Slideshow: Surprising Reasons You're in Pain ( courtecy;- webMD & OTHERS WRITER;S OF THIS ARTICLES )
Slideshow: Surprising Reasons You're in
Pain ( courtecy;- webMD )
1/25
Pain Trigger: Flip-Flops
Often, the blame for our
pain rests on the simple choices we make every day. The Cleveland Clinic
Florida's David Westerdahl, MD, shares a few examples -- starting with
flip-flops and foam-soled sandals. They provide poor arch support, leading to
pain in the feet, ankles, and knees.
Solution: Wear
shoes with arch support. When you know you'll be walking a lot, opt for
sneakers.
1/25
Pain Trigger: Smart Phones
Do you have a phone that
lets you text, surf the web, and play games? That's a lot of mileage for your
thumbs. Doctors have begun reporting cases of arthritis at the base of the
thumb in younger people, possibly related to texting.
Solution: When
your thumbs begin to ache, give the texting a rest. If pain continues, use your
phone to make an actual call -- to a doctor. There are effective treatments for
arthritis.
1/25
Pain Trigger: Your Wallet
Your wallet can be a
real pain in the back and the buttocks, and it can even lead to shooting pains
down one leg. Tucked in a back pocket, it may lead to compression and
irritation of the sciatic nerve day after day. A fat wallet may also put the
spine slightly out of alignment, causing muscle tension.
Solution: Remove your wallet before sitting, especially in
the car.
1/25
Pain Trigger: Driving
Many people set their
car seats at the wrong angle. If the seat is reclined, you may slouch forward
to grip the steering wheel. This pulls your head away from the headrest and can
cause neck pain.
Solution: Put your car seat in an upright position that supports
your head and lower back. The steering wheel should be within easy reach, so
your arms are slightly flexed and relaxed.
1/25
Pain Trigger: Active Video Games
Video games that
simulate the motions of popular sports can result in real sports injuries.
Doctors say overzealous gaming can cause everything from sprains to torn
ligaments and broken bones.
Solution: Do some stretching before starting an active video
game. Make sure you have plenty of space around you, so you won't trip or crash
into anything. And don't play for longer than you would a real sport.
1/25
Pain Trigger: Cheese
Cheese lovers, take note
-- your favorite food may be the reason for all those headaches. Aged cheese,
such as blue cheese, cheddar, parmesan, and Swiss contain high amounts of a
substance called tyramine.This notorious headache trigger is also found in some
processed meats and beverages, particularly draft beer as well as other
alcohol.
Solution: Keep a food diary to help spot links between foods
and headaches, so you'll know what to avoid.
1/25
Pain Trigger: Couch Potato Syndrome
Even down time can be a
source of aches and pains. Do you often lie across the couch with your head
turned toward the television? You're setting yourself up for a sore neck --
especially if you fall asleep in that position.
Solution: Maintain
good posture even when you're relaxing. Sit up straight on your couch and make
sure your TV is not positioned too high.
1/25
Pain Trigger: Your Baby
The simple act of
lifting your baby out of the crib each day can lead to de Quervain's
tenosynovitis. This is a repetitive stress injury that causes pain and swelling
in the wrist and thumb.
Solution: Learn to lift your baby without straining the wrists.
Place your hands under the back and buttocks, and lift with the bigger muscles
of your arms.
1/25
Pain Trigger: Laptop Case
If you carry your laptop
around like an extra limb, you're likely to strain some part of the body.
Handheld laptop cases put stress on the forearm and can actually give you
tennis elbow, says Westerdahl. Bags that you wear over one shoulder can
contribute to back and shoulder pain.
Solution: Try a rolling laptop case or consider switching to
a lighter model.
1/25
Pain Trigger: Your Hairdo
A tight ponytail may
trigger -- or worsen -- a headache. Some migraine sufferers are more sensitive
to sensations that wouldn't bother others, such as a tight hat, headband, bun,
or braids.
Solution: Wear your hair down and skip the hat.
1/25
Pain Trigger: Strong Smells
Doctors aren't sure why,
but strong smells are another common migraine trigger. This can include
obnoxious odors, such as paint and smoke. But pleasant scents, including
perfume and fresh flowers, can also be a problem.
Solution: Identify which smells spark your headaches and try
to avoid them.
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6 Surprising Reasons You're in
Pain
Pain
Triggers.
Some days you find yourself in
acute pain while reaching for some stuff or even bending down to pick up
something from the floor.
A small trigger cause an
unimaginable amount of stress or pain at a particular point. You get shooting
pains up and down in one leg only while sitting and you can't seem to
shake it off. You're driving one day and you feel a lot of pain in the neck
just because you have your seat at an unusual angle. Sometimes there are a
combination of factors that will lead to these kinds of pain not just one
trigger happening somewhere in isolation.
6. Your Hairdo
A tight ponytail may trigger --
or worsen -- a headache. Some migraine sufferers are more sensitive to
sensations that wouldn't bother others, such as a tight hat, headband, bun, or
braids.
Solution: Wear your hair down and skip
the hat.
alt="Man in distress" data-type=image v:shapes="comp-j9y0tsr7imgimage">
1. Couch Potato Syndrome
Think down time is resting?
Even lying on the couch can be
a source of aches and pains. Do you often lie across the couch with your head
turned toward the television? You're setting yourself in a position that would
eventually lead to sore neck -- and that could be even worse if you happen
to fall asleep in that position.
Solution: Maintain good posture even when you're relaxing. Sit up
straight on your couch and make sure your TV is not positioned too high.
2. Sleep Habits
If you wake up sore most
mornings, take a good look at your sleep posture. Stomach sleepers may twist
their necks to the point of hyper-extension. Other people sleep on their sides
with one arm overhead. After many hours, this position can strain the shoulder.
Solution: Better ways to sleep are on
your back or on your side with your arms below shoulder level. Side sleepers
can place a pillow between the knees to support the lower back. Back sleepers
can put a pillow under the neck and beneath their knees.
3. Lifting With the Back
A top source of back pain is
lifting objects the wrong way. A common mistake is curving the back forward to
grab an object, then straightening the back as you lift. This forces your back
muscles to take the brunt of the burden. Twisting while you lift is another
problem.
Solution: To lift properly, bend the
knees and hips until you are squatting. Keep the back upright. Grab the object
and lift with your leg muscles by straightening your knees and hips.
4. Your Workstation
If you spend many hours a day
at your desk or workstation, give some thought to the setup. A poorly
positioned chair can cause you to slouch forward, straining the back and neck.
A monitor that's too low or too high will also strain the neck.
Solution: Place your monitor with the top
of the screen at eye level. Position your chair so that you are sitting
straight with your feet on the floor. Use a cushion to support the lower back
if needed.
5. Grinding Your Teeth
A sore jaw combined with a dull
headache could mean you're grinding or clenching your teeth in your sleep. If
you're a chronic grinder, pain isn't the only concern. You could end up
damaging your teeth, your jaw, and even your hearing.
Solution: See your dentist. He or she can
provide a mouth guard that will protect your teeth during sleep.
12 Surprising Causes of Pain
Trying to understand pain
when there is no obvious explanation
updated Feb 10, 2018 (first
published 2007)
by Paul Ingraham, Vancouver, Canada bio
by Paul Ingraham, Vancouver, Canada bio
The world is full of unexplained pain. When I worked as a massage
therapist, the most extraordinarily desperate people came to see me. Two
memorable examples:
Both of these cases were
successfully (and improbably) treated by massage. At the end of the article,
I’ll reveal what happened.
1. A woman
spends three days in the hospital with severe abdominal pain, but is cleared of
every possible ominous medical cause … and then comes to see me?!A massage therapist!
2. A man
gets a ride in an ambulance with severe chest and left shoulder and arm pain,
but doctors cannot find anything wrong with him … and then he comes to see me.
No pressure! And now I publish a busy website, and I get an email
like this more often than I change my socks:
I’ve been to every
medical specialist you can imagine. They can’t find anything wrong with me. The
psychiatrist says it’s not in my head, and the rheumatologist says it’s not in
my body. But something is
causing my pain. It’s not an infection or a fracture or a cancer. It’s not a
sprain or a pinched nerve or a little man with a knife. What else is there?
What else is left?
What else indeed! When “obvious” and known causes of pain have been
eliminated, what next? What
else causes pain? How else can pain start, change, worsen? This article
summarizes ten not-so-obvious ways to hurt: twelve pain phenomena that might
help you to understand pain that has defied diagnosis or explanation so far.
One of the principle qualities of pain is that it demands an
explanation.
~ Plainwater, by Anne
Carson
1. Muscle Knots
3. Brain pain
1. Muscle Knots
Muscle knots — myofascial “trigger points” — are a factor in most
of the world’s aches and pains. Their biology is still mostly mysterious:
conventional wisdom says they are tiny spasms, but they might also be a more
pure neurological problem. Regardless, they can cause strong pain that often
spreads in confusing patterns, and they grow like weeds around other painful
problems and injuries, making them quite interesting and tricky. Although they
are well known to many specialists and researchers, most doctors and therapists
know little about them, so misdiagnosis is epidemic. See Trigger Points & Myofascial Pain
Syndrome.
Pain itself often modifies the way
the central nervous system works.
2. Sensitization
Pain itself often modifies the way the central nervous system
works, so that a patient actually becomes more sensitive and gets more pain with less provocation. This is called “central
sensitization.” (And there’s peripheral sensitization too.) Sensitized patients
are not only more sensitive to things that should hurt, but also to ordinary
touch and pressure as well. Their pain also “echoes,” fading more slowly than
in other people. See Central Sensitization in Chronic Pain:
Pain itself can change how pain works, resulting in more pain with less
provocation.
3. Brain pain
This is an important subcategory of sensitization: sometimes, the
brain amplifies pain as a consequence of stress, anxiety, and fear. This is not
“all in your head” pain, but “aggravated by your head” pain. Like an ulcer,
there is a real physical problem — but it just happens to be unusually
sensitive to your emotional state.1 Sometimes,
the brain’s interpretation of a situation becomes a major part of the issue.
Like picking at a scab, the brain can become excessively focused on a pain
problem. For more information, see Pain is Weird: Pain science reveals a
volatile, misleading sensation that is often more than just a symptom, and
sometimes worse than whatever started it.
Types of Pain There
are two main kinds of pain: nociceptive and neuropathic. Nociceptive pain is the most familiar
because it arises from damaged tissue, like a cut or a burn. Neuropathic is
more rare, because it is caused by damage to the damage-reporting system
itself, the nervous system. Some pain, like fibromyalgia pain, doesn’t fit into
either category. Read more…
4. Pathological sensitization
Yet another kind of sensitization: sensitization can also be
caused by disease processes we do not yet understand. The first kind of
sensitization is a more-or-less normal and common reaction to chronic pain. The
second kind (“brain pain”) is powered by the worries of a frazzled brain. But
there are also diseases that sensitize the nervous system: not a nerve pinch or
lesion, but nerve failure. For
instance, complex regional pain syndrome causes extreme pain, usually in a
limb, and usually following some trivial tissue insult like an insect bite or
minor cut. When it’s full-blown, the nastiness of this problem is impossible to
understate — suicide is common — and yet there probably are milder variations
of it. Many times in my career I have become quite convinced that a patient had
to be suffering from some lesser form of CRPS, awful but not enough to clinch a
CRPS diagnosis.
5. Vitamin D deficiency
Vitamin D deficiency is probably more common than once suspected —
at least 1 in 20 people in the lowest estimates,2 and possibly many more.3 It can cause subtle
widespread pain that may be misdiagnosed as fibromyalgia and/or
chronic fatigue syndrome, including symptoms like muscle and bone aching,4 fatigue
and weakness, lower pain threshold, and more acute soreness after exercise that
is slower to resolve. For more information, see Vitamin D for Pain.
Reserve a few minutes to read this: “The wilderness of the medically
unexplained.” There’s not much in the way of a take-home message
here: it’s mostly just a really well-written and heart-wrenching tale of a
cancer that flew under the diagnostic radar for quite a while. It’s going to be
poignant for anyone who has felt like a medical mystery … so, you know, just about everyone with chronic pain. I’m
not sure that anyone involved could have done much better. Things that are
tough to diagnose are tough to diagnose, and that’s just life. And death.
But please, doctors (and anyone responsible for diagnosing): try
to remember that when you hear hoofbeats in Texas, sometimes it really is bloody zebras, not horses.
6. Muscle tension and contracture
Ordinary muscle tension itself can cause a surprising amount of
pain. A leg or foot cramp is a common and extreme example, where no one has any
doubt of the cause of pain. But imagine a muscle spasm much less strong, but
lasting for days and days — or years! Although superficially a simple concept,
there are actually several physiological mechanisms by which muscle can become
shortened and painful for a long time, some well understood and straightforward
(spasticity from neurological diseases), while others are quite mysterious
(like spasms people are born with, as in torticollis or wry neck).
One particularly good and sinister example of muscle tension pain
is the “MS hug”: a symptom of
multiple sclerosis that feels like a painfully tight band around the chest,
often experienced long before diagnosis. Although the feeling of constriction
is the classic symptom, many patients also just experience widespread and
erratic pain in the chest wall.
If your muscles are spasmed for long enough, they will actually
“freeze” like that: essentially scarred into place, a phenomenon called
“contracture.”5
7. Referred pain
Referred pain results in an amazing amount of medical barking up
the wrong tree.
Anything that hurts inside the body — anything under the skin — is
difficult for the brain to locate. This is partly because we literally just
don’t have enough nerve endings for it, and partly because the nervous system
isn’t perfect and signals literally get “crossed.” The practical result of this
is that internal pain with any cause may
be felt somewhere completely different. Despite
the fact that this phenomenon is well known, it still results in an amazing
amount of medical barking up the wrong tree. Referred pain isn’t exactly a
“cause” of pain, but it belongs in this list because it’s an important concept
that can help to explain many pain problems that otherwise don’t make sense.
For instance, both of the examples at the beginning of this article were cases
where referred pain fooled doctors — in both cases, the pain was caused by a
trigger point in a nearby muscle, not by
vital organs. The doctors simply looked in the wrong place!
8. The pain of stuckness
Here’s a simple experiment: assume an distinctly awkward posture,
and within minutes you will probably experience severe pain. Why? You haven’t ripped or torn anything. But we are wired to
avoid this situation, because every cell in our body depends on nearly constant
movement to survive. And so the nervous system takes it very seriously whenever
tissues feels “stuck.” The exact mechanism of pain is probably nerve endings
that detect tension on cartilage, ligaments and tendons. Continuous tension on
these structures may be interpreted by the nervous system as a serious threat. But here’s the kicker: you can induce this reaction
quickly with an obviously awkward posture … or you could do it slowly and
insidiously with surprisingly subtle poor posture, muscle imbalances, joint
dysfunctions, or anything that deprives tissue of full movement. When a joint
feels “stuck,” for instance, and there is no obvious way (and sometimes no
anatomical way) of moving to get “unstuck,” the sensation can escalate to a
screaming itch-you-can’t-scratch. This is may be the main causes of neck cricks, for instance,
and scads of other miscellaneous aches and pains. Unfortunately, postural correction is a challenging and
sketchy business.
Actonel (risedronate) is one of the more popular bisphosphonate
drugs, any of which may cause severe musculoskeletal pain years after
first exposure.
9. Drug side effects, especially
bisphosphonates and statins
Some drugs are notorious for causing joint and/or muscle pain as a
side effect. Other kinds of pain are possible too, but those are usually more
distinctive and readily identified as a drug side effect. Joint and muscle pain
are easily mistaken for the ordinary aches and pains of aging, removing
suspicion from the drugs that are actually causing them. Some of the usual
suspects are:
·
statins (for lowering cholesterol)
·
bisphosphonates (for osteoporosis and Paget’s disease)
·
fluoroquinolones (a class of antibiotics)
·
retinoids (for skin conditions, like Accutane for acne)
·
Trintellix (an antidepressant)
Some of these may actually be innocent, others almost certainly do
cause trouble: it’s surprisingly unclear, like most of medicine. Here’s some
more detail about statins and bisphosphonates…
Joint & muscle pain are often
mistaken for the ordinary aches & pains of aging, removing suspicion from
the drugs that are actually causing them
The bisphosphonates — On January 7, 2008,
the U.S. Food and Drug Administration alerted health care professionals and
consumers to the unusual severe side effects of a popular class
of drugs for osteoporosis and Paget’s disease, the bisphosphonate (Wikipedia). They can cause
“severe and sometimes incapacitating bone, joint, and/or muscle pain” which
“may occur within days, months, or years” after first taking the medication.
This medication has almost certainly explained some otherwise inexplicable pain
in some of my patients over the years! Alendronate and risedronate (Actonel) are the two most popular
bisphosphonates, and they are usually prescribed for osteoporosis or for
a bone-deforming condition called Paget’s
disease. If you are 40+ and grappling with a mysterious pain
problem, check your medicine cabinet for bisphosphonates in particular, but of
course any other medication that
could cause pain as a side effect.
The statins — The drugs that lower our blood
cholesterol, like Lipitor and Crestor, may also cause pain. Statins are
important and widely used drugs, and their deleterious effect on muscle is widely
considered a diagnosable condition: statin
myalgia, or statin-associated muscle symptoms (SAMS).6 A few patients, about 1
in 10,000, get a more obvious, serious case of muscle poisoning, rhabdomyolysis,7 and
an even rarer and more serious condition afflicts 1 in 100,000: statin-associated autoimmune myopathy.89
And yet there is also confusion and controversy about the
prevalence of statin myalgia.10 There’s
even clear evidence that it could be some kind of illusion or misunderstanding:
in one head-scratcher of a study, taking statins only increased pain when patients knew they were taking statins.11 So that’s
weird! The truth is probably “all of the above” and “it’s complicated” — it
seems likely that some patients are genuinely intolerant of statins, while
others are suffering from fear of
statins and/or some other cause of musculoskeletal pain (of which there many). There might also be some tricky X-factors, like vitamin D
deficiency, which seems to be linked to statin myalgia.12
Fortunately, for the genuinely statin intolerant — and you
probably do exist! — it’s easy to solve by lowering the dose or switching to
another statin.
10. Analgesic rebound
This almost counts as a drug side-effect, but it’s an important
enough phenomenon in its own right that it deserves separate description. When
you take a lot of analgesics — pain-killers — it’s possible to pre-empt the
production of your body’s own pain-fighting molecules. Endorphin production,
for instance, will drop. This can have disastrous consequences when you stop
taking the drugs, resulting in worse pain than ever. This is part of the
phenomenon of the well-known serious withdrawal symptoms from some drugs; it is
a less well-known problem with over-the-counter pain-killers. Although this
phenomenon isn’t particularly mysterious or difficult to identify, it does show
us something important about how pain works: we aren’t entirely without our own
defenses, and those defenses can actually be undermined by artificial help. And
there are scenarios where analgesic rebound may be difficult to detect. Given
how extremely common analgesic usage is, it’s likely that people with recurrent
headaches may be suffering primarily from bouts of rebound pain, occurring in
the occasional gaps between erratic but generally intensive self-prescribing of
pain killers.
I have a good story about a terrible withdrawal-induced headache:
see my headache tutorial.
11. Stupid, stupid neutrophils
Neutrophils are defender cells that are supposed to destroy
bacteria that invade wounds, a normal part of the inflammatory response to
injury. Bizarrely, neutrophils go to work even when the wound is sterile, not
open to the outside world. Like an overzealous police force with nothing better
to do, they also attack a common cellular organ, mitochondria, whenever it is
spilled from cells by injury. Mitochondria are actually honoured symbiotic
guests that convert our food to energy for us. Normally we live out our lives
in perfect harmony with mitochondria, biological BFFs. But when they get the
chance, neutrophils target and hunt them like they are invaders13 because for millions of
years they haven’t gotten the evolutionary memo that mitochondria should be
left in peace.
Inflammation is excessive for this reason: every trauma causes
pain that is too loud for too long, because a significant portion of the
inflammation is due to this SNAFU immune system policy of attacking
mitochondria. There are many perverse sources of pain in pathology, but this
one really stands out as being particularly ridiculous and unfair. It does have
one practical implication: it directly suggests that it’s quite reasonable to
try to control and limit inflammation with things like Voltaren® and icing. Contrary to the
popular notion that inflammation is “natural” and therefore good, inflammation
is definitely exaggerated, and could do with some controlling!
For more information, see Why Does Pain Hurt? How an evolutionary
wrong turn led to a biological glitch that condemned the animal kingdom — you
included — to much louder, longer pain.
12. Chronic low-grade inflammation and
“inflammaging”
Chronic, subtle, systemic inflammation is a possible factor in
stubborn musculoskeletal pain. It can have many underlying causes, from bad
genes to mild autoimmune disease (including allergies), smoking or other severe
biological stresses, chronic infections, and even just getting old (known as
“inflammaging”). The greatest culprit is metabolic syndrome: a set of biological
dysfunctions strongly linked to poor fitness, obesity, aging, and likely
emotional stress and sleep disturbance as well. See Chronic, Subtle, Systemic Inflammation:
A possible insidious cause of mysterious chronic pain.
Chronic pain as a destiny: many causes for
many years
Nothing’s ever simple and chronic pain least of all: it’s usually caused by a sinister stew of factors that eat away at people
for a long time. Chronic pain may be “destiny” with roots going back many
years, even decades.14 Trying
to solve it by fixing one thing
— like vitamin D, say — may be about as feasible as trying to fix a broken
engine with just one tool. It can be an impossible puzzle to even understand,
let alone treat. Elisa Arnaudo:
Medically unexplained
symptoms (MUS) represent a major challenge for healthcare systems in
industrialised countries. These symptoms are so prevalent that they are
assessed in up to 50% of consultations in primary care.
Probably almost all MUS involve chronic pain, and Arnaudo’s post
seems to be mostly about fibromyalgia. She proposes MUS patients are a stumper
because of “an inadequate explanatory
framework of disease.” In other words, we’re not
just missing some pieces from a puzzle; it’s that we probably
don’t even know what kind of puzzle we’re
looking at.
And… not necessarily such a puzzle.
Ending with a ray of hope
It’s also possible that many of the explanations we need are
really hovering just out
of our current reach, and really not so tricky after all — just too subtle to
be easy. They
get missed not because the problem requires godlike medical insight, but
because most doctors just don’t know that much about chronic pain and economics
keeps appointments relatively short and so even some pretty straightforward
things just get missed.
That possibility is the inspiration for this article. Some of the
ways to hurt described above may be the main factors,
or even the only factors,
for some people.
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