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Because of limited clinical research, the causes of myofascial pain syndrome (MPS) are not thoroughly understood. However, physicians have identified several factors that can lead to the development of one or more trigger points (TrPs) resulting in chronic musculoskeletal pain. These include:

* Trauma to the musculoskeletal tissues (e.g., muscles, ligaments, tendons, bursae)
* Repetitive motion injuries, such as bursitis or tennis elbow
* Poor posture and ergonomics
* Skeletal asymmetry (e.g., gait disturbances such as leg-length discrepancies, short upper arms)
* Sedentary lifestyle
* Nervous tension or stress
* Clenching or grinding the teeth (bruxism)
* Sleep deprivation
* Nutritional deficiencies (e.g., low levels of calcium, potassium, iron and vitamins C, B1, B6 and B12)
* Hormonal changes, such as occurs during menstruation and menopause
* Chilling areas of the body (e.g., sitting under an air conditioning vent for long periods of time)
* Alcohol
* Smoking cigarettes
* Overexertion

Additionally, many chronic illnesses may activate TrPs, such as:

* Viral or bacterial infections
* Inflammatory diseases including:

- Rheumatoid arthritis. Inflammation of the joints that can lead to damage, pain and reduced movement.
- Fibromyalgia. A rheumatic condition characterized by widespread pain in the joints, muscles, tendons and other soft tissues, among other symptoms. MPS can also co-exist with fibromyalgia.
- Appendicitis, gallbladder or stomach inflammation.
- Lupus. An autoimmune disorder that can affect many systems, including the skin, joints and internal organs.

* Other conditions, such as abnormal levels of blood sugar (e.g., diabetes, hypoglycemia), heart attack, hyperuricemia (buildup of uric acid in the blood, associated with gout and kidney stones), and hypothyroidism (underactive thyroid gland).

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Muscle relaxants that address back pain are available as prescription and over-the-counter medications (OTC). Over-the-counter muscle relaxant medications include Robaxin® (methocarbamol), Robaxacet® (methocarbamol and acetaminophen) and Robaxisal® (methocarbamol and ASA). Prescription medications include Soma® (carisoprodol), Flexeril® (cyclobenzaprine) and Valium® (diazepam). Soma is typically prescribed on a short-term basis and may be habit-forming, particularly if used with alcohol or other drugs that affect the mind. Flexeril may be used on a longer term basis. This drug may impair mental and physical function and can lead to urinary retention in men with enlarged prostates.

Valium is usually restricted to one to two weeks of use. Due to this drug’s habit-forming potential, and its propensity to alter the sleep cycle, it is not prescribed for the long-term. Since valium is a depressant, it can worsen the depression often associated with chronic back pain.

Treatment for back pain usually involves strengthening the back through special exercises and adjusting the lifestyle to avoid the stressors (physical and mental) that have contributed towards the injury.

In the case of persistent, debilitating back pain, prescription or over-the-counter analgesics (painkillers) and muscle relaxants may be used. Surgery is considered a last resort for continuing, debilitating back pain.

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We try to do everything in this 21 century — filling our lives with a dozen of activities that tax our bodies and emotions. Multi-tasking is the norm with organizing busy schedules at work, for family and for our social life has become a daily task.

To stay and go on running in the rat race, you must be prepared to endure aches and pains all over your body as well as the lumps and swelling — sure signs of overwork and stress.

Another cause of lower back pain for runners is the thought that running is about going forward, okay of course it is, but it doesnt require you to push forward to do it. Running is really about passing a force into the ground and using the hip, inflamed knee and ankle joints to translate that into a forward motion.

Stiff and swollen joints make it difficult to do any bending. Pain in the knees are usually worse in the morning or after a long period of inactivity. Knee joints are often affected by arthritis.

Muscle pain can be caused by many conditions. The most commo is a “ strain” where the muscle is stretched beyond its maximum length resulting in injury. Muscle pain is most frequently related to tension or muscle injury any physically-demanding work. When muscle pain last beyond the expected healing time, it is then best to consult your doctor.

Every now and then you might be having muscle cramps and if you are working for quite some time and it also involves some heavy work that you might be experiencing a sensation of your muscles making you so tired and there is a decreased in your muscular performance. The underlying cause of muscle fatigue can fall into two categories: central and local.

Regular exercise can help restore proper muscle tone. A good physical therapist can teach you stretching, aerobic exercises to feel a lot better. You can also do it yourself by cycling, swimming and walking. Warm up before you do any kind oe exercising. Do some stretching. Drink lots of fluids before and after exercising. You can overcome muscle fatigue by dieting, getting adequate rest and taking supplements or nutritional stimulants such as caffeine. If you work in the same position most of the day like sitting in front of the computer, get up and do some stretching at least every hour.

Taking some acetaminophen, aspirin or other non-steroidal anti-inflammatory drugs (Cyclobenzaprine, Soma) can also be helpful in pain relief. Workouts in the gym to strengthen the back and shoulders can help restore a good balance.

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What is it?

Most everyone at one time or another develops pain in the neck or in the back. Usually, an activity brings on the pain, and the pain typically improves with rest. There are simple ways to bring relief and a few important signs that indicate when pain is more than a simple strain. Chronic pain usually gets worse despite bed rest, wakes you in the middle of the night, progresses despite medication and interferes with daily activity.

How bad is it?

Pain is a very good messenger. It tells us that something is wrong. The more mysterious it is, the more likely it is to be significant, either by itself or as an indicator of some other condition. Back and neck pain come in all degrees; from a brief, mild ache after a day of painting the ceiling to a crippling years-long misery that defies potent pain-relievers, intense physical therapy and even surgery.

What causes it?

Most back and neck pain is easily recognized as the result of overdoing some activity. It is amazing what the human body can be trained to do, but it is equally amazing how incapable it is of doing something it is not accustomed to.

There are two categories of strain that cause nearly identical pain - acute and cumulative. We all know what weekend warriors feel like on Monday morning, whether they just dug up the garden or began the tennis season. But there is a more insidious type of strain that takes many days or even months to notice. Cumulative stress injuries (CSI) in the workplace are now being recognized as major causes of disability and work loss. The human body is not used to the many activities required of us today. Probably the first CSI to be recognized was the pitcher’s elbow in baseball. Little leagues won’t let children pitch more than a few innings because of the strain it puts on their arm.

Another more common CSI is carpal tunnel syndrome, often the result of hours a day at a keyboard. The back and the neck can suffer similar strains by remaining in certain positions for long periods. The whole science of ergonomics has been developed to prevent these repetitive stress injuries by designing furniture and appliances that place body parts in the optimum position for working.

Not knowing immediately what brought on your current discomfort is the first warning sign to take a pain seriously. Some pains that seem to be coming from the spine are actually referred there from elsewhere inside the body. For instance, a sick gall bladder can masquerade as a strain of the mid-back and usually hurts just beneath the right shoulder blade. Heart attacks can mimic neck pains that pinch nerves going into the left arm.

Other symptoms that accompany the pain are more clues. Some of the most important are related to all nerves that pass through your spine on their way between the brain and the rest of your body. These nerves send feelings in one direction and movement commands in the other. If either of these functions - feeling or movement - is disturbed, something serious is happening. Numbness is the most common failure of feeling, and weakness is the most common disturbance of movement. Certain changes in feeling such as tingling, burning or extreme sensitivity are also signs of nerve problems. Paralysis is the extreme form of weakness. The urinary bladder can also be affected by nerve damage related to back pain. So if your back pain comes with inability to control urinating, there is likely to be a significant relationship between the two.

How do I know I have it?

The important question is: How do you know what is causing it? If your pain is clearly related to what you are doing and has no peculiarities like numbness or weakness associated with it, chances are it’s just mechanical strain. But you should see a doctor for any pain that lasts more than a few days without improving, that has no obvious cause, that gets worse without provocation or that has associated symptoms.

What can I do about it?

If you decide to seek professional care for unusual spinal pain, first get a competent diagnosis from a doctor. This may require X-rays or special scans (CT or MRI) to identify unusual and serious causes such as tumors or bone and joint disease. When nothing beyond mechanical strain can be found, the first and foremost intervention is a good posture and exercise program. Secondly, for the more serious mechanical spinal pains, such as whiplash neck injuries and chronic low back pain that is crippling, a variety of helpful and sometimes controversial treatments are available. Osteopathic/chiropractic manipulations and acupuncture have helped some patients but have also failed in others. The foundation for treatment remains an accurate diagnosis.

Starting new activities

Your body is able to do extraordinary things but not all at once. Remember two things about any physical activity:

* If you are in generally good shape, new activities will be better tolerated.
* Begin any activity gradually.

The first point doesn’t require more than common sense - 15 to 30 minutes a day of anything that tires you out is good. Swimming is close to ideal because you use everything at once, without being able to overuse or abuse anything. Water provides resistance without being as hard on the joints like pavement.

When starting new activities, you should start slowly and briefly. But each beginning should be preceded with a warm-up. Jog in place. Stretch the muscles you will be using. Plan your time.

Points to remember

* Nearly all back and neck pains are because of unwise over-activity.
* If you pay attention, your pain will tell you how serious it is.
* Seek medical advice if there is anything unusual about your pain.
* Stay in good shape and use common sense when beginning new activities.

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What Is Rheumatoid Arthritis?

Rheumatoid arthritis, or RA, is a systemic inflammatory disease that causes pain, stiffness, swelling and loss of motion in the joints. It is an autoimmune disease – one of many in which, for unknown reasons, a person’s immune system attacks his or her own body tissues. In RA, the immune system attacks the synovium, which is the tissue that lines the joints, causing inflammation in and overgrowth of this tissue.

How Do I Know If I Have RA?

The symptoms of RA vary from person to person and can mimic those of other inflammatory joint conditions, sometimes making the diagnosis difficult. Common RA symptoms include:

* Tender, warm, swollen and stiff joints, often first noticed in the hands and feet and usually symmetrical, e.g., both wrists are affected at the same time.
* Stiffness and pain that are usually worse after waking in the morning and last at least an hour before improving, which occurs with use and motion.
* Symptoms like tiredness, low-grade fever, weight loss and a general feeling of malaise that may develop even before the onset of joint symptoms.
* Systemic effects on other parts of the body such as the tear and salivary glands, lungs, heart and blood vessels.
* Soft lumps called rheumatoid nodules that range in size from a pea to a walnut, which occur in 20 to 30 percent of people with RA.

How Is RA Treated?

RA patients use a combination of treatments to relieve pain, improve mobility and slow down or perhaps even stop damage to the joints. A treatment plan may include:

* Lifestyle modifications: exercise, stress reduction, healthful eating
* Medications including non-steroidal anti-inflammatory drugs (NSAIDs), steroids, disease-modifying anti-rheumatic drugs (DMARDs), and biologic therapies
* Physical therapy
* Surgery to repair damaged joints
* Alternative and complementary therapies such as acupuncture, massage or biofeedback for pain control

Sports-related activities as well as falls and other trauma can injure the cartilage within a joint and, if it is not provided sufficient time to heal, chronic pain and persistent disability can follow. These activities and incidents may increase the risk of osteoarthritis, especially if there’s impact involved or there’s the risk of injury to ligaments. Additionally, damage to the bone surface can start a biological process that results in joint degeneration. This in turn, often leads to rheumatoid arthritis or osteoarthritis.

Arthritis is often a chronic disease meaning it can affect the person afflicted over a long period of time. It cannot be cured, but it can be treated through a variety of methods and products. Learning how to manage your joint pain over the long term is an important factor in controlling the disease and maintaining a good quality of life. This is a brief overview of some of the methods that arthritis sufferers can use to alleviate many of the symptoms associated with arthritis, especially joint pain. Products, both prescription and over-the-counter, for relieving arthritic joint pain are described in Joint Pain Products.

Heat and cold

Heat and/or cold therapy is not recommended to alleviate symptoms associated with all types of arthritis and as such, the decision whether to use it or not should be discussed with your doctor or physical therapist. If your care provider determines that the use of heat and/or cold is appropriate for use on your arthritis pain, it must be determined which kind of temperature treatment should be used. Moist heat, such as a warm bath or shower, or dry heat, such as a heating pad, placed on affected joint for about 15 minutes may relieve the pain. An ice pack or bag of frozen vegetables wrapped in a towel and placed on the sore area for about 15 minutes may help to reduce swelling and stop the pain. If you have poor circulation, do not use cold packs.

Joint protection

In order to relieve the stress of everyday activity on an afflicted joint, which can exacerbate the condition and may lead to additional injury, a splint or brace can be used to allow joints to rest and keep them from being used. As with many other treatments, a medical care provider such as a physician or physical therapist can make recommendations and possibly provide you with the brace.

Massage

Massage is associated with temporarily relieving joint pain, one of the major symptoms associated with arthritis, rather than treating the underlying cause of a loss of cartilage. A massage therapist will typically lightly stroke and/or knead the muscles around the joint, which increases blood flow to the stressed area. It is important to realize that arthritic joints are very sensitive, so the massage therapist must be familiar with the disease and problems associated with the affected joints.

Exercise

Low-impact exercises such as stretching exercises, swimming, walking, low-impact aerobics, and range-of-motion exercises may reduce joint pain and stiffness while increasing joint mobility. A physical therapist or gym trainer can help plan an exercise program that will give you the most benefit with the least stress on the arthritis-stressed joints.

Weight Reduction

In addition to alleviating some symptoms, the weight loss associated with an exercise program is beneficial in relieving the extra stress that extra pounds put on weight-bearing joints such as the hips and knees. Studies have shown that overweight women who lost approximately 10 pounds substantially reduced the development of osteoarthritis in their knees. In addition, these studies suggested that if osteoarthritis has already affected one joint such as the knee or hip, weight reduction would reduce the chance of it occurring in the other knee or hip. A physical therapist or gym trainer can help plan an exercise program that will give you the most benefit with the least stress on the arthritis-stressed joints.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation uses a small devi ce that is placed near the joint afflicted with arthritis and directs mild electric pulses to nerve endings in and around the arthritic joint. It is theorized that TENS blocks the pain messages sent to the brain from the nerves and modifies the body’s perception of pain. Although TENS relieves some joint pain associated with arthritis, it doesn’t offset the joint inflammation that is associated with arthritis.

Surgery

In some extreme cases of persons with arthritis, surgery may be necessary. The surgeon may perform an operation to remove the synovium, realign the joint, or in extreme cases, replace the damaged joint with an artificial one. Total joint replacement provides not only dramatic pain relief but also significant improvement in joint motion and mobility for many people with arthritis.

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Reasons why we have neck pain and how to find relief of this excruciating pain.

What is neck pain and how does one find relief after experiencing this type of pain? Neck pain is usually a result of a strain or spasm in the muscles of the neck, which also includes pain in the shoulder area. The pain can also be caused by inflammation in the joints of the neck, arthritis, or damaged disks.

Muscle strain occurs when one sleeps on a pillow that doesn’t support the neck properly, such as, sleeping with a twisted neck (happens when sleeping on stomach), lying down reading or watching TV with the neck in an awkward position, improper positioning of the computer monitor, working too long in front of the computer without a break, sitting hunchback while working at one’s desk, stress, and injuries to the neck.

Knowing this, how can one prevent neck pains in the future?

· Using good posture while walking, sitting, and sleeping.
· Avoid slouching.
· Avoid keeping your head bent forward for long periods of time.
· Exercise the neck muscles by using stretching exercises geared towards the neck.
· Avoid sitting for long periods of time without getting up or changing positions.
· Adjust the computer monitor so that the top of the computer screen is at eye level.
· Use a document holder that attaches to the side of the computer screen, instead of looking down at the paper, which increases neck strain.
· Learning to type without having to look at the keyboard will also decrease neck strains.
· Getting a headpiece, or a speakerphone, will also decrease neck pain for those who spend more than a half hour at time on the phone.
· When driving in one’s car, consider sitting the seat straight up and down.
· Purchase a hard mattress instead of a one with a lot of cushions.
· Purchase a neck support.
· If stress is the cause for the pain, consider relaxation exercises.

Home remedies that may help ease some of the pains associated with neck pain are:

· Place an ice pack, such as a bag of frozen peas, on the neck for fifteen minutes.
· Never use heat to sooth neck pain.
· Sitting in a lukewarm tub of water, or a Jacuzzi, with jet streams hitting the soar muscles will also help to decrease the swelling of the neck muscles.

Neck pain should never be masked with pain relief medications, such as aspirin, ibuprofen or acetaminophen. If your neck pain is severe and constant, seek the help of your doctor or chiropractor.

When home remedies do not seem to relieve the neck pains, chiropractic care may be needed. Sometimes, the nerves in one’s neck may become pinched, causing inflammation in the muscles. To relieve the pain, one has to un-pinch the pinched nerves.

Caution: Meningitis can cause neck pain. If you experience neck pain along with headaches, fever, sleepiness, vomiting, and/or loss of consciousness, get to your doctor right away. While viral meningitis is not usually life threatening, bacterial meningitis can be life threatening if left untreated.

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