Trigger Point Injections: How Can They Help With Fibromyalgia

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What Are Trigger Points?

Trigger points are involuntary tight tender spots in a contracted muscle. This creates pain and dysfunction within the muscle. They are in parts of the muscle where there is decreased circulation, increased muscle contraction, spasm and increased nerve sensitivity causing a sharp pain or a constant ache. They also can cause referred pain, or pain felt in other parts of the body.

What Causes Trigger Points

Trigger points develop from either stress, repetitive or overuse of a muscle. When a muscle is overused or injured a contraction develops and knots occur. These annoying knots develop when individual muscle fibers are over-stimulated and unable to release their contracted state. This contraction reduces blood flow resulting in a diminished supply of oxygen and a build up of metabolic waste. The trigger point then reacts by sending out signals of pain.

What are Trigger Point Injections?

A trigger point injection can help soothe muscle pain, especially in your arms, legs, lower back and neck. It also can be used to treat fibromyalgia, tension headaches and myofascial pain.

Trigger point therapy commonly involves injecting small amounts of anesthetic (lidocaine) and steroid into the trigger point can help alleviate the pain.

Can Trigger Point Injections Help With Fibromyalgia?

Trigger point injections are a safe and effective way to release trigger point knots, loosen the overlying fascia, and restore unrestricted movement to the affected muscle.

The quick treatment starts with a thorough exam to determine the location and severity of your trigger points. After finding a specific trigger point, an APEX doctor cleanses the injection site, gently pulls your skin taut, and injects an anesthetic mixture directly into the trigger point, causing it to relax immediately.

While most trigger points loosen and subside after just one injection, The doctor may have to administer one or two additional injections from slightly different angles to take care of large or overly persistent trigger points.

Most people experience instant pain relief following trigger point injection therapy. To keep your muscles relaxed and pain free as the weeks and months go on, it’s important to stay active and perform any prescribed stretches or exercises as recommended.

Pain relieving benefits of Devil’s Claw (Harpagophytum procumbens)

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Devil’s Claw (Harpagophytum procumbens) Native to southern Africa, gets its name from the tiny hooks that cover its fruit. Historically, devil’s claw has been used to treat pain, liver and kidney problems, fever, and malaria. It has also been used in ointments to heal sores, boils, and other skin problems around the world.

Devil’s claw was introduced to Europe in the early 1900s, where the dried roots have been used to restore appetite, relieve heartburn, and reduce pain and inflammation.

Today, devil’s claw is used widely in Germany and France to fight inflammation or relieve arthritis pain, headache, and low back pain.

Medicinal Uses and Indications

Osteoarthritis

Several studies show that taking devil’s claw for 8 to 12 weeks can reduce pain and improve physical functioning in people with osteoarthritis. One 4-month study of 122 people with knee and hip osteoarthritis compared devil’s claw and a leading European medication for pain relief. The people who took devil’s claw had as much pain relief as the people who took the medication. Those who took devil’s claw had fewer side effects and needed fewer pain relievers throughout the study.

An analysis of 14 studies using devil’s claw to treat arthritis found that higher quality studies showed devil’s claw may relieve joint pain. And a review of 12 studies using devil’s claw for treating arthritis or low back pain found that devil’s claw was at least moderately effective for arthritis of the spine, hip, and knee.

 

Back and neck pain

Preliminary evidence suggests that devil’s claw may help relieve neck and low back pain. In a small study of 63 people with mild-to-moderate back, neck, or shoulder pain, taking a standardized extract of devil’s claw for 4 weeks provided moderate relief from muscle pain. In a larger study of 197 men and women with chronic low back pain, those who took devil’s claw every day for a month said they had less pain and needed fewer painkillers than those who took placebo.

A 54-week study compared 38 people who took devil’s claw with 35 people who took the pain reliever rofecoxib (Vioxx). For these people, devil’s claw worked as well as Vioxx to relieve pain. The Food and Drug Administration (FDA) took Vioxx off the market because it increases the risk of heart problems.

 

Other uses

Many professional herbalists suggest that devil’s claw can help treat upset stomach, loss of appetite, headaches, allergies, and fever. Topical preparations of devil’s claw are also applied to the skin to heal sores, ulcers, boils, and skin lesions. However, there are not any definitive scientific studies that show using devil’s claw to treat these conditions is effective.

Precautions

The use of herbs is a time-honored approach for strengthening the body and treating disease. However, herbs can have side effects and interact with other herbs, supplements, or medications. For these reasons, you should take herbs under the supervision of a health care provider qualified in the field of botanical medicine.

If taken at the recommended dose for a short time, health practitioners consider devil’s claw non-toxic and safe, with few side effects. High doses can cause mild stomach problems in some people. Researchers do not know if it would be safe to take devil’s claw for a long time.

People with stomach ulcers, duodenal ulcers, or gallstones should not take devil’s claw. Studies show taking devil’s claw may vause gastrointestinal side effects.

Pregnant and breastfeeding women should not take devil’s claw since studies in these populations are lacking.

People with heart disease, high blood pressure, or low blood pressure should ask their doctors before taking devil’s claw.

 

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5 natural alternatives to painkillers

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When you experience chronic pain, you may try just about any remedy that will lessen the debilitating physical pain. Multiple trips to the health store will fill your cupboards with bottles of supplements thinking that you will avoid more trips to your pain management doctor. 

Did you know that more than 1 in 10 adults suffer from some form of  chronic pain. To get through the day, many resort to taking painkillers – some of which are powerful drugs that interfere with the nerve signals responsible for perceiving pain. Surprisingly, in 2015, more adults used prescription painkillers than tobacco, cigars and cigarettes combined.

Painkillers powerful strength

Painkillers vary in strength for different levels of pain. For example the prescription fentanyl – an opioid – is up to 100 times more powerful than morphine. In addition, drug morphine is up to 360 times more powerful than aspirin (acetaminophen ).

Opioid overdoses accounted for more than 42,000 U.S. deaths in 2016, more than any previous year on record. An estimated 40% of opioid overdose deaths involved a prescription opioid. In most recent years, opioid addiction has resulted in a deadly drug epidemic in both Canada and the U.S. Currently, Canada ranks as the world’s second largest consumer of prescription opioids.

Drug overdose deaths in the United States rose 4.6% in 2019 to 70,980, including 50,042 involving opioids, according to preliminary data released yesterday by the Centers for Disease Control and Prevention.

The Centers for Disease Control and Prevention released preliminary data last week that suggests U.S. drug overdose deaths have fallen for the first time in 20 years. There were an estimated 68,557 deaths from overdoses in the U.S. in 2018 copared to a preliminary figure of 72,224 in 2017. The 5.6% decline marks the first drop in overdose deaths since 1999.

 

Trump Signs Executive Orders On Drug Prices : NPR

www.npr.org › 2020/07/24 › trump-signs-executive-orde…

5 pain management options

Many pain sufferers use painkillers shows an urgent need for effective and safe alternatives for managing chronic pain. Fortunately, several natural alternatives exist and may help control daily pain. Below are some pain management options that can be incorporated into your lifestyle:

  1. Acupuncture. Acupuncture is an integrative health modality that applies Traditional Chinese Medicine. Licensed practitioners insert very thin needles into the skin to stimulate specific points on the body. Acupuncture has been found to be effective in reducing chronic pain for many health conditions.
  2. Change your diet. It may sound questionable, but what you eat has a significant influence on your pain levels. Inflammatory foods high in arachidonic acid such as red meat, dairy, eggs, and other animal fats should be on your radar. – These foods release of a variety of  substances in the body that produce pain or inflammation – Try to eat foods that are high in omega 3 fatty acids into your diet, like avocados, nuts and seeds, chia, and green leafy vegetables, all of which have been found to help lower inflammation.
  3. Exercises. Studies have found that people who exercise daily are able to better manage their pain than those who don’t. And, keeping the weight off by regularly exercising can relieve pressure on the joints.
  4. Get symptomatic relief. The root of Devil’s Claw (Harpagophytum procumbens) contains powerful analgesic and anti-inflammatory properties and has traditionally been used for joint and muscle pain of all types.
  5. De-stress. Chronic stress leads to inflammation in the body, which can contribute to pain, and vice versa. Relaxation exercises such as meditation, tai-chi, and breathing exercises may help reduce stress and pain.

If you suffer from chronic pain or find yourself taking painkillers, it is important to work with your primary healthcare provider to find a treatment plan that works best for your pain.

References

https://nccih.nih.gov/news/press/08112015
https://www.drugabuse.gov/drugs-abuse/fentany
https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm
https://www.nhms.org/sites/default/files/Pdfs/Opioid-Comparison-Chart-Prescriber-Letter-2012.pdf
https://www.ncbi.nlm.nih.gov/pubmed/22965186
https://www.ncbi.nlm.nih.gov/pubmed/16805330
http://www.webmd.com/pain-management/features/exercise-relief#1

A Runner’s Guide To Hip Pain: Symptoms, Causes & Treatment

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What causes hip pain?

One of the most common causes of hip pain is overuse. This is especially common in runners, Kostyukovsky explains, since it’s a repetitive, high-impact movement.

Mechanics (aka how you’re running) can also play a role in hip pain, as can external factors like footwear or your running surface, says Cass. If you’re wearing shoes that are too old, or not suited for your feet, it could have an impact.

“Some great running surfaces are wood chip trails or groomed grass, as they will absorb more of the load and take strain off of the body,” Cass says. “Concrete is the hardest, most dense surface to run on.” If you live in a more urban area, she recommends running on asphalt or over concrete sidewalks when safe.

The body itself also plays a significant role in potential hip pain, says Cass. Some things are out of your control, like the height and arch of your feel. “Flat feet or pronation with running can lead to the hip muscles having to work harder to support the body,” she explains.

Other factors can be addressed, like your hip strength, flexibility, and balance.

What are hip pain symptoms?

Common areas you may experience hip pain include the front of the hip, the sit bones (where your bottom hits the seat), or on the outside of the hip where the iliotibial (IT) band runs, says physical therapist Meghan Cass, P.T., DPT.

The symptoms can vary depending on the tissue or structure involved, Sarah Kostyukovsky, PT, DPT, OCS, explains. For example, some hip problems may cause sharp pain inside the hip joint, while others can lead to dull, achy pains.

“Even if you’re feeling pain in the hip, it might not necessarily be caused by the hip,” Cass says. “It might be because your calves or your core aren’t quite as strong.”

How can you treat hip pain?

There are several specific injuries that may lead to hip pain (hip strain, stress fractures, tendinitis, etc.), and it can be difficult to identify which one you’re suffering from. In order to do so, Cass recommends reaching out to a medical professional—especially if the pain is interfering with daily activities.

If you find it difficult to reach down and pick up your young kids, a basket of laundry, or sleep well, you should probably seek help from a primary care doctor, Cass says. If your pain is minor, however, there are a few ways you could try treating it at home.

For starters, it’s important to rest and limit the amount of pressure on your injured hip. If your hips feel tight but not injured, you may benefit from yoga practices or hip opening stretches.

Stretching, strengthening, and building a routine is important for runners, Cass says. “Dynamic stretching is what we recommend before running. That’s where you’re moving your muscles. It helps promote blood flow and a little bit more elasticity and flexibility to the muscles,” she says. Dynamic stretches may include a walking hamstring stretch or a walking lunge.

After running, Cass recommends static stretching. “That’s where you’re holding a stretch for a long time—it’s usually what you picture when you think of stretching.”

Working with a personal trainer or physical therapist can also help you figure out the best way to manage your hip pain.

How can you prevent hip pain?

When it comes to preventing hip pain, Cass refers back to the three main causes: overuse, mechanics, and external factors.

“If you have mechanical difficulties, problems with footwear, and a weak core, you have to address all of it,” Cass says, “but prioritize what’s going to make the most impact.”

If overuse is your biggest concern, cross-training in addition to running can reduce the impact. “The biggest way to prevent hip pain is to stay strong throughout the hips, core, and ankles,” she says. Some great options include supplemental yoga or Pilates workouts to increase strength in areas where you’re noticing deficits.

If the soles of your shoes are run down and lacking support, it may be time to buy a new pair. Generally, you should swap them out after 300 to 400 miles of wear. Since everyone’s feet are different, it’s nearly impossible to recommend a “best” running shoe. Instead, Cass suggests finding a small, local running store to find the best shoe for your needs.

Overall, listening to your body by stretching, resting, or cross-training when necessary can help prevent injury.

Is it OK to run if you have hip pain?

“Muscle soreness or a slight strain is OK to run through,” Kostyukovsky says. “This type of pain will typically get better with a light jog.” If the pain continues for days or weeks and is sharper and more significant, you should stop.

Running coach Elizabeth Corkum primarily recommends rest and medical assistance if your hip pain persists. “Sometimes hip pain could be corrected with the help of a physical therapist.”

–Chandler Pain Management