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Hand Pain

Two Ways to Ease Writer’s Cramp

In dystonic writer’s cramp, symptoms will be present not only when you’re writing, but also when performing other activities, such as shaving, using eating utensils or applying make-up.

GETTING THE BODY RIGHT

There are a number of things that might be a problem with your current writing position:

  • Writing posture e.g. a twisted or bent body
  • A painful pen hold or twisted wrist
  • An unnatural arm position such as a raised elbow
  • Pressing too hard on fingers or paper
  • An incorrect paper position leading to uncomfortable twisted wrists and poor posture.

These problems can sometimes be seen better if another person photographs or videos you writing.

Possible solutions:

  • Sit in a good support your chair with feet firmly on the ground, bottom well back in chair, back leaning slightly forward and table height half of your height.
  • Before writing, release any tension e.g. shrug the shoulders, shake the wrists and take a couple of deep breaths.
  • The best position to paper may be slightly to your right if right handed, or the left if left handed.
  • Callewaert, a Belgian neurologist, suggested an alternative pen hold which makes use of different muscles which work together rather than opposing. It consists of placing the writing implement between the index and middle fingers.
  • Bend your fingers into a fist and hold for a second or two, and then extend your fingers out as straight as you can for about five seconds (you’ll feel a stretching sensation in the webs of your fingers as you do this).

HOMEOPATHY

Homeopathy is a form of holistic medicine used to treat both acute and chronic conditions. It is based on the principle of ‘like cures like’ where a substance taken in small amounts will cure the same symptoms it causes if it was taken in large amounts.  Some remedies which could ease discomfort include:

  • Gelsemium:  For when the cramps appear in the hand. There is a sudden spasmodic contraction of muscles of hands or fingers, with weakness of hands.  Jerking or trembling of hands may also be noticed.
  • Magnesium phos:   For when pain occurs along with contracted muscles in the hand. The pain can be stitching, shooting or cutting in nature. A feature is relief from warmth or pressure over the hand.
  • Stannum met:  For when there is jerking of the hands while holding the pen. The hand and arms also feel heavy while writing.
  • Kali phos:  For when slight exertion of hand leads to cramping conditions. Numbness may also be felt along with contracted muscles.
  • Rhus tox:    When stiff fingers with pain more in the tendons than in muscles. Better from rest and heat to area.

To find a qualified homeopath:  Society of Homeopaths http://www.homeopathy-soh.org

FIBROMYALGIA

Cognitive Behaviorial Therapy (CBT) and Fibromyalgia

Fibromyalgia is a long-term condition that causes pain throughout the body and may produce other symptoms such as IBS, insomnia, headaches, low concentration, fatigue and increased sensitivity to pain.

Pain can be particularly distressing and there is considerable research which shows cognitive behavioral therapy (CBT)  may help provide relief. CBT can:

  • alter the way you view your pain by influencing your thoughts, emotions and behaviors related to pain and coping strategies
  • help you diminish pain so that it interferes less with your quality of life
  • change the physical response in the brain that makes pain worse.   Pain causes stress, and stress affects pain control chemicals in the brain, such as norepinephrine and serotonin.  CBT reduces the arousal that impacts these chemicals and can make the body’s natural pain relief response more powerful.

The primary goals of CBT are to change unhelpful thinking and self-defeating behaviors. Using specific tasks and self-observation, you learn to think of pain as something other than a negative factor that controls your life. Over time, the idea that you’re helpless reduces and you learn that you can manage the pain.

CBT is particularly helpful for defining and setting limits, which is important if you suffer from fibromyalgia as you may tend to live your life in extremes. You may push yourself too far causing distressing symptoms. This unhelpful behaviour can undermine how you view yourself, and you may think of yourself as a failure, unable to cope with the simplest task. An important aim of CBT is to help you discover middle ground, learning to prioritize your responsibilities and drop some of the less important tasks or delegate them to others.

CBT usually consists of several one-hour sessions. You receive homework which may involve:

  • Keeping a diary which serves as a general guide for setting limits and planning activities.  You might use the diary to track stress factors, such as a job that may be improving or worsening the pain.
  • Challenging and reversing negative thoughts and beliefs. For example ‘Because I  can’t control this disease I must be useless.’  becomes the coping statement ‘I can cope with small tasks most days.’
  • Setting limits designed to keep both mental and physical stress within manageable levels, so that you do not become discouraged by overdoing it. For example, tasks are broken down into incremental steps which you focus on one step at a time.
  • Seeking out enjoyable low-energy activities that you can conveniently schedule.
  • Prioritizing and learning to drop some of the less critical tasks or delegate them to others.

 Further information:  British Association Behavioral & Cognitive Psychotherapies www.babcp.com/Default.aspx

mother feeding her baby in nature outdoors in the park

Engorgement and Mastitis

The breasts of women play a crucial role in life – it nourishes the infant shortly after birth and can make a difference in the growth, development and health of a baby. It is known that breastfeeding is the best means to nourish a newborn and today breastfeeding is once again becoming the preferred option among new mothers. However, there are two fairly common breast problems that can arise during lactation.

Firstly there is the situation where the breasts become overfilled with milk and painful. This is known as breast engorgement. The other problem that may be seen among breastfeeding women is an infection of a breast or even both breasts simultaneously. This is known as mastitis. Although both involve the breast during lactation, it is two very different conditions. However, engorgement may lead to mastitis.

Breast Overfilling

Breast milk production is a normal process that occurs shortly before giving birth and continues for as long as the infant is feeding. It can sometimes occur abnormally without pregnancy but milk production is usually very moderate in these cases. Some women produce more milk than others but the quantity of milk production is largely based on how frequently a baby feeds.

Milk production is fairly constant during lactation and regularly emptied by the feeding infant. Therefore the more a baby feeds, the more milk the breast produces. Milk production can occur indefinitely in this way. In breast engorgement the milk collects in the breast until it begins to exceed the maximum storage capacity of the breast. It leads to swollen and painful breasts.

Engorgement of the breasts is mainly due to a women stopping breastfeeding suddenly. Blockage of the milk ducts that carry milk out of the breast can worsen the condition but is usually not the sole cause. Contrary to popular belief, engorgement is unlikely to arise because the breasts are abnormally overactive in milk production.

Basically, if a lactating women expresses the milk regularly or allows the infant to feed more frequently, the breasts will not become overfilled. As the baby feeds less with supplementation of solid foods, the breast starts producing less milk and the chances of engorgement is unlikely. It is possible for engorgement to progress further and complicate into mastitis.

Breast Infection

Mastitis, in the true sense of the word, means inflammation of the breast. However, since the majority of cases are due to an infection, the term mastitis has become synonymous with a breast infection. Although mastitis can occur in any woman, it is more common during breastfeeding. Therefore the condition is more correctly known as lactation mastitis.

Breastfeeding is a time in a woman’s life when the breasts experience extensive trauma. However, breastfeeding is a natural process and the breasts are equipped to deal with it to a certain degree. The bacteria that cause mastitis exist naturally on the skin and within the baby’s mouth where it is not harmful. But when the bacteria enter the breast tissue, it can cause a serious infection.

Normally the breast can prevent bacteria from entering the breast tissue. However, when the nipples become chapped with breastfeeding, the bacteria may take the opportunity to infect the
breast. Mastitis can also occur when the milk ducts become blocked. This can lead to engorgement of the breasts as the milk is trapped but bacteria may also enter and infect the breast tissue.

Woman having abdominal pain

Menstrual Cramp and Vitamin D

The first phase of menstruation is the follicular phase and begins on day 1 of your bleed, when the reproductive hormones oestrogen and progesterone are at their lowest. The most active hormone at this stage is estradiol, the most potent of the three types of oestrogen in the body. If fertilization doesn’t occur, the spiral arteries of the lining close off, stopping blood flow to the surface of the lining. The blood pools into “venous lakes” that burst once they are full and with the endometrial lining form your menstrual flow. Uterine cramping is one of the most common uncomfortable sensations women may have during menstruation.

There are two kinds of cramping:

  • Spasmodic cramping: Resulting from the production of prostaglandins, the hormone-like substances that regulate pain and inflammation in the body by causing either relaxation or constriction of the smooth muscles.
  • Congestive cramping: Resulting from possible food allergies (mainly wheat, dairy, or alcohol), which can increase oestrogen levels, creating pelvic congestion and causing the body to retain fluids and salt.

Menstrual cramping and vitamin D

Vitamin D is not actually a vitamin; it’s an essential fat-soluble hormone made through skin exposure to the sun, hence its nickname: the “sunshine vitamin.” Vitamin D is necessary for calcium absorption and deficiency can contribute to rickets and other bone problems, some cancers, and multiple sclerosis and would appear to influence the immune system. The body also makes less vitamin D as you age—typically someone in their 70s makes 75% less vitamin D than someone in their 20s, leading to chronic vitamin D deficiency in the elderly.

Upping your vitamin D intake has been shown to help relieve some of the distress associated with menstrual cramping. That’s because hormone-like substances called prostaglandins trigger the uterus to contract during menstruation as a means of expelling the uterine lining. These substances are associated with inflammation and pain, and high levels are linked to menstrual cramps. Vitamin D helps to decrease both the production of prostaglandins and cytokines, which promote inflammation in your body.

You cannot get adequate vitamin D through dietary sources alone, but upping your consumption of foods fortified with vitamin D, such as cereal flours and milk, and foods naturally containing vitamin D are very helpful. Alfalfa and mushrooms (shiitake and portabella) are good sources of vitamin D2. Free-range egg yolks, beef liver, and wild-caught fatty fishes such as eel, catfish, tuna, salmon, sardines, and mackerel are good sources of vitamin D3, the more important of the two D vitamins. The ideal way to increase vitamin D levels is through safe sun exposure. Take a “sun bath” for 15−20 minutes a day (depending on where you live and the strength of the sun), which should net you 10,000 IU (international units) of vitamin D, a recommended daily dosage to top up vitamin D stores naturally for health. It’s important to expose large areas of your skin to the sun as close to midday as possible in order to receive the correct UV rays for vitamin D production. Limit exposure to just the point when your skin starts to turn pink, then cover up and use your usual sunscreen for the rest of the day to protect the skin. Realistically, it can be very hard to get adequate therapeutic vitamin D from sun exposure in northern latitudes with inadequate sunshine, such as Britain, and modern lifestyles increasingly mean that we are indoors much of the time, so you may well need to take a daily over-the-counter oral vitamin D3 supplement for health. The suggested dosage will depend very much on where you live, your sun exposure, your age, your lifestyle, and the vitamin D levels in your body.

Adapted from Natural Wellness Strategies for the Menstrual Years by Laurel Alexander

Woman in Pain

Managing Breast Pain

Cyclical Breast Pain

Cyclical breast pain is very common and first develops between the ages of 30 and 50 years. In many women the symptoms are mild. However, in around one in ten women the pain can be severe or last up to two weeks before a period. The five days prior to a period are usually the worst. Typically, the pain affects both breasts. Your breasts may also feel more swollen and lumpy than usual. This lumpiness is generalized so does not lead to a single definite lump forming. This swelling and lumpiness decreases soon after your period starts.

If the pain is severe, or for the times when it may flare up worse than usual, treatment options include the following:

  • Support your breasts. Wear a well-supporting bra 24 hours a day for the week before a period. Avoid underwired bras. Wear a sports bra when you exercise. Get yourself measured for the right size bra.
  • Use painkillers and anti-inflammatories e.g. ibuprofen.
  • Use rub-on non-steroidal anti-inflammatories (NSAIDs) e.g. topical ibuprofen.
  • HRT or the contraceptive pill may make cyclical breast pain worse. Some antidepressants and some blood pressure drugs increase breast pain. Discuss with your GP.
  • Medicines such as bromocriptine can ease pain by reducing the level, or blocking the effect of, female hormones such as oestrogen. You need to take them regularly (not just when the pain occurs). However, significant side-effects are common with these drugs.
  • Evening primrose oil. Evening primrose oil needs to be taken for up to four months before you can decide if it is helpful or not.
  • Eat more cruciferous veg e.g. cabbage, cauliflower, spring greens, broccoli, kale, sprouts and soy food such as tofu, soya milk or Pure which is a non-dairy soya spread.
  • Lower saturated fat, carbohydrate, dairy, coffee, salt and caffeine.
  • Eat 3 portions a week of oily fish e.g. mackerel, tuna, trout, herring, salmon, sardines (omega 3s). Flaxseeds are also a rich source of omega 3 (you can get this in supplement form or in seed form to be sprinkled on cereal, in soups, on salads or in stir fries).
  • Take natural vitamin E with selenium (Holland & Barrett) (1 capsule a day)
  • Take a vitamin B timed complex.

Non-Cyclical Breast Pain

Non-cyclical breast pain can be present all the time, or come and go in a random way, is not related to periods and more common in women over 40. The pain may be in just one breast, and may be localized to one area in a breast. Sometimes the pain is felt all over one or both breasts. There are various causes:

  • Pain coming from the breast tissue itself in the absence of any lumps, tumours, or other abnormality being detected.
  • Pain coming or radiating from the chest wall under the breast rather than the breast itself. Muscular or bony problems of the chest wall account for some cases.
  • Infection may be a cause.
  • Shingles may cause pain before a rash develops.
  • Breast tumours, cancer and lumps are a very uncommon cause of breast pain.
  • The cause is often not clear.

In many cases the pain goes after a few months without any treatment. Other treatments may be appropriate, depending on whether a cause is found. As there are various causes, it is best to see your GP for assessment.

NOTES: If you are not sure which type of breast pain you have, keep a pain diary for 3 months. Record the days when you have breast pain and see what pattern emerges.
If you have concerns about breast pain or any other breast symptoms, consult your GP.

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What is the Alexander Technique?

Lessons in the Alexander technique, named after Frederick Matthias Alexander, teach you how to stop using unnecessary levels of muscular and mental tension during your daily activities, the purpose being to help you unlearn bad physical habits and return to a balanced state of body alignment.

Alexander developed the principles in the 1890s as a personal tool to alleviate his breathing problems and voice loss during performances as a Shakespearean orator. After doctors found no physical cause, Alexander reasoned that he was doing something to himself while speaking to cause his problem. His self-observation showed a habitual pattern of pulling the head backwards and downwards which disrupted the normal working of his posture, breathing and vocal mechanisms. After experimenting to develop his ability to stop the unnecessary and habitual contracting in his neck, he found that his problem with recurrent voice loss was resolved. He refined his technique of self-observation and re-training to teach his discoveries to others from 1930 until his death in 1955.

Famous people who have studied the Alexander Technique include: Paul McCartney, Roald Dahl, John Cleese, Judy Dench and Paul Newman.

The technique teaches you how to use yourself when moving, resting and breathing. You learn to become aware of and then change the habits of movement, tension and reaction that interfere with healthy coordination. Coordination and poise rely on the natural balance of the head, neck and back (Alexander called this ‘the primary control’). The technique works through re-establishing this natural balance to promote easy upright posture and efficient functioning, body and mind.