How to Fight Chronic Pain Insomnia

Pain is one of the most common disruptors of sleep. It is bad enough when chronic pain makes it difficult to get through the day’s activities. Being unable to get a good night’s sleep makes it even more difficult to cope and can even make the pain worse. Chronic pain insomnia should be addressed because frequent sleep disturbance poses health risks.

Sleep Disorders and Chronic Pain Go Hand-in-Hand

Chronic pain is caused by any of a number of medical issues, including arthritis, headaches, fibromyalgia and spinal conditions. Chronic pain is also one of the common reasons people have difficulty falling asleep and staying asleep.

The National Sleep Foundation reports that says that one-fourth of people experiencing chronic pain have been diagnosed by a doctor as having a sleep disorder. Only six-percent of other people have been diagnosed. Insomnia is called chronic when it occurs at least three nights a week for three months or longer.

The relationship between chronic pain and sleep is not a healthy one because there is a multiplying effect. Chronic pain interferes with sleep, and a regular lack of restful sleep increases sensitivity to pain. Lack of sleep leads to fatigue and anxiety and even impacts brain functioning. All of the effects of poor sleep increases feelings of pain, which disrupts sleep even more.

Feeling sleepy throughout the day

It is an endless unhealthy cycle. Insomnia caused by pain is called secondary insomnia, meaning the sleep problems are due to something else like medication or pain. Insomnia symptoms include:

  • Difficulty falling asleep
  • Waking up periodically throughout the night
  • Difficulty falling back to sleep after waking up
  • Waking up too soon, even after not sleeping enough
  • Feeling tired after waking up and continuing to experience tiredness
  • Feeling sleepy throughout the day
  • Feeling stressed

Does Lack of Sleep Cause Pain?

Medical researchers continue to study the relationship of sleep and pain. It is known that chronic pain disturbs sleep, and frequent sleep disturbances can increase feelings of pain. However, the biology of the relationship is still not clear, and it is not definitely known if insomnia causes pain.

In a recent study published January on 2019 in the Journal of Neuroscience, researchers found that sleep deprivation has two impacts on the brain. It increases the brain’s responses to pain and suppresses the areas in the brain that regulate pain.

What is known for sure is that not getting a good night’s sleep for several nights a week is unhealthy. Combining chronic pain and sleep problems is a recipe for a life disrupted, making it difficult to work and enjoy life in general. Following are some side effects of poor sleep.

  • Irritability or anxiousness.
  • Memory or concentration problems.
  • Higher risk of heart disease, heart failure, heart attack and irregular heartbeat.
  • Higher risk for high blood pressure.
  • Higher risk for stroke.
  • Higher risk for diabetes.
  • Increased chance of depression.
  • Release of more of the stress hormone cortisol, which breaks down skin collagen.
  • Impact on appetite, making people more susceptible to weight gain.
Poor Sleep

Lack of good sleep on a regular basis is clearly very harmful to the mind and body.

Addressing Sleep Problems

If chronic pain is causing insomnia, chances are you are already working with a physician to address the medical condition causing the pain. If so, there is also a good chance you are already taking medications and do not want take yet another drug for sleep.

In general, people experiencing chronic pain often take a longer time to fall asleep and experience shorter sleep time and low sleep quality. The faster they go to sleep, the better.

There are natural ways to go to sleep.

  • Fall asleep faster by eliminating all distractions, including lights, electronic equipment and noises.
  • Develop a regular sleep-wake cycle and strictly adhere to it.
  • Perform deep breathing exercises right before bed for relaxation.
  • Do a relaxing activity before getting in the bed, like reading or a hobby.
  • Go to bed only when sleepy, and get out of bed if unable to fall asleep within a half hour.
  • Take a warm bath, which eases chronic pain and promotes relaxation and sleepiness.
Take a warm bath to ease chronic pain
  • Sleep on a good mattress with a pillow that keeps the neck in alignment with the spine, which also reduces pain and promotes healthy sleep.
  • Learn good sleep postures to ensure poor posture is not contributing to increased pain at night and insomnia.
  • Regularly do the appropriate exercises during the day but finish exercising within four hours of going to bed.
  • Do not drink alcohol or caffeine late in the day.
  • Learn to meditate, or separate oneself mentally from the pain and the fear of insomnia with guided imagery.
  • If pain disrupts sleep and makes it difficult to fall back to sleep, get up and do low energy, relaxing activity like reading with a low light.

Striving for Deep Sleep

Deep sleep is some of the most important sleep because it is the sleep cycle during which the pituitary gland secretes the human growth hormone, glucose metabolism in the brain increases and the body does much of its healing. People dealing with chronic pain are better off falling into a deep sleep as quickly as possible so there’s no time to focus on the pain, and there is more assurance of getting some of the critical sleep that delivers important health benefits.

There are ways to fall into a deep sleep fast. They include:

  • Lying in bed and focusing on muscle relaxation, beginning with the face and rolling the relaxation down the body while breathing.
  • Visualizing a relaxing place and not letting the mind wander.
  • Cooling a dark room to 60-67 degrees, which is conducive to melatonin production.
  • Learning progressive relaxation in which each of the muscles in the body are tensed for five seconds and relaxed for 30 seconds, working down or up the body.
  • Not taking naps during the day so the body is tired by bedtime.
  • Listening to calming music while falling asleep.
Tips to fall into a deep sleep fast

Seek Professional Help

Notice that most of the natural ways to fall and stay asleep with chronic pain are re-focusing the mind on something other than the pain. If, despite all efforts, you continue to experience insomnia, it is important to let your physician know. There may be treatment options available that can be integrated into an existing pain treatment plan.


  1. Pain and Sleep

  2. The Pain of Sleep Loss A Brain Characterization in Humans

  3. Insomnia Co-Occurring with Chronic Pain: Clinical Features, Interaction, Assessments and Possible Interventions

How to Straighten Your Back and Correct Spine Posture

A stiff neck is usually not a serious medical condition, but it can interfere with your lifestyle in many ways. It is a physical condition that can make it painful to sit, work, enjoy recreational activities, perform daily activities and get a good night’s sleep. Making some changes to posture and avoiding behaviors that strain the neck are often enough to prevent a stiff neck.

Poor posture is a common cause of back and neck pain. Slouching or maintaining a curved spine places undue stress on the spine, the back’s supporting muscles and internal organs. Correcting poor posture begins with awareness and making an effort to sit, stand, walk and sleep with good posture. The goal is to make good posture a regular habit.

Effects of Bad Posture on the Body

It is common for people to sit with a curved spine, slump over a desk while trying to read documents or computer screens and walk with the head pushed forward or tilted while looking down. These are just some of the activities where bad posture is commonly found.

Woman with a curved spine

The spine is crucial to supporting the body, movement and nerve signaling. Consistently maintaining poor posture can lead to a host of medical problems far beyond back or neck pain:

  • Back and neck pain – Supporting back and neck structures like muscles, tendons and ligaments are stressed and forced to move in unnatural ways.
  • Nerve system disruption – The spine is the main nerve channel from which smaller nerves extend outward to serve the body. A misaligned spine disrupts nerve signaling, leading to symptoms like numbness and pain in various areas of the body.
  • Uncontrollable movements – The nerve system disruption, combined with stressed muscles and other tissues, can cause uncontrollable shaking and movements in the legs, arms, hands, etc.
  • Organ functioning disruption – Poor posture impairs the functioning of organs like the intestines and lungs, causing digestive and breathing problems.
  • Joint problems – Over time, bad posture can negatively affect spine, knee, hip, ankle and feet joints because of the unnatural positioning and movement of the body due to bad posture. The misalignment of the knees and spine can contribute to the development of arthritis or make arthritis worse in different joints.
  • Other problems – Bad posture can lead to poor balance, headaches, incontinence, blood circulation issues that can also contribute to vertebrae deterioration, chronic fatigue and more.

It is easy to minimize the impacts of bad posture because it is not a disease or medical condition, per se. The truth is poor posture disrupts much of the entire body’s functioning along with causing back and neck pain.

Focusing on Alignment of the Spine

The spine should be kept in alignment when doing common activities – walking, sitting, driving and sleeping. Poor posture includes features like:

  • Rounded or slumped shoulders
  • Rounded back
  • Posterior pelvic tilt (sway back)
  • Head jutting forward past the shoulders
  • Head leaning backward
  • Sitting in a slouched position with back at an angle and hips placed out
  • Knees bent when walking or standing
  • Sleeping with the neck out of alignment with the spine
  • Anterior pelvic tilt (pelvis tilts forward)
  • Pot belly
Correct and Poor postures

A simple test for checking for bad posture is to align spine at home, and note the results. Stand up and place the back of the head and the back against the wall. The buttocks and shoulder blades should be touching the wall. Measure the gap between the neck or the small of the back and the wall. Either gap should be less than two inches. More than two inches indicates the spine is curved.

How to Align Your Spine

Developing and maintaining good posture requires paying attention to how the head, shoulders, back and hips are held. The key is to maintain a neutral posture and not a stiff one, so it is important to know how to straighten your back.

  • Stand up tall
  • Position the ears over the middle of the shoulders
  • Tuck the chin in
  • Hold the shoulders back in a position that does not force the chest out
  • Keep the back straight but not tense
  • Keep the hips aligned with the rest of the body and not tilted forward or back
  • Keep knees straight (but not locked) or only slightly bent when standing
  • Do not let the chest or butt stick out

Good posture should be maintained whether moving or still. It ensures the muscles supporting the skeleton and organ functioning are not impaired. If you want to know how to correct bad posture, following are a few tips for aligning the spine and maintaining good posture when doing different things.


  • Keep the shoulders back but not tense
  • Slightly bend the knees to take pressure off the hips
  • Keep the chest perpendicular (90-degree angle) to the ground
  • Avoid wearing high heels or shoes with a high angle
  • Do not stand in the same position for long periods of time; move around
Correct and poor postures when standing


  • Keep the shoulders back but relaxed to avoid tension
  • If looking at a computer screen, raise the screen to eye level
  • Keep the knees a little lower than the hips
  • Place feet flat on the floor
  • Do not place arms on chair arms (misaligns the shoulders)
Correct and poor postures when sitting


  • Walk so the heel hits the ground first followed by the toe
  • Keep the chin parallel to the ground
  • Keep the back straight and not arched
  • Keep the buttocks and stomach in line and not jutting forward or back
  • Keep shoulders back and relaxed
  • Do not look down (curves the neck); look forward at least several feet ahead
Correct and poor postures when walking


  • Choose a comfortable position but take steps to maintain neck and spine alignment
  • Choose a pillow that keeps the neck in alignment
  • If sleeping on the back, place a small pillow or rolled up towel under the small of the back
  • If sleeping on the side, place a pillow wherever necessary to keep the body aligned – between or under the knees, where the hips start, between the legs
  • Do not sleep on the stomach (places a strain on the neck)
  • Do not sleep with multiple pillows (forces the neck to bend)

Taking Care of the Body with Good Posture

Poor posture is usually due to a bad habit and not paying attention, rather than a medical problem. Improving back posture is important to good health, and there are three main steps you can take.

  1. First, develop awareness of your posture during various activities, and make necessary corrections for spine straightening. Practice walking, standing and sitting with the correct spine posture.
  2. Second, lose weight if overweight or obese, and maintain a healthy weight. Carrying too much weight makes it difficult to maintain good posture.
  3. Third, exercise regularly to strengthen muscles, tendons and ligaments. These tissues play critical roles in skeletal alignment and movement. Strong core muscles can also assist with keeping the back straight because you are less likely to easily get tired muscles that lead to slouching.

Practice Makes Perfect

If back or neck pain persists, you should see a physician to make sure there is not a medical problem or injury, rather than a posture issue, causing the pain. People who have developed poor posture need to remember that it will take some practice to make good posture something that does not require special attention. With awareness and practice, good posture will soon come naturally, and you will feel and look better.

8 Tips for Preventing a Stiff Neck

A stiff neck is usually not a serious medical condition, but it can interfere with your lifestyle in many ways. It is a physical condition that can make it painful to sit, work, enjoy recreational activities, perform daily activities and get a good night’s sleep. Making some changes to posture and avoiding behaviors that strain the neck are often enough to prevent a stiff neck.

Anatomy of the Neck

The neck is where the spinal column and spinal cord start. The neck contains seven of the 24 bones in the spinal column. Connecting the head to the body, the neck is considered the area from the lower jaw to the bones in the shoulders and upper chest.

Anatomy of the Neck

The neck has a variety of other features besides bones. They include tendons, ligaments, muscles, nerves, blood vessels and lymphatics. Also found in the neck are the pharynx, the larynx, the parathyroid glands and the thyroid gland.

Though many medical conditions can develop in the neck, one of the most common complaints is the stiff neck. A stiff neck usually indicates a muscle strain or a sprain in the ligaments or tendons.

What Causes a Stiff Neck?

A stiff neck may not have a serious underlying cause, but it can still be painful and debilitating. Some of the common causes related to daily activities include:

  • Sleeping in an awkward position.
  • Sitting for a long period of time in a slouching position at work while looking down.
  • Standing with poor posture.
  • Regularly looking down at a cell phone or computer screen.
  • Reading for long periods of time with the neck bent.
  • Sitting in a low seat while driving with the seat pushed back.
  • Carrying heavy items on one shoulder.
  • Stress that causes muscles to tighten.
  • Too strenuous exercising or other activity.
  • Vigorously and repeatedly turning the head sideways, like during swimming.

A stiff neck causes

Underlying medical conditions that can cause a stiff neck include:

  • Muscle sprain or strain
  • Arthritis
  • Infection
  • Injury, i.e. whiplash, falling, etc.
  • Infection
  • Spine disorder
  • Disease, i.e. rheumatoid arthritis, cancer, meningitis, etc.

When experiencing neck pain, bad posture is often the culprit. In some cases, a stiff neck may be a symptom of a more serious medical condition, like cervical degenerative disc disease. If a stiff neck lasts more than a few days or the pain or stiffness radiates down the arms or into the legs, it is important to see a physician for evaluation.

Symptoms of a Stiff Neck

The symptoms of the stiff neck include:

  • Tight muscles or muscle spasms
  • Headache
  • Pain when turning the head
  • Difficulty moving the head
  • General soreness in the neck area

Symptoms of a Stiff Neck

Preventing a Stiff Neck

Preventing a stiff neck may be simple if it is due to something like posture neck pain or computer neck pain. Following are some suggestions of steps to consider taking:

1. Change a sleeping position.

The best sleeping position for neck pain and headaches is one that keeps the neck in alignment with the body. Using the right pillow for neck support while sleeping is important.

The best pillow position for neck pain is one that prevents the neck from flexing or curving while sleeping. The pillow should not be too stiff or too high. Sometimes, it is necessary to use one pillow for the head and a higher pillow under the neck to keep the spine straight. Practice various positions until finding how to sleep to avoid neck pain.

The best sleeping position for neck pain and headaches

2. Improve posture.

Keeping the shoulders back and in a straight line over the hips, with the ears over the shoulder, is good posture. This posture keeps the spine straight. Maintain a straight spine when sitting, standing or walking.

3. Avoid neck positions that cause strain.

Many times, simple activities like regularly looking down at a cell phone, or frequently tucking a phone between the shoulder and ear, and holding it with the side of the face, cause soft tissue strain. Adjust furniture or equipment so the eyes are always looking straight ahead. This may require raising a computer screen, lowering a chair, changing a worktable height and so on.

4. Avoid sitting for long periods without a break.

Keeping the muscles, tendons and ligaments flexible can help a person avoid developing a stiff neck. Take frequent breaks throughout the day, if sitting for long periods of time while working, traveling or at home.

5. Avoid placing a strap on the shoulder to carry heavy items.

The weight of a book bag, backpack or handbag, carried by a strap slung over the shoulder, strains the neck tissues.

Avoid placing a strap on the shoulder to carry heavy items

6. Do neck stretches.

Some activities are prone to cause stiff necks, like frequent turning of the head while swimming, looking over the shoulder often during work and lifting heavy weights at the gym that strain neck muscles. The best way to prevent a stiff neck depends on the activity, but doing neck stretches after activities that involve using the neck may help prevent a stiff neck from developing.

7. Change reading position habits.

Neck pain from reading is common, whether reading a book, cell phone, eBook, tablet computer or computer screen. People read while sitting or lying down, and neck stiffness develops because a straight spine is not maintained. Remember to read the book or screen while maintaining a straight spine from neck to lower back.

When lying down to read while on your back, position pillows in a staggered formation to keep the spine straight while elevating the upper body. Be sure to use a pillow with a small lift to support the lower back, so it does not curve downward. Use a pillow in the lap to prop up the book.

If lying on your side to read, use a pillow to prop up the head and another pillow to prop the book or eBook reader for easier reading.

8. Manage stress and anxiety.

Stress and anxiety cause the body to tense, leading to tight neck muscles or a stiff neck. This is the body saying it is time to better manage stress to reduce its harmful impacts.

Keeping a Neck Healthy

Prevent the lifestyle-limiting impacts of a stiff neck by taking simple steps to maintain spinal alignment and keep neck muscles, tendons and ligaments flexible. A healthy neck is important because of the critical role it plays in so many movements and activities. Keeping the neck strong and healthy can prevent painful stiff neck episodes and enable you to continue enjoying favorite activities.

Rheumatoid Arthritis and Osteoarthritis: What are the Main Differences?

The two most common types of arthritis are rheumatoid arthritis and osteoarthritis. Both affect joints, and both can be painful and debilitating. However, they are different in terms of their underlying cause and the full range of physical impacts. 

Rheumatoid Arthritis vs Osteoarthritis: What is common

Rheumatoid arthritis and osteoarthritis have some things in common. The most obvious commonality is that both affect joints. There is no doubt that both can significantly harm the quality of life, if the disease is not purposefully managed. The most significant difference between the two types of arthritis is the underlying cause.

The most familiar type of arthritis is osteoarthritis OA, also called the wear-and-tear disease. Arthritis a degenerative disease develops when the cushioning cartilage in the joint wears out or disintegrates. Pain occurs when bones rub against each other. Sometimes, bone spurs develop, increasing pain and causing inflammation in surrounding tissues. 

Another common occurrence is when bits of bone or cartilage float around in the joint, causing painful inflammation. Osteoarthritis will continue to get worse over time, which is why it is called degenerative. Eventually, all the cartilage wears away.

Healthy joint, osteoarthritis and rheumatoid arthritis

Rheumatoid Arthritis vs Osteoarthritis: Causes

The cause of rheumatoid arthritis is quite different and still not fully understand. Rheumatoid arthritis is an inflammatory autoimmune disease. A properly functioning immune system attacks foreign substances. In the case of an autoimmune disease, the immune system attacks healthy tissues instead, as if they are foreign substances.

In rheumatoid arthritis what is happening? In this situation, the immune system attacks joints and other tissues and systems, and the result is inflammation of the synovium or joint lining. Synovial inflammation is regulated by cytokines. In rheumatoid arthritis, pro-inflammatory cytokines are present in such a large number that they promote inflammatory responses and induce cartilage degradation. The synovium produces the lubrication fluid for the joint. An inflamed synovium thickens, causing swelling in the joint, which can produce severe pain.

Osteoarthritis is contained in the affected joint and nearby tissues. The inflammatory reaction associated with rheumatoid arthritis is not necessarily contained in joints. It can damage other parts of the body, like organ linings, blood vessels, and eyes.

Osteoarthritis vs Rheumatoid Arthritis: Symptoms

Osteoarthritis and rheumatoid arthritis share some similar symptoms, but there are also a number of differences. Symptoms common to both include joint:

  • Pain
  • Tenderness
  • Swelling
  • Stiffness, especially in the morning
  • Warmth
  • Deformity over time
  • Restricted range of motion

Rheumatoid Arthritis Symptoms

Pain is listed first because in evaluating osteoarthritis vs rheumatoid arthritis pain, a person experiencing either disease will have similar joint pain. Osteoarthritis pain will develop slowly because the disease progresses slowly. Rheumatoid arthritis pain can worsen within weeks or months, so pain is felt earlier.

Another one of the main differences between the two diseases is that rheumatoid arthritis is more widespread, so it can cause havoc throughout the body. Some symptoms beyond the ones mentioned earlier include:

  • Fatigue
  • General malaise or depression
  • Low-grade fever
  • Symmetrical joint swelling
  • Synovial cysts
  • Rheumatoid nodules
  • Displaced or ruptured tendons
  • Restricted lung functioning
  • Atherosclerosis
  • Eye disease
  • Sjogren’s Syndrome (affects lacrimal and salivary glands)
  • Rheumatoid vasculitis
  • Peripheral neuropathy

Left untreated, rheumatoid arthritis can develop symptoms that are actually additional diseases.

Osteoarthritis Symptoms

Differences between RA and OA

As rheumatoid arthritis progresses, the more severe symptoms appear. Following are some differences between rheumatoid arthritis and osteoarthritis.

  • RA is an autoimmune disease so the immune system is compromised, but in osteoarthritis autoimmune issues are not present.
  • RA symptoms have a rapid onset, while OA progresses slowly.
  • RA affects joints throughout the body, while OA affects mostly knees, small finger joints, thumb and hips (though OA can impact any joint, including in the spine).
  • RA creates systemic symptoms, like fatigue and low-grade fever, while OA is localized to a joint.
  • RA is symmetrical, so both sides of the body are affected in similar joints, while OA affects individual joints.
  • RA morning stiffness may last longer than 30 minutes, while the stiffness people with OA experiences is likely to ease within 30 minutes.

Osteoarthritis vs Rheumatoid Arthritis Diagnosis

Rheumatoid arthritis is diagnosed by performing several tests. There is no single test that identifies rheumatoid arthritis:

  • Physical examination to look for swelling, redness and other outward physical symptoms.
  • Blood tests look for the rheumatoid factor, anti-CCP and antinuclear antibodies, and the level of inflammation.
  • Imaging tests that include x-rays, MRIs and/or ultrasounds.

Rheumatoid factor blood tests

Considering what can be determined by an osteoarthritis vs rheumatoid arthritis xray, the x-ray is more beneficial for detecting osteoarthritis because the disease involves the bones in its early stages. Rheumatoid arthritis may not present itself in the bones in its early stages. Instead, the patient may experience non-bone issues first, like chronic fatigue, or synovial and tendon inflammation. For this reason, the MRI and ultrasound are better than x-rays for early diagnose of rheumatoid arthritis. 

Which Arthritis is worse?

A common question people ask goes like this: Is osteoarthritis worse than rheumatoid arthritis? Rheumatoid arthritis is a more complex and widespread disease. It presents itself differently in each patient and is more difficult to diagnose because of its complexity. It can lead to other diseases, like cardiopulmonary disease and makes people more susceptible to diseases like lupus.

Osteoarthritis is localized in the joint, and some joints can be replaced if the damage from arthritis is severe. It does not impact organs or lead to other diseases.

However, both diseases are chronic and neither is curable. They both affect the quality of life. It is important to address the symptoms as soon as they appear. In both types of arthritis, the sooner treatment begins, the better.

What Triggers Arthritis Flare Ups?

The four common types of arthritis are osteoarthritis, a bone degeneration disease; rheumatoid arthritis and psoriatic arthritis, autoimmune diseases; and gout. The causes of the different arthritis types differ, but all patients will likely experience periodic flare ups. A flare or flare up is a sudden and temporary increase in disease activity, during which symptoms worsen. It is a normal but usually very painful event.

What is the Cause of Arthritis?

According to the Arthritis Foundation, a conservative estimate of the number of adults who have arthritis, diagnosed by a doctor, is 54 million. Tens of millions of these people are experiencing flare ups each day. Understanding what triggers arthritis is important to understanding what happens during a flare up.

  • Rheumatoid arthritis

What causes rheumatoid arthritis? This type of arthritis is an autoimmune disease, meaning the body’s immune system attacks joint linings (synovium) and a host of other systems and tissues that include blood vessels, heart, lungs, eyes, skin, nerves and kidneys. The synovium thickens due to inflammation and causes destruction of the cartilage and bones, also stretching the tendons and ligaments, which leads to joint misalignment.

Normal joint and inflamed joint linings

  • Osteoarthritis

Called the wear-and-tear arthritis, osteoarthritis is when the cartilage that serves as a cushion between bones wears away and bones rub together, inflaming surrounding tissues. Cartilage deterioration can also cause the joint lining to become inflamed and the joint cavity to fill with fluid in response.

Normal joint and cartilage deterioration

  • Psoriatic arthritis

This is an inflammatory arthritis. Similar to rheumatoid arthritis, the body’s immune system attacks healthy tissue and cells. It develops in some people who have psoriasis, a skin condition that presents itself as red patches of skin with silvery scales. Usually, the psoriasis appears first, and the arthritis develop afterwards, but psoriatic arthritis can begin first. 

Psoriatic arthritis in the Knee

  • Gout

Gout is an arthritis caused by uric acid crystals building up in a joint. After eating some foods, purines are broken down and one of the elements produced is uric acid. The crystals irritate joints but can also lead to kidney stones and even kidney failure. The most common joint experiencing gout is the joint at the base of the big toe, but it can also affect elbows, wrists, fingers, knees and ankles.


Symptoms of an Arthritis Flare

There are some arthritis flare symptoms found in every type of arthritis, like extreme joint pain and stiffness. Morning joint stiffness is a common symptom for rheumatoid arthritis, osteoarthritis and psoriatic arthritis. However, each type of arthritis also has symptoms unique to the particular arthritis. For example, rheumatoid arthritis is symmetric, meaning it usually affects both sides of the body, like both hands, both knees and/or both feet. Following are some of the typical symptoms of each type of arthritis.

Rheumatoid arthritis – joint pain and swelling; joint is warm to the touch; joint stiffness; fatigue; joint redness; loss of appetite; low-grade fever; limited range of joint motion; symmetrical joint effect.

Osteoarthritis – joint pain and stiffness; joint swelling can occur but is not as common as it is in people with rheumatoid arthritis; fatigue, often induced by pain experienced during the night that keeps a person awake; may affect a joint on one side of the body, like one knee or one ankle.

Psoriatic arthritis – joint pain, swelling and stiffness; joint is warm to the touch; most likely to cause foot pain where ligaments and tendons attach to the bones, swollen fingers and toes and/or lower back pain (spondylitis).

Gout – develops quickly and joint becomes very painful; joint swelling, warmth, reddish discoloration; tenderness.

Arthritis Flare Ups

Arthritis may be a joint disease, but flare ups can create other health issues, like extreme fatigue and a general feeling of sickness. People often find it difficult to explain their many symptoms, and each person is unique. Every flare should be taken seriously.

Triggers for Flare Ups

Rheumatoid arthritis – An RA flare is mostly due to inflammation, but what triggers inflammation? The triggers for inflammation are not specifically known yet, though extensive medical research is in progress. It may be stress, weather or too much physical activity. There is no definitive medical research proving weather impacts arthritis, but many patients have noted their joints react to a change in barometric pressure and humidity or when it is cold. Other triggers include infection or any illness compromising the immune system, and medications.

Osteoarthritis – Flare ups are not triggered by inflammation from an immune system response, but inflammation may be one of the symptoms of an osteoarthritis flare. Scientifically proven flare triggers still do not exist, but there are certain activities that have often triggered flare ups. They include falling on or injuring a joint, repetitive motions and overuse. Other causes include infection, stress, weather and obesity or being overweight. In some cases, continued deterioration of the cartilage can lead to bone spurs developing which then further irritates the joint and possibly the surrounding tissue.

Psoriatic arthritis – Most people experience a flare of psoriasis before a flare of psoriatic arthritis. The suspected triggers for a flare are stress, weight gain, physical trauma, joint strain, infection and medications.

Gout – The triggers for gout include excessive weight gain or obesity, alcohol, high blood pressure, abnormal kidney functioning, medications, disease and low thyroid hormone levels.

Arthritis infographic: symptoms of RA

Foods that Cause Arthritis Flare Up

Specific foods are not scientifically proven to trigger inflammation, but lab tests are indicating there are foods that appear to be pro-inflammatory. Foods to avoid include red meat, fried foods, processed food, refined carbohydrates and alcohol. 

Anti-inflammatory foods include:

  • Fruits (think richly colored choices like strawberries and blueberries
  • Fatty fish (salmon, tuna, mackerel)
  • Green leafy vegetables (collards, kale, spinach, olive oil)
  • Nuts (almonds, walnuts)
  • Whole grains (brown rice, whole grain bread). 

Green leafy vegetables

However, people experiencing flares should note reactions after eating certain foods. If it seems arthritis pain flares after consuming certain items, those foods should be eliminated from the diet.

Follow Sound Advice

There are a lot of myths about arthritis that people continue to believe. They include things like, “Do not eat any nightshade plants, including tomatoes,” and “Physical activity makes joints hurt more and causes more joint damage.” Arthritis flares are common, causing terrible joint pain and making people wonder if they will end up with a disability when the joints show signs of distorting. It is important to faithfully follow the treatment plan a medical professional recommends, likely to include diet , exercise and medications. 

Early Signs and Risk Factors for Developing Osteoporosis

Osteoporosis is sometimes referred to as the “silent disease” because it may not show noticeable signs of its presence until a serious bone fracture occurs. However, there are some signs of osteoporosis that can appear before the disease progresses too far. As the disease slowly and silently develops, bones lose density and become more porous, leading to skeletal changes that can cause pain. It is a progressive disease and not curable, but its progress can be significantly slowed. It is important to recognize the signs of osteoporosis and to begin a treatment plan immediately to prevent further bone loss.

Osteoporosis infographic: healthy and osteoporotic bones

Symptoms of Osteoporosis

Many times people learn they have osteoporosis because a bone fractures when doing something that should not break a bone, like standing up or lightly bumping an object. A bone fracture is one of the top symptoms of low bone density. 

Osteoporosis symptoms

However, there are early signs of osteoporosis that may appear before a bone breaks. Following is an osteoporosis symptoms list:

  • Loss of height over a period of time due to bone degeneration in the spine.
  • Back pain due to a collapsed vertebra in the spine.
  • Back pain due to a spinal fracture.
  • Developing a curvature of the spine near the shoulders (widow’s hump).
  • Developing a curvature anywhere along the spine.
  • Stooped or poor posture.
  • Difficulty doing simple activities, like getting out of a chair, without using the arms.
  • One or more markers for osteoporosis are indicated in blood test results, like low vitamin D levels (vitamin D from diet or supplements is needed for calcium absorption).

Osteoporosis stages with porous bones

In many cases, the pain associated with osteoporosis is mostly due to a bone fracture. Back pain is common when a spinal compression fracture occurs. Pain in the neck or hips is another one of the common signs of osteoporosis. However, osteoporosis and pain also go hand-in-hand when a bone weakens and causes other problems, such as a skeletal misalignment or difficulties with bending and twisting the body.

Osteoporosis develops so slowly that the signs the disease is developing are often overlooked. It is important to never ignore the warning signs of osteoporosis.

Risk Factors for Developing Osteoporosis

There are many risk factors for increasing the chances of developing osteoporosis. Some are not controllable but increase the risks. They include:

  • Race – people who are of Asian descent or Caucasian descent have the greatest risk.
  • Sex – more women than men develop osteoporosis because women’s bones are smaller and less dense than those of men.
  • Age – the natural aging process can lead to diminishing bone density.
  • Genetics – if someone’s parent, brother or sister developed osteoporosis, the risk increases for that person.

Risk Factors for Developing Osteoporosis

Some of the controllable risks that can lead to bone loss include:

  • Hormones – lowered sex hormones or excessive thyroid hormones.
  • Medications – corticosteroids and drugs used for seizures, cancer, gastric reflux, and transplant rejection.
  • Diet – a diet with low calcium intake.
  • Vitamin D level – low vitamin D level impedes the absorption of calcium.
  • Eating disorders – not getting enough nutrients due to a highly restricted food intake, leading to being underweight.
  • Exercise – lack of weight-bearing exercise or a sedentary lifestyle.
  • Alcohol – consuming more than two drinks a day.

At the first signs of osteoporosis, the physician will order specialized tests for measuring bone loss and density. There are two types of medical tests used. One type includes a bone density scan, CT or MRI. The second test type is a blood test that assesses for osteoporosis markers.

The scan is usually done using a bone densitometry (DEXA) or dual-energy x-ray absorptiometry (DXA) test. The DXA and DEXA scan machine produces a T-score and Z-score. The T score measure indicates the amount of bone a person has in comparison to younger people who have not experienced bone loss. The physician will use the T score to estimate the risk of fracturing a bone.  

Diagnosing Osteoporosis

The Z-score measures the amount of bone a patient has in comparison to other people who are in the same age group. Other common tests include a body CT scan, spine CT scan or spine MRI.

The bone density blood test measures osteoporosis markers. The markers measure certain elements in the blood or urine. The blood tests measure:

  • Bone-specific alkaline phosphatase (BALP) – an enzyme involved in the mineralization process; BALP levels indicate the bone formation rate of the skeleton; people with osteoporosis often have BALP levels that are as much as three times the normal level
  • Osteocalcin – a protein associated with bone building and turnover

The physician may also order a urine test:

  • Urinary N-telopeptide of type 1 collagen (uNTX) – type 1 collagen is a protein associated with bone breakdown; test indicates whether or not there is loss of bone and bone resorption

Slowing Bone Loss Due to Osteoporosis

The results of one or more tests will indicate if there are signs of bone loss. If so, the medical professional will recommend a course of action to slow the rate of osteoporosis progress. There is also the possibility that proper treatment and lifestyle changes can lead to some bone rebuilding, though complete reversal of bone damage is currently not possible. 


Arthritis in the hands

The general term of arthritis is used frequently to describe over one hundred types of joint pain or joint disease. People of all ages, sex, and race are affected by arthritis, with women being diagnosed more frequently than men are. 

What Is Arthritis

Osteoarthritis is the primary type of arthritis diagnosed, but other types are not so common. The wearing away of cartilage on the surface ends of the bones causes the inflammation and joint pain associated with arthritis. Mobility and fine motor activities become more difficult and painful. Arthritis can be infrequent in the beginning but can become more severe with time.

Arthritis Symptoms

There are many forms of arthritis; each includes specific symptoms and causes. The classic symptoms of arthritis are joint pain, swelling at the site of inflammation and loss of ability to perform functions such as walking up stairs and tying shoes with arthritis in hands. With some types of arthritis, there can be visible changes to the joints affected. Other types of arthritis require testing and examination to support a diagnosis. 

What Causes Arthritis

The causes of arthritis vary with each type. Each of the following forms of arthritis has a specific cause with joint pain and swelling being the common factor in most of the types:

  • Metabolic arthritis is caused by high uric acid levels. Uric acid allows crystals to form in the joints causing pain and inflammation in the affected area. Gout is a term used to describe this form of arthritis. 
  • Inflammatory arthritis can be caused by genetic or environmental factors. Inflammation occurs due to the autoimmune system triggering a response. Included in this category are psoriatic and rheumatoid arthritis.
  • Infectious arthritis is caused by a fungus, bacteria, or virus entering the system and is treated with antibiotics. Treatment is usually successful, but symptoms of arthritis may be chronic. 
  • Degenerative arthritis or osteoarthritis is the common form of arthritis. Causes of osteoarthritis are the wearing of bone cartilage, in turn, causing inflammation, pain, and swelling.

Diagnosing Arthritis

A diagnosis of arthritis is usually made initially with a primary care physician. The initial exam will include the following:

  • A thorough medical history including past illness and a possible family history of arthritis.
  • Physical examination especially of the joints and mobility.
  • Lab and imaging tests will be ordered to determine the form of arthritis.

The primary physician may do all or most of the testing, or they may refer to a rheumatologist to complete the diagnosis.

Treating Arthritis

Rheumatologists encourage treating arthritis as early as possible. Treating arthritis in its early stages will stop further damage to the body. Drugs to treat arthritis have greatly improved, and treatment is successful when treated early. Preventing the damage to joints and affected parts of the body are successful in arthritis pain relief.

Best Foods for Joint Pain Relief: What Foods Will Help Joint Pain?

All types of arthritis have an element of inflammation, and inflammation causes pain and joint damage. Ideally, preventing inflammation is the goal, but that is not always possible. Once it exists, the goal becomes reducing it for pain relief. A diet for joint pain includes foods with known anti-inflammatory nutrients and also nutrients for bone building and connective tissue strengthening.

Best foods for joint pain relief

Anti-inflammatories in Foods for Joint Pain

Inflammation can cause a lot of damage in the body, including the joints. It is inflammation that causes joint linings to swell, and joints to get red and warm. Chronic inflammation is linked to lupus, rheumatoid arthritis and psoriatic arthritis, and is a symptom of osteoarthritis when bone deterioration irritates soft tissues. Inflammation can cause serious joint damage when left untreated or becomes chronic.

Medical research is learning more and more about the role of foods for joint health and for reducing joint pain. Foods considered anti-inflammatory have certain characteristics. For example, they have higher levels of omega-3 fatty acids and antioxidants compared to other foods. The truth is that many of the foods people are consuming are contributing to more joint pain and more severe arthritis symptoms than would be experienced otherwise.

What Foods are good for Joints?

Food choices for healthy joints will:

  • Help control inflammation
  • Increase build density
  • Strengthen connective tissue
  • Help manage weight
  • Promote overall good health

There is still a lot of ongoing medical research investigating the role of diet in joint pain, but the general recommendation is to eat a lot of cold-water fish, fruits and vegetables. A largely plant-based diet that minimizes consumption of red meat is ideal. 

Plant-based diet for joint pain relief

Preventing and Reducing Inflammation and Joint Pain

Specifically, what foods help with joint pain? Research indicates the following foods can reduce pain.

  • Cold-water fish are high in omega3-fatty acids (polyunsaturated fatty acids) that prevent or reduce inflammation – mackerel, salmon, tuna, herring, oysters, sardines.
  • Leafy green vegetables for joint pain can block an enzyme that is known to cause joint swelling and contain calcium and a variety of vitamins and other compounds that strengthen bones – kale, mustard greens, purple cabbage, broccoli, Brussel sprouts, arugula.
  • Richly colored fruits have nutrients, like anthocyanins and lycopene, that limit the inflammatory response, and citrus fruits are rich in vitamin C that prevents inflammation – blueberries, blackberries, tomatoes (it is a fruit), strawberries, cherries, raspberries, oranges, limes, and grapefruits.
  • Oil is another omega-3 source and a source of healthy fat – extra virgin olive oil, safflower oil, avocado oil, walnut oil.
  • Beans have anthocyanins, antioxidants and anti-inflammatory properties – soybeans, chickpeas, black beans, lentils, pinto beans, kidney beans.
  • Whole grains are high-fiber and contribute to the production of fatty acids, which work to limit inflammation – whole wheat, barley, rye, whole oats, brown rice, buckwheat, quinoa.
  • Dairy has calcium and vitamin D to increase bone building – low fat milk, cheese, yogurt.
  • Nuts contain vitamin E, linolenic acid for immune strengthening, and other nutrients – almonds, pistachios, walnuts, pine nuts.

Dairy products to increase bone building

Foods to Avoid

Just like some foods prevent or reduce inflammation and reduce joint pain, there are foods to avoid. These foods are inflammatory foods that can lead to increased joint pain and other arthritis symptoms. The foods that cause joint pain and stiffness include:

  • Fried foods
  • Processed foods
  • Refined carbohydrates and sugar
  • Salt
  • Alcohol
  • Oils high in saturated fats or omega 6 fatty acids, like corn and safflower oil

Refined carbohydrates and sugar are to avoid with arthritis

Nutrition for Joint Pain

Foods for pain relief are really just healthy food choices. Everyone, whether or not they have arthritis, should avoid processed and fried foods, sugary desserts and marbled red meat. These foods contribute to a variety of diseases and can aggravate the inflammatory response and increase joint pain. Following a healthy diet can help anyone ease joint pain, and in the process, people better manage his or her weight and enjoy better overall health.

The Best Shoulder Pain Remedies

The shoulder area is one of the most used and abused parts of the body. This complex area of the body consists of two joints, tendons, muscles, and bones used for activities such as brushing hair to lifting weighty objects. The complex shoulder area is one of the most susceptible to injury and pain due to use and overuse.

Shoulder Joint Anatomy

How to Relieve Shoulder Pain at Home

With most shoulder pain, it is possible to manage your pain and discomfort at home. Some of the most successful ways to manage pain in the shoulder area are:

  • Shoulder pain relief medication such as ibuprofen, and acetaminophen.
  • Applying a cold compress to the area for the first forty-eight hours then switch to heat application.
  • Wear a compression brace for support.
  • Lift and elevate the area while resting or sleeping.

Simple Exercises to Manage Shoulder Pain

Including shoulder pain relief exercises into your daily routine, along with shoulder pain stretches, can see many positive results. Some simple daily exercises to strengthen the shoulder muscles and tendons and control pain include:

  • Shoulder rotations by lifting the shoulders toward the ear lobes then slowly rotate forward.
  • Rotating shoulders by lifting toward the ear lobes then rotating back toward shoulder blades.

Shoulder rotations to prevent pain

  • Rotations should be done when sitting with back straight and feet flat on the floor.
  • Stretch shoulder by moving both shoulders slowly toward the center of the body and hold the position for a few seconds.
  • Back shoulder stretches are moving both shoulders slowly toward shoulder blades then holding for a few seconds.

These simple exercises can be done several times a day to increase blood flow to the area and assist with pain relief.

Preventing Shoulder Pain

Preventing shoulder pain from occurring again and controlling symptoms will help in reducing the downtime with severe shoulder pain. Tips for preventing shoulder pain include some of the following suggestions:

  • Shoulder pain relief massage to assist in increasing blood flow and improving mobility.
  • Incorporating plenty of vitamin D into diet and exposure to daily sunshine.
  • Stay physically active and continue with exercises and stretches to the shoulder area.
  • Wear a compression brace when doing excessive activities like continued heavy lifting.

It is always wise to assess mattress and pillow for extreme wear and breakdown of materials to prevent severe shoulder pain after sleeping. Replacing an old mattress and pillow can be a simple way to avoid many of the common shoulder pain issues.

Correct and incorrect sleeping positions

A few changes in daily activities and being aware of what causes shoulder pain are some of the best ways to prevent it from occurring again. Most shoulder pain will decrease or go away entirely within a few weeks. A treatment plan that includes exercise, rest, and eating a nutritional diet will assist in controlling shoulder pain. When pain or symptoms increase or become more intense when exercising, consulting with a medical provider will be necessary.

4 Amazing Spinal Injections for Pain Management

Pain in the neck or anywhere on the spine can make it difficult to do even simple activities. The spinal injection for pain can provide temporary relief and is also used as a diagnostic procedure to help pinpoint the source of pain. It is a simple procedure performed by a physician when more conservative treatments fail. 

Following is a discussion of the spinal injection procedure and the types of injections available today.

What is a Spinal Injection?

A spinal injection is a minimally invasive treatment for pain management. It is a simple procedure in which a steroid injection mixture, consisting of a steroid and/or anesthetic and sometimes a numbing agent, is delivered to the area of the spine believed to be the source of pain. 

Spinal Injection

The steroid or cortisone and/or anesthetic medication reduces inflammation, thus providing pain relief. The anesthetic drug is administered in a procedure called a nerve block or nerve root block.

It is not always easy to identify the specific source of spinal pain. For this reason, the spinal injection is used as injection therapy for back pain or as a diagnostic injection back pain procedure.

Types of Spinal Injections

Epidural steroid injections and selective nerve block injections are effective because they deliver medication directly to the location in the spine, causing the pain. Steroid medication is an anti-inflammatory drug. In the nerve block spinal injection, the anesthetic works by blocking pain signals. 

Following are the common injections for back pain relief.

Often used for the treatment of low back (lumbar region) and leg pain, this injection provides pain relief that can last for one week to a year. The injections are also used to relieve pain in the upper back and neck (cervical region) and the mid-spine area (thoracic region). In most cases, the number of injections in a 12-month period will not exceed three. 

Epidural injection

This is an injection of a steroid and numbing agent used to either provide therapeutic relief of back pain or to diagnose the source of pain. Nerve roots that become inflamed and compressed cause the pain, but it may be difficult to identify the precise area of nerve inflammation. If the first injection does not stop the pain, the physician will schedule an additional injection to be administered in a different location of the spine. The treatment in the same area can be administered up to 6 times a year. 

The spine consists of a series of paired joints called facet joints. Cartilage provides cushioning tissue that prevents the bones from rubbing together during movement. Nerves run through these joints. Pain occurs when one or more facet joints is injured or cartilage deteriorates during the normal aging process. An injection of a steroid and/or anesthetic into the capsule surrounding the damaged facet joint in the cervical, thoracic or lumbar regions of the spine can bring pain relief. The treatment can be administered up to three times each year.

Facet joint injection

The sacroiliac (SI) joint is the joint next to the spine that connects the bottom of the spine or sacrum to the hip or pelvic bone. If the joint deteriorates or is injured, pain occurs. An injection of a steroid or anesthetic directly into the SI joint can provide temporary pain relief up to four months. The treatment can be administered up to three times each year. 

All types of spinal injections are limited to a certain number per year because frequent use of steroids can lead to side effects. Serious side effects include weakened spinal bones and muscles near the spine. Other side effects include skin thinning, high blood sugar and insomnia, to name a few. 

Steroid injections interrupt the natural balance of hormones in the body. Spreading the injections out over a period of time allows hormones to re-balance.

Diagnostic Spinal Injections

Spinal injections can help a physician identify the source of pain. If the injection stops the pain, the physician knows the specific spinal area to further evaluate. Sometimes surgery is needed, but surgery is always a last resort. 

A good example is the facet rhizotomy. A cervical fact rhizotomy or a lumbar facet rhizotomy is used as a treatment option after a patient has had several facet joint injections that enabled the physician to pinpoint the source of pain. A facet rhizotomy is a procedure in which nerves are deadened with a heated electrode, giving pain relief for months or years. 

Facet Rhizotomy

Facet Rhizotomy

Easing Pain with Injections

Spinal pain is debilitating, making it difficult to move and manage normal activities. The spinal injection for pain is a low risk procedure that can take place in a medical clinic, hospital or surgical center. 

Usually, the patient is asked to try conservative measures first, like over-the-counter pain nonsteroidal anti-inflammatory medications and short periods of bed rest. If these measures do not work, the next step is injection therapy or a diagnostic injection.