Thursday, September 24, 2015

Pain management

If anyone is still reading these words -- and yes, I shall return to this blog! -- I would like some advice. My ladyfriend has been in pain for the past couple of weeks. Nerve pain, radiating from her upper spine (neck area) through the shoulder blade and down her arm. The severity comes and goes -- when she is active, she feels it very little; when she tries to rest, it flares up horribly.

Have any of you undergone a malady of this sort? Do you have any advice? What I'm looking for is advice beyond the obvious recommendation to see a doctor. My ladyfriend is not keen to do that. Her medical plan forces her go to a rather dismal clinic where she waits and waits and waits all day: Not a pleasant prospect. And frankly, doctors are often useless when it comes to back-related problems.

I keep thinking that there must be some exercise, some form of manipulation, that can turn things around. I give her massages every night, and they do some good. But I can't find a way to make things CLICK into place, as happens in the movies.

Know any tricks...?
In summary:

Until she can see an Orthopedic Surgeon asap, here is the home remedy: 600 mg. gel cap ibuprofen every 5 hours and use a heating pad at night and during the day if possible. VERY small neck movements will help unlock the stiff muscles (movements include look slowly to the right, then to the left, then up, then down. VERY minimal movements, do 5 sets 3x day. No using arms to carry stuff, housework etc. -B.S.
Light weights (2lbs or less) held above head, straight arms, curl backwards (tricep curls). start with light reps, and work up. Helps me, I have the same problem. I'm a guy, I use more weight. Nothing ventured, nothing gained. Hope that helps.
I would look for some older athletes and ask them. Awhile back I fell and broke my tailbone. This resulted in leg pain that I thought had to be related to a pinched nerve or something similar. The doctor gave me neurontin, which helped a little but not enough. I was talking to a friend who was in his late 40s and who was a devoted ultimate frisbee player and bicyclist. He told me about a simple stretching exercise that did the trick, much better than the drugs. With luck, there's something like that that is just what you're looking for. Best of luck to you both; pain is so debilitating.
The Community Acupuncture clinic movement (low cost) was born in Portland OR about ten years ago & now has hundreds of clinics across the country,including three in Balmer.
I am an acupuncturist & have treated back & neck conditions with acupuncture for many years. long story short, IT WORKS. Sadly, many people come to it as a last resort but the sooner back, neck & arm pain is treated, the easier it is to get results.
If always the same arm, I'd say look at the symptoms and treatments for bursitis. If always the same arm *and* it's her predominant hand, look for both bursitis and RSI. I know I've come off a major deadline-driven project -- like 100+ pages in under a week -- with computer mouse-drive RSI so bad I couldn't even lift a cup of coffee for several days. There may also be rotator cuff involvement, um, involved. If there's been no obvious change in habit and no trauma, you may be looking at any of the above as caused/aggravated by calcium deposits, bone spurs, or arthritis.

Usually for any of the above, short-term treatment is to reduce the inflammation with NSAIDs or steroids. Long term usually involves changes to behaviors and activities. In the case of injury (for instance, a tear in the rotator cuff) -- which doesn't necessarily have to be trauma-induced -- a period of rest or limited use may be enough to allow healing; in other cases, or if bone spurs are present, surgery may be required.

Unfortunately, your options for home treatment are limited. Ice, ibuprofen, and rest are about it. A doctor -- in addition to being able actually to diagnose the problem, rather than just throw spaghetti at the wall -- can prescribe higher-powered meds. Personally, I find the guaranteed side-effects of most NSAIDs far more unpleasant than the potentially more-serious ones of steroids, but your mileage may vary.

[Incidentally, I have some friends in the health industry -- researchers and medical writers, not clinicians -- who believe chronic inflammation can cause or exacerbate a number of other conditions. I follow their lead in taking a single low-dose aspirin daily. Seemingly, 81 mg a day is enough to convey possible health benefits -- including reduced risk of heart disease, which may also be because of the drug's anti-inflammatory properties and not because it thins the blood, as originally believed, and a reduced risk of colorectal cancer -- without damaging digestive tissue. While your friend may not receive as much benefit from such a regimen as we old farts, a daily preventative aspirin might help keep such pain from recurring -- once she's past this current flare.]

Radiating pain, to the arm, sounds like a cervical herniated disc. Pain radiating to the leg sounds like a lumbar herniation. It's not something to self diagnose. Get her to an orthopedic doctor or a neurologist.
When it comes to nerve pain, I always reccomend a trip to a reputable accupucturist. If it hasn't improved at least 60% by the end of the third treatment, then it might not be something thats effectively treatable via accupuncture. Chiropractic might be an approach, as its a spine realted pain.
Essentially, I would do the opposite of everything Anonymous B.S. advises. "Until she can see an Orthopedic Surgeon asap." Stay the fuck away from orthopedic surgeons. Do more movements, not less. I like the advice the next two comments have for her. Try the light weights if she can manage them. At least do stretches, etc.

I had back issues, and go over them 100%. Friend gave me this guy's book. Awesome book. Changed the way I look at health issues totally. Got me up and moving:

I've done acupuncture, seems like an expensive placebo.

- Less B.S.
Less BS here. On second thought, think the book I read might have been by this guy:

Anyway, both author's approaches are similar. From the back cover: "It is based on conclusive evidence proving that stress and inactivity are usually the prime offenders, and it allows patients to avoid the restrictions and expense of most other treatments." For me, the important take away is to get more active, not less. And avoid surgeons.
A short while ago I was asked by somebody I know to take my shoes off and WALK on his back.
He often is suffering of pain in his spine.
He lay down on the carpet and I massaged is body with my feet for quite some time.
From the area next to the neck, down to close to the bottom up and down and from down up and so on.
The method is common among people who cannot afford the massage done in the turkish bath.
Pending on the weight of the walker...
But You could make Yourself a bit lighter by help of a pair of chairs, rigth and left, to stemm Your arms on, to reduce the weight.
I had debilitating back and neck pain in the past, chiropractic eliminated it for me (along with getting more exercise and sitting less.....a standing workstation if she is a computer worker does wonders). It took a few sessions to work it out, but I have never had more than passing back and neck pain since (lasting a day or two, at most). I now go in for adjustments ever 6-7 weeks, and I've not had anything remotely like the kind of pain I'd had previously, and mostly none at all. However, I agree that more movement is required to maintain health and that sitting for long periods (more than 30 minutes at a time) is absolutely terrible for your body in many, many ways.
I found the book "Pain Erasure" by Bonnie Prudden very helpful in treating my ex-wife's debilitating pain. What you do is deep tissue point massage with one finger in a zone and along pathways. From the start, a twenty-minute treatment provided relief most times (not always). I was skeptical of the claim that we uncover and release "trigger points" (it sounded too much like Scientology) but it's true. After the treatment had become a routine part of our lives, my deep massage of her face would set off all kinds of involuntary movements of facial muscles.

I am the one and only true Anonymous. Pay no attention to impostors (unless they have good advice).
I had intense recurring shoulder pain for years. It was really depressing and debilitating. And I was more or less resigned to living with chronic pain.

But 5 years ago my sister in law talked me into taking up knitting again. And a month or two into it, I noticed that my pain had totally disappeared. There is something in the tiny movements I make manipulating yarn that is exactly what I need to control that shoulder pain.

As far as I'm concerned, it's a miracle. I had completely forgotten my youthful knitting hobby. And had never even mentioned it to anyone in my husband's family. It just happened to come up.

Anyway, it might not be knitting that's the answer for her problem. But some other unexpected regular motion.
Exercise, stretching, especially certain Yoga poses Tai Chi, a cinch belt, if you can find one for the shoulder, acupuncture.

Anything but surgery.

Carolyn Kay
Self-medicating is a bad idea, self-diagnosis is a worse idea. The situation could be anything from trivial to extremely serious. I know it's a hassle, but get to a doctor. And by the way, repetitive trauma can cause the injury described. I don't know if your friend works, but she may have a work related injury, which may make access to medical help easier.
I've tried everything but surgery. Nothing really fixed it. (Bulging discs in neck from compression from getting drilled into the ground via an accident on active duty-- the VA will not help!) When it decides to hurt, it's hell. When it's not. Well, it's ok.
To find answers to your questions start with Google and select reputable medical sources.
Only a medical doctor can diagnose the underling medical problem. They will recommend treatment but you don't have to follow it (tell them this, they may recommend some other form of treatment), especially if they recommend surgery.

Acupuncture primarily works by the placebo effect [the placebo effect can provide cures in some cases] and chiropractic treatment usually provides only temporary relief [You have to return many times].

Maz's comment above provides sound advice.

Google: "nerve pain radiating from neck"
What is cervical radiculopathy:
Conservative Treatment:

"The pain caused by a cervical herniated disc is caused by a combination of two processes:

Pinching of the nerve root
Inflammation associated with the disc material itself

Therefore, taking anti-inflammatory medications to remove some of the inflammation can reduce this component of the pain while the pressure component (pinching of the nerve root) resolves.

For patients with severe pain from a herniated disc, oral steroids (such as Prednisone or a Medrol Dose Pak) may give even better pain relief. However, these medications can only be used for a short period of time (one week)".

Everyone above is correct, this is an impingement issue. She probably has chronic tendonitis or neuritis under her shoulder blade. It is also possible she has lower back tightness that causes pulling farther up her back. I doubt herniated disc, unless you can clearly see the disc bulging, it's a common misdiagnosis.

What she is dealing with is almost entirely orthopedic. Drugs aren't the solution, chiropractor, physical therapy or more the solution. I get similar numbness when my sub-scapula tendonitis flares up... old bench press injury.
I don't have much time to write, but I want to thank all of you profusely. There are some excellent ideas and suggestions here. You folks are incredible in these situations.
You folks are incredible in these situations.
You should see me in the kitchen...
I've suffered from intractable pain for years...recently fell and fractured more vetebrae...ugh! Anyway, I take tramadol when I can't stand it any longer....I can't tolerate stronger narcotics because of nausea.
Neurontin was great but it made me lose my was created for people with epilepsy.
I also have an Rx cream called Voltaren, PLUS something that surprisingly works on nerve pain (sciatic) called Two Old Goats. I wish her relief. She should get an MRI to nail down the problem.
Darn...comment vanished, I think. Short and sweet...she should get an MRI to determine what may be wrong. Try a natural cream called Two Old Goats that is surprisingly helpful for nerve pain and Resvatrol rx cream. Good luck to her.
C, I am so sorry to learn of your pain issues. And the same goes for everyone else in similar straits. Good lord, I didn't realize how common this problem is. Pain is the great equalizer.

So is this the counter-argument to those who adhere to the theory of intelligent design? I mean, what kind of intelligent designer would have your ultra-sensitive nerve trackways twining around and through our bones and joints?

Well, thanks to you all. And thanks for the head's up on neurotonin. We'll look for Two Old Goats. And I've asked her to do those tricep exercises.
Hi Joseph,

I'm one of your oldest followers from those early posts you did on electron fraud issues from the 2004 election. I visit you once in awhile as it seems one of the authors I respected on this issue you decided to 86 completely because of raising a question on a different issue which can't be raised.

Anyway, the other issue here for your ladyfriend to take notice of is:


The pain is coming from her neck and spinal area below her neck, then radiating down her arms she hunched over doing constant text messaging on her iPhone or iPad.

My sense of her is that this pain comes and stays as a direct result of how much time she spends on her iPhone/iPad/laptop hunched over and this pulls and puts pressure on neck vertebrae that are already out of alignment or maybe compressed.

her neck I'm guessing is badly out of alignment as well so she probably would benefit from seeing a qualified and highly recommended chiropractor.

Yes taking the 600mg of ibuprofen will reduce inflammation and pain, but taking it more than a week can stress out one's liver over time, so go easy on taking high doses of ibuprofen.

hope this helps!
anon from San Francisco will reduce her inflammation naturally by reconnecting her to the Earth.
The people commenting about anti-inflammatory are correct.....many people do not take a focused approach.

Do not fear taking the required amount of OTC drugs to succeed.

I been in pain management for years, hips and back. I do acupuncture, massage, chiropractor, pain killers, of course. Must be very careful on the anti-inflammatories, after years of being on them, my kidneys started to fail, and living without them pretty much stinks. Not sure about the insurance she has, but massage can be considered physical therapy if the coding is right. This is all pretty much what everyone else is talking, if the chiropractor can't help, check out RFA. I used to get it done until Blue Cross Blue Shield decided they no longer will pay. Anyway, its Radio Frequency Ablation, basically it zaps the nevers at the root and stops the pain from going to nerve to brain. The first two times I had it done, it lasted about two years. The last time I had it done lasted about 18 months. I could sit and watch a show or tv with my husband. Not sure what state you live in but I live in Tn. and the Dr. I see in Pain Management does it. If nothing else works might want to talk to the doc to see if it might help. Here's some links about RFA.

That should get ya started, it's not a real long procedure, and it's not painful and the relief is wonderful, down side is once the nerves grow back the pain hits all at once. Pretty much the only downside for me. Hope she gets better and Good Luck!
KImberly...first, I'm very sorry about your own situation. I honestly knew nothing about this RFA stuff. Time to do some research! Hearing your own personal endorsement is fascinating.
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