Health and Pain Mind

Transcutaneous electrical nerve stimulation (TENS) is a method of applying a gentle electric current to the skin to relieve pain. Studies have shown that it can be effective in certain cases of chronic pain.

A small box-shaped device, which patients can put in their pocket or hang on their belt, transmits electrical impulses through wires to electrodes taped to the skin in the painful area. Patients describe the sensation of TENS as buzzing, tingling or tapping.

The patient should experiment with the placement of the electrodes and the timing, intensity, amplitude and frequency of the electrical current to find the most effective setting. Pain relief usually lasts beyond the period when current is applied. TENS can become less effective at relieving pain over time.

TENS is usually safe and well tolerated. However, it is not recommended on inflamed, infected or otherwise unhealthy skin, over a pregnant uterus (except for obstetric pain relief), or in the presence of a cardiac pacemaker.

Many people with cancer experience pain. Thirty to 40 percent of patients in active cancer therapy and 70 to 90 percent of patients with advanced cancer report pain.

Cancer pain can be caused by:

	Tumors pressing on organs, nerves or bone
	Treatment such as surgery, chemotherapy or radiation
	Other conditions related to the cancer, such as stiffness from inactivity, muscle spasms, constipation and bedsores
	Conditions unrelated to the cancer, such as arthritis or migraine

In most cases, cancer pain can be controlled through relatively simple means. Doctors usually use medications, which are prescribed according to a plan that was first described by the World Health Organization and is called the Analgesic Ladder approach to cancer pain management.

Other ways to alleviate cancer pain include:

	Surgery, radiation or chemotherapy to shrink tumors causing pain
	Antibiotic therapy or drainage for pain caused by infection
	Psychological therapies, and social and spiritual support, to influence the perception of pain
	Other pain treatments

Beth Israel Medical Center, a major cancer care provider in New York City, has hundreds of cancer specialists in its network including top-rated surgeons, medical oncologists, physicians, radiation oncologists, radiologists, and oncology nurses.

Following are the definitions for terms commonly used in the diagnosis and treatment of arthritis.

Analgesic: Pain relief medication.

Arthralgia: Pain in the joints.

Arthritis: Inflammation of the joints. There are more than 100 kinds of arthritis.

Autoimmune: A process by which a person’s immune system attacks the body’s own tissues. Rheumatoid arthritis is an autoimmune disease.

Bacteria: Microscopic, one-celled organisms.

Cartilage: Firm, whitish substance at the ends of bones. It acts as the body’s “shock absorbers.”

Collagen: Substance making up the body’s connective tissues.? It gives cartilage its “bounce.”

Corticosteroid: Powerful steroid medication that reduces inflammation.

Glucosamine: An amino sugar occurring in vertebrate tissues including that of marine creatures, from which it’s harvested.

Glucosamine sulfate: A form of glucosamine that has been shown to reduce arthritis pain and rebuild damaged joints.

Gout: A painful inflammation primarily of the big toe, characterized by an excess of uric acid in the blood that leads to crystalline deposits in the small joints.

Ligament: A band of strong connective tissue that connects bones and holds organs in place.

Osteoarthritis: A type of arthritis in which cartilage wears out and joints become stiff and painful.

Prostaglandins: Hormone-like substances that play a part in inflammation.

Proteoglycans: Mortar-like substances made from protein and sugar that are the building blocks of cartilage.

Rheumatoid arthritis: A major form of the disease in which the body’s immune system attacks joints, causing hot, painful swelling and deformity.

Seeking help and advocating for yourself are the first steps to treating your pain. Your physician’s goals in treating you are to reduce your pain, improve your physical functioning, reduce your psychological distress and improve your overall quality of life.11 There are many different ways to treat depression and anxiety related to pain. Your physician may suggest one or more of the following therapies to reduce your psychological distress:

• medication,
• cognitive-behavioral therapy,
• stress management (eg, relaxation techniques, hypnosis, biofeedback),
• supportive counseling, and
• family counseling.12

It’s important to remember that being depressed is not a sign of personal weakness—depression and anxiety are related to chemical imbalances in your brain.13 Depressive and anxiety disorders are illnesses that can be treated. Taking medication and going to therapy to treat your depression is the same as taking antibiotics to treat an infection—the necessary steps you take to get better.

It’s also important to keep in mind that not every medication or therapy works immediately or even works in every person. Medications used to treat depression often take up to six weeks to be effective. If you and your physician decide a particular therapy isn’t effective for you, you may need to try different medications or different combinations of therapies to find the right ones for you. Try not to become frustrated or give up—you and your physician need to work together to achieve results.

Counseling and behavioral therapy—alone or combined with medication—are effective and important techniques in treating depression and pain.14 They also require your active participation in your care and recovery. Following are some suggestions for actively participating in your care and helping you and your physician work together to treat your pain and your depression:

• Keep a diary and record changes in your pain and emotions. Visit the My Pain section of http://www.nationalpainfoundation.org keep pain journal online. You can print it out and bring it with you to your doctors’ appointments to remind yourself of how you were feeling and when you were feeling better or worse.
• Identify a support network. Support persons could include family members, friends, support groups. The National Pain Foundation’s My Community area is an online support group for persons in pain.
• Educate yourself through books, reputable Web sites, and organizations.
• Set realistic treatment goals.
• Stay active—with your doctor’s advice and approval, begin an exercise program, try yoga, or other stretching activities.
• Try the stress management techniques you learn in counseling and use them regularly. Guided imagery, hypnosis, biofeedback, and relaxation techniques really can work if you work at using them.

Depression is an illness, and ignoring it will not make it go away. Seek the treatment you need to get better and be involved in your care—

Chronic pain affects all aspects of life. It affects your quality of life as it limits your physical functioning, your ability to perform activities of daily living, and your ability to work. It has social consequences for your marital and family relationships, it may limit intimacy with your partner, and it may prevent interaction with friends. Chronic pain has societal consequences in terms of increased health care costs, increased disability costs, and lost productivity that is a consequence of missed workdays.

Given the pervasiveness of pain, it’s no wonder that chronic pain affects your psychological well-being as well.3 Research indicates that as number and severity of a patient’s physical symptoms increase, the number and severity of psychological complaints increase.4 In other words, the more places you feel pain and the more severe the pain, the more likely you are to have a depression or problems such as difficulty sleeping or anxiety and the more severe these symptoms are. Some of the signs and symptoms related to depression reported by chronic pain patients treated at pain clinics include:

• physical deconditioning,
• sleep disturbance,
• reduced sexual activities,
• family stress,
• work issues,
• legal issues,
• financial concerns,
• decreased self-esteem,
• fear of injury, and
• altered mood, including irritability, anxiety, and depression.5

Why do pain and depression co-exist so often? Scientists have been studying this relationship through neurosciences and epidemiology and have made important discoveries. First of all, both depression and the suffering of pain are located in the same area of the brain.6 Second, the same chemical messengers are involved in regulating pain and mood.7 What are the mechanisms that affect these parts of the brain and these chemical systems? We find that depression runs in families, so that the stress of having pain may trigger the chemical changes in the brain leading to depression in persons who may be vulnerable because of a family tendency (genetic) to depressive illness. More commonly, however, a person has no family vulnerability to depression, but may get “worn down” by all the stress, losses and problems encountered by having pain over many months.8 Either way, this “wearing down” is biochemical, such that certain important chemicals (similar to vitamins) that are responsible for regulating both pain and mood appear to be functionally depleted. This is why the same medications that are helpful in depression may also effectively treat pain, because they enhance the pain and mood regulating effects of these chemical systems in your brain.

Approximately 40% to 60% of patients being treated at pain clinics report experiencing symptoms of depression.9 Unfortunately, people experiencing pain do not always receive the treatment they need to combat their depression and their pain, especially if they do not see physicians with the training and background to treat both together (eg, pain medicine specialists, psychiatrists, or primary care physicians with this training). Given the nature of today’s health care system, most Americans receive mental health care by visiting their primary care physician, but research studies indicate that 50% of patients who are clinically depressed are not diagnosed by their primary care physicians.10 So be on the lookout for depression in yourself and loved ones and seek treatment before the negative effects occur.

Pain and depression are inexorably linked in a complex way. Pain causes depression—depression causes pain. About 30% of patients with persistent pain conditions suffer from clinical depression related to their pain, and almost all persons will experience some mood changes. 75% of patients with clinical depression present to their doctors because of physical symptoms, including pain.1 People in pain who have symptoms of depression experience more impairment associated with pain than those who do not have depressive symptoms.2

To successfully treat your chronic pain, you and your physician need to examine the emotional factors that may influence your pain level and physical disability. One of the first steps to treating pain is recognizing that depression often accompanies pain and that increases in pain or widespread pain (ie, pain in many areas of your body) can be a symptom of depression. Understanding this aspect of your pain experience may help you identify your own symptoms and seek the care you need to lessen your pain.

Pain so often is accompanied by loss—loss of function, loss of employment, loss of money, loss of friends and relationships to name just a few—it’s no wonder that people in chronic pain have an increased incidence of depression, anxiety, and sleep disturbances. It is natural to feel emotions ranging from fear, anger, denial, disappointment, guilt, and loneliness to hope and optimism. Every person reacts differently to pain at different times, which can make relationships and pain control difficult. The effect emotions and psychosocial well being have on pain cannot be ignored as emotions have a direct effect on your health. Taking care of the emotional aspects of chronic pain is necessary to treat your overall pain condition.

 minimally conscious state (MCS) is different than a persistent vegetative state (PVS), which involves wakefulness without awareness of self or surroundings. MCS patients do show some evidence of awareness of self and their surroundings.

“Increased understanding of the neural processing that can take place in the absence of the conscious awareness, and the patterns of neural activity that are associated with volitional action and conscious experience will undoubtedly shed light on the mechanistic differences among the highly heterogeneous, but functionally restricted, population of patients with disorders of consciousness,” Dr. John Whyte, of the Moss Rehabilitation Research Institute in Elkins Park, Pa., wrote in an accompanying comment.

For more information, Please check

http://www.nlm.nih.gov/medlineplus/news/fullstory_70160.html

Pain is the most common reason people visit their doctor. Pain may be sharp or dull, intermittent or constant, or throbbing or steady. Sometimes pain is very difficult to describe. Pain may be felt at a single site or over a large area. The intensity of pain can vary from mild to intolerable.

People differ remarkably in their ability to tolerate pain. One person cannot tolerate the pain of a small cut or bruise, but another person can tolerate pain caused by a major accident or knife wound with little complaint. The ability to withstand pain varies according to mood, personality, and circumstance. In a moment of excitement during an athletic match, an athlete may not notice a severe bruise but is likely to be very aware of the pain after the match, particularly if the team lost.