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NECK PAIN

Neck pain is a very common problem, affecting about 10 percent of the adult population at any single point in time. Neck pain can range from a dull ache to an electric-shock type of sensation. Other signs and symptoms that accompany neck pain, such as numbness or muscle weakness, can help pinpoint the cause of your neck pain.

Most neck pain lasts just a short time a few hours or days. Neck pain that continues longer than several weeks is considered chronic. But even persistent neck pain can usually be helped by exercise, stretching, physical therapy and massage.

NECK PAIN Neck pain is a very common problem, affecting about 10 percent of the adult

Risk factors for neck pain include injury from involvement in contact sports, motor-vehicle accidents, bull or bronco horse riding, etc. Prevention of neck pain in the context of these activities should include neck strengthening exercises and often neck bracing.

What are other symptoms that are associated with neck pain?

Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck or turning the head. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and lymph node (gland) swelling.

Neck pain can also be associated with headache, facial pain, shoulder pain, and arm numbness or tingling (upper extremity paresthesias). These associated symptoms are often a result of nerves becoming pinched in the neck. Depending on the condition, sometimes neck pain is accompanied by upper back and/or lower back pain, as is common in inflammation of the spine from ankylosing spondylitis.

Causes

Neck pain can result from a variety of causes, including:

Muscle strains. Overuse, such as too many hours hunched over a steering wheel, often triggers muscle strains. Even such minor things as reading in bed or gritting your teeth can strain neck muscles. Worn joints. Just like all the other joints in your body, your neck joints tend to undergo wear and tear with age, which can cause osteoarthritis in your neck. Nerve compression. Herniated disks or bone spurs in the vertebrae of your neck can take up too much space and press on the nerves branching out from the spinal cord. Injuries. Rear-end auto collisions often result in whiplash injuries, which occur when the head is jerked backward and then forward, stretching the soft tissues of the neck beyond their limits. Diseases. Neck pain can sometimes be caused by diseases, such as rheumatoid arthritis, meningitis or cancer.

Alternative medicine

Talk to your doctor if you're interested in trying alternative treatments for your neck pain. Your doctor can discuss the benefits and risks. Alternative treatments include:

Acupuncture. Acupuncture involves the insertion of thin needles into various points on your body. Studies have found that acupuncture may be helpful for many types of pain. But studies in neck pain have been mixed. For best results, you may need to undergo several acupuncture sessions. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. Chiropractic. Given mainly to the spine, a chiropractic adjustment applies a controlled, sudden force to a joint moving it beyond its normal range of motion. Chiropractic treatments to the neck may slightly increase your risk of stroke. Massage. During a massage, a trained practitioner manipulates the muscles in your neck with his or her hands. Little scientific evidence exists to support massage in people with neck pain, though it may provide relief when combined with your doctor's recommended treatments. Transcutaneous electrical nerve stimulation (TENS).Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain. Alternate heat and cold. Reduce inflammation by applying cold, such as an ice pack or ice wrapped in a towel, for up to 20 minutes several times a day. Or alternate the cold treatment with heat. Try taking a warm shower or using a heating pad on the low setting. Heat can help relax sore muscles, but it sometimes aggravates inflammation, so use it with caution. Rest. Lie down from time to time during the day to give your neck a rest from holding up your head. Avoid prolonged rest, since too much inactivity can cause increased stiffness in your neck muscles. Gentle stretching. Gently move your neck to one side and hold it for 30 seconds. Stretch your neck in as many directions as your pain allows. This may help alleviate some of the pain.

SCOLIOSIS

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown.

Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.

Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.

SCOLIOSIS Scoliosis is a sideways curvature of the spine that occurs most often during the growth

What is the treatment for scoliosis?

Treatment of scoliosis is based on the severity of the curve and the chances of the curve getting worse. Certain types of scoliosis have a greater chance of getting worse, so the type of scoliosis also helps to determine the proper treatment. There are three main categories of treatment: observation, bracing, and surgery.

Functional scoliosis is caused by an abnormality elsewhere in the body. This type of scoliosis is treated by treating that abnormality, such as a difference in leg length. A small wedge can be placed in the shoe to help even out the leg length and prevent the spine from curving. There is no direct treatment of the spine because the spine is normal in these people.

Neuromuscular scoliosis is caused by an abnormal development of the bones of the spine. These types of scoliosis have the greatest chance for getting worse. Observation and bracing do not normally work well for these people. The majority of these people will eventually need surgery to stop the curve from getting worse.

Treatment of idiopathic scoliosis is based on the age when it develops.

In many cases, infantile idiopathic scoliosis will improve without any treatment. X-rays can be obtained and measurements compared on future visits to determine if the curve is getting worse. Bracing is not normally effective in these people.

Juvenile idiopathic scoliosis has the highest risk for getting worse of all of the idiopathic types of scoliosis. Bracing can be tried early if the curve is not very severe. The goal is to prevent the curve from getting worse until the person stops growing. Since the curve starts early in these people, and they have a lot of time left to grow, there is a higher chance for needing more aggressive treatment or surgery.

Adolescent idiopathic scoliosis is the most common form of scoliosis. If the curve is small when first diagnosed, it can be observed and followed with routine X-rays and measurements. If the curve stays below 25 degrees, no other treatment is needed. You may return to see the doctor every three to four months to check for any worsening of the curve.

Symptoms

Signs and symptoms of scoliosis may include:

Uneven shoulders

One shoulder blade that appears more prominent than the other

Uneven waist

One hip higher than the other

If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing.

Is there a cure for scoliosis?

At this time, there is no cure for scoliosis. There are good treatment options as discussed above. Researchers are trying to find the causes of the different types of scoliosis. This will hopefully lead to better treatments or a cure.

The treatments and methods used in dealing with scoliosis are varied and greatly different, with many different outcomes and final results. Massage therapy, with its positive effects while being employed as a type of ongoing treatment for patients with scoliosis, continues to rise in popularity due to its palliative effects and proven efficacy during rehabilitation. When combined with acupuncture the health benefits increase even further, firmly placing massage therapy under the umbrella of proven and positive treatments in the fight against scoliosis.

Alternative medicine

Studies indicate that the following treatments for scoliosis are ineffective:

Chiropractic manipulation

Electrical stimulation of muscles

Biofeedback

STRESS

Stress is a normal part of life that can either help us learn and grow or can cause us significant problems.

Stress releases powerful neurochemicals and hormones that prepare us for action (to fight or flee).

If we don't take action, the stress response can create or worsen health problems.

Prolonged,

uninterrupted,

unexpected,

and

unmanageable stresses are the most damaging types of

stress.

Stress can be managed by seeking support from loved ones, regular exercise, meditation or other relaxation techniques, structured timeouts, and learning new coping strategies to create predictability in our lives.

Many behaviors that increase in times of stress and maladaptive ways of coping with stress -- drugs, pain medicines, alcohol, smoking, andeating -- actually worsen the stress and can make us more reactive (sensitive) to further stress.

STRESS    Stress is a normal part of life that can either help us

While there are promising treatments for stress, the management of stress is mostly dependent on the ability and willingness of a person to make the changes necessary for a healthy lifestyle.

What is stress?

Stress is simply a fact of nature -- forces from the inside or outside world affecting the individual. The individual responds to stress in ways that affect the individual as well as their environment. Because of the overabundance of stress in our modern lives, we usually think of stress as a negative experience, but from a biological point of view, stress can be a neutral, negative, or positive experience.

In general, stress is related to both external and internal factors. External factors include the physical environment, including your job, your relationships with others, your home, and all the situations, challenges, difficulties, and expectations you're confronted with on a daily basis. Internal factors determine your body's ability to respond to, and deal with, the external stress-inducing factors. Internal factors which influence your ability to handle stress include your nutritional status, overall health and fitness levels, emotional well-being, and the amount of sleep and rest you get.

Stress has driven evolutionary change (the development and natural selection of species over time). Thus, the species that adapted best to the causes of stress (stressors) have survived and evolved into the plant and animal kingdoms we now observe.

Man is the most adaptive creature on the planet because of the evolution of the human brain, especially the part called the neo-cortex. This adaptability is largely due to the changes and stressors that we have faced and

mastered. Therefore, we, unlike other animals, can live in any climate or ecosystem, at various altitudes, and avoid the danger of predators. Moreover, most recently, we have learned to live in the air, under the sea, and even in space, where no living creatures that we know of have ever survived. So then, what is so bad about stress?

Relaxation techniques

Relaxation techniques are an essential part of stress management. If you're an overachiever, you may put relaxation low on your priority list. Don't shortchange yourself. Everyone needs to relax and recharge.

Relaxation is invaluable for maintaining your health and well-being, and repairing the toll that stress takes on your mind and body.

Almost everyone can benefit from learning relaxation techniques. Relaxation techniques can help to slow your breathing and to focus your attention on the here and now.

Common relaxation techniques include meditation, tai chi and yoga. But there are more-active ways of achieving relaxation. For example, walking outdoors or participating in a sports activity can be relaxing and help reduce stress.

It doesn't matter which relaxation technique you choose. What matters is that you select a technique that works for you and that you practice achieving relaxation regularly.

Research has shown that massage can lower your heart rate and blood pressure, relax your muscles and increase the production of endorphins, your body's natural "feel good" chemical. Serotonin and dopamine are also released through massage, and the result is a feeling of calm relaxation that makes chronic or habitual as well as acute or short-term stress much easier to overcome.

In fact, stress relief is one of the first benefits that come to mind when thinking of massage therapy. It's also a key component for anyone trying to achieve a healthier lifestyle. Clinical studies show that even a single 1 ½-hour session can significantly lower your heart rate, cortisol levels and insulin levels -- all of which explain why massage therapy and stress relief go hand-in-hand.

BACK PAIN

Back pain is a common complaint. Most people will experience low back pain at least once during their lives. Back pain is one of the most common reasons people go to the doctor or miss work.

On the bright side, you can take measures to prevent or lessen most back pain episodes. If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.

Symptoms

Symptoms of back pain may include:

Muscle ache

Shooting or stabbing pain

Pain that radiates down your leg

Limited flexibility or range of motion of the back

Inability to stand up straight

Causes

Back pain often develops without a specific cause that your doctor can identify with a test or imaging study. Conditions commonly linked to back pain include:

Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement may strain back muscles and spinal ligaments. If you're in poor physical condition, constant strain on your back may cause painful muscle spasms. Bulging or ruptured disks. Disks act as cushions between the individual bones (vertebrae) in your spine. Sometimes, the soft material inside a disk may bulge out of place or rupture and press on a nerve. The presence of a bulging or ruptured disk on an X-ray doesn't automatically equal back pain, though. Disk disease is often found incidentally; many people who don't have back pain turn out to have bulging or ruptured disks when they undergo spine X-rays for some other reason. Arthritis. Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis. Skeletal irregularities. Back pain can occur if your spine curves in an abnormal way. Scoliosis, a condition in which your spine curves to the side, also may lead to back pain, but generally only if the scoliosis is quite severe. Osteoporosis. Compression fractures of your spine's vertebrae can occur if your bones become porous and brittle.

Alternative medicine

A number of alternative treatments are available that may help ease symptoms of back pain. Always discuss the benefits and risks with your doctor before starting any new alternative therapy.

Chiropractic care. Back pain is one of the most common reasons that people see a chiropractor. Acupuncture. A practitioner of acupuncture inserts sterilized stainless steel needles into the skin at specific points on the body. Some people with low back pain report that acupuncture helps relieve their symptoms. Massage. If your back pain is caused by tense or overworked muscles, massage therapy may help. Yoga. There are several types of yoga, a broad discipline that involves practicing specific postures or poses, breathing exercises and relaxation techniques. Results of a few clinical trials suggest that yoga offers some benefit for people with back pain.

Prevention

You may be able to avoid back pain by improving your physical condition and learning and practicing proper body mechanics.

To keep your back healthy and strong:

Exercise. Regular low-impact aerobic activities those that don't strain or jolt your back can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good choices. Talk with your doctor about which activities are best for you. Build muscle strength and flexibility. Abdominal and back muscle exercises (core-strengthening exercises) help condition these muscles so that they work together like a natural corset for your back. Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Your doctor or physical therapist can let you know which exercises are right for you. Maintain a healthy weight. Being overweight puts strain on your back muscles. If you're overweight, trimming down can prevent back pain.

Use proper body mechanics:

Stand smart. Maintain a neutral pelvic position. If you must stand for long periods of time, alternate placing your feet on a low footstool to take some of the load off your lower back. Good posture can reduce the amount of stress placed on back muscles. Sit smart. Choose a seat with good lower back support, arm rests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level. Change your position frequently, ideally at least once every half hour. Lift smart. Let your legs do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward. Learning to lift properly may be more effective at preventing a recurrence of back pain than a first episode.

FIBROMYALGIA

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.

Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.

FIBROMYALGIA Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and

Women are much more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.

Symptoms

Symptoms of fibromyalgia include:

Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist. Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea. Cognitive difficulties. A symptom commonly referred to as "fibro fog" impairs the ability to focus, pay attention and concentrate on mental tasks. Other problems. Many people who have fibromyalgia also may experience depression, headaches, and pain or cramping in the lower abdomen.

.

What causes fibromyalgia?

Fibromyalgia has been shown to be genetic. It frequently becomes evident after stressful events. The stressful events may be emotional (such as a traumatic life event), physical (such as a motor-vehicle accident), or medical (such as certain infections). The chronic pain of rheumatoid arthritis,systemic lupus erythematosus, and other autoimmune diseases can trigger the development of fibromyalgia.

The manner in which the brain and spinal cord process pain sensations is abnormal in fibromyalgia. The threshold at which stimuli cause pain or discomfort has been proven to be lower in fibromyalgia. The pain felt is more intense because the pain is amplified by the abnormalities in the central nervous system and in pain processing. Because of this, things that are not normally painful may be painful for someone with fibromyalgia. In addition,

fibromyalgia causes the pain from any given cause to be worse. For example, a patient with fibromyalgia may find a massage painful instead of pleasant. In addition, back pain that someone without fibromyalgia experiences as moderate may be experienced as severe by someone with fibromyalgia, because the pain is amplified by abnormalities in pain processing by the central nervous system.

Is it possible to prevent fibromyalgia?

Fibromyalgia is a syndrome with a genetic predisposition. It can be triggered by certain events, but the exact events leading to the onset of fibromyalgia is unknown. Because of this, there is no known way to prevent fibromyalgia. However, leading a healthy lifestyle, including getting enough sleep, eating healthy foods, and exercising, is the best way to stay healthy.

Lifestyle and home remedies

Self-care is critical in the management of fibromyalgia.

Reduce stress. Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt. But try not to change your routine completely. People who quit work or drop all activity tend to do worse than do those who remain active. Try stress management techniques, such as deep-breathing exercises or meditation. Get enough sleep. Because fatigue is one of the main characteristics of fibromyalgia, getting sufficient sleep is essential. In addition to allotting enough time for sleep, practice good sleep habits, such as going to bed and getting up at the same time each day and limiting daytime napping. Exercise regularly. At first, exercise may increase your pain. But doing it gradually and regularly often decreases symptoms. Appropriate exercises may include walking, swimming, biking and water aerobics. A physical therapist can help you develop a home exercise program. Stretching, good posture and relaxation exercises also are helpful. Pace yourself. Keep your activity on an even level. If you do too much on your good days, you may have more bad days. Moderation means not overdoing it on your good days, but likewise it means not self- limiting or doing too littleon the days when symptoms flare. Maintain a healthy lifestyle. Eat healthy foods. Limit your caffeine intake. Do something that you find enjoyable and fulfilling every day.

Alternative medicine

Complementary and alternative therapies for pain and stress management aren't new. Some, such as meditation and yoga, have been practiced for thousands of years. But their use has become more popular in recent years, especially with people who have chronic illnesses, such as fibromyalgia.

Several of these treatments do appear to safely relieve stress and reduce pain, and some are gaining acceptance in mainstream medicine. But many practices remain unproved because they haven't been adequately studied.

Acupuncture. Acupuncture is a Chinese medical system based on restoring normal balance of life forces by inserting very fine needles through the skin to various depths. According to Western theories of acupuncture, the needles cause changes in blood flow and levels of neurotransmitters in the brain and spinal cord. Some studies indicate that acupuncture helps relieve fibromyalgia symptoms, while others show no benefit. Massage therapy. This is one of the oldest methods of health care still in practice. It involves use of different manipulative techniques to move your body's muscles and soft tissues. Massage can reduce your heart rate, relax your muscles, improve range of motion in your joints and increase production of your body's natural painkillers. It often helps relieve stress and anxiety.

SLEEP DISORDER

What are and what causes sleep disorders?

Sleep disorders are disruptions of the sleep cycle or the quality of sleep. About 40 million Americans are believed to suffer from chronic sleep disorders, with millions more affected on an occasional basis. Doctors have defined over 70 different types of sleep disorders, but the most common sleep disorders

are insomnia, sleep apnea, and narcolepsy.

restless legs syndrome,

SLEEP DISORDER What are and what causes sleep disorders? Sleep disorders are disruptions of the sleep

Insomnia is the perception of poor-quality sleep, including the inability to fall asleep or stay asleep. Because people differ in their need for sleep, there are no fixed criteria that define insomnia. Insomnia is very common and occurs in 30% to 50% of the general population. Approximately 10% of the population may suffer from chronic (long-standing) insomnia. Sleep onset insomnia is characterized as occurring at the beginning of the desired sleep time and lasting for greater than 30 minutes. Sleep maintenance insomnia is when individuals fall asleep, but awaken periodically or for lengthy periods during the night, increasing the wake-after-sleep-onset (WASO).

Sleep apnea is another common sleep disorder characterized by a reduction or pause of breathing (airflow) during sleep. Central sleep apnea (CSA) occurs when the brain does not send the signal to the muscles to take a breath, and there is no muscular effort to take a breath. Obstructive sleep apnea (OSA) occurs when the brain sends the signal to the muscles and the muscles make an effort to take a breath, but they are unsuccessful because the airway becomes obstructed and prevents an adequate flow of air. Mixed sleep apnea occurs when there is both central sleep apnea and obstructive sleep apnea. Restless leg syndrome (RLS), also known as nocturnal myoclonus, is a type of sleep disorder characterized by uncomfortable sensations in the legs and an uncontrollable desire to move the legs. These abnormal sensations usually occur in the lower legs during the evening. Periodic leg movements (PLMs) are related to RLS, but occur after the onset of sleep and are labeled as a sleep disorder or syndrome when the movements cause increased activity in the brain. During the early stages of sleep, these episodes of leg movement often last up to an hour. The abnormal sensations of RLS are quite variable. They have been described as a crawling, creeping, pulling, drawing, tingling, pins and needles, or prickly discomfort. They are not cramping in character. Patients with RLS may have difficulty falling asleep because of the difficulty getting comfortable and an increased urge to move their legs. Many patients with RLS will have PLMs and vice versa, but they are not the same disorder. Narcolepsy is a disease of the central nervous system that results uniformly in excessive daytime sleepiness (EDS). Other primary symptoms of narcolepsy include the loss of muscle tone (cataplexy), distorted perceptions (hypnagogic hallucinations), and the inability to move or talk (sleep paralysis). Additional symptoms can include disturbed nocturnal sleep and automatic behaviors (affected persons carry out certain actions without conscious awareness). All of the symptoms of narcolepsy may be present in various combinations and degrees of severity.

How are sleep problems treated?

The treatment of sleep disorders depends upon the exact disorder and the degree of severity of the symptoms. Both medical and non-medical approaches are generally used in the treatment of sleep disorders. In some cases, such as sleep apnea, surgical treatments may be considered. In some patients, more than one type of sleep disorder may be present, requiring a combination of treatment considerations.

Sleep hygiene

Non-medical treatment options are often referred to as sleep hygiene. Sleep hygiene is the practice of behavioral habits that offer the maximum potential for restorative and sound sleep. Good sleep hygiene practices include:

Avoid caffeine, nicotine, and alcohol use before bedtime. Some

studies have shown that caffeine

consumed early in the day can have an effect on the ability to fall asleep at night. Have and adhere to a regular bedtime and waking schedule. Maintain a comfortable sleep environment, including a comfortable temperature. Avoid watching television in bed and falling asleep with the TV on in the room. Do not lie in bed awake, worrying about not sleeping (or anything else negative). This produces anxiety that can actually make the problem worse. Get regular daily exercise (it is recommended that individuals avoid exercise two hours prior to bedtime).

Of course, many people with sleep disorders will require treatment beyond sleep hygiene measures.

Behavioral therapies are successful for many people who suffer from insomnia. These therapies may consist of stimulus control measures, such as using the bed for sleeping and sex only and not for other activities such as reading or TV watching.

Sleep restriction therapies are often used to help individuals avoid staying in bed too long and actually over- sleeping after a night of insomnia.

How can massage therapy help with sleep disorders?

The benefits of massage are many. It is regularly used in sports clinics and rehabilitation centers to loosen or soothe sore, aching muscles. Massage also helps to reduce stress, improve circulation, release tension, lower heart rate and blood pressure, and possibly even strengthen the immune system. These relaxing effects may therefore make massage a helpful aid in restoring restful sleep. Massage may be especially beneficial in treating sleeping problems that stem from stress, migraine headache, pain, and muscle and joint stiffness.

SCIATICA

Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from the lower back down the back of each leg. Sciatica is the name given to any sort of pain that is caused by irritation or compression of the sciatic nerve.

What Are the Symptoms of Sciatica?

Common symptoms of sciatica include:

Pain in the rear or leg that is worse when sitting

Burning or tingling down the leg

Weakness, numbness, or difficulty moving the leg

or foot A constant pain on one side of the rear

A shooting pain that makes it difficult to stand up

Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes.

SCIATICA Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending

For some people, the pain from sciatica can be severe and debilitating. For others, the sciatica pain might be infrequent and irritating, but has the potential to get worse.

Risk factors for sciatica include:

Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica. Obesity. By increasing the stress on your spine, excess body weight may contribute to the spinal changes that trigger sciatica. Occupation. A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods may play a role in sciatica, but there's no conclusive evidence of this link. Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are. Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

Additional common causes of sciatica include:

Lumbar spinal stenosis (narrowing of the spinal canal in the lower back)

Degenerative disc disease (breakdown of discs, which act as cushions between the vertebrae)

Spondylolisthesis (a condition in which one vertebra slips forward over another one)

Pregnancy

Lifestyle and home remedies

For most people, sciatica responds well to self-care measures. You'll heal more quickly if you continue with your usual activities but avoid what may have triggered the pain in the first place. Although resting for a day or so may provide some relief, prolonged inactivity will make your signs and symptoms worse.

Other self-care treatments that may be helpful include:

Cold packs. Initially, you may get relief from a cold pack placed on the painful area for up 20 minutes

several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel. Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a

heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs. Stretching. Stretching exercises for your low back can help you feel better and may help relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch and try to hold the stretch at least 30 seconds.

Alternative medicine

Alternative therapies commonly used for low back pain include:

Acupuncture. In acupuncture, the practitioner inserts hair-thin needles into your skin at specific points on your body. Some studies have suggested that acupuncture can help back pain, while others have found no benefit. If you decide to try acupuncture, choose a licensed practitioner to ensure that he or she has had extensive training. Chiropractic. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain. Spinal manipulation appears to be as effective and safe as standard treatments for low back pain.

ARTHTRITIS

Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis causes cartilage the hard, slippery tissue that covers the ends of bones where they form a joint to break down. Rheumatoid arthritis is an autoimmune disorder that first targets the lining of joints (synovium).

Uric acid crystals, infections or underlying disease,

such as psoriasis or lupus, can arthritis.

cause other types of

ARTHTRITIS Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis

Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.

Symptoms

The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis you have, your signs and symptoms may include:

Pain

Stiffness

Swelling

Redness

Decreased range of motion

Causes

The two main types of arthritis osteoarthritis and rheumatoid arthritis damage joints in different ways.

Osteoarthritis

The most common type of arthritis, osteoarthritis involves wear-and-tear damage to your joint's cartilage the hard, slick coating on the ends of bones. Enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.

Rheumatoid arthritis

In rheumatoid arthritis, the body's immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining, known as

ARTHTRITIS Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis

the synovial membrane, becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.

Risk factors

Risk factors for arthritis include:

Family history. Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder. Your genes can make you more susceptible to environmental factors that may trigger arthritis. Age. The risk of many types of arthritis including osteoarthritis, rheumatoid arthritis and gout increases with age. Your sex. Women are more likely than are men to develop rheumatoid arthritis, while most of the people who have gout, another type of arthritis, are men. Previous joint injury. People who have injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint. Obesity. Carrying excess pounds puts stress on joints, particularly your knees, hips and spine. Obese people have a higher risk of developing arthritis.

Lifestyle and home remedies

Weight loss. If you're obese, losing weight will reduce the stress on your weight-bearing joints. This may increase your mobility and limit future joint injury. Exercise. Regular exercise can help keep your joints flexible. Swimming and water aerobics may be good choices because the buoyancy of the water reduces stress on weight-bearing joints. Heat and cold. Heating pads or ice packs may help relieve arthritis pain. Assistive devices. Using canes, walkers, raised toilet seats and other assistive devices can help protect your joints and improve your ability to perform daily tasks.

Alternative medicine

Many people use alternative remedies for arthritis, but there is little reliable evidence to support the use of many of these products. The most promising alternative remedies for arthritis include:

Acupuncture. This therapy uses fine needles inserted at specific points on the skin to reduce many types of pain, including that caused by some types of arthritis. Glucosamine. Although study results have been mixed, it now appears that glucosamine works no better than placebo. However, glucosamine and the placebo both relieved arthritis pain better than taking nothing, particularly in people who have moderate to severe pain. Transcutaneous electrical nerve stimulation (TENS). Using a small device that produces mild electrical pulses, TENS therapy stimulates nerves near the aching joint and may interfere with the transmission of pain signals to the brain. Yoga or tai chi. The slow, stretching movements associated with yoga and tai chi may help improve joint flexibility and range of motion in people with some types of arthritis. Massage. Light stroking and kneading of muscles may increase blood flow and warm affected joints, temporarily relieving pain. Make sure your massage therapist knows which joints are affected by arthritis.

FROZEN SHOULDER

Frozen shoulder, also

 

known

as

adhesive

capsulitis,

is

a

condition

characterized by stiffness and pain in your shoulder joint. Signs and

symptoms typically begin gradually, worsen over time and then resolve, usually within one or two years.

Your

risk

of

developing

frozen

shoulder

increases

if

you're

recovering from a medical condition or procedure that affects the mobility of your arm such as a stroke or a mastectomy.

FROZEN SHOULDER Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and

Treatment for frozen shoulder involves stretching exercises and, sometimes, the injection of corticosteroids and numbing medications into the joint capsule. In a small percentage of cases, surgery may be needed to loosen the joint capsule so that it can move more freely.

Symptoms

Frozen shoulder typically develops slowly, and in three stages. Each of these stages can last a number of months.

Painful stage. During this stage, pain occurs with any movement of your shoulder, and your shoulder's

range of motion starts to become limited. Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and

your range of motion decreases notably. Thawing stage. During the thawing stage, the range of motion in your shoulder begins to improve.

For some people, the pain worsens at night, sometimes disrupting normal sleep patterns.

Causes

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.

Doctors aren't sure why this happens to some people and not to others, although it's more likely to occur in people who have recently experienced prolonged immobilization of their shoulder, such as after surgery or an arm fracture.

Immobility or reduced mobility

People who have experienced prolonged immobility or reduced mobility of their shoulder are at higher risk of developing frozen shoulder. Immobility may be the result of many factors, including:

Rotator cuff injury

Broken arm

Stroke

Recovery from surgery

Systemic diseases

People who have certain medical problems appear to be predisposed to develop frozen shoulder. Examples include:

Diabetes

Overactive thyroid (hyperthyroidism)

Underactive thyroid (hypothyroidism)

Cardiovascular disease

Tuberculosis

Parkinson's disease

Lifestyle and home remedies

Continue to use the involved shoulder and extremity in as many daily life activities as possible within the limits of your pain and range-of-motion constraints. Applying heat or cold to your shoulder can help relieve pain.

Alternative medicine

Acupuncture

Acupuncture is a procedure that has been used in China for thousands of years. It involves inserting extremely fine needles in your skin at specific points on your body. Typically, the needles remain in place for 15 to 40 minutes. During that time they may be moved or manipulated. Because the needles are hair thin and flexible and are generally inserted superficially, most acupuncture treatments are relatively painless.

Transcutaneous electrical nerve stimulation (TENS)

A TENS unit delivers a tiny electrical current to key points on a nerve pathway. The current, delivered through electrodes taped to your skin, isn't painful or harmful. It's not known exactly how TENS works, but it's thought that it might stimulate the release of pain-inhibiting molecules (endorphins) or block pain fibers that carry pain impulses.

PLANTAR FASCIITIS

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes.

Plantar

fasciitis

is

particularly

common in runners. In addition, people who are overweight and those who wear shoes with inadequate support are at risk of plantar fasciitis.

PLANTAR FASCIITIS Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain.

Symptoms

Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by long periods of standing or getting up from a seated position.

Causes

Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.

Risk factors

Factors that may increase your risk of developing plantar fasciitis include:

Age. Plantar fasciitis is most common between the ages of 40 and 60. Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue such as long-distance running, ballet dancing and dance aerobics can contribute to an earlier onset of plantar fasciitis. Faulty foot mechanics. Being flat-footed, having a high arch or even having an abnormal pattern of walking can adversely affect the way weight is distributed when you're standing and put added stress on the plantar fascia. Obesity. Excess pounds put extra stress on your plantar fascia. Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia.

Complications

Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.

Lifestyle and home remedies

To reduce the pain of plantar fasciitis, try these self-care tips:

Maintain a healthy weight. This minimizes the stress on your plantar fascia. Choose supportive shoes. Avoid high heels. Buy shoes with a low to moderate heel, good arch support and shock absorbency. Don't go barefoot, especially on hard surfaces. Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. If you're a runner, buy new shoes after about 500 miles of use. Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging. Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or after activity. Or try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes. Regular ice massage can help reduce pain and inflammation. Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles.

IDIOPATHIC OEDEMA (FLUID RETENTION)

Idiopathic oedema is the term for fluid retention which it not caused by a known medical condition. It is most common in women and can sometimes worsen as you get older. Although there is no cure for idiopathic oedema, having a healthy diet which is low in salt can make a real difference. Support stockings and regular exercise are also beneficial.

What is idiopathic oedema?

Oedema is the medical term for fluid retention. Idiopathic is a term which means unknown cause. Idiopathic oedema is therefore a condition of mild fluid retention where the cause is not fully understood. Oedema can be caused by various conditions, especially diseases of the heart or kidney. However, people with idiopathic oedema are otherwise healthy and do not have a kidney or heart disease to account for their oedema. Idiopathic oedema is not serious but can be a nuisance.

IDIOPATHIC OEDEMA (FLUID RETENTION) Idiopathic oedema is the term for fluid retention which it not caused

Who has idiopathic oedema?

Idiopathic oedema mainly affects women in their middle years. It can become worse as you become older. Many women find that the oedema worsens at certain times of the month (usually just before a period).

What causes idiopathic oedema?

The underlying cause seems to be due to fluid leaking out of the small blood vessels into the tissues. Why this occurs in some people is not clear. It is usually worse after you have been standing for long periods, as there is increased pressure in your veins when standing compared to lying down. Going on long journeys or sitting still for long periods of time can also worsen the swelling.

One possible cause is the retention of salt (sodium). When the body retains salt it also holds on to fluid and thereby may cause some oedema.

A possible cause of fluid retention often overlooked by people and difficult to diagnose is due to binge eating alternating with strict dieting. This can cause intermittent fluid retention.

What are the symptoms?

Mild swelling of the feet, hands, tummy (abdomen), breasts and face may occur. This is worse at the end of the day and may disappear after a night's rest. Rings may need to be taken off and looser clothes may need to be worn in the evening.

Many people with idiopathic oedema find that they weigh about two kilograms (four pounds) more in the evening compared to the morning. You should use the same scales to weigh yourself, after you have been to the toilet, morning and evening.

What are the treatments?

Idiopathic oedema is not an easy condition to treat and cannot often be cured. Many people are reassured that their fluid retention is not due to a serious medical condition. Learning to live with it and changing into loose clothes in the evening are all that is required for most people.

However, the following tips may be helpful:

Avoid prolonged standing

This may not always be easy, especially if you are in a job which requires you to stand for long periods of time. Wearing support stockings or tights will often help to reduce swelling of ankles and legs. There are now many different types and sizes, meaning they are fairly comfortable to wear. Many of the tights and stockings are now available on prescription from your doctor.

Weight loss

Many people with fluid retention are overweight and losing weight can make a big difference to improve the oedema. A gradual weight loss (rather than fasting and bingeing) is recommended.

Salt (sodium) restriction

Idiopathic oedema can often improve greatly if you reduce your salt intake. One way is to stop adding salt to food and also reduce the amount of processed foods you eat, as these often contain large amounts of salt.

Eating foods rich in potassium

Eating potassium-rich foods can actually help to reduce the salt levels in the body and so may improve the oedema. Potassium-rich foods include most fruits, especially bananas and also tomatoes. You should not take potassium supplement tablets though.

'Water' tablets (diuretics)

Many people take diuretics for oedema due to other medical conditions. However, in idiopathic oedema, diuretics may make things worse in some people, as they alter the salt and water balance of the body. They are not necessarily the easy answer to the problem. However, they can help for some people.

TENSION HEADACHES

Symptoms

Signs and symptoms of a tension headache include:

Dull, aching head pain

 

Sensation of tightness or pressure across your forehead or on the sides and back of your head

Tenderness

on

your

scalp,

neck

and

shoulder

muscles

TENSION HEADACHES Symptoms Signs and symptoms of a tension headache include:  Dull, aching head pain

Tension headaches are divided into two main categories episodic and chronic.

Episodic tension headaches

Episodic tension headaches can last from 30 minutes to a week. Frequent episodic tension headaches occur less than 15 days a month for at least three months. Frequent episodic tension headaches may become chronic.

Chronic tension headaches

This type of tension headache lasts hours and may be continuous. If your headaches occur 15 or more days a month for at least three months, they're considered chronic.

Tension headaches vs. migraines

Tension headaches can be difficult to distinguish from migraines. Plus, if you have frequent episodic tension headaches, you can also have migraines.

Unlike some forms of migraine, tension headache usually isn't associated with visual disturbances, nausea or vomiting. Although physical activity typically aggravates migraine pain, it doesn't make tension headache pain worse. An increased sensitivity to either light or sound can occur with a tension headache, but these aren't common symptoms.

Causes

The cause of tension headache is not known. Experts used to think tension headaches stemmed from muscle contractions in the face, neck and scalp, perhaps as a result of heightened emotions, tension or stress. But research suggests muscle contractions aren't the cause.

The most common theories support a heightened sensitivity to pain in people who have tension headaches and possibly a heightened sensitivity to stress. Increased muscle tenderness, a common symptom of tension headache, may result from a sensitized pain system.

Triggers

Stress is the most commonly reported trigger for tension headaches.

Risk factors

Risk factors for tension headache include:

Being a woman. One study found that almost 90 percent of women and about 70 percent of men experience tension headaches during their lifetimes.

Being middle-aged. The incidence of tension headaches appears to peak in the 40s, though people of all ages can get this type of headache.

'Complications

Because tension headaches are so common, their effect on job productivity and overall quality of life is considerable, particularly if they're chronic. The frequent pain may render you unable to attend activities. You might need to stay home from work, or if you do go to your job, your ability to function is impaired.

Lifestyle and home remedies

Rest, ice packs or a long, hot shower may be all you need to relieve a tension headache. A variety of strategies can help reduce the severity and frequency of chronic tension headaches without using medicine. Try some of the following:

Manage your stress level. One way to help reduce stress is by planning ahead and organizing your day. Another way is to allow more time to relax. And if you're caught in a stressful situation, consider stepping back.

Go hot or cold. Applying heat or ice whichever you prefer to sore muscles, may ease a tension headache. For heat, use a heating pad set on low, a hot-water bottle, a warm compress or a hot towel. A hot bath or shower also may help. For cold, wrap ice, an ice pack or frozen vegetables in a cloth to protect your skin.

Perfect your posture. Good posture can help keep your muscles from tensing. When standing, hold your shoulders back and your head level. Pull in your abdomen and buttocks. When sitting, make sure your thighs are parallel to the ground and your head isn't slumped forward.

The following nontraditional therapies may help if you have tension headache pain:

Acupuncture. Acupuncture may provide temporary relief from chronic headache pain. Acupuncture practitioners treat you using extremely thin, disposable needles that generally cause little pain or discomfort. The American Academy of Medical Acupuncture website provides referrals to medical doctors who use acupuncture in their practices.

Massage. Massage can help reduce stress and relieve tension. It's especially effective for relieving tight, tender muscles in the back of your head, neck and shoulders. For some people, it may also provide relief from headache pain.

Deep breathing, biofeedback and behavior therapies. A variety of relaxation therapies are useful in coping with tension headache, including deep breathing and biofeedback.

MIGRAINE

A migraine headache can cause intense throbbing or a pulsing sensation in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down.

Some migraines are preceded or accompanied by sensory warning symptoms (aura), such as flashes of light, blind spots, or tingling in your arm or leg.

MIGRAINE A migraine headache can cause intense throbbing or a pulsing sensation in one area of

Medications can help reduce the frequency and severity of migraines. If treatment hasn't worked for you in the past, talk to your doctor about trying a different migraine headache medication. The right medicines, combined with self-help remedies and lifestyle changes, may make a big difference.

Symptoms

Migraine headaches often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages, including prodrome, aura, headache and postdrome, though you may not experience all the stages.

Prodrome

One or two days before a migraine, you may notice subtle changes that signify an oncoming migraine, including:

Constipation

Depression

Food cravings

Hyperactivity

Irritability

Neck stiffness

Uncontrollable yawning

Aura

Aura may occur before or during migraine headaches. Auras are nervous system symptoms that are usually visual disturbances, such as flashes of light. Sometimes auras can also be touching sensations (sensory), movement (motor) or speech (verbal) disturbances. Most people experience migraine headaches without aura. Each of these symptoms usually begins gradually, builds up over several minutes, and then commonly lasts for 20 to 60 minutes.

Examples of aura include:

Visual phenomena, such as seeing various shapes, bright spots or flashes of light

Vision loss

Pins and needles sensations in an arm or leg

Speech or language problems (aphasia)

Less commonly, an aura may be associated with limb weakness (hemiplegic migraine).

Attack

When untreated, a migraine usually lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less often. During a migraine, you may experience the following symptoms:

Pain on one side or both sides of your head

Pain that has a pulsating, throbbing quality

Sensitivity to light, sounds and sometimes smells

Nausea and vomiting

Blurred vision

Lightheadedness, sometimes followed by fainting

Postdrome

The final phase, known as postdrome, occurs after a migraine attack. During this time you may feel drained and washed out, though some people report feeling mildly euphoric.

Causes

Although much about the cause of migraines isn't understood, genetics and environmental factors appear to play a role.

Migraines may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway.

Imbalances in brain chemicals including serotonin, which helps regulate pain in your nervous system also may be involved. Researchers continue to study the role of serotonin in migraines.

Serotonin levels drop during migraine attacks. This may cause your trigeminal system to release substances called neuropeptides, which travel to your brain's outer covering (meninges). The result is headache pain.

Migraine headache triggers

Whatever the exact mechanism of the headaches, a number of things may trigger them. Common migraine triggers include:

Hormonal changes in women. Fluctuations in estrogen seem to trigger headaches in many women with known migraines. Women with a history of migraines often report headaches immediately before or

during

their

periods,

when

they

have

a

major

drop

in estrogen.

Others

have

an

increased

tendency

to

develop

migraines

during

pregnancy

or

menopause.

Hormonal medications, such as oral contraceptives and hormone replacement therapy, also may worsen

migraines. Some women, however, may medications.

find their

migraines occur less

often when taking these

Foods. Aged cheeses, salty foods and processed foods may trigger migraines. Skipping meals or fasting also can trigger attacks.

Food additives. The sweetener aspartame and the preservative monosodium glutamate, found in many foods, may trigger migraines.

Drinks. Alcohol, especially wine, and highly caffeinated beverages may trigger migraines.

 

Stress. Stress at work or home can cause migraines.

 

Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds. Unusual smells including perfume, paint thinner, secondhand smoke and others can trigger migraines in some people.

Changes in wake-sleep pattern. Missing sleep or getting too much sleep may trigger migraines in some people, as can jet lag.

Physical factors. Intense physical exertion, including sexual activity, may provoke migraines.

 

Changes in the environment. A change of weather or barometric pressure can prompt a migraine.

Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.

Lifestyle and home remedies

Self-care measures can help ease the pain of a migraine headache.

Try muscle relaxation exercises. Relaxation may help ease the pain of a migraine headache. Relaxation techniques may include progressive muscle relaxation, meditation or yoga.

Get enough sleep, but don't oversleep. Get an adequate amount of sleep each night. It's best to go to bed and wake up at regular times, as well.

Rest and relax. If possible, rest in a dark, quiet room when you feel a headache coming on. Place an ice pack wrapped in a cloth on the back of your neck and apply gentle pressure to painful areas on your scalp.

Keep a headache diary. Continue keeping your headache diary even after you see your doctor. It will help you learn more about what triggers your migraines and what treatment is most effective.

Alternative medicine

Nontraditional therapies may be helpful if you have chronic migraine pain:

Acupuncture. In this treatment, a practitioner inserts many thin, disposable needles into several areas of your skin at defined points. Clinical trials have found that acupuncture may be helpful for headache pain.

Biofeedback. Biofeedback appears to be effective in relieving migraine pain. This relaxation technique uses special equipment to teach you how to monitor and control certain physical responses related to stress, such as muscle tension.

Massage therapy. Massage therapy may help reduce the frequency of migraines. Researchers continue to study the effectiveness of massage therapy in preventing migraines.

Cognitive behavioral therapy. Cognitive behavioral therapy may benefit some people with migraines.

Herbs, vitamins and minerals. There is some evidence that the herb butterbur may prevent migraines or reduce their severity.

CELLULITE

Cellulite is a term for lumpy, dimpled flesh on the thighs, hips, buttocks and abdomen. Cellulite is most common in adolescent and adult women.

Cellulite isn't a serious medical condition, but it can be unsightly. Cellulite might make you self-conscious about wearing shorts or a swimming suit.

Many cellulite treatments, including massages or cellulite creams, advertise remarkable results. Most of these treatments don't live up to their claims.

CELLULITE Cellulite is a term for lumpy, dimpled flesh on the thighs, hips, buttocks and abdomen.

Researchers are studying possible medical treatments. In the meantime, you can take steps to slightly improve the appearance of cellulite.

Symptoms

Cellulite looks like dimpled or bumpy skin. It's sometimes described as having a cottage cheese or orange peel texture.

Mild cellulite can be seen only when the skin is pinched the dimpling appears in the pinched skin. More-severe cellulite makes the skin appear rumpled and bumpy with areas of peaks and valleys.

Cellulite is most common around the thighs and buttocks, but it can be found on the breasts, lower abdomen and upper arms as well.

Causes

Cellulite is caused by fibrous connective cords that tether the skin to the underlying muscle, with the fat lying between. As fat cells accumulate, they push up against the skin, while the long, tough cords pull down. This creates an uneven surface or dimpling.

Treatments and drugs

Weight loss

Weight loss through healthy eating and regular exercise is probably the most beneficial cellulite treatment. Losing pounds and strengthening muscles in your legs, thighs, buttocks and abdomen can improve the appearance of the dimpled skin. The benefits of weight loss alone are limited, however. Though the cellulite may be less noticeable after weight loss, it won't go away completely.

Lasers and radiofrequency systems

Perhaps the most promising medical therapy is one that uses lasers and radiofrequency systems. One system combines tissue massage, radiofrequency technology and infrared light to treat cellulite. Another system delivers combined tissue massage with diode laser energy. A third system uses radiofrequency at deep and superficial levels simultaneously to treat cellulite. All three systems offer improvements to cellulite after a series of treatments. Results may last up to six months.

Liposuction

Some people may turn to liposuction as a treatment for cellulite. During liposuction, a surgeon inserts a narrow tube under your skin through tiny incisions and then suctions out fat cells. Though liposuction can shape the body, it won't remove cellulite, and it may make the cellulite appear worse. Laser-assisted liposuction is a newer, less invasive form of this treatment that destroys fat cells while tightening the skin and may be a more effective treatment for cellulite.

Topical treatment

A twice daily application of 0.3 percent retinol cream has been shown to improve the appearance of cellulite after six months.

Alternative medicine

Many devices, products and creams claim to treat cellulite. But there is little or no scientific evidence to support these claims. If you do find a cellulite treatment that improves your skin, the results aren't likely to last long.

The following are a few of the many advertised cellulite treatments. Keep in mind that these treatments haven't been proved effective in removing cellulite.

Vigorous massage. Some cellulite treatments are based on the concept that vigorous massage will increase blood flow, remove toxins and reduce excess fluid in cellulite-prone areas. One method in particular, Endermologie (also referred to as Lipomassage), uses a hand-held machine to knead the skin between rollers. You may notice a slight improvement to your skin after this treatment, but the results are typically short-lived.

Mesotherapy. This procedure involves injecting a solution which may contain a combination of aminophylline, hormones, enzymes, herbal extracts, vitamins and minerals under the skin. This treatment can cause several unwanted effects, including infection, rashes, and bumpy or uneven skin contours.

Cellulite creams. Creams that contain a variety of ingredients, such as vitamins, minerals, herbal extracts and antioxidants, are often marketed as the cure for cellulite. But no studies show that these creams used by themselves offer any improvement. In some cases, the ingredients in these products cause skin reactions or rashes.

ECZEMA

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It's common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically and then subside. It may be accompanied by asthma or hay fever.

No cure has been found for atopic dermatitis. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps and other irritants, apply medicated creams or ointments, and moisturize your skin.

Symptoms

ECZEMA Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It's common

Itching, which may be severe, especially at night

Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and, in infants, the face and scalp

Small, raised bumps, which may leak fluid and crust over when scratched

Thickened, cracked, dry, scaly skin

Raw, sensitive, swollen skin from scratching

Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

Factors that worsen atopic dermatitis

Most people with atopic dermatitis also have Staphylococcus aureus bacteria on their skin. The staph bacteria multiply rapidly when the skin barrier is broken and fluid is present on the skin. This in turn may worsen symptoms, particularly in young children.

Factors that can worsen atopic dermatitis signs and symptoms include:

Dry skin, which can result from long, hot baths or showers

Scratching, which causes further skin damage

Bacteria and viruses

Stress

Sweat

Changes in heat and humidity

Solvents, cleaners, soaps and detergents

Wool in clothing, blankets and carpets

Dust and pollen

Tobacco smoke and air pollution

Eggs, milk, peanuts, soybeans, fish and wheat, in infants and children

Atopic dermatitis is related to allergies. But eliminating allergens is rarely helpful in clearing the condition.

Causes

The exact cause of atopic dermatitis (eczema) is unknown. Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is likely related to a mix of factors:

Dry, irritable skin, which reduces the skin's ability to be an effective barrier

A gene variation that affects the skin's barrier function

Immune system dysfunction

Bacteria, such as Staphylococcus aureus, on the skin that creates a film that blocks sweat glands

Environmental conditions

Lifestyle and home remedies

To help reduce itching and soothe inflamed skin, try these self-care measures:

Take an oral allergy or anti-itch medication. Options include nonprescription allergy medicines (antihistamines) such as cetirizine (Zyrtec) or fexofenadine (Allegra). Also, diphenhydramine (Benadryl, others) may be helpful if itching is severe. But it can make you drowsy, so it's better for bedtime.

Take a bleach bath. A diluted-bleach bath decreases bacteria on the skin and related infections. Add 1/2 cup (118 milliliters) of household bleach, not concentrated bleach, to a 40-gallon (151-liter) bathtub filled with warm water measures are for a U.S.-standard-sized tub filled to the overflow drainage holes.

Soak from the neck down or just the affected areas of skin for about 10 minutes. Do not submerge the head. Rinse, pat dry and moisturize. Take a bleach bath no more than two or three times a week.

Apply an anti-itch cream or calamine lotion to the affected area. A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch. Apply it to the affected area before you moisturize. Once your reaction has improved, you may use this type of cream less often to prevent flare-ups.

Moisturize your skin at least twice a day. Use a moisturizer all over while your skin is still damp from a bath or shower. Pay special attention to your legs, arms, back and the sides of your body. If your skin is already dry, consider using oil or lubricating cream.

Avoid scratching. Cover the itchy area if you can't keep from scratching it. Trim nails and wear gloves at night.

Apply cool, wet compresses. Covering the affected area with bandages and dressings helps protect the skin and prevent scratching.

Take a warm bath. Sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal a finely ground oatmeal that is made for the bathtub (Aveeno, others). Soak for 10 to 15 minutes, then pat dry and apply medicated lotions, moisturizers or both (use the medicated form first).

Choose mild soaps without dyes or perfumes. Be sure to rinse the soap completely off your body.

Use a humidifier. Hot, dry indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home. Keep your humidifier clean to prevent the growth of bacteria and fungi.

Wear cool, smooth-textured cotton clothing. Reduce irritation by avoiding clothing that's rough, tight, scratchy or made from wool. Also, wear appropriate clothing in hot weather or during exercise to prevent excessive sweating.

Treat stress and anxiety. Stress and other emotional disorders can worsen atopic dermatitis. Acknowledging those and trying to improve your emotional health can help.

Alternative medicine

Many alternative medicine therapies have helped some people manage their atopic dermatitis. One study showed that people who used Chinese herbal medications experienced reduced itching and other symptoms, but only temporarily. Another showed that four weeks of acupressure resulted in reduced itching and scaling.

Evidence for the following approaches isn't conclusive:

Dietary supplements, such as vitamins D and E, zinc, selenium, evening primrose oil, borage seed oil, oolong tea, probiotics

Other plant-based therapies, including St. John's wort, calendula flowers, tea tree oil, German chamomile, Oregon grape root, licorice, rice bran broth (applied to the skin)

Acupuncture

Aromatherapy

Bath therapy

Use of electrodes to change electromagnetic waves of the body (bioresonance)

Therapeutic use of color, light and relaxation techniques (chromotherapy)

Homeopathy

Massage therapy

PSORIASIS

Psoriasis is a common skin condition that changes the life cycle of skin cells. Psoriasis causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful.

Psoriasis is a persistent, long-lasting (chronic) disease. There may be times when your psoriasis symptoms get better alternating with times your psoriasis worsens.

PSORIASIS Psoriasis is a common skin condition that changes the life cycle of skin cells. Psoriasis

The primary goal of treatment is to stop the skin cells from growing so quickly. While there isn't a cure, psoriasis treatments may offer significant relief. Lifestyle measures, such as using a nonprescription cortisone cream and exposing your skin to small amounts of natural sunlight, also may improve your psoriasis symptoms.

Symptoms

Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:

Red patches of skin covered with silvery scales

Small scaling spots (commonly seen in children)

Dry, cracked skin that may bleed

Itching, burning or soreness

Thickened, pitted or ridged nails

Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.

Several types of psoriasis exist. These include:

Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques)

covered with silvery scales. The plaques itch or may be painful and can occur anywhere on your body, including your genitals and the soft tissue inside your mouth. You may have just a few plaques or many. Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and

discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble. Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. The red or

scaly areas often extend beyond the hairline. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp. Guttate psoriasis. This primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and

scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes. Inverse psoriasis. Mainly affecting the skin in the armpits, in the groin, under the breasts and around the

genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's worsened by friction and sweating. Fungal infections may trigger this type of psoriasis. Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized

pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea. Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your

entire body with a red, peeling rash that can itch or burn intensely. Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.

Causes

The cause of psoriasis isn't fully known, but it's thought to be related to an immune system problem with cells in your body. More specifically, one key cell is a type of white blood cell called a T lymphocyte or T cell. Normally, T cells travel throughout the body to detect and fight off foreign substances, such as viruses or bacteria. If you have psoriasis, however, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection.

Overactive T cells trigger other immune responses. The effects include dilation of blood vessels in the skin around the plaques and an increase in other white blood cells that can enter the outer layer of skin. These changes result in an increased production of both healthy skin cells and more T cells and other white blood cells. This causes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly in days rather than weeks. Dead skin and white blood cells can't slough off quickly enough and build up in thick, scaly patches on the skin's surface. This usually doesn't stop unless treatment interrupts the cycle.

Just what causes T cells to malfunction in people with psoriasis isn't entirely clear. Researchers have found genes that are linked to the development of psoriasis, but environmental factors also play a role.

Psoriasis triggers

Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:

Infections, such as strep throat or skin infections

Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn

Stress

Cold weather

Smoking

Heavy alcohol consumption

Certain medications including lithium, which is prescribed for bipolar disorder; high blood pressure medications such as beta blockers; antimalarial drugs; and iodides.

Lifestyle and home remedies

Although self-help measures won't cure psoriasis, they may help improve the appearance and feel of damaged skin. These measures may benefit you:

Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, colloidal

oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats. Use moisturizer. Blot your skin after bathing, then immediately apply a heavy, ointment-based

moisturizer while your skin is still moist. For very dry skin, oils may be preferable they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day. Expose your skin to small amounts of sunlight. A controlled amount of sunlight can significantly

improve lesions, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer. Before beginning any sunbathing program, ask your doctor about the best way to use natural sunlight to treat your skin. Keep a record of when and how long you're in the sun to help avoid overexposure. And be sure to protect healthy, unaffected skin with a broad-spectrum sunscreen with an SPF of at least 30. Apply sunscreen generously, and reapply every two hours or more often if you're swimming or perspiring. Avoid psoriasis triggers, if possible. Find out what triggers, if any, worsen your psoriasis and take steps

to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis. Avoid drinking alcohol. Alcohol consumption may decrease the effectiveness of some psoriasis treatments.

Alternative medicine

A number of alternative therapies claim to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs. None have definitively been proved effective. But some alternative therapies are deemed generally safe, and they may be helpful to some people in reducing signs and symptoms, such as itching and scaling.

Aloe vera. Taken from the leaves of the aloe vera plant, aloe extract cream may reduce redness, scaling,

itching and inflammation. You may need to use the cream several times a day for a month or more to see any improvements in your skin. Fish oil. Omega-3 fatty acids found in fish oil supplements may reduce inflammation associated with

psoriasis, although results from studies are mixed. Taking 3 grams or less of fish oil daily is generally recognized as safe, and you may find it beneficial. Oregon grape. Also known as barberry, topical applications of Oregon grape may reduce inflammation and ease psoriasis symptoms.

If you're considering dietary supplements or other alternative therapy to ease the symptoms of psoriasis, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies.