
Reply: Does anyone have pain like this?
Idamae, Symptoms of tingling and shooting pains in regions like the hips and legs...
Posted by Peter Abaci, MD
Idamae,
Symptoms of tingling and shooting pains in regions like the hips and legs can commonly occur with herpes, and this is typically seen right before an eruption of lesions takes place. Herpes can also cause other systemic symptoms like headaches and body aches. It might be worth consulting with a specialist about how best to manage the herpes.
Certainly spinal nerve root irritation can also be another source of shooting pain down the arms or legs, and with your history of scoliosis this could be another factor to consider.
At the same time, we know that some folks can become hypersensitive to muscular, joint, or nerve pains for reasons that aren't entirely clear. Learning some simple techniques to calm down pain flare-ups can be really helpful. Even some basic breathing exercises can go a long way to calming down your nervous system and as a result also helping to quiet down these pains when they pop up.View Thread
Posted byPeter Abaci, MD
Symptoms of tingling and shooting pains in regions like the hips and legs can commonly occur with herpes, and this is typically seen right before an eruption of lesions takes place. Herpes can also cause other systemic symptoms like headaches and body aches. It might be worth consulting with a specialist about how best to manage the herpes.
Certainly spinal nerve root irritation can also be another source of shooting pain down the arms or legs, and with your history of scoliosis this could be another factor to consider.
At the same time, we know that some folks can become hypersensitive to muscular, joint, or nerve pains for reasons that aren't entirely clear. Learning some simple techniques to calm down pain flare-ups can be really helpful. Even some basic breathing exercises can go a long way to calming down your nervous system and as a result also helping to quiet down these pains when they pop up.View Thread
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Reply: pelvic pain
Working with a physical therapist sounds like a good place to start. During your...
Posted by Peter Abaci, MD
Working with a physical therapist sounds like a good place to start. During your pregnancy and delivery, your body went through a lot of changes, and this can put a lot of stress and strain on some of the muscles, nerves, and ligaments in your pelvis. On top of that, there can be a lot swelling of the tissues during and after this process that can further aggravate symptoms. Many of these issues can be expected to heal over time, but a physical therapist can help move this process along.
If the pain persists, sometimes this is due to nerve irritation that took place during the birthing process. An example of this would involve the pudendal nerve which can create persistent pelvic pain after delivery. Cyclists sometimes irritate this nerve, as well. Physical therapy can help treat this.
Of note, some physical therapists may have expertise in treating pelvic floor problems while many others may not. I think it would be worth your while trying to work with somebody who has a background with this if at all possible.View Thread
Posted byPeter Abaci, MD
If the pain persists, sometimes this is due to nerve irritation that took place during the birthing process. An example of this would involve the pudendal nerve which can create persistent pelvic pain after delivery. Cyclists sometimes irritate this nerve, as well. Physical therapy can help treat this.
Of note, some physical therapists may have expertise in treating pelvic floor problems while many others may not. I think it would be worth your while trying to work with somebody who has a background with this if at all possible.View Thread
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Reply: I get sick from Pain Meds too...any suggestions?
The best place to start with preventing the nausea is with your anesthesiologist....
Posted by Peter Abaci, MD
The best place to start with preventing the nausea is with your anesthesiologist. He/She can help come up with a plan to use anesthetics with less risk of inducing post-operative nausea. Some anesthetics are less problematic than others. In addition, regional nerve blocks, epidural blocks, or spinals are also options to consider under the appropriate circumstances as tools to help minimize the need for general anesthesia during surgery and to provide added relief after the surgery is over.
Even then, some folks are extra sensitive and certainly practicing some of the alternative techniques that you mentioned like meditation have been shown to be helpful. If the compazine makes you feel icky, ask if you can be given Zofran instead, as it is usually well-tolerated.
Make sure you get to talk to your anesthesiologist ahead of time about these issues so that things get off on the right foot from the get-go.View Thread
Posted byPeter Abaci, MD
Even then, some folks are extra sensitive and certainly practicing some of the alternative techniques that you mentioned like meditation have been shown to be helpful. If the compazine makes you feel icky, ask if you can be given Zofran instead, as it is usually well-tolerated.
Make sure you get to talk to your anesthesiologist ahead of time about these issues so that things get off on the right foot from the get-go.View Thread
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Reply: Pain pills need to know where to start
Lumbee, This is a situation that needs to be treated urgently because you are...
Posted by Peter Abaci, MD
Lumbee,
This is a situation that needs to be treated urgently because you are exposing your liver to toxic levels of acetaminophen. I think you need to go to whatever hospital, addiction treatment program, or pain management center that can help you the quickest to transition off of the Lorcet. One medication that I have found to be helpful with difficult transitions like this is buprenorphine. Consider looking for a doctor in your area who is trained or licensed to prescribe buprenorphine as a potential option for help.
Your primary care physician should be able to help with a referral if you need assistance and your liver function lab work should also be checked.View Thread
Posted byPeter Abaci, MD
This is a situation that needs to be treated urgently because you are exposing your liver to toxic levels of acetaminophen. I think you need to go to whatever hospital, addiction treatment program, or pain management center that can help you the quickest to transition off of the Lorcet. One medication that I have found to be helpful with difficult transitions like this is buprenorphine. Consider looking for a doctor in your area who is trained or licensed to prescribe buprenorphine as a potential option for help.
Your primary care physician should be able to help with a referral if you need assistance and your liver function lab work should also be checked.View Thread
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Reply: Wife having tingling and numbness in her hands
Hi Robert, We certainly see a lot of tingling and pain problems related to...
Posted by Peter Abaci, MD
Hi Robert,
We certainly see a lot of tingling and pain problems related to performing repetitive tasks. As computers are such a prevalent part of peoples' jobs these days, it is common to see problems like carpal tunnel syndrome. Carpal tunnel syndrome is probably one of the most common causes of numbness or tingling in the hands and fingers and is usually associated with the repetitive use of the hands, often in a fixed position for prolonged periods of time.
I have seen a number of patients over the years who developed repetitive strain-type symptoms from performing delicate lab work. Carpal tunnel syndrome is certainly one possible problem to consider here, but there are other places where the nerves, tendons, and muscles can get inflamed to consider as well. For example, if your wife works with her neck in a flexed position for too long, she may be prone to nerve irritation around the neck that could cause referred pain down the arms into the hands.
At this point it would be reasonable to consult with a specialist for further testing and considerations for treatments. Changing positions frequently, taking regular breaks from the same tasks, and re-examining posture, body mechanics, and ergonomics can all help. Here is a link to an article I wrote on things that can be done to help manage pain at the workplace: http://peterabaci.com/how-to-prevent-pain-at-work/.View Thread
Posted byPeter Abaci, MD
We certainly see a lot of tingling and pain problems related to performing repetitive tasks. As computers are such a prevalent part of peoples' jobs these days, it is common to see problems like carpal tunnel syndrome. Carpal tunnel syndrome is probably one of the most common causes of numbness or tingling in the hands and fingers and is usually associated with the repetitive use of the hands, often in a fixed position for prolonged periods of time.
I have seen a number of patients over the years who developed repetitive strain-type symptoms from performing delicate lab work. Carpal tunnel syndrome is certainly one possible problem to consider here, but there are other places where the nerves, tendons, and muscles can get inflamed to consider as well. For example, if your wife works with her neck in a flexed position for too long, she may be prone to nerve irritation around the neck that could cause referred pain down the arms into the hands.
At this point it would be reasonable to consult with a specialist for further testing and considerations for treatments. Changing positions frequently, taking regular breaks from the same tasks, and re-examining posture, body mechanics, and ergonomics can all help. Here is a link to an article I wrote on things that can be done to help manage pain at the workplace: http://peterabaci.com/how-to-prevent-pain-at-work/.View Thread
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Reply: Central Sensitization Syndrome
I appreciate you willing to share this information about what you are working...
Posted by Peter Abaci, MD
I appreciate you willing to share this information about what you are working through. It might help to think of pain as something that affects many of the processing regions of the brain and leads to changes or remodelling of what goes on in these locations. I refer to this as the "pain matrix" in my book, and it helps to show why the presence of chronic pain can affect so many different things like movement, mood, decision making, and even blood pressure and heart rate. Effective pain rehabilitation requires working on all of these different regions so that the body can function better and feel better. Therefore, good pain rehab works requires a very comprehensive approach that works on the mind/body connection.
For everyone who has pain, there are physical factors as well psychological factors to consider as part of the recovery process. I think the military is becoming very aware of this and is trying to offer this type of comprehensive rehabilitation pain treatment.
The brain is very adaptable and this characteristic is called neural plasticity.
With the right treatment or program your brain can start to work with your body again in a way so that you can regain normal movements and functions. Sometimes this can be a slow gradual process.View Thread
Posted byPeter Abaci, MD
For everyone who has pain, there are physical factors as well psychological factors to consider as part of the recovery process. I think the military is becoming very aware of this and is trying to offer this type of comprehensive rehabilitation pain treatment.
The brain is very adaptable and this characteristic is called neural plasticity.
With the right treatment or program your brain can start to work with your body again in a way so that you can regain normal movements and functions. Sometimes this can be a slow gradual process.View Thread
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Reply: Butran Patch & what helps best??
The active ingredient in the Butran Patch is a compound known as buprenorphine. In...
Posted by Peter Abaci, MD
The active ingredient in the Butran Patch is a compound known as buprenorphine. In my practice, we typically use buprenorphine as a tool to help patients who wish to transition off of long-term opioid pain medications. For these folks, the reasons may include tolerance, side effects, dependence, addiction, or a lack of efficacy as reasons for making this type of choice. The buprenorphine, which we often use sublingually, can work well as a transition medicine as far as helping with withdrawal and pain issues, and in some cases the long-term use of buprenorphine can be a good alternative. In short, for patients who are trying to transition away from their chronic dependence on their opioid pain killers, buprenorphine can be a very helpful medication.
I think your particular case, it would be helpful for you to talk to your doctor to see what goals he/she has for you with the Butrans Patch and make sure you two are on the same page with that.View Thread
Posted byPeter Abaci, MD
I think your particular case, it would be helpful for you to talk to your doctor to see what goals he/she has for you with the Butrans Patch and make sure you two are on the same page with that.View Thread
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Reply: Pain, Pills, Seizures, withdrawal from meds...
Angelady, I am deeply sorry about the loss of your son and all that you have been...
Posted by Peter Abaci, MD
Angelady,
I am deeply sorry about the loss of your son and all that you have been through. Going through a process of trying to get your life back can sometims be really challenging and unfortunately it sounds like you are trying to overcome some steep obstacles. At the same time, I have gone through this process with many of my patients over the years and the results will definitely be worth it. Your heart and motivations are in the right place.
Seizures are not generally associated with opioid-withdrawal; however, I did find case reports of this occuring. In fact, there is evidence of epileptic brain wave activity in newborns born to opioid-dependent moms when withdrawing. As for the blurry vision, it sounds like consulting with an opthalmologist is a good next step, and hopefully it is something that will repair itself or is treatable.
Again, as frustrating and challenging as this seems to be, I applaude your resolve to work through this. As you need all of the support you can get, consider talking to your doctors about a referral to a counselor to help you process all of what you have been through and to help you going forward. Keep us posted on how you are doing.View Thread
Posted byPeter Abaci, MD
I am deeply sorry about the loss of your son and all that you have been through. Going through a process of trying to get your life back can sometims be really challenging and unfortunately it sounds like you are trying to overcome some steep obstacles. At the same time, I have gone through this process with many of my patients over the years and the results will definitely be worth it. Your heart and motivations are in the right place.
Seizures are not generally associated with opioid-withdrawal; however, I did find case reports of this occuring. In fact, there is evidence of epileptic brain wave activity in newborns born to opioid-dependent moms when withdrawing. As for the blurry vision, it sounds like consulting with an opthalmologist is a good next step, and hopefully it is something that will repair itself or is treatable.
Again, as frustrating and challenging as this seems to be, I applaude your resolve to work through this. As you need all of the support you can get, consider talking to your doctors about a referral to a counselor to help you process all of what you have been through and to help you going forward. Keep us posted on how you are doing.View Thread
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An Update On Nutrition
The role of food and nutrition in pain treatment is an ever-evolving topic.The...
Posted by Peter Abaci, MD
The role of food and nutrition in pain treatment is an ever-evolving topic.The October issue of the journal Pain published an updated review of nutrition research in pain treatment, and I thought I would pass along some of the information.
If you are interested in supplements, omega-3 fatty acids (like fish oils) have been able to reduce joint pain and stiffness in a number of studies. Magnesium supplementation may reduce the frequency, but not intensity, of pain cycles. Alpha-lipoic acid and vitamin E can reduce nerve pain associated with diabetic neuropathy.
The compounds in these supplements can all be found in the foods we eat including:
Remember to consult with your doctor before making dietary changes. Feel free to share any dietary tips that you have found successful.View Thread
Posted byPeter Abaci, MD
If you are interested in supplements, omega-3 fatty acids (like fish oils) have been able to reduce joint pain and stiffness in a number of studies. Magnesium supplementation may reduce the frequency, but not intensity, of pain cycles. Alpha-lipoic acid and vitamin E can reduce nerve pain associated with diabetic neuropathy.
The compounds in these supplements can all be found in the foods we eat including:
- Omega-3 fatty acids: nuts, seafood, avocados
- Magnesium: Leafy greens, chocolate, nuts, avocados, pumpkins
- Alpha-lipoic acid: Leafy greens and yeast
Remember to consult with your doctor before making dietary changes. Feel free to share any dietary tips that you have found successful.View Thread
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Reply: Having Chronic Pain and dealing with the Holidays!
There is already a lot of great advice here, but I think this time of year can be...
Posted by Peter Abaci, MD
There is already a lot of great advice here, but I think this time of year can be especially challenging for many. Try your best to maintain a balance between doing things for others (like sending cards or shopping) and taking care of your own health and well-being. I think it is important to budget some time each day for yourself, where you aren't doing things for others. It can also be helpful to unplug for a short period of time each day where you are away from smart phones, computers, and shopping malls. Consider creating a schedule for some of your Holiday obligations and try pace yourself and avoid going overboard on the time that you pencil in for things.
In addition to all of the added physical challenges of trying to keep up with the Holiday rush, I think this can be a very stressful time of year, as well. That stress can come from many different places including family, finances, winter weather, and just trying to keep up with everything. Keeping stress levels down can help keep pain under control. Exercise can help boost mood and lower stress, too.
Air travel can also be a source of stress and physical wear and tear. I recommend always trying to give yourself as much time for everything as possible. Show up early to check in so you don't have to rush and fight through crowds. Consider checking in bags as opposed to hauling heavy carry-ons around. Drink lots of water every chance you get to stay hydrated, and stand up and move around whenever you have the chance. Bringing relaxing music and a TENS unit certainly seems reasonable if they are available.
Your friends and family will most appreciate the fact that your thoughts are with them above all else.View Thread
Posted byPeter Abaci, MD
In addition to all of the added physical challenges of trying to keep up with the Holiday rush, I think this can be a very stressful time of year, as well. That stress can come from many different places including family, finances, winter weather, and just trying to keep up with everything. Keeping stress levels down can help keep pain under control. Exercise can help boost mood and lower stress, too.
Air travel can also be a source of stress and physical wear and tear. I recommend always trying to give yourself as much time for everything as possible. Show up early to check in so you don't have to rush and fight through crowds. Consider checking in bags as opposed to hauling heavy carry-ons around. Drink lots of water every chance you get to stay hydrated, and stand up and move around whenever you have the chance. Bringing relaxing music and a TENS unit certainly seems reasonable if they are available.
Your friends and family will most appreciate the fact that your thoughts are with them above all else.View Thread
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