A new web site has been created addressing Chronic Myofascial Pain (CMP). It is estimated that some 44 million Americans have CMP, (also called myofascial pain syndrome). CMP is a painful condition affecting the muscles and the sheath of the tissue, called the fascia, that surround the muscles. CMP can involve a single muscle or a group of muscles. It is characterized by pain and stiffness that is restricted to certain locations on the body. See figure 1 to the right.

CMP is not a psychological disturbance, neither is this condition a mental illness, although chronic pain can cause anxiety and lead to depression. The American Medical Association (AMA), the World Health Organization (WHO), and the National Institutes of Health (NIH) are among those who have accepted CMP as a legitimate physical illness and as major cause of disability.

The mission of CMP RESOURCES is to provide resources to assist and inform people affected with CMP, helping them to live a better life. Resources include:

What is CMP
Possible Causes
Diagnosis
Symptoms
Treatments
Trigger Points
CMP Versus FM
CMP Prognosis

Find A Doctor
Disability Information
Coping Tips
Drug Database
Awareness Day Info.
CMP Fact Sheet

In-Person Support Groups
Online Support Groups
Start A Support Group
List Your Support Group
 
 

The CMP RESOURCES mission is straightforward: to provide support, education, and informational resources to people with CMP, the medical community and others who'd like to learn more. We will keep you up to date on new medical research, as well as continuing to provide coping tips and treatments for the CMP patient.

Be sure to check out the newest resource for CMP patients and their families, CMP RESOURCES.

Yom Kippur, also known as the Day of Atonement, is the most solemn and important of the Jewish holidays. Its central themes are atonement and repentance. Jews have traditionally observed this holiday with a 25-hour period of fasting and intensive prayer.

Five additional prohibitions are traditionally observed, as detailed in the Jewish oral tradition (Mishnah tractate Yoma 8:1):

• Eating and drinking
• Wearing leather shoes
• Bathing/washing
• Anointing oneself with perfumes or lotions
• Marital or sexual relations

Total abstention from food and drink usually begins 30 minutes before sundown (called tosefet Yom Kippur lit. Addition to Yom Kippur ), and ends after nightfall the following day. Although the fast is required of all healthy adults, it is waived in the case of certain medical conditions. Virtually all Jewish holidays involve a ritual feast, but since Yom Kippur involves fasting, Jewish law requires one to eat a large and festive meal on the afternoon before Yom Kippur, after the mincha prayer. Wearing white clothing is traditional to symbolize one's purity on this day. Many Orthodox men immerse themselves in a mikvah on the day before Yom Kippur.

Pain management specialists are concerned about the patient's ability to function and their quality of life. When pain is chronic or complicated by other medical conditions, the patient's primary care physician may refer the patient to a pain specialist, such as a physiatrist. Physiatrists are medical physicians who specialize in physical medicine and rehabilitation with a special interest in musculoskeletal conditions. Some physiatrists have advanced training in Interventional Pain Management (IPM). IPM is an area of medicine devoted to the diagnosis and treatment of pain related disorders.

A pain management specialist develops a treatment plan to relieve, reduce, or manage pain and help patients return to everyday activities quickly without surgery or heavy reliance on medication. To make sure all the patient's needs are met, the physician coordinates care through an interdisciplinary team of health professionals. Such professionals include:

• Physiatrists
• Anesthesiologists
• Internists
• Surgical specialists
• Psychiatrists

Pain management specialists are most concerned with the patient's overall quality of life. To that end, they treat the whole patient, not just one part of the body.

Diagnosis: The Cause of Pain

Before the physician can treat the patient's pain, he must understand the cause of the pain. In cases of chronic pain, the cause(s) may be elusive and make diagnosis difficult. The physician relies on the patient's medical history, physical and neurological examinations. Additional diagnostic tools help to support or rule out a suspected diagnosis.

Detailed Patient History

The physician and patient talk in-depth about the patient's current problem and medical history. The physician may ask when and how the pain started, for a description of the pain, about activities that increase or reduce pain, and current or past treatments.

Physical and Neurological Examination

A physical examination assesses the patient's vital signs; pulse, respiration, heart beat, blood pressure, and so on. A neurological exam evaluates the patient's sensory (feel) and motor (function) capabilities including reflexes, balance, ability to walk, muscle strength and muscle tone.

• An X-Ray or Radiograph is a common test performed to reveal the condition of the body's bony structures. Results may suggest more testing is necessary.


• A CT scan (Computed Tomography) is a 3-dimensional imaging study also used to evaluate bone and soft tissue. Each detailed anatomical picture resembles slices or cross-sections of the specific area of the body.


• An MRI (Magnetic Resonance Imaging) is a powerful imaging tool. MRI is commonly used for musculoskeletal evaluation as it provides great detail about bones and soft tissues.


• A PET scan (Positron Emission Tomography) uses small amounts of radionuclides (radioactive isotopes) to measure tissue changes at the cellular level. This test is performed when cancer is suspected.


• Discography allows the physician to evaluate the intervertebral discs (one or more) as a possible pain source. The test evaluates the structural integrity of the discs and may be used to replicate back or leg pain. The procedure involves the use of a contrast dye injected into each suspect disc to be examined by x-ray or CT scan.


• Electrodiagnostic tools include NCS (Nerve Conduction Study) and EMG (Electromyography).


• An NCS (Nerve Conduction Study) evaluates the speed of nerve impulses as they travel along a nerve. This test can help determine if there is nerve damage, the extent of the damage, and if nerves have been destroyed.


• An EMG (Electromyography) uses nerve stimulation to evaluate electrical activity within selected muscle fibers. The test measures muscle response and detects muscle damage and disease. It can help to distinguish between a muscle and nerve disorder.


• Usually, both tests are performed, although an NCS may be performed without an EMG.

Just because you don't need prescriptions to buy over-the-counter (OTC) drugs doesn't mean they don't contain powerful medication, they do. If you aren't careful, certain OTC medications can cause severe, even potentially deadly, side effects.

A new special report from the Health Sciences Institute shines a light on eight of the worst offenders. These are medications that most people think are perfectly safe, but they really pose quite a substantial threat to your overall good health.

Sominex and Nytol

The key ingredient in Sominex and Nytol is a chemical called diphenhydramine hydrochloride, the same active ingredient found in Benadryl. As anyone who's taken these drugs can attest, they will make you drowsy, which sounds like a dream come true if you're struggling with insomnia. But when you take diphenhydramine hydrochloride, you get a lot more than nighttime drowsiness. In fact, you're setting yourself up for a whole host of potentially dangerous side effects, especially if you make these sleeping pills a regular part of your nighttime routine.

A 2001 study conducted by doctors at Yale-New Haven hospital found that diphenhydramine hydrochloride, the key active ingredient in Sominex and Nytol, appears to contribute to cognitive decline. In fact, it turns out that this drug can be especially dangerous for people ages 70 and over, even after just one dose. In the Yale study, none of the 426 patients showed any history or signs of dementia or delirium before the drug was administered. Then diphenhydramine hydrochloride (a maximum total dose of 100 mg per day) was given to 114 of the patients, while the remaining 312 were not medicated. Within 48 hours of drug administration, trained specialists found that the diphenhydramine group fared much worse on every measure of cognitive decline. Overall, the medicated group demonstrated a 70 percent increased risk of cognitive decline as compared to the controls.

Here's the scariest part: The dosages used in the study are often used by people at home. A standard dose of either Sominex or Nytol contains 50 mg of diphenhydramine, so just two doses in a 24-hour period could put you at the 100 mg level. Add to that the fact that diphenhydramine hydrochloride is also found in many cold and allergy remedies, and you could inadvertently take more than 100 mg in a single day.

Potential Adverse Reactions: (this is just a partial list)

• Hypotension (low blood pressure)
• Heart Palpitations
• Tachycardia (rapid heartbeat)
• Thrombocytopenia (blood disorder)
• Nausea and Vomiting
• Constipation
• Insomnia (yes, you read that right)

 

• Headaches
• Difficult Urination
• Urinary Incontinence
• Wheezing
• Vertigo
• Convulsions
• Blurred Vision
• Excessive Perspiration

The latest drugs for controlling stomach acid are much more than simple acid neutralizers like Tums. Rather, they're high-tech formulations that work by actually stopping acid production, a scenario that sets you up for a lifetime of digestion problems, and an increasing need for acid-blocking drugs. These medications reinforce the idea that stomach acid is bad, but that could not be further than the truth. Your stomach produces acid for a very important reason: You can not digest food without it.

The drugs in question here come in two styles: histamine H2-receptor blockers (or H2-blockers) and proton pump inhibitors. Currently available over-the-counter H2-receptor blockers include Tagamet® (cimetidine), Zantac® (ranitidine), Pepcid® (famotidine), and Axid® (nitazidine). These drugs reduce acid levels by throwing a roadblock right in the middle of the process that leads to acid secretion. While they seem to be effective for hours at a time, the long-term, continuous suppression of gastric acid secretion may have important adverse consequences for your health that are largely ignored by mainstream medical professionals. In addition, these drugs all have well-documented adverse side effects, most of which involve GI disturbances, such as:

• constipation
• diarrhea
• nausea
• vomiting
• and yes, heartburn

Also available OTC is Prilosec® (omeprazole), a proton pump inhibitor (PPI). PPI's are the strongest of the acid-suppressing drugs. They work by blocking the action of the "proton pump," which secretes stomach acid. Just one of these pills is capable of reducing stomach acid secretion by 90 to 95 percent for the better part of a day. That, in turn, makes it nearly impossible for your body to digest food properly, so it's no wonder that Prilosec OTC side effects include:

• gas
• diarrhea
• constipation

And there are far more serious side effects associated with omeprazole (though these are less common):

• impotence
• breast enlargement
• joint pain
• abdominal pain
• headache
• dizziness
• rash

Unfortunately, many of the potential consequences of long-term acid suppression can take years or even decades to develop. But because they seem to have nothing to do with stomach acid, they're rarely (if ever) reported in connection with acid suppressing medications. Check out this (partial) list of long term health issues linked with these drugs:

• skin disorders
• insomnia
• osteoporosis
• gastritis
• depression
• pneumonia

M.D.'s are trained in "allopathic" medicine, just as "osteopathic" and "naturopathic" practitioners are trained in their respective medical fields. Allopathic medical students begin with four years of undergraduate education at a college or university, followed by four years in medical school. After graduating from medical school with their M.D., physicians take an additional three to seven years of specialty training in a residency at a clinic or hospital. The American Board of Medical Specialties lists 24 recognized medical specialties, many of which also have sub-specialties. (An example, Cardiology is a subspecialty of Internal Medicine) In order to practice medicine, an M.D. must be licensed by the jurisdiction in which he or she intends to practice.

Doctors of Osteopathic medicine earn the degree D.O. by completing undergraduate work and graduating from an accredited four year medical school. In the case of an Osteopath, the medical school is devoted to Osteopathy. After graduation, osteopathic physicians serve a one year internship that provides patient care experience in internal medicine, obstetrics and gynecology, family practice, pediatrics, and surgery. Like M.D.'s, D.O.'s can prescribe medicine and perform surgery, and they must pass a state osteopathic medical board examination to practice.

Osteopathy is a system of therapy based on the theory that the body can make its own remedies against disease and other toxic conditions when it is in normal structural relationship, and has favorable environmental conditions and adequate nutrition. It uses generally accepted physical, medicinal, and surgical methods of diagnosis and therapy, while placing chief emphasis on maintenance of normal body mechanics and on manipulative methods of detecting and correcting faulty structure.

Some D.O.'s are also D.C.'s (doctors of chiropractics). Chiropractors believe that all body functions and dysfunctions are related to the nervous system. Hands-on alignment and manipulation of the neuromusculoskeletal system is their main form of treatment. Chiropractors not trained as medical doctors obtain their D.C. degree after completing four years of training in an accredited chiropractic school. they can not perform surgery or prescribe medicine.

Nurses, like doctors, may also specialize in certain areas of care. Nurses must be licensed through the board of nursing in the state in which they practice. The licensed practical nurse (LPN) is qualified to provide patient education and basic nursing care under the supervision of a registered nurse (RN). LPN's can be found in hospitals, nursing homes and home healthcare agencies. They have one year of nursing school.

RN's obtain their credentials by either earning a bachelor's of science degree at a four year college or university with an accredited school of nursing, or by completing an associate's degree at a two year community college. Some nurses choose to go on and obtain a master's degree. After passing a national licensing test and obtaining a license from their state's board of nursing, RN's are ready to practice. If an R. N. decides to move to another state they must be licensed in the new state in order to practice there. R. N., BSN, indicates a registered nurse with a bachelor's of science degree in nursing. Those with master's degrees are indicated by R. N., MSN.

Nurse practitioners (N. P.) have advanced nursing education and training. They can be found working in schools, rural healthcare clinics, taking histories, conducting physical exams, prescribing medication and generally providing basic healthcare in place of a physician.

The expanded use of the physician assistant (P. A.) is the newest trend in the healthcare field. The P. A.'s role is similar to that of the nurse practitioner. According to the American Academy of Physician Assistants, more than 29,000 P. A.'s are currently working in the United States, under the supervision of physicians. They assist doctors by doing everything from taking patient histories and counseling patients to assisting in surgery and in some states, prescribing medicine.

GSK and XenoPort Announce Submission of a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA). They are requesting approval of Solzira (gabapentin enacarbil) Extended Release Tablets for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS). RLS affects an estimated 12 million people in the United States and can result in distressing symptoms that disrupt sleep and significantly impact daily activities.

Solzira is a non-dopaminergic new chemical entity that provides improvement in the symptoms of RLS with the convenience of a once-daily formulation.

The NDA submission is based on a comprehensive Phase 3 clinical development program for Solzira in patients with moderate-to-severe primary RLS, including data from two randomized, double-blind, placebo-controlled trials (PIVOT RLS I and PIVOT RLS II), which evaluated the safety and efficacy of Solzira over 12 weeks. The submission also included results from a third pivotal trial (PIVOT RLS Maintenance) evaluating the ability of Solzira to maintain efficacy in treating RLS symptoms over a nine-month period. The most common side effects of Solzira were dizziness and somnolence.

Solzira is a new chemical entity that is designed to improve upon the pharmacokinetics of gabapentin by taking advantage of high-capacity transport mechanisms in the gastrointestinal tract to improve absorption.

The modern holiday of Halloween has its origins in the ancient Celtic festival known as Samhain (pronounced sow-in). The festival of Samhain is a celebration of the end of the harvest season in Gaelic culture, and is sometimes regarded as the "Celtic New Year". Traditionally, the festival was a time used by the ancient pagans to take stock of supplies and slaughter livestock for winter stores. The ancient Gaels believed that on October 31, the boundary between the alive and the deceased dissolved, and the dead become dangerous for the living by causing problems such as sickness or damaged crops. The festivals would frequently involve bonfires, where the bones of slaughtered livestock were thrown. Costumes and masks were also worn at the festivals in an attempt to mimic the evil spirits or placate them.

United States & Canada

The main event for children of modern Halloween in the United States and Canada is trick-or-treating, in which children disguise themselves in costumes and go door-to-door in their neighborhoods, ringing each doorbell and yelling "trick or treat!" to solicit a gift of candy or similar items. Upon receiving trick-or-treaters, the house occupants (who might also be in costume) often hand out small candies, miniature chocolate bars, nuts, loose change, soda pop, stickers, or even crayons and pencils.

Other common Halloween activities include ghost tours, bonfires, costume parties, visiting "haunted houses", carving Jack-o'-lanterns, reading scary stories and watching horror movies.

Halloween is largely celebrated, particularly by children of a young age, always chaperoned, otherwise it is unadvisable for little kids to leave the house. Young teens take to throwing Halloween parties (mostly to have a reason to throw a party; costumes and candy aren't usually remembered). Celebration of the holiday out on the streets asking for candy has declined.

All over Ireland, huge bonfires are lit. Young children in disguise go trick-or-treating, they are warmly received by their neighbors with gifts of fruit, miniature chocolate bars, loose change, peanuts and of course sweets for the "Halloween Party". Some homes will put up decorations including Halloween lights. Children have the week off from school for Halloween, and it is common for teenagers and for college students to spend weeknights out and about with friends, pranking and causing mischief, if not trick-or-treating themselves, and perhaps even "egging" (throwing eggs at houses), drinking alcohol, and setting off fireworks.

In England, trick-or-treating does occur, although the practice is regarded by some as a nuisance or even a menacing form of begging. In some areas, households have started to put decorations on the front door to indicate that trick-or-treaters are welcome, the idea being that trick-or-treaters will avoid a house not participating in the custom. Tricks currently play a less prominent role, though Halloween night is often marked by vandalism such as soaping windows, egging houses or stringing toilet paper through trees. More serious vandalism often occurs in the form of damage caused by fireworks. The holiday's date being close to the English celebration of 'Bonfire Night' on November 5th, which is traditionally celebrated with fireworks displays, means that those who do with to cause more serious mischief find them to be easily attainable.

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