Sinusitis Home Remedies : Herbal Remedies and Diet for Sinusitis

Complementary Medicine

Sinusitis Home Remedies : Herbal Remedies and Diet for Sinusitis

Sinusitis Home Remedies is a topic that has been gaining popularity in recent years as people are looking for natural and effective ways to alleviate their symptoms. Sinusitis is a common condition that occurs when the sinuses become inflamed or infected, causing symptoms such as facial pain, pressure, congestion, and headache. While conventional treatments like antibiotics and decongestants can provide relief, they often come with unwanted side effects. This is where herbal remedies and diet come into play as a natural and safe alternative for treating sinusitis. In this article, we will explore the latest research on how herbal remedies and diet can help alleviate the symptoms of sinusitis and promote healing.

Eucalyptus oil

 

Eucalyptus oil has been used for centuries in traditional medicine for its antiviral and antimicrobial properties. It is also an excellent expectorant and decongestant, which makes it effective in treating sinusitis. Recent studies have shown that inhaling eucalyptus oil can reduce inflammation and swelling in the sinuses, making it easier to breathe. The oil can be used by adding a few drops to a bowl of hot water and inhaling the steam or by adding it to a diffuser. Eucalyptus oil can also be applied topically by mixing a few drops with a carrier oil and massaging it onto the chest, neck, and temples to relieve sinus pressure.

 

Peppermint oil

 

Peppermint oil is another effective herbal remedy for treating sinusitis. It contains menthol, which has a cooling effect that can relieve sinus congestion and headaches. Inhaling peppermint oil can also clear the sinuses and improve breathing. Peppermint oil can be used by adding a few drops to a bowl of hot water and inhaling the steam or by adding it to a diffuser. The oil can also be applied topically by mixing a few drops with a carrier oil and massaging it onto the chest, neck, and temples.

Garlic

 

Garlic has been used for centuries for its antimicrobial and anti-inflammatory properties. It contains a compound called allicin, which has been shown to have antiviral, antibacterial, and antifungal properties. These properties make garlic an effective remedy for sinusitis caused by bacteria or viruses. Garlic can be eaten raw or cooked, or taken as a supplement. It can also be used as a nasal spray by mixing crushed garlic with warm water and using a dropper to apply it to the nostrils.

 

Ginger

 

Ginger is a popular herb that has been used for centuries in traditional medicine for its anti-inflammatory and antimicrobial properties. It contains a compound called gingerol, which has been shown to have powerful anti-inflammatory effects. Ginger can help reduce sinus inflammation and relieve congestion by increasing blood circulation and warming up the body. Ginger can be consumed as a tea or added to food. It can also be applied topically by mixing ginger essential oil with a carrier oil and massaging it onto the chest, neck, and temples.

 

Turmeric

 

Turmeric is a spice that has been used for centuries in traditional medicine for its anti-inflammatory and antioxidant properties. It contains a compound called curcumin, which has been shown to have powerful anti-inflammatory effects. Turmeric can help reduce inflammation in the sinuses and relieve sinus pressure. It can be consumed as a spice in food or taken as a supplement.

 

III. Diet for Sinusitis

Diet for Sinusitis: Foods to Avoid, Foods to Eat, and Hydration

 

Sinusitis, an inflammation of the sinuses, can cause discomfort and difficulty in breathing. While medications can help relieve symptoms, a healthy diet can also play a significant role in managing sinusitis. In this section, we will discuss the foods to avoid, foods to eat, and the importance of hydration in managing sinusitis.

 

Foods to Avoid:

 

Some foods can trigger sinusitis symptoms, making them best avoided or limited. For instance, spicy foods like peppers, horseradish, and hot sauce can irritate the nasal passages and aggravate the condition. Similarly, alcohol, caffeine, and sugary beverages like soda can dehydrate the body, leading to thick mucus buildup, which can worsen sinusitis.

 

Foods rich in histamines like aged cheese, red wine, and cured meats can also trigger sinusitis symptoms. Histamines cause inflammation in the body, leading to nasal congestion, runny nose, and other symptoms. Additionally, processed foods, refined carbohydrates, and fried foods can weaken the immune system and promote inflammation, leading to worsening sinusitis symptoms.

Foods to Eat:

 

While avoiding certain foods can help manage sinusitis, incorporating certain foods into the diet can help relieve symptoms and promote healing. Foods rich in vitamin C, such as oranges, strawberries, and kiwi, can help boost the immune system and reduce inflammation, helping the body fight off sinus infections.

 

Omega-3 fatty acids

Omega-3 fatty acids found in fish like salmon, mackerel, and tuna, as well as nuts and seeds, can also help reduce inflammation and alleviate sinusitis symptoms. Similarly, garlic and onions, which contain antibacterial and antiviral properties, can help fight off infections and reduce inflammation.

 

Probiotic-rich foods like yogurt and kefir can also help manage sinusitis. Probiotics promote a healthy balance of bacteria in the gut, which can boost the immune system and reduce inflammation.

Hydration:

 

Staying hydrated is essential for managing sinusitis as it helps thin out mucus, making it easier to drain from the sinuses. Drinking plenty of water, herbal teas, and clear broths can help keep the body hydrated, flushing out toxins and promoting healing.

 

Additionally, using a humidifier or spending time in a steamy shower can help alleviate sinusitis symptoms. The warm, moist air helps moisturize the nasal passages, reducing inflammation and promoting healing.

 

In conclusion, diet and hydration play an essential role in managing sinusitis symptoms. Avoiding foods that can trigger symptoms and incorporating anti-inflammatory, immune-boosting foods into the diet can help reduce inflammation and alleviate symptoms. Similarly, staying hydrated and using a humidifier or spending time in a steamy shower can also promote healing and relieve sinusitis symptoms. If symptoms persist or worsen, it is essential to consult a healthcare provider to determine the best course of treatment.

 

IV. Other Natural Remedies for Sinusitis

Other Natural Remedies for Sinusitis: Nasal Irrigation, Steam Inhalation, and Acupuncture

 

In addition to diet and hydration, there are several natural remedies that can help manage sinusitis symptoms. In this section, we will discuss nasal irrigation, steam inhalation, and acupuncture.

 

Nasal Irrigation:

 

Nasal irrigation, also known as nasal flushing, involves flushing out the sinuses with a saline solution. It helps remove mucus, bacteria, and other irritants from the nasal passages, reducing inflammation and promoting healing. Nasal irrigation can be done using a neti pot, squeeze bottle, or nasal spray.

 

Studies have shown that nasal irrigation can be an effective treatment for sinusitis. In one study, researchers found that daily nasal irrigation reduced the duration and severity of sinusitis symptoms and improved quality of life in patients with chronic sinusitis.

Steam Inhalation:

 

Steam inhalation involves inhaling steam to moisturize the nasal passages and relieve congestion. It can be done using a bowl of hot water, a steam inhaler, or a humidifier. Adding essential oils like eucalyptus or peppermint can also help open up the nasal passages and relieve sinusitis symptoms.

 

Studies have shown that steam inhalation can help relieve symptoms of acute sinusitis. In one study, researchers found that steam inhalation twice a day for two weeks improved nasal symptoms and reduced the need for medication in patients with acute sinusitis.

 

Acupuncture:

 

Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to promote healing and balance. It has been used for centuries to treat a wide range of health conditions, including sinusitis.

 

Studies have shown that acupuncture can be an effective treatment for sinusitis. In one study, researchers found that acupuncture reduced the severity and duration of sinusitis symptoms and improved quality of life in patients with chronic sinusitis.

 

While more research is needed to determine the effectiveness of these natural remedies, they can be a safe and effective way to manage sinusitis symptoms. If you are interested in trying any of these natural remedies, it is essential to consult a healthcare provider first to ensure they are safe and appropriate for your individual needs.

 

In conclusion, nasal irrigation, steam inhalation, and acupuncture are natural remedies that can help manage sinusitis symptoms. Nasal irrigation can help remove mucus and irritants from the nasal passages, while steam inhalation can moisturize the nasal passages and relieve congestion. Acupuncture can promote healing and balance in the body. While more research is needed, these natural remedies can be a safe and effective way to manage sinusitis symptoms. As always, it is essential to consult a healthcare provider before trying any new treatment.

 

V. When to Seek Medical Treatment:

 

It is recommended to seek medical treatment if you experience severe or persistent sinusitis symptoms, such as severe headaches, fever, facial swelling, or vision changes. Additionally, if you have a weakened immune system or underlying medical conditions that increase your risk of complications, it is important to seek medical treatment promptly.

 

VI. Conclusion

Sinusitis is a common condition that can cause discomfort and interfere with daily activities. While medical treatment is often necessary, herbal remedies and diet can be effective complementary therapies. Some of the herbal remedies include eucalyptus, ginger, and turmeric, which have anti-inflammatory and antimicrobial properties. Additionally, a healthy diet rich in fruits, vegetables, and lean proteins can help reduce inflammation and boost the immune system.

 

It is important to note that while these remedies are generally safe, precautions must be taken to avoid potential side effects, interactions with medications, and overdose. Allergies to certain herbs and spices should also be considered before using them as a remedy.

 

In addition to these natural remedies, maintaining a healthy lifestyle is crucial for managing sinusitis. This includes staying hydrated, getting enough rest, and managing stress. Avoiding smoking and exposure to environmental irritants can also help alleviate symptoms.

 

While natural remedies and lifestyle changes can be effective, it is important to consult a healthcare professional before starting any new treatment, particularly if symptoms are severe or persistent. They can provide guidance on the best course of action and monitor for any potential side effects.


Acupuncture Benefits : How it can Improve Your Health

Complementary Medicine

Acupuncture Benefits : How it can Improve Your Health

Acupuncture is a treatment modality in which thin needles are inserted into the various parts of the body. Acupuncture is a key component of Traditional Chinese Medicine. The roots of acupuncture reach deep into ancient China as far back as 2,500 years ago.  There are many styles of acupuncture, each one of them based on slightly different philosophies and techniques, depending on the country's origin. In the United States, Traditional Chinese Acupuncture is probably the most widely practiced system. Although Acupuncture is most often used for pain relief, it is also used for a wide range of other conditions since it is a complete medical system focused on correcting imbalances of energy flow in the body.

What is Acupuncture used for?

 

Acupuncture has been used traditionally to prevent, diagnose and treat disease, as well as to improve overall health. The benefits of acupuncture can extend to a wide variety of conditions.

 

It has been used for the treatment of emotional disorders such as anxiety and depression, as well as digestive complaints including nausea, vomiting, and irritable bowel syndrome. Acupuncture has been used effectively for pain syndromes due to an injury or associated with chronic degenerative diseases such as rheumatoid arthritis.

 

Research has supported the use of acupuncture in the treatment of neurological problems like migraines or Parkinson’s disease, but also as a rehabilitation strategy for individuals who suffered a stroke. Many patients also find relief from conditions such as sinusitis, seasonal allergies or a variety of gynecologic disorders.

 

Acupuncture as part of an overall treatment protocol, has also proved beneficial for reducing fatigue and for promoting overall well-being. Despite all of these potential benefits of acupuncture, in US acupuncture has been used most extensively for the treatment of skeletomuscular disorders and pain management.

How does acupuncture work?

 

The traditional explanation for acupuncture’s effectiveness lies in harmonizing the flow of energy throughout the body. This energy is also known as Qi.

 

According to the ancient Chinese philosophy, for the body to be healthy and to function at its full potential, the Qi has to flow unobstructed. When obstructions in the body form as a result of poor lifestyle choices, improper diet or myriad of other conditions, the flow of Qi becomes obstructed.

 

One can imagine a mountain stream being obstructed by debris. New paths to the flow of the stream have to be created. This leaves, however, everything in the immediate vicinity behind the blockage deprived of the water.

Removing the debris restores the flow and supply of the water. Likewise, inserting needles into specific predetermined acupuncture points around the body is said to restore the natural flow of Qi and health in the affected parts of the body.

 

To this day, however, there is no scientific consensus that this is actually how acupuncture works.  In the United States and many other western countries, acupuncture has been used primarily for pain relief, rather than its traditional role of balancing energy flow to address a wide range of disorders. Much of the research has been therefore focused on explaining the analgesic effect of acupuncture.

 

The rise of acupuncture popularity in the US

 

The first time that Acupuncture gained the attention of the mainstream media was when a senior reporter for The New York Times James Reston reported on his experience with acupuncture while visiting China in preparation for President Nixon’s visit.

 

He experienced the benefit of acupuncture at first hand as part of the recovery process from developing paralytic ileus post appendectomy. Teams of US physicians set for China in hopes of exploring its potential for surgical analgesia.

 

While they eventually concluded that acupuncture was not reliable as a sole analgesic, their reports stimulated a number of research studies, particularly in treating pain. Acupuncture finally gained a certain amount of respectability in the USA after the positive conclusions of an NIH consensus conference (NIH Consensus Development Panel 1998).

 

Dry needling or acupuncture ? 

 

Many patients undergoing physical therapy may be familiar with Dry needling which is also known as "trigger point dry needling". Dry needling uses the same needles that are used for acupuncture, however dry needling is used mainly to treat myofascial trigger points.

 

There is ongoing argument among Acupuncturists and other medical professionals using dry needling whether dry needling is adapted from acupuncture or if dry needling is a variation of trigger point injections. While both therapies can be very beneficial for the right patient, it is important to understand that Dry needling is not the same as Acupuncture.   For more information on dry needling please click the tab “dry Needling".


Back Strain: Accelerate Your Recovery with These Tips

Musculoskeletal Health with Dr D. 

Back Strain: Treatment Guidelines for Back Strain

Most back strains do not require specific treatment, because they usually recover spontaneously in relatively short period of time. There are, however, certain strategies that may help you recover faster and make the process less painful. For full list of detailed recommendations on optimizing your recovery process please follow this link.

Mobility: swimming and walking

One of the most important things to keep in mind, is that during the acute phase, it is of outmost importance to stay mobile. While short term bed rest may help to relieve some of the pain initially, staying in the bed more than 24-48 hrs leads to worse outcomes and prolongs the recovery time.

While becoming more mobile is important, you will need to initially modify your daily routine to avoid high impact activities, lifting heavy objects and twisting movements. The best way start increasing physical activity is walking for few minutes several times a day and eventually transitioning to recreational swimming in a slow pace. Swimming is excellent exercise for recovery from back injuries. It’s weightless nature eliminates gravity and pressure on the spine and takes the muscles and joints through full range of motion. Both activities will keep the muscles engaged without additional strain, and get them slowly ready for more physically demanding exercises.

Heat

Heat plays important role in the treatment of back pain. It improves local blood circulation which enables the injured tissue to heal faster while decreasing muscle stiffness and pain. Applying heat to the painful area after the initial 48 hrs from the onset of the injury also helps with stretching. Additionally, heat reduces pain and makes movement easier when getting out of the bed in the morning. Heating pad should not be applied directly on the skin. While it can be used  several times a day, it should never be applied for longer than 20 minutes at a time. Never sleep on your heating pad!!

Stretching, Massage and Acupuncture

Gentle stretching of the back muscles after using heating pad is important to slowly start elongating the tight muscles. Never push beyond the level of gentle stretch. If stretching is painful, you need to pull back. Gentle massage around the painful area can be very relaxing and soothing. You do not need to spend money on massage therapist, but if you can afford it, this might be a good time to splurge on couple sessions. Getting a simple massage from your partner at least once a day for the first few days can be equally if not more effective. Alternately, you can try self-acupressure using a tennis ball while leaning against the wall and finding the tender spots in your back. Both massage and acupressure help to promote local blood circulation and loosen up the tight muscles which results in increased mobility and less pain. If acupuncture is available to you, getting few treatment sessions can be very helpful to promote relaxation of the tight muscles, increase local blood circulation and decrease pain. For more information about acupuncture please follow this link.

The role of pain medication

While pain medication will not help you to recover faster, they can help to make the process more bearable. Motrin, naproxen or Alleve can be used in mild to moderate pain, to take the edge off the pain. Stronger pain medication, prescribed by your provider, may be necessary when pain is more severe.

 

Goals for pain management

It is very important to understand, that complete pain relief is neither realistic, nor the goal of pain medication or any treatment modality discussed in this article. Pain is a protective mechanism. It makes us start paying attention to our body and prevents us from causing further damage. Additionally, there is no single best remedy. Patience in combination with several treatment strategies placed in the context of a comprehensive treatment protocol, has been shown to lead to the best and fastest recovery.

 

To learn more about complementary therapies, visit National Center for Complementary and Integrative Health


Acute Pain Management: A Guide to Complementary Therapies

Complementary Medicine

Acute Pain Management: A Guide to Complementary Therapies

Increasing number of patients do not wish to take any pain medication when they develop acute pain from fear of side effect.  There is an ongoing battle and numerous initiatives to fight the opioid crisis around the world. It is also true that every medication carries a risk of side effects.

 

Complementary medicine such as acupuncture, massage, yoga and meditation has been used to ease the pain and treat acute and chronic injuries long before contemporary medicine became the standard of care. The question arises, should we shy away from conventional pain medication for controlling acute pain and focus primarily on complementary modalities, because they are generally safer and mostly free of side effects?

 

In this post I will try to present unbiased view of  both sides and attempt to come up with the answer that I have found in my practice most successful.

Conventional medicine and acute pain

Conventional pain medication maintains a bad rap in minds of many people. This is especially true for those who are more in tuned with their body and look for complementary medicine as the primary treatment option for their daily maladies.

 

While managing daily aches and pains with stretching, massage, yoga or acupuncture is definitely very reasonable and preferred option, situation slightly changes in case of intense acute pain.

 

It is important to understand that there is a role for pain medication when it comes to severe pain. Getting your pain under control as soon as possible will prevent altering the way your brain deals with pain.

 

Any uncontrolled pain lasting longer than several days can sensitize your brain to pain and lower your pain threshold. This ultimately translates to experiencing pain from similar injury in the future at much lower level than before.

Complementary medicine and acute pain

Complementary medical modalities have been used successfully for management of pain and injuries for hundreds of years. Many of them have been extensively studied and their effectiveness proven in rigorous trials.

 

Despite their popularity, however, their primary role is generally seen in management of chronic conditions. This is largely because their main mechanism of action, by which they help to promote recovery, is through stimulating body’s own healing processes and pain control.

 

In other words, their primary role is to restore the body homeostasis. The subtle changes they produce over time are sufficient to create a noticeable difference when treating chronic pain or injuries.

 

It is, however, usually not enough to promote lasting pain relief in severe acute pain. But that doesn’t mean these modalities cannot be used successfully even in cases of significantly severe pain.

 

There are many practitioners who are quite skillful and capable to accomplish “miraculous” results. This author has treated successfully many patients with significant amount of acute pain in his own private practice with acupuncture and herbal medicine.

 

The problem with using modalities such as acupuncture for treatment of severe acute pain, becomes with the access to these skillful practitioners and the associated cost. In case of acupuncture, it takes years of experience, and additional training in treatment of musculoskeletal injuries to treat patients with severe acute pain, to achieve reliable results.

 

When seeing an acupuncturist for treatment of chronic conditions, weekly sessions are generally sufficient to achieve great results. This is, however, not true in case of significant acute pain.

 

To successfully treat an acute pain, the practitioner will need to see the patient generally up to three times a week for the first two weeks and usually will also prescribe an herbal formula. At the average cost of $70 -$100 per office visit, this can easily add up to $300 - $400 a week x 2.

 

This also does not account for the travel time to and from the office and lost work. Compared to a small co-pay for an office visit with a primary care provider and pain medication if the patient has a medical insurance, this becomes a significant financial burden that majority of patients cannot afford. Just because it is possible, doesn’t therefore mean that it is always feasible and the right thing to do.

Conventional medicine and acute pain

Conventional pain medication works in completely different way. When taking pain medication, the goal is not to restore the body’s homeostasis, or to support the body in its own ability to take care of the pain. The pain medications are designed for one and only purpose. To suppress the pain as fast as possible and as much as possible.

 

There are many different classes of pain medication and they all work in slightly different way. Some of them can be purchased over the counter to suppress mild to moderate pain, but for the severe pain, it is usually necessary to see a medical provider who can write a prescription.

 

While opioid medications are the most powerful tools that we have in our pain arsenal, there are other options which are not classified as opioids, and which your provider can prescribe to control your acute pain.

 

It should be therefore clear, that prescribing pain medication for severe pain, does not necessarily equal prescription for opioids, if that is something that the patient does not feel comfortable with. It is however noteworthy, that taking seven to ten day course of opioid medication is usually sufficient to get even the most severe pain under better control. Different class of pain medication can be prescribed after the initial seven to ten day course of opioid medication, to provide sufficient pain relief.

 

This short course of opioid pain medication is rarely causing any more side effects then some drowsiness and sleepiness. Most individuals with acute severe pain prefer to take this medication only at night when pain becomes more intense, because all the daily distractions are taken away by the silent night.

 

Opioid pain medication is therefore particularly helpful to take before sleep to ease the severe pain and allow for better sleep. To keep the dose of the strong opioid medication as low as possible, the provider usually prescribes one or two other pain medication that work through different mechanism and add to the total pain relieving effect.

Eclectic Approach

An eclectic approach to pain management is in this author’s opinion the best. In the eclectic approach, the patient uses combination of several modalities which complement each other to achieve the best result.

 

Combining one or several complementary modalities such as acupuncture, acupressure, massage, yoga, breathing exercises and meditation along with pain medication, will have much greater effectiveness than using any of them as a standalone modality.

 

This combined approach takes the best from both worlds so to speak. The complementary medical modalities slowly work on helping the body recover faster, while pain medication helps to control the acute pain and allows the patient to focus on the recovery process.

 

Getting sufficient amount of sleep, staying physically active and following an anti-inflammatory diet will further maximize the healing. For more details on how to optimize your recovery process follow this link.

 

To learn more about complementary therapies, visit National Center for Complementary and Integrative Health


Facet Joint Syndrome: A Silent Cause of Chronic Pain

Medicine Corner with Dr D 

Facet Joint Syndrome

Back pain can be caused by degenerative changes and inflammation in the facet joints which is commonly referred to as a Facet Joint Syndrome. The spine is made up of individual vertebral bodies which are stacked one on top of another. On each side of the vertebral bodies are tiny joints called facet joints. Their primary role is to allow the spine to move and make twisting and bending movements. They also keep the individual vertebras from moving too far forward or twisting without limits.  Most facet joint-related pain is seen among individuals over the age of 60 secondary to osteoarthritis. It is, however, not uncommon for younger very active individuals to experience the same pain after engaging for several years in exercises that put lots of stress on the facet joints.

Symptoms

When the facet joints become inflamed because of injury or arthritis, they will generate pain. Acute presentation of facet joint pain may resemble those caused by a herniated disc and at this stage it may be difficult to differentiate between these two. In most case the individual can pinpoint the area of pain indicating involved facet joint. At time, however, the person may experience diffused poorly localized pain in the lower back, hips, and buttocks on both sides. Most patients presenting with pain due to facet joint inflammation have difficulty bending backward which may help to establish the diagnosis. In some cases, the facet joint pain may project pain down to the legs and mimic the sciatic pain. Unlike sciatica, where the pain may project all the way down to the feet, facet joint pain usually terminates at the level of the knees. Only in rare cases the pain may project all the way down to the feet. This is usually seen when osteophyte is causing pressure on the nerve root.

Causes

The major cause for the development of facet joint syndrome appears to be osteoarthritis of the facet joints. Osteoarthritis is generally a consequence of wear and tear. It is characterized by narrowing of joint spaces, loss of joint cartilage and local joint inflammation. This process is similar to the more familiar knee osteoarthritis which is a well-known cause of knee pain among the elderly population. It has been shown that younger individuals suffering from facet joint syndrome tend to have history of strenuous jobs prior to the age of 20 which puts them at high risk for early osteoarthritis of the facet joints.

Diagnosis & Treatment guidelines

Inflammation of the facet joints is generally not well diagnosed by MRI or X-Rays. There is also a poor correlation between the findings on the images, physical exam by the provider and the symptoms that the patient experiences. In most cases injection of an anesthetic medication into the vicinity of the painful facet joint can help to make the diagnosis. If the patient experiences immediate pain relief after the injection, the condition can be diagnosed as facet joint syndrome and steroid injections can then be administered to decrease the local inflammation. The steroid injections are usually administered by pain specialists under fluoroscopy which helps to guide the needle placement. The patient may receive these injections every 3-6 months based on the duration of symptoms relief.

Acupuncture treatment can also be beneficial since needling the musculature in the affected area can improve local blood circulation and decrease the inflammation and muscle tension. Referral to physical therapy to learn appropriate core strengthening and stretching exercise is important in long term management and prevention of further exacerbation.

Avoiding activities that put undue stress on the spine is as important, if not the most important aspect of any long term management of facet joint syndrome. No treatment will be effective if these perpetuating factors are not effectively addressed and appropriate modifications incorporated into daily lifestyle.


Chronic Back Pain: Treatment Options for Chronic Back Pain

Treatment Options for Chronic Back Pain

Chronic back pain continues to be one of the most common musculoskeletal complains seen in primary care.  It is estimated that the incidents of chronic back pain will continue to rise given our increasingly more sedentary lifestyle. While research in the areas of pain management and safer surgical procedures continues, both should be viewed as the last resort.

Cure or management of chronic back pain?

When discussing the treatment of chronic back pain, it is important to understand, that there is no reliable “cure” for chronic back pain. That is not to say that once an individual develops chronic back pain, they will have to suffer from the pain for the rest of their life. In fact, most chronic back pain can be successfully managed, to allow the individual to live a normal productive life. It should be understood, however, that the nature of chronic back pain is fluctuating periods of no pain or only minimal discomfort with periods of severe worsening of back pain. These fluctuations generally correspond to the demands of daily life.  It is usually not possible to completely avoid the periods of more intense back pain. The frequency and the severity of these episodes can be, however, controlled to a large extent. Conscientious adherence to daily routine which includes specific exercises, stretching and self-acupressure, along with minimizing the exposure to activities that pose undue stress on the back, has been shown to significantly reduce the episodes of worsening back pain.

 

Common treatment modalities

Numerous treatment options have been developed for the treatment of back pain. They range from conservative noninvasive options, which can be applied by an individual at home, to more invasive treatments requiring a visit to a health care provider. In extreme cases, surgical intervention may be necessary.

Self-Acupressure

Self-acupressure can be applied to the specific trigger points in the affected musculature by the patient at home on daily bases. It can be used as a sole treatment for the management of mild to moderate back pain. Self-acupressure can be also used along with any other modality to reinforce the treatment effect and promote faster recovery. More information about acupressure can be found by clicking on the tab on the left-hand side of this page.

 

Physical Therapy

Physical therapy is frequently used as a part of an overall treatment protocol to treat acute or chronic back pain. The goal of physical therapy is to relieve pain, help the body in the healing process, and restore normal functional pain-free movement. A physical therapist can prescribe specific rehabilitation exercises alone or in combination with dry needling, TENS, heat application, soft tissue release or gentle manipulations.  Physical therapy is generally initiated if the injury is not spontaneously recovering with conservative treatments within 2-6 weeks. In case of severe acute back pain, however, a referral to physical therapy can be initiated right away. For more information click on the tab on the left-hand side.

Acupuncture and Dry Needling

Acupuncture and dry needling are both very safe therapeutic modalities. Dry needling is mostly available to the patients through the department of physical therapy. The carefully selected patients which may benefit from dry needling usually receive a series of dry needling sessions as part of their physical therapy treatment plan.  There are some primary care providers who have been trained in dry needling. They may offer this treatment modality to their patients on limited bases given their busy schedule. Acupuncture is available to patients only from licensed acupuncturists or physicians with training in medical acupuncture. For more information about Acupuncture and Dry Needling please click on the tabs on the left-hand side of this page.

 

Pharmacologic management

Pain medications play an important role in the management of chronic back pain for many patients. Some patients rely on a daily dose of pain medication to control their pain and there is a definite role for pain medication in the management of chronic pain. It is important to point out, however, that the medication should not be relied on as the sole long term strategy to keep chronic pain under control. This passive approach generally leads to further deconditioning, the need for increasing the dosages of medication and inherently to more side effects associated with their daily use.  Appropriate use of pain medication can be, however, an integral part of a comprehensive treatment plan when used under the guidance of a qualified health care provider. In general, the pain medication should be used at the minimal effective dose and for the shortest amount of time, unless directed otherwise by the health care provider.

Surgical procedure

No surgical procedure is risks free. Formation of scar tissue and the need for subsequent surgery are known complications. Surgery should be therefore reserved only for rare cases. These generally include instances where all other treatment options have been exhausted. In these cases either the pain cannot be successfully controlled by any other intervention or there is a significant functional deficit that can be improved by the surgical procedure.

The information provided on these pages is not intended to treat or diagnose any condition and should be viewed solely for the purpose of education. By no means is this information replacing evaluation by a qualified health care provider. For detailed Terms and Conditions, as well the use of cookies by this website, please see the sections “Terms and Conditions” and “Privacy.”

 

For more information on Acupuncture and other complementary therapies visit Alternative, Complementary & Integrative Therapies: Acupuncture/Acupressure


Trigger Points: The Shocking Culprits Behind Your Pain

Complementary Medicine

What are Trigger Points ?

In the mid-1960s doctor Travel introduced the term myofascial pain.  Over the years, many publications and clinical experience have shown that nearly 80% of local muscular pain can be attributed to myofascial pain. The term myofascial pain has been associated with muscle tenderness that arises from hyperirritable areas in the muscles called trigger points. Muscular pain caused by trigger points has been known to mimic symptoms of a very long list of common maladies. Pain resembling sciatica, herniated discs, joint problems, kidney stones, and even headaches can be caused by the presence of trigger points in the associated muscle groups. Dismissing the concept of trigger points when evaluating common daily pains and aches, can result in incorrect diagnosis and failure to formulate an effective treatment plan to resolve the painful condition.

What is a Trigger Point?

A trigger point is usually defined in textbooks as a painful point that can be felt as a hard nodule in the muscle. Clinically, however, a trigger point is more of an area of the muscle, not necessarily a precise point. There may be a palpable nodule, but that is not always the case. A better definition of a trigger point is an area of muscle that feels tight and ropy and usually is tender on palpation. Not every tender area within a muscle, however, is a trigger point. Several other characteristics have to be present for a tender area of the muscle to meet the criteria for the definition of a trigger point. Trigger points are therefore usually defined as areas that are tender on palpation, but also display twitch response when strumming the tight muscle band in a perpendicular direction.  Compression of the trigger point also needs to reproduce the patient’s familiar pain. In some cases, when pressure is applied to the trigger point, the pain can be felt in a distant area of the body. This phenomenon is known as referred pain. The typical example of referred pain secondary to trigger points is pain at the base of the spine or the buttock, caused by trigger points in the mid-back muscles, at the area of the lowest ribs. A new definition of trigger points, however, suggests that referral of the pain to the distal area of the body does not need to be present in order to make the diagnosis of a trigger point.

Formation of Trigger Points

When a muscle or a group of muscles is subject to repetitive overuse or sudden strain, a contraction will form in a small number of muscle fibers within the affected muscle. We refer to these small contractions as trigger points. The presence of trigger points in the muscle, shortens the length of the muscle, much like making series of knots on a piece of a string. The more knots on the string, the shorter and tighter the string becomes. This analogy can be applied to muscles that become tight due to the presence of trigger points. The shorter the muscle becomes, the more distinct ropy feeling can be appreciated when strumming perpendicularly across the affected muscle.  When a muscle becomes shorter because of the trigger points, it will start to generate greater pull on the tendons and ligaments that attach the muscle to the joints and other structures. In the case of the knee joint for example, if trigger points are present in the quad muscles, they will shorten the quad muscles. The quad muscles attach below the knee through a tendon that runs over the kneecap (patella). The shortness in the quad muscles will therefore cause the kneecap (patella) to be compressed over the underlying cartilage whenever the knee is flexed. Greater friction between the patella and the underlying cartilage will over time result in faster loss of the underlying cartilage or formation of inflammation. This condition is called a chondromalacia patella and is experienced by the individual as a deep achy pain underneath the kneecap.

What causes trigger points?

In general, trigger points tend to form in the muscle that is subject to a higher load than the muscle can tolerate. There are a variety of factors that have been noted as potential causes for the development of trigger points. The most significant of these include acute or chronic muscle overload due to poor posture or over-exercising. Direct trauma to the muscle, as well as trauma due to a car accident which leads to a whiplash, are another common cause for developing trigger points. Additionally, psychological distress, homeostatic imbalances, and certain lifestyle habits such as smoking, have been identified as important contributors to the formation of trigger points. When an area of muscle is constantly overloaded, the resulting muscle tightness in that area will compress the surrounding blood vessels. This leads to poor local blood circulation with subsequent accumulation of various metabolic by-products and chemicals which sensitize the surrounding nerve endings. The impaired metabolism and blood circulation in the muscle further impair the muscle’s ability to fully relax. Eventually, the muscle develops sustained contraction leading to the development of palpable tight and ropy areas of the muscle defined as trigger points.

Consequences of Trigger points

There are many implications of having trigger points in the skeletal muscles. The most well-known include pain, stiffness, and decreased range of motion of the affected muscles. Decreased athletic performance and pain radiation to other parts of the body are two less known facts about trigger points. Understanding how trigger points affect athletic performance is particularly important for anybody interested in maximizing the benefits of their workout routines. Many top athletes pay large sums of money to experts in myofascial release to keep their muscles free from trigger points.

 

Decreased athletic performance   

When muscles develop trigger points, their overall capacity to do their job is impaired.  Physiologically, the basic function of the muscle is to expand and contract. The presence of the trigger points causes the muscle to assume a constant shortened and contracted state, hindering the muscle’s ability to fully flex and contract. This will manifest as overall muscle weakness, decreased range of motion, feeling of stiffness, earlier fatigue, and intolerance to high-intensity workload. Muscles that have trigger points also recover much slower. The combination of all these factors interferes with athletic performance and leads to suboptimal results despite adequate training and preparation.

Pain radiation to other parts of the body

The characteristic feature of trigger points is their ability to refer pain to distal areas of the body, which makes the correct diagnosis of the true origin of the pain challenge.  Detailed pain referral pathways have been described for individual muscles and their trigger points. These referral pathways sometimes overlap, therefore a detailed search of all muscles which can refer pain to a particular area, should be conducted, to identify all the sources of the pain. An example of referred pain to the same area from a different muscle is a pain in a pinky and along the inner aspect of the hand. This referral pattern is typical for trigger points in the Latissimus dorsi. In some cases, however, the pain in the pinky and along the inner aspect of the hand can result also from the presence of trigger points in the Infraspinatus muscle.

 

Several non invasive treatment options are available to address and treat trigger points. Some of the most popular include acupuncture, dry needling and acupressure modalities. Follow these links to learn more about each one of the them.

 

To learn more about complementary therapies. Visit National Center for Complementary and Integrative Health

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