Q: When Should Pain Management Or Chronic Pain Programs Be Involved
A: These services should be considered when the patient has inadequate pain control after working with RN/MD teams with various trials of pharmacologic and alternative health measures. Pain Managementprograms may recommend procedures such as epidural injections, an Intrathecal pump and or a Spinal cord stimulator for pain control. Spinal cord stimulators, at this time, interfere with the use of further MRI imaging for MS management.
New Hope For Treatment Options
Some of those drugs work by suppressing the immune system, which may slow down MS and decrease relapses, but may also put patients at risk for infections and other illnesses, Dr. Scherz says. Depending on the drug, even after discontinuing the medication, it can take months for the immune system to bounce back.
Sensory Impairment Numbness / Tingling
Numbness is the most common sensory symptom, and usually occurs with an onset in one or more limbs. Commonly people awake with abnormal sensation in a portion of a limb, which gradually spreads inward toward the trunk, increasing in extent and intensity. It may extend to include the body trunk.
Sometimes the sensory disturbance can be painful. Achy, burning sensations, a feeling of tightness or banding these are known as dysesthesias.
ManagementDysesthesias usually respond to anti-seizure medication such as carbamazepine. Amitriptyline can be useful as can be gabapentin and some of the newer pregabalin medications.
Key Healthcare Professionals: Neurologist, MS nurse, occupational therapy
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Signs Your Back Pain Might Be An Emergency
In our 20s and 30s, normal back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.
In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.
Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.
Approximately 80% of adults will experience back pain in their lives, so its important to be able to identify the severity of your symptoms and track how long the pain lasts.
If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, its usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition.
Q Can Ms Patients Have Fibromyalgia As Well As Ms
A: MS patients can have fibromyalgia as well as MS. Fibromyalgia patients may also have symptoms similar to MS, and often seek information on whether they have MS causing their symptoms. Medications, graded exercise, aquatic exercise, improved sleep efficacy, and physical therapy can help manage fibromyalgia symptoms. We recommend using international criteria for the diagnosis of fibromyalgia to aide in identification of such patients.
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Problems With Thinking Learning And Planning
Some people with MS have problems with thinking, learning and planning, known as cognitive dysfunction.
This can include:
- getting stuck on words
- problems with understanding and processing visual information, such as reading a map
- difficulty with planning and problem solving people often report that they know what they want to do, but can’t grasp how to do it
- problems with reasoning, such as mathematical laws or solving puzzles
But many of these problems aren’t specific to MS and can be caused by a wide range of other conditions, including depression and anxiety, or even some medicines.
Multiple Sclerosis Spotlight: Early Diagnosis Better Treatments And Hope For Ms
Nearly 1 million adults in the U.S. are living with multiple sclerosis, and yet it remains a misunderstood and often misdiagnosed condition.
In summer 2021, actress Christina Applegate went public with her multiple sclerosis diagnosis and a few years earlier fellow celebrity Selma Blair spoke about her MS struggles, raising awareness of this progressive neurological disease that affects the central nervous system specifically the brain and spinal cord.
Multiple sclerosis is considered an autoimmune condition, in which the bodys immune system attacks the protective myelin sheaths that cover a neurons nerve fibers, called axons. Normally, the axons transmit nervous system signals throughout the body at speeds up to 300 feet per second. But without the insulating protection of the myelin sheath, communication breaks down between your brain and the rest of your body.
This attack, called demyelination, damages the myelin sheath, resulting in myriad symptoms of varied severity.
- Problems using the bathroom
- Numbness or weakness in the arms or legs, typically occurring on one side of the body at a time
But innovations in diagnostic testing and medication therapy have made it possible for UT Southwestern MS experts in Dallas and Fort Worth to create personalized plans for our patients to achieve the best outcomes. Those plans are centered around a patients:
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Key Facts About Multiple Sclerosis
1. OverviewMultiple sclerosis, commonly referred to as MS, is an autoimmune and inflammatory disease. It is caused when the insulating caps on nerve cells in the spinal cord and brain are damaged. This causes a wide array of symptoms all over the entire body. There is currently no cure for MS.
2. CausesThe precise cause of MS is not known but some theories have emerged. Many people believe that it is an autoimmune disorder where the body attacks the myelin in the body. This is the fatty substance that covers the nerve fibers. The reason why some people are affected and others are not is unclear but genetics and child hood infections are thought to play a role.
3. Symptoms The symptoms of multiple sclerosis are never the same in two people. Because this disease affects the brain and spinal cord a huge variety of symptoms may be present, including physical, mental, and psychological. Some of the common signs of MS include unusual sensations, bladder problems, loss of balance, thinking problems, vision problems, lack of coordination, weakness in limbs, dizziness, fatigue, sexual trouble, speech problems, and muscle spasms. Someone can have one or two symptoms and then not have another one for years.
Treatment Options For Lower Back Pain
Most cases of lower back pain will improve with basic care but if your symptoms are persisting after a couple of weeks of self-care, it may be time to get in touch with your doctor. Some treatments will work for some but not for others, so its important to consider the following options and see what works best for you:
- Rest or modify your activities
- Take over-the-counter pain medications
- Alternate between ice and heat therapies to relax muscles and reduce swelling
- Stretch and strengthen back muscles with a series of gentle exercises as recommended by a physical therapist
- Epidural steroid injections relieve pain by reducing swelling around the compressed nerve roots
- Minimally invasive surgery to address conditions such as nerve compression or damaged discs
Spine surgery may be recommended if your if symptoms persist after trying non-surgical methods. Contact Dr. Lewis at Jackson Neurosurgery Clinic today for a comprehensive diagnosis and treatment plan to keep you feeling your best.Contact us today to learn more about lower back pain or to schedule a consultation with one of our specialists. Well find a solution that works for you! Call us at 366-1011.
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How Nerve Damage Can Impact Organs
And because the brain sends messages to the sexual organs through the spinal cord and vice versa, Dr. Scherz says damage anywhere along that path may cause sexual problems, including difficulty getting aroused, reduced sensation and trouble achieving orgasm.
Lesions in the parts of the brain responsible for coordinationoften lead to balance and coordination problems, which tend to begin in the legs and move to other parts of the body as the disease progresses. Muscle spasticity and weakness, stemming from fatigue or other symptoms, may also be to blame.
People with MS may have difficulty walking, and in advanced stages, need a cane or wheelchair or to be bedridden, Dr. Scherz says.
In Your Back And Bones
This may stem from too much pressure on your bones, joints, and muscles. It happens when you push your body to move. You can get it if you have a hard time walking or other movement problems.
Treatment: You can work with a physical therapist. Also try massage and heat. Practice meditation, tai chi, or yoga. Over-the-counter pain-relievers like ibuprofen and aspirin can also help.
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When Should I See A Doctor If I Have Lower Back Pain
In many cases lower back pain stops on its own. But if it doesnt, here are some guidelines on when you may want to start seeking professional help:
- If the pain lasts four weeks or longer
- If the pain keeps getting worse as time goes by
- If you are experiencing other symptoms, such as fever, major weight loss or weight gain, loss of function or weakness in extremities, bladder problems, etc.
Describing The Ms Hug To Your Doctor
Theres not just one medical name that describes everyones MS hug because MS can cause those kinds of feelings in different ways.
So a doctor or nurse will want to know more about your experience of it.
This will help them rule out causes that are not MS, and suggest the best ways to manage it whatever the cause.
If it is an MS symptom, they might describe it as dysaesthesia or muscle spasms two different ways MS could create a hugging, squeezing effect.
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What Are The Symptoms Of Ms
MS symptoms depend on which part of the central nervous system is affected and differ for each individual. People with MS are unlikely to experience all of the symptoms but they might experience more than one.
The main symptoms of MS:
- weakness or numbness in the arms or legs
- unusual sensations
- visual problems
- balance, co-ordination and mobility problems
- muscle spasms
- fatigue and lack of energy
- bladder and bowel problems
People with MS might also experience emotional problems, anxiety and depression. Other possible symptoms include pain, hearing problems, sexual problems, memory problems, and cognitive problems . Speech and swallowing problems are also possible.
Eating To Reduce Symptoms
Your daily diet should include 3 cups of colorful fruits and vegetables a day. These foods are loaded with antioxidants which help boost your immune system.
Some examples include peaches, sweet potatoes, cranberries, oranges, carrots, beets, all the berries and peppers,
A Paleo diet also includes three cups of green leafy vegetables a day. They have a large amount of vitamin ACK and B vitamin.
Include three cups of sulfur rich vegetables. Sulfur helps reduce harmful toxins and it helps with neurotransmittersproducing.
Some of them include onion, cabbage, cauliflower, mushrooms, broccoli, asparagus and turnips.
At each meal you should include fish like salmon or herring, for the omega 3. You should also meat from a grass fed animal. These animals arent full of toxins.
When you cook your food be sure to use an oil that isnt full of trans and saturated fats. Some of them might include flax, coconut, hemp, or olive oil.
Its also suggested to eat seaweed and organ meat once a week.
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How Is Multiple Sclerosis Diagnosed
A neurologist will also look at your personal medical history and then family medical history, because MS is thought to be genetic.
Hell ask you to move your arms and legs first, Hell then move your extremities. This is called active and passive range of motion.
This is to find out how well youre able to move your arms and legs, without causing pain.
A doctor might do a series of tests to make a diagnosis. Some of them might include MRI, spinal tap and evoked potential.
A doctor will use an MRI to take pictures of your brain and spinal cord, to establish the presence of a lesson.
Hell check for other abnormalities in these areas as well.If the doctors really concerned he might inject a metallic dye into your system.
This substance will leak around the abnormalities. In addition, he will check for volume loss due to atrophy.
If he diagnoses you with MS then its likely he will repeat this test periodically, to see how the disease and treatment is progressing.
Your neurologist might drain a little fluid off of your spinal cord, to see if it contains white blood cells.He will also check for oligoclonal band, to determine how well your immune system is doing.
Evoked potential is when a neurologist stimulates your nervous system by using either checkerboard pictures or clicking sounds.
He will then record how your nervous system reacts. This recording is usually taken from the nerves in the arms and legs.
How Is Ms Diagnosed
UT Southwestern follows the McDonald Criteria, along with a patients personal health history and imaging, to diagnose MS. The criteria were updated in 2017 to streamline the diagnostic process and reduce misdiagnosis. Through the criteria, a patient must meet three qualifications:
MS symptoms vary according to the degree or stage of the disease. Since we cant predict how the disease will progress, we classify the type of MS according to the course of the disease:
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Early Multiple Sclerosis Symptoms: Restless Leg Syndrome Numbness And Weakness
Written byEmily LunardoPublished onOctober 19, 2015
Sensory problems, including restless leg syndrome , numbness and weakness, are the first sign of multiple sclerosis . Sensory problems can occur in 20 to 50 percent of individuals with multiple sclerosis with a condition known as paresthesia. The condition can be caused by prolonged sitting or standing or remaining in a certain position for a long period of time.
Restless leg syndrome is a condition that makes the legs feel tingling when they are at rest and creates an overwhelming sensation to move them. Studies have shown that individuals with MS are three times more likely to experience restless leg syndrome compared to the general population. Cervical cord damage plays a large role in the development of RLS and can occur more in those with multiple sclerosis.
Feelings and sensations of restless leg syndrome include crawling underneath the skin, tingling, burning or creeping. Symptoms may be relieved with movement of the legs, but this relief is temporary. Furthermore, its impossible to keep your legs moving constantly, which makes the hours during sleep the most difficult. Many individuals suffer from sleep deprivation when they have RLS.
An Autoimmune Disorder Of Another Nature
Multiple Sclerosis occurs whenfor inexplicable reasonsthe bodys immune system attacks our Central Nervous System . Although traditionally thought of as an autoimmune disease, doctors are now rethinking this concept. But why? Because autoimmune diseases usually have an identifiable, triggering antigen. In other words, we can typically discern the reason for the immune systems attack through careful medical testing.
For example, often this attack occurs in response to a mutation in the genes of a cell . In other autoimmune diseases, the introduction of a virus to the body can trigger the immune response . However, with MS, researchers cannot identify the triggering antigen that urges our T-cells to attack our Central Nervous System.
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A Future Without Ms May Be Within Reach
A major hurdle in diagnosing MS is that 10%-15% of patients dont qualify for an explicit diagnosis, according to current criteria. If theyve had a clinical attack or an indicator of MS, they may be on the MS spectrum but cannot be definitively diagnosed.
However, ongoing research to identify a biomarker for MS is giving patients and providers hope for a future free from MS. With a biomarker, we could diagnose MS and begin treatment before devastating symptoms occur.
Treatment is also advancing by leaps and bounds. Patients will likely have access to at-home infusion treatments within the next five to 10 years, eliminating the need to travel to the hospital for medication. Ongoing research is also studying stem-cell therapies to essentially reset a patients immune system, therefore eliminating the cause of the harmful lesions of MS.
But what has me most excited is the potential to remyelinate axons potentially reversing the MS disease process and repairing nerve damage if the disease is diagnosed in its early stages. If that happens, patients may see improvement in symptoms, though the symptomatic response will need to be monitored for each patient. It is possible that remyelination programs could become mainstream within the next 50 years.
To visit with a multiple sclerosis expert near you, call orrequest an appointment online.
Treating Spine Pain Caused By Multiple Sclerosis
Multiple sclerosis, or MS, is a chronic disease that damages the nervous system. While healthy individuals have a protective coating of a material known as myelin surrounding the nerves, those who suffer from MS have exposed nerves. MS breaks down the layer of myelin and leaves patients with unprotected nerves that do not work as well as they should. As a result, patients may experience a number of uncomfortable symptoms, including spine pain. Back pain treatment offered by our multidisciplinary team can relieve some of this pain and provide a greater degree of comfort for our patients. To undergo treatment for spine pain and MS at our Frisco practice, contact us today. Our team will do all they can to effectively treat this pain.
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