Dennis J. Bonner, MD

Pain Management News

Pain Management News and Updates.

Posts tagged Chronic Pain
Do Red Heads Respond Differently to Pain? Why?

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.

Can Physical Therapy Help With Knee Pain?

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What Is Spinal Decompression System Machine?

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.