Living in Pain
Pain has been defined by the International Association for the Study of Pain (IASP) as “An unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage, or both.”Pain is inherently subjective, therefore patient self report is the only way to assess the problem for relevant diagnosis or management. Ideally, the description of the pain should characterize its severity, topography, quality and factors that re–emit or relieve it.
Pain Intensity
Measuring pain severity is essential and may have important therapeutic implications. Pain can be measured validly and reliably using simple scales or instruments. For chronic pain, setting a time frame may be useful, such as the past week or the past month, and then obtaining separate measurements for pain in general, pain at its worst, and pain at its least. The descriptions used by patients to describe the quality of the pain are considered to diagnose the underlying pathology.
Pain that appears to be sustained by ongoing activation of pain–sensitive nerves, or nociceptive pains, are generally described as familiar by patients. If the injured tissue is somatic, such as bone, the pain is often described as aching or throbbing, and sometimes stabbing. If injury is to skin, then it is often described as burning. If the injured tissue is visceral, the pain often varies with the structures involved and is described as cramping or gnawing pain pattern and is referred to common cutaneous sites. Damage to other visceral tissues, such as mesentery, is associated with pain that is described as aching, stabbing, or throbbing.
Why Pain Management?
Have you ever asked yourself, “Why do I need another doctor for pain management?” Many people
with chronic pain have seen multiple specialists from neurologists, orthopedics therapists to psychologists. They continue to suffer and do not know what to do. There are many reasons why they should see a pain specialist. First, you need to understand the specific reason for your pain, then more focused and individualized treatment can be implemented. This evaluation is as important as all other tests. (MRI, X–ray, etc.). Reassurance and re–evaluating treatment may be necessary. Lastly, if nothing can be done medically, you should begin to live with your pain under pain specialists’ guidance and continue to maintain your physical and medical condition to the best of your capacity.Chronic pain is not a choice but suffering is. What is the scope of pain management?
Pain management includes different modalities and treatments such as medication therapy, injections or nerve blocks, physical therapy and reactivation, psychotherapy, biofeedback, acupuncture, and other implantable devices. Pain Centers usually offer more than one type of treatment. You may be referred for one specific treatment such as nerve block only.
different areas of the sacroliac joint which is located at the lower base of the spine. If the patient feels relieved from specific injections, problematic areas along this joint of the spinal cord become more recognizable. If the patient feels mild to no relief from specific injections, the doctor will concentrate on other possibilities of pain causation. SI's offer temporary relief of pain but may result in longterm diagnosis of pain management.
. Keep in mind that doctors see a lot of patients. You must place emphasis on your most important issues and symptoms. Some doctors have a habit of honing in on key words you mention and making quick diagnoses. It's important that your doctor listen to your specific problems and develop a few different resolutions. By following these simple practices, you will be able to find a great doctor who can lead you to the road to recovery.
rates reach new highs and stress levels climb, it is no wonder more and more people are presenting with this condition. Even prior to the recession, TTH was the most common type of headache experienced by adults affecting 10-65% of the population. The impact on daily living by TTH is significant as it disrupts daily activities, quality of life, and work. These types of headaches, according to the International Headache Society (HIS), can last from 30 minutes to 7 days, do not include nausea/vomiting but may include increased sensitivity to light or noise (rarely both at the same time). The most common frequency is less than 15 TTH's/month. 
Medication has been the primary medical form of treatment and some patients require the regular use of certain medications, even when headaches are not present - - as in some cases, it's too late to start meds once the headache starts. In these cases, Amitriptyline has been the most frequently prescribed medication and it's considered the drug of choice for TTH. Chiropractic spinal manipulation (CSM) has been reported to be helpful in a number of prior studies. One reported equal benefit as Amitriptyline with 6 weeks of treatment.
This study is important as CSM by itself was found to be at least as (if not more) effective than Amitriptyline alone, which is the medication of choice for TTH. Hence, if CSM or Amitriptyline alone are not found to be satisfying, the combination of the two is strongly supported by this study. 
much better they felt so I decided to try it.
and hand. He indicated that several areas were putting pressure on the nerve that goes into the hand and the pinch was not just at the wrist but higher up in my neck, shoulder and forearm. He said if I wasn't at least 50% better in 4 weeks, we would talk about other tests and treatment options and investigate it further. He worked on my neck, shoulder, elbow, forearm and hand, using manipulations and other methods to loosen it up. He said the nerve was getting pinched by the muscles working too fast and not getting enough rest. He gave me exercises to do several times a day at work to stretch the forearm muscles and had me continue the use of the brace at night. He also taught me how to ice massage the wrist for 5 minutes until it got numb, several times a day and he recommended I use vitamin B6, 50mg, three times a day. After the 3rd week, I started to notice a decrease in the intensity, frequency and duration of numbness and weakness. He had me fill out a Carpal Tunnel Questionnaire and my score improved a lot after the first 4 weeks. He said he may have to evaluate my workstation and make some modifications, if possible. He asked me a lot about the position of my wrist and hand when I work and didn't seem to like the type of screw driver I was using. He called my boss and asked if a different type of screw driver with a power source and a pistol shaped handle could be tried and it was arranged. That seemed to really make a difference."
treatments prior to proceeding to surgery.
LBP is also a significant public health problem in older adults ranging between 13% and 49% with "...soaring costs in terms of health care expenditures." So, what about care for the elderly - is chiropractic care equally safe and effective in this older population as it is in younger patients? 
shown by choosing our services. We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and look forward in serving you and your family presently and, in the future. 
sure what just happened as it all happened so fast. Is this a dream? 
late. He said, "...I couldn't have been moving more than 5-10 mph when I hit you!" You ask, "how could this possibly feel so.....hard an impact? Was he lying to me?" There certainly wasn't much damage to your car...maybe he was right??? When he asked you if you would, "...let it go," and not call the police, you almost agree, but something stops you. Even though there is little car damage and, "...he is a nice guy....," you just don't feel right in, "...letting it go." 
about the details of the accident but piece together the best you can the events of the evening. They take x-rays, recommend some Advil and ice, and tell you to contact your primary care physician if you have problems. They tell you that you're going to hurt for a few days and "...that 's normal." However, over the next several days, pain intensifies to a point where neck and headache pain is constant, you can't sleep, your memory seems blurry, you can't seem to concentrate and loose your place during thought and conversation....something is REALLY WRONG! 
That's because crushing metal absorbs the energy of the force (ie, "plastic deformity) and if the speed is "...too low" and little metal crushing/energy absorption occurs, the G-forces that occurred during the collision are transferred to the contents inside the vehicle and that force can be significantly greater than a crash that occurs at 2-4 times the 5-10 mph speed. In general, when there is less damage to the car, be alert that the force exerted on the contents is greater than when car damage occurs. This is why when cars crash during a car race, the race car basically falls apart, leaving the driver enclosed in a cage that prevents bodily damage, and they often walk away from the accident. 
