Texting Can Spell Trouble For Your Neck

With more than 90 percent of American adults and 75 percent of teens carrying mobile phones, texting has become wildly popular—but in ways that don’t bode well for our posture and neck health.

The popularity and mobility of smartphones introduced new verbs into our lexicon. We used to call to communicate; now we text. And since we are carrying our phones with us constantly, we can remain in uninterrupted contact with the world. But the lure of technology has a downside: bending over our phones is taking a toll on the long-term health of our neck and spine.
With the widespread use of smartphones and other wireless technology, spine practices have noticed the emergence of worrisome symptoms that signal spine damage. People have made a habit of looking down at their phones as they use them, and they are using them frequently and for long periods of time. We may not realize how much strain this posture places on our necks. A recent study published in the Surgical Technology International journal reports that when we hold our head erect, our spine bears 10 to 12 pounds of weight to maintain our head’s position. This amount of weight increases as we tilt our head forward. When our head is tilted forward 30 degrees, its weight increases to 30 to 40 pounds. When we tilt our head 60 degrees, we increase the weight to 60 pounds.
The increased stress on our neck is causing neck and shoulder pain and headaches. Over time, “text neck” posture can lead to premature disk degeneration that may put us at higher risk for developing neck arthritis and a permanently hunched back.
The following symptoms could be a warning that you are suffering from text neck:

• Neck pain, soreness, and headaches.
• Upper back pain that begins as an annoyance and gradually becomes more severe.
• Shoulder tightness and pain.
• Pain radiating down your arm and into your hand, caused by a pinched cervical nerve.

You don’t have to give up texting to protect your neck. Prevention is the best defense; practicing posture awareness and keeping your head erect while you use your favorite devices are the easiest ways to prevent neck problems. People with text neck symptoms have responded well to physical therapy and exercises designed to strengthen the muscles that support the neck. And our Summit Orthopedics spine team is here to help make sure that you are able to enjoy all of the benefits of modern communication while protecting spine health and preserving an active, pain-free lifestyle.

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This article provided by  Summit Orthopedics.

This press release was orginally distributed by SBWire
Somerset, NJ -- (SBWIRE) -- 10/31/2016 -- The leading minimally invasive pain management and elimination providers in New Jersey, the University Pain Medicine Center, announced that they now offer top-notch trigger point injections. The practice also explained why treatments as such have been especially lauded by senior citizens and geriatric specialists.

Trigger point injections are meant to combat muscles that fail to relax. When that happens to a person, a trigger point will often arise, resulting in either direct or referred pain. Whereas direct pain affects the specific location in which the issue stems, referred pain occurs when a different part of one's body feels discomfort because of a trigger point somewhere else.

During an injection, a patient's trigger point will be supplied directly with a combination of local anesthetic and various medications via a small needle. The medication will provide long term pain relief, while the anesthetic will work temporarily.

Seniors experiencing chronic pain often benefit enormously from trigger point injections. Anyone with tension headaches, fibromyalgia and myofascial pain syndrome will find relief from the associated pain that comes along with those, and other, conditions.

Best of all, trigger point injections act as effective supplements to overall rehabilitation regimens, and allow many geriatric patients to persevere through their programs without feeling overwhelmed by pain.

The University Pain Medicine Center offers a variety of other treatments beyond trigger point injections, to combat a plethora of conditions. The majority of their procedures are outpatient treatments that involve no recovery time, and are minimally invasive.

To learn more about the University Pain Medicine Center, please visit their website, or call 732-873-6868.

About The University Pain Medicine Center
The University Pain Medicine Center is a medical practice that is committed to helping patients manage their acute and chronic pain or recover from their injuries. In particular, they specialize in using minimally invasive techniques treatment options and procedures to help patients find relief from back, neck, knee, hip, shoulder pain, and much more. Their board-certified physicians work out of five office locations in New Jersey and New York, and those who would like to learn more about the practice, or find the nearest location, are encouraged to visit http://upmcnj.com.
For more information on this press release visit: http://www.sbwire.com/press-releases/university-pain-medicine-center-speaks-of-point-therapy-benefits-among-seniors-733398.htm

Media Relations Contact

Gregory Dyson
Email: Click to Email Gregory Dyson
Web: http://upmcnj.com/


Read more: http://www.digitaljournal.com/pr/3124641#ixzz4OgWLIzrf

Managing pain in the buttocks

Added by Barbados Today on October 15, 2016.
Saved under Column, Health Care

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Pain in the buttock region may not be as common as in other areas of the musculoskeletal system but, in some cases, it can be severe enough to affect sitting, walking or running and negatively affect a person’s quality of life.

The buttock region extends from the iliac crest (the top of the pelvic bones) to the gluteal folds (where the buttock ends and the back of the thigh begins). As with all other areas of the musculoskeletal system, the buttock is made up of bones and joints, ligaments which assist with stability, muscles which allow for movement and nerves which provide power to the muscles and sensation to the skin.

The bones of the buttock region are the pelvic bones and the sacrum and coccyx which form the lower segment of the spine. The sacrum is joined to the pelvic bones on each side at the sacroiliac (SI) joints. The stability of the SI joint is maintained by strong ligaments in the region.

The muscles of the buttock include the three gluteal muscles which are closer to the surface and the deeper muscles which rotate the thigh outwards and help to keep the hip joint stable. The tendons of the hamstring muscles are also attached to the pelvis. The sciatic nerve is a major nerve in the lower limb and this passes through the buttock on the way to the thigh, leg and foot.

Common causes of buttock pain include:

·      SI joint dysfunction

·      Hamstring tendon origin pain

·      Piriformis conditions

·      Referred pain from the lumbar spine

SI joint dysfunction refers to either restricted or excessive mobility of the joint. This causes stress on the surrounding structures. Risk factors for development of this condition include:

·      Muscle imbalance around the hip

·      Leg length discrepancy (one leg longer than the other)

·      Biomechanical abnormalities in the lower limbs

Patients with this condition have buttock pain that feels deep, possibly pain with ascending/descending stairs and tenderness over the joint. The pain can travel down into the thigh in some cases. Pregnant women are at increased risk of SI joint dysfunction as a result of hormones causing the surrounding ligaments to relax.

The hamstrings originate from the ischial tuberosity and this is a possible source of pain. In adults, an injury to the tendon at the origin may occur after an acute tear or as a result of overuse. The severity can range from minor tendon tears to the tendon being torn from the bone.

In adolescents, a similar injury can result in an avulsion fracture (piece of bone being pulled off) if severe. This occurs because the bones are not fully fused in this age group and the tendon is stronger than the bone. An injury at this site results in buttock pain which may extend into the back of the upper thigh, worsening with sitting, standing or attempting to walk.

The piriformis muscle starts at the sacrum and attaches to outer part of the upper femur (thighbone). It rotates the thigh outward and helps to maintain hip joint stability. It can be affected by trauma, overuse in repetitive, vigorous activities such as long-distance running and prolonged sitting.

Conditions affecting this muscle include strain and piriformis syndrome. In the latter condition, other symptoms include numbness, tingling or a burning sensation in the back of the thigh and leg. These symptoms occur as a result of compression of the sciatic nerve by the piriformis, as a result of an enlarged muscle or abnormal path travelled by the nerve.

In some patients, buttock pain is a result of pain referred from the lumbar spine. The source may be the joints in the lower spine or a herniated disc which may be pushing on a nerve root. In such a case, there will also likely be other symptoms such as back pain, numbness, tingling or burning pain in the leg or weakness of the leg. These other symptoms may be made worse by adopting particular postures.

Appropriate management of buttock pain requires a thorough evaluation to diagnose the cause of the pain. This includes a good history and proper physical examination. In some patients, imaging studies such as x-rays, ultrasound or MRI may be required to help confirm the diagnosis.

In patients who have a herniated disc with nerve damage, nerve conduction studies and electromyography will be needed to confirm the presence and severity of the nerve damage.

The rehabilitation specialist possesses the knowledge and skills to accurately diagnose the source of the pain and arrange appropriate treatment. This will usually include physical therapy/therapeutic exercises and pain management using oral or injected medications.

Patients with herniated discs causing nerve compression or patients with severe hamstring injuries may require referral for surgery.

Get evaluated if you have buttock pain that is not resolving so you can start your journey back to optimal physical function.

(Dr Shane Drakes is Specialist in Physical Medicine & Rehabilitation and Sports Medicine.
He can be contacted at sdoptimalfunctioning@gmail.com)

Selenium and zinc vs. chronic myofascial pain

The influence of selenium and zinc intake and concentrations of these minerals in serum and erythrocytes on the risk of chronic myofascial pain were analyzed using logistic regression. We showed an association between the concentration of Zn²⁺ in erythrocytes and pain, after the exclusion of serum and erythrocyte Se_T, serum Zn²⁺ and selenium intake. Hence, in each additional 1 mg of Zn²⁺ per gram of hemoglobin, a reduction of 12.5% was observed in the risk of the individual having chronic myofascial pain (B = -0.133; adjusted OR = 0.875, 95% CI = 0.803 to 0.954, Wald = 9.187, standard error = 0.044, p = 0.002). When the increment of erythrocyte Zn²⁺ (5 μgZn/gHb) was calculated, there was a 48.6% reduction in the risk of myofascial pain (OR = 0.514).

As dry needling moves into physical therapy mainstream, AMA calls for a “standard of practice”

Jun 27 2016 9:00 am

Dry needling is general term for a therapeutic treatment that involves inserting a filament needle into the muscle in the body that produces pain and typically contains a “trigger point.”DAVID QUICK/STAFF

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After a pesky upper hamstring injury stopped me running after the first 100 yards of the Floppin’ Flounder 5K earlier this month, I seized the opportunity to ask a three-time U.S. Olympic Marathon Trials qualifier if she had any suggestions.

Laurie Sturgell Knowles, a 38-year-old mother of two, who ran a 17:04 (beating all but two guys), responded. “Have you tried dry needling?”

David Quick Columnist

Website:http://www.postandcourier.com/david-quick

•  Email
•  @davidquick

That out-of-gate question stumped me. I had “kinda” heard of it, but really knew nothing. And while I’ve always been leery of new, alternative therapies, and even some old ones (I’ve tried chiropractic, but not acupuncture), I figured Knowles knows.

So I bit the needle and gave it a shot, not knowing that I had stumbled onto some news.

Pinpointed acupuncture?

According to the American Physical Therapy Association, the “dry” part of dry needling refers to one that doesn’t include medication. Dry needling is used by physical therapists, where allowed by state law, or other health professionals to treat myofascial injuries or pain by inserting filament needles into trigger points.

The needles target muscular and connective tissues that are more difficult, and often practically impossible, to stimulate blood flow and therefore healing. The therapy is primarily for sufferers of chronic pain and injuries, not athletes.

Dry needling is not acupuncture, which uses the same filament needles in one part of the body to influence the other, distant areas. But it’s probably safe to say that dry needling is a cut-to-the chase version of the ancient Chinese practice, a fusion of acupuncture, acupressure and deep tissue massage.

Despite the differences, the therapy has sparked a turf battle, pitting groups representing acupuncturists against groups representing physical therapists across the nation.

In April, a North Carolina Superior Court judge dismissed a lawsuit filed by the N.C. Acupuncture Licensing Board seeking a declaration that dry needling by physical therapists is “the unlawful practice of acupuncture” and to require the N.C. Board of Physical Therapy Examiners to advise its licensees that dry needling is outside the scope of physical therapist practice.

AMA chimes in

 Enlarge While dry needling is often used on patients suffering from a traumatic injury, such as whiplash, or from chronic or acute pain, athletes such an elite runner Laurie Sturgell Knowles have tapped into the therapy for sports-related injuries. David Quick/Staff

Complicating matters on a national level is the fact that some states allow physical therapists to perform dry needling, while others don’t. And some take just an advisory stance. Case in point, South Carolina allows it, California does not, and New York has made a statement against PTs doing dry needling but does not prohibit it.

Last week, at the American Medical Association’s annual meeting, the group issued an array of policy statements on issues of the day, including the support of a new subspecialty “addiction medicine” to help address the opioid epidemic.

The AMA also called on a standard of practice for dry needling, noting that it is an invasive procedure and that physical therapists, some with as little as 12 hours of training, are increasingly incorporating the therapy into their practices.

“Lax regulation and nonexistent standards surround this invasive practice,” says AMA Board Member Russel W.H. Kridel. “For patients’ safety, practitioners should meet standards required for acupuncturists and physicians.”

Hurts so good

As the bureaucracy sorts itself out, dry needling is gaining fans, including 56-year-old Nancy Hunsicker of Mount Pleasant.

Having had success with acupuncture for nearly a decade, Hunsicker didn’t have any qualms with needles when Michael Goldberg, a physical therapist with Progressive Physical Therapy, suggested she try dry needling to ease the pain of bursitis in her hip.

She had four sessions over eight weeks and considers herself “85 percent pain free.”

 Enlarge The filament needle so long associated with acupuncture contributes to the confusion and conflicts over the therapy known as “trigger point dry needling.” The needle is considered “dry” because it does not contain medication. David Quick/Staff

Elite runner Knowles first tried dry needling in December 2010 for a hip injury and had “amazing results.” Since then, she’s sought out dry needling multiple times for issues with her hamstrings, glutes, back and hip and “maybe calves.”

“The important thing to remember about dry needling is that it does not fix the problems causing the pain, but just helps relieve the pain. You still have to correct whatever is causing the problems, such as a muscle imbalance or tightness,” says Knowles. “But I do think it’s an important recovery tool.’

At her advice and with some guidance from another top local runner, Caitlin Batten, a physical therapist who is not certified in dry needling but performs it on herself, I found my way to Goldberg to deal with my pesky hamstring.

After the obligatory forms and a short consultation, I was on the table getting needles stuck in my right hamstring.

What I didn’t expect was Goldberg shooting some currents of electricity into the needles, which caused some involuntary twitching in my right foot.

Honestly, only two or three of the 10 or so needles inserted hurt to any significant degree. But as a endorphin junkie, I knew my payback was coming. I was able to go to my gym immediately after to lift weights, but took Goldberg’s advice to lay off the legs.

I’ve yet to return to running, but haven’t been deterred from bike commuting, weight lifting (other than lunges, which zinged the hamstring in the first set) and swimming.

As for the cost, I was ready to pay cash, but Goldberg says some insurance plans cover it, so I gave them my car.

If not covered, the evaluation and procedure will likely cost about $150, but I haven’t received the bill yet.

Moving mainstream

Dry needling, as it is practiced today, came into being since Goldberg graduated PT school in 1999. In fact, he didn’t hear about it until 2008, a year before he went for his first-level certification from Colorado-based KinetaCore.

Today, Goldberg says PT students are given a cursory introduction to it, but that it’s considered an “advanced technique.” KinetaCore requires that health professionals, including chiropractors, practice for at least two years before seeking a certification. And in order to get a second-level certification, a health professional must demonstrate that they have treated at least 200 patients with dry needling.

Despite practicing it for seven years, Goldberg says most patients he talked to about it were not familiar with the therapy and ask if it will hurt. Others (like me) seek it out, while a few rule it out, usually because of an aversion to needles.

While dry needling is still relatively new to the mainstream, Goldberg says doctors have been using the technique to stimulate healing for years.

“But doctors don’t get paid to stick needles. They only get paid if they are injecting medications, such as steroids,” says Goldberg. “This takes what’s been done for years but makes it a much more friendly procedure. These needles are so much smaller and the risk is lower and more comfortable than the standard needle.”

Reach David Quick at 937-5516.

10 facts about dry needling to ease pain

AuthorStaff Writer

PublishedJune 07, 2016

Topics

• Fitness
 
• Sports Medicine

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Try Dry Needling

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Picture this recent physical therapy session: A woman comes in with pain so bad around her kneecap that it keeps her from running, an activity she loves.

Her therapist inserts an ultrathin needle into a knotted muscle in her thigh. He gently moves the needle up and down and leaves it to rest while he tries another needle in a different part of the upper leg.

Eventually the muscle relaxes from the procedure called dry needling. Matt Briggs, a physical therapist at The Ohio State University Wexner Medical Center, could tell the resistance had eased because the needle glided through the muscle until it reached bone. “It moves through like butter,” he says.

The patient, Alex Pierce, says she didn’t feel any pain from the dry needling, and the increased muscle function takes pressure off her knees.

Our Sport Medicine physical therapists have the lowdown for you on the practice that people are turning to more and more:

1. It’s called dry needling because the needles don’t deliver an injection or medicine.​
2. The needles are so thin that Briggs can bend them with his finger. They’re not the same needles used to give you a shot.
3. Dry needling goes right to the source of the pain or dysfunction, often making a difference more quickly than other therapies.
4. Therapists approved to perform dry needling require many hours of training and ongoing skill reviews.
5. The procedure is used for all sorts of issues: migraines, tension headaches, chronic conditions and pain in the jaw, neck, low back and shoulder.
6. It’s unclear exactly how needling makes the muscles relax, and that’s one reason Briggs is conducting a study on 150 people with pain around the kneecap, a common condition known as runner’s knee. “Dry needling has been growing in popularity for years for a number of conditions, and while patients often swear by it, we wanted some sort of proof that it works,” Briggs says.
7. People often don’t feel the needles going in, but they sometimes feel an ache or cramp when the muscle relaxes, according to Briggs. “There is a theory that dry needling changes the way nerves and muscles function, and may even change the way our spinal cords help us perceive pain,” he explains. “Those are all things we hope to take a good look at during the study.”
8. It can be used alone, but it’s often combined with other treatments, such as massage, foam rolling, electrical stimulation and strengthening and stretching exercises.
9. People who request dry needling go through a thorough examination to determine if the therapy is right for them.

For Alex Pierce, the runner with kneecap pain, the therapy helped after a couple sessions, going deeper than massage and easing tense leg muscles so she could restrengthen them to support her knees.

“Sometimes I’ll get dry needling and I can feel that pressure go away pretty instantly. Other times I just feel fresher when I run. It feels like there’s less effort; it’s almost as if all my muscles get to help, instead of just a couple.”

If you're interested in trying dry needling or have runner's knee and would like to join the study, give our Sports Medicine physical therapy office a call at 614-293-3600.

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• Monday, May 16, 2016

  NYT Editorial Includes Wider Use of Physical Therapy Among Strategies to Battle Opioid Epidemic

  
  The editorial board of The New York Times (NYT) says that Congress has "snapped to attention" and produced a "flurry of legislation" aimed at battling the opioid abuse epidemic, but warns that the efforts need to be backed up by appropriate funding for prevention and treatment—including the use of physical therapy as an alternative approach to addressing pain.
  "The House last week passed 18 bills related to opioids, and the Senate approved a comprehensive bill in March," the NYT states in a May 16 editorial. "The question now is whether Congress will appropriate enough money to address the scale of the problem."
  In addition to pressing for more federal funding for treatment programs, the editorial also calls for greater attention to prevention strategies related to pain treatment, specifically mentioning physical therapy as a nondrug treatment that should be easier for consumers to access and pay for through insurance.
  "States, which have more sway over doctors and hospitals, need to do more on the prevention side by placing limits on opioid prescriptions," according to the editorial. "States can encourage doctors to order alternative pain treatments, like physical therapy, and require insurers to cover those services."
  The editorial's position is consistent with recent guidelines from the US Centers for Disease Control and Prevention and the National Institutes of Health, which have both pressed for the use of nonopioid treatments, including physical therapy, as a first-line approach to chronic pain.
  "Congress may be late to wake up to the epidemic, but it does at last seem prepared to open more paths to treatment," the editorial concludes.

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    Thursday, May 05, 2016

  Court Dismisses Lawsuit Filed by NC Acupuncture Licensing Board

  
  Advocates for North Carolina physical therapists (PTs) have scored a victory by way of a superior court, which dismissed a lawsuit brought by the North Carolina Acupuncture Licensing Board (NCALB) against the North Carolina Board of Physical Therapy Examiners (NCBPTE), several PTs, and a physical therapy practice over the issue of dry needling by PTs.
  In September 2015, NCALB filed the lawsuit against NCBPTE, asking the Wake County Superior Court to declare that dry needling by PTs is the unlawful practice of acupuncture, and to require NCBPTE to advise its licensees that dry needling is outside the scope of physical therapist practice. The acupuncture board also asked the court authorize it to send cease and desist letters to PTs who practice dry needling and to sue the PTs who refuse to comply.
  On April 26, Judge Louis Bledsoe III dismissed the suit largely on jurisdictional grounds. "There is no reason to stop North Carolina patients from receiving dry-needling treatment," said North Carolina Physical Therapy Association (NCPTA) President C. David Edwards, PT, DPT, CCCE, in a statement posted to the NCPTA website. "This is especially true when the ones who are trying to eliminate dry needling are doing it to protect their power in the marketplace."
  The dismissal of NCALB’s case against the PT board is not the end of the fight over dry needling in the state. A second lawsuit filed in early October challenging NCALB’s efforts to prevent PTs from engaging in dry needling is still pending in US District Court. That lawsuit, supported by NCPTA, argues that NCALB is violating antitrust law and due process rights in its actions to prevent PTs from practicing the skilled intervention.
  The plaintiffs in the case, titled Henry v North Carolina Acupuncture Licensing Board, filed their lawsuit against NCALB after several years of efforts by the acupuncture board to shut down dry needling by physical therapists. NCALB engaged in various actions to prevent PTs from performing dry needling, including the issuing of "cease and desist" letters to PTs and clinics across the state claiming that the PTs practicing dry needling were illegally engaged in the practice of acupuncture, a Class 1 misdemeanor.
  The Henry lawsuit has legal support in a 2015 decision by the US Supreme Court holding that state licensing boards controlled by market participants, such as NCALB, are not exempt from antitrust claims unless their conduct is actively supervised by the state. The NCPTA lawsuit is the first in the country to bring this type of antitrust violation claim on behalf of PTs since the Supreme Court decision.
  NCPTA set up a "Go Fund Me" page to help fundraising efforts. APTA is working collaboratively with the chapter, and is providing support as NCPTA pursues the legal action.
  Dry needling has been discussed in several states, most of which have included the intervention as part of the PT scope of practice. APTA has created a webpage with resources on the topic, and the association's Learning Center offers courses on dry needling and clinical decision-making and background evidence for dry needling.

Thought this was great to pass along.  A bit on the dramatic side of Dry Needling... But it does work!!!!!

LOOK: James Harrison willingly stuck dozens of sharp needles in his leg

By John Breech | CBSSports.com

March 25, 2016 9:01 pm ET

Steelers linebacker James Harrison has spent most of his offseason trying to figure out if wants to play another year.

The problem for Harrison is that he's just not sure his 37-year-old body can make it through another punishing NFL season.

Harrison's still trying to recuperate from last season and apparently, part of that recuperation involves sticking dozens of needles in his legs, as you can see below.

(Via Harrison's Instagram)

Although that looks like acupuncture, it's not exactly acupuncture.

According to Harrison, it's "dry needling."

If you've never heard of dry needling, join the club. According to our friends at the American Physical Therapy association, dry needling "is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments."

Sounds like fun. You probably shouldn't do that to yourself at home though.

Anyway, dry needling isn't the only thing Harrison does to prepare his body for possibly playing another season. He has does normal things, like lifting weights.

Harrison hasn't decided if he's going to play in 2016, and it doesn't sound like Steelers coach Mike Tomlin is going to ask him to rush his decision.

"James is not going to shortchange himself," Tomlin said at the NFL owners meetings this week, via ESPN.com. "James is not going to shortchange the game of football. I believe him when he says he's going through a process to see his overall readiness and potential effectiveness. He knows what he's doing. He;s been doing it a long time. He knows whether or not his body can do what he needs it to do. I respect that mentality."

After one or two or 100 more dry needling sessions, Harrison will probably make up his mind about 2016.

James Harrison loves his dry needling. (USATSI)

Topics: James Harrison, Pittsburgh Steelers, NFL

Sleep is so very important when dealing with pain management !

Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says

Posted on March 25, 2016 in Fibromyalgia with 4 Comments

A new study published in the Clinical Journal of Pain concludes that people with fibromyalgia have difficulty maintaining continuous sleep as compared to patients with primary insomnia and patients who do not report disturbed sleep.
“This post hoc analysis demonstrates that the nature of sleep disturbance among patients with fibromyalgia reporting difficulty with sleep can be distinguished from patients with primary insomnia and from controls,” the study’s authors wrote.
“We demonstrate that despite comparable wake time during the night (WASO), fibromyalgia patients can be differentiated from patients with primary insomnia and from controls without sleep difficulties, on the basis of frequency and duration of wake or sleep bout episodes.”
The researchers studied 132 people with fibromyalgia (FM) who have difficulty sleeping, 109 people with primary insomnia (PI), and 52 people without sleep disturbance. FM and PI patients were preselected to meet the sleep disturbance criteria.
People with fibromyalgia and primary insomnia had decreased total sleep time and slow-wave sleep (SWS), and increased latency to persistent sleep (LPS) and wake time after sleep onset (WASO) versus controls (P<0.05 for each). People with fibromyalgia had shorter, but more frequent wake bouts versus people with primary insomnia.  Both groups had shorter sleep bout duration versus controls
“We feel these characteristics, in addition to broadening our understanding of the sleep disturbances in these populations, may have relevance in terms of the pathophysiology of the sleep disturbance as well as differential treatment practices for physicians evaluating and managing disrupted sleep in patients with fibromyalgia or those with primary insomnia,” the authors wrote.
The authors concluded, “That sleep in FM is characterized by an inability to maintain continuous sleep but a greater sleep drive compared with PI.”

New guidelines helping local doctors to avoid opioid over prescribing


By: Nicole Johnson - Email

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FARGO, N.D. (Valley News Live) - New guidelines for doctors after the CDC reports too many people have become addicted to painkillers.
It's a problem we have seen in our area, and nationally. Opioid over prescribing is a key driver in drug overdose deaths, according to the CDC.
It released voluntary guidelines for primary care doctors, saying go slow, and use less. 40 people overdose on painkillers every day in the United States, and almost 2 million are addicted.
"I would like to say that physicians have had nothing to do with it, but I think we have,” says Sanford's Chief Medical Officer, Dr. Douglas Griffin.
He says the CDC's new recommendations will give more backbone to the fight they have already begun. "This is a difficult position for primary care physicians because people are in pain and they are hurting and you know they have issues these are very tough patients to take care of," says Dr. Griffin.
He says years ago they were encouraged to be liberal with pain medication, which has left patients in a vicious cycle. "They need to have those conversations with their doctor and then look for other alternatives, there are many other medications that can be used," says Dr. Griffin.
Other alternatives, like dry needling. It’s a fairly new practice that's gaining attention. "Basically we are finding an area that seems tight and we are looking for the muscle to twitch a little bit,” says Physical Therapist Drew Zimmerman.
He says people who suffer from chronic pain respond very well to dry needling, saying it could help break a cycle of dependency on medication. "Don't give up, there are lots of different methods out there, there are lots of different practitioners,” says Zimmerman. “Sometimes things get missed just because it doesn't work with one person or one treatment, don't give up."
While the CDC's new guidelines are simply suggestions to doctors, "I think it will make an impact," says Dr. Griffin. He hopes it will create change in this community.

I know sometimes this seems to foreign or hard to do but it just takes practice.!

Mindfulness Meditation Delivers Opioid-Free Pain Relief, Study Says

Posted on March 17, 2016 in Alternative Pain Therapy, Other with 8 Comments

Researchers at the Wake Forest Baptist Medical Center published a study that looked into whether meditation uses natural opioids to reduce pain.
The study, led by author, Fadel Zeidan, Ph.D., assistant professor of neurobiology and anatomy found that mindfulness meditation does not employ the endogenous opioid system to reduce pain.
“Our finding was surprising and could be important for the millions of chronic pain sufferers who are seeking a fast-acting, non-opiate-based therapy to alleviate their pain,” said Dr. Zeidan.
The researchers injected study participants with either naloxone, which chemically blocks opioid receptors, or a saline placebo.

In this randomized, double-blinded study, 78 healthy, pain-free volunteers were divided into four groups for the four-day (20 minutes per day) trial.  The groups consisted of:

• meditation plus naloxone
• non-meditation control plus naloxone
• meditation plus saline placebo
• non-meditation control plus saline placebo.

A thermal probe was used to induce pain by heating a small area of the skin to 102.2 degrees, which is considered very painful by most people.  The participants then rated their pain using a sliding scale.
The authors concluded that pain ratings were reduced 24% from the baseline measurement for the group using meditation and naloxone.  They noted that this is important because the opioid receptors were chemically blocked, while significantly reducing pain.  Pain was also reduced by 21% in the meditation and saline placebo group.
The non-meditation control groups reported increases in pain regardless of whether they got the naloxone or placebo-saline injection.
“Our team has demonstrated across four separate studies that meditation, after a short training period, can reduce experimentally induced pain,” Zeidan said.  “And now this study shows that meditation doesn’t work through the body’s opioid system.”
“This study adds to the growing body of evidence that something unique is happening with how meditation reduces pain.  These findings are especially significant to those who have built up a tolerance to opiate-based drugs and are looking for a non-addictive way to reduce their pain.”
Zeidan’s team hopes to determine how mindfulness meditation can affect a wide range of chronic pain conditions.
“At the very least, we believe that meditation could be used in conjunction with other traditional drug therapies to enhance pain relief without it producing the addictive side effects and other consequences that may arise from opiate drugs,” he said"

Now is a good time to consider safer methods of pain management.  Physical Therapy is such a choice. Please read the following new guidelines coming out this week.

CDC Issues New Guidelines for Opioid Prescribing — Physician’s First Watch

MEDICAL NEWS | 

PHYSICIAN'S FIRST WATCH

March 16, 2016

CDC Issues New Guidelines for Opioid Prescribing

By Kelly Young

Edited by Lorenzo Di Francesco, MD, FACP, FHM

The CDC has issued 12 new recommendations for clinicians prescribing opioids for pain outside of cancer treatment or palliative care. The full guideline is published in MMWR.

Among the recommendations:

• For chronic pain, the first choices of treatment should be nonpharmacologic or nonopioid. Opioids should be an option only if the expected pain and function benefits outweigh the potential risks.
• Patients starting opioids should be prescribed immediate-release opioids at the lowest effective dose, not extended-release/long-acting opioids.
• Individual benefits and risks should be reassessed when increasing the dosage to 50 morphine milligram equivalents (MME) or more per day. Dosages of 90 MME or more should be avoided, or clinicians should "carefully justify a decision" to increase the dosage to that level.
• For acute pain, an opioid prescription for 3 days or fewer will often be enough. More than 1 week is rarely needed.
• Clinicians should regularly evaluate risk factors for opioid-related harms (e.g., history of overdose or substance use disorder) and consider offering naloxone to high-risk patients.
• Concurrent prescriptions of opioids and benzodiazepines should be avoided.

Interesting reading !