If you’re going away on a vacation this month or even just staying close to home and relaxing, the change in routine might make you more aware of that back pain that’s been bothering you for a while. But you’ll learn soon enough that you can’t ignore the problem until it goes away.

Chronic back pain lasts three months or longer. It doesn’t have to be consistent discomfort, so if you have pain that comes and goes, it might be a result of the same problem. It can be difficult to pinpoint the exact source of your issues, but chronic back pain is usually related to age or a prior injury.

You want to be careful not to make any decisions on treatment until you have clearly identified the origin of your pain. Treating the wrong problem can make the pain the worse.  Back surgery, especially, should only be your last resort. It is an extremely serious procedure that can cause more harm than good. Luckily, there are effective nonsurgical treatments for chronic back pain:

 Physical Therapy

Exercise is one of the first treatments you should try under the guidance of your doctor, who will help you develop a tailored regimen to your specific symptoms. Through aerobic and flexibility exercise, you will focus on retraining your posture and strengthening your core. Usually, physical therapy will test the limits of your pain tolerance so that you can make incremental improvement.

Mindfulness

To manage the frustration, depression, and other psychological aspects of dealing with chronic pain, your doctor might refer you to a specialist who will recommend relaxation strategies to keep your mind from focusing on the issue. These include meditation, yoga, and tai chi.

 Diet

Some diets are highly inflammatory—especially those high in trans fats, refined sugars, and processed foods. Consult with your doctor to see if your diet could be contributing to your chronic back pain and how you could change it. Maintaining a healthy weight could also help you feel relief by reducing the pressure on your spine.

 Lifestyle Modifications

Listen to your body and learn to adapt to your circumstances. Take a break when doing yard work or make several trips when carrying groceries. Pay attention to the movements that increase your pain and avoid them if possible. Not only could this help your back feel better, it could also prevent the underlying condition from advancing. If you are a smoker, you have another reason to kick the habit. Nicotine can magnify pain and delay healing.

 Interventional Pain Management Techniques

Nerve blocks, epidural steroid injections, nerve ablations, and other types of injection-based procedures provide relief directly to the source of the pain. Since they are usually localized to a specific area of the body, your doctor can also use these treatments to isolate the cause of your discomfort. Depending on the severity of the pain, one injection might be all you need to feel relief, but if necessary, you can repeat treatment every few months. Injections take place around important structures such as nerves, blood vessels, and spinal fluid, so you want to make sure that you work with a trained interventional pain doctor.

Nearly 50 million adults suffer from chronic pain, but you don’t need to give up hope. With the right treatment, you will be able to manage your pain and go back to focusing on the things that make you happy.

School is out for summer!  Many children will immediately transition into summer activities or vacations. Or they will take much-deserved breaks from their overscheduled lives.  And as is often the case with modern kids with downtime, screens likely will play a large role in their time away from school.

Patients as young as six-years-old are complaining about neck pain. Usually, it’s because they hunch over, neck strained, looking down at their cellphone, tablet, or computer keyboard. Of course, it’s not just children who have this problem. Anyone that spends time looking at a screen sits or stands in an unnatural position, causing constant stress on the back and shoulders or “tech neck.”

While back and neck pain is common, at least 70% of adults report issues that tie back to the use of electronic devices. Your body adapts to the stresses and strains that you put on it. Holding specific positions for longer than 20 minutes can cause that area to lose flexibility. Prolonged periods of hunching over our screens are slowly causing our necks to “get stuck” in a more forward position because those strained tissues lose their pliability.

Stop reading right now and take note of the position your neck is in. Now think about how long you usually look at a screen.

With correct posture the head weighs 10 to 12 pounds, but when you lean over, the head becomes a 40-pound boulder straining your body. This can cause a lot of pain and dysfunction such as headaches and lack of sleep. Over long periods of time, tech neck can lead to muscle strain, disc injury, nerve impingement, and arthritic changes. On the other hand, studies show that proper posture decreases stress and increases testosterone, feelings of power, and comfort with risk-taking.

The good news is that in many cases, you can reverse the effects of tech neck. Here are some tips:

• Take mini-breaks every 15 minutes or so, spending 30 seconds resting your eyes and stretching in place.
• Every hour, take a longer break by getting up for a quick walk or spending a few minutes on a different task to break things up.
• Incorporate exercises into your daily routine with the goal of strengthening the muscles around your neck and back.
• Sit properly or change to a chair that will help your posture. Keeping the back of your head flush against a headrest will ensure that you’re not looking down with your neck flexed forward.

If you’re experiencing pain in your neck, numbness or tingling in the arms, or frequent headaches, there may be a more serious issue. Act quickly to correct your posture and consult with a doctor about managing your pain. There are physical therapy programs, over-the-counter medications, or steroid injections that can help you find comfort.

With children, movement is crucial, so do your best to limit screen time. A child who spends three to five hours a day on a phone or tablet is spending 1,500 hours a year straining their spine. By their 20s, that child could spend their summers trying to manage chronic neck pain.

An increase in temperature can bring on an increase in fatigue. The change in weather can cause you to focus on your sleeping habits—especially if you’re not getting enough rest.

According to the National Sleep Foundation, lack of sleep can affect mood and functional ability as well as have a negative impact on pain perception. At the same time, back pain can make it tough to get a good night’s sleep. But if you dig a little deeper, you’ll learn that how you sleep may make things worse. While certain sleep positions put strain on an already aching back, others may help you find relief.

Some sleep positions can put added pressure on your neck, shoulders, hips, lower back, knees, and even your heels—all of which can lead to pain.

What is the most common offender? Any sleeping position has the potential to amplify back pain if you maintain it for too long, but sleeping on your stomach flattens the natural curve of your spine and puts some additional strain on your back muscles. Plus, stomach sleeping means that your neck is rotated, which can result in pain in your neck or between your shoulders.

To avoid discomfort, you don’t have to worry about keeping your body in the same position all night. It’s normal for you to move around a bit while you sleep, and that can help ease pressure on your back. Also, there’s no universal position to beat back pain, but you can try a few tricks to get it under control so that you can sleep more soundly.

First, you’ve got to be comfortable. A few simple modifications to your regular sleep position will help take a load off your back:

• If you’re a back sleeper: Put a pillow under your knees to allow your spine to maintain its natural curve.
• If you’re a stomach sleeper: Put a pillow under your lower abdomen and pelvis to ease back strain.
• If you’re a side sleeper: Draw your legs up slightly toward your chest and sleep with a pillow (a full body pillow can be comfortable) between your knees.

When it comes to selecting a mattress and pillow (or number of pillows), personal preference and comfort always take priority. Test out different surfaces in your home or spend a night in a hotel that offers options to see what works best for you.

Don’t forget that daily activity—or lack of it—is just as important as sleep position. If you sit too long during the day, or don’t sit properly, chances are that you spend several hours slouching with a rounded back. Try to vary your posture as much as possible, and practice good posture when standing and sitting to help ease back pain at night. Likewise, if you spent all winter indoors, the sudden jolt of strenuous activity outside might catch up with you when you’re sleeping.

If a few changes to your sleep position and daytime routine don’t help your back pain or sleep troubles, it may be time to get a medical opinion. If your pain increases, ask your doctor to check for any potentially serious problems.

May is National Arthritis Awareness Month. In recognition this year, the Arthritis Foundation has launched the “Let’s Get a Grip on Arthritis” campaign with the goal of spreading awareness and gaining support to find a cure.

Arthritis is not a single disease but rather an informal way of referring to joint pain. There are more than 100 different types of arthritis and related conditions that affect people of all ages, sexes, and races. It is the leading cause of disability in America, but since you tend to suffer quietly, people without arthritis often know nothing about it.

Here are some quick facts:

• More than 54 million adults in the United States have doctor-diagnosed arthritis, and 37 million more Americans may have it without knowing.
• Arthritis isn’t just an “elderly disease.” Two-thirds of people with arthritis are under the age of 65, including 300,000 children.
• While it may not be as life-threatening as cancer or heart disease, arthritis accounts for 100 million doctor visits and nearly 7 million hospitalizations each year. It can damage vital organs and make other conditions worse.
• Arthritis is to blame for the loss of 172 million workdays each year and costs the U.S. economy more than $300 billion annually in lost wages and medical expenses.

Arthritis is inflammation of one or more of your joints. The main symptoms are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis, which causes cartilage to break down, and rheumatoid arthritis, which is an autoimmune disorder that first targets the lining of joints.

Perhaps worst of all, arthritis steals quality of life. You must give up intense workouts or any hobbies that require physical movement. Normal activities such as grocery shopping or laundry become a painful burden.  Even picking up your child is a source of discomfort.

There’s no cure yet, but there are effective treatments to reduce symptoms and improve joint function. You may need to try several different treatments, or combinations before you determine what works best for you. Lifestyle modifications and self-care can also make a big difference.

The medications used vary depending on the type of arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce both pain and inflammation and are available over-the-counter and by prescription. Some NSAIDs are also available as creams or gels that you can rub on your joints. Other varieties of ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these on the skin may interfere with the transmission of pain signals from the joint itself. Corticosteroids, which include prednisone and cortisone, reduce inflammation and suppress the immune system. You can take them orally or have them injected directly into the aching joint every three months by a pain management physician.

One of the exciting aspects of Arthritis Awareness Month is that we get a chance to see how far we’ve come in developing treatments. Advances in medicine over the past couple of decades have limited the debilitating effects we used to see. So while there still isn’t a cure, we can use this month to celebrate progress and look ahead to a time when arthritis becomes a minor inconvenience in our lives.

National Stress Awareness Month

Believe it or not, April is National Stress Awareness Month. You might be thinking that makes perfect sense, or you might be shocked that it’s not another time of year when your anxiety is at its maximum.

But the truth is that stress is universal. It doesn’t matter what time of year it is or whether you’re Wall Street banker in New York or a Walmart cashier in Springdale, Arkansas.

Nearly everyone experiences some sort of mental or emotional tension at some point in their lives. Stress is a normal psychological and physical reaction to the regular demands of your day. A small amount of stress can be good, motivating you to perform well. But dealing with multiple challenges every day, such as traffic, deadlines, and bills, can push you beyond your ability to cope.

Your brain is hard-wired to perceive a threat and signal your body to release a burst of hormones that increase your heart rate and raise your blood pressure. This response fuels you to deal with the threat. Once the threat is gone, your body is supposed to return to a normal, relaxed state. Unfortunately, the nonstop complications of modern life can prevent your alarm systems from shutting off.

Pain can be both a source and sign of stress. In fact, headaches, neck aches, and back pain are among the most common symptoms of stress. The brain is always trying to limit pain signals, but stress prevents you from properly filtering these signals. As with any conditions, the symptoms become more severe if left unchecked.

To break this cycle, stress relief becomes a key component of pain management. Try these tips:

• Find a balance. Take the time to examine your daily routine and modify it for better stress control. Consider each part of your life, and identify the triggers that cause your anxiety. Place more emphasis on the activities you like to do.
• Get moving. Whether it’s 30 minutes on an exercise bike, or four times a week at the gym, exercise can heal your mind and your body. Consult with a doctor first to ensure that your routine does not cause your pain to flare up.
• Sleep more. Proper sleep can improve your concentration, ease your mind, and help your body heal. More sleep isn’t always good sleep. Make sure you’re resting with limited distraction.
• Chill out. Relaxation techniques such as deep breathing, yoga, guided imagery, and meditation can essentially force you to relax and decrease stress levels. Once you’ve learned these techniques, you can do them on your own at any time throughout your day.
• Seek support. Evaluation by a mental health professional, such as a social worker with expertise in pain or a pain psychologist or psychiatrist, can also help you deal with stress and provide pain relief.

If pain persists or becomes unbearable, check with your doctor. Stress might not be the only factor, and there are plenty of ways to manage your comfort.

Even though this month is officially focused on stress awareness, managing your mental, physical, and emotional health is a year-round effort. Take some time to find what makes you happy and that can go a long way toward relieving your pain.

March Madness is here. With all that basketball to watch, you might be looking to eat something better than pizza and wings—especially if you read our previous post about foods that help manage pain.  We’ve curated some suggested recipes based on typical causes of pain. If you really want to make a game out of it, you could group these ideas into brackets and pick your favorites. Because food may trigger different reactions in different people, it’s best to consult your doctor before beginning a new diet.

Inflammation
When your body is under attack from foreign invaders, inflammation can help stimulate healing. But chronic, long-term inflammation can cause many different health issues. If you’re taking medication regularly but not rethinking your diet, you’re still fueling inflammation.

• 20 Anti-inflammatory Recipes to Help You Glow from the Inside Out via Spoon University

Arthritis
Arthritis is not a single disease but an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions that affect all different kinds of people. Fortunately, many foods can help manage the pain.

• Arthritis-friendly recipes via Arthritis Foundation

Nerve Pain
Often caused by diabetes, fibromyalgia, shingles, or nutrient deficiencies, nerve pain can be difficult and uncomfortable. Diet can play a large role in managing that pain. Some foods can weaken or damage the nerves further while other foods can strengthen your nerves—helping to guard against further damage and boosting the health of your peripheral nervous system.

• Quick and Easy Recipes for Neuropathy via Cook for Your Life

Muscle Soreness
Your muscles might feel sore after a run or overdoing it at the gym—particularly if you don’t normally exercise rigorously. This occurs due to muscle damage and the buildup of natural waste products in your cells. Eating the right foods before and after physical activity can help your muscles heal faster, ease pain, and even protect against muscle damage in the first place.

• Post-Workout Meals via Cooking Light

Stress
Pain and stress have a similar effect on the body. Your heart rate and blood pressure rise. Breathing becomes fast and shallow. And your muscles tighten. This takes a big toll on your body. Levels of stress hormones increase, and muscles remain in a nearly constant state of tension. Many people forget that stress and nutrition are also closely linked. A well-planned diet would ease strain on both the mind and body.

• 20 Recipes to Help Reduce Stress via Eluxe Magazine

The Winter Olympics are in full swing, and inevitably, you’ll hear tales of athletes’ eating habits. Either they indulge in junk foods to relieve some of the stress of training or they adhere to strict diets to gain a competitive edge.

Those who compete in sports that put a lot of strain on their bodies know that food has many advantages in managing pain. While pills reduce suffering, they can be addictive and produce side effects. Worse, they often fail to eliminate the true cause of the discomfort. However, certain foods ease aches by blocking pain signals.

A common cause of pain is inflammation or the body’s immune response to toxins as it works to “purify” itself. Left unchecked, inflammation will run rampant through your body and trigger chronic diseases. While medications may cause fogginess, memory loss and sleepiness, a carefully managed diet is a natural form of pain management with no side effects. A good amount of research also shows that an anti-inflammatory diet can ease fibromyalgia and chronic pain symptoms.

The first step toward fighting pain with food is to clean up your act. The typical Western-style diet is heavy on meals that cause inflammation, including highly processed foods and refined carbs. No fruit, vegetable, or herb by itself can alleviate your pain if you don’t cut out junk food. A strict vegan or Mediterranean diet can control insulin and cholesterol levels and reduce inflammation.

Studies show that specific foods have more benefits than others, but these basic guidelines should get you started:

• Eat more fruits and veggies. Eight to nine servings a day of cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, and cauliflower are best.
• Restrict dairy and grains. Eat dairy products in limited quantities. When choosing grains, stay away from simple carbohydrates with refined sugar. Opt for whole grains such as barley, buckwheat, oats, quinoa, brown rice, rye, spelt, and wheat.
• Control your calcium. As you age, you’re prone to conditions that weaken the vertebrae in your spine. Calcium contributes to bone mass, which helps you avoid those conditions. Natural food sources include yogurt, milk, and cheese as well as leafy green vegetables.
• Avoid red meat. Replace red meat with fish or vegetarian dishes. Chicken is neutral—not harmful but not beneficial in the anti-inflammatory sense.

For best results, a diet cannot work alone. As any athlete will tell you, the best way to capitalize on a nutrition plan is to take an integrative approach that includes exercise and stress management. And if you stay committed to an integrative lifestyle, you may not only reduce pain but eventually eliminate it.

There’s no other way to put it. We’re facing an opioid addiction crisis in the United States.

Opiates are narcotics that change the way the brain responds to pain stimuli and can also produce a “high” feeling by disrupting the reward and pleasure centers in the brain. Repeated use or abuse of an opioid drug can change the way an individual’s brain chemistry works and lead to physical and psychological dependence. The body may not feel normal anymore without the drug.

When taken as directed, opioids can manage severe pain effectively over a short amount of time. With long-term use, patients need screening and monitoring to prevent them from developing an addiction or physical dependence on the medications. Recent research shows that opioid abuse has a direct link to heroin.

The Centers for Disease Control and Prevention reports a staggering set of numbers:

• Overdose deaths involving prescription opioids were five times higher in 2016 than 1999, and sales of these prescription drugs have quadrupled during that same time.
• In 2014, almost 2 million Americans abused or depended on prescription opioids
• From 1999 to 2016, more than 200,000 people have died in the U.S. from overdoses related to prescription opioids.
• Every day, more than 1,000 people receive treatment in emergency departments for misusing prescription opioids.
• More than 46 people die every day from overdoses involving prescription opioids.

This epidemic is why physicians and pharmacists are increasingly raising the bar on who can receive opioid medications, how much, and for how long. The risk of addiction is not their only concern. Long-term use of opioids can also make pain worse by decreasing your ability to tolerate pain and increasing sensitivity to pain. In fact, people taking opioids over long periods may keep having pain—or may see their discomfort increase—long after the original cause has healed.

Withdrawal symptoms can be severe depending on the level of addiction. Signs appear within a few hours of the last dose, and the symptoms can last for a week or more. Some psychological symptoms and cravings may continue for much longer. Unassisted withdrawal may not be life-threatening, but it can lead to relapse. Medications and therapy through medical detox may make relapse less likely.

One solution to prevent the crisis is to improve the way medical professionals prescribe opioids. Proper guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who abuse these drugs. In 2016, the amended CDC Guideline for Prescribing Opioids for Chronic Pain recommended lower doses and stricter monitoring efforts. And while previous guidelines focused on “high risk patients,” the new recommendations address the risk to all patients.

There is also a wide range of safer options for managing pain. A Fellowship Trained Interventional Pain Doctor would start with a thorough examination to tailor treatment to you. Most patients start with physical therapy and a prescription of non-narcotic pain killers to address stiffness and inflammation. From there, options include localized steroid injections or nerve blocks and a Radiofrequency Ablation, which uses heat and radio signals to destroy small nerves that supply the source of your pain.

The crisis won’t go away overnight. However, if everyone takes a moment to educate themselves about the problem, we can work together to solve it.