mona2007
10-07-2007, 07:18 PM
Pain
When you feel pain, it is really a reaction to signals transmitted throughout your body. These signals are sent from the pain source -- such as a sore back, through the nerves in the spinal cord, and up to the brain, where they are perceived as pain.
Different Types of Pain
The origin of some pain is neuropathic, while other pain is nociceptive. This is important to know because different treatments work better for each type of pain.
Neuropathic pain is caused by damage to nerve tissue. It is often felt as a burning or stabbing pain. One example of neuropathic pain is a "pinched nerve."
Nociceptive pain is caused by an injury or disease outside the nervous system. It is often an ongoing dull ache or pressure, rather than the sharper, trauma-like pain that is characteristic of neuropathic pain. One example of nociceptive pain is arthritis pain.
Some people experience mixed pain, which is a combination of neuropathic and nociceptive pain.
Chronic versus Acute Back Pain
Chronic back pain is commonly described as deep, aching, dull or burning pain in one area of the back or traveling down the legs. Patients may experience numbness, tingling, burning, or a pins-and-needles type sensation in the legs. Regular daily activities may prove difficult or impossible for the chronic back pain patient. They may find it difficult or unbearable to work, for example, even when the job does not require manual labor. Chronic back pain tends to last a long time, and is not relieved by standard types of medical management. It may result from a previous injury long since healed, or it may have an ongoing cause, such as nerve damage or arthritis.
Acute back pain is commonly described as a very sharp pain or a dull ache, usually felt deep in the lowerpart of the back, and can be more severe in one area, such as the right side, left side, center, or the lower part of the back. Acute pain can be intermittent, but is usually constant, only ranging in severity.
Sometimes, acute back pain can be caused by injury or trauma to the back, but just as often has no known cause. Patients with acute back pain, even when it's severe, will typically improve or completely recover within six to eight weeks.
Approximately half of all back pain patients have acute pain caused by trauma. A contusion, torn muscle, or strained joint resulting from a back injury can cause acute pain. Patients with any of these conditions typically exhibit pain, muscle spasms, and decreased functional activities. Treatment is short-term and usually successful. With physical therapy, follow-up treatment, and prevention practices, these patients typically return to full functionality in a few weeks. Occasionally, these patients will re-injure themselves and have to return for a short course of treatment. Patients with acute pain occurring more than three times in one year or who experience longer-lasting episodes of back pain that significantly interfere with functional activities (e.g., sleeping, sitting, standing, walking, bending, riding in or driving a car) tend to develop a chronic condition.
Mechanical back pain —* a form of acute pain —* is aggravated by movement and worsened by coughing. This type of pain is usually alleviated with rest. Mechanical back pain is typical of a herniated disc or stress fracture. For patients with this condition, forward movements of the spine usually cause pain. In addition, posture, coughing, sneezing, and movement can all influence pain coming from the spine.
When acute back pain is severe and travels down both legs, it could be caused by lumbar disc disease —* the most common cause of true sciatica, another form of acute pain.
Diagnosis of Acute Back Pain
· X-rays -** Painless, non-invasive imaging process that utilizes photographic film to absorb electromagnetic radiation — having an extremely short wavelength of less than 100 angstroms and the ability to penetrate solids of various thicknesses — transmitted through a material body. These images, also known as radiographs or roentgenograms, are used to diagnose and monitor the treatment of various disorders.
· CAT Scan (computed axial tomography scan)[also called a CT scan (computed tomography scan)] - Another painless imaging technique that utilizes a computer to produce detailed three-dimensional images of a body from a collation of cross-sectional X-rays taken along an axis. Of all the imaging techniques that are currently available, the CAT scan is best able to produce images of bone, blood, and soft tissues.
· MRI (magnetic resonance imaging) *- Non-invasive technique for imaging the spine that involves rotating a magnet around the body and exciting its hydrogen atoms. A scanner is then utilized to detect the energy emitted by the excited atoms. MRIs provide exceptional detail of the spine's anatomy, since the human body is composed primarily of water, which is two parts hydrogen. The single most useful test available for diagnosing spinal disorders.
· Myelogram -* A test procedure that involves injecting a radiographic contrast media (dye) into the sac (dura) surrounding the spinal cord and nerves, and then taking X-rays of the spine. This allows the radiologist to specifically X-ray the nerve roots. In this way, any abnormalities within the spinal canal can potentially be identified to aid in the diagnosis of certain spinal problems, such as nerve compression or a disc rupture.
· Bone Scan *- A test procedure that involves intravenously injecting a small quantity of a radiographic marker into the patient, and then running a scanner over the area of concern. The scanner detects the marker, which concentrates in any region exhibiting high bone turnover. A bone scan is utilized when there is suspicion of tumor, infection, or small fractures, i.e., conditions that all result in high bone turnover. A Bone Scan does not replace the above tests, but may provide additional information by eliminating other serious problems.
Chronic Pain
You may have chronic pain if your pain has lasted more than six months and is not relieved by medical and/or surgical care. Chronic pain may result from a previous injury long since healed. Or it may be from an ongoing condition, such as back and/or leg pain, cancer pain, complex regional pain syndrome, or painful neuropathy.
Chronic Pain Statistics
It is estimated that 15 percent to 33 percent of the U.S. population,2 or as many as 70 million people,3 are affected by chronic pain. It disables more people than cancer or heart disease and costs the American people more than both combined. Pain costs an estimated $100 billion a year in medical costs, lost working days, and workers compensation.4
Causes and Treatment of Chronic Pain
Pain is a process. Receptors in your skin and other tissues send impulses through the nerves to the spinal cord. The impulses then travel to the brain. It is in the brain, not at the point of injury, where the sensation of pain is registered. This insight led doctors to understand that pain could be controlled by preventing the pain impulses from reaching the brain. If the pain impulses never reach the brain, the pain is not "felt." Pain can sometimes be difficult to control and get in the way of daily activities for you and your family. Medications or other types of treatments help most people control their pain. But for many people whose pain treatment is no longer effective or causes uncomfortable side effects, clinical studies have shown improved pain relief as well as improved ability to pursue daily activities with neurostimulation5-8, 9 and intrathecal drug delivery.10-16 Not all treatment options are applicable to your type of pain.
Why Do People Suffer With Pain?
Many people suffer with chronic pain because they are unaware of treatment options that can help them live more normal lives. Others have fears that prevent them from talking about their pain, which in turn creates barriers to seeking adequate relief. (Not all treatment options are applicable to your type of pain.)
Read the following to see if you fall into one of these categories. If you can relate to these fears, remember that help and relief are possible, but only if you discuss your symptoms with your doctor.
Fear of being labeled a "bad patient." You won't find relief if you don't talk with your doctor about your pain.
Fear that increased pain may mean that your disease has worsened. Regardless of the state of your disease, the right treatment for pain may improve daily life for you and your family.
Fear of addiction to drugs. Research shows that the chance of people with chronic pain becoming addicted to pain-relieving drugs is extremely small. When taken properly for pain, drugs can relieve pain without addiction. Needing to take medication to control your pain is not addiction.
Lack of awareness about pain therapy options. Be honest about how your pain feels and how it affects your life. Ask your doctor about the pain therapy options available to you. Often, if one therapy isn't effectively controlling your pain, another therapy can.
Fear of being perceived as "weak." Some people believe that living stoically with pain is a sign of strength, while seeking help often is considered negative or weak. This perception prevents them seeking the best treatment with available therapies.
Because there are many new ways to treat pain, it is important that you speak openly with your doctor or with a doctor who specializes in treating chronic pain. Refer them to this web site so that they too can learn more about treatment options for your pain.
Chronic Back and Leg Pain
Chronic back and leg pain is described as pain that is felt in the back and/or leg that may result from spinal diseases including: arachnoiditis, degenerative disc disease, epidural fibrosis, failed back syndrome, lumbar disc herniation, osteoporosis, and spinal stenosis. Back pain is often located in the lower back, but it may extend to other areas, such as the thighs, calves, and feet. Affected areas may feel tender or sore to the touch, and the pain may increase with movement. This type of pain can be felt as sharp or knife-like pain, a burning sensation, or as a dull muscular ache. Symptoms can range from mildly uncomfortable to completely disabling.
If you have been diagnosed with this type of pain, talk to your doctor to determine what kinds of therapies would work for you. Your doctor (or a doctor to whom you are referred) will put you through a selection process to determine which treatments may benefit you. Results vary; not every result is the same.
Cancer Pain
Pain caused by cancer usually falls into one of two categories:
Nociceptive pain is caused by damage to tissue. It is usually described as sharp, aching, or throbbing pain. It is often due to tumors or cancer cells that are growing larger and crowding body parts near the cancer site. It may also be from cancer that has spread to the bones, muscles, or joints, or caused a blockage of an organ or blood vessels.
Neuropathic pain happens when there is actual nerve damage. It may be caused by a tumor pressing on a nerve or a group of nerves. People often describe this pain as a burning or heavy sensation, or numbness.
If you have been diagnosed with cancer pain, talk to your doctor to learn whether you may be a candidate for the Medtronic pain-control pump (intrathecal drug delivery). Your doctor (or a doctor to whom you are referred) will put you through a screening process to determine if these treatments may benefit you. Results vary; not every result is the same.
Complex Regional Pain Syndrome (CRPS)
CRPS usually develops in the foot or hand after an injury (such as a broken bone) or surgery that may involve nerve damage. CRPS is the abbreviation used to describe the painful syndrome also known as Reflex Sympathetic Dystrophy (RSD) and Causalgia.
Symptoms and Treatment
The overriding symptom is extreme pain - frequently described as burning. Other symptoms can include sensitivity to touch, skin changes, swelling, weakness, and decreased function of the hand/foot.
If you have been diagnosed with this type of pain, talk to your doctor to determine what kind of therapies would work for you. Your doctor (or a doctor to whom you are referred) will put you through a screening process to determine which treatments may benefit you. Results vary; not every result is the same.
Painful Neuropathies
Painful neuropathies are a common collection of neurological disorders resulting from damage to nerves that generate severe chronic pain. Nerves connect the spinal cord to the body and help the brain communicate with skin, muscles, and internal organs.Painful neuropathies may be caused by nutritional imbalances, alcoholism, toxins, infections, or autoimmunity, or may be the result of illnesses such as kidney failure or cancer. In approximately one-third of cases, the cause of neuropathy is unknown.
Symptoms and Treatment
Although there are many different causes of painful neuropathies, they have common symptoms such as pain, burning, weakness, and numbness. These symptoms most often appear in the hands or feet. Treatment is focused on the underlying disease or condition if it is known. Pain is generally managed with oral pain medications. Medical devices may be considered when conservative pain management treatments fail. If you think you have this type of pain, talk to your doctor to determine what therapies would work for you. Your doctor (or a doctor to whom you are referred) will put you through a selection process to determine which treatments may benefit you. Results vary; not every result is the same.
When you feel pain, it is really a reaction to signals transmitted throughout your body. These signals are sent from the pain source -- such as a sore back, through the nerves in the spinal cord, and up to the brain, where they are perceived as pain.
Different Types of Pain
The origin of some pain is neuropathic, while other pain is nociceptive. This is important to know because different treatments work better for each type of pain.
Neuropathic pain is caused by damage to nerve tissue. It is often felt as a burning or stabbing pain. One example of neuropathic pain is a "pinched nerve."
Nociceptive pain is caused by an injury or disease outside the nervous system. It is often an ongoing dull ache or pressure, rather than the sharper, trauma-like pain that is characteristic of neuropathic pain. One example of nociceptive pain is arthritis pain.
Some people experience mixed pain, which is a combination of neuropathic and nociceptive pain.
Chronic versus Acute Back Pain
Chronic back pain is commonly described as deep, aching, dull or burning pain in one area of the back or traveling down the legs. Patients may experience numbness, tingling, burning, or a pins-and-needles type sensation in the legs. Regular daily activities may prove difficult or impossible for the chronic back pain patient. They may find it difficult or unbearable to work, for example, even when the job does not require manual labor. Chronic back pain tends to last a long time, and is not relieved by standard types of medical management. It may result from a previous injury long since healed, or it may have an ongoing cause, such as nerve damage or arthritis.
Acute back pain is commonly described as a very sharp pain or a dull ache, usually felt deep in the lowerpart of the back, and can be more severe in one area, such as the right side, left side, center, or the lower part of the back. Acute pain can be intermittent, but is usually constant, only ranging in severity.
Sometimes, acute back pain can be caused by injury or trauma to the back, but just as often has no known cause. Patients with acute back pain, even when it's severe, will typically improve or completely recover within six to eight weeks.
Approximately half of all back pain patients have acute pain caused by trauma. A contusion, torn muscle, or strained joint resulting from a back injury can cause acute pain. Patients with any of these conditions typically exhibit pain, muscle spasms, and decreased functional activities. Treatment is short-term and usually successful. With physical therapy, follow-up treatment, and prevention practices, these patients typically return to full functionality in a few weeks. Occasionally, these patients will re-injure themselves and have to return for a short course of treatment. Patients with acute pain occurring more than three times in one year or who experience longer-lasting episodes of back pain that significantly interfere with functional activities (e.g., sleeping, sitting, standing, walking, bending, riding in or driving a car) tend to develop a chronic condition.
Mechanical back pain —* a form of acute pain —* is aggravated by movement and worsened by coughing. This type of pain is usually alleviated with rest. Mechanical back pain is typical of a herniated disc or stress fracture. For patients with this condition, forward movements of the spine usually cause pain. In addition, posture, coughing, sneezing, and movement can all influence pain coming from the spine.
When acute back pain is severe and travels down both legs, it could be caused by lumbar disc disease —* the most common cause of true sciatica, another form of acute pain.
Diagnosis of Acute Back Pain
· X-rays -** Painless, non-invasive imaging process that utilizes photographic film to absorb electromagnetic radiation — having an extremely short wavelength of less than 100 angstroms and the ability to penetrate solids of various thicknesses — transmitted through a material body. These images, also known as radiographs or roentgenograms, are used to diagnose and monitor the treatment of various disorders.
· CAT Scan (computed axial tomography scan)[also called a CT scan (computed tomography scan)] - Another painless imaging technique that utilizes a computer to produce detailed three-dimensional images of a body from a collation of cross-sectional X-rays taken along an axis. Of all the imaging techniques that are currently available, the CAT scan is best able to produce images of bone, blood, and soft tissues.
· MRI (magnetic resonance imaging) *- Non-invasive technique for imaging the spine that involves rotating a magnet around the body and exciting its hydrogen atoms. A scanner is then utilized to detect the energy emitted by the excited atoms. MRIs provide exceptional detail of the spine's anatomy, since the human body is composed primarily of water, which is two parts hydrogen. The single most useful test available for diagnosing spinal disorders.
· Myelogram -* A test procedure that involves injecting a radiographic contrast media (dye) into the sac (dura) surrounding the spinal cord and nerves, and then taking X-rays of the spine. This allows the radiologist to specifically X-ray the nerve roots. In this way, any abnormalities within the spinal canal can potentially be identified to aid in the diagnosis of certain spinal problems, such as nerve compression or a disc rupture.
· Bone Scan *- A test procedure that involves intravenously injecting a small quantity of a radiographic marker into the patient, and then running a scanner over the area of concern. The scanner detects the marker, which concentrates in any region exhibiting high bone turnover. A bone scan is utilized when there is suspicion of tumor, infection, or small fractures, i.e., conditions that all result in high bone turnover. A Bone Scan does not replace the above tests, but may provide additional information by eliminating other serious problems.
Chronic Pain
You may have chronic pain if your pain has lasted more than six months and is not relieved by medical and/or surgical care. Chronic pain may result from a previous injury long since healed. Or it may be from an ongoing condition, such as back and/or leg pain, cancer pain, complex regional pain syndrome, or painful neuropathy.
Chronic Pain Statistics
It is estimated that 15 percent to 33 percent of the U.S. population,2 or as many as 70 million people,3 are affected by chronic pain. It disables more people than cancer or heart disease and costs the American people more than both combined. Pain costs an estimated $100 billion a year in medical costs, lost working days, and workers compensation.4
Causes and Treatment of Chronic Pain
Pain is a process. Receptors in your skin and other tissues send impulses through the nerves to the spinal cord. The impulses then travel to the brain. It is in the brain, not at the point of injury, where the sensation of pain is registered. This insight led doctors to understand that pain could be controlled by preventing the pain impulses from reaching the brain. If the pain impulses never reach the brain, the pain is not "felt." Pain can sometimes be difficult to control and get in the way of daily activities for you and your family. Medications or other types of treatments help most people control their pain. But for many people whose pain treatment is no longer effective or causes uncomfortable side effects, clinical studies have shown improved pain relief as well as improved ability to pursue daily activities with neurostimulation5-8, 9 and intrathecal drug delivery.10-16 Not all treatment options are applicable to your type of pain.
Why Do People Suffer With Pain?
Many people suffer with chronic pain because they are unaware of treatment options that can help them live more normal lives. Others have fears that prevent them from talking about their pain, which in turn creates barriers to seeking adequate relief. (Not all treatment options are applicable to your type of pain.)
Read the following to see if you fall into one of these categories. If you can relate to these fears, remember that help and relief are possible, but only if you discuss your symptoms with your doctor.
Fear of being labeled a "bad patient." You won't find relief if you don't talk with your doctor about your pain.
Fear that increased pain may mean that your disease has worsened. Regardless of the state of your disease, the right treatment for pain may improve daily life for you and your family.
Fear of addiction to drugs. Research shows that the chance of people with chronic pain becoming addicted to pain-relieving drugs is extremely small. When taken properly for pain, drugs can relieve pain without addiction. Needing to take medication to control your pain is not addiction.
Lack of awareness about pain therapy options. Be honest about how your pain feels and how it affects your life. Ask your doctor about the pain therapy options available to you. Often, if one therapy isn't effectively controlling your pain, another therapy can.
Fear of being perceived as "weak." Some people believe that living stoically with pain is a sign of strength, while seeking help often is considered negative or weak. This perception prevents them seeking the best treatment with available therapies.
Because there are many new ways to treat pain, it is important that you speak openly with your doctor or with a doctor who specializes in treating chronic pain. Refer them to this web site so that they too can learn more about treatment options for your pain.
Chronic Back and Leg Pain
Chronic back and leg pain is described as pain that is felt in the back and/or leg that may result from spinal diseases including: arachnoiditis, degenerative disc disease, epidural fibrosis, failed back syndrome, lumbar disc herniation, osteoporosis, and spinal stenosis. Back pain is often located in the lower back, but it may extend to other areas, such as the thighs, calves, and feet. Affected areas may feel tender or sore to the touch, and the pain may increase with movement. This type of pain can be felt as sharp or knife-like pain, a burning sensation, or as a dull muscular ache. Symptoms can range from mildly uncomfortable to completely disabling.
If you have been diagnosed with this type of pain, talk to your doctor to determine what kinds of therapies would work for you. Your doctor (or a doctor to whom you are referred) will put you through a selection process to determine which treatments may benefit you. Results vary; not every result is the same.
Cancer Pain
Pain caused by cancer usually falls into one of two categories:
Nociceptive pain is caused by damage to tissue. It is usually described as sharp, aching, or throbbing pain. It is often due to tumors or cancer cells that are growing larger and crowding body parts near the cancer site. It may also be from cancer that has spread to the bones, muscles, or joints, or caused a blockage of an organ or blood vessels.
Neuropathic pain happens when there is actual nerve damage. It may be caused by a tumor pressing on a nerve or a group of nerves. People often describe this pain as a burning or heavy sensation, or numbness.
If you have been diagnosed with cancer pain, talk to your doctor to learn whether you may be a candidate for the Medtronic pain-control pump (intrathecal drug delivery). Your doctor (or a doctor to whom you are referred) will put you through a screening process to determine if these treatments may benefit you. Results vary; not every result is the same.
Complex Regional Pain Syndrome (CRPS)
CRPS usually develops in the foot or hand after an injury (such as a broken bone) or surgery that may involve nerve damage. CRPS is the abbreviation used to describe the painful syndrome also known as Reflex Sympathetic Dystrophy (RSD) and Causalgia.
Symptoms and Treatment
The overriding symptom is extreme pain - frequently described as burning. Other symptoms can include sensitivity to touch, skin changes, swelling, weakness, and decreased function of the hand/foot.
If you have been diagnosed with this type of pain, talk to your doctor to determine what kind of therapies would work for you. Your doctor (or a doctor to whom you are referred) will put you through a screening process to determine which treatments may benefit you. Results vary; not every result is the same.
Painful Neuropathies
Painful neuropathies are a common collection of neurological disorders resulting from damage to nerves that generate severe chronic pain. Nerves connect the spinal cord to the body and help the brain communicate with skin, muscles, and internal organs.Painful neuropathies may be caused by nutritional imbalances, alcoholism, toxins, infections, or autoimmunity, or may be the result of illnesses such as kidney failure or cancer. In approximately one-third of cases, the cause of neuropathy is unknown.
Symptoms and Treatment
Although there are many different causes of painful neuropathies, they have common symptoms such as pain, burning, weakness, and numbness. These symptoms most often appear in the hands or feet. Treatment is focused on the underlying disease or condition if it is known. Pain is generally managed with oral pain medications. Medical devices may be considered when conservative pain management treatments fail. If you think you have this type of pain, talk to your doctor to determine what therapies would work for you. Your doctor (or a doctor to whom you are referred) will put you through a selection process to determine which treatments may benefit you. Results vary; not every result is the same.