When is your pain chronic?

Your pain is chronic if it last for more than a period of six months. Chronic pain is a long-term pain whose nature can vary from mild to excruciating, and it may trouble you either continuously or at short and regular intervals. Chronic pain is so dangerous that it does not only cause discomfort and inconvenience but also robs you entirely of your capacity to work for a long time.

Chronic pain can occur in a number of organs of the human body like head, joints, back, shoulders, neck etc. In fact, pain in any part of your body can turn into chronic pain. Here are a few symptoms that can help you identify if what you are going through is, in fact, chronic pain:

- persistent and severe body pain

- burning sensation accompanied by the body pain

- fatigue and sleeplessness

- weak immune system

- stiff and sore joints

The 4 types of chronic pain disorders that you should be aware of are:

1. Nociceptive pain

The pain that affects the soft tissues of the body such as the skin and the muscles or the organs that have sensory nerves present in them is called nociceptive pain. The sensory nerves, known as nociceptors can detect the stimuli of pain and send information to the brain and the spinal cord for interpretation. The pain could be either somatic (originating in the outer body) or visceral (originating in the internal organs).

2. Neuropathic pain

This pain is caused when the nerves stop functioning normally. It is caused due to nerve disturbances that result in pain stimuli being spontaneously transmitted to the brain and spinal cord. If you are suffering from this type of chronic pain disorder, you will feel a sharp, shooting and stabbing pain. Neuropathic pain can also be caused due to the formation of neuroma (abnormal growth of the nerve tissue).

3. Psychogenic pain

The pain that is caused by psychological disorders like depression and anxiety is known as psychogenic pain. Sometimes this pain can be accompanied by physical complications like fatigue, body pain and muscle weakness.

4. Idiopathic pain

The pain that exists even though there is no physical or psychological cause for it is known as idiopathic pain. This pain is more common in people who have suffered from a pre-existing painful disorder. Some common examples of idiopathic pain are fibromyalgia (intense pain all over the body) and tmj disorders (pain in the jaw area).

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Related Tip: Why does PAIN occur? Understand the Mechanism of Pain

Your Pain is Chronic if it Falls Under These 4 Types of Chronic Pain Disorders!

Restless leg syndrome is a condition where the nervous supply to the lower legs (and sometimes hands) is affected. The person has a constant urge to move the legs due to the tingly sensation or the pins and needles sensation and so this condition is called as restless legs syndrome (RLS). It is almost never a standalone condition and is often associated with other nervous system conditions.
It is a progressive condition and aggravates with time. The patient may experience episodes of this disease. Most people might experience this problem at night due to which a lot of patients complain of disturbed sleep and restlessness while sleeping.

While there is no permanent solution to this condition, there are various home remedies and techniques which can help control the condition. Read on to know more.

Trigger agents: Some people are able to identify triggers like caffeine or chocolate which induce the condition. The first step would then be to avoid using these, especially before sleeping.
Exercise: Any form of exercise, which gives a good workout for the leg muscles is recommended. This could range from a 30-minute brisk walk to stretches depending on the person s overall health status. This is known to induce a good sleep, reduce muscle tension and relax the mood. Choose yoga, gym, cycling, or any form which suits your overall health and schedule.
Massages:Hot or cold massages, often used alternately, can help in relaxing the muscles. This also helps in reducing tension and improving overall sleep. The ideal time for the massage is the evening so that RLS does not affect during nighttime.
Diet: A diet rich in vitamins and minerals can prove to be helpful. This is because proper muscle and nerve function requires various minerals like zinc, potassium, calcium, sodium, etc. Diet rich in these helps in improving muscle and nerve function and thereby control RLS.
Sleep pattern: Sound sleep practices like having an early dinner, a quiet room free of digital media, optimal temperature, and relaxing ambience helps in a better sleep. This has shown to reduce the incidence of RLS and evidence of sound sleep.
Medications: RLS can also cause mild to moderate pain in the affected legs, and so pain killers can be used once in a while if the pain is not bearable. These should be used only rarely and continued use can lead to stomach ulcers and bleeding. The above mentioned nonmedical methods should be tried before trying medications. Anticonvulsants have been used to control RLS if pain killers alone are not adequate. In more severe cases, antiparkinson drugs are used with great success.

Restless Leg Syndrome - How It Can Be Controlled?

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements, especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket, it clearly shows you are suffering from shoulder pain. Shoulder pain can happen due to various reasons, it varies from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are:

    Biceps Tendonitis
    Acromio-clavicular Joint arthritis
    Scapular Dyskinesia
    Trapezitis
    Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
    Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to:

    Bankart lesion

Diagnose Shoulder Pain

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

    X-rays: Through an x-ray one can view the shoulder in many different views.
    Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
    MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
    Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain

    For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
    Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions

    Pain relief and physiotherapy as first step If this fails then following surgical options are available
    Arthroscopic debridement or repair of labrum
    Biceps tenotomy or tenodesis

Arthritis

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Always remember 'a stitch in time saves nine'

Shoulder Pain: Causes, Diagnoses & Treatment

How To Control Nerve Pain?
Nerve pain or peripheral neuropathy, as it is medically known, is characterized by pain, numbness and weakness that arise out of nerve damage. This pain is usually restricted to the feet and the hands.
What are the common causes?
Diabetes is the most common cause for this condition. However, other causes, such as injuries, infections and prolonged exposure to certain toxins can also trigger nerve pain.
How can you control nerve pain?
Nerve pain can be managed and taken care of at home taking into consideration the points that have been mentioned below:
Topical Painkillers: Certain over the counter ointments and creams can help relieve nerve pain. These medications act as local anesthetics; that is they numb the area of the pain. Capsaicin, a derivative of chili peppers, is one of the major ingredients used in these medicines. Others use botanical oils as the major ingredients.
Painkillers: There are painkillers available OTC which can curb nerve pain. However, painkillers such as ibuprofen, aspirin and acetaminophen do not really work well for severe pain of the nerves.
Supplements: The lack of Vitamin B12 is considered to be a very important cause, and at times, a catalyst for nerve pain. In a case such as this, Vitamin B12 supplements or injections might be administered. Although more research needs to go into this, but certain supplements, especially gamma-linolenic and alpha-lipoic acid can help soothe nerve pain caused by diabetes.
Acupuncture: This time honored Chinese approach is a proven alleviator of nerve pain. Acupuncture releases chemicals which numb the pain, or prevent the pain signals from travelling to the brain.
Physical Therapy and Massages: Physical Therapy can especially heal and strengthen weak muscles that can stem from acute nerve damage and pain. Though more evidence is needed, according to a few sufferers of this condition, massages can be helpful with the tremendously painful muscle spasms that can so often result from nerve pain.
Relaxation Techniques: In combination with the above mentioned approaches, relaxation techniques can go a long way in relieving debilitating neural pain. Besides being helpful with dealing and reducing a few stress phases of life which can cause nerve pain, these techniques might actually root out the actual pain itself.
Lifestyle Modifications: This one s always a winner! Eating a well-balanced diet that guarantees all nutrients in uniform amounts can never go wrong. Regular exercises for about 30-45 minutes can remedy different types of pain; nerve pain being one of them. Try and limit alcohol intake (a peg once a week won t harm one, but binge drinking can play the ultimate spoilsport and make all health plans go topsy-turvy!). Abstain from smoking or chewing tobacco as this is usually the primary contributor towards any medical condition or disorder.

Nerve Pain - 7 Ways You Can Control it 

Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

Pain in the Hands or Legs!

Acupuncture is a kind of therapy that combines needles with pressure and pain points in order to delicately apply pressure for pain relief. This form of physical therapy is being increasingly recognised as an efficient method of treating pain in joints, muscles, bones and even for migraine pain. So let us find out more about Acupuncture and pain management.

    Chronic or Long Term Pain: There are many ailments that cause chronic or long term pain. These include back pain, neck pain, stiffness in the joints, osteoarthritis, headache and migraine, and pain in the shoulders. All this can be treated over a long period of time with the help of simulated acupuncture which uses pointed apparatus for activating better blood circulation for overall improvement in the pain that is being experienced in the area. The use of this apparatus helps in avoiding the harmful medication that can have adverse side effects.
    Menstrual Cramps: A fine needle method at the right points can help in bringing down the symptoms of the painful condition called dysmenorrhoea during menstrual cycles. With acupuncture, the acupuncturist can administer acupoint therapy to relieve menstrual cramps. This will help in moving the qi, or life force, in a better way so that the pain will stop. 
    Acute Pain: Over use of muscles, joints and repetitive, work related movements and strain can lead to acute pain. This includes wrist pain, shoulder pain, elbow pain, back pain, lower back pain, neck pain and even leg pain. With acupuncture, the patient gets rid of the pain in close to twelve sittings.
    Pain due to Cancer Treatment: Cancer and its treatment can take a heavy toll on the body and lead to a series of complications which also includes pain. A clean needle procedure can be followed along with the chemotherapy and radiation or after it, so as to relieve the patient of the pain experienced. Also, it can be used to replace traditional chemotherapy and radiation. 
    Better Rest: When the needles or apparatus touch the pressure points and circulate the blood and life force, it actually creates a soothing effect and helps the patient sleep and get better rest. This is also a requirement for pain relief. It can bring better blood flow to the area and help in removing anxiety and stress related to pain so that there is better chance of getting rest. 

With the use of acupuncture, pain can be taken care of with the needles and various tools that come in various shapes. These tools and equipment can also use laser treatment along with the point focused treatment.

Acupuncture and Pain Management

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