DEAR DOCTOR K: Let's say I stub my toe. How does my brain know where it hurts and how bad?
DEAR READER: Pain serves as the body's warning system. It alerts you to an injury or when something, such as an infection, has gone wrong inside your body. Pain can also help in healing. But in order to respond appropriately, your brain must identify the location and severity of your pain.
DEAR DOCTOR K: I have polymyalgia rheumatica. My doctor has prescribed prednisone, but I'm worried about the long-term effects of this treatment. How long will I need to take it?
DEAR READER: Polymyalgia rheumatica (PMR) is a painful, sometimes disabling condition. Fortunately, PMR responds well to proper treatment.
DEAR DOCTOR K: My neck hurts, but my doctor hasn't been able to figure out why. I think if I had the words to better describe my pain, it might give him the clues he needs. Can you help?
DEAR READER: Many of my patients have trouble describing their discomfort beyond telling me "it hurts." Even a slightly more specific description can help me identify -- or exclude -- a particular diagnosis.
DEAR DOCTOR K: I was just diagnosed with osteoarthritis. What can I do at home to manage my discomfort?
DEAR READER: Osteoarthritis is the most common kind of arthritis. Tens of millions of us in the United States have it, and it becomes more common as we get older. For some people it causes just occasional aches and pains. But for others, pain and stiffness can make it difficult to perform the daily tasks they've always taken for granted. Simple activities such as getting dressed or cooking dinner can become major efforts.
DEAR DOCTOR K: I started taking oxycodone for chronic back pain, but now I'm addicted to it. I've heard there may be medications that can help me quit.
DEAR READER: Oxycodone, like morphine, codeine and hydrocodone, is an opioid drug. Opioids are among the most powerful painkillers available. They can also produce a feeling of well-being and euphoria. Opioids affect the brain by attaching themselves to structures on brain cells called receptors. The opioid is like a key and the receptor is like a lock. When the key fits into the lock, the brain cell is affected.
DEAR DOCTOR K: I have trigeminal neuralgia. Medications haven't helped. What are my other treatment options?
DEAR READER: Trigeminal neuralgia causes pain in the face. The pain can be so bad that it disrupts a person's life. You have two trigeminal nerves, one on each side of your face. These nerves detect touch, pain, temperature and pressure. If you pinch your lip, trigeminal nerve endings in your lips send pain signals up the nerve and into your brain, where the pain registers.
DEAR DOCTOR K: I'm a 55-year-old man with restless legs syndrome for the past several months. The condition is making it impossible for me to get a good night's sleep. What can I do?
DEAR READER: Restless legs syndrome (RLS) is a neurological condition that causes uncomfortable sensations in the legs. In describing these odd sensations, my patients use words such as "tingling," "prickly," "crawling," "pulling" and, sometimes, "painful."
DEAR DOCTOR K: I was just diagnosed with hip bursitis. What will my treatment entail?
DEAR READER: Your hip has several fluid-filled sacs, called bursae. They cushion the hip joint. When one of these sacs becomes irritated or inflamed, the condition is known as bursitis. My patients use different words to describe the pain they have from bursitis: aching, burning, dull, sharp and radiating. The type and location of your pain depend on which bursa is affected.
DEAR DOCTOR K: I'm still recovering from a neck injury, but I'm scheduled to begin rehabilitation exercises with a physical therapist next week. How can I start rehab when I'm in so much pain?
DEAR READER: Although it may be hard to believe, without active exercises it is hard to relieve pain, restore function and reduce the risk of reinjury in your neck. If you're still in too much pain to perform rehab exercises, your physical therapist can do some "passive pain-relieving interventions" to ease your pain and get you ready for active rehab. These techniques are not a substitute for necessary exercises. Instead, they make it easier for you to do them.
DEAR DOCTOR K: I'm getting older and need to find a new way to keep fit. I've heard that tai chi might be a good option. Can you tell me more about it and its health benefits?
DEAR READER: Tai chi is often described as "meditation in motion." I think it could just as well be called MEDICATION in motion. This mind-body practice appears to help treat or prevent many health problems. Tai chi is a low-impact, slow-motion exercise. As you practice it, you move fluidly through a series of motions. The motions are named for animal actions such as "white crane spreads its wings," or for martial arts moves.
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Dr. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publications. Learn more »
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