Monday, December 21, 2015

Pain Receptor Location: A Key to Controlling Pain?

The location of pain receptors, the specialized nerve endings that transmit pain signals throughout the body, may hold the key to control pain effectively. These receptors, according to a research, are essential in determining “how big or small a pain signal will be” and “how effectively drugs can block those signals.”

The study, led by Terence Coderre, director of Anesthesia Research at McGill University, and Karen O'Malley from Washington University, posits that to control pain, pain receptors in the nucleus of spinal nerve cells need to be blocked. The researchers believe that this method could be more effective than interfering with receptors of the same type on cell surfaces. Furthermore, they also discovered that when spinal nerve cells run into painful stimulus, some receptors transfer from the cell surface into the nucleus.
Image source: blogs.nature.com
These findings came to fruition following an experiment involving rats that were treated with investigational drugs that blocked the activity of receptors in the nucleus. After the procedure, it was found that rats with nerve injuries experienced less chronic pain and less pain hypersensitivity, which led scientists to believe that the animals were relieved from neuropathic pain.

Image source: youtube.com
Their discovery, according to professor Coderre, proves that “the location of the receptor in the cell has a major effect on the cell's ability to transmit pain signals.” The researchers are now focusing on the cause of the glutamate receptor’s migration to the nucleus and are finding ways to produce drugs that can block this occurrence.  

Dr. Melanie Novak, M.D., is a pain management specialist who takes a multidisciplinary approach in addressing her patients' specific pain needs. Subscribe to this blog for more articles on pain management.

Thursday, November 12, 2015

'Text Neck': How Technology became a Pain in the Neck

It is a familiar sight these days. People hunched over their smartphones or tablets as they tap and swipe away for hours. And such posture, as research shows, increases the stress on the neck. The human head typically weighs about 12 pounds. But as the neck bends forward and down, the weight of the cervical spine begins to increase. At a 15-degree angle, the head’s weight is about 27 pounds, 40 pounds at 30 degrees, 49 pounds at 45 degrees, and 60 pounds at 60 degrees

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Image source: blog.beaumont.edu

This poor posture is alarmingly becoming common among young people. In fact, children as young as seven are reporting headaches, neck pain, shoulder and arm pain, compromised breathing, and the development of hunchbacks and curved spines, all of which are the result of what the medical community calls the “text neck” syndrome. If left untreated, text neck can result in serious permanent damage, including early onset arthritis, spinal degeneration, nerve damage, disc herniation, and gastrointestinal problems.

Although text neck or forward head posture is not a new condition, the boom of mobile technology plus an increasingly sedentary lifestyle among the general population are contributing to more reported cases. It is therefore important that people become aware of the ill effects of long hours of the use of smartphones and other mobile gadgets on their health.

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Image source: valerieorsoni.com

Dr. Melanie Novak, M.D. employs a multidisciplinary approach in the treatment of chronic pain. This includes the use of injection treatments and medications and physical and behavioral therapy. Learn more about Dr. Novak’s expertise here.

Thursday, October 1, 2015

Acute or Chronic? Understanding Basic Pain Categories

Image source: backpaininfo.co
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.

Image source: criticalscience.com
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.

Tuesday, August 25, 2015

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.

Image source: lifescript.com


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.

Image source: physicaltherapyweb.com


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.

Wednesday, July 29, 2015

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.

Image source: backpainmanhattan.com
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.

Wednesday, June 24, 2015

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.
Image source: flickr.com

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.

Wednesday, December 24, 2014

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.