Did you know that approximately 70 million Americans may have arthritis in one form or another, and that you may be one of them? Think there’s nothing you can do about it? Well, here’s some great news! You can act right now to lessen the incidence of arthritis or to reduce the pain and discomfort that typically accompanies the disease. Here are ten simple steps that can improve your health, emotional outlook, and pain level, and generally make it easier to cope with arthritis.

1. Pay attention to symptoms and see your doctor. If you have pain, stiffness or swelling in or around a joint for more than two weeks, it’s time to see your doctor. Only a doctor can tell if it’s arthritis. Write down observations and symptoms as they occur. Put them in your purse or wallet before your next doctor’s visit. That way, you’ll have them with you when you see the doctor.

2. Get an accurate diagnosis. “You have arthritis” is not a diagnosis. Ask for a specific diagnosis of the type of arthritis you have. There are more than 100 types, and each one requires different treatments. Getting the right treatment requires getting the right diagnosis.

3. Start early. The earlier, the better. Early diagnosis and treatment can often mean less joint damage and less pain.

4. Avoid Excess Stress on Joints. Exercise to reduce pain and fatigue and to increase range of motion. It relieves stress and can help enable you to maintain your daily activities. Use simple stretching techniques to keep joints and muscles flexible. Exercising in the water can build strength and increase range of motion while the water’s buoyancy reduces wear and tear on sore joints. Use assistive devices to make tasks easier.

5. Watch your weight. Try to maintain the recommended weight for your age and body type. Every extra pound means added stress to your knees and hips. Excess weight can mean more pain, contribute to and aggravate osteoarthritis, and increase your risk of gout. Follow a healthy diet regimen. Research has shown the importance of antioxidants in reducing the risk of osteoarthritis and its progression.

6. Take your medication just as your doctor prescribes. If you’re tempted to stop because you feel it’s not working or you believe it’s causing side effects, call your doctor first. It can take weeks, or even months, for the full benefits of a medication to become apparent, and some side effects ease over time. Stopping a medication abruptly may not only cause you to miss out on its benefits, it can be downright dangerous. Be sure to tell your doctor about all the medications you’re taking, both prescription and over the counter.

7. Protect yourself when you go out into the sun. Some forms of arthritis, as well as certain medications, can leave you more vulnerable to the sun’s harmful rays. At a minimum, use sunglasses, sunscreen, and a hat for protection.

8. Talk to Someone About Arthritis. Each week, commit to learning something new about arthritis and sharing it with others. Understanding your disease is an important step in managing it. Talk with family, friends, and co-workers. A support group is important and the more they understand about how arthritis affects your life, the more they’ll be able to help you get through the hard times.

9. Relax. Pain can cause both physical and emotional stress. Pain and stress have similar effects on the body, e.g. increased heart rate and blood pressure; fast, shallow breathing; and muscle cramps. Relaxation can help you reverse these effects, give you a sense of well being, and make it easier to manage your pain.

10. Consider taking a nutritional supplement. If your current medication isn’t working as well as you’d like, or if it’s causing unacceptable side effects, ask your doctor about other treatment options. There are several all-natural functional health beverages available that have desirable anti-inflammatory properties. Check them out online.

Of course, there are many other ways to lessen the pain and discomfort of arthritis, but these ten are an excellent place to start. Most importantly, while arthritis may limit some of the things you can do, it doesn’t have to control your life. Build your life around wellness, and think of pain as a signal to take positive action to help you manage your condition. Think positively, eat well, and exercise regularly.

Lastly, resolve to enjoy our beautiful world. As the old saying goes, “Live like there’s no tomorrow; love like you’ve never been hurt; dance like no-one is watching.”

Bruce Bailey, Ph.D.

Celadrin &ndash or cetyl myristoleate - is one of a number of supplements taken by arthritis sufferers, but it really came into its own recently when the government withdrew popular painkillers like Vioxx from the market due to health concerns. This left many arthritis suffers with no option but to consider an operation to relieve their pain. An operation &ndash or a supplement like Celadrin? Many decided to try the less invasive option first.

Traditionally, doctors have not been keen to offer supplements to their patients, but many are increasingly coming to see that products like Celadrin may be a suitable alternative for those people who for some reason cannot - or choose not to - have an operation.

A scientist who was trying to understand why he couldn’t induce arthritis into mice discovered Celadrin about a decade ago. It contains a blend of eight stable fatty acids that can easily penetrate cell membranes and by providing lubrication to the cell membranes and decreasing inflammation it supports joint health. In fact, research has shown that it definitely improves not only the range of motion in a joint affected by arthritis, but balance, strength and endurance were also improved.

Placebo-controlled studies in 2002 showed that the subjects were able to perform several day-to-day functions like climbing stairs and even simply walking that had been painfully difficult before. Some subjects were even able to return to jogging, an exercise that had been impossible for some time due to the pain and stiffness experienced from arthritis.

Knowledge can give you a real advantage. To make sure you’re fully informed about Celadrin, keep reading.

University bio-chemist Dr. Daniel Gallaher PhD, prescribes Celadrin for many of his patients and has had no side-effects reported. The pills may need to be taken for at least two months before improvement is noticed, though in some cases this time is considerably shorter. Some patients have noted a dramatic improvement within a few days of applying the lotion.

Daniel Hoeffal MD, advises his patients to take the product scientifically. That is, no more than one supplement at a time and stick to the instructions on the bottle. If several supplements are taken at once, there is no way of determining which was the one responsible for giving relief.

Celadrin comes in pill form and topical lotion and is quite affordable compared to some other supplements, with the pills costing about $12.00 a bottle and the lotion half that. It is available as a stand-alone product, or combined with other products such as Glucosamine

Always consult your health care professional before taking supplements, as some can interfere with the absorption of other medications, while others may change how internal organs function, cause blood pressure or clotting

Now might be a good time to write down the main points covered above. The act of putting it down on paper will help you remember what’s important about Celadrin.

Irritable bowel syndrome is a debilitating and distressing condition, which affects 10-20% of the population. IBS is characterized by abdominal pain and altered bowel function such as constipation, diarrhea or alternating diarrhea and constipation. Some people have occasional symptoms, which can be aggravated by stress or food intolerances. Others experience crippling symptoms, and struggle to maintain their quality of life in the absence of any targeted, effective pharmaceutical treatments.

This disorder affects people of all ages and backgrounds, including children, although women are predominantly affected. Severe IBS can dramatically restrict mobility, through loss of control of bowel function and severe abdominal pain. These symptoms contribute to IBS being second only to the common cold as the most frequent cause of absenteeism from work and school.

Despite the significant impact on individuals and the population at large, there is no clear established cause for IBS. Whilst medical investigations are important to eliminate the possibility of an over-lapping pathology such as parasites, candida, inflammatory bowel disease, cealiacs or Crohn’s disease, there is no specific investigation which patients can test positive for in order to confirm a diagnosis of Irritable Bowel Syndrome. A diagnosis of IBS is more often a diagnosis of exclusion ? if its not another gastrointestinal condition, and it fits the symptom picture of IBS, then it is IBS.

The current accepted criteria for diagnosing IBS is the Rome criteria (adopted in medical texts and by the American Gastroenterological Association). Their definition of IBS consists of:

At least 12 weeks, which need not be consecutive, in the preceding 12 months of abdominal discomfort or pain that has two of three features:

• Relieved with defecation and/or
• Onset associated with a change in frequency of stool and/or
• Onset associated with a change in form (appearance) of stool.

The following symptoms support the diagnosis of IBS:

• Abnormal bowel movement frequency (more than three per day or less than three per week),
• Abnormal stool form (lumpy/hard or loose/water),
• Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation),
• Mucous passed with stools,
• Abdominal bloating or distension.

There are few effective treatments for IBS. Pharmaceutical medications include anti-diarrheal agents and laxatives, some of which can be harmful if used repeatedly. Significant improvements can be made through dietary changes which can therefore reducing some trigger factors for IBS. It is also important to practice some stress reduction techniques such as breathing techniques, and positive psychology, as there is a direct link between stress and an aggravation of IBS symptoms.

The most promising, long-lasting and side-effect free results in the treatment of IBS were based on a large clinical trial conducted at an Australian university, and published in the Journal of the American Medical Association in 1998.

These results demonstrated a 64-76% improvement rate on all measures of IBS such as abdominal pain, distention and bowel habits. These results were achieved in a double-blind, placebo controlled clinical trial conducted by gastroenterologists and doctors. The remarkable positive results were achieved in the treatment group that received Chinese herbal treatments. This same formula can be purchased as pre-made capsules from select retailers, and it offers great hope for those struggling with IBS.

Dr. Maia Dodds is the author of ‘The Irritable Bowel Syndrome Improvement Program’

The news has been full of the recent FDA findings on a new set of drugs to help relieve pain. These drugs have been approved for re-release, but it is unclear whether Vioxx will be available again and whether physicians will feel comfortable prescribing Celebrex and Bextra for many of their patients.

What happened to Celebrex and Vioxx?

Celebrex, Vioxx, and Bextra are all non-steroidal anti-inflammatory drugs (NSAIDs, pronounced en-said-z), similar to drugs like ibuprofen and naproxen, that are available over the counter (OTC). Celebrex, Vioxx and Bextra, (sometimes called Cox-2 inhibitors) however, use a slightly different method to achieve the same effect as their OTC cousins; this new method was supposed to limit the side effects some people experience on OTC drugs, including stomach and intestinal problems and allergic reactions. It was thought that because these drugs were less likely to cause such problems, they might be safer for patients with painful chronic conditions (like arthritis) to use for long periods of time.

Unfortunately, some studies of Cox-2 inhibitors suggest that while they don’t cause the sorts of side effects of other NSAIDs, they may create a greater risk of myocardial infarction (heart attack) or stroke. For people already at risk for these diseases (including those who have already experienced a stroke or heart problem), taking these drugs over the long run may significantly increase the risk of heart problems.

Now What Can I Do To Get Pain Relief?

Until a final decision has been made on each of these drugs, what can your healthcare provider do to help you with pain management? Here are important pieces of information to think about in determining what next steps to take:

* The Cox-2 inhibitors were not shown to be more effective than other NSAIDs, like naproxen. If you’ve been on or thinking about trying Vioxx or another Cox-2 inhibitor, you may be able to use an older anti-inflammatory drug. Naproxen, one of the older NSAIDs, may be an anti-inflammatory drug that actually lowers heart attack risk.

* Some people started on a Cox-2 inhibitors because they had a stomach ulcer or other risk factors for stomach or intestine bleeding (for example, people on blood thinners), which may be made worse by older anti-inflammatory drugs. For some people who are at risk for bleeding, other options like acetaminophen may be an option.

* There are lots of other medical options. Steroids can be used for shorter periods of time to manage inflammatory pain from diseases like arthritis and lupus. Opioids (drugs that resemble opium), such as oxycodone, codeine, and hydrocodone (Vicodin) can help with pain management, but they can have serious side effects, and some of them can be addictive, so working closely with your healthcare worker is key to determine if these will work for you. In addition, some antidepressants may help with chronic (long-term) pain, though the way this works isn’t yet known

* New procedures may be of assistance to you. Nerve block therapy (in which certain nerves are temporarily anaesthetized) can relieve pain temporarily. “Implantable “technologies, like spinal cord stimulation (SCS) systems and implantable drug delivery systems, do seem to help some people for whom other pain relief methods don’t work.

* If you aren’t getting the relief you need (with or without the use of Cox-2 inhibitors), you may want to consult a pain specialist. Some large hospitals (such as Stanford University) have departments devoted to pain management. The American Board of Pain Medicine and the PainConnection (at painconnection.org) can help you locate a pain specialist who can work with your other healthcare professionals to put a new treatment plan together for you.

With the recent front-page news about the possible hazards of pain medications, you may be taking a look at your over-the-counter (or OTC) pain medications with a wary eye. While all drugs, including those you don’t need a prescription for, can be dangerous, some basic knowledge can help you avoid the pitfalls for the pain relief you need.

Types of OTC pain medication:

The pain-relief aisle of any drug store can make it seem like there’s an infinite number of pain-relief medications. But there are really only three types. Each type works in a different way and can cause different types of problems.

Aspirin: Aspirin blocks the activity of pain hormones called prostaglandins, which would otherwise send pain information to the brain. In addition, by blocking prostaglandins you reduce the pain and discomfort of inflammation (swelling and heat indicating immune function).

Acetaminophen: Acetaminophen is found in drugs like Tylenol, as well as some generic OTC medications and in prescription pain-relief products. Acetaminophen travels through your bloodstream to the brain, reducing pain-related brain activity and fever. Because it doesn’t work through the hormonal system, it doesn’t do as good a job of reducing swelling and inflammation as the other two types of pain medication.

Non-steroidal anti-inflammatories: These are sometimes called NSAIDs (pronounced N-Saidz). This isn’t a single chemical, like acetaminophen, but a group of chemicals including ibuprofen, naproxen and ketoprofen, all of which block the production of prostaglandins, and thus pain and swelling. A number of NSAIDs are available over-the-counter, including brands like Aleve, Ibuprofen (generic) and Motrin; some newer NSAIDs, like Celebrex and Vioxx , need a prescription.

How To Take Aspirin Safely

In addition to blocking pain signals, aspirin blocks the production of blood clots. Strokes can be caused by blood clots blocking the brain’s blood vessels and aspirin reduces the chance that such clots will form, so physicians will sometimes recommend a low dose of daily aspirin to prevent strokes in high-risk patients.

However, this also means that it’s harder to stop bleeding if you’re taking aspirin. People who are already on blood thinners (like Coumadin) should not take. Similarly, pregnant women have an increased risk of bleeding if they take aspirin, so if you need pain relief while pregnant, speak with your healthcare worker for a better options.

Aspirin can quickly lead to ulcer formation and potentially-dangerous gastric (stomach) bleeding. Enteric coating reduces the likelihood of harm, but even so, aspirin should not be taken for long periods of time without consulting a physician.

Some people are allergic to aspirin, and may experience a variety of symptoms (potentially serious) on taking it. If you’re allergic to aspirin, you shouldn’t take aspirin or NSAIDs without consulting a physician.

Lastly, children and teens with chicken pox, flu, or other viral illness should not be given aspirin (even children’s aspirin) without first consulting a physician, as the combination of certain illnesses and aspirin can lead to a potentially fatal complication called Reye’s syndrome.

How To Take Acetaminophen Safely:

Acetaminophen, taken in high doses or over long periods of time, can cause liver damage and, eventually, liver failure. If you think you may have taken too much, call a healthcare provider or poison control center right away.

Alcohol consumption can magnify the effect of acetaminophen on the liver. If you regularly have three or more alcoholic drinks per day, you should check with your healthcare provider before taking acetaminophen (or any other pain reliever).

Because of the potential for overdose, children should never be given “extra strength” acetaminophen products. Regular strength ones should be given at the stated doses for children or after speaking with a healthcare professional or pharmacist.

How To Take Over The Counter NSAIDs Safely:

NSAIDs slightly increase the risk of bleeding. People on blood thinners, pregnant or nursing women, and people at risk for internal bleeding should not take these products. They can also affect your liver’s function and health and lead to gastrointestinal bleeding.

In order to avoid these effects, you shouldn’t take more than one NSAID at a time or an NSAID with aspirin without first consulting a physician. If you’re taking a multi-drug medication (for example, pills for relief of menstrual symptoms may include several different medications), make sure it doesn’t already contain an NSAID if you’re taking an NSAID separately. Lastly, pregnant and nursing women should speak with their healthcare provider before using an OTC NSAID.

What is R.I.C.E. and why do you need it? One of the most recommended icing techniques for reducing inflammation and treating minor injuries is R.I.C.E., an acronym for rest, ice, compression and elevation. It is best used for pulled muscles, sprained ligaments, soft tissue injury, and joint aches. Applying R.I.C.E. treatments will decrease pain, inflammation, muscle spasms, swelling and tissue damage. It achieves this by reducing blood flow from local vessels near the injury and decreasing fluid hemorrhaging as a result of cell damage.

To administer R.I.C.E. use the following guidelines suggested by the American Academy of Orthopaedic Surgeons:

Rest: Stop using the injured body part immediately. If you feel pain when you move, this is your body sending a signal to decrease mobility of the injured area.

Ice: Apply an ice pack to the injured area, using a towel or cover to protect your skin from frostbite. The more conforming the ice pack the better, in order for the injury to receive maximum exposure to the treatment.

Compression: Use a pressure bandage or wrap over the ice pack to help reduce swelling. Never tighten the bandage or wrap to the point of cutting off blood flow. You should not feel pain or a tingly sensation while using compression.

Elevation: Raise or prop up the injured area so that it rests above the level of your heart.

How long should ice be applied while practicing R.I.C.E. for it to be effective? There are four levels of cold felt by the skin: coldness; a prickly or burning sensation; a feeling of aching pain; and finally a lack of sensation or numbness. When the area feels numb, icing should be discontinued. The skin should return to normal body temperature before icing again. Usually numbness can be achieved in 10 to 20 minutes. Never apply ice for more than 30 minutes at a time or tissue damage may occur.

It is generally recommended to practice R.I.C.E. at intervals of 4 to 6 hours for up to 48 hours after an injury. Heat treatments are appropriate for some injuries, but should only be considered after inflammation has receded, approximately 72 hours after an injury. If the body part does not respond to R.I.C.E. therapy within 48 hours, it would be wise to consult your health care provider in the event a serious injury has occurred such as internal bleeding or a broken bone.

For minor injuries, use R.I.C.E. instead of plain ice!

This information is not intended as a substitute for professional medical treatment or consultation. Always consult with your physician in the event of a serious injury.

Heat has long been used to provide temporary relief of arthritis pain, and is used in many different forms. Contrast baths, whirlpools, electric pads, microwaveable gel packs, hydrocollator packs, infrared lamps, and hot showers are some of the different techniques used. Even warm tap water probably will meet some of your needs for heat therapy at home.

Heat can provide temporary relief of pain and stiffness, and can prepare you for physical activity or exercise. For example, morning stiffness is a common problem for many people with rheumatoid arthritis. Because your body has been still during the night you may need special help to get going in the morning. The following combination of techniques using heat can reduce the length and the severity of morning stiffness:

1. Sleep in a sleeping bag (which helps retain body heat) or with an electric blanket (following the manufacturer’s instructions).

2. Take your aspirin or other anti-inflammatory medication an hour before you get out of bed in the morning. (Keep a few crackers at your bedside to take with the medication to avoid stomach irritation.)

3. Take a warm shower or bath immediately after you get up.

4. Then do limbering-up exercises after your shower or bath while you still feel warm.

Safety is important in choosing the form of heat you use. You should take great care to avoid burns or electric shocks. Heat must be used with much caution on any area of the body with poor circulation or where you cannot feel heat or cold normally. It should not be used over areas where your skin is fragile or broken.

Only mild heat is necessary to get results. You are aiming for a temperature just slightly above body temperature, and you do not have to apply heat for a long time. You will get full benefit by using heat for 20 minutes each time.

Moist heat is any technique in which water is used to conduct the heat, such as a bath or shower or hydrocollator packs. People with arthritis prefer moist rather than dry heat, such as a heating pad. Moist heat penetrates more deeply than dry. You will have to try both and see which is more effective and convenient for you.

Heating pads are available which provide either moist or dry heat, but they should be chosen and used with care. Make sure the pad is approved by the Underwriter’s Laboratory. Look for those which have temperature control switches; those without temperature settings get hotter and hotter until you switch them off.

When using a pad, never lie on top of it and make sure you do not fall asleep while it is on. Severe burns can result! It may be wise to use a timer during the treatment. Check the instructions on use carefully. Regularly inspect the pad for any cracks in the plastic cover.

Hydrocollator packs are canvas bags containing silicone gel which retain heat for a long time. You can buy them in different shapes at pharmacies. Some people like them because they lose heat more slowly than most wet compresses. The pack is heated in water, wrapped in 8 to 10 layers of heavy toweling and placed over the painful joint.

The pack is heated in a large pot of water and placed on heavy towels. Place the surface with the thickest layer of toweling over the part to be treated.

Keep in mind that hydrocollator packs do have drawbacks. They are not practical if heat is needed for several joints, because each pack can be used for only one part at a time. They are also cumbersome to use and may be too heavy placed over a painful joint. If your hands are affected by your arthritis, it may be difficult for you to remove the heavy pack from the water with the tongs. So you may need help. Again, you must be very careful about burns. If you decide to try such a pack, follow the manufacturer’s instructions carefully.

Microwaveable gel packs are popular. Follow the instructions carefully or else the bag containing the gel may leak? or even worse explode and cause serious burns!

Physical therapists sometimes use melted paraffin as a means of applying heat, particularly to the hands. There are units available for home use as well. Because they involve high temperatures, paraffin baths should be used with caution. Patients with osteoarthritis or rheumatoid arthritis involving the hands often find paraffin to be helpful.

You can buy nylon and spandex gloves which can reduce morning stiffness of the hands for some people when worn at night. The gloves are available in both men’s and women’s sizes.

It is important to wear adequate, warm clothing in cold weather. Some people find that knitted, woolen or fleece pullover cuffs on painful joints, especially the knees, ankles and elbows are helpful in keeping the joints warm and more comfortable in cold weather.

Some people with arthritis find that heat does not help them. In fact, the reverse is often best-cold compresses. Cold may be especially effective when active inflammation produces severe pain and joint swelling. Only trying different modalities will enable you to find out which is best for you.

It is easy to make a cold pack by filling a small plastic bag with a few ice cubes. A bag of frozen vegetables wrapped in a towel can be used. Place any cold pack over the painful joint with a layer of terry cloth toweling in between. The same precautions that apply to the use of heat should be observed when using cold. The maximum benefit is achieved in less than 20 minutes. You may wish to repeat this application several times a day.

For many people with arthritis an effective approach is alternating warm and cold water applications, a process called contrast baths. It is most useful for a hand or foot which can be dipped in a large pot filled with water. If you decide to give it a try, use a thermometer to check temperatures.

1. Fill one container 2/3 full with 110 degree F water.
2. Fill a second container 2/3 full with 65 degree F water.
3. Put your hands or feet completely into the warm water for three minutes; then put them into the cold water for one minute.
4. Repeat step #3 two more times.
5. End the treatment with three more minutes in the warm water; then carefully dry the hands or feet.

If you joints are constantly killing you, here are three suggestions:

1. Traumeel is a product that has been used for years in Germany to relieve pain. I have not been overly impressed with the ointment; however, my colleagues claim that injecting it is the way to go. Dave Tate at Elite Fitness sells both forms. Let me just add the mandatory precaution here: make sure to have a qualified medical practitioner administer the injection if you go that route.

2. There’s a product called Nu Joint Matrix that you spray on topically … and guess what, this stuff seems to work! To test it for yourself, perform multiple sets of heavy eccentrics to induce muscular soreness and then apply the spray to only one side. You will notice the difference in no time. In fact, the company claims that it kicks in within 10 minutes of application. It smells like Pledge on your body but works more like Windex does in the movie My Big Fat Greek Wedding!

3. Dr. D’s Joint Support is by far the best joint supplement on the market. It attacks through several mechanisms - believe me, Dr. Di Pasquale makes sure that no stone is unturned! I recommend that you start with 5 tablets three times a day with meals. You can eventually wean down to twice daily (with breakast and dinner), and finally once a day (with breakfast) - the duration of each phase depends upon the severity of your pain as well as your financial status!

Now, imagine taking all three (injectable, topical and oral) applications at once! It should go without saying that regular consumption of Omega- 3 fats (i.e. fish oil and flax seed oil) will help keep those joints well- lubed. Also, forget Tylenol (Acetiminaphen) and NSAIDs such as Advil (Ibuprofen) or Aspirin (ASA.) Research shows that on top of the havoc they pose on the gut’s inner lining, they hinder protein synthesis.

Everyone experiences pain at some point in their lives &ndash in fact, pain is the most common reason why people visit the doctor or require health care services.

What type of people must deal with pain?

* 80% of hospitalized patients

* 37% of cancer patients in long term care facilities

* 55% of home health patients

* Heart attack sufferers: 1.2 million

* Those with headaches: 5 million

* People with acute lung diseases: 4 million

* Dental problems: 3 million

* Digestive problems: 10 million

* Musculoskeletal disorders: 6 million

* 26 million people between 20 and 64 years of age that suffer from back pain

* 80% of people over 65 are affected by arthritis and musculoskeletal pain

* 1 American in 6 has painful arthritis

In some instances pain is a natural part of life that you can control with over-the-counter painkillers, meditation, or other methods. For others, such as those suffering from arthritis, pain is an everyday occurrence, and can be quite severe and more difficult to manage.

There are three main types of pain:

Somatic pain: Occurs in the skin, muscle or bone. Ever felt an aching, throbbing or feeling of pressure? Then you have probably experienced this type of pain.

Visceral pain: Affects the body’s internal organs and cavities. This is a pain that creates a gnawing, cramping or sharp sensation.

Neuropathic pain: Results from damage to the nervous system. Can be experienced as a burning, shooting, or pins-and-needles feeling.

Pain can be characterized as mild, moderate, or severe. Pain categories are used to help physicians select the most effective pain medication.

Mild (BPI rating of 1-4): aspirin, acetaminophen (Tylenol), or NSAIDs (non-steroidal anti-inflammatory drugs such as Motrin and Aleve.)

Moderate (BPI rating of 4-6): tramadol (Ultram), codeine, hydrocodone (Vicodin), or oxycodone (OxyContin)

Severe (BPI rating of 7 or above): morphine, hydromorphone (Dilaudid), or fentanyl (Actiq).

Pain management is important if you want to live each day to its fullest without unnecessary suffering. Pain can negatively affect all aspects of your life and inhibit your ability to carry out simple tasks, such as eating regular meals. It can impact your sleeping patterns, drain your energy, alter your mood and make it difficult or impossible to accomplish daily chores and responsibilities.

Pain management, if done right, makes it possible to lessen or eliminate pain and suffering. The best way to achieve this is to treat the cause of the pain, through the proper use of pain medication. Other pain relief techniques, such as relaxation, can be used in conjunction with medicine to achieve the best results.

Often, doctors prescribe more than one medication to achieve adequate pain relief. Combining two different pain medications is an effective control method because you can give the patient a good dose of medicine, thus providing optimum relief, without administering too much of one drug. Just remember: it’s always best to deal with pain as soon as possible. The longer you wait, the more difficult it will be to control, so make sure you communicate well with your physician and/or caregiver to attain the best results.

How you handle pain and medication depends on your personal physiology, so caregivers are never 100% certain what method of pain control will work for you. Medication may not be able to rid your body of pain entirely, but if it significantly alleviates the amount of pain you experience, enough to allow you to eat, move, and breathe easily, that is considered successful pain management.

Pain and sex are connected in ways that can be obvious and not so obvious. Clearly, if a person is in enough pain, sex is probably the last thing on their mind. Sexual health can also be compromised by painful experiences, particularly during moments of intense physical intimacy. Inflicting pain, whether physical or psychological, is sometimes a component of the S&M community, though it is only an integral part of the “session” in the most extreme cases. Even in such cases, the pain is strictly consensual and is regulated just enough to serve the purposes of both parties and not do any actual damage. Chronic pain, whether physical or psychological, can have incredible effects on a person’s sexual health and performance.

Obviously, if a person is experiencing chronic pain, the psychological drive to have sex is greatly reduced. For most people, finding a way to relieve the pain takes priority over most other physical needs, with the mind typically putting “luxuries” like intercourse lower on the list of sensations that the body craves. Performance can also be affected because the pain provides a distraction for the person, rendering them unable to fully focus their attentions on their partners. Pain can also serve to greatly reduce desire over the long-term, particularly if the problem is left untreated or is being improperly handled. Taking pain killers to help fight chronic pain can also have effects, with some pain killers diminishing libido. There have also been reports of certain pain relief products inhibiting sexual health, though such cases are considered rare. Unfortunately, alleviating the problems caused by physical pain is generally possible only once the pain itself has been dealt with.

There is also another side to this, as psychological pain can be just as debilitating to a person’s sex life and enjoyment as physical signs are. Emotional pain can drive a wedge between two people such that even if both parties are still capable of enjoyment, there is no conscious “desire” to engage the other as a partner. Cases of childhood sex-related trauma have also stunted the sexual health and development of adults, particularly in people who experienced sexual abuse as a child. The chemical signals that the brain uses to signal pleasure and response to stimuli can be affected by mental health conditions such as depression and anxiety, making intercourse difficult, if not impossible.

For the psychological connection between pain and pleasure, most experts advise talking between partners to help sort things out. Preferably, these discussions should occur in what can be considered neutral territory and participants should be fully clothes. Private locations such as the kitchen or dinner table, when no one else is present, are often suggested. Fear can often keep couples from talking to one another about what they feel they need out of the experience, but this is often best confronted early on. Through talking, partners may discover “quirks” about their sexual interests that the other is not aware of that may heighten the experience for both parties. The goal here is to provide an avenue of discussion on what might lead to more satisfaction for all involved.

Rekindling the spark is also a good idea. There are several ways to accomplish this, of course. Some couples attempt to do so by bringing romance into the equation. Others prefer to delve into role-playing sessions or physical exploration that does not involve genital contact or stimulation. There is generally no problem to this, as long as it is consensual.