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Alternative Medicine: The National Center for Alternative and Complementary Medicine (NCCAM) cites back pain as the No. 1 reason why people seek alternative medicine care. Neck pain is No. 3, still a major reason. Reasons for trying CAM include:

* it may work well in conjunction with more traditional type treatment
* other traditional treatments have been tried, with unsatisfactory results
* CAM is less expensive than traditional treatment
* conventional medical professionals suggest it.

Exercise: Consumer Reports Medical Guide rates exercise as the best of all the options for treatment of long-term back pain. Often your doctor or physical therapist will prescribe a set of exercises for your back or neck condition. There are several very popular forms of exercise that appear to help control back pain, among them yoga, Pilates, and the Egoscue Method. Ergonomic experts suggest taking frequent work mini-breaks to do back exercises, as well.

Back surgery: Back surgery is usually tried after conservative treatment methods such as physical therapy, home exercise programs, injections, and other methods have failed after six months or longer of use. While most people don’t need back surgery, the number of surgeries is on the rise. Not all back surgeries are successful. A back surgery that fails to remove the pain, or causes pain or problems not present prior to surgery is a condition known as failed back surgery syndrome.

Implanted Neurostimulation: Implanted neurostimulation, also known as spinal cord stimulation, helps to modulate chronic back pain. This treatment is not for everyone. For one thing, surgery is required to put the device in, take it out, and sometimes to maintain it. It can be inconvenient, as well.

Injections: Injections are an invasive technique that can diagnose the cause of pain, and can treat the pain itself. The great thing about injections for back pain is that they deliver medicine directly to the site of the pain. There are several types of injections. Recent advances in medicine have introduced two new types of injections:

* Botox injections for chronic neck and back pain
* Prolotherapy

Medication: According to the American Chronic Pain Association, analgesics and other medications are the most common chronic pain treatment. While short-term use of drugs from chronic back or neck pain probably won’t get you into trouble, prolonged use may increase the risk for serious side effects. For example, in 2004, Vioxx, a COX-2 inhibitor, was removed from the market after it became evident that prolonged use of these drugs could result in fatal heart problems.

Medications get the best results when used in conjunction with other treatments such as physical therapy, behavioral therapy and more.

Pain Management: The branch of medicine that helps patients manage their pain is called pain medicine or pain management. Pain medicine is a multi-disciplinary approach to managing the presence of pain in your life. Pain management treatment considers physical, social, and psycological lifestyle factors.

Types of Doctors for Back and Neck Pain: Many doctors specialize in one or two areas. Sometimes doctors’ specialty areas overlap with one another. The most important thing to remember when choosing a doctor who specializes is to find one with excellent skills in diagnosing and treating your condition.

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A relative was recently diagnosed with Fibromyalgia and although I had heard the term in passing, I never really new what it was.

And recently it seems to be spoken of in great detail whether in medical journals or commercials that advertise treatments, so I decided to take a closer look.

According to medscape.com: Fibromyalgia is a chronic syndrome that occurs predominantly in women and is marked by generalized pain, multiple defined tender points, fatigue, disturbed and nonrestorative sleep, and numerous other somatic complaints.

Fibromyalgia largely overlaps with other syndromes, such as Chronic Fatigue syndrome, Irritable bowel syndrome, temporomandibular joint pain. and multiple other regional pain syndromes, all of which feature symptoms that remain unexplained after usual clinical and laboratory assessment and all of which are related to, but not fully dependent on, depression and anxiety.

So does that clear things up for you? No? Me either. I mean as I try to categorize it, I need to know if it’s bacterial or viral and is it hereditary? It would even help me more if I knew what could cause it. The fact is, the medical community does not have many of the answers I seek. According to medscape.com, Despite extensive research, no structural pathology has been identified in muscles or other tissues. Although psychological factors associated with chronic distress appear to be important for the development of fibromyalgia in many patients, abundant evidence now indicates that pain in fibromyalgia reflects abnormal pain processing in the central nervous system (i.e., central sensitivity). Clinically, fibromyalgia syndrome is best viewed from a biopsychosocial perspective encompassing multiple variables that contribute to chronic pain and fatigue.

Well, that helps a little but it still sucks because I need to figure this thing out.

Oh well, lets move on to the symptoms. Pain is the hallmark of fibromyalgia. The pain extends from the skeleton and is confined in muscles and muscle-tendon connections in the neck, shoulders, hips, and extremities. And the pain is not one that can be ignored. The pain is usually accompanied by stiffness. Other symptoms include Fatigue and sleep disturbances, Irritable bowel syndrome, Headaches and facial pain, Heightened sensitivity, Difficulty concentrating , Mood changes, Chest pain, Dry eyes, skin and mouth , Painful menstrual periods , Dizziness and Anxiety .

It was once thought that depression caused fibromyalgia pain, but now that it is a bit more understood, studies show that clinical depression can deepen a patients experience of pain. I also feel that because it is hard to diagnose (there is no single laboratory test that confirms it) that people who have it become frustrated as it takes numerous trips to the doctor’s office and numerous blood tests and x-ray’s to basically rule out other diseases before a doctor will consider performing a pressure point exam, and with this along with the medical tests and medical history make a diagnosis.

Is there a cure? Unfortunately no. Like most afflictions, the symptoms are treated rather than a course of treatment that offers a cure given. Analgesics and Pregabalin are prescribed for pain, Antidepressants to help promote sleep and Muscle relaxants to treat muscle pain and spasms. The mayo clinic also offers these treatments that are considered “alternative”, Acupuncture, Chiropractic care, Massage therapy and Osteopathy.

Suggested lifestyle changes include Reduce stress , Get enough sleep, Exercise regularly, Pace yourself , and Maintain a healthy lifestyle.

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Backache is the pain felt in the back that generates from the bones, muscles, nerves, joints or other structures of the spine. It is one of the most common problem faced by individuals today due to many reasons. It has been shown that about nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year.

Lower back pain is usually due to sprains, muscle strains, minor injuries, or a pinched or irritated nerve. Other then daily home activites or poor posturing there are some other causes of back pain which include:

* Lifting, pushing or pulling things incorrectly
* Bending awkwardly
* standing or bending down for long periods
* twisting
* Coughing
* Sneezing
* Muscle Tension
* Over-Stretching
* Driving in hunched position
* Straining of Joints
* Lack of Exercise
* Driving for long periods
* Sitting in a posture for a long period of time.

Sometimes, people often feel back pain when they wake up and if you ask me, i think this is the worst time to experience a pain :p. Other causes of back pain are pregnancy, viral infections, stress related tension, kidney disorders, bone disorders, obesity etc.

Most of the time, you can get rid of back pain without any medication or treatment as it will go away in some days. Other than that, to get rid of back pain you need to be active and performing you daily work. You should exercise everyday as it strengthen your muscles and improve your posture. You can also take some muscle relaxant or a balm and massage it over you back and do bed rest if you experience extreme pain.

Other then these, there are some home remedies to get rid of back pain as well.

* Lemon is an excellent remedy against back pain. Lemon juice mixed with common salt and taken by the patient twice a day.
* Raw Potato is another home remedy for treating back pain and is one of the most successful one. Raw potato in the form of poultice should be applied to the affected area and it will relief pain.
* Vitamin C has also been an effective remedy to treat back pain which is found in most citrus fruits. So about 2000mg of vitamin C should be taken daily means that you should eat fruits and vegetables alot. You can take them in the form of salads of raw fruits and vegetables as it really good in treating back pain and many other diseases.

Now, if you experience extreme pain or pain due to some disease or disorder, then you should visit the doctor and do as he prescribe.

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Chamomile

Chamomile is a natural sedative that is often used not only for the treatment of muscle spasms, but also for common disorders like menstrual cramps, tension headaches, and neuralgia. The sedative properties of chamomile works by easing the tightness in the muscles while its anti-inflammatory qualities soothe stiffened joints.

Valerian

An effective relaxant, valerian used to be known as the all-cure during the medieval times. Rightly so since this herb’s sedative properties has been used throughout the ages to cure disorders caused by muscle spasms and tension. Valerian is especially effective against contracted muscles and neck tension.

Catnip

Particularly effective in alleviating smooth muscle tension, oils extracted from catnip are useful in relieving menstrual cramps and colic. Catnip also has anti-inflammatory qualities that help reduce swelling in the joints and muscles.

Other notable plants with antispasmodic properties include common herbs like basil, bergamot, cardamom, and caraway. Although taking natural muscle-relaxing agents has no or minimal side effects, it is still important to consult a doctor before taking any.

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Prior to the development of drug-based muscle relaxants, people have been using natural remedies to alleviate muscle spasms and soothe stiff joints. These natural muscle relaxants are often herbs and common plants that provide the same effect as drug-based relaxants without the compromise of possibly severe side effects. Some of these popular remedies for stiff joints and muscle spasms can be found right in one’s garden or in community health stores.

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As sedatives, benzodiazepines can relieve the symptoms of anxiety and effectively promote sleep for most people, with very few side effects.

Benzodiazepines have also proven to be very effective in the treatment of panic disorders.

Several different benzodiazepines are very effective in preventing panic attacks.

This class of drugs may also be used for effective long-term treatment of anxiety, although this raises concerns about dependency.

Some physicians have also used benzodiazepines to treat other disorders, such as borderline personality disorder; this has been with some positive results.

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Dependence

It is almost universally accepted that long term use of this class of drugs will lead to dependence. Some withdrawal symptoms may include:

Common withdrawal symptoms may include:

Abdominal pains and cramping
Anxiety
Breathing difficulties
Blurred vision
Changes in perception
Depression
Dizziness
Extreme lethargy
Flu-like symptoms
Heavy limbs
Heart palpitations
Hypersensitivity to light
Indigestion
Insomnia
Irritability
Lack of concentration
Lack of co-ordination
Loss of balance
Loss of memory
Muscular aches and pains
Nausea
Nightmares
Panic attacks
Rapid mood changes
Restlessness
Severe headaches
Shaking
Sore eyes
Tightness in the chest

Because of the severity of some symptoms and the high risk of dependence, make sure that you speak to a doctor before taking any benzodiazepines. Also speak to a doctor or pharmacist for more information on dangers and symptoms of benzodiazepine withdrawal.

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When taken orally, benzodiazepines are absorbed by the stomach and small intestine, and they are metabolized by the liver. Benzodiazepines tend to be highly fat soluble and accumulate in the patient’s fatty tissue.

The benzodiazepines operate in the brain, affecting control of consciousness, emotional reactions, memory, coordination, and concentration.

The benzodiazepines do this by enhancing the action of the neurotransmitter “GABA” (Gamma Amino Butyric Acid). Neurotransmitters are chemicals which enable the brain cells to transmit impulses from one to another. They are released from brain cells by electrical signals. Once released, the neurotransmitters signal inhibition or excitation of neighboring brain cells.

GABA is an inhibitory neurotransmitter, which means that it is a chemical that enables brain cells to slow or calm things down. Benzodiazepines increase the efficiency of GABA, thus causing greater inhibition of signals, or calming.

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Benzodiazepines are a very large class of drugs that are characterized as having six primary effects:

Anxiolytic Effect
Sedative Effect
Anticonvulsant Effect
Hypnotic Effect
Amnestic Effect
Muscle Relaxant Effect

Each different benzodiazepine exhibits varying degrees of these and other, more secondary effects; for example, one drug may exhibit stronger sedative effects, while another may have a stronger Anxiolytic effect.

These drugs (also known as “Benzo’s” in the parlance of seasoned users), have also been described as a group of “minor tranquilizers”, which many physicians believe to be a misrepresentation, considering the strength of modern benzodiazepines.

Doctors generally prescribe Benzodiazepines for anxiety conditions, particularly panic attacks, and generalized anxiety disorder (GAD).

Occasionally, benzo’s are also prescribed for seizure disorders, such as epilepsy, or for insomnia and other sleep problems, such as restless leg syndrome (RLS). Benzodiazepines are also quite frequently prescribed as muscle relaxants.

Valium, Xanax, and Alprazolam are among the most common benzodiazepines prescribed in the United States today. Valium has become less common over the past 15 years.

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Fibromyalgia features a long list of drug treatment options, however, currently there are no drugs approved by the FDA for treating fibromyalgia, although a few such drugs are in development. Doctors treat fibromyalgia with a variety of drugs developed and approved for other purposes.

On June 21, 2007, Lyrica (pregabalin capsules CV) were approved by the U.S. Food and Drug Administration (FDA) for the treatment of fibromyalgia. The approval of Lyrica was long-awaited because it’s the first medicine that is FDA-approved to treat fibromyalgia. More fibromyalgia drugs are in development. Doctors also treat fibromyalgia with a variety of drugs developed and approved for other purposes. Below are some of the most commonly used categories of fibromyalgia medications:

Analgesics

Analgesics are painkillers. They range from over-the-counter drugs, such as acetaminophen, to prescription drugs, such as tramadol, and even stronger narcotic drugs.

For a subset of people with fibromyalgia, narcotic medications are prescribed for severe muscle pain. However, there is no solid evidence showing that narcotics actually work to treat the chronic pain of fibromyalgia, and most doctors hesitate to prescribe them for long-term use because of the potential that the person taking them will become dependent on them.

NSAIDs

NSAIDs (nonsteroidal anti-inflammatory drugs) are used to treat inflammation. Although inflammation is not a symptom of fibromyalgia, NSAIDs also relieve pain. NSAIDs include:

* aspirin
* ibuprofen
* naproxen

NSAIDs work by inhibiting prostaglandins, which play a role in pain and inflammation. These drugs, some of which are available over-the-counter, may help ease the muscle aches of fibromyalgia. They may also relieve menstrual cramps and the headaches often associated with fibromyalgia.

Antidepressants

Perhaps the most useful medications for fibromyalgia are several in the antidepressant class. Antidepressants elevate the levels of certain chemicals in the brain, including serotonin and norepinephrine. Low levels of these chemicals are associated not only with depression, but also with pain and fatigue. Increasing the levels of these chemicals can reduce pain in people who have fibromyalgia. Doctors prescribe several types of antidepressants for people with fibromyalgia.

Tricyclic Antidepressants

When taken at bedtime in dosages lower than those used to treat depression, tricyclic antidepressants can help promote restorative sleep in people with fibromyalgia. They also can relax painful muscles and heighten the effects of the body’s natural pain-killing substances called endorphins.

Tricyclic antidepressants have been around for almost half a century. Some examples of tricyclic medications used to treat fibromyalgia include:

* amitriptyline
* cyclobenzaprine
* doxepin
* nortriptyline

Selective Serotonin Reuptake Inhibitors (SSRIs)

If a tricyclic antidepressant fails to bring relief, doctors sometimes prescribe a newer type of antidepressant called a SSRI. As with tricyclics, doctors usually prescribe these for people with fibromyalgia in lower dosages than are used to treat depression. By promoting the release of serotonin, these drugs may reduce fatigue and some other symptoms associated with fibromyalgia. The group of SSRIs includes:

* fluoxetine
* paroxetine
* sertraline

SSRIs may be prescribed along with a tricyclic antidepressant. Doctors rarely prescribe SSRIs alone. Because they make people feel more energetic, they also interfere with sleep, which often is already a problem for people with fibromyalgia.

Cymbalta (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) that is also showing promise.

Mixed Reuptake Inhibitors

Some newer antidepressants raise levels of both serotonin and norepinephrine, and are therefore called mixed reuptake inhibitors. Examples of these drugs include:

* venlafaxine
* nefazodone

Researchers are actively studying the efficacy of these drugs in treating fibromyalgia.

Benzodiazepines

Benzodiazepines help some people with fibromyalgia by relaxing tense, painful muscles and stabilizing the erratic brain waves that can interfere with deep sleep. Benzodiazepines also can relieve the symptoms of restless legs syndrome, which is common among people with fibromyalgia. Restless legs syndrome is characterized by unpleasant sensations in the legs as well as twitching, particularly at night. Because of the potential for addiction, doctors usually prescribe benzodiazepines only for people who have not responded to other therapies. Benzodiazepines include:

* clonazepam
* diazepam
* triazolam
* temazepam

Other Medications For Fibromyalgia

Doctors may prescribe other medications, depending on a person’s specific symptoms or fibromyalgia-related conditions. For example:

* Tegaserod and alosetron are FDA approved for the treatment of irritable bowel syndrome.
* Gabapentin is being studied as a treatment for fibromyalgia.
* Pregabalin (Lyrica) is the first medicine that is FDA-approved to treat fibromyalgia.
* Modafinil may help with fatigue.
* Sodium oxybate may help with excessive sleepiness.

Symptom-Specific Drugs

Other symptom-specific drugs include:

* various headache remedies
* sleep aids such as:
o zolpidem
o eszopiclone
o ramelteon
o zaleplon
* muscle relaxants
such as:
o carisoprodol (soma)
o metaxalone
o methocarbamol

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Are The Newer Arthritis Drugs Always The Better Choice?

Arthritis drugs have long been considered the “traditional” treatment option. Since individual response to drugs can vary and because potential side effects and adverse reactions are also a factor, finding the most effective combination of arthritis drugs can be a more difficult process than one would expect. Patients should become knowledgeable about the various arthritis drugs so they can make decisions with their doctor.

NSAIDs / COX-2 Inhibitors

NSAIDs (nonsteroidal anti-inflammatory drugs) are among the most commonly prescribed and widely used arthritis drugs. There are three types of NSAIDs: salicylates (both acetylated, such as aspirin, and nonacetylated such as (Disalcid) salsalate, (Trilisate) choline magnesium trisalicylate and (Doan’s Pills, Novasal) magnesium salicylate), the traditional NSAIDs, and COX-2 selective inhibitors.

NSAIDs work by blocking the activity of the enzyme, cyclooxygenase, also known as COX. Research has revealed that there are two forms, known as COX-1 and COX-2. NSAIDs affect both forms. COX-1 is involved in maintaining healthy tissue, while COX-2 is involved in the inflammation pathway. COX-2 selective inhibitors became a new subset of NSAIDs born of this research.

Traditional NSAIDs Include:

* Ansaid (Flurbiprofen)
* Arthrotec (Diclofenac/Misoprostol)
* Cataflam (Diclofenac potassium)
* Clinoril (Sulindac)
* Daypro (Oxaprozin)
* Dolobid (Diflunisal)
* Feldene (Piroxicam)
* Ibuprofen (Motrin, Advil)
* Indocin (Indomethacin)
* Ketoprofen (Orudis, Oruvail)
* Lodine (Etodolac)
* Meclomen (Meclofenamate)
* Mobic (Meloxicam)
* Nalfon (Fenoprofen)
* Naproxen (Naprosyn, Aleve)
* Ponstel (Mefanamic Acid)
* Relafen (Nabumetone)
* Tolectin (Tolmetin)
* Voltaren (Dicolfenac Sodium)

COX-2 Inhibitors include:

* Celebrex (Celecoxib)
* Vioxx (Rofecoxib)(no longer on market)
* Bextra (Valdecoxib)(no longer on market)

DMARDs

DMARDs (Disease-Modifying Anti-Rheumatic Drugs) have also been labeled “slow-acting anti-rheumatic drugs” (because they take weeks or months to work) and “second-line agents”. However, research has shown the effectiveness of DMARDs in the treatment of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis and the importance of early, aggressive treatment with these drugs. For some, these drugs can stop disease progression and halt joint damage.

DMARDs Include:

* Arava (Leflunomide)
* Auranofin (Ridaura, Oral Gold)
* Azulfidine (Sulfasalazine)
* Mycophenolate (CellCept)
* Myochrysine (Injectable Gold)
* Cyclosporine (Neoral,Sandimmune)
* Cytoxan (Cyclophosphamide)
* Imuran (Azathioprine)
* Leukeran (Chlorambucil)
* Methotrexate (Rheumatrex, Trexall)
* Minocin (Minocycline)
* Penicillamine (Cuprimine, Depen)
* Plaquenil (Hydroxychloroquine)

Corticosteroids (Steroids)

Corticosteroids or glucocorticoids, often called “steroids”, are potent drugs which can reduce swelling and inflammation quickly. These drugs are closely related to cortisol, a hormone produced on the cortex of the adrenal glands. They are prescribed in widely varying doses depending on the condition and goal of treatment. Used to control inflammation of the joints and organs in diseases such as rheumatoid arthritis, lupus, polymyalgia rheumatica, vasculitis, it has been determined that the potential for serious side effects increases at high doses or with longterm use. Doctors can prescribe short-term, high-dose intravenous steroids in some situations, or give shots or injections with drugs such as Triamcinolone (Kenalog) locally into a specific joint for relief.

Corticosteroids Include:

* Betamethasone (Celestone)
* Cortisone (Cortone)
* Dexamethasone (Decadron)
* Hydrocortisone (Cortef)
* Methylprednisolone (Medrol)
* Prednisolone (Prelone)
* Prednisone (Deltasone)

Analgesics (Pain Killers)

Analgesics are pain relieving drugs. Controlling pain is a vital part of treating arthritis. However, unlike NSAIDs, analgesics do not relieve inflammation. Acetaminophen (Tylenol) is the most commonly used analgesic. Narcotic analgesic drugs can also be prescribed for more severe pain.

Narcotics Include:

* Codeine (Tylenol#3)
* Darvocet (Propoxyphene/Acetaminophen)
* Darvon (Propoxyphene)
* Duragesic (Fentanyl Skin Patch)
* Hydromorphone (Palladone)
* (no longer on market) Morphine Sulphate (MS Contin)
* Oxycodone (OxyContin)
* Percocet (Oxycodone/Acetaminophen)
* Percodan ( Oxycodone/ Aspirin)
* Talwin NX (Pentazocine/Naloxone)
* Ultracet (Tramadol/Acetaminophen)
* Ultram (Tramadol)
* Vicodin (Hydrocodone/Acetaminophen)

Biologic Response Modifiers (Biologics)

Biologic Response Modifiers (BRMs) stimulate or restore the ability of the immune system to fight disease or infection. BRMs are drugs derived from living sources as opposed to being synthesized chemicals.
Enbrel (etanercept), Remicade (infliximab), and Humira (adalimumab), target TNF-alpha, one of the most important cytokines involved in rheumatoid arthritis. BRMs which bind to TNF-alpha, render it inactive, interfering with inflammatory activity and ultimately decreasing joint damage.

Kineret (anakinra), also a BRM, is considered an IL-1 antagonist. Kineret is the first selective blocker of interleukin-1 (IL-1), a protein which is found in excess in rheumatoid arthritis patients.

By blocking IL-1, Kineret inhibits inflammation and pain associated with rheumatoid arthritis. Kineret can be used alone, or in combination with DMARDs other than anti-TNF drugs.

Orencia (abatacept) is the first T-cell co-stimulation modulator approved for the treatment of rheumatoid arthritis.

Rituxan, the world’s best-selling cancer drug, was FDA approved 3/1/2006 to be used in combination with methotrexate to treat rheumatoid arthritis by reducing the signs and symptoms in adult patients who have moderately-to-severely active rheumatoid arthritis and have failed one or more anti-TNF drugs. Rituxan is the first treatment for rheumatoid arthritis which selectively targets the CD20-positive B-cells.

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