Pain Archive

Pain when sitting can be caused by a number of common problems, including problems with the discs that cushion the vertebrae in the back. Lying down can help the pain temporarily, but the goal should be to get up and move as soon as possible. People should see a doctor if your pain is extremely severe, if it comes back after getting better, or if it occurred after an injury.

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).

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 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.

The primary purpose of your legs is to keep you upright and mobile. Yet, your legs can also act as an indicator of your overall health. Although some symptoms you may experience are specific to a leg problem, others can suggest trouble with your heart, nervous system, kidneys, or other organs. Use the following symptom guide to help you decipher what broader problems your leg pain might suggest.

Symptom: Leg cramps
Possible cause: Dehydration

A cramp in your leg after you've been working out, especially in the heat, could be an important sign that your body is low on fluids. To contract and relax normally, muscles rely on water and electrolytes like sodium and potassium. Too little fluid or electrolytes can hypersensitize the nerves that control muscles in the legs, causing the
muscles to contract abnormally, or spasm.

On call

Q. I suddenly developed low back pain for the first time. My doctor said I did not need an x-ray or other imaging test. Is that normal and are there any situations when a test would be needed?

A. Yes, your doctor is following the current guidelines. Unless you have other symptoms in addition to low back pain, an x-ray, CT scan, or MRI is not likely to be helpful. But it could cause unnecessary worry while waiting for the results and cost you some money if it's not covered by your health insurance. In addition, many people have "false-positive" results in which an abnormality is detected but turns out to be harmless.