What Causes a Tension Headache?

Everyday AZ Pain Centers treats patients suffering from Tension Headaches

The exact cause of tension headaches is still unknown. It has long been believed that they are caused by muscle tension around the head and neck. However although muscle tension may be involved, there are many forms of tension headaches and some scientists now believe there is not one single cause for this type of headache. One of the theories is that the pain may be caused by a malfunctioning pain filter which is located in the brain stem. The view is that the brain misinterprets information, for example from the temporal muscle or other muscles, and interprets this signal as pain.

 

One of the main molecules which is probably involved is serotonin. Evidence for this theory comes from the fact that tension headaches may be successfully treated with certain antidepressants. Another theory says that the main cause for tension type headaches and migraine is teeth clenching which causes a chronic contraction of the temporalis muscle.

Like migraines, tension headaches seem to be more common in women than in men. Unlike migraines, which often make their initial appearance during adolescence, tension headaches usually begin in middle age. As such, their onset often is equated with the development of adult stresses, anxieties and depression that can characterize mid-life. The name “tension headache” therefore can be said to describe a response by the body to emotional strains and pressures, rather than to excessive muscular tightness and resultant constriction of the scalp arteries, as was once widely presumed. In many such cases, researchers have found that patients complaining of frequent headaches, which are generally not migraines, also exhibit varying degrees of depression, anxiety and worry.

Despite these findings, many physicians and researchers still believe strongly that stress-induced muscular tension in the head, neck and shoulders can bring on tension headaches. This is supported by evidence of muscular tenderness in areas of the neck, the base of the skull, scalp, forehead, face, jaw, shoulders or upper arms in many tension-type headache sufferers. Others show signs of pronounced clenching of the teeth, suggesting that problems related to the temporomandibular joint (TMJ) are causative factors, along with cervical disorders, such as arthritis or degenerative disease of the neck and/or spine, leading to chronic muscular contraction.

Tension headaches result from the contraction of neck and scalp muscles. One cause of this muscle contraction is a response to stress, depression or anxiety. Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or use of computers, fine work with the hands, and use of a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position can also trigger this type of headache.

Other causes include eye strain, fatigue, alcohol use, excessive smoking, excessive caffeine use, sinus infection, nasal congestion, overexertion, colds, and influenza. Tension headaches are not associated with structural lesions in the brain.

If you suffer from tension headaches, give us a call and let us help.  Change YOUR Life Today and Call AZ Pain Centers now.  623-889-PAIN.

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December 6, 2010

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Back and Sciatica Pain…WHY???

Sciatic Pain shoots down the leg and causes a sharp pain that worses over time without treatment

If you suffer from chronic back pain or sciatica, there is hope for a pain-free life. Dr. Cecil Graham of AZ Pain Centers says sciatica, a radiating leg pain usually on the back or side of the leg, often originates in the spine of the lower back as a result of disc bulging, disc thinning, stenosis or other degenerative issues which narrow the nerve canals.

“Anything that puts pressure on the nerve itself is going to cause that pain,” Graham explained. “The actual, physical approximation of something touching the nerve … causes an inflammatory response.” For years, steroids have been the usual treatment. “It works, but there are side effects,” Graham said.

Those side effects can be quite serious, even potentially dangerous. That’s why AZ Pain Centers has come up with a unique approach to treating sciatic pain, and it doesn’t involve steroids.

“What we do has no known side effects,” Graham explained. “We use a non-steroidal substance. That way, you can do as many injections as you need over time.”  Graham said the injections are relatively pain-free and do not require any sedation. Doctors use a Dermo Jet to numb the area. “It feels like somebody’s popping you with a rubber band,” he said. “Everything else from the procedure is essentially painless.”

Graham said it’s important for patients to do something sooner rather than later, while the pain is still in the acute phase.

“If you get the acute, shooting pain — the acute sciatica — where the pain is shooting down the hip and leg — if you can get that in the first two to three months … you’ve got over a 95 percent cure rate.”

Give AZ Pain Centers a call and let us help you get rid of that nagging pain.

Watch us on Your Life A to Z as we discuss Back and Sciatica Pain.

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December 3, 2010

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How Common is Chronic Pain

Up to 56 Million American Adults experience chronic pain.  That is 28% of the adult population.

  •  16 million have low back pain
  • 48 million have arthritis—a disease associated with chronic pain
  • 25 million have migraine pain
  • 20 million have jaw and lower-facial pain
  • 4 million have neuropathic pain

Many people have lived with pain for more than 5 years and experience it almost six days/week

Younger people are as likely to experience chronic pain as are older people. One-third of Americans lose 20 hours of sleep a month because of pain.  Chronic pain is a very important public health issue

Total U.S. direct and indirect cost of chronic pain is almost $50 billion per year

  • $4 billion of lost income and productivity, as well as healthcare costs, associated with arthritis pain
  • People with headache pain spend $4 billion on medications according to a 2007 study

Chronic pain is associated with millions of days of lost work

  • 25% of people in industrialized countries lose work because of chronic pain
  • People with low-back pain lose 93 million days of work according to a 2007 study
  • People with headaches and migraine headaches lose 157 million days of work according to a 2007 study

Stop letting chronic pain take control of your life.  Call AZ Pain Centers today and let us help you Get YOUR Life Back.

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December 2, 2010

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Yoga Helps with Fibromyalgia Pain

Studies show that yoga can help decrease the pain associated with Fibromyalgia

Yoga that includes gentle stretching exercises combined with meditation can lessen the symptoms of fibromyalgia, a U.S. study found.

Twenty-five women diagnosed with fibromyalgia, a chronic pain syndrome, took part in a 2-hour weekly yoga class for eight weeks.

At the end of the study, the group reported improvements in both physical and psychological aspects of fibromyalgia, including decreased pain, fatigue, tenderness, anxiety and better sleep and mood, HealthDay reported Thursday.

Fibromyalgia is characterized by multiple tender points, fatigue, insomnia, anxiety, depression, and memory and concentration problems.

The debilitating condition affects some 11 million to 15 million Americans, about 80 percent to 90 percent of them women.

The yoga sessions in the study included 40 minutes of gentle stretching and poses, 25 minutes of meditation, 10 minutes of breathing techniques, a 20-minute lesson on applying yoga principles to daily life and coping with fibromyalgia, HealthDay reported.

We see patients everyday struggling with fibromyalgia pain and recommend combining a yoga practice in association with our treatment to help relieve some of that pain.

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November 29, 2010

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Neck and Shoulder Pain…Get The Answers You Need

AZ Pain Centers can help treat your neck pain

Your neck and shoulders contain muscles, bones, nerves, arteries, and veins, as well as many ligaments and other supporting structures. Many conditions can cause pain in the neck and shoulder area. Some are life-threatening (such as heart attack and major trauma), and others are not so dangerous (such as simple strains or contusions).

The most common cause of shoulder pain and neck pain is injury to the soft tissues including the muscles, tendons, and ligaments within these structures. This can occur from whiplash or other injury to these areas. Degenerative arthritis of the spine in the neck (cervical spine) can pinch nerves that can cause both neck pain and shoulder pain. Degenerative disc disease in the neck (cervical spondylosis) can cause local neck pain. Abnormal conditions involving the spinal cord, heart, lungs, and some abdominal organs also can cause neck and shoulder pain. Here are some examples:

If you have sholder pain, get help from AZ Pain Centers

  • Broken collarbone: Falling on your outstretched arm can cause your collarbone to break. This is particularly common when cyclers fall off of their bicycles.
  • Bursitis: A bursa is a sac over the joints to provide a cushion to the joints and muscles. These bursae can become swollen and painful after injuries.
  • Heart attacks: Although the problem is the heart, heart attacks can cause shoulder or neck pain, known as “referred” pain.
  • Broken shoulder blade: An injury to the shoulder blade usually is associated with relatively forceful trauma.
  • Rotator cuff injuries: The rotator cuff is a group of tendons that support the shoulder. These tendons can be injured during lifting, when playing sports with a lot of throwing, or after repetitive use over a long time.
  • Shoulder or A-C separation: The collarbone (clavicle) and shoulder blade (scapula) are connected by ligaments. With trauma to the shoulder, these ligaments can be stretched or torn.
  • Whiplash injury: Injury to the ligamentous and muscular structures of the neck and shoulder can be caused by sudden acceleration or deceleration, as in a car accident.
  • Tendonitis: The tendons connect the muscles to the bones. With strain, the tendons can become swollen and cause pain. This is also referred to as tendinitis.
  • Gallbladder disease: This can cause a pain referred to the right shoulder.
  • Any cause of inflammation under the diaphragm can also cause referred pain in the shoulder.

Shoulder and Neck Pain Symptoms

 Pain: All pain seems sharp, but pain can also be described as dull, burning, crampy, shocklike, or stabbing. Pain can lead to a stiff neck or shoulder and loss of range of motion. Headache may result. The character of each symptom is important to your doctor because the particular features can be clues to the cause of your pain.

  • Weakness: Weakness can be due to severe pain from muscle or bone movement. The nerves that supply the muscles, however, also could be injured. It is important to distinguish true weakness (muscle or nerve damage) from inability or reluctance to move because of pain or inflammation.
  • Numbness: If the nerves are pinched, bruised, or cut, you may not be able to feel things normally. This may cause a burning sensation, a loss of sensation, or an altered sensation similar to having your arm “fall asleep.”
  • Coolness: A cool arm or hand suggests that the arteries, veins, or both have been injured or blocked. This may mean that not enough blood is getting into the arm.
  • Color changes: A blue or white tinge to the skin of your arm or shoulder is another sign that the arteries or veins could have been injured. Redness can indicate infection or inflammation. Rashes may be noted as well. Bruising may be evident.
  • Swelling: This may be generalized to the whole arm or may be localized over the involved structures (a fracture area or an inflamed bursa, for example). Muscle spasms or tightness may simulate actual swelling. Dislocation or deformity may cause a swollen appearance or, paradoxically, a sunken area.
  • Deformity: A deformity may be present if you have a fracture or a dislocation. Certain ligament tears can cause an abnormal positioning of the bony structures.

If you are experiencing any form of neck or shoulder pain, let the professionals at AZ Pain Centers help relieve your pain.  Give us a call today and get started on your road to recovery.

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November 24, 2010

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Exercise Helps Ease Arthritis Pain and Stiffness

As you consider starting an arthritis exercise program, understand what’s within your limits and what level of exercise is likely to give you results.

Exercise is crucial for people with arthritis. It increases strength and flexibility, reduces joint pain, and helps combat fatigue. Of course, when stiff and painful joints are already bogging you down, the thought of walking around the block or swimming a few laps might make you cringe.

Even moderate exercise can ease your pain and help you maintain a healthy weight. When arthritis threatens to immobilize you, exercise keeps you moving.

Why exercise is vital

Exercise can help you improve your health and fitness without hurting your joints. Along with your current treatment program, exercise can:

  • Strengthen the muscles around your joints
  • Help you maintain bone strength
  • Give you more strength and energy to get through the day
  • Make it easier to get a good night’s sleep
  • Help you control your weight
  • Make you feel better about yourself and improve your sense of well-being

Though you might think exercise will aggravate your joint pain and stiffness, that’s not the case. Lack of exercise actually can make your joints even more painful and stiff. That’s because keeping your muscles and surrounding tissue strong is crucial to maintaining support for your bones. Not exercising weakens those supporting muscles, creating more stress on your joints.

Check with your doctor first

Talk to your doctor about how exercise can fit into your current treatment plan. What types of exercises are best for you depends on your type of arthritis and which joints are involved.

Exercises for arthritis

Exercises that are best for you might include:

Range-of-motion exercises
These exercises relieve stiffness and increase your ability to move your joints through their full range of motion. Range-of-motion exercises involve moving your joints through their normal range of movement, such as raising your arms over your head or rolling your shoulders forward and backward. These exercises can be done daily or at least every other day.

Strengthening exercises
These exercises help you build strong muscles that help support and protect your joints. Weight training is an example of a strengthening exercise that can help you maintain your current muscle strength or increase it. Do your strengthening exercises every other day — but take an extra day off if your joints are painful or if you notice any swelling.

Aerobic exercise
Aerobic or endurance exercises help with your overall fitness. They can improve your cardiovascular health, help you control your weight and give you more stamina. That way you’ll have more energy to get through your day. Examples of low-impact aerobic exercises that are easier on your joints include walking, riding a bike and swimming. Try to work your way up to 20 to 30 minutes of aerobic exercise three times a week. You can split up that time into 10-minute blocks if that’s easier on your joints.

Other activities
Any movement, no matter how small, can help. If a particular workout or activity appeals to you, don’t hesitate to ask your doctor whether it’s right for you. Your doctor might give you the OK to try gentle forms of yoga and tai chi. Tai chi may improve balance and help prevent falls. Be sure to tell your instructor about your condition and avoid positions or movements that can cause pain.

Tips to protect your joints

Start slowly to ease your joints into exercise if you haven’t been active for a while. If you push yourself too hard, you can overwork your muscles. This aggravates your joint pain.

Consider these tips as you get started:

  • Apply heat to the joints you’ll be working before you exercise. Heat can relax your joints and muscles and relieve any pain you have before you begin. Heat treatments — warm towels, hot packs or a shower — should be warm, not painfully hot, and should be applied for about 20 minutes.
  • Move your joints gently at first to warm up. You might begin with range-of-motion exercises for five to 10 minutes before you move on to strengthening or aerobic exercises.
  • Exercise with slow and easy movements. If you start noticing pain, take a break. Sharp pain and pain that is stronger than your usual joint pain might indicate something is wrong. Slow down if you notice inflammation or redness in your joints.

Trust your instincts and don’t exert more energy than you think your joints can handle. Take it easy and slowly work your exercise length and intensity up as you progress.

Don’t overdo it

You might notice some pain after you exercise if you haven’t been active for a while. In general, if your pain lasts longer than two hours after you exercise, you were probably exercising too strenuously. Talk to your doctor about what pain is normal and what pain is a sign of something more serious.

If you have rheumatoid arthritis, ask your doctor if you should exercise during general or local flares. One option is to work through your joint flares by doing only range-of-motion exercises, just to keep your body moving.

Most importantly, keep moving and working through the pain that arthritis can bring.  Following these few steps can help relieve you of the chronic pain you may feel from arthritis.

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November 16, 2010

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What is a facet joint?

Facet joints are located at the posterior (back) aspect of the spine. Each back bone (vertebra) has four facet joints, an upper and a lower pair. These joints link the back of the spine together. They are designed to provide stability and control motion between the vertebrae. There is not a lot of movement at each individual facet joint, however, when all the facet joints are linked together they contribute to a significant amount of movement of the spine and allow complex movements such as bending backwards and rotation of the spine.

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What does facet joint syndrome feel like?

These small joints are prone to injury, deterioration, and inflammation. Facet joint syndrome can occur anywhere in the spine including the low back. Pain arising from the facet joints is usually at the level of the affected facet joint(s), and is made worse by activities that put pressure on these joints i.e. leaning backwards and “extending” the lower back or twisting at the waist. Occasionally the pain may radiate to other areas such as the buttocks.

What causes facet joint syndrome?

There are a number of causes of facet joint syndrome. The facet joints may be irritated from trauma, repetitive movements, or arthritic changes. It is very common to develop degenerative changes in facet joints after trauma to the spine, as a result of an injury to the intervertebral disc or secondary to degenerative disc disease. If the intervertebral disc is damaged and the cushioning effect of the disc is lost, the facet joints at that level will undergo more stress, which may result in degeneration of the facet joint.

Poor posture can also cause undue stress on the facet joints. There is a natural inward curve in the lumbar (low back) section of the spine. In this position, the facet joints in the lumbar section are designed and positioned to handle a certain amount of stress. When the natural curve of the lumbar spine is exaggerated excess stress is placed on the facet joints. Poor body mechanics or how we use our body can also cause problems with the facet joints. Bending from the back, improper lifting, poor rest positions, and prolonged sitting in poorly designed chairs can all cause undo stress on the facet joints.

How is facet joint syndrome diagnosed?

Most cases facet joint syndrome are diagnosed by a good medical history and a physical examination. X-rays of the lower back may help to rule out degenerative changes in the facet joints or degenerative disc disease. Depending on the severity of the problem, further tests such, as MRI and CT scans may also be required. Pain relief after an injection of local anaesthetic into the facet joints is a very accurate diagnostic tool for assessing facet joint irritation.

How is facet joint syndrome treated?

The majority of the time facet joint syndrome is treated without surgery. Treatment may involve hands-on physical therapy (joint mobilization or manipulation), exercise, and education on good spine posture, anti-inflammatory medications, pain medications and activity modification. In some cases these treatments may not be effective and other options such as joint injections (with a steroid) or procedures that block the pain messages from the nerves that surround the affected facet joints may be helpful. Rarely, surgery is required.

Most individuals with facet joint syndrome will recover and return to normal activities. Proper posture, proper body mechanics, and certain exercises should be maintained in order to ensure ongoing back health. Doctors and Physical Therapists that deal with people with facet joint syndrome can help outline an individualized treatment program.

Take care of your body…don’t let your facet joints become a problem.

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November 10, 2010

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Sidelined by Low Back Pain????

Don't let Low Back Pain get a hold of your life. Call AZ Pain Centers for relief.

Patents with subacute low back pain and/or a resulting disability that does not improve after three months are likely to become chronic low back pain sufferers, as are those with higher pain intensity or a higher kinesiophobia score, according to research published in the October issue of The Spine Journal.

If you are like most people, you will have at least one backache in your life. While such pain or discomfort can happen anywhere in your back, the most common area affected is your low back. This is because the low back supports most of your body’s weight.

Low back pain is the number two reason that Americans see their doctor — second only to colds and flus. Many back-related injuries happen at work. But you can change that. There are many things you can do to lower your chances of getting back pain.

You’ll usually first feel back pain just after you lift a heavy object, move suddenly, sit in one position for a long time, or have an injury or accident. But prior to that moment in time, the structures in your back may be losing strength or integrity.

A common misbelief about back pain is that you need to rest and avoid activity for a long time. In fact, bed rest is NOT recommended.

You may want to reduce your activity only for the first couple of days. Then, slowly start your usual activities after that. Do not perform activities that involve heavy lifting or twisting of your back for the first 6 weeks after the pain begins. After 2-3 weeks, you should gradually resume exercise.

  • Begin with light cardiovascular training. Walking, riding a stationary bicycle, and swimming are great examples. Such aerobic activities can help blood flow to your back and promote healing. They also strengthen muscles in your stomach and back.
  • Stretching and strengthening exercises are important in the long run. However, starting these exercises too soon after an injury can make your pain worse. A physical therapist can help you determine when to begin stretching and strengthening exercises and how to do so.

Bottom line, take care of yourself and your back!  Don’t let low back pain sideline you.  If your acute back pain has become a chronic condition, give us a call and let us help you.  We treat patients daily with chronic back pain and see them hunched over when they walk into the office and standing tall, pain free, when they leave.

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November 5, 2010

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Does Age and Gender Play a Role in Pain?

It is now widely believed that pain affects men and women differently. While the sex hormones estrogen and testosterone certainly play a role in this phenomenon, psychology and culture, too, may account at least in part for differences in how men and women receive pain signals. For example, young children may learn to respond to pain based on how they are treated when they experience pain. Some children may be cuddled and comforted, while others may be encouraged to tough it out and to dismiss their pain.

Many investigators are turning their attention to the study of gender differences and pain. Women, many experts now agree, recover more quickly from pain, seek help more quickly for their pain, and are less likely to allow pain to control their lives. They also are more likely to marshal a variety of resources-coping skills, support, and distraction-with which to deal with their pain.

Research in this area is yielding fascinating results. For example, male experimental animals injected with estrogen, a female sex hormone, appear to have a lower tolerance for pain-that is, the addition of estrogen appears to lower the pain threshold. Similarly, the presence of testosterone, a male hormone, appears to elevate tolerance for pain in female mice: the animals are simply able to withstand pain better. Female mice deprived of estrogen during experiments react to stress similarly to male animals. Estrogen, therefore, may act as a sort of pain switch, turning on the ability to recognize pain.

Investigators know that males and females both have strong natural pain-killing systems, but these systems operate differently. For example, a class of painkillers called kappa-opioids is named after one of several opioid receptors to which they bind, the kappa-opioid receptor, and they include the compounds nalbuphine (Nubain) and butorphanol (Stadol). Research suggests that kappa-opioids provide better pain relief in women.

Though not prescribed widely, kappa-opioids are currently used for relief of labor pain and in general work best for short-term pain. Investigators are not certain why kappa-opioids work better in women than men. Is it because a woman’s estrogen makes them work, or because a man’s testosterone prevents them from working? Or is there another explanation, such as differences between men and women in their perception of pain? Continued research may result in a better understanding of how pain affects women differently from men, enabling new and better pain medications to be designed with gender in mind.

To read more on this topic, click here

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October 31, 2010

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Coping with Chronic Pain…What’s the secret?

AZ Pain Centers has successfully treated thousands who suffer from chronic pain

Chronic pain affects people of all ages, races, and occupations. Severe chronic pain is a devastating health problem that affects as many as one in ten Americans (more than 25 million people).

Chronic pain disables more people than cancer or heart disease. It costs the U.S. economy more than $90 billion per year in medical costs, disability payments, and productivity. Yet it has received little attention from medical researchers until recently and is one of the most under funded major health problems in the United States. For every person seeking relief from chronic pain, others are inevitably affected: spouses, parents and children, friends, employers and co-workers. Chronic pain can interfere with every aspect of a person’s life: work, relationships, self-esteem, and emotional well-being. Chronic pain can bring a burden of depression, anxiety, frustration, fatigue, isolation, and lowered self-esteem.  Pain makes it hard to work, hard to play, hard to get support from others, and hard to live a happy life. Chronic pain shatters productive lives.

So what’s the secret to dealing with chronic pain???  Well, isn’t that just the million dollar question???  Dealing with chronic pain is an on-going challenge.  One way to deal with your pain is to get a handle on how bad your pain is on a daily, weekly, and monthly basis. You may be asked “How have you been doing lately” and reply “my pain is out of control”.  That answer may be true for that particular day, but is it true for the past week or month?  Keep track of your pain in a calendar or a journal and don’t be afraid to ask your doctor questions about your pain, your symptoms and how aggressive you can be in treating your pain.  The physicians at AZ Pain Centers are here to help heal your pain.  Whether you are suffering from headaches, back pain, arthritis pain, neck pain, fibromyalgia, myofascial pain, sciatica, carpal tunnel syndrome, pelvic pain, neuropathy and neuralgia pain, phantom limb pain, osteoporosis, lupus (SLE), rheumatoid arthritis, scoliosis, or any other pain –  give us a call today…we can help you!  Change Your Life Today!

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October 21, 2010

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