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CAN SPINAL CORD STIMULATORS HELP YOU TAKE FEWER PAINKILLERS?…

The use of electrical stimulation to relieve pain began in ancient times with the placement of torpedo fish directly onto painful body parts. Since then, the application of electrical stimulation to the body for pain relief has become much better and more sophisticated.

An article on the  Neuromodulation website explained the Spinal Cord Stimulator, is a tiny battery-powered transmitter similar to a pacemaker which is fitted for chronic pain is now stopping patients from needing as many painkillers.

Researchers at Jefferson University in the US, monitored 5,000 people with chronic pain and found that one year after having the spine implant fitted, 93% of patients were on lower daily doses of painkilling drugs.

Spinal Cord Stimulators is a type of neurostimulation therapy proven to be effective for many chronic pain sufferers. Recommended by doctors for over 40 years to manage chronic pain in the back, arms and legs, SCS helps mask pain by blocking or changing pain signals before they reach the brain. In spinal cord stimulation, a tiny programmable generator and electrical leads are implanted beneath the skin. Small electrical currents are applied to the areas of the spinal cord involved in pain. For reasons that are not completely understood, these electrical impulses interfere with the transmission of pain signals to the brain and relieve pain without causing the side effects that medications can cause.

A pleasant tingling sensation is substituted for the pain and blocks the brain’s ability to sense pain in the stimulated areas. This is similar to the relief felt by rubbing an area after getting an injury. The electrical impulses can be targeted to specific locations and, as pain changes or improves, stimulation can be adjusted as necessary.

Spine Universe wrote that in 1989, spinal cord stimulation (SCS) was approved by the Food and Drug Administration (FDA) as a treatment for chronic pain. Since that time, SCS has become a standard of care for patients with neuropathic chronic back and limb pain (nerve injury with abnormal nerve function producing pain). New technology has allowed for the development of neurostimulators that can allow patients with chronic back pain to reduce or eliminate their need for pain medications and return to comfortable, productive lives.

To make sure the patient will benefit from SCS, a temporary system is implanted and tried for a few days or a week. For the SCS trial, leads are placed beneath the skin and attached to a small generator the patient carries. The generator is similar to a pager or cell phone. If the SCS trial is successful, a complete permanent system with a generator is implanted at another time. The leads for the permanent system can be inserted the same way as in the trial. A small generator is surgically implanted beneath the skin in the upper buttock or abdomen. The wires are then connected, and the entire system is implanted beneath the skin. Nothing is visible on the body.

Nice wrote that a rechargeable spinal stimulator costs in the region of £13,000 – £22,000 so it has to work for you if you are self funding or even if you are insured. Non rechargeable ones are considerably cheaper and start from around £8,000 – £14,000.

Spine Health wrote about the disadvantages and risks of having a stimulator with the potential risks which is  mainly related to the surgical procedures required for a trial period or long-term therapy. One extensive study in the medical literature found 38% of the research participants had device-related problems. The most common complications were unintended movement (also called migration) of the leads, failed connections in leads, and breakage of leads. However serious injuries are rare. 

Advances in SCS technology have allowed people with chronic spine-related pain to reduce or eliminate their need for pain medications and return to comfortable, productive lives. To better understand what you need to know before undergoing SCS, SpineUniverse spoke with Jason M. Highsmith, MD.

Source: Jefferson University, Spine Universe, NeuromodulationNice , Spine Health

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DYSTONIA – PAIN IN YOUR HANDS OR WHEN WRITING?…

Do you experience pain in your hands or when writing? Dystonia is a condition whereby sometimes it becomes painful to write or play an instrument due to cramps in the hand or arm.

The Dystonia Society is the only national charity providing support, advocacy and information for anyone affected by the neurological movement condition known as dystonia.

If the doctor is not able to explain what is causing the cramps, one possible cause is a hand dystonia (otherwise known as Writer’s or Musician’s Cramp). The symptoms vary and may be one or more of the following:

  1. Twisting or curling up of the hands while writing or playing an instrument.
  2. Fingers move of their own accord to unusual positions while writing or playing an instrument.
  3. Writing or playing an instrument becomes painful.
  4. Symptoms usually disappear when the above activities stop.

Hand dystonia commonly appears in people between the ages of 30 and 50. It is one form of dystonia – a condition that causes uncontrollable and often painful muscle contractions believed to be as a result of incorrect messages from the brain to the muscles.

Dystonia is a neurological movement disorder and, if the symptoms listed above are severe or damaging to quality of life, the correct course of action is for a GP to make a referral to a neurologist specialising in movement disorders. There are treatments for hand dystonia that can significantly reduce the symptoms in many cases.  Only a specialist neurologist has the knowledge and skill to diagnose and treat dystonia.  If the patient and their GP agree that the symptoms might possibly indicate dystonia then the GP should refer the patient to such a specialist.

Dystonia can mimic PD in various and assorted ways and diagnosis can be difficult depending on how the disease manifests its symptoms, which are quite similar to not only PD, but other neurological disorders as well. 

Focal dystonias are the most common types of dystonia. Cervical dystonia affects the neck muscles, whereas blepharospasm is known to affect the muscles around the eyes. When the jaw and tongue muscles are affected, it is known as oromandibular dystonia. The voice can be affected, causing a ‘crackling’ sound and known as spasmodic dysphonia. 

There are three primary types of dystonia: basal ganglionic, mesolimbic, and dystonia from the cerebellum. All three types are from the brain or brainstem, but presentation can be clinically different with symptoms.

 

There are also other conditions that can cause similar symptoms, one of which is carpel or cubital tunnel syndrome. The carpal tunnel is a narrow space in the wrist that contains the median nerve. It is surrounded by the bones of the wrist (carpals) and a thick tendon sheath. Friction will cause the tendon sheath to swell and enlarge limiting the space within the carpal tunnel. As a result, the median nerve becomes compressed leading to numbness and tingling within the wrist and hand. Symptoms can be treated conservatively, with night splinting, medications, and cortisone injections. However, carpal tunnel syndrome does not resolve on its own and worsens over time.

Cubital tunnel syndrome is caused by compression of your ulnar nerve at the elbow.  The ulnar nerve travels from neck down your arm through a tunnel at your elbow called the “cubital tunnel.” The nerve is especially vulnerable to compression because the cubital tunnel is very narrow and has very little soft tissue to protect it. This compression causes numbness and/or tingling pain in your elbow, hand, wrist, or fingers. This is commonly caused by leaning on your elbow for long periods of time or swelling caused by friction of your ulnar nerve rubbing along structures of the cubital tunnel.

Carpal Tunnel

Carpal tunnel and cubital tunnel syndrome are treated at first with conservative treatments like rest, changes in patterns of use, immobilizing the affected area with devices like splints or braces, physical therapy, medication and injections. If the symptoms do not improve after some time, your doctor may suggest a surgical procedure to relieve compression.

As you know I had cubital tunnel release surgery last year and my nerve conduction tests showed I also have carpal tunnel both of which are giving me a lot of pain at the moment. However, on the NHS list of symptoms of Fibromyalgia they do include tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia)

The best way forward if you are suffering from any of these types of pain is to go and see your GP for him/her to decide your next move to finding out what the problem is.

Living Well with Dystonia is a great book on the subject written by by Daniel Truong;Mayank Pathak;Karen Frei (Author)  A Patient Guide provides comprehensive information on a wide array of Dystonias. It is intended for individuals with various forms of Dystonia who want to adjust lifestyle activities to accommodate this chronic condition, but do not want the disorder to define them. It is a resource and tool for both individuals with the disorder and their families to become better educated about the options available to them.

Source : Ezine Dystonia UK NHS Back Pain Blog UK

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HAND REFLEXOLOGY POINTS FOR LOWER BACK PAIN…

Most people know ‘reflexology’ as something that is done to your feet but hand reflexology is definitely another technique that is becoming just as popular.

Hand reflexology certainly provides some benefits compared to foot reflexology. The obvious example is that our hands are far more easily accessible compared to our feet, which makes hand reflexology the most usable self-help tool for both adults and children.

Hand and foot reflexology has actually been used as part of medical care since as far back as the ancient Egyptian and classic Chinese times. The basic assumption used by the reflexologist is that each organ, gland and part of the body is reflected in both the hands and the feet. Stimulation of the so-called ‘reflex points’ promotes relaxation, improves circulation and encourages the body to heal itself. This explains why hand reflexologists sometimes use the axiom: “Health is at your fingertips!”

Hand reflexology is also brilliant as a relief from the new stresses technology has placed on our hands.

For lower back pain press the point where the centre of your hand joins your wrist and stimulate it. Always take medical advice if you don’t know what the problem is. This is a perfect antidote to a backache caused by sitting at a computer for too long.

A great site Reflexology Map that explains in detail how to start a hand massage.

YOU CAN FOLLOW THESE STEPS TO START YOUR HAND MASSAGE:

Step 1:  Sit in a comfortable chair in a quiet room.

Step 2:  Enter a state of relaxation using a bit of your favorite oil hands. Oils and creams are normally not used in professional reflexology sessions, but will not hurt to use them in an informal session.

hand reflexology

Step  3: Rub the cream on your hands for several minutes until completely absorbed. This will relax your hands and increase flexibility in preparation for applying reflexology. Be sure not to use a cream or oil greasy your hands are not slippery.

Step 4: Close your eyes and focus on any area of your body where you feel an uncomfortable pain. Sometimes you just feel as if some part of your body feels misaligned.

Step 5: Consult a hand reflexology map to identify the points of reflection in your hands that correspond to the parts of your body you want to work. For example, if you have pain in your left shoulder, you have to query the map and see that the points of reflection for your shoulder are located on the little finger of the left hand.

Step 6: Firmly press the reflex point. You can gradually increase the pressure to make sure you’re “activating” the reflex, but loose a little if you feel some pain.

Step 7: Hold the pressure for 30 seconds and release.

Step 8: Wait a few seconds and repeat. You can press either 30 seconds or you can press and release the point of a pulsed for 30 seconds.

Step 9: Use your thumb to apply light pressure technique pressure if you are uncomfortable. To do this, use a circular motion over the same point of reflection for about 5 seconds, then rotates in a circular in the opposite direction for 5 seconds. Repeated several times for each point of reflection.

Step 10: Reflexology applies to all areas in both hands, but lend him more attention on problem areas.

Step 11: When you’ve finished your reflexology session sit quietly for at least 10 minutes. If possible, lie down and rest well for half an hour.

Step 12: Drink several glasses of water after applying reflexology. Water will help to drain the toxins released from your organs and muscles during the session.

 

Hand Chart