So-Much-Pain.com

Ankylosing Spondylitis is a rheumatic disease that causes degeneration in the spine and sacroiliac joints. During the autoimmune response the body believes it is attacking foreign cells between the vertebrae causing inflammation, swelling, pain and loss of mobility. The disease can also cause inflammation to the eyes, lungs and heart valves.

This disease can vary from an intermittent episodic condition that causes back pain throughout life to a severe chronic disease that attacks the spine, peripheral joints and other body organs.

Ankylosing Spondylitis is a member of spondylarthropathies, a group of arthritic conditions with similar patterns. The cause of Ankylosing Spondylitis isn’t known but the group of spondylarthropathies share a common genetic marker, HLA-B27. In some cases Ankylosing Spondylitis will occur after the predisposed person has had a bowel or urinary tract infection, potentially triggering the autoimmune response.

This condition affects approximately 130 out of 100,000 people in the United States. These are typically young adolescents and young adult males. There is a cultural link as it is most prevalent in Native Americans.

The first symptoms are usually a dramatic loss of flexibility in the lumbar spine. Doctors also may find arthritis present in the shoulders, hips and feet. Delay of the initial diagnosis is common because the symptoms often mimic those of other more common back problems. In other more severe cases people show up at the doctor’s office with progression to the inflammation of the eye, fever, fatigue, weight loss or anemia.

With early diagnosis and treatment people are able to decrease the amount of functional loss and pain caused by Ankylosing Spondylitis.

Two strong developments in the diagnosis and treatment of Ankylosing Spondylitis have been discovered through research. Earlier diagnosis is possible that will prevent the structural damage that results in less loss of function. Both developments are available at most hospitals.

The first is the use of Magnetic Resonance Imaging (MRI) to visualize the inflammatory changes in the sacroiliac joint. The MRI gives a much better view of the earlier changes that happen in the sacroiliac joint early in the progression of Ankylosing Spondylitis. This gives physicians a better chance to begin therapies and treatments to slow the loss of function and mobility.

The second new breakthrough is the use of tumor necrosis factor blockers. These treatments, usually reserved for patients with tumors, show a high effectiveness in reducing the spinal inflammation and slowing the progression of the disease as shown in x-ray. Unfortunately research has also shown that once the treatment has stopped most patient’s relapse. The study used this treatment over four years with little problems with toxicity for patients.

Patients and physicians have found that the simplest treatments for Ankylosing Spondylitis, such as exercise and non-steroidal anti-inflammatory drug therapies still give good relief from the degenerative response. The non-steroidal anti-inflammatory medications used are often Indomethacin and sulfasalazine. Patients with problems in their peripheral joints, arms and legs, may respond well to methotrexate.

Even with optimal therapy patients may develop a stiff back but if fusion happens in the upright position they are more functional for the remainder of their life. The goals of therapy are to increase joint flexibility and enhance lung capacity.

If you are dealing with arthritis, one of the hardest things to deal with is the insomnia. The sleeping disorder is going to prevent you from getting the rest that you need to stay healthy and this will in return make your arthritis worse. It can be a terrible cycle that you are dealing with. There are many things that you can do to take on arthritis and it is important to consider all of the options so that you can get a better night’s rest every time you go to bed.

Insomnia is determined by a number of problems. You first have difficulty falling asleep. Many people will experience this at some point in their life. However if you are frequently finding it hard to drift off to sleep, you may want to talk to your doctor about it. If you are waking up often through the night for no good reason, this is a symptom too. This will usually happen to everyone and more so to people if they are new parents. If you are finding that you are constantly tossing and turning more than once a week, you are probably dealing with insomnia. Some with insomnia will sleep throughout the night, their problem may be that they wake up too early or they do not feel refreshed after many hours of sleep. It will depend on how frequently insomnia happens for you and if you can be diagnosed with short-term insomnia, intermittent insomnia or chronic insomnia.

Anyone that suffers from arthritis will also find that they have chronic insomnia or insomnia that does not go away and occurs for a long time period. There are many reasons that chronic insomnia is found in people that do have arthritis. The pain will keep some awake at night and will occur with illness but some of the patients find that their joints are painful and inflamed after they do activity. A second reason of insomnia due to arthritis, is a high level of stress that most patients with arthritis have. Worrying about an appointment with a doctor can cause a person to stay awake all night long. There is no difference whether a patient is young and just recently
diagnosed, or older and has had the problem for many years. Insomnia can be a side of effect of the medicine that is used to treat arthritis. These medicines may rid the pain but can make you stay up all night. Without taking the medication, you may also be awake all night with pain.

There are a number of alternatives for a person with insomnia and you will need to talk to your doctor about any medications that you are taking that keep you up all night. There are going to be side effects of drugs and they can be addicting as well. Taking the right steps to take the stress out of your life is going to help you sleep better at night too. You and your doctor are the only people that can take the right course of action to fix the insomnia in your life. Talk to them and get a good night’s sleep because it is essential for healthy living.

Types of Pain – An Excerpt from “Healing Pain”
Innovative, Breakthrough Plan to Overcome Your Physical Pain/Emotional Suffering

It’s clear that pain is understood by anyone and that everyone feels it a bit differently. Overall, pain is an unpleasant sensation that occurs in varying degrees of severity and is a consequence of a number of processes. In order to manage pain, doctors discern its intensity and frequency and the circumstance from which it springs.

Types of Pain

Pain is typically categorized into two broad areas: acute and chronic.

Acute pain is easier to diagnose and treat than chronic pain. It usually occurs after an injury, and people in this state look like they’re in pain. This type of pain usually disappears when the injury heals. If you break your nose in a fall or cut yourself in your workroom, you probably feel the pain pulsing like a silent alarm throughout your body. With acute pain, your heart rate, respiratory rate, fight-or-flight response, and sweating increase. While acute pain is severe, the good news is that it lasts a relatively short time.

Chronic pain is a lot more complex.

A Closer Look at Chronic Pain

An article on chronic pain in the Journal of the American Medical Association noted that chronic pain is expensive, mainly because of the resulting disability and absence from work. In recent studies, researchers say, “more attention has been paid to the impact of chronic pain on daily living.” And what an impact it has.

What is chronic pain? A typical definition says that chronic pain is not one thing, but a condition that varies depending on the person. The variables include where the pain is, what its cause is, and how an injury heals. In some cases, the pain is simply inexplicable. However, one description is consistently applicable: All chronic pain is long-term pain that persists even after healing has occurred or when the condition that’s causing the pain does not go away. This is pain beyond what doctors expect to see from a condition or injury that does clear up.

Some women with endometriosis have worse symptoms during their cycles, while others begin feeling pain a week before that. When these women describe their pain as chronic, it’s because they’re uncomfortable for at least 2 weeks of the month. People who get bad migraines usually experience them intermittently rather than every day. So in that way, you may perceive your migraines as not actually being chronic, but recurring. I also get migraines once a month, but I don’t consider the condition chronic. Healing starts here! Chronic pain cannot have power over your thinking when you at least partly define it as something you will not allow to affect how you function.

Unlike people in the throes of acute pain, patients with chronic pain often do not appear to be in pain — but indeed they are! Research done with chronic pain sufferers shows that some exhibit greater brain activity than healthy people when subjected to pain. This may be why they experience pain more severely. Yet, they’ve gotten good at “getting through” and soldiering on. Rather than seeing an elevated change in vital signs, like increased heart rate, one usually sees vegetative signs, and, not to be dismissed, such a person may appear depressed.

People with chronic pain tell me that they have sleep disturbances, decreased libido, anhedonia (an inability to feel pleasure), constipation, lethargy, and personality change; lose their appetites; and sometimes are preoccupied with their bodies. These are all classic symptoms of chronic pain. But why the pain? Often, it’s due to a disease, while at other times, it’s the treatment of the disease that produces the pain. When a person has any type of surgery, they can be left with a long-term pain problem secondary to scarring, or even permanent nerve damage.

Chronic or persistent pain may range from mild to severe, and it is present to some degree for long periods of time. Some people with chronic pain that is controlled by medication can have “breakthrough pain,” which occurs when the medication does not work and moderate to severe pain breaks through or is felt for a short time. This can occur several times a day, even when the proper dose of medicine is given.

Healing Pain: The Book
The Innovative, Breakthrough Plan to Overcome Your Physical Pain and Emotional Suffering
—————-

Authors
Ann Berger, MSN, MD, is one of the foremost specialists in pain management in the nation. A medical oncologist specializing in pain treatment, she has written and edited numerous books on pain and palliative care for patients and health-care providers. Dr. Berger is also senior editor of the most widely used textbook on palliative care, Principles and Practice of Palliative Care and Supportive Oncology. She currently resides in Darnestown, Maryland.

C. B. deSwaan is a New York City-based freelance writer specializing in nonfiction. She has written 20 books with expert collaborators, including the best-selling Men Are Just Desserts and Smart Cookies Don’t Crumble.

Go On To Part 2 — Healing Pain: Types of Pain —>

Read more…

Types of Pain – An Excerpt from “Healing Pain”
Innovative, Breakthrough Plan to Overcome Your Physical Pain/Emotional Suffering

Following from part 1

In treating chronic pain, it’s important to understand the different potential types and mechanisms of pain.

Referred pain:
is felt some distance from where the pain actually originates. In other words, the site of the pain is not necessarily the source. Osteoarthritis of the hip, for example, causes pain to be experienced in the knee. In acupuncture, a form of Chinese medicine, kidney problems can be indicated by pain in the knees.

Phantom pain:
occurs when you have had a limb, breast, or other body part removed by surgery. People describe the pain or unpleasant sensations as if they were coming from the absent body part, but phantom pain is real and not in patients’ minds.

Somatic pain:
is caused by activation of a pain receptor. Remember, pain nerve endings, called nociceptors, are programmed to respond to various stimuli, such as heat, cold, and other physical sensations. The characteristics of the pain are very well localized aching, throbbing, and a gnawing feeling. Examples include joint and bone pain. This type of pain is generally very responsive to nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin, and when they are no longer helpful, one can use opiate medications to treat this type of pain.

Visceral pain:
is also caused by activation of a pain receptor. The patient often feels achy, vaguely localized pain. It commonly originates in the abdomen or the chest, it does not feel as if it is limited to only one area. A good example of visceral pain is chest pain due to a heart attack. In this case, the pain occurs in the chest, but it can go up the neck and down the arm, too. This type of pain is a little more difficult to treat, but it can respond to opiates and adjuvant medications.

Neuropathic pain:
is caused by destruction of a nerve in either the peripheral or central nervous system. Neuropathy can be best thought of as a seizure of a nerve. People often describe a severe, sharp, shooting, or stabbing pain or a burning, numb, or tingling sensation.

Myofascial pain:
is muscle pain that occurs in conjunction with other pains. The trigger point is a localized, highly irritable spot in a taut band of skeletal muscle. Palpation of these trigger points will alter the pain, causing it to increase or radiate. You may feel as if you are having a muscle spasm.

Healing Pain: The Book
The Innovative, Breakthrough Plan to Overcome Your Physical Pain and Emotional Suffering
—————-
Authors

Ann Berger, MSN, MD, is one of the foremost specialists in pain management in the nation. A medical oncologist specializing in pain treatment, she has written and edited numerous books on pain and palliative care for patients and health-care providers. Dr. Berger is also senior editor of the most widely used textbook on palliative care, Principles and Practice of Palliative Care and Supportive Oncology. She currently resides in Darnestown, Maryland.

C. B. deSwaan is a New York City-based freelance writer specializing in nonfiction. She has written 20 books with expert collaborators, including the best-selling Men Are Just Desserts and Smart Cookies Don’t Crumble.