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SparkPeople.com is the largest onlinet and healthy living community with over 12 million registered members. Create a free account today to get the tools, support .View the latest health news and explore articles on fitness,t, nutrition, parenting, relationships, medicine, diseases and healthy living at CNN Health..Introduction to articles and videos on healthy eating, vegetarian health, 5 A DAY, weight loss and eating disorders..TODAY Parents is the premiere destination for parenting news, advice community. Find the latest parenting trends and tips for your kids and family on TODAY.com..Accurate, unbiased women's health information. Questions and answers on PMS, pregnancy, breastfeeding, birth control, weight, wellness, menopause and more..

Chronic Inflammatory Neuropathy Is That What You Have

Today's post from nlm.nih.gov (see link below) may confuse some readers; partly because there are just way too many names for neuropathic conditions but also because they're not sure if their symptoms are 'bad' enough to qualify as having chronic inflammatory neuropathy. This article describes what it is, what the symptoms are and why it happens, as well as showing some tests and assessments. The main difference lies in the cause - the immune system attacks the nervous system and gradually degrades nerves and their linings but after that, the reasons why can be (as you know) many and varied.

Chronic inflammatory polyneuropathy
 US National Library of medicine 2014
 
Chronic inflammatory polyneuropathy involves nerve swelling and irritation (inflammation) that leads to a loss of strength or sensation.

Causes

Chronic inflammatory polyneuropathy is one cause of damage to nerves outside the brain or spinal cord (peripheral neuropathy). Polyneuropathy means several nerves are involved. It usually affects both sides of the body equally.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic neuropathy caused by an abnormal immune response. CIDP occurs when the immune system attacks the myelin cover of the nerves.

The cause of chronic inflammatory polyneuropathy is an abnormal immune response. The specific triggers vary. In many cases, the cause cannot be identified.

It may occur with other conditions, such as:
Autoimmune disorders
Chronic hepatitis
Diabetes
HIV
Inflammatory bowel disease
Systemic lupus erythematosus
Lymphoma
Paraneoplastic syndrome
Thyrotoxicosis
Side effects of medicines to treat cancer or HIV

Symptoms

Difficulty walking due to weakness or trouble feeling your feet
Difficulty using the arms and hands or legs and feet due to weakness
Sensation changes, such as numbness or decreased sensation, pain, burning, tingling, or other abnormal sensations (usually affects the feet first, then the arms and hands)
Weakness, usually in the arms and hands or legs and feet

Other symptoms that can occur with this disease:
Abnormal movement
Breathing difficulty
Fatigue
Hoarseness or changing voice
Loss of function or feeling in the muscles
Muscle atrophy
Muscle contractions
Speech impairment
Swallowing difficulty
Uncoordinated movement

Exams and Tests

The doctor will examine you and ask questions about your medical history. The physical exam shows:
Loss of muscle mass
No reflexes
Muscle weakness or paralysis
Sensation problems on both sides of the body

Tests may include:
Electromyography (EMG)
Nerve conduction tests
Nerve biopsy
Spinal tap
Blood tests may be done to look for specific proteins that are causing the immune attack on the nerves

Which other tests are done depends on the suspected cause of the condition. Tests may include x-rays, imaging scans, and blood tests.

Treatment

The goal of treatment is to reverse the attack on the nerves. In some cases, nerves can heal and their function can be restored. In other cases, nerves are badly damaged and cannot heal, so treatment is aimed at preventing the disease from getting worse.

Which treatment is given depends on how severe the symptoms are, among other things. The most aggressive treatment is usually only given if you have difficulty walking or if symptoms interfere with your ability to care for yourself or perform work functions.

Treatments may include:
Corticosteroids to help reduce inflammation and relieve symptoms
Other medications that suppress the immune system (for some severe cases)
Plasmapheresis or plasma exchange to remove antibodies from the blood
Intravenous immune globulin (IVIg), which involves adding large numbers of antibodies to the blood plasma to reduce the effect of the antibodies that are causing the problem

Outlook (Prognosis)

The outcome varies. The disorder may continue long term, or you may have repeated episodes of symptoms. Complete recovery is possible, but permanent loss of nerve function is not uncommon.

Possible Complications

Pain
Permanent decrease or loss of sensation in areas of the body
Permanent weakness or paralysis in areas of the body
Repeated or unnoticed injury to an area of the body
Side effects of medications used to treat the disorder

When to Contact a Medical Professional

Call your health care provider if you have a loss of movement or sensation in any area of the body, especially if your symptoms get worse.

Alternative Names

Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathyPolyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathy

References

Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds.Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 76.

Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds.Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 428.

Update Date 7/27/2014

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

https://www.nlm.nih.gov/medlineplus/ency/article/000777.htm

Autonomic Neuropathy The Nerve Damage You Have No Control Over

Today's post from dressamed.com (see link below) talks about autonomic neuropathy, which may be a new term to many people. Basically, it's a form of neuropathy that affects the involuntary functions of the body, breathing, digestion, excretion, sweating, sexual function, etc. You have no control over these functions and when they go wrong thanks to nerve damage, the consequences can make life pretty miserable. Most people begin their neuropathy lives with the well-known symptoms of numbness, tingling, burning etc in the feet and/or hands and for some it stays that way but for others, the damage spreads to the autonomic functions and you begin to notice things going wrong. Your doctor will inevitably try to rule out all other other possible reasons why this is happening and it may be years before you get a proper diagnosis of autonomic neuropathy. The treatment for your pain will remain the same but you may find your medicine chest being expanded to include treatments for dysfunctions elsewhere in your body. I'm sorry, there's no sugar-coated pill to this story: if you have autonomic neuropathy it sucks but there are always ways to improve your situation but you need to take time to research and explore your options. Working with your doctor and not waiting for him or her to provide answers, is the key.

When Autonomic Neuropathy Affects Bodily Functions 
Posted on May 11, 2016 Posted in Staff Pick by Staff Pick

Do any of these symptoms sound familiar? 
 
Dizziness and fainting when you stand up
Difficulty digesting food and feeling really full when you’ve barely eaten anything
Abnormal perspiration – either sweating excessively or barely at all
Intolerance for exercise – no, not that you just hate it but your heart rate doesn’t adjust as it should
Slow pupil reaction so that your eyes don’t adjust quickly to changes in light
Urinary problems like difficulty starting or inability to completely empty your bladder

If they do, you could have autonomic neuropathy. Especially if you have diabetes, your immune system is compromised by chemotherapy, HIV/AIDS, Parkinson’s disease, lupus, Guillian-Barre or any other chronic medical condition.

You need to see a doctor immediately. A good place to start would be a physician well versed in diagnosing and treating nerve disease and damage, like your local clinician who specializes in our treatment protocol.
What Is Autonomic Neuropathy?

Autonomic neuropathy in itself is not a disease. It’s a type of peripheral neuropathy that affects the nerves that control involuntary body functions like heart rate, blood pressure, digestion and perspiration. The nerves are damaged and don’t function properly leading to a break down of the signals between the brain and the parts of the body affected by the autonomic nervous system like the heart, blood vessels, digestive system and sweat glands.

That can lead to your body being unable to regulate your heart rate or your blood pressure, an inability to properly digest your food, urinary problems, even being unable to sweat in order to cool your body down when you exercise.

Often, autonomic neuropathy is caused by other diseases or medical conditions so if you suffer from: 

Diabetes
Alcoholism
Cancer
Systemic lupus
Parkinson’s disease
HIV/AIDS

Or any number of other chronic illnesses, you stand a much higher risk of developing autonomic neuropathy. Your best course of action is not to wait until you develop symptoms. Begin a course of preventative treatment and monitoring with a clinician to lessen your chances of developing autonomic neuropathy.

How Will The Clinician Diagnose My Autonomic Neuropathy?

If you have diabetes, cancer, HIV/AIDs or any of the other diseases or chronic conditions that can cause autonomic neuropathy, it’s much easier to diagnose autonomic neuropathy. After all, as a specialist in nerve damage and treatment, your clinician is very familiar with your symptoms and the best course of treatment.

If you have symptoms of autonomic neuropathy and don’t have any of the underlying conditions, your diagnosis will be a little tougher but not impossible.

Either way, your clinician will take a very thorough history and physical. Make sure you have a list of all your symptoms, when they began, how severe they are, what helps your symptoms or makes them worse, and any and all medications your currently take (including over the counter medications, herbal supplements or vitamins).

Be honest with your clinician about your diet, alcohol intake, frequency of exercise, history of drug use and smoking. If you don’t tell the truth, you’re not giving your clinician a clear picture of your physical condition. That’s like asking him to drive you from Montreal to Mexico City without a map or a GPS. You may eventually get to where you want to be, but it’s highly unlikely.

Once your history and physical are completed, your clinician will order some tests. Depending upon your actual symptoms and which systems seem to be affected, these tests might include:
Ultrasound
Urinalysis and bladder function tests
Thermoregulatory and/or QSART sweat tests
Gastrointestinal tests
Breathing tests
Tilt-table tests (to test your heart rate and blood pressure regulation). Once your tests are completed and your clinician determines you have autonomic neuropathy, it’s time for treatment. 

Treatment and Prognosis

Our clinicians are well versed in treating all types of peripheral neuropathy, including autonomic neuropathy. They adhere to a very specialized treatment protocol that was developed specifically for patients suffering from neuropathy. That’s why their treatments have been so successful – neuropathy in all its forms is what they do.

Autonomic neuropathy is a chronic condition but it can be treated and you can do things to help relieve your symptoms.

Your clinician will work with you and your other physicians to treat your neuropathy and manage your underlying condition. They do this through:

Diet Planning and Nutritional Support
You need to give your body the nutrition it needs to heal.

If you have gastrointestinal issues caused by autonomic neuropathy, you need to make sure you’re getting enough fiber and fluids to help your body function properly.

If you have diabetes, you need to follow a diet specifically designed for diabetics and to control your blood sugar.
If your autonomic neuropathy affects your urinary system, you need to retrain your bladder. You can do this by following a schedule of when to drink and when to empty your bladder to slowly increase your bladder’s capacity.

Individually Designed Exercise Programs
If you experience exercise intolerance or blood pressure problems resulting from autonomic neuropathy, you have to be every careful with your exercise program. Make sure that you don’t overexert yourself, take it slowly. Your clinician can design an exercise program specifically for you that will allow you to exercise but won’t push you beyond what your body is capable of. And, even more importantly, they will continually monitor your progress and adjust your program as needed.

Lifestyle Modifications
If your autonomic neuropathy causes dizziness when you stand up, then do it slowly and in stages. Flex your feet or grip your hands several times before you attempt to stand to increase the flow of blood to your hands and feet. Try just sitting on the side of your bed in the morning for a few minutes before you try to stand.
Change the amount and frequency of your meals if you have digestive problems.

Don’t try to do everything all at once. Decide what really needs to be done each day and do what you can. Autonomic neuropathy is a chronic disorder and living with any chronic condition requires adaptations. Your clinician knows this all too well and will work with you to manage your level of stress and change your daily routines to help you manage your condition and your life.

All of these changes in conjunction with medications, where needed, will make it easier to live with autonomic neuropathy and lessen the chances of serious complications. Early intervention with a NeuropathyDR® clinician is still the best policy if you have any of the underlying conditions that can cause autonomic neuropathy. But if you already have symptoms, start treatment immediately.

About The Author

Dr. John Hayes, Jr. is an Evvy Award Nominee and author of “Living and Practicing by Design” and “Beating Neuropathy-Taking Misery to Miracles in Just 5 Weeks!”. His work on peripheral neuropathy has expanded the specialty of effective neuropathy treatments to physicians, physical therapists and nurses. A free Ebook, CD and information packet on his unique services and trainings can be obtained by registering your information at neuropathydr.com. To book interviews and speaking engagements call 781-754-0599.

Syndicated by EzineArticles

https://www.dressamed.com/root/autonomic-neuropathy/

Ten More Things To Consider If You Have Nerve Pain

Today's post from dailyhealthrecords.com (see link below) is yet another list of learning experiences from someone living with chronic pain. People love making lists and judging by their popularity on the internet, people love reading them too. There's nothing wrong with that and nothing wrong with sharing tips based on your own experiences, so long as you don't descend into cliché and so long as you keep it practical and realistic. Having said all that, with it's implied criticism of new age wisdoms, if you skim through the 10 headings and don't want to read it after that, then this article is not for you. Personally, I agree with everything she says!

10 Things I’ve Learned About Living With Chronic Pain
December 26, 2015 lussy

I was first diagnosed with chronic pain when I was 7 years old. I just turned 21. For the past 14 years, I have told as few people as possible about my illness. I have my reasons for this. It’s not a very glamorous topic, and I would like for most people to assume I’m a normal 21 year old.

Recently, my condition seems to be changing, deteriorating more rapidly than doctors can, or want to, deal with. These past few months have been full of exercises in looking for silver linings, but there are times I’ve had to be honest with myself about my disease and my pain. Learning how to cope with pain is a process, and I had to start writing down things I needed to remind myself: don’t take your pain out on other people, try to remember that people won’t understand when or how much pain you’re in, don’t defend yourself for making your health a priority. They were hard truths to deal with, but they have helped me.

I wake up in pain, and I go to sleep in pain. I can not explain the kind of toll this takes on you mentally, physically, and emotionally. These coping mechanisms worked for me, and I can only reference my own pain, hence the following truths are my stories, but I do believe that other pain patients experience many of the same frustrations I do. I can’t talk about what living in pain is like for everyone. What I can do is talk about my pain, something I largely avoid for several reasons — the chronically ill and in pain are meant to be brave and handle their suffering in inspiring ways, talking about it with the wrong people can make it worse, and trying to keep up a positive front all being important ones.

These are some things I’ve learned about how to be chronically ill, and how to manage living with chronic pain, and still try to remain as sane as possible. I hope that should other chronic pain patients read this, that they will find some comfort in knowing they are not alone in their pain.

1. People can’t understand.

Unless you live in chronic pain, or with a chronic illness, you cannot possibly imagine it. For months, my health has been rapidly deteriorating, and I realized quickly most people either don’t understand, or don’t care.

The hardest part of dealing with chronic illness/pain for me has been cutting people out of my life who make it harder to deal with. This wasn’t a choice, but a necessity. I couldn’t take any extra negativity, I couldn’t handle defending my situation time and time again to people who were supposed to be my friends. I guess I understand, it’s hard for them to deal with, maybe. Unlike me, they don’t have to deal with it. It is also important to remember that when people can’t see your suffering, when they can’t see outwardly that you are in pain, they can’t be expected to understand.

The reason for the archaic pain scale with the faces slowly becoming more warped in pain with a scale of 1-10 is because there is no test for pain, no base line, there is just pain. I’m lucky to have a few friends who — while they don’t pretend to understand — still put up with me and do their best to help me be comfortable and get out of the house. Find your people and keep them by your side, you’re going to need them. Get anyone out of your life who is making your journey more difficult, you don’t need that kind of negativity.

2. Some medical professionals suck at their job.

First, all hail good nurses. Good nurses have done more for me than any doctor I’ve seen so far. That said, for every one good nurse there seem to be two bad ones. The ratio changes for doctors. By my experience, almost all doctors suck at managing chronic illness and pain. They want you in and out of their office, and they don’t want to deal with you on a weekly, or even more frequent basis. Yes, most people I have gone to asking for help — be it an ER doctor, an internist, or one of the dozens of specialists I’ve seen — have shrugged, decided they don’t want to deal with this and washed their hands of me. Not all doctors are created equal. I have had exactly one good doctor so far, and I’ve seen dozens.

I’m not saying good doctors don’t exist, I’m saying that, as in any profession, some people excel far above others. Keep searching for the right doctor for you, it’s going to be miserable and time consuming and frustrating, but despite all the bad doctors I’ve met, I believe there is one out there that can help me. I’ve just got to find them.

3. You get to feel however you want.

People won’t understand what it’s like to try to get through a day, and you don’t have to explain why you feel how you do today. I found myself frustrated whenever someone asked “How are you feeling?” If my answer was “good,” then I found they were less likely to be understanding if I needed a break, or if I couldn’t keep up with the group. Wasn’t I feeling good today? It’s all relative.

For me, a good day is one where I do not reach a 9 on that pain scale. If I told someone I was feeling bad, or having a bad pain day, I would quickly be reminded there are worse conditions than mine, that I could be dead already, that there are people starving all over the world. These are all true things, but do not negate my right to have a bad day.

Staying positive is an important part of managing life with chronic pain, but bad days still happen. To lie and say that even when you’re in pain every day has to be bright and sunshine-y is not mental health, it’s crap. You get to feel however you want and you don’t have to explain why you are having a bad day. You also don’t have to defend why your health takes priority over everything else. If people around you don’t understand that, you might want to re-consider who you are keeping in your inner circle. While you have the right to feel however you want, be careful not to let your pain cause you to lash out at people. It is hard to be patient when you are hurting, but you can’t get let your frustrations out on people. You have the right to be in pain, but pain does not give you a free pass to become cruel.

I have also noticed that people seem to think that chronic illness somehow instills some sort of super human strength inside the person suffering. As if all sick people experience pain but survive solely by persevering with integrity and grace. I have to side with Julius Caesar who said, “It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.” Make no mistake, I do not wish for my life to end. But there are days where the pain has been so great that I would have been very happy to die. That’s the side of chronic pain the universe doesn’t see — how much you keep wrapped up to try to put on a façade of a “normal” person.

I’ve had many days where I found myself losing track of the conversations happening around me, enveloped in pain and trying to hold back tears or outward manifestations of the pain. I know many other chronic pain patients who try to stay quiet about their illness, and it is brave and wonderful and inspiring and all those words often used to describe those of us living in the genre of sick personhood. You still are allowed to have bad days, even if the world could be a worse place, and you don’t always have to pretend the bad days aren’t bad days.

4. Be honest.
 
I’ve learned you must be honest with people when you are sick, and when you need them to understand. My teachers, coaches, and friends I’ve trusted with the details of my illness/treatment are all people I need to be up front with when I need extra time for an assignment, or I can’t go to practice, or I’m not feeling up to going out. However, it’s also very important to state that you don’t have to disclose any of your medical history to people you are not comfortable discussing it with. It’s your choice to decide how, when, and in what detail you would like to discuss your illness with someone, so never feel bad about keeping details to yourself if you are uncomfortable discussing them. Your body, your rules.

Also, be honest with your doctors. This can be difficult because I feel that, culturally, I have been raised to think that doctors had the answer and that I didn’t need a second opinion. If you don’t think they’re listening, if you don’t think the current treatment is working, if you think more tests need to be run — demand it. I’ve learned that playing nice while trying to get treatment just doesn’t work. I don’t seem to get any attention until I start advocating for myself. I’ve also learned to be honest when evaluating doctors. Before I tried to always be kind. Maybe that doctor had a bad day, maybe their head is somewhere else, perhaps they’re exhausted. These are all things that are understandable- but if you are not receiving the care you deserve it’s time to start making calls. I’ve realized that the only way to get better treatment is to make them give it to you. You deserve the best quality of life possible.

5. Listen to your body.

When you’re a professional sick person, you have to learn to listen to your body. Stay in if you need to stay in. I was a 20 year old student-athlete who was active on my university’s campus when my illness quickly took a turn for the worse. Giving up my sport was heart breaking, but physically I couldn’t do it anymore. I pushed myself long and hard before I listened to what my body was telling me: slow down, you can’t do this. I needed to take a step back from all the things I was participating in and try to get my health back. I still find myself frustrated when I have to cancel plans with friends, I even had to cancel my 21st birthday celebrations because I just wasn’t feeling up to it. I could have pushed it, but I knew how I felt, and I knew that if I went out and forced myself to stay out all night that I would pay for it later. It is hard to give up things you want to do just because your organs suck at being organs, and it is disappointing to be stuck in a body you particularly care for. I do believe that I have more good days when I slow down, and don’t push myself harder than my body can handle. Learn to listen to your body’s limits, and it can help increase your overall wellness.

6. Go out when you feel up to it.

When you’re in constant pain, or you just don’t ever seem to feel good, it can be easy to become a homebody. Maintaining your quality of life as much as possible is essential to coping with chronic illness. I know — I just said you should stay in if you need to, but if you are feeling up to going out by all means do so! Staying in sick all day every day can quickly lead to depression and anxiety. Even small things like going out to a movie seem to do wonders to cheer me up if I’ve been stuck home sick for a few days. If I find myself having a good day and I didn’t have plans, I try to take advantage of healthy moments, even if that just means a walk around the block with a friend. It can be tricky to find where the line between going out and having fun and going out and wearing yourself out so that you’re even sicker after is, but searching for that area is well worth the effort it requires.

7. Accept your body, even when you hate it.

Having my body shut down on me so painfully and rapidly was hard for me to accept, I was so active before and my illness was very manageable. While I have every intention to stay involved with my case, to find relief and answers, I had to accept that — for right now — this is the one body and one life I have. I’ve had to sit back and watch my athleticism slowly disappear, the dark circles develop under my eyes from sickness and exhaustion, and watched the color drain from my lips. It is beyond frustrating to watch my body waste away and have no say in it, no way to stop it. I am not particularly fond of my current situation. But when I accepted it, when I stopped trying to act as if I wasn’t sick, and started to listen to my body I found myself having more less bad days, which for chronic pain patients are synonymous with good days.

8. Seek out anything that will keep you smiling.

Every chronic pain patient I have met has also struggled with depression, some mild some as debilitating as the pain that caused it. Find anything you can to keep your spirits up: good books, movies, a special tea to drink, a place in the park that you like to visit — do whatever you can to keep smiling. It sucks to be sick and in pain, and unfortunately for chronic pain patients the elimination of pain is a fantasy. So we must deal with the pain while trying not to let it change who you are. Pain can change you, quickly. It makes you angry, depressed, frustrated, exhausted, scared, and other unpleasant adjectives. If you can find one song, one poem, one comedy sketch that can get you to smile hold onto it, and refer back to them often. Try to find whatever you can to get you through the next second, hour, or day.

9. You are allowed to ignore people who think they know what’s best.

For some reason if you are chronically ill, people in your life from family members to random hospital personnel will start to fancy themselves physicians. They might recommend a new diet, snorting some homeopathic remedy, covering yourself in some sort of home made salve, or some other ridiculous thing they once read on the internet. These people mean well. They hope that their insight will bring you relief. You are allowed to ignored these good intentioned people, specifically the ones who have no knowledge of your illness or medicine. I’ve taken to smiling, saying “I’ll look into that,” and then politely excusing myself from the conversation.

10. Advocate for yourself.
This is the single most important thing I’ve learned as a professional sick person: you must advocate for your own health. Doctors see many patients every day, nurses are busy, and none of them know what it’s like to live in your body. Take action, get involved in your case, start doing research. Go into appointments with documentation, ideas, second opinions, anything you can get to push your treatment forward. Medical professionals may not understand the urgency of your case, or the severity of your pain, so make it clear. Write down everything you need to talk about before your visit, and make sure you get every question you have answered. If your doctor can’t answer them, get a referral or find another opinion. Nothing is more important than your health and trying to maintain the best quality of life possible.

http://dailyhealthrecords.com/10-things-ive-learned-about-living-with-chronic-pain-2/

PARALYZED PATIENTS HAVE WEAKER BONES HIGHER RISK OF FRACTURES THAN EXPECTED

People paralyzed by spinal cord injuries lose mechanical strength in their leg bones faster, and more significantly, than previously believed, putting them at greater risk for fractures from minor stresses, according to a new study by a research team at Worcester Polytechnic Institute (WPI).

The results suggest that physicians need to begin therapies for spinal cord injury patients sooner to maintain bone mass and strength. The data also serve as a warning to physicians treating patients with osteoporosis to think beyond the standard bone density test when assessing risks of hip and other fractures. Details of the study are reported in the paper "Reduction in Proximal Femoral Strength in Patients With Acute Spinal Cord Injury" published by the Journal of Bone and Mineral Research.

"It's not just a question of how much bone mass is lost, but where that loss is occurring," said Karen Troy, PhD, assistant professor of biomedical engineering at WPI and senior author of the paper. "We found that bone loss occurred sooner in mechanically important areas and significantly increased the risk of fracture."

Estimates of the number of Americans living with spinal cord injuries range from 300,000, according to the National Spinal Cord Injury Statistical Center, to 1.2 million in a study funded by the Christopher and Dana Reeve Foundation. Both sources agree that the leading causes of these injuries are auto accidents, workplace accidents, falls, sports injuries, and violent crime.

Healthy bones adapt to the mechanical forces they encounter, with new bone formation and existing bone resorption constantly occurring to meet the body's needs. When bones stop carrying loads, however, they begin to lose mass and weaken. For patients with spinal cord injuries, this dramatic decline in bone strength often causes broken legs or knees from otherwise minor impact or stresses. "Their bones are so fragile, that just the act of rolling over in bed can snap their knee or leg," Troy said.

In the current study, Troy and her co-authors, W. Brent Edwards at the University of Calgary and Thomas Schnitzer at Northwestern University, captured and analyzed data from 13 spinal cord injury patients treated at the Rehabilitation Institute of Chicago. Each patient received two standard scans (a DXA bone mineral density scan and a CT scan) of their leg bones at specified time intervals for nearly four months after the original injury. The scans documented the change in bone mass over time. The team then used sophisticated computer modeling systems to process the scan data and simulate how the amount and distribution of bone loss would affect the ability to sustain mechanical loads and movements.

That analysis showed that patients in the study lost 2 percent of their leg bone mass each month, yet that correlated with a 6.9 percent loss in leg bone strength. "In just 3.5 months, reductions in strength for some patients were on the order of that predicted for lifetime declines owing to aging," the authors wrote.

Starting therapies early to maintain bone mass and strength is important for these patients, Troy noted, not only to prevent injuries but also to keep patients eligible for treatments and technologies now in development. "In ten or fifteen years, with advances in tissue regeneration to repair the spinal cord, and exoskeleton assist devices, many of these people will have the opportunity to get back on their feet, if their bones are strong enough to carry the load," Troy said. "It's very difficult to restore bone mass once it's lost, so the better approach is to prevent the loss in the first place."

Bone loss and the risk of fracture is also a serious concern for the 54 million people in the United States who have low bone density or osteoporosis.1 The three-fold difference observed in bone mechanical strength versus density in the current study should prompt additional review of how physicians assess risk and treat patients with this condition. "Bone mineral density is important, but it doesn't tell the whole story," Troy said.

The Right To Do Less If You Have Chronic Pain

Today's post from health.com (see link below) is a short article intended to make people feel less guilty about being able to do less than others with chronic pain. It quite rightly says that the psychological effects of living with chronic pain can have a severe effect on a person's mental health. They feel constantly guilty that they're not contributing as much as they should and are becoming a burden. The fact is, you can do more than you think you can but you should never do more than your body tells you is healthy. Being at peace with your limitations will help you bear them so much better.

When You're in Pain, You Have a Right to Do Less
Lead writer: Suzanne Levy Last Updated: May 08, 2008

Ironically, letting go can sometimes help you keep control of the pain.
(SUNNY S. UNAL/CORBIS) The American Chronic Pain Association has issued a list of the basic rights of a chronic pain sufferer. Perhaps one of the most important of them is the right to "do less than you are humanly capable of doing."

In a culture that celebrates efficiency, maximum productivity, and pushing limits, doing less is a radical concept. But Penney Cowan, executive director of the association, believes it is crucial.

Real Life Strategies for Coping with Chronic Pain

Patients and experts share surprising ways you can bring the joy back and lessen the pain Read more

More about coping with chronic pain
Keeping Your Marriage Healthy When You're in Pain
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 "People with pain tend to be overachievers who don't listen to what their body is telling them when the pain starts," says Cowan. "They push themselves until the pain is screaming, instead of stopping when the pain is whimpering."

For many, stopping an activity before it's done may result in a complete reappraisal of how they see themselves.

Andrea Kramer, a back-pain and fibromyalgia sufferer from Montgomery Village, Md., describes herself as "a doer, a pusher, a runner." But as the reality of her condition set in, she had to adjust to the fact that she "couldn't do laundry, dishes, lifting, washing a car—it depended upon the level of pain," says Kramer.

The lurking tendency to overdo it
 
One problem is that even if pain temporarily sidelines the superachiever, that person's underlying mindset doesn't disappear. It just lays low until pain takes a brief vacation.

Then on a good day the go-getter wants to do as much as possible. "You push, you don't pace, you overexert," says Cowan.

Dan Clauw, MD, director of the Chronic Pain and Fatigue Research Center at the University of Michigan, sees this ebb-and-flow pattern all the time and says it's not good for pain management.

"I would suggest that people do the same amount of activity every day so they can even out their peaks and valleys," says Dr. Clauw.
Too many bad days in a row can leave a lot undone, making a pain sufferer feel overwhelmed and melancholy. Cowan says chronic pain demands a clear eye for priorities, which is why she suggests that the pain patient make lists. "Set realistic goals for yourself," she says, "and narrow them down to a point where you're not going to set yourself up for failure."

Accepting your limits is critical
 
Judy, 49, who runs a headache support group in Nashua, N.H., has taken the "right to do less" mantra to heart. But it's not easy if the price is a less tidy home.

"I've lessened expectations on myself over the years," she explains. "If things don't get done, they don't get done. I just can't get down on myself about them, because it's a choice between trying to feel well and saying my house has to look absolutely perfect."

Amanda, 39, a migraine sufferer who attends Judy's support group, has also learned to pace herself. For example, she cleans early and often, little bits at a time. "My parents are coming in a few weeks, and I've already started cleaning because I have no idea how I'm going to feel. So I do things slowly or piecemeal here and there. I've learned to work around it."

http://www.health.com/health/condition-article/0,,20189766,00.html

Which Type Of Nerve Pain Do You Have

Today's post from verywell.com (see link below) is directly related to fibromyalgia, which has recently been confirmed as a form of neuropathy because of its relation to nerve system damage. However, the beauty of this article is that any neuropathy sufferer can relate very easily to it and recognise their own symptoms in both the official pain types and those described by the author. It takes an intelligent imagination and a certain sense of humour to come up with the descriptive terms she uses for her pain types but one thing is sure, you'll recognise them immediately (and maybe use some of them when trying to convince your doctors that what you're going through isn't between your ears!) By reading this article, you may learn something new about your own form of neuropathy. However, after reading this article, don't be convinced that you have fibromyalgia - it's just that the symptoms and feelings are very much shared experiences among neuropathy patients.

The Seven Types of Fibromyalgia Pain. Which Ones Do You Have?

By  
Adrienne Dellwo - Reviewed by a board-certified physician.
Updated June 12, 2016

You hear a lot about "fibromyalgia pain," but those of us with fibromyalgia (FMS) experience several kinds of pain.

Medically speaking, only a few of the pain types I talk about here have names and definitions. But just as Eskimos have several words for snow, I think we need to have several ways to name, define and categorize our pain. I've created some of my own categories, based on my experience and on conversations with other fibromites.

My hope is that understanding the medical terms will help us communicate better with doctors, while my categories will help you understand your illness and let you know you're not alone.

Types of Pain

The first three types of fibromyalgia pain are medically defined:

Hyperalgesia
Allodynia
Painful Paresthesia

The next four types are my own creation, which is obvious by their names. Don't use these terms in a doctor's office (unless you want to be seen as crazy), but these labels may help you get to know your body's quirks, triggers, patterns, etc.:

Knife in the Voodoo Doll
Randomly Roving Pain
Sparkler Burns
Rattled Nerves

First, our medically defined pain types

Hyperalgesia

"Hyper" means excess and "algesia" means pain. Hyperalgesia is the medical term for pain amplification in FMS. Our brains appear to take normal pain signals and "turn up the volume," making them more severe than they would normally be.

Most of the drugs used for managing FMS pain are aimed, at least in part, at reducing hyperalgesia.

Allodynia

Is your skin painful to the touch? A symptom that perplexes a lot of us is allodynia. That's what it's called when mild pressure from clothing or gentle massage causes pain. A lot of people describe allodynia as similar to a bad sunburn.

Allodynia is a fairly rare type of pain -- other than FMS, it's only associated with a handful of conditions, including neuropathy, postherpetic neuralgia (shingles) and migraine.

Allodynia is believed to be a hypersensitive reaction that may result from the central sensitization associated with FMS. The pain signals originate with specialized nerves, called nociceptors, that sense information about things like temperature and painful stimuli right from the skin.

Painful Paresthesia

Paresthesias are odd nerve sensations that can feel like crawling, tingling, burning, itching or numbness. Sometimes, these sensations can be painful. Paresthesias are also associated with peripheral neuropathy, chemotherapy drugs, multiple sclerosis and migraine.

Many common FMS treatments can help alleviate paresthesia-related pain, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Some people also have good luck with vitamin B12, capsaicin cream, massage, and acupuncture.

My Own Pain Categories

Once again, the following categories are not medically recognized -- they're things I came up with to fill a gap in how we classify different types of pain. They're intended to help you track symptoms, gauge effectiveness of treatments, and to let you know you're not crazy.

Knife in the Voodoo Doll

Sometimes, out of nowhere, I'll get an intense stabbing pain that seems to cut through my body. I've also described this as a fireplace poker in the ribs or being impaled on a spear.

For me, the voodoo doll pain is often my body's early warning system -- it tells me that I need to stop what I'm doing and rest. Other times, I have no idea why it strikes. I generally get this pain in my chest or abdomen, but some people say they get it in other parts of the body. It can be so intense that it can double me over and make it hurt to breathe. It usually goes away as after a few minutes. I have no idea how to prevent this type of pain, other than by pacing myself. (If only I could find that darned doll....)

Randomly Roving Pain

This is one of those things that reminds you FMS just doesn't make a lot of sense. A lot of us get pain that migrates around the body, sometimes moving between certain places, sometimes striking in new areas.

If you also have myofascial pain syndrome, it can be especially hard to tell randomly roving pain from the referred pain caused by trigger points.

Sparkler Burns

One 4th of July, when I was young, I hung onto a sparkler for too long and some sparks hit my hand. They caused tiny pin-pricks of pain almost identical to sensations I now get regularly. They make me jump, and scratching them triggers tactile allodynia. These sensations usually just last a few seconds. I have no idea what triggers them or how to prevent them.

Rattled Nerves

Most people won't understand why I call this a type of pain, but I'm sure most fibromites will get it. Certain things tend to get my whole body on edge, jumpy, and feeling rattled. It makes me ache all over, and sometimes I get nauseous, dizzy and anxious. Things that rattle my nerves generally involve sensory or emotional overload, such as:

Certain sounds (repetitive, loud, shrill, grating);
Visual chaos (crowds, flashing lights, busy patterns);
Stressful situations (busy traffic, confrontations, fibro-fog induced confusion or disorientation).

When my nerves are rattled, I try to get out of the situation as quickly as possible and relax, preferably somewhere quiet.

Living with Pain

It's difficult to live with pain, especially when it's unpredictable. The more you learn about your pain and its triggers, the better you may be able to manage it. Finding the right set of treatments takes time and experimentation, but many of us do find significant relief.

https://www.verywell.com/seven-types-of-fibromyalgia-pain-716138