THREE DIFFERENT TYPES OF BACK PAIN…

1. Acute Pain

Acute Pain is a pain that lasts less than 3 to 6 months, or pain directly related to tissue damage. This is the type of pain caused by a paper cut or needle prick. Other examples of acute pain are like labour pains, the pain is acute and identifiable.

Acute low back pain is defined as a pain present for up to six weeks. It could feel like an aching, stabbing, burning, or dull pain. The actual intensity of this type of low back pain could range from mild to severe and could fluctuate or move to other areas of your body like your hip or thigh area.

2. Chronic Pain

Chronic pain describes pain that lasts more than three to six months, or beyond the point of tissue healing. Chronic pain is usually less directly related to identifiable tissue damage and structural problems. Chronic back pain without a clearly determined cause, failed back surgery syndrome (continued pain after the surgery has completely healed), and fibromyalgia are all examples of chronic pain. Chronic pain is much less well understood than acute pain.

Chronic pain can take many forms, but is often described as a pain with an identifiable cause, such as an injury. Certain structural spine conditions, including degenerative disc disease, spinal stenosis, and spondylolisthesis, can cause ongoing pain until they are successfully treated.

3. Neuropathic Pain

Neuropathic pain could be placed in the chronic pain category, but it has a different feel than chronic musculoskeletal pain. The pain is often described as severe, sharp, lightning-like, stabbing, burning, or cold. The individual may also experience ongoing numbness, tingling, or weakness. Pain may be felt along the nerve path from the spine down to the arms/hands or legs/feet.

It is thought that the pain is caused by damage or disease affecting the somatosensory nervous system. Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli (allodynia). It may have continuous and/or episodic (paroxysmal) components.

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MAGNETIC BACK SUPPORT BELTS FOR TRAVELLING…

Magnetic back support belts are great for back pain but can also help avoid back pain by wearing them when you travel.

I have recently come back from a holiday which involved two long hall flights and I used a magnetic belt as well as a heat patch for both journeys. I am firm believer that if you go armed with a few different types of pain relief you can manage a journey pain free.

I would never travel without my coccyx cushion and have worn heat pads for a long time now but previously I wore a support back girdle which was made for me after one of my spinal surgeries, but it was far from comfortable to wear.

The Bad Back Company have a vast array of products for pain and their Back Support Belt has 20 High Grade ceramic magnets that generate a constant magnetic field over your low back. It costs £39.99 and you will never need to re charge the magnets. Their belt has a high quality adjustable support in a double layer for varied degrees of support and compression for your back. There are also a number of other Back Support Belts without the magnets also available from The Bad Back Company.

Heat has always helped me and it has 3 flexible boned supports to support your lumber spine and keep your muscles and joints warm to reduce muscular spasm or discomfort.

Please check their caution note for people who have pacemakers, defibrillators, insulin pumps or similar devices that are powered by a battery whether as an implant or an external unit. It is also not recommended for use during pregnancy. You can also watch a video about the back support on The Bad Back Company page.

The heat pads I use the Thermacare Advanced Back Pain relief pads which last up to 16 hours and are available from Amazon at £5.50 for 2.

 

TREATING ACUTE PAIN BEFORE IT TURNS INTO CHRONIC PAIN…

Although acute back pain can be frustrating to live with, they say that you should try to remain as positive as possible. Research has shown that people with a positive mental attitude tend to have quicker recovery times and are much less likely to progress from acute to chronic back pain.

For acute back pain, they say you should remain as active as possible. If you find it too painful to return to your normal daily activities immediately, pace yourself and aim to do a little more each day.

Going back to work can help you to return to a normal pattern of activity, and it can often distract you from your symptoms of pain so don’t wait until all the pain has gone before you go back.

People with back pain find that using either hot or cold compression packs helps to reduce pain. Personally, I prefer heat rather than ice.

Placing a small firm cushion beneath your knees when you are sleeping on your side, or using several firm pillows to prop up your knees when lying on your back, may also help to ease your symptoms.

If the symptoms persist then go and see your GP or a professional chiropractor or physiotherapist.

MYOFASCIAL PAIN -v- DISC PAIN…

As most of my readers know I suffer from chronic back pain after four previous spinal fusion surgeries only alleviated the pain for a matter of years before it came back.

Nowadays spinal fusion is not used as the first choice for prolapsed discs with pain management being the first treatment and only if nerves are compressed is it used as another option.

The problem with spinal fusion especially if you have more than one surgery is the pressure it puts on the disc below and above your fusion.

Another condition which you can also suffer from after any type of surgery is Myofascial Pain Syndrome which is a chronic painful muscle disorder and is common if you have experienced a muscle injury. Over time these myofascial restrictions can lead to poor biomechanics, altered structural alignment, compromised blood supply and pain. Other causes of myofascial pain are injuries to an intervertebral disc, general fatigue, repetitive motions, and some medical conditions.

It is characterised by the myofascial trigger points and the symptoms include persistent or worsening pain, deep and aching muscle pain, tender knots located in the muscles and pain after exercise or sporting activity.

Myofascial Pain Syndrome (MPS) is the name given to pain caused by trigger points and fascia (connective tissue) adhesions in the body, usually in muscle tissue, and inflammation in the body’s soft tissues.

Myo = muscle
Fascia = the main connective tissue in the body
Release = to let go, ease pressure

Treatments include anti-inflammatory medication, pain killers, physical therapy, stretching, massage therapy and trigger point injections.

A trigger point injection is either a cortisone injection or dry needling. Pain relief is quick and helps in continuing physical therapy. Trigger point injections can also be used for people suffering from degenerative disc disease.

Understanding the cause of your pain is an important step to finding an effective solution. It may involve a series of sessions and an at home program to keep the area strong.

Disc pain can come from a disc bulge or prolapse but you can also get myofascial pain which could be treated conservatively instead of surgery. Fibromyalgia patients can also suffer from myofascial pain. According to history, Sir William Gowers introduced the term fibrositis for a common, but idiopathic, localized form of muscular rheumatism that is now recognised as myofascial pain syndrome in 1904. And, despite the intervening years, it still constitutes the largest group of unrecognised and undertreated acute and chronic pain problems. Some people (like myself) have also been told they could have Fibromyalgia, previously named ‘fibrositis’.

My neck and arm pain have been giving me a lot of problems since last summer and after extensive tests, MRI’s, ct scans and more it was decided that a nerve block would help with the pain. There is never any guarantee with any injection but they hope to give the patient a few months of pain relief.

Nerve block injections into your neck for a disc bulge can be quite dangerous as they are quite tricky to do and they go through the front of your neck. I had this injection about six weeks ago. It’s not a very nice injection (if any are) but I knew the pain consultant had hit the spot and soon felt total relief. Unfortunately, it was short lived and only gave me pain relief for a few weeks. Not all the pain has come back but most of it as did the pins and needles.

I then had another appointment at the pain clinic and after looking at my MRI’s etc I was given a quick check where my pain consultant felt that the pain I now have could well be myofascial and not from the bulging disc so he has booked me in for a series of steroid injections in my shoulders.

I guess with any spinal pain after you have had all the tests it’s then worth trying alternative treatments well before you resort to surgery which is something I have always said I would avoid having.

 

CAN LONG TERM USE OF OPIOIDS CAUSE RESPIRATORY PROBLEMS AND IS IT TIME FOR A CHANGE…

Can long term use of opioids cause respiratory problems and is it time for a change?

The straight answer is ‘yes’, according to Desert Home Treatment who say that ‘ The long-term effects of opioids on the bowels are significant, but it is the damage they do to the respiratory system that is behind most of the overdoses and fatalities that are related to opioid use. As opioids depress the central nervous system, they directly interfere with the body’s breathing mechanisms.’

Science Daily pointed out that ‘ Opioids are highly effective at killing pain, but they can also kill people by depressing their breathing and at the same time sedating them so that it can be impossible for them to wake up from oxygen deprivation,” says Richard Horner, a professor in the departments of Medicine and Physiology.’

Most pain killers opioids or otherwise can cause side effects but they tend to improve shortly after starting the treatment or following an intended dose increase. The most common side effect being constipation and itching but a respiratory problem is feared by many. They say it is mostly a concern in acute pain management where patients have not developed tolerance.

So should we be right to be sceptical about taking opioids for long term pain when they keep appearing in the news as sceptical ? Drug Abuse has written a great article on a ‘Need for Change’ with a list of 10 opiate alternatives. They include –

Over-the-Counter Acetaminophen

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Cortiosteroids

Serotonin and Norephinephrine

Reuptake Inhibitors

Neurostimulators

Anticonvulsants

Injections

Physical Therapy Massage, Acupuncture and Chiropractic Care

Exercise

It’s certainly something to ponder about.