Articles filed under 'Chronic Pain'
Pain and weakness in the shoulder joint is often described medically as “impingement syndrome.” This condition results when tendons of the rotator cuff are pinched as they pass between the top of the upper arm and the tip of the shoulder. A group of four muscles and bones, the “rotator cuff,” share a common tendon. “Tendonitis” of the shoulder joint is another frequently used term.
Impingement syndrome of the shoulder joint occurs when muscles and tendons don’t slide easily and normally. Tendons and bursae, fluid-filled sacs that protect the tendons, become irritated and swollen. Typical symptoms of this syndrome are pain, tenderness and the inability to move the shoulder joint fully and normally. An injury or repetitive motions over many years may result in the onset of a cycle of inflammation, swelling, and misery.
Other symptoms can include pain or weakness in raising the arm above your head or away from the side of the body; a grating or catching of muscles when you rotate or raise your arm; and inability to sleep on the affected side due to pain.
Risk factors for impingement syndrome:
* Injuries to the shoulder joint
* Age 50 or older
* Athletes engaging in activities such as tennis, swimming, baseball, and football that involve repetitive movements of arm and shoulder
* Persons who develop bone spurs or rough spots on bone that can irritate surrounding tissue and cause swelling
* Those whose bones are shaped in a manner that allows less space between the joint than the average person
Treating Impingement Syndrome:
Treatments may be as simple as taking aspirin and resting the arm, or it may ultimately involve surgery, depending on the severity of the condition. Some treatments that may be effective in resolving the condition are the following:
* Conservative care: rest the joint and use ice packs for up to 20 minutes at a time, as needed, up to three or four times a day.
* Take anti-inflammatory drugs such as aspirin or ibuprofen.
* Avoid activities that cause pain such as lifting something heavy or stretching to reach past your comfort zone.
* Physical therapy, including exercises or stretching to strengthen, preserve or extend your range of motion; faithfully perform exercises at home.
* Cortisone or steroid injections given if other approaches don’t eliminate the symptoms; some doctors give a cortisone injection early in the syndrome to reduce pain and swelling.
* Surgery, the last resort
Impingement syndrome may take many months or even a couple of years to heal. This is especially true when it is complicated by the “frozen shoulder” syndrome, where one cannot raise the arm overhead. Patience, your doctor’s guidance, physical therapy, and prescribed home exercises should help to ultimately resolve the condition.
Sources: Cedars-Sinai Medical Web site and personal experience; blog article by Anna Dabney
http://www.cedars-sinai.edu/9837.html
February 11th, 2009
For over 50 years, Darvon or Darvocet has been prescribed to treat pain. Recently, an advisory panel of the Food and Drug Administration (FDA) recommended that the risks and benefits of the drug be re-examined. Problems such as addiction and suicide have been associated with its long-term use.
First approved in 1957, Darvon was one of the few drugs at that time for treating pain. The alternatives were aspirin or powerful narcotics. Today, it continues to be marketed as Darvocet and it is one of the top 25 most commonly prescribed medications. Over 20 million prescriptions of the Darvon/Tylenol combination are written annually.
Dr. Sidney Wolfe, a drug safety expert with Public Citizen, is spearheading the drive to ban Darvon. He first spoke out and proposed a ban against the painkiller in the 1970s. It is Dr. Wolfe’s opinion that Darvocet offers weak pain relief and poses a risk of overdose and potential for use in suicide.
The two companies that market Darvocet say that the medication is safe and effective when used as directed. They argue that physicians need a range of medications for use in treating pain. Some company representatives point out that many other painkillers have become drugs of abuse, and with considerably worse consequences.
A professor of medicine at Harvard and critic of the pharmaceutical industry commended FDA advisers for looking hard at Darvon. His point, that it is not the most dangerous drug in its class, but that doesn’t mean that Darvon is a good drug.
The United Kingdom banned its version of Darvon in 2005. If the FDA decides to take the advisory panel recommendations, it could mandate stiffer warning labels, safety studies, and more efforts to educate doctors and patients about its shortcomings and potential risks.
In the U.S., Davon-related deaths in 2007 rose to 503 from the 446 that occurred the previous year. In both years, about 20 percent of these emergency room visits and deaths were considered suicides. Only about one-third of the U.S. population is tracked in these reported statistics from emergency rooms.
On a personal note: I took Darvocet for chronic pain for many years as prescribed by my physician, and I believe it can become a problem with long-term use. It is, in my opinion, a good drug to ease pain following surgery – especially for those who can’t tolerate a more powerful pain reliever such as Vicodin or Percocet. Chronic pain in itself is a debilitating and depressing condition. Few options are available that have no risks or undesirable side-effects. I eventually tried the strategies urged by Dr. Dean Edell, who recommends that persons taking drugs for chronic pain over long periods try phasing off painkillers. They might find, as I did, that their pain can be managed without them. Sometimes the drug itself can be responsible for recurrent cycles of pain and depression. I have felt much better since gradually phasing off Darvocet.
Source: Associated Press story; January 31, 2009; and, personal experience.
Written by Anna Dabney
February 4th, 2009
If you’ve ever experienced chronic pain (lasting more than six months), you were probably depressed. Pain and depression can form a vicious cycle, with one fueling the other. When your quality of life takes a big nosedive, you generally get depressed. If a significant disability is also involved, your chances of depression are even greater.
Most physicians who treat patients with chronic pain also treat the depression that usually accompanies it. Your internist may wish to give you a prescription or refer you to a psychiatrist. Sometimes you may be referred to a licensed “behavioral medicine” specialist. So-called “cognitive therapy” classes may be especially useful in helping you find new ways of thinking and thus reduce your pain levels.
Talk therapy usually takes a back seat to prescription antidepressants these days. In fact, sometimes talking about your pain can actually make it worse because you focus on it more. Antidepressant medications are often a primary treatment for depression, especially when chronic pain syndromes or nerve-related disorders are involved.
The earlier your depression is treated, the better the outcome can be. Early diagnosis and appropriate medications can reduce distress and even prevent suicide, in many cases. Those receiving treatment for depression that takes place while experiencing chronic pain often have an improvement in their overall medical condition.
Antidepressants work by altering certain chemical levels in the brain. It may take a while to find a particular antidepressant with minimal side-effects that works well for you. Every person experiences pain and reacts to medications differently. Among the antidepressants which are commonly prescribed today are the following:
• Celexa
• Prozac
• Zoloft
• Elavil
• Norpramin
• Effexor
• Serzone
• Wellbutrin
• Cymbalta
• Paxil
• Remeron
If you are depressed about a serious, life-changing event or due to severe, unremitting pain and disability, you should consult a physician about treating your depression.
Source: WebMD
March 11th, 2007
Today I visited WebMD Health and a message board post titled “Long Days of Fibro Pain: What do you all do?” spoke to my heart. I can completely sympathize with what the writer is enduring in pain, disability, feelings of loneliness, and isolation. “Worthless, hopeless, friendless” are words that describe exactly how I have felt so many times over the past 14 years since my back injury.
Like Mindy, I have been diagnosed with fibromyalgia and chronic pain. I also have osteoarthritis, mild scoliosis, and degenerative disk disease. You name it. I’m osteopenic in my lumbar spine, had a knee replacement for an old ski injury, and I’m a breast cancer survivor of 17 years.
Before my health problems began, I was a vibrant PR professional working in a hospital setting as director of public relations and marketing. I was outgoing, had many friends, traveled frequently, went to concerts, plays, movies, enjoyed eating meals out, and I could keep up with activities of my two children – now in their 30s. Then, at age 52, just three months after my second marriage, I ruptured a disk at L5-S1. Two disks above that level are also deteriorating.
I was told I was not a candidate for surgery – just learn to live with it. I have been through two pain management programs, extensive physical therapy, biofeedback, counseling, and I’m on a lot of different medications. I was turned down for Social Security Disability twice and gave up. They told me I was still “walking around.” My marriage broke up after two years, due to my greatly changed condition. My husband could not cope with a woman he called “an old woman and an invalid.” So, I left him under duress. Talk about feeling worthless!
Fortunately, I still had my rented out home to move back to, where I slowly began my own business as a writing consultant for various health care providers. Within two months of my back injury, I had been laid off from work. I couldn’t have continued to work full-time and commute as I had previously done, anyway.
I knew I must find something I could do part-time, at my own pace. I began working as a healthcare contract writer from home. Gradually, I built up my clients and the hours I was able to work. Now almost retired, I continue to pace myself through each day.
Usually, I try to walk about a mile and a half about mid-morning. I also do a moderate series of stretching and strengthening exercises in the evening. After exercising, my tolerance for sitting at the computer usually improves. I sometimes set a timer to remind me to get up and stretch. In the beginning, I had two computers, one where I could stand to input copy, and one for sitting, to vary my position all day.
Of course, I have to lie down frequently or sit back in my recliner. I use a back support pad whenever I’m on the go, and I keep grabber devices handy to keep from bending and stooping. I often choose a restaurant based on the comfort of their seating. I’m tall, so I modified a good deal of my living and working environment to avoid stooping. I bought a refrigerator with the freezer portion on the bottom, as I don’t use it as much. I also have a shower stall with a built-in seat.
I am now blessed to have a man in my life who understands my disabilities and helps to take care of me. He accepts me for who I am and I never feel put down by him because I can’t do much. I don’t have as many friends, but I do go for lunch with various girlfriends, those who have stuck with me through my trials, about once a month. I write poetry and I’m working on my life story. I joined a women’s group at church where I read from my autobiography every other week. It’s a great bunch of women who understand when I have to stand to stretch mid-way through our meeting.
I have also scanned and retouched many old family portraits and organized them into binders. Photography has always been a passion for me, and I’m grateful that I can continue that hobby. I’m thinking about painting with acrylics again, something I enjoyed in my 30s.
My male friend and I do a lot of listening to classical music and watching movies on DVD. He also reads to me. My trips by plane are generally short, and I stand up and stretch when I need to. If I’m traveling alone, I swallow my pride and get wheelchair assistance, as I can’t lift a suitcase.
Recently, I had another adjustment to make. My last corporate client told me he was retiring following a hospital merger. Although I am now Medicare age, I wasn’t ready to quit working or feeling like I was doing something constructive. Many former nurses and PR professionals in a hospital setting like me still have a desire to interact with people and feel like they might be making a difference in someone else’s life.
Today, the Internet provides wonderful networking opportunities and support systems for persons facing physical challenges. This Blog is still in its early stages, but I am enjoying summarizing new developments and trends in the health care field. I feel like I am keeping my mind active and possibly helping others to find solutions to their health care issues. I continue to do what I can on good days and rest when I’m having a bad flareup.
My best advice to you is NEVER GIVE UP. Find a way to do at least a portion of what you love. The friends that remain are TRUE friends. Find ways to show them how much it means to have them in your life.
April 18th, 2006