Friday, 30 September 2016
Common Signs That You May Have Nerve Damage
Today's post from prevention.com (see link below) is a good one to start the new year for people experiencing strange, new symptoms that they can't explain. It's a good reference to use before going to your doctor because if you're suffering from these physical symptoms, then at least you'll have a pretty good idea that they're nerve related and possibly evidence of nerve damage...or neuropathy. What's most useful about this list of symptoms is that it doesn't just concentrate on the most commonly known pain, tingling or numbness in the feet but also looks at a wide range of symptoms which indicate 'autonomic' neuropathy. Autonomic neuropathy is where nerve damage has affected some or all of the involuntary functions of the body we take for granted (such as breathing, digestion, sexual performance, and many others and can be a source of great confusion for both patients and doctors alike, who assume those symptoms indicate other conditions. With over 100 sorts of neuropathy and over 100 causes, it remains one of the most frustrating and life-changing ailments, so this list is a place from which to begin your questions and research, even before going to see the doctor. No reason to panic but a little knowledge goes a long way when faced with a new medical problem!
8 Signs You Might Have Nerve Damage
By Crystal Harlan November 7, 2016
Sebastian Kaulitzki/Shutterstock
There are tens of thousands of nerves in your body. Most of them, your peripheral nerves, are like branches of a tree that spread out all over and transmit messages back to the "trunk"—your brain and spinal cord. When everything goes smoothly, your brain gets the info it needs so that you can move your muscles, recognize pain, and keep your internal organs working properly. But when peripheral nerves get damaged, it's another story: Walking could become challenging, you might experience unrelenting pain, or you could end up with a serious injury because you had no idea how hot that stove was.
An estimated 20 million Americans suffer from peripheral nerve damage, aka neuropathy, according to the National Institute of Neurological Disorders and Stroke. "Diabetes is the No. 1 cause. Bad luck [meaning you inherited an anatomical defect] is number two. Repetitive motion and Lyme disease follow," says Andrew Elkwood, MD, a surgeon who specializes in nerve reconstruction at The Institute for Advanced Reconstruction in New York and New Jersey.
Other causes include aging, vitamin deficiencies, exposure to toxins (including alcohol and cancer medications), and infections and autoimmune disorders like hepatitis C, diphtheria, HIV, Epstein-Barr, rheumatoid arthritis, and Guillain-Barré Syndrome. Meanwhile, about 30% of neuropathy cases are "idiopathic," meaning there's no known cause.
The good news is that nerve damage generally develops slowly, says Isha Gupta, MD, a neurologist at IGEA Brain and Spine in New York and New Jersey. That means you might be able to treat it before it worsens—but getting the right diagnosis isn't always easy. Your best shot? See a doctor right away if you have any of the following symptoms. (Make 2017 YOUR year by taking charge of your health and jump-starting your weight loss with the Prevention calendar and health planner!)
You have numbness, tingling, or burning.
1/8 memorisz/Shutterstock
You have numbness, tingling, or burning.
This sensation may radiate from your hands or feet into your arms or legs. "Compression of sensory nerves (often while sleeping) is relatively common, and symptoms such as numbness or tingling can be temporary," says Gupta. But if the pins-and-needles feeling doesn't go away, get it checked out.
It's difficult or impossible to move part of your body.
2/8 Mycteria/Shutterstock
It's difficult or impossible to move part of your body.
"If motor nerves are affected, then weakness or even paralysis may occur," says R. Glenn Smith, MD, PhD, a neurologist at Houston Methodist. These same symptoms could also indicate that there's an underlying issue that needs urgent attention, so it's best to head to the ER. If it turns out that you're actually having a stroke, you'll need medical attention ASAP.
You have pain running down just one leg.
3/8 Sebastian Kaulitzki/Shutterstock
You have pain running down just one leg.
A constant sharp pain, burning, or tingling that starts in the lower back and travels down the back of your leg could mean that you have sciatica—meaning that your sciatic nerve has become compressed, perhaps thanks to a slipped or worn down disc in your spine.
You're way clumsier than usual.
4/8 jiw ingka/Shutterstock
You're way clumsier than usual.
Suddenly stumbling and falling a lot? "If large nerves affecting sensation are damaged, then lack of coordination and failure to sense position of the body can lead to falls," says Smith. It might also turn out that you have a condition like Parkinson's, in which the nerve cells in your brain have become damaged.
You're running to the bathroom all the time.
5/8 Momoforsale/Shutterstock
You're running to the bathroom all the time.
Damaged nerves can send your bladder faulty messages, so you feel like you have to pee a lot or have trouble making it to the restroom in time. You have a higher than average risk of this problem if you gave birth to a child vaginally or have diabetes.
You get brief, intense headaches that feel like electric shocks.
6/8 andrei simonenko/Shutterstock
You get brief, intense headaches that feel like electric shocks.
You may have something called occipital neuralgia, a condition that can occur when a nerve in your neck gets pinched. You may need a nerve block—an injection that temporarily blocks the troublesome nerve from transmitting pain signals.
You're sweating too much or too little.
7/8 werayuth tes/Shutterstock
You're sweating too much or too little.
It might be a sign that the nerves carrying info from your brain to your sweat glands have become compromised. Your doctor might order tests to measure your sweating and heart rate.
You got injured because you didn't feel something you should have.
8/8 Corbac40/Shutterstock
You got injured because you didn't feel something you should have.
Sensory nerves are supposed to tell your brain that a surface is dangerous in some way, and if they're not doing their job properly you could seem more accident-prone. If you have burns, cuts, or other trauma because you didn't realize that you were touching something hot, sharp, or otherwise uncomfortable, see your doc, says Smith.
http://www.prevention.com/health/8-signs-you-might-have-nerve-damage/slide/8
Pain Care Bill of Rights
Something to think about when your sitting on the other side of a table from a doctor who's had a long day, or has a hangover, or didn't pay attention in neurology class, or just doesn't give a damn!
As a person with pain, you have:
The right to have your report of pain taken seriously and to be treated with dignity and respect by doctors, nurses, pharmacists and other healthcare professionals.
The right to have your pain thoroughly assessed and promptly treated.
The right to be informed by your doctor about what may be causing your pain, possible treatments and the benefits, risks and costs of each.
The right to participate actively in decisions as to how to manage your pain.
The right to have your pain reassessed regularly and your treatment adjusted if your pain has not been eased.
The right to be referred to a pain specialist if your pain persists.
The right to get clear and prompt answers to your questions, take time to make decisions, and refuse a particular type of treatment if you choose.
Although not always required by law, these are rights you should expect, and if necessary demand, for your pain care.
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Wednesday, 28 September 2016
HOMOEOPATHIC REMEDIES FOR TRIGEMINAL NEURALGIA
How Nerve Cell Stiffness Can Make You Cry From Pain
Today's post from .sciencedaily.com (see link below) may not be the easiest read but is nevertheless a fascinating one which once more looks into research progress in neuropathy treatment at a cellular and molecular level. Put in its simplest terms, it talks about the discovery that hypersensitive nerve pain may have a lot to do with nerve cell stiffness. If they can find a way to 'relax' this stiffness, they will be able to reduce pain to a manageable level. You will need to read the article to understand it better but it's worth the effort, if only to see where scientists are going in the search for ways of controlling nerve pain.
Study offers approach to treating pain
Date: December 13, 2016 Source: European Molecular Biology Laboratory (EMBL)
For many patients with chronic pain, any light touch -- even just their clothes touching their skin -- can be agony. Scientists at EMBL and the Werner Reichardt Centre for Integrative Neuroscience (CIN) of the University of Tübingen have found a possible new avenue for producing painkillers that specifically treat this kind of pain. In a study published online today in eLife, they discovered how the stiffness of our nerve cells influences sensitivity to touch and pain.
"Being able to stop this mechanical pain could be very powerful, and it's something that current drugs are not very good at doing," says Paul Heppenstall, who led the work at EMBL.
Whether it's a light brush or a painful poke, when something touches you, receptors on the nerves under your skin sense it and carry that information to the brain. To be more precise, those receptors detect -- and respond to -- the bending of the nerve cell's membrane. The EMBL scientists have now discovered a molecule which, by influencing how stiff or bendy a nerve cell is, affects how sensitive a mouse is to touch and pain.
Heppenstall and colleagues genetically engineered mice so that they could not produce a molecule called Atat1. Working with Jing Hu's lab at CIN and Laura Andolfi at Istituto Officina dei Materiali-CNR, in Trieste, they found that the nerve cells in the affected mice became more stiff, and they became insensitive to light touch and to mechanical pain. This happened both when they prevented all of a mouse's cells from producing the molecule and when they did so just in the mouse's sensory neurons.
The Atat1 molecule is present in all cells. Scientists know that it modifies microtubules -- tiny tubes that act as transport network and scaffolding inside cells -- and that this happens in all cells, especially in nerve cells. So Heppenstall, Hu and colleagues were surprised to find that the other senses seem not to be affected in the mice.
"It could be that the molecule also affects the stiffness of nerves involved in other senses, but because stiffness is not important for detecting smells or tastes, for example, changes in cell stiffness might not have a detectable effect on those senses," says Shane Morley, who carried out the work at EMBL.
One difference that the scientists found between nerve cells that detect touch and other cells is in how their microtubules are arranged. In sensory cells, they form a ring just below the cell membrane. In other cells, they don't. The scientists think that this ring probably fine-tunes how stiff or bendy a nerve cell's membrane is, influencing how sensitive that cell -- and the animal in general -- is to touch.
The nervous system and sense of touch are similar in mice and humans, so the results likely hold true for people, too. And although problems in cell stiffness are unlikely to be at the root of most patients' hypersensitivity to touch, controlling how stiff nerve cells are could nevertheless be an effective way of treating that sensitivity.
"We're now looking for small molecules that interfere with this fine-tuning of cell stiffness, and which might one day be used to make painkillers specifically to treat this mechanical pain," says Heppenstall. "This is the first step in our sense of touch, so if we can stop the signal there, then we have a good chance of stopping everything which is downstream. And because only these touch-sensing nerve cells would be affected, there's hope that such a drug might not have many unwanted side-effects."
Story Source:
Materials provided by European Molecular Biology Laboratory (EMBL). Original written by Sonia Furtado Neves. Note: Content may be edited for style and length.
Journal Reference:
Shane J Morley, Yanmei Qi, Loredana Iovino, Laura Andolfi, Da Guo, Nereo Kalebic, Laura Castaldi, Christian Tischer, Carla Portulano, Giulia Bolasco, Kalyanee Shirlekar, Claudia M Fusco, Antonino Asaro, Federica Fermani, Mayya Sundukova, Ulf Matti, Luc Reymond, Adele De Ninno, Luca Businaro, Kai Johnsson, Marco Lazzarino, Jonas Ries, Yannick Schwab, Jing Hu, Paul A Heppenstall. Acetylated tubulin is essential for touch sensation in mice. eLife, 2016; 5 DOI: 10.7554/eLife.20813
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European Molecular Biology Laboratory (EMBL). "Study offers approach to treating pain." ScienceDaily. ScienceDaily, 13 December 2016.
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Tuesday, 27 September 2016
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HOMOEOPATHIC REMEDIES FOR BODY ODOR
How Is Your Nerve Pain Categorised
Today's post from inquisitr.com (see link below) looks at how chronic pain is categorised, with special reference to neuropathic nerve pain. Reading this may sort out some confusion in your mind as to exactly what sort of pain you are experiencing but it also highlights the fact that nothing to do with nerve pain is black or white. Definitely worth a read.
Pain Studies Show Nerve Pain Can Cause Sleep Problems, Depression And Anxiety
Jessica Reveles February 29, 2016
According to the Huffington Post, one in three Americans suffer from daily pain and “the financial cost due to pain tops more than half a trillion dollars per year.” But not all pain is the same across the board. Pain is personal and thereby subjective, with individuals experiencing various levels of intensity and types of pain based on factors related to age, gender, family history, injuries and more.
Next on #MayoClinicRadio, Dr. William Cross explains the sacroiliac joint which can be the cause of low #backpain. pic.twitter.com/vk3vhA0Up5
— Mayo Clinic (@MayoClinic) February 27, 2016
There are two general classifications for types of pain: acute and chronic.
“On the most basic level, pain can be classified as two types: acute (short-term) or chronic (long-term). Acute pain results mostly from injury to our tissues due to trauma, inflammation or disease. In most cases, this type of pain is self-limiting and can be easily localized, diagnosed, and treated. In some cases, acute pain can lead to chronic pain. In contrast, chronic pain is present over an extended period of time and is more difficult to treat. This type of pain can be made worse by environmental and psychological factors.”
Pain can also be classified based on how it is activated in the body.
“Something called nociceptive pain occurs when specific receptors on cells are activated. This can be in response to temperature, vibration, stretching, or chemical signals released from damaged cells. This type of pain can be somatic, meaning it’s associated with musculoskeletal elements of the body like skin, muscles, and bones. Somatic pain is localized and can be distinguished by the ability to activate the pain by touch or movement. There is another type of nociceptive pain called visceral. As the term implies, it involves our internal organs like the kidneys, liver, or gastrointestinal tract. Visceral pain is harder to localize and is usually described as more of an ache. Intestinal cramps are an example of this type of pain.
The other large category of pain is referred to as non-nociceptive.
Non-nociceptive pain does not require the action of specific receptors. The source of this pain can be the nervous system directly. Non-nociceptive pain can originate in the pathway between a specific tissue and the spinal cord, such as the pain from a shingles infection. Alternatively, this pain can occur farther along the pathway, between the spinal cord and the brain, such as the pain of a slipped disc. The other type of non-nociceptive pain is called sympathetic pain. In this case, a damaged nerve becomes unstable and fires randomly, which is interpreted by the body as pain. This can occur after a tissue injury or a bone fracture.”
Nerve pain specifically can occur symptomatically as a result of shingles, diabetes, cancer and HIV, and can have serious consequences that limit daily activity. Pain sensations can range from aches and burning to pins and needles and shooting pains. According to WebMD, “studies show that people with nerve pain have higher rates of sleep problems, anxiety, and depression.” These issues may result from chronic, or long-term pain.
The ‘Treatment Algorithm’ is a Major FAIL for Chronic #BackPain #Healthcare: https://t.co/pSd4386alz #UPRISE pic.twitter.com/HuTQ3wP0VG
— Sean Wheeler, MD (@DrSeanWheeler) February 19, 2016
Although pain can cause both short-and long-term discomfort, pain actually serves an important purpose–it alerts the brain and may even prevent injury. Pain sensations are what tell our bodies that something is wrong or trigger a reactive response that may prevent further pain, like when you step on a nail or stub your toe.
According to WebMD:
“That’s how it’s supposed to work, at least. But in people with nerve pain, that messaging system isn’t working correctly. Your brain receives a pain signal, and you feel the pain, but there’s no actual cause. Now, it’s just pain without a purpose–and because there’s no cause, there’s no immediate way to relieve it.
What makes the nerves behave this way? Usually, it’s damage from a physical injury or disease.”
In some of the most painful conditions like neuropathy and fibromyalgia, distinguishing between the type of pain and the disease can prove difficult. For example, people with peripheral neuropathy, often caused by diabetes, or fibromyalgia, which results from pain processing problems in the central nervous system, may experience similar symptoms. Usually affected individuals experience tingling, pins and needles, numbness and weakness in the hands and feet.
We may not look sick….
Meet others who understand: https://t.co/uzH3OK0mlQ#Fibro #Fibromyalgia pic.twitter.com/V5RCYkjPgX
— MyFibroTeam (@MyFibroTeam) February 24, 2016
In the case of fibromyalgia, symptoms come and go, whereas with neuropathy, symptoms are generally constant. People with fibromyalgia can additionally experience tender points on the body and pain in muscles and joints. When testing for either type of condition through biopsies or electrical impulse tests, neuropathy patients typically show peripheral nerve damage, while those with fibromyalgia do not usually show nerve abnormalities. People with fibromyalgia often experience burning, tingling and shooting pains in the neck, shoulders, arms, lower back and legs.
Treatments for general pain, nerve pain or other conditions resulting in chronic pain may include exercise, changes to diet including dietary supplements, massage, acupuncture, electrical stimulation and more.
http://www.inquisitr.com/2839072/pain-studies-show-nerve-pain-can-cause-sleep-problems-depression-and-anxiety/
Toughing it out with Neuropathy
Today's post from aidsmap.com (see link below) is a hard-hitting personal account of an HIV-patient with neuropathy. It's the sort of story that people without neuropathy may need to read but is difficult reading if you're in the same boat. It's just very close to home for many people and while it's perversely comforting to know that someone else is going through the same thing or worse, it's an uncomfortable feeling to be confronted with the 'what might be' scenario. Don't get me wrong, everyone will have the utmost sympathy for this guy and would do anything to help if they could and like in the old cliche, 'can feel his pain' but it does touch a raw nerve. It highlights how important it is for neuropathy patients to find and keep an effective support system - it's not a disease that's easy to bear alone.
Living with Peripheral Neuropathy
by Chip
I didn’t know, at first, why my feet hurt so bad. I would wake up every 90 minutes or so every night.
Because of the ‘way’ they hurt I thought they were just cold. I tried wool socks. Wore wool socks at work. (Came to find out later heat exacerbates the pain.)
Then one day, sitting in a bar reading a gay-rag advertisement for HIV meds, I saw it. PERIPHERAL NEUROPATHY. That had to be it.
Why didn’t my doctor tell me about possible side-effects I should watch for? Is there some medication that could help? Would I always deal with this pain?
My doctor confirmed the diagnosis and said that some patients deal with the pain anywhere from 6 to 18 months. He explained the reason for the way my brain was ‘sensing’ that my feet hurt. He prescribed an antidepressant that works on nerves that may eradicate the pain.
I was so hopeful! How desperately I needed a full night’s sleep! Well, the medication DID help me sleep but the pain persisted.
After two or three medication trials and a pain specialist intervention, as well as about 10 years later… I still suffer the with pain of peripheral neuropathy. Everyone has heard of a cure, something that helps, how I can deal with this pain. I’m beginning to understand now, that I have become a completely different person because of this pain. Consider for yourself the possibility of a headache or toothache for ten long years. At times I joke that the original antidepressant was prescribed to prevent me from going crazy with this pain.
Don’t doubt for a second that I haven’t considered suicide. I’m not going to make this a long philosophical discussion that has become my life (my HIV status is playing second fiddle now). Everyone listens, everyone cares, everyone hopes and prays for me, people love me, and for that I am grateful.
Someone with a physical abnormality has no way to hide so that people won’t look and wonder or show compassion. Maybe that WOULD actually be harder to deal with on a daily basis than to just be in pain with no one noticing. Maybe I’m the cry-baby now, wanting somehow to make people know about my pain. Funny thing is that when the same people who know of my condition ask "how are you doing?" and I answer "okay", I sometimes want to scream “THEY HURT AS BAD AS ALWAYS AND EVEN WORSE TODAY!”
It would be very easy (let me tell you, very VERY easy) to give up. You may want to as well if you are reading this in between medicating yourself, whether physically, mentally or spiritually. I’m still here. I don’t wanna stick around all by myself. Hang in there. Tough it out with me. Rub some dirt in it. We’ll be OK some day. If not in this world, well for sure in the next…
http://www.aidsmap.com/Living-with-peripheral-neuropathy/page/2053217/
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Monday, 26 September 2016
Capsaicin Trials Reveal Moderately Positive Results For Nerve Pain
Today's post from clinicalpainadvisor.com (see link below) reveals the results of recent trials of the capsaicin (chili-based) patch Qutenza in relation to neuropathic pain. Now capsaicin is one of those treatments that regularly returns to the neuropathy forums on the internet but mostly without conclusive results. The results here can also hardly be called 'conclusive' but they do indicate that there is benefit to be had from capsaicin patches, if applied properly. That's the problem: it's a controversial treatment because it carries the risk of potential burn issues and is both tricky to use and needs medical supervision (especially with the 8% versions that are pretty strong). Alternatives include capsaicin creams but they do tend to be messy and less effective than the patches. If you are considering trying capsaicin patches, please talk to your doctor first before ordering them on the internet. Hopefully your insurance will cover them anyway so it's always best to go through the official channels.
Capsaicin 8% Patch Effective on Nondiabetic Peripheral Neuropathic Pain
Christin Melton, ELS May 03, 2017
The patch used in the study is approved in the United States for postherpetic neuralgia and in Europe for PNP arising from any etiology.
Results from the ASCEND study recently published in BioMed Central Neurology indicate that an 8% capsaicin patch is effective in relieving peripheral neuropathic pain resulting from a wide range of etiologies.1
Peripheral neuropathic pain (PNP) may arise from several medical conditions and is commonly encountered in clinical practice.2 Conditions including diabetes, cancer and cancer treatments, traumatic nerve injury/entrapment syndromes, and infections such as herpes zoster virus (HZV) or human immunodeficiency virus (HIV) are known etiologies of PNP.1,2 Many patients with PNP are treated with oral nonsteroidal anti-inflammatory drugs (NSAIDs) despite a lack of evidence of their efficacy in relieving neuropathic pain.3 A phase 4 open-label study, ASCEND (Clinicaltrials.gov ID NCT01737294) sought to determine whether a high-dose capsaicin patch (8%; QUTENZA™) was effective on several measures of PNP in a real-world setting.1 The patch used in the study is approved in the United States for postherpetic neuralgia (PHN) and in Europe for PNP arising from any etiology.
ASCEND, which was an observational study conducted from February 2012 to August 2014, included 429 adults from 7 European countries who had non-diabetic PNP, with etiologies including HZV, HIV, back injury or inflammation, cancer, and surgery or trauma. Some participants had newly diagnosed PNP, whereas others had previously received 1 or more treatments for PNP. The patches were prescribed as part of routine clinical practice, with patients receiving up to 4 capsaicin patches per treatment. Patches were applied for 30 minutes to the feet and for 60 minutes at other sites. Subsequent capsaicin treatments could be prescribed every 90 days.
The study's primary end point consisted of follow-up, which was conducted by phone or at the prescribing clinic at weeks 2 and 8. Additional follow-up sessions were conducted at weeks 12, 26, 39, and 52. At each time point, patients were asked to rate their pain intensity over the past 24 hours and over the past 7 days using a 0 to 10 numeric pain rating scale (NPRS). In addition, health-related quality of life (HR-QOL) and perceived changes in health were evaluated.
Between the first capsaicin patch application and follow-up at weeks 2 and 8, mean NPRS scores decreased 26.6% (95% confidence interval (CI: 23.6, 29.62; n = 412). Almost half of patients had at least a 30% reduction in pain at weeks 2 (44.4% reduction; n=183) and 8 (49.1% reduction; n=79). In some patients, pain relief (as indicated by ≥50% reduction in pain scores) occurred as early as the second week after treatment (26.2% of patients; n=108). Improvement was similar in patients with PNP resulting from PHN, neuropathic back pain, postoperative or posttraumatic neuropathic pain, and other causes.
Median time for first re-treatment was 191 days, which was administered to 43.1% of study participants (n=181). In the 16.7% (n=70) of patients who received a third dose, a median of 301 days elapsed between first and second re-treatments. The capsaicin 8% patch showed evidence of long-term effectiveness, with an overall 37% reduction in NPRS scores between baseline and week 52. The investigators noted that “patients in the primary stage of treatment or with short duration of disease had the greatest pain reduction, suggesting that patients with PNP may benefit from early treatment with the capsaicin 8% patch.” Sustained improvement in HR-QOL and in patients' self-perception of health status were also observed. At week 12, 61.0% of patients (n=224/367), indicated their health had improved.
The capsaicin 8% patch was well tolerated. More than 92% of patients completed at least 90% of the suggested patch applications. Only 11% of patients experienced an adverse event, the most common of which were site reactions. The researchers concluded that “the capsaicin 8% patch may benefit patients who have inadequate pain relief from systemic therapies or for those suffering intolerable systematic side effects.”
Summary and Clinical Applicability
The ASCEND study observed meaningful decreases in pain and improvement in health-related quality of life in patients with PNP with wide-ranging etiologies. In many patients, the capsaicin 8% patch showed long-term effectiveness and good tolerability. In the United States, the capsaicin 8% patch is only approved for PHN. However, the current study indicates that the patch may be an effective option when first-line therapies for PNP are ineffective or not tolerated.
Limitations and Disclosures
The ASCEND study is limited by the fact that it was an open-label observational study vs a randomized controlled trial.
The study was sponsored by Astellas Pharma Europe Ltd., which manufactures the Qutenza 8% capsaicin patch used in the study.
Several study investigators and individuals who designed the study were Astellas employees. However, the researchers who recruited and treated study participants had no relevant disclosures. Astellas funded the data analyses and medical writing and editing services for the study.
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References
Mankowski C, Poole CD, Ernault E, et al. Effectiveness of the capsaicin 8% patch in the management of peripheral neuropathic pain in European clinical practice: the ASCEND study. BMC Neurol. 2017;17(1):80.
Jay GW, Barkin RL. Neuropathic pain: etiology, pathophysiology, mechanisms, and evaluations. Dis Mon. 2014;60(1):6-47.
Moore RA, Chi CC, WIffen PJ, Derry S, Rice AS. Oral nonsteroidal anti-inflammatory drugs for neuropathic pain. Cochrane Database Syst Rev. 2015;(10):CD010902.
http://www.clinicalpainadvisor.com/neuropathic-pain/capsaicin-patch-for-non-diabetic-peripheral-neuropathic-pain/article/654496/
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Link Between Poor Sleep And Suicide
Today's post from medicinenet.com (see link below) looks at the serious problem of sleep-deprivation and the effect it can have on your mental health. People living with neuropathy very often have disturbed sleep patterns. For some reason that nobody seems to be sure of, neuropathy symptoms can flare up during the night and pains in legs and feet can seriously affect your quality of life. It's logical really that prolonged lack of quality sleep will leave you drained during the day. Over a period of time that lack of energy and constant tiredness can lead to depression. If this is the case with you and you feel yourself being impacted by this, don't hesitate to contact your doctor and get help and advice but remember, sleeping tablets may not be the answer because the symptoms will continue despite being masked by the drugs. One thing is sure, don't ignore it and hope it will go away; make sure your medical professionals are aware of the problem.
Study Hints at Link Between Poor Sleep, Suicide Risk
By Tara Haelle HealthDay Reporter WEDNESDAY, Aug. 13, 2014 (HealthDay News)
Sleeping difficulties may increase the risk of suicide in older adults even when other symptoms of depression aren't present, a new study suggests.
The study focused on adults 65 and older, and poor sleep included difficulty falling or staying asleep, waking up early in the morning, experiencing daytime sleepiness and not feeling fully rested after a night's sleep.
"These findings suggest that sleep disturbances stand alone as a valid risk factor -- independent of depressed mood -- and worthy of focus as a potential [suicide] risk factor, screening and intervention tool," said lead researcher Rebecca Bernert, an instructor of psychiatry at Stanford University School of Medicine. "Compared to many other known suicide risk factors, sleep disturbances are arguably less stigmatizing and may be undone, and are highly treatable."
Among the 20 study participants who died by suicide, 19 were men. The researchers randomly matched these 20 people to 400 living participants based on shared age, sex and location, and then compared their sleep quality and depression scores.
The study couldn't prove that sleeping problems cause suicidal thoughts or attempts, nor could it explain why the link may exist. But, Bernert said, it's likely that poor sleep affects the ability to regulate moods.
"The idea is simple: when we sleep poorly, it impacts how we feel and the way in which we manage our emotions, as well as decision-making," Bernert said. Past research has shown that fragmented sleep can result in more intense negative emotions, impaired judgment and difficulty managing fear or anger.
Those who reported having poor sleep quality at the start of the study had 40 percent greater odds of dying by suicide during the next 10 years before depression symptoms had been considered. Even after making calculations to remove the effects of depression symptoms, the odds of dying by suicide were 30 percent higher for those reporting poorer sleep quality, the study authors said.
Also, those who reported not feeling well-rested after sleeping had twice the odds of dying by suicide compared to those not reporting sleeping problems, even after symptoms of depression had been considered. And sleep disturbances better predicted who died by suicide over a decade than depression symptoms did, the study authors reported in the Aug. 13 online edition of JAMA Psychiatry.
The researchers used two separate questionnaires, one on sleep quality and one on depression symptoms, for their calculations.
Yet William Kohler, medical director of the Florida Sleep Institute in Spring Hill, Fla., said he's skeptical about how well the researchers could completely account for depression symptoms since they are so similar to the symptoms of poor sleep.
"We have to ask what's the cart and what's the horse because it's not common to be really sleep-deprived and then be wide-eyed and bushy-tailed and positive about things," Kohler said.
"We know that sleep disturbance causes depressive symptoms, such as lack of energy, lack of interest in things one enjoys and feeling a little down the next day, so I'm not sure how they would separate that out," he added.
Separating them out is what the researchers said they attempted to do.
"Sleep disturbances and suicidal ideation are both symptoms -- among a constellation of symptoms -- of depression, which is why it is crucial to disentangle them as risk factors and the way in which they may interact to increase risk," Bernert said. "It is important to note that suicide is the tragic outcome of multiple, often interacting risk factors and medical conditions."
Approximately 12 out of every 100,000 people die by suicide each year in the United States. Individuals thinking about suicide can reach a nearby certified crisis center by calling the National Suicide Prevention Lifeline at 1-800-273-TALK.
The U.S. Substance Abuse and Mental Health Services Administration ranks sleep difficulties as one of the top 10 warning signs of suicide. Past studies have linked insomnia, nightmares and overall poor sleep quality to an increased risk of suicidal thoughts and attempted suicide. But those studies did not usually control for depression.
This new study differs from past research because of its size, length and focus on older Americans. The researchers tracked more than 14,000 adults, aged 65 and older, for 10 years. The adults assessed their sleep quality and depression symptoms six times during that decade.
Bernert said she and her colleagues are now investigating why the link between poor sleep and suicide might exist.
The U.S. Centers for Disease Control and Prevention and the U.S. National Institutes of Health contributed funding for the study.
http://www.medicinenet.com/script/main/art.asp?articlekey=180048