Shoulder Pain Treatment

Pins and needles is the common name for what the medical world call paresthesia. The feeling of tingling in the hands or feet is a symptom of nerve root irritation. This nerve irritation can be due to nerve pressure in the neck or the back - or it can be due to pressure on a nerve in a more peripheral part of the body, such as the wrist or the foot and ankle.

If a nerve root or peripheral nerve is subjected to sustained pressure then the feeling of pins and needles will develop in the skin supplied by that nerve. We are all familiar with this when we sit too long on a hard chair or bench and our foot "goes to sleep". When we get up and start to move again the pins and needles feeling starts in the limb and lasts for several minutes.

Nerve pressure or nerve root irritation will cause pins and needles, or pain, or weakness - and often all three will happen at the same time or within a few days of each other.

Carpal tunnel syndrome is the commonest example of peripheral nerve pressure when the median nerve is compressed as it passes through the carpal tunnel at the wrist. Pins and needles in the thumb and palm is the commonest symptom of carpal tunnel syndrome.

Labels: carpal tunnel syndrome, joint pain, nerve pain shoulder, paresthesia, pins and needles, whiplash

The company who make Synvisc - a synovial fluid replacement product - have announced a new approach and a new version of their product.

Genzyme say that they are seeking approval to use a single treatment of Synvisc-One to treat osteoarthritis of the knee for up to six months. Synvisc treatment is currently approved to be given in three separate doses at once weekly intervals. Synvisc-One combines those doses in one treatment. This means that patients will need only one injection and not three as at present.

A number of companies make synovial fluid replacement products.
Synovial fluid is the natural "oil" that we all have in our joints. When osteoarthritis develops the supply of synovial fluid dries up and the joint becomes dry and stiff. The idea behind synvisc and related drugs is to replace the missing synovial fluid and thus to provide lubrication, better movement and pain relief.

At present synvisc and the other related drugs are mostly used for knee osteoarthritis but some doctors are beginning to experiment with their use in other joints.

Labels: arthritis, injections for joint pain, joint pain, synvisc

We can all learn something new every day! And good doctors are constantly alert to learning from all of their patients. It takes a lot to surprise me after twenty years in medicine but - I hold my hand up - this is a new one!

I had never heard of cherry juice or fresh cherries being used to treat gout or for gout pain relief until I heard it recently from a patient (who had been told it by his pharmacist, who had heard it from a relative etc etc). Anyway - a quick search for the "treatment of gout" on google turned up one (rather ancient -1950) research paper and a whole stream of anecdotal reports about the positive effect of cherries and their juice. It seems that consuming about half a pound of fresh cherrys a day or half a litre of fresh cherry juice can significantly lessen the pain and swelling of gout.

I've never had gout and I hope you haven't either but I can tell you it's one of the most painful conditions known in medicine.

Our blood contains a salt called uric acid. It's there all the time in everyone but is normally fully dissolved in the way that sugar is fully disolved in a hot cup of tea. But ... if the tea cools down ... what happens to the sugar? It comes out of solution as little sharp edged crystals. Well, guess what - that's exactly what happens in an attack of gout pain.

A change in the blood chemistry allows the uric acid to crystalise out of solution and form little jaggy crystals (like bits of broken glass) in the joints. For some reason the first joint of the big toe is the most commonly affected - and the pain when walking is horrific. Quite literally "like walking on broken glass" as many of my patients describe it.

Anyhow - back to those cherries.

My patient swore that taking the cherry juice had made a big impact on his gout pain and had provided rapid gout pain relief. You might want to try this yourself if you have gout or you might want to recommend it to a friend or relative.I'm not clear whether tinned cherries can have the same effect.

The most commonly quoted explanation of the effect is that cherries contain flavonoid compounds that may lower uric acid and reduce inflammation. As I described above, uric acid is the body salt that triggers gout attacks.

I have found nothing published to suggest that taking regular cherry juice lessens the risk of you having an attack in the first place but if you suffer from gout regularly it may be worth a try. Cherry juice, cherry pie, ice cream with cherry sauce? Mmmm - sounds good to me!

Labels: arthritis, foot pain, gout, joint pain

Back pain due to cancer is very rare - that's the good news - but it does happen and it's very important for both doctors and their patients to be aware of the warning signs.

A recent article published in the European Spine Journal highlights the most important issues.

The researchers looked at all published studies covering issues related to back pain and cancer.

Six studies evaluating 22 different clinical features and tests were identified.

Malignant cancer as a cause of back pain is rare - the scientists in this study foun rates between one in a thousand cases and, at most in some groups of patients, three in a hundred.

Features that acted as major warning signs or red flags for cancer were

• A previous history of cancer
• A high ESR blood test
• A reduced hematocrit blood test
• And overall clinician judgement

A combination of age more than 50 years, a previous history of cancer, unexplained weight loss, and failure to improve after 1 month were highly worrying features.

The authors emphasised that malignancy is rare as a cause of low back pain. The most useful features and tests are a previous history of cancer, elevated ESR, reduced hematocrit, and clinician judgement.

I'll say again here what I've said many, many times before .... if you are concerned about a persistent back ache then go see your doctor. Now please !

Labels: back pain, cancer, joint pain, red flag signs

Sandals and lightweight shoes may be comfortable in summer but in many cases they are bad for your feet and can trigger off quite troublesome foot and heel pain.

The most commom problem is a condition called plantar fasciitis.

Plantar fasciitis is an inflammation along the bottom surface of the foot of a band of tissue that connects from the ball of the foot to the heel. This band of tissue becomes strained and inflamed and causes pain on the sole of the foot near to the heel.

The strain occurs because your foot muscles are stressed trying to keep the shoes on. It's worse in shoes that are flexible, with no support in the midshaft, and in shoes that are perfectly flat, with no heel elevation.

There's good evidence that having a shoe with a slight heel can take some of the strain off the foot.

There are several different ways to treat plantar fasciitis - some specialists recommend foot stretches, some special insoles and some doctors use injections.

But the best advice for summer is to limit the amount of time you spend in flip-flops. Doctors say they're not good for long walks, or for exercise.

Labels: arthritis, foot pain, heel pain, joint pain, muscle injury

Whiplash Injury Treatment

How to treat acute whiplash neck injury

New research has confirmed what many involved in treating whiplash injury patients already know. If the initial treatment is too intensive or aggressive then recovery can be delayed not quickened. There may be something to be said for going back to an inital period of rest in a neck collar - something doctors, physiotherapists and chiropractors had moved away from recently.

The new research study was published in the May 25 Early View issue and June print issue of the journal Arthritis & Rheumatism.

"Although there are few effective treatments for curing whiplash, a growing body of evidence suggests that the delivery of intensive aggressive health care shortly after the injury may lead to a longer recovery period" said one of the researchers.

The study showed that those who simply attended their family doctor got better quicker than those who had early intensive hands on treatment from a chiropractor or a physiotherapist.

The results add to the body of evidence suggesting that early aggressive treatment of whiplash injuries does not promote faster recovery.

In particular, the combination of chiropractic and general practitioner care seemed to significantly reduce the rate of recovery

Labels: joint pain, neck pain, pain control, whiplash

Surgery for Back Pain

Should you have an operation for chronic back pain?

The majority of those with chronic back pain will get better or find pain relief without surgery but new research shows that an operation may speed recovery for some

The New England Journal of Medicine have published new research to compare surgery with the simple passing of time for people with severe back pain. Those in the study mainly were known to have a slipped or herniated disc or sciatica

A spine specialist in Holland looked at 283 patients who had suffered from sciatica for at least six weeks before the study began. He found that 95 per cent of patients reported recovery after one year, whether or not they had surgery.

But about 40 per cent of the participants assigned to conservative wait-and-see care also opted for surgery, which seemed to relieve symptoms more quickly than would otherwise have been expected.World recognised spine expert: Richard Deyo of the University of Washington in Seattle - said in a journal editorial

"For patients with persistent sciatica, there seems to be a reasonable choice between surgical and nonsurgical treatment, which may be influenced by aversion to surgical risks, the severity of symptoms, and willingness to wait for spontaneous healing,".

Most experts agree that surgery should only be considered an option if the pain has persisted for at least six weeks .

Labels: arthritis, back pain, joint pain, pain control

Shoulder Blade Pain

What causes a pain in the Shoulder Blade area?

Interestingly, but importantly, shoulder blade pain only rarely arises due to a problem with the shoulder blade.

The shoulder blade is also called the scapula. True problems in the region of the scapula are rare and include bone disease such as infection or bone tumour. These causes account for no more than a tiny percentage of shouder blade pain problems.

Nearly every case of shoulder blade pain is due to a problems in the lower part of the neck or in the upper part of the back. This pattern of pain is known as referred pain. Referred pain from the neck is usually felt along the inner side of the shoulder blade - the side nearest the spine in other words.

How to diagnose Shoulder Blade Pain
Your doctor or therapist will begin the diagnosis of shoulder blade pain with a simple examination. They will examine your shoulder joint, muscles and the nerves of the upper arm. Your cervical spine (or neck) will also be examined - along with your upper back or thoracic spine.

If your shoulder blade pain is arising in the cervical spine then neck movements will trigger it or make it worse.

Your doctor may organise an x-ray of the neck or an MRI scan to confirm the diagnosis of a neck problem although this is not always required.

If your doctor suspects another reason for your shoulder blade pain then you may need blood tests, a chest x-ray or an MRI scan of the chest or thoracic region.

Severe shoulder blade pain of sudden onset can be an indication of serious heart or blood vessel problems. You should seek medical attention immediately if this occurs

How to treat Shoulder Blade Pain
The treatment of shoulder blade pain will in part depend on the cause that your doctor or therapist discovers. The commonest cause is related to the neck or cervical spine and treatment is usually best directed at this area.

Neck treatments for shoulder blade pain often result in a quick and full recovery.

Treatment options for shoulder blade pain include:

painkiller or anti-inflammation medication
physical therapy from a physiotherapist, chiropractor or osteopath
manipulation of the neck or thoracic spine
acupuncture

Labels: arthritis, joint pain, shoulder blade, shoulder pain

Can Coffee Drinking Help Gout?

Gout is triggered by high uric acid levels in the blood. Gout is the commonest inflammatory arthritis in adult men and is becoming more common in women.

Scientists have long thought that high intake of coffee and tea can reduce uric acid levels in the blood and thus reduce the risk of a gout attack and a new study published in the June 2007 issue of Arthritis Care & Research seems to support this - for coffee drinkers at least. Even decaffeinated coffee might help if you are a gout pain sufferer.

The researchers found that coffee consumption is associated with lower uric acid levels but this appears to be due to components in coffee other than caffeine.

The results of the research showed that levels of uric acid in the blood significantly decreased with increasing coffee intake, but not with tea intake.

Interestingly, there was an association between decaffeinated coffee consumption and uric acid levels. These findings back up the idea that components of coffee other than caffeine contribute to the observed association between coffee intake and uric acid levels.

The scientists emphasise that they do not really know how the connection between coffee, gout and uric acid works but they believe that the chemicals in coffee are affecting insulin levels and also producing powerful antioxidant chemicals within our body.

Labels: arthritis, caffeine, gout, joint pain

The rotator cuff are the group of muscles that surround the shoulder and help to keep it stable and strong during movement.

These muscles can often become a source of pain - either due to inflammation or to tearing in the muscle fibres or in the muscle tendons that join the muscles to the bone.

Recovery from rotator cuff pain can be a long process - and you may receive a bewildering range of advice along the way.

Check out this great Guide to Rotator Cuff Injury - written by tennis pro Brent Abel. It's a comprehensive overview of the nature of the problem and of the available treatments.

Labels: joint pain, muscle injury, shoulder pain

Who gets gout

Who gets gout - there are lots of myths around. Gout has been called the arthritis of the rich and the disease of the kings. People often think of gout as a problem that afflicts boozy, overweight pleasure seekers. These are all myths about gout.

Australian world cup soccer star Harry Kewell developed gout during the world cup soccer championship and has helped to dispell some of the often heard fictions about a widely misunderstood disease

So who gets gout?
There are two types of people who get gout: those who inherit a gene for it, and those that get it from drinking too much alcohol and being overweight.

If it was gout that felled the star striker — or a combination of gout, bad blisters and a chronic groin injury — then it was most likely hereditary.

Read more about gout in an athlete

Labels: arthritis, gout, joint pain