Entries in pain management (13)


Alternative Treatment for Pain Management: Hot Yoga

Yoga by Augusto Mia BattagliaBy April 

Recently I have returned to my hot yoga practice, in some instances I realize I must strengthen my weaker arm consistently to restore my strength. I dare to hold each pose with real body power as I visualize a much more fit version of myself. I’ve listened to the hot yoga instructors words as we attempt each pose with much determination. I hear the instructor gently assist our inner doubts, “roll your arms under your body face down on the floor, this will be very therapeutic if you have any minor injuries”, she mentions. Ahhh… what a relief I think to myself. I am really assisting in my bodies recovery is what I am thinking during the entire 90 minute hot yoga class. I understand that to some extent, some injuries may not be gently healed in a hot yoga class. However, for minor injuries I believe some sort of yoga practice, including more gentle types of yoga may be therapeutic. Healing the body from pain takes a lot of energy, hydration in the body and determination.  So be sure to give your body extra tender, loving, care as much as you can with your particular circumstance. Our bodies will thank us for consistently tending to it as our temple.

Bikram Choudhury started learning a Hatha type of yoga at age five. At age eleven Bikram was the youngest winner ever of a National India Yoga Competition. However at age twenty, Bikram suffered a weightlifting injury that crippled him. With the help of his guru, “Bishnu”, at age twenty Bikram created a twenty six posture yoga series and two breathing exercises that completely restored his health. This yoga is now called “Bikram Yoga”. Bikram Yoga is a 90 minute yoga class performed in a heated room, so being very hydrated is essential. Toxins are released during hot yoga, also the twenty six postures are all performed as a sequence to prevent illness, injury and limit the effects of aging. This type of yoga also creates balance and strength in the body.

If you find yourself interested in hot yoga for healing your body, find a local studio and try it out. I highly recommend checking with your doctor first before engaging in this type of exercise.

Here are a couple links for more information or to locate a convenient class:




Old, New, And Alternative Treatments For Pain Management

Massage Therapy, Michael Oh, FlickrIce, Ice Baby! 

Lying in a hospital bed, with close to twenty pounds on ice packed around my shattered leg, I wondered when humans first thought about using cold for pain therapy.

It has to have been used for thousands of years, in areas where it could be collected. At least the nurses covering me in ice didn't have to travel to a nearby glacier, chip away their supply, and haul it back to the sixth floor of Harborview Medical Center. 

Reducing swelling, pain and inflammation resulting from injury using cold therapy is a balancing act. Many people cannot tolerate ice on or near an injury for more than ten minutes at a time, while others can fall asleep and need to be monitored to avoid frostbite. It is up to the individual to determine how long they can deal with the cold and try to work within a range of ten to thirty minutes per session. Avoid heat on injuries for the first twenty-four hours or as recommended by your physician. While it may feel nice at first, heat can create more problems down the road.

Alternating Hot And Cold

Using a cold pack first then a hot pack later ( +24 hours post-injury or at doctor's advice) can often help relieve muscle and joint pain for me in about half an hour. A quick note about heat pads - microwave and electric heating pads are great if used according to instructions. Seriously, read the instructions. Severe burns and a worsening of your condition can quickly follow improper use of heat. If you do not have someone monitoring you while using heat, use timers capable of waking you up, should you fall asleep. You can get a serious burn while asleep that won't wake you up until too late, if at all. 

My wife fell asleep using an ultrasound device and suffered a serious burn to her shoulder that took weeks to heal, so be careful with other common machines used for pain control.

Seek medical attention if any unusual symptoms develop after a cold and heat session. Be sure to let doctors know exactly what you had been doing and for how long. Inform them of any and all medications, too. Don't forget about any herbal supplements or remedies in the disclosure as some have the ability to block or alter drugs and their effects.

Fish Oil

I had been taking a high quality fish oil capsule two or three times a day for about a year before I crashed my bike, and continue to take it daily.  The main reason was for heart health and inflammation reduction. One of the unintended benefits seems to be rapid healing and fading of the scars at the repair sites. 

The scars from the August 2010 surgeries are much less noticeable than my August 1979 football knee repairs. A woman who had a recent double knee replacement I would see at physical therapy asked me if I put some kind of anti-scar cream or something on my leg because she was noticing my scars fading much faster than hers. We had surgery about the same times and are roughly the same age.

While I will not name a brand of fish oil, I would recommend that any brand you try be of a high quality fish stock, like salmon or other omega-3 rich source fish, and a brand that is purified to remove unwanted elements. I works well for me, but my wife can't take any of the fish oil products without getting heartburn or the "fish burps".

Massage And Magnets

Healing massage can work wonders to get your blood and your joints moving again.

In my family, we have also used a couple of non-powered massage roller devices that have some fairly powerful magnets in them. I can't say that the magnets actually do anything, but the massaging action they give feels pretty terrific.

It is not unusual for the spouse receiving the roller massage to start snoring a few minutes into the session, so something relaxing is happening there.

The types of injuries I sustained were severe enough that blood clot formation was likely without blood thinner medication, so I could not use various massage devices until cleared to do so and neither should you, to help avoid possible complications. Check with your health care provider before using any device, powered or not, before using it anywhere near a seriously injured site.

Read Up On It But Don't Believe Everything You Read!

Check out your friends and relatives to see what they have tried out for pain relief then check that information against WebMD and other sites put up by the Mayo Clinic and the like.

Before subjecting yourself to additional risk of injury from an unproven therapy, Check It Out!  Got it?

Thanks again for checking us out!


Shoreline, WA


Elizabeth Taylor, Pain Killers and End of Life Pain Management

With Elizabeth Taylor's death this week, there has been significant discussion about end of life pain management and the use of pain killers.  During her life, Taylor suffered many injuries, skin cancer, scoliosis, and 30 surgeries, before eventually succumbing to congestive heart failure.

ABC News has done a nice piece on the "Double Effect" or Taylor's challenge of using pain killers at the end of life when overuse or improper use of pain killers can actually hasten death.  Many pain killers like morphine and benzodiazepines are prescribed to alleviate the pain caused by medical conditions, BUT can actually make it harder to breathe, causing death in some instances.  Use of pain killers at the end of life is defended by many doctors.  Proper use of pain killers at the end of life can reduce pain so that pain sufferers can properly say goodbye to their loved ones.

Three doctors had been accused of overprescribing pain medication in 1990 to help Taylor manage her back pain.



Pain Management - Team Approach During And After The Hospital

Hospital Team, ReSurge International, FlickrIn The Hospital, Down In The Dumps

Whenever a serious injury occurs to someone, there is often an associated feeling of being alone - even when family and friends are close by or still in the room with you. It may be a side effect of the drugs being administered to you or something to do with the injuries. Expressing your feelings can be difficult at an early stage of treatment and recovery, but can go a long way towards helping you deal with pain levels. Try to be  more positive in outlook and not dwell  on uncertainties to help keep your brain working in ways that diffuse and reduce pain.

Try to engage the hospital staff a little when your family and friends  aren't around to keep your spirits up and to help avoid getting  depressed about your situation. Should you already have issues with  depression, let your nurses know about it if you haven't told any of the  staff about it. The trauma center will have a variety of people  available to help. You endured a physical trauma and are getting help -  some help for mental trauma isn't beyond their scope or capability.

The Hospital Pain Management Team

At Harborview, there is an actual team of three doctors - two residents and an attending, who come around before surgeries proven historically to be painful and will go over the strategies in current use to help keep you from going over the pain edge. For me, it was the use of the standard intravenous pain meds with the addition of a femoral catheter block. This was inserted into my leg up at the inner thigh and threaded down to the nerves just above my knee to help block the pain signals that come from the repair sites below. From what I have read since about tibial plateau fractures, I'm glad they did the block. It's supposed to be one of the most painful recoveries imaginable without one.

The pain medications are not without side effects. Nausea is a big one for many people, including me. It took a couple of attempts at finding the right combination of pain reliever and anti-nausea drugs to work for me. The first attempts shut off my appetite and I continued to lose twenty five pounds of weight until we hit on the right mix. There is something to the old sage advice that a little extra weight isn't such a bad thing. Had I been at what I used to consider my ideal weight, I don't know how much weaker I would have become with my body using up more muscle instead of fat. Good thing I was a bit chubby, I guess.

The i.v. drip pain meds today have a controller that is a bit like the buttons used on "Jeopardy". Using this system taught me to identify the onset of pain when the medications would begin to wear off and the need to watch the clock to see how much time I would get from the dosage controller. It was set up to allow the patient (me) a dose every 15 minutes as needed, with one push of the button.

Pushing it more often or more times within the 15 minutes didn't work. This teaches one to pay attention to one's body signals, the machine and the clock.

Thanks to that infernal machine, I can now pick up on subtle clues that tell me it's time to grab some ice and Tylenol before the pain goes nuclear.

Stay On Top Of It

You may have had someone tell you about the difference in pain control when they either skipped a dose or waited too long to take something for the pain. It's true - heading it off at the pass, cowboy-style, does help keep it down to a dull roar. Once you let the pain get beyond control, it becomes much, much more difficult to reign back under to a manageable level.

Specifically, what I'm referring to is pain that started out as a twinge, a dull ache, or even a momentary pop, that then turns into a raging pain monster refusing to let go of your leg, arm, back,or whatever is ailing you. Keeping on schedule with RICE (rest, ice, compression, elevation) and your medications , as well as learning to identify the onset of serious pain and to deal with it in a timely fashion is the way to keep on top of it.

Don't Overestimate Your Strength

Before and after surgery you will be told what to expect in the way of recovery time estimates and how your progression though the different stages of recovery might go. The best advice I can impart to you at this point is to be acutely aware of weakness in the legs and back. You culd very easily injure another part of your body just when you need it the least.To enable my bones to start healing properly, I was non-weight bearing ( no weight whatsoever) on the repaired leg for three full months. After that, I was allowed gradual 25% weekly increases, while still using crutches. So, quads? What quads? The muscles that help stabilize knee joints were basically gone. I had to be extremely careful to not twist the leg when beginning to put some weight on it, and so should you if you find yourself in a similar situation. Yeah, it is necessary to push yourself a bit to improve and build strength, but don't be stupid about it. It takes time.

Here Comes Physical Therapy

In my case, the doctors had to bolt together a good portion of my lower leg. 

Due to the high energy impact nature of the crash, the parts list of stainless steel screws, bolts and internal fixator was quite long, indeed (On more than one occasion, the x-ray techs at followup appointments missed getting a picture of the entire assembly since they rarely see one as big as the one that's a part of me now). A level VI (6) on the Schatzker scale tibial plateau fracture repair can have a high complication /failure rate, so physical therapy is no joking matter. You have to do it and do it correctly.

In order to keep your knee joint from freezing up and having significant loss of range of motion, many hospitals will start you on a CPM (continuous passive motion) machine right in the hospital bed. The idea is to get you moving the joint as soon and as much as possible before scar tissue starts to interfere with motion. The CPM machines kind of worked for me, allowing me to maintain a real range of about 48 degrees on the repaired leg. This in contrast to my other leg at 140 degrees.

When I started P.T. in earnest at the 48 degree point, every single movement was a challenge. I was still on crutches, non-weight bearing, with the hinged brace off for the sessions. Just doing simple stretches, then a few leg lifts was enough to have my leg remind me I was alive. (Yeow!) Looking back, it hurt but was absolutely necessary for me to be able to walk again without dragging my leg behind me. It took months, but I'm walking with only a small limp and can move my leg beyond 112 degrees. Not perfect, but I still have the leg.

Yay, Team !

You, your family, your doctors and nurses, and physical therapists all have to work together in order for a successful outcome after a major surgery or surgeries. Communication between everyone is a critical component to avoid relapses, re-injury or more surgeries. If you notice that something isn't working or there are differing opinions on how to proceed in your recovery, stop the show and hash it out. Get up to date information and make informed decisions. It's your body and you have the final say on what to do with it. It's your team and you are allowed to make substitutions where you deem appropriate.

No more sports analogies for now, I promise.




My Trusty Arm & My Shoulder Pain - April, Our New Writer on Hurt.com

Who likes to cook? I do most of the time. I vividly recall four years ago, rushing around in the kitchen to get breakfast on the table for my family. I wanted to make what we all consider a “Sunday” breakfast. Well, since at the time, my son was only one years old, I kept a baby safety gate up at the kitchen entry. I had the most wonderfully cooked breakfast made and ready to serve.

So, I like to believe I am not your average server. No, I am the ‘All mighty super mom super server’ right. I take not one, but two plates, one in each hand. I also have a tall cup of orange juice tucked inside my inner elbow on the right. If you can visualize that, I then attempt to step over the baby gate with two plates and a cup of orange juice in tow. The top of my right foot didn’t quite make it over the baby gate, and so I completely lost my balance. As I destabilized, there was no way for me to break my fall and since I was holding so much, my right shoulder had to break my fall. Ouch! My right shoulder slammed into the ground and the last thing on my mind was how much pain was to come from this injury.

I started to get chronic pain radiating through my right shoulder at night, it was sort of a burning sensation in the beginning. I noticed that my pain would come in waves. The pattern of when my pain would emerge was every few months. Since my pain was so seldom in the beginning, I found myself dismissing it or thinking it would just go away. After a year of having shoulder pain every few months, I noticed the pain occurrence had shifted to every month for a couple days long. I do not recommend ignoring chronic pain, or toughing it out, but that is what I did for the first two years and it was because my pain would come and go.

Mentioning my pain began one year ago at a regular yearly medical check-up with a Family Physician doctor.  I brought up my concerns about my shoulder pain and surprisingly I didn’t get much response regarding a diagnosis. After my yearly medical check-up, I self referred to a Sports Medicine doctor to get an x ray of my shoulder. I remember being so excited when I went to see the Sports Medicine doctor. I thought, finally I am going to get a diagnosis and treatment options. X rays were taken, the doctor then told me that the x ray only shows bone, not tissue damage. So, I was told that nothing was fractured. That was good news to me for starters. However, I was told by this particular physician that the reason my pain would only surface a couple days a month is because of the water retention that women experience. She prescribed me a diuretic to decrease water retention. I chose not to try the diuretic she prescribed to me because I wanted the chance to look into Alternative therapies. I started reading books and doing a little research on Alternative therapies.

I started doing gentle stretches on my arm and shoulder, using smaller weights at the gym and naturally going easy on my arm. Over time, I notice my pain slowly decrease in frequency and duration. I also came across a sample of Tiger Balm, which created a cool, tingly sensation for pain relief. Tiger Balm is a balm made by a Chinese herbalist and is an analgesic remedy for pain relief. I found it to be a good product. Please check with your doctor before using Tiger Balm or any product though. To find out more  information about this product, please visit: www.tigerbalm.com

WHY WRITE ON HURT.COM: I wanted the opportunity to share my experience with pain. I also wanted to share tips from how I dealt with pain. I believe there is more than one way to find pain relief and I believe in getting second opinions. Writing for hurt.com is a chance to share information, solutions, and to discuss the many remedies out there for pain relief. Although, I am highly interested in Alternative medicine, I do recognize the importance of seeing your regular Physician and taking medication as necessary.