Pain Medications

Pain medications exist to help treat numerous sources of pain, from the occasional headache to arthritis and bone conditions to cuts, scrapes and breaks. While some aches and pains can be treated with over-the-counter pain medications, including ibuprofen and acetaminophen, other sources of pain require prescription pain medications.

Over-the-counter pain medications include the following, among others:

  • acetaminophen
  • aspirin

Prescription pain medications include:

  • certain NSAIDs
  • COX-2 inhibitors
  • Vicodin®.

No matter which pain medication you use, you should discuss its potential side effects with your doctor or pharmacist. In addition, you should always take your pain medication as advised and never take more than the recommended dosage. While some pain medication side effects are minor, some can be life-threatening.

In this section, we’ll discuss a number of pain medications. We’ll offer information on opioids, COX-2 inhibitors and more. We’ll also offer the pros and cons, costs and effectiveness of each pain medication.

Opioids

An opioid is a chemical substance that is often used for pain relief. It produces a morphine-like action in the body by binding to opioid receptors in the central nervous system and the gastrointestinal tract.

Opioids can be divided into four categories:

  • endogenous opioid peptides (which are naturally produced in the body)
  • fully synthetic opioids (methadone, fentanyl, etc.)
  • opiates (morphine, codeine, heroin, etc.)
  • semi-synthetic opioids (opioids create from natural opioids).

Opioids have a long history of treating acute pain, such as pain that occurs following surgery. However, opioids have also been found to alleviate chronic pain, such as pain that results from terminal diseases, including some forms of cancer.

Side effects of opioids include:

  • constipation
  • drowsiness
  • nausea

Depression, confusion and hallucination can also be caused by the use of opioids.

COX-2 Inhibitors

COX-2 inhibitors are typically prescribed for pain relief from such conditions as:

  • menstrual pain
  • osteoarthritis
  • rheumatoid arthritis.

In some studies, COX-2 inhibitors have been shown to produce less stomach bleeding and ulcer formation in patients than non-selective non-steroidal anti-inflammatory (NSAID) pain relievers, such as Advil® (ibuprofen) or Naprosyn® (naproxen).

As COX-2 inhibitors have been linked with an increased risk of heart attack and stroke, both physicians and patients should weigh the risks and benefits of COX-2 inhibitors. While some people are considered good candidates for COX-2 inhibitors, others, including those with heart problems, should not take COX-2 inhibitors.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are used to relieve pain, inflammation and fever. Some of the more popular NSAIDs include:

  • diclofenac(Cataflam®, Voltaren®, Voltaren®-XR)
  • ibuprofen(Advil®, Midol®, Motrin®, Nuprin®)
  • naproxen(Aleve®, Anaprox®, Naprelan®, Naprosyn®).

While NSAIDs are popular pain medications, they do carry some risks. For example, the main risk of prolonged use of naproxen and ibuprofen is stomach ulcers. Other common side effects of NSAIDs include:

  • abdominal or stomach cramps
  • dizziness
  • drowsiness
  • heartburn
  • indigestion
  • lightheadedness
  • mild to moderate headache
  • mild to moderate pain or discomfort
  • nausea

If you take NSAIDs on a regular basis, consult your doctor about any potential health risks. Also, follow dosage instructions when taking NSAIDs.

Pain Management with Opioids

Opioids are a group of narcotic drugs that are used to treat coughing and diarrhea and are often prescribed to help control pain. In addition, opioids are used as anesthetics during surgery. Opioids are classified as depressants and can be addictive.

Types of Opioids

Opioids are often classified by how the drugs are sourced. Three types of opioids are available:

  • Natural opioids, often referred to as opiates, are derived from the seed pods of opium poppy plants.
  • Semi-synthetic opioidsare made by adding chemicals to natural opiates.
  • Synthetic opioidsare made completely synthetically and do not include any natural opiates.

Opioid Side Effects

Side effects of opioids can include:

  • constipation
  • drowsiness
  • dry mouth
  • extreme pain sensitivity
  • itching
  • nausea
  • pinpoint pupils of the eye.

Opioids, when taken improperly, can lead to drug addiction. Therefore, when taking opioids, always follow your doctor’s orders. Do not increase dosages if the pain killers become less effective over time without discussing your situation with your physician first.

Also, never take any opioids that were not prescribed specifically to you.

Natural Opiates

Natural opiates include codeine and morphine.

Codeine is included in:

  • Fiorinal®
  • Robitussin A-C®
  • Tylenol® with codeine.

Codeine is generally combined with other analgesic painkillers such as Tylenol® and is used to treat mild to moderate pain.

Morphine is also known by the following names:

  • Duramorph®
  • Morphine Sulfate
  • MS Contin®
  • Roxanol®.

Morphine is used to treat moderate to severe pain and severe diarrhea.

Semi-Synthetic Opioids

One type of semi-synthetic opioid is heroin. Other semi-synthetic opioids include:

  • Hydromorphone, with a brand name of Diaudid®, is produced from morphine and is used to treat moderate to severe pain as well as severe coughing.
  • Meperidine, with the brand name Demerol®, is used to treat moderate to severe pain.
  • Percocet® is a brand name of a combination of oxycodone and aspirin and is used to treat moderate to severe pain.
  • Percodan® is a brand name of the combination of oxycodone and acetaminophen (brand names includes Tylenol®) and is used to treat moderate to severe pain.

Synthetic Opioids

Synthetic opioids include:

  • Darvon® is the brand name of apropxyphene and aspirin combination that is used to relieve mild pain.
  • Fetanyl, or brand name Sublimaze®, is used as an anesthetic during surgery and to treat moderate to severe pain.
  • Methadone, or brand name Dolophine®, is used to treat drug withdrawals.

Long-Term Pain Management with Opioids

Because opioids can be addictive, opioids are not generally prescribed for long-term pain management. However, opioids are sometimes prescribed for pain management during terminal illnesses, as addiction is less of a concern than comfort in those situations.

Opioids and Medical Conditions

Discuss any medical conditions that you have with your physician before he prescribes a medication from the opioid family. You might not be able to take opioids if you suffer from:

  • asthma
  • colitis
  • emphysema
  • enlarged prostate
  • heart disease
  • liver disease.

In addition, discuss any medications that you are currently taking with your doctor to prevent negative drug interactions.

If you are pregnant or are planning on getting pregnant, talk to your doctor about any implications that taking opioids might have for you. Also, avoid taking opioids when breast feeding, as some opioids can be transferred to your baby through breast milk.

Pain Intervention Techniques

While some people can turn to over-the-counter pain medications to treat the occasional headache or minor cuts or sprains, other people who suffer from severe pain or chronic pain may need to seek pain intervention techniques in order to cope with pain that is often debilitating.

Pain comes in a variety of forms. Some pain lasts only a few hours and can be treated with such pain medications as ibuprofen or acetaminophen. Chronic pain, however, can last for years and often cannot be treated with over-the-counter pain medications or even prescription medications. Often, people with chronic pain must turn to surgery or other interventions for chronic pain.

In this section, we’ll discuss the different types of pain interventions that can help you manage your chronic pain. From local anesthetics to spinal cord stimulation to ablation, we’ll cover the pain intervention techniques available and also discuss their pros, cons, costs and more. We’ll also help direct you to the pain intervention techniques that can best help you cope with your chronic pain.

Pain Intervention: Local Anesthetics

In addition to treating pain with medication, people also seek other ways to interfere with the transmission of pain signals, thus blocking that body’s ability to sense pain.

For instance, people who are experiencing intense lower back pain may have a doctor inject a local anesthetic into their spinal cords in order to block pain signals. While this application of a local anesthetic can be extremely helpful in blocking pain and can allow a person to return to normal, everyday activities, it is also a temporary solution to pain.

Local anesthesia works by blocking nerve impulses, reducing the body’s ability to feel pain. There are a number of local anesthetics, each of which differs in absorption, toxicity and duration of action. Your doctor can recommend a local anesthetic to best block your pain.

Pain Intervention: Spinal Cord Stimulation

People who suffer from chronic pain often consider spinal cord stimulation to treat pain. In spinal cord stimulation, a small implanted device transmits small electrical pulses to replace the feeling of pain with a tingling or massaging sensation. Spinal cord stimulation is beneficial for certain types of chronic pain.

In spinal cord stimulation, a person most often is required to undergo two procedures:

  1. trial procedure
  2. permanent procedure.

In the trial procedure, a physician implants the device in order to test how well you respond to the stimulation. If you are a good candidate, you will undergo the permanent procedure, in which your permanent spinal cord stimulation device is implanted.

While not for everyone, spinal cord stimulation can greatly reduce chronic pain for many.

Pain Intervention: Ablation

People who experience chronic pain due to endometriosis or a spinal condition may benefit from ablation. In ablation, tissues are destroyed or removed using any of the following, among other methods:

  • drugs
  • heat
  • hormones
  • radiofrequency

In addition to endometriosis and certain spinal disorders, heart problems may benefit from ablation.

NSAIDs: Non-Steroidal Anti-Inflammatory Drugs

Millions of people suffer from acute and chronic pain associated with sports injuries, arthritis and other conditions. Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs frequently prescribed to treat pain caused by inflammation.

NSAIDs are generally safe and non-addictive, making them the ideal treatment for many conditions.

How NSAIDs Work

NSAIDs work by targeting an enzyme produced in the body called cyclooxygenase. Cyclooxygenase comes in two forms: COX-1 and COX-2. Both enzymes create prostaglandins, hormone-like substances that play a role in inflammation:

  • COX-1creates prostaglandins that aid kidney function, protect the stomach lining and aid the production of platelets. Thus, blocking COX-1 can lead to stomach irritation and can increase bleeding times.
  • COX-2produces prostaglandins that indicate pain in joints and muscles as well as promote fever as a defense against bacterial and viral infections.

Most NSAIDs prohibit the production of both COX-1 and COX-2 enzymes. However, certain NSAIDs have little effect on COX-1 and target COX-2 specifically. One of the most common COX-2-specific NSAIDs is Celebrex®. Often, you will hear this category of NSAIDs called COX-2 inhibitors. Since COX-2 inhibitors do not inhibit COX-1, they are much gentler on the stomach than typical NSAIDs.

NSAIDs: Common Names

There are a number of NSAIDs on the market. Each varies in its potency, how it is processed by the body and the duration of its effects. Common over-the-counter NSAIDs include:·aspirin·ibuprofen (i.e. Motrin® and Advil®)·naproxen (e.g., Aleve®).

Taking NSAIDs

NSAIDs are most commonly prescribed to individuals who are suffering from acute pain and fever. Over-the-counter NSAIDs, including aspirin and ibuprofen, are effective in treating:

  • arthritis
  • headaches
  • menstrual cramps
  • sports injuries.

Stronger prescription NSAIDs, such as ketorolac, are often used in place of opioids to treat severe pain. However, many prescription NSAIDs should not be used for longer than five days, as they can cause irritation to the stomach as well as stomach ulcers and stomach bleeding.

NSAIDs: COX-2 Inhibitors

Since COX-2 inhibitors only block COX-2 enzymes, they do not affect the stomach in the way traditional NSAIDs do and do not increase a person’s risk of developing stomach ulcers. Thus, COX-2 inhibitors are particularly attractive to people who want to reduce inflammation without increasing the risk of developing stomach conditions, including people with arthritis.

However, COX-2 inhibitors have been linked with an increased risk of cardiovascular problems. Thus, a doctor will review a patient’s medical history thoroughly before prescribing a COX-2 inhibitor. People with a history of heart conditions should not take this type of medication.

Some brand names for COX-2 inhibitors include:

  • Bextra®
  • Celebrex®
  • Vioxx®

In 2004, drug company Merck voluntarily recalled Vioxx®, due to its potential to cause heart attacks and stroke. Bextra® was removed from the market in 2005.

NSAIDs: The Risks

Like all other drugs, NSAIDs do carry some risks. The most common side effects of NSAIDs include:

  • decreased appetite
  • diarrhea
  • drowsiness

Additionally, prolonged use of certain NSAIDs can lead to stomach problems. Stomach problems associated with prolonged use of certain NSAIDs include:

  • holes in the stomach and intestines
  • stomach bleeding
  • stomach ulcers.

NSAIDs are not recommended for people with certain conditions, including those who suffer from kidney disease and those who experience stomach ulcers.

Women who are pregnant should also consult with their doctor prior to taking NSAIDs, as there are some risks involved with specific products. Children with chickenpox should not take NSAIDs, as they can lead to Reye’s syndrome, a condition that can cause brain swelling and liver damage.

In addition, NSAIDs can negatively impact the performance of certain prescription drugs. People who take diuretics may experience additional kidney problems when taking NSAIDs, due to the fact that COX-1 helps support healthy kidney functions.

Individuals on a regimen of prescribed anti-coagulants should also avoid most NSAIDs, as they can contribute to increased bleeding times.

In general, NSAIDS are an effective and safe treatment for acute pain, inflammation and fever. While there are some risks associated with these drugs, their side effects are limited to specific conditions that may be avoided given the great variety of NSAIDs available.

Local Anesthetic Pain Treatment

Local anesthesia is an injection of a nerve-numbing, pain-killing substance that doctors administer to a particular area of the body. Unlike general anesthesia, which numbs the entire body and brain, local anesthesia allows the patient to stay conscious and alert while a procedure is performed.

Because local anesthesia can numb a specific area without affecting the rest of the body, it not only lowers the risk of side effects, but it also allows the patient to recover more quickly from the effects of the anesthesia.

Local anesthesia blocks nerve impulses by decreasing the amount of sodium ions that permeate the nerve membranes. When performing a procedure that requires anesthesia, doctors can choose between a variety of local anesthetics that all have different duration periods, toxicity levels and absorption rates. The type of anesthetic your doctor chooses will depend on the procedure you are getting, as well as your current state of health.

Types of Local Anesthesia

Local anesthesia comes in several different forms, each of which are used to treat different, but specific, health issues. These types of local anesthesia are:

  • Dental Anesthetics:These are administered during dental treatments or to relieve pain in the mouth or throat. While some of these anesthetics are available by prescription, others are available over the counter.
  • Injectable Anesthetics:Given by injection during medical procedures, injectable anesthetics can only be administered by a trained professional.
  • Ophthalmic Anesthetics:These are anesthetics for eye procedures and can only be administered by a trained professional.
  • Topical Anesthetics:Absorbed through the skin, topical anesthetics are typically over-the-counter ointments or creams.

Uses of Local Anesthetics

With so many different types of anesthetics available, there are a number of medical uses for them. For example, local anesthetics are used to numb an area of the body while a doctor operates or performs a procedure on a specific part of the body. Similarly, local anesthetics may be used outside of the operating room to treat and reduce chronic pain. Doctors also use local anesthetics for:

  • arm, hand, leg or foot surgery
  • biopsies
  • eye surgery
  • insect bites, poison ivy
  • mouth sores such as cold sores or canker sores
  • small scratches and cuts
  • sore throat
  • sunburn
  • urinary tract surgery.

Advantages of Local Anesthetics

Using local anesthetics when possible presents a number of advantages to the patient. Patients can:

  • avoid losing consciousness as they would if they and their doctors opted for general anesthetics
  • avoid unpleasant side effects of general anesthesia, including respiratory problems, hypertension and an increase in heart rate
  • receive long-lasting pain relief
  • reduce blood loss.

As a result, many doctors opt for local anesthetic whenever possible. For those who can’t handle the psychological effects of being awake during a surgery, doctors may administer other medications to relieve anxiety. Alternately, they may choose the general anesthetic instead.

Side Effects of Local Anesthesia

Like any type of drug, local anesthetics do come with their own associated side effects. In general, however, side effects are rare and usually minimal. Some of the possible side effects that can occur with local anesthetics include:

  • anxiety or nervousness
  • blurred vision
  • breathing problems
  • confusion
  • convulsions
  • drowsiness or dizziness
  • feeling cold, hot or numb
  • hives or swelling
  • severe headache
  • slow or irregular heartbeat.

People who have had a reaction to local anesthetics in the past should consult their doctors before using them again. In addition, some people are more sensitive to local anesthetics than others, increasing their risk of suffering from possible side effects. This is often true for older people and children. Consequently, these patients should talk to their doctor about their best possible options.

Anyone who thinks they may be experiencing a side effect of a local anesthetic should seek immediate medical attention to prevent serious health complications.

Home Allergies: Dust Mites, Mold and Cockroaches

Dust mites, mold allergies and cockroach allergies can make your life miserable. In extreme cases, they can make homes unlivable and force people out of jobs. Fortunately, a number of strategies can minimize your exposure to these common allergies.

Dust Mites: An Ever Present Problem

No one really has an actual dust allergy: The true culprit is a tiny little eight-legged insect called adust mite. To call a dust mite tiny is understating the reality: Over 100,000 dust mites can live on one gram of dust. The dust mite subsists on skin flakes shed by humans. People with allergies to dust mites breathe in dead dust mites and their droppings, which contain allergenic proteins.

Avoiding dust mites is difficult: They live on humans, animals, in carpets, upholstered furniture and stuffed toys. They prefer dark, warm, humid places, so they can be found in great numbers in bedding, pillows, bed mattresses and box springs. Experts estimate that the average bed contains over one million dust mites. Dust mites are especially fond of areas were the humidity is over fifty percent for parts of the year.

Symptoms of an allergy to dust mites include hayfever symptoms and a chronic cough that lasts year-round. You can reduce your exposure to dust mites with these procedures:

  • Replace carpet with hard flooring (wood or linoleum).
  • Keep upholstered furniture to a minimum.
  • Wash bedding every week in hot water.
  • Keep pets out of the house (dust mites thrive on animal dander as well as human skin flakes).
  • Use shades instead of curtains or drapes.
  • Have someone else dust or vacuum. Dust with a damp cloth.
  • Use mattress, box spring and pillow covers to minimize contact with the mites.
  • Outfit your home with a good air filter to keep mite particles out of the air.

Mold Allergies

Mold allergies have been linked to a number of health concerns, including asthma, fatigue and chronic cough. Molds can be found almost anywhere, although they prefer dark, humid and warm locations. Bathroom condensation, leaky areas of the roof, plumbing leaks and water seepage in basements can all attract mold. You may also discover mold in some of the following, less obvious, locations:

  • foam pillows
  • washing machines
  • carpets
  • refrigerators
  • closets (where the mold may be transferred to clothing or bedding)
  • wood panels

Symptoms of a mold allergy vary. In addition to chronic cough, you might experience wheezing, skin rashes, nasal congestion, a sore throat, itchy eyes and shortness of breath.

Toxic Mold: Toxic mold produces substances called mycotoxins, chemicals that can cause seizures, skin rashes, respiratory difficulties, fatigue, coughing up blood, and even death. Toxic mold can harm anyone’s health, but is especially dangerous for people with mold allergies.

If you suspect toxic mold has entered your house or workplace, talk to your allergist. Have your house inspected for the deadly intruder. In extreme cases, toxic mold has spread throughout buildings so thoroughly that the buildings have had to be demolished.

Cockroaches and Allergies

The cockroach is an unwelcome guest anywhere. If you needed another reason to dislike the pests, consider this: Between 17 to 41 percent of Americans are allergic to cockroach allergens. People react to the feces of the cockroach, which can easily become airborne. The cockroach actually shares an allergen, tropomyosin, with dust mites.

Cockroaches prefer dark areas with plentiful food and water. For that reason, they can often be found lurking in kitchens, bathrooms, and often inside walls. They also favor areas behind dishwashers, refrigerators and water heaters. They reproduce prolifically, so elimination of the little beasts is a problem best left to professional exterminators. In order to keep your house free of roaches, consider taking some of the following precautions:

  • Seal all cracks in walls to prevent entry.
  • Wash dishes promptly, and clean up any spilled food immediately.
  • Store food in airtight containers.
  • Seal garbage containers.
  • Keep plumbing in good repair.

Genetic Allergies and Research

Strong evidence suggests a link between allergies and genetics. The evidence for genetic allergies lies in family histories of allergies and asthma as well as clinical studies of genetic allergy in twins. The situation, however, is neither clear nor obvious: most studies suggest we inherit an inclination toward getting allergies, rather than specific allergies themselves.

The Allergic Response

An allergy occurs when the body’s immune system mistakes a harmless substance for a threat. This substance becomes the allergy trigger, or allergen. Upon exposure to the allergen, white blood cell action is activated by IgE antibodies, resulting in the release of histamine and a rapid inflammatory response.

An allergy attack can be mild, such as the runny nose and itchiness caused by hay fever (an allergy to pollen). More severe allergies can cause asthma, or in the worst scenarios life-threatening anaphylaxis.

Allergy Symptoms

Allergy symptoms vary depending on the part of the body affected. Some allergic reactions only affect one area of the body. The most dangerous type of allergic reaction, anaphylaxis, affects the entire body.

Symptoms may affect any combination of the following body parts:

  • Eyes: bloodshot eyes, itchiness, swelling, watery eyes.
  • Face:headache, swelling of the eyelids, face, tongue, lips or throat.
  • Gastrointestinal Tract:abdominal pain, diarrhea (with or without blood), nausea, vomiting.
  • Nose: runny nose, sinus inflammation, sneezing, or stuffy nose.
  • Respiratory System:chest tightness/pain, cough, shortness of breath or wheezing.
  • Skin Reactions: blisters, crusting, eruptions, hives, rashes, redness, swelling or weeping.

Families and Genetic Allergies

The evidence for genetic allergies is based primarily on family histories. Children seem to be more likely to develop allergies if one or both parents have allergies or asthma. However family histories do not seem to indicate what form allergies take. A parent may have an allergy to peanuts, while the child develops an allergy to dust mites.

In other words, while we appear to inherit a tendency to develop allergies, people don’t necessarily inherit the same allergies as their parents.

Genetic Allergy Research and Twins

If a specific genetic allergy existed, one would expect to see evidence in studies of identical twins, who share the same genetic codes. If, for instance, a peanut allergy was a true genetic allergy, if one twin developed the allergy the other should as well.

Studies do suggest that in at least some cases this is true. A large scale study of 3,600 pairs of identical and fraternal twins in the Netherlands found that 50 to 80 percent of the time identical twins shared the same allergies, while fraternal twins only shared allergies in 25 to 40 percent of cases.

While twins may share allergies, they do not necessarily share the same symptoms. A pair of identical twins may be allergic to peanuts, but while the allergy causes respiratory symptoms in one, it may cause the other twin to break out in hives. Even if genetic allergies exist, it seems how allergies are expressed is influenced by environment and exposure.

Eczema and Genetic Allergies

Research at the Oregon Health and Science University has found a genetic link between atopic dermatitis and food allergies that lends credibility to the concept of the genetic allergy. The study discovered a mutation in the filaggrin gene lead to “breaches ” in the skin’s outer layer, the epidermis. These breaches allow allergens and irritants to enter the skin, resulting in the release of IgE antibodies.

A link between food allergies and atopic dermatitis, or eczema, has been known for some time. However, it was thought that food allergies cause the eczema. The Oregon research suggests that the source of the eczema is what causes the food allergy.

As genetic allergy research continues, similar discoveries will shed more light on genetic allergies and their complex relationship with the environment and allergens.

Food Allergies vs. Food Intolerance

One in three Americans believes that either they or a close family member has food allergies. But medical reports indicate that only five percent of children, and between one and two percent of adults suffer from true food allergies.

What many people believe to be a food allergy is more properly diagnosed as food intolerance (lactose intolerance is common). The distinction between the two requires a medical diagnosis.

A true food allergy occurs when the immune system mistakes something we eat as a threat, and reacts accordingly. An allergic reaction may occur within a few minutes of ingesting an allergen, or take as long as an hour to develop. Most reactions are mild, as with a rash or hives, but a severe reaction can cause anaphylactic shock, a life-threatening condition in which the lungs constrict, restricting breathing. Experts estimate that 125 Americans die every year from food allergies.

Food Allergens

Anything we eat has the potential to be an allergen, but some products are more likely to cause allergies than others. Ninety percent of all food allergies can be attributed to milk, eggs, fish, shellfish, soy products, peanuts and tree nuts (i.e., walnuts). Of these, peanut allergies are most likely to result in anaphylaxis.

Children are more likely to suffer from milk, egg and peanut allergies, than other food allergies. Children can also sometimes outgrow allergies, compared to adults, who rarely lose their sensitivity to an allergen once it develops.

Symptoms: Itching, Hives and More

Allergy symptoms differ from person to person. Hives, itching, and skin rash are common responses, as are wheezing, nasal congestion and respiratory difficulties. Some may experience swelling of the lips, tongue, throat or face (angioedema). These are the reactions most people recognize when they think of allergies.

Occasionally, allergens can affect the gastrointestinal tract, particularly in young children. Vomiting, nausea and diarrhea are possible indications of an allergic reaction, especially if they are accompanied by a skin rash or respiratory problems.

Celiac Disease: Gluten Intolerance

Celiac disease, also called Celiac sprue, is a hereditary disorder that involves an adverse reaction to gluten, a protein found in wheat, oats, rye and barley. People with Celiac disease lose proper function of the small intestine as a result of their immune system’s response to gluten and suffer frommalabsorption, or a decreased ability to digest essential nutrients, vitamins and minerals. Normally, a gluten-free diet will restore the function of the intestine.

Celiac disease is often mistaken for a wheat allergy.

Hidden Dangers for Someone with a Food Allergy

In the high-tech world of processed food, avoiding allergens is a challenge. Soybeans and soy products, for instance, are present in many processed foods, as are egg whites, wheat, and peanuts. Here are just a few places where undetected allergens can crop up:

Eggs: Egg whites are often used in the foamy topping of specialty coffees, where most people wouldn’t think to look for them. Egg pasta is, of course, an obvious danger, but who’d think that many commercial egg substitutes include egg whites?

Fish and Seafood: Watch out for Caesar salad dressing and Worcestershire sauce: Both can contain anchovies. Imitation crab is usually made from fish products. And avoid both seafood restaurants and fish markets: People have suffered reactions just from airborne fish proteins.

Milk: Milk includes all dairy products. Casein, the main protein found in milk, is present in many processed foods.

Peanuts: “May Contain Peanuts” is a common candy warning. Most chocolate candies have possibly come into contact with peanuts or other nuts. Many ethnic restaurants, including Chinese, African and Thai, use peanuts in cooking. Some hypersensitive individuals may react to the scent of peanuts, particularly in closed spaces such as airplanes.

Soy Products: Soybeans are common ingredients in Oriental cooking, and as noted above, soy products are used extensively in processed food.

Tree Nuts: People with nut allergies are usually diligent about checking ingredients, but the danger isn’t just in food. Foot bags (such as hacky sacks), beanbags and some stuffed toys are sometimes filled with crushed nutshells.

Wheat: Wheat can be found in some imitation crab products. While people with a wheat allergy should avoid ingesting wheat-containing products, they are also sensitive to inhaling traces of wheat flour in the air-so avoid your local bakery. Also watch for “country-style” decorations, where wheat is woven into wreaths, dolls and other items-inhaling airborne particles can aggravate a wheat allergy.

What’s for Breakfast?

Whole-wheat toast with butter and coffee with cream? A bowl of cereal with milk? Not if you have a wheat or milk allergy! Rice is generally well tolerated by those with a wheat allergy. And remember: Many other options to fulfill your daily calcium requirements are available.

Cross Reactivity

Often, an allergic reaction to one item indicates a probable reaction to other foods. This is called cross reactivity. People who develop allergies to crab, for instance, often turn out to be allergic to other forms of shellfish, as well. An allergic response to peanuts is often an indication of other nut allergies. Some types of cross reactivity, called oral allergy syndrome, are not even food-related. People who react to birch tree pollen, for instance, are often allergic to apple peels.

Psychological Causes

Some people react adversely to food at a psychological level. Any trigger associated with traumatic or unpleasant memories, for instance, may cause someone to respond with physical symptoms. Once a person believes he or she has a food allergy, the mind may produce allergy-like symptoms whenever the person comes into contact with it.

Cryotherapy and Pain Management

Cryotherapy, also referred to as crymotherapy, is the therapeutic use of localized cold or freezing temperatures to treat pain that primarily targets the body’s soft muscle tissues. Damage to the soft tissue results from strained or ripped muscles, as well as from torn or damaged blood vessels within these muscles.

Because many professional athletes suffer from acute and chronic injuries that affect their soft tissues, cryotherapy is a popular pain treatment technique in the world of sports medicine.

Cryotherapy treatment can effectively:

  • decrease muscle spasms
  • limit bleeding and swelling
  • reduce cell metabolic rate (i.e., reducing the body’s oxygen demands to keep cells healthy)
  • reduce pain.

Methods of Cooling in Sports Medicine

Cryotherapy in sports typically uses various methods of cooling, including:

  • ethyl chloride and other skin refrigerants
  • frozen gel packs
  • ice massage
  • ice packs and towels
  • inflatable splints filled with refrigerant gas.

Although athletes may not be familiar with the term “cryotherapy,” many have, in fact, used it and related therapies to treat their injuries. For example, the use of the R.I.C.E. method of treating an injury is very common. According to the R.I.C.E. treatment, athletes should do the following after being injured:

  • Rest the injured body part to allow the tissues to heal.
  • Ice the injury for 10 minutes immediately after the injury and periodically (typically every two hours) for the next 48 hours.
  • Compress the affected area to minimize the swelling.
  • Elevate the injury to limit blood flow.

Cryotherapy Treatments for Other Conditions

Although cryotherapy is primarily used for sports injuries, it can also treat a variety of other medical conditions, including:

  • abnormal skin growths (such as warts)
  • benign nerve growths
  • cervical cancer, mainly as a method of prevention
  • pinched nerves
  • prostate cancer.

In cryotherapy, doctors locally freeze the nerve or skin growth to deaden the irritated nerve. Professionals freeze the affected area either by inserting a probe into the tissue or by applying a freezing agent to the skin.

When Cryotherapy Shouldn’t Be Used

Although the risks of cryotherapy are generally low, associated side effects may include:

  • damage to underlying tissue
  • infection

Cryotherapy should not be used if:

  • a skin growth may be malignant (Malignant growths should be removed surgically for testing.)
  • the area to be treated is susceptible to scarring or is in a noticeable location
  • the patient has diabetes or may have a predisposition to infection
  • the patient is planning to get pregnant (see section below)
  • the patient has an intolerance or hypersensitivity to the cold.

Cryotherapy and Pregnancy

Patients who are pregnant or contemplating pregnancy need to make informed decisions regarding cryotherapy. Although the medical community has yet to provide any conclusive clinical evidence, some professionals believe that using cryotherapy to prevent cervical cancer may cause infertility.

Cryotherapy for sports-related injuries, however, should have no effect on potential pregnancy. Also, in some cases, cryotherapy may be the best treatment for pregnant women. For example, removing skin growths through cryotherapy during pregnancy may be safer than undergoing surgery.

For decades, both experts and amateurs alike have been using cold therapy to treat a variety of conditions. Because cryotherapy typically has minimal, if any, side effects, it will continue to be a mainstay in both sports medicine and other pain treatment techniques.

COX-2 Inhibitor Drugs

COX-2 inhibitors are a hot topic in health news. At first, these drugs were called wonder drugs for the benefits they offered people with rheumatoid arthritis and osteoarthritis. However, recent research has revealed that COX-2 inhibitors, including Vioxx®, can increase the risk of heart attack and stroke in patients. However, for some people, the benefits offered by COX-2 inhibitors outweigh the risks.

The most common reason doctors prescribe COX-2 inhibitors is to treat arthritis. However, COX-2 inhibitors can also be used to treat pain associated with tendonitis and inflammatory joint pain caused by conditions other than arthritis.

Using COX-2 Inhibitors

COX-2 inhibitors are a relatively new analgesic designed to treat inflammation. They work by blocking COX-2, an enzyme in the body that produces the chemicals that cause swelling.

COX-2 inhibitors are part of a category of drugs called non-steroidal anti-inflammatory drugs, or NSAIDs. Traditional NSAIDs such as aspirin, naproxen and ibuprofen block both COX-1 and COX-2 enzymes. COX-1 enzymes are located throughout the body and especially in the stomach. As a result, traditional NSAIDs can irritate the stomach and even cause ulcers.

COX-2 enzymes are not located in the stomach. They are located specifically in the area of the body where inflammation is occurring. Since COX-2 inhibitors only block COX-2 enzymes, they do not affect the stomach in the way traditional NSAIDs do and do not increase a person’s risk of developing stomach ulcers.

COX-2 Inhibitors: Brand Names

Some brand names for COX-2 inhibitors include:

  • Bextra®
  • Celebrex®
  • Vioxx®

In 2004, drug company Merck voluntarily recalled Vioxx® due to its potential to cause cardiovascular problems. Bextra® was removed from the market in 2005.

COX-2 Inhibitors: Side Effects and Risks

While traditional NSAIDs can cause upset stomach, diarrhea, heartburn and even ulcers, those side effects are not typically associated with COX-2 inhibitors. However, in 2004, the makers of Vioxx® took the product off the market, due to worries over an increased risk of heart attack and stroke in people who were taking the prescription medication. Later, the makers of Bextra® followed suit.

Celebrex® is still on the market. However, many doctors are very careful about prescribing the medication. Doctors will carefully review a patient’s history before prescribing Celebrex®. Patients who have existing heart problems or high blood pressure are usually advised not to take the drug.

Some other side effects associated with COX-2 inhibitors are:

  • fluid retention
  • headaches
  • liver and kidney problems

The chance of developing these side effects increases the longer you take a COX-2 inhibitor. Carefully discuss potential side effects with your doctor.

Also, it is important to note that COX-2 inhibitors have not been found to treat pain more effectively that traditional NSAIDs. However, they are able to treat inflammatory pain without increasing a person’s chance of stomach irritation and ulcers.

Natural COX-2 Inhibitors

 Some people claim that a diet rich in omega-3 fatty acids and antioxidants can reduce inflammation and can work much in the same manner as COX-2 inhibitors. Foods rich in omega-3 fatty acids include:

  • eggs
  • flax seed
  • kiwi fruit

Antioxidants can be found in:

  • apples
  • beans
  • berries
  • red cabbage.

Other people stand by the use of ginger as a natural COX-2 inhibitor. Proponents recommend buying a fresh ginger root and slicing or grating it into food.

No studies have obtained conclusive results about the effectiveness of these natural alternatives to COX-2 inhibitors. However, since most of them would mean instituting a healthy diet, there is probably little harm in trying them out for a time. Your doctor can provide insight into how trying these alternatives might work in combination with a COX-2 inhibitor such as Celebrex® or a traditional NSAID.