Migraines In Women

Posted on Posted in Continuing Education, Homestudy, Pain, Seminars

woman-565132_640Migraine headaches are usually characterized by throbbing, severe pain (usually on one side of the head), an upset stomach, and — sometimes — disturbed vision.

Migraines were recognized as early as the 7th century BC—when the usual treatment involved trephining, or creating a hole in the skull to relieve the headache pressure, and release the “evil spirits or demons” thought to be causing the pain.

Women are three times more likely than men to suffer from migraine headache. Hormonal changes and the patient’s stage of life may play a role in women’s higher susceptibility to migraine. Even in ancient history, women with migraines probably greatly outnumbered men with the disorder.

Throughout history, a number of myths about migraine in women have flourished. Migraines in women were often attributed solely to PMS (pre-menstrual syndrome) or hormonal changes, such as those that occur during menopause. Another myth was that headaches in general — and headaches in women, in particular — were due to psychological problems, rather than being a biological condition. Consider some facts about migraines and women:

  • In the United States, almost nine million women suffer from migraines each year, and over three million have more than one migraine attack per month.
  • Sixteen out of every 100 women suffer from migraine headaches.
  • The highest prevalence for migraine in women occurs between the ages of 35 and 45, a time when many women are at the height of their professional careers and have the most family responsibilities and social obligations.
  • Half of all women with migraines report having 24 or more migraine attacks each year, and over 25 percent report having such headaches every week.
  • In women who have migraines, 60 percent experience headaches during menses as well as at other times of the month. Just 14 percent of women have migraine pain only during their menstrual period.

Headache is one of the most common conditions seen by clinicians today. Migraine headaches can be especially troublesome for patients and can cause symptoms that include significant pain as well as neurologic symptoms. Fortunately, there are now many effective treatments for migraine and other headaches, including medications and lifestyle changes.

In women with migraines, hormonal changes can play a significant role in the severity of symptoms. Thus, successful treatment of female migraineurs requires knowledge of neuro-endocrine changes from menarche to menopause. With such knowledge, clinicians can help female patients find relief from this challenging condition.

A thorough medical history and careful physical examination are essential to rule out less common but serious causes of headache. The best treatment always starts with the right diagnosis.

INR offers continuing education courses such as Women’s Health: Migraines and Headaches.  Click below for this and more from our library.


Rheumatic Diseases

Posted on Posted in Continuing Education, Homestudy, Pain

marseille-142394_640Rheumatic diseases have been with us for centuries—since at least the early Bronze Age. According to the Arthritis Foundation, American Indians living in 3000 BC showed signs of rheumatoid arthritis.

The symptoms of rheumatic disease were first formalized in 1680 by the British physician, Thomas Sydenham. At the time, he described the pain of acute gout flares in his patients as “so exquisite and lively…it cannot bear the weight of bedclothes nor the jar of a person walking into the room.”

As Sydenham observed, many types of arthritis can be painful and even disabling. Today’s treatments, including new pain relievers, Disease Modifying Anti-Rheumatic Drugs (DMARDs), and biologic agents can help reduce symptoms and slow the progression of arthritis. Surgery can repair joints, bones, and tendons damaged by arthritic disease. Lifestyle changes, including diet, exercise and assistive devices, make it possible for many people with arthritis to live fully functional, even active lives.

Approximately 50 million U.S. adults—about one in five—have physician-diagnosed arthritis. However, nearly one in three adults have arthritis or chronic joint symptoms. Arthritis is the most prevalent cause of disability in the United States, and results in upwards of 66 million physician visits each year.

As the population ages, the incidence of arthritis will rise dramatically and is expected to increase to 67 million by 2030.  Arthritis will create an important public health problem as well as tremendous personal suffering.  The societal costs of arthritis are immense. The estimated yearly medical care costs for arthritis total nearly $81 billion in the U.S. The cost of medical care plus lost work productivity is even larger—approximately $128 billion.

In general, rheumatic diseases are characterized by:

  • Inflammation
  • Redness and/or heat in a joint
  • Swelling in the joints
  • Recurring or constant pain
  • Decreased range of motion in joints
  • Stiffness
  • Fever, weight loss, and fatigue — in some types of rheumatic disease.
  • Loss of function in connective tissues
  • Involvement of joints, tendons, ligaments, bones, and muscles

Rheumatic diseases are systemic and often involve internal organs.  Though arthritis is a growing problem by virtue of demographics, the disease is also becoming increasingly manageable. With improved screening and today’s treatments, people with arthritis may live active, independent lives. Every effort should be made to protect sleep, preserve functional independence, and provide for effective pain management.

New research is also pointing the way toward increased knowledge about the causes of arthritis, which will ultimately improve available treatments. Appropriate diagnosis, comprehensive treatment, and prevention of complications will continue to improve in the next decade, enhancing quality of life for millions.

Rheumatic Disease and Arthritis are just two of the topics covered in our Homestudy Courses.  Click below for more information.


Knee Pain

Posted on Posted in Continuing Education, Homestudy, Pain

Knee PainBy Rajinder Hullon, MD, JD

Knee pain is one of the most common complaints seen in outpatient medical-treatment centers. This disorder affects 20 percent of our population and is the fifth most common health complaint, accounting for millions of doctor visits each year.

Physicians treat knee pain more frequently these days for a number of reasons. Better health care options and availability have resulted in people living longer. Because the knee joint is one of the key weight-bearing joints in the body, it is subject to more wear and tear with age. Older people are more likely to suffer from some degree of knee pain.

The nationwide problem with obesity has also contributed to the increasing frequency of knee complaints. More stress is placed upon the knee joint the heavier a person is. At some point, the knee joint will be unable to support this stress, and surgical intervention may be required.

Preventing Knee Injuries

As everyone knows, an ounce of prevention is worth a pound of cure. In the case of the knee joint, the American Academy of Orthopedic Surgeons and the American Orthopedic Society for Sports Medicine offer these suggestions to avoid pain or injury:

  • Stay in shape. Good general conditioning helps control or prevent knee pain, particularly patello-femoral pain. Overweight individuals may need to lose weight to prevent excessive stress on the knees. Doctors recommend a 5-minute warm-up before running or beginning any other exercise.
  • Stretch. Stretching is a good warm-up technique before and after any exercise. When performed in the prone (face down) position, it helps maintain the flexibility of the ligaments, muscles, and tendons within the knee joint.
  • Increase training gradually. Work up gradually and avoid sudden changes in the intensity of exercise.
  • Use proper running gear. Running shoes should have good shock absorption and quality construction. Be sure shoes fit properly and are in good condition. If you have flat feet, you may need shoe inserts. Running shoes should be replaced every 3-4 months if used consistently.
  • Use proper running form. Lean forward and keep the knees bent. Also, try to run on a clear, smooth, and reasonably soft surface. Never run straight down a steep hill. Walk down it, or run in a zig-zag pattern.

Since there can be many different causes for such pain, the clinician must take great care to make an accurate diagnosis in order to ensure proper medical and/or surgical treatment.

Many knee pain cases also involve overuse or injury from sporting activities. In these situations, individuals should be aware of the importance of warm-up exercises and, and if pain arises, the need to seek early treatment to avoid permanent or disabling knee injury.

Of course, if you experience knee pain, the best thing you can do is see a doctor, and remember that if you’ve been diligent about exercise for a long time, a week off for rest and recovery might be the best thing you can do, whether you’ve come down with an injury or not.

INR (Institute for Natural Resources) offers continuing educations courses that cover many medical conditions including knee pain.