Intense Shoulder Pain: Why and What to Do About It

Intense Shoulder Pain Why and What to Do About It

Do you sometimes experience sudden, stabbing shoulder pain that you can’t explain? Is it so painful that you find it hard to concentrate on anything else?


This kind of pain can be common not only because shoulder movement is essential to the way we function but also because the shoulder is one of the largest and most complex joints in the body and is the center of a collection of muscles and tendons. Muscles require a lot of oxygen, so issues with the circulatory system can radiate out to the shoulder.


In an effort to identify some of the potential sources of pain, I was featured in a helpful article that describes some of these issues, Cause of Sudden Severe Shoulder Pain that Comes and Goes:

So where can this intense, sudden shoulder pain come from, if you haven’t recently fallen on this joint, been hit there by a baseball or broken a bone there?


“Making sure there is not a muscle or ligament tear is important, i.e., clinical exam and MRI,” says Dr. Moshe Lewis, MD, Chief of Physical Medicine and Rehabilitation at California Pacific Medical Center - St. Luke’s Campus in the Department of Orthopedics.


“If this is negative, presumably, the pain still has to be minimized or else therapy will only flare things more. Options include an anti-inflammatory or icing for acute pain, heat for chronic pain.”

To learn more about shoulder pain and what to do about it, read Cause of Sudden Severe Shoulder Pain that Comes and Goes from ScarySymptoms.com. If the discomfort is too great, see your doctor immediately.


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Plantar Fasciitis - The Athlete’s Arch Nemesis

Plantar Fasciitis The Athletes Arch Nemesis

Do you find your feet to be in aching pain when going for a run in the morning or afternoon? Is it an intense, sharp pain on the heel of your foot and arch? You are not alone. Most likely, you are one of the ten percent of Americans who have an inflammatory condition in their feet known as “plantar fasciitis”. Plantar fasciitis is caused by stress in the foot’s arch tendon, and it can affect anyone. It is one of the most common medical conditions seen in America, affecting over two million people per year. It accounts for over one million physician visits yearly. Those who are most at risk are athletes, soldiers, and obese people who find themselves standing frequently and placing heavy strain on their feet.


Athletes of all levels and abilities are particularly vulnerable, because they are frequently driven to overtrain. Today more Americans than ever are under constant pressure to succeed at the next level, and neglecting healthy and recuperative rest leads to chronic strains and tears in ligaments. Furthermore, with increasing competition from other players to take over starting roles on a team, athletes are pressured more than ever to rush through injury rehabilitation. Without proper healing time, an athlete can quickly fall into a cycle of failing to properly heal and re-aggravating inflammatory conditions.


Pathology

Plantar fasciitis is the most common cause of pain on the bottom of the heel. The plantar fascia, a fibrous band of tissue that supports the arches, becomes inflamed and irritated. The plantar fascia is a very thin ligament that connects the heel to the front of the foot in order to absorb stress and shock that we place on our feet. The direct result of straining this ligament? Pain, swelling, weakness, and irritation that affects daily living activities.


Symptoms

The symptoms are generally noted as an intense sharp heel pain when a person takes her first few steps of activity. Sometimes there is occasional relief of the pain after a few minutes. However, the feet will hurt more as the day goes on, if activity (and weight-bearing pressure) continues. Walking on hard surfaces is especially hard on the plantar fascia.


Relief

Plantar fasciitis is usually a difficult problem to completely eliminate. However, treatment is generally nonsurgical and conservative in nature. To reduce pain and swelling, many physicians recommend taking an over-the-counter pain reliever like ibuprofen (Advil or Motrin), naproxen (Aleve), or aspirin. It will also help to do preventative calf stretches several times a day, especially when waking up and beginning daily exercises. Try to not run or walk on hard surfaces, and pick shoes that have good arch support and well-cushioned soles.


This article was written in collaboration with Haroon Andar MS on UglyFinish.com.


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5 Geat Alternative Exercises for Osteoarthritis

Alternative Exercises for Osteoarthritis

Osteoarthritis, being a debilitating and painful disease, can turn athletes into couch potatoes. We all understand that exercise is important to stay healthy and live longer, but it’s tough for those with osteoarthritis to do the bare minimum of exercise. The catch 22 of osteoarthritis is that exercise is an important way to reduce pain in the joints and prevent the pain from getting worse in the future. EverydayHealth.com showcases a few low impact exercises that allow patients with osteoarthritis to maintain their health and keep their joint pain from worsening:


1. Tai Chi

2. Yoga

3. Qigong

4. Water Aerobics

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The Bionic Knee: Improving Joints Without Surgery

Bionicare Knee System

I was featured in an article from SOMA Orthopedics a while ago. It’s still relevant, so I wanted to share it with you!

Ashley is an avid cyclist who started noticing increased pain earlier and earlier in her exercise routine after she turned 42. When she learned she had an early form of arthritis, she asked her physician if there were any safe, non-invasive treatments for the condition. Her physician told her about the BioniCare Knee Device, an exciting alternative to the use of medications or surgery for knee pain due to joint wear and tear.


“Ashley’s case is somewhat unique,” said Dr. Moshe Lewis, a Physical Medicine and rehabilitation physician at California Pacific Medical Center, St. Luke’s Campus. “Osteoarthritis occurs more frequently in males before the age of 45. Women are more prone to the disease after age 55.”


Osteoarthritis is the breakdown and eventual loss of the articular cartilage in one or more joints and occurs more frequently as we age. This process destroys the cushion-like qualities of cartilage, which is a natural shock absorber. About 50 million Americans suffer from some form of osteoarthritis and is sometimes found in multiple members of the same family, implying a genetic basis for the condition.


With aging, the water content of the cartilage in the knee increases and the protein makeup degenerates. Repetitive use of the joints over the years irritates and inflames the cartilage, causing joint pain and swelling. Eventually, cartilage begins to degenerate by flaking or forming tiny cracks. In advanced cases of osteoarthritis, there is a complete loss of the cartilage cushion between the bones of the joints. The result is friction, leading to pain and reduced joint mobility.


Dr. Lewis specializes in non-surgical treatments for conditions that cause chronic pain, such as arthritis and degenerative disc disease. In the past two years, he has placed the Bionicare Knee Device on more than 100 patients.


“The device has reduced the use of pain medications and, in some cases, postponed the need for surgery in these patients,” Lewis said. “Active people want to stay healthy and perform at peak levels longer without pain. As a result, there is a growing interest in treatment options that have few side effects and the BioniCare device is a great example of that technology.”


The Knee Device was cleared for home use by the Food and Drug Administration in 2004 and requires a physician prescription. It transmits pulsed electrical stimulation to the knee and may help rejuvenate of cartilage. During therapy, a wrap is applied and worn for 8-10 hours, typically while the patient sleeps. Patient’s who accumulate more than 750 hours of cumulative wearing time demonstrate the best results.


“This product has proven itself to be a great alternative for people like Ashley, who are in the early stages of osteoarthritis and wish to remain active without being dependent on pain medications or invasive procedures,” Lewis said. “It’s really represents good news.”

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How You Can Reduce RSI Risk

How you can reduce RSI risk

Every day at work you execute thousands of precise, frenetic keystrokes while hunched painfully over a monitor. You text and type and staple and file throughout the day, performing a daily marathon with your forearms and fingers.


And like a marathoner, your tireless performance comes at the cost of physical pain. If left unchecked, your low-impact daily tasks may put you at risk for a repetitive stress injury.


Repetitive stress injuries, or RSIs, are caused by repeated everyday actions. The two most common RSIs are tendinitis, the inflammation of a tendon; and bursitis, the inflammation of a bursa sac. Some well-known examples include carpal tunnel syndrome and tennis elbow.


Though repetitive stress injuries often start as an inconvenient ache, the symptoms can become far more severe if they are ignored. People sometimes assume that their risk of RSI depends on the amount of time spent on a certain action. The time spent is actually less important than the number of repetitions.


For example, if you spent two hours typing only 100 words, your risk is far lower than a friend who typed an epic 2,000 words in only 20 minutes. Furthermore, if your friend repeated her typing binge several times daily over weeks and months, she might start to accumulate orthopedic damage if she didn’t rest prudently.


This repetition of a task over time is what leads to RSI symptoms. The most severe RSIs require physical therapy and medication—even surgery. But the majority of RSIs are easily reversible. Paying attention to posture and switching to more ergonomic products can help to prevent or alleviate painful symptoms.


Computer use is a leading cause of office-related RSIs. To fight this epidemic, many ergonomic products are now available to help improve your posture and take stress off vulnerable joints. One of the most common and effective office aids is the ergonomic keyboard. Its split curved keypad surface elevates typing hands to a less damaging posture. Critics have questioned the effectiveness of ergonomic keyboards since their inception, but it’s hard to argue with results; a 2010 study showed that typists with RSI-related disorders were able to reduce the severity of their symptoms by using ergonomic keyboards.


But what about the computer user on the go? In this modern era, mobility is everything, and laptops are more common than ever. But a laptop is a terrible surface for a portable computer. The hip-height keyboard and screen put strain on your wrists and your neck, and your lap is less steady than a table, which also makes for high-stress typing.


To reduce RSI risk, try elevating the computer to eye level and connecting an external keyboard to your laptop. This will allow you to use the computer as comfortably and ergonomically as you might use a desktop.


If you are at risk for RSIs, it may be best to avoid buying an ultra-compact netbook. Netbooks have keyboards that are smaller than regular laptops, and this can increase the likelihood of typing with incorrect posture.


Phone texting and browsing have become key parts of professional communication, and they have simultaneously become a frequent source of RSIs. Smartphones tend to be heavier than regular cell phones. Android phones and iPhones increase RSI risk for the very reasons they make such enticing gadgets—the touch-screen and added functionality make them more useful, and thus they tend to keep your fingers active when you might otherwise be still.


A recent study suggests that to reduce the likelihood of RSI, you should use both thumbs when texting and take breaks between writing messages. If you find your hands truly in need of rest, try an old-fashioned remedy: use your phone to talk instead of type.


Your home life has just as many possible sources of RSIs. Cooking, gardening, needlecraft, and leisure sports all have their own risks. Game controllers are notorious culprits.


To prevent home and leisure injuries, simply remember that even light exercise puts stress on joints. During leisure time, take it easy. Stretch before playing and take breaks before a slight stiffness becomes a full-blown injury.


This article was featured at SFGate.

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BioniCare Knee System: Improving Joints without Surgery

The BioniCare Knee System Improving Joints without Surgery

In the following press release, I offer a personal testimonial for VQ OrthoCare’s BioniCare Knee System, a utility and alternative treatment for reducing osteoarthritis-induced knee pain and enabling increased functionality.


Ashley is an avid cyclist who started noticing pain earlier in her exercise routine after she turned 42. When she learned that she had an early form of arthritis, she asked her physician if there were any safe, non-invasive treatments available for the condition. Her physician told her about the BioniCare Knee System, an exciting alternative to the use of medications or surgery for knee pain due to joint wear and tear.


“Ashley’s case is somewhat unique,” said Dr. Moshe Lewis, a Physical Medicine and rehabilitation physician at California Pacific Medical Center, St. Luke’s Campus. “Osteoarthritis occurs more frequently in males before the age of 45. Women are more prone to the disease after age 55.”


Osteoarthritis is the breakdown of the knee joints and occurs more frequently as we age. This process destroys the cushion-like qualities of the knee joint, which performs as a natural shock absorber. About 50 million Americans suffer from some form of osteoarthritis and it is sometimes found in multiple members of the same family, implying a genetic basis for the condition.


With aging, the water content within the knee increases and the protein makeup degenerates. Repetitive use of the joints over the years irritates and inflames the knee joint, causing pain and swelling. In advanced cases of osteoarthritis, there is a complete loss of the cushion between the bones of the joints. The result of this is friction, leading to pain and reduced joint mobility.


Dr. Lewis specializes in non-surgical treatments for conditions that cause chronic pain, such as arthritis and degenerative disc disease. In the past four years, he has placed the BioniCare Knee System on more than 100 patients.


“The device has reduced the use of pain medications and, in some cases, postponed the need for surgery in these patients,” Lewis said. “Active people want to stay healthy and perform at peak levels longer without pain. As a result, there is a growing interest in treatment options that have few side effects and the BioniCare device is a great example of that technology.”


The BioniCare Knee System was cleared for home use by the Food and Drug Administration in 2004 and requires a physician prescription. The system transmits pulsed electrical stimulation to the knee to reduce pain and improve overall function. During therapy, a wrap is applied, and worn for 8–10 hours, typically while the patient sleeps. Patients who accumulate more than 250 hours of cumulative wearing time demonstrate results (roughly one month), with full results at 2,250 hours (roughly 9 months).


“This product has proven itself to be a great alternative for people like Ashley, who are in the early stages of osteoarthritis, looking for long term results and wish to remain active without being dependent on pain medications or invasive procedures,” Lewis said. “It really represents good news in Osteoarthritis treatment.”


Dr. Moshe Lewis specializes in the non-surgical management of musculoskeletal and neurological injuries and diseases. He has devoted his professional career to providing compassionate care to people who suffer with chronic pain. He can be reached through his website www.mosheleiwsmd.com. For more information on VQ OrthoCare’s BioniCare® Knee System or the OActive™ Knee Brace, please visit, www.bionicare.com or call (800) 444–1456.

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Quick Remedies for Headache Pain

Quick Remedies for Headache Pain

It can be tempting, or even necessary, to use pain killers in moments of extreme discomfort—especially when it disrupts our productivity and our lives. Headaches, a universally common symptom, are frequently the culprit behind these effects and while they can be alleviated with compounds such as acetaminophen and ibuprofen, there are other methods available to those who are concerned about their medicating habits.


In a piece for EverydayHealth I talk about how temperature, light sensitivity, sleep, and other factors can change the way you feel and how to use this knowledge to relieve headaches naturally.

“It is easy to become reliant on drugs — we all live in a fast-paced nation, and there is little understanding when you miss obligations over a headache,” says Moshe Lewis, MD, a pain management specialist in Redwood City, Calif.

For example, acupressure, a procedure that utilizes familiar acupuncture principles but involves instead pressure rather than the insertion of needles, may prove beneficial:

Performed by a qualified practitioner, acupressure can bring relief for headaches and a variety of other pain-related conditions, says Lewis. Japanese research explains that acupressure may work by stimulating the autonomic nervous system, which is why it may have an impact on headache and related conditions such as chronic neck pain. Though recent studies haven’t been done, earlier research on 500 people with frequent headaches found that self-administered acupressure was helpful and worth trying because there are no negative side effects.

If you’d like to know more, read the article at EverydayHealth.com.

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Video: 5 Tips for Workplace Wellness Routines


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It’s no secret that it can be really difficult to maintain your fitness and overall health when so many of your days are spent in the office. Employees can develop carpal tunnel from repetitive wrist movements and a constant deficiency in circulation can cause a number of cardiovascular problems. There are, however, some great solutions to prevent discomfort and a deterioration in health while at work. Some of the best results come from employers that lead by example and implement programs such as a walking group or a push for ergonomics awareness.


A recent post on the Nuesoft Blog shares some great advice when it comes to workplace wellness. In the featured Neusoft video podcast, I talk with Lindsey Coates about how to engage in a routine that works for everyone as well as how to encourage good habits and comfort. Here are some ideas to get you started:

  1. Designate a coordinator to get everyone involved.
  2. Create a board that will centralize all wellness information (leaflets, routines, leader board – if you want to make it a competition, etc.).
  3. Walk as a group during lunch around the building or floor you are on.
  4. Sit on a yoga ball for an hour a day while working on the computer. When your hour is up pass it to another team member.
  5. Sign up as a group to do a 5k, softball team or other sporting activity. It’ll also promote morale!

To find out more, read the article and watch the interview on the Nuesoft Blog.

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Dealing with Chronic Pain: Working Out When You Hurt

Dealing with Chronic Pain Working Out When You Hurt

Exercise is a great way to reduce pain. In fact, a sedentary lifestyle tends to exacerbate pain. It may initially seem that pain can be avoided when you avoid activity, but the truth is muscles atrophy over time and small, daily tasks can become troublesome. But just getting even a little bit of exercise in each day can make a huge difference. The movement that comes from activities such as stretching, walking, and water therapy can loosen up tightened muscles and relieve pain from achy joints. Movement is incredibly effective in the workplace as well–a quick walk around the office could boost your mood and increase productivity. Without painful distractions and frequent discomfort, you can get back to living again.


If you’re looking for some great tips and tricks, see my interview at Fitness and Wellness News.

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6 Ways to Get Through a Painful Workday

6 Ways to Get Through a Painful Workday

Chronic pain causes The United States around $558 billion a year in lost productivity and medical bills. Not surprisingly, thats more than the entire effect of heart disease, America’s number one killer. Chronic pain can be managed to increase your productivity in the workplace.


EverydayHealth has another great article about how to reduce chronic pain in the office. I was interviewed for tips 3 and 4, Move During Your Breaks and Get Help for Heavy Lifting. Here are the links to EverydayHealth’s tips:


1. Practice Good Posture

2. Set Up an Ergonomic Workstation

3. Move During Your Breaks

4. Get Help for Heavy Lifting

5. Wear Comfortable Shoes

Read this EverydayHealth Article on their website.

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5 Ways to Maximize Your Doctor’s Visit

5 Ways to Maximize Your Doctor s Visit

Doctor visits typically increase as the year comes to an end. How many times have you been to the doctor’s office, been poked and prodded, leaving with a prescription, only to recall all of the  things you didn’t ask? Or maybe there was something the doctor said you didn’t quite understand? Since many people are going to the doctor’s office to improve their overall health, the next time you go, make the most of the visit with a few strategic tips.


1. Take an active role in your medical care and treatment.

  • Listen intentionally to what the doctor says during all doctor visits, and be proactive with taking notes.
  • Do some research on your own and consider that you may just need to talk to more than one healthcare professional.
  • COMMUNICATE! Share important information with your doctor — such as other medications and supplements you take, whether you have claustrophobia, and how you handle your symptoms.
  • Learn your treatment options and work with your healthcare professional to customize your treatment plan.

2. Take proper care of your body and mind.

  • Incorporate stress reduction techniques such as medication, exercise, and stretching into your day.
  • Eat well! Proper nutrition goes a long way toward helping heal the body.
  • Get counseling or join a support group.

3. Effectively utilize healthcare resources.

  • Make a plan and stick to it, such as walking more or eating less carbohydrates.
  • Know what triggers your pain/condition and AVOID those triggers.
  • Develop effective responses to deal with flare-ups.
  • BE PREPARED with extra medications, equipment for long trips, or other necessary preparations.

4. Know your health plan coverage.

  • Does your plan put a cap on the services that your doctor is requesting?
  • Does your insurance company cover alternative treatments such as acupuncture or chiropractic care?
  • Can you receive reimbursements for treatments that may be considered complementary such as nutrition, biofeedback, yoga, or medical equipment? Check to see if your flexible savings account will cover any of these.

5. Ask, ask, ask, and ask again.

  • Don’t be afraid to ask questions or about what a medical term means. You did not go to medical school.
  • Ask the doctor to clarify or elaborate on any medical jargon used.
  • Ask about medication samples. Your doctor may have drug samples that could work for you.
  • Ask if any of the special services you need, such as physical therapy or assistance taking care of basic needs, can be done in your home especially if you have limited mobility.
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Do Women Feel More Pain Than Men?

Do Women Feel More Pain Than Men Study Says  Yes

Chronic pain has the ability to strip individuals of their productivity, happiness, and well-being. ABC News wrote this great piece about Tiiu Leek and her pain in the workplace, describing how women feel more pain than men do. The article references a relatively new study from The Journal of Pain that showed women generally feel more pain than men. However, this study wasn’t thorough since it didn’t account for confounding factors such as emotional effects or an additional painful disease. Women tend to be better at analyzing and describing their pain to doctors which give the illusion they feel more pain. As a culture, men are expected to complain about pain less as well as talk about their emotions. One’s mental well-being has a huge effect on physical pain, thus conclusive studies are hard to produce.  Nevertheless, the findings reflect what I see as a chronic pain specialist. Here is a telling excerpt from the ABC News article:

Meyer saw 13 doctors before she got a proper diagnosis and the majority were men. “It’s very uncomfortable for them to see real emotion: ‘Tell me the facts, m’am, just the facts.’ I see them tune out.”


Now, she consciously spares the doctor the emotional talk. “I can literally be in so much pain I am crying when the staff is in there, but I pull it together when the doctor is in the room and have no tears at all. And it’s not easy to have to do that.”


She said doctors need to listen more to their female patients – “feelings are a part of the equation … Patients shouldn’t have to shut things down.”


Both Meyer and Leek sit on the leadership circle at For Grace, an advocacy organization that educates, supports and empowers women in pain through annual conferences and legislative outreach.


For Grace’s “Fail First” bill recently got through the California State Assembly’s appropriations committee on a 12-5 vote. If signed by the governor, it will allow women in pain much better access to pain medications, bypassing insurance companies.


As for Leek, she has seen marked improvement in her pelvic pain thought exercise and homeopathic approaches. She also tries to surround herself with positive people.


“My career was lost, but not my optimism,” she said. “I continue to live well. I once read that if you can get through your 60s unscathed, you can have a pretty good life.”

Read this article on ABCnews.com 

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Does Acupuncture Have a Place in Western Medicine?

Does Acupuncture Have a Place in Western Medicine

As I’ve mentioned several times in my blog and in my videos before, acupuncture has been around for thousands of years and withstood the test of time, but the traditional medicine community turns a blind eye towards the eastern approach to acupuncture. In this article written by BeckerSorthopedicAndSpine.com, author Abby Callard quotes me along with Christian Nix, an acupuncturist in Chicago, about the utility of acupuncture. Christian Nix explains how many aren’t educated in philosophy and practice of acupuncture and its place in the medical industry. I always recommend acupuncture to my patients due to its effectiveness, its low cost, and practicality. Below is an excerpt from the article:

Moshe Lewis, MD, SpineCare Medical Group, Daly City, Calif., and Pain Management and Rehabilitation, Redwood City, Calif., is an interventional pain management physician who employs acupuncture to help his chronic pain patients. He agrees that acupuncture has a place complementing interventional pain management procedures.

“Everything that we do in medicine is based on experience, data and clinical presentation,” he says. “I don’t want to say that acupuncture is going to work for everyone. However, on the flip side, I think that it has an important place in medicine and can be an effective treatment for several conditions.”

Acupuncture can be helpful with acute conditions such as epicondylitis, and it can also treat chronic conditions such as repetitive stress syndrome well, Dr. Moshe says. “Anyone who sits at a computer long enough is likely to encounter symptoms of repetitive stress syndrome or tendinitis,” he says.

This disorder generally presents with pain in the wrists and hands, and can cause achy muscles and even myofacial pain. Dr. Moshe says acupuncture works better with muscle disorders than bone disorders because the treatment can help to relax the muscles. Bones, discs and cartilage disorders are much harder to treat definitively. For example, an 80-year-old woman who has arthritis and is no longer walking straight will not be likely to improve her posture with acupuncture. It might alleviate the pain, but it won’t actually treat the problem, Dr. Moshe says. Therefore, acupuncture should always be customized for the appropriate patient and diagnosis where it is likely to be of benefit.

However, it’s the low cost of the treatment that has some insurance companies realizing the benefits of acupuncture, Dr. Moshe says. The cost is low, and patients want it. Insurance companies are beginning to cover it for some providers.

Read this article on BeckerSorthopedicAndSpine.com.

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Get Through a Painful Workday




EverydayHealth.com has another great well-researched piece about getting through a painful workday. Surveys have found that around 90% of employees with chronic pain still go to work even though it effects their job. This is no surprise since many jobs are the source of chornic pain itself. Government reports suggest that 30% of workers’ compensation claims are due to work-related muscolskeletal disorders such as carpal tunnel syndrome and tendonitis. Check our of some of these great tips EverdayHealth.com has provided.

Practice Good Posture

Slouching or being hunched over can stress or pull the back muscles and cause pain. Having good posture helps maintain the natural curves of the back and keeps it strong.”

Get Help for Heavy Lifting


Often, workplace injuries comes from lifting heavy objects. Remember to push objects rather than pull them.

Wear Comfortable Shoes

Wearing comfortable shoes is important because it can easily fatique your feet and negatively effect your entire work day. Wear flat and comfortable shoes that support your arches to best avoid feet pain.

Talk to Your Boss or Human Resources Manager

It is not recommended that you keep your workplace pain a secret. Discuss your pain with management and bring up what you believe to reasonable accommodations that will improve your productivity.

Take Care of Your Body

Taking care of your entire body is important for preventing and ridding yourself of chronic pain. Maintaining a healthy weight and exercising everyday, even if it’s in short bouts, are essential to working comfortably throughout the day.

Is Your Pain Normal?

Check out EveryDayHealth’s symptom checker to learn more about your pain.

Read through the thorough comments on how to get through a painful workday at EverydayHealth.com.
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Six Tips for the Weekend Warrior

Weekend Warrior

Stretching, warming up, building endurance, taking care of your nutrition and feet, and mainly having fun are great ways to be healthier!


If you’ve been using your weekends to their athletic maximum to make up for sedentary time during the week, congratulations, Weekend Warrior! Weekend sports and outdoor adventures like team sports, hikes, swimming and skiing are good for both the mind and the body. Your well-earned weekend recreation has the added benefits of boosting your mood, reducing stress, increasing muscle and cardiovascular health, and providing a great social outlet.


But using physical recreation as a weekends-only reward comes with its own set of risks. Intermittent exercise quickly increases the risk of a muscle strain or ligament tear. Joints can easily be injured without the proper warm-up during the week. Repetitive stress injuries like plantar fasciitis or shin splints can put you in a walking boot for weeks. Skimping on weekday workouts leaves muscles stiff and poorly conditioned for weekend performance, so you’re far more likely to get injured in the pursuit of weekend excellence.


Luckily, a little bit of preparation goes a long way. You can start immediately to optimize your weekday routines in order to excel at your weekend sports activities. Here are six simple tips that can make your weekend performance better, safer and more fun.


1. Reach for the Sky

Stretching should always be the first step in a warm-up routine. Basic stretching allows you to prepare the muscles for the work they are going to do, preventing muscle strain injuries. More advanced stretching exercises like yoga and Pilates also improve your balance, core strength, back strength, and conditioning for the spine. You can reap the benefits of stretching even if you are unable to take a dedicated weekday class—just devote fifteen minutes to stretching a few days every week. Stretch before any strenuous athletic activity, on the weekend too. For a bit of variety, try an online yoga routine. You’ll feel better during your weekend activities, as well as the rest of your week.


2. Pump Iron, Or Soup

Strength training is an essential way to build endurance for the Weekend Warrior. Muscles need resistance training to function at their full capacity. Utilize lighter weights with multiple reps to improve tone initially—even doing curls with a soup can will help to tone your muscles for endurance-based activities like hiking or distance running. If you’d like to build strength and bulk, gradually move to higher weights with fewer reps. When using heavier weights, don’t forget to rest and pace yourself.


3. Know The Condition

Many of us are weekend warriors by necessity, not choice—our routine simply does not permit a lot of time to train during the week. But if you can find the time for even a little bit of simple aerobic conditioning, you’ll see a huge change in both your weekend performance and your everyday energy level. Activities like light jogging, hiking, aqua-therapy, tai-chi, yoga and rowing are easy, low impact ways to optimize cardiovascular health, limit damage to the cartilage and joint while having our body burn calories, thereby mobilizing muscles in a very natural way. For the athlete who prefers structured activity, a class or a second sport is an ideal way to train for weekend events. Aerobic fitness classes, dance classes, golfing, tennis and cross country skiing can all help you to step up your game while providing good cross training of multiple muscle groups simultaneously. Sometimes even tried-and-true exercises like running can cause knee pain, so don’t hesitate to decrease impact by using the elliptical or hopping in the pool every other day instead.


4. Did You Say Supplements?

From Omega 3′s to glucosamine to antioxidants to vitamin D, the right nutrition and dietary supplements can make a big difference in your sports performance and your general wellbeing. Always consult your doctor, who can support your good health through the appropriate supplements. Remember, a healthy diet, including adequate fluid intake, are essential to all athletes, professionals and weekend warriors alike.


5. Happy Feet Are Healthy Feet

Good ergonomics, posture and even the wear of your shoes can make or break your technique. Take a page from professional athletes, who optimize the mechanics of their technique with custom orthotics, proper shoes, and correct body mechanics. Consider taking a few lessons from a professional trainer in your sport of choice. Also, consider seeing a podiatrist for advice on inserts and shoe wear, especially if you have foot pain. An investment in proper foot support is an investment in your long-term orthopedic health.


6. The Fun Factor

Most importantly, realize that exercise should be fun! This certainly goes for your weekend recreational events, but the fun doesn’t have to end on Sunday night. It’s far easier to keep up on your regular conditioning if you genuinely enjoy it and look forward to it. If you’ve been having trouble jogging to prepare for your weekend pursuits, why not substitute rigorous swing dancing? Swimming? Dog frisbee? Or even aerobic gardening? Any weekday physical activity is better than none, and regular light activity will help your body to be acclimated for weekly hard activity. If you can keep moving, stretching, and having fun during the week, you’ll reach new levels of excellence in your weekend pursuits in no time.


Resources:

1. http://www.ncbi.nlm.nih.gov/pubmed/19761960

2. Rehab Manag. 2011 Apr;24(3):18-9. An ounce of prevention: physical activity plan can help weekend athletes allay overuse injuries. Berliner M.

3. N J Med. 1991 Sep;88(9):639-40. Recreational sports and the weekend athlete. White KM, McInerney VK, Hirsch PJ.

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Tips for Caregivers of Loved Ones with Chronic Pain

Alice Francis and her husband Alan had always been a dynamic and evenly-matched couple. They both worked in high-energy careers that they loved; they traveled the world together; they exercised together regularly, and led extremely active lives. When Alan’s first flares of chronic back pain prevented him from keeping up with their fast-paced lifestyle, Alice quickly realized that their relationship was about to undergo some drastic adjustments.

 

“This transition has been life-changing,” she admitted, “and although I wouldn’t want anyone to have chronic pain, I have learned a lot of lessons regarding pain care and advocating for my spouse in this ‘adventure’ ”.

 

Alice does not like referring to herself as her husband’s “caregiver”, but it is an apt description of the role she has had to fill in Alan’s health care management. As her husband’s treatment progressed through office visits, complex pain regimens, and four corrective surgeries, Alice has taken on an active role in helping her Alan to manage his chronic pain. In the six years since Alan’s degenerative disc disease was first diagnosed, Alice has learned to be an effective champion of her husband’s medical care while maintaining her own positive outlook on life.

 

Thousands of spouses and children of pain sufferers find themselves in Alice’s position every year. Becoming involved in the care and treatment of a suffering loved one is a natural and loving gesture, but it can easily take its toll on even the most patient caregiver. Here are some of Alice’s tips for others who are caring for loved ones suffering from chronic pain.

 

Selecting doctors

  • After you or your partner have researched several doctors, set up “appointments/interviews’ with your top 3 choices.
  • It’s a good idea for you as the partner/caretaker to attend these appointments so that you have two sets of ears. It’s amazing how things can be interpreted differently between the person who is in pain and the person who is there to support!
  • This sounds crazy, but I suggest you and the pain patient dress nicely for the appointment. We have found we are definitely treated with a higher level of credibility and respect.
  • Let the doctor know that you are deciding what will be the best match in terms of a relationship with a new doctor and you have some questions as well. Sometimes I asked the questions and sometimes my husband did. It really depended on his pain and anxiety level that day. If a doctor is reluctant to be “interviewed”, that should tell you something.
  • Take notes! It is very important in all appointments, quite frankly.
  • Here are some good questions to ask at an initial interview:
  1. How long has the doctor provided pain management?
  2. Does the doctor give injections, and if so, where were they trained and what is their general outlook on patient injection needs? (In our experience, doctors who were trained via Mayo Clinic will give only 3 injections per year. Doctors trained in other programs are sometime more open to assessing the number of injections based on the need of the patient.)
  3. What is the doctor’s general philosophy on pain management? If they don’t have one, that’s a red flag.
  4. How many doctors are in the practice? Will patients generally see the doctor or the physician’s assistant?
  5. How far in advance do you need to make an appointment?
  6. Who is the contact when you are unable to reach the doctor?
  7. Will you be able to get copies of all medical records and appointment notes? (I always request this on a monthly or quarterly basis. It’s important to see what the doctor’s interpretation of the appointment was, which can be quite different than yours or the patient’s.)
  8. Has the doctor ever experienced long-term or chronic pain? Although this isn’t a deal-breaker, the doctor’s firsthand experience is a plus. They will most certainly have a high level of compassion and understanding for what the patient is going through.

Alice stresses that finding the right rapport between a doctor and the patient is extremely important, since this doctor-patient relationship could potentially last for years. She found that helping Alan to be proactive about his own emotional needs made it easier to find doctors who were a good match for Alan. “At the beginning of our pain journey, it was very important for my husband to explain to a doctor who he was before pain. He wanted them to have a glimpse of what his life was like before this happened. He was struggling to deal with all the changes going on, and needed people to know that he hadn’t always been the ‘patient’.

 

“Some doctors were very attentive during this dialogue. Others were very dismissive and condescending. Their reaction was almost always a sign of the care and compassion to come. I suggest the patient or caretaker come up with some brief summary of activities and interests prior to the pain and see what kind of reaction you elicit.”

 

Providing care for your loved one

  • Carry a list of all medications and amounts the patient is taking. If there is an emergency situation, it will be necessary to provide the EMT’s or other medical help with that information
  • If you live with the patient you care for, be observant as to what time of day they take their meds. Make it clear that this isn’t policing, but rather just another set of eyes. When someone is in chronic pain, memory can be affected, and it’s just good to have a general idea of your patient’s pattern of medication use.
  • Get to know your pharmacist. I know our pharmacist very well. In fact, I can call the pharmacy and say, “It’s Alice”, and they know who I am! It’s important to build a rapport so that you can ask questions and receive the best customer service possible.
  • LISTEN to your loved one! This was VERY difficult for me to learn. When he would complain about the pain or express frustration, I wanted to ‘fix it”. Listening was not part of my plan. Many times, he didn’t want me to fix anything. He just needed me to say, “That must be really hard”, or “ I’m so sorry you are having to go through this”. Understanding and improving our communication has helped both of us a great deal.

 

Alice offers further perspective on the changing relationship of chronic pain patients and their caregiver companions. “My husband went through not only a huge physical adjustment to dealing with chronic pain, but an equally large psychological adjustment. Without work or exercise or the ability to live an active lifestyle, he just didn’t know who he was anymore. I went through a similar adjustment, I’m sure.

 

“Acknowledging this transition, and how hard it must be, was very important for both of us. Be patient during this time, because your loved one really needs to feel vital and normal. Strongly suggest to your loved one they go see a therapist or psychologist to work through these issues. It can be a huge help to you both.”

 

Take care of yourself

“Of all the things I have done in my life,” says Alice, “taking care of or being in a relationship with someone you love who is in chronic pain is by far the most difficult. In the beginning I felt like my good days were completely dependent on his good days. That’s no way to live.

 

“You do need to provide love, compassion, sometimes some physical and mental support. But you also have to realize that you CANNOT fix or change the situation. You can’t make the person take meds or not take meds. You can’t do physical therapy for them. You can’t take the pain away so you just have to let it go. “I developed a sense of normalcy around all of this. I have a career that I love-- it keeps me very busy. I go shopping and traveling some with girlfriends. I exercise on my own, and do things just for me. This new ‘normal’ life really helps provide Alan with a sense of ‘normal’ as well. I strongly encourage you not to forget about you in this process.”

 

This article is summary and companion article to Taboo Talk's April 6th (2011) radio show/podcast.

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Managing Arthritis: Healthline Interviews Dr. Moshe Lewis

Arthritis-Hand Moshe

I recently helped write an article on managing Arthritis pain with Healthline.com. It’s comprehensive and gives quite a few treatment tips that pain management specialists prescribe. If you are currently suffering from Arthritis, I highly recommend you employ some of these methods. Here is the list of the categories they dive into:


  • Healthy Lifestyle
  • Cold/Heat Treatment
  • Over-the-Counter Medication
  • Prescription Medications
  • Disease Modifying Drugs
  • Trigger Point Injections
  • Physical Therapy
  • Surgery
  • Alternative Treatments
More than 40 million Americans are affected by Arthritis. If left untreated, arthritis can become a chronic condition with symptoms of severe pain and swelling that seriously disrupts everyday life. Learning how to live with arthritis can be extremely difficult, but by making healthy lifestyle changes and incorporating different treatments, you can manage the symptoms and improve your quality of life.

Treatments for arthritis will depend on your individual health needs, severity of pain and other symptoms associated with the arthritis.

Read the entire Healthline article Managing Arthritis Pain

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Dr. Moshe Lewis on TV - Special on Heart Disease and Managing Your Pain



Dr. Moshe Lewis will be interviewing Dr. John Cunniff of the Stanford Medical Center for two special segments titled "Heart Diseases: A Silent Killer" and "Managing Your Pain." Both of these specials will be featured on channel 15 (Comcast) at these times:


Heart Disease: A Silent Killer

Thursday, March 17 @ 6:30p.m.
Saturday, March 19 @ 9:30a.m.
Sunday, March 20 @ 1:00 p.m.
Tuesday, March 22 @ 7:30 p.m.

Managing Your Pain

Thursday, March 24 @ 7:30p.m.
Saturday, March 26 @ 9:30a.m.
Sunday, March 27 @ 1:00 p.m.
Tuesday, March 29 @ 7:30p.m.

Both specials will be live-streamed at creatvsj.org
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Pain often under-treated on fears of drug abuse


Freud Reia needs two narcotics, a muscle relaxer and anti-anxiety medications to get through the day. In fact, he needs them just to get out of bed in the morning.
But he's thrilled to be able to live as well as he does.
It took three years with a San Francisco pain specialist to figure out the right drug combination to help him manage his chronic pain, brought on by dozens of accidents in his wild youth. But his mom, who lives halfway across the country and also suffers from chronic pain, is having a much more difficult time.
"She says her doctors are scared to death to prescribe anything stronger than ibuprofen 800 (mg)," said Reia, 37. "She's a teacher, she's a professional like me, she has no history of abusive behavior, and they won't help her. It just kills me."
Their dissimilar experiences are at the core of the pain management field in the United States.
It can be immensely challenging to find just the right combination of drugs and other pain therapy tools to give someone with chronic pain, like Reia, a decent quality of life. At the same time, doctors walk a thin line: By keeping dangerous narcotics out of the hands of addicts, or taking care to avoid creating addicts by doling out drugs to patients who misuse them, they risk undertreating someone like Reia's mother.
"I have colleagues who are board certified in pain who will not write significant pain medication for treatment. Many of them are feeling overwhelmed and scared," said Dr. Moshe Lewis, a pain management specialist with California Pacific Medical Center who has treated Reia. "Most of the patients I see, probably 90 percent, have legitimate pain. The challenge is figuring out who's who."
A decade ago, 1.7 percent of Americans had abused prescription drugs in the month prior to the national survey. Public health officials agree that the jump is due almost entirely to a huge increase in drug prescriptions.
Prescriptions for narcotic pain relievers - opioids like OxyContin, Percocet and Vicodin - increased tenfold from 1990 to 2000, according to multiple studies. The increase is driven primarily by two factors: New prescription drugs are being heavily marketed to doctors and patients, and Baby Boomers are getting older and suffering more chronic pain.
But with the increase in use has come a rise in the instances of drug abuse and deaths from overdoses. Nearly 12,000 people died from narcotic pain medicine overdoses in 2007 - up from roughly 3,000 deaths in 1999, and more than the number of deaths from cocaine and heroin combined, according to the U.S. Centers for Disease Control and Prevention.
"Someone is going to suffer either way," said Keith Humphreys, a professor of psychiatry at Stanford University School of Medicine and a researcher at the Veterans Administration in Palo Alto who specializes in addiction. "There is no way to get around this basic problem that the looser we are (with pain meds), the more pain reduction we get, but the more addiction we get. And the tighter we are, the less addiction but the more pain."
The challenge to find a solution has drawn an increasing number of specialists to the field of pain management. The idea is for these doctors, who have studied the vast and complicated options for treating pain, to take over when primary care physicians can't help their patients or are wary of prescribing medications that could be addictive.
It's possible, pain specialists said, that a combination of nondrug therapies and over-the-counter drugs - such as ibuprofen or acetaminophen - will help many people avoid narcotics.
"We are talking about something for which there is no magic wand, no quick fix," said Dr. Darshan Patel, a pain specialist at Kaiser San Jose Medical Center. "Medications are reserved only for a last option, when all other things fail to provide some kind of relief."
But for many types of chronic pain, medication will end up being the best option, and drugs like OxyContin are going to play a big role in how doctors fight pain in the United States for the foreseeable future.
To a large degree, the heaviest burden falls on doctors to make sure that patients get the pain relief they need and avoid addiction or overdose. But it's up to patients, too, to take care of themselves and avoid addiction and overdose, doctors said.
"As much as any area of medicine, probably more, pain management is about trust. It's trust between the doctor and the patient, and it has to be both ways," said Dr. Robert Brody, medical director of the pain clinic at San Francisco General Hospital.
Freud Reia had to learn to trust himself and his doctor when it came to developing a pain management regimen. He was terrified of taking narcotics, but as his chronic pain worsened, and physical therapy and other nondrug alternatives weren't working, he'd reached a point where he could barely function.
"It's a scary thing, being on these meds. But I wouldn't be at the level of medication I'm at if it wasn't the most effective thing for me," Reia said. "I can't imagine my life without it. I'd have to go back to being a crippled young man."

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