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Hyperextended Knee – Help My Knee Bent Backwards!!

What Is a Hyperextended Knee?

Knee hyperextension (Genu Recurvatum) in simple terms is when your knee is straightened beyond your joints normal range of motion.  More technically speaking knee hyperextension is a condition where the back of the knee joint opens too far and the tibia is allowed to slip backwards.  The normal range of motion of the knee-joint is from 0 to 135 degrees in an adult. Full knee extension should be no more than 10 degrees, so once you surpass that you are getting into hot water.  As you can imagine, the damage from a hyperextended knee can range from mild to severe.  A severe hyperextended knee can involve meniscus tears and/or ligament tears including your ACL, PCL, or MCL.

Symptoms You May Have a Knee Hyperextension

  • You either hear or feel a pop at the time of the injury
  • Swelling or Inflammation
  • Instability – unable to bear weight or continue your activity normally
  • Pain in the back or on the sides of your knee



Treatment Options                                                                          

  • Rest
  • Ice
  • Elevate – get your leg up
  • Crutches
  • Compression
  • Knee Brace
  • Physical Therapy
  • Surgery
    • If there is ligament damage or tear involving your Anterior Cruciate, Posterior Cruciate, or Medial Cruciate ligaments
    • If there is cartilage damage or tear involving your Meniscus

For a mild knee hyperextension, you can expect your knee to heal in 2-4 weeks. For sever knee hyperextensions with additional injuries such as a meniscus tear and ligament tear (acl,pcl,mcl), it will probably be necessary to have surgery.  In surgical cases recovery times will vary and be much longer.

Consulting a doctor is the only way to know which treatment option is best for you.





Medical Marijuana – Yes? No? Maybe So?

The debate over medical marijuana is definitely bubbling in the United States at the moment.  Many U.S. states now have active medical marijuana laws, but the federal government still classifies it as a Class I controlled substance, which is illegal to possess. In fact, on August 11th The U.S. Drug Enforcement Administration said would not camedicalmarijuanall for reclassifying marijuana, dashing the hopes of advocates of legalization and rejecting calls from some states and members of Congress who say growing knowledge and public acceptance should result in looser regulations.

With strong supporters on each side of the debate, the arguments for and against the legalization or marijuana are hot topics.

What side of the debate are you on?

As a person living in chronic pain, living in a state wherein medical marijuana is mostly illegal, the thought that medical marijuana could improve my quality of life is both intriguing and frustrating.

Intriguing because there is a growing body of research that suggests it’s a viable option in the fight against chronic pain.

For example according to one a 2012 study,

Cannabis as an adjunct to or substitute for opiates in the treatment of chronic pain.

There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting.¹

Another study by UCSF suggested patients with chronic pain may experience greater relief if their doctors add cannabinoids – the main ingredient in cannabis or medical marijuana – to an opiates-only treatment. The findings, from this small-scale study, also suggest that a combined therapy could result in reduced opiate dosages.²

Both studies are similar in both nature and conclusion.  The moral of the story is that there is a growing amount of evidence that medical marijuana can and is improving chronic pain patients medical marijuanaquality of life.  That being said, many of us will never be able to find out if it could help ease our battle with chronic pain.  The fragmented state of marijuana legalization does not help matters.  Some states have full legalization where others have none and pretty much everywhere in between.

I’m hopeful yet skeptical that at some point in the near future the federal government will make the move to legalize marijuana across the board so that each state doesn’t have different laws.  Honestly the current situation is a nightmare.  To know that there is an opiate alternative and not have legal access to improve your own quality of life, is depressing to say the least.

As always, much love

Leave me a note and tell me your opinion on the state of medical marijuana legalization.

¹J Psychoactive Drugs. 2012 Apr-Jun;44(2):125-33. Review. PMID:22880540
²Donald Abrams is the lead author of the paper; co-authors are Paul Couey, BA, and Mary Ellen Kelly, MPH, of the UCSF Division of Hematology-Oncology at SFGH; Starley Shade, PhD, of the UCSF Center for AIDS Prevention Studies; and Neal Benowitz, MD, of the UCSF Division of Clinical Pharmacology and Experimental Therapeutics.
The study was supported by funds from the National Institutes on Drug Abuse (NIDA), a subsidiary of the National Institutes of Health (NIH).

 

What I Wouldn’t Give? Trade This Pain Away!

Have you ever considered what you’d be willing to give away or sacrifice to get rid of your chcrying,pain,chronic painronic pain for good?

This is one of my many funny thoughts as I live this chronic life. I have come to the conclusion that I would gladly go through drugless childbirth a few times if I could live the rest of my life pain free. Probably give up an arm. I know it’s morbid in a way but hey pain sucks.

What would you trade if you could get rid of your chronic pain?

Stop Suffering From Neck Pain at the Base of your Skull?

Ever have neck pain at the base of your skull and not be able to tell if its a headache or a neck ache?
A severe headache at base of skull pain may radiate to the shoulder and alter the function of the shoulders and neck. The pain can make the muscles in the neck firm and inflexible resulting in stiff neck. It can radiate down to the arms, causing arm weakness. With severe pain, it will be difficult for the neck to bear the weight of your head and the neck may bend on either side. Considering an adult head weighs around 10 to 11 pounds (4.5 to 5 kg), there’s a lot of pressure.

Pain at the base of neck is responsible for an occipital headache.  The vertebrae of your neck (cervical spine) support the weight of your head and all its motions, which may not seem like much – until you consider your head weighs as much as a bowling ball. When your neck bones are not positioned properly, the result is tightening of the muscles and irritation of the nerves that connect with your head.

Any of the following can contribute to a headache at the base of the skull.

  • Occipital neuralgia
  • Poor posture
  • Slipped Disc
  • Arthritis
  • Trauma
  • Bone Spur
  • Skull Base Tumor
  • Stress
How do I make it stop?
One very common cause of tension headaches is rooted in the neck, resulting from muscle tension and trigger points. At the base of the skull there is a group of muscles, the suboccipital muscles, that can cause hSuboccipital_muscles_-_animation04eadache pain for many people.
Pain from the suboccipital muscles commonly feels like a band wrapping around the head.  Also, tension in these muscles may cause compression of a nerve that exits the base of the skull, and trigger pain that wraps over the head and above the eyes.
So you see the headache is sometime an actual pain in the neck!  Now what?  With muscle rooted headaches it seems that one could start by eliminating some of the causes that one can control such as posture and stress.  We are all guilty of looking down at our phones too much:(  I’m sure technology is a contributing factor to many a skull base headache!
Other helpful therapies could include
  • warm/cold compresses
  • massage
  • chiropractic care
  • anti-inflammatories
  • muscle relaxants
  • traction
  • physical therapy
  • surgery
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.

Interested In Guest Posting?

I have had some inquiries regarding possible guest posting opportunities.  If any of you are interested in contributing to the blog just drop me an email at admin@beyondmypain.com.  Let me know what your interests or expertise is and we can go from there!

As always much love!

 

Pudendal Neuralgia – Rare and Devastating Pelvic Pain

What is Pudendal Neuralgia?

Pudendal neuralgia is a rare painful neuropathic condition caused by inflammation pudendal nerveof the pudendal nerve. The condition can affect both men and women. The pudendal nerve runs through your pelvic region, including your genitals, urethra, anus, and perineum. Your perineum is the area between your anus and genitals.

Pudendal neuralgia was first described in 1987 as a painful, neuropathic condition involving the dermatome of the pudendal nerve by Amarenco et al.1

The International Pudendal Neuropathy Association estimates the incidence of this condition to be 1/100,000; however, most practitioners treating patients with this condition feel the actual rate of incidence may be significantly higher (Hibner et al, 2010). Pudendal neuralgia can occur in either men or women although about two thirds of patients are women.

Also referred to as

  • pudendal neuropathy
  • pudendal nerve entrapment
  • cyclist’s syndrome
  • pudendal canal syndrome
  • Alcock’s syndrome.

What Causes It?

Damage to the nerve during surgical procedures in the pelvic or perineal regions

Transvaginal Mesh Surgery

What Is Transvaginal Mesh?  How Does Surgery Contribute to Pudendal Neuralgia?

  • Transvaginal mesh is a term used to describe a surgical mesh used for repairing pelvic organ prolapse
  • Direct Injury to the pudendal nerve during surgery is commonly found to cause Pudendal Neuralgia

Trauma to the buttocks or pelvis including childbirth

Cycling

Bio-mechanical abnormalities (e.g., sacro-iliac joint dysfunction, pelvic floor dysfunction)

Chronic Constipation

Compression from lesions or tumors in the pelvis

What Are The Symptoms?

  • Primary Symptoms

Burning, numbness, increased sensitivity, stabbing or aching pain, abnormal temperature sensations in pelvic region

  • Other Possible Symptoms
    • Pain sitting
    • Loss of sensation, difficulty achieving orgasm or pain after orgasm; possible scrotum/testicular pain
    • Problem with urinary retention after urination; urethral burning with or after urination; urinary frequency
    • Pain with bowel movement; constipation.
    • Buttock sciatica including numbness, coldness, burning sensation in legs, feet, or buttock, often due to a reaction of the surrounding muscles to the pain in the pelvic region
    • Pain with intercourse in females
    • Erectile dysfunction in males

What Are My Treatment Options

  • Lifestyle changes
  • Physical Therapy
  • Medication Management
  • Botox
  • Pudendal Nerve Blocks
  • Pudendal Nerve Decompression Surgery
  • Neuromodulation
  • Intrathecal Pain Pump

 

 

Amarenco G, Lanoe Y, Perrigot M, Goudal H. [A new canal syndrome: compression of the pudendal nerve in Alcock’s canal or perinal paralysis of cyclists]. Presse Med 1987;16(8):399

Disclaimer

I’m not a health care professional. All the information found on this website should be used for informational purposes only and is not intended to replace proper medical advice. Always consult a qualified health care provider for medical advice.

5 Things You Need to Know about Facet Joint Pain

  • What is a Facet Joint?

Clinically the correct term for the facet joints is the zygapophysial joints. Each spinal level has a pair of facet joints. The main role of these joints is to help guide the motion of the spine.facet joint facet joint pain facet joint injection

Each facet joint is innervated by two nerves (specifically the medial branch of the primary dorsal rami). These sensory nerves actually transmit the signal of pain from our facet joints to our spinal cord.  This pathway plays a vital role in both the diagnosis and treatment of neck and back pain from the facet joints.

  • Signs and Symptoms

Lumbar Pain – low back

Cervical Pain – upper back and neck

Muscle spasms

The pain is greater when the patient leans backwards than when he or she leans forwards.

A point of tenderness over the joints that are inflamed.

A loss of flexibility within the spinal muscles, often to the point of limiting mobility in a serious way.

“Getting stuck” where a specific movement is made and then the patient suddenly finds that they are in pain and can’t move well.

Pain radiating down the back of the legs and buttocks but not below the knee.

Pain radiating upwards to the shoulders or upper back but not down the arms.

Headaches

Pain that moves to the buttocks and hips or the back of the thighs—usually a deep, dull ache

Stiffness or difficulty with certain movement, such as standing up straight or getting up out of a chair

 

  • Cause of Facet Joint Pain

Osteoarthritis

When the cartilage layer between the bones of a facet joint is damaged or worn away, the bones can rub together and degenerative arthritis [osteoarthritis] occurs.

Compression of facet joints is generally the main culprit of joint pain.  Extended periods of standing, jumping, twisting, and running can all cause joint excessive compression.

As we get older, the discs that separate each lumbar vertebra become thinner. Over time this can lead to increased facet compression. Chronic compression or previous injury can lead to facet arthritis and pain.

Disc height changes

When the height of the disc between your vertebrae changes, it changes the amount of weight your facets must support and the way that they move.

Injury

Synovial Cysts

  • Diagnosing Facet Joints Pain

Physical Exam

X-ray

CT Scan

MRI

Facet Joint Injections

  • Treatment Options

Physical Therapy

Anti-inflammatories

Chiropractic care

Facet Joint Injections

Nerve Ablation



 

Read of The Day – Minn. medical marijuana program opens doors to chronic pain patientsMinn

Minn. medical marijuana program opens doors to chronic pain patients

Great news out of the State of Minnesota as they just opened up their medical marijuana program to chronic pain patients.

“On Monday, the state will expand its medical cannabis program to include a new category of patients suffering from severe, chronic pain that is not eased by traditional drugs or therapies. Opening to intractable pain patients could bring relief to thousands, while bringing new customers into a program that has struggled with low enrollment and high prices.”

This is great news on many fronts.  First and foremost it gives chronic pain patients some much needed hope.  Any additional options, that we have to fight the life sentence of chronic pain, are so crucial for patients.  Congratulations to Minnesota!! Hoping to see more states follow:)

 

 

Opiate Constipation – Train Stuck in the Tunnel?

All joking aside, opiate induced constipation is a real problem for some chronic pain patients.  It’s really the last thing someone with daily pain needs on their plate.  I personally have two secret weapons and honestly both have worked for me.

Florajen is my first recommendation.  A quality probiotic that works by morning if I take it before bed.  Has never failed me!

 

 

 

Magnesium is my second recommendation.  Another effective supplement I myself take.  Bonus with magnesium is that it supports optimum nerve function, helps muscles relax properly and helps us to maintain a healthy heartbeat.

I have been happy with both of these as far as keeping constipation in check.  Let’s face it, it not fun:(  If any of you have any other suggestions drop them in the comments.  Not everything that works for me will work for you so the more options the better.

Pain Mismanagement: It’s All About the Meds

I have to chat about my latest appointment to a local pain management clinic.  I’ve been going to this clinic for several years.  In the last year, between insurance issues and clinic turnover, I have seen no less than five different providers.

How does a clinic provide quality care with this much turnover?  My argument is that they don’t.

Today I was scheduled to see a new NP at my pain management clinic, named Susan.  Susan came in and after a brief hello, she looked right at my medication counts.  Now this didn’t really concern me too much at first.  Why should it?  I was fine on my pill counts or so I thought.  Turns out, I had too many pills left over.  She immediately started with the questions.  I’m like, I don’t know, I take them when I need them.  Not like I sit and count em.  Susan interjects, “well it’s my job to count them”.  From there it was a “shitshow”.  I have never failed a drug test and never had an issue at this clinic on my end.  By all accounts, I would think I was a dream patient.  Apparently, self regulating your medications is frowned upon.  God forbid I choose not to take a dose here and there as to minimize the dependence.  In any case, Susan went straight to why don’t we lower the dose.  Because there is always the risk of accidental overdose.  I’m like, “I’m not going to overdose”.  She goes on about well you could, if you got a really bad kidney infection and didn’t know you had it until it was too late.  Your body might not metabolize the medication correctly, your respiration could fail. Wow- who knew?!  Google that and see what you come up with.  But apparently now I’m at risk for an overdose.  Super.  I said, “well you can ultimately do whatever you want with my medications”.  Then I got “well it’s a decision we make together”.  Wait, what? Now we are a team?  Susan has known me all of 5 minutes and wants to mess with meds I have been taking for years.  I cannot respect that! Sad that the healthcare system has come to such inconsistent care.

I finally said, “look I don’t feel a whole helluva lot better today than I did when I started coming here.  I’ve seen 5 different people in the last year and everyone wants to do something different.  There’s no consistency here.”  I think that is what was most upsetting.  I am a grown woman.  I don’t need to be treated like a 12 year old kid.  I would settle for consistent care if compassionate care is too much to ask for.  What I won’t settle for is being treated like I am incompetent of deciding on my own course of treatment.  If Susan wants to count pills for a living she should have been a pharmacist.  Seems her interpersonal skills would be better suited for something else.

Finally, she decided to look back at my chart and reviewed the last notes from my most frequent provider.  Presumably, Susan would have looked at my chart before she tried to change my current course of treatment, but what do I know?!Immediately after she looked back at the notes her focus changed, she said we will leave things as they are.  She got up and left me weeping.  With not one ounce of consolation.

Congratulations Susan, you are officially the first health care provider to make me cry in an clinical setting.  That includes natural childbirth!

Can anyone else relate?  Drop me note about your experience!