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Parkinson’s disease






What is the cause? Sometimes the cause of pain is known. In other cases it is difficult to find the cause of the pain. This can be frustrating. While it is normal to want to know the cause of your pain, it is important to remember that your pain can still be treated even if the cause is not known.

There are two types of pain:

· Neuropathic pain – Pain caused by injury to the nerves or to the central nervous system (the brain and spinal cord). Examples include: carpal tunnel syndrome, pain from spinal cord injury, and trigeminal neuralgia, a facial pain syndrome.

· Nociceptive pain – Pain caused by a process in another tissue of the body besides the nervous system. Examples include: low back pain, neck pain, and muscle pain. Pain is the result of a series of transmissions along your peripheral nerves, your spinal cord, and your brain. Your peripheral nerves are the network of nerve fibers that run throughout your body. Attached to these fibers are special nerve endings, or receptors, that can detect an unpleasant stimulus, such as a cut or a burn. These nerve endings are called nociceptors.

The nociceptors send an electrical impulse along the nerve to your spinal cord. The spinal cord acts as a relay center, where the pain signal can be blocked, enhanced, or modified before it is interpreted by the brain.

What are the symptoms? There are hundreds of pain syndromes or disorders. Some involve pain in only one area of the body. Others affect several areas or the whole body. For some people with chronic pain, the pain comes and goes over time. For others, the pain is constant. Some people experience sharp, shock-like pain. Others feel dull aching and cramping.

You are the only one who knows what you are feeling. Pain cannot be seen on an X-ray or measured in a lab test. The better you can describe your pain, the better your doctor will be able to help you. The words you use to describe the pain may help your doctor determine the source and cause of the pain. Here are some words that are often used to describe pain:

· Stinging

· Stabbing

· Penetrating

· Dull

· Throbbing

· Nagging

· Tingling

· Sharp

· Pressing

· Burning

You will also want to tell your doctor how long the pain lasts and how intense it is. Chronic pain can often lead to other problems. These may include depression, sleep disorders, and conditions that result from lack of activity due to pain, such as high blood pressure.

How is it diagnosed? All pain is subjective and can be measured only indirectly. Your description of the type of pain you are having, its location, and duration plays a key role in determining the cause of the pain. Tests can also help find the cause. These may include:

· A physical and neurological examination. This tests functions such as reflexes, sensation, and balance.

· X-rays also provide pictures of the body’s structures.

· Imaging tests, such as magnetic resonance imaging (MRI) and computerized tomography (CT) scans. These provide pictures of the body’s structures and tissues and can show whether there are any abnormal areas.

· Electrodiagnostic procedures, such as electromyography (EMG), nerve conduction studies, and evoked potential studies. EMG can help show which muscles or nerves are affected by pain. Nerve conduction studies and evoked potential studies can show whether there is nerve damage.

What are the treatments? Many people with chronic pain have been told, “There’s nothing we can do, ” or “You just have to live with it.” These statements are not true. There are many treatments for pain. And studies show that people who take an active role in their pain management get the best results. They have less pain and are more active in their lives.

Unfortunately, not everyone’s pain can be eliminated. But everyone’s pain can be managed. The goal of pain management is to improve your ability to function so you can work, go to school, or take part in other daily activities. Chronic pain is often treated by a team of doctors and therapists. This is called a multidisciplinary approach. This approach often works best because pain can involve several areas of the body and because it often occurs with other problems.

The right doctor for you may be your primary care doctor or a specialist who manages your condition. You may want to see a doctor who specializes in pain management. Pain specialists often work in multidisciplinary teams in pain centers or pain clinics. Treatments for chronic pain can include:

· Medication

· Surgery

· Physical therapy and electrical stimulation

· Coping skills, such as counseling and cognitive and behavioral treatments, relaxation training and biofeedback

· Lifestyle changes, such as stress management and exercise

Chronic pain can involve many factors. Successful treatment may take time. For example, you may have both back and neck pain. You may need to treat the back pain first, and then focus on the neck pain. Or, you may have pain and sleep issues. You may need to treat the pain first and then the sleep issues. Even when you and your doctor are focusing on one problem, it may take time to find the treatment or combination of treatments that works best for you. Everyone is different. No one treatment works for everyone.

Just remember that chronic pain is treatable. Some people can eliminate or significantly reduce their pain. For others, the goal is to manage the pain so that they can continue to take part in life and enjoy it.

Prevention. Getting treatment early for any sudden and severe pain is vital. This may reduce your risk of developing chronic pain.

Maintaining good physical and mental health may also help prevent chronic pain. Exercising, eating a balanced diet, getting enough sleep, and reducing your stress level may also help. However, in many cases, chronic pain cannot be prevented.

Migraine. Many strategies can be used to help prevent migraine.

Back pain. Back pain is second only to headache as the most frequent source of pain. Most back pain can be prevented. Even if you’ve injured your back before, you can make changes to help prevent another injury. Taking these steps can keep your back healthy and strong:

· Maintain a healthy weight. This will reduce the stress on your back.

· Exercise. Activities that don’t strain or jar your back can increase your strength and endurance. Walking, swimming, and biking are good low-impact exercise for most people. Increasing the strength in your abdominal and back muscles will help support your back. You can build strength by doing a few simple daily exercises. Ask your doctor to recommend some.

· Use good body mechanics.

To avoid stress and injury to your back, focus on good body mechanics while standing, sitting, lifting, and sleeping. If you must stand for long periods, shift your weight from one foot to the other. Use a small footstool to take some of the load off your back. Choose seating that supports your back. Get up and stretch periodically when sitting for long periods. Let your legs do the work while lifting. Hold the weight close to your body and lift straight up and down. Don’t lift and twist at the same time. Choose a firm mattress. Use pillows for support, but don’t use a pillow that forces your head up at a severe angle.

Living with. Living with chronic pain can be a challenge for you and your family. It is easy to become frustrated. It is important to have realistic expectations. In most cases, there is no quick solution to chronic pain. Many people find that taking an active role in their treatment can be helpful. Talk to your doctor about all of your symptoms and problems, even if you think they may not be related to what’s causing your pain. Treatments and help may be available for many of these problems.

As you work with your doctor on treatment, report on your progress. It may help to keep a pain diary. Jot down the answers to these questions:


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