Which pain is the strongest?

From newsukraine.rbc.ua

Scientists have identified the most excruciating pain a human can experience — one that surpasses even childbirth on the intensity scale. This type of pain can lead to complete physical and emotional exhaustion, according to a study published in the Headache journal.

What is the most intense pain?

Everyone experiences pain at different levels, as pain thresholds vary from person to person. There is a common belief that childbirth is the most intense pain a woman can experience. However, it turns out this is not the case.

A study listed the most intense types of pain humans can endure, including childbirth, gunshot wounds, and herniated discs.

Childbirth ranked second, while cluster headaches unexpectedly took first place. This type of pain can occur multiple times a day and last for weeks or months.

The pain may subside for a period (a week, month, or year), or there may be no break at all between episodes of pain.

                                                                                                          Photo: Freepik

Symptoms of cluster headaches

The main symptoms of cluster headaches include:

• Sharp, burning, or piercing pain, usually on one side of the head, around the eye

• Headaches that occur at the same time of year or at a specific time of day

• Headaches that start and stop suddenly, without warning

• Headaches that last from 15 minutes to three hours.

According to scientists, cluster headaches affect approximately one in 1,000 people.

Pain intensity ratings

American researchers concluded that cluster headaches are more painful than childbirth, knife wounds, and pancreatitis. They asked 1,604 people to rate the intensity of pain they experienced during an attack, compared to other painful conditions.

Participants were asked to rate the pain for each condition on a scale from 0 to 10, with any score above seven classified as "severe."

Cluster headaches received an average pain score of 9.7 out of 10, while childbirth pain was rated at 7.2.

Pancreatitis, a condition in which the pancreas becomes inflamed for a short period of time, ranked third with a score of 7.

Next were kidney stones (6.9), gallstones (6.3), and gunshot wounds, which received a surprising rating of 6.

Following these were migraine attacks with 5.4 points, fibromyalgia with 5.2 points, and bone fractures, also with 5.2 points.

Heart attacks and sciatica, which occur when the sciatic nerve running from the lower back to the legs is irritated or compressed, both scored 5.0, while knife wounds scored 4.9, and shingles scored 4.6.

https://newsukraine.rbc.ua/news/which-pain-is-the-strongest-details-of-the-1746024987.html 

"My bouts of sciatica drove me to despair. Here’s how I finally cured it"

From telegraph.co.uk

By Zoe Strimpel

After years of chronic back pain, these four exercises have transformed my health 

The beginning of the worst lower back trouble of my life – the most chronic, dispiriting, obstinate discomfort; the first real taste in my bones of middle and old age – began roughly six months into my pregnancy. I was 41. At the time, I attributed it to having to sleep on my side: pregnant women are told this reduces risk of stillbirth. But as time wore on, the baby was born, and life resumed its normal levels of activity, my lower back went from bad to worse.

Struggling with pain

At previous junctures, I had struggled with lower back pain but a week of bum-lifting exercises, plus plenty of walking, had sent it packing. But over the past year, with the pain focused in the lower left of my back, nothing has shifted it. I am no slouch. My average daily steps before, during and – once I recovered from my C-section – after pregnancy come to more than 10,000. Many weeks see a daily norm of around 13,000 steps, which is about six miles. I walk up numerous hills most days, now often while pushing a buggy. I swim in the often freezing waters of the Hampstead Heath ladies’ pond year-round three or so times a week and have done so for a decade.

And yet there I found myself, desperate to find relief as I lay in bed, exhausted. It’s bad enough, at any time, not being able to get comfortable enough to sleep, constantly jabbed and nagged at by a pain whose cause you cannot locate and therefore relieve. But with a new baby, snatching sleep when you can is vital. Not to be able to get comfortable when sleep is so desperately needed, no matter how many pillows are squeezed between your knees, or ice packs taken from the freezer, is the stuff of nightmares and despair. In the end, between ice, Voltagel (painkiller gel) and more ibuprofen than is recommended, I would get to sleep and wake up feeling pain-free.

Wear and tear on my back

This would last until I had my first proper sit of the day, either with the baby, inevitably hunching over her to feed, or with my laptop, as I didn’t take any time off from work. I’d feel like I’d just climbed Everest, with a feeling of painful wear and tear that made me feel miserably old at 42. And then would begin my cycle of stretching, standing, walking – slight relief – then sitting again, which would last in various forms, albeit punctuated by at least one long walk, all day. But even that walk wasn’t entirely pain-free, as the back pain from earlier translated into a feeling of stiffness.

Sometimes, this infernal ache in the lower left of my back spreads beyond that area, into the sciatic nerve. That sharp electric pain then fires down my buttock and into the front of my thighs. If the ache of a useless lower back is bad enough, the piercing discomfort of sciatica – an umbrella term for referred pain from a pinched sciatic nerve – is insanity-making.

My desperation to find a cure

I was desperate. Nothing I did was working: not the exercises I remembered from previous physio for a shoddy lower back, and not the numerous deep tissue massages that were taking such a chunk out of my bank account.

The usual way to treat lower back pain is to stretch the hip flexors and strengthen the glutes, which are meant to bear the brunt of the weight of your body, not your back. And, of course, to lose weight. These measures work for most causes of back pain, but not, this time, for me (dramatic weight loss, which might well help, still feels impossible). I needed to do something else.

Lower back pain is incredibly common. In the United Kingdom, 60-80 per cent of people will experience lower back pain at some point; those who experience it severely as a chronic condition are around 5 per cent, according to the National Institute for Health and Care Excellence (Nice). Much of this is caused by stagnant lifestyles and poor posture. Tens of millions of working days are lost due to back pain.

Sciatic nerve pain

Many people experience the feeling of sciatic nerve pain, but long-term sciatica caused by the pinching or irritation of the sciatic nerve as it leaves the spinal cord affects around 5 per cent of people with back pain. Clearly, I am in the unlucky 5 per cent with chronic lower back pain and intermittent sciatic pain.

Crucially, treating my issues as localised, short-term effects of hunching or sitting does not work. Nor do sloppy home-based exercises. In the end, it was a massage therapist who came to the rescue.

A boot camp for your back

She pointed me in the direction of Hazel Amper, of the Amper Lab in Primrose Hill, north London, which runs a boot camp of intensive strengthening of the core and glutes, along with – as I would soon find out – an emphasis on retraining the brain to use the right muscles in walking, sitting, standing and exercising. The Lab is a tiny outfit with just three Reformer Pilates machines, overseen by the luminous, energetic physiotherapist Hazel and a single colleague, a truly lovely young woman called Akata Sud, whose job is to take clients through the boot camp.

Hazel’s boot camp idea is this: people come in pain, and despair, and after 10 sessions (which cost from £600) are different people. Pain is gone, the right muscles have been woken up and, crucially, thanks to “neurological retraining”, they keep being used instead of the wrong ones. Her success is famous the district over, and her lab is a constant do-si-do of people from children to the elderly grateful not to have to rely on doing exercises at home.

Relief at last

Hazel gave me a once-over and as she kneaded my back, she explained that the causes of back pain are nurture, nature or both (as in my case). With nature: the “structure of the spine is not quite right. There’s hypermobility, or one leg is longer than the other. Pregnancy, menopause… All that creates a spine without enough space.

“Nurture is sitting all day – when you’re sitting, you can’t use other muscles, especially glutes. You can only use the glutes when the leg is behind you, but by the time you start walking, they’ve turned off, and what gets activated instead are front thigh muscles and lower back.

Zoe pictured with physiotherapists (L-R) Kat and Hazel  Credit: Andrew Crowley for The Telegraph

“Bad posture, stress and tension, anything that takes you into flexion – this is nurture. What we want is for you to straighten up.” I had told her I try to stand up straight and I walk a huge amount every day. She could see that was true in my superficially upright posture and my rock-hard calves. After examining me, she said that the source of my woes was my hypermobility: a bendiness defined by joints that “don’t quite know what they’re doing”.

Why some of us are more prone to back pain

Unfortunately I was born this way. I never crawled; just went straight to walking. My core and glutes have always played second fiddle to my bendy, swaying hips and lock-prone, knocking knees. My weight has always been lugged by the wrong muscles – especially in the hamstrings and calves – and the result is that my glutes almost don’t work, producing devastating strain on my lower back. It’s not just the muscles; the whole area has been compressed by years of bad posture and over-adjustment for weak core and glutes, Hazel explains. The added downward drag of extra belly weight, made much worse by the baby, has further reduced the space in which the vertebrae of the lower back can operate, making bulging discs more likely.

On top of this, Hazel explained that my bouts of sciatica had been years in the making. “In the beginning, it might be, ‘Oh, got a bit of a tight muscle in my back.’ But by then, the shape of the spine had already changed. You might get an exaggerated curve in the lower back, which squashes the space. The tummy starts sticking out. The muscles at either side of the spine get shorter, the thigh muscles get tighter and the muscles at the front of the tummy and bum get weaker.

There’s tightness down the front of the thigh. All this compresses the lower back even more, the space gets smaller, and eventually, the structures inside the spine get affected, which can be seen as a permanent fixture on the X-ray.”

Breaking the cycle of doom

This is what Hazel and I refer to as the “cycle of doom” responsible for my chronic back pain.

“When the core and glutes are activated, you don’t need to use all the other areas. If they aren’t, you’ll be trying to stabilise yourself using the wrong muscles. So you will have a tight neck, tight jaw, tennis elbow, tight lower back, tight thighs, knee pain, plantar fasciitis [pain on the ball of the foot]… loads of ‘itises’. Then the brain starts to see this as normal and configures you wrong. It means you get used to walking in that way and always activate the wrong muscles. The weakness and tightness continue, the neurology keeping the magic alive, making a habit of it.”

A few weeks in, this causes soft-tissue injuries, but years in, “You’re looking at arthritis, inflammation, bone rubbing on bone.” Any of these can cause spasms in the surrounding muscles, similar to the ones that kept attacking me at night.

Learning to stretch

Kat and I get to work, with short 30-minute sessions beginning with deep thigh and side stretches, and then focusing on core activation and glutes. We always began with a few deep breaths followed by a clenching of my insides, as if holding in wee, and the instruction to zip my core in towards my back. We did 30-second planks. I had improvement in core strength within days. The glutes were worked through one- and two-legged bridges, pushing back against the Reformer Pilates machine, and a range of other glute-pushing exercises using the stirrups on the machine, set to gradually heavier weights.

My goal was to be able to sit through a forthcoming transatlantic flight to Boston with the baby on me without being in hell. This was achieved. But soon after I landed, the pain returned. Without the near-daily routine on the Reformer Pilates under supervision, my brain and muscles fell back into decades-old habits.

Usually, the boot camp is followed immediately by top-ups to keep it all going properly until the patient is ready to sustain their new posture. Hazel says that 95 per cent of patients find their pain sorted permanently this way.

In my case, the timing of my trip was fatal. So when I returned to London, I limped back to Hazel, who, exceptionally, put me on to a second round of boot camp.

The pain hasn’t receded as fast this time and it has become clear how severely my hypermobility, combined with those old habits of walking with locked knees, my chin poking out first while I walk, my core utterly unengaged and my glutes asleep, have damaged my back.

The verdict

In the three months since the first boot camp, my core has remained strong. The problem is my glutes and posture, and that is where we have zeroed in. I love lying on the Reformer Pilates machine, my heels on the bar, and pushing or lifting. “Squeeeeeze those glutes!” urges Kat, until I quiver, and it works. I also love the loops I do with my feet in stirrups lying on my side – these are instant glute-quiverers. I have learnt this: no quiver, no relief. It is amazing how badly the body wants to fight effort, especially in bits of it that have been dormant for years.

At home without a Reformer I also have a daily routine for working the glutes and core: a series of simple cat-cow stretches to loosen up the back before leaning against the wall with my back up pressed against it and legs in squat position, sucking in my lower abdomen. This is a good double whammy: tiring on the glutes and the core. I hold this for two minutes. I also like to lie on my back, bend a knee and cross it over the other, hook my hands under the thigh connected to the foot on the floor, and pull. This is delicious agony for hamstrings that, when too tight and not working properly, puts added strain on the back. Then it’s both knees up and feet on the floor for a series of low bridges, which is where you mimic the glute quivering enabled by the machine’s loops. And I always do a plank, with elbows on the floor.

So if like with me your lower back woes stem from weakness in glutes first, and core second, then there are good ways you can target these without access to a Reformer Pilates machine – though most towns now have studios with the machines and I strongly recommend classes that use them for hardcore strengthening of core and bum.

Here are four exercises that will boot up your glutes and provide relief to your lower back. On top of that, learning to walk properly is key. Remember: chin in, then it’s tummy, pelvis, and soft heel that rolls out. Practice may not make perfect but it sure can help.

1. Lie on your back with your legs bent, feet on the floor, band around mid-thighs. Make sure knees are hip-width apart.
2. Inhale and exhale several times. Then, on exhale, zip up pelvic floor towards navel, tense it and hold it.
3. Inhale and bring hips up off the floor, ensuring all the effort is in the glutes. Drive up through the heels.
4. Exhale and push thighs part-way out against the band.
5. Return to centre, and slowly lower down.

1. Face the floor with hands and knees down. Make sure you are aligned: hips above knees, neck straight as you look down, shoulders squared.
2. Raise your knees a few inches off the floor. Keep belly button drawn in, pinch imaginary pencil between shoulder blades.

1. Lie on your side.
2. Put top foot into stirrup, with bottom leg bent under you, ensuring hips are stacked on top of each other and you’re not falling one way or the other.
3. Push that top leg back, hard against the resistance of the machine, flexing the hip and pushing from the glute.
4. Reverse direction.

1. Lie on your back, placing both feet on the bar.
2. Slowly push up so that your bum is raised, using your glutes, not your back.
3. Inhale, then exhale, raising your right leg, knee still bent.
4. With the leg raised, slowly push back and forth, pushing with each exhale.
5. Slowly lower down, and repeat on the other side.

---

Zoe was photgraphed and filmed at Amper Lab in Primrose Hill

https://www.telegraph.co.uk/health-fitness/wellbeing/sleep/how-i-cured-sciatica/

Herniated Disc Self-Care Remedies to Relieve Back Pain, Numbness and Tingling

From womansworld.com 

Plus learn the warning signs you should seek urgent care

One day, everything is fine. The next day, you wake up to a radiating pain in your spine every time you cough, sneeze or twist your back. What gives? If this story sounds familiar, you may have a herniated disc. Back pain of any type can be alarming, but herniated disc treatment can often be managed at home. We reached out to the experts to find out the herniated disc self-care practices they recommend, as well as when you should seek more advanced medical care.

What is a herniated disc? 

Let’s start off with an even simpler question: What’s a disc? 

“Vertebral discs are thickened tissues that lie between each of the spinal vertebrae and provide cushioning and shock absorption,” says Sarah Cash Crawford, DPT, founder of Anchor Wellness in Cincinnati. “Their primary role is to absorb forces that travel throughout the body and help distribute them evenly, reducing wear and tear on the joints.”

Herniation occurs when the outermost layer of the disc starts breaking down and the inner contents start pushing out of the disc, putting pressure on spinal nerves. This can happen suddenly—for example, when lifting a heavy object—or over a long period of time. 

“While some herniations happen suddenly due to exertion, the majority are degenerative, meaning they develop slowly over time,” says Crawford. “This is why they often go unnoticed and remain asymptomatic.”

                                                                                                                               Javi Sanz

Herniated disc self-care remedies

If you begin to notice pain radiating down your arm or leg and suspect you have a herniated disc, the first thing you should do is visit your doctor. He or she can assess the severity of the herniation and recommend how to relieve the pain.

The good news? The first step toward easing discomfort is often more conservative treatments you can do right from home.

“For the most part, herniated discs get better on their own after several days or weeks,” says Christynne Helfrich, DPT, physical therapist consultant at Hinge Health. Here’s what Helfrich and other experts recommend.

Apply ice and heat

“Surprisingly, both ice and heat can be helpful,” says Stephen Stache Jr., MD, chief of non-operative sports medicine at Rothman Orthopaedics. “Typically, if you feel your muscles are tight, applying heat works best. But if you’re in pain and there are radiating symptoms (also known as sciatica of the lower back) icing the lower back is generally recommended.”

You can buy inexpensive 2-in-1 hot and cold packs to alternate hot and cold treatment on the affected area. Always apply the hot or cold pack with a thin towel between the pack and your skin, and remove it after 15-20 minutes to avoid burns or frostbite. This treatment is safe to do multiple times throughout the day. 

Try these simple stretches

“I always love to say that movement is medicine,” says Helfrich. “Research has shown that physical therapy exercises help relieve herniated disc symptoms by improving flexibility, strength and posture.” 

The best part? You can do these stretches right at home, without any extra equipment. Here, three to try:

Standing back extension 

• Stand with your feet hip width apart and your hands on the back of your hips
• Push your hips forward while leaning your shoulders, head and neck backwards until you’re looking up at the ceiling
• Hold for three seconds before returning to your starting position
• Repeat three to five times, performing this stretch as often as you’d like throughout the day

“This backward-bending exercise helps redistribute pressure on the discs in your back,” explains Helfrich. “You can also do this exercise while sitting at a desk.” 

Seal stretch 

• Lie down on a yoga mat (or similar flat surface) on your stomach with your hands at the sides of your chest
• Push up through your hands, lifting your head, neck and upper torso off the ground while your lower torso and legs remain as relaxed as possible
• Hold for three seconds before bending your arms and lowering yourself back onto the ground. 

“This stretch helps counteract back pain from bending forward,” says Helfrich. 

Knee hug

• Lie on your back on a flat surface
• Bend your knees and bring them in towards your chest
• Rest your hands on your shins, pulling your legs closer towards you
• Breathe into your lower back, and hold the stretch for 20 seconds 
• Relax then repeating three to five times

“This exercise helps stretch your lower back and hips, relieving tension and reducing pressure on nerves affected by a herniated disc,” says Helfrich.

Consider OTC pain medicine

When a disc slips out of place, it can cause inflammation and pressure in the affected area, as well as neck and leg pain. One of the simplest ways to relieve that inflammation is with over-the-counter medication such as Advil.

“Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen (Advil) and naproxen (Aleve) reduce pain and inflammation and are often greatly helpful,” says Dr. Stache. “Other medications like Acetaminophen (Tylenol) can help with the pain, but do not affect inflammation.”

When to see a doctor for herniated disc treatment

When home remedies aren’t doing the trick, you may need to seek more intensive treatment options. As a general rule of thumb, if you’re still in pain after a full week of herniated disc self-care at home, you should schedule an appointment with your doctor to discuss other options. That may include nonsurgical treatment such as steroid injections or nerve block injections, or potentially surgery. 

Note: “If you experience loss of bladder or bowel control associated with spine pain and radiating symptoms, severe progressive weakness with numbness in the legs or arms or pain that worsens despite all treatments, you should seek immediate medical attention,” advises Dr. Stache.

https://www.womansworld.com/wellness/pain-management/herniated-disc-self-care-tips-for-pain-numbness-and-tingling