Acute Pain

Types of Pain You Shouldn’t Ignore

John Naumann Acute Pain, Headaches Comments Off on Types of Pain You Shouldn’t Ignore

Everybody experiences pain at one time or another and we will often ignore it.  But there are certain types of pain you shouldn’t ignore.

Chest pain 

Heart attack pain can feel like pressure in the center of your chest, which may spread to the jaw, neck and arm. Other possible heart attack signs include pain that gets worse when you exert yourself, shortness of breath, nausea and sweating.

Headaches

While most headaches are not a sign of a severe medical problem, there’s one exception: pain that comes on suddenly, particularly after exertion, and feels like the worst headache of your life. This could be a sign of an aneurysm, or bleeding in the brain. This type of headache needs immediate medical attention.

Abdominal pain

Stomach pain is one of the most common complaints seen in the ER. In as many as half of cases, there’s no specific diagnosis. Common causes of abdominal pain include appendicitis, gallstones (hardened deposits of digestive fluid that can form in your gallbladder), pancreatitis (an inflamed pancreas) and diverticulitis (when pouches in the wall of the colon get inflamed or infected).

Appendicitis is associated with pain in the right lower section of the abdomen and is often accompanied by fever, nausea and vomiting. Anyone with these symptoms should go directly to the ER. If the pain is caused by appendicitis, a quick diagnosis is important because if it’s caught before the appendix ruptures, the surgeon often can remove the appendix with laparoscopic surgery. If the surgery isn’t done until after the appendix ruptures, the surgery becomes more complicated, and the recovery is longer.

Gallstones cause pain in the right upper section of the abdomen, often after eating a fatty meal. The pain can be severe and is often associated with nausea. As with appendicitis, removing gallstones early makes surgery simpler, with a faster recovery.

Back pain

While most cases of back pain are caused by muscle strain, some types of back pain are a sign of a more serious problem. Back pain associated with weakness and numbness in the arms and legs, or accompanied by fever, should be evaluated immediately. This type of back pain could be a sign of a spinal cord infection, which should be treated right away to reduce the risk of permanent damage to the spinal cord.

Severe upper back pain, whether or not it’s accompanied by chest pain, could be a sign of a heart attack or aneurysm.

Leg pain

If you have leg pain along with swelling of the leg, it could be a sign of a blood clot. The risk of a blood clot is higher after a long period of immobility, such as a long plane ride or after a person has been in bed for a while following surgery. The pain caused by a blood clot feels more like throbbing or aching. A blood clot is diagnosed with an ultrasound.

You will want to identify and treat a blood clot as quickly as possible, because an untreated clot could get larger, break off and go to the lungs, where it can cause a life-threatening problem.


Difference between a strain, sprain, or tear

John Naumann Acute Pain, Chronic Pain Comments Off on Difference between a strain, sprain, or tear

strain, sprain, or tearMost people don’t know what the difference is between a strain, sprain, or tear of a muscle.  But as a provider these are very important delineations in how we approach the care of an injury. So what is the difference?

A sprain is a ligament injury. A ligament is fibrous connective tissue that connect bones to each other and stabilize them.  Typically ligament injuries occur when a joints range of motion is pushed to an unnatural position.  Sprain injuries can vary in severity, which will contribute to the time for recovery

A strain injury is a muscle or tendon injury.  This is commonly caused when a muscle is overloaded and is over stretched.  There are two types of strain injuries, acute strains and chronic strain injuries.  Acute strains are instantaneous strain injuries and chronic strains are caused by repetitive motions over time that place stress on muscle or tendon.  Strain injuries, like sprain injuries, can vary in severity, which will contribute to the time for recovery.

A tear injury is a muscle, tendon or ligament injury that results in the tearing of the fibrous tissue.  These can be more serious than strain or sprain injuries.  They can result in the need for a surgical repair in order to restore proper function.

The rehabilitation process is strongly driven by identifying the type of injury that has occurred.  It is recommended that you seek a medical professional in order to identify that severity of the injury before beginning treatment.


Are Back Braces Bad For You?

John Naumann Acute Pain, Back Pain, Chronic Pain Comments Off on Are Back Braces Bad For You?

back braces bad for youThe most common injury in the work place was a back injury.  Back Braces were the big “safety” feature in the late 1990’s and early 2000’s in helping protect workers backs when lifting objects.  The problem arose when people would wear back braces for any lifting activities and gradually their abdominal core muscles became weaker and weaker because of lack of use.  This led to people becoming more susceptible to having a back injury from performing even the most basic of movements.   The question arose, “Are back braces bad for you?”

The popularity of back bracing has waned from this heyday, but we are beginning to see a resurgence of back bracing again.  This time around many of them are more compression based wraps versus the more rigid support provided by the older back braces.  The benefit of compression based wraps is they provide light support but encourage more abdominal muscle engagement to brace the back.  In acute cases this can help people get over the “hump” with back pain.  For people with chronic back pain, wearing a brace all the time could actually be exacerbating the injury.  The important thing is to focus on spending time strengthening you back and abdominal core muscles


Better Night Sleep with Back Pain

John Naumann Acute Pain, Back Pain, Chronic Pain Comments Off on Better Night Sleep with Back Pain

One of the biggest challenges for people with back pain is getting a good night sleep.  Getting a better night sleep with back pain isn’t impossible if you do a few things.  Follow these tips to a better night sleep.

  1. Check your mattress – If your mattress is over 10 years old you will want to consider replacing it.  An old mattress doesn’t do a good job provide good back support.
  2. Check your pillows – Pillows break down quicker than mattresses and can reduce support for the head and neck.  Having the proper head and neck support will help provide a good nights sleep
  3. Stretch – Stretches like hamstring stretch, piriformis stretch, iliopsaos stretch, and back lying trunk rotations can help get muscles loosened up in the back encouraging better blood floor for recovery while you sleep
  4. Check your position – Laying flat on your back is the most decompressed position you can put your spine in.  Place a pillow under the knees to provide even better support.  Side-lying is sometimes more comfortable, especially if you place a body pillow between your arms and knees.  Avoid laying on your stomach.
  5. Give yourself time – Making sure you go to bed early enough to let your back get into a position to relax is important.  Often slight shifts in position may pull us from deep sleep, due to pain response.  If you normally sleep 7 hours, go to bed an extra hour earlier to help you hit your target.

Getting a good nights sleep will help with stress and irritability with back pain.  Before you go to bed tonight try these tips to get a better nights sleep.


How to treat back pain

John Naumann Acute Pain, Back Pain, Chronic Pain Comments Off on How to treat back pain

A recent article published on Harvard Health Publications cites how the approach to treat back pain has changed since the 1980’s.  Up until the 1980’s bed rest was the most prevelant way to treat back pain.  By the early 1990’s, use of anti-inflammatory medication and light activity where commonly prescribed.  Recent studies now state that use of any medication in the initial treatment of back pain is ineffective and possibly harmful.  The new way doctors are prescribing treatment is to try, massage, heat, accupuncture, and spinal manipulation for treating acute back pain.  For chronic back pain the recommendation is to prescribe physical therapy, accupuncture, and stress reduction programs.

The new approach to treating back pain is not using any new techniques, but by limiting, if not eliminating the prescription of non-steroidal anti-inflammatories is definitely a big change for many physicians.  Learn more:  Here’s something completely different for low back pain.


Steroid Injections and Back Pain

John Naumann Acute Pain, Back Pain, Bulging Disc, Herniated Disc Comments Off on Steroid Injections and Back Pain

Chronic lower back pain affects millions of Americans. Many try steroid injections to ease their discomfort, but researchers now say this remedy provides only short-term relief.

A study performed in France recently found that people that had steroid injections to relieve back pain had no long term effects.  They found that a single injection had the most benefit, but follow up injections had only a limited effect.

Patients rated their pain severity before the injection and again one, three, six and 12 months after the treatment.

One month after treatment, 55 percent of those who got the steroid injection experienced less lower back pain, compared with 33 percent of those who weren’t treated.

“However, the groups did not differ for the assessed outcomes 12 months after the injection,” Nguyen said.

For example, patients who did or didn’t received a steroid injection ended up in similar circumstances, with the same incidence of disc inflammation, lower quality of life, more anxiety and depression and continued use of non-narcotic pain pills, she said.

Overall, most patients found the steroid injections tolerable, and would agree to have a second one if necessary, Nguyen said. “We had no specific safety concerns and found no cases of infection, destruction or calcification of the disc 12 months after the injection,” she added.

The results were published March 21 in the Annals of Internal Medicine.

The study doesn’t say that steroid injections should not be used to treat back pain.  In certain cases of acute back pain, it can be helpful in the recovery and addressing pain management.  People experiencing chronic back pain would be better served seeking alternative methods of treatment.


10 tips to reduce stress

John Naumann Acute Pain, Chronic Pain, Headaches Comments Off on 10 tips to reduce stress

Reducing stress in your life helps with your overall well-being and helps reduce pain. When we are stressed the body is at a continuous state of fight or flight through the release of cortisol which can inhibit our mind from returning to a state of calm.   Here are 10 tips to reduce stress that doesn’t involve a vacation or spa weekend.

  1. Meditate – This can take place anywhere at anytime.  Sit up straight with feet on floor, and think of something warm and relaxing and close your eyes.  Shut out the world around you and let your mind focus on this peaceful, serene place.  A few minutes of meditation can make a big difference in
  2. Deep breathing – This is excellent when you feel frantic and hot tempered.  Sitting calmly for about 5 minutes just taking slow deep breaths that go from your diaphragm to the upper part of your chest can reduce your heart rate and blood pressure.
  3. Be Present – Reduce the number of things you are thinking about and focus on one sense, like, taste, touch, hearing, smell, or sight.  Listen to nature or watch a pretty view.  Bring yourself to the now.
  4. Reach out to people – Reach out to your family or friends, do this face to face, not online.  Talk to them about what you are dealing with and invite a new perspective that may help you find solace.
  5. Tune into your body – Find a place to lay down flat on your back and start with your toes and go up, taking a moment to see how each body part feels.
  6. Decompress – Take a warm bath, lay on a heating pad, place a warm wash cloth on your face, or massage an area that is holding tension.
  7. Laugh out Loud – Think of something funny, listen to a comedian you like, but the act of smiling and laughing triggers the release of endorphins that helps suppress the release of cortisol.
  8. Listen to music – Listening to your favorite up-beat music and even singing along with it can do wonders in relieving your stress.
  9. Get moving – Exercise and activity can help release chemicals that help provide positive energy and emotions.
  10. Be grateful – Create a journal that you write in daily that documents what you did for yourself, work, family, and community.  Even if it is what you might consider a minor thing it triggers a positive emotional response in the brain.

Highly effective people lead stressful lives but have understand that stress doesn’t have to be contained in the body, but released in a way that can lead to a positive lifestyle.  It’s the harboring of stress in the body that does damage to it and can lead to more pain.


Best exercise programs for people with back pain

John Naumann Acute Pain, Back Pain Comments Off on Best exercise programs for people with back pain

What are the best exercise programs for people with back pain?

f0505_Hot-Yoga

One of the foundations we try to establish with our patients is the importance of proper exercise to keep your back healthy.  There are a lot of different programs out there, some are better suited with dealing with back pain.  We take a look at some of the more popular programs out there and provide some advice on which ones may be better for back pain conditions.

  • Yoga – Yoga is a great option for people with back pain.  It focuses on flexibility and core stability will working on breathing and relaxing.  Stress is strongly correlated to the intensity of back pain.  Yoga is not the best option for weight loss, cardiovascular conditioning, or building muscle mass, but is probably on of the best options for people returning to an exercise program right after a bout of back pain. Many local gyms offer Yoga to its members and exercises can be easily practiced at home with minimal equipment
  • Pilates – Pilates also ranks very high as a great option for people with back pain.  Pilates focus is flexibility, strength, stability and control and endurance for the whole body.  It will have some increased benefits for strength because it will use some resistance training.  Pilates strong foundation of improving core stability can definitely help improve spine instabilities that can lead to back pain.  Pilates requires some very specialized equipment, commonly known as a “Reformer”.  Classes are typically offered by certified Pilates instructors and are often provided one-on-one. Pilates is not something you can easily do at home.  Pilates, like Yoga, is not the best option for weight loss, cardiovascular conditioning, but may improve muscle mass due to the resistance element with the reformer.
  • Interval training – Interval training is a general term and includes many of the popular programs you see today, P90x, Orange Theory, Crossfit, etc.  These programs are very popular because they reduce exercise boredom, by constantly varying exercises.  Many people can experience weight loss, better cardiovascular health, increased endurance and more muscle mass with these programs.  There is not as much focus on flexibility, as compared to Yoga and Pilates.  Many of the programs involve a group setting, which for some people can be encouraging or create a competitive atmosphere.  This can be motivating but can also lead people to push beyond their bodies limits, which for people with back pain can exacerbate the condition.  These types of programs are widely available and can also vary widely in cost.  Having a properly trained coach/trainer is important when doing this type of program.  A properly trained individual can help make modifications to the program to better suit an individuals condition.  People with back pain should approach this type of program with caution and discipline to stay within their limits and listen to their body.

 

The important thing is to stay active!  People with sedentary lifestyles often experience more back pain than ones with active lifestyles.  Doing any activity within your body’s tolerance is better than doing nothing at all.  A structured, consistent program can help people with back pain experience a better quality of life.  So get out there and move!


Living with Series: Degenerative Disc Disease

John Naumann Acute Pain, Back Pain Comments Off on Living with Series: Degenerative Disc Disease

degenerative disc disease

What is Degenerative Disc Disease (DDD)?

Degenerative Disc Disease is the narrowing of the space between the vertebrae of the spine.  It sounds nasty, but is very common as we age and most people can be diagnosed with having this condition but don’t have some of the symptoms that come along with it.  The disc’s in our spine provide multiple functions in our torso, like, twisting, bending, and shock absorption.  As we get older these disc will naturally compress which narrows the space between the vertebrae and this begins to affect mobility and in some case encourage compression of the nerves leaving the spine.  Even though it is more common in older populations, people with disc injuries or genetic predispositions for the condition can develop degenerative disc disease at an earlier age.

Can you prevent Degenerative Disc Disease?

Prevention is not an option as this is a natural process as we age.  The good news is, many people already have the condition but experience very few symptoms that can be related to this condition.  There are some things you can do to reduce symptoms related to degenerative disc disease:

  • Stop smoking – Smoking is not a main cause to degenerative disc disease, but contributes to a lot of conditions that are related to DDD, such as, hypertension, obesity, cardiovascular issues.
  • Proper nutrition – Eating a healthy balanced diet helps maintain proper weight and decreases risk of cardiovascular problems, which significantly contribute to DDD.
  • Exercise – Exercise helps keep the back strong and provides extra support for the spine decreasing the risk of injury
  • Stretch – Proper flexibility and mobility in the spine decreases the risk of injury and can decrease symptoms related to DDD.

 

When should I seek medical attention?

Living with degenerative disc disease doesn’t mean you have to live in pain.  There are many treatment options that can help address pain related to DDD and improve overall quality of life. Physical therapy and chiropractic care can help by breaking the cycle of pain.  Some people call these “Flair-ups”.  Often people may experience a minor back injury and the result guarding (tightening) of the muscles around the spine activating the symptoms related to DDD.  While this is the way the body protects the injured area it is actually counterproductive to the healing process.  Effective treatment can include, spinal decompression, massage, stretching and strengthening.  Find a medical provider that specializes in this treatment in order to get the best results..


Dealing with back pain as we get older

John Naumann Acute Pain, Back Pain, Uncategorized Comments Off on Dealing with back pain as we get older

The Wisdom of an Aging Back

Dealing with back pain as we get older

Ahh, the joys of getting older and dealing with back pain.  As our body and back changes as we get older, so should our behaviors. The challenge is to recognize these changes because they are affected by many different factors, including, physical activity, diet, weight, height, life experiences and genetics.  These all play major factors on how we approach an aging back.

Understanding our own body’s history helps prepare us for dealing with back pain as we get older.  So let’s breakdown the factors that contribute to your history.

Physical Activity

Physical Activity or lack there of can significantly influence how health your back is a you age.  Being physically active doesn’t necessarily mean you are going to have less back pain as you get older.  The reality is that it depends on the type of physical activity.  A person that plays high impact sports, like, football, basketball, volleyball, rugby, etc. and/or sports that put increased stress on the spine, like, golf or tennis are more likely to deal with back pain as they get older vs. a person that does yoga, Pilates, cycling.

Lack of physical activity will definitely increase the risk of back pain due to decreased back strength and increased static postures.

As we get older, it is important to stay active with a good balance of cardiovascular and strength training exercise.  We just need to take in account what our body has already been through.

Diet

We are what we eat, is ever so true.  Keeping our back healthy requires a proper balanced diet.  A person with a healthy diet has a healthier weight, and provides the proper nutrients to the nervous system, bony structures of the back and to the discs that connect these bony structures.  Poor diet over time weakens these structures and will lead to a higher risk of back pain as we get older.

As we get older, diet becomes more important, not just from a weight management standpoint, but also a nutritional standpoint we can get much more sensitive.  Some of the foods and drinks we drank in our youth may not settle as well with us in our older years and can have a negative affect on our body

Weight

Every person is different and so is their healthy weight.  If you are overweight, it will put extra stress on your back, therefore, increasing the potential for pain.  These stresses can create permanent damage to the back and spine, resulting in lifelong pain management.

As we get older, controlling our weight becomes more difficult.  A slowing metabolism and decreased activity can be to blame.  But with proper diet and exercise you can help to keep your back and spine healthy.

Height

Simply put taller people are more likely to experience back pain vs. shorter people.  We can thank the principles of leverage and gravity to that.

As we get older, we shrink.  This is due to bone density loss and more importantly the degeneration of the discs in our spine.  As these structures “shrink” the narrowing of space can put pressure on our nerves, resulting in impingement related back pain.  Practicing proper posture and maintaining proper spinal alignment can help decrease the potential for height related back pain.  It is never to late to practice!

Life experiences

Falls, accidents, things striking you, poor posture and lifting heavy objects can potentially affect your back health resulting in lifelong problems.

As we get older, the impact of our life experiences can be can be felt more often.  There is no point in looking back and wondering, “What if?”, but we can look forward!  Treating and managing these life experience conditions can help improve our quality of life.

Genetics

Some people were blessed with genetics that helps them from rarely having any back pain.  Some are challenged with structural defects of the spine resulting in a significantly increased risk of back pain.

As we get older, this is the 10% of life that we have no influence on.  But understanding our family background and history, can help us be proactive in managing the risks later in life.

The body of our youth is one of learning and designed to absorb the challenges that can increase back pain.  The body of our older years is one of wisdom and works best when we practice the wisdom gained from our youth!


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