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Is It Time to Talk About Managing Pain Without Opioids?

Is It Time to Talk About Managing Pain Without Opioids?

http://www.instituteforchronicpain.org/blog/1269-2/

Opioids are certainly in the news. The US Surgeon General recently issued a statement on the relationship between their widespread use for chronic pain and the subsequent epidemics of opioid addiction and accidental overdose (US Surgeon General, 2016). The US National Institute for Drug Abuse and Centers for Disease Control have also issued concerns (see here and here, respectively). Mainstream media reports on the problems of opioids appear almost daily.

After a couple of decades of strong proponents and persistent messaging on the benefits of opioids, the tide of public opinion and the opinion of health experts seems to be turning against the widespread use of opioids for chronic pain.

Among people with chronic pain who use opioids, this change in perspective on the use of opioids can be alarming. For about two decades, people with chronic pain have been encouraged to take opioid medications. Many have subsequently come to rely on them. Some may have even come to believe that it is impossible to manage chronic pain well without the use of opioid medications.

We now face a dilemma in the management of chronic pain. We have strong managing pain without opioidsproponents for the use of opioids and strong proponents against the use opioids. Both sides have valid concerns that lead to their respective positions.

Often, the sides in this dilemma seem to get expressed in untenable ways. It’s as if the stakeholders in the field have to choose between two bad options: either you take opioids on a chronic basis and expose yourself to the risks of addiction and accidental overdose, which are actually occurring to people with chronic pain at epidemic proportions; or don’t take opioids, remain safe from addiction and accidental death, but expose yourself to pain, which may be intolerable. Healthcare providers seem to face a corresponding dilemma: either manage patients on chronic opioids while exposing them to addiction and accidental overdose or refrain from opioid management and expose them to what might be intolerable pain. Whether patient or provider, both options seem bad.

Is there a third option?

There is another way, of course. It’s called chronic pain rehabilitation and it effectively shows people how to successfully self-manage chronic pain without the use of opioid medications. Chronic pain rehabilitation clinics have been around for three to four decades. However, it’s hard to get people to go to them. It’s not because they are ineffective. Research over the last four decades shows clearly that they are effective (Gatchel & Okifuji, 2006; Kamper, et al., 2015).

Managing pain without opioids

People who’ve been managing their pain with opioids are often a little leery of recommendations to go to a chronic pain rehabilitation clinic. The recommendations seem to run counter to much of what’s been previously recommended throughout the long course of care for their chronic condition. After years of recommendation and encouragement to take opioids by some providers, it’s hard to understand why other providers might recommend and encourage the exact opposite. Maybe they are recommending learning to self-manage pain without the use of opioids because:

  • They don’t believe my pain is as bad as it is.
  • They think (wrongly) that I’m addicted to opioid medications.
  • They think my pain is all in my head.
  • They just want to make money off their program that they are recommending.
  • They are ignorant of what’s most effective for chronic pain (i.e., they don’t know what they’re talking about).
  • They are not as compassionate as the previous providers who recommended opioid management.

In all these concerns, people become leery of a recommendation to forego opioids because it’s hard to believe that the recommendation is being made in the best interest of the patient. It seems that relief of pain through the use of opioids is what’s best for the patient and anything that runs counter to that recommendation must be in the best interests of someone else.

Moreover, it’s a sensitive topic. Let’s face it, no one feels especially proud of managing their chronic pain with opioids. Rather, people with chronic pain do it because it seems a necessity – they believe that the pain will be intolerable without opioids. The recommendation and encouragement to take opioids by healthcare providers and by society, more generally, is helpful in this regard. Such encouragement supports the decision to use opioids, one in which there’s always been some ambivalence. Again, no one is exactly proud of taking opioids for chronic pain; upon reflection, there is always some degree of doubt or concern about their use that leads to a sense of vulnerability and sensitivity. It’s helpful to have others, especially healthcare providers, recommend and encourage their use.

When, however, other healthcare providers recommend against opioid use and encourage learning to self-manage pain instead, it can sting because it taps right into the inherent sense of vulnerability and sensitivity that occur when taking opioids.

It’s hard to see a healthcare provider as acting in the best interest of patients when they openly question the issue that can be so sensitive. The recommendation to learn to self-manage pain without the use of opioids shines a direct light onto the inherent sense of vulnerability or shame that so many feel when using opioids for the management of chronic pain.

tapering opioidsThe recommendation inadvertently breaks all the tacit rules that healthcare providers (and pharmaceutical companies) have heretofore been following. The rule up until now has been to reassure patients that it’s okay to take opioids for chronic pain. Over the last two decades, the field has asked patients to trust these assurances that they shouldn’t be ashamed of their need for opioid medications. Now, the field is changing and has begun to question the need for opioids. In so doing, we break the trust of patients who have been on opioids for some time: we expose them to potential pain, but also the shame that heretofore we alleviated with assurances that taking opioids is okay. It’s no wonder that patients are now upset.

In a microcosm, it’s this dynamic that occurs in the offices of chronic pain rehabilitation clinics everyday when, after the initial evaluation and recommendation to participate in the therapies of the clinic occurs, patients leave and refrain from accepting the recommendation to learn to self-manage pain. Such patients are doubtful that it will work and are afraid of the pain that would ensue if it doesn’t. Moreover, though, they tend to leave feeling somewhat ashamed that the provider so openly talked about the fact that they could learn to self-manage pain without the use of opioids. Providers are supposed to provide reassurance that it’s okay to be on opioids, not question their use.

Even when it’s well-informed and done in the best interest of the patient, the recommendation and encouragement to learn to self-manage pain without the use of opioids can be heard as a subtle yet stinging rebuke because of the inherent sensitivity that occurs when taking opioids for chronic pain.

How, then, do we bridge this divide?

The Institute for Chronic Pain has a new content page that may play a small role in such bridge building. When patients come to chronic pain rehabilitation clinics for the first time, they may have never had an experience of a provider talk to them about self-managing pain without the use of opioids. As we’ve seen, it’s a complex and sensitive interaction that occurs under the surface of the words that are spoken. It can be a lot to take in. It can feel like the rules are being broken. As we’ve seen, it can be easy to become angry and accuse the provider of incompetence, ill-will or insensitivity. Oftentimes, people need a little time to reflect on the discussion and talk it over with their loved ones. No one comes lightly to the decision to taper opioids and learn to self-manage pain instead.

The new content page provides assistance with this reflection. The hope is that patients can use the information on the page to further reflect on if and when it may be time to begin learning to self-manage chronic pain. Providers can refer their patients to the page too, ask them to read it, and come back for further discussion.

For countless people over the last four decades, chronic pain rehabilitation has provided hope and a way to take back control of a life with chronic pain. However, it must be approached with sensitivity and compassion. Initially, the idea that one can successfully self-manage chronic pain without the use of opioid medications can be threatening, especially for those who have been managing pain with opioids for some time and for those whose providers have long provided reassurance that it’s okay to take opioids. Nonetheless, if your providers have recently begun to express concerns about the long-term use of opioids or if you yourself have concerns about their long-term use, you might find it helpful to read the new ICP page on the common benefits of learning to self-manage pain without the use of opioid medications.

You can find the new page by clicking on the link here.

References

Gatchel, R. J., & Okifuji, A. (2006). Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic non-malignant pain. Journal of Pain, 7, 779-793.

Kamper, S. J., Apeldorn, A. T., Chiarotto, A., Smeets, R. J., Ostelo, R. W., Guzman, J., & van Tulder, M. W. (2015). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ, 350. doi: http://dx.doi.org/10.1136/bmj.h444

Author: Murray J. McAllister, PsyD

Date of last modification: January 23, 2017

About the author: Dr. McAllister is the executive director of the Institute for Chronic Pain (ICP). The ICP is an educational and public policy think tank. Our mission is to lead the field in making pain management more empirically supported. Additionally, the ICP provides scientifically accurate information on chronic pain that is approachable to patients and their families. Dr. McAllister is also the clinical director of pain services for Courage Kenny Rehabilitation Institute (CKRI), part of Allina Health, in Minneapolis, MN. Among other services, CKRI provides chronic pain rehabilitation services on a residential and outpatient basis.

 

The post Is It Time to Talk About Managing Pain Without Opioids? appeared first on Institute for Chronic Pain Blog.

How to Get Better When Pain is Chronic

http://www.instituteforchronicpain.org/blog/how-to-get-better-when-pain-is-chronic/

In the last post, we began to introduce a broad definition of coping, as one’s subjective experience, or reaction, to a problem. In this post, let’s expand on this definition and explain how coming to cope better with a problem is a process of coming to experience the problem in a different and better way.

Coping is how we subjectively experience a problem

In our society, when having a problem, we tend to focus on the problem itself, its characteristics and how they do or don’t lend themselves to resolving the problem. In so doing, we put our focus and energy towards fixing or getting rid of the problem. This way of thinking about the problem is all well and good. It likely lends itself to our society’s successes in developing technological solutions to many of the great problems that we have faced.

As an example of this tendency to focus on problems and fixing them, we need only to look to the problem of pain and how we tend to focus on it, and how we try to get rid of it or otherwise reduce it. Knees and hips can now be replaced and we have a large assortment of different medications that can reduce pain and sometimes get rid of it entirely.

However, instead of focusing primarily on the problems itself, we might also coping with painbring our attention to the unique characteristics of each individual with the problem and how they understand it, feel about it, perceive it, and how they behave in regards to it. In effect, we might focus on the characteristics of each person and how these characteristics influence the way individuals experience the problem.

For wherever there is an objective problem in the world, there are also perceiving subjects who have the problem.

We typically call the ways that people experience problems “coping.” It’s something that usually we only direct our attention to when we can’t come up with a solution, or fix, to a problem itself. Nonetheless, it comes in handy in such situations because it offers a way to still get better even if there is no fix to the problem. Namely, we get better at coping with the problem: we can become less distraught by the problem or less impaired by the problem.

In this regard, in returning to our pain example above, we might focus not so much on how to get rid of pain, but how to get better at coping with pain. This change in the approach to getting better may come in handy when pain is truly chronic and you’ve already tried every reasonable procedure and medication without any significant benefit. In such a situation, you focus not so much on how to reduce pain, but on how to increase coping.

In doing so, you can come to learn to tolerate pain that at present is intolerable. You might even get so good at coping that you do more than simply tolerate it – you might get so good at coping that the pain goes from something that is the central focus of your life to something that occurs in the background of your life. It becomes a problem, in other words, that’s not very problematic.

Moreover, you can do such thing without ever reducing pain itself. It can all occur by changing how you experience, or cope with, pain.

It may sound too good to be true.

How coping better makes problems less problematic

It’s important to recognize that people who cope well with a problem tend to experience the problem as less significant or severe than those who don’t cope well with the problem. In other words, when we aren’t coping well, we tend to perceive or judge the problem that we face as more problematic than those who cope well with it. For example, if you had taken a speech class and had actually given many speeches before in the past, you might find the prospect of giving a speech to a packed auditorium as less problematic as someone without your level of expertise and practice. You might find it quite tolerable, in fact possibly even not problematic at all – something in the category of “Well, it was no big deal.” However, another individual, who faces the challenge of giving the exact same speech to the exact same auditorium, might find it overwhelming, paralyzing or intolerable. This individual might judge the problem as one of the hardest things he has ever done in his life.

Objectively, it’s the exact same problem, but the two people subjectively experience it in very different ways. We might say, in such cases, that the differences lie in how well the individuals cope with the problem of giving a speech to a packed auditorium.

How well we cope depends, of course, on how significant the problem is. Big or complicated problems are more difficult to deal with than small or simple problems. Most people will find talking to a group of two or thee people easier than an auditorium of two or three hundred. Nonetheless, how well we cope with problems is also dependent on other things too.

Cope with PainNotably, it’s dependent on certain characteristics of the person who is coping with the problem. If one knows a lot about the problem and is actually an expert on the topic, then typically that person copes better than someone who doesn’t know as much about the problem. Or, if someone has experienced the problem before or expects the problem to occur, then that person often copes better than the individual who has never encountered the problem before or someone who is taken by surprise by the problem. Confidence plays a role here too. Someone who knows a lot about the problem and is well-versed or well-practiced with dealing with the problem tends to be more confident and that confidence aids in coping better. Someone who lacks such confidence tends to be more alarmed or even distraught, which makes for more difficulty in coping. In any of these cases, the subjective experiences of the problem are different for the different people, even if the problem was objectively the same problem.

We could go on indefinitely about the subjective characteristics of the coper, which play a role in how well the individual deals with a problem. We might make a list of subjective characteristics that determine, in part, how well one copes:

  • Degree of knowledge or expertise about the problem
  • How one conceptualizes the problem
  • Degree of accurate information that one has about the problem
  • How much one has practiced overcoming the problem
  • Other attitudes about the problem
  • Degree of confidence in facing the challenge
  • Degree of attention directed on the problem
  • How one feels about the problem
  • What one’s mood is at the time of encountering the problem (e.g., whether one is calm or irritable, depressed or anxious)
  • How much sleep one has had in the past few days prior to encountering the problem
  • How many other problems one is experiencing at the time of encountering a new problem
  • What one goes on to do about the problem (behaviorally)
  • Degree of loving support one has in facing the problem

There are literally countless aspects of the coper that determines, in part, how well one experiences, or copes with, a problem. Some of these characteristics lend themselves to better coping and some lend themselves to worse coping.

Getting better by getting better at coping

So, think about this simple fact: if you have a problem that can’t be entirely fixed, you could still get better by setting out in a concerted effort to get better at coping with it. You could, in effect, obtain training at having the problem and get so good at it that having the problem becomes less and less problematic. It could become, for example, something that occurs in the background of your day-to-day activities, but for the most part you’ve moved on and focus on the meaningful activities of your life. Indeed, there is simply no end to how good one can get in coping with a problem, even a problem that can’t be entirely fixed, like chronic pain.

Here is where true hope lies. Even when your pain is chronic, you can get so Needing Hopegood at coping with it that living with chronic pain is no longer a distressing or impairing problem. Alternatively, you can get so good at coping with it that it no longer requires opioids to manage it and so you can move on with the rest of your life.

Usually, this level of advanced coping requires a concerted effort of training, done over time, and typically with a team of healthcare providers who coach you and support you throughout the process. Traditionally, patients find such support and training in chronic pain rehabilitation clinics. Such clinics are a type of pain clinic that involve an interdisciplinary team of healthcare providers (consisting of at least pain psychologists, medical providers, and physical therapists, but oftentimes other kinds of providers as well) who work with patients over an extended period of time in the pursuit of not so much reducing pain, but improving the patient’s coping. Such clinics are not new, but have been around since at least the early 1970’s and as a result they have about four decades of published research proving their effectiveness (see, for example, these meta-analytic studies and literature reviews: Chou, et al., 2007; Flor, Frydrich, & Turk,1992; Gatchel & Okifuji, 2006; Neusch, et al., 2013; Turk, 2002).

When talk of the possibility of coping better feels like a criticism

Sometimes, when healthcare providers like me talk in these ways, it feels to patients with chronic pain like a judgment. It feels like blame. It feels like you’re being told there’s something wrong with you — that you aren’t coping well enough.

Oftentimes, when patients have people in their lives who judge them or stigmatize them for how they have been coping, they can come to hear their healthcare provider talking about the benefits of learning to cope better as a similar criticism.

In such cases, patients can come to refuse the recommendation to participate in chronic pain rehabilitation. The hopeful message that there is a traditional and scientifically proven treatment that helps patients to learn to cope better with pain can be met with quick and sometimes sharp rebuttals. Common examples are the following:

  • The provider must be insensitive.
  • The provider must not know what he or she is talking about (i.e. the provider is incompetent).
  • The provider doesn’t (or won’t) recognize that I’m coping as well as humanly possible given the amount of pain I have.
  • The provider must not have chronic pain or otherwise he or she would understand.
  • The provider must not believe me that I have real pain.
  • The provider is just out to make money and so wants me to go to yet another treatment from which he or she will profit.
  • The provider just wants me to get off opioid medications.

Obviously, talk of how to learn to cope better is a sensitive topic. It’s as if the same words can engender almost two opposite interpretations. The healthcare provider intends it to be a hopeful message – you can get better by undergoing extensive training over time and as a result come to cope better with a condition that is incurable. The patient, however, can hear it as an insensitive criticism of how the patient isn’t coping well right now.

Importance of trusting your healthcare provider

In such situations, what can make the difference is having a good, therapeutic relationship with your healthcare provider. If you know your provider and trust him or her, then you know that your provider isn’t just being mean or insensitive or ignorant of what’s it like to have pain or out to make money off you. Instead, you know that your provider has your best interest at heart.

Your thoughts

Have you ever had a healthcare provider talk to you about chronic pain rehabilitation or learning how to cope better with pain? What were your reactions? Have you ever attended a chronic pain rehabilitation program? Why or why not?

[Please note our comment publishing policies. All participants in the discussion will appreciate your cooperation with this policy.]

References

Chou, R., Amir, Q., Snow, V., Casey, D., Cross, T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478-491.

Flor, H. & Frydrich, T., Turk, D. C. (1992). Efficacy of multidisciplinary pain treatment centers: A meta-analytic review. Pain, 49, 221-230.

Gatchel, R., J., & Okifuji, A. (2006). Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic non-malignant pain. Journal of Pain, 7, 779-793.

Neusch, E., Hauser, W., Bernardy, K., Barth, J. & Juni, P. (2013). Comparative efficacy of pharmacological and non-pharmacological interventions in fibromyalgia syndrome: Network meta-analysis. Annals of the Rheumatic Diseases, 72, 955-962

Turk, D. C. (2002). Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain. The Clinical Journal of Pain, 18, 355-365.

Author: Murray J. McAllister, PsyD

Date of last modification: September 11, 2016

About the author: Dr. McAllister is the executive director and founder of the Institute for Chronic Pain (ICP). The ICP is an educational and public policy think tank. Our mission is to lead the field in making pain management more empirically supported. Additionally, the ICP provides scientifically accurate information on chronic pain that is approachable to patients and their families. Dr. McAllister is also the clinical director of pain services for Courage Kenny Rehabilitation Institute (CKRI), part of Allina Health, in Minneapolis, MN. Among other services, CKRI provides chronic pain rehabilitation services on a residential and outpatient basis.

The post How to Get Better When Pain is Chronic appeared first on Institute for Chronic Pain Blog.

Developing an Observational Self: How to Cope with Pain Series

http://www.instituteforchronicpain.org/blog/developing-an-observational-self-how-to-cope-with-pain-series/

From the time before Socrates in ancient Greece there stood a temple built upon a spring at a location the Greeks would have considered the center of the world. Inscribed on the walls of this holy temple was the simple phrase, “Know Thyself”.

This simple phrase inspired Socrates to a life of learning and teaching, and, from him, Plato learned to be a philosopher and later came to teach Aristotle. Subsequently, Western civilization, in large measure, began.

This maxim – “Know thyself” — and others similar to it were not uncommon in the ancient world. Indeed, a few thousand years previously, early Hindus and later Buddhists practiced a form of moment-to-moment self-knowledge, later coming to be called mindfulness.

The directive inherent to this maxim has two components. The first is to pay attention. In observational selfother words, slow down and observe what’s happening. In today’s language, we might express the maxim as something like, “Get out of your head and notice what’s going on around you.” When we carry out such a dictum, we become observant and reflective. We see or otherwise perceive things that we might not have heretofore noticed. We subsequently create opportunity to consider what it is we observe.

Good things happen when we do. We see good things and become appreciative. We stop and smell the roses because we were observant enough to even notice them as we walked by and as a result we are able to appreciate their visual and olfactory beauty. Whereas in one moment our kid might be bugging us because of her need for attention is interrupting our apparent need to make a phone call or put dinner on the table, in the next moment, once we get out of our head, we recognize just how funny or cute the kid is and we subsequently are overwhelmed by how much love we have for her.

So much of life goes unnoticed because we are simply and persistently reacting to whatever thoughts, feelings and needs that pop into our attention. Whatever pops into our heads tends to have a sense of immediacy to which we react impulsively, without thinking in the sense of thoughtful consideration. It’s just a never-ending chain reaction of stimulus and response, like billiard balls knocking into each other. Notice that when we live life as if we are a player in a video game that goes on in our head, simply and persistently reacting to whatever momentary thought, feeling, or need that pops into our head, so much of what goes on around us gets missed.

We don’t see how cute our kid is in that moment. We don’t notice that our spouse made coffee for us before leaving for work. We don’t smell the fresh air. We don’t taste our lunch. We don’t fully appreciate how funny it was when our coworker or neighbor made that comment yesterday.

Instead, we were busying ourselves with the immediacy of whatever popped into our head at the time.

Notice too all the things we could have done in those moments but didn’t do simply because it never occurred to us. When we react to whatever thought, feeling or need that pops into awareness at any given time, it’s as if the reaction that we have is the only possible thing to do at the time. We might even justify the reaction, if anyone ever were to ask us about what we did, by saying ‘Oh, I had to,’ as if the thing we did was the only possible thing that could have been done. However, it’s not really true, and this point brings us to the second good thing that happens when we get out of our heads and start to observe what in actuality is happening in any given moment.

Namely, we become liberated from being a passive recipient of what happens to us to an active decision-maker of a well-informed life. By observing what in actuality is happening in life, and by considering the various possible ways we might respond, we exercise choice. No longer is our life dominated by the apparent ‘must’ and ‘have to’ and ‘got to’, but rather we are free to choose. When we pay attention, we recognize that we do not have to simply endure things happening to us. We are not victims. We have the power to choose among a number of different options as long as we slow down enough to recognize and consider the options that are available to us.

The simple maxim – Know thyself”, then, is a truth that sets us free. It’s freedom from a determinism of automatic reactions to whatever life gives us. We no longer ‘have to’ do this, that, or the other thing, but are free to choose how we live our life. We no longer ‘can’t’ do anything but the reaction that we have automatically done countless times in the past and are now free to choose how we might respond and move forward. From moment to moment, we are free to choose how to respond even to the things in life that we do not choose – like bad things that happen to us. We still are free to choose how we react to them and the perspective by which we see them.

In sum, the second good thing that happens when we observe what’s happening is that we become intentional about what we do, how we react to things, and even how we perceive the things around us.

This ability to observe life and intentionally choose how to respond to the things that come up from moment to moment is the main goal of psychotherapy. Freud called this ability the development of an ‘observing ego’ and considered analysis a way to develop this ability. In more recent psychotherapies, we call it an ‘observational self’. It’s the ability, as described, to step out of any given moment, consider what’s happening, and intentionally choose how to react. Of course, in this day and age, we also call it ‘mindfulness’.

What does developing an observational self have to do with pain?

The development of the ability to step out of the moment and reflect on how to react to pain is the initial and most important thing to do in pain management. Everything else in pain management follows from this skill.

Pain has a sense of immediacy about it. It’s a sensation that is inherently emotionally alarming and to which we automatically react with avoidance behaviors – we stop what we’re doing, pull away and guard. This sensory, emotional and behavioral experience happens all at once, of course, and it happens automatically. We don’t typically choose any of it. The sensation just is alarming and we pull away and guard without ever intending to do so.

For example, if you were out hiking in the woods and, without looking, you stepped in a hole and twisted your ankle, you’d have pain. That is to say, you would have a sensation that was emotionally alarming and to which you would stop walking and guard your ankle in some manner. The whole experience would be almost instantaneous. It would also be automatic, in a sense. The alarming sensation and behavioral avoidance would occur without any intentional decision-making on your part.

However, if you had chronic pain, and you set out to pay attention to the pain that occurred with activities, you could learn to make the whole experience more intentional. You would do so in a multiple step process. You would first simply pay attention to the pain that occurs and not be taken by surprise by it. Chronic pain often has a degree of predictability that the pain of an acute injury doesn’t have. So, by paying attention, you could practice the skill of not being taken aback by the pain. Just as importantly, you could recall that you have chronic pain and that you’ve had it for some time and you know what it is. In most cases, chronic pain is the result of the nervous system having become highly reactive to the stimuli of activities that are normally not painful to do – like walking, sitting, standing up, laying. You could consider that, even though it is painful, these activities are safe to do– that you are not injuring yourself even though it is painful. In this manner, you start to control the sense of emotional alarm that you have with pain. You set out to intentionally remain emotionally grounded in the presence of pain. To this end, you also practice taking deep, diaphragmatic breaths to assist you in remaining calm. From this new-found perspective, you can also choose how to behaviorally react. You intentionally choose to engage in the activity and have the sensation while practicing remaining calm.

Suppose, for example, every time an individual with pain sits down she knows she’ll experience pain. More often than not, however, she doesn’t keep this fact in mind and she goes about her day, like most of us, simply reacting to whatever pops into her attention. She does this and then that, checking things off her to do list. Each time she sits down, she lets out a soft groan, grabs whatever is within reach in order to brace herself, and becomes, for an instant or two, emotionally and physically tense. The pain is severe and it takes her breath away.

She could, though, with some proper coaching from a psychologist at her pain clinic, set out to learn and practice the ability to step out of the moment and pay more attention to her actions. She could then practice slowing down the process of experiencing pain. In doing so, she pays attention to what she does and predicts the severe pain prior to sitting down. In this way, she isn’t taken by surprise each time. With knowing that it’ll hurt, she takes some deep diaphragmatic breaths as she works and reminds herself that even though it is painful she isn’t injuring herself every time she sits down. She intentionally recognizes that it is safe to sit down even though it hurts badly. In these ways, she practices remaining grounded while having pain. With her budding abilities to remain calm in the presence of pain, she intentionally sets out to control her pain avoidance behaviors. She makes the decision to stop letting out the groan because she’s predicted the pain and isn’t taken aback by it as she sits down. She intentionally stops her tendency to abruptly reach out for something to hold on to while she sits, reassuring herself that it is safe to sit down. She also tries to refrain from grabbing her back and instead sets out to remain as calm as she can be in the presence of her pain, even severe pain. She intentionally does all things, moreover, on a repetitive basis through the course of her day, day after day. She discusses her strategies with her psychologist each week, and her psychologist gives her pointers, which she tries at home. Over time and with practice, she gets better and better at it. By developing her abilities to pay attention, observe herself and engage in intentional decision-making, she comes to be able to control, in part, her experience of pain. She comes, in other words, to be able to control the alarming and behavioral aspects of pain and subsequently becomes able to remain grounded and productive in the course of her day, even though she continues to have severe pain.

This description is what good coping looks like. Good coping is not getting rid of pain, but getting so good at reacting to pain that it is no longer as problematic as it once was. It requires the development of an observational self from which you can have pain, remain aware of how you are reacting to it, and intentionally attempting to remain grounded and active while having pain.

From the river Ganges to the temple at Delphi and all the way through to the modern pain clinic, the dictum to know thyself travels through time because good things happen when we follow it. The ability to pay attention and engage in intentional decision-making when having pain is the initial and most important skill to develop in pain management.

Author: Murray J. McAllister, PsyD

Date of last modification: 6-19-2016

The post Developing an Observational Self: How to Cope with Pain Series appeared first on Institute for Chronic Pain Blog.

How to be a great significant other to a person with illness #AWAPwednesday

http://www.chronicbabe.com/how-to-be-a-great-significant-other-to-a-person-with-illness-awapwednesday/

Hey, sick chick! So glad you found this video. Now, press pause and go get your significant other, or your SO. I’ll wait.

OK, great! Hi there. I’m so excited to talk to BOTH of you. This week’s video is the last of 2016, and it’s for all those folks who love us ChronicBabes: husbands, wives, spouses, partners, girlfriends, boyfriends, lovers… this video is packed with advice for how to be a great significant other (SO) to a woman with chronic illness. I hope you find the advice helpful, and I encourage you share this video with anyone who might benefit:

*AWAP = As Well As Possible

Now it’s your turn:

How do YOU support your ChronicBabe? How does your SO support you, babelicious? I want to hear from both of you! Tell me all about it in the comments below.

Want more #AWAPwednesday? Check out our #AWAPwednesday video playlist, which has more than 130 videos packed with practical advice, lots of humor, and bloopers. Lots of bloopers.

Is there a question I can answer for YOU? Add it to the comments below, or shoot me an email.

Until we meet again: Be AWAP! Smooches!


(Loose) Transcript:

Hi! I’m Jenni Grover Prokopy of ChronicBabe.com and today is AWAP Wednesday (that stands for As Well As Possible).

Each week, I offer you my personal favorite tips and techniques to help you craft an incredible life beyond illness. Yes! I know you can.

Subscribe to the ChronicBabe YouTube channel today to make sure you never miss another video, OK?

Checking in

Everyone gets a little embarrassed about feeling sick and can feel afraid to burden friends and family with problems. That’s where you come in. Once a day, you should check in with your SO and ask how she’s doing and if there’s anything you can do to help.

Sometimes she’s really, really hoping for some help but won’t ask for it because she doesn’t want to create extra work for you. Checking in is a good way to let her know you are always willing to make the time to help her and show that you’re there for her.

Listening

Sometimes we just need a shoulder to cry on. Seriously. It’s understandable that you’ll want to problem-solve, because you hate to see your SO in pain or sad. But try not to assume that’s always the best move.

When your SO brings up a tough subject or challenge, consider asking this question: “How can I help you right now?” She might say “I just need you to listen so I can get this off my chest.” There will be time for problem-solving later.

Be a battle buddy

I recently spoke to a U.S. Army war veteran, who told me how battle buddies work when men and women are on the battlefield: They don’t leave each other’s side, they always make sure the other person is doing everything they need to be safe, and they always keep the necessary tools at hand. He explained that now that he’s back in the states and getting treatment for chronic pain and injuries, his wife is his battle buddy: she goes to all his health care appointments, she helps him remember the questions he needs to ask of his docs, and keeps him on schedule. So be your ChronicBabe’s battle buddy.

Understanding and non-judgement

ChronicBabes can experience judgement from all sides, even sometimes from close friends and family. You know her best and you know that when she’s lying in bed all day, unable to go out and get things done, it’s not because she’s lazy or selfish – it’s just an off day. You can make her feel better by being a shield from the judgement.

Make sure she knows that you know a day in bed is absolutely warranted and defend her from those who act like it’s not. The last thing she needs is another person demanding her to “pull it together” and “suck it up.” Some soup and TV in bed will go a long way.

Take care of yourself, too

This should go without saying but you can only be the best SO possible if you’re taking care of yourself as well. Always be there for her, but don’t neglect your needs in the process. She will be there for you too, as much as she can. Loving her and loving yourself go hand in hand.

The most valuable thing you can do for a ChronicBabe: Be her cheerleader. And when she can, she’ll cheer for you, too.

Thanks for watching today! What kinds of special things do YOU do for your SO that make your relationship strong? I’d love to know. Share your strategy in the comments here or head on over to the blog at ChronicBabe.com to join the conversation—I want to hear what YOU have to say.

If you liked what you saw today, subscribe to our channel—and watch another one of my favorite videos right now. I think you’re gonna like it!

Until we meet again, be AWAP! Smooches!

Sprains and Strains can Affect Your Life

Sprains and Strains can Affect Your Life

https://www.dolmanlaw.com/sprains-strains-can-affect-life/

Sprains and strains are often considered to be “minor injuries.” They are anything but. Most sprains and strains can result in a significant amount of pain. The severity of some injuries may even require medication, physical therapy, or even medical procedures. Sprains and strains can create significant complications.

Sprains and Strains are the Most Common Work-Related Injury

Strains and sprains are quite common. In fact, according to a recent Bureau of Labor Statistics report,1 strains and sprains remain as the number one cause of all work-related incidents, accounting for nearly 31 percent of work-related injuries. For employees, strains and sprains can mean time away from work. For hourly workers, the lack of work can mean that there will be no money coming in. For small business owners, employees who suffer from strains and sprains may require time off. This can result in being understaffed or even unable to open.

Understanding one’s injury is critical to identifying potential medical and legal remedies. Both sprains and strains are considered to be “soft tissue injuries.”2 A sprain occurs whenever a ligament is either overextended or torn as a result of stress. The most common sprains are sprained wrists and sprained ankles. Although these sprains often occur during sports and exercise, they may occur at any time. Strains are similar to sprains but affect muscles or tendons.

Sprains and Strains are Capable of Causing Lifelong Medical Problems

Sprains and Strains can create lifelong complications. Doctors have concluded that these types of injuries can be considered permanent injuries. While they may become less painful with proper treatment and time, they will never completely go away. In fact, these injuries may be aggravated by minor movements. Further problems can arise whenever sprains and strains are neglected. Neglected injuries often become serious, chronic injuries.

Examples of Ways Sprains and Strains can Affect Your Life:

Recurring Pain. Many sprains and strains can be remedied with time and care. However, these injuries can cause nagging pain that doesn’t seem to go away.

Loss of Enjoyment of Life. The pain from an injury may keep you from being able to engage in some of your favorite activity. Lower body sprains may keep one from exercising, dancing, or even walking without a cane.

Ongoing Medical Care. Lingering injuries may require physical therapy, assistance such as a cane or brace, or even having to regularly take medicine to quell the pain.

Recovering Damages

If you have suffered a strain or a sprain, you may be entitled to recovering compensation by filing a workers’ compensation claim or filing a lawsuit against a third party. If your accident was the result of the negligence of someone other than your employer, you may be entitled to damages for your medical expenses, lost income, loss of quality of life, and physical and emotional pain and suffering.

Contact a St. Petersburg Personal Injury Attorney Today

If you or a loved one has suffered a sprain or strain as a result of another person’s negligence, you need an experienced, aggressive attorney. The attorneys at the Dolman Law Group have the experience and wherewithal to get you the maximum recovery. To schedule a free consultation, call us today at 727-222-6922 or contact us online.

Dolman Law Group
1663 1st Ave S.
St. Petersburg, FL 33712
(727) 222-6922

https://www.dolmanlaw.com/st-petersburg-personal-injury-attorney/

1 https://www.bls.gov/news.release/pdf/osh2.pdf

2 http://orthoinfo.aaos.org/topic.cfm?topic=a00111

The post Sprains and Strains can Affect Your Life appeared first on Dolman Law Group.

Control Neck and Back Pain with Medical Weight Loss  in Pinellas Park and St. Petersburg

Control Neck and Back Pain with Medical Weight Loss in Pinellas Park and St. Petersburg

http://gulfcoastrehab.us/blog/b_76674_control_neck_and_back_pain_with_medical_weight_loss__in_pinellas_park_and_st_petersburg.html

Control Neck and Back Pain with Medical Weight Loss

in Pinellas Park and St. Pete

A medical weight loss program, combined with nutrition and lifestyle counseling as well as chiropractic care, can be your pain management.

Dr. Kevin Lee, chiropractor and owner of Gulf Coast Rehabilitation and Wellness Center, noticed many of his patients were suffering from conditions like low back pain that could be treated or vastly reduced with exercise, diet, and weight reduction.

“So many of my patients were taking a pill for this and a pill for that, and I’m thinking they just need a prescription for weight loss,” said Dr. Lee. “A medical weight loss program combined with chiropractic care and nutrition counseling has led so many to a pain-free life off medication.”

Chiropractic care focuses on natural treatments curving away from surgery, narcotics, or other invasive treatment methods.

“Too often pain management is handled with a short-term fix like drugs or high-risk treatment like surgery instead of actually fixing the underlying problem which could be as simple as diet and exercise,” said Dr. Lee.weight loss healthy choices

Dr. Lee’s statement is backed by growing evidence that more and more Americans are addicted to prescription medications year over year. Drugs are cheaper for most people and covered by nearly all health insurance plans. It is much easier to pop a pill than it is to undergo a lifestyle change, not to mention less time-consuming.

There seems to be a tangible shift in the climate of healthcare away from the easy and convenient fixes and back toward the natural, safe, and healthy.

“I hope to see more insurance companies covering natural treatments that would prevent diabetes and heart disease from forming in the first place instead of paying for the treatment patients need after the diseases develop,” he said.

Extra Weight is a Problem

Many folks struggle to maintain a healthy body weight as they age, especially as metabolisms slow down and hormones change. Carrying too much weight is a sign of inflammation and stress of your body. Treatment of the serious conditions caused by obesity like diabetes, heart disease, and cancer can get expensive. Ignoring the issues can cause them to worsen to the point of affecting your quality of life.

The majority of patients are not surprised to hear they need to lose weight. Most, however, do not realize the degree to which most of their health problems are caused by carrying the extra weight. Most do not realize how much better they will feel once they shed the weight. The following symptoms are a sure indicator you’ve reached an unhealthy weight:

•          Lack of muscle tone in your limbs, abdomen, and back

•          Loose or extra skin in previously tight areas of your body

•          A buildup of fatty tissue around your middle section

•          Less energy and vitality

•          More prone to sedentary activities (sitting, watching TV)

•          Your clothes feel tighter or no longer fit

Call Us to Discover More Information About Weight Loss Management

To reach the fullest of your health potential, chiropractors see the greatest success from patients who take advantage of a combination of chiropractic methods and advice, including medical weight loss in Pinellas Park and St. Pete. Every case is unique, which is why chiropractors offer a unique combination of care so there is a treatment plan available for everyone to suit individual needs.

Always choose a chiropractor whom you are comfortable with and who adequately meets your treatment and scheduling needs. At Gulf Coast Rehabilitation and Wellness Center, all consultations are risk free, and staff will thoroughly cover any of your treatment concerns. A qualified and experienced chiropractor will safely rule out any serious injury while also using a variety of modalities to help the body heal itself along with manipulation.

The medical professionals at Gulf Coast Rehabilitation and Wellness Center have over 20 years’ experience providing pain management services, including neck and back pain. Their number one goal is to return you to a pain-free and healthy life through safe, natural, and effective treatment. Call (727) 541-2520 or visit http://gulfcoastrehab.us/ to discover how chiropractic care, medical weight loss, massage therapy, nutritional counseling, or other therapies available in Pinellas Park and St. Pete can help with your neck and back pain. 

Slip-and-Fall Accidents: Common Injuries and Liability

Slip-and-Fall Accidents: Common Injuries and Liability

Posted From: https://www.dolmanlaw.com/slip-fall-accident-clearwater/

One of the sneakiest accidents that can happen to almost anybody, at any time, is a slip-and-fall. These accidents almost always occur in an unforeseen place, at a time when you are least expecting it—at the grocery store, in the hallway at the office, exiting the restroom at a restaurant, or even while visiting someone else’s home.

These unfortunate accidents can be minor, and even humorous. The entire America’s Funniest Home Videos television show was almost solely built on this concept. But they are not always funny, and they are not always minor.

Slip-and-falls can be seriously dangerous with grave consequences and injuries. These incidents are often caused by a change in the expected surface someone is walking on. Whether the ground is slippery from a liquid, uneven from a crack in the sidewalk, or has a random step that is difficult to see, it only takes a small change to cause someone to hit the ground with force. Part of what makes slip-and-falls so dangerous is the physics behind how a human falls. When someone slips or trips, their feet often slide ‘out from under them’. As their feet move out and upward, the head and upper-torso move in the opposite direction, straight toward the ground. And when someone falls without the chance to put out their hands, the results can be disastrous.

It should be noted that these types of accidents are easy to prevent if the responsible party acts accordingly. Fixing the walkway, buying a non-slip mat, or painting a step bright yellow could make all the difference between someone going on with their day and someone suffering from a life-altering accident.

COMMON CAUSES FOR A SLIP- OR TRIP-AND-FALL

  • Debris on floors
  • Exposed electrical wiring
  • Uneven stairs
  • Inadequate lighting
  • Cracked pavement
  • Uneven flooring
  • Wet flooring
  • Lack of handrails
  • Holes in flooring
  • Poorly placed fixtures
  • Inadequate warning signage
  • Worn carpet
  • Spilled food or drink
  • Broken floor tiles

COMMON INJURIES THAT RESULT FROM A SLIP OR TRIP AND FALL

According to the National Safety Council, accidents in which a person either slips or trips while walking result in almost 9 million hospital emergency room visits per year. Most people would assume that these accidents only result in minor injuries like a little bruising or scraping. However, serious injuries can occur due to the way the human body falls and the unexpected and surprising nature of the accident. Often, it is the suddenness of the incident that allows so much room for injury, since the body has little time to prepare itself.

Common injuries from slip- or trip-and-falls include:

Bruises, Cuts, and Scrapes. As mentioned earlier, slip and falls are not always serious or life-threatening events. Often, the most common injuries from the resulting fall are bruising, scrapes, and/or cuts that can range from mild to major, but they almost always are completely recoverable. This doesn’t mean they aren’t painful; they just won’t cause lasting trauma or disability.

Sprains and Fractures. The second most common injury from falling is an injury to the muscles, ligaments, and bones. In many cases, these parts of the body absorb most of the impact and take most of the falling pressure. For example, slipping or tripping can cause a person to twist their ankle, spraining the connective ligaments. Some sprains and twists are caused by the body’s natural reaction to trying to catch itself, but other injuries are caused by the impact itself. For example, the impact of landing on the ground can fracture or break bones. The most common fractures resulting from falls are to the hand, forearm, upper arm, spine, hip, pelvis, leg, and ankle; whichever is the first point of contact.

Shoulder Dislocation. As a person slips and falls, it is not uncommon for them to land on their shoulder directly, or for it to take a brunt of the impact through the hand and arm. These injuries could be minor, like sprains or bruising, or more serious like the dislocation of the shoulder—known as a brachial plexus injury. The brachial plexus is a network of nerves connecting the spinal cord to the shoulder, arm, and hand. The injuries tend to be common in slip and falls and are extremely painful. They are, however, considered highly treatable.

Hip Fractures. The younger and older population are most at risk of slipping and falling. The younger population is limber and more prone to healing; the older segment is more fragile and heals more slowly. Elderly people, in addition to being prone to falling, are more likely to be injured when they do fall. Quite simply, our older population is at a high risk of being seriously injured by these types of incidents. One of the most dangerous injuries resulting from a fall is a fractured hip. More than 95% of broken hips are suffered from falls. One in five hip fracture patients dies within a year of their injury. This is because hip fractures in elderly people often require long periods of hospitalization, bed rest, and long-term care. Once this cycle begins, it is often hard to break out and make a full recovery.

Head and Brain Injuries. Falls are the most common cause of traumatic brain injury—also known as a TBI. As mentioned above, slip and fall type injuries often cause a person’s head to go speeding towards the ground, with little or no warning. These injuries are called ‘traumatic’ because any damage that occurs to the brain—the body’s most important organ—is considered serious. However, TBIs run the gamut on a scale of severity. Some people may suffer a minor concussion that heals relatively quickly, while others may receive a TBI that causes severe swelling of the brain, accompanied by seizures, mood changes, cognitive impairment, and other life-long debilitations. Slip- and trip-and-falls cause 40% of all TBIs in the US that require emergency treatment.

Back and Spine Injuries. Next to the brain, which is required to breathe, the spine is almost equally important in maintaining life. The spine and the spinal cord are responsible for almost every movement in the human body. When a person slips and falls, they often injure their back in some way. It may be from the twisting motion, from the sudden impact of falling on their head or buttocks, or from contact with a foreign object like the corner of a step. This impact can strain the spinal muscles and ligaments, fractured vertebrae, cause spinal discs to bulge or herniate, or damage the spinal cord itself. Because of the 100 billion+ nerves the spine is connected to, these types of injuries are almost guaranteed to be painful. An injury to the spinal cord can lead to temporary or permanent paralysis, varying disabilities, a lifetime of pain and suffering, or any other number of neurologic and sensory impairments.

Neck Injuries. When someone injures their neck, they’re actually injuring the upper, cervical portion of their spine. For this reason, most neck injuries are similar to back injuries in that damage can occur to the vertebra bone, the spinal cord, the spinal disc, or any of the nerves, muscles, and ligaments around it. What makes a neck injury so serious is its relation to the rest of the spine and body. Since damage to the neck occurs at the upper portion of the spine, it increases the chances of temporary or permanent disability or paralysis to more part of the body. Basically, everything from the neck down is at risk. Neck injuries from slip and falls can be caused by the whiplash motion of the sudden fall, or from a person actually landing on their head or neck.

WHO IS LIABLE?

The most common person liable for slip and fall injuries is the property owner where the fall occurred. However, other, third-parties may be responsible as well.

If the trip or slip and fall occurred on someone else’s property, and they were negligent toward that property, the owner of that property will most likely be held responsible. It’s also possible that the party responsible for the upkeep  and maintenance of that property may be liable for the injuries you’ve suffered. For example, a woman in Louisiana has recently filed a lawsuit against the grocery store chain Winn-Dixie after she slipped and fell in a puddle of clear liquid at one of their grocery stores. She severely injured her shoulder as a result. However, not all slip and fall injuries are a result of someone’s negligence. We all have a responsibility for our own safety and to watch where we’re going. The best way to determine who is liable is by contacting an experienced trip and fall attorney. Once an attorney is retained, an investigation can be carried out to look into the many different factors involved in the slip and fall accident and the coupled liability.

CONTACT PINELLAS COUNTY TRIP AND FALL ATTORNEYS DOLMAN LAW GROUP

If you or a loved one has been seriously injured due to slipping or tripping on someone’s property, you may be entitled to compensation for your damages. The easiest and smartest way to determine if you have a case is to contact an experienced trip and fall attorney.

Our attorneys at Dolman Law Group will aggressively fight to hold the negligent party responsible for the damages they have caused and to ensure our client gets the compensation they deserve. We make it our mission to ensure that our clients heal physically, emotionally, and financially.

For a free and confidential consultation on your case, call us today at 727-451-6900 or contact us electronically via our online contact form.

Dolman Law Group
800 North Belcher Road
Clearwater, FL 33765
727-451-6900

http://www.dolmanlaw.com/practice-area/clearwater-trip-fall-attorney/

The post Slip-and-Fall Accidents: Common Injuries and Liability appeared first on Dolman Law Group.

Injection Therapy Following a Car Accident

Injection Therapy Following a Car Accident

Posted From: https://www.dolmanlaw.com/injection-therapy-following-car-accident/

Spine and back injuries are an exceptionally common result after someone has been involved in a motor vehicle accident. Clients often show up at our office in varying levels of pain after such accidents, hoping we can help them to get on the right track towards recovery. Sometimes their pain level improves over time; other times it progressively gets worse to the point that’s it’s a constant disturbance in their normal life.

Car accidents are so unexpected. But what my clients are often even more surprised about is just how debilitating back pain can be. In our experience as a law firm, these injured victims who are suffering from this kind of debilitating pain are desperately seeking a solution. Injection therapy could just be the answer. Although it does not work for all patients, in all cases, the patients who do see results are often very pleased with the pain-relief they experience.

More traditional diagnosis techniques, like an MRI, don’t always reveal the exact location of an injury or the exact source of pain. More recently, techniques have been developed that serve multiple purposes, two of which are to help locate the sources of the back pain, while simultaneously relieving pain. These two types of injections serve the same purpose but are used for different parts of the back. The general idea is to inject pain medication into an area; if the pain is gone, then the causal area has been determined.

Selective Nerve Root Blocks

Selective Nerve Root Blocks (SNRB) are used to help diagnose the exact location that is causing pain in a patient’s neck, while also helping to alleviate some of the actual pain. During an SNRB, the nerve is injected by guiding a needle through a small gap at the point where to vertebrae meet. This is called the foramen. [Read this article to learn more about the basic anatomy of the spine.]

Two medications are often used, either together or one at a time. The first of these medications is a steroid, an anti-inflammatory medication (usually cortisone) that reduced painful swelling. The second medication is a numbing agent called lidocaine which is used to reduce pain. In order to ensure the needle is guided into the correct spot, fluoroscopy (a form of live x-ray) is used to help guide the doctor.

The way in which this type of injection can be diagnostic is almost too simple—but extremely effective. Basically, if the patient’s pain goes away after the injection, it can be inferred that the pain generator is the specific nerve root that has just been targeted. The anti-inflammatory goes to work reducing the swelling and tension in the area, and the numbing agent instantly stops the pain. It’s similar to receiving a Novocain shot at the dentist. The results are instantaneous.

Because of this immediate result, a Selective Nerve Root Block can be a crucial factor in determining the source of pain when other techniques fail. In addition to the diagnostic function of SNRBs, they can actually provide a great source of therapeutic relief for lower back pain, radiating pain, pain from herniated discs, and neck pain.

The reason for nerve root pain in the neck and back is compression. When an injury or old age causes the vertebra to push down on a nearby spinal nerve root, it becomes pinched and inflamed. The result is a debilitating pain in the neck, back, or extremities.

This technique is also used to help patients more easily tolerate physical therapies. Often, the level of pain a person is experiencing can greatly reduce their ability to perform the exercises and stretches that will help them to get better. If the patient can have time without the debilitating pain, they can move along in therapy more quickly.

SNRB injections are more difficult to perform than the more standard epidural steroid injections, which is why they should be performed by an experienced physician. Since the injection site is next to the nerve root itself, it can occasionally cause pain in the area or nearby extremities to temporarily worsen.

Success rates vary depending on the primary diagnosis and whether or not injections are being used primarily for diagnosis. Immediately after the injection, patients often feel a noticeably lesser degree of pain or even no pain at all. However, this is only from the numbing agent which will wear off in a few hours. After that, the anti-inflammatory will take a few days to kick in. Once the cortisone starts working, the pain relieving effects last anywhere from a few weeks to many months. While there is currently no definitive research to clearly dictate the frequency of SNRBs, it is considered reasonable to limit the injection to three times annually.

Facet Joint Blocks

The facet joints are responsible for allowing your back to be flexible, enabling you to bend and twist. Nerves branch off from your spinal cord through these joints on their way to other parts of your body. The facet joints can become painful due to arthritis of the spine, repeated stress to the area, or from a back injury.

When the facet joint itself is the generator of the patient’s back pain, a facet joint block injection can be utilized to alleviate the pain. Similar to SNRBs, facet block injections can be both a diagnostic tool and an alleviator of pain. Just like the nerve block injections, facet joint blocks can isolate and confirm the specific source of back pain too. They also work to numb the source of pain and soothe the inflammation for the patient.

The procedure is nearly identical to that of the SNRB. In a facet block procedure, physicians use fluoroscopy to guide the needle into the facet joint capsule itself. At this point, they inject the numbing agent lidocaine and/or a steroid, likely cortisone, as an anti-inflammatory agent. If the patient’s pain ends after the injection, it can be inferred that the pain generator was indeed the specific facet joint capsule that was injected. There are very few risks associated with this technique.

Dolman Law Group

If you or a loved one has neck, back, or extremity pain that cannot be soothed, you should consider having therapeutic injections. If this procedure is right for you, it will be recommended by an experienced physician. Likewise, if you are unaware of the cause of your nerve or joint pain, you should consider one of the injections above.

Dolman Law Group works with our clients to ensure that they recover completely: physically, emotionally, and financially. If you or a loved one has been injured as a result of a car accident, and now you have neck or back pain, you should seek medical treatment right away. After you have secured health care, be sure to contact an experienced attorney at Dolman Law Group. You can call us at 727-451-6900 or send us an email through our contact page.

Dolman Law Group
800 North Belcher Road
Clearwater, FL 33765

(727) 451-6900

https://www.dolmanlaw.com/legal-services/auto-accidents-attorneys/

The post Injection Therapy Following a Car Accident appeared first on Dolman Law Group.

5 Chiropractic Solutions for Treating Fibromyalgia

5 Chiropractic Solutions for Treating Fibromyalgia

http://gulfcoastrehab.us/blog/b_76093_5_chiropractic_solutions_for_treating_fibromyalgia.html

5 Chiropractic Solutions for Treating Fibromyalgia

Fibromyalgia affects an estimated 3-6 million people in the United States. Scores of pharmaceutical companies offer drugs to treat the condition although there is no cure.

Few people are aware that your local Pinellas Park, Florida, chiropractor has several solutions to treating this condition. Through a combination of chiropractic care, pain-free Laser Therapy, massage therapy, and lifestyle and nutritional counseling, our patients experience a decrease in the severity and duration of their physical pain of fibromyalgia.

Fibromyalgia Explained

Fibromyalgia syndrome is a chronic disorder that includes muscle pain, fatigue, and multiple tender points. The American College of Rheumatology defines the condition as a history of pain in your left and right sides and above and below the waist for longer than 3 months. For reasons yet to be discovered, 90% of people who develop fibromyalgia are women. Additionally, people with fibromyalgia may experience:

  • Headaches
  • Sleep disturbances
  • Morning stiffness
  • Temperature sensitivity
  • Cognitive and memory problems ("fibro fog")
  • Irritable bowel syndrome
  • Painful menstrual periods
  • Numbness or tingling of the extremities
  • Restless legs syndrome

Fibromyalgia is currently believed to be a stress-related condition. Metabolic changes result from a stress-induced decrease in blood flow to an area of the brain called the pituitary. This causes a decrease in many essential hormones, like the growth hormone-releasing hormone and the thyroid-stimulating hormone. Hormonal changes lead to irregular muscle healing, hypothyroid, and memory and cognitive changes.

Pinellas Park Chiropractors Treat Fibromyalgia

Fibromyalgia is sometimes difficult to treat. It is important for you to find a medical professional who is familiar with fibromyalgia and treatment. The most effective treatments with the largest results are those that include a variety of methods like those available at the Gulf Coast Rehabilitation and Wellness Center serving the Tampa Bay area. Our team approaches the condition from multiple treatment sources.

Here are five ways the Gulf Coast Rehabilitation and Wellness Center treats fibromyalgia:

1. Chiropractic Care

Chiropractic care keeps the spine and muscles from losing too much movement in those who suffer with fibromyalgia. The tightening up and lose of the muscle’s natural pliability leads to a neurological reflex that causes further tightening. This vicious cycle will continue and over time leads to increased pain and other symptoms like increased sleep disturbance.

Regular adjustments to the spine keep it moving. Due to the diminished healing ability of those with fibromyalgia, chiropractors with experience treating the condition modify their adjustments to be more gentle than normal. When seeking chiropractic care, it is imperative that patients make sure their doctor is familiar with the muscular changes that occur with fibromyalgia.

2. Treating Fibromyalgia with Laser Therapy

 is a new technology that provides pain relief to any area of the body. The treatment is non-invasive and painless, although some patients report a warming sensation that many find pleasant. Laser Therapy reduces inflammation and treatment is completed in about 10 minutes. 

3. Lifestyle Counseling

A good chiropractor will include lifestyle counseling as part of your treatment plan. This may include advice about:

  • Work activities (restrictions or reducing hours)
  • Posture
  • Daily exercise and rehabilitation
  • Sleep practices

4. Nutritional Counseling

Chiropractors understand that what you put in your body can have the ability to either stress your body or to help your body heal. A chiropractor can provide you with nutritional guidance so that you learn to avoid foods that will worsen your symptoms and increase intake of foods that will lead you toward health and wellness. This may include nutritional supplements as well.

5. Massage Therapy

For the greatest success at treating your fibromyalgia, ensure your chiropractor has a licensed massage therapist on board. Massage therapy relaxes the muscles and can focus on trigger points where you feel pain. This will help reduce the pain caused by your condition.

Here’s What To Do

Fibromyalgia is a treatable condition. If you are suffering from this condition, here are a few simple steps to begin living a higher quality life:

Step 1: Find a medical professional in Pinellas Park, FL, familiar with fibromyalgia. 

Step 2: Set up a consultation. Call (727) 541-2520 or visit http://gulfcoastrehab.us/ for a free consultation.

Step 3: Before your consultation, think about your entire medical history and your current symptoms. Take notes and write down any accidents or injuries you sustained, including dates and when you believe your symptoms began. Bring this with you to your consultation.

Step 4: Stick to the course of treatment and recommendations exactly as your chiropractor outlines. Failure to follow their treatment plan will likely not produce the quality of life you seek.

Call Today for Fibromyalgia Relief

We know fibromyalgia treatment. Call (727) 541-2520 or visit http://gulfcoastrehab.us/ for a free consultation. An evaluation by one of our chiropractors is the beginning to sleeping better and living well in control of your fibromyalgia pain in Pinellas Park. 

What is Whiplash Associated Disorders (WAD) Caused by Car Accidents?

What is Whiplash Associated Disorders (WAD) Caused by Car Accidents?

http://gulfcoastrehab.us/blog/b_75912_what_is_whiplash_and_whiplash_associated_disorders_wad__caused_by_car_accidents.html

What is Whiplash and Whiplash Associated Disorders (WAD)

Caused by Car Accidents?

A common car accident neck injury in Pinellas Park is whiplash and also whiplash associated disorder or WAD. To understand this condition and how it occurs, let’s first take a look at the make-up of the spine.

Spine Mechanics

The spine is divided into three parts: the cervical spine (neck), thoracic spine (upper back), and lumbar spine (lower back). It is comprised of a chain of ligaments, discs, muscles, and bones. This chain extends from the base of the skull down to the tailbone.

Bones/vertebrae provide structural support. A disc sits between two vertebrae. Each vertebra has a facet joint on each side. Facet joints allow smooth motion for rotating and bending backward and forward. Ligaments and muscles surround the spinal column and provide support. Injury to any one of these structures can cause mild to extreme pain and is a common result of a car accident.

Causes of Chronic Neck Pain

The cervical spine or c-spine supports your head while protecting your nerves and spinal cord. The cervical structure is vital to your health and well-being. 

After a car accident in Pinellas Park, you may suffer from strained muscles and/or ligaments, which can take up to 6 to 10 weeks to heal. More unfortunate car accident victims experience more serious car wreck neck injuries to the facet joint or disc, which can take several months to heal. Injuries left untreated can last a lifetime or cause other chronic health problems like degenerative disc disease.

The most common cause of neck pain following a car accident is facet joint pain either alone or in conjunction with disc pain. You feel pain to the right or left of the cervical spine. The neck may also be tender to the touch.  

Chronic neck pain can also result from disc injury. Whiplash, or the sudden thrusting forward and back of the head as occurs during a vehicle collision, often damages the outer wall of the disc. The nerve endings in the outer wall signal pain. Without treatment, the disc can weaken over time and hurt under stress of normal daily activity like performing computer work. A damaged disc in the neck can also herniate out and pressure a nerve. 

Neck muscles can become sore and hurt when overworking to protect injured discs, joints or the nerves of the neck. They may also ache due to another factor like poor posture, lack of exercise, and work habits.

Symptoms of Whiplash

Whiplash neck injuries cause a whole host of symptoms after a car accident in St. Pete or Pinellas Park. Whiplash Associated Disorders are other symptoms you can experience as a result of whiplash, including:

·         Cervicogenic or neck-related headache

·         Worse migraines (than prior to the car accident)neck pain

·         Arm pain resulting from pressure on the nerve

·         Referred pain between the shoulder blades

·         Low back pain  

·         Difficulties with concentration or memory

·         Depression

·         Mild brain injury

·         Irritability

·         Sleep disturbance

·         Blurry vision

·         Ringing in the ears

·         Tingling in the face

·         Fatigue

Treatment for Whiplash

You should always seek treatment after a car accident, regardless of whether you experience any neck pain or not. It is possible for you to have a neck injury from a car wreck, but not feel pain for several weeks. An evaluation by a Tampa Bay chiropractor will help diagnose any injury. Treatment may include:

·         X-ray imaging to diagnose fracture, instability, disc height, and bone spurs.

·         Magnetic resonance imaging (MRI) scan can find disc herniation, disc injury or compression of a nerve or the spinal cord.

·         Chiropractic spinal adjustments to realign the neck to its correct anatomical position.

·         Massage therapy by a licensed therapist to relax strained muscles and relieve pain.

·         Laser Therapy to reduce inflammation and pain.

·         Rehabilitation exercises to strengthen muscles around the spine so they provide better support.

Call Us After A Car Accident

Gulf Coast Rehabilitation and Wellness Center offers a complete risk free neck pain evaluation for men, women, and children as well as car accident victims. Our trained medical professionals examine your health and customize a treatment plan using various methods to relieve neck pain in Pinellas Park, FL, including spinal adjustments, neck pain exercises, massage by a licensed massage therapist, and weight loss management. We believe in treating the whole person instead of just focusing in on one problem to achieve overall health and wellness.

Call (727) 541-2520 or visit http://gulfcoastrehab.us/ to schedule an appointment to discuss your whiplash, an injury, chronic pain, or your general health.