If you are suffering from pain, insufficient sleep can delay your recovery and even make your pain worse.
Eight-nine hours of sleep is considered ideal for most adults. Anything less than this, especially if your body is already compromised with obesity, diabetes, heart disease, high blood pressure, arthritis, or other systemic disease will make matters worse.
Insufficient sleep raises cortisol levels. Cortisol is the hormone secreted by your adrenal glands (above kidneys) and is involved in a number of physiological functions including stress response, mood, and metabolism. When cortisol levels remain abnormally high, it drives blood glucose levels up and suppresses insulin sensitivity of cells prolonging the high glucose levels. This is how sleep deprivation promotes obesity.
Insufficient sleep also abnormally lowers the satiety hormone leptin and raises the hunger hormone ghrelin. This combination leads to overeating. In one study involving rats, sleep deprivation delayed healing of burn injuries in the sleep-deprived rats.
But perhaps the most dangerous thing sleep deprivation can cause is increased systemic inflammation. Inflammation is your body’s way of quarantining an injury site and healing injured tissue. But if it is ongoing and present throughout the body in small amounts, it can damage blood vessels, nerves and other tissues.
On June 22, 2002, researchers at the annual meeting of the Endocrine Society held in San Francisco reported that sleep deprivation markedly increases inflammatory cytokines. This finding helps explain why pain flare-up occurs in response to lack of sleep in a variety of disorders. According to the researchers, even modest sleep restriction adversely affects hormone and cytokine levels. In a carefully controlled study, sleep deprivation caused a 40% to 60% average increase in the inflammatory marker IL-6 in men and women, while men alone showed a 20% to 30% increase in TNF-a. Both IL-6 and TNF are potent pro-inflammatory cytokines that induce systemic inflammation (Vgontzas et al. 1999; Vgontzas et al. 2001).
Interleukin-6, Tumor necrosing factor alpha, and C-reactive protein– these are the inflammatory markers that can be measured by a blood test. Get yours checked if you haven’t done so. Studies show that high levels are associated with heart disease, diabetes, stroke and early death. TNF-a especially attacks cartilage and bone and is found in high quantities in persons suffering from arthritis.
Life Extension provides the following nutritional interventions that one can use to counteract systemic inflammation:
The docosahexaenoic acid (DHA) fraction of fish oil may be the most effective nonprescription nutrient to suppress pro-inflammatory cytokines (it’s best to get concentrated EPA-DHA fish oil for this purpose).
Gamma-linolenic acid (GLA) is a precursor of PGE1, a potent anti-inflammatory agent.
DHEA is a hormone that decreases with age. DHEA has been shown to suppress IL-6, an inflammatory cytokine that often increases as people age. Typical doses of DHEA are 25-50 mg daily, although some people take 100 mg daily.
Nettle leaf has been shown to suppress the pro-inflammatory cytokine TNF-a. Take 1000 mg daily.
Vitamin E and N-acetyl-cysteine (NAC) are protective antioxidants with anti-inflammatory properties. Vitamin E that contains gamma-tocopherol and tocotrienols provides the most broad-spectrum protection. NAC is an amino acid with antiviral and liver protectant properties. Six hundred milligrams daily is recommended.
Vitamin K helps reduce levels of IL-6, a pro-inflammatory messenger. Vitamin K also helps in the treatment of osteoporosis by regulating calcium and promoting bone calcification. If you are taking Coumadin or other anticoagulant medicine, consult your physician before taking vitamin K.
Consuming at least 1000 mg per day of carnosine and/or 300 mg of the European drug aminoguanidine can inhibit pathological glycation reactions in the body.
Also, avoid eating foods that are cooked at high temperatures, as they tend to form advanced glycated end-products, or AGE. These are basically denatured proteins that can accumulate in your tissues and promote inflammation. Food that this pertains to are deep fried foods, junk foods/ chips cooked at high temperature, and charred foods from barbecuing.
Back to the point– make sure you get at least eight hours of sleep daily, especially if you suffer from back pain, neck pain, herniated discs, and post-surgical pain. Insufficient sleep can interfere with healing by raising inflammatory cytokines in your bloodstream, which may also increase pain levels.
If you have difficulty sleeping, here are some suggestions:
Avoid watching and reading emotional content (news on TV, newspaper, internet, emails). Better yet, unplug everything electronic 2-3 hours before bedtime.
Take a walk in nature frequently where there is no noise pollution
If you’re hungry around bed time, avoid eating anything with carbs or sugar; stick with protein (whey smoothie, plain Greek yogurt, boiled egg).
Read a book or listen to relaxing music.
Practice deep breathing and meditating
Do high intensity interval training 3-4 hours before bed time
Practice present-time consciousness (turn off stray thoughts, focus on the present moment)
If you have trouble sleeping, keep your eyes open and let yourself get drowsy
Make sure your room is completely dark, with no ambient light entering; make sure you have fresh air ventilating through
Move all electrical devices (alarm clock, cell phone, etc.) far away from your head
If you always have to get up to go to the bathroom, avoid drinking water 2 hours before bed (drink an adequate amount before then to get hydrated).
If you are considering getting a cortisone shot for pain or allergies, I highly recommend that you do your due diligence in researching the safety of cortisone injections before you do it.
What exactly is cortisone? It is a type of corticosteroid. Corticosteroids are a class of chemicals naturally produced in the adrenal cortex (adrenal glands above the kidneys) that are used to regulate multiple body functions. The cortisone in cortisone shots are analogues (molecularly identical) of these hormones that are synthesized in laboratories.
According to Medicinenet,
Corticosteroids can be taken by mouth, inhaled, applied to the skin, given intravenously (into a vein), or injected into the tissues of the body. Examples of corticosteroids include prednisone and prednisolone (given by mouth), methylprednisolone sodium succinate injection (Solu-Medrol) (given intravenously), as well as triamcinolone, Kenalog, Celestone, methylprednisolone (Depo-Medrol), and others (given by injection into body tissues).
Corticosteroids affect a number of physiological responses including inflammation modulation, immune response, carbohydrate metabolism, protein catabolism (breakdown), stress response, immune response, and behavior/mood.
Cortisone shots for pain reduction have powerful anti-inflammatory capabilities, which is why they are a popular with orthopedic doctors in the treatment of injuries and joint pain. Cortisone shots, when they work, act almost instantaneously. They reduce pain by reducing the inflammatory response around the localized injection. Cortisone shots also usually include an anesthetic drug such as lidocaine.
Side effects can include redness and temporary increase in pain, and dermatological effects like skin discoloration (especially in dark-pigmented patients).
Severe side effects from prolonged steroid use or large doses can include hyperglycemia, insulin resistance, diabetes mellitus, osteoporosis, cataract, anxiety depression, colitis, hypertension, seizures, fainting, peptic ulcers, erectile dysfunction, hypogonadism, hypothyroidism, increased menses, and retinal damage.
Kenalog (Triamcinolone) is a type of corticosteroid that is used to treat inflammation; particularly inflammatory skin diseases like lupus; allergies, rhinitis, and bronchospasm. It is known to cause plenty of undesirable side effects especially dimpling/pitting at the injection site. Women especially are known to get terrible side effects from Kenalog injections, notably prolonged/ painful menstrual cycles.
Previously I related a personal experience where, due to the urgency of the situation, I decided to get a cortisone shot for severe neck pain and spasm (which I found out later was hyperkalemic muscle paralysis and did not involve inflammation). I had three Kenalog injections along my left upper trapezius muscle, about a 5 mL dose. Normally I avoid taking medications and injections for pain as much as possible, but I was scheduled to drive a 400 mile trip the next day and needed immediate relief.
Well, it turned out to be a very bad experience. The shot atrophied the muscle, and now I am unable to raise it above shoulder level from the side. The doctors I consulted with were uncertain of the long term prognosis. I was advised to get physical therapy (which I have been doing myself) to encourage the muscle to regain its functionality. However, it doesn’t appear to be changing. An ominous fact I learned during my research of corticosteroids is that protein catabolism (breakdown of protein into its amino acids components) is one of the functions of natural corticosteroids. Could it be that the Kenalog shot “dissolved” some muscle tissue? I certainly hope that is not the case. If it were, it is not possible to rebuild that muscle tissue through weight lifting, as muscle hypertrophy from weight lifting works for existing muscle tissue only.
The experience was so bothersome that I decided to make a case study out of it for readers of this blog, and hopefully save someone from going through this awful experience. Before you get a Kenalog injection, make sure you know what you are getting into. My advice, skip it— the problems it causes appear to outweigh the benefits (see this internet message board on muscle atrophy from Kenalog injection). Instead, try less invasive procedures appropriate for your condition such as massage, chiropractic, acupuncture/cupping, botanicals/herbs, laser treatment, ultrasound, traditional Chinese medicine, gluten-free diet, ketogenic diet, fasting, juicing, and detox/cleanses.
Opioids are strong drugs that are typically prescribed for cases of acute pain such as that from major trauma or post-surgery, and also for patients experiencing severe, chronic, debilitating pain; primarily from terminal cancer and rheumatoid arthritis. Opioids chemically bind to receptors in the central and peripheral nervous system and produce an analgesic effect via decreased pain perception, decreased reaction to pain, and increased pain tolerance.
Morphine and codeine are opioid drugs derived from natural opiates of the opium poppy plant; hydromorphone, hydrocodone, oxycodone, oxymorphone, ethylmorphine and buprenorphine are semi-synthetic and created from either natural opiates or from morphine esters; fentanyl, pethidine, levorphanol, methadone, tramadol and dextropropoxyphene are fully synthetic opioids.
Doctors usually prescribe opioids with caution because of their side effects and propensity of addiction. Known side effects include nausea and vomiting, drowsiness, itching, dry mouth, miosis, and constipation. More potent doses can result in respiratory depression, confusion, hallucinations, itching, hypothermia, bradycardia/tachycardia (abnormally slow/fast heart rate), orthostatic hypotension, dizziness, headaches, urinary retention, ureteric or biliary spasm, muscle rigidity, myoclonus (involuntary muscle twitches) and flushing of the skin. If the dose is not closely monitored and adjusted appropriately to the patient, side effects can often lead to serious consequences. There is a troubling trend where
opioid drugs are increasingly being prescribed for less serious forms of pain such as back pain. Not surprisingly, the number of documented cases of adverse drug reactions has risen accordingly.
When patients are not properly informed about how to take opioid painkillers or are prescribed too high a dose of these drugs, or too long a course of treatment, serious and potentially fatal side effects may result, including respiratory depression (reduced respiration or breathing). If left untreated, patients who develop respiratory depression as a result of a painkiller overdose may die from a lack of oxygen due to shallow breathing caused by the medication.
Thousands of patients die each year as a result of a prescription painkiller overdose.
The CDC reports that prescription painkiller overdoses were responsible for more than 15,500 deaths in 2009. While all prescription painkillers have contributed to an increase in overdose deaths over the last decade, methadone has played a central role in the epidemic. More than 30% of prescription painkiller deaths involve methadone, even though only 2% of painkiller prescriptions are for this drug. Six times as many people died of methadone overdoses in 2009 than a decade before.
When these deaths are the result of patients who were given excessive doses of pain medications, improperly warned about the side effects of the drug, or prescribed more potent drugs than were necessary, the doctors or hospital that prescribed these medications may be at fault. The law firm of Heygood, Orr & Pearson is one of many in the country that offer legal assistance to those injured or damaged by taking prescription drugs. The firm recently launched a website, Painkiller Overdose Lawyers . The site will serve as a resource with the latest news and legal information for patients who believe they were injured after using a prescription opioid painkiller.
No, it’s not quit smoking, exercising more, or eating a healthy diet I’m talking about; although these things can add years to your life.
You know what it is? Answer: stop sitting too much!
We are living in a society that encourages sitting, thanks to computers. Many jobs require it. Using the computer at home to surf the web, check bank accounts, shop, etc. require it. School requires it. Going to restaurants and coffee shops require sitting. Evidence is showing that prolonged sitting promotes disease, malady and death in epidemic proportions.
The latest study examining the relationship to prolonged sitting and morbidity tracked over 50,000 men and 69,000 women over the course of 13 years. Study participants indicated if they sat less than 3 hours per day total or over six hours per day, total. The results showed that women who sat the most were 37% likely to die, and for men who sat the most, they were 18% more likely to die than the rest of the study participants. The association remained virtually unchanged after adjusting for physical activity level; meaning, a woman who sat for more than six hours a day who exercised regularly still had the same chance of dying than a woman who sat for more than six hours per day and did not exercise regularly.
Numerous other studies done in the past show that prolonged time spent sitting, independent of physical activity, affects metabolism and may influence things like triglycerides, high density lipoprotein (HDL cholesterol, the good cholesterol) fasting plasma glucose, resting blood pressure, and leptin, which are biomarkers of obesity and cardiovascular and other chronic diseases.
It is clear by now that prolonged sitting, which can be defined as over four hours per day, is a threat to your health. There needs to be more public health announcements on this. Imagine the billions of dollars in health care costs that we as a country can realize if everyone knew not to sit too long, as well as all the lives that can be saved.
If you are in a job that requires prolonged sitting, I suggest that you print out the study (link below) and show it to your supervisor. Tell him or her that you take this seriously, and you must be allowed to stand up and walk at least once an hour, for 15 minutes. Or, stand up and walk every 15 minutes of sitting, for about five minutes.
Functional exercises, in my opinion, are the “best” kind of exercises in that you get the most “overall benefit” per unit time doing them. This is especially true for those who don’t have that much time to dedicate to exercise.
Basically, functional exercises are those that engage the whole body rather than one section at a time. They improve strength, coordination, and muscle stamina; and have cardiovascular benefits as well. For example, arm curls, bench pressing, and leg pressing are not considered functional exercises because they target just one area. An example of a functional exercise would be carrying a 30# sandbag on your shoulder and walking up a hill.
Most people group exercise as either cardio or strength. But coordination is often forgotten. You see, muscle groups need to have good coordination between them in order for your body to function at its peak and be the most resistant to injury. Muscle coordination is a neurological function as much as it is a muscular contraction function. The proper “firing sequence” of neurons to each muscle fiber must be fine tuned in order to have optimum muscle performance, and this is done by repetitious, combined movements of multiple groups. Functional exercises do just that. Do them often, and you will notice that common movements will be easier to do, such as walking up a long flight of stairs, or lifting something heavy and placing it on a higher level.
Delayed Onset Muscle Soreness, or DOMS is a condition where your muscles feel pain a day or two after hard or unfamiliar exercise. DOMS is thought to more likely be worse with exercises that emphasize eccentric muscle contraction, where the muscle lengthens as it contracts. Examples of eccentric contraction include negative weight lifting (like lowering a curling bar slowly, squatting, and lunges). It is believed to be the result of microscopic tears of muscle and fascia fibers and consequential inflammation. Pain from micro injury is generated by inflammatory biochemicals interacting with nociceptors (nerves that transmit pain signals). In DOMS, the injuries are so small that it takes 12-24 hours before the inflammatory response is enough to generate pain and stiffness.
The muscle pain from DOMS is different in nature than a typical muscle sprain/strain injury. It generally is more widespread, depending on the muscle groups that were worked out the most. Contracting the affected muscles will increase symptoms. For affected muscles that cross a joint such as the knee and shoulder, stiffness reduces joint range of motion.
DOMS, while it can be quite uncomfortable, usually self-resolves in about 7-10 days, with rest and a break from physical exertion. But for some people, that is too long.
So, what can one do to prevent and treat delayed onset muscle syndrome?
(1) Take it easy, tiger. If you do not exercise frequently and decide one day to make up for all the months you slacked off by going “all out” you are setting yourself up for pain, stiffness, and movement limitations. If you haven’t been exercising for months, your muscles won’t be acclimated to taking loads and repetitions and will likely incur microtears in the fascia, tendons, and muscle fibers. So, use the 10% rule, which basically is a scaling up of exercise over a week or two depending on how often you go, to re-acclimate your muscles to your normal, maxed workout. Let’s say you usually curl 40 pound dumbbells. Start day one with 5 pounds, day two with 10 pounds, day three with 15 pounds, until you get up to your max.
(2) Seek out a professional. A personal trainer can show you the right exercises to do for your goals, and the proper technique to get the most out of it, without injuring yourself.
(3) Warm up. Do about 15 minutes of cardio before you do strength or functional training like Boot Camp and similar, full body exercises. Jumping jacks, jump rope, treadmill with incline are good choices.
(4) Do some light stretching. Although recent studies showed that stretching before exercising did not significantly reduce injuries, stretching feels good and can put you in tune with your body.
(5) Hydrate 30 minutes before your workout, competition, or task that will involve heavy lifting (like helping a friend move out of his house). Most sports drinks are formulated to provide the major electrolytes (sodium, potassium, calcium) that muscle use to contract.
(6) Know your limitations. As you age, you lose muscle mass; and therefore strength. Adapt your workout routine accordingly: lighter weights, exercises that are easier on the joints; more rests in between sets.
Now, if you still get DOMS, congratulations, you weren’t cheating; way to go for it! But seriously… here are things you can do to minimize it:
(1) Get a Swedish style or lymphatic drainage massage (NOT a deep tissue or acupressure massage) from an experienced, skilled massage therapist. The long, light pressure strokes towards the heart will increase lymph circulation and help your body clear out the inflammatory products. If you can find a place in your town that does endermologie (cellulite treatment), that is even better. Endermologie is a type of negative pressure massage done with a special machine that can increase skin circulation by over 300%, for up to six hours.
(2) Rest, ice, compress, elevate (RICE). If your whole body is affected, try a cold water bath for 20 minutes. Epsom salts added to the water, and eucalyptus can be helpful.
(3) Do some light exercise– walking, stretching, yoga.
(4) Take fish oil supplements. This may reduce the inflammation somewhat.
(5) Get some protein in you: whey protein drinks, eggs, fish. This gives the body the amino acids it needs to rebuild torn muscle.
(6) Rest. Try to get at least an hour more sleep per day while you are recovering.
And of course, no smoking or over indulging in alcohol during DOMs. When you are ready to start up exercising again, work up to max gradually over a week.
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If you are suffering from pain, insufficient sleep can delay your recovery and even make your pain worse.
If you are considering getting a cortisone shot for pain or allergies, I highly recommend that you do your due diligence in researching the safety of cortisone injections before you do it.
