Pain Archive

What Is It?

Bedsores, also called pressure ulcers or decubitus ulcers, are areas of broken skin that can develop in people who:

• Have been confined to bed for extended periods of time
• Are unable to move for short periods of time, especially if they are thin or have blood vessel disease or neurological diseases
• Use a wheelchair or bedside chair (a hospital chair that allows a patient to sit upright next to the bed)

Bedsores are common in people in hospitals and nursing homes and in people being cared for at home. Bedsores form where the weight of the person's body presses the skin against the firm surface of the bed.

What Is It?

In the wrist, nerves and tendons pass through a space called the carpal tunnel. 

Because the carpal tunnel is somewhat narrow, a major nerve called the median nerve that passes through this tight space, can become irritated or compressed. Carpal tunnel syndrome is a combination of numbness, tingling, pain and weakness in the hand caused by compression of the median nerve in the carpal tunnel.

What Is It?

A hernia occurs when part of an internal organ or body part protrudes through an opening into an area where it shouldn't. A hiatal hernia is named for the hiatus, an opening in the diaphragm between your chest and your stomach. Normally, the esophagus (the tube that carries food to the stomach) goes through this opening. In a hiatal hernia, part of the stomach and/or the section where the stomach joins the esophagus (called the gastroesophageal junction) slips through the hiatus into the chest.

There are two types of hiatal hernias:

• Sliding — A part of the stomach and the gastroesophageal junction slip into the chest. Sliding hiatal hernias are common, especially in smokers, overweight people and women older than 50. These hernias are related to naturally occurring weaknesses in the tissues that normally anchor the gastroesophageal junction to the diaphragm and to activities or conditions that increase pressure within the abdomen. These activities or conditions include persistent or heavy coughing, vomiting, straining while defecating, sudden physical exertion and pregnancy.
• Paraesophageal — The gastroesophageal junction remains in its proper place, and a fold of the stomach slips into the chest, pinched between the gastroesophageal junction and the diaphragm. Of the two types of hiatal hernias, paraesophageal hernias are more likely to cause severe symptoms.

Symptoms

Sliding hiatal hernias may not cause any symptoms, or they may cause heartburn that is worse when you lean forward, strain or lie down. There may be chronic belching and, sometimes, regurgitation (backflow of stomach contents into the throat).

Age is an important factor in deciding when to go ahead with a hip replacement because artificial hip implants have limited life spans. You can only put a certain number of miles on your new hip before it wears out. If you are overweight or very physically active, your new joint may wear out faster.

Given the average life span for Americans, many of the older adults who get a new hip in their 60s or 70s may never need to have it replaced.

News briefs

A large study published online Nov. 4, 2019, by JAMA Internal Medicine offers hope for people who want to reduce their reliance on opioids. The powerful prescription painkillers, such as oxycodone (OxyContin) and hydrocodone (Vicodin), are typically used to treat severe pain after surgery, pain with terminal illness, and chronic pain. But use of these drugs comes with the risk of dependence, addiction, overdose, and death. So researchers set out to determine if mind-body therapies (such as meditation or hypnosis) could help ease pain. Scientists reviewed 60 randomized trials with more than 6,400 people taking opioids for reasons such as surgery, burns, cancer, or chronic pain. Researchers noted moderate to large improvements in pain among people who added meditation, hypnosis, cognitive behavioral therapy (CBT), or therapeutic suggestion to their pain control regimens. Meditation, hypnosis, and CBT were so effective that people were able to slightly reduce the amount of opioids they were taking. Two other therapies — relaxation therapy and guided imagery — did not have a significant impact on pain. The great news: you have nothing to lose by adding one of these mind-body therapies to your regimen, and it may even help.

Image: FatCamera/Getty Images

What is the test?

Doctors have used x-rays for over a century to see inside the body in order to diagnose a variety of problems, including cancer, fractures, and pneumonia. During this test, you usually stand in front of a photographic plate while a machine sends x-rays, a type of radiation, through your body. Originally, a photograph of internal structures was produced on film; nowadays, the image created by the x-rays goes directly into a computer. Dense structures, such as bone, appear white on the x-ray films because they absorb many of the x-ray beams and block them from reaching the plate. Hollow body parts, such as lungs, appear dark because x-rays pass through them.

Doctors use back x-rays to examine the vertebrae in the spine for fractures, arthritis, or spine deformities such as scoliosis, as well as for signs of infection or cancer. X-rays can be taken separately for the three areas of the spine: the cervical spine (neck), thoracic spine (middle back), and lumbar spine (lower back). Occasionally, doctors x-ray the pelvis to help diagnose the cause of back pain.

What Is It?

Doctors have used x-rays for over a century to see inside the body. X-rays can diagnose a variety of problems, including bone fractures, arthritis, cancer, and pneumonia. During this test, you usually stand in front of a photographic plate while a machine sends x-rays, a type of radiation, through a part of your body. Originally, a photograph of internal structures was produced on film; nowadays, the image created by the x-rays goes directly into a computer.

Dense structures absorb many of the x-rays and block them from reaching the plate. Calcium in bones is dense, so it absorbs lots of x-rays, making the image of the bone appear white. Fat and other soft tissues are less dense, so they allow more radiation to pass through them and appear in shades of gray. Hollow body parts, such as the lungs, appear dark or black because lots of x-rays pass through them.

What is the test?

A myelogram is an x-ray test in which dye is injected directly into your spinal canal to help show places where the vertebrae in your back may be pinching the spinal cord. It is sometimes used to help diagnose back or leg pain problems, especially if surgery is being planned.

How do I prepare for the test?

Tell your doctor ahead of time if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist's office, or to x-ray dyes. You should also tell your doctor if you might be pregnant, since x-rays can harm the developing baby.

What Is It?

Sutures, commonly called stitches, are sterile surgical threads that are used to repair cuts (lacerations). They also are used to close incisions from surgery. Some wounds (from trauma or from surgery) are closed with metal staples instead of sutures.

What It's Used For

Sutures may be used to close surface wounds or deep wounds. To close a deep wound, a doctor may need to sew the two edges together layer by layer, placing and leaving some sutures under the skin surface.