McKenzie Method For Chronic Low Back Pain

Chronic low back pain (CLBP) remains a challenging condition to manage, one that carries a significant socioeconomic burden. There are a plethora of non-surgical treatments for CLBP, which can overwhelm stakeholders such as patients, third party payers, health care providers, researchers, and policy makers. Although all involved should strive for the most effective treatment that utilizes minimal health care resources, there is often clinical uncertainty as to which treatment is most appropriate for the individual patient.

In order to better understand the state of existing literature on non-surgical treatments for CLBP, the North American Spine Society sponsored a special focus issue of The Spine Journal. This review of the McKenzie method was one of the papers featured in this issue. An executive summary of background information and pertinent findings will be presented in this review.

Terminology/History of the McKenzie Method:

• in 1958, the basis for the technique was discovered accidentally, when a patient with leg symptoms inadvertently lay prone in an extended position for about 10 minutes, after which he reported to McKenzie that his leg had not felt as good for weeks

• studies on the McKenzie method began in 1990, including many studies that have been done on the concept of centralization

• the McKenzie method includes both an assessment and an intervention component (NOTE: commonly in general practice and research, the term "McKenzie" is incorrectly applied when referring only to the application of extension exercises)

• the assessment component aims to classify the patient into one of three syndromes, and is commonly referred to as Mechanical Diagnosis and Therapy (MDT)

• the main objective of the assessment is to achieve a pattern of pain response called "centralization"

• Centralization: refers to the sequential and lasting abolition of distal referred symptoms, and subsequent reduction/elimination of spinal pain in response to a single direction of repeated movements or sustained postures

• Directional Preference: refers to a particular direction of lumbosacral motion or sustained posture that cause symptoms to centralize, decrease, or even disappear while the individual's spinal motion simultaneously returns to normal

General Description:

The overall objective of the McKenzie method is patient self-management, which includes three important phases:

1. Educating and demonstrating to patients the benefits of positions and end range movements on their symptoms, and the aggravating effects of the opposite positions.

2. Educating patients in methods to maintain the reduction and elimination of their symptoms.

3. Educating patients how to regain full function of the lumbar spine without symptom recurrence.

Additional Points:

• McKenzie noted that the value of a single direction of movement is frequently not apparent unless repeated a number of times to end range (it should be noted that often the initial attempts in a particular direction may increase symptoms)

• provided that each direction of lumbar motion is tested repeatedly and to end-range, a directional preference can normally be identified

• a regular McKenzie assessment includes a full medical history and physical examination, including assessment of response to repeated lumbar movements

Utilizing this information, patients can be classified into one of three mechanical syndromes proposed by McKenzie:

1. Derangement Syndrome: has the distinctive pain response of centralization with a directional preference.

2. Dysfunction Syndrome: found only in patients with chronic symptoms, characterized by intermittent pain produced only at end range in a single direction restricted movement. Unlike derangement, there is no rapid change in symptoms or ROM as a result of performing repeated motions.

3. Postural Syndrome: typically not seen in chronic LBP, is intermittent in nature, located in the midline and is provoked by sustained slouch sitting. Symptoms are typically abolished by correction of sitting posture (normally restoration of lumbar lordosis).

Management According to McKenzie Syndrome Classification:

• Derangement Syndrome: aim is to rapidly centralize and eliminate all symptoms while restoring normal lumbar motion

• Dysfunction Syndrome: treatment is intentionally aimed at reproducing the symptoms at end range so that the short, painful structure can be adequately lengthened in order to heal and become pain-free over time

• Postural Syndrome: education is aimed at improving posture, which will remove undue physical stress from involved tissue and improve symptoms

• it is important to note that each patient requires individualized exercises, and no generic prescription of exercises will suffice

• for a minority of patients, generally those with chronic LBP, the end range force they can generate will be insufficient to eliminate pain - in these instances, clinicians can provide manual assistance/pressure to the movements, and even progress to spinal manipulation/mobilization in the patient's directional preference

Evidence Surrounding the McKenzie Method and Centralization:

• at least six studies have demonstrated that centralization is a positive prognostic factor for LBP (i.e. those who "centralize" with a particular movement or direction have better outcomes)

• in fact, a recent systematic review1 on centralization concluded that, when elicited, centralization predicts a high probability of positive treatment outcome when treatment is guided by assessment findings

• two studies have demonstrated that centralization is a more important prognostic indicator than fear-avoidance and work-related issues

• further, failure to change pain location on assessment (non-centralization) has been shown to be a poor prognostic indicator and a predictor of poor behavioral response to spinal pain

• although seemingly evident, in the literature there is some indication that those patients with mechanical LBP that is affected by posture will respond favorably to directional exercises

• in many published clinical guidelines, the interventional component of the McKenzie method has been mentioned, while the assessment component has been overlooked

• two systematic reviews2,3 on the McKenzie method have been conducted - both concluding that there was limited evidence relating to chronic LBP, but also suggesting that small benefits were noted versus a variety of comparison treatments

• a third systematic review4 on physical therapy-directed exercise interventions after classification by symptom response methods (included mixed duration LBP patients), concluded that exercise implemented based on patient response was significantly better than control or comparison interventions (4/5 studies investigated McKenzie method, all scored 6+ on PEDro scale indicating high quality)

• studies investigating the reliability of the McKenzie assessment have produced mixed results - further studies are required

• there are numerous ongoing studies on the McKenzie method, including subgroup determination in CLBP, clinical prediction rules, comparative prognostic value studies, anatomical studies, and treatment RCTs

Conclusions & Practical Application:

The McKenzie method certainly has a role to play in the overall assessment and management of low back pain. It has the potential to reliably classify patients into groups based on directional preference, which have distinctly different treatment and self-management needs. It is relatively simple, and straightforward in its approach. Considering the recent emphasis in the literature on sub-grouping LBP patients in the context of a Clinical Prediction Rule (which does include a category for directional exercise), research attention paid to the McKenzie method, MDT, and the centralization phenomenon should continue to rise. Such classification approaches can help guide clinical decision making, and improve treatment outcomes for LBP patients.

How to Help Chronic Fatigue Syndrome - CFS - With Self Hypnosis

Getting help with CFS, otherwise known as CFIDS and chronic fatigue syndrome is of the utmost importance. This condition is enigmatic but you can find support through self-hypnosis. This approach can guide you to overcome the condition.

Chronic fatigue syndrome involves fatigue that goes beyond tiredness. You may need help with CFS because the symptoms are debilitating. The condition leads to severe fatigue that does not go away no matter how much rest you get. Mental activity and physical exertion can make the condition worse.

Ramifications

CFIDS has a profound impact on your daily life. You are unable to function normally because you are so terribly tired. You can't concentrate or engage in physical activity for a significant amount of time. The condition affects your personal relationships and you career.

This condition can lead to overwhelming feelings of hopelessness and loss. The symptoms seem to come out of nowhere and there does not seem to be any explanation for the condition. Some people who are close to you may not understand your dilemma.

Discovering CFIDS

You may have times in your life in which you experience significant fatigue for an extended period. This does not necessarily mean that you need help with CFS. If extreme tiredness has plagued you for at least six months, it is time to seek support and guidance. There are other symptoms to consider as well.

Symptoms include an inability to focus. You have impaired concentration and memory. You feel extremely tired after engaging in mental activities and cognitive tasks. Headaches are also prominent as a symptom of chronic fatigue syndrome.

The mind is affected and so is the body. You feel pain in your joints without swelling or redness. Your muscles ache and your lymph nodes are tender. You may also have an ongoing sore throat. You are exhausted after physical exercise.

Self-Hypnosis as Help with CFS

You can get the support and guidance you need through self-hypnosis. This approach assists you as you deal with the flu-like symptoms and exhaustion. This approach helps you enter an altered state that is conducive to healing. After seeking a treatment approach from your physician, you can see excellent results through hypnosis.

Self-hypnosis provides help with CFS by helping you enter the alpha state. This naturally calm and relaxed state connects you to your subconscious mind. There, you work through the symptoms and psychological ramifications with the help of your subconscious.

The subconscious mind works differently than your conscious mind. This realm deals with emotions, sensations and automatic responses while you conscious deals with conceptual thought.

As you guide yourself to replace negative feelings, sensations and thoughts with positive ones, your body responds appropriately. Self-hypnosis is effective help with CFS that can yield excellent results.

Piriformis Pain - What Are the Causes, Symptoms and Available Treatments?

Piriformis pain is the pain due to Piriformis Syndrome which is apparent in around 10 to 15% of hip and lower back pain patients. Unlike nerve impingement issues like sciatica, stenosed spinal foramen and canal, and spinal abnormalities like scoliosis, lordosis, and kyphosis, Piriformis Syndrome is a neuromuscular disorder.

The Development. Generally, the sciatic nerve should pass underneath the piriformis muscle though for some lower back pain patients, it goes directly through the muscle which brings about pain when the muscle contracts and suffocates the nerve.

The issue can be further irritated when sitting for extended periods of time since the gluteal muscles remain inactive. Flexion of the hips leads to overactivity in the psoas major, iliacus and rectus femoris muscles at the cost of the gluteals, like the gluteus minimus and the obturator internus. As a result of this, the hamstrings, adductor magnus, and the piriformis, which are the synergist muscles of the gluteals, will have to perform a lot harder which they shouldn't. This disease mechanism induces the piriformis to hypertrophy resulting in pain.

The Symptoms. Known by extreme pain in the gluteal, piriformis pain may expand down to the leg. Certain exercises like running, walking, bicycling, and rowing may lead to pain. If pain is eased by walking with the foot of the impacted side directed outward and if pain is experienced when sitting in an awkward placement, Piriformis Syndrome should be assumed.

The Diagnosis. Piriformis pain is identified clinically by stretching the irritated piriformis muscle and causing sciatic nerve compression through physical exam procedures like the Race and Freiberg maneuvers. Imaging procedures are only utilized to exclude other disorders, such as herniated discs, spinal stenosis, facet arthropathy, and lumbar muscle strain. The MRN or the Magnetic Resonance Neurography is the only imaging technique that can discover Piriformis Syndrome. The presence of the inflammed sciatic nerve where it passes through the muscle can be visualized.

The Treatment. There are obviously, numerous traditional treatments that are shown useful in relieving piriformis pain. These treatments are:

• NSAIDs and/or muscle relaxants


• Stretches and other gentle workout routines


• Therapeutic massage


• Cold compresses at the onset of pain followed afterwards by hot compresses


• Osteopathic and chiropractic manipulation

Shots of anti-inflammatory drugs and/or steroids, local anesthetics (such as lidocaine), botulinum toxin (BOTOX), or a combination of the three may be provided if traditional treatments are unsuccessful. Although surgery is rarely suggested, the latest procedures of minimally-invasive surgery have been proven successful in freeing the entrapped sciatic nerve from the piriformis muscle. All of these procedures help in relieving piriformis pain.

A Look at Pain Relief for Fibromyalgia

Fibromyalgia syndrome (FMS) is a chronic disease that affects the musculoskeletal system. Symptoms vary widely among sufferers, but generally include muscle and joint aches, chronic fatigue, irritable bowel syndrome, headaches and tenderness in several of eighteen specific areas, or "trigger points" on the body. Fibromyalgia is often overlooked by sufferers as the inevitable result of a busy schedule and everyday stress. When patients do seek treatment, doctors often misdiagnose fibromyalgia as rheumatoid arthritis, chronic fatigue syndrome, or another musculoskeletal condition. It affects women far more often than men, at a ratio of about ten to one. While some cases result from a specific trauma, more often the exact cause is unknown.

The first step to fibromyalgia pain relief is being properly diagnosed. The condition is not completely understood by the medical community, and there is no specific course of treatment. Most advice given to patients reads like a weight-loss program, recommending low-intensity exercise, drinking lots of water, and reducing mental and physical stresses such as those caused by saturated fats, caffeine, alcohol, nicotine, meat and sugar.

Anti-depressants are often prescribed as part of the treatment, which elevate the mood of the patient. Muscle relaxants and sleep aids may also be recommended. Since fibromyalgia sufferers are often found to be low in manganese and magnesium, both of which help balance thyroid function, nutritional supplements may prove beneficial as well.

Physical therapy is another essential component for fibromyalgia pain relief, as it teaches patients methods of walking, stretching, and exercise that reduce muscle tension and fatigue. A physical therapist will also teach patients how to make use of ergonomic tools in their daily life, like padded chairs and special keyboards designed to minimize muscle strain.

Some patients choose to incorporate alternative treatments such as acupuncture, chiropractic, and massage therapy into their treatment. While the efficacy of these natural treatments has not been carefully studied and quantified, testimonials of fibromyalgia sufferers indicate that all of these alternative treatments may help alleviate symptoms of the disease. Whatever patients decide upon, it must be remembered that there is no simple cure for fibromyalgia, and a comprehensive plan that address mental and psychological symptoms and promotes healthy lifestyle habits is the most direct method of obtaining fibromyalgia pain relief.

What Is Chronic Hyponatremia?

Chronic hyponatremia is a prolonged state of low serum sodium levels, often experienced by patients after surgery. It can also be caused by several conditions such as psychiatric illness. It has a high rate of mortality. Chronic hyponatremia that presents clinical signs and symptoms must be treated immediately. Lack of treatment can result to seizure that may lead to neurologic impairment, coma, and even death. Normal serum sodium level is 135-145 mEq/L. Diagnosis of chronic hyponatremia can be done several days after onset for serum sodium levels drop gradually and steady compared to acute hyponatremia. Signs and symptoms often include:

- Nausea

- Vomiting

- Weakness

- Anorexia

- Restlessness

- Headache

- Confusion

- Lethargy

- Malaise

- Muscle spasms

- Seizures

- Deteriorating level of consciousness

- Coma

Once these symptoms manifest, treatment is necessary. Administration of IV fluid is usually the first step in treating chronic hyponatremia. Depending on the type of hyponatremia and severity of symptoms, IV fluid can be of 0.9% saline (isotonic) or 3% saline (hypertonic).The correction is done rapidly but with caution in patients with severe hyponatremia due to danger of brain herniation. Mild cases are often treated with fluid restriction of 1-1.5 liters of free water in a day. Fluid restriction is very important especially if there is presence of SIADH.

Raising serum sodium levels should be at a rate of no more than 1 mEq/L for every hour. For patients with severe hyponatremia symptoms, an hourly rise of 2 mEq/L for the first 2-3 hours may be done. Total 24-hour raising of serum sodium levels should be equal but not greater than 10 mEq/L. Faster administration poses risk of over-correction leading to osmotic demyelination syndrome.

Additional medication is given for patients having problems in complying with fluid restriction, or who have severe, persistent hyponatremia even through IV management. Demeclocycline (Declomycin) 600 to 1,200 mg is given daily, resulting to elimination of free-water. This medication can cause some effects on the liver and kidneys, requiring caution and careful monitoring on patients with renal and hepatic insufficiency. Arginine vasopressin receptor antagonists are also helpful in treating patients with chronic hyponatremia. It acts on the renal tubules, causing elimination of free water and retention of sodium.

Prompt diagnosis and management of chronic hyponatremia is essential to correct the condition and prevent complications.

How to Manage Your Chronic Pain Naturally Without Dangerous Drugs

What if I told you that you probably have this medicine in your house that can cause a potentially fatal condition to your brain and liver. Would you still take it?

Although the amount of people who will be affected is small, it is still a risk.What medicine am I talking about? Do you know?

It is none other than the common aspirin!

Believe it or not, aspirin has caused a condition known as Reyes Syndrome. What else is probably in your house right now? Non aspirin items, such as Tylenol can also be dangerous to your health. It has been suggested that it can cause liver damage. So it is not any safer than aspirin.

Lets look at another one. Ibuprofen, which seems to be the choice of a vast majority of people, can cause gastrointestinal bleeding. All analgesic painkilling medicines have some risk of serious and even fatal side-effects!

While these side effects will probably only affect a small amount of people, any amount is to much. Medical science wants deals with pain on a reactive basis, natural pain management is all about preventing the pain ever starting rather than dealing with it after it has.

There is in fact no need to use these medicines, because there are plenty of natural substances - herbs and the like - that are often every bit as effective. One is hot pepper.

Hot peppers contain a substance called capsaicin and the hotter it is, the more of this substance it contains. It is a well known fact that eating hot peppers helps improve circulation, strengthen the nervous system and heart, relieve indigestion and increased appetite as well.

For someone who suffers from constant chronic pain because it is believed that it has the ability to reduce the levels of the protein that is believed to transport pain signals from the nerve endings to your brain. If these levels can be reduced, your pain will also be reduced in a similar manner.

When taken internally, capsaicin can assist in managing various gastrointestinal problems as it stimulates the flow of digestive juices. There is also some evidence that the antibacterial qualities of capsaicin can help reduce colds and infections such as flu too!

By combining proactive techniques for preventing pain with using only natural substances to deal with pain, you might be able to throw away the analgesics forever.

Lower Back Pain - Diagnosing the Severity and Cause of the Pain

Living in an era of technological advancements with developments in every field, we have somewhere along the line been able to manifest the importance of our work and make it bigger than ourselves. All of us are so consumed in winning the race of making the best presentation, pitching the best product idea, giving the most impressive speech that we put ourselves and our health at the lowest on our priority list.

The effect of our Lifestyle on our Health

"Who needs to take a lunch break at work, I'll just have a coffee instead"

"A jog? no I'm too tired from the extra hours I logged at work last night" Everything seems to be just so much more important than our health. Except for a handful of people who haven't been trapped in the vortex of technology, every other person seems to be spending their day hunched across their computer screens preparing assignments, proposals, presentations and documents. Our lifestyle demands that we stay put in a position for nearly 8 hours a day. A desk job may sound like an ordinary thing and somewhat comfortable, but it can give rise to a variety of health problems, especially back and neck problems.

A significant number of people today complain of lower back pain, neck cramps, shoulder pain and even hip pain. There may be a variety of reasons behind the occurrence of such pains and to get it checked and treated is highly important.

Identify your Pain

Pain is a mechanism designed by the body to alert and inform us of its ailment. The nature of every pain that we experience is different. Some last short term, some long terms; some are isolated to a certain limb others spread out throughout the body.

Some pains are very distinctive to identify others any come along as signs of uneasiness, temporary cramps and stimulate nausea.

No matter what the pain is like no one is able to understand your body better than you, if it is an unpleasant pain and something that you have never experienced before or don't know the cause of, then consult your doctor and find out more about it to prevent it from progressing.

Pain Management Techniques

Sometime a general physician may not be able to cure your lower back pain or even figure out why you're having it in the first place. However, that doesn't imply that you now have to spend the rest of your life with a stinging pain. Seek alternative medical help and consult a pain management team that specializes in identify and treating bodily pain.

A Pain Management Team

A pain management team consists of physicians of varying fields and practices. A typical pain management team may consist of clinical psychologists, physiotherapists, pharmacists, medical practitioners and occupational therapists. The group of professionals work together alongside the history given by your general physician and conduct a full work, keeping in consideration any mental or emotional instability along with a detailed physical examination.

Pain Management Techniques that can treat your lower Back Pain

A relatively new field in therapeutic medicine but significantly effective, pain management has enabled individuals to lead a pain free life. The distinctive feature about pain management techniques is its approach towards the pain.

If a patient is complaining of lower back pain the team will firstly conduct a full examination on the patients and then prescribe not only drugs but may use methods from neuromodulation, pharmacological pain management, chiropractic techniques, minimally invasive surgeries and interventional pain management. This gives a greater spectrum for doctors to find a cure for your constant pain without using invasive and extreme measures.

Chronic Fatigue and Sleep Apnea

Chronic Fatigue Syndrome (CFS) is a serious condition that is not well understood. It generally causes its sufferers to not be able to deal with life's daily issues as they are simply too tired. Moreover, it results in "Brain Fog" (cognitive deterioration) and/or poor memory, weakness of muscles, irritable bowel syndrome and a host of other problems. Those that are diagnosed with CFS often find that sleep is simply does not refresh them; no mater how much they sleep, hey still wake up feeling tired.

Sleep Apnea is a different issue that is occasionally relates to Chronic Fatigue Syndrome. As you may know, there are five levels of sleep. The deepest level is called REM (for Rapid Eye Movement) and is dream sleep. Most people spend a quarter of heir time at level 5 sleep, which is refreshing and necessary. People who suffer from Sleep Apnea, for various reasons, literally choke in their sleep for a very short period of time. During this time, the brain detects the lack of Oxygen and brings back the person to a lower level of sleep. This can literally happen dozens of time every hour, resulting in very poor quality of sleep, and consequently, a never ending feeling of being tired.

Chronic Fatigue can explain a wide range of problems, and sleep apnea is just one of them.

One of the doctors I was sent to sent me to a sleep clinic. I have to say that this was much less pleasant than I thought it would be, trying to sleep with so many things hooked on to me, and being unable to go to a restroom without calling an aide to untie you. But I eventually managed to. They discovered I have "mild to moderate" sleep apnea.

Can this explain my chronic fatigue? Probably not, because I've had sleep apnea my entire life, and chronic fatigue for only for two years. However, any improvement in my sleep may result in a big improvement of my CFS. Makes sense, no?

Thus, I was sent to the sleep clinic for a second time, to try sleeping using a machine called CPAP (which stands for "Continuous Positive Airflow Pressure"). Sleeping with CPAP is a very strange feeling, as the machine constantly pushes air into your nose, basically keeping the air passages open. The idea is that it will prevent the choking that takes place, and the person could reach a deeper level of sleep. Some people have reported a almost miraculous improvement in their quality of life using a CPAP machine.

Unfortunately, I never got my results. I came to the clinic feeling ill, and simply was not able to fall asleep.Particularly with a machine stuck up my nose, and tens of wires hooked up to me. At 2am the technician and I gave up, and we decided to try it another time. My personal feeling is that the machine would have helped me sleep better, despite the fact it is generally uncomfortable (though it is said this is very easy to get used to).

I intend to go back and be tested again. But so far have not.

My conclusion: check with your doctor whether you may have sleep apnea. If he suspects you suffer from it, he'll send you to a sleep clinic. If you do have sleep apnea, you'll be tested with a CPAP machine, and if that proves effective, you'll be given one from your insurance provider (or so I am told). This could eliminate a large component if not the major component of what causes you to be chronically tired.

Fibromyalgia and Related Chronic Pain

Opinions in the case of fibromyligia are still split some saying it's just an imaginary thing of the particular person while others say that it's a real chronic pain condition. One certain thing that the doctors have found out is that fibromylgia and chronic are closely related.

Defining this disease would go something like this: fibromylgia is a disorder of the central nervous system in a patient that make that particular person be more hypersensitivity to pain. After not many years of research, some doctors still have the opinion that this is all in the patient's head, a real disease not being at all present. Genetical en heritage has also been proven to be an important factor in the patients development of this.

Doctors have decided to take serious action and determine once and for all what makes this illness appear in some people, thus treating patients as normal sick people. They have embarked on a quest to find and learn more about the factors that cause this and this way, if possible, find the best treatments available with modern medicine.

An astonishing number of some 10 million people have been found out to be suffering from this particular and strange fibromylgia.

Symptoms have been shown to vary a lot in patients: from mild ore severe chronic pain trough out the body of the person, to headaches and fatigue and most strangely memory problems and difficulty in concentration.

With the help of modern technology doctors and scientists have come to new and helpful conclusions in understanding fibromylgia. Recent brain studies made at the University of Michigan have shown that people with this illness tend to be a whole lot more response in the case of pain when it comes to compare them with normal people. The study of the brain waves in the cases of patients have shown a lot more activity for those who were exposed to pain. Because of this doctor have come up with the conclusion that people suffering from fibromylgia have some abnormalities within their central brain structures. Pain relievers have been found not to be affective in the cases of people suffering from this rare illness.

With all this being done effective treatments have yet to be found. Still understanding the disease has come a long way from saying it's all in the patient's mind making us believe that the finding of a reliable treatment is just around the corner.

TMJ Symptoms: Does TMJ Cause Fatigue?

Temporomandibular joint disorder or TMJ can be a problem that exists undetected for years before noticeable symptoms such as pain begin to appear. Identifying the problem early on can prevent the condition from becoming chronic later in life, and possibly avoid years of suffering from pain and other debilitating symptoms.

Some of the TMJ symptoms can include fatigue and tiredness. Tiredness as a result of TMJ is one of the TMJ symptoms that is often overlooked in patients. At times the tiredness can manifest itself as muscle fatigue throughout the body, but sometimes it is simply a feeling of being tired that can be chronic and persistent. Pain is one reason for excessive tiredness. The body is unable to rest properly or the patient does not experience good quality sleep due to the symptoms of TMJ.

In order to restore the body to a more rested state, the problems of TMJ need to be dealt with first. There are traditional methods of dealing with this such as visiting a dentist or doctor, but it is often difficult to get a proper diagnosis. Sometimes numerous visits with multiple doctors are required, and sometimes a diagnosis is never given by a traditional doctor. However, there are home remedies for relieving TMJ symptoms that you can use to feel better.

Applying warm compresses to the jaw is one way to help relieve the symptoms. Compresses should not be so hot that the skin could be burned, and should not be left on for more than 20 minutes at a time. A break should be taken in between applications of approximately 30 minutes. The heat will help to increase blood flow to the area, promoting healing. It will also help reduce any inflammation, which can impede the healing process. Cold compresses can also be applied if desired for a short period in between applications of heat and can be applied for no more than five to ten minutes each time.

Massaging the joints of the jaw can also help facilitate healing. While doing this, the muscles will relax, allowing the jaw and the temporomandibular joint to settle into a more natural position, thereby relieving stress on the area and relieving your TMJ symptoms. The proper area to massage is the area just in front of the ears. To feel the joint, move the jaw while pressing on this area.

Homeopathic remedies for TMJ can also be a way to alleviate symptoms and allow your body to rest properly and naturally again. A homeopathic doctor or a naturopath can help choose the remedies that would best suit your needs. These may involve relaxation techniques, healing herbs, and acupuncture for the relief of pain. By combating the problem, the tiredness resulting from TMJ can be eliminated.

Managing Chronic Back Pain

We all get some back pain now and again. Perhaps you overdid it a little playing tennis, or lifted a few too many heavy things. Your back will probably hurt a little bit for a day or two.

There are plenty of remedies for occasional pain: ointments, pills and so on which can banish the ache, at least for a time. A heating pad may even get rid of your pain if it is a minor case. However, if you are one of the many who suffer from chronic back pain, than it will take more than that - the lack of an effective treatment is something of which you are already all too aware.

A Lifelong Problem

Persistent backaches are often a lifelong problem. You can do exercises to strengthen your back and reduce the effects somewhat, but when the weather changes or the barometer drops, there will be a flare up. It's as if your back is reminding you of your injury and that there is nothing you can do to eliminate the pain entirely.

If the pain was entirely limited to your back, it would be a lot easier to live with. Usually though, muscle spasms, damaged discs and the like affect you far beyond just the immediate area.

A damaged disc or discs will usually cause leg and ankle pain during a flare up along with the pain in your back. Which leg and ankle experience this pain depends on which side your damaged disc is bulging out on. A bulge on the left equals pain in the left leg and ankle and vice versa.

The pain in your leg can be harder to bear than the pain in your back! Sometimes the leg pain can be more intense. It's no picnic, no matter how you slice it.

The Stiffness Really Happens

It's certain that you have seen people, whether on TV or in real life, complaining of stiffness due to chronic back pain. These people aren't faking it; something you yourself know if you suffer from this ailment. This is not only real, but very painful!

Living with chronic back pain is an unpleasant experience; however the pain can be managed by various treatments. You should take care of your back, however, to ensure that the odds of your having to live with this disability are low.

Is It Chronic Fatigue Syndrome or Narcolepsy?

Are you tired all of the time? Do you feel like you need naps or more rest than other people? Do you wake up tired and exhausted even after you've gotten plenty of sleep? If you've been struggling with long-term fatigue and exhaustion, you may be thinking that you are experiencing chronic fatigue syndrome. However, chronic fatigue syndrome is not the only disorder that can cause debilitating symptoms, like extreme tiredness. It may be possible that you are confusing the symptoms of chronic fatigue syndrome with narcolepsy.

Chronic fatigue syndrome and narcolepsy are very similar and yet very different at the same time. Both cause extreme tiredness, the excessive need for naps, forgetfulness, restless sleep, and muscle weakness. However, there are slight differences that can help you and your doctor determine what you're up against.

Before either condition can be diagnosed, your doctor must check for other sleep disorders and medical problems. In fact, there is no specific test for chronic fatigue syndrome. It is simply diagnosed when everything else is ruled out.

The causes of chronic fatigue syndrome are unknown, but are suspected to be triggered by an immune or autoimmune disorder. It is mostly diagnosed in women between the ages of 40 and 50. Symptoms include a new onset of extreme fatigue or tiredness that is not relieved by sleeping and lasts for longer than six months. The fatigue experienced can become worse after exercise that is normally tolerated by the individual. Other symptoms include headaches, forgetfulness, an inability to concentrate, lymph node tenderness, joint pain, muscle weakness, and mild fever.

Narcolepsy is also thought to be caused by an autoimmune disorder. It is usually diagnosed in teenagers or individuals in their twenties. Your doctor can give you a test for narcolepsy by performing a spinal tap and checking for low levels of a chemical that regulates wakefulness and REM sleep, called hypocretin. People with extremely low levels of hypocretin in their spinal fluid usually experience the more severe symptoms of narcolepsy. However, in some cases, high levels of hypocretin are detected, which has lead researchers to determine that the receptors for hypocretin are damaged, making it unusable by the person.

The most common symptoms of narcolepsy are extreme fatigue and tiredness, much like chronic fatigue syndrome. However, narcoleptics often experience 2-4 hours of feeling fine before they are hit with a sudden "sleep attack" or extreme muscle weakness. Other symptoms associated with narcolepsy include cataplexy, hypnopompic hallucinations, and sleep paralysis. We will discuss these symptoms of narcolepsy more in depth in our next article, "Do I Have Narcolepsy?".

Treatments for narcolepsy and chronic fatigue syndrome should be discussed with your doctor, but there are some things that you can do at home to help lessen the severity of the symptoms. Both disorders are considered to be an overreaction or under reaction of the immune system. Taking a daily multi-vitamin along with vitamin C can help to regulate the immune response and give you some relief. You can buy discount vitamins and the best vitamin C, vitamin c powder, online to save money on long-term treatments.

Why Do I Have Chronic Fatigue? - 3 Common Causes

Why do I have chronic fatigue? It's a question that many people are seeking an answer to. Constantly feeling tired can have many different root causes, and it is necessary to find out why you are like this before you can do anything about it. Here are 3 common reasons.

Insomnia or lack of sleep.

Apart from literally not going to bed for a decent of time every night, there are other reasons why your sleep pattern may be disturbed. Insomnia is where you find it impossible to get to sleep, or you manage to drop off, only to awaken after a short period of time and can't get back to sleep. There can be many reasons for this. Worry and stress are a very likely cause, and the worse the problem gets, the more stressed out it makes you, so you end up with a problem spiralling out of control. Sorting out the actual primary cause of the insomnia is the key, but this may not be that straightforward to do.

Anemia

This means that the tissues of your body are not receiving enough oxygen. It is quite a common condition and very likely to be the answer to your question - why do I have chronic fatigue. Your doctor will be able to diagnose this and set you on the road to recovery.

Poor quality diet

If you constantly eat highly refined foods such as ready meals, take outs and canned products then you may well not be getting all the essential nutrients and minerals that your body requires in order to function correctly. Modern processing methods remove a lot of the goodness from food, so although you may not realise it, your diet could well be lacking in what you need.

If tiredness is starting to affect your day to day life, then you owe it to yourself to find out exactly what the problem is. Visit your doctor and ask him 'why do I have chronic fatigue?'

Chronic Fatigue Syndrome, Fibromyalgia and the Stress Spiral

Stress and anxiety are an unfortunate, but sometimes necessary and inevitable feature of modern life.

As with diet, obesity, alcohol and smoking I am afraid that the news is simple. They have to be addressed.

Learning to deal with stress is something that can be consciously learned and practiced and new techniques have proven very effective.

A higher than average percentage of patients undergoing Fibromyalgia and Chronic Fatigue treatment are, or were, engaged in high stress environments.

This may be or have been at home, as carers of relatives or young children. It may have been in work detail or during a divorce or home move.

Whatever the cause a significant increase in stress is frequently cited at the time of onset of the sufferers Fibromyalgia or Chronic Fatigue Syndrome symptoms.

As well as being implicated pre-onset, stress reactions are involved in the maintenance and exacerbation of the Syndrome post-onset.

Blood pressure, heart rate, the entire endocrine system which controls hormone production are all implicated and involved during stress reactions.

Unfortunately, the system that directly controls all these systems, the Autonomic Nervous System, in particular the Sympathetic Nervous System or "day nerve" remains malfunctional post-onset.

The result, unfortunately, will be an exacerbated negative reaction of your Fatigue and Fibromyalgia symptoms to stress and anxiety producing situations.

To make matters worse there is evidence that once activated the stress reaction lasts abnormally longer in patients afflicted with Fibromyalgia and Chronic Fatigue Syndrome.

Is CFS more common in stressed people?

Let me first give a very broad outline of how general medical advice is presented to Healthcare providers in diagnosing Fibromyalgia and CFS patients:

"frequently seen characteristics of CFS and Fibromyalgia patients

* People who through their own personal attitudes and anxieties tend to make their own lives mores stressful.

* People who are highly ambitious, they appear to be always active physically and mentally.

* People whose lives are fully absorbed coping with the needs and requirements of others.

* People who avoid taking the time they need for themselves to rest, relax and recuperate and build supportive relationships that are entirely their own.

*People who have difficulty finding others to confide in, so bottling up years of emotions and pain at times of bereavement or loss. "

In itself this is not an inaccurate description of frequently seen characteristics of Fibromyalgia and CFS sufferers. However it is so broad that it can describe patients with a multitude of other conditions.

As I have said many times the human body is a remarkably resilient organism, able to accommodate fantastic pressures and stresses, but as with all machines and organisms there comes a breaking point.

Stress appears to be a very large facilitating factor for people who become the unfortunate ones to develop CFS and Fibromyalgia post "trigger" infection or trauma.

A lesser, but still analogous example of stress related conditions is frequently referred to as "burnout", or simply "stress" and I quote.

"A series of personal life circumstances combine to create a "breaking point", for example; death of a close family member, chronic pain, moving house, bullying at work, divorce, separation, financial loss or redundancy have all been linked to detrimental changes in health "

How stress can become a causal factor in Fibromyalgia and CFS

The initial trauma that was the notable "trigger" of your CFS or Fibromyalgia is usually cited as a bacterial/viral or chemically invasive attack of some kind, but it has been noted that in some sufferers extreme acute stress, such as bereavement, divorce, bullying, extremes of overwork may also be a trigger for CFS symptoms in the absence of a notable infection or exposure.

This makes sense in that scientific evidence has shown conclusively that stress lowers our immune defenses against infection as witnessed by white blood cell and lymphocyte counts.

Also, stress has been shown to directly affect the body in the short to medium term causing extreme fatigue and more disabling problems such as migraine, impairment of concentration and memory and interrupted sleep patterns.

Fortunately, as a society we have been woken up to the negative effects of stress.

As is often the case it has taken the negative economic implications of stress to spur employers and healthcare providers into action.

Sufferers no longer have to fight against the labeling that was common with previous generations which took the basic premise that "stress, depression and anxiety are all in the mind and are a sign of weakness"

How stress can maintain and exacerbate CFS and Fibromyalgia

Stress, depression and anxiety are known to slow down and in severe cases prevent recovery from infectious illnesses, and this is partly where the confusion and malpractice surrounding the CFS/depression arena was instigated and fed by general practice and psychologists over the last few decades.

The dividing line between the two conditions can appear very close to the untrained eye, but on closer inspection CFS and Fibromyalgia do in fact have a totally unique subset of features when compared to depression of any type.

To further muddy the waters both CFS and depression cause physical symptoms which can be similar to each other on initial presentation and also there is crossover with the symptoms of various infectious illnesses of the rheumatic and auto-immune spectrum.

As I have mentioned several times in my text, establishment apathy and nonchalance about the true nature of CFS and Fibromyalgia have lead to it being sidelined as a subdivision of psychology and particularly depression.

Historically, when help is sought, sufferers are left feeling isolated and misunderstood to the extent that they will begin to hide their symptoms, live in denial worried about other peoples reactions, and press on regardless while understating their illness.

Unfortunately, these typical reactions only serve to heighten overall stress levels which is precisely the opposite of the reaction needed for recuperation and so leads to a further exacerbation and worsening of symptoms.

A lot of sufferers understandably avoid further professional help.

Some work very hard to find a cure and convince people that CFS/ME/Fibromyalgia is a real illness. This leads to sufferers experiencing a desperate urgency to recover which is met and fed by a cynical and irresponsible health industry full of fake cures, miracle pills and treatments.

All this while sufferers are feeling threatened, scared, angry, stigmatized and generally ill.

The stress cycle goes even higher, and the result, sufferers sink even lower.

There are times in a person life when it may become particularly difficult to actually be ill at all.

For example as a carer of an ill relative, or a baby or young children, during a period of house renovation or construction, the demands of work as primary source of income.

In the absence of people that can help practically and emotionally in these life scenarios it can be very difficult to actually say "STOP".

Traditional medicine understood the importance of recuperation, rest, relaxation and contemplation as an important therapeutical facet of overcoming serious illnesses and infections.

In the presence of a frightening array of diseases which are now largely purged from modern society, and the absence of powerful antibiotics and antivirals, painkillers and analgesics, the body was largely left to its own devices.

In Traditional medicine patients were often treated with herbal tonics and natural cures, a lot of these were incidentally quite effective but have now been largely forgotten, dismissed or dismantled and reproduced in synthetic form to provide the basis of 75% of modern pharmaceuticals.

However the primary strategy of the era involved long periods of rest and recuperation.

By contrast, modern medicine and society place more importance on masking the symptoms, " keeping a stiff upper lip", "knocking it on the head" and "getting back on the job" as quickly as possible.

A "get well quick" protocol which unfortunately is completely at odds with a recuperative strategy for illnesses such as CFS and fibromyalgia.

Learning to control and reduce stress is an important and essential adjunct to any CFS and Fibromyalgia recovery strategy.

You will need to learn how to recognize stress and how to short circuit the sequence of events that leads to a "stress spiral".

Techniques of physical and psychological relaxation are essential and very effective.

Learning when to say NO is essential and avoiding all events and activities that place you under unnecessary stress or anxiety are essential in the short to medium term.

In my next article on this subject I will be talking about techniques that can be used effectively to short circuit and alleviate stress and anxiety at home, in the car and at the workplace.

Fibromyalgia - It's Not Just In Your Head

"My doctor says the pain is just in my head."

Thankfully, I don't hear that from patients as much as I used to. The most common health complaint this applied to was a set of symptoms now referred to as fibromyalgia. And until recently, many doctors dismissed these symptoms as being purely psychosomatic.

Fibromyalgia (also called Fibromyalgia Syndrome or FMS) is sometimes a bit hard to get a handle on since it can show up in a variety of ways. The most common symptoms are chronic widespread pain and a heightened and painful response to pressure on muscles and tissues.

But there are also other symptoms in addition to pain. These can include extreme fatigue, difficulties sleeping, and stiff joints. Sometimes depression, anxiety or brain fog accompany the symptoms.

As you can tell, fibromyalgia is not fun.

So imagine how difficult it is to be going through all that only to be told by your physician that "it's all in your head." Not very helpful.

Fortunately, in the past few years research has uncovered some of the underlying problems associated with fibromyalgia. That research used MRI imaging to identify brain changes associated with FMS symptoms. Most of the FMS symptoms are associated with inflammation.

But you don't have to get an MRI to know if you have FMS. The official criteria for a diagnosis is:

• Widespread pain lasting more than three months, affecting all four quadrants of the body, i.e., both sides, and above and below the waist.


• Tender points - 11 of 18 possible tender points are reactive to moderate pressure. (Although a person with the disorder may feel pain in other areas as well).


• f this pain is accompanied by sleep problems, depression, foggy brain, etc., then there is a greater likelihood it's FMS.

More importantly, if you have symptoms like any of the above and your doctor can't find anything wrong, the thing you most want is relief...

How To Treat FMS

The typical medical approach for FMS is a combination of exercise, prescription medications and occasionally nutritional supplements. Results from this approach are generally mixed.

My approach is somewhat different because I start with the assumption that something internal is driving the inflammation, which in turn is creating the symptoms. That means a bit of detective work is needed to get to these deeper issues and correct them.

Of course each person will be different, so it's not possible to give a comprehensive list of things to look for here. Even so, there are some general triggers that you can watch out for:

• Sugar in any form is very often a big contributing factor. By "n any form" I mean white sugar, brown sugar, turbinado sugar, sucrose, fructose, dried fruit and fruit juice (even 'all natural').


• Processed foods are not natural nutrition for the body. Avoid anything in a can, a jar, a box, a bottle or a package.


• Exercise is important. Ironically, when you are tired, in pain and possibly depressed, you don't feel much like exercise. I generally recommend that people gradually add increasing amounts of movement into their routine. This can be as easy as taking a 5 minute walk every day if that's all someone can do.

Depending on the pattern of symptoms, there may be some vitamins, herbs and amino acids that will help. Again, these are so specific to an individual that it doesn't make sense to mention them here. However the above suggestions are a great start towards finding relief.

Treatments For Your Failed Back Surgery Syndrome

What Is Failed Back Surgery Syndrome?

The failed back surgery syndrome (FBSS) is also known, simply, as the failed back syndrome. It refers to the pain that persists in the back and or its extremities even after spinal surgeries. This condition is also sometimes known as post-laminectomy syndrome. It is the chronic back pain that may or may not be, accompanied by a pain in the leg.

Thus, it can be said that failed back surgery syndrome is a consequence of an unsuccessful or failed spinal or back surgery. The surgery, which is aimed at relieving a person's back pain, may end up doing exactly the opposite. Sometimes it makes the pain even more excruciating, and may also reduce the person's mobility and flexibility.

Besides this, people suffering from a failed surgery syndrome become hostage to physiological disorders such as depression, extreme rage and/or anxiety.

Causes Of FBSS

The incidence rate (percentage of people) that suffers from FBSS is not a definite figure. Doctors and medical professionals have failed to answer what may actually cause FBSS. Doctors may tell you the probability of a successful surgery but it does not mean that a successful operation will mean eliminating the pain. Therefore, according to a study done in Prague in 2005, the incidence rate for FBSS ranges between 5 to 50 percent. But, the following are the most probable causes:

• Incompetence or mistake of the surgeon


• Incorrect diagnosis


• Scar tissue


• Iatrogenesis

Treatment For FBSS

People suffering from FBSS want to stay as far away from another surgery as possible. The following are some (not all) of the treatments patients can opt for:

• Stem cell treatment - minimally invasive laser surgery that deposits adult stem cell directly at the affected area


• Spinal epidural steroid injections


• Selective nerve root block


• Spinal cord stimulator


• Fusion alternatives

Piriformis Syndrome - What is it and How to Treat

What Is Piriformis Syndrome?

Piriformis syndrome (PFS) is a pain and discomfort condition much like sciatica, except due to a very dissimilar source. Piriformis syndrome is sometimes referred to as back pocket disease. People that keep a wallet in their back pocket and sit on it throughout the day often develop symptoms of pain in the rear and down the leg. In this ailment, the sciatic nerve is compressed by the piriformis muscle. Piriformis Syndrome is an entrapment neuropathy in which a tight and/or inflamed piriformis muscle compresses the sciatic nerve, the largest nerve in the body, producing radicular type of symptoms. There are many causes of this problem to altered foot biomechanics to poor hip joint function. PFS occurs when part of the sciatic nerve becomes entrapped, compressed, or irritated by this muscle. The syndrome can be very persistent and painful. It is estimated that six percent of all patients with sciatica have piriformis syndrome.

The existence of piriformis syndrome has been doubted for years, but with the power of the Internet the reality of this syndrome has finally reached a tipping point. Previously, it was not even considered as a diagnosis, in others it was quickly ruled out. Chiropractors note that PFS seems to occur most in those people who don't stretch adequately before exercise. People who are obese, or who spend much of their time sitting (as on workdays) and then are active on the weekends might be prone to the condition.

Located deep within the gluteal (buttock) muscles PFS can reek havoc with the body, causing extreme discomfort, pain and inconvenience in general. This muscle is deep inside the body, under the gluteals. The sciatic nerve passes directly under the piriformis muscle. Tension in the soft tissue of the piriformis, gluteal and other related muscles is usually the cause behind it. Such tension may be caused by incorrect posture, sports, and improper exercise.

Women may be affected more frequently than men, with some reports suggesting a six-fold incidence among females.

PF syndrome also causes sciatica. Its treatment is much less invasive and severe than the treatment of herniated lumbar disks.

How To Diagnose Piriformis Syndrome -



Diagnosis of piriformis syndrome is mostly clinical and requires a high suspicion for the diagnosis as many of the symptoms can be somewhat vague. Patients are often tender over the attachments and length of the muscle especially at the greater trochanter on the thigh bone or femur. It includes an empirically-based interactive means to determine the probability that a given case of sciatica is due to piriformis syndrome.

If it hurts to touch a point that's in the middle of one side of your buttocks, you probably have piriformis syndrome. This chronic condition is very difficult to diagnose, because other injuries may produce exactly the same symptoms.

In PFS, you feel pain, tingling and a numb sensation in your buttock region. You can feel ache in the mid butt area that radiates through the whole of back legs. Trying to stretch the piriformis muscle has been suggested as a way of diagnosing the problem - if it hurts to stretch it, you may have piriformis syndrome. The instructions for stretching it are: Lie flat on your face on a bed. The prognosis for most individuals with piriformis syndrome is good. Once symptoms of the disorder are addressed, individuals can usually resume their normal activities.

Symptoms of PFS -



The first symptom suggesting piriformis syndrome would be pain in and around the outer hip bone. The tightness of the muscle produces increased tension between the tendon and the bone which produces either direct discomfort and pain or an increased tension in the joint producing a bursitis.

How To Treat Piriformis Syndrome -



Diagnosis and treatment of Piriformis syndrome should be carefully and extensively done. Multimodality treatments should be considered before jumping into surgery or the like. Therapy for piriformis syndrome often begins with progressive stretching exercises that are simple to do at home or the office and require no equipment. One easy exercise, for example, involves standing with the left foot flat on the floor and the right foot flat on a chair so that the right knee is at a 90 degree angle with the floor.

Targeting the piriformis is done with a single knee to the chest with painful side cross-over. The stretching exercises are performed three times a day, five times each time, maintaining the stretch between 5-10 seconds. If the muscle pain is causing altered gait, slow down and start therapy before causing additional end injury.

One of the main ways a person can treat piriformis syndrome without seeing a doctor, according to SportsInjuryClinic.net, is to apply heat to the buttocks region. Patients should also work to stretch the muscles in the buttocks and hips to help relieve the spasm and inflammation. A person with piriformis syndrome has irritation and inflammation of the sciatic nerve. Usually people with piriformis syndrome do not like to sit. When they do sit down, they tend to sit with the sore side buttock tilted up rather than sitting flat in the chair.

There are a number of preventative techniques that will help to prevent piriformis syndrome, including modifying equipment or sitting positions, taking extended rests and even learning new routines for repetitive activities.

Besides stretching, there a couple of therapies that can greatly assist in treating piriformis syndrome. Ultrasound can be used to provide an anti-inflammatory effect to a swollen piriformis. Stretching is not only a treatment but also a preventive.

Patients with piriformis syndrome may also find relief from ice and heat. Ice can be helpful when the pain starts, or immediately after an activity that causes pain. If pain is persistent during stretching then a combination of warm moist therapy with Infrex treatment during and after exercising may be most beneficial. The thermal effects of warm moist heat have limited residual pain relief, however the carryover pain relief from interferential therapy may provide total comfort extending from one stretching session to the next.

The warm moist heat also attracts blood to the area and the interferential treatment goes deeper into the human tissue structure due to decreased electrical resistance.

Inactive and weak gluteal muscles can also be a predisposing factor of the syndrome. The Gluteus maximus is important in both hip extension and in aiding the piriformis in external rotation of the thigh. Most patients also need gluteal strengthening. Try to maintain flexibility in the hip joints, including the iliopsoas, iliotibial band (ITB) and gluteal muscles. This will help prevent injuries caused by friction.

Vulvodynia Sufferers - Seek Massage Therapy to Help Ease Pain

Vulvodynia is a complicated condition that affects so many women that there is no consensus as to how many actually suffer from this type of chronic pain. Vulvodynia is a pain syndrome that involves the vulva, labia, and entrance to the vagina. The pain associated with this condition is described as burning, stabbing, achy, itching, throbbing or irritated. The syndrome can present generalized or localized pain and can be triggered by pressure or can occur at rest.

Experts believe that some risk factors may contribute to the development of vulvodynia. One consideration is an injury to the nerves that supply sensation to the vulva. Another cause may be an abnormal response of various cells in the vulva to environmental factors such as infection or trauma. Other considerations might include genetic factors associated with susceptibility to chronic vestibular inflammation or a localized hypersensitivity to yeast (Candida). Lastly, researchers have speculated that spasms of the muscles that support the pelvis might be correlated to vulvodynia. Though it is undetermined what triggers individual cases of vulvodynia, the pain is pervasive and massage can help to manage some discomfort associated with this chronic condition.

Women who suffer from vulvodynia oftentimes have associated hip, sacroiliac, coccyx or low back pain. Many women also experience tightness in their adductors, hamstrings, and gluteal muscle groups that are in constant state of contraction due to the body favoring the pain of the pelvic floor. The attachments of these muscles can become tight and inflexible, adding further pain in the pelvic region. The excess muscle tension occurring in the hamstrings, adductors, gluteals, and lower back becomes a pain cycle and can worsen the physical symptoms of vulvodynia, leading to decreased quality of life. Some women have reported disengaging from activities that they once enjoyed because the pain of their condition prohibited movement or interest.

Muscle relaxation training and massage therapy is an important and overlooked treatment method for addressing vulvovdynia. The physiological effects of massage have shown to provide relief for women suffering from vulvodynia. Massage helps to relax and soften injured and overused muscles by causing vasodilation in the skin and muscles that have become used to stimulating and stressful responses of the sympathetic nervous system. Deeper tissue massage causes the release of endorphins, the body's natural pain killers. If pain is diminished, the body is under less stress and the parasympathetic nervous system is more likely to be activated, which helps to support homeostasis. Thus, since massage relaxes the client and reduces sympathetic activity, pain is likely to be less intrusive and disruptive to the individual.

Chronic Shoulder and Neck Pains - A Menace No More

Neck and Shoulder Pain Overview

The shoulders support the neck through bones, muscles, arteries and veins, nerves, ligaments etc. That is why; it is seen, most of the time that pain in the shoulders gradually results in a pain in the neck and wise versa. Some conditions that result in shoulder and neck pain may turn out to be life threatening such as heat diseases, while others may turn out to be inconsequential such as simple sprains, strains, or contusions.

Some of these pain conditions can turn out to be chronic. However, if you pay proper attention to your pain it is easily manageable. Instead of performing the exercises for a limited period of time, in case of chronic pains, you will have to treat them as a daily routine for a greater part of your life.

Causes for Shoulder And Neck Pain

Either or all of the following conditions can cause shoulder and neck pains:

• Whiplash - Injury to surrounding tissues such as tendons, ligaments, muscles etc.


• Pinched nerves


• Arthritis


• Abnormal conditions of the spinal cord, heart and/or lungs


• Damaged or broken collarbone


• Bursitis


• Injuries to the rotator cuff


• Inflammation of the diaphragm can cause shoulder pains; etc.

Symptoms

The symptoms include weakness, pain, numbness, coolness, swelling, color changes and/or deformity.

Treatment

The following methods can be used to treat the shoulder and/or neck pain:

• Ice packs - put ice pack on the affected areas, but only in case of acute strains.


• Heat - heat or warm the affected area through heating pads or hot water bottles for 15 to 20 minutes; in case of chronic strains.


• Use a cervical pillow


• Reduce stress


• Avoid bad postures

Exercises For Shoulder And Neck Pain Relief

Shoulder Pain Relief

• Range of motion exercise


• Rotator cuff strengthening


• Upper extremity strengthening

Neck Pain Relief

• Side stretches


• Chin tuck


• Turning exercises

Preventing Chronic Muscle Pains

Usually old people do tend to complain about their sore knees or back aches a lot. People mistakenly tend to think that these problems can only take place in the life of elderly people. However, such a problem can occur in any adult's life. You can make sure that you do not end up facing the same problem by taking a few precautionary measures such as the following:

It is best to be aware about it from this very moment. There are a number of conditions that cause chronic pain, so in case you are aware about them, you can take more steps to prevent the problem from becoming more serious.

A few triggers that take place among young people include injuries of the joint and back, engaging in activities such as body lifting and typing regularly, accidents and a lot more. If you make it a point to get treatment for these in the early stages, you will go a long way in preventing chronic pain problems for taking place.

It is essential to include exercise in one's daily schedule. This is not only important for weight loss and to look good but doing yoga is beneficial for also preventing problems such as back and joint pain from occurring.

It is obvious that having a reasonable weight will help you in preventing any sort of chronic pain related to obesity from taking place.

It is always wise to visit a physical therapist and chiropractor. Such professionals, along with doctors, work in keeping the spine properly aligned and manipulate the body parts in such a way which enables the body to heal after an injury takes place.

Of course, it is not possible to control and prevent all the causes that lead to chronic pain, for example, fibromyalgia and similar conditions associated with cancer which is difficult to diagnose accurately and treated.

Just keep in mind and realize the importance, as it is just not easy to live through with agony. There are amazing doctors out there who especially focus on providing relief from pain. Just explore this to have a peaceful life.

Coping With Chronic Pain - My Personal Story

My pain story begins in my late twenties, around the year 2002. Back then, I worked long hours as a software engineer. I started to suffer from arm pain.

At that time, I thought it was normal to feel pain. I would come home and rest at night and during the weekends, and then feel OK again. Eventually, it got to the point I thought I had Carpel Tunnel Syndrome. I went to several doctors and was misdiagnosed many times. Finally, I got second and "third" opinions and received other diagnostics. I had two doctors agreeing that I had Cervical Radiculopathy. I am currently being treated for this condition.

Cervical Radiculopathy is the swelling of a root nerve around the neck area. In my case, the doctors ordered a Nerve Conduction Velocity test (NCV), and then determined I had Radiculopathy. In an NVC, doctors use needles to test for nerve damage using electrical stimulation. However, both the needles and the electricity used are very uncomfortable for patients.

My neck pain travels down my arm and my back, mainly on the left side. The prescription medicine that are now working for me are: Neurontin (for nerve pain) and Baclofen (a muscle relaxant). I also wear Lidoderm patches on the back.

Another thing that works for me is wearing a soft cervical collar. I also use a pillow or cushion to support my lower back when I am driving.

Using the muscle relaxant helps me to fall asleep faster and to sleep better. Tossing and turning on the bed are frequent, and sometimes I cannot find a position to use for sleeping. But after a while, I fall asleep, with the aid of medication, and wake up more relaxed.

Other things that help is not using the computer at home excessively and taking breaks at work. At work, I try to take a break every 20-30 minutes, when possible.

To summarize, these are the things I use to cope with my neck pain:

• Taking prescription medicine as directed by my doctor.


• Using a cushion for lower back support while driving


• Taking breaks at work, and minimizing computer use


• Standing up or stretching after sitting down for a long period of time


• Using a soft cervical collar

Much more can be said. For now, I hope these ideas can help if you suffer from neck pain

Depression and Chronic Back Pain - Symptoms, Diagnosis and Treatment

Depression is by far the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major depression or clinical depression. This type of depression goes beyond what would be considered normal sadness or feeling "down for a few days". The symptoms of a major depression occur daily for at least two weeks and include at least 5 of the following (DSM-IV, 1994):

• A mood that is depressed, sad, hopeless, low, or irritable, which can include periodic crying spells
  
  


• Sleep problems of either too much (hypersomnia) or too little (hyposomnia) sleep
  
  


• Poor appetite or significant weight loss or increased appetite or weight gain
  
  


• Feeling agitated, restless or sluggish (low energy or fatigue)
  
  


• Decreased sex drive
  
  


• Loss of interest or pleasure in usual activities
  
  


• Feeling of worthlessness and/or guilt
  
  


• Problems with concentration or memory
  
  


• Thoughts of death, suicide, or wishing to be dead
  
  

Chronic pain and depression are two of the most common health problems that family physicians, spine specialists and mental health professionals encounter, yet relatively few studies have investigated the relationship between these conditions in the general population (Currie and Wang, 2004).

Major depression is thought to be up to four times greater in people with chronic back pain than in the general population (Sullivan, Reesor, Mikail & Fisher, 1992). Studies on depression in chronic low back pain patients show that the prevalence is even higher.

Depression is common for those with chronic back pain

Depression is more commonly seen in patients with chronic back pain problems than in patients with pain that is of an acute, short-term nature. How does depression develop in these cases? This can be understood by looking at the host of symptoms often experienced by the person with chronic back pain or other spine-related pain.

The pain often makes it difficult to sleep, leading to fatigue and irritability during the day.

Then, during the day, because patients with back pain have difficulty with most movement they often move slowly and carefully, spending most of their time at home away from others. This leads to social isolation and a lack of enjoyable activities.

Due to the inability to work, there may also be financial difficulties that begin to impact the entire family.

Beyond the pain itself, there may be gastrointestinal distress caused by anti-inflammatory medication and a general feeling of mental dullness from the pain medications.

The pain is distracting, leading to memory and concentration difficulties.

Sexual activity is often the last thing on the person's mind and this causes more stress in the patient's relationships.

Understandably, these symptoms accompanying chronic back pain or neck pain may lead to feelings of despair, hopelessness and other symptoms of a major depression or clinical depression.

A recent study by Strunin and Boden (2004) investigated the family consequences of chronic back pain. Patients reported a wide range of limitations on family and social roles including: physical limitation that hampered patients' ability to do household chores, take care of the children, and engage in leisure activities with their spouses. Spouses and children often took over family responsibilities once carried out by the individual with back pain. These changes in the family often led to depression and anger among the back pain patients and to stress and strain in family relationships.

Psychological theories about depression

Several psychological theories about the development of depression in chronic back pain patients focus on the issue of control. As discussed previously, chronic back pain can lead to a diminished ability to engage in a variety of activities such as work, recreational pursuits, and interaction with family members and friends. This situation leads to a downward physical and emotional spiral that has been termed "physical and mental deconditioning" (See Gatchel and Turk, 1999). As the spiral continues, the person with chronic back pain feels more and more loss of control over his or her life. The individual ultimately feels totally controlled by the pain, leading to major depression. Once in this depressed state, the person is generally unable to change the situation even if possible solutions to the situation exist.

Relieving Chronic Pain - Loving the Inner Lizard

A client recently asked for help with an inexplicable pain in her left shoulder. There was no recent injury or incident that directly or indirectly caused the pain. I asked her to describe the sensation she felt in her shoulder.

"Small, round, heavy, like a dark cloud."

She wondered aloud if it was a bursitis, similar to one experienced in the opposite shoulder, related to a work injury that occurred more than 11 years ago. I asked if there was any particular person from her former workplace now coming to mind.

"There were many unresolved issues from work."

Aha.

I asked if any particular person came to mind as she focused her attention on her shoulder.

"My boss."

"If your shoulder could speak, what would it do or say to your boss right now?"

(Pause.) "It wants to punch her in the nose."

With the image of her boss' face in her mind we did slow motion punching gesture in the air. She laughed. Her arm began to tingle through to the fingertips and the pain magically disappeared.

The body stores all memory. When we experience a real or perceived threat, the most primitive part of our brain, the brain stem, which we refer to as "reptilian brain," triggers the nervous system to fight or flee. The body releases hormones that makes our hearts race, the blood moves to the extremities and our focus narrows. Nowadays we seldom have to scramble up a tree to escape from a wild tiger.

However, while our daily external conditions are less precarious, our threat response may be triggered while being reprimanded by an authority figure at a workplace or by engaging in a challenging relationship. In difficult interpersonal situations, we often hold back our impulses to strike, yell or kick. In general this is a good thing. We do not wish to physically harm another being. We can resort to dialogue rather than dueling to resolve difficult situations and no one gets physically harmed in the process.

However, the lizard doesn't understand negotiation. The lizard only knows that it wants to rip someone's head off. Every time the lizard brain perceives a signal in the form of a threatening voice, the familiar scent of the boss's perfume, even the sight of a a familiar-looking car model parked in a nearby lot, the lizard brain involuntarily triggers the nervous system to respond with the flood of hormones, tightening of the muscles and the impulse to fight or flee. It's just that the rest of our brain doesn't immediately make the connection.

When we hold our bodies back from responding in these situations, our inner lizard gets confused. It receives the impulse to move, but remains still. The energy in the body remains bound up in the system which over time may manifest as pain in the shoulder, pain in the hip, pain in the foot. Inexplicable chronic pain. The dull ache that cannot be attributed to any accident or injury. In extreme cases, an incomplete defense response, the learned inability to fight may cause the body to turn on itself and manifest as frozen shoulder, depression, irritable bowel syndrome, chronic fatigue or fibromyalgia. A strong desire to escape, or an incomplete fleeing response, may develop into severe anxiety or panic attacks.

When these incidents occurred a long time ago, perhaps when we were young adults, children, or possibly even earlier, how can we work to resolve the issue and make the pain go away?

The body stores all memory.

Trust the body.

Pay attention to the pain.

Focus on the pure quality of sensation.

Notice words, images or people bubbling up in the periphery.

Linger with these sensations that are connected to these words, images or people.

The body is attempting to heal itself. It needs to move. Long ago, an interrupted incomplete defensive response took place that lizard brain remembers through the body and has been nudging you to complete it. We can address and resolve the issue, via the nervous system, and bring mind and body into balance. Trust that the body knows what it needs to do. All it requires is that we pay attention.

Lara Triback

lara (et) bodyprajna.com