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.
--- Questions come in by hundreds. I'm bailing the ocean with a bucket. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Certain headaches can be initiated or aggravated by tense facial muscles (squinting, scowling, furrowing brow), and by tight, tense, overstretched muscles in back of the head, neck, and shoulders, common with letting the upper body slouch forward. Headaches from tight muscles were formerly categorized as tension headaches. A growing theory includes upper body muscle use among triggers of a different kind of headache, the migraine, previously thought of as only a vascular event.
The wide range of kinds of headache is not my major field of study. I had previously had results with patients retraining upper body position to stop tension headache. I was not aware my own research would be useful to people with other kinds of headache, so I am learning from my patients who frequently report stories just like this one recently in from engineer Johannes Ernst:
Dr. Ernst writes:
"Some mindblowing ideas one might come across by accident instantly convert you into a new missionary because they are so clearly and obviously true, no further check required. Your particular religion ;-) of fitness is one of them.
"I would summarize it as follows: if our ancestors, over 10's of thousands of years, had had as many ailments as we have today, the human race would have died out a long time ago. No ergonomic chairs but only rocks and logs to sit on? No exercise equipment? Not even one pill a day? Just leaves and furs instead of expensive mattresses and beds? Humans clearly had no chance.
"Well, but here we are nevertheless. So given how many ailments we have, something that we are doing these days must be much worse than what our ancestors did in the forests. Jolie's mindbogglingly straightforward answer: instead of using ever-more complicated medical and fitness tools and regimens, whose benefits, never mind costs, often are marginal or doubtful, what about we use our bodies how they were meant to be used? Duh!!
"The shameful thing is that medicine, as a profession, does not necessarily nudge anybody in that direction. Often, its leading practitioners seem totally oblivious to what should be a "Duh".
"What is wrong with this picture?
"In my case, over the course of 25 years of headaches, healthcare professionals on two continents, etc. etc., nobody, never, not once, suggested, that I could improve my posture. I got all the drugs, regardless of how expensive, few of which would make much difference other than to put me out cold.
"Last week, for the first time, about 6 weeks since I got a few of Jolie's books, I managed to extinguish an immobilizing headache through some rather simple exercises, completely without drugs. I totally expect that I will be able to do it again. (I did! This morning!)
There is more to headache than muscles and posture. Many causes can be controlled without unhealthful pills. The book Health & Fitness in Plain English THIRD edition has an entire chapter devoted to known ways to prevent and end a headache.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Limited Class spaces for personal feedback. Top students may apply to get certifiedDrBookspan.com/Academy.
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.
Rich Tarpinian, IT systems engineer, musician, hockey coach, and vegan, fixed grinding neck pain, back spasms, disc pain, and tension-type headaches. He had not been comfortable sleeping in any position. Rich said the neck grinding and discomfort, "felt like it was never going to go away."
Rich writes:
"Thanks again for your help! Here's my update. I stopped cranking my neck around and the grinding stopped within the 2 weeks or so that you had indicated.
"I am controlling my body positioning, more aware, and have eliminated lots of neck tension even though I work at a computer all day. The anxiety I was having about disc problems, etc., has mostly been replaced with good knowledge, a feeling of control, and an ability to heal.
"Every morning (instead of sitting on the bed) I get out of bed the way you have recommended - why? because it makes sense. I don't sit on the bed and then try to straighten my body as I start to walk. I get up from the face down position in the already standing position.
"I've always had an interest in the mechanical aspect of how the body moves and what the sources of problems can be which is why, when I was pouring over information on the internet, your information regarding cause/effect relationships instantly caught and held my attention.
"I eat a pretty good diet - vegan with a good amount of raw foods, but had not paid much attention to posture and movement. I will now.
"As a side note, I coached hockey for about 8 years and played up until about 4 years ago. I had an opportunity to get back into some coaching recently but was really worried about the neck issues that I had been having for weeks. I also used to get a lot of back spasms when I played/coached. After experiencing the progress from your recommendations, which came just in time, I stepped confidently back on the ice a couple of weeks ago and have felt good given some expected muscle soreness that is now gone. The hardest thing was lacing up the skates but, once I was on the ice, I felt great.
"What you have done effectively is to empower people with the knowledge of how to find and return to the correct answers in order to maintain their own bodies. You've done that by providing reasons where needed, presenting conflicting information to show contrast, and using repetition to help solidify the important concepts."
"The key is that I now understand the causes of the problem and can, for the most part, manage the process when things start going wrong. As I cruised the internet looking at information, my anxiety meter kept rising - until I found your article on fixing the neck grinding problem which prompted me to read your other articles on sitting, lifting, etc. The article was immediately positive with a no strings attached approach to fixing and preventing the problem. My overcoming the neck issues is directly attributable to you."
Rich first fixed his pain using my web site summary sheets. These Fitness Fixer posts also describe techniques used:
Two important stretches to do first thing in the morning and throughout the day to restore ability to sit, move, and stand without unhealthful neck position - Fixing Upper Back and Neck Pain and Nice Neck Stretch
Having muscles soreness is not bad, it means you're out having fun. Make sure there is no pain or soreness in the joint. That is the difference. See Teen Dies After Using Muscle Soreness Rub
It has made recent news that certain symptoms during air travel are due to altitude sickness. This seems simple enough. Air pressure inside common passenger aircraft is equivalent to mild altitude exposure.
People who get symptoms when going to the mountains may get the same headache, tiredness, achyness, and other symptoms of altitude in flight. Drinking alcohol adds to symptoms. Severity of symptoms depends on several things, mainly how high the altitude, and how fast you reach it.
Cabin pressure varies with cruising altitude and type of aircraft. During a flight, the inside of a large commercial passenger air flights may range between 5000 to 9000 feet (~1525-2743 meters), occasionally higher or lower. Small lower planes flying may be able to maintain pressures closer to (or equal to) ground pressures.
How fast aircraft reach these altitudes depends on the flight path, final cruising altitude, type of aircraft, and other factors. Some of my commercial pilot friends say they will pressurize the cabin far more gradually when they see babies onboard, so that they (the babies) cry less as pressure changes around their ears. Pressure change on the ears is not altitude sickness, just simple air volume change. Earplugs do not prevent this problem, and can make it worse in some situations. Future posts can cover why.
Susceptibility to altitude sickness does not seem to be affected by better or lesser physical conditioning, or any kind of fitness or physical training. It is still a hugely interesting topic to understanding how the body reacts to and works at altitude, why certain interventions work or don't, and how soon you can fly after going scuba diving - important to risk of decompression sickness.
Reader Bill, athlete and pilot, writes, "Regulations require no more than a 10,000 foot cabin altitude (3048m) be maintained for commercial passenger flights. Anyone not acclimatized to altitudes between 7 to 10 thousand feet (~2-3 thousand meters) will feel some symptoms of a mild hypoxia, surely after several hours or/and a couple stiff drinks."
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