Pain Archive

Ask the doctors

Q. I often wake up with a sore neck in the morning. What can I do to prevent this?

A. Poor sleep habits can cause neck pain or make it worse. Simple changes can make it less likely that you will wake up in pain in the morning.

Pain from ruptured discs and arthritis doesn't have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.

Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull of gravity on our vertebrae take their toll over time. Nearly every adult has had a stiff or sore back at some time.

People who experience chronic migraine headaches may benefit from treatment with botulimun neurotoxin (Botox), though other treatments such as medication are usually tried first.

Don't ignore back pain, height loss, or osteoporosis. They could be signs of a compression fracture.

You didn't fall, and you didn't do anything strenuous. So it may come as a surprise when the bad back pain you've been experiencing turns out to be one or more broken bones in your back. "A common story is that someone bends down to put something in the dishwasher or steps off a curb a little hard and puts additional load on their spine. The weakened bone is not adequate to take that load, and it collapses," says Dr. Julia Charles, a rheumatologist and bone cell researcher at Harvard-affiliated Brigham and Women's Hospital.

What weakens the spine?

Your spine contains about 30 bones called vertebrae, stacked on top of each other like a roll of quarters. Each vertebra consists of an external bone surface (like plaster), and an inside filled with a honeycomb of support rods called trabeculae.

Nerve damage might be causing everything from low blood pressure to gastrointestinal distress without your knowing it.

Doctors have long known peripheral neuropathy as a nerve condition that causes reduced sensation, tingling, weakness, or pain in the feet and hands. But those symptoms may be just the tip of the iceberg. Doctors are now learning that neuropathy can cause many more problems.

What is peripheral neuropathy?

Peripheral neuropathy refers to damage to the peripheral nerves throughout the body. These nerves carry messages to and from the brain.

Women sometimes neglect their feet until they start to experience foot pain and other problems.

Most women get their teeth cleaned at least once a year, keep tabs on their heart, and may even have an annual eye exam. While they might clip and paint their toenails on a regular basis, women often neglect the health of their feet.

That lack of attention can lead to pain and other foot problems, which are common and — for some people — life-altering.

Ask the doctor

Image: Karl Rosencrants/ Thinkstock

Q. It's been suggested that drinking 2 to 3 ounces of tonic water before bedtime can prevent leg cramps at night. Is that true?

A. Tonic water—and the quinine it contains—have been promoted for preventing leg cramps for decades despite the lack of evidence that they are effective. Quinine is FDA-approved only for treating malaria and is sold with a warning against using it to treat leg cramps or muscle pain, because it increases the risk of bleeding and heart rhythm disturbances. Tonic water contains no more than 83 mg of quinine per liter—a much lower concentration than the 500 to 1,000 mg in the therapeutic dose of quinine tablets. Drinking a few ounces of tonic water shouldn't be harmful, but it isn't likely to prevent your leg cramps.

The negative emotions that come from coping with chronic pain can lead to depression, and that very depression can lead to worse pain. Understanding the connection between pain and emotional health with the help of a psychologist can address these issues, and there are evidence-based therapies that can help as well.

There are several things you can do to prevent or minimize the aches and pains that might accompany statin use.

If you're not taking a statin now, you may well be soon. These medications are commonly prescribed to lower "bad" LDL cholesterol and have been shown to reduce the risk of heart attack, stroke, and death. They are routinely recommended for people who have cardiovascular disease and for many people ages 40 to 75 who don't have cardiovascular disease but have at least one risk factor (high blood pressure, high cholesterol, diabetes, or smoking) and a 7.5% or greater risk of a stroke or heart attack in the next decade. Moreover, recent research indicates that they may benefit high risk individuals over age 75 as well.

Muscle pain and other statin side effects

Taking a statin may give you some assurance that you're doing all you can to avoid heart attack and stroke, but you may also experience side effects. Reported side effects include an increased chance of developing diabetes — which is largely restricted to people who are already at risk for diabetes, and who can be monitored with glucose or hemoglobin A1c tests. Statin use has also been associated with difficulties with memory and reasoning, although there is no clear evidence that the drugs were responsible. In very rare cases, statins may cause liver problems or a potentially life-threatening breakdown in muscle cells.