APM Blog

So your doctor says you need a nerve block, but you’ve never even heard of this type of procedure before. You start thinking: What will this entail? Will it hurt? And, most importantly, will it really help relieve my pain? Let this in-depth look at nerve blocks answer all your most pressing questions.

Definition and Types

Nerve blocks do what the name implies: They block the pain signals traveling along a nerve or a group of nerves before they get to the brain.[1] Nerves work like sensory superhighways, transmitting sensations – like pain – from the source to the brain. Blocks involve injecting various types of medications around the nerve or nerves to stop the transmission of pain.

There are two main types of nerve blocks that may be performed at different points in the body; some nerve blocks will be diagnostic, helping doctors find the source of the pain to better determine future treatment, while other blocks may be therapeutic, providing prolonged pain relief.

  • Diagnostic blocks are utilized to determine if a specific nerve or nerves are the source of the problem. During this procedure, a doctor will inject a temporary numbing agent around the nerves, which – if the right nerves were targeted – will relieve pain for a few hours or days. You will then be told to go about your day, moving around as normal and monitoring your pain levels for signs of improvement. If you and your doctor deem the block successful, you may have another block to verify these results, or just move on to a more lasting treatment option, like radiofrequency neuroablation.
  • Therapeutic blocks aim to relieve pain for a longer period of time. This is due to the type of medication injected around the nerves, which will include an anesthetic for short-term relief and an anti-inflammatory medication for longer relief.

Procedure Overview

To begin, you may be given sedation to help you relax, but you will remain awake during the procedure. Your provider will use a local anesthetic to numb the area around the nerves that are being treated. Using a state-of-the-art X-ray device called a fluoroscope, along with contrast dye that’s been injected into the region, your physician will locate the nerve or nerves that may be causing the problem. A mixture of pain-relieving medications will then be injected around the nerves.

Following the procedure, you will usually be able to go home in about 30 minutes. After a nerve block, people may feel soreness at the site of the injection.

Therapeutic Outcomes

The ultimate goals of therapeutic nerve blocks are similar to those of many other procedures: decrease pain, increase function, decrease opioid usage and increase the ability to perform physical therapy. Yet everyone responds differently to different procedures and nerve blocks are no exception.

After the nerve block procedure, it’s possible that the pain may return after the anesthetic wears off but before the anti-inflammatory medication takes effect. This is normal and should decrease within a few days. Usually, more than one injection will be required to provide sustained relief from pain, and relief may last longer after each injection. The amount and frequency of these injections will depend on your specific condition.

Learn More

To learn more about nerve blocks, including if they may be right to help treat or diagnose your condition, please schedule a consultation with one of our experienced pain management providers by calling (888) 901-PAIN. You can also learn more on our treatment pages:

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[1] “ViewMedica Patient Engagement Videos.” Swarm Interactive 2016. Accessed October 6, 2016. http://www.viewmedica.com/.

Published in Pain-Treatment
Thursday, 02 November 2017 12:37

Re-Tool your Garden Arsenal to Ease Aches

Gardeners are no strangers to aches and pains. The constant bending, kneeling and twisting can take its toll on even the toughest among us. But there’s an easy way to guard against garden injury, and it starts in the toolshed.

Focus on the Padding

Kneeling

Padding isn’t just for contact sports; it’s an important element of any gardener’s toolbox. To reduce knee pain and injury, turn to a padded kneeler or knee pad when weeding and planting. And tools need padding, too. Gardening expert Melinda Myers says she uses pruners, saws and trowels with a cushioned, ergonomic grip to lessen hand pain, cramping and fatigue.

Brace Yourself

There are a variety of braces available, including back, wrist and knee, which can help support your body when you bend and twist. Braces, which are especially effective for dealing with chronic pain, carpal tunnel and osteoarthritis, among other conditions, can reduce pain and help prevent further injury, while assisting in recovery and improving mobility. Myers, who suffered from knee pain, used a knee brace to stabilize and reduce pain, and currently uses a foot /ankle brace to reduce pain while standing for long periods or walking on uneven ground.

Lighten the Load

Heavy lifting in the garden — from rocks and fertilizer to water and hoses — is a common cause of injury. Consider using a wheelbarrow, wagon or garden cart to haul the heavy stuff, saving your back and knees from the strain. When loading in your gardening gear, though, remember to start from a kneeling or squatting position, with your back straight, and lift with your legs while holding the object close to your body.

Published in Melinda Myers
Thursday, 02 November 2017 12:35

Save your Back from Hunting Pain

 Deer hunting season is finally upon us again. After months of sunshine and fair skies, the weather has at last turned cold, leaves clutter the ground and the deer are out in full force. That can only mean it’s once again time to grab your orange and camo gear, haul out your hunting rifle and take to your tree stand.

But before you hunker down for long days (and nights) in your stand, make sure you’re prepared for all the dangers of hunting. I’m not talking about dangerous animals or other hunters, but a far closer hazard: pain. Sitting in your tree stand, dragging your trophy buck to the car or even walking over uneven terrain can spell disaster for your hunting trip if done improperly. So before embarking on your yearly pilgrimage to the woods, consider these tips for avoiding hunting pain and injuries.

Sit Up Straight

No matter your skill level or stand location, sitting and waiting is nearly always part of a successful hunting trip. But sitting for long periods on a hard surface or improper chair can be detrimental to your body. According to Advanced Pain Management (APM) physical therapist Courtney Wack, “Ideally you want to be sitting in a comfortable chair that’s high enough so that when you sit your hips are higher than your knees. This allows for better posture.”

Unfortunately, low hunting chairs or cushions don’t allow your body to maintain proper posture, causing your back to curve more than it should, which puts more pressure on your spine. This, in turn, can lead to initial or worsening back pain.

If a comfortable chair with proper lumbar support is simply not an option for your hunting space, consider placing a rolled up blanket or sweatshirt behind your lower back to provide additional support.

Keep it Movin’

When you keep your body in the same position for hours, it’s inevitable that your joints will begin to stiffen, often causing joint pain. It’s a simple concept: Joints need movement, since that’s how they get lubricated. Less movement equals less lubrication. And, depending on your position, this could lead to pain in any of your joints. According to Courtney, prolonged time in a single position can actually flare up many chronic pain conditions.

The solution is an easy one: Get up and walk around every 30 minutes. But if walking around isn’t in the cards, you can at least stand up and walk in place for a bit, or do some stretches to loosen up your body. 

Stretch it Out

Just like your joints, your muscles can get tense and painful when you’re stuck in the same position for long periods. Thankfully, there are some simple stretches you can do even in the tiniest of tree stands.

  • Neck stretches: Sit on your right hand and slowly lower your left ear down to your left shoulder until you feel a stretch in your right shoulder. Hold the stretch for 20-30 seconds and repeat two or three times on both sides.

  • Mid-back stretches: Pinch your shoulder blades together for three to five seconds. Repeat five times. This stretch can be done every 10 to 15 minutes.

  • Low back stretches: While in your chair, rock forward on your seat, arching your lower back forward as much as you can. Then rock back and curve your back, with your chest moving toward your knees. Repeat this five times. You can also do a seated turn, where you sit in your chair with your back straight and gently turn your head and shoulders to one side. If available, you can hold onto the chair arm or side of your tree stand to help you stabilize, and hold for 5 seconds. Repeat three times on both sides.

  • Hamstring stretches: While sitting on your hunting chair, extend one leg out straight, bend forward and reach toward your toes until you feel a stretch behind your knee. Hold for 20-30 seconds, then switch sides.

  • Ankle stretches: While sitting in your chair, bend your ankles up and down, pointing your toes first toward the sky, then down to the ground. This can be repeated 10 times every 15-20 minutes, helping increase blood flow and decrease cramping and leg pain.

The Dangers of Dragging

It’s happened: You’ve finally shot a good-sized buck. Now, all you have to do is get it to your car . . . half a mile away. But dragging it all that way can be damaging to your body. If at all possible, try to use a cart, ATV or some other piece of equipment to help you move the animal.

If you don’t have equipment readily available, try wrapping a rope around the deer before starting to pull it. This will add leverage so you don’t have to bend over. While pulling the deer, try to change your grip and positioning often. If you don’t, you’ll be relying on a single set of muscles, making injury more likely. And, just like every other task, make sure to take a break whenever you feel tired and hydrate well.

Build up your Strength

One of the best ways to protect your body from injury while hunting – and in other parts of your life – is to strengthen it. Specifically, says Courtney, “Strengthening your back and core can be very helpful not only when sitting for long periods of time or dragging deer, but even just walking on uneven terrain.” Your core, she explains, is what helps your back brace for impact if you step into a hole or twist to avoid injury.

Core exercises can help improve both balance and stability, and even help you maintain a proper posture. Plus, they’re easy to do in the comfort of your own home. This list of core-strengthening exercises, including planks, hip lifts and kneeling extensions, can help get your back and core up to snuff to help you avoid serious injury.

Stay Safe!

Taken together, these tips, exercises and stretches can keep you safe and help reduce hunting-related pain and soreness so you can focus on what really matters: your search for your best buck yet. 

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Published in Deer hunting
Thursday, 02 November 2017 12:25

Shoveling Safety Tips to Prevent Pain

As the winter weather comes to the Midwest, keep these simple snow safety tips in mind as your grab your shovel! Being smart before you get to work outside can help prevent back pain and neck pain in the future.

1. Warm up – Shoveling uses many muscles in your body – arms, shoulders, legs, and upper and lower back. Warming up with a few gentle stretching exercises and a short walk around the block before you even pickup the shovel could save you pain tomorrow. Start with some simple back pain stretches.


2. Use proper tools – A shovel that is the appropriate height and weight will help reduce the need to hunch over when shoveling. Before buying snow equipment, test it out in the store to see how it feels, and make sure it is the proper size for you and the type of work that will be done.

3. Lifts with your legs, don’t twist or hunch – When shoveling, try to avoid lifting a full shovel of snow using your back muscles. Instead, bend your knees and lift with your legs, keep your back aligned, try to stand as straight as is comfortable with your knees bend and your feet hip-width apart. In addition, you should avoid twisting your upper torso because it can aggravate the muscles in your back. Instead, turn your whole body.

4. Switch sides while shoveling – Like dribbling a basketball, people tend to favor one hand or side of their body when they’re shoveling. To avoid using the same muscles to do the same movement repetitively, try switching sides every few minutes to avoid muscle fatigue.

5. Pace yourself and know your limits– Ease into winter clean up and take regular breaks every 15-20 minutes. Stop, walk around, stretch and enjoy some hot chocolate. These frequent breaks will give you time to relax, rejuvenate and enjoy the winter weather.

6. Exercise year-round – People who exercise year round are less likely to injure themselves while doing outdoor chores, as their muscles are more accustomed to physical activity.

Published in Snow-shoveling
Thursday, 02 November 2017 12:22

Simple Lifestyle Changes to Reduce Back Pain

Many people hear the same thing every time they visit the doctor: Being overweight can have serious effects on your health. But what your doctors may not be telling you is that, in addition to things like high blood pressures, heart disease and high cholesterol, your weight may be causing or increasing your back pain.

Being overweight can increase your risk of developing low back pain. Your weight can also cause spinal disc pain and joint pain, since your body is putting added strain on your spine and joints. Knee pain, hip pain and leg and ankle pain can all result from weight problems.

Taking weight off the spine and the affected joints is one of the best ways to start decreasing your back pain and joint pain – but it’s never an easy process. Weight loss can be a daunting task – especially for those already experiencing pain. But weight loss is a necessary path toward a better, more pain-free life. These tips can get you moving in the right direction.

Get a Doctor’s Advice

Before making any lifestyle or diet changes, always consult your doctor. Your doctor can help you decide which diets or exercise programs can work best for your particular situation, lifestyle and pain level. Exercise and dieting for pain relief are great ideas – just make sure you do them right!

Eat Right to Reduce Pain

Eating a healthy diet is one of the first steps to losing weight and, subsequently, reducing pain. When planning out your meals for the week, try to reduce your sugar intake. That means that to decrease pain, you should eat fewer items containing high-fructose corn syrup, dextrose, fructose, maltose and sucrose. Unfortunately, these are common additives in everyday foods, such as prepackaged meals, granola bars, juices and crackers. If you’re not already, start checking a product’s ingredient list before purchasing it; you might be surprised how many things labeled as “healthy” are actually filled with sugar.

In addition to helping you lose weight, cutting sugars out of your diet can decrease inflammation in your body. The same can be said for simple carbohydrates, which break down in your body into forms of sugar, causing inflammation and weight gain. Anything made of white flour contains carbs, including pasta, bread and crackers. A good tip for pain relief is to decrease carb intake and increase healthy fats and proteins. This means low-fat or lean meats and poultry, as well as fish, nuts, seeds and beans.

Some healthy foods even have the ability reduce back pain, knee pain and general pain. Cherries are high in antioxidants and anthocyanins, which block inflammation and inhibit pain enzymes. Fish that is high in omega-3 fatty acids can help relieve back pain. And hot peppers like jalapenos and habaneros can help with arthritis and muscle pain, due to their high levels of capsaicin.

Supportive Equipment to Reduce Pain

There are many items to help reduce back pain and assist you in staying active. Many times, supportive equipment can make all the difference.

One of the first things to help you lose weight and exercise with less pain is getting the right shoes for back pain. This means shoes that are lightweight and support your arch and foot. The best shoes help your body maintain proper alignment when walking or jogging. Many good shoe stores have employees trained to help you find the best shoes for your feet.

Beyond shoes, finding a supportive mattress can help you sleep better with pain. Since sleep is one of the ways your body renews itself, it’s crucial to get a good night’s sleep to help with pain. Most adults need 7 to 9 hours on average.

A back brace, knee brace, wrist brace or cervical brace can also provide the support you need to get out there and start an exercise routine. Back braces, for instance, provide back and abdominal support for weak muscles, allowing you to get out there and do the things you normally wouldn’t be able to, like prolonged walking, gardening or participating in sports. Braces help your body build muscle strength while still providing the support you need.

Interventional Pain Procedures

Sometimes, losing weight through exercise and diet isn’t enough to completely rid your body of pain. When that’s the case, it may be time to consider interventional pain procedures, which can be administered by pain management doctors. Interventional pain procedures can help restore function, giving you the ability to make lifestyle changes that may have been previously impossible due to your pain. These minimally invasive procedures can include epidural steroid injections, nerve blocks and radiofrequency ablation. All of these procedures have the ability to significantly reduce pain. Without high levels of pain, people can often return to exercising and physical therapy.

Request an Appointment

Although the concept is simple, losing weight and reducing pain can be a complicated process. If you’re feeling overwhelmed by your pain, consider scheduling an appointment with one of Advanced Pain Management’s specially trained providers. They can help you reduce your pain and get back on your feet, helping you return to a healthy, fulfilling life.

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Published in Back Pain

A new study released in the journal Pain had some interesting findings about the state of pain in America. The research particularly concentrated on the socioeconomic groups that are currently experiencing the most severe pain, but it also delved into the overall state of pain in America. (Hint: It’s on the rise.)

Study Overview

The study,[1][2] completed by University at Buffalo medical sociologist Hanna Grol-Prokopczyk, utilized data from 19,776 adults aged 51 and older. Instead of focusing on a single point in time, the researcher followed the participants over 12 years, from 1998 to 2010, using information gathered from the Health and Retirement Study.

While most studies on the topic have examined only if people had pain or not, Grol-Prokopczyk’s research went one step further, asking whether the pain was mild, moderate or severe – with interesting results.

Key Findings

One of the most surprising findings to come out of the study is that chronic pain levels are on the rise. As it turns out, people who were in their 60s in 2010 are experiencing more pain than those who were in their 60s in 1998.

Furthermore, there is an extreme disparity when it comes to the people who are experiencing the most severe pain. People with less wealth and lower levels of education are far more likely to suffer from more severe pain and disability than those who are more privileged. While this trend was generally known beforehand, the extent of the disparity was a surprise. According to the research, chronic pain is 80% more likely to occur in the least educated people compared to the most eudcated.[3] And those who didn’t finish high school are 370% more likely to experience severe pain when compared to those with graduate degrees. Since severe pain is also the most associated with disability and death, the disadvantaged are most likely to experience those, as well.

Implications for the Future

Currently, it’s not clear why there’s such an unequal distribution of chronic pain in general and severe pain in particular, and Grol-Prokopczyk says more research needs to be done in order to better understand the matter. But what is clear is that there’s a rapidly increasing need for effective pain treatments.

“If we as a society decide that opioid analgesics are often too high risk as a treatment for chronic pain,” Grol-Prokopczyk says, “then we need to invest in other effective treatments for chronic pain, and/or figure out how to prevent it in the first place.”

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[1] Grol-Prokopczyk, Hanna. “Sociodemographic Disparities in Chronic Pain, Based on 12-Year Longitudinal Data.” PAIN 158, no. 2 (February 2017): 313–22.

[2] University at Buffalo. Poor And Less Educated Suffer The Most From Chronic Pain. February 8, 2017. Accessed February 14, 2017 https://www.sciencedaily.com/releases/2017/02/170208160411.htm.

[3] Fitzpatrick, Caitlyn. “Pain Is Getting More Painful, Study Shows.” February 9, 2017. Accessed February 14, 2017. http://www.mdmag.com/medical-news/pain-is-getting-more-painful-study-shows.

Published in Pain-in-America

The national numbers on opioids are clear: Opioids are a dangerous drug with concerning risks and side effects. But what’s going on beneath those numbers, among the individuals currently taking opioids for chronic pain, is equally important. Specifically, how helpful do they find opioids in treating their pain – and what drawbacks are they seeing from prolonged use? A new study presented at the America Society of Anesthesiologists’ annual meeting sought the answers to these crucial questions.

Study Overview

The study, titled “Do Patients Perceive Opioid Treatment as an Effective Way to Mange Chronic Low Back Pain?,”[1] was one of the research projects presented as part of the ANESTHESIOLOGY 2016 annual meeting.

The authors utilized data from a January 2016 survey of more 2,000 low back pain patients. They chose low back pain, in part, because these patients are more likely than patients with other types of pain to be treated with opioids. In fact, 46% of the survey respondents were currently utilizing opioids for pain.

The respondents were divided into three categories based on their opioid usage: those currently on opioids, those who were not currently on opioids but had been in the past year (28%) and those who had never been on opioid therapy (26%).

Key Findings

As part of the survey, patients were asked how successful they felt opioids were at relieving their pain levels. When taken together, only 13% of all respondents selected “very successful.” The most highly selected answer was “somewhat successful,” which was selected by 44% of people. Of the others, 31% said “moderately successful” and 12% said “not successful.” When the results were divided by opioid usage status, “somewhat successful” was still the most common answer for those currently on opioids, while those previously on opioids most commonly selected “not successful.”

The study also examined side effects and stigmas associated with opioid use. The researchers found that the vast majority – 75% – experienced side effects due to their opioid treatment. The most common of these side effects were constipation, sleepiness, cognitive issues and dependence.

On top of that, 41% of people reported feeling judged based on their usage of opioids. And, as it turns out, this feeling of being judged was unique to opioids; despite 68% of respondents also taking antidepressants, only 19% felt judged for using those.

Implications for the Future

These results put further emphasis on the dangers and inefficacy of long-term opioid treatment for chronic pain. Not only does their use create additional physical and social problems, but for most people they don’t even effectively address the pain.

Lead author Dr. Asokumar Buvanendra of Rush University in Chicago sees this as yet another reason pain patients should seek care from a multidisciplinary pain management specialist.[2] Whether it’s interventional procedures, physical therapy, alternative medications or complementary therapies, pain management providers are able to offer and coordinate a variety of services that oftentimes not only work better than opioids, but also pose far fewer side effects.

“Patients are increasingly aware that opioids are problematic, but don’t know there are alternative treatment options,” said Dr. Buvanendra in a press release regarding the research. If you want to learn more about what treatment options are available for your condition, call (888) 901-PAIN to speak to a member of our care team staff.

Download your free opioids and pain in-depth guide

[1] Buvanendran, Asokuma, Rae M. Gleason, Mario Moric, Sherry J. Robison, Jeffrey S. Kroin. “Do Patients Perceive Opioid Treatment as an Effective Way to Manage Chronic Low Back Pain? A Survey of Opioid Treatment Perception and Satisfaction.” ANESTHESIOOGY 2016 Annual Meeting (October 23, 2016). Accessed January 3, 2017, http://www.asaabstracts.com/strands/asaabstracts/abstract.htm;jsessionid=431585AA0967E7E27C850BD8C99D1E06?year=2016&index=3&absnum=4614

[2] AMERICAN SOCIETY OF ANESTHESIOLOGISTS, Many Back Pain Patients Get Limited Relief From Opioids And Worry About Taking Them. 2017. Web. 9 Jan. 2017.

Published in Back Pain
Thursday, 02 November 2017 11:57

Pain-Fighting Fall Planting Tips

Grab your shovel, knee pads and trowel and start planting your way to a beautiful landscape.

Most gardeners are used to adding a few (or a few hundred) bulbs to their gardens in fall. But fall is also a great time to add trees, shrubs and perennials to your yard. The soil is warm and the air cooler, so the plants are less stressed and establish more quickly. And many of these plants are on sale, extending your planting budget.

Fall Bulb PlantingAvoid pain this fall when planting bulbs.

Plant hardy bulbs now for a welcome burst of color next spring. Tulips, daffodils and hyacinths are a few favorites. But don’t overlook lesser-used bulbs like squills, winter aconites and snowdrops. These early bloomers are some of the first to greet you in spring, and the animals tend to leave them be.

Set the bulbs at a depth of two to three times their height. Next, cover them with soil and sprinkle a low-nitrogen, slow-release fertilizer over the soil to promote rooting without stimulating the kind of fall growth that is subject to winter kill. Water them thoroughly and as needed until the ground freezes.

Minimize Pain during Planting

It’s easy to take care of your knees and back when planting spring bulbs. Use a kneepad or kneeler to protect your knees and hold your back as straight as possible when reaching down to plant. If you experience back pain stemming from lumbar instability, a herniated disc, degenerative disc disease or just general muscle weakness, a back brace can help you maintain the proper posture – and help you avoid more pain in the future. Similarly, a wrist brace can help combat carpal tunnel syndrome, tendonitis and arthritis to help you plant more easily.

Use a trowel with a cushioned grip or a long-handled bulb planter that allows you to dig the planting holes with minimal bending and kneeling. If you must bend over, remember that bending the knees and hips while tightening your abs is much safer than bending at the back. But always try to avoid bending for long periods of time.

Safely Plant Perennials, Trees and Shrubs

Fall is also a good time to plant perennials, trees and shrubs. Select plants suited to the growing conditions and be sure to give them plenty of room to reach their mature size.

Protect your body and avoid damaging your newly purchased trees and shrubs with proper transport, planting and care. Ask for help unloading, moving and planting bulky and heavy plants. You’ll find an extra set of hands makes these heavy jobs go faster with less stress on your body. Together, squat to grab the object and hold it close to your bodies as you lift. As you move, avoid twisting your body and take small steps. Squat again to set it down, keeping your back straight and your core tight.

You can also utilize tools and equipment to help lighten the load. For instance, a wheelbarrow or even just an old snow saucer with a towing rope can help you easily move plants from your vehicle to the planting hole.

Fall Planting Tips

Plant trees so the root flare (the place where the roots curve away from the trunk) is even with the soil surface. Dig a hole the same depth as the rootball and about two to five times as wide. When digging the hole, use a long-handled shovel to move manageable amounts of soil, and be sure to lift with your legs and avoid twisting your body. Roughen the sides of the hole and backfill it with the existing soil. Water the tree thoroughly and spread a 2- to 3-inch layer of mulch over the soil surface, keeping it away from the tree trunk.

Follow a similar planting procedure for perennials and shrubs. Plant these so the crown (the place where stems meet the roots) is even with the soil surface. And be sure to keep the mulch away from the stems.

Adding a few new additions to the landscape now will give you more time for spring gardening tasks, including a few early season plantings in your flower and vegetable gardens. And doing it safely will reduce your risk pain in the future.

Weed Out The Pain Toolkit Download

Published in Melinda Myers

Toward the end of September and beginning of October, a plethora of crops are ready to harvest. Tomatoes, peppers, melons and squash, including pumpkins, continue to ripen and will fill our harvest baskets until the first killing frost, says gardening expert Melinda Myers. “And, even with cooler temperatures,” she says, “mid-summer plantings of cool crops like broccoli, Brussels sprouts, cauliflower and kale will mature. Their flavor actually improves after a light frost.” Even late plantings of things like greens, radishes, turnips and beets continue to grow and can be harvested as they mature throughout the fall season.

But before you head out to the garden to start gathering your harvest haul, make sure you know the best way to pick your plants in order to avoid doing damage – to both the plants themselves and to your body.

Grab the Right Tools

“Too often we head to the garden for a few minutes,” says Myers, “and an hour and a half later we are still out there, often without the equipment that protects our bodies.” Don’t fall into that trap. Without the right tools, you run the risk of hurting yourself and damaging your plants to the point where they will no longer keep producing

Consider investing in a sharp knife or garden scissors, which can make harvesting easier and do less damage than picking. For fruit trees, physical therapist Courtney Wack suggests using an apple picker to minimize repetitive hand motions.

When shopping for tools, “buy tools with wider handles, or bulk them up yourself with foam or a washcloth and some tape,” Wack suggests. This, along with stretching out your hands and wrists, can reduce the risk of hand pain later, especially for those suffering from arthritis.

And to reduce the risk of knee pain during prolonged periods of kneeling, a padded knee pad combined with a proper stance can go a long way. With the kneeler in position, drop down onto one knee and keep one foot one the ground to give your back more stability.

Carry Carefully

When it comes to transporting your haul to the house, make sure to do so carefully; fruits and vegetables can easily sustain damage en route, and so can you. “Stack veggies in a shallow basket or crate to minimize bruising,” says Myers. And empty the basket often, both to prevent bruising and because carrying too much weight in front of you can increase the strain on your back.

For greens like lettuce (on which you harvest the outer leaves when they reach 4 to 6 inches) and chard (8 to 10 inches), take a bucket of water into the garden and place the greens into it to keep them fresh.

To haul your harvest back indoors, squat to grab your basket of produce, tightening your core muscles, then lift with your legs. Don’t forget to keep the basket or crate close to you as you walk and avoid twisting at the waist. Or consider looking for a basket or bag you can wear on your back and use both straps to disperse the weight more evenly.

Protecting Perennials

Perennial plants like raspberries, strawberries and fruit trees, along with spring-harvested perennials like asparagus and rhubarb, require their own kind of care to protect them throughout the winter. “Do not fertilize them now,” warns Myers, since “fertilization stimulates late-season growth that can be killed in winter.” After a frost, she advises, remove any diseased or insect-infected leaves, but do not compost. Instead, contact your city for ideas on how to dispose of this type of material.

For protection from animals, consider erecting a fence around your fruit trees and bushes or use a repellent labeled for use on edibles. Scaring the animal away through the use of visual or auditory scare devices is also an option, although it’s not as effective in urban areas. In suburban and rural areas, noise-makers and motion-activated water sprayers may be useful. Or try visual items like reflective tape or predator statues to keep critters at bay. For the best results, use a combination of tactics, monitor them throughout the year and make adjustments as needed.

Pace Yourself

Although it’s tempting, don’t try to harvest all of your plants in one day. Spread it out over multiple days to reduce the risk of overworking yourself and your muscles. If you do pull a long harvesting shift, though, make sure to take frequent breaks, walking around and stretching every 20-30 minutes.

You can also try to enlist the help of a friend – both to share in the work and take home some of the produce. Having a partner means being able to switch between strenuous tasks, like carrying or picking produce, and easier ones, or even allow you time to rest. Besides, says Myers, “most gardeners plant more than they can use.” You’ll be grateful for both the extra help in the garden and the fact that they take some of your bountiful harvest off your hands.

Weed Out The Pain Toolkit Download

Published in Melinda Myers

The placebo effect is well-known, especially when it comes to clinical trials. Conventionally, patients receive a placebo believing they are getting an active medication and afterward report improved symptoms. But the ethical problem of giving patients a placebo without their knowledge has impeded its use as a treatment method. Until now, that is. A new study[1] has found that patients who knowingly take a placebo for the treatment of chronic low back pain see improvements in both pain and function – which could lead to another avenue of treatment for those battling chronic pain.

Study Overview

The study, titled “Open-Label Placebo Treatment in Chronic Low Back Pain,” was published in the December issue of PAIN, the official journal of the International Association for the Study of Pain.

The authors selected 97 patients (83 of whom completed the trial) with chronic low back pain, who were then examined by a nurse and board certified pain specialist before receiving a brief overview of the placebo effect. The majority of these patients were already undergoing some kind of treatment for their pain, mostly NSAIDs. (Patients taking opioids were not included in the study.)

Some of the patients were instructed to continue with their treatment as usual, while the others were told to add a placebo pill (in a bottle clearly labeled “Placebo”) twice daily to their existing regime. They were instructed not to make any other lifestyle or medication changes during the study. Both groups spent three weeks doing their respective treatments, while monitoring their average, minimum and maximum pain levels, as well as their level of disability. At the end of the trial, the group that did not take placebo was also given the chance to incorporate it into their treatment for three weeks.

Key Findings

At the end of the three weeks, both groups of patients were brought in for an interview, during which they rated their maximum, minimum and usual pain, as well as their back-related dysfunction. Those in the placebo group experienced a 30% reduction in both usual and maximum pain, while those in the normal treatment group only experienced a 9% reduction in usual pain and a 16% reduction in maximum pain.

Similarly, the placebo group saw a 29% drop in pain-related disability, while those in the normal treatment group saw almost no improvement.[2] These results were seen despite the fact that 70% of the placebo group was initially either skeptical of the placebo or didn’t believe it would have much of an effect.

After the normal treatment group was allowed to utilize placebos for three weeks, they also saw significant pain relief (a 29% decrease in maximum pain and a 46% decrease in minimum pain) and an improvement in back-related disability (which decreased by 40%).

Implications for the Future

It’s not entirely clear why placebos produced such staggering pain relief, but the researchers did put forth several theories. The success could be due, in part, to the positive way placebos were introduced to the group. Presenting the experiment to participants in a positive manner – for instance, as a “novel mind-body clinical” option – may have helped curate hope in the participants. For chronic pain patients who often feel hopeless in the face of ineffective treatment options, this may have been enough to convince them to suspend their disbelief, the researchers hypothesize.

The effects could also be attributed to the physical process of taking a pill. Several other studies have recently shown that the ritual aspects related to pill-taking – like opening the bottle and swallowing – may be linked to positive placebo responses.

No matter the reason, what is clear is that many patients currently suffering from chronic low back pain – and possibly other chronic conditions, as well – might benefit from adding a placebo to their treatment plan. While further studies are necessary to determine how best to utilize this new information on the placebo effect  and how it might relate to longer-term relief, these findings do suggest that placebos may eventually become an important component of treatment, reducing the need for other (possibly harmful) types of drugs.

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[1] Carvalho, Cláudia, Joaquim Machado Caetano, Lidia Cunha, Paula Rebouta, Ted J. Kaptchuk, and Irving Kirsch. “Open-Label Placebo Treatment in Chronic Low Back Pain.” PAIN 157, no. 12 (December 2016): 2766–72.

[2] “Study Finds Knowingly Taking Placebo Pills Eases Pain.” October 14, 2016. Accessed November 11, 2016. http://www.bidmc.org/News/PRLandingPage/2016/October/Kaptchuk-placebo-effect.aspx.

Published in Scientific-Research
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