Common, Missed Cause of MusculoSkeletal Pain - Your Drugs
Wednesday, July 15, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Three years ago, I started a series of Fitness Fixer posts about the extensive phenomenon of muscle, joint, and body pain occurring from common prescription drugs. The editors at that time asked me to defer writing about it. I have been watching the medical reports grow, substantiating the numbers and secondary problems of chronic pain from common medicines. This is a short summary, with more coming this summer.
Major side effects of body and muscle pain from common prescription drugs are not rare as once thought. Misdiagnosis of this pain is common. Unnecessary treatments, surgeries, and more drugs are often given. Exercises and stretches do not stop body pain from drugs:
Statin drugs for cholesterol are a frequent cause of muscle and joint pain, and sometimes, numbness or tingling in the fingers or toes
Common prescription drugs for anxiety and depression. Even though this class of medicines may be prescribed for nerve pain, they can cause nerve and muscle pain as side effects
Ritalin (methylphenidate hydrochloride) and related drugs
Some prescription allergy medicines such as Allegra (Fexofenadine)
Prescription acid prevention medicines called PPIs - proton pump inhibitors (Nexium, Prilosec, Prevacid, Zoton, Inhibitol, and others). PPIs have also been shown to greatly increase risk of hip fracture
Erectile enhancing drugs
The calcium channel-blocker drug verapamil
The antibiotics erythromycin and clarithromycin
Some HIV medications
Prescription medicine for constipation like Zelnorm (Tegaserod), irritable bowel, and others digestive complaints.
Migraine and headache prescriptions
Medicines for fibromyalgia
Even many medicines for pain, sadly have pain both as direct side effects and rebound pain, increasing drug dependence and pain cycles
There are several more prescription drugs that cause more problems than they relieve. List your additions in the comments below.
Often the need for the original medicine can be stopped with simple healthy changes. Motivated people can address and change the original problem, making their life better and more active than before instead of paying for more medicines and the problems that come with them.
Two of my books teach how to fix pain and mention specific drugs and what to look for:
Fix Your Own Pain Without Drugs or Surgery. Each chapter on each kind of pain gives a list of drugs that are known to cause pain.
Health & Fitness THIRD ed - How to Be Healthy Happy and Fit For The Rest of Your Life. Several chapters include drug information pertinent to the condition covered, plus several chapters on general health, offering many ways to avoid needing the original medications.
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Sunlight deprivation has been found in a clinical study to cause profound negative change to portions of your brain associated with depression.
Further, "neurons that produce norepinephrine, dopamine and serotonin, which are common neurotransmitters involved in emotion, pleasure and cognition, were observed in the process of dying."
Study source - Proceedings of the National Academy of Sciences March 25, 2008, vol. 105 no. 12 4898-4903
In the Northern hemisphere of the Earth, February brings deep wintertime, with short days, and greatly reduced light. For the last 30 years or so, each summer has brought warnings to stay out of the sun, practically zero tolerance for light exposure, urging hats, sunscreens, dark glasses. There also seems to be a sharp rise since then in incidence of serious diseases usually not seen in the young - soft and porous bones, depression, chronic body pain (fibromylagia and related), diabetes, and others. Sunlight seems to have several effects, one of which is helping the body produce Vitamin D. Lack of Vitamin D is now known to be directly linked to higher risk of lung cancer, Parkinsons disease, diabetes, high blood pressure. Vitamin D is available in food sources, however you can also take a prudent approach to getting the several different beneficial effects of the sun, many of which cannot not be gotten though a vitamin supplement.
Last summer Scientific American published a survey finding, "Americans are losing interest in going outdoors." As health providers, we need to see if part of that is telling people that staying out of the sun is necessary for health. We also tell kids to finish everything on their plate and sit still, two more practices, that on examination, translate into, "Practice and learn to be sedentary and overeat."
Try to get outside every day, even if cold (within reason). Bundle up, if you have to.
Get light in your eyes. This does not mean to stare at the sun and induce cataracts, but to get sunlight in healthy ways for the several different crucial mental and physical benefits.
Melanoma skin cancer is not confirmed from lack of use of sun screen - NYTimes article. For a post on balancing needed benefits of sunlight and stopping unwanted negative effects, click Junk Food Through Your Skin?
Click the label "sunlight" for posts that tell more of the benefits of sunlight.
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FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others
Tuesday, December 16, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
The FDA issued a public health alert today based on their review of 199 clinical trials. Specific drugs for epilepsy and psychiatric disorders are often prescribed to patients with migraine, back and body pain. The FDA review was released last January, and showed that patients taking those drugs had "almost twice the risk of suicidal behavior or thoughts than patients taking a placebo."
One of the drugs on the warning list is Neurontin (Gabapentin). Patients with back and various nerve and diabetic pain are commonly prescribed this drug. More drugs on the list are frequently prescribed for fibromyalgia and other pain: Lyrica (Pregabalin), Topamax (Topiramate), Celontin (Methosuximide), Felbatol (Felbamate), Zarontin (Ethosuximide) and others.
Here is a list of the medications required to add the warning:
* Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR) * Clonazepam (marketed as Klonopin) * Clorazepate (marketed as Tranxene) * Divalproex sodium (marketed as Depakote, Depakote ER, Depakene) * Ethosuximide (marketed as Zarontin) * Ethotoin (marketed as Peganone) * Felbamate (marketed as Felbatol) * Gabapentin (marketed as Neurontin) * Lamotrigine (marketed as Lamictal) * Lacosamide (marketed as Vimpat) * Levetiracetam (marketed as Keppra) * Mephenytoin (marketed as Mesantoin) * Methosuximide (marketed as Celontin) * Oxcarbazepine (marketed as Trileptal) * Phenytoin (marketed as Dilantin Suspension) * Pregabalin (marketed as Lyrica) * Primidone (marketed as Mysoline) * Tiagabine (marketed as Gabitril) * Topiramate (marketed as Topamax) * Trimethadione (marketed as Tridione) * Zonisamide (marketed as Zonegran) Some of these drugs are also sold generically.
I will be covering migraine and other headache in the future. Instead of drugs to mask back pain, neck pain and various musculoskeletal and nerve pain, fixing the cause is healthier than drugs. By no longer injuring the area, the pain will stop and the area can heal. It is not matter of choosing between pain and often worse problems from the treatment.
To stop common causes of pain, and the need for drugs, start with these:
Health&Fitness - How To Be Healthy Happy and Fit For The Rest of Your Life. THIRD edition.
The Ab Revolution - No More Crunches No More Back Pain THIRD edition.
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Questions come in by the hundreds. I make posts from selected ones.
See if your answers are already here - click Fitness Fixer labels, links, archives, andIndex. For personal medical questions - Replies to Medical Questions. Read success stories of getting off pain medicine using healthy methods instead. Limited Class space for personal feedback. Certification for top students throughDrBookspan.com/Academy. More in Dr. Bookspan's Books.
We live part of each year in Asia. For a few months, I was posting articles for you from various villages. The town shower of one is pictured at right - not the hut, the outdoor green post with hose. Imagine what the Internet café was like.
On the flights over, our only bag was lost. US transportation security required us to check our sole knapsack, since it had a small gift for friends containing liquid. It never reappeared. We don't need "things" and it was just as easy to make our own soap, comb, and toothbrushes as carry them.
In Western stores, I am astonished by the number of "personal care items." Not just shelves full, but aisles. Each promising better hair, skin, nails, and other parts, but with ingredients that are not healthy for your body, produced in ways that pollute the world, and packaged in plastics that are unhealthy to produce, pollute when discarded, and which apparently leak chemicals into the product that can be absorbed through your skin - see Green Water. A study commissioned by the Organic Consumers Association found that even shampoos, body washes, and lotions labeled "natural" and "organic" can contain unhealthful, even carcinogenic compounds.
I feel high maintenance just carrying a toothbrush. Then we arrived without even that. What freedom.
We made simple hand sanitizer from coarse salt, rubbed between the palms.
For body, face, and hair, we picked aloe leaves, squeezed out the gel inside, and rubbed directly on - see Fast Fitness - Aloe Inside and Out. It dries non-sticky, and makes your hair shiny, clean, and healthy. We used the rest of the gel in food and drink for healthy digestion.
Bamboo is easily made into cooking pots (photo above left). We also visit our favorite bean sprout PadThai restaurant - an outdoor wok on wheels run by a friend. Paul is always popular when we travel (photo at right). The others are not sitting; Paul is really that tall, and has to duck those umbrellas, doorways, and ceilings.
Baking soda and salt makes clean toothpaste. Even without them, a short branch called a neem stick with one end mashed until fibrous, makes a soft, effective bristled toothbrush. Neem extract is said to be a good antiseptic, and effective against various health ills and germs.
After a long day at work and after hard training, instead of hand lotion, you can rub sesame or other light healthy cooking oil onto your hands and feet. You can scent it with mint leaves, citrus peels, spices, and flowers. More ideas in Healthy Mother's Day.
I don't use sunblock, even in the tropics. I do use something to stop some of the unwanted effects of too much sun, but I do not want to block the Vitamin D and other helpful effects of sunlight. Vitamin D deficiency can lead to osteoporosis (thin, brittle bones) and osteomalacia (rubbery, demineralized bones). Vitamin D deficiency is associated with increased risk of a few types of cancer, including lung cancer. Studies find that people with low blood levels of vitamin D were more likely to have high blood pressure, cardiovascular disease, cystic ovary, and type 2 diabetes. Another study found that a number of patients with aches and weakness were vitamin D deficient and concluded, "A lot of 'fibromyalgia' may be D deficiency."
Instead of blocking or deflecting UV rays using chemical sunblocks that may contain chemicals that I am not sure are healthy, I mix my own, that I hope stops the oxidizing effects and makes my own body better able to stop skin cancer mechanisms. I mash together fresh coconut pulp, green tea, vegetable sprouts, mashed turmeric root, and aloe gel. Here is how to get a simple fresh aloe - Fast Fitness - Aloe Inside and Out.
A study by Johns Hopkins researchers, reported in the Proceedings of the National Academy of Sciences (October 30, 2007, vol. 104, no. 44, 17500-17505) found that rubbing an extract made from broccoli sprouts on your skin may help prevent skin cancer from high levels of ultraviolet (UV) radiation. Broccoli, and the sprouts in particular, contain a chemical called sulphoraphane, which is found to activate cancer-fighting enzymes in your own cells throughout your body, not only skin cells.
Instead of chemical anti-mosquito products, we try various things. Marigold flowers rubbed on the skin seem to work for us. I don't seem to be "sweet," and mosquitoes often ignore me while going after Paul. We have heard various theories from locals. One is that he eats sweet rice while I eat more garlic. Various grasses rubbed on the skin also work well for us.
There are vines growing in Thailand with beautiful purple flowers. When you rub them on wet hair, it leaves your hair soft and shiny and sweet smelling, but the bugs do not like it. There are other vines that, when mashed with water made effective gentle soap and mosquito control combined.
In Asia, martial arts training is often more rigorous and disciplined than is common in the states. After hard evenings of training, I would sit by a candle made from oil and tightly wrapped bamboo leaves, and rub salt and oil into my, and Paul's, tired feet. Bliss.
A Reader Asks About Osteoporosis and Walking Lightly
Tuesday, March 04, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
One good question launched many answers. The post Walk Lightly - Shock Absorption for Happier Joints explained a light step prevents joint, soft tissue, and plantar fasciitis pain. In the comments, Carol asked if there were, "a connection between walking lightly and oesteopenia?" This is interesting, since osteopenia is lower than normal bone density, that lack of enough pulling or tension on the bones reduces bone density, and a certain amount of impact and loading keeps bones denser. The simple answer seems to be, that walking lightly should not be enough to reduce bone density, by itself.
Walking, running, and jumping lightly is good exercise to load the bones, while being better for your ankles, knees, hips, and spine than jarring with each step. The post Why So Many Aerobics Injuries? cited news accounts attributing joint pain and injury to high impact activities, with examples of popular aerobics personalities of the 1980s who now say they are too crippled to exercise. Their injuries were avoidable, but not by avoiding impact exercises. Impact activities can be done safely by not stomping down hard. Even repeated jumps from a height can be done with soft landings. Good athletes run, jump, and box with far less impact than most people walk, and have good strong bones. Exercise, done right, is crucial for your bones - Exercise is More Important Than Calcium Supplements for Bones.
When muscles pull your bones during walking, running, and other exercise, the pulling increases bone density. Adding external weight loads bones further. That is a major way weight-bearing and weight lifting exercise increases bone density. The effect of muscles contracting to provide good shock absorption when moving also pulls on the bones,which should be good. The post Forensic Anthropology and Bone Density looked at influencing the shape of our bones by how we move.
The reader went on to comment, "I have always been very light on my feet, and now in my 50s I have found out I have low bone density. I have a cousin who shakes the house when she walks who has been told that she doesn't ever have to worry about her bone mass." Walking lightly alone should not have caused the osteopenia. Questions would be, what other exercise the reader does, and what things might be decreasing her bone density? For the cousin, "shaking the house" by itself may not be enough bone stimulus that anyone could tell her that she "doesn't ever have to worry." Has the cousin taken a bone density test and was found to be high (for whatever reason)? Then you can say there is lowered risk of fracture. Is this cousin is very heavy, which helps load bone? Does this cousin do regular exercise to increase her bone density? It is not likely to be a valid prediction that someone never has to worry about bone density just because they walk badly.
The reader went on to ask, "I went to a bones for life class and was taught to do heel bouncing to stimulate bone growth. i.e. dropping repeatedly from toes onto heels while standing in proper alignment. Do you agree with that exercise?" I did a few searches on the bones for life class and found that the class uses many exercises, not bouncing on the heels alone. Bouncing for a few minutes would not be enough to undo an entire sedentary life style and the various things people do that actively take away from bone density. You need to do all the other exercises. How much the shock wave of the impact may additionally load or stimulate the bone is an interesting open possibility.
There are studies looking at effects of vibration and tapping on bone building. Mechanisms have been studied from the effect on cat bones of their purring, to various machines that bang or vibrate. Some advertising for vibration machines goes as far as making claims that they will increase bone density. So far, none have been found to have as much bone building effect as muscular activity (exercise). Too much occupational vibration, like jack-hammer, helicopter and similar environments produces joint pain, injuries to the spine, eyes, ear, nervous, and other systems. That was one of the topics I was looking into when I did aviation medicine research, explained in Indiana Jones Rocket Sled. A news article that came out on last year's fitness fad of vibration plates promising weight loss and fitness building, mentioned a few of the problems with too much vibration, and, ironically had an accompanying photograph showing severely hyperlordotic (overarched) lower spine positioning by a person listed as the trainer. Hyperlordotic spine posture, by itself, damages the facet joints of the spine over time. It seems safe to say that the jolting of the vertebral joints against each other in this overly arched position would only be worsened by vibration. The post Prevent Back Surgery shows examples of overarched lower spine and why it causes so many injuries in fitness.
It would be interesting to know if low levels of vibration and impact, through tap dancing, Flamenco dancing, pogo stick jumping, and similar activities, would change bone compared to the same amount of exercise without the impact. Some studies claim that swimmers or cyclists do not have as high bone density as runners, while others do not find that when they control for the direct muscle work applied to the area. There are even studies showing that Tai Chi, a most mild form movement with almost no foot-falls at all, can increase bone density in older people, just from the movement.
Along with walking or running, and weight lifting to build bone density, and using your muscles to stop stomping which can hurt the joints, you can prevent bone loss by avoiding things that reduce bone density:
Smoking
Drugs that are known to greatly increase risk of bone fracture: stomach acid drugs and steroid anti-inflammatory drugs, regular use of SSRI antidepressants such as Prozac and Paxil. Numerous medications used to treat different cancers may produce osteopenia (bone shortage) and osteoporosis in long-term cancer survivors. See Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
Lack of sunlight. Calcium cannot be absorbed or do its job without enough sunlight
High consumption of meat and dairy products
Drinking alcohol too often
Lack of fruit and vegetables, and vegetable calcium sources
Eating wheat and related grains by people with celiac
Osteoporosis and osteopenia cause major problems for men, not only women. More on this to come. Move, walk, lift weights, stand on your hands, and jump for fun, exercise, and bone building. You do not need to ooze around on tiptoe to avoid impact injuries. Jump and dance and stamp your feet for fun, for bone building, and for all the refreshing good feeling it gives, without jarring your joints and retinas loose. Have fun.
Carol ended her comment to me with, "Thanks for your site - I've learned a lot about alignment, which has helped in many ways." Thank you Carol for writing so many helpful questions for our benefit.
Neolithic groups (stone age) worshiped the mother. Ancient Germans worshipped the virgin Hertha holding her child. Scandinavians worshipped virgin Disa holding her child. In ancient Egypt it was Isis with infant Osiris. In India, Devaki had Krishna (also by virgin birth). In Asia, Cybele and Deoius. Chinese holy mother Shing Moo held her child in arms. Christian missionaries to Tibet, China, and Japan found that holy mothers depicted with splendid light around their head and holding a divine child had been worshiped long before they got there.
In Rome, the goddess was Demeter, meaning Earth Mother, wearing wreathes of braided corn in her hair. In ancient Greece, Demeter was called Ceres, the great mother with baby at breast. From her name "Ceres," we get the word "cereal" (grains), "which made man different from wild animals."
In the spring in ancient Greece, celebrations were held in honor of Rhea, the Mother of the Gods. Christian Europe celebrated the spring festival of "Mother Church" who (they believed) would protect them from harm. During the 1600's, England celebrated "Mothering Sunday" on the 4th Sunday of Lent, honoring the mothers of England. All cultures worshiped the divine, the Mother, who gives life and food, compassion and love.
So. How to celebrate this Sunday on Mother's Day? I'm in favor of some goddess worship, probably involving some rocks and food and chocolates and compassion and love. Not so original, but time tested and universal:
Visit Mom (or a Mom) and give her a massage (if she wants one). Neck, hands, feet, back. Good for circulation for giver and receiver. Touch can be healthy. Ask her stories.
Make her (and you) something healthy to eat. For light teas, try cinnamon, cloves, grated orange peel, or ginger in hot water.
For a cold treat without unhealthy junk food, mash a frozen banana with crushed raw walnuts or flax seeds. Use a food grinder or get free exercise by mashing them yourself in a bowl. It will taste like creamy ice cream. Flax seeds and walnuts have been found to be effective to help bone health as vegetarian sources of omega-3 (n-3) fatty acids. Raw walnuts (as part of a general low fat and cholesterol diet) have also been found to have a beneficial effect to decrease cardiovascular disease risk, among other benefits. This treat has fiber and is non dairy, both associated with lower breast cancer risk.
Goddess worship often is helped with chocolate. The primary chemical in chocolate is theobromine. "Theo-" means God and "broma" comes from a word meaning food. The theobromine in chocolate was named for "food of the gods." Theobromine is an antioxidant, weak diuretic, stimulant, and mood booster, opens breathing airways, and relieves coughing. Dark chocolate has more theobromine than lighter chocolate, with flavonoids and phenolics, plant substances that are good for the heart. People who get a kind of vascular headache called migraine do better not to eat chocolate. For others, get plain cocoa, unsweetened, not junked up with sugar. Add the unsweetened cocoa to the frozen mashed banana and walnuts for a healthy sweet wonderful treat that tastes better than you would expect. For exotic flavor and more health benefit, add fresh grated ginger root.
Sit outside in the air and sun to have your tea and frozen banana. Warnings on the dangers of overtanning are important for preventing skin cancer for people who work outdoors, who over-tan for cosmetic purposes, and a few other populations. Another group to consider is those spending too little time outdoors. Sunlight exposure and the Vitamin D it makes your skin produce, is increasingly documented as crucial to bone density, healthy immune function, positive mood, sound sleep at night, relief of symptoms of rheumatoid arthritis, fibromyalgia, MS, Parkinsons, polycystic ovary, diabetes, and other health issues. A nice massage and tea and chocolate outside in the sunlight could be made into a wonderful Mother's Day. Nice excuse to buy a hat.
Make Mom (or a Mom) some homemade healthy skin lotion. Commercial products have preservatives, dyes, and chemicals. Try combinations of grape seed oil, tea tree oil (very small amount), vitamins C and E, ginger, honey, tea, fresh aloe, and fragrances from oils, fruit, flowers like lavender, or leaves like mint. (Don't wear citrus oils like lime out in the sun.)
Help out at a woman and child shelter. Or help at a men's shelter to help the guys get back on their feet to help their own families.
Celebrate Mother Earth - go out and pick up litter. It's good exercise. Bend right.
Make a trip to look around a home improvement center to see about some do it yourself solar projects, even if only to replace a few lights.
