Patient : Neuropathic Leg Pain And Knee Osteoarthritis
A 50-year-old right handed teacher, married father of two, was diagnosed with severe osteoarthritis of the knee. He had left knee pain for the past 30 years due to a lacrosse injury where he sustained an ACL and meniscus tear. At the time he had surgery to remove the medial meniscus in his left knee. Pain was mostly related to activities such as jogging, twisting, pivoting, going upand particularly, downthe stairs. MRI results revealed degenerative changes with marked loss of joint space in medial compartment.
He had physiotherapy to treat his knee pain which incorporated acupuncture, manual therapy, and exercise. He also had three injections of synvisc into the left knee but experienced severe post-injection swelling.
Physical exam revealed a height of 58 with a weight of 240lbs. BP was 138/88 mmHg. Biomechanical examination revealed left knee pain in both medial and lateral compartments of the knee, slightly more severe in lateral parts. Knee range of motion was 150° bilaterally with end range pain and flexion of the knee. Range of motion was adequate with mild effusion noted in the left knee and mild signs of synovial thickening. Neurological testing revealed motor strength at 5/5 and a DN4 score of 5/10 His average pain was reported at 7-8/10 with a best of 5/10 and worst 8/10. His SF-MPQ was 11/45.
How To Confirm An Omega
Its uncommon for healthcare providers to routinely evaluate a persons omega-3 status. Theres no standard test to diagnose an omega-3 deficiency. However, there are ways to analyze omega-3 levels, if necessary.
First, healthcare providers can take a blood sample and analyze levels of omega-3s in the blood fats or blood plasma, which are expressed as a percentage of total phospholipid fatty acids by weight .
Healthcare providers can also assess omega-3 status indirectly by analyzing the fatty acid composition of red blood cells. This approach looks at the long-term dietary intake of fats over several months and may provide an idea of overall omega-3 intake .
Still, its important to note that the amount of fatty acids in the blood can vary significantly depending on what you ate last and when. This is why most healthcare providers require a person to fast overnight before giving a blood sample to assess the lipids in their blood.
The Western diet is known to be high in saturated fat and low in unsaturated fat, including omega-3 fats. Among populations that eat more fish, theres less concern about omega-3 deficiency (
You may be at a higher risk of omega-3 deficiency if you dont consume fish, seafood, and dietary sources of ALA or take a supplement that contains EPA and DHA.
Theres no standard test to diagnose omega-3 deficiency, but there are a couple of lab tests that clinicians may use to evaluate blood fat composition and provide some guidance.
What Role Does Nutrition Play In Treating Back Pain
Nutrition is a form of medicine. It will help relieve inflammation and pain: from the inside out. External stimuli like acupuncture, massage, foam rolling, etc. are geared to reduce pain, muscle spasm, and inflammation. Nutrition offers internal balance to you treatment strategy. I often recommend supplements to our patients that suffer from lower back of pain.
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Where Tofind Fish Oil
Picking up a bottle of fish oil from any major grocery store or supplement center is a common way many people incorporate this omega-3 fatty acid into their diet. Aside from oral supplements, fish oil can be obtained through eating fresh fish from your local supermarket. To reap the full benefits provides, lean toward cold water fish options, such as salmon, sardines and anchovies.
If youre experiencing severe joint pain or arthritis that has resulted in long-term pain, this supplement might not be the best remedy for your situation. For those who have mild joint pain, this supplement could be just what you need to experience joint relief and get back to your normal routine.
Its important to consult your physician before adding a new supplement to your daily regimen. Make an appointment at Campbell Clinic to see if fish oil supplements are a safe option for your joint pain.
Patient : Worker Compensation Burn Injury
Figures 5.Second and third degree burns sustained by Patient 5.
A 54 yr old rt-handed restaurant worker fell down stairs with a vat of hot oil and sustained 30% total body surface area burns . He was stabilized in the local hospital and then transferred to Sunnybrook Health Sciences Centre . He was hospitalized in the burn unit for 40 days and underwent extensive skin grafting and debridement procedures. When he was transferred to the rehabilitation hospital in March 2006, he was taking morphine 10mg up to 9/day. Despite extensive multidisciplinary management , he still had severe burning pain . Numeric Ratings Scale pain 8/10. Neuropathy Pain scale : 85/100.
He was transitioned to long-acting morphine . Pregabalin was added at 25mg qam and 75mg qhs. Wellbutrin was introduced and helped with mood. NRS pain improved to 6/10. Neuropathy Pain Scale: 68/100. In May 2006, omega-3 fatty acids were added and titrated up to 2 capsules for every 50 lbs of body weight. When reassessed on September 29, 2006, there were objective improvements in goniometric range of motion of the shoulder and neck. The NRS pain was 4.5/10 and the Neuropathy Pain Scale further improved to 32/100.
The patient transitioned successfully to outpatient care and subsequent voca-tional retraining. He was able to wean down the morphine and found that the high dose omega-3 fatty acids to be most beneficial.
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Natural Supplements To Consider
A plant from the ginger family, turmeric is often used in South Asian cuisine, such as curry. It contains curcumin, the key ingredient that can help decrease inflammation. To be effective as either a supplement or food and not simply metabolized and excreted turmeric should be absorbed with fatty oils, such as avocado or olive oil, and black pepper, which most supplements contain.
I recommend making turmeric a part of your daily diet for three to six months to gauge any benefits. Turmeric supplements can be expensive, and inflammation can be treated in other ways. So, if your pain hasnt decreased after this amount of time, we can try something else
2. Cherry juice extract
Anthocyanin supplies both the red coloring and anti-inflammatory benefits in cherries and other red fruits and vegetables. Most of my patients who say cherry juice helps relieve their pain drink about one glass a day, but you can eat a handful of cherries daily or take supplements that contain the pure juice extract cherries are high in anthocyanin. However, because of its high sugar content, I do not recommend cherry juice for diabetic patients.
3. Omega-3 fatty acids
Most patients I see have taken these supplements before without good results. For better absorption I recommend incorporating omega-3s into your diet through foods such as tuna, salmon, sardines, tofu, walnuts, and flaxseeds.
5. Chondroitin and glucosamine
7. Cannabidiol oil
Fish Oil For Back Pain
The virtues of fish oil have been well documented. Claims fish oil can naturally ease inflammation have attracted the attention of people living with persistent discomfort. For back pain sufferers, omega-3 essential fatty oils naturally found in fish like salmon, herring, mackerel, and tuna or available in supplement form may reduce dependence on anti-inflammatory drugs that can have unintended side effects. Learn more, presented by leading Los Angeles spine surgery center, The Spine Institute.
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Joint Pain And Stiffness
Its common to experience joint pain and stiffness as you get older.
This may be related to a condition called osteoarthritis, in which cartilage covering the bones breaks down. Alternatively, it may be related to an inflammatory autoimmune condition called rheumatoid arthritis .
Some studies have found that taking omega-3 supplements helps reduce joint pain and increase grip strength. Research also shows that PUFAs may help with osteoarthritis, though more human studies are needed .
Moreover, research suggests that omega supplements may help reduce disease activity in those with RA, as well as improve symptoms in people with the disease .
If youve noticed an increase in joint pain or related arthritic symptoms, your omega-3 fat status could be low and taking supplements may help.
However, its important to speak with your healthcare provider if youre experiencing joint pain or arthritis symptoms. They can help determine the proper treatment.
Taking omega-3 supplements has shown promise in helping decrease joint pain and stiffness, though scientists need to do more research in humans to investigate this.
Know The 3 Types Of Omega
Omega-3 fatty acids come in more than one form. The types found in fish, called DHA and EPA, seem to have the strongest health benefits. Another form known as ALA is found in vegetable oils, flaxseed, walnuts, and dark leafy vegetables such as spinach. The body can change a small amount of ALA into EPA and DHA, but not very well.
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The Supplement That May Be Better Than Pain Killers For Sciatica
Most of our clients are extremely health conscious and HATE to take pain killers. They will look for alternatives to prescription medication whenever they can, knowing that natural methods are often as effective and less harmful than the drugs handed out by their doctor. Today, we are going to talk about a super-food supplement that you can get from most supermarkets that may be MORE effective for back pain, disc bulges and sciatica than prescription medication.
Before we dive in, please be aware that we are part of the Amazon Affiliate programme. This page may contain Amazon affiliate links, so if you choose to purchase a product for your sciatica that we recommend through a link on this page, we will receive a small commission at no extra cost to you. This helps us keep Overcome Sciatica alive! Thank you for your support. Please be assured that we only ever recommend products that we truly believe can help.
Whats The Problem With Pain Killers For Back Pain
While pain killers do undoubtedly help some people get relief from back pain, they also come with a whole host of problems.
For a start, opioid pain killers can be addictive. They can also put stress on the liver during their transit through the body.
One of the most commonly prescribed families of medication for back pain are anti-inflammatories. These include drugs like ibuprofen, Naproxen and Diclofenac. These drugs are known to cause potentially serious adverse effects, including stomach ulcers, gastric bleeding, heart attacks and even death.
Whats more, the people we help at HT Physio who suffer from back pain are often sick to death of taking pills that make them feel awful! Long-term use of pain killers can have a psychological effect as well as a physical one. People get in contact with us all the time asking us to help them get off pain killers once and for all.
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How Much Is Too Much Omega
Ideal amounts of omega-3s can vary from person to person depending on a number of factors, including age and health concerns. Ask your health care provider about an ideal dosage for your needs. In general, taking more than three grams of fish oil each day may prevent healthy blood clotting and increase the risk of bleeding.
According to the Mayo Clinic, it is not clear if people with fish or shellfish allergies can safely take fish oil. Its always best to talk to your health care provider before taking omega-3 supplements, especially if you have any fish/shellfish allergies.
What about Lovaza? Lovaza is a brand name of omega-3-acid ethyl esters. Common omega 3 acid ethyl esters side effects may include back pain, upset stomach, burping, skin rash, and an unusual or unpleasant taste in your mouth. Very serious side effects can include easy bleeding/bruising, black or tarry stool, or vomit that looks like coffee grounds.
Its also important to note that fish oil can possibly interact with anticoagulant and anti-platelet drugs, herbs and supplements blood pressure drugs, herbs and supplements contraceptive drugs weight loss drugs like orlistat and vitamin E. Talk with your doctor before combining omega-3 supplements with any of these.
Vegetarian Sources Of Omega
If you don’t eat fish or fish oil, you can get a dose of DHA from algae supplements. Algae that is commercially grown is generally considered safe, though blue-green algae in the wild can contain toxins. Vegetarians also can get the ALA version of omega-3 from foods such as canola oil, flaxseed, walnuts, broccoli, and spinach — or products fortified with omega-3s.
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The Effects Of Fish Oil On Patients With Chronic Nonspecific Low Back Pain
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|First Posted : May 17, 2016Last Update Posted : June 7, 2018|
To investigate the efficacy of omega-3 polyunsaturated fatty acids on patients with chronic nonspecific low back pain .
Methods and Materials:
Twenty-nine patients with chronic NLBP were randomly divided into experimental and control groups. For 8 weeks, participants in the experimental group received omega-3 PUFA at 3000 mg/day plus physical therapy, while those in the control group received placebo plus physical therapy. The visual analog pain scale, pressure algometer, Biering-Sorenson test, Roland-Morris Low Back Pain and Disability Questionnaire , and occupational burnout inventory were used in assessments at baseline and after 4 and 8 weeks . Serum erythrocyte sedimentation rate and hypersensitive C-reactive protein were checked at baseline and T2.Condition or disease
|Dietary Supplement: Fish oilDietary Supplement: PlaceboProcedure: HotpackingProcedure: Transcutaneous electrical nerve stimulation||Not Applicable|
Information from the National Library of Medicine
How To Choose A Good Quality Fish Oil Supplement
Sections on how to choose a good quality fish oil supplement are found in almost every health or nutrition magazine.
When you are buying a fish oil supplement, it is important to look for the following:
- The type of omega-3s that the product provides
- A high concentration of EPA and DHA -The amount of EPA and DHA per capsule or serving size
- The number of capsules in the bottle
- The expiration date.
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Aa/epa Ratio Is Reduced With N
In the n-3 FA group, average ratios of AA/EPA were significantly different between blood samples that were obtained pre-surgery versus post-surgery after rats had received daily n-3 FA diet supplementation for 1 month . In the control group, no significant differences were detected between the pre-surgery and the post-surgery. At post-surgery, no statistical differences were found between n-3 FA and the control diet groups .
Reduction in serum AA/EPA ratio between pre-surgical and 4 weeks post-surgical rats receiving n-3 FA diet. Graphs show AA/EPA ratios tested in blood samples that were obtained pre-surgery, and after surgery in the n-3 FA diet group versus control diet group. n=4 per group. AA/EPA â arachidonic acid/eicosapentaenoic acid n-3 FA â omega-3 fatty acids MRI â magnetic resonance imaging.
Why Fish Oil For Pain
In 1971, research found that blocking the COX enzyme would block conversion of arachadonic acid to other pro-inflammatory chemicals that result in inflammation and pain. Since then, over 70 million prescriptions are written each year, and 30 billion over-the-counter NSAID tablets are sold annually. 10-15% of US adults routinely use NSAIDs. All of this does not come without any risk. Half of users experience dyspepsia. Nearly all patients who take long-term NSAIDs demonstrate gastric bleeding and up to 20% have ulcerations. 3% develop serious side effects resulting in 100,000 hospitalizations and 16,500 deaths each year. NSAIDs are the most common cause of drug-related sickness and death. Other NSAIDs like Celebrex and Vioxx specifically inhibit the COX 2 enzyme, yet are associated with increased heart attack and stroke and are no improvement on the prevention of ulcers. Vioxx was voluntarily withdrawn from the market in 2004 because of the risk of heart attack and stroke.
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Traditional Chinese Herbal Medications
Traditional Chinese medicine with herbal remedies that originated thousands of years ago has made its way to the United States. But not all Chinese herbal supplements are created equal, Farahmand cautions.
There have been reports of serious and life-threatening events such as liver damage associated with their use, as these products are not standardized or regulated, he explains. NCCAM warns that some Chinese herbal medications have been found to be contaminated with toxins or heavy metals or dont actually contain the ingredients listed on the label.Farahmand recommends consulting your health care provider before starting any type of Chinese supplement.
Learning And Healing Together
I love continually learning about natural ways to heal the body and mind. Patients from many different cultures and nationalities teach me their perspectives on herbs or remedies they grew up with, which I research further to determine whether the treatments are safe for other patients or even myself.
The NCCIH recently funded three new research networks that will focus on the science of how emotional well-being correlates to physical health, so we can expect many more years of discovering how complementary and modern medicine can improve the mind-body connection.
If you are curious about a complementary treatment, talk with your doctor. We can help you safely and effectively incorporate new options into your care plan.
To visit with a physical medicine and rehabilitation expert, call orrequest an appointment online.
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