Archive for the 'Pain' category
Chronic Pain| Groin Muscles
July 4, 2008 5:54 pmFriday, July 04, 2008
Hip stiffness in athletes is associated with later development of chronic groin injury and as such may be a risk factor for this condition. "Sports hernia," pubic bone edema, and entrapment neuropathies-are potential causes of chronic groin pain in assessing athletes.
Groin injury is among the most common cited injuries in the sports of ice hockey, soccer, Australian Rules football, calisthenics and cricket. There are very few prospective studies examining risk factors for groin strain injury in sport. There is support for an association of previous injury and greater abductor to adductor strength ratios as well as sport specificity of training and pre-season sport-specific training, as individual risk factors in groin strain injury in athletes. Core muscle weakness or delayed onset of transversus abdominal muscle recruitment may increase the risk of groin strain injury. Debate exists in the literature regarding the role of adductor strength and length as well as age and/or sport experience as risk factors for groin injury. There is no strong evidence to support a causal association for any of these risk factors and groin injury. (Maffey L. Emery C. What are the risk factors for groin strain injury in sport? A systematic review of the literature. Sports Medicine. 37(10):881-94, 2007).
MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain showed MR imaging to have more sensitive and specific for rectus abdominis tendon injury and for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group. Only two patients had hernias at surgery. (Zoga AC. Kavanagh EC. Omar IM. Morrison WB. Koulouris G. Lopez H. Chaabra A. Domesek J. Meyers WC. Athletic pubalgia and the "sports hernia": MR imaging findings. Radiology. 247(3):797-807, 2008).
Adductor dysfunction is a condition that can cause groin pain in competitive athletes. A single pubic cleft injection of local anesthetic and steroid into the adductor enthesis (tendon thickening) had been used. This single injection gave at least one year of relief of adductor-related groin pain in a competitive athlete with normal findings on a magnetic resonance imaging scan; however, it should be employed only as a diagnostic test or short-term treatment for a competitive athlete with evidence of adductor longus tendon thickening (enthesopathy) on magnetic resonance imaging. (Schilders E. Bismil Q. Robinson P. O'Connor PJ. Gibbon WW. Talbot JC. Adductor-related groin pain in competitive athletes. Role of adductor enthesis, magnetic resonance imaging, and entheseal pubic cleft injections. Journal of Bone & Joint Surgery - American Volume. 89(10):2173-8, 2007).
eToims has been useful in the treatment of groin pain related to adductor dysfunction since it can be used repeatedly and regularly without side-effects. Treatments have to be directed to all hip muscles supplied by multiple nerve roots as well as to muscles segments supplied by spinal nerve roots above and below the hip joint.
www.stopmusclepain.com Chronic Pain| Groin Muscles
Knee pain| Anterior cruciate ligament injury
June 26, 2008 10:41 pmThursday, June 26, 2008
Increased knee-laxity measures may contribute to increased risk of anterior cruciate ligament injury. Female soccer and basketball players had an anterior cruciate ligament injury rate seven times that of male players. The integrative effects of fatigue and decision making may represent a worst case scenario in terms of anterior cruciate ligament injury risk during dynamic single leg landings. Females display knee moments and kinematics that may place them at greater risk for ACL injury during a stop-cut task. Females should be coached to perform stop cuts with more knee flexion and a more neutral knee rotation angle upon foot contact in an effort to reduce moments that may place the ACL at risk (Wallace BJ. Kernozek TW. Bothwell EC. Lower extremity kinematics and kinetics of Division III collegiate baseball and softball players while performing a modified pro-agility task. Journal of Sports Medicine & Physical Fitness. 47(4):377-84, 2007). Women with anterior cruciate ligament reconstruction have neuromuscular strategies that allow them to land from a jump similar to healthy women, but they exhibit joint moments that could predispose them to future injury if they participate in sports that require jumping and landing. (Ortiz A. Olson S. Libby CL. Trudelle-Jackson E. Kwon YH. Etnyre B. Bartlett W. Landing mechanics between noninjured women and women with anterior cruciate ligament reconstruction during 2 jump tasks. American Journal of Sports Medicine. 36(1):149-57, 2008. Altered equilibrium position of the tibiofemoral joint associated with reduced patellar ligament insertion angle and adaptations of gait patterns following anterior cruciate ligament injury may be associated with degenerative changes in the articular cartilage (Shin CS. Chaudhari AM. Dyrby CO. Andriacchi TP. The patella ligament insertion angle influences quadriceps usage during walking of anterior cruciate ligament deficient patients. Journal of Orthopaedic Research. 25(12):1643-50, 2007 Dec. Revision anterior cruciate ligament surgery allowed approximately 60% of patients to go back to sports, most of them at lower levels than their prerevision function. Instrumented laxity of <3 mm was associated with a better result. Radiographic arthritis was associated with duration of instability symptoms after primary failure. Patients who undergo revision anterior cruciate ligament surgery should be counseled as to the expected outcome and cautioned that this procedure probably represents a salvage situation and may not allow them to return to their desired levels of function. Battaglia MJ 2nd. Cordasco FA. Hannafin JA. Rodeo SA. O'Brien SJ. Altchek DW. Cavanaugh J. Wickiewicz TL. Warren RF. Results of revision anterior cruciate ligament surgery. American Journal of Sports Medicine. 35(12):2057-66, 2007
Strength training as a single intervention method may not be sufficient to reduce the risk of noncontact anterior cruciate ligament injury in female recreational athletes.
www.stopmusclepain.com Knee pain| Anterior cruciate ligament injury
Muscle fatigue| Stress fractures
June 21, 2008 11:07 amSaturday, June 21, 2008
Stress fracture is a common musculoskeletal problem affecting athletes and soldiers. Repetitive high bone strains and strain rates are considered to be its etiology. The strain level necessary to cause fatigue failure of bone ex vivo is higher than the strains recorded in humans during vigorous physical activity.
A study was performed to prove that during fatiguing exercises, bone strains may increase and reach levels exceeding those measured in the non-fatigued state. To test this hypothesis, this study was performed in 4 subjects to measure tibial strains, the maximum gastrocnemius isokinetic torque and ground reaction forces before and after two fatiguing levels of exercise: a 2km run and a 30km desert march. Strains were measured using strain-gauged staples inserted percutaneously in the medial aspect of their mid-tibial diaphysis. There was a significant decrease in the peak gastrocnemius isokinetic torque of all four subjects' post-march as compared to pre-run indicating the presence of gastrocnemius muscle fatigue. Tension strains increased 26% post-run and 29% post-march as compared to the pre-run phase. Tension strain rates increased 13% post-run and 11% post-march and the compression strain rates increased 9% post-run and 17% post-march. The fatigue state increases bone strains well above those recorded in rested individuals and may be a major factor in the stress fracture etiology. (Milgrom C. Radeva-Petrova DR. Finestone A. Nyska M. Mendelson S. Benjuya N. Simkin A. Burr D. The effect of muscle fatigue on in vivo tibial strains. Journal of Biomechanics. 40(4):845-50, 2007.
Consider stress fracture as a diagnosis in adolescent athletes complaining of worsening vague pain without a clear mechanism of injury. Remember that initial radiographs may be normal, especially early in the clinical course. If the fracture is of low risk for delayed or non-union, conservative management is indicated, with repeat radiographs 2 weeks after initiation of treatment. If a high-risk fracture is suspected, early diagnosis with MRI, bone scan, and, in some cases, CT is important for surgical decision making. (Logan K. Stress fractures in the adolescent athlete. Pediatric Annals. 36(11):738-9, 742, 744-5, 2007)
www.stopmusclepain.com Muscle fatigue| Stressfractures
Pain| Basketball Injuries
May 25, 2008 12:06 amSunday, May 25, 2008
An estimated 326396 ankle injuries occurred nationally in 2005-2006, yielding an injury rate of 5.23 ankle injuries per 10 000 athlete-exposures. Ankle injuries occurred at a significantly higher rate during competition (9.35 per 10 000 athlete-exposures) than during practice (3.63) (risk ratio = 2.58; 95% confidence interval = 2.26, 2.94; P < .001). Boys' basketball had the highest rate of ankle injury (7.74 per 10 000 athlete-exposures), followed by girls' basketball (6.93) and boys' football (6.52). In all sports except girls' volleyball, rates of ankle injury were higher in competition than in practice. Overall, most ankle injuries were diagnosed as ligament sprains with incomplete tears (83.4%). Ankle injuries most commonly caused athletes to miss less than 7 days of activity (51.7%), followed by 7 to 21 days of activity loss (33.9%) and more than 22 days of activity loss (10.5%). Sports that combine jumping in close proximity to other players and swift changes of direction while running are most often associated with ankle injuries. (Nelson AJ. Collins CL. Yard EE. Fields SK. Comstock RD. Ankle injuries among United States high school sports athletes, 2005-2006. Journal of Athletic Training. 42(3):381-7, 2007. Female professional basketball athletes who did not wear an external ankle support, who played in the key area, or who functioned as centers had a higher risk for ankle sprain than did other players. (Kofotolis N. Kellis E. Ankle sprain injuries: a 2-year prospective cohort study in female Greek professional basketball players. Journal of Athletic Training. 42(3):388-94, 2007).
From 1988-1989 through 2003-2004, 12.4% of schools across Divisions I, II, and III that sponsor varsity women's basketball programs participated in annual Injury Surveillance System data collection. Game and practice injury rates exhibited significant decreases over the study period. The rate of injury in a game situation was almost 2 times higher than in a practice (7.68 versus 3.99 injuries per 1000 athlete-exposures, rate ratio = 1.9, 95% confidence interval = 1.9, 2.0). Preseason-practice injury rates were more than twice as high as regular-season practice injury rates (6.75 versus 2.84 injuries per 1000 athlete-exposures, rate ratio = 2.4, 95% confidence interval = 2.2, 2.4). More than 60% of all game and practice injuries were to the lower extremity, with the most common game injuries being ankle ligament sprains, knee injuries (internal derangements and patellar conditions), and concussions. In practices, ankle ligament sprains, knee injuries (internal derangements and patellar conditions), upper leg muscle-tendon strains, and concussions were the most common injuries. (Agel J. Olson DE. Dick R. Arendt EA. Marshall SW. Sikka RS. Descriptive epidemiology of collegiate women's basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. Journal of Athletic Training. 42(2):202-10, 2007).
www.stopmusclepain.com Pain| Basketball Injuries
Pain| Man-made disasters
May 18, 2008 12:04 amMay 18, 2008 There is limited research on the connection between the Holocaust and chronic pain, despite evidence suggesting that medical and psychological sequelae are common in survivors. The goals of this study were: (1) to define Holocaust survivors' (n = 33) chronic pain characteristics as manifested 50 years after the war, (2) to compare survivors with controls (n = 33) who did not experience World War II atrocities, and (3) to investigate the connection between past trauma and chronic pain. Data were collected through questionnaires that included a detailed medical and pain history, visual analog scale (VAS), McGill Pain Questionnaire (MPQ), Beck Depression Inventory (BDI), Symptom Check List-90 (SCL-90), and Pain Disability Index (PDI). A comparison of variables between the two groups was conducted using multivariate analysis of variance (MANOVA) and ANOVA, and canonical discriminant analysis. Results showed that Holocaust survivors reported higher pain levels (73 +/- 18 vs. 56 +/- 21; P < 0.005), more pain sites (4.5 6 2.8 vs. 2.7 6 1.4; P < 0.05), and significantly higher depression scores (17.6 +/- 8.4 vs. 9.2 +/- 4.6; P < 0.001); they tended to utilize more medical services (5.9 +/- 3.0 vs. 5.1 +/- 2.8). Nonetheless, survivors did not regard themselves more disabled as compared with controls. They reported a higher activity level as measured by walking distance capacity, and spent significantly fewer hours resting (4.3 +/- 3.6 vs. 7 +/- 4.6; P < 0.05). This paradoxical combination of high pain intensity, moderate to severe depression, and high activity level characterizes Holocaust survivors' chronic pain. It is conceivable that by remaining active Holocaust survivors fight back their pain, distress, and depression. These findings suggest that Holocaust atrocities affect survivors' chronic pain even years later. (Yaari A. Eisenberg E. Adler R. Birkhan J. Chronic pain in Holocaust survivors. Journal of Pain & Symptom Management. 17(3):181-7, 1999).
Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment.Stesssman J. Cohen A. Hammerman-Rozenberg R. Bursztyn M. Azoulay D. Maaravi Y. Jacobs JM. Holocaust survivors in old age: the Jerusalem Longitudinal Study. (Journal of the American Geriatrics Society. 56(3):470-7, 2008).
As President of the Alumni Myanmar Institutes of Medicine Association (AMIMA), I urge you to to support of the victims of Cyclone Nargis who also are subjected to man-made disasters in Myanmar.
Please donate by clicking on the link below: http://www.amima.net/projects4
www.stopmusclepain.com Pain| Man-made disasters
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Pain | Natural Disasters
May 11, 2008 12:21 amSunday, May 11, 2008 The effects of the cyclone Nargis in Myanmar that killed over 100,000 people, with displacement of over 2 million people prompted my search of the effects of natural disasters in the causation of musculoskeletal pain and psychological trauma.
Of most frequent types of Physical Medicine and Rehabilitation (PMR) conditions of patients treated in the Astrodome Clinic after a historic hurricane Katrina showed the majority (75%) of PMR conditions presented in the first week. Most frequent were swollen feet and legs (22%), leg pain and cramps (17%), headache (12%), and neck and back pain (10%). Persons with headaches were younger than those without (41.3 vs. 46.3 yrs, P = 0.048). Persons with neck and/or back pain were older than those without those conditions (51.3 vs. 44.8 yrs, P = 0.004). Women had more headaches (20.9%) than did men (6.7%, P = 0.002). There were no Caucasians with leg pain/cramps, whereas 20.2% of African Americans had this condition (P = 0.028). (Chiou-Tan FY. Bloodworth DM. Kass JS. Li X. Gavagan TF. Mattox K. Rintala DH. Physical medicine and rehabilitation conditions in the Astrodome clinic after hurricane Katrina. American Journal of Physical Medicine & Rehabilitation. 86(9):762-9, 2007).
Severe natural disasters can cause long-term psychological impact on the survivors. This study aimed to examine the prevalence and risk factors of posttraumatic stress symptoms and psychiatric morbidity among survivors of the severe earthquake that occurred in Chi-Chi, Taiwan, in September 21, 1999. A total of 6412 earthquake survivors whose houses were destroyed by earthquake were recruited about 2 years after the disaster. The estimated rates of posttraumatic stress disorder and psychiatric morbidity were 20.9% and 39.8%, respectively. Psychiatric morbidity occurred mainly in survivors who were female, older, with low education level, and currently living in a prefabricated house and experienced complete destruction of property. The findings of risk factors suggest avenues for targeting postdisaster interventions (Chen CH. Tan HK. Liao LR. Chen HH. Chan CC. Cheng JJ. Chen CY. Wang TN. Lu ML. Long-term psychological outcome of 1999 Taiwan earthquake survivors: a survey of a high-risk sample with property damage).
The post-tsunami health and nutritional statuses of survivors were surveyed three months after the disaster struck. The study group still suffered from injuries after the disaster, and complained of back pain, stress, and sleep disorders. Most in the study group had unsatisfactory health behaviors, and obesity was an increasing problem among female participants. (Kwanbunjan K. Mas-ngammueng R. Chusongsang P. Chusongsang Y. Maneekan P. Chantaranipapong Y. Pooudong S. Butraporn P. Health and nutrition survey of tsunami victims in Phang-Nga Province, Thailand. Southeast Asian Journal of Tropical Medicine & Public Health. 37(2):382-7, 2006).
At present, saving the lives of the survivors of the Myanmar Cyclone is of paramount importance since there is scarcity of food, water, clothing and shelter. These victims living under deplorable conditions need dire help. At a time when international aid organizations and United Nations is unable to supply age to these victims, we as native physicians are able to help these victims at Ground Zero level and at this very moment as we speak, we have physicians saving lives.
As President of the Alumni Myanmar Institutes of Medicine Association, we urge assistance in our endeavors. To donate, please visit:
http://www.amima.net/projects4
Organization summary
Alumni Myanmar Institutes of Medicine (AMIMA) is a PA, USA incorporated, nonprofit 501(c)(3) organization. It is organized for the purpose of providing charitable giving to nonprofit organizations promoting health, economic development and humanitarian aid in Myanmar. We have 750 physician members world-wide and have donated in 2007 to the Myanmar Dengue Hemorrhagic Fever Project and for the establishment of the medical school library of the Institute of Medicine in Yangon.
Involvement in Myanmar cyclone disaster relief.
AMIMA can reach the people needing the most help since as native physicians we are able to co-ordinate and work with members of the Myanmar Medical Council (local non-governmental organization). AMIMA has already donated $40,000 to Emergency Medical Relief Team for Cyclone Areas headed by Professor U Hla Myint, President, Myanmar Medical Council assisted by Dr. Kyi Minn, adviser, World Vision. This established Myanmar traveling medical team has dealt with previous epidemics, such as Dengue hemorrhagic fever and will provide medical care, clean water and food to prevent infectious diseases, as well as provide psychological counseling.
Donate at: http://www.amima.net/projects4
www.stopmusclepain.com Pain | Natural Disasters
pain
Pain| Disc Degeneration
May 3, 2008 11:33 pmSunday, May 04, 2008
A recent report in the Lancet medical journal reports that in a survey of 3,982 Americans, 29% of men and 27% women reported feeling some pain. Those who have higher levels of pain are usually those with lower income and less education working in manual labor and other blue-collar jobs. About $60 billion in productivity is lost each year because of workers experiencing pain and about $13.8 billion was spent on prescription medicines in 2004.
Pain can start as early as the teen years and increases to the mid-40s and then plateau to increase again after age 75. The degenerative changes seen in autopsies confirm the reason for these pain symptoms (see below).
The intervertebral discs lies between the vertebral bodies, linking them together. The components of the disc are nucleus pulposus, annulus fibrosus and cartilagenous end-plates. The blood supply to the disc is only to the cartilagenous end-plates. The nerve supply is basically through the sinovertebral nerve. The important components of the disc are collagen fibers, elastin fibers and aggrecan. As the disc ages, degeneration occurs, the nucleus dries up, and the disc flattens. During these changes, pain producing nuclear material tracks and leaks through the outer rim of the annulus. This is the main source of disc related pain. While this is occurring, the degenerative disc, having lost its height, effects the structures close by, such as ligamentum flavum, facet joints, and the shape of the neural foramina. This is the main cause of spinal stenosis and radicular pain due to the disc degeneration in the aged populations. (Raj PP. Intervertebral disc: anatomy-physiology-pathophysiology-treatment. Pain Practice. 8(1):18-44, 2008).
In a study of 248 sections of lumbar disc and vertebral bodies from 41 routine autopsies (range, 7 months to 88 years), these degenerative changes were noted: fibrous transformation starts in the nucleus, then annular disorganization, endplate, and vertebral body alterations progress. These changes occur predominantly in the first 2 decades and in the 5th to 7th decades. In the 3rd and 4th decades, little progression occurs. Nuclear clefts and annular tears appear later, mostly starting in the 2nd decade, with clefts preceding formation of tears. Radial and concentric tears develop similarly over time, whereas rim lesions mostly develop after the sixth decade. Significant differences are observed between upper and lower lumbar spine. Haefeli M. Kalberer F. Saegesser D. Nerlich AG. Boos N. Paesold G. The course of macroscopic degeneration in the human lumbar intervertebral disc. [Journal Article. Research Support, Non-U.S. Gov't] Spine. 31(14):1522-31, 2006.
www.stopmusclepain.com Pain| Disc Degeneration
Chronic pain| Foot Hydrotherapy
April 26, 2008 12:13 am Saturday, April 26, 2008 Alternate hot and cold hydrotherapy of the legs were given at ten 25-minute treatments during a three-week period to 20 patients with walking induced pain in the feet and lower limbs. 70% of the patients reported reduced pain after treatment, walking ability before pain and also maximal walking ability sustained up to 1-year later. Among those who reported improved walking ability one year after treatment, systolic blood pressure in both right and left ankles and toes increased. (Elmstahl S. Lilja B. Bergqvist D. Brunkwall J. Hydrotherapy of patients with intermittent claudication: a novel approach to improve systolic ankle pressure and reduce symptoms. International Angiology. 14(4):389-94, 1995).
Footbathing at 42 degrees C for 10 min, with or without additional mechanical stimulation (air bubbles and vibration) has also been shown to increase autonomic nerve and immune function. White blood cell (WBC) counts, ratios of lymphocyte subsets, and natural killer (NK) cell cytotoxicity were used as indicators of immune function. Footbathing with mechanical stimulation produced (1) significant changes in the measured autonomic responses, indicating a shift to increased parasympathetic and decreased sympathetic activity which are measures indicating pain relief and (2) significant increases in WBC count and NK cell cytotoxicity, suggesting an improved immune status. Saeki Y. Nagai N. Hishinuma M. Effects of footbathing on autonomic nerve and immune function. Complementary Therapies in Clinical Practice. 13(3):158-65, 2007
www.stopmusclepain.com Chronic pain| Foot Hydrotherapy
Headaches | Sleep Apnoea
April 17, 2008 11:36 pmFriday, April 18, 2008
In a study to investigate the co-morbidity of chronic refractory headache with obstructive sleep apnoea syndrome, seventy-two patients (51 women and 21 men) with chronic and refractory headaches, whose headache occurred during sleep or whose sleep was accompanied by snoring, were submitted to polysomnography.
Patients diagnosed with obstructive sleep apnoea syndrome began continuous positive airway pressure (C-PAP) treatment and were followed up for >or= 6 months. Twenty-one cases of obstructive sleep apnoea syndrome were identified (29.2% of the total investigated).
Headaches were classified into several headache disorders, medication overuse headache and cluster headache being the most prevalent. Multivariate regression analysis revealed that age, male gender and body mass index were associated with obstructive sleep apnoea syndrome. C-PAP treatment improved both sleep apnoea and headache in only a third of the cases.
Patients suffering from chronic refractory headache associated with sleep or snoring, in particular those who are also middle-aged, overweight men, should be considered for polysomnography. C-PAP treatment alone does not seem to improve headache, but further investigation is needed. (Mitsikostas DD. Vikelis M. Viskos A. Refractory chronic headache associated with obstructive sleep apnoea syndrome. Cephalalgia. 28(2):139-43, 2008).
In another study, it was found that headache and neck pain were more likely among patients admitted for polysomnography compared with the general population (n = 41 340). This association was mainly restricted to those with frequent complaints (> or =7 days per month).
Chronic headache (headache > or = 15 days per month) was seven times more common among individuals with and without confirmed obstructive sleep apnoea syndrome than in the general population. There was no linear dose-response relationship between headache and neck pain and severity of apnoea or oxygen desaturation. Thus, hypoxia per se is less likely to explain the high headache prevalence among patients admitted for polysomnography. (Sand T. Hagen K. Schrader H. Sleep apnoea and chronic headache. Cephalalgia. 23(2):90-5, 2003 Mar)
It is essential to have chronic pain patients especially those on long-term narcotics complaining of sleep difficulties examined for sleep apnoea. There is a dose-dependent relationship between chronic opioid use and the development of a peculiar pattern of respiration consisting of central sleep apneas and ataxic breathing. (Walker JM. Farney RJ. Rhondeau SM. Boyle KM. Valentine K. Cloward TV. Shilling KC. Chronic opioid use is a risk factor for the development of central sleep apnea and ataxic breathing.[erratum appears in J Clin Sleep Med. 2007 Oct 15;3(6). Journal of Clinical Sleep Medicine. 3(5):455-61, 2007)
www.stopmusclepain.com Headaches | Sleep Apnoea
Chronic Pain| Fibromyalgia| Physical Function
February 29, 2008 1:55 pmFebruary 29, 2008
An online survey to investigate predictors of high physical function in 2,580 people with fibromyalgia (FM) showed that significant explanatory variables of high physical function were: men, greater education, younger age, lower intensity fatigue, spasticity, and balance problems, not using prescription pain medications, using aerobic or strength training exercise, and not using relaxation methods.
Conclusions were that people with FM suffer from multiple symptoms and use many modalities to control symptoms to remain functional. The authors had questions pertaining to developing strategies to promote better functioning, prospective trials to track the natural course of study variables, measuring their effect on function, and to test effects of interventions to maximize function. (Rutledge, Dana N.; Jones, Kim; Jones, C. Jessie Predicting High Physical Function in People With Fibromyalgia. Journal of Nursing Scholarship. 39(4):319-324, December 2007).
Important to note is that the study variables can be seen in earlier and milder cases of fibromyalgia which relates to better function levels in these types of individuals.
Self-care education is very important in patients with fibromyalgia to maintain physical function. Repetitive motion activities (even if aerobic) are to be avoided as much as possible with frequent rest periods if exposed to such tasks.
Strength training activities are not encouraged. Weightlifting should be curtailed and anything lifted should be less than 2 pounds (maximum less than 5 pounds) at a time and lifting must be with using both arms. There should be no reaching forward or lifting with arms outstretched or performing overhead activities. Any lifting should be done with the elbow at the side of the body. This pertains also to any activities that involve pushing or pulling. Unsuspecting injuries occur with opening or closing heavy-duty doors and drawers.
Any activities done should have equal duration of rest for the duration of activity performed. There is tendency for patients to continue exercises either by number of repetitions or by a set time session for the exercise. The best way is to titrate the activities by the level of feelings of discomfort, soreness, pain, achiness, tightness, stiffness, and fatigue. The activities must be stopped immediately and the patient must rest as soon as the symptoms increase so that the pain symptoms do not escalate.
Pain and discomfort symptoms in nerve related muscle pain is from ischemia and anoxia to nerve and muscle tissue when the muscles shorten and tighten. Pushing through pain will just make to ischemia and anoxia worse leading to escalating pain through ireversible nerve damage.
Chronic pain and fibromyalgia are lifelong diseases and patients must learn how to preserve their physical functions for as long as possible by knowing about self-care techniques.
Treatments to decrease the level of pain is essential for maintaining or increasing function with improvement in quality of life. eToims reverses the ischemia and anoxia that causes nerve damage allowing nerves and muscles to heal. Please visit the main site of www.stopmusclepain.com to learn about the role of eToims in relieving acute and chronic nerve related muscle pain such as that experienced by patients with fibromyalgia.
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