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Pain Archive
Articles
Unlocking the mystery of chronic pelvic pain syndrome
The condition is an all-too-real problem for men, and one of the more difficult to treat.
After age 50, men often have periods of discomfort "down there." It could be a cramping, aching, or throbbing pain in and around your pelvis and genitals. You also may have issues in the bedroom and bathroom. While the problems are real, the cause is often difficult to pinpoint.
It's called chronic pelvic pain syndrome (CPPS) — also known as chronic prostatitis — and it's one of the most puzzling and difficult-to-manage conditions for older men.
Diffuse Pain
We're sorry you have pain!
The word "diffuse" means "widespread" and refers to pain that is more or less all over, or at least in many areas. The goal of this guide is to provide information while awaiting evaluation with your doctor, or for additional information after you have seen him or her. Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor. The diagnoses provided are among the most common that could explain your symptoms, but the list is not exhaustive and there are many other possibilities. In addition, more than one condition may be present at the same time. For example, a person with rheumatoid arthritis could also have tendonitis.
Do you have severe diffuse pain with fever, redness over the skin or joints, marked swelling, inability to use the muscles or joints, or recent significant trauma (a fall, car accident, etc.)?
Foot Pain
We're sorry to hear you have foot pain!
Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor. The goal of this guide is to provide information while awaiting evaluation with your doctor or additional information after you have seen him or her.
Foot pain may develop for a number of reasons -- fracture and infection are among the most serious while sprains and arthritis are among the most common. There are rare causes of symptoms that will not be included here and would require more detailed evaluation than this guide can provide.
Severe pain, swelling, bruising, or inability to bear weight are "alert" symptoms that could indicate serious injury to a bone or ligaments. When accompanied by fever, an infection becomes a major concern. However, most people with foot pain have no serious or dangerous cause. In fact, many have pain due to poorly fitting or tight shoes; for women, high heels only make a tight shoe more uncomfortable. Try changing your footwear to something with more cushion, support and room for your feet -- and read on to learn more about the causes of foot pain.
Certain symptoms suggest a serious cause of foot pain that requires prompt attention. It's important to ask questions about these symptoms first.
Did your pain begin after a significant injury, such as a fall or car accident?
Along with foot pain, have you noticed swelling or redness in your foot (or feet)?
Stress-induced brain activity linked to chest pain from heart disease
Research we're watching
Doctors have long known that mental or psychological stress can lead to angina (chest pain or discomfort caused by inadequate blood to the heart). Now, new research reveals a direct correlation between angina and stress-related activity in the brain's frontal lobe. The study included 148 people with coronary artery disease with an average age of 62. All underwent brain and heart imaging tests done in conjunction with mental stress testing, which involved mental arithmetic and public speaking. Imaging tests were also done under "control" conditions, which featured simple counting and recalling a neutral event. Researchers monitored the participants for angina during the tests; they also assessed angina rates again after two years.
Activity in the inferior frontal lobe area of the brain during mental stress was linked to the severity of self-reported angina, both during the brain imaging and at the two-year follow-up. A better understanding of how the brain reacts to stress may be an important consideration for doctors who treat angina, according to the study's lead author. The study was published online Aug. 10, 2020, by the journal Circulation: Cardiovascular Imaging.
Use topical painkillers for strains and sprains
In the journals
Hold off on taking pain pills to treat a sprained ankle, strained neck, or bruised knee. A new guideline from the American College of Physicians and the American Academy of Family Physicians recommends certain topical (gels, liquids or patches placed on the skin) painkillers as the first line of defense for musculoskeletal injuries in areas other than the lower back. The new guideline, published online Aug. 17, 2020, by Annals of Internal Medicine, was based on a review of more than 200 studies including a total of 33,000 patients with short-term injuries (pain lasting less than four weeks). It recommends using a topical nonsteroidal anti-inflammatory drug (NSAID) with or without menthol (which creates a cooling sensation). Topical NSAIDs come in gel, liquid, or patch forms; diclofenac gel (Voltaren Arthritis Pain) and aspirin cream are available without a prescription. Topical NSAIDs may have fewer risks than oral NSAIDs, which raise risk for stomach ulcers and bleeding, high blood pressure, kidney damage, and heart attacks. However, if topicals don't work, the guideline says you can move to oral NSAIDs such as ibuprofen (Advil, Motrin) or the non-NSAID painkiller acetaminophen (Tylenol); acupressure; or transcutaneous electrical nerve stimulation. The guideline recommends against using opioids such as tramadol (Ultram) except in severe cases.
Image: Victor_69/Getty Images
Age-proof your knees
Improving range of motion, muscle strength, and weight control can help reduce pain and make your knees feel younger.
Image: © jacoblund/Thinkstock
Knee pain is common in older age, often caused by osteoarthritis (the wearing away of knee cartilage). Fortunately, there are ways to fool Father Time and postpone knee problems or even prevent them entirely. "In many cases, you can delay or avoid the need for surgical intervention, such as a knee replacement," says Dr. Lars Richardson, an orthopedic surgeon with Harvard-affiliated Massachusetts General Hospital.
The aging knee
Your knees absorb a huge amount of pressure with every step — typically one-and-a-half times your body weight. That pressure, plus regular wear and tear, takes a toll over time. Muscles and ligaments get weaker. The knee's two shock absorbers — pads of cartilage called menisci — start to deteriorate. So does the articular cartilage protecting the ends of the leg bones where they meet at the knee. If you have a family history of osteoarthritis, if you're overweight, or if you've had some knee injuries, you may be more prone to this deterioration.
What to do for a sprained ankle
It takes less force to sprain an ankle as we age. A few precautions can help to reduce the severity of these injuries or avoid them altogether.
Few of us have gone through life without spraining an ankle. Sprains are among the most common musculoskeletal injuries in people of all ages, and ankles are particularly vulnerable because of the small size of the joint and the forces exerted on it when the body is in motion. While younger people usually sustain sprains while running or jumping, for older people just stepping off a curb awkwardly or walking on an uneven ground can do it. "As you age, your balance and strength can diminish, especially if you've been immobile, increasing your risk for sprains," says Dr. Holly Johnson, a foot and ankle orthopedic surgeon at Harvard-affiliated Massachusetts General Hospital.
How sprains occur
The injury occurs when one or more of the ligaments — elastic bands of tissue that keep the ankle bones in place — are stretched or torn. The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. The foot rolls inward, damaging the ligaments of the outer ankle. Less common are sprains affecting the ligaments of the inner ankle and sprains that injure the ligaments that join the two leg bones (the tibia and the fibula) just above the ankle.
Pelvic physical therapy: Another potential treatment option
This treatment approach may help provide relief for many women with chronic pelvic pain and urinary symptoms.
The exact cause of pelvic pain for many women can be elusive, despite lots of tests and scans. In some cases, the symptoms are related to a problem that is often overlooked, says Dr. Eman Elkadry, an instructor in obstetrics, gynecology, and reproductive biology at Harvard Medical School. Pelvic pain may stem from a pelvic floor muscle problem that can be helped by a specialized form of physical therapy known as pelvic physical therapy.
"Although pelvic physical therapy may not work for everyone, it can be quite effective for certain individuals," says Dr. Hye-Chun Hur, director of the Division of Minimally Invasive Gynecologic Surgery at Harvard-affiliated Beth Israel Deaconess Medical Center and associate faculty editor of Harvard Women's Health Watch. She stresses that pelvic physical therapy is normally undertaken by a trained female practitioner.
What is chronic inflammation?
Ask the doctor
Q. I have suffered from rheumatoid arthritis for many years, and recently I also developed diabetes. My doctor says they are both related to inflammation. What is inflammation, and how can two such different diseases be connected to it?
A. Inflammation is both an old and a new idea in medicine. Roman physicians 2,000 years ago noted that wounds that were healing and joints that suffered from arthritis (like yours) became red, warm, swollen, and painful. It was like they were on fire: inflammare was the verb for setting on fire. But why did a wound become red, warm, swollen, and painful? They had no idea.
Recent Articles
Gratitude enhances health, brings happiness — and may even lengthen lives
Skin care for aging skin: Minimizing age spots, wrinkles, and undereye bags
Medicare versus Medicaid: Key differences
Lost a tooth? What to know about dental implants
Hyperbaric oxygen therapy: Evidence-based uses and unproven claims
Gatorade. Liquid IV. Do you need extra electrolytes?
Sexual violence can cast a long shadow on health
Prostate cancer: Short-course radiation just as effective as longer-term treatments
Eggs, protein, and cholesterol: How to make eggs part of a heart-healthy diet
Can a quick snooze help with energy and focus? The science behind power naps
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