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Kamis, 04 Juni 2009

new pain cure for woman



You’ve got achy shoulders from carrying the kids, the groceries, or your incredibly heavy handbag. You look for the right pill to pop, but what should you take? Aspirin? Ibuprofen? Or, you’re about to get your period. You know you’ll get killer cramps or that nasty headache any minute now, but nothing you take seems to help once the pain hits.

You’re not alone: Many women have a tough time finding the right kind of relief for their pain—and for good reason: Until recently, experts hadn’t actually studied women’s pain specifically, and most research wasn’t conducted with a woman’s hormones and physique in mind. All that’s changing, though. Docs now know that to banish our aches, they must develop treatments formulated for women’s bodies. What’s more, researchers are also looking for—and finding—ways to head pain off at the pass, so those of us with chronic troubles like migraine, fibromyalgia, or backache don’t have to be hobbled by pain on a daily basis. Here, how the new research will help you live an (almost) pain-free life.

The old way of dealing with pain was to ‘wait until it hurts enough to treat it,’” says Carol A. Foster, MD, director of Valley Neurological Headache and Research Center in Phoenix and author of Migraine: Your Questions Answered. “But in the last few years, there has been a complete turnaround. Now we know that prevention and early intervention are absolutely critical.”

The new thinking has made all the difference for Carolyn Robbins of Petaluma, California, who suffers from chronic back and neck pain, the result of a spinal-disk injury combined with nerve damage from Guillain-Barre syndrome. “If you’ve ever had an exposed nerve in your tooth, you know what it feels like,” says Robbins, who describes her pain as “electrical shocks” in her upper and lower back.

The 45-year-old mother of two doesn’t wait until pain hits her full force before treating it. She now relies on a daily prevention regimen, starting with a hot shower and a double dose of ibuprofen. She swims two to three times a week for strength and mobility, and gets weekly massage and chiropractic treatments. And during those times when things get really bad, she pulls out the stronger painkillers prescribed by her doctor. “I’ve found that it’s not a good idea to try to power through the pain, because other things start to go wrong,” Robbins says. “Pain depletes your system as much as exposure to germs.”

Just five years ago, a “kitchen sink” approach like Robbins’ might have been pooh-poohed by pain-management types, who would have been quick to prescribe hard-core, addictive drugs like oxycontin for such a serious condition. But now the focus has switched. “It used to be, people treated the pain and didn’t always treat the underlying disease,” Foster says.

The problem with such an approach, though, is that it sets up a vicious cycle of dependence. “Giving narcotic pain pills to headache patients is like giving cookies to diabetics,” she adds.
So how do you break the habit of heading straight for the medicine cabinet? No matter what your source of pain, the first step is to get an accurate diagnosis and then set up an early intervention strategy with your doctor, says Neil Kirschen, MD, president of the American Association of Orthopedic Medicine and chief of pain management at South Nassau Community Hospital in New York. “The whole goal of pain management today is to keep pain from becoming chronic,” he says.

The reason? Pain actually causes the brain to fire off a stress response that, over time, makes nerves more and more sensitive—and thus better able to telegraph intense pain to you. In other words, pain actually begets pain.

Nan Weiner, executive editor at San Francisco magazine, is a case in point. When she broke her ankle eight years ago, it never completely healed, and the pain became chronic. What should have been a relatively simple injury became an odyssey that had Weiner visiting specialists all over San Francisco. She finally found a podiatrist who “took a detective-like approach to the problem,” Weiner says, by exploring and treating each joint and tendon in a methodical search for the pain’s source. Thanks to this care, which includes regular pain-preventing cortisone shots, the 55-year-old mother of one has been able to resume her hobby of salsa dancing.



We know that men don’t suffer menstrual pain, but that’s not the only fun they’re missing. “Research is uncovering very dramatic differences in how the genders experience pain,” says Mark Allen Young, a professor at New York College of Podiatric Medicine and author of Women and Pain: Why It Hurts and What You Can Do.

It all starts with hormones. There is no getting around how profoundly hormones like estrogen and testosterone affect the central nervous system, which is responsible for perceiving and transmitting the sensation of pain.

According to experts, this is one reason why conditions such as osteoarthritis, headaches, and irritable bowel syndrome strike women at much higher rates than men.

Our physical differences really matter, too. “We’ve only recently begun to grasp that women’s body architecture is completely different from men’s,” Young says. Because women walk differently, for instance, they put pressure on joints, muscles, and bones in very different ways than men do. “Starting with the knees and hips and working up to the shoulders, spine, and neck, how a person walks can have a huge impact on how pain develops later in life,” Young says. Just last year, one medical-implant maker finally recognized this fact by creating a knee implant just for women.

Women are also more prone to conditions involving the immune system, says Deborah Metzger, MD, an OB-GYN and specialist in integrative pain management in Los Altos, California. Scientists have long known that women have stronger immune systems than men, she says. That strength can backfire, though, leading women to suffer from far more autoimmune disorders—in which the immune system attacks itself—and the host of mysterious diseases thought to sometimes result from an overreactive immune system, such as celiac disease, irritable bowel syndrome (IBS), fibromyalgia, chronic fatigue syndrome (CFS), and many types of pelvic pain.

“Women tend to have hyperalert immune systems, which is good,” Metzger says. “But once the immune system gets stirred up, it can turn into a feeding frenzy.” The fired-up immune activity produces inflammatory chemicals that fuel all types of muscle and joint pain; it can also activate nerves in vulnerable spots like the lower back (sciatica), the head (migraines), and the pelvis (endometriosis and pelvic pain).

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