Chronic Pain and Depression

Stress, disappointments, feelings of inadequacy are all common at this time of year and can lead to or add to depressions which are not uncommon this time of the year.   Feelings of depression can be more intense and disabling if accompanied by chronic pain.

Our friends at the American Chiropractic Association put together some information for recognizing and dealing with chronic pain.

Depression is thought to be 3 to 4 times more common in people with chronic pain than in the general population. In addition, 30 to 80% of people with chronic pain will have some type of depression. The combination of chronic pain and depression is often associated with greater disability than either depression or chronic pain alone.

Signs and Symptoms

Some of the common signs and symptoms of chronic pain include:

• Pain beyond 6 months after an injury
• Allodynia—pain from stimuli which are not normally painful and/or pain that occurs other than in the stimulated area
• Hyperpathia—increased pain from stimuli that are normally painful
• Hypersensation—being overly sensitive to pain

Signs of major clinical depression will occur daily for 2 weeks or more, and often include many of the following:

• A predominant feeling of sadness; feeling blue, hopeless, or irritable, often with crying spells
• Changes in appetite or weight (loss or gain) and/or sleep (too much or too little
• Poor concentration or memory
• Feeling restless or fatigued
• Loss of interest or pleasure in usual activities, including sex
• Feeling of worthlessness and/or guilt

What is the treatment for chronic pain and depression?

The first step in coping with chronic pain is to determine its cause, if possible and addressing the problem.  Consult with your doctor of chirpractic, they are very knowledgeable and effective in helping control many types of chronic pains.  Aside from that:

• Stay active and do not avoid activities that cause pain simply because they cause pain. The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.
• Relaxation training, hypnosis, biofeedback, and guided imagery, can help you cope with chronic pain. Cognitive therapy can also help patients recognize destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.
• Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and dissociation (detaching yourself from the chronic pain) can be useful.
• Involving your family with your recovery may be quite helpful, according to recent scientific evidence.
   
   Stay well, be safe and enjoy the Holiday season with friends and family.
   
  For your better health,
  Dr. Heller
  
  
   
   

What is Sciatica

Sciatica is actually a symptom of another ailment.

Many people who hear the term, "sciatica," think of a painful condition or ailment. Not so. Sciatica is actually only a symptom of a condition or ailment. Those who have experienced it describe it as pain that starts in the lower spine and radiates to the buttock and down into the back of the leg, from the thigh through the calf. The pain can range from mild to excruciating and may be accompanied by muscle weakness or numbness in the leg or a feeling of "pins and needles" in the toes or foot of the affected leg.

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Fun in the Summertime Sun

In case you haven’t noticed, the summer weather is upon us and with it the risk of heat exposure as the humidity and heat indexes send the temps into the danger zone. 

According to the Centers for Disease Control, excessive heat caused the deaths of 8,015 people between 1979 and 2003, the last year for which statistics are available. This tally was higher than those who lost their lives from hurricanes, lightning, floods, and earthquakes combined.

According to the American Heart Association, heart attack deaths peak not only in the winter, but in the heat of summer as well.

Overheating of the body can result in hyperthermia, a condition in which the body’s core becomes overheated.  Coupled with dehydration, this condition can result in an electrolyte imbalance and, as a result, people can go into cardiogenic shock. 

In cardiogenic shock, the heart becomes suddenly weak and cannot pump enough blood to the rest of body. “This can cause a multi-organ failure that can trigger a heart attack or sudden cardiac death,”  according to Dr. Crandall, chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach Gardens, Fla. 

One of the biggest dangers of hot temperatures is dehydration. This loss in body fluid can also result in the life-threatening heartbeat irregularity known as atrial fibrillation.

Another danger is that extreme heat causes the blood vessels to widen, as the body attempts to rush blood to the surface in an attempt to cool down. This is especially dangerous for people who take common medications such as blood pressure drugs.  Many of these drugs increase the risk fainting in the heat.

Heat exhaustion, over heating of the body,  is strongly related to the heat index, which is a measurement of how hot you feel when the effects of relative humidity and air temperature are combined. A relative humidity of 60% or more hampers sweat evaporation, which hinders your body's ability to cool itself.

The risk of heat-related illness dramatically increases when the heat index climbs to 90 degrees or more. So it's important -- especially during heat waves -- to pay attention to the reported heat index, and also to remember that the heat index is even higher when you are standing in full sunshine.

There are a number of factors that can make an individual more susceptible to heat exhaustion.  They include:

Age. Infants and children up to age 4, and adults over age 65, are particularly vulnerable because they adjust to heat more slowly than other people.

Health conditions. These include heart, lung, or kidney disease, obesity or underweight, high blood pressure, diabetes, mental illness, sickle cell trait, alcoholism, sunburn, and any conditions that cause fever.

Medications. These include diuretics, sedatives, tranquilizers, stimulants, some heart and blood pressure medications, and medications for psychiatric conditions.

The most common signs and symptoms of heat exhaustion include:

• confusion
• dark-colored urine (which indicates dehydration)
• dizziness
• fainting
• fatigue
• headache
• muscle cramps
• nausea
• pale skin
• profuse sweating
• rapid heartbeat

Cramping is usually among the first symptoms. Cramps usually occur in the arms, legs and stomach. If untreated, heat exhaustion occurs next, resulting in any number of symptoms from the above list.  If these symptoms are not addressed, the condition can progress to life-threatening heat stroke. 

One of the most important things to recognize about heat stroke, and other heat-related problems, is that for the most part these problems are avoidable with a bit of attention and common sense. 

Tips for being safe in hot weather: 

• Wear light fitting breathable clothing.

• Make sure you are well hydrated. Drink one to three cups of water before heading outside, and then continue drinking water at 20-minute intervals, even if you are not aware that you are thirsty.

• If you are on high blood pressure or heart medications, remember that you may feel the effects of heat more keenly and take extra precautions. Also ask your doctor if they need adjusting.

• Wear well-ventilated shoes and socks.

• Wear a wide-brimmed hat.

• Caffeinated drinks pull water out of the body so avoid them or drink them very sparingly.

• When walking or exercising in the heat; stick to shady areas when possible.

• Avoid the sun between noon and 3 p.m., when it’s the most intense.

• Make sure you protect your pets from the heat as well. 

So keep yourself safe as you enjoy the summer weather.