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WHAT’S ALL THE BUZZ ABOUT PAIN AND NEUROMODULATION…
Harvard Health Publishing wrote that “ Chronic pain is an enigma for both pain doctors and their patients: difficult to understand (as everyone’s pain is different), challenging to treat effectively, and frustrating to live with. Desperate patients sometimes turn to drastic and irreversible surgical procedures, like amputating nerves to relieve pain, and unfortunately even those procedures may fail to provide the hoped-for results.”
Fortunately there have been great strides in research related to pain perception and our nervous system’s reaction to various pain treatments, and we’ve been able to develop novel devices that provide many people with much-needed relief and improve their quality of life.
Neuromodulation is “the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.” Dr. Norman Shealy, a neurosurgeon, implanted the first device for the relief of intractable pain in 1967, and his work ushered in a new era for chronic pain management.
One of the most common examples of neuromodulation is the use of spinal cord stimulation (SCS) for chronic pain management. SCS consists of a very thin lead (or wire) that is placed in the space just outside the spinal cord (known as the epidural space). The lead is attached to a small generator device that is implanted under the skin and subcutaneous layer in the back or buttock. The devices will deliver frequent, low-voltage electrical impulses to the spine, with subsequent modulation of the pain signals in transit to the brain. Those impulses often feel like a gentle tingling or buzzing (which is called paresthesia) on the body.
Harvard explain that another form of neuromodulation is the intrathecal pump, which is a device designed to deliver a desired medication directly into the spinal fluid surrounding the spinal cord.
Neuromodulation treatments have typically been offered to patients only after they have tried conventional treatment options such as medications, physical and occupational therapy, or surgery. Although the treatment is not without risks it is a cost affective option for managing chronic pain, in particular after failed surgery,
Guy’s & St. Thomas’ NHS Hospital in London have a Chronic Pain Management & Neuromodulation Centre. It is internationally recognised as a centre of clinical and academic excellence in the management of chronic pain.
They have a long history of providing traditional chronic pain management treatments such as day case procedures and outpatient treatments.
They have also established world prominence in the fields of spinal cord stimulation and other neuromodulation techniques, as well as in addressing the psychological, physical and social impacts of chronic pain with our pain management programmes. This is delivered through the INPUT pain management department.
The centre collaborates closely with spinal surgeons in the assessment and treatment of spinal pains, and similarly provides highly specialised, multidisciplinary assessments for conditions including chronic headache, facial pain and pelvic pain.
LACKING IN VITAMIN D – IS THAT CAUSING BACK PAIN AND/OR FIBROMYALGIA?…
After meeting my new Pain Team last week I was sent for a blood test to check my Vitamin D levels.
Symptoms of Vitamin D Deficiency include –
Getting sick and infected often
Fatigue and Tiredness
Bone and Back Pain
Impaired Wound Healing
Any Fibromyalgia or Back Pain sufferer will pick up on some of these symptoms and I know people say you should never read into these things but if you have the symptoms you can’t help but look into it.
Today I received a call from my GP to say I am Vitamin D deficient and I have been put on a strong course of Vitamin D only available from your GP for one month.
According to Biomed Central “Vitamin D is a pleiotropic hormone with a critical role in modulating several inflammatory and pain pathways in addition to calcium homeostasis. Observational studies suggest an association between vitamin D deficiency and chronic pain, most promisingly in fibromyalgia “.
On one NHS website they explain why Vitamin D is vital for health?
Vitamin D is needed by the body for both physical and mental health, but is best known for making sure bones are strong and grow properly. Vitamin D is needed all through life and even before birth. Pregnant and breastfeeding women need to have enough vitamin D so that developing and growing babies form healthy bones. Vitamin D is also essential for calcium to enter the body and strengthen bones.
Recently, it has been found that not having enough vitamin D is also related to other physical conditions such as diabetes mellitus, heart disease and certain cancers. The development or worsening of mental health conditions, such as depression, low mood and schizophrenia, may also be related to inadequate levels of vitamin D.
Where is vitamin D found?
Vitamin D is made in the skin by the action of sunlight. This is the best natural source of vitamin D. In northern countries, such as the UK, sunlight is only bright enough to make useful amounts of vitamin D from April to October and between 11am to 3pm. Sunscreen and clothing blocks out sunlight, so vitamin D cannot be made in the skin. Being out in the sun without sunscreen is associated with skin cancer, however sunbathing for about 10-15 minutes without sunscreen is considered safe for most adults. You should aim to get out of doors everyday. Sun beds and tanning salons are not recommended.
Some medication used in mental health can make your skin more sensitive to sunlight, therefore discuss safe sunbathing with your doctor or pharmacist.
Vitamin D can be found in some foods, but is usually only present in small amounts, so dietary sources are unlikely to provide enough.
Some vitamin D can be found in oily fish (such as kippers, sardines, mackerel, trout and salmon), meat and eggs. A few foods have vitamin D added to them, such as some margarine and low fat spreads, some breakfast cereals, powdered milks, dairy and soya products.
So Vitamin D is really important to our health and well being and I just have to wonder that had I not moved to a new GP and Pain Clinic who are looking at my chronic pain in a completely different light if it would ever have been spotted that I am deficient in it. Have you had your vitamin D levels checked?
I am also now waiting for an appointment for a bone density cytometry appointment. Not sure what that is as again I’ve never had one done before, have you?