Nerves and Muscles

What is shoulder impingement?

DEAR DOCTOR K: I have pain in my shoulder when I raise my arm above my head. My doctor says it's caused by "impingement." What does that mean, and what can I do about it?

DEAR READER: You know the wide variety of things your shoulder allows you to do -- such as reach for a box of cereal, swing a golf club and wash your hair. Its wide range of motion makes all these things possible. However, the design of a joint that lets you do all of that also leaves the joint vulnerable to injury. Joints are places where two or more bones meet. The shoulder joint is where three bones meet: the clavicle (collarbone), the scapula (shoulder blade) and the humerus (upper arm bone).

What causes charley horses?

DEAR DOCTOR K: Over the past few months, I've been experiencing severe "charley horses." What causes them? How can I prevent them?

DEAR READER: Almost everyone has a "charley horse" at some point in his or her life. These are muscle spasms in which a group of muscles involuntarily contracts. This causes pain and inability to use those muscles. Stretching typically stops the cramp. But you may continue to have soreness for several days.

Will multiple sclerosis affect my pregnancy?

DEAR DOCTOR K: I have multiple sclerosis. My husband and I would like to have a baby. What do I need to know before I get pregnant?

DEAR READER: Multiple sclerosis (MS) is a disease that affects communication between nerve cells in the brain and spinal cord and the rest of the body. This results in symptoms that may include fatigue, weakness, pain and trouble with movement. In the most common form of the disease, sudden worsening of symptoms (flare-ups or relapses) alternate with symptom-free periods (remissions)

What is fibromyalgia?

DEAR DOCTOR K: My sister was just diagnosed with fibromyalgia. Can you tell me more about this condition?

DEAR READER: Fibromyalgia is a somewhat controversial condition, although less so than it was 20 years ago. It causes pain, aches and stiffness in muscles and joints throughout the body. Patients also feel unusually tired. The results of common blood tests, X-rays and other tests are usually normal for people with fibromyalgia, but depression and anxiety are also more common. Some doctors believe that the symptoms of fibromyalgia are explained by these psychological conditions.

What are treatments for chronic neuropathic pain?

DEAR DOCTOR K: I suffer from what my doctor calls "chronic neuropathic pain." What are my treatment options?

DEAR READER: There are two main types of pain. Nociceptive pain results from an injury to tissues outside your nervous system. Burns, sprains and broken bones are all examples of nociceptive pain. Tiny nerve fibers are always present in tissues. When the tissue gets injured, the nerve fibers detect it. The signal they send the brain is nociceptive pain. The signal says to the brain: "Do something to avoid further injury!"

Is it safe for me to ride a stationary bike if I have sciatica?

DEAR DOCTOR K: I have sciatica. Is it safe for me to ride a stationary bike for exercise?

DEAR READER: Sciatica is persistent pain felt along the sciatic nerve. This nerve runs from the lower back, down through the buttock and into the lower leg. Pain results when this nerve is compressed or injured. It most commonly results from inflammation, bone chips caused by arthritis, or a herniated ("slipped") disk in the lower spine.

I strained my hip flexor — how can I relieve the pain?

DEAR DOCTOR K: I've strained a muscle where my hip meets my pelvis. What can I do to relieve the discomfort?

DEAR READER: It sounds like you've strained your hip flexor. That's a group of muscles that runs from your lower back to the front of your thigh. These muscles help flex your hip when you lift your leg to the front. A hip flexor strain can lead to pain where your thigh meets your pelvis, as well as pain or pinching when you pull your knee to your chest or when you climb stairs.

What is a “sliding hernia”?

DEAR DOCTOR K: My mother was recently diagnosed with a "sliding hernia." What is this?

DEAR READER: A "sliding hernia" is a type of hiatal hernia. OK, so what's a hiatal hernia? A hernia occurs when part of an organ juts through an opening into an area where it shouldn't. The stomach is an organ that is supposed to stay in the abdomen, for example. The abdomen is separated from the chest by a flat, dish-like plate of muscle called the diaphragm.

What is Bell’s palsy?

´╗┐DEAR DOCTOR K: I went to my doctor with some alarming symptoms and he diagnosed me with Bell's palsy. I don't know anything about this condition.

DEAR READER: Bell's palsy, named after the person who first reported it in the medical journals, Charles Bell, is a weakness of the muscles on one side of the face. All muscles in your body take their orders from nerves leading to them. When you think of muscles, you probably think of the big, bulky muscles in your arms and legs. But there are small muscles in your face as well.