EXPLANATION of COMMON PAIN DISORDERS
Low back pain, low back ache or lumbago is the most common chronic pain in the United States affecting about 60% of the adults during their lifetime. Back pain could be due to involvement of any of the following:
- Ligaments – sprain
- Cartilage – degeneration
- Nerves– compression, irritation
- Bone – fracture, disease
- Joints – degeneration, arthritis, disease
- Muscles– fibromyalgia, strain, spasm
The most common causes of back pain are muscle pain and arthritis pain. The nerve pain is to due to pinched nerve where the sciatic nerve gets pinched by the herniated discs. Diagnosis is done with x-rays, CT scan and MRI scan. Treatment is with analgesics and physiotherapy and chiropractic.
Osteoarthritis is the most common joint disease in the world. The osteoarthritis joint pain typically worsens with weight bearing and movement and improves with rest. Osteoarthritis is primarily a disease of the cartilages. It is common in the knee joints and is the commonest cause of knee pain.
Osteoarthritis is one of the causes of hip pain also. The other joints involved are bases of thumb, neck and lower back. The arthritis pain is both a bone pain and muscle pain. The bone pain is due to the pain in the joints resulting from the destruction of the joint surface of the bone. The muscle pain is due to the spasm of the muscles and other soft tissues around the joint.
The pain is usually relieved by arthritis pain medications and physiotherapy. If the arthritis pain medicines are not effective then other forms of treatment are given that include, wax bath, infrared therapy and joint replacement.
One of the best pain relief sprays for temporary relief of arthritis pain is CryoDerm analgesic spray
Growing pain affects children of 3-5 years and 8-12 years. The pain is usually felt in the calf or shin area, legs and feet and is worsened by cold temperature and humidity. Most often the pain occurs after an active day.
A complete examination is necessary in children presenting with these calf, leg and foot pain. If serious illness is ruled out, a reassurance alone is enough as this type of pain is generally self limiting.
Fibromyalgia is a poorly understood pain disorder. It affects 2% of the US population. The American College of Rheumatology lists criteria for fibromyalgia which include a history of pain for at least 3 months duration and pain in at least 11 of the 18 fibromyalgia pain points that are tender to touch.
Patients without fibromyalgia do not experience pain at these pain points. Persons who are destined to develop fibromyalgia appear to be either genetically predisposed or have had events or experiences that favor its development. One of the causes of fibromyalgia is increased pain sensitivity. These patients often develop sleep problems, irritable bowel syndrome, head ache, fatigue and depression. They have increased activity of the sympathetic nervous system. The fibromyalgia pain medication is based on these findings.
Temporomandibular joint syndrome:
Temporomandibular disorder(s) (TMD) or temporomandibular joint (TMJ) syndrome is the most common cause of facial pain after toothache. The temporomandibular joint is the joint where the lower jaw is attached to the skull bone. Temporomandibular joint syndrome consists of two types of pain disorders.
- Muscle related
- Joint related
The TMJ pain or the jaw pain is felt around the ears and is associated with chewing and click, pop and snap are the sounds heard while experiencing it.
There is limited jaw opening which may sometimes get locked. The other symptoms include neck pain, ear pain, head pain, shoulder pain, back pain and dizziness.
Shoulder pain could be due to involvement of either the shoulder bones and joints or the muscles & soft tissues around it. Most of the cases of shoulder pain are muscle pains due to the involvement of the muscles around the shoulder joint. Most of the shoulder problems fall in to the following three categories.
- Tendonitis / bursitis pain
- Injury / instability of the shoulder joint
Frozen shoulder or adhesive capsulitis is one of the important cause of shoulder pain in which the movements at the shoulder joint is restricted and painful
Neck pain or cervical pain is due to the involvement of the cervical vertebrae or nerves of the cervical spine or the muscles of the neck. There are a number of causes of neck pain. Some of the important neck pain causes are:
- Injuries and accidents
- Osteoarthritis in the neck
- Spinal stenosis
- Degenerative disc disease
- Poor posture
- Cervical spondylosis
Cervical spondylosis is one of the important causes neck pain, shoulder and upper arm pain. It can present with neck muscle pain alone in the initial phase of the disease process. In this condition the cervical vertebrae undergoes wear and tear and the nerves get caught between them. This pinched nerve causes pain.
Sciatica is a condition similar to cervical spondylosis. In this condition, the lumbar vertebrae get degenerated or get slipped off. The sciatic nerve gets caught between these vertebrae and the pinched nerve causes pain. The sciatica pain is a severe pain which radiates from the lower back to the back of the thigh and legs. The sciatic nerve pain worsens during movement and abnormal posture.
Migraine is a condition characterized by intermittent episodes of intense headache on one or both sides of the head. It is due to the involvement of blood vessels.
Migraines are often accompanied by increased sensitivity to light, increased sensitivity to sound and nausea. The treatment consists of avoidance of the trigger factors and symptomatic treatment with medication. One of the newest and best families of migraine medications at this time are the triptan’s such as Imitrex and Zomig.
The chest pains could be due to problems in the chest or the upper abdomen. Some of the causes of chest pain are pneumonia, pleurisy, pleural effusion, angina, myocardial infarction, costochondritis, gastro esophageal reflux disease and peptic ulcer disease. The myocardial infarction pain could be in the form of chest pain radiating to the neck, shoulder, jaw and left upper arm.
There are a number of causes of abdominal pain. Most of them are nociceptive pains. Some of the important causes of abdomen pain are peptic ulcer disease, pancreatitis, biliary colic, appendicitis and gastroenteritis.
Gout, also called metabolic arthritis, is a condition in which uric acid is not metabolized normally. This leads to accumulation of crystals of monosodium urate in the joints and in the tendons. This leads to inflammation of that tissue causing pain.
The gout pain treatment is of two types. One is taking analgesics like non steroidal anti inflammatory drugs either orally or through injections. The other is administering steroids directly in to the joints. A few other drugs called disease modifying drugs like colchicines is also used to treat the disease and the pain.