It's September, which means it's officially Sickle Cell Disease awareness month. This disease affects up to 100,000 Americans and more than 100 million people worldwide. It's a common occurrence, and it's passed on through genetics. So, what is Sickle Cell Disease, and how does it affect those who have it?

In this piece, we'll give you the 101 on Sickle Cell Disease and why September is the awareness month.

Sickle Cell Disease Basics

Sickle Cell Disease is a genetic blood disorder that affects the blood cells specifically. Anyone who has it has gotten the gene from someone they're related to. This condition causes blood cells to form a sickle shape, like the standard antique farming tool.

With this unique shape, the blood cells cannot pass through the body properly and are likely to die more quickly, causing a severe lack of red blood cells in the body. With this lack of blood cells, anemia can start, and this causes complications. The shape of the blood cells also causes blood to not be able to enter certain parts of the body at times or to clot.

There are several types of Sickle Cell Disease, which we've outlined below.

HbSS

This type of SCD is considered Sickle Cell Anemia. People who have this form have received two separate sickle cell genes from each of their parents.

HbSD, HbSE, and HbSO

These forms of SCD are often considered rarer than HbSS. This is when someone inherits a sickle cell gene from one parent and an abnormal hemoglobin gene from another.

HbSC

This is another form of SCD that is due to an unnatural hemoglobin gene and a sickle cell gene combined. This form is less severe than the first two forms.

HbS Beta Thalassemia

This type of SCD is when someone inherits a sickle cell gene from one parent and a beta-thalassemia gene from another. The beta-thalassemia gene is another form of anemia that is rare. This can have varying effects depending on the person.

Symptoms of Sickle Cell Disease

Depending on which type of SCD you have, the symptoms can vary. Some of the first signs of SCD include:

·       Severe fatigue

·       Swelling in the limbs, hands, or feet

·       Jaundice (when the whites of your eyes or skin turn yellowish)

·       Feeling unwell

Most people with severe SCD get anemia. When SCD becomes severe, it is due to anemia. The symptoms of Sick Cell Anemia include:

·       Pain in the body

·       Extreme fatigue

·       Paleness of skin

·       Frequent infections

·       Fever from infections/sickness

·       Blood clots

·       Swelling

·       Nerve pain

·       Dizziness

·       Unable to walk properly

If you have any symptoms of anemia or you suspect you may have SCD, you can get a blood test to see if you have this condition at any clinic or doctor.

How to Get Diagnosed for Sickle Cell Disease

If you think you may have Sickle Cell Disease or you know that your parents could potentially have one of these types of genes, it's a good idea to get an SCD test.

Your doctor will give you a regular blood test by taking a sample from your vein and testing it in a lab. It is possible to have this test done from as early as 5-months old, so you can get your baby tested if you have Sickle Cell Disease or Sickle Cell Trait.

Frequently Asked Questions: SCD

Here are some of the most frequently asked questions about Sickle Cell Disease and similar conditions.

Are Certain Communities More Likely to Get SCD?

Yes. Sickle Cell Disease is more common in those of Sub-Saharan African descent, those from Spanish-speaking countries, and Mediterranean countries like Italy and Greece.

In the US, SCD is found in every 1 out of 365 Black or African American babies and 1 in every 16,300 Hispanic-American babies.

Due to a lack of resources, education, and visibility to this disease, many minority communities are not given proper care for Sickle Cell Disease, causing more deaths in these communities from the disease. It's imperative that efforts are made to care for these communities and bring awareness to SCD.

What's the Difference Between Sickle Cell Disease and Sickle Cell Trait?

Sickle Cell Disease is when someone has both an (S) sickle cell gene and another (S) sickle cell gene or an abnormal hemoglobin gene paired with the S gene.

Sickle Cell Trait is when one sickle cell gene is present, and the other is a normal gene. People with this trait generally lead everyday lives, and although they can experience mild anemia, it isn't as severe as SCD.

Keep in Mind: Even if you have SCT and not SCD, you should be careful and get your partner tested as well. You can pass on this gene to your children, and if your partner does as well, your child can be born with SCD.

Can Sickle Cell Disease be Cured?

The only cure for SCD is a bone marrow transplant or stem cell transplant. This is often done unless there are serious risks, major strokes, etc., causing continuous danger to a person. However, these procedures are costly in the US.

Complications of SCD

When it comes to Sickle Cell Disease, there are many complications that can occur. You should check with your doctor if you have this disease and continue with frequent checkups. Some of the difficulties you can face as a person with this disease include:

·       Stroke

·       Heart attack

·       Anemia

·       Vision Loss

·       Acute Chest Syndrome

·       Ulcers

·       Hand and Foot Syndrome

·       Reynaud's

·       Jaundice

·       Organ Damage

It's important to know that it is still entirely possible to live a normal and healthy life with SCD. It is not a death sentence.

Continue reading below to find resources specific to SCD for those who have it or education for those who'd like to learn—and happy Sickle Cell Awareness month!

Resources

If you have SCD, know someone who does, have SCT, or just want to learn, there are plenty of resources out there about SCD so you can learn more.

Support and Education Platform for SCD and SCT- Sickle Cell Disease Association of America

CDC Information on SCD and SCT- Centers for Disease Control and Prevention USA

American Society of Hematology- Education, and information on blood diseases

Bone Marrow Donation Site- Find a bone marrow donor match

Online Sickle Cell Community- For those with the disease or trait

Dealing with Sickle Cell in School- For kids and families

If you're looking for more resources, you can check out the resource page at SCD Association of America.

Sources Used

https://www.sicklecelldisease.org/get-involved/events/national-sickle-cell-awareness-month/

https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/diagnosis-treatment/drc-20355882#:~:text=A%20blood%20test%20can%20check,a%20vein%20in%20the%20arm.

https://www.cdc.gov/ncbddd/sicklecell/data.html

https://www.sicklecelldisease.org/

https://www.hematology.org/

https://raremark.com/sickle-cell-disease

https://www.sicklecelldisease.org/files/sites/181/2019/06/SickleCellDiseaseGuidelines-1.pdf

Physical therapy is a healthcare profession that utilizes therapeutic exercises and techniques to promote mobility, function, and pain relief for individuals with various musculoskeletal and neuromuscular conditions. Physical therapists, also known as physiotherapists, are licensed healthcare professionals who are experts in assessing and treating movement-related issues.

How Physical Therapy Works to Treat Chronic Pain:

1. Assessment and Diagnosis: The first step in physical therapy for chronic pain is a thorough assessment of the patient's medical history, pain symptoms, functional limitations, and mobility issues. The physical therapist will conduct various tests and evaluations to identify the root cause of the pain and develop an individualized treatment plan.

2. Pain Relief Techniques: Physical therapists use various pain relief techniques to help manage chronic pain. These may include heat or cold therapy, ultrasound, electrical stimulation, and manual therapy. These modalities aim to reduce pain, muscle spasms, and inflammation, providing immediate relief and preparing the body for therapeutic exercises.

3. Therapeutic Exercises: Therapeutic exercises are a cornerstone of physical therapy for chronic pain. The physical therapist designs a personalized exercise program tailored to the patient's specific needs and condition. These exercises aim to strengthen muscles, improve flexibility, and enhance joint stability, which can lead to better pain management and improved function over time.

4. Posture and Body Mechanics: Physical therapists educate patients on proper posture and body mechanics to prevent further strain on affected areas and minimize pain. Correcting postural imbalances and adopting ergonomic principles in daily activities can alleviate chronic pain and promote healing.

5. Manual Therapy: Manual therapy techniques involve hands-on manipulation of muscles, joints, and soft tissues by the physical therapist. These techniques can help reduce muscle tension, improve joint mobility, and release trigger points, all of which contribute to pain relief and improved functional movement.

6. Functional Training: Physical therapists focus on functional training, which involves practicing movements and activities that are essential for daily life and specific to the patient's needs. Functional training helps patients regain confidence in performing everyday tasks and reduces pain during daily activities.

7. Education and Self-Management: Physical therapists play a vital role in educating patients about their condition, pain triggers, and how to manage chronic pain independently. They may provide strategies for home exercises, self-care, and lifestyle modifications to enhance the long-term benefits of physical therapy.

8. Gradual Progression: Physical therapy for chronic pain typically involves a gradual progression of exercises and activities. As the patient's strength, flexibility, and pain tolerance improve, the physical therapist adjusts the treatment plan to challenge the individual appropriately.

9. Prevention of Recurrence: Physical therapy not only addresses current pain but also aims to prevent recurrence and future injuries. By addressing underlying issues and promoting proper movement patterns, physical therapy helps patients reduce the risk of chronic pain returning.

Physical therapy is a comprehensive and evidence-based approach to treat chronic pain. Through a combination of pain relief techniques, therapeutic exercises, manual therapy, and education, physical therapists work collaboratively with patients to alleviate pain, improve function, and enhance overall quality of life. This non-invasive and patient-centered approach empowers individuals to take an active role in managing their chronic pain and helps them regain independence and confidence in their daily activities. For individuals experiencing chronic pain, consulting a qualified physical therapist can be a crucial step toward finding effective and sustainable pain management solutions.

Background Of Postherpetic Neuralgia:

Herpes zoster (HZ) is a viral disorder, often manifesting as chickenpox. Human herpesvirus-3 (HHV-3) is also known as the varicella-zoster virus (VZV). Following the acute phase, the virus reaches the sensory nerve system, which resides in the geniculate, trigeminal, or dorsal root ganglia for many years. The virus reactivates with age or immunocompromised individuals, resulting in an eruption (shingles). Discomfort can continue or reoccur even after the acute rash has faded in shingles-affected areas. Postherpetic neuralgia is the medical term for this ailment (PHN).

What Is Postherpetic Neuralgia, And How Does It Affect You?

The nerves and skin are affected by postherpetic neuralgia, which is a painful disorder. It's a side effect of herpes zoster, also known as shingles. Shingles is a distressing, blistering skin rash caused by the varicella-zoster virus reactivating.

Chickenpox is the most common way to catch this virus during childhood or adolescence. After childhood, the virus can remain dormant in the body's nerve cells and be reawaken decades later.

Postherpetic neuralgia is a disorder that occurs when the pain produced by shingles does not go away after the rash and blisters have healed. The most common shingles consequence is postherpetic neuralgia. It happens when shingles damage the nerves.

Because the injured nerves cannot transmit messages from the skin to the brain, the messages become jumbled. This causes continuous, excruciating pain that can last months. As per a 2021 study, roughly 20% of shingles patients also experience postherpetic neuralgia. Furthermore, those over 50 are more likely to have this illness

WHAT IS THORACIC OUTLET SYNDROME?

Compression, damage, or irritation of nerves or blood vessels (arteries and veins) in the lower neck and upper chest region are used to describe a range of illnesses collectively known as thoracic outlet syndrome (TOS). A cluster of nerves and blood vessels known as thoracic outlet syndrome is present in the region between your lower neck and upper chest (the thoracic outlet).

Symptoms Of Thoracic Outlet Syndrome

Affected parts of the neck, shoulders, and arms may experience discomfort, numbness, or decreased blood flow due to TOS.

Many people confuse the pain of thoracic outlet syndrome with angina (chest discomfort owing to an insufficient supply of oxygen to the heart muscle). However, thoracic outlet syndrome pain does not develop or intensify when walking, but angina pain frequently does. In contrast to angina, the pain from TOS usually worsens as you raise the afflicted arm.

Patients with TOS can be diagnosed based on their symptoms and signs. Depending on where the body is affected, there are several different types of thoracic outlet syndrome problems. The nerves, veins, and arteries can be affected by Thoracic outlet syndrome (the least common type). The thoracic outlet space is reduced in all kinds of TOS, and scar tissue forms around the structures.

Diagnosis of Lyme Disease

Upon your first visit to the healthcare provider, they will diagnose your condition. For Lyme disease diagnosis, the professionals will go through your health history to see if you have any underlying disease causing these symptoms. Furthermore, they will take a look at the tick bites and confirm your residential location or if you visited an endemic area.

The Healthcare provider will also conduct a physical exam ensuring the availability of rash or any other symptoms of Lyme disease. The doctor will not perform tests while you are in the early localized stage of the infection. Because the bite of the tick will not show any immediate effect on the body, a doctor has to wait for a week or two. Therefore, the doctor will perform blood tests after weeks after the infection for reliable results. Here are some tests that you may undergo during the diagnosis of Lyme disease:

1. Enzyme-linked Immunosorbent Assay

ELISA test will ensure the availability of antibodies after the bite of B. burgdorferi.

1. Western Blot

Western blot confirms the positivity of the ELISA test. You will go through this test for the confirmation of B. burgdorferi proteins.

1. PCR or Polymerase Chain Reaction

PCR help to evaluate the symptoms related to the nervous system. The healthcare professional will take the samples from your joint fluid to evaluate you with Lyme arthritis. Because the diagnosis of CSF using PCR testing is low sensitivity, doctors will only suggest this test in rare conditions. The negative result from this testing does not indicate any final results.

Treatment of Lyme Disease

Regardless of which stage you are in, you can seek effective treatment from a professional healthcare provider. During the early localized disease, the doctor will recommend oral antibiotics for 10 to 14 days eliminating the infection. Here are some medications you can take for the treatment:

• Amoxicillin, doxycycline, or cefuroxime are the first line of treatments for children and adults.

• Amoxicillin and cefuroxime are helpful to treat the condition in a breastfeeding or nursing woman.

If your symptoms affect your cardiac or central nervous system, the doctor will prescribe Intravenous antibiotics to treat Lyme’s disease. Once the healthcare provider notices improvement in your condition, they will change your medications to oral treatment. You have to undergo this treatment for 14 to 28 days.

If you suffer from Lyme arthritis, late-stage symptoms, a doctor will recommend oral antibiotics for 28 days to reduce the symptoms.

Prevention from Post-treatment Lyme Disease Syndrome

Treating a post-treatment Lyme disease can be difficult. Therefore, it is essential to take precautionary measures and avoid direct contact with the infection. Here is what you can do to reduce the risk of getting a disease and developing the symptoms.

Contact your doctor once you experience the initial symptoms. The doctor will observe the development of the signs for 30 days. You shouldn’t completely depend on the doctor but learn and identify the early Lyme disease stage signs. Upon identification, immediately consult with the doctor and seek treatment. 

A professional doctor will prescribe antibiotics at the early stage of the condition reducing your risk of spreading the infection throughout your body. Here are some symptoms of Lyme disease you may notice within 3 to 30 days of the bite.

• Headache

• Itching

• Bull’s eye rash on the bite

• Dizziness and faintness

• Neck stiffness

• Fatigue, general feeling of illness, and chills

• Swollen lymph nodes

• Joint and muscle pain or swelling

Conclusion

The bite of a diseased tick increases your risk for developing post-treatment Lyme disease syndrome. The condition may also lead to a chronic situation. When this happens, you may experience symptoms for weeks, months, and years after the tick bite. 

If you didn’t seek medical help soon after the bite during your first stage, your condition might become severe. To avoid the severity, a professional healthcare provider will recommend an antibiotic. Consuming the antibiotics will reduce your risk of developing long-term symptoms of Lyme’s disease. 

However, it is no possible way to determine the severity of your condition as the symptoms may vastly vary from one individual to another. Also, it would be difficult for a professional doctor to anticipate the duration for which you suffer from this condition. 

Lyme disease is an under-researched and underreported disease caused by bacteria. This bacterium has four main species affecting different locations. In the United States, Borrelia burgdorferi and Borrelia mayonii are responsible for the spread of Lyme disease. However, in Europe and Asia, people suffer from the disease because of Borrelia garinii and Borrelia afzelii. 

The common reason why you might develop Lyme disease is through the bite of the deer tick. A deer tick is a black-legged tick that sucks blood from big animals such as deer. Furthermore, they also bite humans, causing diseases such as babesiosis, anaplasmosis, and Lyme disease. 

People residing in wooden areas have a high risk of developing Lyme disease because these blood-sucking parasites live in grassy and wooden areas.

Stages of Lyme Disease

Lyme's disease is a condition with wide-ranging symptoms. These symptoms may appear in various stages. However, it is possible that you experience an overlap in the stages. Different people undergo different patterns and symptoms, making it hard for healthcare experts to diagnose and identify the actual reasons for the symptoms. Here are three stages of Lyme disease that you might undergo after the bite:

• Early localized

• Early disseminated

• Late disseminated

It is important to understand these stages because you will experience the symptoms depending on the stage. However, as you already read in the above section, the symptoms are not dependent and may vary by individual. The following description of the stages based on a common pattern of the symptoms will give you a general idea:

1. Early Localized Disease

Once the deer tick bites you on the skin, you develop a red and small bump. This bump is similar to the mosquito bite, so it is possible that you might confuse it at first. Also, you will not develop the signs and symptoms for almost a month after the bite. The appearance of bull’s-eye rash is one of the early signs. The rash occurs on the spot where the tick bites.

However, the appearance of the rash is not necessary. You may also develop a clear spot similar to the mosquito bite. You may feel warmness on the spot when you touch. Another strange thing about this spot is that it does not pain or itch. Also, in some people, the rash gradually disappears in few days. 

You can formally refer to this type of rash as erythema migrans. It is one of the characteristics of Lyme disease. If you have a dark complexion, you will likely develop a bruise-like rash. Some people also develop a solid red rash on the spot. The development of inflammation may cause flu-like or systemic viral-like symptoms to the body. Here are some other symptoms you might develop during the early localized stage of the disease.

• Fever

• Sore throat

• Chills

• Enlarged lymph nodes

• Muscle aches

• Fatigue

• Vision changes

• Headaches

1. Early Disseminated Lyme Disease

You will develop the symptoms from this stage after several weeks or months of the bite. Generally, the intensity of the symptoms will increase and the rash will appear in different parts of your body. When you reached this stage, your entire body, including the organs consists of the infection. Here are the symptoms that you might show during this stage:

• Neuralgic conditions including tingling, numbness, meningitis, and facial and cranial nerve palsies. During this condition, you will develop a membrane around your brain causing temporary paralysis on the one side of your face, impaired muscle movement, and weakness in your limb.

• Lyme carditis will change the rhythm of your heartbeat.

• Multiple erythema multiforme lesions appear in which you develop rash on different parts of your body.

The above symptoms may overlap in different peoples suffering from the disease. Some people experience the first stage before others.

1. Late Disseminated Lyme Disease

If you did not get proper treatment for the first and second stages of the disease, you may develop the third stage of the infection. This stage may appear after months or even years of the bite. Some characteristics of this stage are:

• Brain disorders, including encephalopathy. This condition includes difficulty in concentration, short-term memory loss, mental fogginess, sleep disturbance, and other problems affecting your conversational abilities.

• You will also develop numbness in your hands, arms, feet, or legs.

• Arthritis of large joints cause severe pain and inflammation in the affected area. However, the pain may also shift to other joints.

People on the third stage of the condition may also experience these less common symptoms:

• Eye inflammation

• Heart problems

• Severe fatigue

• Liver inflammation

 Pain levels may differ from one person to another. Keep in mind that pain is a personal experience. It may differ depending on various factors, such as overall physical health and emotional state. These factors play a significant role in defining how you feel about the pain.

When you can accurately describe your pain to an emergency doctor, they provide proper treatment. The best way to keep track of your pain is by writing details about your pain in a pain journal. When you visit the doctor, you can hand over the journal to them, so they can clearly understand how you feel. Here are some questions that your doctor may ask upon visit:

• When did you experience a certain pain for the first time?

• What are the intervals of pain?

• Why do you experience the pain?

• What activities relieve you from pain or make it worse?

• What is the exact location of the pain?

• Are you feeling pain at a specific spot, or is it spreading?

• Is the pain constant or pulsating?

Also, you need to know some words to describe your pain. Some of these words are:

• Dull

• Sharp

• Burning

• Shooting

• Cramping

• Aching

• Intense

• Tender

• Heavy

• Pressure

• Gripping

• Gnawing

• Stabbing

• Stinging

• Prickly

A pain journal is of great help when it comes to tracking your pain. You can make different columns and fill them out to explain how you are feeling:

• At what time you started to experience the pain?

• How are you feeling?

• How long did the pain last?

• What is the exact location of the pain?

• What is the severity of the pain? (You can rate your pain out of 10)

• What are the triggers of the pain?

• What activities help you relieve?

• What treatments or medications you take?

If possible, you should bring the pain journal while visiting an emergency room. This diary will help the doctor understand the kind of pain you are experiencing.

Have you ever been in pain but had no idea if it was an emergency or not? This article will outline the different types of pain and their levels. That way, you can identify if you need to go to an emergency room or take OTC medications for pain management. Describing your pain levels is not an easy task. Different health conditions involve similar types of pain. Furthermore, the intensity of pain may differ between people. This subjective nature makes it difficult for you to differentiate between mild and severe pain. Even if you find it difficult to explain your pain, the emergency room doctor needs details, so they can diagnose the underlying condition. Consequently, you should have enough knowledge to describe your pain for proper treatment. Remember to visit the emergency room if your pain severity affects the quality of life.

What is Pain?

Medically speaking, pain sensation is uncomfortable, but it’s a sign that you are suffering from an illness or injury. In simple words, pain is a signal that indicates something wrong with your body. Your brain triggers the pain response to notify that you are performing an activity that is hurting the body. For instance, when you touch something hot, you feel the pain in the location of contact. In response, you try to keep your skin cold by applying ice. Also, if you are walking, regardless of an injured ankle, your brain will send signals to immediately stop.

Different Types of Pain

1. Acute Pain

Acute pain is a sudden pain you will experience in the short term. A common cause of acute pain is tissue injury. This pain may last for few months, but you may experience pain once in a while. You can relieve acute pain by treating the underlying condition. Acute pain will start out intense and sharp, but it will gradually improve. If you immediately experience acute pain, you need to head to the emergency room. The ER doctor will diagnose your pain and identify the underlying condition. They will provide appropriate treatment offering relief from the pain. Here are some common causes of acute pain:

• Surgery

• Broken bones

• Cuts

• Labor and childbirth

• Dental work

• Burns

1. Chronic Pain

Unlike acute pain, chronic pain will not improve with time. Even after treating the underlying condition, you will experience pain. This pain will last longer than six months. Chronic pain may range from mild to severe. The level of pain may also change over time. However, this type of pain will last years. In the United States, more than 50 million adults suffer from chronic pain. 

You may develop chronic pain because of damage, injury, or illness. But, it is possible that you may experience chronic pain without any apparent cause. If you fail to manage the pain appropriately, it will affect your quality of life. That’s why people suffering from chronic pain also develop depression or anxiety. Here are some symptoms of chronic pain:

• Limited mobility

• Lack of energy

• Tense muscles

Here are some common chronic pain examples:

• Low back pain

• Frequent headaches

• Nerve damage pain

• Arthritis pain

• Fibromyalgia pain

1. Nociceptive Pain

This type of pain can be acute or chronic. If you suddenly experience nociceptive pain, you need to rush to the emergency room. Due to the stimulation of nociceptors, you will experience this pain. Nociceptors are the pain receptors that trigger pain in the event of tissue injury. Nociceptors are spread throughout the body, but they are most commonly present in the skin and internal organs. External injury, including a cut on the skin with a knife, will trigger these receptors. The signal stimulated through these receptors reaches the brain. As a result, you feel the pain. You may feel this type of pain for inflammation or injury. 

1. Visceral Pain

You will experience visceral pain because of damage or injury to the internal organs. The pain occurs in the trunk region, including your abdomen, chest, and pelvis. You might find it hard to identify the exact location of the pain. If you are suffering from visceral pain, you need to head to the nearest emergency room. When the doctor asks about your pain, you can describe it as:

• Cramping

• Squeezing

• Aching

• Pressure

Other than that, you may also feel vomiting or nausea. This pain will elevate your body temperature, blood pressure, and heartbeat. Here are some examples of visceral pain:

• Irritable bowel

• Appendicitis

• Gallstones

1. Somatic Pain

Somatic pain occurs due to pain receptors in the tissues. This condition does not relate to internal organs. For instance, it arises in your joints, muscles, skin, bones, and connecting tissues. You can easily pinpoint the exact location of somatic pain. In contrast, it is not possible to identify the location with visceral pain. 

Your somatic pain may be acute or chronic. If you are suffering from acute somatic pain, visit the nearest emergency room. Suffering from somatic pain, you will experience a gnawing or aching sensation. You can further classify this type of pain as superficial or deep. For instance, if you have pain because of a tear in a tendon, it is deep somatic pain. On the other hand, your pain is superficial if you have a canker sore on the inner cheek. Here are some examples of somatic pain:

• Strained muscles

• Bone fracture

• Bones and skin cancers

• Osteoporosis or other connective tissue diseases

• Arthritis pain or other joint pain

• Burns, scrapes, and skin cuts.

1. Neuropathic Pain

When you experience dysfunction or damage to your nervous system, it can result in neuropathic pain. Because of damaged nerves, your brain will receive false signals of pain sensations. There is no proper reason for pain development. When your nerves are sensitive, you will feel pain in response to unusual things, including clothes or air touching the skin. There are two types of neuropathic pain; acute neuropathic pain and chronic neuropathic pain. If you suddenly develop neuropathic pain, you need to visit the emergency room. Here are some terms to describe your neuropathic pain to the ER doctor:

• Shooting

• Stabbing

• Tingling

• Numbness

• Freezing

• Burning

• Electric shocks

Diabetes is a neuropathic pain disease. Here are some other common conditions that can lead to neuropathic pain:

• Radiation

• HIV

• Shingles

• Bell’s palsy and other facial nerve problems

• Chronic alcohol consumption

• Infections

• Accidents

• Chemotherapy drugs

• Parkinson’s disease, multiple sclerosis, or other nervous system disorders

• Carpal tunnel syndrome

• Compression or inflammation of the spinal nerve

Company Description
Private medical practice located in Levittown, PA

About this position:

Part-time/Full-time candidates being considered, hourly position
Monday through Friday, normal business hours

Primary Duties:
Responsible for billing activities including data entry, payment posting, reconciliation, depositing checks, completing log sheets, accounts receivable/collections, billing procedures, accurate record maintenance, pre-authorization and insurance verification.

The Medical Biller is responsible for following up on pending and past due reimbursement for medical services rendered.

• Print patient statements and send out delinquent notices weekly.

• File claims to insurance companies on a daily basis

• Performs other related duties as assigned

• Maintain all compliance of HIPAA regulations

Qualifications

• Qualified candidate must have a High School Diploma or equivalent. College degree is preferred.

• Two years experience in billing, three to five years preferred.

• Three years customer service background required

• Excellent oral and written communication skills

• Personal computer skills

• Ability to work independently and as part of a team

• Must have work experience billing for Medicaid, Medicare and all 3rd party insurances.

• Strong computer & communication skills.

• Related work experience & medical terminology

• Ability to perform office procedures to established protocols

• Good time management and organizational skills.

• Willingness to learn new skills and help in different areas.

Any eligible candidate must be able to pass a background check (including drug screen) and have reliable transportation.

Valid Driver’s License

Physical Demands

• Ability to stand, walk, or sit for an extended period of time

• Excellent written and verbal communication skills.

• Ability to stoop, bend, push or lift 50 pounds.

Compensation:

Pay is commensurate to experience and qualifications.

We are an Equal Opportunity Employer and a Drug Free Workplace.

Job Types: Full-time, Part-time

Apply Here

Do you know only 2% of the entire world population are redheads? This makes them different from others. But that's not the only distinctive characteristic of these people. Redheads respond to pain differently. This may sound weird but there are some convincing researches. Not just that, their sensitivity to pain medication is also distinct from their dark-haired counterparts. In this article, we will clear all the myths by explaining the difference between a redhead and a dark head for pain tolerance.

What is Pain?

Pain is an uncomfortable sensation indicating that something is wrong with the body. It negatively influences your ability and capability to perform everyday tasks. Sometimes, pain is the signal generated by brain warning you about a health condition such as injury or infection. When your body nerves detect tissue damage, they send signals to the brain through neuroreceptors. Pain may vary due to numerous factors such as intensity, cause, and tolerance level of the person. Furthermore, pain could be acute or chronic.

When it comes to pain tolerance level in Red heads, you may find various views and researches conflicting with each other. In following context, we will understand whether red heads experience pain differently or this is just a myth. Keep in mind that with so many rumors and limited researches, it is hard to understand the reaction of redheads for all types of pain. Other than pain, there are rumors that red heads have different tolerance level of hot and cold environment. Below, we will try to clear all the doubts about pain tolerance level in red heads.

What is the Science Behind Redheads Responding Differently?

Red hair is common in the western and northern countries of Europe, especially around the United Kingdom. For instance, in Ireland, more than 10% population consists of red head. However, more than 6% of people in Scotland are born with natural red hair. Still, having natural red color hair is quite rare. Now you may wonder why people born with red hair are different and do they feel pain differently? Below, we will go deeper and clearly understand this phenomenon:

• MC1R

Many studies about this mutation suggest that the presence of MC1R, an additional protein-coupled receptor, is responsible for red hair. The receptor regulates melanoma risk, UV responses, and skin pigmentation. MC1R produces brown-black melanin pigment referred to as eumelanin and the amount of this pigment defines the color of the hair. The more production of eumelanin by MC1R indicates blacker and darker hair. The major reason why redhead and dark head perceive pain differently is because of MC1R. This receptor is similar to other protein-based receptors. In 2% redheads, MC1R produces red pheomelanin pigment. Redheads cannot naturally produce eumelanin because of the mutation. As a result, the reddish-toned pheomelanin is the dominant pigment influencing the skin tone and eye color as well. Similarly, MC1R is responsible for pain stimulation as well.

This mechanism also links with the secretion of hormones including endorphins. Endorphins work as sedatives and help minimize the perception of pain. Your body produces these hormones in different parts of the body including the spinal cord and brain. When you experience pain, the neurotransmitters, transmit the information to the brain. In response, your brain releases these hormones for pain relief and pleasure. Today, researchers are confident that MC1R genes are directly related to pain responses.

Redheads and Pain Response

For a long time, people believed that redheads have different response systems for pain. But, the evidence to prove this phenomenon was insufficient. With time, the researcher found that the MC1R gene influences the midbrain function and regulates the pain response. This brings us on the track that there is some mechanism that is impacting the responses of discomfort and injury in red-haired people. In the last 20 years, researchers conducted some small researches to understand how and why redheads respond to pain differently. Unfortunately, there are immense differences and conflicts between those researches. Let’s understand the contradiction with these two examples:

In 2004, a study conducted on female redheads suggested that the tolerance level for inhaled anesthesia is higher than among them. For sedation, they need more anesthesia than dark hair. Apart from that, redheads find lidocaine injections less effective.

Another research contradicts the 2004 study by suggesting that redheads find less morphine to decrease their while black and brown heads need more. The participants in this research involved both males and females. Even during labor, redhead women require fewer opioids to ease the pain than dark-haired women.

What is the Tolerance Level of Redheads?

There isn’t a simple answer to this question. Accumulating the results from different researches we can say that:

• Redheads require approximately 20% more anesthesia than dark heads.

• Their tolerance level for local anesthesia including novocaine and lidocaine is higher.

In contrast, they have high sensitivity to painkillers including opioids. Therefore, they require low doses. Additionally, they are less sensitive to needle pricks, electric shock, and other stinging-type pain. Also, when it comes to weather, their body detects changes faster than others.

Different Types of Pain

This does not end here as the number of studies also suggests that redheads may react differently to different types of pain. It depends on how their body reacts with and perceives the pain. The result of these researches implies that:

• Redheads cannot tolerate cold.

• Their body is less responsive to anesthesia.

• They are at higher risk of developing endometriosis and sclerosis.

• They are afraid of dentists and feel higher pain from toothaches.

There are some studies, which indicate that redheads are likely to get sick more often. This may be true because redheads stay out of the sun exposure. Therefore, they lack vitamins resulting in vitamin deficiency. You may have heard the rumor that doctors are being hesitant to perform surgeries on redheads as they bleed more than dark heads. However, recent studies showed that redheads do not bleed more. Furthermore, doctors never refused to perform surgery for people with red hair.

Read Heads are Surprisingly Tough

Numerous researches on female mice and redheaded women claimed that they perceive the pain differently. They are tougher than most blackheads. Even though the participants for the researchers were female, it is understood that the same concept will work for the men too. Evidence is declaring that redheads can tolerate stinging pain better than others. 

Researchers injected capsaicin into the body of some redhead. Capsaicin is a chili substance and has the same effects either you orally consume it or inject it into your body. After injecting this chili, researchers concluded that redheads are not that sensitive as dark heads.

Opioid Sensitivity Among Redheads

The dependency level and susceptibility of redheads for pain depend on the painkillers such as opioids. Some researches about opioid abusers showed that twins are likely to become addicted to opioids. This suggests that there is a relationship between genes and vulnerability to addiction. However, there aren’t enough researches about the influence of MC1R on addiction to drugs. Some of these researches for redheads contradict others. 

For instance, one researcher indicates that redheads have lower dependency level and they require less dosage for pain management. On contrary, another researcher found that redheads are at high risk of developing drug abuse. He claimed that if redheads are pain sensitive, they need more opioids to cope up with the sensation.

Prevention against Pain

Redheads in general are less sensitive to pain. However, it depends on the type of pain. Also, they have a high tolerance level while anesthetized. As a result, doctors should increase the dosage of anesthesia in redheads.

Many physicians from different medical fields are unaware of the fact that redheads require more dosage of pain medication. Therefore, red headers need to communicate your dosage before surgery or other procedures that require pain medication. If you are a red header, you need to remind the anesthesiologist, surgeons, and dentists that you are highly sensitive to opioids. Also when a physician prescribes pain medication, you need to discuss the dosage beforehand. Because of your sensitivity, you need fewer doses of opioids. Additional dosage may lead to drug abuse and addiction. 

Conclusion

Redheads have a different way to perceive pain than others because of their genetic composition. The result from various studies about pain sensitivity in redheads suggests that redheads have a different response to a different type of pain. For instance, they have a low tolerance level to the change in temperature. If the temperature is cold, they are likely to get sick than dark heads. Also, their body requires more anesthetic dosage. 

Moreover, their body is less sensitive to spicy food, electric shocks, and has a greater risk of developing different diseases such as endometriosis and sclerosis. In contrast, their body is more sensitive to painkillers. Apart from pain sensation, redheads produce abundant natural vitamin D.

Knee injuries are pretty common and one of the most painful types of injuries. You might have an issue with your knee the moment you realize you cannot move your legs properly or are facing difficulty in carrying out a particular task that involves a lot of moving around. The good thing is that there are ways to curb the pain and stiffness in your knee with the help of physical therapy.

Physical therapy (PT) is a type of rehab that allows you to relax all your muscles and joint pain. This type of therapy is usually conducted with the help of a professional therapist who will show you different exercises and moves to strengthen your muscles and improve your knees. Read further and learn how physical therapy can help with knee pain. 

Why Do You Need Physical Therapy?

People require physical therapy to strengthen the muscles in their body, allowing them to move freely. One of the most important reasons why people acquire physical therapy is to curb knee pain. The knee, which is more like a hinge joint, comprises of the shin, thigh and the kneecap, which is located right in front of the knee. The knee gets its support from four ligaments and two shock absorbers known as the meniscus.

When your knee experiences continuous trauma through strain and injury, then you’re most likely to suffer from knee pain. Sometimes the pain might just occur out of the blue for no particular reason. When you experience pain in your knee, you’re limited in carrying out certain tasks and find it difficult in engaging in simple physical activity such as sitting, walking, or climbing up and down the stairs. When things get this difficult, you need to stop doing what you are doing and undergo physical therapy, as that is the best way to get relief from knee pain and get back on your feet. 

Types of Knee Pain 

There are different types of knee pain that you might experience. It is important to what type of knee pain you’re experiencing, as this way, you can attain better diagnosis and treatment. Mentioned below are the three main types of knee pain:

·       Chronic Knee Pain: Chronic knee pain lasts for more than 8-12 weeks as it’s the type of pain where you will need immediate medical assistance to figure out a proper treatment.

·       Acute Pain: Acute pain is the more severe type of knee pain that lasts around for only 1-7 days after you’ve experienced an injury. In order to deal with this type of pain it is best to get some rest before things get worse. 

·       Sub-Acute Knee Pain: Sub-acute pain lasts for around 2-6 weeks after your injury. During this time period it is best to let your knee to heal by engaging in gentle motions so that you knee is able to regain mobility. 

How to Ensure Proper Physical Therapyfor Knee Pain 

If you require immediate physical therapy, then you must first know where exactly your knee hurts. Physical therapy involves focusing on a particular part of the knee so that it gains enough attention and relaxation. You have to be able to determine where in the knee structure you’re experiencing pain, and that if it requires treatment. Mentioned below are the different locations you might experience knee pain, and the symptoms that come with it:

Internal Knee Pain 

If you’re experiencing internal knee pain, then it is most likely that there is an injury in the medial collateral ligament or the medial meniscus. These injuries usually take place due to extra athletic activity when the foot come in regular contact in the ground and the body twists over the knee. This part of the knee is located right inside and you might experience occasional arthritis in this area, and it is very prone to damage even if there is no specific injury caused. 

External/Front Knee Pain 

External knee pain usually occurs when there is an issue in the kneecaps positioning and tracking. This is often known as patellofemoral stress syndrome (PESS). If you ever happen to have this syndrome then your kneecap and the tendon that lies between the shin and the kneecap may experience inflammation, leading to crucial pain. Because of the pain experienced through this, you are usually unable to move about freely, kneel, jump, run and ascend or descend the stairs. 

Back Knee Pain 

Back knee pain is a very rare place for pain to occur. If you experience back knee pain, it means that one of your hamstring tendons may be strained and that is why the pain occurs. The Baker’s cyst is another reason why you may be experiencing pain in the back of the knee. Baker’s Cysts is an abnormal swelling of the knee joint that takes up space in the area behind your knee and causes the knee to bend. 

External/Outside Knee Pain 

Outside knee pain occurs mainly due to an injury in diffenrt structures. The outside portion of the knee, including a ligament could sustain an injury during athletics. The term used to describe this type of pain is  Iliotibial band stress (ITB).

ITB is a thick tissue situated on the outside of your hip and runs to the front of your knee. When this crosses the knee, the ITB tends to rub abnormally against your knee and cause excessive burning. The outside of your knee also includes one of the three hamstring tendons that may be strained and this also leads to pain. 

What Happens During Physical Therapy for Knee Pain?

Before starting with the main part of physical therapy that involves all the exercises and movement to relieve muscle tightness and pain, you will first begin with the evaluation process. Once you are able to find a professional licensed physical therapist, he/she will examine you and try to come up with the best treatment plan.

Your therapist will discuss different types of ways you can receive treatment. When examining your knee, the therapist will lightly move it to see if you are able to balance, stand on one leg, and the weakness in your knees. Mentioned below are the different types of ways your physical therapist will examine your knee:

Range of Motion Measurements

Range of motion measurement is a type of evaluation to see how far your knee is able to bend or straighten out. To carry out this examination, the therapist will use specific instruments to measure the movement in your knee, and according to this, they can curate a proper treatment plan. 

Gait Evaluation 

Gait evaluation is a type of assessment to see how well or bad you can walk. Though you might find yourself walking perfectly fine, physical therapists are able to detect small changes in the walking motions and the way your knees move. This way, they will be able to tell if there is a major issue in the knee or not, and what type of treatment to offer.

Strength Measures

Strength measurement allow the therapist to determine if there is any muscular weakness or imbalance that is leading towards pain in your knee. This is easily determined with the help of muscular attachments included around your knee. 

Palpation

Palpation is another form of examination that involves touching the different structures around your knee using ones hands. This way a professional can tell whether there are any abnormalities present on the knee and to see how much pain is caused in that particular area.

Swelling or Girth Measurements

This assessment involves measuring the level of swelling present in your knee. After an injury, there is usually a lot of swelling present in the knee. Using this type of evaluation, your physical therapist will be able to determine the amount of swelling present.

Balance Assessment

There is a good chance that you may have poor balance if there is excessive strain and stress around the knee. This usually leads to pain and is something that a physical therapist will check for. 

Specific Tests

There are special types of test conducted around the knee that will help the therapist determine the main structure on the knee causing overall knee pain. 

Types of Physical Therapy Exercises for Knee Pain

Once the therapist conducts a proper examination and knows what the main issue in your knee is, they will then move on to the treatment plan made for you. There will be different exercises that will help straighten and improve your knee. Mentioned below are a few exercises that your therapist will teach you, and you will most likely have to follow them at home as well:

·       Balance Exercises

·       Short arc quads

·       Hip strengthening exercises

·       Low stretches

·       Straight leg raises

·       Quad sets

Takeaway 

If you experience any type of discomfort in your knee, it is important to attain professional medical help and go through physical therapy. The only way to improve any major knee pain caused by an injury is to relax it and follow the guidelines of your physical therapist.

It’s not easy trying to manage physical pain, especially when you’re not sure why you’re experiencing it. Your healthcare professional will suggest different treatments depending on your condition.

One of the most effective ways of treating pain is through selective nerve root injection. Health professionals commonly prescribe selective nerve root injection to treat an inflamed spinal nerve in patients. They also use it as a form of diagnosis. Healthcare professionals inject an anesthetic or steroid into the spinal nerve during this process. But why not use epidural injection for pain management?

An epidural injection is another type of treatment that helps manage pain for spinal disc herniation and spinal stenosis. However, you may want to consider using the selective nerve root injection instead, and this article will tell you why. There are many similarities between both the injections, but one is safer and more effective. 

The Similarities between Selective Nerve Root Injection & Epidural Injection

Both selective nerve root injection and epidural injection help treat pain but are similar in different ways. Both of these injections are great numbing agents and include steroid medication when administered to the patient for pain relief. Experts administer both medications through fluoroscopy. It is an imaging technique that helps them inject the medicine in the right area. 

Though both these injections are quite similar, there are also a few differences. These nuances are important to consider when choosing one. One of the main differences is that selective nerve block injection is both a diagnostic and therapeutic procedure. However, epidural steroid injections only have therapeutic properties. 

The SNRJ also manages a specific part of pain while the epidural injection treats a broader area. This broader area also includes several pathologies along with the spine. Lastly, experts administer selective nerve block injection through a specific nerve. Conversely, the epidural injection goes through the spinal cord in the epidural space offering symptomatic relief, covering a bigger area. 

How Effective are Selective Nerve Root Injections For Pain Management?

The Malaysian Orthopedic Journal posted a study, which included 40 patients suffering from disc prolapse and nerve-related pain. Each individual felt immense relief after taking the selective nerve root injection. The study found that selective nerve root injections provide short-term relief of pain when treating spinal disc herniation. 

5 Reasons to Use Selective Nerve Root Injection Instead of an Epidural Injection for Pain Management

Both the selective nerve root injection and epidural injection are somewhat similar. Nevertheless, many healthcare professionals opt for selective nerve root injection, which is best for pain management. Here are 5 reasons why you should get a selective nerve root injection instead of an epidural injection:

1.     SNRI’s Provide Pain Relief in the Cervical Spine and Lumbar Spine 

Pain from the cervical spine and lumbar spine can be quite excruciating to bear. But through selective nerve root injection, you can attain immediate short-term relief from pain. It also helps reduce inflammation. 

The success rate with selective nerve root injections is quite high. When treating pain in the cervical spine, according to a study, one injection helped around 57% of patients. These patients reported a massive improvement in their pain within 6 months.

Another study showed the success rate of a selective nerve root injection in the lumbar spine. It reduced pain in 46% of patients within a year. This injection proves to be quite effective when treating the cervical spine and the lumbar spine. While some patients might not experience similar relief through this injection, others will only experience short-term relief for some weeks. 

The steroid in the injection takes time to work, so the therapeutic effect may differ for everyone. These injections prove more effective in relieving pain when patients engage in physical therapy and strengthening exercises. 

2.     It’s Safe to Use 

Experts claim that selective nerve root block injections are safer as the procedure is simpler. Furthermore, there are very few side effects or complications that come with it. The selective nerve root injection procedure is safer than epidural injections. The procedure involves going through the epidural, which invites many complications. Selective nerve root injections don’t have these complications, making them safer to use for pain management. 

3.     Many Complication’s in The Epidural Injection 

Compared to the selective nerve root injection, the epidural injection has more side effects. One of the main side-effects that come with the epidural injection is the hypothalamic-pituitary-adrenal (HPA) axis, this comes with Cushing’s syndrome in which a fatty lump develops between the shoulders and come in a round pink appearance. Other side effects include insomnia, hiccups, sleeplessness, and radicular pain. These side effects are why many professionals prefer not to use the epidural injection for pain management

4.     Concern of Arachnoiditis

According to a few cases reported by the FDA, people complained about spinal pain experienced after their epidural shot. This specific spinal pain leads to Arachnoiditis. Arachnoiditis is a pain disorder from inflammation that derives from the arachnoid. This is one of the membranes that protect the spinal cord. Inflammation caused by Arachnoiditis leads to scar tissue formation, causing the spinal nerves to stick together leading towards a malfunction. 

The FDA came forward with 131 neurological adverse cases of which 41 cases consisted of Arachnoiditis. According to a few reveals, the complications related to epidural injections were linked to neurological complications. 

5.    Epidural Injections Lead to Bone Loss

According to recent research, Epidural injection for pain management especially in the back leads to bone loss in postmenopausal women. A single epidural injection is more than enough to affect the bone density of the hip among postmenopausal women. Although more research is necessary to prove these effects, patients must account for it, especially postmenopausal women. 

The Process of Selective Nerve Root Injections: How Do They Work?

As you already know, selective nerve root injection helps treat pain. Healthcare experts might mix anesthetics in the injection at times or they might use it alone. The steroid has different mechanisms that allow it to blocks the fibers within the nerves resulting in less pain.

The steroids also decrease the permeability of the nerve fibers to receive blood. This gradually leads to a decrease in pain transmission. Along with this the steroids it engages in the action of specific enzymes like phospholipase A that leads to pain and irritation.

These are the mechanisms through which the pain signals are reduced by the target nerve. When administering the injection, the expert will first thoroughly clean the skin where the injection will go. This step is usually carried out to prevent the risk of infection. The needle placement needs to be correct. So to measure this expert will first insert small amounts of contrast dye to check the needle's location.

This also prevents the chances of injecting the medicine into your blood vessels. Every patient has different anatomic variations due to which the doctor will need an ultrasound or fluoroscopy to locate the nerve. The injection can recreate the usual pain which the patient was experiencing before. 

Risks of Selective Nerve Block Injection 

The risks from a selective nerve block injection are very rare; however, there is a small chance that these could occur. The different risks that you should watch out for are allergic reactions, infection, bleeding, Pneumothorax, and spinal cord damage. Temporary muscle weakness is also very common and some patients might experience it if the medication flows towards the nerves motor fibers. The good thing is that the weakness doesn’t last for long and goes away within an hour. 

Final Words

With the help of this article, you can now see why you should get a selective nerve root injection other than an epidural injection for pain management. Whatever injection you plan to get, you must make sure you get a proper consultant from a professional healthcare expert and don’t do anything before that because you could make the pain worse.

Pain management in the elderly is a very effective and required segment, as this is very commonly faced among people ageing. When you become older, the prevalence of severe pain syndromes increases in intensity and at times it becomes excruciating. Pain in elderly is a very diverse subject, as there are different types of pains experienced. When people reach a certain age they usually think that it’s okay to experience this type of pain due to their age. However, there could be something more life-threatening behind the pain felt. 

This is why it is important to visit a healthcare professional to know the reason behind the pain and mange it effectively. There are many ways to manage pain in elderly. At the same time, it is worth keeping in mind that pain can derive from many things. Read further to learn more about pain management in the elderly. 

Types of Pain Mechanisms in the Elderly 

There are different types of mechanisms that lead to an increase in and sensitivity in elderly. Mentioned below are the two types of pain mechanisms:

Physiological Changes 

Physiological changes in the elderly cause a decrease in the neurotransmitters such as the gamma-aminobutyric acid (GABA), no adrenaline, serotonin, and acetylcholine. This in turn leads to a decrease in the number of increased pain thresholds, peripheral nociceptive neurons, and reduced endogenous analgesic response leading to an increase in pain. 

Aging Homeostenosis

Homeostenosis in aging is the loss of homeostatic reserve of different organ system shown as a renal and live function decline. This also includes a decrease in the muscle mass, low appetite, depression, agitation, and increase in vulnerability leading to more falls, sleep disturbances, and much more.

Treatment Options for Managing Pain in Elderly 

There are different treatment options available for the elderly when it comes to managing pain. Before you go with a certain treatment plan, it is always best to first consult a health professional, and they will tell whether the treatment will help and suit the patients taking other things into account. When going for a treatment option, it is important to take in to account other issues faced by the elderly as well. 

Pain Management in Elderly Using Medications

There are different medications out there for treating pain in elderly, but it can get very complicating choosing a specific course as almost 75% of people who are 65 or more have 2 or more other chronic conditions, and this has to be taken into account when prescribing a specific medicine. No matter how much pain prevails in the elderly, sometimes the pain is untreatable.

In a study conducted by Maxwell, it was found that in 21% of adults, the pain felt remained untreated in different nursing homes. Untreated pain is most likely to happen in patients suffering from Alzheimer’s, as it become difficult for them to communicate or express the pain felt. 

When using medication as a treatment for managing pain in the elderly, each person must have a separate evaluation. This way, professionals can come up with an effective strategy on what to prescribe that will come with the least amount of side effects. 

There is no doubt that this is difficult to strategize, as there are so many health issues and challenges faced by the elderly. Issues such as physical limitations make it hard to receive treatment such as physical exercise, physiotherapy, stretching and other physical activities.

Physical therapy is one of the best ways to relieve pain in muscles and become more flexible. However, this isn’t the best form of treatment for the elderly individuals who are physically impaired. This is why medication treatments are more common in elderly as compared to alternative treatments. 

Researchers have also found this in a study conducted by Macfarlane et al. However, the side effect sometimes get worse with medications, especially when you’re not sure of the other chronic conditions the elderly may be dealing with.

According to a report in 2008, around 31% of the 65 elderly patients were hospitalized because of an adverse drug reaction. Elderly patients become more prone to a higher drug risk if they have natural, physiological changes in the body, and this usuallyhappens with age. If there is slow movement in the gastro intestinal tract, then that indicates the absorption of a few drugs, and even a liver oxidation rate can interfere with the timing of the drug. 

Risks of Using Medication as Pain Management in Elderly

As mentioned earlier, there are different types of medications prescribed to the elderly when it comes to managing pain. However, many risks that come with different types of medications, and you should be well aware of them. Mentioned below are a few of the common drugs prescribed to the elderly for pain management and the risks that come with it:

NSAIDs

NSAIDs are one of the most common types of drugs used to treat musculosketal pain in the elderly. These types of medications are usually used for the elderly when it comes to pain management. However, these medications come with a significant amount of side effects. If an elderly patient is facing other health issues such as heart problem, blood disorders, renal problems or more, the medication could interact with these conditions and make them worse.

According to a study, gastrointestinal toxicity becomes very prevalent in adults taking NSAIDs. NSAIDs usually have a negative interaction with other prescribed medications such as aspirin, anti hypertensive meds and certain serotonin receptor inhibitors (SSRIs). Most of the time, this leads to hospitalization. This is why it is important to take your medical history into account, especially when taking strong drugs as this puts you at a higher risk of \an intense drug reaction. 

Opioids

Opioids are another type of medication recommended by the World Health organization (WHO). It is recommended to use this type of medication after the use of NSAIDs .Opioids consist of fentanyl, methadone, oxycodone, and morphine, which are commonly prescribed to elderly patients for the treatment of pain. However, Opioids are said to be very addictive, and not the best forms of medications. There are many risks associated with Opioids, especially when elderly patients take them.

Some of the common type of risks elderly patients may experience are nausea, constipation, more falls, sleep disturbances, respiratory depression, and gastro intestinal complications. Many elderly patients are advised not to consume alcohol when on an Opioid-based treatment as well as sedatives like benzodiazepines, as these increase the risk of respiratory depression in elderly patients. Opioids also may lead to unhealthy body consumption changes which could lead to a decrease in bone mass, muscle, and fat which increases the risk of an overdose. 

Alternative Approaches to Managing Pain in Elderly 

As pain management in the elderly is becoming more and more common, people are looking towards other alternatives to medications considering the side-effects. It is best to talk to physical therapists, yoga instructors, and chiropractors when wanting to look for alternative treatments.

Most of the elderly are physically impaired, making it difficult to use physical therapy as a treatment plan. However, it is best to discuss the different ways that can still attain physical therapy. This will involve tailoring treatment plans so that the elderly can benefit from it and use it easily. Mentioned below are a few therapies for pain management in the elderly:

Chiropractic Care 

Chiropractic care is the fourth most used alternative methods in  according to a survey conducted by the National Health Interview. What’s more, chiropractic treatment is one of the most effective outpatient treatments when it comes to improving flexibility and pain disability in the elderly.

There is a high chance of experiencing side-effects from chiropractic care such as a spinal manipulation, which involves temporary discomfort in the treated area. This also depends on the skills and efficiency of the chiropractor. So you have to make sure you get in touch with the best chiropractor near you to attain effective treatment. 

Acupuncture

Acupuncture is another well-known alternative treatment for managing pain in the elderly. This type of treatment could help relive certain types of pains such as neck pain, knee pain, low back pain, headaches, migraines, and osteoarthritis. These are some of the common types of pains usually experienced by the elderly. 

Final Thoughts 

Pain management in the elderly is quite a challenging thing, especially when it comes to treating the pain. You have to be very careful as to what treatment option you should opt for. It would be best if you consulted with your healthcare professional before starting any treatment. There are many things to consider when managing pain in the elderly, and hopefully this article has given you some idea on the essential things to take into account.

Chronic back pain is debilitating. It can leave you desperate for a solution. There can be several reasons why your back, aches in pain when you move. This pain can also be associated with other pains such as neck pain. It can also include problems that cause your arms and legs to ache as well.

You might have tried many treatments and remedies to address this pain but to no avail. It is very difficult to find a treatment for your back pain that is actually effective. However, there have been many doctors who have recommended Spinal Decompression Therapy. This type of therapy has been popular among patients with stubborn back pain as it has been able to yield results. But what exactly is Spinal Decompression Therapy?

Spinal Decompression Therapy 

Despite being a victim of bad press the spinal decompression therapy is a great way to address problems such as chronic back pain. It is a treatment that does not include any kind of surgery, it can be considered a non-invasive treatment plan. Spinal decompression therapy relaxes and stretches the back muscles of patients with the help of a decompression table. This treatment is used to heal several different lower back problems such as herniated discs.

The therapy targets a particular spot on your back and expands the muscles and then relaxes them, this helps in removing any problems within the muscles. The same is done for the spine. The therapy pulls at the spine that creates negative pressure within the spine and the disks. This helps the materials that have slipped out to get back in. It also focuses on bringing back the fluids that have escaped that help healing the pain in a better way.

Disc problems are usually the biggest reason why people suffer from chronic back pain. If that issue is resolved most back pains are resolved on their own. To fix the disc issues you do not have to get any surgeries, this therapy is more than enough to alter any problems. The purpose of this pain is to first get rid of the pain and then address the root cause of that pain. The same therapy can be provided with the help of surgery but spinal decompression therapy does not include any surgical procedures which makes it a better choice for many patients. Since the treatment is non-invasive, there are lesser risks involved. It is also more affordable as compared to the surgical counterpart. This type of treatment also has a higher percentage of success as compared to surgery-based decompression.

To deliver this therapy a spinal decompression table is used. Delivering spinal decompression therapy without this table cannot be possible.

Spinal Decompression Table 

A spinal decompression table is a tool that permits the doctors to pull at the spine of the patients while stopping in-between so that the patient does not feel any pain. You can find two different types of spinal decompression tables that doctors use.

1. Cable And Pulley Systems 

The cable and pulley systems use that uses the mechanism to create a pull in the spine. However, these types of tables are not usually recommended in comparison to decompression tables.  

2. Decompression Tables

Decompression tables are the most recommended for their advanced technology. This table is made of two different portions. One is for the upper body while the rest is for the lower body. The two portions pull away, therefore, stretching out the spin. Though it does the same thing as the cable and pulley system, it is a lot more convenient for your muscles. It guards them and ensures that they are not hurt in the process.

Since decompression tables are the obvious choice of doctors let's talk more about them.

How Does A Decompression Table Work? 

A decompression table works on the principle of creating a negative intradiscal pressure within the spine. The table is connected to a computer that helps the table move. The technician controls the computer and assesses the condition of the patient. Once the assessment is done they will decide on a program that caters to the needs of the patient. It is important to use the machine in the right settings so that the patients are able to reap the most benefits.

The program chose for each patient depends on their diagnosis. It is also reviewed if you have received any treatments prior to this. The structure of the table allows patients to be strapped to the table using different harnesses. While being strapped to a table can be uncomfortable, it is important to keep the patient in place to avoid any complications during the process. However, the patient's comfortability is well taken care of. To make sure that the patient is not uncomfortable or is lying in an awkward position they are provided with pillows. These pillows not only provide comfortability but also make sure that the spine does not move from its place.

The decompression starts when the two portions of the table begin to move away from each other. The pull works on poundage between 5 to 100 pounds. It all depends on the physical aspects of the patient. The bigger and heavier the patient is the heavier the decompression protocol they will have.

At the bottom of the table, you can find sensors. These sensors help the doctor see what exactly is happening with the muscles and if they are resisting. The table stretches the spine and because of that negative pressure is created between the spinal discs and that helps the discs to reposition themselves properly. This helps patients relieve pain. Further on, the fluid also goes back to its place that focuses on healing. Once the treatment is complete, the fluids can further help the spine to heal itself.

For a human body, it is abnormal to stretch the spine. This is why it resists the stretch and to combat that we have already discussed the sensors. If the technician finds out how well the body is resisting the stretch they can come up with a regimen that works for them. To get the therapy in the best way possible and without any complications, you must follow the protocol designed.

Protocol 

Each patient will have a unique protocol that they might have to follow. The protocol essentially depends on the symptoms of the patient. You are first required to make a visit to the doctor and they will then come up with an analysis of your condition and decide whether you qualify to get a decompression treatment. The assessment includes a collection of complete medical history as well as any x-rays and MRIs.

Once the doctor has the complete data they will come up with a protocol depending on your diagnosis and the progression of the problem. They might even come up with the number of sessions you should take. For different types of problems, the table will move in different directions. For instance, if you are struggling with cervical herniated discs, only the top part of the table will move.

Who Qualifies For Spinal Decompression Treatment? 

You may be wondering if you qualify for spinal decompression treatment. Well, anyone who is suffering from back problems that might originate from herniated or perhaps bulging discs is eligible for spinal decompression treatment. However, it is very important to first complete the diagnosis process and make sense of where the pain is originating from. There are certain problems that the decompression treatment does not work for. If the treatment is provided for those particular cases, it can do more harm than good.

Sciatica

Sciatica is the pain in the legs that originates from the lower back. It basically travels down the sciatic nerve and is a high-intensity pain. This problem leaves the patient to be unable to stand or walk. Though it only affects one leg it still makes it difficult for the patient to balance. Patients suffering from Sciatica reap great benefits from decompression therapy.

Herniated Discs 

As mentioned previously, herniated discs can be easily treated with decompression treatment. That is because this treatment helps the disc to be aligned back into its position again. Herniated discs usually occur in the neck and the spine but the pain can stretch to your leg or your arm. 

Spinal Nerve Root 

The nerves often get pinched in-between two discs and that can cause a lot of pain. the pain is mostly felt in the back and the arms. The alignment of the spine needs to be fixed to ensure that the pain goes away and that can easily be done with decompression treatment.  

Worn Out Spinal Joints 

When two joints rub together they get worn out and because of that, patients can be in a great deal of pain. Decompression treatment does not exactly fix the problem but it helps the bones from being further worn out.

Decompression treatment is a great alternative to invasive surgeries that are not only a hassle but also quite expensive. In addition to that, they do not always turn out to be successful which is why spinal decompression treatment is the best possible option.

“Novel 'Blended Therapy' May Help Cut High-Dose Opioid Use”

“BOSTON — A novel "blended therapy" may help pain patients who are taking high doses of opioids to reduce their intake to safer levels without reducing efficacy or causing withdrawal symptoms, preliminary research suggests.

In a small study, participants received blended therapy consisting of hydroxyzine pamoate and codeine plus ondansetron, gabapentin, and docusate.

"There were no side effects, no withdrawal, and a decrease in pain," Dennis J. Bonner, MD, St. Mary Medical Center and Bonner Pain Management, Levittown, Pennsylvania, told Medscape Medical News.”

To read more visit this link.

We are excited to announce that Dr. Dennis Bonner, MD will be exhibiting at the New York State Pain Society 2018 Annual Meeting.

To learn more about the meeting, visit NYSPS online at http://www.nypainsociety.org.