Treating Chronic Muscle Pain by Robert Gerwin

Chronic muscle pain (myalgia) is a common problem throughout the world.

Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain.

The two common muscle pain conditions are Fibromyalgia and Myofascial Pain Syndrome.

Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis.

Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle.

The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying causes of persistent or chronic muscle pain in order to develop a specific treatment plan.

Chronic myalgia may not improve until the underlying precipitating or perpetuating factors are themselves managed.

Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypo-mobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency.

Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition.

Smartphone users ‘risking health’ with overuse of devices

People are risking their health by working on smartphones, tablets and laptops after they have left the office, according to the Chartered Society of Physiotherapy.

It says people have become “screen slaves” and are often working while commuting or after they get home.

The society said poor posture in these environments could lead to back and neck pain.

Unions said people needed to learn to switch off their devices.

An online survey, of 2,010 office workers by the Society found that nearly two-thirds of those questioned continued working outside office hours.

The organisation said people were topping up their working day with more than two hours of extra screen – time, on average, every day.

The data suggested that having too much work and easing pressure during the day were the two main reasons for the extra workload.

Ergonomics at Work

Alexander Technique helps with Posture

ERGONOMICS… The term “ergonomics” is derived from two Greek words: “ergon,” meaning work, and “nomoi,” meaning natural laws. Ergonomists study human capabilities in relationship to work demands. POSTURE… In recent years, ergonomists have attempted to define postures which minimise unnecessary static work and reduce the forces acting on the body. All of us could significantly reduce our risk of injury if we could adhere to the following ergonomic principles: All work activities should permit the worker to adopt several different, but equally healthy and safe postures. Where muscular force has to be exerted it should be done by the largest appropriate muscle groups available. Work activities should be performed with the joints at about mid-point of their range of movement. This applies particularly to the head, trunk, and upper limbs.

Acupuncture studies by NCCAM

Introduction

Physical pain is a common occurrence for many People; in fact, a national survey found that more than one-quarter of U.S. adults had recently experienced some sort of pain lasting more than a day. In addition to conventional treatments, such as over-the-counter and prescription medications, people may try Acupuncture in an effort to relieve pain. This fact sheet provides basic information about pain and acupuncture, summarizes scientific research on acupuncture for specific kinds of pain, and suggests sources for additional information.

Key Points

• People use acupuncture for various types of pain. Back pain is the most commonly reported use, followed by joint pain, neck pain, and headache.
• Acupuncture is being studied for its efficacy in alleviating many kinds of pain. There are promising findings in some conditions, such as chronic low-back pain and osteoarthritis of the knee; but, for most other conditions, additional research is needed. The National Center for Complementary and Alternative Medicine (NCCAM) sponsors a wide range of acupuncture research.
• Acupuncture is generally considered safe when performed correctly.
• In traditional Chinese medicine theory, acupuncture regulates the flow of qi (vital energy) through the body. Research to test scientific theories about how acupuncture might work to relieve pain is under way.

Can Twisting cause the Agony of Back Pain?

THE first comprehensive model of the human spine is challenging our assumptions about the causes of back pain. Contrary to the idea that spinal injuries are caused by a combination of compression, bending, tension and shear forces, the 3D animated model suggests many injuries are the result of quick twists of the vertebrae, making the joints between them rotate.

Nick Beagley and Vladimir Ivancevic of the Defence Science and Technology Organisation in Edinburgh, South Australia, have spent the past 18 months developing their mathematical model, called the Full Spine Simulator (FSS). Existing models of the spine evaluate forces placed on a single joint, or a simple series of joints, and allow each just a few degrees of freedom. But the FSS represents all 25 movable joints of the spine, and gives each its full six degrees of freedom.

MRI Scans show Acupunctures effect in the Brain

Originating in ancient China, Acupuncture has been used for 2500 years. Traditional Chinese medicine holds that disease is caused by blockages and imbalances of energy (known as chi) flowing through meridians in the body, and can be eased by inserting needles at specific points.

Since the 1970s, Acupuncture has become more popular outside east Asia. Once widely considered a quack medicine, there is now tentative support for its use in certain conditions from respected official bodies such as the World Health Organisation, the National Health Service in the UK and the National Institutes of Health in the US.

There is evidence that Acupuncture is effective in treating a range of conditions including spinal injuries, back & neck pain, migraine headaches, infertility and the side effects of chemotherapy , and that its effects aren’t entirely due to the placebo effect. Recent research is now showing why Acupuncture works.

Wenjing Huang of Charité University Medical Center, Berlin, Germany, and colleagues used more than 100 studies to produce these brain maps of 18 acupuncture points. Areas of the brain activated by stimulating a point are shown in red; areas deactivated are shown in blue.

For example, the two vision-related points GB37 (gall bladder) and UB60 (urinary bladder) showed deactivation in visual brain areas like the Cuneus. The team concluded that Acupuncture seems to affect the brain’s processing of both physical Sensations and Emotions. For now, though, the source of Chi remains elusive.

His Pain : Her Pain

JON LEVINE was just testing painkillers on people who’d had a wisdom tooth extracted, when he uncovered rather more than he’d bargained for. The women in his study group found that strong painkillers related to morphine, called kappa-opioids, were most effective at numbing pain. But the same drugs didn’t work for the men at all. “In fact, the doses used in the clinical trial made pain worse for men,” says Levine, a clinical neuroscientist from the University of California in San Francisco.

He was shocked. “The idea that a therapy that had been around for decades could affect women and men in such dramatically different ways was anathema,” he says. “It was such an incredible mindset in the field of pain, missing what had clearly gone on in front of their eyes for years.”

Neck & Back Pain.

Neck & Back Pain

Patient: Woman 29 years
Occupation: Nurse
Pain: Can reach 6/10

Complaint: Back and Neck Pain can often occur simultaneously. This Woman works as a Nurse, and has developed left sided Neck & Back Pain over the few months. She recalls hurting her low back about 6 months ago, while lifting a heavy patient. She is unsure how neck pain has developed.

Treatment: This Woman responded well to Spinal Manipulation of her back and neck. The range of movement in her neck and low back was initially poor, but quickly improved with treatment.

She visited weekly for 4 treatments, and was pain free by this stage.

Prognosis: This Woman visits me if and when she feels the need.

She now goes to Pilates classes twice per week, and feels much stronger and able to cope with the demands of her job.