Migraines, Headaches, and Hormones

It has been estimated that 70% of migraine sufferers are female. Of these female migraine sufferers, 60%-70% report that their migraines are related to their menstrual cycles — hence the name, menstrual migraines.

What Is the Relationship Between Hormones and Headaches?

Headaches in women, particularly migraines, have been related to changes in the levels of the female hormone estrogen during a woman’s menstrual cycle. Estrogen levels drop immediately before the start of the menstrual flow.

Premenstrual migraines regularly occur during or after the time when the female hormones, estrogen and progesterone, decrease to their lowest levels.

Migraine attacks typically disappear during pregnancy. In one study, 64% of women who described a menstrual link to their headaches noted that their headaches disappeared during pregnancy. However, some women have reported the initial onset of migraines during the first trimester of pregnancy, with disappearance of their headaches after the third month of pregnancy.

What Triggers Hormonal Migraines in Women?

Birth control pills as well as hormone replacement therapy during menopause have been recognized as migraine triggers in some women. As early as 1966, investigators noted that migraines can become more severe in women taking birth control pills, especially those containing high doses of estrogen.

The frequency of side effects, such as headache, decreased in those who took birth control pills containing lower doses of estrogen and did not occur in those who took birth control pills containing progesterone.

What Are the Treatment Options for Menstrual Migraines?

The medications of choice to stop a menstrual migraine are nonsteroidal anti-inflammatory medications (NSAIDs).

The NSAIDs most often used for menstrual migraines include:

• Orudis
• Advil and Motrin
• Nalfon
• Naprosyn
• Relafen

NSAID treatment should be started two to three days before the menstrual period starts and continue til the period ends. Because the therapy is of short duration, the risk of gastrointestinal side effects is limited.

For people who have severe menstrual migraines or who want to continue taking their birth control pills, doctors recommend taking a NSAID, starting on the l9th day of the cycle and continuing through the second day of the next cycle.

Other medications that may be used are given by prescription only. They include:

• Small doses of ergotamine drugs (including Bellergal-S, Cafergot, Migranal)
• Beta-blocker drugs such as propranolol
• Anticonvulsants such as valproate (Depakote)
• Calcium channel blockers such as verapamil

These drugs should also be started two to three days pre-menses, and continued throughout the menstrual flow.

Because fluid retention is often associated with menses, diuretics have been used to prevent menstrual migraine. Some doctors may recommend limiting salt-intake immediately before the start of menses.

Lupron is a medication that affects hormone levels and is used only when all other treatment methods have been tried and have been unsuccessful.

What Are the Treatment Options for Menopausal Migraines?

For people who need to continue post-menopausal estrogen supplements, the lowest dose of these agents should be used, on an uninterrupted basis. Instead of seven days off the drug, you should take it on a daily basis. By maintaining a steady dose of estrogen, the headaches may be prevented. An estrogen patch (such as Estraderm) may also be effective in stabilizing the levels of estrogen.

What Are the Treatment Options for Migraines During Pregnancy?

During pregnancy, no treatment is recommended to treat migraines. Medication therapy used to treat migraines can affect the uterus and can cross the placenta and affect the baby, so these medications should be strictly avoided during pregnancy.

A mild pain reliever can be used, such as Tylenol. It is important that pregnant women suffering from headaches discuss the safety of headache medications with their obstetricians and headache specialists before taking anything.

Tags: Headaches, Hormones, Migraines

When to Call the Doctor About Your Migraines or Headaches

Any kind of pain is your body’s way of warning you about an injury or illness. Although migraines and headaches are rarely the symptoms of a serious illness, occasionally they may indicate a serious medical condition such as a tumor or aneurysm (blood vessel rupture). It is important for you to become familiar with your personal headache symptoms, and those that require immediate medical attention.

If you or a loved one has any of the following headache symptoms seek medical care immediately:

• A sudden, new severe headache
• A headache that is associated with neurological (nerve) symptoms such as weakness, dizziness, sudden loss of balance or falling, numbness or tingling, paralysis, speech difficulties, mental confusion, seizures, personality changes/inappropriate behavior, or vision changes (blurry vision, double vision or blind spots)
• Headache with a fever, shortness of breath, stiff neck, or rash
• Headache pain that awakens you at night
• Headaches with severe nausea and vomiting
• Headaches that occur after a head injury or accident
• Getting a new type of headache after age 55

The following migraine or headache symptoms do not require urgent care, but you should contact your doctor if you, or your loved one, have any of these symptoms.

• Have three or more headaches per week
• Have headaches that keep getting worse and won’t go away
• Need to take a pain reliever every day or almost every day for your headaches
• Need more than 2-3 doses of over-the-counter medications per week to relieve headache symptoms
• Have headaches that are triggered by exertion, coughing, bending, or strenuous activity
• Have a history of headaches, but have noticed a recent change in your headache symptoms

Tags: doctor, headache, medication, migraine

Migraines May Up Risk of Painful Skin

A new study shows migraine sufferers are more likely to have a type of pain condition called “allodynia” — pain from something that normally should not evoke pain, such as rubbing the head, combing hair, or wearing necklaces and earrings.

The study looked at questionnaire answers from 16,573 people who have headaches; 11,737 of them have migraines, 1,491 have probable migraines, and 3,345 have other types of headaches.

Researchers explored what types of headaches these people have and how often they get them, among other things.

When it came to allodynia, here’s what the researchers found:

• 68% of respondents who had migraines every day reported allodynia.
• 37% of those who had chronic daily headaches said they experienced allodynia.
• In people with migraines, allodynia was more common in women and people who were obese.
• Depressed people reported more extreme skin sensitivity and pain.
• Extreme skin sensitivity and pain decreased with age.

Skin Pain and Headaches

Exactly what causes brain pain and extreme skin sensitivity? Researchers speculate that the constant activation of certain neurons in the brain may eventually damage those neurons, which could play a part.

Researcher Marcelo E. Bigal MD, PhD, from Albert Einstein College of Medicine in Bronx, N.Y., says allodynia may be a “risk factor for migraine progression, where individuals have migraines on more days than not.”

This type of pain and sensitivity seems to decrease as we age. Why? According to researchers, one reason may be that “the activation of pain pathways in the brain decline as attacks become less frequent and severe.”

Study researchers say identifying risk factors for how migraines progress can lead to better treatment. 

Researchers believe that there may be a link between female hormones and skin pain associated with headaches.

The study shows that the pain areas in the brain changed as women went through their menstrual cycle, with the most pain being reported during menstruation.

The study was sponsored by the National Headache Foundation and appears in the April 22 edition of Neurology.

Tags: headache, migraine, Pain, skin

Common Pregnancy Pains and Their Causes (continued)

Pregnancy Leg Cramps

Pressure from your growing uterus can cause leg cramps or sharp pains down your legs.

Recommendations:

• Be sure to eat and drink foods and beverages rich in calcium (such as milk, broccoli or cheese).
• Wear comfortable, low-heeled shoes.
• Try wearing support hose but avoid any leg wear that is too tight.
• Elevate your legs when possible; avoid crossing your legs.
• Exercise daily.
• Stretch your legs before going to bed.
• Avoid lying on your back, since the weight of your body and the pressure of your enlarged uterus can slow the circulation in your legs, causing cramps.
• Gently stretch any muscle that becomes cramped by straightening your leg, flexing your foot, and pulling your toes toward you.
• Try massaging the cramp, or apply heat or a hot water bottle to the sore area.

Pregnancy Nasal Congestion

You may have a “stuffy nose” or feel like you have a cold. Pregnancy hormones sometimes dry out the lining in your nose, making it inflamed and swollen.

Recommendations:

• Apply a warm, wet washcloth to your cheeks, eyes, and nose to reduce congestion.
• Don’t use nose sprays; they can aggravate your symptoms.
• Drink plenty of fluids (at least 6-8 glasses of fluids a day) to thin mucus.
• Elevate your head with an extra pillow while sleeping to prevent mucus from blocking your throat.
• Use a humidifier or vaporizer to add moisture to the air.

Shortness of Breath During Pregnancy

Shortness of breath can occur due to increased upward pressure of the uterus

Recommendations:

• When walking, slow down and rest a few moments.
• Raise your arms over your head (this lifts your rib cage and allows you to breathe in more air).
• Avoid lying flat on your back, and try sleeping with your head elevated.

Pregnancy Stretch Marks

Stretch marks are a type of scar tissue that forms when the skin’s normal elasticity is not enough for the stretching required during pregnancy. They usually appear on the abdomen and can also appear on the breasts, buttocks or thighs. While they won’t disappear completely, stretch marks will fade after delivery. Stretch marks affect the surface under the skin and are usually not preventable.

Recommendations:

• Be sure that your diet contains enough sources of the nutrients needed for healthy skin (especially vitamins C and E).
• Apply lotion to your skin to keep it soft and reduce dryness.
• Exercise daily.

Swelling in the Feet and Legs During Pregnancy

Pressure from the growing uterus on the blood vessels carrying blood from the lower body causes fluid retention that results in swelling (edema) in the legs and feet.

Recommendations:

• Try not to stay on your feet for long periods of time. Avoid standing in one place.
• Drink plenty of fluids (at least 6-8 glasses of fluids a day).
• Avoid foods high in salt (sodium).
• Elevate your legs and feet while sitting. Avoid crossing your legs.
• Wear loose, comfortable clothing; tight clothing can slow circulation and increase fluid retention.
• Don’t wear tight shoes; choose supportive shoes with low, wide heels.
• Keep your diet rich in protein; too little protein can cause fluid retention.
• Notify your health care provider if your hands or face swell. This may be a warning sign of preeclampsia.
• Rest on your side during the day to help increase blood flow to your kidneys.

Vaginal Discharge During Pregnancy

Increased blood supply and hormones cause your vagina to increase normal secretions. Normal vaginal discharge is white or clear, non irritating, odorless and may look yellow when dry on your underwear or panty liners.

Recommendations:

• Choose cotton underwear or brands made from other natural fibers.
• Avoid tight-fitting jeans or pants.
• Do not douche. It is possible that you can introduce air into your circulatory system or break your bag of waters in later pregnancy.
• Clean the vaginal area often with soap and water.
• Wipe yourself from front to back.
• Contact your health care provider if you have burning, itching, irritation or swelling, bad odor, bloody discharge, or bright yellow or green discharge (these symptoms could be a sign of infection).

Pregnancy Backaches

Backaches are usually caused by the strain put on the back muscles, changing hormone levels, and changes in your posture.

Recommendations:

• Wear low-heeled (but not flat) shoes.
• Avoid lifting heavy objects.
• Squat down with your knees bent when picking things up instead of bending down at the waist.
• Don’t stand on your feet for long periods. If you need to stand for long periods, place one foot on a stool or box for support.
• Sit in a chair with good back support, or place a small pillow behind your lower back. Also place your feet on a footrest or stool.
• Check that your bed is firm. If needed, put a board between the mattress and box spring.
• Sleep on your left or right side with a pillow between your legs for support.
• Apply a hot water bottle, heating pad on low setting, take a warm bath or shower, or try massage.
• Perform exercises, as advised by your health care provider, to make your back muscles stronger and help relieve the soreness.
• Maintain good posture. Standing up straight will ease the strain on your back.
• Contact your health care provider if you have a low backache that goes around your stomach and does not go away within one hour after you change position or rest. This might be a sign of premature labor.

Abdominal Pain or Discomfort

Sharp, shooting pains on either side of your stomach may result from the stretching tissue supporting your growing uterus. These pains may also travel down your thigh and into your leg.

Recommendations:

• Change your position or activity until you are comfortable; avoid sharp turns or movements.
• If you have a sudden pain in your abdomen, bend forward to the point of pain to relieve tension and relax the tissue.
• Apply a hot water bottle, heating pad, or take a warm bath or shower.
• Try massage.
• Make sure you are getting enough fluids.
• Take Tylenol (acetaminophen), occasionally.
• Contact your health care provider if the pain is severe or constant or if you are less than 36 weeks pregnant and you have signs of labor.

Braxton-Hicks Contractions

The muscles in your uterus will contract (tighten) as early as the second trimester of pregnancy on. Irregular, infrequent contractions are called Braxton-Hicks contractions (also known as “false labor pains”). These are normal during pregnancy.

Recommendations:

• Try to relax
• Change positions. Sometimes this can alleviate the contractions.

Tags: Abdominal, Backaches, Discomfort, Pain, pregnancy

Common Pregnancy Pains and Their Causes

Your body is constantly changing now that you are pregnant, which may cause discomfort. Some pregnancy discomforts may occur in the early weeks, while others occur only as you get closer to delivery. Other pregnancy discomforts may appear early and then go away, only to come back later. This is normal and usually does not mean something is wrong.

Every woman’s pregnancy is unique, and some of the discomforts described in this article may not affect you. Discuss any concerns about pregnancy discomforts you are having with your health care provider.

Pregnancy Breast Changes

Most pregnant women will feel some changes in their breasts. Your breasts will increase in size as your milk glands enlarge and the fat tissue increases, causing breast firmness and tenderness in the first and last few months of pregnancy. Bluish veins may also appear as your blood supply increases. Your nipples will also darken and a thick fluid called colostrum may leak from your breasts. All of these breast changes are normal.

Recommendations:

• Wear a bra that provides firm support.
• Choose cotton bras or those made from other natural fibers.
• Increase your bra size as your breasts become larger. Your bra should fit well without irritating your nipples. Try maternity or nursing bras, which provide more support and can be used after pregnancy if you choose to breastfeed.
• To ease discomfort and maintain support, try wearing a bra during the night and day.
• Tuck a cotton handkerchief or gauze pad into each bra cup to absorb leaking fluid. Nursing pads, which you can buy in a pharmacy, are also available. Make sure to change these pads as needed to prevent irritation to the underlying skin.
• Clean your breasts with warm water only; do not use soap or other products since they can cause dryness.

Pregnancy Fatigue

Your growing baby requires extra energy, which may make you feel tired. Sometimes, feeling tired may be a sign of anemia (low iron in the blood), which is common during pregnancy.

Recommendations:

• Get plenty of rest; go to bed early at night and try taking naps during the day.
• Maintain a regular schedule when possible but pace your activities; balance activity with rest when needed.
• Exercise daily to increase your energy level.
• If you think anemia may be a concern, ask your health care provider to test your blood.

Pregnancy Nausea or Vomiting

An upset stomach is one of the most common discomforts during pregnancy. Nausea is a result of hormonal changes and most often occurs early in pregnancy until your body adjusts to the increased production of hormones.

Nausea can begin in early pregnancy, but is usually gone by the fourth month. It can occur at any time of the day but may be worse in the morning when your stomach is empty (this is often called “morning sickness”) or if you are not eating enough.

Recommendations:

• If nausea is a problem in the morning, eat dry foods like cereal, toast or crackers before getting out of bed. Or, try eating a high-protein snack such as lean meat or cheese before going to bed (protein takes longer to digest).
• Eat small meals or snacks every 2-3 hours rather than three large meals. Eat slowly and chew your food completely.
• Sip on fluids throughout the day. Avoid large amounts of fluids at one time. Try cool, clear fruit juices, such as apple or grape juice.
• Avoid spicy, fried, or greasy foods.
• If you are bothered by strong smells, eat foods cold or at room temperature and avoid odors that bother you.
• Talk to your doctor about taking vitamin B6 or other treatments.
• Contact your health care provider if your vomiting is constant or so severe that you can’t keep fluids or foods down. This can cause dehydration and should be treated right away.

Pregnancy Frequent Urination

During the first trimester, your growing uterus and growing baby press against your bladder, causing a frequent need to urinate. This will happen again in the third trimester when the baby’s head drops into the pelvis before birth.

Recommendations:

• Avoid tight-fitting underwear, pants, or pantyhose.
• Contact your health care provider if your urine burns or stings. This can be a sign of a urinary tract infection and should be treated right away.

Pregnancy Headaches

Headaches can be caused by tension, congestion, constipation, or in some cases, preeclampsia . They can occur anytime during pregnancy.

Recommendations:

• Apply an ice pack to your forehead or the back of your neck.
• Rest, sit, or lie quietly in a low-lit room. Close your eyes and try to release the tension in your back, neck, and shoulders.
• Try Tylenol (acetaminophen) occasionally. Ask your health care provider before taking any other medications for your headaches.
• Contact your health care provider if you have nausea with your headaches, if your headache is severe and does not go away, or if you have blurry vision, double vision, or blind spots

 

Pregnancy Bleeding and Swollen Gums

The increase in your circulation and supply of certain hormones may cause tenderness, swelling and bleeding of gums.

Recommendations:

• Take proper care of your teeth and gums. Brush and floss regularly.
• Get a dental checkup early in your pregnancy to make sure your teeth and mouth are healthy. See your dentist if you have a problem.

Pregnancy Constipation

Your hormones as well as vitamins and iron supplements may cause constipation (difficulty passing stool or incomplete or infrequent passage of hard stools). Pressure on your rectum from your uterus may also cause constipation.

Recommendations:

• Add more fiber (such as whole grain foods, fresh fruits, and vegetables) to your diet.
• Drink plenty of fluids daily (at least 6-8 glasses of water and 1-2 glasses of fruit or prune juice).
• Drink warm liquids, especially in the morning.
• Exercise daily.
• Set a regular time for bowel movements; avoid straining when having a bowel movement.
• Discuss the use of a laxative with your health care providers; they may recommend natural fiber laxatives or stool softeners.

 

Pregnancy Dizziness (Feeling Faint)

Dizziness can occur anytime middle to late pregnancy. The pregnancy hormone progesterone dilates blood vessels so blood tends to pool in the legs. In addition, more blood is going to your growing uterus. This can cause a decrease in blood pressure, especially when changing positions, resulting in dizziness.

Faintness and dizziness can also be affected by poor eating habits. When your blood sugar levels are too low, you may feel faint.

Recommendations:

• Move around often when standing for long periods of time.
• Try lying on your left side to rest.
• Try to move slowly when standing from a sitting position; avoid sudden movements.
• Eat regular meals to prevent low blood sugar.

Common Pregnancy Pains and Their Causes

Difficulty Sleeping During Pregnancy

Finding a comfortable resting position can become difficult later in pregnancy.

Recommendations:

• Don’t take sleep medication.
• Try drinking warm milk at bedtime.
• Try taking a warm shower or bath before bedtime.
• Use extra pillows for support while sleeping. Lying on your side, place a pillow under your head, abdomen, behind your back and between your knees to prevent muscle strain and help you get the rest you need. You will probably feel better lying on your left side; this improves circulation of blood throughout your body.

Pregnancy Heartburn or Indigestion

Heartburn (indigestion) is a burning feeling that starts in the stomach and seems to rise to the throat. It occurs during pregnancy because your digestive system works more slowly due to changing hormone levels. Also, your enlarged uterus can crowd your stomach, pushing stomach acids upward.

Recommendations:

• Eat several small meals each day instead of three large meals.
• Eat slowly.
• Drink warm liquids such as herbal tea.
• Avoid fried, spicy, or rich foods, or any foods that seem to give you indigestion.
• Don’t lie down directly after eating.
• Keep the head of your bed higher than the foot of your bed. Or, place pillows under your shoulders to prevent stomach acids from rising into your chest.
• Don’t mix fatty foods with sweets in one meal and try to separate liquids and solids at meals.
• Try heartburn relievers such as Tums, Maalox, Titralac, Mylanta, Riopan, or Gaviscon.

Pregnancy Hemorrhoids

Hemorrhoids are swollen veins that appear as painful lumps on the anus. They may form as a result of increased circulation and pressure on the rectum and vagina from your growing baby.

Recommendations:

• Try to avoid constipation; constipation can cause hemorrhoids and will make them more painful.
• Try to avoid sitting or standing for long periods of time; change your position frequently.
• Make an effort not to strain during a bowel movement.
• Apply ice packs or cold compresses to the area or take a warm bath a few times a day to provide relief.
• Avoid tight-fitting underwear, pants, or pantyhose.
• Discuss the use of a hemorrhoid treatment with your health care provider.

Pregnancy Varicose Veins

An increased volume of blood and the pressure of your growing uterus can slow your circulation, sometimes causing the veins in your legs to become larger or swollen.

Recommendations:

Although varicose veins are usually hereditary, here are some preventive tips:

• Avoid standing or sitting in one place for long periods. It’s important to get up and move around often.
• Avoid remaining in any position that might restrict the circulation in your legs (such as crossing your legs while sitting).
• Elevate your legs and feet while sitting.
• Exercise regularly.
• Wear support hose but avoid any leg wear that is too tight.

Tags: Hemorrhoids, hurtburn, Pain, pregnancy, sleeping

Low Back Pain - Medications

Low Back Pain - Medications

Tags: Acetaminophen, back pain, drug, medication, muscle

What Is Back Pain?

We’ve all experienced back problems from time to time — a pain in the lower back or strain of the neck. In fact, problems from back pain are the most common physical complaints among American adults and are a leading cause of lost job time — to say nothing of the time and money spent in search of relief. Back pain includes sore muscles and tendons, herniated discs, fractures, and other problems. Most often, the causes of back pain have developed over a long period of time.

The spinal column is an extraordinary mechanism. It keeps us stable enough to stand upright but flexible enough for movement. The backbone, or spine, is actually a stack of 24 individual bones called vertebrae.

A healthy spine is S-shaped when viewed from the side. It curves back at the shoulders and inward at the neck and small of the back. It’s the body’s main structural support. It also houses and protects the spinal cord, the intricate network of nerves that runs through the vertebrae to transmit feeling and control movement throughout the entire body.

What Causes It?

Back pain ranks high on the list of self-inflicted ailments. Most of our back troubles happen because of bad habits, generally developed over a long period of time. These include:

• Poor posture
• Overexertion in work and play
• Sitting incorrectly at the desk or at the steering wheel
• Pushing, pulling, and lifting things carelessly

Sometimes, the effects are immediate, but in many cases back problems develop over time. One of the more common types of back pain comes from straining the bands of muscles surrounding the spine. Although such strains can occur anywhere along the spine, they happen most often in the curve of the lower back. The next most common place is at the base of the neck.

Sometimes backache occurs for no apparent reason. This is called nonspecific backache. It may develop from weakened muscles that cannot handle everyday walking, bending, and stretching. In other cases, the discomfort seems to come from general tension, lack of proper sleep, and/or stress.

A condition called fibrositis causes chronic backache from localized muscle tension. Sometimes this original muscle tension comes from stress or other emotional problems.
Whether the muscle strain is from lifting heavy objects or from something as innocuous as a sneeze makes little difference — the pain can be agonizing.

Pregnancy commonly brings on back pain. Hormonal changes and weight gain put new kinds of stresses on a pregnant woman’s spine and legs.

Injuries from contact sports, accidents, and falls can cause problems ranging from minor muscle strains to severe damage to the spinal column or the spinal cord itself.

Tags: back pain, bending, fracures, Pain, pregnancy, weight loss

Classification of Broken Bones and Fractures

A fractured bone is a bone which has had its tissue broken. A fractured is a name of the type of the break experienced. When a bone has been broken a doctor must first look for deformities of the bone which may require palpation (feeling for broken bone ends) and auscultation (listening for crepitus). There is generally local bruising and tenderness in the effected area as well as possible skin stretch marks, band marks, localized swelling and forming hematomas. An X-ray is the best diagnostic method available to confirm a broken or fractured bone.

Butterfly Fracture
This type of fracture has slight comminution at the fracture site which looks largely like a butterfly. The fracture site has butterfly fragments.

Closed Fracture
When there is a closed fracture there is no broken skin. The bones which broke do not penetrate the skin (but may be seen under the skin) and there is no contusion from external trauma.

Comminuted Bone Fracture

Comminuted Bone Fracture
A comminuted fracture has more than two fragments of bone which have broken off. It is a highly unstable type of bone fracture with many bone fragments.

Complete Bone Fracture

This is where the bone has been completely fractured through it’s own width. This is opposite from a hairline fracture or incomplete bone fracture where there is only a “crack” and not a complete break.

Complex Fracture
This type of fractured bone severely damages the soft tissue which surrounds the bone.

 

Compound Bone Fracture

Compound Bone Fracture
When this occurs, the bone breaks and fragments of the bone will penetrate through the internal soft tissue of the body and break through the skin from the inside. There is a high rise of infection if external pathogenic factors enter into the interior of the body.

Compression Fracture
This type of bone fracture generally occurs after a fall where the vertebral column is compressed and then under the extreme pressure cracks or breaks. This type of bone fracture may also be referred to as a Impact Fracture.

Double Fracture

With this type of broken bone there is multiple fractures on the same bone or two bones which are fractured at the same time (ie - tibula and fibula). This type of trauma generally requires internal fixation of the fractured bones. It is also known as a Segmental Fracture.

Fissure Fracture
This bone fracture has minimal trauma to the bone and surrounding soft tissues. It is a incomplete fracture with no significant bone displacement and is considered a stable fracture. In this type the fracture the crack only extends into the outer layer of the bone but not completely through the entire bone. It is also known as a Hairline Fracture.

Fracture-Dislocation
This type of fracture is complicated with a dislocation of the joint proximal to the fracture site.

Fragmented Fracture
During this fracture the trauma will result in many broken bones leaving many pieces of bone within the patient.

Greenstick Fracture
The pathology of this type of fracture includes a incomplete fracture in which only one side of the bone has been broken. The bone usually is “bent” and only broken of the outside of the bend. It is mostly seen in children and is considered a stable fracture due to the fact that the whole bone has not been broken. As long as the bone is kept rigid healing is usually quick.

Hairline Fracture
This bone fracture has minimal trauma to the bone and surrounding soft tissues. It is a incomplete fracture with no significant bone displacement and is considered a stable fracture. . In this type the fracture the crack only extends into the outer layer of the bone but not completely through the entire bone. It is also known as a Fissure Fracture.

 

Incomplete Fracture
This occurs when the bone breaks but the ends do not completely separate leaving the bone with a “crack” which does not extend the complete width of the bone. This is opposite from a complete bone fracture where the broken bone ends are completely severed from each other.

Impact Fracture
This type of bone fracture generally occurs after a fall where the vertebral column is compressed and then under the extreme pressure cracks or breaks. This type of bone fracture may also be referred to as a Compression Fracture.

Impacted Fracture
Type of fracture where the ends of the broken bones are wedged together.

Multiple Fractures
In this type of fractured bone there are several fracture lines on one bone. It can also mean several fractures in one patient but on separate bones but generally due to the same injury. Generally due to traumatic injuries, this will be evident in a patient who has a fractured pelvis and clavicle due to a fall or hit by a car.

Oblique Fractures
These types of fractures are one of rarest forms. They are a oblique break in the bone which is very unstable (break at an angle). They can be easily diagnosed as spiral fractures.

Open Bone Fracture
This type of fracture classified as when a broken bone protrudes to the exterior of the body giving rise to soft tissue injuries of the muscles, tendons and ligaments. There is a high risk of injection to the internal tissues.

Segmental Fracture
With this type of broken bone there is multiple fractures on the same bone or two bones which are fractured at the same time (ie - tibula and fibula). A bone break in which several large pieces of bone have broken away from the broken bone. This type of fracture easily becomes an open fracture. It is also known as a Double Fracture.

Simple Fracture
A simple bone fracture is one of the better types of fractures as there is only bone damage with little or no soft tissue damage and the broken bone ends do not penetrate the skin.

Spiral Fractures
In this pattern a bone has been broken due to a twisting type motion. It is highly unstable and may be diagnosed as a oblique fracture unless a proper x-ray has been taken. The spiral fracture will look like a corkscrew type which runs parallel with the axis of the broken bone

Stable Fracture
A stable fracture is a broken bone which is generally transverse, oblique, greenstick or a hairline fracture which is somewhat secure.

Transverse Bone Fracture
In this type of fracture the bone has been broken giving rise to a transverse break or fissure within the bone at a right angle to the long portion of the bone.. It is most often caused by direct traumatic injuries.

Unstable Fracture
An unstable fracture is generally a broken bone which is comminuted, oblique or a spiral fracture requiring external or internal fixation.

Genital Area Pain or Genital Discomfort, Pelvic Pain and Groin Pain

Male Genital Pain and Discomfort - Female Genital Pain and Discomfort

Male Genital Pain and Discomfort

The male genital area is primarily made up of the penis, scrotum, testes, epididymis, vas deferens, seminal vesicles and the prostate gland. 

 

Epididymal pain

This type of pain is also well localized and upon examination will reveal tenderness with a focal bead-like thickening on the epididymis. 

 

Penis Pain

Penis discomfort and pain may show up with many different signs and symptoms.  Pain may be more sharp or burning in acute infections which MAY be related to STD’s and should be diagnosed by a professional.  Other more mild pain may be from possible scar tissue from prior traumatic injuries. 

 

Prostate Pain

Prostatic pain is predominantly perineal and possibly associated with other static symptoms.  A loaded rectum or a digital rectal examination can increase the prostate pain or disAcupuncture and Pain Langley

comfort.  If a prostate problem is expected a rectal examination if recommended.  Possible disorders of the prostate are infections, swelling and cancer.  Prostate pain is most often associated with urination and show similarities with urinary obstruction.  In acute prostatitis (swollen prostate) patients generally will have an unwell feeling with a possible fever.    In chronic prostate pain, patients may be mostly asymptomatic except for their perineal and lower back pain. 

 

Scrotum and Testicular Pain

Possibly due to hydrocoele – fluid surrounding  the testis making the testicles unable to be palpated.

If there is marked scrotal swelling it may be due to a indirect hernia.

 

Testicular Pain

With this type of pain, the area of pain should be easily identifiable although the pain may radiate upwards into the lower abdomen it should be rooted in the testicles.  Testicular pain may be caused by an acute traumatic injury but should improve quickly.  If there is a torsion pain the pain will persist for a long period of time. 

 

 

 

Female Genital Pain and Discomfort

Generally there is no pelvic or groin pain in females. Possibilities of pain are from the multiple organs found in the female perineal and lower abdominal area.  Examples of such organs are the ovaries, uterus, vagina, labia, bladder, urethra and many more.  The uterus is supported by various ligaments which may become weekend and allow the uterus to prolapse causing a sinking type of pain.  Many other organs may give similar pain in the same area such as the bladder which will press on the vaginal wall if prolapsed.   The labia becomes dry and more rigid in post menopause which can cause discomfort and pain.  This is only a general reference for these types of pain and a proper diagnosis is recommended by a professional in this field.

 

Acute Pelvic Inflammatory Disease

Pain in the lower abdominal area which may be caused by gonorrhea, chlamydia, gardnerella vaginalis infection.  It is an inflammatory disease related with pain and a variety of other signs and symptoms. 

 

Cervicitis

Pain similar to that or a urinary tract infection or mucopurulent vaginal discharge.  It is caused by sudden or chronic inflammation of the narrow lower end of the uterus.  In acute cases there may be pain accompanied with bleeding, redness and swelling of the cervix.  Other symptoms may be a foul smelling odour with leucorrhea and a burning or itching sensation around the vaginal area.  In chronic cases of cervicitis there are similar symptoms of the acute cervicits but are more commonly found among women in their reproductive years.  If chronic, cysts are more likely to form with a congested and swollen cervix. 

 

Dysmenorrhea – Menstrual pain

Dysmenorrhea is pain which associates with the menstrual period generally causing worse pain at the beginning of menstruation.  The pain may be continuous or spasmodic (colicky) in nature.  Menstrual pain can be felt in the lower back and pelvis areas.  Dysmenorrhea may be related to endometriosis if it is felt for several days prior to menstruation.

 

Dyspareunia – Painful Sex

Pain during sex maybe caused by several reasons and may have many types of different pain (sharp, dull, burning, …)  The possible causes of shallow vaginal pain are: a rigid hymen, proposed ovaries into perivaginal area, narrowed vagina due to scaring (operations), poor coital technique and genital tract infection.  If the pain is found more deeply (deep dyspareunia) the cause may be cervicitis, endometriosis, salpingitis or in rare cases malignancies.  Dysparenuia may also have a psychological  background or cause. 

 

Endometriosis Pain

Pain associated with menstruation (dysmenorrhea) due to a growth of endometrial tissue outside the uterus with ectopic uterine tissue which secretes blood.  With endometriosis the pain may also be felt during sexual intercourse (dyspareunia) or with bowel movements. 

 

Ovarian Pain

Generally, ovarian pain will be unilateral and diagnosis depends greatly on when the pain occurs.  If ovarian pain occurs in the middle of a woman’s cycle (mittelschmerz) it is diagnosed as ovulation pain.  This is usually due to torsion of an ovarian cyst producing a unilateral lower abdominal pain.  If the pain is severe there will be cell death (infarction) at the site of the torsion.  If there is a haemorrhage into an ovary or ovarian cyst the pain will be similar but be less severe.  A ruptured ovary or part of an ovary (from a small cyst or corus luteum) will produce unilateral ovarian pain signs of peritoneal irritation which may be similar to that of appendicitis. 

 

Salpingitis

Inflammation of one or both fallopian tubes which will give rise to unilateral or bilateral lower abdominal pain.  There may be swellings palpable in the lower regions where the fallopian tubes are found and may cause pain.  A vaginal examination may cause pain on movement of the cervix.  Salpingitis is a type of Pelvic Inflammatory Disease.

 

Uterine Pain

Uterine Pain is an anterior lower abdominal pain which is not lateralized like ovarian pain.  Uterine pain may also be felt in the lower back area. 

Tags: Epididymal, Groin, Pelvic, Penis, Prostate, Scrotum

Breathing Pain and Breathing Discomfort

Tags: Cavitation, Crackles, Haemoptysis, Pleural, Pneumothorax, Pulmonary, Wheezing