Why Chronic Pain and Fibromyalgia Challenge Pain Specialists

8 05 2014

Sticky Tongue to Ice Can Be Painful

Updated:  8 May 2014

Chronic Pain Syndrome (CPS) is a poorly defined condition “and somewhat” similar to fibromyalgia as a chronic pain experience.  CPS is where a neurologically based pain has not resolved, or finding the exact cause of pain may have not been identified.  We’ve all experienced pain at one time or the other, e.g., a broken bone, or speck of dirt in the eye, a bruised, or strained muscle, or maybe you’ve been unfortunate enough to experience a passing kidney stone.  These painful experiences are considered temporary or acute pain conditions.  If the injury heals then the acute pain will typically resolve itself within a 30 day window.  The difference between chronic and the acute pain, you healed and are no longer in pain, or that pain is triggered infrequently when aggravated.

If a pain condition has not healed significantly after 30 days, or you still experience significant pain for a 3-6 month time period, this is a chronic pain condition.  Those diagnosed with CPS can appear to experience pain all over and at any point of the neurological body.  This is much akin to those that experience frequent phantom pain anywhere at any time throughout the body.  You hurt and the pain varies in frequency and intensity throughout each day.  Nevertheless, your body always seems to be in pain.  For those with this type of chronic pain it is much harder for medical specialists to explain what is causing it, especially when a pain origin is not obvious.  Understanding and treating a CPS is certainly a challenge for the medical professional.

The most mysterious thing about CPS is that the chronic pain conditions can occur without evident exasperation, or aggravation of past injury, illness or disease.  And on the other hand, chronic pain can be a substantiated medical pain origin finding caused from illness and disease, i.e., cancer, immune disorders, rheumatoid arthritis, migraines, back condition(s), past injuries and other radiating neuropathies that affect and cause pain.  CPS is typically a complex treatment pain story “often” without an origin of pain and/or lacks medically substantiated cause of injury or disease.

Regardless of pain origin or cause, or lack thereof, chronic pain patients will require a pain management specialist or team of various resources to treat a complex pain etiology, especially if the cause is unclear.  Those resources might include acupuncture, electroneuro-stimulation, hot/cold modalities, exercise, physical therapy, specialized diet, supplements, pharmaceuticals, or deep muscle massage, etc.

If you’re a pain patient with unexplainable pain and you’ve not been diagnosed with fibromyalgia or some other form of immune disorder for example, you may likely be diagnosed with CPS.  What is the difference between the two diagnoses?  Fibromyalgia is a neurosensory disorder where one feels widespread pain throughout the body, but most specifically; joint and muscle stiffness and pain with fatigue.

During the early years of fibromyalgia diagnosis, it was thought this type of pain originated from the brain and where chemical imbalance may be connected somehow to the cause of muscle and joint pain.  In other words, at one time a great portion of the medical community believed it possible to think the pain and from the psychosomatic (brain-body) connection, the pain manifested itself into chronic pain.  Although this is partially true, it is not the whole truth.

The American College of Rheumatology diagnosis criteria has proven that the origin of pain does not solely stem from a brain signal that produces the pain.  Instead a physiological chemical shortfall is present in many pain patient cases that prevent the patient from completely alleviating pain.  In my mind, this would be the equivalent of a person whose immune system is down, gets a cold and can never completely get rid of the cold.  So you always feel under the weather sort of speak and where it does not take much physical activity or stress to aggravate low-sensory acute pain to a high chronic pain condition.

Another difference between fibromyalgia versus CPS appears to be three primary symptoms for those that suffer with fibromyalgia:  Muscle tenderness, aches and joint pain, which produce stiffness and fatigue and/or emotional stress that can continue for years.  There also appears to be a chemical identifier in the way fibromyalgia pain origins present pain symptoms.  That’s where the neurosensory pain connection between the brain and spinal cord are now known to be chemically interlinked.

People with Fibromyalgia tend to have a low chemical P substance, and low levels of neurotransmitter chemical production of dopamine, serotonin and norepinephrine.  It appears pain patients with a low P substance condition are more sensitive to acute low sensory pain perceived by the brain and spinal cord.  So it can be stated, if our bodies are low on P substance and neurotransmitters, anyone of us would be susceptible to low-acute to chronic pain conditions by lacking the ability to immunological and physiologically low stress environmental aggravation we’d not experience otherwise.

If our ability to produce natural pain alleviating chemicals is compromised than it is reasonable to deduce this makes pain patients more likely to be sensitive to daily stress.  And this everyday stress pain could be amplified 10-fold from the way anyone else would experience it given the same environment.

So the stress most of us experience daily is likely shielded chemically by normal levels of P substance and natural neurotransmitters in the body.  If pain protection is not chemically balanced to shield the body from the mental to physical pain, then those that lack this protection will experience more pain.  In time this can chronically fatigue a person into manifesting itself into illness-disease and painful medical condition.

Patients now diagnosed with fibromyalgia are taken much more serious as a real chronic pain condition where chemical deficiency and immune systems are likely compromised.  I suspect there are many hormonal and chemical imbalances within the brain-body barrier that creates an unshielded pain recipient experience.  It is amazing to realize that ~35% of all Americans have some form, or have experienced chronic pain.  And some 50 million have experienced partial to full disability due to chronic pain.

Many patients that experience CPS also experience the same internalizing and rationalizing effect of fibromyalgia depression for lack of ability to provide help for self and family.  This depression stress is often brought about by the obvious… Chronic unrelenting pain and addiction to pain alleviation drug use, anxiety, fatigue, reduced activities including sexual desire, and maybe simultaneous experience of other disabilities that are secondary to the primary cause of pain and medications.

This vicious cycle of internalizing and inability to control the pain becomes exhausting and to the point where it is difficult to get a good night sleep.  If this exhaustion cycle is not alleviated the calamity of suffering, sleeplessness and sadness can have a demoralizing impact on self and family.

CPS, fibromyalgia and chronic fatigue pain patients are typically treated as outpatients and require a variety of pain alleviation drugs and other clinical resources to help manage their pain.

If you experience chronic pain, and/or pain depression and anxiety and are experiencing a complex pain condition and need help, be sure to seek medical referrals to a pain management specialist, rheumatologist, immunologist, or physiatrist through your primary care physician to get the treatment you need.

Referrals,

The Free Dictionary, by Farlex.  Fibromyalgia.  http://medical-dictionary.thefreedictionary.com/fibromyalgia

Dellwo, Adrienne. About.com. Fibromyalgia and Chronic Fatigue.  July 2, 2012.  http://chronicfatigue.about.com/b/2012/07/02/sound-off-about-symptoms-fibromyalgia-chronic-fatigue-syndrome.htm

Wikipedia.  Chronic Pain.  http://en.wikipedia.org/wiki/Chronic_pain

Health Encyclopedia – Diseases and Conditions.  http://www.healthscout.com/ency/1/629/main.html

Singh, Manish K. Chronic Pain Syndrome.  Medscape. http://emedicine.medscape.com/article/310834-overview

Woodamarc.  Pain Depression Origins.  Hubpages.com. http://woodamarc.hubpages.com/_sigsinmula/hub/Pain-Depression-Origins

Author: Marc T. Woodard, MBA, BS Exercise Science, ARNG, CPT, RET. 2014 Copyright. All rights reserved, Mirror Athlete Inc., http://www.mirrorathlete.com, Sign up for your Free eNewsletter.





Why Chronic Pain and Fibromyalgia Challenge Pain Specialists

19 07 2012

Sticky Tongue to Ice Can Be Painful

Chronic Pain Syndrome (CPS) is a poorly defined condition “and somewhat” similar to fibromyalgia as a chronic pain experience.  CPS is where a neurologically based pain has not resolved, or finding the exact cause of pain may have not been identified.  We’ve all experienced pain at one time or the other, e.g., a broken bone, or speck of dirt in the eye, a bruised, or strained muscle, or maybe you’ve been unfortunate enough to experience a passing kidney stone.  These painful experiences are considered temporary or acute pain conditions.  If the injury heals then the acute pain will typically resolve itself within a 30 day window.  The difference between chronic and the acute pain, you healed and are no longer in pain, or that pain is triggered infrequently when aggravated.

If a pain condition has not healed significantly after 30 days, or you still experience significant pain for a 3-6 month time period, this is a chronic pain condition.  Those diagnosed with CPS can appear to experience pain all over and at any point of the neurological body.  This is much akin to those that experience frequent phantom pain anywhere at any time throughout the body.  You hurt and the pain varies in frequency and intensity throughout each day.  Nevertheless, your body always seems to be in pain.  For those with this type of chronic pain it is much harder for medical specialists to explain what is causing it, especially when a pain origin is not obvious.  Understanding and treating a CPS is certainly a challenge for the medical professional.

The most mysterious thing about CPS is that the chronic pain conditions can occur without evident exasperation, or aggravation of past injury, illness or disease.  And on the other hand, chronic pain can be a substantiated medical pain origin finding caused from illness and disease, i.e., cancer, immune disorders, rheumatoid arthritis, migraines, back condition(s), past injuries and other radiating neuropathies that affect and cause pain.  CPS is typically a complex treatment pain story “often” without an origin of pain and/or lacks medically substantiated cause of injury or disease.

Regardless of pain origin or cause, or lack thereof, chronic pain patients will require a pain management specialist or team of various resources to treat a complex pain etiology, especially if the cause is unclear.  Those resources might include acupuncture, electroneuro-stimulation, hot/cold modalities, exercise, physical therapy, specialized diet, supplements, pharmaceuticals, or deep muscle massage, etc.

If you’re a pain patient with unexplainable pain and you’ve not been diagnosed with fibromyalgia or some other form of immune disorder for example, you may likely be diagnosed with CPS.  What is the difference between the two diagnoses?  Fibromyalgia is a neurosensory disorder where one feels widespread pain throughout the body, but most specifically; joint and muscle stiffness and pain with fatigue.

During the early years of fibromyalgia diagnosis, it was thought this type of pain originated from the brain and where chemical imbalance may be connected somehow to the cause of muscle and joint pain.  In other words, at one time a great portion of the medical community believed it possible to think the pain and from the psychosomatic (brain-body) connection, the pain manifested itself into chronic pain.  Although this is partially true, it is not the whole truth.

The American College of Rheumatology diagnosis criteria has proven that the origin of pain does not solely stem from a brain signal that produces the pain.  Instead a physiological chemical shortfall is present in many pain patient cases that prevent the patient from completely alleviating pain.  In my mind, this would be the equivalent of a person whose immune system is down, gets a cold and can never completely get rid of the cold.  So you always feel under the weather sort of speak and where it does not take much physical activity or stress to aggravate low-sensory acute pain to a high chronic pain condition.

Another difference between fibromyalgia versus CPS appears to be three primary symptoms for those that suffer with fibromyalgia:  Muscle tenderness, aches and joint pain, which produce stiffness and fatigue and/or emotional stress that can continue for years.  There also appears to be a chemical identifier in the way fibromyalgia pain origins present pain symptoms.  That’s where the neurosensory pain connection between the brain and spinal cord are now known to be chemically interlinked.

People with Fibromyalgia tend to have a low chemical P substance, and low levels of neurotransmitter chemical production of dopamine, serotonin and norepinephrine.  It appears pain patients with a low P substance condition are more sensitive to acute low sensory pain perceived by the brain and spinal cord.  So it can be stated, if our bodies are low on P substance and neurotransmitters, anyone of us would be susceptible to low-acute to chronic pain conditions by lacking the ability to immunological and physiologically low stress environmental aggravation we’d not experience otherwise.

If our ability to produce natural pain alleviating chemicals is compromised than it is reasonable to deduce this makes pain patients more likely to be sensitive to daily stress.  And this everyday stress pain could be amplified 10-fold from the way anyone else would experience it given the same environment.

So the stress most of us experience daily is likely shielded chemically by normal levels of P substance and natural neurotransmitters in the body.  If pain protection is not chemically balanced to shield the body from the mental to physical pain, then those that lack this protection will experience more pain.  In time this can chronically fatigue a person into manifesting itself into illness-disease and painful medical condition.

Patients now diagnosed with fibromyalgia are taken much more serious as a real chronic pain condition where chemical deficiency and immune systems are likely compromised.  I suspect there are many hormonal and chemical imbalances within the brain-body barrier that creates an unshielded pain recipient experience.  It is amazing to realize that ~35% of all Americans have some form, or have experienced chronic pain.  And some 50 million have experienced partial to full disability due to chronic pain.

Many patients that experience CPS also experience the same internalizing and rationalizing effect of fibromyalgia depression for lack of ability to provide help for self and family.  This depression stress is often brought about by the obvious… Chronic unrelenting pain and addiction to pain alleviation drug use, anxiety, fatigue, reduced activities including sexual desire, and maybe simultaneous experience of other disabilities that are secondary to the primary cause of pain and medications.

This vicious cycle of internalizing and inability to control the pain becomes exhausting and to the point where it is difficult to get a good night sleep.  If this exhaustion cycle is not alleviated the calamity of suffering, sleeplessness and sadness can have a demoralizing impact on self and family.

CPS, fibromyalgia and chronic fatigue pain patients are typically treated as outpatients and require a variety of pain alleviation drugs and other clinical resources to help manage their pain.

If you experience chronic pain, and/or pain depression and anxiety and are experiencing a complex pain condition and need help, be sure to seek medical referrals to a pain management specialist, rheumatologist, immunologist, or physiatrist through your primary care physician to get the treatment you need.

Referrals,

The Free Dictionary, by Farlex.  Fibromyalgia.  http://medical-dictionary.thefreedictionary.com/fibromyalgia

Dellwo, Adrienne. About.com. Fibromyalgia and Chronic Fatigue.  July 2, 2012.  http://chronicfatigue.about.com/b/2012/07/02/sound-off-about-symptoms-fibromyalgia-chronic-fatigue-syndrome.htm

Wikipedia.  Chronic Pain.  http://en.wikipedia.org/wiki/Chronic_pain

Health Encyclopedia – Diseases and Conditions.  http://www.healthscout.com/ency/1/629/main.html

Singh, Manish K. Chronic Pain Syndrome.  Medscape. http://emedicine.medscape.com/article/310834-overview

Woodamarc.  Pain Depression Origins.  Hubpages.com. http://woodamarc.hubpages.com/_sigsinmula/hub/Pain-Depression-Origins

Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2012 Copyright, All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter.





Body Posture and Pain Relationship

6 03 2008

Is there a relationship between correct anatomical posture and pain?  “The answer is definitely yes!”  Have you experienced acute (short-term), or chronic (long-term) pain in your major weight bearing joints or muscles?  The joint areas that come to mind:  Feet, ankles, knees, hips, back, neck.  Do you experience muscular and/or joint swelling, radiating pain, or nerve aggravation in these areas especially when you exert yourself (working, or exercising, etc.)?  Have the doctors diagnosed you with “acute, or chronic body strains, or sprains?”  Does the only answer for relief seem that your pain management program has a never ending supply of pharmaceuticals?  Have you begun to experience other health issues since you’ve been taking pharmaceutical prescriptions [such as headaches, Irritable Bowel Syndrome “read IBS health article at our site,” upset stomach, racing, or irregular heart rate, sick more often, no energy, body weight out of control, etc., the list goes on!].

What would you say if I told you, “You could completely remove or significantly reduce the pain at the joint, thereby eliminating your only other pain intervention options:  More pills and unnecessary health risks.  No doubt surgical intervention “will” follow if nothing else changes as you age [conditions will turn chronic if not managed correctly!].  Do you really want to go this route?  Or do you want an alternative and preventative measure to get your health back?  I think the answer is 100% “Yes, I want my health!”  To reduce or eliminate pain one needs to consider correcting the foot posture first as there is a high correlation with other posture pain.   Poor posture is responsible for many strains i.e., overexerted muscle, ligament, nerve, disc, tendon that has become overworked, overstretched around a joint [or where a traumatic impact has created a short-term injury].  The biggest difference with a strain vs. “sprain” is the severity of damage [sprains are typically long-term injuries].  The sprain injury is commonly substantiated and verified with MRI equipment (Magnetic Resonance Imaging can see muscular, tendon, disc or ligament tear(s), etc.).   Postural pain typically begins at the feet and works its way up the major load bearing joints of our bodies creating many radiating pain centers as we age (back strains are common posture problems and can become sprained!).  Follow my recommendations listed below to correct poor posture… “Look first at the foot, the most under diagnosed cause of postural pain.”  Don’t live in pain!  You don’t have to.

Recommendations:
1.   I highly recommend you read “Manage Acute Back Pain.”  Go to our home site; also see other “Recently Syndicated Health Articles (Health, Weight Management & Fitness Categories).
2.   Seek a referral from your Primary Physician to get a diagnosis from podiatry (foot) specialist if your feet are causing you pain and/or if other weight bearing structural areas of your body hurt.
3.   Get foot orthotics that exercise the foot arches.  Don’t pay $300-$1500/year from your podiatrist. Click on our site foot, or postural alignment image icon on our home page www.mirrorathlete.com..  Then click on Pain Center Page.  Read about “Posture Control Insoles” ~$50.00/pair.
4.   Also a good weight reduction plan will reduces “pain load” on your postural structure (See Purity Supplements, etc.,” look in our “Wellness Product Stores tab”).
5.   Exercise routine with low pain aggravation.  Walk, stationary bike, etc., 20min day/3x wk.
6.   Wean off of pharmaceuticals if you’re having a pain free day.  Drink 6-8 glasses of water/day.
7.   Use the Wellness store supplements for Natural Joint health maintenance.
 

Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2008 Copyright.  All rights reserved, Mirror Athlete Publishing,  www.mirrorathlete.com,, Sign up for your Free eNewsletter





How to Manage Acute Back Pain

18 01 2008

The most common muscular skeletal disorders involving the low back are muscular ligaments, muscle and tendons. Human studies have shown low back pain, regardless of severity will account for more sick leave and disability than any other single medical condition. Nearly 80% of adults will experience back pain some time in their lives. Through time the discs begin to loss elasticity and is indicative of an acute low back event with a rapid onset and short course of pain. This pain center may not be triggered again for years [“a weak point once an event has occurred”]. Overstretching of the muscles during work can become overstretched and torn, resulting in localized pain, stiffness, and inflammation, also bruising around the muscle. A Repetitive Strain Injury (RSI), also known as Cumulative Trauma Disorder (CTD) [muscle-tendon relationship] is a result of overuse on the body due to some short/long term repetitive activity, e.g., shoveling, raking, running, picking up items, etc. Poor posture puts force and strain on the lower back, “focus on proper back posture!”

  Acute low back pain touches almost every American at some point in their life. Low back medical conditions and diseases we are most familiar with: Degenerative discs (wear & tear on the discs between vertebraes), herniated discs, (swollen, and irritated “overblown” discs between the vertebrae), spinal stenosis (narrowing of vertebrae canal presenting sciatica pain & numbness down the legs, etc.). These conditions share a relationship with acute back pain. Continued aggravation of the pain center can create long lasting bouts of recurrent episodes where the damage typically is permanent and chronic. A chronic low back condition typically involves overstretched, or torn ligaments and, or misalignment of posture brought about by a sudden impact, such as a car accident, fall, or long term RSI, or CTD activities. If your acute low back pain condition appears more frequent and severe lately…. “Pay Attention!” The acute to chronic crossover condition has longer recuperative periods and if the low back ligaments are stretched, or worse, become torn, surgical procedures “may likely” be necessary to limit long-term immobilization and pain. “Don’t Go There!” Read the following Recommends: Also visit our Site Pain Store for product use ideals.

Recommendations: · 1) If acute low back pain occurs, use ice no more then 20 minutes every 2 hours (to reduce swelling) and take medications as prescribed. 2) Maintain Ideal Body Wt (“IBW” see our site Fitness calculator-to determine your IBW). 3) Exercise (e.g., biking, walking, not less then 3/week @ 20-30min/day). 4) Proper nutrition (reduce fats in your diet and total calorie consumption/day). 5) Quality foot inserts (“Posture Control Insoles at our “Pain Store”). · 1) If acute back pain becomes “Intolerable” long-term chronic pain [consult your physician]. 2) “Tens Therapy” electro muscular-stimulation at our site “Pain Store,” can provide significant relief. 3) Do you need surgery? Ask your doctor about Spinal Cord Stimulation (SCS). This technology may provide new hope for you. Web search for more [Tens, Pain & SCS]. Reports show: 84% of SCS recipient’s quality of life improved significantly. (Neuromodulation. 2001 Apr;4(2):59-66). 4) Acclaimed success for acute to chronic back pain conditions: Acupuncture – “May also reduce chances of chronic back pain from occurring.” (Patel M, Gutzwiller f, Paccaud F, Marazzi A., Inter J Epidern 1989;18:900-906).

 Author: Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET. 2008 Copyright. All rights reserved, Mirror Athlete Publishing, www.mirrorathlete.comSign up for FREE Monthly eNewsletter.