Pain Management

Will steroid shots relieve spinal stenosis pain?

DEAR DOCTOR K: I have spinal stenosis. Will steroid shots help with pain relief?

DEAR READER: Spinal stenosis is a narrowing of the open space in the spinal canal. This squeezes nerves, causing pain in the lower back, buttocks and legs. I have spinal stenosis, so I know about it both as a physician and a patient. Medicines and physical therapy are usually the first treatments for spinal stenosis pain.

What is the best treatment for cubital tunnel syndrome?

DEAR DOCTOR K: I have cubital tunnel syndrome. What's the best treatment for it?

DEAR READER: Cubital tunnel syndrome is a trapped or pinched nerve problem, much like its better-known relative, carpal tunnel syndrome. Cubital tunnel syndrome occurs when the ulnar nerve gets compressed. The ulnar nerve extends from the spinal cord in your neck to your forearm and the pinky side of your hand. The nerve passes through a series of passageways, or tunnels. The tunnels are composed of tough layers of fibers that can pinch the nerve running through them.

How can I manage my arthritis pain while traveling?

DEAR DOCTOR K: Can you give me advice for managing arthritis pain while traveling?

DEAR READER: Vacations often involve being more physically active than normal, which can worsen arthritis pain. But arthritis doesn't have to spoil your vacation. I spoke to my colleague Dr. Susan Ritter, associate physician in the Division of Rheumatology, Immunology and Allergy at Harvard-affiliated Brigham and Women's Hospital. She made the following suggestions to help make travel relatively pain- and hassle-free:

How can I relieve knee and hip pain without drugs or surgery?

DEAR DOCTOR K: I have constant knee and hip pain. How can I relieve my pain without drugs or surgery?

DEAR READER: For several years, I asked myself the same question. I had severe arthritis in my right hip, the result of a sports injury when I was a young adult. The pain really was interfering with my life. I was limping, and that made me feel old. Worse, I loved long walks -- particularly in new places, on vacation -- and I just couldn't do it anymore. But I didn't want to have surgery.

Is there a drug-free way to relieve PMS symptoms?

DEAR DOCTOR K: Every month I have awful PMS. Can you suggest drug-free ways to relieve my symptoms?

DEAR READER: Premenstrual syndrome (PMS) is a collection of symptoms that occur just before and during menstruation. The most common symptom is unusual mood swings. In addition, women with PMS also experience irritability, anxiety, depression, headaches, hot flashes, bloating, abdominal cramping, breast tenderness and food cravings.

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!"

How can I relieve the pain from my injured rotator cuff?

DEAR DOCTOR K: I've injured my rotator cuff. What can I do to relieve the pain?

DEAR READER: When people hear "rotator cuff injury," they often think of baseball pitchers. But most people with rotator cuff injuries are like you and me. Gradual wear and tear from everyday activities, over many years, makes all older adults vulnerable to such injuries.

What can I do to help with my neck pain?

DEAR DOCTOR K: I work at a computer all day, and as a result, I frequently have neck pain. What can I do?

DEAR READER: Did you know that for every 10 degrees forward you tilt your head, the weight of your head on your neck increases about 10 pounds? It's no wonder, then, that bending your head over a computer all day can strain muscles, ligaments, joints and other structures in your neck.

What can I do to ease the pain from my broken ribs?

DEAR DOCTOR K: I recently broke a couple of ribs, and the pain is so bad I can hardly move. I can't sleep at night and I can't take a deep breath. I went to the doctor, but he said there isn't much he can do. I was surprised that he didn't even tape up my ribs. Is there anything I can do to help my ribs heal quicker and ease my discomfort?

DEAR READER: I understand why you ask the question. If you've ever fractured a bone, it has probably been put in a plaster cast or a splint. Keeping the broken parts of the bone from moving helps the bone heal and reduces the pain. The pain from a fracture generally occurs when the broken parts of the bone move. You know the old joke: "I'm OK, doc. It only hurts when I move."

How can I relieve my carpal tunnel discomfort without drugs or surgery?

DEAR DOCTOR K: I have carpal tunnel syndrome. How can I relieve the discomfort without drugs or surgery?

DEAR READER: Carpal tunnel syndrome causes pain and discomfort in the wrist that can extend into the hand or forearm. It's often caused by activities that require constant use of the wrists. People who spend a lot of time at a computer keyboard, for example, pounding away at the keys, are more likely to experience it.