Restless leg syndrome (RLS) is a common and sometimes
devastating condition. I see it quite frequently
in many of my chronic pain patients. In
fact, it contributes to quite a bit of chronic pain, because of the difficulty
it causes in terms of getting a good night's rest, and because it in and of
itself can be rather painful. And there
are diseases associated with chronic pain which can result in so-called
Restless Leg Syndrome is a nighttime condition that has a huge impact on
daytime functioning for those afflicted.
The diagnosis of RLS is mostly arrived at through interviews
with the patient, and basically involves four important features:
is a compelling need to move, usually associated with unpleasant
sensations in the legs, which have been described variously as painful,
electric or "creepy-crawly."
sensations of RLS are worse or exclusively present at rest.
sensations are at least partial...
Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
Are you 55 years old or older and still pain free? Chances are you have osteoarthritis and don't know it. X-rays show arthritic changes in eight out of every 10 adults age 55 and older. Knees, hips, and spines are affected most, in that order. Older adults with leg pain may have arthritic changes in both the hip and spine. They sometimes have a total hip replacement (THR) only to develop groin and buttock pain next. Or suddenly they have muscle weakness that isn't related to the THR. In these cases, lumbar spinal stenosis (LSS) may be the problem. LSS occurs when age-related changes narrow the canal where the spinal cord and nerves travel. Bone spurs, thickened ligaments, and worn-down joints are just some of the changes leading to LSS. These doctors from Baylor College of Medicine offer other orthopedic surgeons some guidance. They say that when a patient with a recent THR has severe pain after the operation, look for infection, an unstable implant, or LSS. Location of the pain is a key...
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