Identify The Cause Of The Pain
The first step in treating pain is to try to identify the cause. As I noted in the last essay, there are many different causes of pain for people with PD. If we look at the most common pain problems, low back and neck pain, we can see that there are many different causes for each. Many doctors order x-rays of the spine for these conditions, and they may be needed. The main problem with x-rays of the spine is that they always show arthritis, which is because virtually everyone over the age of 60 has arthritis in the spine. Whether thats the cause of the pain or not is usually not clear.
However, x-rays will show if theres a compression fracture , or a tumor. Since older women frequently develop compression fractures even without a fall, this can be important because we know then that the pain is likely severe, but time limited, and will resolve in a month or two. This makes it easier to treat with strong medication, like narcotics, because there is less concern for addiction. X-rays do not show discs, but disc herniation is much less common in older people so its of less concern.
Chiropractors focus entirely on spine pain and may be very helpful. Since many medical doctors are not very familiar with PD, I assume that many chiropractors probably arent either. Therefore it will be helpful to find one who is familiar with PD. Probably the best way to do this is through a Parkinsons Disease support group in your area.
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A total of 97 Parkinsons patients at a mean age of 67.7 years, including 60 men, and 97 individuals used as controls at a mean age of 67.5 years, including six men, without the disorder or other neuromuscular diseases, filled out a questionnaire on the intensity of local lumbar back pain. The intensity of leg radicular pain caused by inflammation and/or injury to a spinal nerve root was quantified by the visual analogue scale a continuous scale used to measure pain intensity.
In addition, the participants permanent functional disability was assessed via the Oswestry Low Back Pain Disability Questionnaire a self-completed questionnaire that includes 10 different topics: intensity of pain, lifting, ability to care for oneself, ability to walk, ability to sit, sexual function, ability to stand, social life, sleep quality, and ability to travel.
Patients were further asked to describe the painful sensation they experience as pricking, tingling, burning, paresthesia often described as feelings of pins and needles, or numbness or other.
The team also assessed Parkinsons duration, medications being used, severity of motor symptoms as assessed by the Unified Parkinsons disease rating scale part III and the Hoehn and Yahr stage, which is a system used to assess symptom progression.
According to the ODI results, minimal disability was reported by 43.8% of Parkinsons patients, moderate disability by 27.5%, severe disability by 22.5%, and crippled by 6.3%.
Living With Parkinsons Disease
Depending on severity, life can look very different for a person coping with Parkinsons Disease. As a loved one, your top priority will be their comfort, peace of mind and safety. Dr. Shprecher offered some advice, regardless of the diseases progression. Besides movement issues Parkinsons Disease can cause a wide variety of symptoms including drooling, constipation, low blood pressure when standing up, voice problems, depression, anxiety, sleep problems, hallucinations and dementia. Therefore, regular visits with a neurologist experienced with Parkinsons are important to make sure the diagnosis is on target, and the symptoms are monitored and addressed. Because changes in your other medications can affect your Parkinsons symptoms, you should remind each member of your healthcare team to send a copy of your clinic note after every appointment.
Dr. Shprecher also added that maintaining a healthy diet and getting regular exercise can help improve quality of life. Physical and speech therapists are welcome additions to any caregiving team.
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Contact Gillette Law Group
The pain you experience from degenerative disc disease can deeply affect your work, your earnings, and your life overall. If you believe you truly need assistance, do not be discouraged by the strict application process for disability benefits. We at the Gillette Law Group can give you get the best chance at the benefits you need and deserve.
Your consultation with us is free, so dont hesitate to talk to us. Call us today at 873-2604
Barriers To Service Connection For Degenerative Disc Disease
Degenerative disc disease is known to be a condition that develops over time. When filing a VA claim for DDD, veterans will want to be sure they are submitting a current diagnosis from a doctor, a statement explaining what in service events or conditions contributed to the DDD, as well as a medical nexus from a doctor linking the degenerative disc disease to your time in service.
When denying service connection for degenerative disc disease, VA often relies on an examiners finding that the veterans condition is due to normal wear and tear and the natural progression of aging rather than their time in service. However, if VA examiners arrive at this conclusion, they must provide adequate rationale to support it, otherwise, VA should not rely on it for adjudication purposes. It is not enough for the examiners to simply say that a veterans DDD is due to natural progression and aging. Instead, they must also explain why it is not due to other factors, such as service.
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Q What Role Does Exercise Play In Pain Management In Pd
Dr. Fleisher: Exercise and physical therapy can be tremendously helpful in managing pain in PD, in addition to being important for overall disease management.4,8 Evidence suggests that exercise is the best option we have to alter the course of PD, and it has been shown to promote neuroplasticity and neurorestoration in PD.9,10 In addition, research suggests that exercise can activate both dopaminergic and non-dopaminergic inhibitory pain pathways, which may help to modulate the experience of pain in PD.10
Good exercise options include walking, swimming, dancing, and using a recumbent bike. In particular, forms of dance with smooth movements and those that encourage bigger steps appear to be especially beneficial in helping retrain the brain that the shuffling gait of PD is not the norm. Incredible work has come out of the Mark Morris Dance Company, in New York City, which has started a Dance for PD class that has spread throughout the country. In addition, yoga and tai chi can help with balance and core strength, which are critical for people with PD.
Importantly, there doesnt appear to be an upper limit for the benefits of exercise on the disease. I encourage patients to aim for at least 30 to 45 minutes a day at least 3 to 4 days a week. Patients who are sedentary should start with 5 minutes per day for a week, and then increase the duration each week.
Collect Other Documentation Supporting Disability Due To Degenerative Disc Disease Because You May Need It
Many people that apply for SSD with back issues are initially denied benefits. This is especially true for those under the age of 50. Additional documentation can help fortify your claim, including any evidence that documents your specific symptoms and the types of common job functions they prevent you from performing. Use the following evidence to your advantage:
- Statements from your former employer or a human resources representative,
- Records of sick days, short term disability leave, and family medical leave from your former employer,
- Information in the disability application,
- A formal statement or report from your doctor, summarizing your condition and its effects on everyday activities, including employment-related activities.
Other items that may be useful as part of your appeal hearing include job descriptions, performance evaluations from work, and formal statements from family members or others that can attest to your daily limitations and your common need for assistance in completing everyday tasks.
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The 5 Stages Of Parkinsons Disease
Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.
Complementary Treatments For Back Pain
Massage therapy and acupuncture are two complementary treatments that are often used for pain. There have been small studies investigating the use of massage therapy and acupuncture for motor symptoms of PD, but more studies are necessary to s determine if they specifically help with PD pain. You can also view a Q+A about complementary treatments in PD.
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What Do They Look For In An Mri Or Ct Scan
These scans are looking for problems that can occur in the discs that rest between the bones. As you get older, not only does the jelly part of the disc begin to dry up, the radial tire part that holds the jelly inside also can begin to weaken. As it weakens, the pressure of the spine on the disc can begin to squeeze the jelly part against the weakened radial tire part. If the disc sees a lot of stress, the pressure of the jelly can cause a bulge in the disc, . This bulging of the disc is very common as you get more mature, and almost everyone has some disc bulging in their spines. This bulging rarely causes symptoms and is considered a normal part of getting older. If the pressure is great enough and the radial tire part weak enough, this bulge can get larger. This larger bulge is called a protruding disc, and if it gets big enough it may actually push against the nerves as they leave the spinal cord and run to your extremities . This can cause pain or the symptoms of an unhappy nerve: tingling, numbness and weakness.
Common Symptoms Of Degenerative Disc Disease
With symptomatic degenerative disc disease, back pain sometimes radiates to the hips, or there is aching pain in the buttocks or thighs while walking tingling or weakness in the legs or feet may also be evident. Sitting, lifting and twisting may cause or increase pain and other symptoms. Degenerative changes in the neck can produce similar symptoms in the shoulder, arm or hands.
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Myopathy Associated Postural Deformity In Pd
Inflammatory myopathy of the paraspinal muscles can mimic the appearance of camptocormia in PD. Wunderlich et al.38 have described a 63-year-old man with PD in whom a camptocormia-like deformity developed. They noted hyperintensity within the paraspinal muscles and histopathological features consistent with myositis. The patient was treated with steroids and they noted marked improvement in forward flexion.
Myopathy with nemaline rods, end-stage myopathy with autophagic vacuoles, mitochondrial myopathy, and necrotizing myopathy have all been associated with camptocormia in patients with PD.15,25,30 Gydnia et al.15 have studied 19 consecutive muscle biopsies obtained in patients with PD and either camptocormia or dropped-head syndrome , finding abnormal muscle biopsies in all patients. Although MRI images were not abnormal in all patients, MR imaging generally showed fatty degeneration of the paravertebral musculature or neck extensor musculature in many of them. Electromyography was also generally consistent with myopathy changes.
Q Which Pharmacotherapies Are Best For Treating Pain In Pd
Dr. Fleisher: The first step is to make sure that Parkinsons medications are optimized. For example, dystonic or musculoskeletal pain may be caused by Parkinsons motor symptoms when dopamine levels are too low. If the patient is able to keep a pain diary, it may show a clear pattern of pain occurring the hour before each dose or before specific doses, suggesting the need to either increase the dosage preceding the pain episode, increase the frequency of medication dosing, or use adjunctive dopaminergic therapies to achieve more steady dopamine levels throughout the day.
In addition, optimal management of comorbidities that may contribute to pain is needed. The choice of pain medication depends on the pain type.
The first lines of treatment for musculoskeletal pain can be heat and cold packs and nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen.
For dystonic pain, adjustment of dopaminergic medications is particularly critical however, if dystonia consistently occurs in 1 particular body part, botulinum toxin injections also can be helpful. The goal of botulinum toxin injection is to weaken the muscle enough to stop the abnormal contractions and twisting, but the patient may lose function in the body part as a result . Thus, patient counseling is important to manage expectations.
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How Do I Decide Whether To Have Surgery
The decision to have surgery on your spine should be done after careful consideration of all of the factors involved. Most spine problems get better without surgery, but when the symptoms begin to take over your life, consultation with a spine specialist is recommended. There is little doubt that a structured exercise program helps people with spine disease. Surgery for spine problems should only be done after a careful consideration of the potential benefits, risks and the long-term consequences of surgery.We recommend that the patient seek out information from reliable sources and from careful consultation with physicians and family. There are other spine conditions that can cause pain and nerve irritation that were not discussed here. This guide discusses the most common form of spine disease and provides general information about spine problems. However, the information here may not apply to other conditions, and you should consult your physician if there are any problems.
Everything You Need To Know About Spine Disorders
Back pain is one of the most common symptoms, even in healthy individuals. Most of us will experience at least one episode of back pain throughout our lifetime. If were lucky enough to never experience this symptom, we will definitely have someone around who does. Thats why we want to understand spinal disorders as a significant cause of back pain.
In this article, were going through 2 types of spine disorders and their subtypes. First, were talking about degenerative spine disorders including arthritis and degenerative disc disease. Then, were listing other structural spinal disorders such as kyphosis and spinal tumors.
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Cervical Degenerative Disc Disease
Cervical spondylosis is a term used for osteoarthritis of the upper spine, and it involves accidental disc degeneration or joint facets.
When there are no symptoms , it is commonly the spontaneous degeneration, whereas the alternative terms are degenerative joint disease and degenerative disc disease .
It is very important to know the symptoms. For example,
- loss or pain in neck movement, joint incompetence can be due to cervical spondylosis, neck arthritis
- spinal cord pressure and related pain can be due to cervical spondylitis myelopathy)
- neurological complications of joint degeneration can be a symptom of cervical nerve root compression due to cervical spondylitis radiculopathy.
Tip: Sciatica is a common complication of sciatic nerve compression. Here are tips for sciatica prevention and proven remedies for the cure.
Treatment For Degenerative Disc Disease
Degenerative disc disease treatment includes occupational or physical therapies, either or both can be used as a treatment. Moreover, special exercises, medications, surgery or losing weight can be used.
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What Is The Treatment For A Herniated Disc
The initial treatment is to have a complete evaluation by your physician to assess the extent of the damage to the nerves. If you have numbness and weakness, it should be done sooner rather than later, and if you find that you are getting progressively worse it also should be done as soon as possible by your physician or in the emergency room. Once the extent of the damage is assessed, in most cases the treatment is the same as for arthritis of the spine.
The initial treatment is rest, heat or ice, pain medication, NSAIDs and sometimes oral steroids. The symptoms usually take several weeks to several months to decrease. In most cases the symptoms will decrease on their own with no other treatment.
Physical therapy can be of some help in the early stages to help decrease the pain and help with range of motion. Sometimes traction is helpful but it should be gentle and at the instruction of your physician. Once the pain is better, there are exercises that can increase muscle strength and keep the risk of recurrent pain down. This treatment should be directed by your physician. Also, taking precautions not to stress your spine is helpful. For example, heavy lifting is not recommended, and if the disc is in the neck, then heavy lifting with the arms away from the body is not conducive to good health.
Two Parts Of Intervertebral Disc
Between the vertebrae of each spinal segment are two facet joints. The facet joints are located on the back of the spinal column. There are two facet joints between each pair of vertebrae, one on each side of the spine. A facet joint is made of small, bony knobs that line up along the back of the spine. Where these knobs meet, they form a joint that connects the two vertebrae. The alignment of the facet joints of the lumbar spine allows freedom of movement as you bend forward and back.
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