Can Statins Cause Neck Pain?

by LMatthews on February 26, 2017

statins and neck pain coq10 myopathyMillions of people worldwide take statins in an attempt to lower their cholesterol levels and reduce their risk of heart attack. The sad irony is that by blocking endogenous cholesterol production, which is how statin drugs work, these medications also block production of coenzyme Q10, a nutrient needed for the production of energy, especially in muscles and particularly in the heart. As such, statin drugs may cause side effects including fatigue, muscle weakness, and neck pain which clinicians refer to as statin-induced myopathy. Continue reading “Can Statins Cause Neck Pain?” »

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Concussion and Cervicalgia Headaches

by LMatthews on March 5, 2015

concussion and cervicalgia headachesMore than 1.7 million people in the US are affected annually by concussion, also known as mild traumatic brain injury (mTBI), and often concussion and cervicalgia headaches go hand in hand. Around 15% of people with concussion have symptoms that persist for three months or more, and sometimes patients don’t realize that neck and head pain are related to the earlier injury. This is especially true of people who have a minor bump or experience of whiplash on top of earlier head injuries. Continue reading “Concussion and Cervicalgia Headaches” »

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vancomycin powder cuts rate of infection after cervical spinal surgeryInfection after cervical spinal surgery is just one possible complication of surgery to treat neck pain. Finding ways to reduce the risk of infection is important, especially as this complication can lead to failed back surgery syndrome, serious scarring, ongoing and worsening neck pain, and even paralysis or death, depending on how serious the infection becomes and how responsive it is to treatment. Continue reading “Decreasing the Risk of Infection After Cervical Spinal Surgery” »

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fibromyalgia brain activity pain neck

Fibromyalgia - all in your head? Perhaps, but it isn't imaginary.

Fibromyalgia patients may be used to having people tell them that their condition is all in their head, but new research offers more weight to the theory that people with this condition have a unique response to pain due to altered brain function.

The research, published in the journal Arthritis & Rheumatology, involved 35 patients with fibromyalgia, a condition that frequently involves symptoms such as neck pain, back pain, fatigue, muscle tenderness, sleep disturbance, altered mood and cognitive dysfunction. Continue reading “Unique Brain Activity in Fibromyalgia – A Cause of Neck Pain” »

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Occipital Neuralgia – What is it?

by LMatthews on February 15, 2015

occipital-neuralgia head and neck pain nerve blockHead and neck pain could be caused by occipital neuralgia, a non-fatal condition that involves nerve irritation or injury from a variety of causes. The prefix ‘neuro’ means nerve and ‘algia’ means pain, while ‘occipital’ describes a region of the head running from the spinal column in the neck up to the scalp at the back of the head.

There are numerous possible causes of this kind of spreading neck pain and headache resulting from injury or compression of the greater and lesser occipital nerves. Continue reading “Occipital Neuralgia – What is it?” »

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TMJ, Ear and Neck Pain

by LMatthews on February 9, 2015

jaw, ear and neck painNeck pain may occur in isolation, but often neck pain, ear pain and jaw pain co-exist, leading to pain when eating, speaking, moving the head, and even when lying down to sleep. Sometimes, this triad is a result of temporomandibular joint disorder (TMJ), where the jaw joint and related bones, ligaments, and cartilage are typically swollen and painful, making it hard to open the jaw. Continue reading “TMJ, Ear and Neck Pain” »

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Top 10 Chiropractors in the World

by LMatthews on January 22, 2015

dr david warkentin chiropractor

Dr. David Warkentin, voted the top chiropractor in the world, according to patients.

As patients and potential patients we are pretty spoilt these days in terms of access to information about our health care professionals. Before we even step into the office of a family physician, orthopedic surgeon, or chiropractor, we can search online for details of their educational history, disciplinary hearings, board certification, and even reviews by fellow patients. Continue reading “Top 10 Chiropractors in the World” »

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Neck Pain as a Heart Attack Symptom in Women

by LMatthews on January 15, 2015

heart attack symptoms in women neck pain

Is this what a heart attack feels like for women?

Men and women experience heart attacks differently, meaning that it is important to be able to recognize which symptoms of a heart attack you are likely to encounter. For women, neck pain can indicate a heart attack, but this symptom is often ignored or dismissed as a result of muscle strain. Continue reading “Neck Pain as a Heart Attack Symptom in Women” »

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Neck Pain and Nausea – Signs of Flu?

by LMatthews on January 8, 2015

neck pain nausea flu 2014 15According to the US Centers for Disease Control (CDC), the 2014/15 flu season is especially bad, with about half of the US experiencing high flu activity. This is expected to increase over January and spread to states where flu has remained relatively less active. December to February is typically the worst time for flu cases in the US, with symptoms including neck pain and stiffness, sore throat, nausea, fever, chills, and fatigue causing many to stay away from work and school. Continue reading “Neck Pain and Nausea – Signs of Flu?” »

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medical marijuana vaporiser neck pain reliefMany more American states legalized the use of cannabis for medical concerns like chronic neck pain in 2014, but new research shows that in those states where medical marijuana is legal, visits to the emergency room for cannabis-related crises have increased. The same study also found an overall increase in the use and misuse of cannabis as well, so is it worth the risk to use medical marijuana for neck pain relief?

50% Increase in Medical Marijuana ED Visits

Colorado was one of the first two states to legalize medical and recreational cannabis use and in this latest study emergency department visits involving cannabis use rose 50.4% in Colorado between 2007 and 2012. ED visits also rose in states where only medical use is legalized, with the largest increase in Hawaii, where visits related to cannabis rose by 55% from 2007 to 2012. New Jersey saw a 49.1% increase in visits, and Arizona had a 32% rise in the number of ED visits involving cannabis.

In some states where marijuana use remains illegal, even for medical purposes, there was also a significant increase in ED visits; in Texas, for example, there was a 43.2% increase in cannabis-related ED visits. In Oklahoma and South Carolina however, the increase was only 7.21% and 0.75%, which makes you wonder what’s going on in Texas.

The Cost of Cannabis for Pain Relief

The impact of cannabis on the health care system appears to be increasingly significant, with the author of this study, Dr. Rai, also presenting figures related to the costs of cannabis-related hospital stays. An average nationwide increase of 13.3% in cannabis-related hospital admissions was higher than that for alcohol abuse (8.6%), and the average hospital charge increased 39% for cannabis-related issues, compared to 29.5% for alcohol abuse. Interestingly, there was a 67.9% decrease in the percentage of visits related to cocaine use, but there was a 42% increase in visits related to opioids.

This is Not Your Mother’s Marijuana

One of the problems with cannabis is that there is such a wide variety available that users may be unaware of the strength and potential toxicity of their drug of choice. As well as the plant matter itself, cannabis oil and liquids have become popular, and there have even been incidents of serious explosions from home-based laboratories cooking up high-potency THC oil, which produces highly volatile gases.

Getting a prescription for medical marijuana may have become simpler in recent years, but with so many options available for users it is now increasingly complex to decide what product to choose and how to ingest it. This means that many people are ending up in the emergency room because they have taken too much and are overintoxicated.

This may be especially true for those who used marijuana recreationally in their youth and who are now using it medicinally some 30 or 40 years later, without appreciating that selective breeding of the plants has dramatically increased the level of THC and other active constituents. Essentially the cannabis now available is not that of the 70s, 80s or even the 90s. In fact, the authors of this study note that today’s cannabis is around four times as potent as cannabis of the 1970s.


Who Uses Medical Marijuana?

In a 2003 paper published in the journal Pain, Ware and colleagues reported that those surveyed who used cannabis for pain relief were more likely to be younger and to also use tobacco, and that the largest group of patients using cannabis did so for pain related to trauma and/or surgery. Some 68% of the patients were using cannabis to relieve neck pain or upper body pain, with 65% using it to treat myofascial pain (which can also involve neck pain).

The majority of these patients (53%) used 4 puffs per dose of cannabis for pain, 25% smoked a whole joint, and 12% smoked more than one joint at each dose. Most patients used it only on rare occasions (28%), 25% used it weekly, 16% used it daily, and 22% used it more than once a day for pain relief. The patients most often reported improvements in pain, sleep and mood with the use of the drug, with the most common side effects being feeling high and having dry-mouth.

Can Cannabis Relieve Neck Pain?

In a more recent study, patients with central and peripheral neuropathic pain were given vaporized cannabis at a 3.53% or 1.29% THC dose, or a placebo and their pain was assessed using a visual analog scale. Wilsey and colleagues also looked at any psychoactive side effects and the patients’ neuropsychological performance. The two active groups had no significant differences in analgesic response, and the number needed to treat was comparable in both cases to that of traditional medications for neuropathic pain.

Psychoactive effects were deemed to be minimal and reversed within 1 to 2 hours, suggesting that vaporized cannabis may be an effective option for relief of neuropathic pain resistant to other forms of treatment.

How Cannabis Helps with Chronic Pain

THC, or tetrahydrocannabinol, is the active pain-relieving cannabinoid in medical marijuana, but its psychoactive effects limit its use, as does the typical method of delivery (smoking). Other cannabinoids also have analgesic effects however, including oral doses of cannabidiol and beta-caryophyllene, which appear to have a higher level of safety and limited adverse effects.

These drugs act on the endocannabinoid system, including CB(1) receptors in the spinal cord which process and modulate nociceptive information. In addition, CB(2) receptors appear to be a primary cause of the anti-inflammatory effect of endocannabinoids, which also helps relieve pain locally. Specifically, these CB(2) receptors may affect mast cells and neutrophils (immune system cells), which then helps prevent pain related to an inflammatory response.

What these studies suggest is that there is evidence in support of the use of cannabis for relief of pain such as neuropathic neck pain, but that it is increasingly important to find safe delivery mechanisms, and to put in place regulatory systems that help patients to choose more wisely when using medical marijuana.


References

American Academy of Addiction Psychiatry (AAAP) 25th Annual Meeting: Abstracts 20 and 52, presented December 5, 2014.

Rice AS, Farquhar-Smith WP, Nagy I. Endocannabinoids and pain: spinal and peripheral analgesia in inflammation and neuropathy. Prostaglandins Leukot Essent Fatty Acids. 2002 Feb-Mar;66(2-3):243-56.

Fine PG, Rosenfeld MJ. The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides Med J. 2013 Oct 29;4(4):e0022. doi: 10.5041/RMMJ.10129. eCollection 2013.

Wilsey B, Marcotte T, Deutsch R, Gouaux B, Sakai S, Donaghe H. Low-dose vaporized cannabis significantly improves neuropathic pain. J Pain. 2013 Feb;14(2):136-48. doi: 10.1016/j.jpain.2012.10.009. Epub 2012 Dec 11.

Ware MA, Doyle CR, Woods R, Lynch ME, Clark AJ. Cannabis use for chronic non-cancer pain: results of a prospective survey. Pain. 2003 Mar;102(1-2):211-6.

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