APM Blog

Sunday, 19 November 2017 05:37

8 Daily Habits That Reduce Pain

Oftentimes a patient’s most complicated challenge is pinpointing the source of what is causing them pain. Pain specialists are trained to recognize conditions and recommend new treatments, procedures and pain management techniques. Relief can come in the form of not only medications, but also a few simple habits that can be incorporated into our daily routine to help alleviate both acute & chronic pain. From exercise to meditation, quitting smoking to eating healthy foods, these simple habits could change your quality of life.

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8 daily habits to help reduce pain

Published in Acute and Chronic Pain
Saturday, 18 November 2017 14:04

5 Tips for Apple Picking

Autumn offers an opportunity for fun outdoors activities, like apple picking in the fresh, crisp air. But before you head out to your local orchard, there are few things you should consider.

The pain team at Advanced Pain Management has five tips for you before you grab your pail and hit the outdoors.

  1. Pack light. To make the most of your apple-picking adventure, plan ahead so you are prepared for lots of walking. Be sure to pack only the items you need so you have room to carry all of the apple you pick!
  2. Dress in layers. The weather can change quickly in the Autumn so be prepared with layers you can add or remove at any time.
  3. Stay hydrated. Bring a full water bottle so you can stay hydrated as you walk the orchard grounds. The cool weather may mask how hard your body is working to walk and pick apples.
  4. Take regular breaks. It is important to rest your body as you work. Take a break every 15 - 30 minutes and sit and enjoy the sceanery.
  5. Wear comfortable shoes. To get the best crop, you'll need to do a lot of walking. Be prepared with light, comfortable running to tennis shoes that provide ample support. Also note that you'll likely we walking on all types of terrain.

Did you know there is a right way to pick apples off a tree?

Place your hand under the apple and then gently twist the apple rather than pulling it.  The stem should break free from the spur.

Are you storing your apples properly?

Apples stay fresh longer when they are kept in a cool place. To help your apple last even longer, don’t wash an apple until you are ready to eat it, and be careful not to bruise your apples because bruised apples will rot more quickly.

Published in Healthy Living

Fibromyalgia can be a confusing diagnosis and difficult to understand. Prior to receiving this diagnosis you many are sent to numerous specialists including immunologists, neurologists, and rheumatologists. Each specialist may have given you a different diagnosis or treatment option, with various medications that you tried and failed. Now what? It is important to have a clear understanding of what fibromyalgia is.

Fibromyalgia is defined as widespread pain and hypersensitivity to normal touch and daily activities. The latest research is suggesting that fibromyalgia is a product of a sensitivity of the nervous system, starting in your brain. When your brain decides there is a threat to your survival, it will increase the sensitivity of your whole system to ensure you are aware of how to protect yourself. Your brain is doing too good of a job trying to protect you.

So what can you do about it?
There is no reason to believe that you can’t live a normal life without constant pain, fatigue, and other symptoms associated to fibromyalgia. Physical therapists are equipped to work with you to determine the best way to manage your symptoms. Here are a few of the things your PT will do to decrease your symptoms and help you get back to doing what you love!

  • Develop a routine exercise program. This is vital in the recovery and management process. The human body is designed to move, and a regular exercise program will help restore a chemical balance that decreases sensitivity. Your physical therapist will help you determine which mode of exercise is the most appropriate for you.
  • Learning how to pace yourself will help improve your ability to perform activities without causing a flare up of pain.
  • Therapeutic neuroscience education to help understand why you have pain and what is happening in your body when you experience pain. Knowledge is power! The more you understand about fibromyalgia, the more you can empower yourself to take charge of your pain! YOU are the best tool against fibromyalgia pain.

There are resources out there to help you through this process. A recommended workbook that will help guide you down the road to recovery is “Your Fibromyalgia Workbook” By Adriaan Louw PT, Ph.D., CSMT.

Don’t be discouraged by fibromyalgia, move forward with physical therapy!!

Published in Fibromyalgia
Saturday, 18 November 2017 07:10

What Is A Headache?

What is a headache?
A headache is defined as an ache or pain in the head caused by irritation to the nerves around the face, neck, skull or head. A headache is often described as dull, throbbing, sharp and gradually or it can suddenly appear and can last for hours or days. The International Headache Society categories headaches two ways: primary and secondary.

What is a primary headache?
A primary headache is a headache that is considered a standalone illness. That means that the headache is caused by over activity and/or problems with structures in the head that are sensitive to pain. Common primary headaches include migraines, tension and cluster headaches.

What is a secondary headache?
A secondary headache is a headache that is a symptom of another condition. That means another condition causes the headache. For example, you may have a secondary headache if you are dehydrated, have influenza or have a concussion. In some cases, a secondary headache could be a result of a more serious condition.

What does episodic and chronic mean when it comes to headaches?
An episodic head means that the headache can last for a few hours but could last for a few days. Whereas a chronic headache is considered to be continuous, as in, they occur for 15 days or more in a month.

What are the symptoms of primary headaches?

  • Tension headaches are the most common type of primary headaches. A tensionheadache is often described as a tight band feeling around the head with a constant, dull ache on both sides of the head. The pain can spread to or from the neck.
  • Migraine headaches are the second most common type of primary headache. Migraine headaches may cause a pulsating, throbbing pain on one or both sides of the head. Other symptoms include lightheadedness, blurred vision, nausea and sensory disturbances.
  • Cluster headaches are the most uncommon type of primary headache. A cluster headache can typically strike quickly with little to no warning. Cluster headaches are described as sharp or burning, and typically are located around one eye. The affected area can become swollen and red.

If you experience headaches on a regular basis, it is important to seek help. Once you know what type of headache you are experiencing it is easier to understand your triggers and find treatment that works for you. To learn about headaches and possible treatments options, click here.

What are headaches? What causes headaches?, http://www.medicalnewstoday.com/articles/73936.php#signs_and_symptoms

How to use this classification, http://ihs-classification.org/en/01_einleitung/03_anleitung/ 

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Published in Headache

Has managing your pain become a challenge when it comes to settling down for a restful night’s sleep? While sleep plays a critical part in our overall well-being, the good news is that even if you suffer from pain, there are many ways you can improve habits to help get the quality sleep your body needs. Before counting sheep, consider these easy tips:

1. Eat Healthy Throughout The Day:  Eating healthly throughout the day can be an important factor in how well you sleep at night. If you are someone who experiences hunger before bedtime, eat a small serving of carbohydrates and fat (berries and nuts) about 15 – 30 minutes before you go to bed. Be sure to avoid heavy, rich foods, alcohol and fatty foods 2 -3 hours before bed as these can cause indigestion and insomnia.

2. Nap Strategically: If you need to make up for lost sleep at night, it is ok to take short naps during the day rather than sleeping in late in the morning. This prevents disruption to your natural sleep – wake pattern. If insomnia is a problem for you, consider eliminating naps altogether.

3. Keep To An Evening Routine: Setting a bedtime and going to bed at the same time each night may prevent tossing and turning. If you must change your schedule on the weekends, try doing it in small increments. If you change your bedtime, help your body adjust by changing in small daily increments, such as 15 minutes earlier or later each day. It is also beneficial to incorporate relaxing rituals in the evening prior to going to bed such as taking a bath, reading or meditating. 

4. Exercise Most Days:  Physical activity, especially cardiovascular workouts, are known for improving the length and quality of your sleep. That said, it’s best not to exercise within 4 hours of going to bed because body temperature elevates. As you cool down, your brain receives signals to produce sleep-inducing melatonin.

5. Pay Attention To What You Drink: Watching what you drink in the late afternoon and evening hours has a number of implications on your ability to get a good night’s rest. Drinking too much before bed can cause disruptive, middle-of-the-night trips to the bathroom. Caffeine should be limited as it can keep you awake 10 to 12 hours after drinking it. After lunch, cut back on your overall intake or consider avoiding caffeine altogether. Be cautious when drinking alcohol as well – it can take hours to wear off and wreak havoc on your quality of sleep. 

6. Get Comfortable:  Create a comfortable room that is cool, dark and quiet. When sharing a bed with someone else, make sure it is big enough and at the comfort level for both of you. Set limits on how often children or pets share your bed or encourage they use their own beds most, or all of the time.

What tips do you have to help improve sleep?

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Published in Sleep-and-Pain

Did you know that eating certain foods increases the inflammatory markers in our bodies, while eating others can decrease signs of inflammation? People with acute and chronic pain often have a high amount of inflammation in their joints, muscles and blood. Changing your eating habits can decrease inflammation in your body, increase your energy, help you maintain a healthy weight and allow you to feel better both physically and emotionally.

There are three important dietary improvements you can make today that can help you reduce pain.

Limit Sugar

Sugar, AKA corn syrup, high-fructose corn syrup, dextrose, fructose, maltose and sucrose. You know that you can find sugar in cookies and brownies, but did you also know that sugar is hiding in many foods that are advertised as “healthy”? These include granola bars, instant oatmeal, juices, crackers, prepackaged meals and more. Think like a detective, and be sure to carefully read foods labels on everything you eat, paying close attention to grams of sugar.

Limit Simple Carbohydrates

Simple carbohydrates include “white” foods, like: white pasta, white breads, white crackers and anything made with white flour. Why should you limit these foods? Simple carbs quickly break down into forms of sugar, which we know to be inflammatory and related with weight gain, cardiovascular diseases and cancers. Studies have shown that eating a diet lower in carbs and higher in healthy fats and proteins also reduces inflammation in the body.

Limit Food Additives

Try to limit food additives in your meals, particularly MSG and artificial sweeteners and preservatives. These additives are found in several “low fat” and “diet” products, as well as prepackaged foods and processed meats.

What Should You Eat More?

You might be worried that abiding by the above recommendations that you will be limiting your foods choice but that isn’t true! Foods shown to be especially anti-inflammatory and good in all sorts of other ways include: berries, cherries, spinach, kale, sweet potatoes, olives and olive oil, fish (especially salmon, halibut, sardines, tuna, trout, whitefish, cod and oysters), avocados, green tea and nuts including walnuts, hazelnuts, almonds and sunflower seeds.

Another Tip: Try seasoning your foods with seasonings that have anti-inflammatory benefits such as with ginger, cinnamon, basil, cloves, mint, turmeric, thyme and chili pepper. Moderation is key in life, but being informed and making changes to help manage your life and your pain is important. What changes can you make today? Do you have pain fighting foods or recipes you might suggest to our readers?

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Published in Acute and Chronic Pain
Thursday, 16 November 2017 10:00

Low Impact Walking for Pain Relief

There is nothing quite like a walk on a crisp autumn day; watching the leaves fall from the trees and hearing the crunch of leaves beneath your shoes. But there is more to a good autumn walk than seeing the beautiful changing scenery. Did you know that walking is considered exercise and when completed regularly, walking can provide lasting health benefits? It’s true. The pain experts at Advanced Pain Managements have five more reasons why you should consider starting a walking exercise program.

  • Walking is cheap –No need for expensive gym memberships or countless DVD workout programs. If you decide to start a walking exercise program, all you need is a good pair of shoes! Walking can be done anywhere- outside, inside or even at the mall. If you walk outside, the fresh air and vitamin D can also help you relax and help improve your mood.
  • Pain and injury prevention – You might think getting more active can lead to more injuries, but it is just the opposite! Being active helps strengthen your muscles, bones and joints and can help you reduce pain. Walking for exercise has a minimal risk to degenerative joints, like knees, hips and the lumbar spine. This means that your body can still get a good workout without doing damage to joints. In addition, being active can help improve muscle flexibility and reduce those minor aches and pains. Walking also puts less stress on your spine than sitting.
  • Walking does a body good – Walking regularly as exercise has been medically shown to help prevent or reduce the symptoms of heart disease, type 2 diabetes, high blood pressure and depression.
  • Improved sleep – Being active during the day can help your body become more restful at night. After a good workout, your body needs time to rest and recover which can often mean a better night’s sleep. Zzzz…
  • Kick-start a healthy lifestyle – Often, the first step to a healthy lifestyle is getting out and getting active! Walking regularly will help build your appetite, so fill up on healthy vegetables, protein and fruit and start a new healthy lifestyle.

Do you have any other walkign benefits to share? Let us know in the comments below.

Published in Acute and Chronic Pain
Thursday, 16 November 2017 08:44

How Does Back Pain Affect Sleep?

If you suffer from acute or chronic pain, especially back pain, the thought of a good night’s rest may be only a dream. Most adults need 7 to 9 hours a night for the best amount of sleep, although some people may need as few as 6 hours or as many as 10 hours of sleep each day. Oftentimes, individuals who suffer from pain associated from back conditions experience additional issues with insomnia and sleeping disorders. According to the National Sleep Foundation, pain and sleep problems are significant. In the adult population, about 15% of those surveyed reported experiencing chronic pain. In older adults, the number increases to over 50%. Among those with pain, 2/3 reported poor or disrupted sleep.

Sleep is one of the most critical ways that we renew our mental and physical energy on a daily basis. While there are many conditions and environmental factors that cause sleep problems, disturbances in sleep can intensify many conditions – including back pain. If you suffer from chronic pain or acute back pain and it is effecting the quality of your sleep, it is essential that you incorporate effective strategies and a treatment plan that will aid sleep deprivation from interfering with work, driving and social activities. 

Pain and Sleep Facts:

  • Each year, at least 40 million Americans suffer from chronic, long-term sleep disorders, and an additional 20 million experience occasional sleeping problems.
  • 2/3 of chronic pain sufferers have sleep problems.
    • Sleep deprivation accounts for an estimated $16 billion in medical costs each year, while the indirect costs due to lost productivity and other factors are much greater.
    • Sleep complaints and related daytime symptoms occur in 54–70% of adult rheumatoid arthritis patients.
    • One study estimated that the prevalence of sleep disturbance among people with low-back pain is 58.7%.
  • 75% of patients with fibromyalgia complain of sleep disturbances.

Causes Of Sleep Problems When You Are In Pain

If you live with pain, you know that sometimes your only relief is when you are asleep. However, some people’s pain prevents them from finding a way to become comfortable – oftentimes leading to the development of sleep problems. These problems not only result in overtiredness, but may cause pain to worsen. Here are a few conditions that may trigger a sleep problem to develop:

  • Anxiety and depression can make it hard to fall asleep or stay asleep. Consequent sleep loss can lead to increased pain. Anxiety and depression may also increase a person’s sensitivity to pain.
  • Some breathing related sleep disorders are associated with obesity – and obesity is also linked with back pain. Sleep disorders like sleep apnea interfere with normal sleep patterns, leading to insufficient sleep and poor sleep quality.
  • Limb movement disorders, such as restless legs syndrome, might further disrupt the normal sleep pattern.
  • Fibromyalgia can cause pain throughout the body. It is also linked with fatigue, anxiety and sleep problems.
  • Many prescription medications can impair the quality of your sleep. For instance, medications for conditions such as high blood pressure, epilepsy and ADHD may also cause sleep problems.

If you'd like more information on sleep and pain, take a look at the best sleep positions for back and neck pain.

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Published in Sleep-and-Pain
Thursday, 16 November 2017 09:08

5 Ways Sleep Position Can Reduce Aches and Pain

Whether you suffer from back pain, leg pain, joint pain or chronic pain, sleep position can have profound affect on both worsening and alleviating medical conditions. Have you ever stopped to think about how you sleep at night? A good night’s sleep allows your body to repair and rejuvenate as it prepares for another day. If you are waking up tired or with aches and back pain, consider consulting your pain specialist to discuss sleep position and how to alter it to effectively get much-needed zzz’s.

Advanced Pain Management’s Dr. Kim Litwack answers 5 important questions related to modifying sleep position to reduce and prevent pain.


Q: What should I consider if I sleep on my back?

A: If you choose to sleep on your back, your lower back can arch too much and increase pressure on your spine. To combat this, bend your knees slightly upwards. Try using a few pillows underneath your knees to help maintain this position throughout the night. 

Q: Should I consider sleeping on my side?
A: This is usually the most desired sleeping position because it keeps the spine in the best alignment. Try not to curl up in a ball, however; the spine should stay in a neutral spine alignment from the neck all the way down.

Q: Why is it important to have a pillow between your knees?
A: A pillow between the knees in a side-sleeping position helps keep the spine and pelvis in the best alignment and can also be more comfortable for the knees.

Q: Which sleep position is best for shoulder pain?
A: If it is difficult for someone to lie directly on their shoulder, they can try rotating their shoulder slightly forward or backward. I would also suggest using extra pillows for support to help maintain a comfortable position throughout the night. 

Q: Which sleep position is best for neck pain?
A: For neck pain, it is helpful to use a small rolled up hand towel right under the neck for added support. The towel can be placed inside the pillowcase to help it stay in place.

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Published in Acute and Chronic Pain
Thursday, 16 November 2017 09:01

What is Anxiety?

The Medical Dictionary defines anxiety as “a painful or apprehensive uneasiness of mind, usually over an impending or anticipated ill.” This definition would suggest that anxiety seems to be a normal part of being human. All of us have worried about things like our finances, our health, or the well-being of those closest to us. Anxiety is even a healthy emotion, because it motivates us to plan for our future and, take care of ourselves. For example, without some anxiety, we might not pay our bills on time, watch what we eat or install smoke detectors.

So how can anxiety be a problem? There is a fine line between healthy and unhealthy anxiety. In general, anxiety can be unhealthy when it comes from irrational worries or fears about events that are unlikely to occur. For example, those who suffer from an anxiety condition called panic disorder may believe a sudden change in their heart rate is a sign they are about to have a heart attack. Individuals who have a generalized anxiety disorder might worry about not being able to pay their bills even though they have plenty of savings and have no debt. Anxiety is also unhealthy when it leads an individual to avoid activities, places, or people unnecessarily. Among those with chronic pain, for example, anxiety about causing injury or harm to the body is one of the biggest obstacles in the way of patients getting more physical activity.  Finally, anxiety that seems to increase your pain consistently, causes you to lose sleep, or causes you other physical symptoms; it is likely you are dealing with anxiety of the unhealthy kind.

So what do I do about anxiety? Although there are various types of anxiety problems, treatments for each type share some common elements. Simply put, treatments involve making changes in three areas: changes in physical experiences, changes in behavior and changes in thoughts. Making changes in physical experience might include learning how to relax and learning how to tell the difference between tense and relaxed muscles. Changes in behavior could include challenging oneself to confront those things that are typically avoided: e.g. increasing physical activity despite fears that to do so would cause damage to the body. Finally, making changes in thought involves looking at the ways in which we think of events. By keeping a record of thoughts that occur along with anxiety, for example, one can detect ways in we might exaggerate potential dangers.  

Published in Anxiety
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