DEALING WITH DEPRESSION WITH CHRONIC PAIN …

Depression is quite common with people suffering from chronic pain. I mean who wouldn’t feel a bit low when trying to cope with constant pain but there is help out there to deal with this type of depression. Research shows that some of these antidepressants may help with some kinds of long-lasting pain.

Web MD state that Doctors don’t know exactly why antidepressants help with pain. They may affect chemicals in your spinal cord — you may hear them called neurotransmitters — that send pain signals to your brain. 

It’s important to note that antidepressantsdon’t work on pain right away. It can be a week or so before you feel any better. In fact, you may not get their full effect for several weeks.

After my second spinal surgery I was put on a very low dose of an antidepressant which I took over a period of 20+years. I am still on this antidepressant ( Prozac) even though over the many years I haven taken it there have been numerous articles on the pros and cons of taking it for so long. In fact, only last year the Professor of Medicine whom I call my Medicine Man who I see on a regular basis, suggested that maybe I should stop taking it.

I started with reducing it to one every other day and had no ill effects except that I wasn’t feeling as perky as I usually am. I put it down to the fact that at that time last year I ways constantly going back and forth to stay at my Dads so that I could go and be with him in hospital. He was in three months and my sister and I would do three week shifts of going in for most of the day over a period of three weeks then coming home for a rest. Sadly Dad passed away in hospital by which stage I had already started increasing my drug to nearly what I had been on before as I had an even bigger reason for feeling low.

On the NHS website they say that even though a type of antidepressant called tricyclic antidepressants (TCAs) weren’t originally designed to be painkillers, there’s evidence to suggest they’re effective in treating chronic (long-term) nerve pain in some people.

Chronic nerve pain, also known as neuropathic pain, is caused by nerve damage or other problems with the nerves, and is often unresponsive to regular painkillers, such as paracetamol.

Amitriptyline is a TCA that’s usually used to treat neuropathic pain. I also take this for my neuropathic pain and it also helps me to sleep better.

We are all different and try to deal with chronic pain, stress and even loss in different ways but for me personally I felt this one little pill I took every morning worked for me. When I went back for my review with my Medicine Man I told him what I had been through and said I felt for me personally it was one drug I would like to continue taking indefinitely if he felt that was safe. He said that every single person will have different views and reactions to different types of antidepressants but if I had found one that I truly felt helped me ‘feel good’ every day no matter what I was going through then he was happy for me to take it indefinitely.

I know there are lots and lots of alternative things to try for any type of depression from Cognitive Behavioural Therapy to Group Therapy and much more but I do feel that some people are nervous of taking medication on a long term basis but if that works for you, then why not.

Try everything that is available to you and when you find something that works for you then stick with it even it is taking a daily dose of medication. Feeling low and depressed is awful and most people in chronic pain must feel that at some stage but life really is to short to feel that way on a daily basis so why not try something just for you to help you feel better on the outside even if the pain on the inside is still there.

Some great websites and organisations that can help with chronic pain and depression are Away With Pain.

BLB Solicitors have a long list with links to UK support and help with depression from pain. The NHS also has details on Cognitive Behavioural Therapy in the UK and how to find a therapist.

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11 TOP TIPS TO HELP YOU COPE WITH THE SYMPTOMS OF FIBROMYALGIA…

1. If at all possible try to de-stress as apparently stress may trigger Fibromyalgia Symptoms. Some of the best de-stress treatments you could try are yoga, exercise, sleep and meditation.

2. ‘Fibro Fog’ is a common ailment of Fibromyalgia so rather than getting frustrated that your short-term memory has let you down, try and get into the habit of jotting things down on paper on a daily basis,

3. Exercise, as in low-intensity exercise like walking, or warm water exercise is great for helping the pain of Fibromyalgia. This type of exercise can decrease pain and stiffness.

4. Have a long soak in a warm bath or hot tub as this has been proven to relax tense muscles which will then reduce pain.

5. Try to use decaf as caffeine can increase anxiety and insomnia, so watch your intake of chocolate, coffee, teas and some soft drinks.

6. Also, try and make some ‘me time’ for yourself every day as part of your treatment.

7. Make your work life balance work for you. If work is leaving you exhausted and in pain then design a flexible plan that works better for you and your boss. Maybe try some products like a telephone headset or keyboard tray.

8. Talk about your Fibromyalgia with your family and those around you. Let them know what can trigger it or make it worse. Never be afraid to ask for help from either your friends, family or other Fibro sufferers or a counsellor.

9. Many people call Fibro the ‘invisible illness’, as you can look find be feeling awful. So, when arranging your social life be prepared to say ‘no’ to something if you know it will be too much for you.

10. Try and keep a journal so that you can see what can trigger off an attack, then you can do something about it.

11. Join a support group, be it in person or online, they offer a place to talk to others who share your problems.

ALL YOU NEED TO KNOW ABOUT A SLIPPED DISC – A BRILLIANT GUEST POST BY NEIL VELLEMAN…

A slipped disc? Ouch! 

 By Neil Velleman, of Atkins Physiotherapy Consultants

A slipped or herniated disc is amongst the most debilitating of back pain problems – sometimes with added symptoms such as the grinding leg pain of sciatica.  There are many levels of back and neck pain but a herniated or ‘slipped’ disc is one of the most painful and it can cause long-term immobility if it’s not treated correctly.

This is a condition where the centre of a spinal disc bulges outwards and presses onto a nerve.  The spinal discs act as shock absorbers and through a variety of causes, including injury, poor posture and general “wear and tear” (meaning gradual deterioration), the walls of the disc can become weaker. If the centre of the disc pushes out, this can cause the disc wall to bulge and that can be when pain strikes!

There are six steps of management to consider in this situation:

1) Pain Killers

2) Manual therapy

3) IDD Therapy

4) Injections

5) Surgery

6) Other options including exercise and acupuncture

Pain Killers

When you have a disc problem or simple back pain, the first thing the NHS recommends is to take some anti-inflammatories such as ibuprofen.  Relieving pain is the first step to being able to move, because if you can move, the mechanisms which keep our backs healthy can operate.

This will be what your GP will recommend because in approximately 90% of cases, back pain resolves within six weeks.  But if the pain isn’t going away or it is so severe that you can’t carry out your normal functions, then some form of manual therapy is advisable.

Manual Therapy

There are a variety of types of therapy and we typically think of physiotherapy, osteopathy and chiropractic.  Where there is pain, the body usually limits how we move – it hurts!

Some conditions have built up over time leaving the spine stiff and unable to move properly.  This can put tremendous pressure on the discs.  So generally speaking manual therapists will seek to ease muscle spasm and then, through either some manual mobilisation or manipulation, free the joints which may be stuck They will also look at how our bodies are moving.

This is where we consider the “cause”; what led the disc wall to get weak?  Often some gentle stretches and exercises can help to get movement back, all with the goal to help the body heal itself. Typically, four to six sessions are enough, although you may need to additional exercise sessions.

IDD Therapy

IDD Therapy is the next step when manual therapy and exercise alone aren’t enough.  IDD Therapy is a computer-controlled treatment which helps physiotherapists to decompress the specific spinal segment where the disc is “slipped” or herniated.  Patients lie on a treatment couch where they are connected to a machine with a pelvic harness and a chest harness.

The IDD Therapy machine then applies a gentle pulling force at a precise angle to take pressure off the targeted disc and to gently mobilise the joint and surrounding muscles.  The goal with IDD Therapy is to relieve muscle spasm, reduce or reverse disc bulging and gently stretch the tissues to free the movement in the spine.  As pain subsides therapists use gentle exercise and possibly some manual therapy to strengthen the back or neck to help avoid a recurrence.

Patients typically have a programme of IDD Therapy and long-term problems can need 20 sessions over a six-to-eight week period.  IDD Therapy is still relatively new to the UK but there is a network of providers around the country.

Injections

Injections are quite controversial because until recently they have been given widely to people with long term disc problems.  When a patient has a slipped disc and pain, there can be inflammation in the area.  This inflammation can cause pain on its own.

There are different injections, but a steroid injection with or without some local anaesthetic may be given to reduce the inflammation.  Injections can provide temporary relief with the goal to create a window of pain relief where the body can move or where therapists can work with a patient to address the causes of the problem.

The controversy about the effectiveness of injections is because injections do not address the causes of the problem. They can address inflammation but a slipped or bulging disc will still be bulging after the injection.  Hence the question of whether injections really help or not, and why many NHS trusts are scaling back the availability of injections as the cost/benefit is not clear.

Surgery

Spinal surgery can be a very important step for patients with a slipped disc which has not responded to any of the treatments described.  This is particularly the case if the disc is putting pressure on nerves to such an extent that it causes weakness in the legs or arms, or in very severe cases, if a slipped disc puts pressure on the spinal cord and affects our bowel or bladder control, then emergency surgery can be essential.

The most common surgery for a slipped disc is a “microdiscectomy”.  If the disc material is stubbornly pressing on a nerve, the offending disc material may be cut out surgically and removed.  Such surgery is commonly given for leg pain (sciatica) where the disc is pressing on the sciatic nerve and the pain is intolerable.

Surgery can remove the pain immediately.  However, it is not without risks and surgery does not address the causes which led to the weakness in the first place.  Thus, some patients can get complete relief whilst others the pain may remain or even get worse.

Generally, surgeons will operate as a last resort and it can be advisable to get a second opinion before embarking on surgery.

Other treatments

Yoga and Pilates can be helpful in maintaining your body once you resolve the pain. It is important to find a teacher who suits you and understands your condition.

We hear a lot about “core muscles” and whilst there is some debate about how important our core is, generally the more our muscles can support our spines and move freely, the better our discs are protected.

Acupuncture can relieve muscle spasm and back pain, though for a slipped disc it would work best in conjunction with manual therapy and IDD Therapy rather than as a stand-alone treatment.

What next for slipped discs?

We are potentially going to see more slipped discs because generally, people are less active than they used to be and spend a lot more time sitting.  Discs hate to be squashed!

There is a general move in healthcare away from invasive treatments such as injections and surgery, and the emergence of treatments like IDD Therapy, which has replaced traction, means that, combined with increased knowledge about the spine and exercise, we can keep more people on the non-invasive side of spine care.

If the pain is persisting longer than six weeks, I would advise seeing a professional who works with spines, just to make sure that something short term doesn’t progress into something more debilitating and long term.

ABOUT THE AUTHOR

Neil Velleman is a backpain expert, IDD Therapy provider and owner of Atkins Physiotherapy Consultants in Essex.

 ‘Intervertebral Differential Dynamics” or IDD Therapy is the fastest growing non-surgical spinal treatment for intervertebral discs with over 1,000 clinics worldwide and 34 clinics across the UK. Safe, gentle and non-invasive, IDD Therapy helps patients who need something more for their pain when manual therapy alone is insufficient to achieve lasting pain relief. http://iddtherapy.co.uk/

Facebook: IDD Therapy Europe

Twitter: https://twitter.com/iddtherapyeuro

 

 

 

OPIOID PAINKILLERS CRISIS THE SILENT EPIDEMIC ON THE ITV ‘TONIGHT’ PROGRAM…

 

On ITV Tonight Britain on Painkillers: The Silent Epidemic.

A quarter of a million people are struggling with opioids in the UK. There are many risks involved with taking them for long-term use. They say they are of no use for long-term pain and they think that exercise, meditation and tai chi are a good option or soothing alternative to get through your pain.

Over the past decade in Britain, prescriptions for these drugs have gone through the roof – up 80% in England alone. We’re now among the biggest consumers of opioids in Europe.

And the tragedy and irony is that while the drugs are super-effective for acute emergency pain, in 90% of long-term chronic pain cases, they don’t even work.

Pain specialists are also trying to get to grips with the fact we’ve practically sleepwalked into a public health crisis: GPs under pressure to help their patients deal with pain and patients sometimes too in distress to find other strategies rather than popping the pills.

According to the British Pain Society, approximately 8 million adults in the UK  report chronic pain that is moderate to severely disabling[1]. Back pain alone accounts for 40% of sickness absence in the NHS[2] and overall it costs £10 billion for the UK economy[3].  The UK has some of the best pain services in the world and the multidisciplinary British Pain Society is at the forefront of informing the public and professionals of what is available.

However, the British Pain Society believes more research is essential to allow pain services to offer the latest effective and safest treatments.  Unfortunately, pain research is not a priority for major UK funders.

So how have we got here and how do we step back from the brink?

Is it time to radically rethink how we manage pain?

I’ve been on Tramadol for over 15 years so a rethink of how I can cope with my pain would be amazing.

MY FIBRO TEAM, THE SOCIAL NETWORK FOR THOSE LIVING WITH FIBROMYALGIA…

MyFibroTeam My fibromyalgia Team

My Fibro Team is a social network for those living with Fibromyalgia which makes it easy for you to:

  • get the emotional support you need from others like you, and
  • gain practical advice and insights on managing treatment or therapies for fibromyalgia

When you or a loved one are first diagnosed, it’s not uncommon to feel alone and uncertain of where to find the best information and people that can help you now. My Fibro Team believe in making it easy to find the best people around you to help you get the answers you need, and to find support from people who can truly relate. The main currency on their site is trust – the more you share in posts and your stories, the more questions you ask and answer, the more your support will be valued by other members.

MyFibroTeam is the only social network where you can truly connect, make real friendships, and share daily ups and downs in a judgment-free place.

Below are the most popular areas of the site:

  • Activity page is where everyone posts updates – including images, stories, thoughts and anecdotes. It’s where daily triumphs and trials are shared and supported.
  • Find People Like You based on location, your diagnosis, and age. You can browse everyone’s story and updates, which helps provide insight as you share with others.
  • Q & A section enables you to search previously asked questions and answers, and gives you the ability to ask your own question that will be answered by others on MyFibroTeam.
  • Find Providers best suited to meet your needs based on keyword and zip/postal code or city, and you can see which ones other members have recommended.

The spirit of the site is to foster a welcoming community with open arms. Maintaining an atmosphere free of judgment and drama is very important to them to make sure every member can share their experiences, thoughts and feelings as openly as they wish. All of their members share compassion and deep empathy for each other’s journey. When signing up, many people feel shy at first, but quickly discover new friends and people who truly understand what you’re going through. Once you begin interacting on the site by posting updates, or sharing your story, even answering other’s questions, you’ll quickly feel embraced and accepted by the team of individuals already on the site, who are, by all measures, strangers, yet feel closer than well-intentioned friends and family.

My Fibro Team is an independent, venture-capital-backed startup (called MyHealthTeams) based in San Francisco. MyFibroTeam should not only provide you emotional support through the social network, but also be a resource for practical tips, personal experiences, and even referrals to other great doctors from the community. Information shared on the site can be seen by everyone who signs up for an account, but that is it.

So why not pop along and join the team like I have, you will be surprised what you can soon pick up from this network.

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