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Neck Pain, Back Pain, Sciatica and Pregnancy – The Back Pain Complex, Causes and Treatment

Buy Tramadol — Mon, 03 Jan 2011 03:49:32 +0000

John Zajaros asked:

The back pain complex, to include neck pain, back pain and sciatica, is one of the most common complaints among mothers-to-be during pregnancy. The spine is made up of two primary and two secondary curvatures. The secondary curvature of the lumbar region is most affected during pregnancy. The lumbar curvature, established after birth and responsible for our ability to walk upright, comes under tremendous pressure during pregnancy. Back pain is quite common during pregnancy with as many as 80% of all women experiencing neck pain, back pain and/or sciatica in varying degrees. The back pain complex is expressed from mild to acute and may become chronic if not properly addressed. We will discuss some of the reasons why back pain is so prevalent during pregnancy and offer a few solutions, as well.

While women with previous back problems are at greater risk for neck pain, back pain and sciatica, it is common among all women beginning as early as two months and continuing through, and well after, the completion of the pregnancy. During pregnancy the body produces a number of hormones, some in much higher quantities than typically found. One of the principal hormones having the most dramatic impact during pregnancy is called Relaxin. Relaxin’s function it is to make the ligaments associated with birth, and the pelvis aperture itself, softer and more pliable. The reasons for this are obvious, it is vitally important for the baby, particularly the baby’s cranium or skull, to be able to pass through the birth canal with relative ease, Relaxin makes this possible. Additionally, as the uterus grows and weight shifts forward, the center of gravity changes and the relaxation of the uterine ligaments impacts the spine and the surrounding musculature. The core muscles, to include key abdominal muscles, spinal muscles, and para-vertebral muscles, are also stretched and taxed beyond normal capabilities. The combination of hormonal and structural factors often contribute to varying degrees of neck pain, back pain, and sciatica.

Obesity, always a significant factor in diagnosing and treating the back pain complex, becomes an even greater issue during pregnancy. Normal weight gain, not to be confused with obesity, may also negatively affect mothers-to-be. The combination of an exaggerated spinal curvature, called lordosis in the lumbar region, a shift in the center of gravity, additional weight carried forward, and a weaker core muscle complex are also contributory factors. The core muscles, as well as other synergistic muscle groups, may be strengthened through a program of exercise and stretching. It must be recognized that back pain during pregnancy is the rule rather than the exception, the challenge is to deal effectively with the underlying cause or causes with an intelligent and individualized treatment program.

Two of the most common back pain expressions during pregnancy, are lumbar pain, centered primarily in the lower back, and posterior pelvic pain, with symptoms very much like those associated with sciatica. The low back or lumbar pain is generally centered in the lower back and may radiate unilaterally, one side, or bilaterally, both sides, across the iliac crest, which is the region to each side of the spine at the upper level of the pelvis. Once again, pain may range from mild to acute and grow increasingly intense the deeper into the pregnancy the mother-to-be is. Back pain in this region is exacerbated by extended periods of standing, particularly in one place, sitting for long periods of time, and by poor posture, as in the old military idea of “stomach and chest out” which simply does not work for obvious reasons. Posterior pelvic pain can be quite severe and may be four to five times more prevalent than any other back pain expression during pregnancy. Posterior pelvic pain, as noted above, may be indistinguishable in its expression from sciatica. Pelvic pain may be felt as a deep ache or even a burning sensation, may radiate across the buttocks and into the legs, unilaterally or bilaterally, and in its worst configuration or state may also be felt in the feet and toes, very much like sciatica. The biggest distinction between posterior pelvic pain and sciatica is that posterior pelvic pain is more commonly experienced bilaterally. Sciatica, on the other hand, is generally a unilateral expression affecting the buttocks, legs, feet, and toes.

While quite common, neck pain, back pain and/or sciatica, including posterior pelvic pain, should not be taken lightly. If the back pain complex is not addressed properly, it may have negative consequences throughout the pregnancy and felt in virtually every aspect of the new mom’s life. It is not uncommon for women who experience severe back pain throughout the pregnancy to continue to have problems well into the post partum period. Pregnancy can be, and usually is, a wonderful time in both the family’s life and in the life of the mother-to-be. However, if back pain is not addressed it may have a negative impact during and afterwards, in some cases for years after the pregnancy.

As noted above, there may be a myriad of causes and consequences associated with the back pain complex, as it relates to pregnancy. An intelligent, individualized, and medically supervised program of exercise and stretching is not only advisable it is absolutely necessary. Certain exercises, such as the pelvic tilt and crunches, at least until the latter stages of the pregnancy, may be appropriate and advisable. However, it is usually the case that such self-treatment programs of exercise are not only misguided but fail to achieve any real and lasting relief or benefit. Additionally, because of the shift in the center of gravity and the exacerbated lumbar curvature, a complete program focusing on the core muscles may be the best approach. Improper posture, standing for long periods of time, sitting for long periods, and even remaining inactive for extended periods of time may have a negative impact, ultimately leading to even greater pain. Finally, it is advisable for pregnant women, particularly those who work deep into the pregnancy or have other children, to take special care when lifting anything heavy. Because of the number of physiological and anatomical changes that take place during pregnancy, a program that seeks to strengthen the musculature and to improve endurance, so fatigue doesn’t lead to other problems and injuries, should be initiated as soon as possible. Only through a comprehensive program of treatment and exercise can a prospective mom hope alleviate or eliminate neck pain, back pain, and sciatica.

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Tension Headaches In Adults And Adolescents

Buy Tramadol — Mon, 15 Nov 2010 21:13:39 +0000

Alyssa Nair asked:

Tension headaches are one of the most common forms of headaches and are more likely to occur in adults and adolescents also statistics show that they are 40% more likely to occur in women than men which could be because woman tend to worry more about the family, bills and overall health. Tension headaches are usually triggered by some type of environmental or internal stress and are not associated with structural abnormalities in the brain.

What are Some Causes of Tension Headaches?

Tension headaches are often a response to stress, anxiety, and emotional conflict in a person’s life. Many occur when you already have a migraine headache and often in the middle of the day which just adds fuel to the fire, causing a more intense pain. They can last for a few hours, several days, weeks, or even months.

What are the symptoms of a tension headache?

While symptoms may differ, the following are common symptoms that you could experience: pain on both sides of your head around the temple area, neck pain, change in vision, numbness or tingling in your arms or legs, a sudden fever or vomiting, blurred vision, headaches that seem to be increasing in intensity or frequency over time, difficulty walking or speaking and a thunderclap headache or a headache associated with loss of consciousness. These symptoms could resemble other conditions or medical problems and could be severe, so please notify your doctor immediately if you have any of the symptoms above. Tension headache symptoms are very different from a migraine headache so let’s determine how they differ. A migraine headache is usually a pulsating type of pain where tension headache symptoms are a continuous pain that can last for weeks or months.

Medications

Managing a tension headache is often a balance between fostering healthy habits, finding effective herbal treatments and using medications appropriately. Rebound headaches may occur from overuse of analgesic medications. Caffeine and codeine containing medications should be avoided in cases a chronic tension headache occurs and due to the risk of overuse in medication which could cause a rebound headache. Your health care provider may prescribe one or more of the following medications.

Analgesics – These medications reduce the pain of a tension headache.

Muscle Relaxants – These medications aid in relaxation by causing sedation and decreasing anxiety. They have little or no direct effect on relaxing the muscles of the head and neck that contribute to the headache. Some of these medications can become addictive.

Tension headaches are sometimes related to contraction or spasm in the muscles of the head and neck and can come from bad posture or stress, which causes tightening of the muscles in the neck and the scalp. Make sure you understand what is causing your headaches because if either depression or anxiety plays an underlying roll that you should seek treatment right away. Even if your tension headaches are responding nicely to over-the-counter pain medications, look at whether other triggers are contributing to your headache and try and find a natural way of helping your tension headaches.

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Cervical Nerve Root Neck Pain Treatment by Physiotherapy

Buy Tramadol — Wed, 06 Oct 2010 05:58:42 +0000

Jonathan Blood-Smyth asked:

Severe neck pain with pain radiation into the arm and hand is usually the result of a herniated disc or a traumatic injury causing the nerve exit to be compromised, compressing the nerve. Most commonly affected are the C6 nerve in 25% of cases and the C7 nerve in 60%. About 25% of arm pains are from an acute prolapsed disc. In older people the cause is more likely to be narrowing of the exit channel from bony outgrowths, disc bulging, ligament infolding and arthritic enlargement of the facet joints. Physiotherapists routinely assess and treat this kind of neck pain.

Factors making nerve root pain more likely are routine lifting of weights above 25 pounds (12 kilograms), driving or operating vibrating machinery and smoking. Cervical radiculopathy is not common and occurs much less frequently than lumbar root lesions such as sciatica.

There can be many reasons for the onset of nerve root neck pain or it can come on slowly without clear reason. If the neck is moved backwards, tipped to one side and rotated to the same side this can sharply narrow the nerve exit space and injure the nerve, occurring in a traumatic accident or a sporting injury. The opposite can occur with a quick side bend, combined with flexion or extension, tractioning the nerve and causing injury. Sudden loading of the neck in any posture can cause disc prolapse. There may be degenerative changes in an older group and with repetitive or sustained neck postures an osteophyte can impinge the nerve and give a slower development of arm pain.

The onset of cervical radiculopathy can be insidious without obvious cause or after an incident. During sport or trauma like a fall the neck can be extended back, bent to one side and rotated, suddenly narrowing the exit for the nerve and compressing it, causing an injury. Or a sudden bend to the opposite side with either cervical flexion or extension can traction the nerve on the one side with consequent injury again. If there is a sudden load on the cervical spine, in any position, it’s possible for a disc prolapse to occur. If there are osteophytes present in an older person, sustaining or repeating extension with rotation may cause nerve irritation with a slower onset.

People with root pain look tired due to poor sleep, don’t find anything funny and guard their arm in a protective posture against the abdomen or hold it out to the side with their hand on the back of their neck or the other side of the head. This may reduce the forces through the inflamed nerve root and so reduce pain.

A postural abnormality is often present with the neck held side flexed or rotated away from the painful side. Examination by the physiotherapist includes recording any muscle spasm, checking reflexes, sensibility and muscle power, any combined movements which might aggravate the pain and any easing factors such as manual traction. Acupuncture and cervical epidural injections of steroids may be useful if physiotherapy cannot reduce the pain sufficiently.

Posture is usually abnormal with the head tilted away from the painful side and the neck held stiffly with reduced ranges of movement. The physio notes the muscle spasm and tests the muscle power to determine which nerve root is affected, looks for sensory and reflex loss and notes which combination of movements are provocative and if manual traction reduces symptoms.

Reducing the pain and inflammation is the first goal of treatment and the physiotherapist can employ analgesics such as NSAIDs, cryotherapy, mechanical or manual traction and avoidance of aggravating activities and postures. Limiting the forces transmitted through the nerve root is an overall goal of management, using a collar to reduce neck movement, a cervical pillow or collar at night and manual traction from the physio to distract the joints. After the acute phase has settled physiotherapy concentrates on regaining neck movement and muscle power, starting with isometric exercises and moving on to isotonic and exercises for multiple muscle groups. Long term adherence to a regime of aerobic exercise, muscle strengthening and stretching may be useful.

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What is Neck pain and How can I prevent it

Buy Tramadol — Sat, 31 Jan 2009 16:33:01 +0000

Neck Pain Definition

Most people will experience neck pain at some point in their lives. Neck pain can be acute, meaning it lasts a few hours to a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain. Most causes of neck pain aren’t serious. Poor posture at work, such as leaning into your computer, and during hobbies, such as hunching over your workbench, are common causes of neck pain. But sometimes neck pain can signify something more serious. If your neck pain is so severe that you can’t touch your chin to your chest despite a few days of self-care, seek immediate medical attention.

Symptoms

Neck pain takes many forms. Signs and symptoms of neck pain may include:

Pain in your neck that may feel sharp or dull
Stiffness in your neck
Difficulty going about your daily tasks because of pain or stiffness in your neck
Shoulder pain in addition to neck pain, in some cases
Back pain in addition to neck pain, in some cases

Causes

Neck pain can result from several causes, including:

Muscle strains. Overuse, such as too much time spent hunched over a steering wheel, often triggers muscle strains. Neck muscles, particularly those in the back of your neck, become fatigued and eventually strained. When you overuse your neck muscles repeatedly, chronic pain can develop. Even such minor things as reading in bed or gritting your teeth can strain neck muscles.
Worn joints. Like the other joints in your body, your neck joints experience wear and tear with age, which can cause osteoarthritis in your neck. Neck (cervical) osteoarthritis can cause pain and stiffness in your neck.
Disk disorders. As you age, the cushioning disks between your vertebrae become dry and stiff, narrowing the spaces in your spinal column where the nerves come out. The disks in your neck also can herniate. This means the inner gelatinous cartilage material of a disk protrudes through the disk’s tougher cartilage covering. Neck pain may occur or nearby nerves can be irritated. Other tissues and bony growths (spurs) also can press on your nerves as they exit your spinal cord, causing pain.
Injuries. Rear-end collisions often result in whiplash injuries, which occur when the head is jerked forward and back, stretching the soft tissues of the neck beyond their limits.

When to seek medical advice

Neck pain doesn’t always require medical care. Rarely, it can be a sign of an emergency. When to try home care Neck pain caused by muscle irritations is usually easy to self-diagnose, and it usually gets better on its own within a few of days. This type of neck pain typically develops after excessive activity, a period of overuse or prolonged postures that put excessive strain on your neck muscles. If your neck pain doesn’t let up within a week or two, see your doctor. When to seek immediate medical care See your doctor if the following signs and symptoms occur in conjunction with neck pain:

Severe pain from an injury. After head or neck trauma, such as whiplash or a blow to your head, see your doctor immediately. Severe pain over a bone might indicate a fracture or an injury to a ligament.
Shooting pain. Pain radiating to your shoulder, through your shoulder blades or down your arm, with or without numbness or tingling in your fingers, may indicate nerve irritation. Neck pain from nerve irritation can last from weeks to six months or longer. More sophisticated tests and treatments are available for this type of continued nerve irritation, so see your doctor.
Loss of strength. Weakness in an arm or a leg, walking with a stiff leg, or shuffling your feet indicates a possible neurological problem and needs immediate evaluation.
Change in bladder or bowel habits. Any significant change, especially a sudden onset of incontinence, could indicate a neurological problem.

Tests and diagnosis

Your doctor often will be able to diagnose the cause of your neck pain and recommend treatment just by asking questions about the type, location and onset of your pain. In less clear-cut cases, your doctor may use imaging techniques or other tests such as:

X-rays
Magnetic resonance imaging (MRI)
Computerized tomography (CT) scans
Electromyography (EMG)

Treatments and drugs

Most neck pain responds well to home care. If neck pain persists, your doctor may recommend other treatments. Self-care for neck pain Self-care measures you can try at home to relieve neck pain include:

Over-the-counter pain relievers. Try over-the-counter pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and acetaminophen (Tylenol, others).
Alternate heat and cold. Reduce inflammation by applying cold, such as an ice pack or ice wrapped in a towel, for up to 20 minutes several times a day. Alternate the cold treatment with heat. Try taking a warm shower or using a heating pad on the low setting. Heat can help relax sore muscles, but it sometimes aggravates inflammation, so use it with caution.
Rest. Lie down from time to time during the day to give your neck a rest from holding up your head. Avoid prolonged rest, since too much inactivity can cause increased stiffness in your neck muscles.
Gentle stretching. Gently move your neck to one side and hold it for 30 seconds. Stretch your neck in as many directions as your pain allows. This may help alleviate some of the pain.
Over-the-counter pain creams. Creams and gels made to relieve muscle and joint pain may provide some temporary relief from neck pain. Look for products with ingredients such as menthol and camphor.

Treatment for persistent neck pain For pain that doesn’t get better with simple home-care measures, your doctor may recommend one or more treatments, such as:

Neck exercises and stretching. Your doctor may recommend that you work with a physical therapist to learn neck exercises and stretches. A physical therapist can guide you through these exercises and stretches, so that you can do them on your own at home. Exercises may improve pain by restoring muscle function and increasing the strength and endurance of your neck muscles.
Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.
Injections of medication. Injections of medications into your neck may help relieve pain. Your doctor may inject corticosteroid medications near the nerve roots, near the small neck joints or into the muscles in your neck to help with pain. Numbing medications, such as lidocaine, also can be injected to numb your neck pain.
Pain medications. Your doctor may prescribe stronger pain medicine than what you can get over-the-counter. Opioid analgesics are sometimes used briefly to treat acute neck pain. Muscle relaxants, tramadol (Ultram) or tricyclic antidepressant medications used for pain also may be prescribed.
Traction. Traction uses weights and pulleys to gently stretch your neck and keep it immobilized. This therapy, under supervision of a medical professional and physical therapist, may provide relatively fast relief of some neck pain, especially pain related to nerve root irritation. Relief may last for hours or even days.
Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck.
Surgery. Surgery is rarely needed for neck pain. However, it may be an option for relieving nerve root or spinal cord compression.

Prevention

Most neck pain is associated with poor posture on top of age-related wear and tear. To help prevent neck pain, keep your head centered over your spine, so gravity works with your neck instead of against it. Some simple changes in your daily routine may help. Consider trying to:

Take frequent breaks if you drive long distances or work long hours at your computer. Keep your head back, over your spine, to reduce neck strain. Try to avoid clenching your teeth.
Adjust your desk, chair and computer so the monitor is at eye level. Knees should be slightly lower than hips. Use your chair’s armrests.
Avoid tucking the phone between your ear and shoulder when you talk. If you use the phone a lot, get a headset.
Stretch frequently if you work at a desk. Shrug your shoulders up and down. Pull your shoulder blades together and then relax. Pull your shoulders down while leaning your head to each side to stretch your neck muscles.
Balance your base. Stretching the front chest wall muscles and strengthening the muscles around the shoulder blade and back of the shoulder can promote a balanced base of support for the neck.
Avoid sleeping on your stomach. This position puts stress on your neck. Choose a pillow that supports the natural curve of your neck.

Alternative medicine

Talk to your doctor if you’re interested in trying complementary and alternative neck pain treatments. Your doctor can discuss the benefits and risks of various alternative neck pain treatments. Alternative neck pain treatments include:

Acupuncture. Acupuncture involves the insertion of thin needles into various points on your body. Studies have found that acupuncture may be helpful for many types of pain. But studies in neck pain have been mixed. For results, you may need to undergo several acupuncture sessions. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. But don’t undergo acupuncture treatment if you’re taking blood thinners.
Massage. During a massage, a trained practitioner manipulates the muscles in your neck. Little scientific evidence exists to support massage in people with neck pain, though it may provide relief when combined with your doctor’s recommended treatments. Massage is generally safe for most people with minor neck strains, as long as it’s performed by a trained massage therapist. If you have chronic neck pain or neck pain that’s caused by injury or arthritis, ask your doctor if massage would be safe for you.