We’ve already received a lot of questions from readers, so let’s get to it.
Hi Kate, I think healthy eating and weight management is an important part of a good pain management plan. Choosing anti-inflammatory foods provides anti-oxidants to the tissues which can help reduce inflammation and improve brain function which can be effected by pain and stress. I am a believer in an anti-inflammatory diet and propose trying to eat 7 different types of produce each day as a guide based on some past studies.
Hi Delores, there does seem to be some positive studies on using hypnosis for certain types of pain problems, although I personally don’t see hypnosis used much in my area. I think if you are interested in hypnosis, then it would be worth discussing this with your doctor.
Nerve pain is typically treated with medicines like lyrica, Neurontin, pamelor, for example. Muscle pain is usually inflammatory and best treated with anti inflammatories or even topical treatments.
Shingles pain can be an intense burning pain. Antiviral medications are usually started once the virus breaks out, and medications that can help during this phase can include nerve pain medications like gabapentin and topical pain relievers like lidocaine patches. Corticosteroid (cortisone) medications can sometimes reduce the nerve inflammation created by the infection. In some cases, injections of cortisone around nerves, such as with epidural injections, can help acutely relieve the nerve pain.
You could consider Neurontin which is mechanistically similar to lyrica and generic, so it should be less expensive. You could also consider pamelor, a tricylic antidepressant for the syndrome. This was used before the FDA approved medications.
Hi Lucy, continued nerve pain after spine surgery is a common problem that I see in my practice. I comprehensive approach to improve symptoms and function with daily activities may include typical nerve pain medications like Lyrica or Cymbalta, but learning other tools like how to use meditation or mindfulness, tai chi, stretching and exercise can all help better manage symptoms related to failed back syndrome. Ask your doctor to help you develop of more comprehensive approach to a touch problem.
Sounds like you have chronic abdominal pain (visceral pain), actually if the acute episodes occur frequency. You can try drugs like Neurontin, Lyrica, pamelor, Cymbalta for relief. I have been starting to use spinal cord stimulation for abdominal pain with good results, and may do a study using this device for patients like yourself.
Hi Barbara, nerve pain is often a sharp, shooting, or electrical pain, while muscle pain is typically more of an ache or throb with tenderness. Many times, both occur at the same time, so keep that in mind if your treatment doesn’t seem to be working well, yet.
There’s a new treatment called disc biacuplasty for degenerative disc disease in the lumbar spine. It uses radiofrequency waves to disrupt transmission of the nerves in the disc and may even treat the degenerative elements of the disc. Two probes are placed in the disc while the patient lies on her belly. Risks are minimal. A recent study on this procedure showed quite good results that were lasting. I did a great show on the topic of low back pain and on disc biacuplasty: www.paulchristomd.com
Hi Meg, I also dealt with this type of loss after a difficult knee injury. I think it is important to find some new things to feel passionate about that you can still enjoy. For example, I took up cycling and later yoga, and that has done a lot to boost my morale and improve my health.
We don’t have a lot of data on the use of medical marijuana yet. There may be concerns about inhaling marijuana and higher cancer rates among cannabis smokers. So, some experts advise against inhaled THC. That being said, medical marijuana does show efficacy in treating neuropathic pain. I also did a show with Montel Williams on this subject: www.paulchristomd.com
Hi Bill, for many years, my patients have reported that their pain worsens with certain weather changes, particularly during the winter time. I think problems that seem particularly sensitive to weather changes include nerve pain problems like CRPS, and complicated spine problems, like for patients who have had spinal fusion surgeries with hardware implanted. The cold weather and barometric pressure changes may be factors. Research on the subject, however, has never really found a strong connection between pain and the weather, but my experience tells me otherwise.
First line treatment is tegretol. Other treatments consist of baclofen, trileptal, Dilantin, or combinations. I’ve also used pamelor with some success. Some topical treatments can help like lidocaine and ketamine. Some of my patients have placed ambusol on their gums too. Surgically, consider the gamma knife or radiofrequency ablation of the nerve. Finally, microvascular decompression is the mainstay if other treatments fail. Acupuncture, cognitive behavioral therapy, and even herbals have some effect as well.
Hi Taylor Rae, I think your disc problem can do real well without back surgery. There are lots of great ways to manage this while your body goes through the normal healing process. Try to stay active and exercise and walk as tolerated. Other things that can help include acupuncture, deep tissue work, and epidural injections can sometimes provide short term relief. Developing a good rehabilitation plan is also important. Sometimes is hard to stay patient!
Despite some of the media hype, addiction in the pain population is pretty low. Addiction relates to things like craving, and use of the drug despite adverse consequences. It’s a neurobiological and genetic condition. I wouldn’t be as concerned about addiction in your husband based on what you write. All of the opioids confer the same risk of abuse, misuse, or addiction. Codeine is no better or worse. Your doctor should monitor use by having your husband review an opioid agreement and do urine drug testing. Please take a moment to listen to an informative show I did on this subject: www.paulchristomd.com.
Pain Warrior, I have worked with many over the years who felt kind of “stuck” on pain meds and not sure where to turn. Many of these patients have been able to get off of their traditional pain medications and done real well. Our practice has used buprenorphine as an alternative for patients who feel stuck or tired of their narcotics and found it to be a nice alternative for many. They then go through a very comprehensive, intensive program that we offer, where they learn a whole host of new tools to manage their pain, and at the end of it, most feel pretty positive about the changes. The more tools that you have to help, the better you can manage the pain and the less dependent you start to feel on just the medications.
Plantar fasciitis is an inflammatory condition. Pain is usually in the inner foot, bottom of the foot and near the heal. Make sure you have had an MRI to make sure there is no fracture or severe tendon tears. It’s best treated with orthotics which take the pressure off the heal. Steroid injections into the area of pain or even along the posterior tibial nerve can help. 5% acetic acid iontophoresis can be quite helpful as well. This is electrical therapy that allows drugs to cross the skin. Check out my show on Foot Pain which can give you a more comprehensive understanding: www.paulchristomd.com.
Tayfray, being a caretaker is one of the toughest jobs out there, and I hope you are getting enough help and support. Your father’s disease may be affecting his spine and the nerves that go down to his legs. Muscle spasms can be painful and make it difficult to do things like get restful sleep. There are traditional medications that can help, like baclofen. The most important thing is to understand the causes. For example, if his electrolytes are off, supplementing with magnesium or potassium could help. Talk more with your doctors about possible causes to see what are your best options.
Whiplash often causes musculoskeletal pain and can specifically cause injury to the facet joints of the neck. Patients certainly can recover. I perform nerve blocks to these facet joins and if successful, then offer a nerve ablation (denervation) procedure that offers more long term relief. Massage therapy, acupuncture can help. Medications like Cymbalta and pamelor can ease the discomfort too.
Dave, you may want to ask your doctor about some alternative options to traditional NSAIDS. For example, in some studies fish oils have been shown to provide just as much of an anti-inflammatory effect as prescription NSAIDS. Other nutritional choices that could help would include ginger and turmeric. Again, talk to your doctor first before making changes.
You could try topical agents that don’t include any anti inflammatories. These drugs may include ketamine, gabapentin, lidocaine, clonidine for example. Some of the mind-body therapies can help along with oral intake of glucoamine and chondroitin at therapeutic doses, especially for the joint pain.
Lydia, we are starting to see rebound headaches become a bigger and bigger cause of headaches or worsening of existing headache problems. It may help to consider other non-traditional approaches to supplement your medications. It is really important to understand possible triggers that you may have. Relaxation training and meditation can be really valuable in decreasing the impact of your headache problem. Also, consider things like posture, work station ergonomics, and exercise as things to explore.
If it’s due to diabetes, then tight glucose control is very important. You may be referring to small fiber neuropathy which is caused by conditions like diabetes, or HIV, or other medical conditions. I find that my patients benefit from drugs like lyrica, Neurontin, or pamelor. I even use opioids if necessary. Acupuncture can help along with spinal cord stimulation, actually. We are hoping for even more innovative treatments in the future for diseases of the peripheral nerves. Stay tuned.