Chronic Pain Blog

A recent study published in the July 30, 2008 edition of Arthritis Research and Therapy suggests that the herb Boswelia serrata (also known as Indian Frankincense) can help to reduce the symptoms of osteoarthritis. Seventy patients completed the study. The study was a 90 day double-blinded randomized placebo-controlled trial, which is considered a high quality research study. The herb was used for patients with osteoarthritis of the knees. Pain was decreased and function was improved. Indian Frankincense is believed to work by decreasing inflammation. It has been used for thousands of years, primarily through Ayurvedic medicine.

Sending text messages has become a very common form of communication these days. Unfortunately, like anything in excess, it can cause problems. I see more and more patients with wrist, hand and thumb pain. Often these are people who send and check text messages frequently. The pain often start mildly, but can progress to severe pain with swelling. Some people report clicking or locking when moving the thumb.

When sending text messages we use the thumbs more than usual. This puts excess strain onto the joints and tendons. Some people develop dequervains tenosynovitis, which is inflammation of two tendons that control the thumb. Others develop or aggravate arthritis where the thumb attaches to the wrist.

The solution is to limit texting to when absolutely necessary. If the pain is severe rest, ice and NSAIDS can be very helpful.

Chronic back pain is a very common complaint. The heavy bags that many people carry may be contributing to the pain. Our bags can be used to carry books, paperwork, computers, makeup, wallets, keys, gym clothes and more. It's not uncommon for a women to carry ten to fifteen pounds of weight in her handbag. Men are not immune to this trend. The heavy weight adds to chronic back pain and can create pain for those who were pain-free. The weight places strain onto the muscles of the back, resulting in muscle soreness and spasm. Here are some solutions that can decrease or eliminate the pain:

• Carry no more than 5 pounds in your bag
• Alternate arms if you carry an over-the-shoulder bag
• Use a backpack to evenly distribute the weight
• Take out the contents of your bag once a week and throw out anything unneccessary
• Buy a smaller bag so that you can't fit as much into it

The U.S. Food and Drug Administration is recommending that anti-seizure medications carry a "Black-Box Warning", which is the highest level of warning. These medications are believed to carry an increased suicide risk. This is of concern to many with chronic pain, because anti-seizure medications such as lyrica, neurontin and depakote are often used for pain control. The list of medications under review is:

• Carbamazepine (CARBATROL, Shire Pharmaceuticals, EQUETRO, Validus Pharmaceuticals Inc,
• TEGRETOL, Tegretol XR, Novartis Pharmaceuticals Corp).
• Felbamate (FELBATOL, Meda Pharmaceuticals Inc).
• Gabapentin (NEURONTIN, Pfizer Inc).
• Iamotrigine (LAMICTAL, GlaxoSmithKline).
• Levetiracetam (KEPPRA, UCB Inc).
• Oxcarbazepine (TRILEPTAL, Novartis Pharmaceuticals Corp).
• Pregabalin (LYRICA, Pfizer Inc).
• Tiagabine (GABITRIL, Cephalon Inc).
• Topiramate (TOPAMAX, Ortho-McNeil-Janssen Pharmaceuticals Inc).
• Valproate (DEPAKOTE, DEPAKOTE ER, DEPAKENE, DEPACON, Abbott Laboratories).
• Zonisamide

If you are on one or more of these medications, please do not stop taking it, as abruptly stopping the medications can be harmful. Discuss the medications with your physician to find out what you should do.

There's so much going on in the world today that almost everyone is feeling stressed out! Excess emotional stress aggravates chronic pain. So what can you do? Below are a few tips that you can use to lower your stress level:

• Count to ten--Sounds simple, but slowly counting to ten when you feel very stressed out can help to calm you down. It gives you a moment to re-center
• Breathe slowly--Sit still and put one hand over your lower abdomen.Breathe in through your nose for a count of five and feel your abdomen expand as you take the air in. Breathe out through your mouth for a count of five and feel your abdomen deflate. Repeat this a few times.
• Close your eyes--close your eyes and cover them with the palms of your hands. Take ten deep breaths in and out.

Learn more about stress management on Stress.about.com

As mentioned in a previous blog post, there has been a correlation between low levels of vitamin D and chronic pain. Below are some of the articles that look into this issue:

• "Hypovitaminosis D among rheumatology outpatients in clinical practice." Rheumatology (Oxford). 2008 May 22.
• "Prevalence and Clinical Correlates of Vitamin D Inadequacy among Patients with Chronic Pain." Pain Med. 2008 Mar 11.
• "Associations between vitamin D status and pain in older adults: the Invecchiare in Chianti study." J Am Geriatr Soc. 2008 May;56(5):785-91.
• "Vitamin d deficiency in iraq and afghanistan veterans with chronic musculoskeletal pain." J Occup Environ Med. 2008 Jun;50(6):613-4.

Whether you are a democrat, a republican or an independent, the coming presidential race must be on your mind. Among the many important issues at hand, addressing the problems with health care in the United States is crucial.

For information on Barack Obama's plans for healthcare, go http://www.barackobama.com/issues/healthcare/

For information on John McCain's plans for healthcare, go to http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm

This is a choice that you have to make for yourself, so read the information, ask questions and make an informed decision.

With the high costs of many prescription medications, many more people are turning to herbal supplements, hoping that they can use these in place of costlier treatments. Although popping a few herb pills may sound tempting, it is best to use caution. Some of the herbal supplements can interact with prescription medications. There also may be side effects. It is crucial that you tell your doctor about any supplements you are taking or are thinking about taking. Communication is the key to your safety.

A recently published study indicates that smokers are more likely to suffer from chronic back pain. The study, published in Deutsches Arzteblatt International, includes information from more than 8,000 interviewed subjects. Based on the information collected, it was determined that smokers and former smokers experienced chronic back pain more frequently than non-smokers.

Several recent studies have shown that low levels of vitamin D may have an impact on chronic musculoskeletal pain. Vitamin D is a vitamin that is produced when ultraviolet rays from sunlight strike the skin. Since it's summer anyway, use this to your benefit. Try to get 5-15 minutes of sun exposure daily.