Everyone experiences pain at some time. It might be the result of an injury, operation, or pushing your body too hard. Headache, infection, arthritis, and other health problems cause pain. Unchecked, pain can rob you of the ability to sleep, work, and enjoy life. It can also lead to depression and anxiety.
We've come a long way from the days of "grin and bear it," or "no pain, no gain." Pain begets pain, so it's important to stop it early. There is no one-size-fits-all approach to pain relief. Standard medications can be a good option for many pain sufferers, but a wide range of effective nondrug therapies are also available.
Trigeminal neuralgia, also known as tic douloureux, is a painful disorder of a nerve in the face called the trigeminal nerve or fifth cranial nerve. There are two trigeminal nerves, one on each side of the face. These nerves are responsible for detecting touch, pain, temperature and pressure sensations in areas of the face between the jaw and forehead.
People who have trigeminal neuralgia usually have episodes of sudden, intense, "stabbing" or "shocklike" facial pain. This pain can occur almost anywhere between the jaw and forehead, including inside the mouth. However, it usually is limited to one side of the face.
An ankle sprain is a stretch or tear in one or more of the ankle ligaments. Ankle ligaments are slightly elastic bands of tissue that keep the ankle bones in place. Ankles are particularly prone to sprain because of the small size of the joint and the forces exerted when walking, running and jumping, especially if the surface is uneven.
Depending on the severity of the injury, an ankle sprain is classified as:
Grade I — The ankle is painful, but there is little ligament damage and little loss of function.
Millions of ankle injuries occur each year in the United States. Most of them are sprains. Most sprains happen when the ankle twists suddenly. The most common injuries happen when the foot rolls onto the outside of the ankle, straining the outside ligaments of the ankle joint. These are called inversion injuries. Less common are eversion injuries, which happen when the ankle rolls onto the inside of the joint, stretching the ligaments on the inner side of the ankle.
Corns and calluses are a thickening of the outer layer of skin. This thickening is known medically as hyperkeratosis. Corns and calluses develop as part of the skin's normal defense against prolonged rubbing, pressure and other forms of local irritation.
Corns — A corn is a protective thickening of the skin on a bony, knobby portion of a toe. At the center of a corn is often a very dense knot of skin called a core, which is located over the area of greatest friction or pressure.
Firm, dry corns that form on the upper surfaces of the toes are called hard corns. Pliable, moist corns that form between the toes are called soft corns. In most cases, corns develop when the foot has been squeezed into a shoe that has a very narrow toe area. Less often, corns develop on deformed toes that cannot fit comfortably into regular shoes.
Calluses — A callus is a thickening of skin that is exposed to prolonged rubbing. Unlike a corn, the thickening in a callus is evenly distributed. There is no dense central core. Although calluses usually occur on the soles of the feet, they also can form on other parts of the body that are exposed to long-term friction. For example, calluses often are found on the hands of manual laborers, guitar players, gymnasts, weight lifters, tennis players and other people who routinely handle tools, instruments or sports equipment. Calluses can be a physical advantage — for example, among laborers and athletes — because they cushion the hands and allow the person to function without pain.
On the soles of the feet, calluses typically develop near the base of the toes, where they are caused by friction from the inside of shoes. Less often, calluses are related to walking problems or foot abnormalities that place unusual stress on parts of the foot during walking.
According to the American Podiatric Medical Association, painful corns and calluses affect about 5% of people in the United States every year, and many people never seek professional help.
A finger dislocation is a joint injury in which the finger bones move apart or sideways so the ends of the bones are no longer aligned normally. Finger dislocations usually happen when the finger is bent backward beyond its normal limit of motion.
The bones in the fingers are known by the medical terms phalanges and metacarpal bones. Every knuckle in the hands and fingers contains a joint between two of these bones, and any of these joints can be dislocated in an injury:
Distal interphalangeal joints are in the finger knuckles closest to the fingernails. Most dislocations in these joints are caused by trauma, and there is often an open wound in the location of the dislocation.
Proximal interphalangeal joints are the middle joints of the fingers. A dislocation in one of these joints is also known as a jammed finger or coach's finger. It is the most frequent hand injury in athletes, and it is especially common among those who play ball-handling sports, such as football, basketball and water polo. In most cases, the dislocation happens because the fingers are bent backward when an athlete tries to catch a ball or block a shot. Proximal interphalangeal joint dislocations also can happen when an athlete's fingers are twisted or bent by an opponent, especially when two athletes wrestle or grab for control of a ball.
Metacarpophalangeal joints are in the knuckles, located where the hand joins to the fingers. These joints connect the metacarpal bones in the palm with the first row of phalanges in the finger. Because these joints are very stable, metacarpophalangeal joint dislocations are less common than the other two types. When metacarpophalangeal dislocations do occur, they are usually dislocations of either the index finger or little finger (pinky).
Reactive arthritis is an uncommon disease that causes inflammation of the joints and, in many cases, other areas, particularly the urinary tract and eyes. It is triggered by an infection, usually by a sexually transmitted organism or by certain gastrointestinal bacteria.
The most common infection causing reactive arthritis is the sexually transmitted disease (STD) chlamydia. Reactive arthritis can also be caused by gastrointestinal infection from bacteria such as salmonella, shigella, campylobacter or Yersinia, infections that can cause diarrhea and vomiting. These bacteria often are found in contaminated food or water. While these infections are common, reactive arthritis is not. Scientists believe that people who develop reactive arthritis have a certain genetic makeup. Supporting the theory that genetic makeup is a risk factor, about 50% of people with reactive arthritis carry a gene called HLA-B27, compared with 8% of the general population.
Reactive arthritis is thought to be an autoimmune disorder, which means the body's immune system mistakenly attacks its own tissues. In this case, the immune system is jolted into action by the infection but continues attacking after the infection is gone.
Reactive arthritis typically includes arthritis, eye inflammation (conjunctivitis or uveitis) and inflammation of the urethra (urethritis). However, some people develop only one or two of these. Reactive arthritis is most common in people between the ages of 20 and 40, with a prevalence of about 0.03% (30 per 100,000).
A sprain in the wrist is an injury to its ligaments, the tough bands of fibrous tissue that connect bones to one another inside a joint. Although most people speak of the wrist as a single joint between the forearm and hand, the wrist actually contains many joints that link 15 separate bones. The ligaments that connect these bones can be torn by any extreme twist, bend or impact that suddenly forces the wrist into a position beyond its normal range of motion.
There are three levels of sprain:
Mild (Grade I) — The wrist's ligaments are stretched or have microscopic tears.
Moderate (Grade II) — The damage is more severe, and some wrist ligaments may be partially torn.
Severe sprains (Grade III) — One or more wrist ligaments are entirely torn or torn away from where they normally attach to bones.
Sprains of the wrist are fairly rare in everyday life and in the workplace. Under certain weather conditions, such as during ice storms or after a snowfall, a wrist sprain is commonly caused by a fall in which a person lands on outstretched arm.
For athletes, sprains and other injuries to the wrist or hand account for 3% to 9% of all sports injuries. They are especially common among young males who play football, basketball or baseball. In addition, at least 36 Olympic events have been linked to an unusually high rate of wrist sprains, including roller hockey, baseball, boxing, basketball, volleyball, weightlifting, ice hockey, wrestling and judo.
Among skiers, wrist sprains commonly occur when the skier falls while still gripping a ski pole or still having the pole strapped to the hand. Falls are also a frequent cause of wrist sprains and fractures among snowboarders and inline skaters. In platform divers, wrist sprains can occur when the wrist absorbs an unusually forceful impact as the athlete hits the water. Wrists sprains also occur in racquet sports, wrestling and pole vaulting because the wrist is subjected to extreme twisting movements during these sports.
Takayasu's arteritis is a chronic (long-term) disease in which arteries become inflamed. It is also known as Takayasu's aortitis, pulseless disease and aortic arch syndrome. The name comes from the doctor who first reported the problem in 1905, Dr. Mikito Takayasu.
In most cases, Takayasu's arteritis targets the aorta and its major branches, including arteries to the brain, arms and kidneys. The aorta is the body's main artery, which pumps oxygen-rich blood from the heart to the rest of the body. Less frequently, the pulmonary artery and coronary arteries also are involved. This problem causes damage to the body's major organs; reduced or absent pulses in the arms and legs; and symptoms of poor circulation, such as a cool or cold arm or leg, muscle pains with use or exertion, or symptoms of stroke if brain arteries are narrowed or blocked. Over time, Takayasu's arteritis can cause scarring, narrowing and abnormal ballooning of involved blood vessels. The disease can be fatal.
Lyme disease is an infection caused by bacteria called Borrelia burgdorferi. These bacteria are transmitted through the bites of ticks, primarily the deer tick. Not everyone who develops symptoms of Lyme disease remembers getting bitten by a tick because the deer tick is very small and its bite can go unnoticed.
Lyme disease is most common in the northeastern and midwestern United States. More than 90% of cases have been reported in nine states: Connecticut, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island and Wisconsin. Even within states, there are regions of high risk and others with very low rates of disease. This variation relates to where ticks that carry the bacteria live, breed and come into contact with humans.
Rheumatoid arthritis is a chronic (long-lasting) inflammatory disease that causes pain, stiffness, warmth, redness and swelling in joints. Over time, the affected joints may become misshapen, misaligned and damaged. Tissue lining the joint can become thick, and may wear away surrounding ligaments, cartilage and bone as it spreads. Rheumatoid arthritis usually occurs in a symmetrical pattern, meaning that if one knee or hand has it, the other usually does, too.
The cause of rheumatoid arthritis is unknown, although it appears to be an autoimmune disease. When the body's immune system does not operate as it should, white blood cells that normally attack bacteria or viruses attack healthy tissue instead — in this case, the synovium, or joint tissue. As the synovial membrane (the thin layer of cells lining the joint) becomes inflamed, enzymes are released. Over time, these enzymes and certain immune cells damage the cartilage, bone, tendons and ligaments near the joint.
Some research suggests that a virus triggers this faulty immune response. However, there is not yet convincing evidence that a virus is the cause of rheumatoid arthritis. At the same time, it appears that some people are more likely to get the disease because of their genetics. Environmental factors may also be important. For example, smoking is a risk factor for rheumatoid arthritis.
Rheumatoid arthritis, the most disabling form of arthritis, generally affects more than one joint at a time. Commonly affected joints include those in the hands, wrists, feet, ankles, elbows, shoulders, hips, knees and neck. Rheumatoid arthritis can result in loose, deformed joints, loss of mobility and diminished strength. It also can cause painless lumps the size of a pea or acorn, called rheumatoid nodules. These develop under the skin, especially around the elbow or beneath the toes.
Generally, the pain of rheumatoid arthritis is described as a dull ache, similar to that of a headache or toothache. Pain is typically worse in the morning. It is not rare to have 30 minutes to an hour or more of morning stiffness. On days when the disease is more active, you may experience fatigue, loss of appetite, low-grade fever, sweats and difficulty sleeping.
Because rheumatoid arthritis is a systemic disease (meaning it can affect the entire body), you also may have inflammation in other areas, including the heart, lungs or eyes. Symptoms vary between people and even in one person over time. People with mild forms of the disease are bothered by pain and stiffness, but they may not experience any joint damage. For other people, damage occurs early, requiring aggressive medical and surgical treatment. People with rheumatoid arthritis may notice worsening and improvement for no apparent reason. Although this disease most often afflicts people between the ages of 20 and 50, it may affect children and the elderly. Of the 2 million people with rheumatoid arthritis in the United States, at least 75 percent are women.
Ankylosing spondylitis is a form of arthritis that mainly affects the lower back. It causes inflammation and damage at the joints, and first affects the sacroiliac joints between the spine and the pelvis. It also can affect other areas of the spine and other joints, such as the knee. Eventually, inflamed spinal joints can become fused, or joined together so they can't move independently. The word spondylitis refers to inflammation of the spine; ankylosis means fusion or the melding of two bones into one.