# Hip & Back Pain = No sleep for me : (



## BigCutieAsshley (Jan 21, 2008)

For the last few weeks I've had a really hard time sleeping. Before bed I take 2 Tylenol PM and 3 Advil but by 2am to 3am I am up and in pain (my lower back and hips). In the past I could fall back to sleep but the last few nights no matter what I try and I can't get comfortable enough to get back to sleep. My husbands side of the bed is usually more comfortable for me but lately that's not helping either. HELP!!

I need a quick fix, or at least a fix that doesn't include a doctor. I have fantastic medical insurance but I'm sick to death of the doctors always blaming everything on my weight and trying to pressure me into having a sleep study done. 

Any suggestions would be greatly appreciated by my husband and I (I'm sure I'm keeping him up at night with all my tossing and turning).

Thanks!


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## Miss Vickie (Jan 21, 2008)

Ashley, have you tried sleeping on your side with a pillow (or two) between your knees? When my low back and hips hurt, that's the best way for me to sleep.

Also, I know I sound like a broken record with this, but I've had terrific luck with chiropractors. They can treat back and neck pain beautifully, without meds, and in my case I've never been hassled about my weight. I struggled with what you're struggling with when I was bigger, and I still have some trouble because of my hernia (now fixed, so I should be better). I have great insurance that covers massage and chiropractic and so between them both I have great relief.

Good luck!


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## moore2me (Jan 21, 2008)

Have you tried using a heating pad? (Having one with a shut off is helpful so if you do sleep you won't get burned - also set it on low for sleep.)

I also drew a little simple sketch to show another possible way of sleeping with your legs elevated as an alternate - or as a variation so you can switch around during the night. I use two pillows (king size ones or longer) when I try this at home. 

View attachment back helpx.jpg


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## southernfa (Jan 21, 2008)

BigCutieAsshley said:


> For the last few weeks I've had a really hard time sleeping. Before bed I take 2 Tylenol PM and 3 Advil but by 2am to 3am I am up and in pain (my lower back and hips). In the past I could fall back to sleep but the last few nights no matter what I try and I can't get comfortable enough to get back to sleep. My husbands side of the bed is usually more comfortable for me but lately that's not helping either. HELP!!
> 
> I need a quick fix, or at least a fix that doesn't include a doctor. I have fantastic medical insurance but I'm sick to death of the doctors always blaming everything on my weight and trying to pressure me into having a sleep study done.
> 
> ...



I've had neck & back problems ever since a childhood accident. In my experience; chiropractic: good temporary relief but no permanent solution; physiotherapy: dead waste of time. Medication: Analgesics give temporary relief (I have a script for Voltaren pills which are banned in the US because they are rough on the gut, and they are!). 

The only thing that has made any significant, sustained difference in 36 years is exercise. I suspect it both strengthens the joints themselves and also provides better muscular support/suspension. In my case anything that involves jolting the neck ie sports/running is out of the question, so I walk a lot and swim. 

I imagine a local ladies gym could give you a program for strength building rather than fitness/weight loss.

One other thing that has helped is a water pillow and a good overlay on the mattress. But without the exercise it is only a matter of time before things get unpleasant again.


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## BigCutieAsshley (Jan 21, 2008)

Last night I tried a pillow under my knees and one near my lower back. Neither pillow helped. Maybe it was cause I was already in pain or maybe I didn't give it long enough. I'll try it tonight...I'm praying it helps. I don't know if I can take another sleepless night.

I've been thinking about checking out a chiropractor. I'll call my insurance company tomorrow and see how that works. 

Thanks for your help!!!



Miss Vickie said:


> Ashley, have you tried sleeping on your side with a pillow (or two) between your knees? When my low back and hips hurt, that's the best way for me to sleep.
> 
> Also, I know I sound like a broken record with this, but I've had terrific luck with chiropractors. They can treat back and neck pain beautifully, without meds, and in my case I've never been hassled about my weight. I struggled with what you're struggling with when I was bigger, and I still have some trouble because of my hernia (now fixed, so I should be better). I have great insurance that covers massage and chiropractic and so between them both I have great relief.
> 
> Good luck!


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## BigCutieAsshley (Jan 21, 2008)

I never thought about a heating pad, I'll have to pick one up tomorrow. 

Thank you so much for taking the time to replay and even draw a picture! You rock! Last night I tried a pillow under my knees but it didn't seem to help. Tonight I'm gonna try and recreate your drawing. I'll let you know how I make out.

Thanks again!!!



moore2me said:


> Have you tried using a heating pad? (Having one with a shut off is helpful so if you do sleep you won't get burned - also set it on low for sleep.)
> 
> I also drew a little simple sketch to show another possible way of sleeping with your legs elevated as an alternate - or as a variation so you can switch around during the night. I use two pillows (king size ones or longer) when I try this at home.


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## BigCutieAsshley (Jan 21, 2008)

I may have to break down and hit the gym. I can't take many more sleepless nights. 

Thanks!




southernfa said:


> I've had neck & back problems ever since a childhood accident. In my experience; chiropractic: good temporary relief but no permanent solution; physiotherapy: dead waste of time. Medication: Analgesics give temporary relief (I have a script for Voltaren pills which are banned in the US because they are rough on the gut, and they are!).
> 
> The only thing that has made any significant, sustained difference in 36 years is exercise. I suspect it both strengthens the joints themselves and also provides better muscular support/suspension. In my case anything that involves jolting the neck ie sports/running is out of the question, so I walk a lot and swim.
> 
> ...


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## Sandie_Zitkus (Jan 21, 2008)

I have been dealing with back pain for about 18 years now. If I learned one thing - heat alone can make the pain worse. If it is muscular the heat can cause more swelling and that will cause more pain. I would try either just ice or ice and heat alternating. 20 min ice - 20 min heat etc. 

Also - try stretching. I have to sleep on my side with a pillow between my knees. Try both sides - one may work better than the other.

Also - don't totaly throw out the idea of a sleep study. After I got my C-PAP a lot of my aches and pain went away. Being able to get a good nights sleep can do a lot toward helping ease pain.

A chiropractor is a good idea - make sure they x-ray you so you can be sure it's not something more than muscular.

Good luck I hope you find relief.


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## Zandoz (Jan 21, 2008)

Unfortunately there is likely to be no quick and easy fix. As much as I dislike chiropractors in general, I think a good one is more likely to find joint/back problem if there is one...as you've experienced, mos MDs just write off problems like this to being caused by weight, without serious investigation. I'll second what Sandie said about getting the sleep study...get one, if for nothing more than to rule that out as contributing to the problem. The other thing I'll add from experience is to take a long hard look at your mattress...few if any will give folks of any size good support for more than a few years, regardless of their advertised claims.


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## tonynyc (Jan 21, 2008)

*
Ashley,
Here's another source "The Healthy Back" website. They might have some 
supplies that could releive your discomfort. Also , check out a physical therapist as they may suggest specific exercises for you to do AND what should be avoided based on your pain. 
*


http://www.healthyback.com/?mt=B&se=G&KNC-54RI45467954&gclid=CLLVgor9iJECFUWoGgodqlMZFw


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## comperic2003 (Jan 22, 2008)

Most lower back pain is caused by a lack of mobility in the hips. And spinal loading, whether through exercise or excess body weight, is only going to exacerbate the pain until the mobility issue is resolved. This, of course, only applies to you if your back pain was not caused by a traumatic injury.


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## Miss Vickie (Jan 22, 2008)

In my own case, my low back pain is caused by an extra mobile joint in my sacrum which allows excess flexibility in my hips. Between that and my hernia, my low back had little stability. I'm hoping that my hernia repair will help my low back settle down; so far it does seem a lot better.

Having an extra, mobile joint in my sacrum is great for birthin' babies and wild and crazy sex, but it's not so great for having a stable pelvis for things like walking or sitting. 

Ashley, if your back doesn't feel better with position changes and ice, a trip to the doctor is definitely in order. Obviously I'm a fan of chiropractic but I've also had good luck with a muscle relaxant called Flexeril which really helps relieve the muscle spasm that sometimes happens.

Hope you feel better...


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## comperic2003 (Jan 22, 2008)

To expand on my previous post: the hip joint is the second most mobile joint in the body, after the shoulder. When the hip joint becomes less mobile due to muscular imbalances, tightness in the hip flexors and quads, and weakening of the glutes, the joint directly above (the lumbar region) will try to compensate. Unfortunately, the lower back is one of the joints in that body that needs stability, mobility's antagonist, the most. Hence, the pain.


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## Just_Jen (Jan 22, 2008)

aww im really sorry to hear about your pain!! i'm still suffering with sciatica so i know how bad it can be when those areas hurt. i dont even know what to advice to be honest, im still battling my stuff with uber painkillers..

i just wanted to show some support! *hugs*


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## jamie (Jan 22, 2008)

I have a lot of back problems and the only thing I have found that was much help was Naproxen (Aleve). I take 3 Aleve twice a day when I am having a flair up. That is a lot, but it is under Dr's advice. 

My lower 5 discs are squished and when they get angry it causes swelling that presses in on my nerves that then makes me feel like I am being sawed in half by dull rusty knives. The Aleve (any NSAID, but I find Advil is not strong enogh) will take care of the swelling in a couple to three days and I am back on my feet. 

I tried all kinds of pain relievers and muscle relaxers, but nothing could get me up and I was bed-ridden for a couple of weeks two years in a row. With the Aleve, I have been able to keep it down to a few bad nights (knocking on wood). 

Good luck...I hope you don't have many more miserable evenings and can get some rest. I don't know how you are managing running after a 5 year old with that back.


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## comperic2003 (Jan 22, 2008)

Before you start treating the symptoms and taking some form of medication, really consider mobility work.


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## southernfa (Jan 22, 2008)

jamie said:


> My lower 5 discs are squished



Love the technical terminology.  According to the chiropractor, my 2nd/3rd vertebrae are 'buggered', another highly advanced description...


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## BigCutieAsshley (Jan 22, 2008)

I want to thank everyone for taking to time to post! I'm working on a few things to help with the pain...I'll post in a few days with an update.

Fortunately, the pain is mainly at night. Unless I'm doing a lot of walking or standing my back and hips don't give me a problem during the day. I swear the problem is my excess weight putting to much pressure on my hips while I'm sleeping. I may have to break down and buy a new bed. Our bed in only about 3 years old but with all my tossing and turning I've given it a intense work out.

Thanks again for all of your suggestions! You guys are the best!

Hugs,
Carla :kiss2:


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## wi-steve (Jan 22, 2008)

Hi Ash,

If you do find that heat helps it, you might want to look for a heated mattress pad. My wife and I use one, mainly cause we're cheapskates and keep the thermostat set at 60 at night. Our has separate controls for each side and makes the bed a very cozy place.

I hope you find a way to feel better soon.

Steve


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## irish_redhead (Jan 24, 2008)

With regards to the bed - look into the Memory Foam beds or toppers. My parents have the entire mattress, which I don't find all that comfortable. But I invested in a 2 inch topper for my current mattress, and it makes a world of difference. I had an injury and have herniated discs, bone spurs and sacroiliitis, which is agonizing when you try to sleep.

Secondly - while there's been some good advice here about helping with pain, it is important too see a doctor. Back pain, especially spontaneous pain with no known trauma, is important to have properly diagnosed. Things such as a kidney infection can manifest as back and flank pain, even without other symptoms. 

Be up front with the doctor in regards to your weight - stress that you have no ongoing issues, no trauma, and haven't had any alterations in your weight or lifestyle that can contribute to this. Also specify that this pain came on suddenly, as opposed to a progressive issue. 

Some things you may want to consider looking into are x-rays (which can show any trauma, or also inflammation in the joints), blood work (for elevated C-Reactive Protein that indicates inflammation, as well as RH factor for elimination of inflammatory arthritis) and a complete chemistry profile to eliminate any other systemic issue. 

When dealing with the initial pain stages, immobility is generally not the best route to go for MOST muscle strains. While you may want to rest, it's important to keep active and strengthen the muscles. 

That said - if there is ANY inflammation in any joints, proceeding directly to any form of activity or therapy for treatment will not help, only make it worse and will take longer to heal. You need to get past the acute phase with rest, anti-inflammatories etc. before you can look at improving strength and flexibility. I was initially diagnosed with a muscle strain, and the treatment was the complete WRONG thing to do, since the pain was disc herniations and inflammation of the joints in the hips. The treatment was appropriate for long term, but not in the intial stages. 

I'm not a proponent of chiropractors personally, but if you do go that route, any decent chiro is going to order a work up and x-rays before treating anyway. Either way, get someone to order tests.


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## Risible (Jan 24, 2008)

Actually, I second that on the memory foam mattress as something to try. It worked for me. I got a brand-new, expensive standard construction mattress and box springs about eight years ago, and it quickly, within a few months, developed a huge hole on the side where I slept about 2 inches deep. I got that mattress exchanged under warranty, and the replacement mattress also developed a hole, same place, same depth. Oy, the backaches! I couldn't sleep for more than 6-7 hours at a time, and that not very restful.

We then bought a Tempur-Pedic. It is amazing, so comfortable, and I can sleep all I want without developing a backache. It allows for wonderful rest!


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## fatgirlflyin (Jan 24, 2008)

BigCutieAsshley said:


> For the last few weeks I've had a really hard time sleeping. Before bed I take 2 Tylenol PM and 3 Advil but by 2am to 3am I am up and in pain (my lower back and hips). In the past I could fall back to sleep but the last few nights no matter what I try and I can't get comfortable enough to get back to sleep. My husbands side of the bed is usually more comfortable for me but lately that's not helping either. HELP!!
> 
> I need a quick fix, or at least a fix that doesn't include a doctor. I have fantastic medical insurance but I'm sick to death of the doctors always blaming everything on my weight and trying to pressure me into having a sleep study done.
> 
> ...




My hips have been killing me lately, to the point where sometimes when I'm taking a step I feel like I'm gonna fall down. I feel your pain and I hope that you find some kind of relief soon!


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## SocialbFly (Feb 1, 2008)

missaf said:


> Just a warning about Flexeril. I can only take half a pill, and then I'm knocked out for 10 hours. A whole pill and I'm comatose for about a day.




Good advice, lol.


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## SocialbFly (Feb 1, 2008)

Risible said:


> Actually, I second that on the memory foam mattress as something to try. It worked for me. I got a brand-new, expensive standard construction mattress and box springs about eight years ago, and it quickly, within a few months, developed a huge hole on the side where I slept about 2 inches deep. I got that mattress exchanged under warranty, and the replacement mattress also developed a hole, same place, same depth. Oy, the backaches! I couldn't sleep for more than 6-7 hours at a time, and that not very restful.
> 
> We then bought a Tempur-Pedic. It is amazing, so comfortable, and I can sleep all I want without developing a backache. It allows for wonderful rest!




i third it, i bought a memory foam topper for my cheap rental bed (gag me it is a piece of...) and it has helped although not 100%, but it is maybe 80% better, try overstock.com if you want a topper, 2 inches is enough for me (i had 3, wayyyy too much) and it came fast and helped lots...


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## Tina (Feb 1, 2008)

Carla, I don't know if this will help or not, but being build kind of like you, though not quite as extreme, laying down flat doesn't work for me. My butt sticks out too much and it throws my spine out of alignment. I also get sciatica, which worsens the situation. The solution sucks though: if I want a good night's sleep, I have to sleep on an adjustable bed. A good chiro can help, and maybe even the right kind of stretching and accupuncture. After too many nights of terrible pain no matter what position I slept in, and then having knee surgery and sleeping on a recliner for that time because it was easier on my knee, I found that my back stopped hurting at night. Wasn't long after that I got an adjustable bed. That was years ago, and now my hubby and I have one he purchased for us. It kind of sucks to have to go that route, because it can be expensive, but I'll admit, it's the only way I can truly rest without pain -- and it's nice when we watch movies in bed sometimes, too.


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## artinfos (Feb 4, 2008)

Carla,

I had chronic lower back pain for years after pulling a muscle. I can only sleep on my side now with a pillow between my knees and my neck straight. The pain is pretty much gone after going to this great physical therapist in my area (Delaware). He worked through a slew of stretches and excercises that specifically targeted my back. While he did conceed that my gut doesn't help matters, he was confident that if I do the stretches and excercises he prescribed on a regular basis, that the muscles in my back would strengthen and relieve the constant discomfort. I'd refer you to him if it wasn't such a hike for you, but out of the 3 physical therapists I saw, he was the one that was most informative and was able to show me how to relieve my back pain doing simple stretches and exercises at home. In addition he was full of useful information and took the time to educate me about how to take care of the muscles in my back to avoid continued injury.

artinfos


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## BigCutieAsshley (Feb 8, 2008)

SocialbFly said:


> i third it, i bought a memory foam topper for my cheap rental bed (gag me it is a piece of...) and it has helped although not 100%, but it is maybe 80% better, try overstock.com if you want a topper, 2 inches is enough for me (i had 3, wayyyy too much) and it came fast and helped lots...



I ordered the memory foam topper from Overstock. Last night Phil took it out of its plastic wrap so it should be ready to go on our bed by tonight. I'll let you know how we like it. 

Thanks again for the info!


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## arimis (Feb 8, 2008)

BigCutieAsshley said:


> For the last few weeks I've had a really hard time sleeping. Before bed I take 2 Tylenol PM and 3 Advil but by 2am to 3am I am up and in pain (my lower back and hips). In the past I could fall back to sleep but the last few nights no matter what I try and I can't get comfortable enough to get back to sleep. My husbands side of the bed is usually more comfortable for me but lately that's not helping either. HELP!!
> 
> I need a quick fix, or at least a fix that doesn't include a doctor. I have fantastic medical insurance but I'm sick to death of the doctors always blaming everything on my weight and trying to pressure me into having a sleep study done.
> 
> ...




I preface this by saying I'm a guy and so my knowledge is limited. However, I like watching What Not To Wear and How to look great naked and they are always having women who have back problems because of having large breasts go have a profesional bra fitting. The women seem to be suprised at how much better they feel afterwards. I don't know if that is your problem and being a guy, my advice might be completly wrong. Also you might try lying down on a hard surface to relax the muscles. Finally my mom goes to a chiopractor and that helps her alot. xxx, Arimis


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## SocialbFly (Feb 17, 2008)

here is hopin that the memory foam topped helped...i hate when my back and hips hurt, that just is the worst feeling..


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## Ruby Ripples (Feb 17, 2008)

I just found this thread, how did you get on with the memory foam mattress topper? 

I have a good friend who has arthritis in both hips, she needs replacements but it's the NHS here, so they wait til you're virtually crippled first! she also has lower back pain again due to arthritis. (btw she isnt bbw). she couldnt sleep on her back or either side either, as it was so painful. She eventually bought one of these adjustable beds, it cost a fortune but she paid it up monthly for a couple of years. She looks SO much better now, her hips are better during the day, she has more energy, all because she is sleeping comfortably for the first time in years. She adjusts the bed so that she is sleeping on her back but with the head and foot of the mattress raised, so she is like in a reclined position, so there is no strain on her lower back or hips. I've put a pic on here from an ad to show you the position she sleeps in. 

I know it's an expensive solution, but if the mattress topper doesn't work, it might be the answer. 

(Just saw Tina's post recommending this kind of bed too!) 

View attachment testim_woman3.jpg


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## AnnMarie (Feb 17, 2008)

SocialbFly said:


> i third it, i bought a memory foam topper for my cheap rental bed (gag me it is a piece of...) and it has helped although not 100%, but it is maybe 80% better, try overstock.com if you want a topper, 2 inches is enough for me (i had 3, wayyyy too much) and it came fast and helped lots...



Yeah, just proves how different we're all built. I have a 4 inch, highest density they make, and I'd love one more inch. It has worked wonders on my hip pain while sleeping (I'm a side sleeper), it allows my hips to rest down into the pad while supporting my upper body without the bend I'd normally get. 

Love it - to the point where sleeping without it for any extended time really takes a toll on my back.


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## Sandie_Zitkus (Feb 18, 2008)

This is something I do that might help the others who have big hips and relatively small waist.

I put pillows under me from my waist up. My hips are about 20 inches bigger than my waist and sleeping on my side with pillows under me from waist up really helps.


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## florida.cutie (Feb 22, 2008)

Since your pain only happens at night then most probably it is your bed. I suffer from cronic back pain as well and can only spend about 3 hours in bed and then I have to move to a recliner chair (which is very comfortable). If you can afford it, your best bet might be to invest in one of those adjustable beds. I know I sure am when I can afford it. Also if you can't find relief, a pain management doctor might be able to help. I found that none of my regular doctors were really willing to do much of anything.....putting it all on losing weight. My pain management doctor is wonderful. He never even mentioned my weight.......his only concern was getting me out of pain.


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## Jes (Feb 22, 2008)

Has anyone tried (and this may be on target or not, I'm not sure what the OP suffers from and I'm not sure what I'm going to mention treats, per se) chondroitin/glucosamine? My parents have it in the house b/c of their age, and ... well, I'll hold off saying anything but I'm very curious what experience this community has with this stuff.

thanks


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## Red (Feb 22, 2008)

I suffer from this and it's very painful and uncomfortable. Cheap mattresses are a no-no for me as I sleep on my side a lot. I found that the thickest Sultan mattress from Ikea works a treat, it has an extra top layer that minimises spring pokage but is still fairly firm. I am tempted to get the memory foam topper too but it's quite pricey in the UK so I think I will save it for when the mattress finally starts giving up the ghost. 

Going to the chiropractor really helps too, he really knows what he's doing. The best thing is he never blames any ailment on my weight, he just hangs me off the edge of the bed and beats the crap out of me and I always leave feeling better and refreshed.

The shape of my body also stops me from enjoying spur of the moment camping trips unless on sand. I love going camping, but I have to take an airbed as sleeping on a flat/hard service is impossible, my arse just gets in the way and cheap roll up mattresses are a rubbish solution. I HAVE to stick my legs up on something or I wake up with my muscles locked up and my spine crushed 

Hopefully the memory foam topper will help you out, they look fantastic.

If anyone spots anything similar in a 'camping' roll-up style please spread the word!


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## comperic2003 (Feb 22, 2008)

Jes said:


> Has anyone tried (and this may be on target or not, I'm not sure what the OP suffers from and I'm not sure what I'm going to mention treats, per se) chondroitin/glucosamine? My parents have it in the house b/c of their age, and ... well, I'll hold off saying anything but I'm very curious what experience this community has with this stuff.
> 
> thanks



Regarding glucosamine and chondroitin, 



Consumer Report
What’s Wrong with Glucosamine?
by Cy Willson



Nowadays, I’m real cautious about sounding like a know-it-all. Even though I’m a young whippersnapper, I’ve learned that things you take as Gospel today, are often found to be completely wrong tomorrow.

Consider that HMB and androstenedione were once thought to be enormously beneficial toward our muscle-building efforts. Conversely, there are things that we once thought to be worthless, but then suddenly got an 11th-hour reprieve. Remember "whey rules, casein sucks," or soy is the bomb?

Anyhow, my point is that we should continually watch and research the various supplements that are currently available and assess whether they’re beneficial or harmful, and to what degree. Along these lines, I’m going to take a look at one supplement that has become VERY popular with both the bodybuilder and even Joe Average.

Beef takes it for that knee injury he got while trying to rip a fire hydrant out of the ground and Stevie takes it for the sore digits he got while opening letters. Hell, even the old lady down the street uses it.

So what is it? Glucosamine. Now, before I get to why you might want to reconsider your use of this supplement, I’ll do the obligatory rundown on the supplement itself and why it’s so popular.


What is it?

Glucosamine, chemically known as (2-amino-2-deoxy beta-D-glucopyranose) is an aminomonosaccharide found in the body that’s synthesized from glucose and utilized for biosynthesis of glycoproteins and glycosaminoglycans.

Considering that glucosamine serves as a substrate for, and enhances the production of, proteoglycans (proteoglycans are vital components of articular cartilage that attract water molecules in order to stay healthy), it makes sense that it might inhibit deterioration of cartilage.(1)

It’s also demonstrated somewhat of an anti-inflammatory effect as well as relieving related pain. No wonder it’s been prescribed as a possible treatment for osteoarthritis. To top it off, it was also shown to be just as effective as ibuprofen at treating osteoarthritis, with the exception of a slower onset of action. All the while, glucosamine is much safer than NSAIDS in terms of potentially toxic side effects. This is why glucosamine is so versatile. Its use applies to everyone.

Whether you’re a body builder, fighter, football player, or an old lady, this substance can really help alleviate the pain and help aid recovery of injuries. So, if it’s so good, why am I even writing this-here article? Good question.


What’s the Problem?

The problem as some of you may or may not know is that numerous studies have shown glucosamine to cause insulin resistance: in rats, humans, in vitro, and in vivo.

It induced insulin resistance in human skeletal muscle cultures from both non-diabetic and Type-2 diabetics.(2) Another study, this time using rats, showed that it induced insulin resistance in both skeletal muscle and throughout the rest of the body, thereby preventing the insulin-induced increase in muscle glycogen.(3) Another study had similar findings.(4) Glucosamine also induced insulin resistance in adipocytes.(5,6,7,8)

Insulin resistance in fat cells isn’t necessarily a bad thing, as it may help you to drop body fat. Still, if the compound is also causing insulin resistance in muscle tissue, you’re on the fast track to trouble.

To see if this would happen to humans, researchers took 10 healthy subjects and gave them glucosamine. What they found was that it would indeed affect insulin action and the subjects displayed some of the characteristics associated with diabetes.(9)

Additionally, glucosamine has been shown to impair exercise induced glucose uptake. This may be because of its ability to affect GLUT 4 translocation in skeletal muscle. This puts a big damper on the whole idea of glucose entering cells without insulin after a workout.(10,11) Not only that, but it impairs the action of insulin itself. This can be very detrimental and can actually affect the use of certain supplements.

For instance, this could affect how quickly you can recover from your workouts as well as to what extent. New and powerful supplements like Biotest Surge could be negatively affected as well. For those of you who have been reading about Biotest Surge, its main mechanism of action is to elicit a large release of insulin. However, if muscle tissue is resistant, how in the hell are you going to get any benefit from this mode of action?

Well, you obviously won’t. So what’s a T-man to do? Keep reading and I’ll give you an alternative, one that’s also well known and often used in conjunction with glucosamine.


Chondroitin

This substance is classified as a mucopolysaccharide that’s found in cartilage. It provides the same benefits to cartilage as glucosamine, but appears to work through a different mechanism. While glucosamine serves as a substrate for glycosaminoglycan synthesis, it appears that chondroitin works instead by being incorporated into cartilagenous tissue itself.(12)

It’s basically just as effective as glucosamine in terms of treatment of osteoarthritis, pain, and inflammation.(13,14,15) Numerous studies have also shown it to be as effective as ibuprofen and allowed people to lower the dosage of NSAIDs.(16,17,18,14) As an interesting side note, chondroitin was also found to improve joint function and pain for up to 3 months after cessation of use.

Let’s not forget that chondroitin is devoid of dangerous effects on the stomach, platelets, and kidneys.(14) The same can’t be said for NSAIDS.

The obvious benefit to using chondroitin over glucosamine is the fact that chondroitin hasn’t been shown to affect insulin action/sensitivity in a negative manner, while glucosamine has. As far as dosages go, 800-2400 mg per day is the usual dosage used to treat osteoarthritis. For the typical body builder however, a minimum dosage of around 1600-2400 mg may be necessary for treatment. For prophylactic use, a dose of 400 mg would be sufficient.


Closing Statement

Now I don’t want you guys freaking out on me here. I’m not saying that glucosamine will break into your house, rob you, and add insult to injury by messing up your Star Wars diorama. All I’m saying is that there’s quite a bit of evidence pointing to the idea that it can affect you in a negative manner. And when I say "in a negative manner," I mean that glucosamine might slow down your muscle gains. Similarly, glucosamine may make it easier to put on fat, which probably isn’t something you want to do.

Anyhow, if you’re currently using glucosamine, I’d recommend either monitoring yourself in terms of gains (muscle and/or fat) and possibly the way you feel, or you can go ahead and actually have your insulin sensitivity checked. Personally, I’d rather play it safe and avoid glucosamine — including the glucosamine/chondroitin blends —and just stick with plain chondroitin. Either way, take this as a friendly warning.


References Cited

1. Runkel DR, Cupp MJ. "Glucosamine sulfate use in osteoarthritis." Am J Health Syst Pharm 1999; 56(3):267-269

2. Ciaraldi TP, et al. "Glucosamine regulation of glucose metabolism in cultured human skeletal muscle cells: divergent effects on glucose transport/phosphorylation and glycogen synthase in non-diabetic and type 2 diabetic subjects." Endocrinology 1999 Sep;140(9):3971-80

3. Patti ME, et al. "Activation of the hexosamine pathway by glucosamine in vivo induces insulin resistance of early postreceptor insulin signaling events in skeletal muscle." Diabetes 1999 Aug;48(8):1562-71

4. Virkamaki A, et al. "Activation of the hexosamine pathway by glucosamine in vivo induces insulin resistance in multiple insulin sensitive tissues." Endocrinology 1997 Jun; 138(6):2501-7

5. Kresko RC, et al. "Glucosamine-induced insulin resistance in 3T3-L1 adipocytes is caused by depletion of intracellular ATP." J Biol Chem 1998 Aug 7;273(32):20658-68

6. Ross SA, et al. "Development and comparison of two 3T3-L1 adipocyte models of insulin resistance: increased glucose flux vs glucosamine treatment." Biochem Biophys Res Commun 2000 Jul 14;273(3):1033-41

7. Nelson BA, et al. "High glucose and glucosamine induce insulin resistance via different mechanisms in 3T3-L1 adipocytes." Diabetes 2000 Jun;49(6):981-91

8. Hawkins M, et al. "Role of the glucosamine pathway in fat-induced insulin resistance." J Clin Invest 1997 May 1;99(9):2173-82

9. Monauni T, et al. "Effects of glucosamine infusion on insulin secretion and insulin action in humans." Diabetes 2000 Jun;49(6):926-35

10. Miles PD, et al. "Exercise-stimulated glucose turnover in the rat is impaired by glucosamine infusion." Diabetes 2001 Jan;50(1):139-42

11. Baron AD, et al. "Glucosamine induces insulin resistance in vivo by affecting GLUT 4 translocation in skeletal muscle. Implications for glucose toxicity." J Clin Invest 1995 Dec;96(6):2792-801

12. Menzel EJ. "Polymeric chondroitin sulfate vs. monomeric glucosamine treatment of osteoarthritis." Wien Med Wochenschr 2000;150(5):87-90

13. Uebelhart D, et al. "Effects of oral chondroitin sulfate on the progression of the knee osteoarthritis:a pilot study." Osteoarthritis Cartilage 1998 May;6 Suppl A:39-46

14. Ronca F, et al. "Anti-inflammatory activity of chondroitin sulfate." Osteoarthritis Cartilage 1998 May;6 Suppl A:14-21

15. Alekseeva LI, et al. "Structum (chondroitin sulfate) — a new agent for the treatment of osteoarthrosis." Ter Arkh 1999;71(5):51-3

16. Fioravanti A, et al. "Clinical efficacy and tolerance of galactosaminoglucoronoglycan sulfate in the treatment of osteoarthritis." Drugs Exp Clin Res 1991; 17:41-44

17. Leeb BF, et al. "A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis." J Rheumatol 2000; 27:205-211


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## Miss Vickie (Feb 22, 2008)

Jes, back when I had creaky knees, a course of glucosamine and chondroiton helped me a lot to get those guys nice and quiet. I was able to wean off of it; I have never been diagnosed with arthritis or anything and I think that what happened was that I had an excess of inflammation in the joints from my Sarcoidosis which was causing some irritation in the joint and the subsequent noise. Once I got the Sarcoidosis under control my joint creakage eventually stopped. I think that it might help with hip pain, but I'm not sure about low back pain since I don't think the vertebrae have a joint capsule like hips and knees do. I could be wrong, though. Ortho was never my strong suit.


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## Jes (Feb 22, 2008)

can you define a course, vickie? timewise/dosage? and are you talking OTC or an Rx strength (is it even prescribed...?)thanks


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## Risible (Feb 22, 2008)

Jes, my brother takes or used to take glucosamine/chondroitin, and says it works/worked for him; he urged me to try it. I took it for a couple months, but it did nothing to alleviate my joint pain.


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## altered states (Feb 24, 2008)

This sounds like a good case for a chiropractor. If you have good insurance, use it, but in general a chiro will have to see you many more times than most insurance will indulge. This isn't a scam, that's how chiropractic works - you need many frequent visits up front and then maintenance even after the problem goes away. Any decent chiro will definitely x-ray you and won't lecture you about your weight. I went this route for a my back/neck/shoulder pain and RSS and though it cost me a big chunk, I have never felt any pain since and never took anything stronger than aspirin again for it. And I went into it a total skeptic, desperate but pill- and surgery-phobic.


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## Miss Vickie (Feb 25, 2008)

Jes said:


> can you define a course, vickie? timewise/dosage? and are you talking OTC or an Rx strength (is it even prescribed...?)thanks



I took it for a few weeks, J, using the directions on the bottle. I'm not sure if it's prescribed (I doubt it) but I picked up some at Costco to give it a try. It did seem to help but naturally, as I started to feel better, I stopped taking it; fortunately for me, it did what it needed to do and whatever was going on was resolved so I was okay after the fact.

I know... could I BE more vague?


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## Tinkertoy (Feb 26, 2008)

Have you tried getting one of those body pillows (like from walmart) and put it under your knees if sleeping on back or between knees if on side. I have terrible sciatica and also see a chiropractor when I can afford it. I was shocked at how much this silly body pillow helped my sciatica and low back pain. I won't sleep without it now!


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## OppositesAttract(fa) (Feb 26, 2008)

Chronic musculoskeletal pain is the number one cause of chronic disability in North America. And back pain alone is the leading cause of disability in Americans under the age of 45.

Western medicines conventional and prevailing model of chronic musculoskeletal pain management relies heavily upon both steroidal and non-steroidal anti-inflammatory drugs, muscle relaxants, bed rest, massage, physical therapy, and chiropractic treatment. More serious cases may be addressed by a full neurological examination, including a myelogram to check for ruptured discs or other sources of pressure on the spinal cord or other nerve structures. And in the most serious cases, surgery is often recommended.

But despite all of the above-stated treatment methods being perpetually applied to the problem of chronic musculoskeletal pain, and despite the enormous emotional, financial, and economic price that said treatment methods have exacted, conventional medicine has yet failed to provide any significant solution to this longstanding and widespread concern.

Enter Prolotherapy

The practice of prolotherapy stands in stark contrast to the protocols of conventional medicine by effecting the actual repair of the joint dysfunction that is the root cause of most musculoskeletal pain. And to ice the cake, prolotherapy does so at far lower cost, with significantly less risk, and with far more predictable and superior results.

Practitioners of the time-honored practice of prolotherapy are not oblivious to the fact that most musculoskeletal pain is caused by weakness, or laxity, of tendons and ligaments. Tendons and ligaments are of course the connective tissues that attach muscles to bone, and bone to bone. When tendons and ligaments are weakened, local pain proceeds from the nerves associated with the damaged connective tissue and referred pain may also proceed from the nerves associated with the surrounding muscles. Only when the weakened tendons and ligaments are adequately strengthened will the local and referred pain, and the chronic muscle pain and contracture, have opportunity to permanently subside.

The value of prolotherapy is readily illustrated by its application to the problem of back pain associated with vertebral instability. With vertebral instability, the vertebrae slip, or migrate, from their optimal position. By strengthening the tendons and ligaments that serve as the first tier of the spine's support structure, prolotherapy has with rare exception brought significant relief to those back pain patients who have been privileged to receive it.

PROLOTHERAPY QUESTIONS AND ANSWERS

What is prolotherapy?

Prolotherapy catalyzes the bodys own healing processes via injections of a proliferant into an area where tendons or ligaments have been weakened or damaged. Upon a proliferant's having been administered, inflammation occurs and circulating immune cells called macrophages migrate to the area, mopping up any debris to there be found. Cells called fibroblasts follow next in rank, with their role being to deposit new collagen fiber atop damaged tendons and ligaments. When the collagen that is laid down cures and shrinks, the treated tendons and ligaments become tighter and thus stronger, and the nerve irritation that had resulted from the tendon and ligament laxity is alleviated.

How quickly can prolotherapy alleviate my pain?

Two out of three prolotherapy patients experience at least partial relief of pain after only one treatment session, with the anesthetic in the prolotherapy solution often providing immediate pain relief, and with the joint-stabilizing effects of prolotherapy providing continuing pain relief upon the anesthetics having worn off.

Between the second and fourth weeks following a prolotherapy treatment session the initial joint stabilization induced by prolotherapy subsides and some measure of the original pain is liable to return.

With continuing treatment and healing progression, the quantity of injections required per session, and the measure of pain experienced by the patient, both diminish.

How many prolotherapy treatments are necessary to attain complete recovery?

While most patients require four to six prolotherapy treatment sessions to attain complete recovery, some experience more immediate results, with patients who are in optimal health generally requiring fewer treatments. Acute injuries may heal in as few as within two to three weeks after the administration of just one prolotherapy treatment.

What is the frequency of prolotherapy administration?

Prolotherapy treatment sessions are, depending on the practitioners orientation, given in the range of from every one to two or four to six weeks.

Am I an ideal candidate for prolotherapy?

The ideal prolotherapy candidate has, aside from pain originating from tendon or ligament damage, a strong immune system, a healthy diet, a positive mental outlook, and the intent to pursue prolotherapy treatment to its conclusion.

Those prolotherapy patients dogged by chronic fatigue, weak immunity, or hormonal or allergic problems typically heal more slowly than those graced with optimal health.

How badly do prolotherapy injections hurt?

Shots are shots, and there is almost nothing that a doctor will stick one with that will not provoke some measure of discomfort. Individual temperament is of course a significant factor here, with some patients not so much as flinching upon receiving a host of prolotherapy injections, and with others becoming significantly distressed upon receiving but a few. In order to assist the minority of patients who find prolotherapy significantly distressing, the physician may either (1) prescribe analgesics such as Tylenol with codeine or Vicodin to be taken prior to prolotherapy treatment or (2) administer anesthesia at the time of prolotherapy treatment. Some practitioners also use a device called a Madajet that sprays an anesthetic such as Lidocaine into the skin to deaden the pain provoked by a proliferant-bearing needle.

For those patients requiring injections in many areas at one time or in very delicate areas like the neck, intravenous anesthesia may be indicated. Occasional nausea and a few instances of vomiting have been the only side effects experienced by our prolotherapy patients in such cases. It is our experience that many patients who have been given intravenous anesthesia along with prolotherapy prefer to risk experiencing the occasional side effects of intravenous anesthesia over having to experience the pain inherent in receiving prolotherapy.

It is common for prolotherapy patients to experience muscle stiffness in the days immediately following treatment. Such muscle stiffness can readily be remedied via moist heat and natural protease enzymes such as bromelain. 

How effective is prolotherapy?

While prolotherapys effectiveness in eliminating chronic pain is inherently linked to both the competence of the practitioner administering it and to the overall well being of the patient, it generally falls in the range of from 80 to 90 percent. The most important determinant of prolotherapys effectiveness is that an adequate amount of proliferant solution be injected into the injured area. When this criteria is met, the likelihood of success is excellent.

How safe is prolotherapy?

Prolotherapy is an extremely safe procedure. Gustav A. Hemwall, M.D., bore out this fact by treating more than 10,000 patients with more than four million prolotherapy injections without experiencing a single episode of infection, paralysis, permanent nerve injury, or death.

Prolotherapy is significantly safer than merely taking aspirin or ibuprofen on a daily basis. Prolotherapy is moreover significantly safer than living with chronic pain, with chronic pain creating chronic stress, and with chronic stress in turn increasing the likelihood of chronic illness and premature aging.

There is of course at least a slight risk inherent in any medical procedure, and the risks and side effects of prolotherapy will vary depending upon the area being treated, the skill and experience of the prolotherapist, and the overall health of the patient. It is standard practice for a doctor to discuss such risks with a patient during a pre-treatment consultation.

How can prolotherapy help both arthritic bone spurring and fibromyalgia?

Arthritic bone spurring and fibromyalgia, while having significantly contrasting apparent causation, can in fact both originate from the same root cause of tendon or ligament laxity. Both arthritic bone spurring and the chronic muscle contracture typical of fibromyalgia are means by which the body endeavors to support a weakened joint through some auxiliary means, with arthritic bone spurring providing auxiliary internal support to a joint and chronic muscle contracture providing auxiliary external support. Prolotherapy, via its action of strengthening tendons and ligaments and thereby stabilizing joints, is thus able to alleviate not only the bone overgrowth that occurs in arthritic bone spurring but also the muscle spasms descriptive of fibromyalgia.

Which other medical conditions can effectively be treated by prolotherapy?

Medical conditions not elsewhere mentioned in this piece that can effectively be treated by prolotherapy include: Achilles tendon injuries, ankylosing spondylitis, annular ligament (elbow) pain, anterior cruciate ligament (knee) sprains, arachnoiditis, carpal tunnel syndrome, hip replacement laxity, migraines, neck pain, patella (knee cap) disorders, rotator cuff (shoulder) injuries, sciatica, slipping rib syndrome, spinal stenosis, scoliosis, tarsal tunnel syndrome, and temporomandibular joint (TMJ) syndrome. At least one patient successfully treated by prolotherapy would otherwise have received knee replacement surgery.

Is prolotherapy the same as cortisone injections?

Cortisone injections relieve pain by an entirely different pharmacology than do the proliferants used in prolotherapy. Moreover, while studies have shown that cortisone injections have the unfortunate effect of weakening connective tissue, prolotherapy injections have the opposite effect of strengthening connective tissue.

Is prolotherapy covered by insurance?

There are cases where insurance companies cover prolotherapy, whether in whole or in part. Such cases are, however, the exception to the rule.

How costly is prolotherapy compare to conventional therapy?

While the cost of individual prolotherapy treatment sessions is typically between $100 to $200 for each body region treated, surgical procedures performed to treat, for instance, back injury are routinely billed out at hundreds of times that amount!

What can I do to optimize the effectiveness of prolotherapy treatments?

At least one patient reported that she followed her prolotherapy treatments with a warm bath and warm compresses to get the serum into the joint faster. 

Why is prolotherapy so little known?

The position of the American Association of Orthopaedic Medicine is that the teaching of prolotherapy is suppressed in medical schools and residency training programs because there are organizations, namely, surgical interests and pharmaceutical companies, having a vested interest in the continuation of traditional treatment methods.

Former Surgeon General, C. Everett Koop, a chronic pain sufferer, prolotherapy patient, and prolotherapy practitioner, offers another explanation. "Medical folks are skeptical and prolotherapy, unless you have tried it and proven its worth, seems to be too easy a solution to a series of complicated problems that afflict the human body and have been notoriously difficult to treat by any other method."

Dr. Koop has also stated that "Many insurance companies do not pay for prolotherapy, largely because many of their medical advisors do not understand it, have not practiced it, and therefore do not recommend it." And treatments that patients must typically pay for out of pocket of course suffer a competitive disadvantage to treatments that are typically covered by insurance.

What is in the prolotherapists syringe?

Osmotic proliferants such as dextrose and glycerin are the substances used most commonly in prolotherapy injections. Also among the class of osmotic proliferants are the minerals zinc, calcium, and manganese. 

Osmotic proliferants, being by nature water-soluble, do not deposit in fatty tissues. Any vestige of an osmotic proliferant that is not utilized metabolically is therefore quickly eliminated from the body.

Osmotic proliferants work by causing cells at the injection site to go into osmotic shock, a state of cellular dehydration wherein membrane integrity is compromised to the breaking point. The resultant localized state of cell trauma, death, and dismemberment marshals the influx of circulating immune cells that (1) rid the area of cellular debris and (2) secrete chemical messengers summoning the next wave of the cellular cavalry, tissue-repairing cells called fibroblasts. Fibroblasts, by secreting collagen and other regenerative compounds at the site of injection, round out the healing cascade that culminates in tendon and ligament tissue fortification.
Irritant proliferant solutions act by attaching themselves or their byproducts to cell surfaces and by thereby rendering the affected cells reactive to the immune system. The irritants that are used most commonly in prolotherapy include dextrose, phenol, guaiacol, tannic acid, and plasma QU (quinine, urea). Sarapin, the alkaline extract of the pitcher plant, is sometimes counted among the irritant proliferants.

The prolotherapy solution used in certain double-blind studies, P2G, is comprised in significant part of the irritant phenol.

Cells that have been rendered reactive to the immune system by an irritant proliferant solution instigate the inflammatory process that is the initial phase of the healing cascade that culminates in tendon and ligament tissue proliferation.

Particulate proliferant solutions are typified by pumice flour. The particles found in particulate proliferant solutions, being on the order of one micron in size, are notable for their ability to attract macrophages. When macrophages are drawn to an area that has been treated with a particulate proliferant solution, they not only ingest the particles found there but also actively secrete polypeptide growth factors that promote tendon and ligament tissue proliferation.

Chemotactic proliferant solutions consist of chemical or organic compounds that serve as direct precursors of biological inflammatory mediators. Sodium morrhuate, an arachidonic acid-containing compound derived from cod liver oil, is classified as a chemotactic proliferant. The fact that arachidonic acid is known to serve as a direct precursor to various inflammatory compounds provides the most likely explanation of both sodium morrhuates apparent inflammation-mediating activity and sodium morrhuates evident prolotherapeutic effect.

Growth factors represent the future of prolotherapy. With the advancements that have been made in understanding the regenerative mechanisms of the body, growth factors that directly stimulate the repair of various cells, tissues, and organs have been discovered. Polypeptide growth factors that act directly upon fibroblasts are among this class of biological compound. Various growth factors available in homeopathic form may be taken orally during the course of prolotherapy treatment to augment prolotherapys efficacy.

MEDICAL RESEARCH AND PROLOTHERAPY

George S. Hackett, M.D.

George S. Hackett, M.D. used Sylnasol as the proliferant in his original work. Animals were given between one and three injections of proliferant solution into the tendon and the fibro-osseous junction. There was no destruction of nerves, blood vessels, or tendinous bands noted in any of the animal specimens. When compared to noninjected tendons, tendons treated with prolotherapy showed a 40 percent increase in diameter. Moreover, the fibro-osseous junction increased by 30 percent, with permanent tendon tissue having been formed.

In 1955, Dr. Hackett analyzed 146 consecutive cases of undiagnosed low back disability and found that 94 percent of the patients experienced joint ligament relaxation. 

In 1956, a similar survey by Dr. Hackett of 124 consecutive cases of undiagnosed low back disability revealed that 97 percent of patients possessed joint instability from ligament weakness. The sacroiliac ligaments were involved in 75 percent of the low back ligament laxity cases, and the lumbosacral ligaments were involved 54 percent of the time. Dr. Hackett moreover noted that approximately 50 percent of the patients had already undergone back surgery for a disc problem that had been diagnosed previous to their having taken part in his study. Despite the fact that 50 percent of Dr. Hacketts patients had undergone back surgery previous to becoming his patients, Dr. Hackett yet achieved an 80 percent cure rate. The surgical intervention that so many of Dr. Hacketts had previously received evidently had not relieved their pain, whereas prolotherapy in most cases did.

In 1958 Dr. Hackett published the details of a prolotherapy research study of nineteen years duration. The study surveyed 656 patients from 15 to 88 years old whose duration of pain prior to treatment: had ranged from three months to 65 years and whose average duration of pain prior to treatment: was between four and five years. The number of injections given in the course of the study was 18,000. Twelve years after Dr. Hacketts 1958 prolotherapy study had been completed, 82 percent of the patients considered themselves cured. Dr Hackett considered the cure rate that he experienced in using prolotherapy to have ultimately exceeded 90 percent on account of improvements he devised in his technique over time.

Dr. Hackett attributed those instances wherein patients responded poorly to prolotherapy to: 1) inability to clearly confirm the diagnosis by the injection of a local anesthetic solution, 2) failure of the patient to return for completion of the treatment, 3) treatment in the presence of another disability, 4) a less refined technique and less experience in the earlier studies, 5) low morale among patients on account of years of suffering and disappointment from unsuccessful treatments and dependence on prescription pain medications, and 6) nonresponsiveness to the stimulation of prolotherapy.

Gustav A. Hemwall, M.D.

Gustav A. Hemwall, M.D., learned the technique of prolotherapy from Dr. Hackett and then proceeded to treat more than 10,000 patients worldwide. Dr. Hemwall collected data on 8,000 of those patients and presented his largest survey, which survey concerned 2,007 patients who had received some 6,000 prolotherapy treatments, to the Prolotherapy Association In 1974.
R. Hemwalls survey reported that, of the 1,871 patients who completed treatment, 1,399 (75.5 percent) reported complete recovery and cure, 413 (24.3 percent) reported general improvement, and only 25 (0.2 percent) showed no improvement.

More than 99 percent of the patients who completed their prolotherapy treatment under Dr. Hemwalls care thus found relief from their chronic pain. As such, Dr. Hemwalls results were similar to those published by Dr. Hackett in demonstrating that prolotherapy is completely curative in many cases and that it provides some pain relief in nearly all.

Harold Wilkinson, M.D.

Harold Wilkinson, M.D., professor and former chairman of the Division of Neurosurgery at the University of Massachusetts Medical Center, performed a 16-year prolotherapy study culminating in 1995. In his report on the study, Dr. Wilkinson noted that "A sizeable portion of people with unresolved chronic pain had more than a years pain relief with only one prolotherapy injection." 

Abraham Myers, M.D.

Abraham Myers, M.D., in his study concerning his having administered prolotherapy to 267 patients with low back pain with and without sciatica from May 1956 to October 1960, stated, "Over 4,500 prolotherapy injections have been given without the occurrence of any complication."

Kenneth D. Reeves, M.D. and Khatab Hassanein, Ph.D.

Kenneth D. Reeves, M.D. and Khatab Hassanein, Ph.D. published double-blind placebo-controlled prolotherapy studies in 2000 concerning (1) osteoarthritic thumb and finger joints and (2) knee osteoarthritis. Both of these studies concluded that prolotherapy was clinically effective and safe. The knee osteoarthritis study demonstrated clinically and statistically significant improvements.

PROLOTHERAPY ENDORSEMENTS

C. Everett Koop, M.D., Sc.D., whose credentials have already been mentioned in this piece, wrote in the preface of Prolo Your Pain Away!, "I hope that Dr. Hauser's book, written for laymen, will push them to inquire more about prolotherapy and that it might receive the place in modern therapeutics that I think it really deserves." 

Lloyd R. Saberski, M.D., Former Medical Director, Yale University School of Medicine Center for Pain Management, had the following to say about prolotherapy. 

"Ten years ago I was skeptical regarding prolotherapy. I had heard the testimonials and I had spoken to senior physicians. I thought it was professional mass confusion until I developed my own experience. I was surprised about positive and lasting results on selected patients.

Prolotherapy is the only methodology I have ever utilized with limited risk yet potential for significant benefit. As a practitioner of prolotherapy I encourage athletes and chronic pain patients with chronic soft tissue injuries to consider prolotherapy. Prolotherapy is a secret that needs to be discovered."

DEBUNKING COMMONLY HELD MISCONCEPTIONS ABOUT PROLOTHERAPY

The numerous telephone inquiries that are received by our practice concerning prolotherapy provide us with candid insight into what is happening with prolotherapy around the country. Following are some of the common misconceptions about prolotherapy that have been related to us by both doctors and patients alike.

"I do lots of injections, I can do prolotherapy." We can't tell you the number of doctors who, upon their having read our first book, call and ask, "Is there anything else I need to know before doing prolotherapy?" Perhaps they failed to read the disclaimer in the front of the book that states, "Physicians should use and apply the technique of prolotherapy only after they have received extensive training and demonstrated the ability to safely administer the treatment." Do not allow a doctor to inject you who has learned about prolotherapy only by reading a book.

"I can treat your shoulders with prolotherapy, but not your back." We have heard this over and over again. Patients come to our office in Oak Park, Illinois because the prolotherapist in their area does not do injections around the spine. If a physician does not feel comfortable giving injections around the spine, would you consider the physician an expert at shoulder prolotherapy?

"I cannot do prolotherapy until you get an x-ray." Our office occasionally requests X-rays of chronic musculoskeletal patients, but in our experience, which experience is confirmed by perusal of the medical literature, x-rays seldom provide insight into determining the course of treatment that is most appropriate for the chronic musculoskeletal pain patient. Neither is there any study that shows proper spinal alignment to hold any bearing upon ones obtaining a good response to prolotherapy. Patients who are most likely to respond to prolotherapy are patients whose pain is due to tendon or ligament laxity, regardless of whether they possess good vertebral alignment or not. Of course, if a physician believes that a broken bone may be present, x rays are positively indicated. And while x rays may in fact be employed in certain cases where even a prolotherapy patient has failed to respond to treatment, medical clinics that pressure all their patients to receive x rays are going overboard.

"I was told that I am not a prolotherapy candidate." It is amazing how many people are experts on who is and is not a prolotherapy candidate! Various of our patients had at one time been told by chiropractors, physical therapists, orthopedic surgeons, their fathers, and a host of other so-called "experts" that they were not prolotherapy candidates. The only individuals who are qualified to determine the advisability of prolotherapy to any patient are experts in prolotherapy. 

"The doctor gave me a 50/50 chance of prolotherapy working." 50/50 chance? Ridiculous! There is an 85 percent probability that the chronic pain sufferer will achieve complete healing upon receiving prolotherapy, and nearly a 95 percent probability for the young athlete.

"Prolotherapy did not work for me; the doctor gave me two shots." When someone tells us that prolotherapy did not work for them, we ask them how many shots the doctor administered during the course of their treatment. Inevitably, the response is along the lines of, "The doctor gave me two shots in the back." Two shots is not prolotherapy. The lower back typically requires a minimum of 50 injections per treatment session. And yes, these shots are all given all at one sitting! 

"The doctor said I would need at least fifteen sessions of prolotherapy." Every prolotherapy practitioner has had patients who required significantly more treatment sessions than others. By and large, however, most patients only require four or five prolotherapy treatment sessions, with injuries of brief duration typically requiring less. With patients of ours who are not significantly improved by the third session we usually either increase the strength of the prolotherapy solution or recommend some diagnostic nutritional/hormonal testing in an effort to determine the reason they are a slow healer. A prolotherapist who routinely treats every patient 15 times is typically either using a very weak proliferant or is not administering an adequate number of injections in any given treatment session.

"The doctor said I was too inflamed to get prolotherapy." The only inflammatory diseases for which prolotherapy may be contraindicated are autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosis. Remember, however, that anyone with an autoimmune disease is much more likely than the average person to have poor healing, and thus, to have tendon and ligament injury and chronic pain. If someone with autoimmune disease has an erythrocyte sedimentation rate (ESR) showing their inflammation to be under control, then prolotherapy may be advisable. The advisability of prolotherapy in such cases should be tested by palpation over a tendon or ligament believed to be associated with the pain. Should pain in fact be experienced upon such palpation, the diagnosis of tendon or ligament laxity is tentatively confirmed.

"The doctor said that prolotherapy could not help a herniated disc." The fact of the matter is that almost all vertebral disc herniations can be cured with prolotherapy. The reason this is so may be grasped by studying the anatomy of a vertebral disc, which is composed of (1) a softer, inner portion called the nucleus pulposus and (2) a surrounding ring of ligamentous tissue called the annulus fibrosis. Since a vertebral disc herniation is by definition a breach of the nucleus pulposus through some portion of the (ligamentous) annulus fibrosis, prolotherapy is ideally suited to strengthen the annulus fibrosis and to thereby directly effect healing of a herniated disc. The prolotherapist skilled in the art will augment the just-described direct treatment of a herniated vertebral disc by concomitantly treating the external cause of the typical vertebral disc herniation, with said external cause being such laxity as would exist in the tendons and ligaments forming the supporting structure of the surrounding vertebrae. Prolotherapy is thus able to deftly address the problem of vertebral disc herniation on its primary front, on its secondary front, and without the need for any surgical intervention. 

SUMMARY

Prolotherapy is a treatment that has both been well documented scientifically and that has also well weathered the test of time. As such, the time for its broader application in medical practice is more than ripe.

-

Please note that this piece is derived in significant part from information obtained from http://www.prolonews.com, copyright 1999 2004 by Caring Medical and Rehabilitation Services, Oak Park, Illinois.

Please note further that prolotherapy practioners may be found via http://aaomed.org/page.asp?id=40&name=Find a Doctor


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## comperic2003 (Feb 27, 2008)

OppositesAttract(fa) said:


> Chronic musculoskeletal pain is the number one cause of chronic disability in North America. And back pain alone is the leading cause of disability in Americans under the age of 45.
> 
> Western medicine’s conventional and prevailing model of chronic musculoskeletal pain management relies heavily upon both steroidal and non-steroidal anti-inflammatory drugs, muscle relaxants, bed rest, massage, physical therapy, and chiropractic treatment. More serious cases may be addressed by a full neurological examination, including a myelogram to check for ruptured discs or other sources of pressure on the spinal cord or other nerve structures. And in the most serious cases, surgery is often recommended.
> 
> ...



That is all well and good, but even if Prolotherapy is effective at relieving pain and repairing cartilage damage, in many cases, it still fails to address the cause of the injury. If the injury was induced by traumatic accident, such as a car accident, than Prolotherapy could be an excellent solution. But if the injury is the result of poor mobility or instability of a joint, poor muscular balance, poor soft tissue quality etc., as most chronic joint problems are, Prolotherapy will only address the pain, it will not induce a lifestyle change that will prevent the injury from occurring again. If you drive your car extremely hard and fast, your engine may blow. All Prolotherapy does is repair, or in some cases, replace the engine. Sure, you can drive again, but you are still very likely to blow your engine again because your behavior has not changed.

Do not get me wrong, prolotherapy's potential in managing pain is great, but it will never be able to address the underlying problem. Therefore, I vehemently disagree with your criticisms of massage and physical therapy. Regarding massage, self myofascial release is an enormously effective method in treating a vast array of joint disorders. Most people, including physical therapists and doctors, just don't know about it. Physical therapy and lifestyle and behavioral modifications are the only ways to address the majority of chronic joint pain causative agents (ie pain not resulting from a traumatic accident). Unfortunately, most physical therapists suck and are taught by a broken and dogmatic institution, but excellent ones do exist.


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## comperic2003 (Feb 27, 2008)

For clarification, when I say a traumatic accident, I generally mean things that would injure somebody despite their level fitness and muscular balance. Getting your back crushed by a falling safe is a traumatic accident, having your knee bend the other way from a tackle is a traumatic injury, but rupturing an intervertebral disk while lifting something heavy, or tearing a ligament in your shoulder while throwing a ball, are not traumatic accidents.


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## BigCutieAsshley (Feb 27, 2008)

*So its been a few weeks since I got the memory foam topper. I'm sleeping better and I'm not in as much pain but I'm still not 100% comfortable. I need to find a good (fat friendly) Chiropractor. Anyone have any ideas on how to find a fat friendly Chiropractor or any fat friendly doctor for that matter?

Thanks again for all of your ideas!!*


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## Sandie_Zitkus (Feb 27, 2008)

BigCutieAsshley said:


> *So its been a few weeks since I got the memory foam topper. I'm sleeping better and I'm not in as much pain but I'm still not 100% comfortable. I need to find a good (fat friendly) Chiropractor. Anyone have any ideas on how to find a fat friendly Chiropractor or any fat friendly doctor for that matter?
> 
> Thanks again for all of your ideas!!*




I used to go to a chiropractor in NJ and one in Colorado. I never had a size issue. And I was over 350 both times. They can adjust you while sitting up but since you do not have a big belly like I do I don't see a problem.

I was honest when I spoke to them on the phone (make sure you speak to them not their secretary) and I asked bluntly on the phone:

"Do you have a problem working on large people? I'm a very large woman and I need to know if you would have a problem with my weight."

Honestly, I think my question took them by surprise and they both were very nice and very accomodating. 

Also if you have a choice I recommend trying to find a young Chiro to work with, either a new one in a big practice or a young Chiro out on their own. They have less pre-conceived notions about patients and REALLY want to help you feel better.


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## Red (Feb 29, 2008)

BigCutieAsshley said:


> *So its been a few weeks since I got the memory foam topper. I'm sleeping better and I'm not in as much pain but I'm still not 100% comfortable. I need to find a good (fat friendly) Chiropractor. Anyone have any ideas on how to find a fat friendly Chiropractor or any fat friendly doctor for that matter?
> 
> Thanks again for all of your ideas!!*



I would go with Sandies advice, just ask them out right. They're expensive buggers so it's very important that they know how to work with fat people. It was really on my mind when I first went so I was nervous. He told me to lie flat on the bed and I just laughed saying, dude I can't lie flat, my hips and arse just make it impossible. He just shrugged, said it's not a problem and told me to lie down with my knees up. I wear comfy soft trousers that I keep on and a sports bra, and a lot of the work is done standing up looking into a mirror with him stood behind me moving me around in certain ways. It's interesting stuff. I'm always facinated at the noises he gets out of me. Good luck on your search!


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## ZainTheInsane (Feb 29, 2008)

BigCutieAsshley said:


> *So its been a few weeks since I got the memory foam topper. I'm sleeping better and I'm not in as much pain but I'm still not 100% comfortable. I need to find a good (fat friendly) Chiropractor. Anyone have any ideas on how to find a fat friendly Chiropractor or any fat friendly doctor for that matter?
> 
> Thanks again for all of your ideas!!*



I don't know any fat friendly doctor's besides my old childhood doctor who moved out to Boston...but I do know this a doctor who likes big butts...
He lives in the Tri-State area...I cannot for the life of me remember his name.


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## Jes (Feb 29, 2008)

Risible said:


> Jes, my brother takes or used to take glucosamine/chondroitin, and says it works/worked for him; he urged me to try it. I took it for a couple months, but it did nothing to alleviate my joint pain.


thanks for the reply.


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## SocialbFly (Mar 6, 2008)

Risible said:


> Jes, my brother takes or used to take glucosamine/chondroitin, and says it works/worked for him; he urged me to try it. I took it for a couple months, but it did nothing to alleviate my joint pain.



how much did you take, they say you need to start with 3000mg/day then back down to 1500mg once it starts to help....is this what you did??? often times we dont take enough...i use Dr Weil as a resource for natural supplements...just saying...


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## GrowingBoy (Mar 7, 2008)

A few years back I have had severe lower back pain that generated shooting pains down my legs, and as well as occasional numbness. This made it difficult for me to walk, and as a result I put on a lot of weight (75+ pounds). The doctor blamed the condition on my weight (even though I developed the problem *before* I gained), diagnosed it as a disc that was out of place, and wanted to give me injections followed potentially by surgery. 

Luckily, I ignored him and went to a physical therapist. They diagnosed me with a rotated pelvis and gave me exercises to keep it in place, as well as to strengthen my stomach and back muscles. Within a month I was back on my feet and pain free. 

The lessons I learned are:

a. Weight is *not* the fundamental cause of every back problem. I'm still heavier than I was when I had my first back problem, but now I'm pain free. 

b. Core strengthening/physical therapy can help, and is definitely worth a try before cortisone and/or surgery. 

c. Get a second opinion.


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## rob1974 (Mar 7, 2008)

i have back and shoulder issues and I use something called "true back". All you do is lie down on it on the floor. It realigns the natural curvature of your spine, which will in turn help your hips and lower back as well. Look into it but check with your doctor before using it because i am not a doctor and would not want to recommend anything without your doctors approval. it helped me a great deal though.

http://www.trueback.com/

:smitten:


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## Risible (Mar 8, 2008)

SocialbFly said:


> how much did you take, they say you need to start with 3000mg/day then back down to 1500mg once it starts to help....is this what you did??? often times we dont take enough...i use Dr Weil as a resource for natural supplements...just saying...



Ooops, just saw this - Let's see, it was a few years ago, and I recall that I did some internet research, comparison shopped and, after buying a product, took the recommended dose, no more, no less. I was doing the medical transcription work at the time and was reading medical reports of people taking the stuff. Some of the doctors (Kaiser) were of the opinion that yes, it works; some were no, it doesn't work; some were maybe, there's no proof that it does or doesn't work, try it and see. None of them mentioned mega-dosing, or I would have tried that (where were you at the time, probably being a social butterfly elsewhere ).

I'm gonna check out Dr. Weil. I've been wanting to get some fish oil supplement and some good vitamins.


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## SocialbFly (Mar 9, 2008)

Risible said:


> Ooops, just saw this - Let's see, it was a few years ago, and I recall that I did some internet research, comparison shopped and, after buying a product, took the recommended dose, no more, no less. I was doing the medical transcription work at the time and was reading medical reports of people taking the stuff. Some of the doctors (Kaiser) were of the opinion that yes, it works; some were no, it doesn't work; some were maybe, there's no proof that it does or doesn't work, try it and see. None of them mentioned mega-dosing, or I would have tried that (where were you at the time, probably being a social butterfly elsewhere ).
> 
> I'm gonna check out Dr. Weil. I've been wanting to get some fish oil supplement and some good vitamins.



I have a trick too for not getting the burp back from fish oil caps...my sister told me, and it works! put them in the fridge, then take them cold...walllllahhhh, no more fish back blech.....


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## AlethaBBW (Mar 10, 2008)

BigCutieAsshley said:


> *So its been a few weeks since I got the memory foam topper. I'm sleeping better and I'm not in as much pain but I'm still not 100% comfortable. I need to find a good (fat friendly) Chiropractor. Anyone have any ideas on how to find a fat friendly Chiropractor or any fat friendly doctor for that matter?
> 
> Thanks again for all of your ideas!!*



I found my fat-friendly ob-gyn through this site:

http://www.cat-and-dragon.com/stef/fat/ffp.html

I'm in TX, so I didn't look through the NJ listings, but I hope it helps someone out there to find good medical care.


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## Tracy (Mar 10, 2008)

BigCutieAshley, How much water do you drink during the day? I was having the same problem and did a little research. What I have found if I drink the appropriate amount of water that my body needs to function properly then my pain goes away. Studies have shown if you take your current body weight and divide it by 2 that the number that you get is the ounces of water that you should be drinking per day (I drink 5- 32oz. bottles of water a day). I have been doing this for the past 3 weeks and in all honesty I feel so much better. My knees don't hurt, the water helps with my appetite and I have actually lost 13lbs. I am feeling so much better. I think maybe you should do some research on this. Just sharing my opinion.  Tracy


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## Neen (Mar 21, 2008)

I second the water thing. I have terrible lower back problems, and on days i drink enough water.. (about 114 oz a day for me) i really feel great. I honestly, never put the two together until just now..:doh:


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## matt82 (Mar 22, 2008)

i hope you get some relief but don't keep taking tylenol, it kills your liver


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## lypeaches (Apr 10, 2008)

Just FYI...I have a similar problem...sciata in my right hip, making sleeping, and rising very painful at times. Last couple nights I tried sleeping with a heating pad under my hip ( I'm a side sleeper) and both mornings I've gotten up with vastly reduced pain and stiffness. Big improvement.


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## Miss Vickie (Apr 10, 2008)

lypeaches said:


> Just FYI...I have a similar problem...sciata in my right hip, making sleeping, and rising very painful at times. Last couple nights I tried sleeping with a heating pad under my hip ( I'm a side sleeper) and both mornings I've gotten up with vastly reduced pain and stiffness. Big improvement.



That's a good idea, too, peaches. My chiro always tells me not to use heat because it can increase inflammation but it feels so damn good, how can it be wrong?  BTW, is it me or are heating pads not nearly as hot as they used to be? It seems like they're WAY cooler than they once were, despite my trying several brands and types; I'm sure it's a safety thing but I sure do miss those high settings.


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## lypeaches (Apr 10, 2008)

It's not just you. Damn you safety regulations...lol. *shaking my fist*

At any rate, I don't think I'll do this all the time, but it's nice to know that it is effective, for me at least. I'm not real comfortable with concept of sleeping on top of electric currents...but I'm a little crazy like that


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## Miss Vickie (Apr 10, 2008)

lypeaches said:


> It's not just you. Damn you safety regulations...lol. *shaking my fist*



Oh, good. Burtimus thinks I'm crazy (so what else is new?) but I swear they're not as hot as they used to be.



> At any rate, I don't think I'll do this all the time, but it's nice to know that it is effective, for me at least. I'm not real comfortable with concept of sleeping on top of electric currents...but I'm a little crazy like that



Then let me join you in the crazy box because I'm the same way. That's the reason we don't have an electric blanket, despite the fact that I live in the friggin' Arctic. I'm much more of a flannel sheets, and piled on down comforters kind of gal. But I do loves me a heating pad from time to time.


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## AnnaO (Jun 7, 2008)

Thought I'd be a brave new poster and bump this thread because I think it's an important thread. Do not let health care professionals (doctor, chiropractor, physical therapist, etc) blame everything on your weight or make it sound like the only option you have is to lose weight. I have had a problem with pain since I was 95lbs because of being in a car accident and being a one time athlete. My 190lbs have little to do with my pain now. I can't say the weight helps, but losing weight will not solve the problem. Find a health care professional who will listen to you and not just jump to conclusions. If you have not gained a significant amount of weight in a short time and you weren't in pain before, it is probably not the weight.

I don't have any new suggestions. I do know that nothing works for everyone. Here are some of the things that I do.

* Memory foam mattress pad and pillow
* Pillow between my knees and my back (I used to sleep on my stomach but when my neck was injured in the accident I had to really work hard to change my position)
* Glucosamine, Chondroitin and MSM (It works wonders on me but it doesn't work for everyone. Some people see zero results but if it works for you it is wonderful)
* Chiropractor (My chiropractor is a BHM himself. I go to him rarely now. In the beginning I was in his office every few days, and if I have a flair up in pain I visit more frequently)
* Stretches and Flexing Exercises that I learned from the physical therapist after the accident and my chiropractor
* good bra (it really does help if you have more than a handful)
* Ibuprofen like Advil (It works for me. For flair ups, it is necessary. Taking it like a vitamin is not the answer but finding which OTC painkiller helps is important)
* good shoes (helps with the pain in my lower body joints)

Doctors hate to hear this, exercise doesn't seem to help. I don't notice a significant change in pain. Gentle stretching exercises seem to work for me. Sometimes even a water aerobics session can actually cause pain, for me. That's just me though. I know many people for whom exercise is key to keeping their pain under control.

BigCutieAsshley, and anyone else in pain, there are answers and pain management is possible. Good luck


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