CERVICAL DISC PROTRUSION AND ARTHRITIS…

After the brilliant guest post from Neil Velleman on ‘All you need to know about a slipped discI found myself being diagnosed with yet another disc problem in my cervical spine.

For the last six months, I have been having constant pain going down my arm from my neck as well as pins and needles down to my little finger.  Initially, we thought it may have been my ulnar nerve again. I say ‘again’ as I had surgery last year for a trapped ulnar nerve which was a total success but they said it can come back even after surgery.

After a 2 hour consultation with a physiotherapist, it was decided that it could be one of two things. Either the ulnar nerve or a disc in my cervical spine so the first port of call was a nerve conduction test.

The nerve conduction test showed no problem with the ulnar nerve so I was then sent to have an MRI scan. Those results have shown that I have another disc bulge which is compressing a nerve and giving me the pins and needles and pain and it also showed that I have arthritis in that area.

Neil Velleman explained that ‘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!’

Mine is definitely in the ‘wear and tear’ category as I have had two previous surgeries on the C3/4 area of my spine which has meant the disc below it has had to do all the work. I have now been told I will need to see a consultant about the sort of treatment they can give me for the pain which could be IDD Therapy, Injections, Manual Therapy or Surgery.

Back in 1996 when I had my second surgery on the C3/4 discs they gave me traction first but IDD Therapy seems to have taken over from that method but I shall just have to wait and see what they suggest.

The worst pain is doing the simplest of things like cleaning my teeth or drying my hair so I am just hoping an appointment comes through sooner rather than later.

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TEN GIFTS FOR SOMEONE IN CHRONIC PAIN…

My top ten Christmas gifts for people suffering from #fibromyalgia and chronic pain.

  1. Walking Sticks Online – an online marketplace full of unique and trendy walking sticks to suit everyone’s budget and style. From walking sticks with animal handles to ladies selection of petite handles and many more. Plus a collection of accessories for your walking sticks like this ‘Carry Wallet’ for £4.50
  2. Pain Relief Cushions – another online marketplace for all types of shapes and sizes of pain relief cushions to pop in your microwave or your freezer. From £16.99
  3. The Sciatica Relief Cushion – for anyone suffering from sciatica and low back pain.The Sciatic Pain Relief Cushion is an entirely new form of relief for Sciatica, developed by people who have experience of suffering and treating sciatic pain, from £34.00
  4. Joya Shoes Bliss for Back – shoes designed specifically for people with back painJoya shoes have come up with a type of shoe which can solve all those problems. The positive effect of a soft, springy surface on the locomotive system has been put to good use by physiotherapist for a long time now and is a highly topical subject in the fields of prevention/rehabilitation. The Joya brand has developed a shoe which makes use of this principle. The soft, supple material of the patented Joya sole means the load on the sole of your feet is ideally distributed as you walk and stand instead of being concentrated only on certain spots from £154.95e
  5. Dreamland Electric Heat Pad – I could not manage without mine. There are other makes on the market but this is my favourite. With new Intelliheat Technology for perfect temperature control.Instant heat up with 5 heat settings to choose from. Machine washable at 30 degrees. Very low running costs, less than 1p per session3 hour treatment auto shut off for your safety and peace of min, from £32 
  6. The All New Kindle Fire HD – I have the right music, the right books and the right audiobooks to help me relax and use it every single day. I think probably the best place to buy one without a doubt is from Amazon and new ones start at £79.99 
  7. A Massage from Groupon – all people in pain appreciate a massage and Groupon has some amazing offers all over the UK from as little as £15. 
  8. The  N:rem Sleep System which has an offer for my readers. If you wish to purchase a mattress you can have £30 off your order  – just quote BACKPAINBLOG at the check out.
  9. You can try the N:rem mattress for 100 nights in the comfort of your own home. This will give you the time to ensure you relax and get the perfect set-up to meet your needs. You can sleep on it and adjust the comfort and support up and down your body until it is just right for you, your partner can do the same on their side. The N:rem mattress provides the ability to tailor each side differently offering different levels of support wherever they’re needed. Simply unzip the N:rem’s cotton top cover and you’ll discover two sets of 5 variable density foam tablets,  from £540
10. iPad cushion -the perfect gift for all # fibromyalgia sufferers so they do not have to hold their iPads from Etsy from £7.00

TOP SIX BOOKS AS GIFTS FOR FIBROMYALGIA AND CHRONIC PAIN SUFFERERS…

This is my top six of books as Christmas gifts for people who are suffering from #fibromyalgia and/or chronic pain.

Pain Tracking – Your Personal Guide to Living Well with Chronic Pain by Deborah Barrett Phd, available from Amazon and other good bookstores.

This book offers a hands-on approach to improving life with chronic pain, whatever the underlying cause. As a sociologist, psychotherapist, and someone with firsthand experience with chronic pain, the author understands the challenges that accompany pain and has devised realistic strategies to fare better.

Paintracking provides a systematic method that empowers individuals to navigate the otherwise overwhelming array of treatment options and incorporate the effective ones into their lives for continued, incremental progress. Its cornerstone is a self-study tool that enables readers to improve. Readers are instructed on how to track and interpret their experience, whether using a pen and paper or the online tool offered as a companion to the book. By cultivating awareness of how their body responds in different situations and to different therapies, readers will become capable self-advocates, able to make informed choices.

Written in clear, understandable prose and filled with sociological insights, therapeutic lessons, practical tips, and empathy, this book offers realistic hope to individuals who often feel hopeless in the face of confusing, debilitating pain.

The New Bible Cure for Chronic Fatigue and Fibromyalgia by Don Colbert, available from Amazon as a book or audible and from other good bookstores. This book includes

· Steps that take you from feeling burned out to fired up
· Foods that harm and foods and supplements that restore energy and health
· Exercises that help relieve pain
· The emotional and spiritual roots of these debilitating disorders

Living with Fibromyalgia New Edition by Christine Craggs-Hinton, her third revised edition of this great book on Living with #fibromyalgia available from Amazon and other good bookstores. In line with the latest thinking of fibromyalgia as a disorder of the CNS (central nervous system), this third edition looks at how an over-sensitised system may amplify pain messages and trigger the symptoms of fibromyalgia. It also looks at research into the link between poor sleep and the disorder. Other topics include: a physical cause? – the evidence for fine nerve damage in fibromyalgia sleep problems and manage the benefits of yoga and music therapy updated recommendations on diet and supplements the importance of posture and exercise pain and stress management complementary therapies.

Take Back Your Life: Find Hope and Freedom from Fibromyalgia Symptoms and Pain by Tami Stackelhouse and Ginevra Liptan, available from Amazon and other good bookstores. A #fibromyalgia patient herself, author and Fibromyalgia Coach, Tami Stackelhouse, has gone from disabled to thriving. In this book, you will learn how to Take Back Your Life using the techniques and strategies Tami has used to get well. More than just a lifestyle or self-management guide, this is a concise reference book woven with Tami’s own #fibromyalgia story.

This book is a page-by-page survival guide for the action-oriented #fibromyalgia patient who wants to feel better as quickly as possible. It’s written for the patient overwhelmed with a new #fibromyalgia diagnosis and for the fibro-veteran who is stuck and needing new ideas. It is also a great resource for the caring family members and support team of anyone suffering from #fibromyalgia.

To finish my list I have included two books that will just make you feel good when you read it. The Man I Think I Know: A feel-good, uplifting story of the most unlikely friendship by Mike Gayle, available from Amazon and other good bookstores. A powerful and bittersweet story of an unexpected male friendship and an unlikely love story, a thought-provoking storyline told, this uplifting tale reminds us of the simple courage at the heart of every human being.

Ever since The Incident, James DeWitt has stayed on the safe side. He likes to know what happens next. Danny Allen is not on the safe side. He is more past the point of no return.

The past is about to catch up with both of them in a way that which will change their lives forever, unexpectedly. But redemption can come in the most unlikely ways.

The Map of Us, The Most Uplifting Feel Good Fiction Book of 2018, by Jules Preston and available at Amazon and other good bookstores. A story of love and lost directions

Violet North is wonderfully inconvenient. Abandoned by her family and lost in an imagined world of moors and adventure, her life changes in the space of just 37 words exchanged with a stranger at her front door.

Decades later, Daniel Bearing has inherited his father’s multi-million pound business, and is utterly lost. He has no idea who he is or where his life is headed.

When Violet’s granddaughter’s marriage falls apart, Tilly, always adept with numbers, compiles a detailed statistical report to pinpoint why. But the Compatibility Index Tilly creates has unforeseen consequences for everyone in her world. Tilly and Daniel share a secret too. 10.37am, April 22nd. Soon, a complex web of secrets and lies is exposed and an adventure begins with a blue typewriter…

 

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

 

 

 

WHAT IS CHRONIC PAIN? TWO GREAT ARTICLES ON HOW TO EXPLAIN YOUR CHRONIC PAIN…

What is a chronic pain? These two great articles explain how you can tell other people what chronic pain feels like.

New Life Outlook says that it’s almost funny that the single word #pain is supposed to mean all of the different sensations you feel when you live with a chronic pain condition. I find it hard to describe in words how different pains physically feel, especially to someone who does not have chronic pain. Sometimes a metaphorical image captures it best.

Visual metaphors are better able to evoke understanding and empathy in others (G. D. Schott). If I tell you about a large needle being slowly inserted into my eyeball, your reaction is likely to cringe, grimace or squint your eyes. When you hear someone describe an image of something happening to them, your brain will “mirror” that experience – you imagine what it would feel like for the same thing to happen to you. Using visual metaphors can help you to describe your #pain better to your doctors and your family and friends. If you have chronic pain, just reading or hearing descriptions of #pain metaphors might start to make you feel tense and stressed. Images can elicit a very physical response, bypassing the analytical parts of our your brain.

New Life Outlook also points out that using your imagination is a helpful way to distract from focusing on #pain, which is likely another reason that visualization can help to manage #pain. Numerous studies have demonstrated that guided imagery reduces pain and improve physical function.

The National Pain Report says that people who don’t have experience with it seem almost incapable of understanding chronic pain. This is so true. We live it, but we don’t even understand it ourselves, so how can we expect anybody else to? It’s unnatural to have #pain without an injury, it’s unnatural not to heal and get better, but this is exactly what chronic pain is and does. It’s persistent, pervasive, and permanent nature is almost incomprehensible, even to those of us who live with it.

We are expected to “get better”, and people seem to lose patience with us when we don’t. Often we can’t even explain why it hurts, just that it does, and this lack of a clear reason seem to invalidate our experience in others’ eyes. We live in a visual, evidence-based culture. The same doctor that is willing to prescribe us loads of pain medication for a broken bone or after surgery becomes unsympathetic when our #pain isn’t visible. To overcome these obstacles, we must find a way to explain our suffering in a way others can understand.

To start telling someone about your chronic pain, you should explain to them the root of your #pain. You may not feel comfortable giving specific details, and you don’t need to. You may want to tell the person what hurts you, like your back, head, or the entire body. If you don’t feel like going into all the details, you may suggest that the person research the condition. You may also choose to print out basic information for the person to read.

Tell them about the #pain scale. Most people with chronic pain evaluate the #pain on a #pain scale. You should tell the person about this scale so they can understand the intensity of your #pain when you give them a number.

Describe the type of #pain. You could use words like stabbing, dull, sharp, tingling, throbbing, feeling warm/hot/numb, etc. It might also be helpful to compare it to a minor #pain that the other person may have felt (if applicable). “It kinda feels like the pinch from a shot, but never goes away,” or, “It feels like a rubber band snap. This is just like using visual metaphors like New Life Outlook has shown. If your artistic in any way you could maybe draw a person and indicate where you feel the #pain.