Neck pain, back pain, and sciatica, also referred as the back pain complex, have many causes. One the principle, least understood causes of back pain, and there are myriad causes, is commonly referred to as the musculoskeletal pain syndrome. Musculoskeletal pain syndrome is expressed in one of two forms, fibromyalgia or myofascial pain syndrome. The two pain syndromes are responsible for pain in various parts of the body, to include the neck, back, both upper and lower, and the legs (sciatica). This article will deal with the former, fibromyalgia. Fibromyalgia results in pain to the affected area when touched, these areas are known as trigger points. Fibromyalgia may also be responsible for fatigue, stiffness, and sleep disturbances. Fibromyalgia is a more widespread condition than myofascial pain syndrome and is found throughout the body. Both pain syndromes are thought to be related to a change in or alteration of the body's pain threshold, meaning that the pain reported is out of proportion with the actual pain stimuli. Fibromyalgia is an often disputed classification and in fact has been referred to as the "non-disease."

Fibromyalgia is defined as muscle and connective tissue pain. The condition is characterized by widespread, chronic pain combined with an overly sensitive reaction to allodynia, or gentle touch. As noted above, fibromyalgia is not only responsible for widespread pain, to include neck pain, back pain, and sciatica but may also be characterized by debilitating and disabling levels of fatigue, sleeplessness and sleep dysfunction, stiffness and soreness, difficulty breathing and swallowing, and a myriad of symptoms expressed by and affecting various body systems. The concert of symptoms, not always present in full, are generally referred to collectively as the "fibromyalgia syndrome." In addition to the above mentioned symptoms, fibromyalgia may also be expressed in terms of cognitive dysfunction, as in difficulty shaping and expressing concepts and thoughts, and an increase incidence of anxiety and affective symptoms. The link between stress and fibromyalgia appears to be a significant one, with a number of psychological manifestations being present, to include depression. In fact, there is a powerful link between major depression and fibromyalgia. The etiology or cause remains highly speculative, as it has not been shown that there is a true causal link between the two. It has been suggested, and this author concurs, that depression may be a consequence of having to endure multiple symptoms, including sleeplessness and sleep dysfunction, with no clear cause or treatment options.

Fibromyalgia, as noted above, is defined as widespread, chronic pain and a response to allodynia or gentle touch, particularly at various trigger points on the body. Additionally, pain expressions or symptoms may include deep muscle aches and pains, at times deep, almost burning sensations; muscle cramps and spasms, mild to severe and debilitating, particularly low back pain radiating into the legs (sciatica); nerve pain, to include prickly or needle-like sensations on the skin; generalized weakness, particularly in the limbs; and, disturbances of the bowel, to include colitis-like spasms.

Sleeplessness and sleep disturbances are common in fibromyalgia sufferers, and may grow in severity and frequency over time; and, as psychological symptoms become more prevalent, particularly anxiety and depression. Significantly, a kind of "fibrofog" or "brain fog," manifesting itself as cognitive dysfunction, may be a consequence of sleeplessness and dysfunction. There is a clear and demonstrable link between fibromyalgia symptoms and the inability to concentrate, difficulty with memory, both short and long term, and impaired attention span and an inability to multi-task. There are many more symptoms expressed by fibromyalgia sufferers but they are beyond the scope of this article.

Ultimately, there are a multitude of symptoms and consequences linked to this devastating and debilitating syndrome. Neck pain, back pain, and sciatica are certainly significant in fibromyalgia patients but the concert of symptoms, the syndrome, has multiple expressions and possible causes, physiological and psychological. The fibromyalgia treatment focus must be a holistic one, primarily because of the multiple-system, multi-symptom nature of the syndrome. There is no clear and systematized approach to the handling of, much less a cure for, fibromyalgia sufferers. Treatment strategies often include analgesics such as NSAIDS (naproxen-sodium) for aches and pain. Antidepressants are often prescribed for depression and for possible serotonin dysfunction and its impact on the central nervous system's ability to properly process pain impulses. The impact of norepinephrine and serotonin affecting and stimulating drugs is being explored, a link has been discussed and it is suggestive but the outcome is still unclear. Additionally, behavioral intervention and alternative medicine are options many pursue. As with most cases of neck pain, back pain, and sciatica, exercise is an essential component in the treatment strategy, more so due to the wide-ranging, often ambiguous constellation of pain symptoms. Again, a holistic approach is vital if there is to be a resolution for not only the neck pain, back pain, and sciatica but the myriad of additional symptoms collectively classified as the fibromyalgia syndrome.

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Laminitis is sometimes called Founder. When the laminae in the hoof of horses, ponies, and donkeys swells the animal is said to have Laminitis. Concussive forces to the hoof can cause Laminitis in horses although the disease can also result through a decrease in blood supply and flow to the laminae. This leads to ischemia, necrosis, and edema of the laminae. What causes a decrease in the flow of blood in this way is still not yet known however, a number of pathophysiologic mechanisms have been suggested.

Laminitis, irrespective of the precise cause, is a really debilitating disease that can have a very detrimental effect on the animal. For the owner it results in frustration, expense, and is demanding when it comes to treatment. Thankfully, our knowledge about the disease is expanding. With this growth in knowledge comes the possibility for effective treatment. Indeed, treatment has progressed from what it was a few short years ago. Nevertheless, much about Laminitis in horses is yet to be learned.

Some horses can be predisposed to Laminitis. Those that are fed an improper diet top the list. It has been known for some time that horses that consume too much grain and/or lush green grass rich in clover are more susceptible to developing Laminitis. Likewise, horses whose diet is changed suddenly to a diet that is high in energy are also more at risk.

Other factors that predispose horses to Laminitis include systemic illness such as:

  • Intestinal Inflammation

  • Obstructions of the Small Intestine

  • Colitis

  • Diarrhea

  • Uterine Infection

  • Septicemia

  • Toxemia

Further contributing factors include:

  • Excessive weight on one leg

  • Working unshod horses

  • Working horses on hard surfaces

  • Weight gain

  • Over trimming of hooves

  • Certain medications

What To Look For

Laminitis in horses presents hooves that are distorted in their appearance. Founder rings on the wall of the hoof will also be discernible, and they will have overgrown heels, flat soles, and long toes.

Laminitis in horses leads to lameness that can be either mild to severe. It is usually found in the front feet rather than in the back feet simply because horses support roughly sixty percent of their total body weight on their front legs. The degree or severity of the lameness is determined using Obel grades ranging from one to four. If the horse has grade one Laminitis they will be seen to alternate their weight between their front feet repeatedly. Horses that have grade two Laminitis or higher show an affected gait as they attempt to carry more weight on their back limbs.

Because of the pain associated with Laminitis in horses it is characteristic of affected horses to attempt to walk their heels and avoid pressure to the toes. They are reluctant to move around due to the pain and discomfort. Affected horses will also have a stronger arterial pulse in the front feet as well as experiencing swelling and heat.

Diagnosing Laminitis in Horses

Lateral radiographs of the affected limb are critical in making a diagnosis and for determining the prognosis of the animal.

Treating Laminitis in Horses

Successful treatment hinges a lot on discovering the cause of the Laminitis. Initially treatment can vary depending upon the causes. Treating Laminitis might involve IV Fluid Therapy, Anti-inflammatory drugs, Systemic Antimicrobials, and Mineral Oil.

The goal of treatment is to lessen or reduce the swelling in the hoof as well as to lessen the pain the animal experiences. To this end, NSAIDs (non-steroidal anti-inflammatory drugs) are administered. Another major goal in treatment is to improve or increase the blood supply to the laminae and there are a number of drugs that are used for this purpose.

Frog support is very important as part of the treatment process and this is achieved through the use of frog support devices or special shoes. It is advisable that the animal is kept in the stable and on a soft bedding of 10cm or more. If the horse has passed the initial stages of Laminitis special care of the foot will be required. Proper trimming and shoeing is.

Some biotin supplements have been known to promote and encourage faster tissue growth which is beneficial to the successful treatment of Laminitis. Because the horse is recumbent for much of each day skin abrasions and ulcers can develop. These must be addressed without delay.

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Diabetics are not the only ones to suffer foot pain, people with arthritis are also prone to foot pain. Due to the fact that the foot has 33 joints, it is especially prone to arthritis. Arthritis is characterized by the inflammation and swelling of the cartilage and lining of the joints, and often includes an increase of joint fluid. Walking and moving is often extremely difficult for those with arthritis foot pain.

What causes arthritis foot pain? There are different causes, but those that put a person at greater risk include:

- Injury and strain not properly taken care of

- Bacteria and viral infections

- Certain disorders such as ileitis and colitis

- Certain prescription drugs and illegal drug use

- Genetics

In addition to the above causes, there are two forms of arthritis that can lead to foot pain:

1. Rheumatoid arthritis - This is a systemic disease that causes non-specific inflammation of joints belonging to the hands and feet. Over time, rheumatoid arthritis may result in the destruction of the joints and cause serious, chronic foot problems including hammertoes, bunions, etc.

2. Osteoarthritis - This is a degenerative form of arthritis, and it often affects more than one joint. Osteoarthritis is more common among the elderly, obese or those who've suffered a physical trauma. Osteoarthritis can cause changes in the foot bones such as cartilage destruction, spurs, narrowing of joint space and cystic changes.

How can arthritis foot pain be treated? Arthritis foot pain shouldn't be ignored, and should be treated as soon as possible. The following are 10 treatments you can try to help relieve inflammation and pain, as well as improve the flexibility of joints -

1. Exercises - Stretching, range of motion, and functional exercises are all ideal for preventing arthritis foot pain. These exercise help to improve blood flow to the feet, improve flexibility, and keep bones and muscles strong. It's best to ask your podiatrist to recommend exercises.

2. Lose weight - Weight puts plenty of stress and strain on your joints. If you are overweight, shedding excess pounds can make a significant difference to your feet.

3. Supportive footwear - It is imperative that you invest in shoes that provide your foot with support, and feature a high, wide toe box. Shoes with rocker-bottom soles are a good choice for those suffering from heel pain. You should avoid wearing high heel shoes and shoes with pointed toes. In fact, it's a good idea to have your shoes custom made or ask a podiatrist for recommendations.

You should also consider acquiring removable insoles or orthotics for your shoes to provide your foot with more support.

4. Knee, ankle and foot supports - Tensor bandages and braces that provide mild compression and support can help reduce stress placed on the joint.

5. Heat/cold therapy - Applying heating pads or ice packs to the inflamed joint can help relieve inflammation and sooth the aching joint.

6. Physical therapy - Talk to your doctor about physical therapy treatment.

7. Glucosamine and chondroitin sulfate supplements - These supplements help to slow the deterioration of cartilage between joint bones and reduce pain. Talk to your doctor about these supplements before taking them.

8. Over-the-counter pain medication - If you are suffering from pain due to joint inflammation, common over-the-counter medications that may be effective at reducing inflammation and pain include aspirin, acetaminophen and ibuprofen.

9. Anti-inflammatory creams and topical ointments - There are topical medications that help relieve acute pain (I.E. "JointFlex"), and those that relieve pain and reduce inflammation (I.E. "Aspercreme").

10. Surgery - Those who suffer from severe, disabling foot pain may require surgery to realign or replace joints.

Finally, remember that it is not normal for joints to hurt anywhere in your body. If you are experiencing frequent or recurring foot pain, it's time to visit your doctor.

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