Theraputic Massage...big fat ouch!!

Okay, normally a massage is nice and relaxing but theraputic massage is a whole different kettle of fish! First...it hurts like a mother! It hurts to get it done and it hurts after.
There are different types of massage so people with FMS should be careful when they go to a massage session.
Thanks to Wikipedia for the information.

Types of massage
There are well over 150 types of massage therapy. Various styles of massage have developed from a number of sources.

Barefoot Deep Tissue
Barefoot Deep Tissue is a blend of Eastern barefoot techniques with Western manual medicine. Clients are typically loosely clothed and lain on floor mat in supine, prone and side-lying positions with pillows or bolsters. No oil is used. Sessions may last 2 minutes or well over an hour. Because the therapist can apply a broad range of pressure with ease and does not have to strain, more effort and concentration can be used to sense and manipulate tissue, release fascia, as well as search for and attack trigger points and other problems, regardless of client's size or build. John Harris, the proceleusmatic mentor who worked in the 1984 Olympics and developed this modality, states that the combination offers a potent new tool for powerfully satisfying, effective deep tissue massage and Trigger Point work regardless of client's size or build. Mr. Harris and Fred Kenyon wrote Fix Pain in 2002, and have been hired by Human Kinetics to write a trade publication with DVD for elite athletes.

Bowen therapy
For more details on this topic, see Bowen Technique.
Bowen Technique involves a rolling type movement over fascia, muscles, ligaments, tendons and joints.

Breema
Breema bodywork is performed on the floor with the recipient fully clothed. It consists of rhythmical and gentle leans and stretches which leads to deep relaxation, increased vitality, and stimulation of the self-healing processes of the body. Sessions can be any length of time, although 50 minutes is common. There are also self-Breema exercises. The essence of Breema is expressed in the Nine Principles of Harmony. The Breema Center is located in Oakland, California, and there are Breema practitioners and instructors in many locations around the world.

Chair massage
Chair massage, also known as Corporate Massage, is by far the most convenient method of massage therapy. A chair massage session typically lasts 12-24 minutes, and is performed while fully clothed. Chair massage promotes better circulation, muscle stimulation and stress relief. This form of massage reduces tension in the back, neck, shoulders, head, arms, hands, legs or feet, providing a deep relaxation effect.

Chair massages are also advantageous because chair massage practitioners will frequently make work- or housecalls. Chair massage can also be done in hotels, airports and convention centers.

Chinese Tui Na massage
For more details on this topic, see Tui Na.
Tui Na is a form of Chinese massage that is similar to Zhi Ya, but focusing more on pushing, stretching and kneading the muscle.

Chinese Zhi Ya massage
Zhi Ya is a form of Chinese massage based on acupressure. It is similar to Tui Na massage except it focuses more on pinching and pressing at acupressure points.

Deep muscle therapy
Deep muscle therapy (created by Therese Pfrimmer), is a massage technique that focuses on using a very specific set of movements applied to all muscles and concentrating on all layers of the muscle that have become depleted of their regular blood and lymphatic flow. This technique aims to restore the circulation with its healing properties to the cellular level. Deep muscle therapy is widely used to treat the following ailments: carpal tunnel syndrome, neck and back pain, headaches, poor circulation, whiplash, and more.

Deep tissue massage
Deep tissue techniques are generally designed for more focused massage work. Working a specific joint, muscle or muscle group, the practitioner can access deeper layers of the soft tissue. Starting superficially and easing into the depth of the muscle slowly often allows more movement. This is the recommended approach in this modality since each person experiences pressure differently. If the pressure is applied too deeply or too quickly, the muscle may tighten to protect that area, and unnecessary damage or inflammation can be induced. Very little lubricant is used as the pressure doesn't travel much over the skin.

The most commonly used 'tools' during deep tissue massage may include, 3 and 6 fingers, reinforced fingers, a flat elbow, opposing thumbs, the heel of the hand or foot, and the forearm. See also: Myofascial Release

Effleurage
Effleurage (from the French effleurer, 'to skim over') consists of long, flowing or gliding strokes, performed with open hands. In many massage sessions, effleurage is used as the initial type of stroking, as it has a calming effect when performed slowly. Effleurage is usually performed in the direction of the heart to promote circulation and lymphatic drainage.

Erotic massage
Erotic massage is a form of massage that includes the genitals and leads to sexual arousal and (sometimes) orgasm. Widely practiced by couples as part of lovemaking. Also sometimes practiced commercially, which may be illegal in some jurisdictions. See also Tantramassage.

Esalen Massage
The basis of Esalen Massage is traditional massage, which works in a very precise manner on the muscle and circulation systems. This is combined with the bodywork approach developed by Charlotte Selver, which emphasizes the deeply relaxing and emotional responses of the body when a conscious, structured and pleasant touch is applied. In addition, gentle rocking of the body, passive joint exercises and deep structural work on the muscles and joints, together with an energetic balancing of the body, are all part of this Esalen Massage “experience”.

Foot or sole massage
Foot massage, as practiced by the Chinese is performed in the context of chi, in that each spot on the sole of the foot corresponds to an internal organ, and the applied therapy is healing to one's overall well being. The theory supposes that an ailment of an internal organ will be associated with the nerve ending on the sole of the foot.

Before the massage, the patient's feet are soaked for about ten minutes in a foot bath, typically a dark colored solution of hot water and Chinese herbs. The massage therapist uses liberal amounts of medicated cream, to moisturize the foot and to provide lubrication. The knuckles on the therapist's hand are usually used to provide a hard and smooth implement for the massage. As pressure is applied to the sole, theory holds that a healthy patient should not feel any strong pain. Painful spots, reflexologists believe, reflect illnesses of other parts of the body. The practitioner rubs and massages the painful spots to break down rough spots and accumulated crystals and increase circulation.

The ailments are healed when the sore spots of the sole are treated and removed by massage. Based on this theory, some shoe liners are made with pressure points to stimulate the soles of the feet to promote better health of the overall body. The nature of these "crystals" has yet to be elucidated or demonstrated scientifically. Regardless of the actual correlation of reflexology to internal organs, many enjoy it for the mix of stimulation and relaxation.

Lomilomi — Traditional Hawaiian Massage
Lomilomi massage is an ancient art from the Hawaiian healing specialists. They were taught their art over 20 years and received their last instructions from their master on his death bed. There are hundreds of styles of Lomilomi, the main ones being the style of Big Island which was passed on by Aunty Margaret Machado, and Maui style from Uncle Kalua Kaiahua. On the island of Kaua'i, Kahu Abraham passed on what is today called Kahuna Bodywork. It is not clear if other current practices - temple style, lomi lomi nui and others - are from Native Hawaiian practitioners or are modern adaptations.

MA-URI massage
MA-URI is a new form of massage introduced by Hemi Hoani Fox in 1990, who cites as its roots Hawaiian Lomi-Lomi Nui dance, claiming increased so-called energy flow within the body and mind. Focus is internal, upon breathing, intent, and concentration. Claimed benefits include mental and physical health. Study and advocation is primarily carried out at the MA-URI Institute, headed by Hemi and Katja Fox. It is currently difficult to find practitioners, though this may change as it grows more popular.

Muscle Energy Technique (MET)
Reciprocal Inhibition (RI) is when the therapist uses a client’s muscle to stretch the opposing muscle. The therapist takes the muscle that they are wishing to stretch to its point of bind. The therapist then gets the client to use the opposing muscle by moving away from the therapist. When the client relaxes the therapist then moves the muscle to realign the muscle fibres therefore stretching the muscle.

As an example, Muscle Energy Technique (MET) Reciprocal Inhibition (RI) can be applied to the calf when the client is lying supine on the treatment couch. The masseur can place one hand on the tibia just below the knee to isolate the knee preventing it from moving. The other hand is placed around the heel so that the masseurs forearm can be used to dorsiflex the foot. This is one of the techniques used by sports massage therapists.

Myofascial Release
Myofascial Release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia and integument, muscles, and bones, with the goal of eliminating pain, increasing range of motion and balancing the body. Injuries, stress, trauma, overuse and poor posture can cause restriction to fascia. Myofascial release frees fascial restrictions, and allow the muscles to move efficiently. This is usually done by applying shear, compression or tension in various directions, or by skin rolling. This is one of the techniques used by sports massage therapists and physical therapists. Myofascial release originators come from Physical Therapy and from Structural Integration (Rolfing); its current developers include John Barnes PT from a Physical Therapy background, and from a Rolfing or Structural Integration background, Art Riggs, Michael Stanborough, Tom Myers, Til Luchau, and others.

Myoskeletal alignment technique
Myoskeletal Alignment Technique (MAT) identifies postural distortions to improve and prevent pain conditions. Proprioceptive Neuromuscular Facilitation (PNF) and myofacial techniques are used to lengthen tight/facilitated muscles while fiber activation techniques tone weak/inhibited muscles. MAT was developed by Erik Dalton.

Neuromuscular therapy
Neuromuscular Therapy (NMT) is used for pain relief and specific problems. Structural and postural imbalances are identified through an initial postural assessment. These are then addressed through systematic and site specific massage. NMT reduces pain, tension, postural imbalance, and lengthens and strengthens tissues. NMT was developed by Paul St. John.

Petrissage
Petrissage (from the French petrir, 'to knead') is one of the five basic strokes of a Swedish massage. It is performed with kneading movement with the whole palm or finger tips, wringing, skin rolling, compress and lifting. Petrissage is usually applied vertically to the muscle tissue.

The benefits include the warming of tissue for deeper work, increase circulation, increase the supply of nutrients and oxygen to muscle, softens superficial fascia, decreases muscle tension, and restoring mobility by decreasing adhesion.

Scalp massage
In some barber shops in Hong Kong, scalp massage often lasts 30 minutes to 45 minutes during shampooing of the hair. It is also very common in India, after applying oil on the hair.

Shiatsu
Shiatsu is a form of Japanese massage that uses thumb pressure and workes along the energy meridians in the body also with a lot of streches the same meridians as acupressure. You are worked on fully clothed on a mat on the floor. It is uncertain whether it originated from Chinese Zhi Ya.

Soft Tissue Therapy
The Assessment, Treatment and Management of Soft Tissue Injury, Pain and Dysfunction. Treatment techniques include:

Trigger point therapy for the alleviation of trigger points.
Myofascial (muscle and fascia) therapy for flexibility/mobility of the connective tissues of our body, or for alleviating fibrous adhesions and decreasing the severity of scars.
Broad handed techniques for reducing swelling or inflammation
Frictions for the ridding of adhesions between fascial layers, muscles, compartments and the like. Frictions also promote healing in tendon pathologies as well as decreasing pain perception.
Sustained pressure (digital pressures) to alleviate hypertonic (tight)areas within muscle and fascia
Other techniques such as Active Release Therapies, Myofascial Release and deep tissue massage are all derivatives of the techniques above. They are NOT unique techniques with unique results.
Stretching - static, dynamic, and/or PNF stretches (proprioceptive neuromuscular facilitation)
Muscle Energy Technique (MET)
Exercise Prescription
Advice:
This is one of the techniques used by sports massage therapists.

Stone massage
Massage in which hot or cold stones, usually basalt or marble, are used to massage the body. Often the stones are placed on key energy points, such as Chakras or meridians, in order to improve energy flow and healing.

Structural muscular balancing
A gentle and effective technique that releases chronic contraction in the muscles. The nervous system is triggered to release contractions through compression applied to muscles placed in a shortened position.

Swedish massage
This style utilizes long, flowing strokes, often but not necessarily in the direction of the heart.Swedish massage is designed to increase circulation and blood flow. There are six basic strokes:effleurage,petrissage,friction,tapotement,compression and vibration.Oil, cream, or lotion is applied on the skin to reduce friction and allow smooth strokes. This style of massage is generally attributed to the Swedish fencing master and gymnastics teacher Pehr Henrik Ling (1776-1839).However, it was in fact the Dutch practitioner Johan Georg Mezger (1838-1909) who adopted the French names to denote the basic strokes under which he systemized massage as we know it today, as Swedish or classic massage. Somehow, the term Swedish Movement System was transposed to Swedish Massage System sometime during the second half of the 19th century. Ling’s system was the Swedish Movement System or Swedish Gymnastic Movement System. This may be how he has become incorrectly associated for so long with Swedish massage. In Sweden, the term "Swedish massage" is not used.

Tai Ji Massage (Tai Chi Massage)
Tai Ji / Tai Chi Massage is massage using the natural principles of Tai Ji, Yin and Yang to achieve balance in the energies of the body, leading to a healthy mind body and spirit.
Tai Ji / Tai Chi The traditional Chinese term refers to the Dao, which is the inexpressible oneness and connectedness of all things. This is inexpressibility of Tao is referred to by Lao Tzu:
Chapter 32
"The Tao is constantly nameless….
As soon as we start to establish a system we have names.
And as soon as there set names,
Then you must also know that it's time to stop"
Te Tao Ching
Translation by Robert G. Hendricks. Ballantine books 1989
Qi/ Chi: This is the linking element material and spiritual (Jing and Shen), or in health terms mind and body.
Chinese medicine is often able to treat sicknesses and problems which are difficult to treat by western medicine by virtue of the fact that they consider the state of the Chi to be an important factor in diagnosis.
Qi Field theory: Qi appears as a field. In order for a sickness to become chronic an integral Qi field establishes itself in the body of the host. The shape and size of this field is variable and can stretch from head to toes in some cases.
Tai Ji Massage Qi Diagnosis: Tai Ji Massage is a Qi treatment and it makes a treatment in terms of Qi. The master practitioner can sense the Qi blockages inside the body and the relationship which they have to each other.
Qi blockages can be a way of getting insight into causes of chronic sicknesses, recurring sicknesses, psychosomatic sicknesses, future sicknesses.
The main use of this techniques is, relaxation and self-exploration, and in a therapeutic way, funtional organ problems, chronic sicknesses and psychosomatic sicknesses.
Tai Ji Massage was developed by Richard Wickes, Li Cun De.

Tantramassage (Tantric massage)
Original Tantramassage is a new form of massage developed in the early 1980s by Andro, Andreas Rothe an experienced Tantra and Bodywork Teacher in Berlin, Germany. The method includes various massage techniques, elements from Bioenergetic, Yoga and Sexualtherapy. The word "Tantra" emphasizes the connection with the old Indian cultural background where the body is seen as the temple of the soul. Clients are in a passive role, supported by breathing techniques they experience a very deep and intense journey through their own body. Every Massage session lasts 90 Minutes or longer. The Tantramassage movement is very popular in Germany and Switzerland, some practitioners are organized in the Association of Tantramassage in Germany.

Thai massage
Known in Thailand as นวดแผนโบราณ (Nuat phaen boran), IPA which correctly translates only as ancient massage or traditional massage, this form of massage is also known as Thai ancient massage, traditional Thai massage, Thai yoga massage, yoga massage, Thai classical massage, Thai bodywork, passive yoga or assisted yoga. It is usually soothing because of its emphasis on stretching and loosening the body. Its roots go back far into history, originating in India based on the Ayurveda, and then becoming popular in Thailand.
Originating in India and drawing from Ayurveda, it has inevitably incorporated modalities like yoga. The receiver is put into many yoga like positions during the course of the massage. In the northeren style there are a lot of stretching movements unlike the southern style where pressure is emphasised. It was believed that the massage art was brought over to Thailand by Shivago Komarpaj (Jivaka Kumarabhacca), a contemporary of Buddha almost about 2500 years ago.
The massage recipient changes into pajamas and lies on a mat or firm mattress on the floor. (It can be done solo or in a group of a dozen or so patients in the same large room). The massage giver leans on the recipient's body using hands and forearms to apply firm rhythmic pressure to almost every part of the taker's body. The massage generally follows the Sen lines on the body-somewhat analogous to Chinese Meridians and Indian nadis. In some gestures, legs and feet of the giver are used to fixate the body or limbs of the recipient. In other gestures, hands fixate the body, while the feet do the massaging action. Usually no oil is applied. A full course of Thai massage typically lasts two hours or more, and includes pulling fingers, toes, ears etc., cracking the knuckles, walking on the recipient's back, arching the recipient's back in a rolling action etc. There is a standard procedure and rhythm to the massage. Sometimes in a large group massage, the practitioners do the procedures in unison.
Note: The traditional therapeutic practice of Thai massage should not be confused with the sexual service of the same name that is available in some hotels and brothels.

Trigger point therapy
A trigger point is an area of a muscle (about 50 cells) that may refer pain sensations to other parts of the body. Trigger Point Therapy applies manual pressure, or CO2 injections, to these points. With the proper pressure, duration and location, immediate release of tension and improved muscular functioning may occur. This therapy has been known to diminish migraine pain, mock sciatica, mock carpal tunnel syndrome and other pain syndromes, and other symptoms that may have been misdiagnosed. This work is based upon the trigger point research and manuals of Dr. Janet Travell, President Kennedy's physician.

Sometimes this work is incorporated into other styles of massage therapy such as neuromuscular therapy (NMT) or even Swedish

Psychiatric ills common in adults with Fibromyalgia

Thank you www.pain.healthcentersonline.com for the article. Considering I suffer from FM, depression and anxiety disorder, I thought this article was right on the money!

Psychiatric ills common in adults with Fibromyalgia

Sep 21 (Reuters Health) - Many people with the chronic pain disorder fibromyalgia have also suffered from depression, anxiety or other psychiatric conditions at some point in their lives -- suggesting, researchers say, that the disorders have some common causes.

In a study of 336 adults with and without fibromyalgia, researchers found that those with the condition were substantially more likely to have ever had depression, bipolar disorder or an anxiety disorder. They also had higher rates of eating disorders and substance abuse problems.

In most cases, the psychiatric condition preceded the development of fibromyalgia, making it unlikely that the mood disturbances were simply a reaction to having chronic pain.

Fibromyalgia is a syndrome marked by widespread aches and pains, fatigue and sleep problems, among other symptoms; the cause is unknown, and there are no medications specifically approved for the condition. Treatment usually involves a combination of approaches, such as painkillers, antidepressants, behavioral therapy or exercise therapy.

The new findings, published in the Journal of Clinical Psychiatry, are based on a comparison of families with members affected by either fibromyalgia or rheumatoid arthritis, another condition marked by chronic pain.

Between both groups of families, there were 108 adults, nearly all women, with fibromyalgia and 228 without the condition.

Overall, those with fibromyalgia were almost three times more likely to have ever had major depression and nearly seven times more likely to have suffered an anxiety disorder. They also had a two to three times greater risk of eating disorders and substance abuse problems, and a much higher risk of bipolar disorder.

The associations between fibromyalgia and these psychiatric conditions suggest that there is some "shared vulnerability" at work, according to study chief Dr. Lesley M. Arnold, an associate professor of psychiatry at the University of Cincinnati College of Medicine.

"We are not saying that fibromyalgia is a psychiatric disorder," Arnold told Reuters Health.

Rather, some people may be vulnerable to developing both fibromyalgia and certain psychiatric disorders -- possibly because of genes, Arnold explained, or because of environmental factors such as chronic stress. But no one yet knows for certain.

Still, the evidence suggests that people with fibromyalgia should be screened for psychiatric disorders, according to Arnold. Even when people aren't currently suffering any psychiatric symptoms, their mental health history can influence how their fibromyalgia is treated, she noted.

For example, Arnold explained, medication with both antidepressant and pain-relieving effects might be the first choice for people with a history of depression. Another option is cognitive behavioral therapy, which addresses harmful thought patterns and behaviors; this approach, Arnold said, might help fibromyalgia patients with a history of depression or anxiety disorders.

SOURCE: Journal of Clinical Psychiatry, August 2006.

Publish Date: September 21, 2006

Painful recovery

Well after 5 days since my procedure my left leg still has not recovered as of yet. The only position that doesn't tire out my leg is laying down. Too much walking, sitting and standing causes my leg to fatigue and my lower back begins to ache.
While I knew that this would probably be a longer recovery than any other procedure than I have had in the past, I wasn't expecting this. I was supposed to start physical therapy last week but driving is very dangerous for me right now. I can't sit normal on the seat and have to twist to the right because of the swelling on my back.
While each day it does get better, it is a slow process.
Wish me luck!

Day after the Radio Frequency Ablation

Well, I had the RFA yesterday and needless to say boy did it hurt!!! Today I am very tired and my back/backside is very sore. I had my nerves diddled from the L3 to L5 area. So I am sure that the area is full of bruises. According to the doc, it should take up to 7 days for it to finally take hold totally. I feel a little different already. Normally I have this numb, painfully heavy feeling in my left leg but not last night for once. It was a little strange but welcome relief.
Friday I also start physical therapy again. That should be interesting....NOT! It should be painful. Well I gotta do what I gotta do I guess.

Well its a few days of rest so that my back can heal a little before tomorrow.

Well it is off to my next step

It seems that the facet injections I had a couple of weeks ago didn't take so now it is time for the next step....Rhiziotomy!!! I am a little scared about it and asked a bunch of questions yesterday while seeing my pain doc. It seems hopeful but we will see. For those of you who do not know about this procedure here is a description.
It is also know as Radiofrequency Ablation.
Thank you to www.christianaspinecenter.com for the information.

What is radiofrequency nerve ablation?

Radiofrequency nerve ablation is the term used when radio waves are generated and used to produce heat. By generating heat around a nerve, the nerves ability to transmit pain is destroyed, thus ablating the nerve.


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What nerve is ablated?

Radiofrequency ablation is used to destroy the nerves that supply the facet joints in the spine. These joints are the small posterior joints on either side of the spine. These joints can be one source of back pain.


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How is it determined if I am a candidate for this procedure?

Prior to consideration of a radiofrequency nerve ablation procedure, the source of your pain needs to be determined by using diagnostic blocks on the various structures in the spine. Once it is established that the facet joints are causing your back pain, you may be a candidate for the actual procedure. The nerve ablation will effectively destroy the nerve fibers around the joint, which transit the pain sensation from the facet joint.


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What procedure is done for the ablation?

The technique used for the nerve ablation is similar to that used for the diagnostic blocks. A thin needle is inserted down to the region of the facet joint, which is responsible for the pain. Each joint has two nerves, which supply the joint therefore, 2 needle positions for each joint will be needed. The placement of the needle will be under x-ray guidance. Once the needle is in place you will receive a numbing medication and the radiofrequency stimulation will occur through the needle already in place. This takes approximately 90 seconds. This will be repeated at each needle site. The needle will be removed and the procedure is complete.


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What is the long-term effect of the injections?

Once the nerves which carry pain sensation from the painful joint are destroyed you should be free of the back pain you are experiencing, if it is coming from this structure. These nerves may regrow over a period of approximately 6 months. Time, physical therapy and increased muscle strength around this joint may make this joint less painful over the following 6 months so that when the nerves do regenerate you will not experience the same intensity of pain as prior to the procedure. If you have a recurrence of pain this procedure can be repeated.


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What do I do prior to the procedure?

You should allow approximately 1 to 2 hours for the procedure. You should not have taken any anti-inflammatory medication for at least 5 days prior to the injection. You will need to arrange a driver to take you home after the procedure.


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What do I do after the procedure?

You should receive some pain medications upon leaving the office. You should not experience debilitating back pain fever or chills. If this occurs you should contact the treating physician. If you have some mild increased pain this should subside over the following 10 days to two weeks. A follow up appointment will be made for you on leaving the office for 1-2 weeks after the procedure.

How To Recognize the Signs and Symptoms of Fibromyalgia

How To Recognize the Signs and Symptoms of Fibromyalgia
From Carol & Richard Eustice,
Your Guide to Arthritis. www.arthritis.about.com. Thank you for the info.

Fibromyalgia symptoms can overlap with autoimmune diseases and other musculoskeletal conditions making it difficult to diagnose. The defining symptoms of fibromyalgia are often associated with other subjective and objective symptoms which occur in combination.

It is estimated that fibromyalgia syndrome affects about 2 percent of the U.S. population.

**In 1990, the American College of Rheumatology (ACR) listed two primary criteria for the classification of fibromyalgia. 1) A history of widespread pain involving all four quadrants of the body (right side, left side, above waist, below waist) for a period of at least 3 months.

**The second criteria from the ACR which points to fibromyalgia is, upon physical examination, the presence of pain in at least 11 of 18 tender points when touched or pressed with force amounting to the equivalent of 4 kg. or 9 lbs.



**More recent data indicates that there may be an increased sensitivity to pain throughout the body, pain may be migratory (move around) or may exist as chronic regional pain. Most experts are said to believe fibromyalgia results from abnormal central nervous system function. Response to stress and psychobehavioral factors may also contribute to fibromyalgia.

**Fibromyalgia primarily occurs in women of childbearing age. Children, the elderly, and men can also be affected. Besides the defining symptoms of pain and tenderness, there are many nondefining symptoms associated with fibromyalgia including:

**Fatigue, night sweats and sleep disturbances.

**Memory difficulties and cognitive difficulties.

**Tension or migraine headaches, temporomandibular joint syndrome, rib cage pain (noncardiac chest pain), chronic pelvic pain, plantar or heel pain.

**Fluctuations in weight, heat or cold intolerance, subjective feeling of weakness.

**Ear-nose-throat complaints, multiple chemical sensitivities and a wide array of allergic symptoms.

**Hearing, vision, and vestibular (balance) abnormalities.

**Heartburn, palpitations and irritable bowel syndrome.

**Evidence on echocardiogram of mitral valve prolapse, esophageal dysmotility (muscles of esophagus not working properly), neurologic conditions causing hypotension (low blood pressure) and syncope (fainting).

**Mood disorders such as depression and anxiety occur more commonly in people who have fibromyalgia.

Tips:

Fibromyalgia can be difficult to diagnose because its symptoms can be non-defining and mimic other diseases. Persist in getting a proper diagnosis.

Aerobic exercise, such as swimming and walking, improves muscle fitness and reduces muscle pain and tenderness.

Heat and massage may also give short-term pain relief.

Pain Relief Techniques

Patients with fibromyalgia may benefit from a combination of exercise, medication, physical therapy, and relaxation.

How is Fibromyalgia Treated?

Fibromyalgia medication options include:

antidepressants
muscle relaxants
analgesic painkillers
NSAIDs
seditives
other medications that elevate mood, ease pain, relax muslces, promote sleep and fight off fatigue.

What You Need:
A Good Relationship With Your Rheumatologist Or Doctor.
A Physical Therapy Regimen You Will Follow.
A Treatment Program Involving Medication And Exercise.
A Good Understanding Of Meditation And Relaxation Techniques.
Ongoing Education - Stay Aware Of Fibromyalgia News And Research.

Interesting theory about FMS and CFS

Acid Stomach - or Not Enough Stomach Acid? The Symptoms Are Similar, but For CFS and FMS Patients It’s Often the Latter
by Editor
ImmuneSupport.com

09-01-2006

Betaine hydrochloride, derived from beets, is near the top of the list of dietary supplement and health aid rocommendations that CFS specialist Paul Cheney, M.D., Ph.D. had developed for Chronic Fatigue Syndrome patients.1 Why? “Because most CFS patients don’t have enough stomach acid, and Betaine (hydrochloric acid) is stomach acid,” according to the article “Dr. Paul Cheney on Betaine for Chronic Fatigue Syndrome and Fibromyalgia Patients,” by Carol Sieverling. 2

Importantly, Dr. Cheney points out:

**Hydrochloric acid is responsible for converting another stomach secretion - pepsinogen - to pepsin, an enzyme largely responsible for breaking proteins down into substances that the body can absorb more easily.

**This is considered “the first step” in digestion, and is ultimately a necessity for cellular growth and repair.

**Hydrochloric acid also works in the stomach to fight infection of the digestive system by microorganisms such as bacteria that are ingested in food and water - since most of these are destroyed by an adequately acidic environment. Dr. Cheney notes that “a UCLA study of 52 FM/CFS patients found [small intestine bacterial overgrowths (SIBO)]in 90 percent of the patients.” Low levels of stomach acid may create a Ph in the small intestine that facilitates the overgrowth of bacteria. This may cause inflammation and even leaky gut syndrome.

**Further,it is thought that many people suffer recurrent yeast infections because low levels of stomach acid allow them to be reinfected continually by yeast consumed with their food.

Overall, a reduction in the stomach’s natural production of hydrochloric acid – often associated with the aging process and referred to as “hypochlorhydria” – can interfere with the stomach’s digestive and infection-fighting functions. A Betaine hydrochloride supplement with pepsin, taken with food, is especially useful to enhance digestion in individuals with hypochlorhydria because it raises the levels of both hydrochloric acid and pepsin in the stomach. For individuals with low hydrochloric acid production, Betaine hydrochloride has been described as a “stomach tonic.”

But to confuse matters, the symptoms of hyperchlorhydria are similar to the symptoms of too much stomach acid which are so frequently described in over-the-counter and prescription antacid drug advertising.


**An excess of digestive acid may cause acid reflux, which is a burning backflow of stomach acid into the esophagus or “swallowing tube,” sometimes referred to as gastroesophageal reflux disease (GERD).


**By contrast, if there isn’t enough digestive acid in the stomach after food is ingested (with hyperchlorhydria), the valve at the stomach’s base that releases food into the small intestine may not open as it normally would, Dr. Cheney has explained. Then, the food/stomach acid mixture may be forced back up toward the esophagus, creating a burning sensation similar to the one associated with acid reflux. And the mistaken addition of antacid remedies to the mix is likely to create a “vicious cycle.” 2

One test for hypochlorhydria is to determine the extent of undigested protein in the stool. There is also a definitive test of stomach acidity, called the Heidelberg test. It involves swallowing a “telemetry” device the size of a large vitamin capsule, and tracking the acidity-level signals it broadcasts from the stomach as doses of acid-neutralizing sodium bicarbonate (baking soda) are ingested. If the acid level doesn’t return after a few doses, hypochlorhydria is a likely diagnosis. A simple preliminary test is to drink a small amount of baking soda in water first thing in the morning. If you have not belched within a few minutes, you may not be producing enough stomach acid, since hydrochloric acid reacts with baking soda to produce carbon dioxide gas.3

Conversely, if an individual takes a dose of a Betain hydrochloride supplement (this should always be at the start of a meal) and experiences the warmth/burning or indigestion associated with excess acid, further B-CHl supplementation is not advisable, and a neutralizing teaspoon of sodium bicarbonate in water should provide relief.

Individuals who believe they have symptoms of either excess or insufficient hydrochloric acid in the stomach should consult with their doctor, and should never change their health management regime without doing so. Additionally, supplement manufacturers commonly advise that:

1. People using non-steroidal anti-inflammatory drugs such as ibuprofen (NSIADs), cortisone-like drugs, or other medications with the potential to cause a peptic ulcer (a break or sore in the tissue lining the upper digestive tract) should avoid supplementation with Betaine hydrochloride.

2. Pregnant or nursing women, children, and people with kidney or liver disease should avoid Betaine hydrochloride supplementation, because its safety for these populations has not been established.

If you are in doubt about what over-the-counter or prescription drugs, dietary supplements, or combinations of these may irritate the digestive tract or affect the production of digestive juices, consult a pharmacist.

________
1. “Dr. Paul R. Cheney’s Basic Protocol Supplement/Health Aid Recommendations, (2003),” CFIDS & FMS Support Group of Dallas-Fort Worth, www.dfwcfids.org/medical/basc2003.html
2. “Dr. Paul Cheney on Betaine for Chronic Fatigue Syndrome and Fibromyalgia Patients,” by Carol Sieverling, November 7, 2001, www.immunesupport.com/library/showarticle.cfm/ID/3171/e/1/T/CFIDS_FM/
3. “Stomach Acid Assessment,” by Dr. Joseph A. Debé, at www.drdebe.com/BAKESODA.htm

Our Illnesses May Be Invisible, but They're Very Real

Thank you www.headaches.about.com for the information.
From Teri Robert,
Your Guide to Headaches / Migraine.

Our Illnesses May Be Invisible, But They're Very Real

September 11-17 is National Invisible Chronic Illness Awareness Week. We have some great resources and opportunities to learn more yourself and to educate others...


National Invisible Chronic Illness Awareness Week

We who live with chronic headaches and Migraine disease have something in common with 96% of people who live with a chronic illness -- our illness is invisible. We don't live with our heads bandaged, walk with a cane, or show any other outward sign of our illness.

This can create a problem in terms of public awareness, the support we receive from those around us, and in how we're perceived by others. "Out of sight, out of mind" applies here. People can't see signs of our illnesses, so they often think we're perfectly healthy. We can look great even when we're debilitated. Looking great, however, doesn't diminish the huge impact of such conditions.

Chronic Illness Facts

**Nearly 1 in 2 Americans (133 million) has a chronic condition.

**That number is projected to increase by more than one percent per year by 2030, resulting in an estimated chronically ill population of 171 million.

**96% of them live with an illness that is invisible.

**These people do no use a cane or any assistive device and may look perfectly healthy.

**90% of seniors have at least one chronic disease and 77% have two or more chronic diseases.

**The divorce rate among the chronically ill is over 75%.

**Studies have reported that physical illness or uncontrollable physical pain are major factors in up to 70% of suicides.

Building Awareness
September 11-17, 2006, is National Invisible Chronic Illness Awareness Week (NICIAW). The theme this year is, "My Illness Is Invisible But My Hope Shines Through!" NICIAW is an annual major public awareness campaign sponsored by HopeKeepers Magazine, a consumer magazine that offers spiritual encouragement for those who live with chronic illness or pain.

Paul J. Donoghue and Mary Siegel, co-sponsors of the week and authors of "Sick and Tired of Feeling Sick and Tired: Living With Invisible Chronic Illness" say,
"Invisible chronic illnesses (ICI) have symptoms that are difficult to see and impossible to measure such as pain and fatigue. So those with ICI frequently encounter not compassion and support but impatience and skepticism from physicians and loved ones."

Lisa Copen, the editor of HopeKeepers Magazine who lives with rheumatoid arthritis and fibromyalgia, commented,
"Living with an illness that is invisible to those around us can often have a more devastating affect on our emotional health than the physical pain... Each day we must choose to have hope, despite how medications and alternative treatments may help or hinder us... Just because someone isn’t using a wheelchair doesn’t mean that she doesn’t have a disability. Friends and family of those with chronic illness care a great deal about what their loved ones are going through, but oftentimes the invisibility of the illness sets up an environment for misunderstandings and even doubt about the validity of the illness. We hope to increase awareness of how many people ‘look great’ but are hurting deeply."

Online conference
During NICIAW, an online conference of more than 20 online seminars is being held. The seminars are being conducted via an online chat room. The seminars are being conducted by chronic illness coaches, authors, patient advocates, nutritionists, and other professionals. On Thursday, September 14, I'll be conducting a seminar "Empowerment over the pain," at 6p.m., eastern time. For more information on the conference and a complete schedule of seminars, visit www.invisibleillness.org.

Summary
For many of us, the invisibility of our illness and the resulting lack of understanding and compassion from others is as difficult to handle as the illness itself. During National Invisible Chronic Illness Awareness Week, let's make an extra effort to learn more ourselves as well as help educate others.

_____________
Resources:


Press Release: "96% of Illness is Invisible – Many Look Good but Feel Terrible." HopeKeepers. September, 2006.

"Chronic Conditions: Making the Case for Ongoing Care." Chronic Care in America: A 21st Century Challenge, a study of the Robert Wood Johnson Foundation & Partnership for Solutions: Johns Hopkins University, Baltimore, MD for the Robert Wood Johnson Foundation (September 2004 Update).

United States Census Bureau. 2002.

Anderson, Gerard, Ph.D. "The Growing Burden of Chronic Disease in American." Public Health Reports. Volume 110, May-June, 2004.

Mackenzie TB, Popkin MK. "Suicide in the medical patient." International Journal of Psychiatry in Medicine 17:3-22, 1987

The Anniversary of 9/11

I guess it would be downright silly of me not to mention this date in my blog.

I remember where I was the exact moment I heard. I was at work, in my cube and the woman sitting across from me was listening to Howard Stern (when you didn't have to pay to listen to him!). Suddenly she screams out, a plane has crashed into the WTC. I told her she was kidding and that it was a Howard Stern joke. After many calls from listeners to the show, Howard Stern had to confirm that it was NOT a joke. Majority of the morning was spent in the auditorium watching CNN with the rest of my company until I couldn't take it anymore.
Today is a little funny, the weather is exactly like it was 5 years ago. A brilliant blue sky and a coolish fall-like day. Normally a gorgeous day. Now it just reminds me of 5 years ago.
The down side of this day is the anniversary is all that you will hear on TV. From what I understand Fox News and CNN are going to be rebroadcasting the footage from that day in its original time. Its going to be strange but luckily I don't have either of those channels.
Unfortunately I didn't sleep well last night. It didn't have anything to do with 9/11 but I overdid it this weekend with things to do and I got overtired and then I couldn't get to sleep last night. So today is going to be a rough day all around. Blah!

Tips for dealing with people in pain

Another great open letter to people who do not suffer from chronic pain.

TIPS FOR DEALING WITH PEOPLE IN PAIN

People with chronic pain seem unreliable (we can't count on ourselves). When feeling better we promise things (and mean it); when in serious pain, we may not even show up.

An action or situation may result in pain several hours later, or even the next day. Delayed pain is confusing to people who have never experienced it.

Pain can inhibit listening and other communication skills. It's like having someone shouting at you, or trying to talk with a fire alarm going off in the room. The effect of pain on the mind can seem like attention deficit disorder. So you may have to repeat a request, or write things down for a person with chronic pain. Don't take it personally, or think that they are stupid.

The senses can overload while in pain. For example, noises that wouldn't normally bother you, seem too much.

Patience may seem short. We can't wait in a long line; can't wait for a long drawn out conversation.

Don't always ask "how are you" unless you are genuinely prepared to listen it just points attention inward.

Pain can sometimes trigger psychological disabilities (usually very temporary). When in pain, a small task, like hanging out the laundry, can seem like a huge wall, too high to climb over. An hour later the same job may be quite OK. It is sane to be depressed occasionally when you hurt.

Pain can come on fairly quickly and unexpectedly. Pain sometimes abates after a short rest. Chronic pain people appear to arrive and fade unpredictably to others.

Knowing where a refuge is, such as a couch, a bed, or comfortable chair, is as important as knowing where a bathroom is. A visit is much more enjoyable if the chronic pain person knows there is a refuge if needed. A person with chronic pain may not want to go anywhere that has no refuge (e.g.no place to sit or lie down).

Small acts of kindness can seem like huge acts of mercy to a person in pain. Your offer of a pillow or a cup of tea can be a really big thing to a person who is feeling temporarily helpless in the face of encroaching pain.

Not all pain is easy to locate or describe. Sometimes there is a body-wide feeling of discomfort, with hard to describe pains in the entire back, or in both legs, but not in one particular spot you can point to. Our vocabulary for pain is very limited, compared to the body's ability to feel varieties of discomfort.

We may not have a good "reason" for the pain. Medical science is still limited in its understanding of pain. Many people have pain that is not yet classified by doctors as an officially recognized "disease". That does not reduce the pain, - it only reduces our ability to give it a label, and to have you believe us

OPEN LETTER TO PEOPLE WITHOUT CHRONIC PAIN

This is a letter that has been circulating around for years. It has been recently posted on a message board I belong to so I thought it would be useful here.

LETTER TO PEOPLE WITHOUT CHRONIC PAIN

Having chronic pain means many things change, and a lot of them are invisible. Unlike having cancer or being hurt in an accident, most people do not understand even a little about chronic pain and its effects, and of those that think they know, many are actually misinformed.

In the spirit of informing those who wish to understand.
These are the things that I would like you to understand about me before you judge me...

Please understand that being sick doesn't mean I'm not still a human being. I have to spend most of my day in considerable pain and exhaustion, and if you visit, sometimes I probably don't seem like much fun to be with, but I'm still me-- stuck inside this body. I still worry about school, my family, my friends, and most of the time I'd still like to hear you talk about yours, too.

Please understand the difference between "happy" and "healthy". When you've got the flu, you probably feel miserable with it, but I've been sick for years. I can't be miserable all the time. In fact, I work hard at not being miserable. So, if you're talking to me and I sound happy, it means I'm happy. That's all. It doesn't mean that I'm not in a lot of pain, or extremely tired, or that I'm getting better, or any of those things. Please don't say, "Oh, you're sounding better!" or "But you look so healthy!¨ I am merely coping. I am sounding happy and trying to look normal. If you want to comment on that, you're welcome.

Please understand that being able to stand up for ten minutes doesn't necessarily mean that I can stand up for twenty minutes, or an hour. Just because I managed to stand up for thirty minutes yesterday doesn't mean that I can do the same today. With a lot of diseases you're either paralyzed, or you can move. With this one, it gets more confusing everyday. It can be like a yo-yo. I never know from day to day, how I am going to feel when I wake up. In most cases, I never know from minute to minute. That is one of the hardest and most frustrating components of chronic pain.

Please repeat the above paragraph substituting, "sitting", "walking", "thinking", concentrating, "being sociable" and so on ... it applies to everything. That's what chronic pain does to you.

" Please understand that chronic pain is variable. It's quite possible (for many, it's common) that one day I am able to walk to the park and back, while the next day I'll have trouble getting to the next room. Please don't attack me when I'm ill by saying, "But you did it before!" or Oh, come on, I know you can do this!¡¨ If you want me to do something, then ask if I can.

In a similar vein, I may need to cancel a previous commitment at the last minute. If this happens, please do not take it personally. If you are able, please try to always remember how very lucky you are--to be physically able to do all of the things that you can do.

Please understand that "getting out and doing things" does not make me feel better, and can often make me seriously worse. You don't know what I go through or how I suffer in my own private time. Telling me that I need to exercise, or do some things to get my mind off of it¨ may frustrate me to tears, and is not correct if I was capable of doing some things any or all of the time, don't you know that I would? I am working with my doctor and I am doing what I am supposed to do.

Another statement that hurts is, "You just need to push yourself more, try harder..." Obviously, chronic pain can deal with the whole body, or be localized to specific areas. Sometimes participating in a single activity for a short or a long period of time can cause more damage and physical pain than you could ever imagine.

Not to mention the recovery time, which can be intense. You can't always read it on my face or in my body language. Also, chronic pain may cause secondary depression (wouldn't you get depressed and down if you were hurting constantly for months or years?), but it is not created by depression.


Please understand that if I say I have to sit down/lie down/stay in bed/or take these pills now, that probably means that I do have to do it right now - it can't be put off or forgotten just because I'm somewhere, or am right in the middle of doing something. Chronic pain does not forgive, nor does it wait for anyone.

If you want to suggest a cure to me, please don't. It's not because I don't appreciate the thought, and it's not because I don't want to get well. Lord knows that isn't true. In all likelihood, if you've heard of it or tried it, so have I. In some cases, I have been made sicker, not better. This can involve side effects or allergic reactions. It also includes failure, which in and of itself can make me feel even lower.

If there were something that cured, or even helped people with my form of chronic pain, then we'd know about it. There is worldwide networking (both on and off the Internet) between people with chronic pain. If something worked, we would KNOW. It's definitely not for lack of trying. If, after reading this, you still feel the need to suggest a cure, then so be it. I may take what you said and discuss it with my doctor.

If I seem touchy, it's probably because I am. It's not how I try to be. As a matter of fact, I try very hard to be normal. I hope you will try to understand. I have been, and am still, going through a lot. Chronic pain is hard for you to understand unless you have had it. It wreaks havoc on the body and the mind. It is exhausting and exasperating.

Almost all the time, I know that I am doing my best to cope with this, and live my life to the best of my ability. I ask you to bear with me, and accept me as I am. I know that you cannot literally understand my situation unless you have been in my shoes, but as much as is possible, I am asking you to try to be understanding in general.


In many ways I depend on you - people who are not sick. I need you to visit me when I am too sick to go out... Sometimes I need you help me with the shopping, cooking or cleaning. I may need you to take me to the doctor, or to the store. You are my link to the normalcy of life. You can help me to keep in touch with the parts of life that I miss and fully intend to undertake again, just as soon as I am able.

I know that I asked a lot from you, and I do thank you for listening. It really does mean a lot.

New Mechanism for Chronic Pain Relief Identified

Pharmaceutical Drug News - New Mechanism for Chronic Pain Relief Identified
by Editor of ImmuneSupport.com

08-25-2006

Researchers at the University of Edinburgh have identified a way to produce a dramatic natural painkilling effect using small doses of certain “cooling chemicals,” either injected or applied to the skin. Working with rats in an animal model study, they demonstrated that the key to this effect is a recently identified protein – TRPM8 – which is found in nerve cells in the skin and can be activated to mediate the sensation of pain by either cool temperatures or cooling chemicals, such as the active ingredient in mint.

The researchers believe their discovery of a mechanism for making use of the body’s own capacity to suppress pain will produce an improvement over conventional painkillers for the treatment of “neuropathic pain” and arthritis, and “has great potential for relieving the suffering of millions of chronic pain patients.” Neuropathic pain is believed to be generated by the nerves themselves rather than by an external cause that can be removed, as in Fibromyalgia.

The TRPM8 protein is one member of a class of recently identified proteins known to mediate various types of stimuli. Research indicates that other proteins in this class can affect the sensations of touch, temperature, and taste, for example.

The report of this study, “Analgesia Mediated by the TRPM8 Receptor in Chronic Neuropathic Pain,” by Susan Fleetwood-Walker and Rory Mitchell, was published in the August 22 issue of the journal Current Biology. It will be freely available to all readers online at www.current-biology.com

FM Patient Awarded $747,000 in Disability Bias Suit

FM Patient Awarded $747,000 in Disability Bias Suit
by Editor of ImmuneSupport.com

09-01-2006

A jury in the federal District Court of Cumberland County, Maine, has awarded Fibromyalgia patient Ronald Harding $747,000 in back pay and damages in a suit against his former employer, Cianbro Corp., according to a report published August 24, 2006 in the Kennebec Journal.

Mr. Harding’s civil rights suit against Cianbro charged that the Pittsfield-based heavy industrial company had discriminated against and terminated him in 2002 after 18 years of employment because he suffered from a disability caused by Fibromyalgia. The jury’s decision, which came after a six-day trial, marked what “could be the largest employment disability discrimination case in the state’s history,” stated Jeffrey Young, one of Mr. Harding’s attorneys.

The suit was brought “on a civil rights theory, 42 USC [United States Code] 2000e,” according to MoreLaw.com, an online litigation digest, which also noted “The defenses asserted by Cianbro are not available.”

Congrats Ronald! This is a big step for recognizing FM for what it is!!!

Still trying to figure out this Baclofen

Ever since I adjusted up my Baclofen from 60 mgs a day to 120 mgs a day my life has been an almost hourly beat of ups and downs. Sometimes I feel okay other times I feel like I have the flu.
The headaches and the extreme fatigue is getting to me and I don't know if this is a permanent state or just an adjustment period. I drink more Diet Coke now than I have in months. The facet injection sites are still sensitve but overall I am okay.
I just wish that this Baclofen hangover would just go away.

Low Levels of Certain Cytokines May Be Linked to Fibromyalgia

Thank you www.arthritis.about.com for the information.

Low Levels of Certain Cytokines May Be Linked to Fibromyalgia
From Carol & Richard Eustice

Fibromyalgia is among the conditions marked by chronic widespread pain. Fatigue, depression, and insufficient sleep can be associated with conditions characterized by chronic widespread pain, making diagnosis difficult.

How Is Fibromyalgia Diagnosed?

Fibromyalgia Diagnosis Is Difficult

Research shows that people with fibromyalgia typically see many doctors before receiving the diagnosis. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, overlap with many other conditions.

Doctors often have to rule out other potential causes of these symptoms before making a diagnosis of fibromyalgia.

No Diagnostic Laboratory Tests For Fibromyalgia

Another reason fibromyalgia diagnosis remains difficult is that there are currently no diagnostic laboratory tests for fibromyalgia; standard laboratory tests fail to reveal a physiologic reason for pain.

Because there is no generally accepted, objective test for fibromyalgia, some doctors unfortunately may conclude a patient's pain is not real, or they may tell the patient there is little they can do.

Diagnostic Criteria For Fibromyalgia

A doctor familiar with fibromyalgia, however, can make a diagnosis based on two criteria established by the American College of Rheumatology:

A history of widespread pain lasting more than 3 months
The presence of tender points

Pain is considered to be widespread when it affects all four quadrants of the body; that is, you must have pain in both your right and left sides as well as above and below the waist to be diagnosed with fibromyalgia.

Fibromyalgia Tender Points

The American College of Rheumatology also has designated 18 sites on the body as possible tender points. For a fibromyalgia diagnosis, a person must have 11 or more tender points.

What are Fibromyalgia Tender Points?
One of these predesignated sites is considered a true tender point only if the person feels pain upon the application of 4 kilograms of pressure to the site. People who have fibromyalgia certainly may feel pain at other sites, too, but those 18 standard possible sites on the body are the criteria used for classification.

Study results published in the August 2006 issue of Arthritis & Rheumatism revealed cytokine profiles of 40 patients with chronic widespread pain. Of the 40 patients, 26 had fibromyalgia. Cytokines are proteins which serve as messengers between cells and play a role in the inflammation pathway.

Researchers found that patients with chronic widespread pain had significantly lower levels of two cytokines, IL-4 and IL-10. Further studies will determine if the lower cytokine levels (of which there may be more) are a consequence of chronic widespread pain or if they are part of the cause.

Still revcovering....again

Well still working on making my back feel better. The injection sites are always senstive to touch espcially since it is around where the waist of pants and underclothes seem to settle.
Each night I have been putting on a Lidoderm patch to help with the irritation and that seems to be helping. The downside is that I think that my right side is acting like my left side did before the facet injections. I am not sure what that means but it doesn't bode well that is for sure. I think when I see my doc next week I will tell him about it and skip right to the Rhziotomy instead of these facet injections. Unfortunately I hope that the side effects won't be as bad as this last set of injections. Icky!!!