Sacramento Injury Attorneys Blog

Finger amputations may sound small but they really cause a lot of changes in the way the patient performs certain activities, such as punching the buttons on a phone or using a keyboard. This is why the surgeon will attempt to put the finger back on if it is severed from the hand.

When a finger is initially severed, the bystander should wrap the amputated finger in moist, cool gauze. The finger should not be immersed in water because it can become waterlogged. Simply use a paper towel if you have no medical gauze. Put the finger on ice with a Ziploc bag. Do not use dry ice for this part of the process. If there will be an attempt to reimplant the finger, there should be immediate medical attention with a surgeon who can put arteries, veins and nerves back together. The time from amputation to reimplantation should be less than 12 hours.

The finger should not be reattached if it has become crushed, contaminated or mangled. Injuries of just one finger often mean that it does not have to be reimplanted. Injuries at the base of the finger are far harder to recover from than injuries partway up the finger. Fingertip injuries should also not be reattached.

Children with severed fingers should have an attempt at a reattachment. Thumb injuries and injuries with multiple digits involved should have an attempt at reattachment. Fingers in which the chances of success are good should have a shot at reattachment.

One study looked at finger amputations that were not work-related. Finger amputation data was obtained between 2001 and 2002 from the National Electronic Injury Surveillance System All Injury Program. It represents 66 hospitals in the US. They found 948 cases of finger amputations that were not work related. It included both partial amputations and complete amputations. They determined that there is an annual number of 30,673 non work related amputations. Of these, about 27,886 incidences involved amputations of one or more fingers. Almost twenty percent were transferred to a specialized trauma care facility.

Most victims were male at a 3 to 1 ratio with women. Interestingly, the highest rate of finger amputations occurred in children who were younger than age 5 years. The rate was 18.8 per 100,000 population, followed by adults between the ages of 55 go 64 years who sustained finger injuries at a rate of 14.9 per 100,000 population. Kids who were 4 years of age or younger often sustained their injuries as a result of contact with a door (73 percent). For adults older than 55 years, they had their injuries as a result of power tools about 47 percent of the time.

The research study indicated that the very young and the relatively old were at the highest risk for finger amputations. Where children are involved, there should be responsible adults watching where their children's hands and fingers are when doors are shut. This includes the open part of the door and the part of the door which is hinged.

People can sustain burns and heat-related injuries from their motor vehicle. Children, pets and the elderly are at the highest risk of injury. Such injuries can show up even after being in a motor vehicle for a short time. For example, when it is 93 degrees Fahrenheit outside, the vehicle can reach 125 degrees Fahrenheit after only 20 minutes. Within 40 minutes, the temperature can reach 140 degrees Fahrenheit.

Don't allow kids to play inside vehicles or their trunks in extremely warm weather. They can get heat stroke, which can lead to permanent injury and death within just a few minutes. Don't leave a child in a hot car unattended and teach kids not to play around vehicles in hot weather. Make sure all passengers in your car have left the vehicle. Don't leave a sleeping child or older person in the car. Stay away from leather seat, safety belt buckles and latch plates when riding in a hot car until they cool down. Shade the front and rear windows when not using your car so the heat doesn't build up.

Run the air conditioner to cool off the vehicle before getting in. Lock your car and trunk when not around your vehicle so children don't get in and suffer heat stroke. Lock rear seats so kids don't have access to the trunk from the back seat. Teach kids how to unlock the vehicle from the inside if they are old enough so they can get out when unintentionally locked in the car. Get a trunk release that allows people to get out of the trunk if locked inside.

If a person suffers heat stroke, remove them from the car and put them in a cool environment. Call 911 and keep the victim calm. Treat minor burns with first aid cream.

If your car overheats, the radiator pressure goes up. If you take the radiator cap off, the liquid explodes or boils over and you can get serious burns. If there is antifreeze in the liquid, you can get a chemical burn as well. Common areas of burning are the hands, face, arms and chest. You need to minimize idling of your car in hot weather and you should never open a hot radiator cap. Keep a first aid kit with you in your vehicle.

Burns secondary to cars account for as many as ten percent of all admissions to burn units. One research group looked at burns in a regional burn center over a six year period of time, ending in 2003. There were 2,745 burn unit admissions with 8 percent being related to automobiles. The average age was 30 years and 84 percent of victims were men. In terms of total body surface area, the average burn size was 14 percent of the TBSA. Twenty five people had inhalation damage and 25 individuals had non-burn related injuries. They stayed in the hospital on average 2 weeks or more and 108 patients had some kind of procedure, such as a skin graft. Most patients who had surgery had more than 2 skin graft procedures with an average of 2,780 cm of skin grafted. Two patients in the group died. Hospital charges were on average about 53,200 dollars or more.

Severe injuries from automobile burns were generally from carburetors and radiators; the patients suffered injuries from ordinary maintenance and use of their vehicle.

Spinal cord stimulation is used to manage chronic pain. Doctors implant a pulse generator that delivers an electrical pulse to the spinal cord. The electricity impairs the function of the nerve signals sent by the painful area to the pain.

Spinal cord stimulators are implanted in the back using sedation and local anesthesia. A trial run is done first using a small, temporary pulse generator. This type of percutaneous stimulator is a temporary pain-relieving device because it tends to migrate under the skin. If it works, however, a permanent spinal cord stimulator is implanted under the abdominal skin with wires passed around to the back and inserted in the spinal cord. This stimulator is considered more stable and can be used for years.
When a spinal cord stimulator is in place, the painful area feels tingly instead of painful. After the stimulator is put in place, it's necessary to keep the small incision dry and sanitary so it doesn't get infected.

Who gets spinal cord stimulation surgery? It is usually done for those people who have had back surgery that failed to relive their pain or for people who have had neurological pain or numbness. People with complex and chronic pain conditions like complex regional pain syndrome or reflex sympathetic dystrophy are also good candidates for spinal cord stimulation. It has been used in investigational studies for people with multiple sclerosis, intractable angina or paraplegia but is not in common use.

Stimulation of the spinal cord does not work in all cases. It can be helpful in situations where back surgery failed and in reflex sympathetic dystrophy or complex regional pain syndrome. Some cases of chronic, unremitting low back pain get better with spinal cord stimulation.

Research reveals that, in a majority of the people treated with spinal cord stimulation in cases of leg pain, ischemia of the leg due to peripheral arterial disease and chronic low back pain, there is relief of the pain using this technique. People with low back pain that does not go away also have relief of pain about half of the time.

One problem with this technique is that many people get pain relief in the beginning but have a gradual loss of pain relief due to the spinal cord becoming tolerant to the therapy.
There are risks to be concerned with when undergoing spinal cord stimulation. One can get scar tissue formation where the electrode is inserted into the spinal cord. There can be pain that moves up past the level of the stimulation and a hardware failure or breakage of the electrode. In addition, infection can occur after the surgery and the spinal cord fluid can leak around the electrode causing a spinal headache. Problems urinating are possible and tolerance can render the therapy useless. If a person has a stimulator implanted, they are unable to have an MRI examination.

The proof that spinal cord stimulation actually works is limited; clearly, more and better research is needed. The treatment appears to be related to the actual cause of the pain. The batteries, incidentally, need to be changed every 2-5 years and this requires an additional surgery.

There are two facet joints at either end of a vertebral segment in the spine. In the lumbar spine, these joints help give stability to the spine and help guide its motion. Because of a back injury, arthritis or mechanical stress on the lumbar spine, there can be low back pain. One treatment of this type of pain is the lumbar facet injection. The relief of pain the person receives can help them participate in physical therapy in order to strengthen the back and keep it pain free.

Lumbar facet injections have two primary goals: the first is to help diagnose the cause and location of the low back pain and the other is to give pain relief. A facet joint injection can find the source of the pain by injecting the joint with an immediate relief anesthetic. If the pain is relieved at a particular facet joint, it is the likely source of the pain. This is especially true if complete relief is obtained.

The lumbar facet injection is also used for pain relief. Longer acting anesthetics and cortisone can be injected into the joint. The cortisone acts as an anti-inflammatory medication, killing the pain for up to three months or more. It can also help the patient begin a program of physical therapy to strengthen the back. This pain relief is called a facet block.

During a lumbar facet injection, an IV is started and medications for sedation or relaxation are given. The patient lies stomach down and the lumbar area is exposed. The area is cleaned well with a cleansing agent to sterilize the area and the affected area is numbed with a local anesthetic. Fluoroscopy or x-ray guidance is used to locate the facet joint so that a small needle can be inserted into the joint. Contrast die is included in the injecting agent so that x-ray can confirm that the facet joint has indeed been entered. Usually a mixture of cortisone and lidocaine can be injected at the same time. The injection is done slowly so as to avoid pain and to make sure the solution gets into the joint.

The injection takes just a few minutes; however, the patient must remain on the table in a resting position for twenty to thirty minutes before being asked to try and mimic the pain. If the injection was successful, there should be a decrease in the amount of pain the person feels although pain relief may not be felt for a few hours. If the joint was the wrong one, there may not be pain relief at all. Weakness on the side of the injection can happen for a few hours after the injection, and it is advised not to drive or do any strenuous activities on the day of the procedure.

A person who has received a lumbar facet injection will be asked to record the degree of pain for approximately a week after the injection. This will help the doctor know whether or not the injection was successful or whether another type of treatment plan is necessary. There can be a few days of pain relief from the lidocaine with an increase in pain until the cortisone begins to work. Ice can be applied to the site of injection so as to relieve pain in the first few days.

If the patient receives no pain relief after getting the injection, it can be inferred that the facet joint was not the source of the pain. It takes about ten days to see if pain relief occurs. If not, then further diagnostic testing may need to take place.

Thoracic discography is done at a lesser rate than cervical or lumbar discography because the thoracic spine is relatively stable and disc problems are much less likely in the thoracic area when compared to the cervical area and the lumbar area. It is a test to look for disc problems in the thoracic part of the spine. There are many more problems with the thoracic spine, such as muscle pain, pain with the spine, visceral pain masking thoracic pain and facet joint pain.

The purpose of having a thoracic discogram is to see if a damaged disc is causing thoracic pain. It is similar to a lumbar and cervical discogram in that it is used to identify specific discs that are pinching on nerves causing pain in the back or in the area a peripheral nerve serves. It is done in cases of thoracic back pain or pain in the trunk and is a more successful test than an MRI or CT scan of the thoracic spine because a disc severely damaged on CT scan may not be painful while a mildly damaged disc can be the source of the pain.

The test was originally called a diagnostic disc puncture by its originator, Dr. Lindblom. It is done under local anesthesia so that the patient can identify whether or not stimulating the disc causes their pain. After numbing up the suspicious areas, a fine needle is inserted into the back and finally into the disc. The disc is then pressurized with contrast medium, thus expanding the soft disc. The patient is then asked to say if there is pain and if the pressurizing of the disc recreates their exact pain or a different type of pain. If the disc pressurization does not cause the patient's typical pain, another disc is pressurized. At the end of the procedure, the patient is given a CT scan of the back to look for leakage of contrast medium through radial tears in the disc annulus.

The major risk factor of a thoracic discogram is infection in the disc afterward, which is extremely hard to treat. There is also a risk of puncturing the lung or pleural sac. This is why the procedure should be performed by an expert in the procedure. Fortunately, the procedure has been performed for more than 50 years so experts exist who can identify the disc, pressurize it and can obtain effective answers.

While thoracic disc abnormalities are not that common, there can be degeneration of the thoracic disc and end-plate problems and changes in the disc due to osteophyte formation seen in the middle of the thoracic disc. These can all cause local pain in the mid back or pain in the radicular area, along the trunk or upper abdomen. This kind of pain has been found to be as disabling as low back pain. Facet joint pain in the joints of the thoracic back has been seen in 48 percent of those with thoracic spinal pain without obvious evidence of disc problems.

Interestingly, pain in the discs can mimic visceral pain when no visceral injury exists. In such cases, a thoracic discogram needs to be done in order to identify the offending disc as the real cause of the visceral pain. Disc problems in the lower thoracic area or the thoracolumbar area can feel like gynecological pain and much can be done to work up a nonexistent gynecological problem when the problem is really in the disc.

The important part of having thoracic discography is to have a skilled practitioner do the test so that the side effects and complications can be minimized.

An intrathecal pump is one way doctors can provide pain medication directly to the spinal cord. The pump is placed beneath the skin of the abdomen and is programmed to deliver a specific amount of pain drug to the spinal cord. The pump itself is attached to a catheter similar to the one used on women during childbirth.

The catheter goes into the back and is inserted into the intrathecal space around the spinal cord itself. Because the spinal cord is given the medicine directly, there are fewer generalized symptoms and less medication needs to be given. One needs only about 1/300 of the medication necessary when given by intravenous means.

The intrathecal pump in the abdomen is a round metallic device about 3-4 inches in diameter that is implanted through surgery just beneath the skin of the abdomen. It is attached to a tube that is, in turn, attached to the catheter in the intrathecal space around the spinal cord. The pump has an empty cavity called the reservoir which contains the medication. The pump is programmed to release medication slowly at the same rate or at different rates, depending on the time of day. When the reservoir is empty, a healthcare provider uses a needle to inject more medication into the reservoir through a port.

Those who might be good candidates for the intrathecal pump include those who fail conservative therapies, those who are dependent on pain medication, those who are not candidates for surgery, those who are good medical candidates to have the surgery and those who have responded positively in the past to medications that are used in these intrathecal pumps.

An intrathecal pump is useful in the following chronic pain syndromes:

• Failure of previous back surgery


• Pain due to cancer pushing on spinal nerves


• Scar tissue due to radiation around the spinal cord


• Pain and inflammation of the meninges of the spinal cord (called arachnoiditis)


• Causalgia, a burning sensation from peripheral nerve problems


• Chronic pancreatitis


• Reflex sympathetic dystrophy, which is a disease of the nervous system


• Spasticity caused by cerebral palsy, MS, stroke, spinal cord injury or brain injury

Doctors perform screening tests to see who is a good candidate for pain relief by means of an intrathecal pump. These screening tests involve getting a single injection of morphine or baclofen into the intrathecal space. The medicine used depends on the use of the intrathecal injection. If one injection works, the doctor may try multiple injections over several days to see if the medication works. Continuous relief is attempted by means of an external pump, which allows the doctor time to see which dosage of medication might work in the intrathecal pump. If this works, the patient will be scheduled to have the intrathecal pump placed.

The cervical facet joints are important for cervical spinal stability and for providing motion of the neck. Unfortunately, they can easily become injured or arthritic, leading to localized joint pain or pain along the spinal nerve that exits the lateral spinal canals. This kind of pain leads to radicular pain, which can be on the arms or upper chest.

When the facet joint becomes injured or arthritic, the choices of pain relief might include surgical fusion, pain medication and facet joint infection. The advantages of facet joint injection include short recovery time after the procedure and the lack of addiction potential, as would be seen with some pain medications.

A facet joint injection must be done by a physician qualified and well-practiced in doing this type of injection. A cervical facet joint injection begins with an IV placed in order to provide sedation or relaxation to the patient. Once this is accomplished, the doctor uses x-ray technology to guide the needle into the middle of the facet joint. Often a small amount of contrast dye is inserted into the joint space and x-ray fluoroscopy verifies the needle's position.

When the needle is properly placed as verified by x-ray, a mixture of local anesthetic and cortisone is given to the patient through the same needle. If the correct joint has been injected, there is often immediate relief because the local anesthetic has kicked in and relieves the pain in the joint. This unfortunately wears off after a few hours. Within 1-3 days, the cortisone begins to work so there is usually relief after that.

The relief from a cervical facet injection lasts about 3 months. After that, another injection can be done. Cortisone has some systemic effects on the body so that repetitive injections with cortisone are not recommended.

The indications for cervical facet joint injections include osteoarthritis of the facet joint, injury to the facet joint, narrowing of the spinal canal at the level of the cervical joint or radicular pain from a narrowing of the spinal facet joint canal. Narrowed canals can result in a "pinching" of the nerve. Fortunately, cortisone can shrink the swelling of the nerve so there is better nerve function, at least for a period of time. The pain involved in facet joint injury can be in the neck, shoulders, arm or chest.

The biggest risk of having a cervical facet injection is that the facet joint is not the right one or is not the problem at all. The joint is injected with drugs that actually do no good to help the problem and can have side effects all their own. Another risk is infection inside the joint, which can be difficult to treat. A blood vessel can inadvertently be injected or punctured with a needle, leading to bleeding or the intravenous injection of cortisone that is not meant to be an intravascular drug.

While the injection itself takes only a few minutes, it takes up to an hour to do the procedure, so it's necessary to lie still for up to 30 minutes after the injection. It is after that that the doctor will ask the patient to reproduce the pain to see if it has been relieved.

Cervical pain rivals low back pain as the number one type of spinal pain injured people can have. It is a particularly annoying pain as it can lead to headaches, neck pain and pain along the exit route's travel, which, in the case of the neck, is usually in the upper arms.

Cervical pain can be caused by many things. In most cases, it is the result of musculoskeletal pain or ligamentous pain in the cervical area. In some cases, there can be damage to the disc so that pressure is put on the spinal nerves, leading to referred pain to the neck, shoulders or arms. The discs are soft, cushiony pads that separate the hard vertebrae of the spine. The disc can bulge into the spinal canal, pushing on the spinal cord, leading to distal pain. It can also tear or degenerate causing localized cervical pain.

The gold standard for assessing the status of the discs is the MRI of the spine. Some people can have a CT scan or plain x-ray of the spine but these are less helpful. Cervical discography is a great adjunct to the MRI scan and works well because it can tell if a damaged disc is the source of the pain. There can be several damaged discs and the doctor may not always be able to tell which one is the cause of the pain. To make matters more complicated, the more damaged looking discs are not automatically the ones causing the pain. It all depends on the cervical discography evaluation.

The cervical discography exam is able to confirm or deny that the disc is the cause of the pain. It is actually a very straightforward test. The area of the cervical spine is numbed with local anesthesia. Sedation is not used because it may hide the pain at the time of the procedure. A small needle is inserted into the disc and the disc has contrast dye injected into it in order to pressurize the disc. If the pain is reproduced exactly during the pressurization, that disc is the likely source of the pain. If there is no pain on pressurization with contrast dye, or if the pain is in a different place or of a different quality from the typical pain, this would mean that the disc being pressurized is not the cause of the pain.

After the test is over with, a CT scan of the disc is done using the contrast in the disc to further outline the shape of the disc and the presence of tears or other abnormalities of the disc. This makes cervical discography a functional test that can subjectively tell the doctor where the offending disc is located. It could mean that a patient is going to need surgery, such as a spinal fusion to eliminate the source of the disc problem.

During the procedure, IV antibiotics will be given in order to prevent infection in the disc, and relaxation medication can also be given. For cervical discography, the patient will lie on his or her back. This is different from lumbar and thoracic discography, in which one lies on the stomach. X-ray guidance will be used to locate the disc, which is entered after putting antiseptic and analgesic agents on the skin. The procedure generally takes one hour or less. The CT scan is done immediately after the test. A person should not drive and should limit daily activities for a day after the test and should expect neck soreness for 2-3 days after the test.

Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.

Most practitioners will agree that, while the effects of the injection tend to be temporary -- providing relief from pain for one week up to one year -- an epidural can be very beneficial for a patient during an acute episode of back and/or leg pain. Importantly, an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program. If the initial injection is effective for a patient, he or she may have up to three in a one-year period. In addition to the low back (the lumbar region), epidural steroid injections are used to ease pain experienced in the neck (cervical) region and in the mid-spine (thoracic) region.

Although many studies document the short-term benefits of epidural steroid injections, the data on long-term effectiveness are less convincing. Indeed, the effectiveness of lumbar epidural steroid injections continues to be a topic of debate. This is accentuated by the lack of properly performed studies.

Epidural steroid injections deliver medication directly (or very near) to the source of pain generation. In contrast, oral steroids and painkillers have a dispersed, less-focused impact and may have unacceptable side effects. Additionally, since the vast majority of pain stems from chemical inflammation, an epidural steroid injection can help control local inflammation while also "flushing out" inflammatory proteins and chemicals from the local area that may contribute to and exacerbate pain.

While the effects of an epidural steroid injection tend to be temporary (lasting from a week to up to a year) an epidural steroid injection can deliver substantial benefits for many patients experiencing low back pain.

• When proper placement is made using fluoroscopic guidance and radiographic confirmation through the use of contrast, > 50% of patients receive some pain relief as a result of lumbar epidural steroid injections.


• Pain relief is more often felt for primary radicular (leg) pain and, less prominently, low back pain.


• The pain relief and control brought on by injections can improve a patient's mental health and quality of life, minimize the need for painkiller use, and potentially delay or avoid surgery.

Continue reading "Epidural Steroid Injections" »

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are pain medications often used to treat muscle and joint pain. NSAIDs fall under the heading of non-narcotic pain medications. Using NSAIDs for chronic pain is most effective when pain is mild or moderate.

Many NSAIDs can be purchased over the counter. Ibuprofen and naproxen, both NSAIDs, are readily available in drug and convenience stores. Prescription-strength NSAIDs for chronic pain are also available if the pain is more severe. In these cases, NSAIDs may also be combined with opioids to better control the pain.

NSAIDs reduce pain in two ways. First, they alter the sensation of pain by blocking certain enzymes that participate in the pain response. Second, they work to reduce swelling that is often associated with certain types of pain. Some NSAIDs are only effective at reducing swelling when taken at higher doses.

Most NSAIDs are taken by mouth. NSAID strength varies depending on the type of medication and dosage.

Some of the more commonly available over-the-counter NSAIDs for chronic pain include aspirin, ibuprofen, naproxen, and ketoprofen. These pain medications are sold in different non-prescription strengths, and may be combined with other ingredients such as caffeine or acetaminophen.

Prescription strength versions of NSAIDs are available as well. Some commonly used prescription NSAIDs for chronic pain include meloxicam and celecoxib. Nearly all NSAIDs, both prescription and over the counter, are taken orally.

Evidence suggests that the potential for NSAID-associated complications increases as you get older. Some more common side effects include:

• Stomach irritation and ulcers


• Gastrointestinal (GI) bleeding


• Increased potential for bruising


• Exacerbation of asthma symptoms


• Increased risk of stroke, heart attack and blood clots

If a person plans to be on NSAIDs for chronic pain long-term, his or her doctor may alter the dosage. The doctor may also provide other prescription medication that offsets the potential for developing any of the above conditions, such as misoprostel. The potential for NSAID complications may be increased for people who:

• Smoke


• Drink alcohol regularly


• Are a senior


• Have a history of heart disease


• Have high blood pressure


• Have ever had any GI problems


• Have kidney or liver disease

All NSAIDs, both prescription and over the counter, now have warning labels thanks to a ruling by the Food and Drug Administration. Despite the warnings, taking NSAIDs remains one of the most popular ways to relieve pain.

Continue reading "Nonsteroidal Anti-Inflammatory Drugs and Chronic Pain" »

Massage can provide great relief, and isn't just for pampering. It works by stopping the cycle of pain. When an injured person has pain, the muscles tighten around the affected area, mobility is reduced, and circulation is reduced. Massage works by restoring mobility to tightened muscles and trigger points and by lengthening the muscles. Massage can improve circulation, as well as help to relieve emotional stress and anxiety that can contribute to chronic pain. Massage has been able to help hospitalized patients manage chronic pain and relieve anxiety. It also helps by reducing anxiety and increasing sleep.

There are many types of massage that can help relieve chronic pain. Deep massage techniques, including deep-tissue massage, shiatsu and trigger point therapy, can help release deep muscle knots, scar tissue, and muscle spasms that cause chronic pain. With deep-tissue massage, the therapist applies firm pressure to the deep muscles and connective tissue to relieve sources of chronic pain. Trigger point therapy involves the application of steady pressure on specific areas or "trigger points" to release muscle spasms.

Therapeutic massage techniques, such as Swedish massage, involve gentle kneading of the surface muscle tissues. They are not effective for long-term chronic pain management.

To relieve chronic pain, a person will need to receive massage treatments regularly, and may not begin to experience relief until after several massage treatments. A massage therapist can recommend the frequency of massage sessions to provide the most effective relief of chronic pain. In addition, massage therapy works best when it's part of a complete treatment program that includes other therapies such as chiropractic treatment, acupuncture, physical therapy, and occupational therapy.

Chronic pain can be debilitating, not only limiting a person's ability to participate in activities of daily living but also contributing to emotional stress and depression.
Here are some tips for managing chronic pain:

1. Seek an experienced certified massage therapist for treatment: It is important to seek treatment from a certified massage therapist who can evaluate your condition and recommend the massage techniques that are right for the individual.


2. Maintain good posture of the back and spine to relieve chronic back or neck pain: Try to always maintain a natural, aligned spinal position when sitting, standing, and walking.


3. Exercise regularly and practice strengthening exercises: Regular exercise is helpful to improve posture, maintain flexibility, increase strength, and reduce pain. A physical therapist can recommend specific stretching and strengthening exercises to decrease pain. When performed correctly, yoga can be an excellent method to both stretch and strengthen the body to relieve chronic pain.


4. Practice relaxation techniques: Utilizing deep breathing, guided imagery, and other relaxation techniques can help manage chronic pain by reducing tension and producing a calming effect on the body and mind.

Continue reading "Massage Therapy in Pain Management" »

Often distributed in liquid tinctures or lactose sugar pellets, homeopathic remedies are a safe and easy way to treat yourself with little-to-no side effects. Homeopathy is the natural medical system developedin the 1800s by a German allopathic physician, Dr. Samuel Hahnemann. Unique to Hahnemann's work is the idea that every cure is given in minute doses to heal the body rather than forcing the body to function unnaturally from the strong effect of medicine. Homeopathy was used throughout Europe and by early settlers and pioneers in the USA. Homeopathy has now split into two major schools of thought, Classical and Clinical. Classical homeopathy is the study of Hahnemann's early work in Europe and is characterized by a single remedy to fit the ailments of a person. Clinical homeopathy is Hahnemann's later work, which combines single remedies into "complexes" to combined get a desired effect.

Homeopathic medicines are generally distributed as pellets or liquids, and are found online at many health food stores and pharmacies around the country. For liquid forms, a dropper is used, and dosage is measured in drops. Homeopathic remedies are generally dissolved sublingually -- taken under the tongue. Popular brand names include Hyland's, Newton's and Doliso's. By having some of these useful remedies on hand, you can treat yourself at home, and find pain relief from acute injuries and chronic problems. Of course, a person should always discuss the use of homeopathic medicines -- along with all medications, even vitamins and supplements -- with their physicians.

Some that are available include Arnica, which is available as a topical cream, a lotion, and in pill and droplet forms. It is considered a remedy for back pain relief. Nux vomica is also a popular choice for back pain, especially at night when it may interfere with sleep. For those with shooting neck pain, belladonna is often the choice. Guaiacum is also a common remedy for stiff neck due to cold or draft. And for those with chronic neck pain due to spondylosis, Calc Carb is often the choice. And Newton's 'Muscle Ease' is a simple remedy for those who have muscle tension, due to stress and overexertion. For those with tearing, burning stiffness and shoulder pain, Rhus Tox is available. With shoulder pain radiating to the whole arm with weakness, Chelkidonium. Of course, Newton's 'Aches and Pains Relief Complex' can be used for general shoulder and neck pain. For acute cases of sciatica, the frequent remedy is Colocynthis. Of course, the aforementioned belladonna and ruta also may be recommended. Newton's 'Sciatica Relief' formula is marketedt for inflammation of the nerves in the lower back and legs.

Continue reading "Homeopathic Medicine for Pain Management" »

Traditional Chinese medicine (TCM) originated in ancient China and has evolved over thousands of years. TCM practitioners use herbs, acupuncture, and other methods to treat a wide range of conditions. In the United States, TCM is considered part of complementary and alternative medicine (CAM).

• Herbal remedies and acupuncture are the treatments most commonly used by TCM practitioners.


• TCM's view of how the human body works, what causes illness, and how to treat illness is different from Western medicine concepts. Some Chinese herbal remedies may be safe, but others may not be.


• TCM is typically delivered by a practitioner. Before using TCM, ask about the practitioner's qualifications, including training and licensure.


• Tell all your health care providers about any complementary and alternative practices you use.

Traditional Chinese medicine, which encompasses many different practices, is rooted in the ancient philosophy of Taoism and dates back more than 5,000 years. Today, TCM is practiced side by side with Western medicine in many of China's hospitals and clinics.
Underlying the practice of TCM is a unique view of the world and the human body that is different from Western medicine concepts. This view is based on the ancient Chinese perception of humans as microcosms of the larger, surrounding universe--interconnected with nature and subject to its forces. The human body is regarded as an organic entity in which the various organs, tissues, and other parts have distinct functions but are all interdependent. In this view, health and disease relate to balance of the functions.
The theoretical framework of TCM has a number of key components:

• Yin-yang theory--the concept of two opposing, yet complementary, forces that shape the world and all life--is central to TCM.


• In the TCM view, a vital energy or life force called qi circulates in the body through a system of pathways called meridians. Health is an ongoing process of maintaining balance and harmony in the circulation of qi.


• The TCM approach uses eight principles to analyze symptoms and categorize conditions: cold/heat, interior/exterior, excess/deficiency, and yin/yang (the chief principles). TCM also uses the theory of five elements--fire, earth, metal, water, and wood--to explain how the body works; these elements correspond to particular organs and tissues in the body.


• These concepts are documented in the Huang Di Nei Jing (Inner Canon of the Yellow Emperor), the classic Chinese medicine text.

TCM emphasizes individualized treatment. Practitioners traditionally used four methods to evaluate a patient's condition: observing (especially the tongue), hearing/smelling, asking/interviewing, and touching/palpating (especially the pulse).
TCM practitioners use a variety of therapies in an effort to promote health and treat disease. The most commonly used is acupuncture. Acupuncture is done by stimulating specific points on the body, most often by inserting thin metal needles through the skin, practitioners seek to remove blockages in the flow of qi.1

1. Partap Khalsa, D.C.PhD, National Center for Complementary and Alternative Medicine, National Institute of Health, Traditional Chinese Medicined , 1/18/2012

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The experience of pain is as old as recorded history. The ways in which people conceptualize and treat pain have varied across space and time. Cultural and social factors are the foundation for the expression and treatment of pain, especially pain caused by traumatic injury.

The prevalence of pain will continue to grow as people are treated for diseases that were previously were fatal. Most of the top ten causes of death such as heart disease, cancer, and chronic lower respiratory diseases are associated with pain. Presently 7% to 50% of Americans suffer from some type of pain and 1 in 6 live in chronic pain. Chronic pain is estimated to cost 90 billion dollars per year in the United States. Healthcare providers are not uniformly trained in the treatment of pain. Factors such as age, ethnicity, family history, sex roles, anxiety, depression, cognitive factors, sociocultural differences influence pain and how it is treated. It has been observed that minorities report more pain, increased severity of pain and are more likely to be disabled from pain. It has been reported in Michigan that pharmacies in minority predominant zip codes were 52 times less likely to carry sufficient opioid analgesics than were pharmacies in white predominant zip codes regardless of incomes.

Belonging to a particular ethnic group makes an individual respond to pain differently and receive different pain treatment . Culture is the framework that directs human behavior in a given situation. The meaning and expression of pain are influenced by people's cultural background. Pain is not just a physiologic response to tissue damage but also includes emotional and behavioral responses based on people's past experiences and perceptions o f pain. Not everyone in every culture conforms to a set of expected behaviors or beliefs, so trying to categorize a person into a particular stereotype will lead to inaccuracies. However, knowledge of a individual's culture may help to better understand their behavior.

In particular, women are at risk of having their pain undertreated and poorly assessed. Women have a higher prevalence of most chronic pain conditions, including widespread pain, regional pain, fatigue, irritable bowel syndrome, migraine and tension headache.

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Chronic pain especially after a car accident may leave you wanting to curl up with a warm blanket and a bottle of medications. Doing exercise may sound horrible but it might be the best option for chronic pain. One of the goals of treating chronic pain is to help chronic pain patients become stronger because they are usually weak from not moving. Physical therapy can teach people how to move in ways that they haven't moved for quite some time.

Physical therapy involves a number of different types of methods including massage, manual therapy using hands or tools on soft tissue, cold laser therapy to alleviate inflammation and pain and release endorphins, microcurrent stimulation, which emits alpha waves into the brain and increases serotonin and dopamine to alleviate pain naturally, movement therapy and exercises. Within each category, a physical therapist can offer a wide range of treatments.

Exercising for just 30 minutes a day, 3 to 4 days per week will help chronic pain management. It will increase strength in the muscles, endurance, stability in the joints, and flexibility in the muscles and joints. A consistent exercise routine will also help to control chronic pain. Physical therapy handles the physical side of inflammation, stiffness, soreness with exercise, manipulation, and message. It also helps the body heal itself by producing the body's natural born pain relieving chemicals. 1. Rodriguez, Diana, Physical Therapy for Pain Management, Pain Management Center 3/9/10.

Each individual is different and may respond to therapy differently. Physical therapists can monitor each individual and correct improper habits alignments and movement patterns. If needed, you will learn how to correct your posture and incorporate ergonomic principles into your daily habits. Through physical therapy, you learn good habits and principles that enable you to take better care of your body. 2. WebMD, By De Palma,Claudio MD, Pain Management and Physical Therapy, 8/28/11.

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