pain hereditary?

A report in the journal PAIN®, the official publication of the International Association for the Study of Pain (IASP) published by Wolters Kluwer, looked at this question in-depth. Researchers visited with families to investigate the role genetics might play in chronic pain. Amanda L. Stone of Vanderbilt University and Anna C. Wilson of Oregon Health & Science University developed a framework of chronic pain transmission, writing:

“Such a framework highlights chronic pain as inherently familial and intergenerational, opening up avenues for new models of intervention and prevention that can be family-centered and include at-risk children.”

To be clear, this report does not indicate a clear genetic marker for pain. The report looks at not only genetic evidence but also environmental factors. This framework includes five specific ways in which chronic pain risk might be passed from parent to child.

Is pain hereditary?

Researchers believe that nearly half of the risk of chronic pain can be genetically linked.

Is pain biological?

The report found that neurobiological development in children could be affected by a parent’s chronic pain, especially in early, formative years.

Is pain social?

Children with a parent in chronic pain may be more prone to “maladaptive” behaviors such as negative thinking and catastrophizing (exaggerated response to or worries about pain).

Is pain practical?

How parents in pain interact with their children seems to play a role in chronic pain transmission. Parents in pain may not be as active or display as much warmth towards their children. They may also be more permissive or inconsistent in their rules and parenting due to pain level fluctuations.

Is pain environmental?

Simply living in an environment where pain is a daily event can be stressful. Add in the high cost of chronic pain and a parent’s inability to contribute to the household. Children may be affected by this stress for years, well into adulthood.

Researchers Stone and Wilson created this framework to help understand the complex ways in which chronic pain is passed down from parent to child. Their work does not quite answer the question “Is pain hereditary?” They looked to see more if pain was prevalent across generations in families and to figure out what factors influenced that.

Genetics and disc degeneration study

Other studies have specifically looked for a genetic link in pain across generations. A study out of King’s College London found a specific gene that is connected to degeneration of discs in the lower back. This degeneration is connected to an increased risk of age-related lower back pain.

Dr. Frances Williams, senior lecturer from the department of twin research and genetic epidemiology at King’s College London, summed up the genetic link, noting:

“We have performed, using data collected from around the world, the biggest genome-wide association analysis of lumbar disc degeneration (LDD). We know that people whose discs wear out are at increased risk of episodes of lower back pain, but normal human discs are hard to get hold of to study so until now our knowledge of normal human biology was incomplete. We have identified a gene called PARK2 as associated with LDD. We have shown that the gene may be switched off in people with the condition.”

Research on pain perception in families

Other research into the hereditary link to pain found that genetics may play a role in the perception of pain itself. Tobore Onojjighofia, MD, MPH, with Proove Biosciences and a member of the American Academy of Neurology, looked at over 2,700 people with chronic pain. All of these patients were taking opioids for pain.

He asked participants to rate their pain as follows on a scale from one to ten:

  • Low: One, two, or three
  • Moderate: Four, five, or six
  • High: Seven, eight, nine, or ten

Patients who rated their pain as zero were not included in the findings.

Of the study participants, 9% had low pain perception, 46% had moderate pain perception, and 45% had high pain perception.

Researchers compared the ratings to the presence of certain genes.  They looked for variations in the DRD1, COMT, OPRK, and DRD2 genes. Their findings indicated certain commonalities in gene variants, including:

  • Low pain perception: The DRD1 gene variant was 33% more prevalent in the low pain group compared to the high pain group
  • Moderate pain perception: COMT and OPRK variants were 25% and 19% more prevalent than in those with a high pain perception
  • High pain perception: DRD2 variant was 25% more common than in those with moderate pain

These results indicate that even if pain itself is not hereditary, pain perception may be. The findings of this study confirm earlier research done by King’s College London. This study showed that those with increased pain sensitivity had less variation in their genes than people who were less sensitive to pain.

What the research means for patients

Studying genetic links to pain can lead to more targeted and individualized treatments tailored to an individual’s DNA. Ruth McKernan, chief scientific officer of Pfizer’s research unit noted that research findings on genetic links to chronic pain can result in tremendous progress for effective pain medication, saying:

“This study demonstrates the value of collaborative efforts between academia and industry. The genetic influence on normal pain processing in human volunteer populations will add to other approaches and help us prioritise potential new mechanisms for treating pain.”

Has your family experienced intergenerational chronic pain? And what do you think: Is pain hereditary?

21 Of The Best Pillows For Neck Pain

21 Of The Best Pillows For Neck Pain

Finding the best pillow for neck pain is a critical concern for the millions of people who suffer from neck pain. It’s estimated that up to 25% of all women will experience neck pain at some point, with up to 15% of men experiencing it. Finding the best pillow for neck pain can help reduce neck pain from sleeping, while also providing better quality sleep overall.

What is the best pillow for neck pain?

Finding the best pillow for neck pain isn’t straightforward. Many things will depend on finding it, including your specific cause of neck pain and your sleep habits. However, focusing in on a few key areas can help. When it comes to finding the best pillow for neck pain, consider the: pillow characteristics, the material the pillow is made from, and your sleeping style.

Your goal, with all of these, is to keep your neck in the proper alignment in order to reduce pain. Kammi Bernard, PT, a physical therapist at the Baylor Health Care System in Dallas notes:

“The goal of using a pillow is to help keep your head in what is called a ‘neutral alignment,’ meaning your head is sitting squarely on your shoulders without bending back too far or reaching too far forward.”

This simple adjustment can make a world of difference for neck pain patients. It’s important to get the pillow right and, if done correctly, some patients can find that their neck pain reduces or goes away completely. Dr. Raymond Hall on Pillo1.com states that:

“I consider the lack of proper neck and head pillow support that almost all ordinary pillows and even 99% of the so-called “therapeutic pillows” on the market, are the MAJOR cause of neck pain in our society.”

ChooseMattress.com echoes this sentiment, noting that old pillows or sagging mattresses are leading to many neck pain issues for patients. Let’s take a look at these different areas before we dive into our list of the best pillow for neck pain options.

Finding The Best Pillow For Neck Pain | PainDoctor.com

The best characteristics of pillows for neck pain

Where do you start when it comes to getting the best pillow for neck pain? Loom & Leaf suggests focusing in on six characteristics of pillows for neck pain. They note that pillows should:

  • Be fluffy
  • Fill the gap between your neck, head, and back
  • Be durable
  • Have the right filling
  • Support your particular sleeping position
  • Keep your neck in a neutral position

Jennifer at MomActivity talks about a few more of her must-haves when it comes to pillows for neck pain. She suggests readers look for wider pillows that can support your head, as well as using additional pillows between your knees if you’re a side sleeper.

Check out your pillow materials

PainAway Devices gives an in-depth look on the different materials that are used to make the best pillow for neck pain. On their post, they discuss pillows made from:

  • Buckwheat
  • Down or down alternatives
  • Feathers
  • Latex
  • Memory foam
  • Microbeads
  • Polyester
  • Water

You can find additional pros and cons about each of these different materials used to make pillows for neck pain at PillowAdvisor or Everyday Health. Many of these options are hypoallergenic, easy-to-clean, and dust mite resistant. We’ll be looking at a number of these different types of materials throughout this post, with most pillows coming in memory foam, down, or with water.

Figure out your sleeping style

There are three types of sleepers: back sleepers, side sleepers, and stomach sleepers. Universally, back sleeping tends to be the healthiest for reducing pain levels for all patients, however, side sleepers can often find the support that they need with a few modifications.

We typically find that stomach sleepers experience higher levels of both neck and back pain, so generally suggest that patients modify their sleep routine to avoid this sleeping style. However, in this post we will be discussing a few pillows for neck pain that work for each sleeping style.

Finding The Best Pillow For Neck Pain | PainDoctor.com

Why is sleep so important? 

We’ve discussed often on the blog the need for appropriate sleep for pain patients. Harvard Medical School supports this, noting that sleep researchers:

“Found that people who reported moderate to severe problems in at least three of these four categories were significantly more likely to develop chronic musculoskeletal pain after one year than those who reported little or no problem with sleep. One possible explanation is that sleep disturbances disrupt the muscle relaxation and healing that normally occur during sleep. Additionally, it is well established that pain can disrupt sleep, contributing to a vicious cycle of pain disrupting sleep, and sleep problems contributing to pain.”

Health.com also notes that not getting the right sleep can increase your risk of obesity and depression, other known comorbid conditions occurring with chronic pain.

21 overall best pillows for neck pain

With all of this in mind, let’s take a look at options for the best pillow for neck pain for you. This list is based on our trials and other customer reviews. Finding the best pillow for neck pain for you will depend largely on what you need to have your best night’s sleep, as well as your budget and sleep style. Because of that, we’ve included information on prices and materials for all of these. Do note that these prices are subject to change. Always check the original site for the most up-to-date prices.

1. Mediflow Waterbase Pillow for Neck Pain 

There’s a reason why BPillow, one of the best resources for pillows for neck pain reviews, calls the Mediflow Waterbase Pillow for Neck Pain their favorite. This neck pain pillow is backed by a clinical study at John Hopkins University that showed it was the best in class, receiving high marks in every category they studied, especially neck pain relief. The neck pain pillow’s inner water chamber allows you to adjust the level of support you need, whether you sleep on your back or side. And, over 2,000 reviewers agree, giving this pillow 4-stars on Amazon.

Type: Water | Price: $34.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

2. Core Products Therapeutic Sleeping Pillow 

This pillow for neck pain is one of the most unique, as it creates the perfect sleeping position based on your size and shape. To get this one, you’ll choose from multiple sizes, as explained in more detail on their site. Some reviewers call it a life saver, helping them to relieve neck and headache pain that has plagued them for years. Back Pain Relief Productscalls it one of their top three best pillows for neck pain. Some reviewers have found it too firm, however, so as with all of these pillows for neck pain, it’s best to find the one that works best for you and your comfort level.

Type: Memory Foam | Price: $81.25

21 Of The Best Pillows For Neck Pain | PainDoctor.com

 

3. CustomSleeping’s Cervical Orthopedic Pillow

For all the bells and whistles, check out this: the best pillow for neck pain when it comes to creating a custom fit and support. You can customize your direct neck support with this one, and a zipper on the bottom lets you change the pillow’s firmness. And since it’s filled with a shredded gel memory foam, it’s also soft and cool to sleep on.

Type: Memory Foam and Gel | Price: $49.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

4. Shredded Memory Foam Pillow from Xtreme Comforts

Shredded memory foam pillows allow you to shape the pillow to your neck and sleeping position. Xtreme Comfort’s pillow for neck pain is made in the USA, stays naturally cool thanks to its bamboo cover, and is machine washable. It also has the added benefit of being comfortable for those who sleep with their arm under their pillow, as the pillow is adjustable to any shape.

Type: Memory Foam | Price: $44.97

21 Of The Best Pillows For Neck Pain | PainDoctor.com

5. Core Products Tri-Core Standard Support Neck Pain Pillow 

Core Products’ pillow for neck pain provides options for all sleepers, whether they sleep on their side, back, or stomach. And it provides options for comfort, all in one uniquely designed pillow. Its center depression allows sleepers to customize their level of support–larger or smaller neck support options and thick padding along the edges for side sleepers, making it a great choice as one of the best pillow for neck pain options.

Type: Memory Foam | Price: $40.96

21 Of The Best Pillows For Neck Pain | PainDoctor.com

6. Chiroflow Premium Water Pillow

Looking for the best pillow for neck pain, at a reasonable cost? The Chiroflow water pillow is one of the best, with multiple reviewers noting that they loved how it could be customized to provide the support they needed. Many reviewers noted specifically that it worked great to help them after neck injuries. They also noted that it was leak-proof, comfortable to sleep on, and easy to set up.

Type: Water | Price: $59.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

7. CozyCloud Bamboo Shredded Memory Foam Pillow

CozyCloud’s take on the shredded memory foam pillow combines breathable and cooling options while also allowing for proper neck and spinal alignment. This neck pain pillow was designed by a chiropractor, comes with a 10-year warranty, and is made in the USA from high-quality products.

Type: Memory Foam | Price: $49.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

8. Tempur-Pedic® Swedish Neck Pillow

Tempur-Pedic® is one of the leaders of pillows for neck pain. Their classic Swedish neck pillow provides support to help properly align your spine for a better sleep posture. It’s the leading neck pain pillow by Bed, Bath, & Beyond reviewersfor a reason!

Type: Memory Foam | Price: $99.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

9. PharMeDoc Memory Foam Pillow with Cooling Gel

The PharMeDoc pillow provides neck support, but it also is engineered with a cooling gel that helps keep the pillow cool in hotter climates (or for those suffering from hot flashes!). Reviewers loved the support of this pillow and that it was made with top-of-the-line products.

Type: Memory Foam and Gel | Price: $26.95

21 Of The Best Pillows For Neck Pain | PainDoctor.com

10. Perform Pillow Low Profile Memory Foam Pillow for Neck Pain

Low profile, chiropractor-approved, and eco-friendly? This pillow for neck pain is a great overall option for those who are looking to find the right kind of support they need while sleeping. The bamboo cover is also machine washable, and all products used in this pillow are hypoallergenic. It got one of the highest ratings over at CrushReviews!

Type: Memory Foam | Price: $74.95

21 Of The Best Pillows For Neck Pain | PainDoctor.com

11. Beautyrest Latex Foam Pillow 

The reviewers over at DecentSleep.com think this is one of the best pillow for neck pain options–soft, made from all-natural latex, and resistant to bacteria, mold, mites, and fungus. They especially think it might be the best pillow for neck pain and headaches. And, neck pain and headaches caused by the wrong pillow is definitely a thing. MemoryFoamDoctor.com notes that:

“When your spine is out of alignment as you sleep, the muscles surrounding your neck and head try to make up for that lack of support. This is why you will wake up feeling stiff if your head isn’t properly supported, and in fact, the tension in these muscles can actually cause significant headaches over time.”

Type: Latex | Price: $43.45

21 Of The Best Pillows For Neck Pain | PainDoctor.com

Best pillow for side sleepers with neck pain

12. Sleep Innovations Contour Memory Foam Pillow

Sleep Innovations creates one of the best pillows for side sleepers with neck pain. It’s a standard memory foam construction (made entirely in the U.S.) that is lighter than some of the other pillows for neck pain on the market. It’s also one of the cheapest on the market, but still has a 4-star review on Amazon, from over 3,000 shoppers.

Type: Memory Foam | Price: $24.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

13. Classic Brands Conforma Memory Foam Pillow

Hypoallergenic, dust-mite resistant, and designed to keep your head cool while you sleep? The Conforma Memory Foam Pillow is a great option for those who are looking for the best pillow for side sleepers with neck pain, as it combines solid construction and support that help keep the neck supported during sleep. With its firm support, many larger people also love the pillow. Additionally, Classic Brands prides themselves on their customer service, with many customers noting that they were quick to help with questions.

Type: Memory Foam | Price: $37.62

21 Of The Best Pillows For Neck Pain | PainDoctor.com

14. Beyond Down Gel Fiber Side Sleeper Pillow

This pillow, made by SleepBetter, uses a micro-denier gel fiber that mimics the feeling of the softest down feathers. Many reviewers claim that this pillow gives them the softness they love, with the support they need to relieve their neck pain. And, these pillows stay fluffy for even the hardest sleepers.

Type: Gel | Price: $42.30

21 Of The Best Pillows For Neck Pain | PainDoctor.com

15. MALOUF’s Z Gel Memory Foam L-Shape Pillow

Another unique option, this one for side sleepers! SleepComfortably.org calls this the most unique and possibly best pillow for side sleepers with neck pain. It also reduces the need for multiple pillows. Other reviewers say it did wonders for their neck and shoulder pain, since it was able to provide them support on both sides.

Type: Memory Foam | Price: $57.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

16. MALOUF’s Latex Zoned Pillow For Neck Pain

MALOUF provides one of the highest-end neck pain pillows on the market. With the higher price tag, you’ll get more customizable options for bed size, height, and firmness. It’s also made from all-natural latex, with no synthetic additives, and is naturally antimicrobial, mildew-proof, and dust-mite resistant. And since it’s created with zones, it means you’ll feel less pressure on the back of your head and more support under your neck.

Type: Latex | Price: $91.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

17. ComfyComfy’s Buckwheat Pillow

Buckwheat pillow?? Many sleepers find that buckwheat gives them the solid support they can’t find in other pillows. This one was specially made for larger sleepers, those with broad shoulders, or those looking for the best pillow for side sleepers with neck pain. You can completely customize how much buckwheat is in the pillow, and many reviewers claim that it holds its shape better than any pillow on the market.

Type: Buckwheat | Price: $115.00

21 Of The Best Pillows For Neck Pain | PainDoctor.com

Best pillow for back sleepers with neck pain

18. COOP Home Goods’ Shredded Memory Foam Pillow

COOP Home Goods provides one of the best pillows for back sleepers with neck pain. And, with all U.S.-made products, it means the pillow doesn’t contain any ozone depleters, mercury, or other heavy metals. It’s also hypoallergenic, dust mite resistant, and machine washable.

But does it really help relieve neck pain? Over 9,000 neck pain pillow reviewers seem to think so, claiming that they were able to customize the support and shape of the pillow to give them their best sleep.

Type: Memory Foam | Price: $52.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

19. Relax The Back’s PureContour Dual Pillow

Relax the Back offers a wide variety of eco-friendly pillows that can help relieve neck and back pain. Their PureContour dual pillow is made with memory foam, contoured to best support the cervical neck region. It’s especially well-suited for back sleepers with neck pain.

Type: Memory Foam | Price: $119.00

21 Of The Best Pillows For Neck Pain | PainDoctor.com

Best pillow for stomach sleepers with neck pain

20. ExceptionalSheets’ Extra Soft Down Filled Pillow

While we don’t recommend sleeping on your stomach if you have neck pain, ExceptionalSheets does offer one of the best pillows for stomach sleepers with neck pain if you can’t kick the habit. This is a down-filled pillow that is hypo-allergenic and machine washable. Some reviewers call this pillow the best they’ve ever slept on.

Type: Down | Price: $54.99

21 Of The Best Pillows For Neck Pain | PainDoctor.com

21. Primaloft Down Alternative Pillows

Primaloft offers another pillow for neck pain that many stomach sleepers love. The pillow comes in three density options to provide support and comfort during the night.

Type: Down alternative | Price: $100.00

21 Of The Best Pillows For Neck Pain | PainDoctor.com

Next steps

We hope you’ve found a pillow that provides some relief from your neck pain. Once you’ve found the pillow that works for you, though, don’t expect it to be magic the first night. PhysioWorks notes that:

“Your neck may feel different or uncomfortable during the first few nights of using any new pillow. This is because it is still adjusting to the healthy support. In the vast majority of cases, you’ll look forward to extreme comfort within a few days. However, a pillow that does not ease your neck pain within a week is probably not supportive or you have a neck condition that requires professional treatment.”

The Arthritis Foundation also suggests making time for neck pain exercises and physical therapy to help relieve pain. If using a pillow, along with some gentle neck pain stretches, don’t work, it’s likely time to call in a neck pain doctor. A trained neck pain doctor can suggest interventional and focused treatment options for your neck pain condition.

What do you think is the best pillow for neck pain? Which one do you use? 

Why Pregnancy Back Pain Occurs (And What To Do About It!)

Why Pregnancy Back Pain Occurs (And What To Do About It!) | PainDoctor.com

Why Pregnancy Back Pain Occurs (And What To Do About It!)

It’s no secret that pregnancy brings sweeping changes in a woman’s body from head to toe, but what about from front to back? Approximately 75% of pregnant women experience some degree of pregnancy back pain. Here’s why, and here’s what to do about it.

Why pregnancy back pain occurs

It seems obvious to state that growing a child brings about tremendous changes in a woman’s body, but pregnancy back pain is not only about the what, but also the where. Pregnancy shifts a woman’s center of gravity as the baby grows. The average woman gains between 25 and 40 pounds during pregnancy. A growing baby puts pressure on blood vessels and nerves in the pelvis and lower back. Little by little, weight shifts forward. Without thinking about it, it is common for women to compensate for this shift by moving their shoulders back. After nine months of this compensation, the lower back begins to feel compressed and tight.

Ligaments and connective tissues are also getting more fluid and relaxing to make way for shifts in the pelvis that occur during childbirth. This results in tremendous structural instability within the body, including the spine.

Another reason for pregnancy back pain is muscle separation in the abdomen. As a woman’s belly expands, the rectal abdominis muscles (two parallel muscles on the abdomen) separate to make room. This separation weakens the abdominal muscles in general. Weak abdominal muscles increase the chances for pregnancy back pain.

What to do about pregnancy back pain

While it is common, pregnancy back pain does not have to be inevitable. There are several things pregnant women can do from the moment they see two pink lines to prevent pregnancy back pain.

Exercise

In the first trimester of pregnancy, when hormones are coursing through your body and wreaking havoc, it can be difficult to get motivated to get moving. Add fatigue to hormones and it’s a perfect storm of zero motivation.

Exercise, however, is imperative for a healthy pregnancy in general and to prevent pregnancy back pain specifically. When fatigue is high and hormones are raging, simple pelvic tilts to keep the muscles of the abdomen toned may be the only thing you can do. As you begin to feel better and more energetic, increase your exercise. Aim for low-impact workouts that engage the entire body. Think swimming, walking, and biking for full-body toning.

Prenatal yoga is also a great way to keep the back strong and healthy and to prepare for childbirth. Prenatal yoga focuses on breath as well as movement and can also help deal with the stress that may arise throughout pregnancy.

Improve your posture

Exercise will help with energy levels and keeping stress levels low, but poor posture when you aren’t exercising can still result in a sore back. If you are used to standing with poor posture, it can be challenging to re-train your body to stand correctly, but since it is already changing, pregnancy is a great time to make adjustments.

As a general rule, imagine that, when viewed from the side, there is a straight line that connects the ears, top of the arm bones, hip bones, knees, and ankles. Many of us slump forward, removing the curve in our backs, but pregnant women often have an exaggerated curve due to the weight of the baby. Learning how to stand correctly aligned helps the spine do the major work of supporting the body and allows the muscles to work more effectively with each other.

Try chiropractic care

Chiropractic care during pregnancy can be a great tool to help treat pregnancy back pain when it arises. When looking for a practitioner, ask if they have experience treating pregnant women, both before and after giving birth. Labor and relaxed, loose ligaments and tendons allow bones to actually shift during the powerful contractions of labor. Quality chiropractic care can help relieve back pain during pregnancy and may also help shorten labor, delivery, and recovery time post-partum.

Consider acupuncture

Acupuncture is an ancient Chinese medical practice that works with energy flow in the body. Practitioners believe that any sign of illness or pain in the body is a result of blockages in energy. These blockages are released when acupuncturists place hair-thin needles into specific points on the body to release the energy and allow it to move freely.

There is evidence that acupuncture can help with back pain, so it stands to reason that acupuncture could provide relief from pregnancy back pain. Large scale studies have shown that at the very least it provides relief similar to some medications. This is a plus for pregnant women who don’t want to (or can’t) take certain types of medicines. Additionally, acupuncture has few, if any, side effects and is rated as safe for people of all ages and conditions.

Consider drug-free post-partum solutions

Even if you have not experienced pain during pregnancy, pregnancy back pain may occur postpartum. Major shifts occur in the musculoskeletal system during pregnancy, labor, and delivery. A new study has found that osteopathic manipulative therapy (OMTh) in postpartum women can help reduce their back pain by as much as 70%.

Jennifer Caudle, DO, assistant professor of family medicine at Rowan University School of Osteopathic Medicine, pointed out that this type of care can relieve pregnancy back pain with little or no risk to the new mother, improving quality of life for both mother and child. She noted:

“Women who’ve recently given birth are rarely studied beyond screening for postpartum depression and delivery complications, even though it’s well documented that low back pain is a common issue that hinders their quality of life during an already stressful time. This study shows that osteopathic manipulative therapy can relieve their pain without medication that could be passed to a breastfeeding infant.”

Pregnancy back pain is common but not inevitable. If you have experienced (or are currently experiencing) pregnancy back pain, what worked to help you find relief?

What Herniated Disc Treatment Works?

What Herniated Disc Treatment Works? | PainDoctor.com

What Herniated Disc Treatment Works?

Herniated disc is one of the most painful, debilitating lower back pain conditions that a person can experience. The pain caused by herniated disc is different for each person who experiences it and can even change as the condition progresses. Because this condition can be unpredictable, a herniated disc treatment that works can also vary from person to person.

Herniated disc treatment – What is herniated disc?

The spine consists of 33 individual vertebrae, each stacked upon a fluid-filled sac that keeps the bones cushioned from rubbing against each other. This fluid-filled sac is called an intervertebral disc. It is made up of a jelly-like interior (the nucleus pulposus) and the outer layer that contains the nucleus pulposus (the annulus fibrosis). When an intervertebral disc herniation occurs, the outer layer becomes weakened, allowing the nucleus pulposus to leak out. The cushion between the bones is gone, and the result can be very painful.

A herniated disc can be caused by a number of different factors:

  • Time: The continued action and pressure of gravity as people age can begin to wear down the annulus fibrosis.
  • Injury: If the spine is injured (i.e., as a result of a car accident or other trauma to the back), the intervertebral disc may be weakened and begin to leak.
  • Improper use: A sudden, awkward movement such as lifting a heavy object improperly can cause a herniated disc.

Symptoms of a herniated disc are as varied as the condition itself.

  • Pain: Pain location varies depending on which disc is herniated. A herniated disc in the lower back can produce pain in the buttocks, thigh, and calf (and possibly the foot). If the disc is herniated in the neck, pain may be shooting in the arm and shoulder area.
  • Tingling or numbness
  • Weakness

Over time and left untreated, disc herniation can cause permanent nerve damage.

Herniated disc treatment – Risk factors to watch out for

There are several risk factors that increase the likelihood that a person will experience a herniated disc.

  • Age: Because herniated discs can be caused by bone deterioration, older adults have a higher incidence.
  • Genetics: There is a potential hereditary connection to disc herniation.
  • Weight: Being overweight or underweight increases an individual’s risk for developing herniated disc.
  • Lifestyle: Smoking contributes to bone density loss and can increase the spine’s vulnerability to fracture, either from injury or wear-and-tear. Excess consumption of alcohol and prolonged use of steroids can also contribute.
  • Occupation: Occupations that feature repetitive motion and twisting or bending increase a person’s risk of a herniated disc.

Herniated disc treatment – What works?

What herniated disc treatment works varies widely depending on many different factors. These include:

  • Location of the herniation
  • Activity levels
  • Other health conditions
  • Severity of the herniation

For some patients, a course of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) combined with targeted exercise and strengthening may be all that is necessary. Most treatment plans are guided by the following steps.

Step 1: Anti-inflammatory medications

Whether over-the-counter or prescribed, a herniated disc treatment generally begins with a period of anti-inflammatory drugs used to control pain and inflammation. For some patients, this is enough to allow them to begin exercise or other activities to heal the herniated disc.

Step 2: Injections

Epidural steroid injections or nerve blocks may be recommended for those patients who find no relief with NSAIDs. These injections target the affected nerves directly. Steroid injections are anti-inflammatory and offer pain relief but have only been proven effective for approximately 50% of patients. Nerve blocks numb the nerve so that other treatments can begin.

Step 3: Physical therapy or chiropractic care

Because a herniated disc can be the result of decreased space between the vertebrae, doctors may recommend chiropractic care to help lengthen the spine and physical therapy to strengthen the supporting muscles. Physical therapists may design an exercise plan, offer manual therapy, apply hot and cold treatments, or administer electrical stimulation.

Step 4: Surgical options

Surgery is an option that is exercised only after all other options have been tried. If pain and numbness persists, the pain management specialist may recommend a surgical procedure called a discectomy. This procedure removes the herniated material that is pressing on the nerve and causing pain.

For more serious and unresponsive pain due to a herniated disc, the entire disc may need to be removed. This is a rare procedure that also includes inserting metal hardware to connect the remaining vertebrae for stability.

If a patient experiences sudden loss of bowel or bladder control, this is considered a medical emergency that is often addressed with surgery. This condition can become very serious very quickly, and patients should go to the emergency room if this arises.

Prevention before treatment for a herniated disc

As with many lower back pain conditions, the best way to treat a herniated disc is to take steps to prevent it from occurring in the first place. There are ways to keep your lower back safe and healthy.

Exercise

Regular exercise that focuses on strengthening the abdomen and lower back is the best way to prevent a herniated disc. Rather than spending hours doing crunches, exercises that focus on the whole body are just as valuable. Swimming, standing poses in yoga (including planks), and targeted exercises for the back are excellent ways to help strengthen the muscles that support the spine.

Eat well

A well-balanced diet that includes plenty of calcium and vitamin D-rich foods helps maintain strong muscles to support the spine. A healthy diet also helps maintain an appropriate weight for your frame.

Stop smoking

Among other things, smoking contributes to a loss of bone density that can contribute to spinal fractures and herniated discs. Quitting smoking is one of the best things you can do for your health, with benefits that start just 20 minutes after your last cigarette. It may be difficult, but there are many resources out there to help.

Herniated disc treatment can be as varied as the herniated disc itself. Have you ever experienced herniated disc? What treatments worked for you?

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