All posts by Personal Injury Physicians

Who Has The Higher Pain Tolerance – Women or Men?

Woman Neck Pain

Who Has the Higher Pain Tolerance – Women or Men?

Consider the Biological and Psychological Factors

There are a number of factors that contribute to an individual’s tolerance to pain. Most of the factors are either biological or psychological. Biological is the physical pain, i.e., the pricking of skin and psychological is the brain’s perception of the pain.

“Pain is both a biochemical and neurological transmission of an unpleasant sensation and an emotional experience,” says Doris Cope, MD, an anesthesiologist who leads the Pain Medicine Program at the University of Pittsburgh Medical Center. “Chronic pain actually changes the way the spinal cord, nerves, and brain process unpleasant stimuli causing hypersensitization, but the brain and emotions can moderate or intensify the pain.” Past experiences and trauma, Cope says, influence a person’s sensitivity to pain.

According to the American Pain Foundation, 76 million people report having pain lasting more than 24 hours. Persistent pain was reported by:

  • 30% of adults aged 45 to 64
  • 25% of adults aged 20 to 44
  • 21% of adults aged 65 and older

http://tinyurl.com/lnh6ejg

A 2012 study of more than 70,000 patients indicates that women report more intense physical pain than men. As part of the study, for more than 250 similar diseases, women reported higher pain levels on a 1-to-10 scale than did men, with the reported difference approaching a full point for most ailments.

Researchers say it’s not clear whether women actually feel more pain than men. They only can conclude that women report feeling more pain. Women’s ability to tolerate more pain than men remains up for scientific debate.

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According to Martin Grabois, MD, professor and chair of the department of physical medicine and rehabilitation at Baylor College of Medicine in Houston, pain tolerance is influenced by people’s emotions, bodies, and lifestyles.

Here are several factors that can affect pain tolerance:

  • Depression and anxiety can make a person more sensitive to pain.
  • Athletes can withstand more pain than people who don’t exercise.
  • People who smoke or are obese report more pain.

The most common type of chronic pain in the U.S. is back pain; the most common acute pain being musculoskeletal pain from sports injuries, says Grabois.

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Wellness Tips for the Holidays

Family Holiday Dinner

Wellness Tips for the Holidays

6 Ways to Maintain Your Health

Food and family gatherings characterize the holiday season which make it easy to forget about exercise routines and healthy eating. The average American puts on more than a pound during winter holidays, so avoiding weight gain is nearly impossible. However, with the right approach, good health can be easily maintained. Here are some tips that can help.

PLAN AHEAD
Be mindful of the holiday dinners and parties that you will attend and avoid overdoing it on other occasions. Eat a healthy snack, like fruit or nuts, before you leave the house or go shopping so you’re not hungry when faced with holiday food temptations. It is also okay to discard holiday treats that are not consumed, so that you do not eat them all week.

EXERCISE REGULARLY
Don’t forget to balance your increased caloric intake with regular cardiovascular exercises. Group exercise classes, swimming and strength training can help offset the effects of your holiday indulgences.

DRINK WATER AND EAT SLOWLY
Sometimes people feel hungry when they are actually dehydrated. A minimum of eight glasses of water are recommended each day, and may help quell those hunger pains. Eating slowing will also prevent overeating, because it takes about 20 minutes for your hormones to signal your brain that you’re full.

CONTROL YOUR PORTIONS
Dividing your holiday dinner plate into thirds can help prevent overconsumption. Devote one-third for proteins (including dairy), one-third for fruits and vegetables and one-third for carbohydrates, which includes dessert carbs. Fitting all these items into just one-third of your plate automatically reduces the total amount you eat. Eating the proteins first and saving the carbohydrates for last will also help reduce over-stuffing.

WATCH WHAT YOU EAT
Many people respond to holiday stress by overeating simply because there is so much food available at parties and family gatherings. While there is no need to completely avoid your favorite holiday foods, eating them in moderation is key. Take a moment first to think about what you are putting on your plate. In the event that you overdo it, try not to beat yourself up about it.

LESSEN THE STRESS
Holidays can lead to high (and somewhat unrealistic) expectations about relationships and social interactions. The reality can lead to disappointment when the situation doesn’t live up to your ideals. Financial limitations coupled with gift-giving obligations, family responsibilities and too much to do in too little time can aggravate stress even more.

It is important to acknowledge your feelings and set realistic expectations. Make sure you take time to relax, even if it’s just a few minutes of watching TV, listening to music, calling a friend on the phone or putting your feet up and reading.

http://tinyurl.com/q6d47az

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Burning Hand, Could Be Your Wrist

Woman at steering wheel

 

Burning Hand, Could Be Your Wrist

Wrist Pain Can Be Related To A Motor Vehicle Accident

When bracing the steering wheel during an automobile accident, you can potentially cause damage to your median nerve in your wrist. Because the base of the thumb can be injured by the steering wheel and the carpal tunnel is in close proximity, the carpal tunnel takes blunt trauma during impact. This sudden impact can cause long-term issues in your wrist and hand which may result in acute carpal tunnel syndrome (ACTS).

Carpal tunnel syndrome is caused by compression of the median nerve which goes through the carpal tunnel in the wrist. It causes tingling, numbness and pain, mostly in the hand. These symptoms may go unnoticed immediately following an accident due to the adrenaline rush flooding and covering up pain areas. Additionally, paramedics and medical staff may overlook injuries to the hands and wrists as they seek other obvious injury areas.

Wrist_Pain_Blog1

 

What should I do if my wrists are injured?
If you’ve been in a motor vehicle accident and have pain in your wrists, you should consult a doctor or physical therapist. They can help with the primary diagnosis of ACTS by using two basic tests – Tinel’s and Phalen’s.

Tinel’s
Tinel’s test is performed by tapping the median nerve along its course in the wrist. A positive test is found when this causes worsening of the tingling in the fingers when the nerve is tapped.
(http://tinyurl.com/y3dcha)

Phalen’s
Phalen’s test is done by pushing the back of your hands together for one minute. This compresses the carpal tunnel and is also positive when it causes pain in your wrist. (http://tinyurl.com/y3dcha)

 
Additional tests can be performed that include detecting how well an electric impulse conducts along the median nerve. A device called an EMG can detect abnormalities in nerve impulse conduction; these nerve conduction abnormalities are the cause of carpal tunnel syndrome symptoms. (http://tinyurl.com/y3dcha)

The medical staff at Personal Injury Physicians are experienced in diagnosing and treating acute carpal tunnel syndrome. Testing and diagnosis can be performed the same day. If you are experiencing pain in your wrist or hand, contact us to schedule an appointment. Personal Injury Physicians can help.

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Back Pain, Try This!

female has backache

Exercise & Modalities Relieve Back Pain

Pain affects more individuals than diabetes, heart disease and cancer combined. In fact, the Institute of Medicine of The National Academies reports that more than 100 million Americans suffer from chronic pain. A recent survey conducted by National Institute of Health Statistics indicated that low back pain was the most common pain followed by headaches and facial aches. (http://tinyurl.com/koox2gq)

If you’re one of the millions who suffer from back pain, back exercise and modalities can provide relief and increase function. Back exercise and modalities are sometimes referred to as active and passive physical therapy. Physiatrists, also known as rehabilitation physicians, monitor and administer these therapies. (http://tinyurl.com/ycqac5u)

Exercises That Relieve Back Pain

Active physical therapy (exercise) is necessary to rehabilitate the spine and should include stretching and strengthening exercises and low-impact aerobics. Examples of these exercises include:

  • Hamstring Stretch
  • Ankle Pumps
  • Wall Squats
  • Dynamic Lumbar Stabilization
  • Stationary Bike
  • Treadmill
  • Swimming

(http://tinyurl.com/8yfbed8)

Even for patients who have very busy schedules, stretching, strengthening and aerobic exercises can be accomplished in less than an hour.

  • Hamstring stretches should be done for 15-20 minutes and become part of a recovering patient’s daily exercise routine.
  • To build strength, patients should perform 20-30 minutes of dynamic lumbar stabilization every other day.
  • Low-impact aerobic conditioning such as walking, biking or swimming should be done for 30-40 minutes at least three times a week.

Passive Physical Therapy (Modalities)

Modalities are referred to as passive physical therapy because they are performed on the patient. Heat/ice packs, TENS Units and ultrasound are the most commonly used modalities.

  • Heat/ice packs are used for heat and cold therapy and help reduce muscle spasm and inflammation. These therapies are easily accessible and are the most widely used.
  • The transcutaneous electrical nerve stimulator (TENS) unit uses electrical stimulation to provide pain relief by overriding the painful signals that are sent to the brain.
  • Ultrasound applies sound waves to the skin and penetrates into the soft tissues. Ultrasound can relieve acute pain episodes and may enhance tissue healing.

(http://tinyurl.com/mpf9thr)

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Physical Therapy versus Surgery

Physical Therapist and Woman Scaled

Conservative Pain Management May Be Your Best Option

Recent studies in the British Medical Journal and the New England Journal of Medicine highlight physical therapy as being a viable option to surgery to improve pain symptoms related to sciatica and a myriad of knee injuries. Physicians encourage patients to consider conservative pain management first before undergoing surgery.

The benefits of surgery and physical therapy for treating sciatica are typically the same according to a study published in the British Medical Journal. Sciatica is the pain that spreads along the path of the sciatic nerve. The sciatic nerve branches from your lower back through your hips and buttocks, and down each leg.

In some cases, sciatica resolves quickly, but in others, it may linger. In the study, patients were split into two groups. A group that chose surgery and a group that opted for physical therapy. The group that underwent surgery had short-term relief, but by month six the improvement was the same as those who participated in physical therapy only.

Physicians advise that surgery is not the only option to reduce sciatica symptoms. In fact, Dr. Pens who’s identified in the British Medical Journal study, states, “Patients should be aware that surgery is not the only option to reduce the symptoms of sciatica. All aspects of conservative management should be exhausted before considering surgery as a treatment option.”  The study concludes that well-informed patients should consider other options besides surgery to relieve sciatica, since surgery’s early benefits are gone by month six.

The results of this study, and others, further suggest that expensive treatments for low back pain are not necessarily the best options. In fact, less expensive conservative options such as physical therapy may be preferred. These physical therapy treatments include hands-on physical therapy to mobilize the spine, and exercises designed to alleviate low back pain and/or address prevention of reoccurrences. Physical therapists should be consulted for these options.

Furthermore, Dr. Edward Laskowski, co-director of the Mayo Clinic Sports Medicine Center in Rochester, Minnesota, indicates many types of knee injuries tend to be treatable without surgery, including MCL, PCL, and cartilage tears. However, Laskowski says ACLs, once torn, don’t knit back together very well, so if you play aggressive, high-impact sports such as football, reconstruction may be the better option. Yet, he further states, “But even if you’re an avid swimmer or cyclist, you might do fine without surgery, since those sports don’t require as much ACL use”.  Therefore, physical therapists should be consulted and conservative pain management should be explored as a viable option to surgery when optimal to do so.

Additionally, the study from the New England Journal of Medicine (NEJM) showed that physical therapy is as effective as arthroscopic surgery for treating patients with knee injuries. The study looked at 351 patients aged 45 years or older who had various knee conditions and applied surgery and physical therapy to two different groups. At six months, both groups showed similar improvements but 70% of patients who underwent just physical therapy avoided having to undergo surgery.

Physical therapists have the ability to help patients suffering from sciatica and certain knee injuries. Physicians support conservative pain management before opting for surgery. Patients who undergo surgery don’t typically show any more improvement than physical therapy patients after six months. It is important to consult both physicians and physical therapists to determine the best options for pain relief.

 

 

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