Pain is one of my very first memories. A stomachache, a Kmart bathroom, five years old, shaking. I remember the details. Not of the pain itself, but of the surroundings. The way the bright light made the white walls seem misty blue. The grimy floors, with trails of dirt closing in around a drain below my feet. The latch that didn’t lock quite right, leaving the door off-kilter.
I escaped my body as the pain twisted, stabbed, and burned, moving into my abdomen. It was something I would learn to do again and again for years as my body begged to be heard, sometimes in whispers and sometimes in screams.
At age 10, I started to have searing leg pain—not an ache or a throb, but something else. The sensations pulsated and burned, seeming to originate deep in the bones. My parents called it “growing pains.” I cried myself to sleep at night.
At 12, I had my first dynamite headache— not a migraine, not tension. It moved across my skill in bands from front to back, blurring my vision, making me wince. By 16, I had trouble controlling my bladder; the burning and urgency made it hard to sit through a class, let alone get through basketball practice.
I struggled to eat without bouts of diarrhea, so I’d frequently go all day without eating at all until 10 p.m. I had crippling period cramps that sometimes kept me home from school. I got rashes across my hands, too, which were so red and lined with cuts that people would ask me what happened to them. My symptoms became increasingly difficult to hide.
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My doctors ran lots of tests. Every time, they would return and happily declare me a normal teen. I was young and did not yet know how to be insistent, so I looked for answers on my own; I covered up my online searches for brain tumors and urinary frequency. I told myself that I was fine, as I learned to cut corners in life.
Sometimes I wouldn’t eat to avoid digestive issues. Other times I’d cut class, so I didn't have to sit through six of them in a row, my bladder in agony. I avoided group activities and public outings; I made many excuses.
I coped with the onslaught of symptoms, not stopping to ask myself if there was another way because I did not think there was one. But as I silently self-managed the pain in all its forms, I grew more anxious and exhausted. Sometimes you’re broken long before you finally break. And when the full-body pain and sensitivity began to appear in the summer of 2011, I could no longer manage on my own.
At age 19, the pain took over and started to ravage me, moving from one are of the body to the next. It began with searing flank pain I tried to fight through for three days before going to the ER. They tested me for a kidney stone that they could not find on a CT scan; they flushed my system with several IV bags of fluid. “You probably passed it in the ER,” a doctor said.
“Would I still be in pain, though?” I asked. I remember the shrug of her shoulders. “It’s possible,” she replied.
I left the ER, only to return several days later when the pain had turned to full-body sensation. I felt like a live wire; I could not lay flat without extreme discomfort. Placing my head on a pillow was impossible without exacerbating my stripe-like headaches, which had grown more pronounced and constant. That rip-roaring pain in my legs was suddenly ever-present. They ran more tests, then released me when they found nothing. The pain grew and grew.
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When I had been awake for almost 48 hours without sleeping, yet could not lay down at all because of the sensitivity, I went back to the ER again with skyrocketing blood pressure. This time, they admitted me to the hospital for one day. I had a few more tests and rounds of oxycodone. At this point, I was terrified that there was no end to how bad it would get, as “follow up with your primary-care doctor” was the dismissive line I’d grown used to.
I remember that one of my trips to the ER included a CT scan. I tried to steady my body to lay flat on the table, but the pain of the hard surface was so intense that I could not do it without shaking. When I returned, my doctor asked my parents to leave the room. “Do you drink?” he asked. Knowing my history included just one accidental glass of wine at church communion, I said no. “What about drugs?” No, I said again. They released me.
Have you ever wanted to escape your own body? There’s no rest in that. I wasn’t sleeping. I was having panic attacks. I stopped brushing my hair; a tangled knot beneath the layers grew to the size of a softball. There were dark circles under my eyes that looked like shiners. I developed chest pain, which shot down my left arm and mimicked a heart attack, and I was forced to go to the ER again. This time, they gave me Valium.
I kept wondering if, eventually, my only option would be to mask the pain like this. Maybe it would always be with me. Maybe it always had been with me.
After months of negative tests, I was diagnosed with fibromyalgia, a chronic condition characterized by widespread pain, fatigue, plus sleep and mood issues. Ultimately, it was a possible diagnosis I brought to my own doctor in late 2011, with research papers and symptom lists printed off the internet in tow. It is a label of exclusion, bestowed when everything else has been ruled out, and one he was willing to give me. I knew it was close to an answer, if not a complete one.
Fibromyalgia is a constellation of symptoms, and the underlying cause is unknown. It often encompasses other labels as well, and I would be diagnosed with irritable bowel syndrome, interstitial cystitis, and premenstrual dysmorphic disorder for my digestive, urinary, and menstrual problems in the months that followed. I take a whole list of pills, including pregabalin for the underlying nerve sensitivity, nortriptyline for digestion (sometimes Linzess), Robaxin for muscle spasms.
At the time, part of me was just happy to have a name to call my pain, until I spoke with Anne Louise Oaklander, MD, over the phone in spring 2015.
I had become a health journalist, partly by fate and partly by chance. I had a solid understanding of the body’s mechanisms, which helped me manage my fibro symptoms while working from home. Dr. Oaklander, a neurologist and director of the nerve unit at Massachusetts General Hospital, was consulting on a story for me. She wasn't my doctor, but I mentioned my diagnosis of fibromyalgia off-hand, knowing it was connected to her research. She proceeded to stun me with answers I never thought I’d get.
She reminded me that fibromyalgia was not a diagnosis, but a label, and introduced me to the main subject of her research: small fiber polyneuropathy (SFPN), a condition that is also called small fiber neuropathy or small fiber peripheral neuropathy. Dr. Oaklander began to describe her patients to me for my story, their symptoms and their struggles, which were so remarkably similar to my own that I could hardly digest what she was saying.
“Fibromyalgia” was always a tricky resting place for me, knowing there was next to nothing known about the condition’s origin. I’d worked to accept that I might never have a real answer for my symptoms, that managing them was enough, and some people might not even believe the pain was real.
After talking to Dr. Oaklander, I couldn’t help but try one more time to explain my pain. A few months later, I completed a punch biopsy, where a small sample of skin was taken from my lower leg using local anesthesia. It was mailed to Mass General for analysis, and I was finally given my first conclusive answers. There were so few nerve endings left in my skin—the nerve endings that regulate pain all over the body—that I was diagnosed with small fiber polyneuropathy in August 2015.
The condition affects the microscopic sensory nerves all over the body; the nerve ending damage could be caused by can be various problems including genetics, autoimmune conditions, injury, or diseases. Small fiber polyneuropathy’s connection to fibromyalgia started to boom onto the scene in 2013 with a swath of new research. In Dr. Oaklander’s study, published in Pediatrics, more than half of her previous young patients fit the diagnostic criteria for SFPN. She then published a prospective study that found objective evidence of small fiber polyneuropathy in 41% of the fibromyalgia patients studied, versus only 3% of matched normal controls.
Small fiber polyneuropathy is hard to diagnose, because most doctors do not order tests that might confirm it. “These are the axons within the peripheral nerve,” Oaklander explained to me, adding that "a doctor can examine a patient with small fiber neuropathy and say they look great.”
What those patients feel, like me, is pain and tenderness coming from the deep cellular level. Three-quarters have pain in the feet and legs. Many have surface pain. They do not like to be touched, and bed sheets can hurt, as can clothes. Deep pain is common, movement hurts, and the pain affects multiple regions of the body. The pain can also be classified as chronic; think constant stomach pains, headaches, muscle aches.
Those of us with small fiber polyneuropathy look fine. We’ve learned to mimic “normal.” But inside, the pain is chipping away at us. Every once in a while, I go from okay to sobbing in front of my fiancé. During my most painful episodes, my parents would ask why I was not more emotional in front of doctors. The truth is simple. Over time, I had stopped responding to the pain in obvious ways, so much so that you can’t access a typical pain response. I had learned, instead, to attempt to rationally articulate it.
As Dr. Oaklander explained to me, doctors are trained to look for signs of acute pain, but those of us with chronic pain may have blunted pain reactions. We have to learn to operate above distress, because we are constantly told we’re fine, just fine.
There are potentially millions of people living with undiagnosed SFPN, perhaps misdiagnosed, as I was. Importantly, these small-fiber neuropathies in kids and young adults are often autoimmune and potentially treatable with existing medications. I wish there was more awareness; I wish I’d had doctors who’d known what to look for. Had I received this diagnosis sooner, I could have started treatment sooner.
What would I advise others living with the kind of pain I had—or any other unexplained symptom? Look for a primary-care physician who is collaborative. It took me maybe a decade to find one I really love, and I wish I would have been more intentional about that search sooner. No one knows your body like you do, and a good doctor will listen to your symptoms, ask questions, offer suggestions, and see how you feel about the direction of your care. Make sure your doctor is asking you questions, just like you are asking them questions. If you leave the office feeling frustrated or dismissed, look for a new doctor.
Also, if you're not satisfied with your diagnosis, don't give up. Do research on your own, as much as you can. Suggest possible conditions to your care team, and ask for tests where appropriate. I never felt settled in my fibromyalgia diagnosis. I have consistently had to keep my eyes and ears open for potential conditions that fit my symptoms, and then bring them to my doctors. When you have a difficult condition to diagnose and understand, it's even more critical that you be active in your own care.
I feel more sane and self-assured now that I have a conclusive diagnosis. I don’t worry that I am making a big deal out of pain, that I’m just too weak to handle it. When you don’t have answers, there is always a little voice inside that asks you if you are blowing things out of proportion. When few doctors validate what you’re feeling, it’s a horrible mind trap a lot of us with invisible illnesses cannot fully escape.
I still have problems today. Last year was one of the worst yet, with regular crippling abdominal pain attacks that would leave me screaming and crying. Sometimes it’s exhausting. Sometimes I am angry. But ultimately, I don’t know who I’d be without pain. Pain is as ingrained in me as my oldest memories or my closest friends. I can’t deny that it’s molded me into the person I am today. However, I wouldn’t wish it on anyone else either.
I still remember that little girl I used to be, quietly weathering a storm of symptoms. She had no way of understanding what was happening deep inside her own body, that everyone didn’t feel the burning, aching, stabbing, and gnawing. Perhaps there are thousands more like her, but so few know where to look.
If you have a story to share about being misdiagnosed, email us at misdiagnosed@health.com and join our Misdiagnosed Facebook community to talk to women who share the same struggle.
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]]>“For many patients, it flips their lives upside down,” says Jack Lam, MD, a physician at the Rex Pain Management Center in Raleigh, North Carolina. Though they may look fine on the outside, they could be in agony, he adds.
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Pain is considered chronic when it lasts longer than three months or persists beyond the expected healing time for a particular injury. It can affect any part of the body and may entail more than just physical discomfort. This complex condition can sap a person’s energy; make it difficult to get a good night’s sleep; and lead to mental health issues, like anxiety or depression.
It’s also probably more widespread than you think: According to the CDC, roughly one in five Americans has chronic pain. The most common types include migraines, low back pain, nerve pain, and joint pain.
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Certain medical conditions—such as endometriosis and Lyme disease—can cause chronic pain. But it typically starts with postsurgical pain or an injury. “It’s not clear why some people get it and others do not,” says Beth Darnall, PhD, an associate professor in the Department of Anesthesiology, Perioperative and Pain Medicine at the Stanford University School of Medicine.
One theory is that the brain develops an “imprint” of the neurological pathway of the original pain, says Sharvani Durbhakula, MD, a physician at the Johns Hopkins Hospital Blaustein Pain Treatment Center in East Baltimore. As a result, the brain continues to transmit pain signals even after the physical damage to the body has healed.
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Persistent aches can also set up a vicious cycle. The longer some people experience pain, the more they focus on it, and the more stressed they become. We know that both attention and stress hike up pain processing in the brain, says Darnall.
Indeed, one 2017 study from the University of Hiroshima in Japan suggested that repeatedly thinking about pain—or worrying about when it will strike next—may amplifies the perception of those aches. But make no mistake, chronic pain is not purely psychological: “It’s important for people to know that all pain is real. Pain has a medical basis,” says Darnall. “It’s not all in your head.”
Another misconception about the condition is that it’s not treatable. “People think chronic means unsolvable,” says Darnall, and that’s not the case.
Your primary care provider might suggest starting with physical therapy or an over-the-counter medicine. (It can be tempting to self-medicate, says Dr. Lam, but an MD can point you to a drug that’s most effective for your type of pain.) If those initial treatments don’t work, it’s a good idea to see a doctor who specializes in pain management. Try to find a physician who has experience with your specific issue, says Darnall—and someone who will take a holistic approach that goes beyond the medical underpinnings of your pain.
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Specialists use a variety of therapies to ease persistent pain, from meds such as anti-inflammatories and antidepressants to steroid injections and surgical procedures. In some cases, a spinal cord stimulator may be helpful. This implanted device emits tiny electrical pulses that mask pain signals traveling to the brain; you feel a gentle tingling or fluttering sensation instead. Research suggests some complementary practices, including mindfulness meditation, can offer relief too. (Check out the latest findings on promising methods at right).
After exploring many other options, your doc may recommend trying an opioid. Because these powerful drugs can be so addictive, she should help you carefully weigh the risks and benefits. If you decide to fill the script, you’ll have regular follow-ups so she can evaluate its effects.
Does your pain mess with your sleep? It turns out restless nights are a double whammy: The quality of your sleep is one of the most important predictors of pain intensity the next day. So if you’re struggling to get enough shut-eye, be sure to tell your physician. She may suggest techniques to help you relax or change the timing of your medication to give you the most relief at bedtime.
Some people with chronic pain report that CBD helps them get to sleep, and also eases anxiety and dampens pain sensations—but this phytochemical derived from the cannabis plant hasn’t been well studied yet in humans. It’s thought to work by quieting nerves that are overfiring, says Dr. Lam.
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If you’re looking for a more tried-and-true method for managing the everyday realities of chronic pain, consider cognitive behavioral therapy, or CBT. There is a vast body of research behind this form of talk therapy, which teaches techniques to control pain-related distress. “Over time, these skills help to calm the central nervous system and decrease pain signals in the brain,” says Darnall. Her research has also shown that CBT can make medical treatments more effective.
With a multipronged approach, most chronic-pain patients are able to find relief, she says. “Whether you’ve had pain for months or decades, there are things you can do on a daily basis to reduce both the intensity and the impact of the pain.”
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]]>Now there's one more product featuring this warm and joyful seasonal flavor: CBD oil.
First, a primer on CBD: It's short for cannabidiol, the chemical compound from the cannabis plant. It won't get you high, but fans rave that CBD products can lower anxiety, clear up skin, and ease pain, among other wellness benefits.
That said, CBD products aren't regulated by the Food and Drug Administration (FDA). Aside from one medication to treat seizures, the FDA "has not approved any other CBD products, and there is very limited available information about CBD, including about its effects on the body," according to a statement on the FDA website.
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I can speak about CBD from experience. I've used CBD-infused products like oils, roll-ons, and salves every day for about a year now to reduce inflammation and relieve pain flareups caused by Lyme disease. I've definitely noticed a positive difference in how it makes me feel. Whether it's a placebo effect or not, CBD works for me.
CBD oil can be ingested, but it tastes like hemp, which certainly isn't the most delicious flavor ever. So the idea of a pumpkin spice variety sounded much more appealing. When I heard about it, I had to test it out so I could report just how well it worked (or didn't work).
I tried Toast Spiked Pumpkin CBD Oil, which is a full-spectrum hemp product. What does “full-spectrum” mean? It contains all of the many cannabinoids found within the cannabis plant, not just CBD. It’s also vegan, gluten-free, and sugar-free, so it’s basically a dream for folks with fun, complicated dietary and health restrictions, like me.
The ingredients are organic and super simple: full-spectrum hemp extract with cannabidiol, organic pumpkin seed oil, organic cinnamon oil, organic nutmeg oil, and organic ginger oil. You can taste each of those notes when you ingest it orally, and the flavor is exactly as spicy as it smells.
As a self-proclaimed CBD snob, I’ve tried tons of edibles and flavored oils in the past, but this one tastes the best. Do I sound like a cannabis connoisseur yet?
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At 8.5 mg of CBD per full dropper, I didn’t notice a drastic difference in how I felt after taking a dose under the tongue. It did chill me out, though. My anxiety is basically always at lovely 6/10, and this probably lulled it down to a 4/10. Hey, any little bit helps.
As I mentioned above, the oil tastes great, even better than what I’d imagine a pumpkin spice latte would taste like. One of the perks of this product is that you don’t need to ingest it orally, although that’s the most common way to take CBD oil. It’s an extract, so you can add it to a batch of cookies or a loaf of pumpkin bread for an extra kick.
I’d totally infuse homemade treats with it in the future. If you’re feeling really wild, you can drop it into apple cider and coffee, or even into your pumpkin spiced latte. Double the pumpkin spice, double the fun, right?
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A salve is my personal favorite form of CBD, so the fact that this oil can be used topically is a huge selling point for me. To see how well it performed as a pain reliever, I massaged it onto my key trouble points (wrists, neck, shoulders, and knees). Not only did it subtly enhance the scent of any room I walked into, but it actually helped to relieve my chronic pain. I don’t think I’d swap it out for my go-to salves, but it did work.
My final thoughts? I hate to admit that I genuinely like this product—solely because of the trendy flavor. I tend to shy away from seasonal trends (#hipster), but pumpkin spice CBD oil is one I can get behind. Blame it on my love of cannabis and its magical healing qualities, but I’ll be using this festive fall oil long after the season officially ends.
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]]>Her health deteriorated rapidly. "Compared to even where I was just a couple years ago, it's been a very quick decline to me," Rachel, now 38 and living in Bucks County, Pennsylvania, tells Health. "But amazingly, as my health has been going down, my spiritual and emotional well-being has been on an upward trajectory. And thank goodness for that, because I don't know how I would have gotten through otherwise."
Rachel credits this to Chronic Pain Anonymous (CPA), a fellowship modeled after Alcoholics Anonymous that applies the 12-steps approach to help people cope with chronic pain and illness. Founded in 2004, CPA has grown slowly and remains under the radar. Today, the group estimates it has no more than 350 members nationwide—a small percentage of the reported 50 million U.S. adults living with chronic pain, according to a 2018 report from the Centers for Disease Control and Prevention (CDC).
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A 15-year member of Alcoholics Anonymous, Rachel was not only familiar with 12-step recovery fellowships but indebted to one. "AA saved my life and gave me a life beyond my wildest dreams, but CPA has brought it to a whole other dimension as well," she says.
CPA meetings are held in churches, community centers, and other public spaces in 16 states and Canada. But the group also offers virtual meetings via phone, video, and text-based forums. Many members call in or log on from their bedrooms or from treatment facilities. While their health issues vary widely, members are united by their ongoing pain and illness—and their desire to recover. CPA defines recovery this way: "The ability to live peacefully, joyfully, and comfortably with ourselves and others."
Unlike a 12-step program for alcoholics, there's no abstaining from chronic pain. "You can't go on vacation from it," a co-founder of the group tells Health. There's often no way to control it, as the first step of CPA acknowledges: "We admitted we were powerless over pain and illness—that our lives had become unmanageable."
But CPA helps people understand that life isn't over just because it's restricted by pain. One of the group's goals is to help members discover "how I can have a life I love, even with this illness," the co-founder says.
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People have always lived with chronic pain. But in recent years, medical professionals have begun to take it more seriously and even view it less as a side effect or symptom and more as a health condition of its own. An estimated 22% of American women live in chronic pain, and approximately 18% of men do as well, according to the CDC report.
Treating pain is notoriously complex. No one medication, surgery, or therapy can ease it for every patient, anesthesiologist Shravani Durbhakula, MD, assistant professor in the division of pain medicine at the Johns Hopkins School of Medicine in Baltimore, tells Health. "It's not something we can treat as easily as other conditions," she says.
Chronic pain management typically involves physical therapy, medications, and mental health interventions like cognitive behavioral therapy, says Dr. Durbhakula. If these mainstream treatments don't offer relief, a patient might try alternative options like biofeedback, osteopathic manipulation, or acupuncture.
If the pain persists, a health care team might next consider steroid injections or nerve blocks, she says. "We would like to have more options to treat our patients, especially non-opioid therapies in the midst of this opioid crisis. We really do have a limitation of medications, and the drugs that we do have work for some people, but there are people none of them really work for."
The physical pain is always a struggle for patients. But the mental and emotional anguish takes a heavy toll as well. Living with pain can lead to depression, anxiety, and isolation, as a person starts to withdraw from the daily activities that worsen the pain, pain psychologist Heather Poupore-King, PhD, clinical assistant professor in the department of anesthesiology and perioperative pain medicine at Stanford University, tells Health. "If you're not engaging in things that are meaningful to you, it predisposes you to problems with mood," she says. "Canceling lunches or stopping working, you become isolated and less involved in meaningful activities."
Feeling less defeated thanks to CPA, Jan started her own bookkeeping business she could run out of her home as often her pain and fatigue allowed. "I'm very happy with my life," she says. "I'm not glad I have this condition, but it has brought so much into my life that I wouldn't have had, and I've learned so much and grown so much that I can see a lot of positive."
This kind of acceptance, as well as practicing mindfulness, can help people living with chronic pain "bring purpose and meaning to their life," says Poupore-King. "Acceptance exercises are really about identifying what are your values in life—what do you care deeply about, how did you show up for yourself and others in your life—and trying to match your behavior on a day-to-day basis in line with those values."
"Chronic pain is often a kind of silent illness," says Dr. Durbhakula. "People walk around essentially with a mask on; others don't necessarily understand what their day is like if it's something you can't see." Connecting with people who have similar challenges, however, can make chronic pain patients feel less alone. "Being with other people who get it, who are in the same boat, they give us encouragement, we see how someone else handled something, and we learn from each other," Jan says.
Adds Poupore-King: "We know these psychological and behavioral factors make a huge impact on living a full life with the pain they have, yet most patients have never heard of [these treatments.] What a tragedy to have to suffer in silence and not get the help they deserve."
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Jan attends an in-person meeting weekly in Phoenix; Rachel usually opts for video meetings and joins at least once a day. In the video meetings I observed, between eight and 15 participants—mostly women—logged on, introducing themselves by first name only, as in AA. Many expressed their gratitude for the other faces on their computer or phone screens that day. While it's fine for members to share the illness or condition that's caused their chronic pain, not everyone does, and that's OK, too.
The leader opened the meeting with the serenity prayer and a moment of silence. A volunteer then read the 12 steps of CPA before participants launched into the meeting's discussion. Depending on the group, members might talk through a particular step they'd been working on or discuss a reading in a CPA-approved book like Stories of Hope: Living in Serenity With Chronic Pain and Chronic Illness. With their devices on mute, many members held up their hands in the shape of a heart to communicate support for whoever was speaking.
I recognized several faces the second time I joined a meeting; participants told me they often logged on for two or three meetings each day. Some were clearly calling in from care facilities. Others were sprawled on a couch or a bed at home. Several snuggled with pets while they listened in. A few people cried.
"Going to the meetings every day has really helped me believe in a very general sense that I'm OK as I am," Irene,* a self-described former workaholic living in Illinois who has belonged to CPA for eight years, tells Health. "I'm a lot more grateful, and I just take it one day at a time—sometimes one hour at a time. Today, where I am, it's a beautiful day and I have windows. I probably won't get outside, but I get to see how beautiful it is."
Before Irene joined CPA, she hadn't thought of applying the 12 steps she learned in AA to the back pain that confined her most of the time to a special chair. Still looking for a medical fix when she first attended a CPA meeting, she was quickly won over by the other members. "The people there had something I wanted," the 54-year-old recalls. "They seemed happier than I was, they seemed less stressed, they seemed at peace."
CPA has taught her to be more compassionate, both to her own body when she's feeling especially bad pain and for others who don't always understand what she's going through. "I'd tell them there was no fix, and then I'd have a good day, and they'd say, 'It looks like you're getting better!'"
Regular meetings also help members cope with the struggle of getting doctors to take their chronic pain seriously. "I feel stigma from doctors," says Rachel. "It's easy to be dismissed." Thankful to have finally found a health care team that's supportive, she now passes out flyers in doctors' offices in hopes of publicizing CPA so the group can reach others who might benefit from meetings.
RELATED: How to Actually Get Your Doctor to Listen to You
Along the way, Rachel has also had to cultivate more compassion for herself. "You're not crazy, you're not a lazy person—there is a lot of shame and blame and guilt about the things I want to do and can't do," she says. "What really has benefited me beyond words is that it is accessible by video or by phone, so I am able to reach over, grab my iPad, and attend a meeting with people who are so open, honest, and encouraging."
Taking pain day by day is one of the principles of CPA. "If I'm going through a period of more pain than usual or more fatigue, I'll start to get depressed and I'll start to have fear for a few hours or a day or two," Jan says. "Then I'll go, 'hey, wait a minute, I have a program I can use…we remember we can call somebody or turn to the literature or the tools we've learned or go to a meeting."
Rather than swap pain treatment strategies, members bolster each other emotionally and mentally. They share "tribal wisdom" in a "non-judgmental, compassionate atmosphere" about living with the unpredictability of their conditions, accepting their powerlessness over pain, and recognizing their needs and the needs of others, as two members put it to me.
After the formal end of a meeting, the conversation opens up for "fellowship," Here, CPA members are freer to express themselves outside of the structure of a meeting.
"CPA is why I'm alive today," one member told me during fellowship. The comment resonated with several others who had remained logged into the video chat; they agreed that the biggest difference in their lives before and after joining CPA was that they no longer feel suicidal, that they're "looking forward to living, not just surviving," as another member explained it.
Suicidal thoughts are common among chronic pain patients, Poupore-King says. "How am I going to live with this for the next year, five years, 10 years—and do I even want to?" patients often ask themselves. "Part of something like a support group is it gives you hope and validation, and we can never underestimate the power of hope."
*Names have been changed.
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]]>While some types of arthritis can be genetic, other risk factors for developing arthritis include age, gender (women are more likely to have certain types of arthritis, while men are more likely to have others), a previous joint injury, and obesity. Here are the three most common forms of arthritis, how to tell the difference, and the ways health-care providers will treat it.
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People who have osteoarthritis experience pain, decreased range of motion, aches, pain when walking, and a feeling of stiffness that sets in after you’ve rested. Sometimes, joints like the knees even emit creaky sounds when bent.
With this form of arthritis, symptoms typically come and go. “Osteoarthritis joint pain is worse in the morning, and improves with activity as the day goes on,” says Stella Bard, MD, a rheumatologist in New York City.
If you have osteoarthritis, your healthcare provider will want you to manage your weight and stay active, which can help support and maintain the structures around the joint, says Lisa Gale Suter, MD, a Yale Medicine rheumatologist. Physical therapy can also be helpful in teaching exercises that will help keep the muscle around that arthritic joint strong.
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“If it’s your knee that’s painful, for example, you will want to be sure your quad and hamstring muscles are healthy and strong,” says Dr. Suter, “and that you have flexibility in those muscles so that the tendons and ligaments can work.” In addition, patients often take anti-inflammatory medications (such as over-the-counter pain relievers) to ease symptoms.
This common forms of arthritis is actually an autoimmune disorder. That means that the body’s immune system is targeting the lining of the joints—which, in turn, prompts inflammation in the part of the joint that protects and lubricates. Once it becomes inflamed, pain and swelling occur.
Rheumatoid arthritis (RA) causes joint pain and swelling, especially in the knuckles, heels, or elbows. It also causes skin lumps, known as rheumatoid nodules, and stiffness that can last for hours or days.
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After a diagnosis of RA, people may be prescribed oral medications or injections to manage their symptoms. These drugs can include corticosteroids (such as prednisone), DMARDs (an acronym for disease-modifying anti rheumatic drugs), and biologic injections to control the inflammation.
“We recommend powerful anti-inflammatories that work to change the inflammation pathways,” Dr. Suter says. But she adds one caution: “These medications carry a risk of lowering your immunity, so patients have to be particularly vigilant about infections and may need to stop medications if they become ill.”
While the cause of psoriatic arthritis is not entirely clear, experts do know that it’s also an autoimmune disease that manifests in similar ways to rheumatic arthritis. The main difference is that when you have psoriatic arthritis, the skin can be involved, as well.
Between 5% and 20% of psoriasis patients will also have psoriatic arthritis. “Some patients can have it with a lot of skin disease, where the body is very covered in rashes, while others have more joint symptoms and no active skin disease,” Dr. Suter says.
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Symptoms of psoriatic arthritis include pain, swelling, redness in the joints (especially in the hands), nail changes, fatigue, eye problems, skin rashes, and swelling and tenderness in fingers and feet.
To control inflammation, psoriatic arthritis patients will take similar medications as those who have RA. These include NSAIDs, DMARDs, biologics, as well as new oral treatments.
While osteoarthritis, RA, and psoriatic arthritis tend to be the most common forms of arthritis, there’s a long list of other types of arthritis. These include bursitis, carpal tunnel syndrome, gout, Raynaud’s phenomenon, and ankylosing spondylitis, according to the Arthritis Foundation. Other conditions—such as Lyme disease, lupus, fibromyalgia, and inflammatory bowel disease—can also include arthritis as one component of a more complex illness.
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Arthritis usually occurs in adults, and advanced age is a risk factor for many different types. But children can also get a rare type of arthritis known as childhood or juvenile arthritis.
Because inflammation of the joints can be caused by so many different conditions, it’s important to see a doctor if you’re experiencing pain and stiffness. A primary-care physician is a good first step, or you may be referred to a rheumatologist who can help diagnose and treat your specific joint problems.
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]]>Health looked at recent research and spoke with several experts about who might want to try it, who should avoid it, and what any marijuana user should know.
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The relaxing effects of marijuana are well known, so it’s not surprising that a 2016 paper in the journal Clinical Psychology Review concluded that it may have benefits for people with depression, social anxiety, and post-traumatic stress disorder. A study published in Drug and Alcohol Dependence also found that a very low dose of THC, one of the main compounds in marijuana, helped people feel less nervous about a public-speaking task.
But it may not be that simple: That dose was equivalent to only a few puffs on a marijuana cigarette, say the study authors. They also found that slightly higher amounts of TCH—anything that would produce even a mild high—actually made anxiety worse. Other research has also suggested that marijuana may be more harmful than helpful for people with certain mental health conditions, like psychosis or bipolar disorder.
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The research “indicates cannabinoids could be helpful for people with anxiety,” lead author Emma Childs, PhD, associate professor of psychiatry at the University of Illinois at Chicago, tells Health. But more research is needed, she says, to determine appropriate dosages and delivery methods, and to prevent the opposite effects from happening.
Pain relief is a common use for medical marijuana, and the National Academies of Sciences concluded there is indeed good evidence to support this practice. Marijuana products also appear to be effective at calming muscle spasms caused by multiple sclerosis and easing nausea and vomiting due to chemotherapy, the report stated.
The National Academies also determined that there is moderate evidence that cannabis or cannabis-derived products may help people who have trouble sleeping due to sleep apnea, fibromyalgia, or chronic pain.
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In a New England Journal of Medicine study, cannabidiol oil—a derivative of marijuana—reduced seizures by 39% in children with Dravet syndrome, a rare form of epilepsy. That was big news for parents who have been using medical marijuana for years, often illegally, to help their kids suffering from this debilitating condition.
The cannabidiol oil used in the study—approved by the FDA in 2018 and marketed as Epidiolex—won’t make people high, because it doesn’t contain THC. Experts say that results may be riskier and more unpredictable with other marijuana products.
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Despite beliefs that marijuana is a “gateway drug,” research suggests that the use of medical marijuana may actually reduce dependence on dangerous prescription painkillers like those fueling the nation’s opioid epidemic.
In a 2016 study in the journal Health Affairs, researchers found that there were 1,826 fewer daily doses of painkillers prescribed per year, on average, in states where medical marijuana was legal compared to states it’s not. And in a review article published in Trends in Neuroscience, researchers wrote that cannabinoids may help people recover from opioid addiction. Human trials have been limited because of marijuana’s classification as a Schedule 1 drug—but the authors argue that more studies are urgently needed.
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Olivia Newton John uses cannabiodiol oil (along with conventional medicine) to fight her metastatic breast cancer, the actress’s daughter recently revealed. Studies have shown that the oil may inhibit the growth of cancer cells outside of the human body, but there haven’t been any real-life trials to back up these findings.
Gregory Gerdeman, PhD, assistant professor of biology at Eckerd College, told Time that there have also been anecdotal patient reports and “increasing numbers of legitimate clinical case studies … that all indicate tumor-fighting activities of cannabinoids.” It’s still unknown, however, whether traditional forms of marijuana would be an effective cancer therapy, or what cancer types it might actually work against.
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As pot use becomes more prevalent, more pregnant women are getting high, according to a 2016 JAMA study—either for recreational use or, sometimes, to treat morning sickness. But evidence suggests that prenatal exposure to marijuana is associated with developmental and health problems in children, including low birth weight, anemia, and impaired impulse control, memory, and attention, the authors wrote. Until more is known for sure, they say women who are pregnant or considering becoming pregnant should be “advised to avoid using marijuana or other cannabinoids.”
Current parents should also use marijuana with caution, University of Washington researchers suggest. Their study in Prevention Science found that people tend to cut back on marijuana use once they have kids, but they don’t always quit. That’s concerning, says lead author and research scientist Marina Epstien, PhD, because parental marijuana use is strongly related to children’s use—and children’s use is associated with higher rates of health problems.
“Children watch what their parents do,” Epstein tells Health. “I would encourage parents to be talking to their kids and be clear about expectations for their kids about using or not using marijuana and the amount, especially with their teenagers.”
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In 2014, a study in Forensic Science International documented what German researchers claimed to be the first known deaths directly attributed by intoxication from marijuana. The authors pointed out that, during autopsies, it was discovered that one of the two young men had a serious but undetected heart problem, and that the other had a history of drug and alcohol use.
The researchers concluded that the absolute risk of cannabis-related cardiovascular effects is low, especially for healthy people. But they say that people who are at high risk for heart-related complications should avoid the use of cannabis, since it can have temporary effects on the cardiovascular system.
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A study by the Insurance Institute for Highway Safety found that insurance claim rates for motor vehicle accidents from 2012 to 2016 were about 3% higher in states with legalized marijuana than in states without. But other studies have found no such increase in fatal car crashes in states with legalized marijuana, compared to similar states without.
Experts say it’s possible that driving under the influence of marijuana may increase the risk of minor fender benders—but may also reduce rates of alcohol consumption and therefore help prevent more serious, deadly crashes. The bottom line? Driving while stoned may be less dangerous than driving drunk, but it’s still riskier than driving sober.
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The Canadian Research Initiative in Substance Misuse published a set of “lower-risk cannabis use guidelines,” aimed at helping people who use marijuana make responsible decisions about their health. (The drug was legalized for recreational use in Canada in 2018.) Among other advice, the guidelines urge people to “avoid smoking burnt cannabis,” which can harm the lungs and respiratory system—especially when combined with tobacco.
They recommend choosing vaporizers or edibles instead, but caution that these methods also come with some risks. And if you do smoke cannabis, the guidelines say, “avoid ‘deep inhalation’ or ‘breath-holding,’” which increase the amount of toxic materials absorbed by the body.
It’s not just lung-health that frequent weed smokers should worry about, either. A study in the Journal of Periodontology found that frequent marijuana users were twice as likely as people who didn’t use frequently to have gum disease, even after controlling for other factors such as cigarette smoke. The research didn’t distinguish between methods of marijuana use, but they do point out that smoking is the most common form of recreational use.
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Canada’s low-risk guidelines may sum it up best with this statement: “To avoid all risks, do not use cannabis. If you decide to use, you could experience immediate, as well as long-term risks to your health and well-being.” The guidelines also recommend avoiding marijuana use during adolescence, because the later in life people start using the drug, the less likely they are to experience these problems.
Finally, the guidelines recommend adults choose natural cannabis over dangerous synthetic versions, and limit themselves to “occasional use, such as on weekends or one day a week at most.”
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Cannabinoid hyperemesis syndrome (CHS) causes some marijuana users to experience severe nausea, vomiting, and abdominal pain. A study published in the Annals of Internal Medicine found that, among study participants, 18.4% of people who inhaled cannabis and ended up in the emergency room of a Colorado hospital and 8.4% of those who ate edible cannabis and ended up in the emergency room had CHS symptoms.
CHS hasn’t been studied extensively, says Joseph Habboushe, MD, who specializes in emergency medicine at NYU Langone. While it’s possible to use marijuana for years without experiencing symptoms of CHS, once a person does experience CHS symptoms, the symptoms tend to stick around as long as the person continues using marijuana. Stopping marijuana use is the only known way to permanently alleviate CHS symptoms, but it takes time. “We know that if you stop smoking you get better, but it takes days to weeks,” Dr. Habboushe says.
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This post was originally published on June 29, 2017 and has been updated for accuracy.
]]>But even though it's infiltrating pretty much every corner of the wellness world (hi, vegan CBD brownies!) many people still find CBD a little confusing—especially when it comes to figuring out the right way to use it and how to make sure the stuff you're buying is, you know, actually legit. Below, we asked experts to answer the most pressing questions about CBD.
CBD, short for cannabidiol, is a chemical compound from the Cannabid sativa plant, whish is also known as marijuana or help, according to the US National Library of Medicine.
It's a naturally occurring substance that's used in products like oils and edibles to impart a feeling of relaxation and calm. Unlike its cousin, delta-9-tetrahydrocannabinol (THC), which is the major active ingredient in marijuana, CBD is not psychoactive.
Nope. The cannabis plant is made up of two main players: CBD and THC. "CBD is the non-psychoactive portion of the plant, so what that means is you won't have any effects like euphoria," says Junella Chin, DO, an osteopathic physician and a medical cannabis expert for cannabisMD. "You won't feel sedated or altered in any way."
There are two possible exceptions to this. The first is that some people, for unknown reasons, just react differently to CBD. According to Dr. Chin, about 5% of people say they feel altered after taking CBD. "Usually they're the same people who have side effects from Advil or Tylenol," she says. You never know how your body will react to any new supplement, so when taking CBD for the first time, do so safely under supervision.
It's also crucial to buy third-party-tested CBD for quality assurance (more on this later). Because the FDA doesn't regulate CBD, it is possible to buy a product that is more or less potent than advertised, or even contains small amounts of THC.
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You've probably heard the terms cannabis, marijuana, and hemp all tossed around in relation to CBD. The plant Cannabis sativa has two primary species, hemp and marijuana. Both contain CBD, but there's a much higher percentage in hemp, which also has very low (less than 0.3%) levels of THC compared to marijuana.
When people talk about hemp oil, they're referring to oil extracted from the seeds of the hemp plant. There are no cannabinoids—CBD or THC—in hemp oil. This ingredient is packed with healthy fats and often appears in beauty products for its moisturizing benefits.
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The only CBD medication that is currently FDA-approved is Epidiolex, which the agency approved last year for the treatment of certain types of epilepsy. But many people swear CBD has helped with a slew of other health conditions, including back pain, osteoarthritis, even cancer.
"My practice has patients walking in every day asking about CBD," says Houman Danesh, MD, director of integrative pain management for the Mount Sinai Hospital in New York City. But while there's lots of anecdotal evidence, he says, "it's still very difficult to say" what the real benefits are due to a serious lack of research.
"Right now, you just have pharmacies trying to make some sort of sense out of it and say, 'Yes, it works for this,'" he says, "but that's not the way medicine is practiced—it should be based on evidence, and there's not a lot of evidence to really support these claims."
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There are two main types of pain, Dr. Danesh says: musculoskeletal and nerve. "There could be benefit for both conditions," he says.
The tricky part is that there's some evidence suggesting CBD works best for pain when combined with a little THC, says Dr. Danesh. "Depending on what type of pain you have, you might be able to do just CBD, but sometimes you need CBD and THC." This makes accessing a product that will actually help you more difficult due to different regulations in each state. In New York, where Dr. Danesh practices, for example, CBD is available over the counter. But as soon as you add THC, you need a prescription.
Figuring out how much you should take is challenging as well; the dosage that alleviates one patient's pain might do very little for someone else. "And until we can study it, it's the wild west," Dr. Danesh says.
The takeaway? "I think CBD is a safe thing to try," says Dr. Danesh. But he urges patients to push for more research by putting pressure on representatives to get national bills passed that allow scientists to look closer at CBD and the conditions that respond to it.
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CBD might be worth trying to manage symptoms of anxiety. "[CBD] tells your body to calm down and reminds you that you're safe," Dr. Chin says. "It mellows out the nervous system so you're not in a heightened 'fight or flight' response," she says, so people with anxiety may find it helps them feel more relaxed.
Still, one of the biggest misconceptions about CBD is that it's a wonder drug. "A lot of times people think CBD is a cure-all, and it's not," Dr. Chin says. "You should also have a healthy lifestyle with plenty of exercise and good nutrition—CBD is not going to fix everything."
It really depends on what your goal is and why you're taking CBD in the first place.
Some people don't want to ingest anything and therefore prefer a topical CBD cream or ointment. "You can apply it to muscles, joints, and ligaments and still get a nice, localized release," Dr. Chin says.
The biggest differences between tinctures, edibles, and vape pens are speed of delivery and how long the effects last. Vape relief is faster but wears off faster too—usually in about two hours, says Dr. Chin. "Say you wake up in the morning and pulled your back out, you might want to take CBD through a vape pen, which delivers in 10 minutes."
Tinctures and edibles take longer to work but last four or five hours. "A tincture looks like a little liquid that you put under your tongue, and you feel relief within half an hour," Dr. Chin says. "If you prefer to taste something, you choose an edible, whether it's a capsule, gummy, or baked good."
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"There are literally hundreds of CBD brands at this point," says Brandon Beatty, founder and CEO of Bluebird Botanicals and an executive vice president of the U.S. Hemp Roundtable. Here are a few things you should keep in mind when shopping.
We don't mean the color or millennial font. If it's a dietary supplement, it should have a back panel with an FDA disclaimer and warning section, according to Beatty. "Ideally, it would be preferable to have access to their third-party lab testing results too."
Nearly every expert Health spoke to agreed that your CBD products should be tested by a third party to confirm the label's accuracy. This is a real concern in the industry—take the 2017 Journal of the American Medical Association study, for example, which tested 84 CBD products and found that 26% contained lower doses than stated on the bottle. Look for a quality assurance stamp or certificate of analysis from a third party (aka not the actual brand) or check the retailer's website if you don't see it on the product's label.
This is a confusing one for many people. "A lot of brands don't do a good job of clearly instructing their consumer on the dosing," says Chris Roth, CEO and co-founder of Highline Wellness. When thinking about dosing, also consider whether your CBD is full-spectrum or isolate: Full-spectrum could include other cannabinoids like cannabidivarin or cannabigerol (this is important, since "there's something called the 'entourage effect' when all together, they're more effective than any one of them alone," Roth explains), while isolate is 100% CBD. "Some people might only need 10 milligrams of full-spectrum CBD, but with isolate, even taking 80 or 100 milligrams might not have the same effect," he says.
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If so, hard pass. "You should avoid any company that makes disease claims," says Beatty. "If so, it means they're either willing to break the rules or they're not aware of the rules."
You know how you check your raw chicken or bagged lettuce every time there's a recall to make sure the one you bought isn't going to make you sick? You should be able to do that with CBD products too. "This is a huge indicator as to whether they are following good manufacturing practices," says Beatty. "There should be a way to identify this product in case it was improperly made so the company can carry out a recall."
As with any supplement, you want to know everything you're ingesting in addition to the main event. For example, "sometimes I notice that [CBD manufacturers] will add melatonin," says Dr. Chin.
You can find CBD products in shopping malls, convenience stores, even coffee shops in many states right now. But when in doubt, natural grocers are a safe brick-and-mortar place to buy CBD, Beatty says. "Typically they have a vetting process that does some of the legwork for you."
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First, a little background. Industrial hemp was legal in the United States until Congress passed the Marihuana Tax Act in 1937. ("Some of our early presidents grew hemp," notes Sarah Lee Gossett Parrish, a cannabis industry attorney based in Oklahoma.) Nearly 80 years later, the 2014 Farm Bill took the position that states can regulate the production of hemp and, as a result, CBD. Then last year, President Trump signed a new Farm Bill that made it federally legal to grow hemp.
This means that "consumers everywhere, if they're compliant with their state, can grow hemp and use hemp products," Parrish explains, "and among those will be CBD."
In other words, the latest bill removed hemp from the Drug Enforcement Administration, or DEA's, purview. "Hemp can now be grown freely under federal law, which, of course, is huge," Parrish says. "But while it's legal under federal law, it's up to each state to set their own policy."
These policies vary widely. Marijuana and CBD are currently fully legal for both medicinal and recreational purposes in Alaska, California, Colorado, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, Washington, and Washington D.C. In 23 states, it's legal in some form, such as for medicinal purposes. Another 14 states permit just CBD oil. But both are illegal in Idaho, Nebraska, and South Dakota. For more information, the organization Americans for Safe Access has a helpful guide to the specific laws in each state.
"It's kind of ironic," says Parrish. "With marijuana, we have got the federal government saying 'No' and a bunch of states saying 'Yeah, it's OK'—but with hemp, the feds say 'Yeah, it's OK,' but we still have some states saying it's not."
That same 2018 Farm Bill means you can now travel between states with legit CBD products. "Flying with CBD should pose no issues now," Parrish says. However, if you're traveling with a tincture, be mindful of TSA limits on how much liquid you can carry on an airplane, she adds. (You can also mail CBD products, just like "companies that comply with the Bill can ship their hemp-derived CBD products anywhere in the U.S.," Parrish notes.)
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It should not, as long as you're buying third-party tested CBD with no added THC, says Dr. Chin. But she does point out that athletes, who often are required to take drug tests that are more sensitive, "could potentially test positive" for trace amounts of THC if they've been using CBD products.
Tempted to give your pup one of those CBD dog biscuits? "Generally we expect CBD products to be safe, and they could show some benefit for anxiety in pets," says John Faught, DVM, a veterinarian based in Austin, Texas.
But the challenge when considering CBD products for pets is the same as with people: lack of research. "I believe there are good products out there today, but I also don't know how to distinguish them at this time," Faught says.
Looking for CBD recommendations? Check out our roundups of the best CBD oil brands this year, dietitian-recommended CBD gummies, and the best topical CBD creams for pain.
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]]>But while the photogenic studio quickly started popping up on wellness influencers' Instagram feeds, WTHN's goal isn't just to make acupuncture cool—it's also to demystify the treatment and make it more accessible to everyone. "In the world of SoulCycle and DryBar, we were lacking a modern re-imagination of acupuncture," Larivee tells Health.
Auth and Larivee are hoping patients will embrace acupuncture as a lifestyle habit rather than a onetime fix. With this in mind, the studio offers a varied menu (including services for pain, reproductive health, and better skin), a membership program that encourages repeat visits, and the ability to pay using pre-tax dollars on an HSA debit card.
Studios like WTHN are inspiring more people to try the ancient treatment to ease their aches and pains. But is it right for you? And what kind of benefits should you actually expect? Here's what you should know about acupuncture before booking your first session.
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Like meditation and cupping, acupuncture is getting a trendy image makeover from the wellness movement right now, but it's certainly nothing new. The treatment has been used for centuries in traditional Chinese medicine, where it's believed to help regulate the flow of chi throughout the body and heal imbalances.
"With the body stimulated at specific points, the flow of energy along those channels can be modified, rebalanced, and redirected to its healthy order," explains Juhi Singh, a wellness expert and acupuncturist who founded the Juhi Center in New York City.
Practitioners use small, sterile needles to activate acupuncture points at various depths. And no, they're not the same needles you get your flu shot from—these are much finer, about the width of a single strand of hair.
So, how does it work? Harvard-trained newborn intensive care physician Charles Anderson, MD, a strategic partner for Modern Acupuncture, a franchise with 30 locations nationwide, tells us there are a few different hypotheses. "One is that when needles are placed to stimulate certain nerves, these nerves send signals to the brain," he says. "The brain releases neural hormones that naturally relieve pain."
There are so many purported benefits of acupuncture, it can be overwhelming to determine what's legit and what's… less so. Fans of the practice claim it has eased osteoarthritis, helped them get pregnant, and eliminated chronic pain. One Health beauty writer swears it got rid of her acne. For his part, Dr. Anderson says he's seen the most dramatic improvements in patients who were suffering from back pain, insomnia, migraine headaches, and anxiety.
John S. Cullen, MD, a family physician in Valdez, Alaska, and president of the American Academy of Family Physicians (AAFP), tells Health that acupuncture can be particularly beneficial for patients with chronic pain, especially if it's nerve-related. "I generally recommend it for pain that's not easily treated by other means," he says. "For neuropathic pain, where it’s the nerves themselves that are hurting, I find it useful."
Research has linked various forms of acupuncture to improvements with neck pain, back pain, fibromyalgia pain, migraines, carpal tunnel symptoms, stress urinary incontinence in women, and hot flashes in breast cancer patients. Women undergoing fertility treatments are often encouraged to try acupuncture as well (although the American Pregnancy Association stresses that it shouldn't be used to treat infertility associated with tubal adhesions). It's also frequently suggested as a low-risk treatment for anxiety.
Other studies have raised questions about whether it's acupuncture itself or a placebo effect helping people feel better. But Dr. Cullen notes that trying to apply Western scientific methods to the entire tradition of acupuncture doesn't always work.
"It's hard to get really good scientific studies on acupuncture," he says. "In the process, we sometimes interpret results in ways that may not be the best."
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I booked my first appointment more out of general curiosity than to tackle a specific health concern, but I did tell my acupuncturist I was interested in tailoring my session for back pain (I have scoliosis, and recently noticed that long days hunching over my laptop were making it worse). She recommended a face-down treatment to better focus on the acupuncture points in my back.
Like many people trying acupuncture for the first time, I was nervous about the whole needle thing. It turns out, I didn't need to be. Although a few of them registered as a slight prick, for the most part I felt nothing at all. And once my therapist finished inserting the needles (I counted about 14) and placed headphones over my ears for 30 minutes of sound therapy, I zoned out and completely forgot I was a human pin cushion.
At the end of the session, I felt relaxed and maybe a little woozy—but not drastically changed. A few days later, though, I realized I didn't have the usual ache in my upper back at the end of the work day. I decided to make a follow-up appointment, something many experts recommend.
"Acupuncture is not a 'one and done' thing," says Leah Chischilly, an acupuncturist and manager of clinical operations at Modern Acupuncture's Scottsdale location. "It may require several treatments to see improvement."
Even if you're skeptical about the claims, there's probably no harm in trying acupuncture—after all, there are countless success stories from people who say it changed their lives.
Singh is one of them. She was diagnosed with Crohn's disease and ulcerative colitis at 16, and these conditions "quickly turned critical within a few years," she says. When Western treatments alone didn't offer relief, she pursued alternative therapies like acupuncture in India. Today, "I've remained nearly symptom-free for over 20 years," Singh says.
Others simply find their sessions relaxing. "You don't have to be sick or in pain or trying to get pregnant to benefit," notes Auth.
And as long as you're treated by a licensed acupuncturist who uses sterile, disposable needles, there's little risk. Most states require practitioners to take an exam from the National Certification Commission for Acupuncture and Oriental Medicine; visit nccaom.org to find an acupuncturist near you.
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]]>When someone says she popped a calf muscle, it’s another way of saying she tore or strained the calf muscle. The expression comes from the popping sound of the tissue tearing, which happens when the muscle fibers are stretched too quickly or too far—say, when you accelerate to chase a ball on a tennis court or change directions abruptly in a soccer game. Warming up before you exercise can help improve flexibility in your muscles. But because our muscles naturally lose some of their elasticity as we age, you’re more likely to suffer a strain as you get older, especially if you’re overtraining or fatigued.
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A pulled calf muscle is quite painful, and there may be bruising and swelling. The injury makes it difficult to walk or bear any weight on that leg. You should definitely get checked out by your doctor because recovery will most likely require physical therapy. There are also potential complications from a torn muscle, such as blood clots. But until you can get to an appointment, resting and icing your calf will help control the pain and inflammation.
Health’s medical editor, Roshini Rajapaksa, MD, is associate professor of medicine at the NYU School of Medicine and a cofounder of TULA Skincare.
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]]>Because it's a homeopathic remedy, you might not be sure that it's safe and really works. "Homeopathic products are regulated as drugs under the Federal Food, Drug, and Cosmetic Act (FDCA)," states the National Institutes of Health's National Center for Complementary and Integrative Health. "However, under current agency policy, the FDA does not evaluate them for safety or effectiveness."
While some users have given arnica gel rave reviews online, it’s a good idea to get an overview of what it is, which conditions users claim it can treat, and what science says about it before trying it. Here’s what you should know about arnica gel before dabbing it on your skin.
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Arnical gel comes from the flowers of the arnica plant. “Arnica is an herb that mostly grows in mountain regions in Europe as well as in East Asia, Canada, and the northern U.S.," says Sonia Batra, MD, a dermatologist and co-host of the TV show The Doctors. "People use the plant’s flowers to decrease inflammation from ailments such as a sore throat, insect bites, swelling, bruising, muscle pain, arthritis, and other general pain.”
Arnica is a close relation to the sunflower and common daisy, says Kim T. Tran, PharmD, pharmacy manager at Jackson Memorial Hospital in Miami. “The plant contains an active ingredient, helenalin, which in small concentrations can be beneficial as an anti-inflammatory and analgesic,” she says.
While arnica gel is often used to treat many types of pain, it’s mainly for sprains and bruising, believes Tran. It's applied to the affected area and massaged into skin, she says.
Arnica can also be taken orally and is sold over the counter in tablets. Oral arnica is diluted, says Dr. Batra, and is commonly used to treat a sore throat and pain after dental work.
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Arnica gel's effectiveness is controversial. Some homeopathic doctors swear by its efficacy, as do many users. But there is limited scientific evidence. “Overall, studies do not show arnica gel to be a sufficient treatment for pain management or prevention of muscle damage,” says Dr. Batra.
“There are a few studies that have reported improvement in osteoarthritis after several weeks of use and that have compared its effectiveness to that of ibuprofen,” she says. One study showed that a 20% arnica gel formula sped up the healing of bruises comparably to a topical 5% Vitamin K formula.
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Still, Tran warns that arnica gel isn't a magic fix for pain. “Though this may sound promising, further clinical studies need to be conducted in order for this to be a proven remedy,” she says.
“The efficacy of helenalin for treatment of pain and swelling, when applied topically, is not supported by the current available evidence at doses of 10% or lower,” Tran says. For doses higher that 10%, more research investigating safety and effectiveness is required.
Though arnica gel has not been widely studied, says Tran, she says it is generally safe for use. Side effects of topical arnica are very rare, she adds; these include redness, itching, and skin irritation. If you notice these symptoms, stop using arnica gel.
Topical arnica should not be applied to broken skin or mucous membranes, as it can cause irritation, says Dr. Batra. If you have a ragweed allergy, you’ll want to take a pass, too. “If you are allergic to ragweed or other plants of the same family that arnica belongs to, taking arnica will trigger an allergic reaction similar to what you would experience if exposed to ragweed or one of those other plants,” she warns.
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Play it safe and don't use arnica if you are pregnant or breastfeeding. Like many other homeopathic medications, "there are not enough studies to show effects on pregnant or breastfeeding patients. Since its mechanism of action has only been theorized, it is recommended to be on the side of caution to avoid this product if you are pregnant or breastfeeding,” says Tran. This goes for both topical and oral arnica. One more word of caution about oral arnica: Almost all experts and health agencies recommend against using it at all, says Tran.
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