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Melatonin for Migraine Headaches

by Pain Doc | Feb 10, 2011 | Headaches

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If you suffer from migraine headaches, take note: a small study done in Brazil concluded that taking melatonin 30 minutes before bed time can reduce migraine frequency and intensity.

The study involved 34 subjects; 29 of which were female. The participants reported experiencing 2-8 migraines per month, on average. Some had migraines with auras– visual disturbances such as seeing wavy lines, spots, or sparks.

Of the 32 participants completing the study, more than two-thirds said their migraine frequency was reduced by half or better after taking melatonin for three months.

This included eight patients who reported no migraines, seven who reported a 75% drop in migraines, and 10 who said their migraine frequency decreased by 50% to 75%.

The findings, which come from a team of researchers led by Mario F.P. Peres, MD, PhD, of Hospital Israelita Albert Einstein in Sao Paolo, Brazil, show that melatonin may be used as a preventive therapy for frequent migraine sufferers. However, since it was a small study with no control group, the researchers suggested a controlled study to test the idea further.

What Makes a Migraine a Migraine? (everydayhealth.com)
Could oxygen help a migraine? (zocdoc.com)
Migraine Surgery Seems To Have Nearly 90% Success (lockergnome.com)

Recommended Back Exercises

by Pain Doc | Jan 18, 2011 | Low Back Pain

I am a firm believer that strengthening and conditioning the core, back and leg muscles is the best way to guard against getting back pain.

If you’re prone to having your back “go out”, then these exercises are the best way to guard against recurrence. Don’t wait until you get degenerative disc disease, because once you reach this point the chances of living a pain- free life take a big nosedive. The reason is that the best exercises for strengthening your back are more risky for those with disc degeneration.

What typically happens is the disc degeneration patient will naturally stay cautious or apprehensive and will avoid back exercises for fear of re-injuring his back. This eventually leads to back muscle weakness and loss of muscle coordination–precursors for back injury and chronic pain.

So, if you don’t have back pain or degenerative joint disease (weak, thinning and/or herniated discs with accompanying bone spurs and cartilage degeneration) consider yourself lucky. Make sure your exercise regimen involves engaging the primary muscles of the trunk primarily, and the whole body, secondarily.

Do functional exercises which force the muscle groups to work synergistically rather independently. Such exercises can mimic common body movements; for example, carrying something on your shoulder while walking.

In strengthening the back, I like to do squats using a 20 lb bar on my back with feet apart in different distances.

Throwing a 12 lb. medicine ball using your whole upper body is another great functional exercise. Get a partner and have him stand 10 feet to your right. Throw the ball to your partner while using your core as well as arms. This simple exercise will strengthen your abs, your paraspinals, arms, and even your leg muscles.

Next, use a Freemotion or similar cable-weight machine where you can raise an arm above your head. With both hands, grip the cable handle and swing it down towards your feet, as though you were chopping wood with an axe. Boy, this is a great exercise as you will feel just about every muscle in your back, arms and chest work together to move the weight.

Pain in Calf While Jogging

by Pain Doc | Dec 23, 2010 | Uncategorized

Muscle strain to the calves can occur while engaging in heavy leg use, such as jogging, hiking (especially uphill), cycling, and basketball or other sport that requires frequent running. This is due to damage to the muscle fibers, tendon, fascia (muscle covering) and/or blood vessels.

But before you assume that your calf pain is a muscle strain, know that calf pain can also be caused by a thrombus, or blood clot. This is a medical emergency that demands a visit to your physician and special tests. For more information on blood clotting in the legs (deep vein thrombosis or DVT), read this article.

Strains occur in different grades. The most simple strains and sprains (Grade I) occur when there is mild tearing of some muscle fibers. Grade III sprains and strains involve complete tears to the muscle and/or ligament (the ligaments are on the ends of the muscle and connect it to bone) and joint damage. Grade III sprains and strains are emergency in nature and will most likely require surgery.

If you get leg (lower) cramps when jogging, you’ll probably need to stop or risk getting a “pulled” calf muscle. This can be painful enough to force you to get off your feet and sit on the ground. A pulled calf muscle starts with a twitchy sensation in the calf, followed by an involuntary, painful contraction that forces you to bend your knee for relief. It signifies a strained gastrocnemeus muscle, tendon or fascia and is related to abnormal muscle physiology due to muscle exhaustion.

You see, muscle contraction involves very complex biochemical reactions. Calcium, sodium and potassium ions modulate the actions of actin and myosin, the specialized protein structures that make up skeletal muscle and enable changes in muscle length. Lactic acid builds up as the muscle contracts and relaxes continuously during running. It is flushed out of the area by normal biological pathways but eventually builds up as the activity continues.

If you get calf pain after engaging in heavy leg use, use the PRICE protocol:

Protect the muscle from further injury
Rest the muscle
Ice the muscle for 20 minutes using a frozen gel pack*
Compress the ice around the muscle (use two long socks or ace wrap)
Elevate your leg for gravity-assisted swelling reduction

If you keep getting calf pain during heavy physical activity, it could be that your legs need more exercise/ conditioning before attempting to engage in such activities. This is usually the case for those who spend a lot of their time sitting. You can do the following leg exercises at home to strengthen your calves:

1. Lunges. Find a place where you can walk 10 yards doing lunges; switch legs.

2. Squat/knee bend exercises. Even better if you can hold a 10-16 pound medicine ball while doing.

3. While standing (bare feet) go up on the balls of your feet, hold one second and go back down; repeat 20 times and hold the last three (on the balls of your feet) for 20 seconds each.

4. Calf stretch. Stand two feet in front of a wall, put one leg back, bend the other. Keep the bottoms of both feet touching the ground (don’t let your heel come off the floor). Bend your front leg; keep your rear leg straight and keep bending until you can tolerate the maximum stretch to your rear leg. Hold for 10 seconds; release. Repeat five times.

The Top 5 Best Calf Exercises (projectswole.com)
Study: High heels may alter anatomy of calves (abclocal.go.com)

Reduce Headaches with Peppermint Oil

by Pain Doc | Dec 21, 2010 | Headaches

Peppermint (Mentha piperita L.) is one of the most widely consumed single ingredient herbal teas. Medical research shows that peppermint oil can reduce spasm of smooth muscle (the type of muscle that comprises the esophagus, stomach, lungs, intestines) and can therefore provide some relief for conditions like IBS (irritable bowel syndrome), esophageal spasm, and spastic colon. In lab tests, peppermint has significant antimicrobial and antiviral activities, strong antioxidant and antitumor actions, and some antiallergenic potential.

Animal model studies demonstrate a relaxation effect on gastrointestinal (GI) tissue, analgesic (pain reducing) and anesthetic (nerve desensitizing) effects in the central and peripheral nervous system, immunomodulating actions and chemopreventive potential.

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The effects of peppermint oil and eucalyptus oil preparations on headaches and cognitive function were investigated in 32 healthy subjects in a double-blind, placebo-controlled, randomized cross-over design.* Four different test preparations were applied to large areas of the forehead and temples using a small sponge and their effect was evaluated by comparing baseline and treatment measure. The combination of peppermint oil, eucalyptus oil and ethanol increased cognitive performance and had a muscle-relaxing and mentally relaxing effect, but had little influence on pain sensitivity. A significant analgesic effect with a reduction in sensitivity to headache was produced by a combination of peppermint oil and ethanol (rubbing alcohol). The essential plant oil preparations often used in empiric medicine can thus be shown by laboratory tests to exert significant effects on mechanisms associated with the pathophysiology of headache.

The evidence suggests that peppermint can somehow relax smooth muscle. Since blood vessels are also comprised of smooth muscle, and some types of headaches are caused by spasms in the blood vessels that lead to the head, taking peppermint either as a tea or concentrated oil may provide relief.

*Göbel H, Schmidt G, Soyka D, Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters. Cephalalgia. 1994 Jun;14(3):228-34; discussion 182.

Foot Pain Can Be Caused By This

by Pain Doc | Dec 20, 2010 | Foot and Ankle Pain

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If you have pain in your feet, it could be that your feet’s intrinsic muscles are weak and are not supporting and moving your foot bones properly during gait (walking). As a result, certain bones can bear more weight pressure than others and develop pain; for example the first metatarsal-phalangeal joint (big toe joint).

Muscles can become weak when they are underused, or immobilized in some way over a long period of time. For example, if you fracture your lower leg and had to wear a cast for three months, that leg would be smaller than the non-injured leg after taking off the cast. This is because the calf muscle in the injured leg would experience some atrophy due to three months of decreased muscle activity. You would most likely feel the difference in leg strength as well, after removing the cast.

But what would cause the foot muscles to weaken? It’s a very simple action just about everyone does in the morning before going to work, and that is putting on shoes. Shoes, especially snug fitting ones like lace-up formal leather shoes with hard heels constrict the feet and don’t allow proper engagement of the foot joints when walking. Basically, shoes act like a cast or splint on your feet. Imagine wearing a shoe-equivalent on your hands, lacing them up tightly for nine hours a day. Your hands would weaken eventually, and probably experience pain.

So what’s the solution? Realize that the feet are designed to grip the ground with the toes/ forefoot, and elongate slightly at the arch to build up energy for toe-off during gait. The toes splay out when bearing weight to increase stability to the body above. Wearing shoes inhibits all these actions and can have an adverse effect on foot biomechanics.

Therefore, it is a good idea to exercise your feet by walking barefoot; preferably on a non-flat surface. Find a grassy park and try running barefoot. These activities will offer badly needed exercise (strengthening and stretching) for your feet. If you’re like most people who have been wearing shoes most of their lives, your feet will be highly sensitive to the pebbles and small objects on the ground; this is normal. Keep walking and running barefoot as much as you can, breaking them in but obviously avoiding sharp objects on the ground. This will strengthen your feet and make it more resistant to developing foot problems.

If you arent’ into going barefoot, the next best thing is to wear the Vibram Five Fingers KSO – Men’s walking “shoe.” It offers the protection of a shoe, while offering the most freedom of movement of your feet.