Acute or Chronic? Understanding Basic Pain Categories

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The causes and intensity of pain vary widely, depending on the extent of damage to the body part. Although the experience of pain differs from case to case, pain falls under general categories, which are the following:

Acute pain typically occurs unexpectedly but has a limited duration. It is frequently caused by an evident damage to cells and tissues such as the muscles, bones, the skin, and other body organs. The onset is often accompanied by anxiety or emotional distress.

Chronic pain, meanwhile, is much more serious, may take months or even years to heal, and is generally resistant to standard medical treatments. It is commonly associated with or leads to a long-term illness, such as osteoarthritis. In some cases, such as with fibromyalgia, it is one of the key symptoms of the disease. Chronic pain could still be the result of a damaged tissue, but it is very often attributed to nerve damage.

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Both acute and chronic pains are debilitating and can adversely affect a person’s state of mind, physical well-being, and even self-esteem. Moreover, the most serious types can make patients more susceptible to psychological consequences such as depression and anxiety.

At the same time, psychological distress can intensify the sensation of pain. A pain management physician, Dr. Melanie Novak employs a multidisciplinary approach to treating acute or chronic pain using injection treatments, medications, physical therapy, and behavior therapy. For more details on her practice, visit this website.

Rotator cuff tears: Symptoms and treatment options

Rotator cuff disorders are some of the most common injuries that affect the shoulder. According to the American Academy of Orthopaedic Surgeons (AAOS), every year, approximately 200,000 Americans undergo surgery to repair their rotator cuff.

The shoulder is a ball and socket joint with three main bones: the upper arm bone or humerus, the collarbone or clavicle, and the shoulder blade or scapula. The rotator cuff is a group of tendons and muscles that connect the humerus and the scapula. As their name suggests, the rotator cuff muscles allow the shoulders to rotate as well as provide them with dynamic stability.

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There are numerous causes of rotator cuff tears ranging from injury (trauma) to degeneration (repeated micro-trauma.) An acute rotator cuff tear occurs quickly. It could result from making a sudden, jerking motion such as lifting a heavy load or from falling and landing on one's arm while it's outstretched. However, degeneration is the most common cause of rotator cuff tears. A tear due to degeneration, also called a chronic tear, occurs over time: Repeated straining and pinching of the rotator cuff syndromes could squeeze the rotator cuff tendons, eventually causing them to tear.

Symptoms 

Symptoms for both types of tears include pain in the shoulder or arm that often disrupts sleep, difficulty moving the shoulder, difficulty lifting objects or raising the affected arm over the head, weakness, and soreness.

With an acute rotator cuff tear, intense pain sets in immediately after an injury or fall. With a chronic tear, the symptoms are initially mild, and the pain and mobility issues worsen over time.

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Treatment options

It is important to visit a physician as soon as symptoms arise. Treatment of a rotator cuff injury depends on the severity of the tear.

A partial tear could only require rest, pain relief and anti-inflammatory medications, cold and heat therapy, and physical therapy. However, a complete tear typically requires surgery to correct, especially if the patient does not respond to other forms of treatment. A doctor could also administer a corticosteroid shot to reduce pain and swelling.

Physical therapy and rehabilitation are essential for complete tears, as well, to strengthen the weakened muscles supporting the arm and shoulder and to restore full shoulder range of motion.

 Dr. Melanie Novak, M.D., utilizes a multidisciplinary approach in the treatment of chronic and acute pain. For related discussions, subscribe to this blog.

Understanding Stress-induced Pain

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Unknown to many people, stress actually triggers most pain conditions. Although the body is designed to handle stress, too much of it can wear one down and can result in emotional and physical ailments.

According to studies, 43 percent of all adults suffer adverse health effects from stress. Furthermore, it is estimated that 75 to 90 percent of doctor's office visits are for stress-related ailments and complaints.

By definition, stress is a bodily response to harmful situations, whether real or perceived. Events that make one feel threatened or upset can cause stress, and the reaction to that particular event is known as “stress response.”

Negative stress response, which is also called the fight-or-flight response, induces pain, affecting one’s physical, mental, and emotional wellness. Depending on the person’s stress response, however, stress can play a part in different types of health problems.

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Some of the most common stressed-induced pains include physical and physiological problems, such as headaches, high blood pressure, heart problems, diabetes, skin conditions, asthma, arthritis, depression, and anxiety.

All things considered, it is important to be ready on how to act and how to protect oneself from stress. Moreover, it is also essential for a person to know his stressors and to find ways on how to manage stress and its adverse effects.

Find more resources on pain management by liking this Dr. Melanie Novak, M.D., Facebook page.

Chronic Pain and the Elderly: A Caregiver's Guide to Pain Management

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Many elderly adults experience acute or chronic pain. Although this is an unavoidable part of growing older, it doesn't mean that seniors should suffer through it, especially as there are many ways to treat or manage this discomfort. With the help of family members and caregivers, the elderly can still continue living productive lives despite their conditions.

Chronic and acute pain don't just cause intolerable physical discomfort, they can also affect a person's emotional well-being, lifestyle, and relationships, so the best course of action is to nip them in the bud by introducing healthy living habits. Helping the elderly eat a nutritious and balanced diet, get enough sleep, and perform age-appropriate exercises regularly is a great start for staving off illnesses that might cause some pain. Regular check-ups, consistency in taking their supplements and prescribed medications are also recommended.

It's important also to note that some elderly individuals might not be too forthcoming about any pain they might be feeling or in some cases, might be unable to communicate how they're feeling such as in seniors with dementia. Family members and caregivers must be especially observant of signs of discomfort like grimacing, grunting, favoring one side of the body, and unease. But when possible, it's recommended to talk to the person in pain to find out what can be done.

Doctors may recommend a variety of pain treatments ranging from medication to injection treatments, physical therapy, and radiofrequency nerve ablations (a minimally-invasive pain reduction procedure), among others, as a means of treating the patient's pain. Caregivers must remember that medicines should only be administered under a doctor's supervision as older patients react to pain relievers differently from younger ones.

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In addition to the methods mentioned, elderly patients may also benefit from relaxation techniques, counseling, support groups, and even alternative medicine like acupuncture, which a report in the Harvard Health Blog showed to be beneficial for chronic pain sufferers. Most importantly, however, a senior person with chronic or acute pain problems will be able to maintain normal, active lives with a supportive network.

Pain management specialist Dr. Melanie Novak, M.D., takes a multidisciplinary approach in addressing her patients' specific pain needs. Follow this Twitter account for more on chronic pain symptoms and their treatments.

REPOST: 5 Ways to Survive and Thrive in Cold Weather with Chronic Pain

The final stretch of the holidays is approaching, and certainly no one can afford to be absent from the usual yuletide activities because of sore and aching bodies. PainCamp.com lists down five ways to stay pain-free during the remaining days of the season.  

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Pain Camp is located in the upper midwest region of the United States of America. We’ve been blessed that we’ve not seen extreme sub-zero temps during the winter time in several years. So what is a Pain Camper to do in cold weather? How can we go from surviving to thriving with Chronic Pain in the winter time?

Temperature in the winter never bothered me BCP. In fact, I used to do a lot of skiing (downhill and XC) and was even on the Cross Country Ski team in High School (I wasn’t very good, but hey, I looked darn cute in my spandex suit at that age). ACP is a completely different story. My body’s “I HATE WINTER” response is not effective as I live where winter happens. It happens every year. My body (and my mind) need to survive and thrive because I will most likely continue to reside here as this is where my family and friends are.

Pain Camper Plan of Action

Bundle Up!

Those of us moving from surviving to thriving have decided “We don’t care what other people think” and this applies to being puffy like a marshmallow with all of our layers in the winter time too! Layers, hats, mittens, gloves, scarves, warm socks, throw it all on! Long johns, hoodies and scarves are my go-to clothing in the winter. This year, I’m even donning a turtle neck.

Think Warm!

When my Physical Therapist first proposed this idea, I looked at her like she had 3 heads. Then I remembered how powerful our brains are and what I used to teach people in therapy sessions (think guided imagery). Before you walk out into freezing cold, close your eyes and briefly imagine your muscles being relaxed and that you’re on a nice warm beach laying in the sun. Yes, this only works for a few minutes for me (until my CNS takes over), but it does help me increase my awareness and be mindful of how tense my muscles are. When I’m more aware of my muscle tension, I can use my tools to help relax them.

Energy Conservation!

In Chronic Pain Rehab I learned about the importance of conserving my energy. When I look at my daily list of Pain Camper activities, I need to pick and choose what I can realistically do on that day, at that specific time, with my level of pain. I also need to be mindful of looking a day or two ahead. My experience, strength and hope: yesterday (30+ degrees) I took care of the car (gas, wash, air in tires) and got errands taken care. Today (3 degrees) I went out to one place. Tomorrow (-5 as the high) I will be out driving over 100 miles (in and out of 3 homes) for work. Tomorrow is going to be a “pulled pork from the crock-pot for dinner” day.

Blankets, heating pads and hot packs – oh my!

For Christmas, my Supportive Spouse got me a full size heated blanket. I turn it on about 30 minutes before getting into bed and it keeps me toasty all night. I have my eye on a throw that went on clearance for the living room so I don’t have to keep hauling the full size back and forth. Heating pads and hot packs are great for specific areas of pain. Microwaveable wraps are awesome too!

Warm House! 

I know that this increases our costs somewhat, but a cold Pain Camper is not a happy Pain Camper. We have our thermostat a bit higher on the sub-zero days. We also have invested in some other ways to control the drafts such as plastic over the windows and plug covers for electrical plugins that are not in use. After an ice dam a couple of years ago, we re-insulated the attic and that has helped as well.


Don't let chronic pain ruin your holiday. Dr. Melanie Novak offers treatments that will help you enjoy a worry-free season. Visit this website to help you manage chronic pain all year round.

REPOST: Smoking linked to increased risk of chronic back pain

A new study published in the journal Human Brain Mapping suggests that people who smoke are more likely to develop chronic back pain. Smokers are advised to quit their habit to reduce the risk of developing the disease. Medical News Today has the full story below.

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People who smoke are much more likely to develop chronic back pain than those who do not smoke. These are the findings of a new study by researchers from Northwestern University in Evanston, IL.

This is not the first study to link smoking to chronic pain. But according to the research team, led by Bogdan Petre of the Feinberg School of Medicine at Northwestern, it is the first study to suggest that smoking interferes with a brain circuit associated with pain, making smokers more prone to chronic back pain.

Back pain is one of the most common medical problems in the US, estimated to affect 8 out of 10 Americans at some point in their lives. According to the American Chiropractic Association, back pain is the main reason for missed days at work and the second most common reason for doctor's visits.

This latest study, published in the journal Human Brain Mapping, suggests that smokers could reduce their risk of developing chronic back pain by quitting the habit.

To reach their findings, the researchers analyzed 160 participants who had recently developed subacute back pain, defined as back pain lasting 4-12 weeks. They also assessed 32 participants with chronic back pain - defined as having back pain for 5 years or more - and 35 participants with no back pain.

On five separate occasions over a 1-year period, all participants completed questionnaires that gathered information about their smoking status and other health conditions. They also underwent magnetic resonance imaging (MRI) brain scans.

The brain scans, the researchers say, were used to assess activity between two brain regions - the nucleus accumbens and the medial prefrontal cortex. Both of these regions play a role in addictive behavior and motivated learning.

Smoking increases brain activity that reduces resilience to chronic back pain

Petre and his team found that the connection between these two brain regions plays a crucial role in chronic pain development. They explain that the stronger the connection between them, the less resilient an individual is to chronic pain.

Smoking appears to affect this connection. The researchers found that compared with nonsmoking participants, those who smoked had a stronger connection between the nucleus accumbens and the medial prefrontal cortex, increasing their risk of chronic back pain. The team calculated that smokers are three times more likely to develop chronic back pain than nonsmokers.
 
"But we saw a dramatic drop in this circuit's activity in smokers who - of their own will - quit smoking during the study," explains Petre. "So when they stopped smoking, their vulnerability to chronic pain also decreased."
Commenting on their findings, the researchers say:

"We conclude that smoking increases risk of transitioning to chronic back pain, an effect mediated by corticostriatal circuitry involved in addictive behavior and motivated learning."

The team points out that smoking participants who managed their chronic back pain with medication - such as anti-inflammatory drugs - did experience some pain reduction, but that these medications did not alter brain circuitry.

As such, they suggest that smokers could reduce their risk of chronic back pain by engaging in smoking cessation programs or other behavioral interventions that may help them quit the habit.
Because the team's findings show that smoking affects brain circuitry linked to chronic pain, they suggest that there may be a link between addiction and chronic pain in general.

Dr. Melanie Novak, M.D., is a pain management specialist who treats all types of chronic pain. Read more about pain management on this blog.

REPOST: Chronic pain and painkillers: Why you should consider alternatives

The sustained use of painkillers can lead to serious health problems such as ulcers and liver failure. However, the good news is that there are natural alternatives for pain management that don’t come in the form of a pill. The article below lists four natural suggestions for pain management. 

Physician Offers 4 Natural Ways to End the Pain 

Roughly 100 million Americans suffer from chronic pain lasting more than six months, according to a report from the Institute of Medicine. Throughout the past decade, the use of painkillers such as Vicodin, Percocet and OxyContin has soared by 300 percent. For many – 17,000 people per year, or 46 each day – the treatment is worse than the pain; those are the number of users who die from the medicine, according to the Centers for Disease Control. 

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For every person who dies from the use of painkillers, 30 more are admitted to emergency rooms due to complications. 

“Those figures are appalling,” says Dr. Frank King, a doctor of naturopathy, president of King Bio natural medicine company, and author of The Healing Revolution (www.kingbio.com). 

“Death is just one of the many side effects of heavy-duty pharmaceuticals, and researchers unanimously agree that addiction to painkillers has risen drastically in recent years. People are so focused on pain that they miss the fact that it is a signal of deeper health problems. Don’t shoot the messenger! Listen to the pain, and it will lead you to the root causes.” 

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With decades of experience helping patients, Dr. King offers four natural suggestions for pain management. 

• Identify the root causes of pain. Pain is a signal of deeper problems, similar to the warning light on the dashboard of your car. You can mask the light with duct tape, which is what prescription drugs do with pain. You can cut the wires, which might symbolize a surgical approach. Or you can look for the root causes, which is what our more natural, holistic approach seeks to do. Address the problem, and the pain will subside. 

• Make good choices. Most chronic conditions are caused by bad lifestyle choices. Try walking more, eating and sleeping better, eliminating stress and bad habits from your life, and watch pain decrease and health increase. It’s that simple. Moreover, surround yourself with a healing community of like-minded “healing buddies” who support your healthy choices. 

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• Explore natural healing techniques, and if necessary, see a natural healing practitioner. You are your best doctor, on call 24/7. I developed many self-healing techniques that address the needs of every aspect of mind-body health. These techniques are free and easy to implement at home, on the job, and wherever you might be. You might also explore meditation, yoga and other approaches for filling the holes in your wholeness. 

• Look into homeopathy. Homeopathy predates modern medicine. Homeopathic medicines are safe and effective, with no known side effects or negative drug interactions. They target the root causes, not the superficial pain. I have personally seen homeopathy dramatically raise the quality of life and happiness for countless of my patients.
With the appalling death toll due to pharmaceutical pain medication, natural solutions like homeopathy are our safest, brightest hope for the future of pain management. 

About Dr. Frank King 

Dr. Frank King is a chiropractor, doctor of naturopathy, and founder and president of King Bio, an FDA-registered pharmaceutical manufacturing company dedicated to education, research, development, manufacture and distribution of safe and natural homeopathic medicines for people and pets. Dr. King is also the author of, The Healing Revolution: Eight Essentials to Awaken Abundant Life, Naturally! (www.kingbio.com). A fourth-generation farmer, Dr. King raises yak, camel, boar, wisent and American bison sold under the Carolina Bison brand. He is a member of the Homeopathic Pharmacopoeia Convention of the United States.

Dr. Melanie Novak approaches pain management with an individualized treatment plan consisting of conventional medications and physical and behavior therapy. Follow her on Twitter for more educational resources on pain management.