Chronic Pain and PTSD

Chronic Pain and PTSD

Chronic pain is an expensive health condition and a leading cause of non-fatal disability worldwide. Many people with chronic pain have PTSD owing to trauma-related suffering, but PTSD is also a prevalent cause of chronic pain. Understanding this comorbidity may help treat both conditions.

Understanding the Overlap

PTSD prevalence estimates in chronic pain patients vary due to sampling and assessment methods. Many research rely on PTSD screening questionnaires to determine prevalence rates.

Two recent systematic evaluations found 11.7% to 19.1% PTSD prevalence in clinical pain groups, with considerable subgroup heterogeneity. Similarly, 80% of PTSD sufferers report chronic pain symptoms.

Chronic pain problems were frequent among PTSD refugees in a recent review. Almost all study participants complained about this.

Several studies have demonstrated that higher levels of PTSD symptomatology in chronic pain patients are related with higher levels of pain, disability, and psychological distress, suggesting the potential that the illnesses may negatively influence one another.

Why the Overlap?

PTSD and pain coexist for unknown reasons. These have generally focused on common, predisposing vulnerabilities or how the circumstances may interact.

Common Flaws

Anxiety sensitivity may intensify the initial emotional response to a stressful incident, raising the chance of developing either illness. Other biological and psychological weaknesses, such as a lowered physiological threshold for alarm responses, have been postulated.

Vulnerabilities and traumatic event circumstances alter emotional responses and generate cognitive bias, hypervigilance, avoidance behavior, autonomic responses, and muscular responsivity. Several vulnerabilities and mechanisms may increase the risk of comorbidity after trauma.

The Mutual Maintenance Model

Chronic pain and PTSD maintain and enhance each other through 7 pathways, says this model. Attentional and reasoning biases toward potentially threatening stimuli and catastrophizing may lead to heightened expectations, overestimations, and negative interpretations of pain- and fear-evoking stimuli.

Pain can trigger dread, PTSD, and hyperarousal, and vice versa. Avoidant coping methods, depressive symptoms, and weariness may lead to deconditioning, inactivity, and impairment, inhibiting fear extinction. PTSD anxiety can affect pain perception. Both diseases are characterized by cognitive overload, which limits coping abilities.

Dysfunctional cognitions, intrusive symptoms, hyperarousal, avoidance, and inaction fuel each other. The paradigm proposes that hyperarousal can cause or aggravate discomfort, leading to fear-avoidance and inactivity.

Fear-learning deficits and reduced capacity to suppress fear in PTSD may contribute to increased pain perception, pain sensitivity, and fear responses to painful stimuli, according to Jenewein and colleagues.

This notion draws on classical fear conditioning theory, which says fear-learning deficits over-associate pain cues and inhibit adaptive safety learning. Incorrect interpretations of symptoms can reinforce and catastrophize. Anxiety-related stress can also cause discomfort.

Pain Sensitivity and PTSD

Experimental investigations indicate increased, decreased, and unaffected pain perception with PTSD.

Distinct pain profiles may be linked to different PTSD symptoms and coping techniques. Hyperarousal is linked to greater pain perception in PTSD, but detachment decreases it. Trauma type may also alter how PTSD affects pain sensitization. Accident-related PTSD was associated with lower pain thresholds than combat-related PTSD.

Dissociation and derealization have different coping techniques. Dissociation reduces conscious attention to physical sensations and incoming stimuli like pain, but worry and frightened evaluations may increase attention to painful stimuli and lower pain threshold.

Accident-related trauma seems to cause an apprehensive and sensitizing reaction, while combat-related trauma may cause a dissociative and habituative response. Experimental investigations can identify variations in pain processing, but subjective pain reporting indicates a more severe symptom profile when PTSD and pain persist.

Complex molecular causes include the hypothalamic-pituitary-adrenal axis, inflammation, immune system suppression, and weariness.

Complex interpersonal traumas, such as physical and mental abuse from war or sexual assault, can harm the ability to trust others, resulting in attachment concerns that increase the likelihood of long-term misery.

Possible Interventions for Managing Chronic Pain

These comorbid cases require biopsychosocial interventions. Few randomized controlled studies target comorbid PTSD and pain, making it difficult to propose therapy. Although each ailment has evidence-based therapies, it’s still debatable whether they should be treated sequentially, in parallel, or with an integrated intervention.

If a sequential method is chosen, which disorder should be treated first? First, treat the primary disorder. Untreated disorders can worsen each other, and it’s not always clear which is main, especially if they occurred simultaneously.

Parallel approaches provide complications. Collaboration and treatment planning might be tough with multiple physicians. Each disorder’s specialists must ensure the patient can afford both therapies. An integrated intervention may solve some of these obstacles, but there are no clear standards.

Evidence suggests using cognitive behavior therapy (CBT) to treat PTSD and chronic pain. However, not all sizes fit.

Consider the trauma’s intricacy. Accident-related trauma (in which the primary symptoms may be musculoskeletal pain with elevated levels of arousal, catastrophizing, and pain-related fear avoidance beliefs) may be treated with psychologically informed physiotherapy or cognitive behavioral therapy focused on pain management and exposure to feared activities.

Physiotherapist-led stress inoculation training mixed with physiotherapeutic exercise has been found to reduce pain-related impairment compared to exercises alone. Complex interpersonal traumas or chronic pain and PTSD that have endured for years may require specialized treatment for both. First, recognize the co-occurrence of pain and PTSD and examine both illnesses.

Comorbid conditions might further complicate pain and PTSD assessment and therapy. Many studies on PTSD and pain are undertaken in military samples, who are at heightened risk of traumatic brain injuries (TBI). Some accidents exhibit this pattern. Some studies demonstrate that veterans with TBI and PTSD experience higher pain than those with either condition alone.

Despite TBI, chronic pain and PTSD are linked to suicide and aggressive thoughts in veterans. While this trio is understudied, narrative reviews and therapy reflections exist.

Summary

We hope this post has shed light on the intricacy of chronic pain and PTSD and inspired some readers to learn more for the benefit of patients. While visiting patients with chronic pain or PTSD, physicians should be cautious of symptom overlap when screening for PTSD in chronic pain.

Treatment strategy requires knowing the nature of the traumatic experience. If pain and PTSD are related to the same traumatic incident, integrated or parallel treatment may be appropriate. Complex PTSD owing to interpersonal trauma or events years ago may require trauma-focused care.

Finally

For more information on chronic pain management, pain disorders, chronic pain resources, psychogenic pain, effective chronic pain treatment options or other physical therapy, you should book a consultation session with a specialist at Chronic Therapy today, to give you professional advice that will suit your personal experience.

Also, for people with chronic pain who are constantly worried on how to treat chronic pain or get their chronic pain treated, our specialist at Chronic Therapy have made huge success over the year in recommending reliable resources to manage chronic pain from nerve pain or any other developing chronic pain conditions.

Related: Relieving Chronic Pain Without Drugs

Relieving Chronic Pain Without Drugs

Relieving Chronic Pain Without Drugs

Many people dislike taking pain pills routinely. Many pain relievers aren’t pills. Vioxx only came out in 1999, but arthritis, menstrual cramps, post-surgery pain, and other aches and pains have been there far longer.

This article discusses a few common options. Many additional pain alleviation methods exist. Still, it’d be wise to consult your doctor before adopting pain relief methods. Even nonpharmaceutical interventions might be unsafe or ineffective. Your medical condition and history must be examined before therapy.

No resources are perfect chronic pain treatments. Not all pain is relieved and everyone’s different. You may need to mix many pain-relieving treatments before getting relief. There are dangers and adverse effects with any medication.

Physical Therapy Relieves Pain

Physical therapists teach self-management, according to the APTA. Therapists help arthritis patients manage daily discomfort. They teach clients how to build strength, enhance range of motion, and prevent arthritic flare-ups.

Physical therapy isn’t a cure-all. Many sees immune-modulating medications as a first choice for treating severe rheumatoid arthritis, which can chop 10 to 15 years off life.

Untreated edema might aggravate osteoarthritis in people. Physical therapy reduces inflammation to a certain amount, but medicine makes the most dramatic alterations, adds Wilson.

First, find out if your health plan covers physical therapist appointments. Next, find a state-licensed professional. Find a therapist experienced with your illness.

Acupuncture for Chronic Pain Relief

Ancient acupuncture uses needles to relieve pain. Acupuncture began in ancient China. Traditional acupuncture involves piercing the skin in precise spots to increase energy flow. Western experts assume the practice may encourage the release of pain-relieving or healing hormones.

The NIH has financed acupuncture studies on arthritis, inflammation, and chronic pain. Until studies can specify how acupuncture relieves pain, doctors like Wilson say patient faith is key.

It can work for everyone, but it will work for those who believe in it. Many therapy procedures are effective because patients believe in them. People who don’t think they’ll get better are less likely to recover.

Relieving Chronic Pain Without Drugs

Acupuncture isn’t suggested for persons on blood thinners or with bleeding disorders. Infection, organ puncture, mild bleeding, and broken or forgotten needles are risks of the operation.

Stress Management is an Excellent Pain Reliever

The fact is, the brain rules pain. You can’t have pain without a brain to comprehend it. This organ helps people interpret unpleasant sensations and assess their severity. Psychological factors can alter how people perceive stimuli, react to them, and interact with their reality.

Stress worsens pain perception. Tensed muscles can irritate already fragile tissues when people are upset. Emotionally, pressure may intensify pain. Emotional arousal or tension may make them see their situation as more difficult and make them avoid particular activities.

Experts suggest changing the stressor to reduce pressure. If you always argue with your partner, try communicating instead. If you can’t change the cause of anxiety, distract yourself with friends, a movie, or music. Pleasure can distract from suffering.

Unwinding is another method. Deep breathing, PMR, meditation, visualization, massage, yoga, and Tai Chi are relaxation techniques. These methods work. Some people find stress alleviation by attending support groups or seeking individual counseling.

Generally, these stress-management tactics work. Not everyone can use every technique. People have different approaches. Going to support groups reduces pain and improves physical and emotional functioning, for example. A person who won’t talk about their illness isn’t suited for a support group.

Relieving Chronic Pain Without Drugs

Exercise to Reduce Pain

Because movement hurts, many in pain avoid exercising. Inactivity may worsen their health. That is because the human body was created to be in motion. Thus, an inactive body degenerate.

Muscle degeneration can cause bone loss, melancholy, and heart weakness. Regular exercise keeps joints flexible and strong, reducing arthritic discomfort. Physical activity releases mood-enhancing hormones that reduce pain perception.

Arthritis patients should do three exercises. Flexibility workouts increase range of motion through stretches. Walking, water exercises, and cycling are cardio workouts. Strength conditioning uses isometric or isotonic exercises.

Isometric exercises utilize resistance without joint movement. By pressing your hands on the wall, you work out your chest muscle. Isotonic workouts involve entire motion. Bicep curls and leg extensions are included.

For less discomfort and fewer injuries, use proper form. Not everyone should exercise. There are always alternative workout possibilities. Consult your doctor and a fitness professional before starting a program.

Improve Your Diet to Fight Pain

Losing weight may lessen pain risk. If you’re overweight and deconditioned, your joints take a tremendous impact. Regular exercise and a healthy diet are proven weight loss measures.

Underweight, poor food, and inactivity might worsen discomfort. In that state, your hormone levels are off. Hormones assist the body fight pains and activate its healing processes.

Experts opine that pain-relief vegetarianism is unnecessary. Rather, they recommend minimizing animal protein and saturated fat and eating more omega-3s, antioxidants, vitamins, and minerals from healthy grains and organic foods. Steroid hormones and preservatives may suppress the immune system.

Pain-Relieving Supplements

Chondroitin sulfate and glucosamine may reduce osteoarthritis pain. Long-term safety and effectiveness need more study.

Headache, motor unease, exhilaration, hives, rash, photosensitivity, hair loss, and breathing difficulty are unusual side effects of chondroitin. People with bleeding disorders or taking blood thinners should not use the supplement.

Glucosamine causes upset stomach, tiredness, sleeplessness, headache, skin responses, and sun sensitivity. Some glucosamine products are produced with shellfish, which can trigger allergic reactions.

Bio-Electric Therapy

Bioelectric therapy may help arthritic patients. People with chronic muscle pains benefit from bioelectric therapy, noting that others with joint inflammation, such as rheumatoid arthritis, may not.

Bioelectric therapy uses electric current to distract the brain from pain. The therapy overloads the brain with feelings to distract from pain.

Bioelectric therapy may cause discomfort and redness. This technique isn’t indicated for persons with pacemakers, pregnancies, blood clots in the arms and legs, or bacterial infections.

A Completely Healthy lifestyle

Your doctor may recommend combining nonmedical and medical treatments. Don’t dismiss drugs. Pain relief should not only relieve discomfort, but also keep you alive and healthy.

Eating well, sleeping enough, exercising, and controlling stress are the easiest ways to relieve pain. Pain treatment is just healthy living, we suffer if we don’t live and pay attention. 

Finally

For more information on chronic pain management, pain disorders, chronic pain resources, psychogenic pain, effective chronic pain treatment options or other physical therapy, you should book a consultation session with a specialist at Chronic Therapy today, to give you professional advice that will suit your personal experience.

Also, for people with chronic pain who are constantly worried on how to treat chronic pain or get their chronic pain treated, our specialist at Chronic Therapy have made huge success over the year in recommending reliable resources to manage chronic pain from nerve pain or any other developing chronic pain conditions.

More to read: Chronic Pain and PTSD

Excessive Sweating - Complete Guide to Causes, Treatments & Diagnosis

Excessive Sweating Treatments

There are various oral medications available known to be prescribed by some doctors to help treat hyperhidrosis.

Ditropan, Robinul, Probanthine
All these oral medications are from the same family of drugs. They have an anti cholinergic effect which in essence blocks the neuro transmission responsible for the production of sweat. All of these medications are not specifically for hyperhidrosis but have been known to have the side effect of dryness. Among other side effects they can cause blurry vision, dry mouth, etc. The success rate is known to be very limited.

Other oral medications people use are mild sedatives for example Xanax. This is a very non specific medication that sometimes reduces the sympathetic overtone. Another type of medications being used is a group of medications known as beta blockers. Those medications are being used in the treatment of certain cardiac problems such as hypertension. They may also have some sedative effect on the adrenergic system which plays a role in the production of excessive hand sweating/palmar hyperhidrosis.

More to read: Chronic Pain and PTSD

Foot Sweating / Plantar Hyperhidrosis

Foot Sweating / Plantar Hyperhidrosis

Foot sweating or as its known in the medical literature as plantar hyperhidrosis is also a part of the focal excessive sweating syndrome. It may not have the same social impact on the patient as hand sweating but can be very bothersome to people. Over the last few years when more follow-up on patients who had ETS done it became obvious that excessive foot sweating (plantar hyperhidrosis) can pose the same social and functional difficulties that patients have with excessive hand sweating. Stories like severe embarrassment from the smell, necessity to change shoes and socks constantly are being heard more often.

Lumbar Sympathectomy:
Now lumbar sympathectomy is offered as a surgical solution for those cases with severe plantar hyperhidrosis or plantar foot sweating. Recent evidence from different centers in the world showed that this operation is very effective to treat excessive foot sweating. This operation is done separately from the Thoracic Sympathectomy but necesitates an overnight stay. At present a good percentage of patients have the procedure done on an outpatient basis.

New Information on Lumbar Sympathectomy:
The operation is done endoscopically or in the open fashion. When it is done endoscopically then there are three small cuts made in each flank and obviously attempts should always be done to perform it this way. In cases of technical difficulties it can be done in an open fashion through one incision and the difference in the amount of pain is minimal. Also the cosmetic results from the open approach are very well accepted due to the fact that those single incisions on each side are still small.

One of the only doctors known to do this new approach in the U.S. is Dr. Reisfeld.

With regard to the male population so far the information that was obtained from clinical cases is that if the sympathectomy is done below L2 then retrograde ejaculation should not be a problem.

Sweaty feet as the sole presentation of hyperhidrosis appears in less than 5% of the patients. The majority of the patients will also have sweaty hands and this is the reason why it’s an added benefit when sympathectomy is done for the hands. As more time is gained more and more patients with only foot sweating (plantar) are coming for lumbar sympathectomy as their initial operation.

The Success Rates for Different Types of Procedures:
ETS is very successful for those suffering from focal palmar hyperhidrosis. With ETS those who also suffer from plantar hyperhidrosis (sweaty feet) the success rate is very low. For those patients with remaining plantar hyperhidrosis the lumbar sympathectomy is now offered with a great deal of success. This is also true for people who suffer from isolated plantar hyperhidrosis and never had ETS done.

Additional Foot Sweating Resources:

  • Foot Sweating – Leading Los Angeles Surgeon Dr. Reisfeld and The Center for Hyperhidrosis. The only known doctor to perform both the ETS (hand sweating) and ELS (foot sweating) procedures.
  • Foot Sweating Treatment – Learn about the surgical treatment for foot sweating.

More to read: Relieving Chronic Pain Without Drugs

Excessive Sweating Resource

Excessive Sweating Resource

Antiperspirants:
A commercial preparation(s) that are available over the counter in order to help with normal (physiological) armpit sweating. There is a huge variety and each individual can choose the best antiperspirant for him/her. For severe armpit sweating there are some medicated antiperspirants such as drysol.

Apocrine gland:
There are two types of sweat glands, eccrine and apocrine. The apocrine glands are located in the groins armpit areas and also in the facial regions. They are secreting more oily secretion rather the watery type of sweat. The apocrine glands are not usually affected by sympathectomy.

Axillary Sweating:
A physiological mechanism which secretes sweat under normal conditions. Hot weather and anxiety conditions might increase the amount of sweating. Physical activity is known to increase armpit sweating. A small percentage of the population is affected by severe armpit sweating that can cause discomfort as well as embarrassment. This can be treated by extra strong antiperspirants or surgery.

Botox:
Botox is the commercial name given to a toxin which is produced from botulism toxin. See our botox page

Bromhidrosis:
This is another medical term used to describe excessive axillary sweating which is dark in color as producing odor.

Clipping:
Clipping or clamping is the medical term used to describe one of the methods of doing sympahtectomy. Here titanium clips are applied on the nerve to block the transmission of nerve impulses. Unlike the cutting method in which the sympathetic chain is destroyed with electrocautery or with the harmonic scalpal the clamping/clipping method gives a possibility of reversal by removing those clips.

Compensatory Sweating (CS):
A medical term used to describe sweating on parts of the body that otherwise would not sweat so much. Compensatory sweating is one of the side affects of sympathectomy and affects most or all patients. Most of the patients will describe it as mild to moderate and in about 5% it will be described as severe.

Cutting:
A term used in sympathectomy surgery where the nerve is destroyed by electrocautery, harmonic scalpal, or excising a segment of the nerve.

Drionic:
A commercial name given to an iontophoresis machine in which low voltage electric currents are running through the skin. This process is said to disrupt the function of the sweat glands. The machine has to be used on a regular basis and some patients report success. There are special drionic machines for the palms, armpits, and feet. See drionic our page

Drysol:
A commercial preparation made of aluminum chloride in alcohol that is used for the treatement of moderate to severe armpit sweating. This can be obtained in the pharmacy and should be applied to affected skin site when dry usually at night. The alluminum component acts by plugging the sweat pores. Side affects are rashes or a possible burning sensation of the skin. Drysol can be found at your local pharmacy or at Drugstore.com

Eccrine Gland:
Eccrine is a type of sweat gland that produces watery sweat. Usually this type of sweat has no smell to it. It is affected by sympathectomy. Our bodies have millions of these glands which are concentrated in the palms of the hands as well as the plantar surfaces.

Electrocautery:
A term used by surgeons to describe a way to destroy or coagulate blood vessels or tissue. There is monopolar and bipolar instruments and in essense they are producing the same effect.

Endoscopic:
A medical term used to describe a surgical procedure done with the help of optical instruments. Endoscopy means to look inside and endoscopic surgery relates to surgical procedures done through small cuts avoiding tissue damage and enable quick recovery.

Erythrophobia:
Also known as social phobia. In these cases the person reacts with severe facial blushing (redness) to an otherwise harmless social interaction. Patients complain that a mild social situation can cause their face to become red and in return it affects social performance. Patients complain also that this reaction prevents them from being engaged in normal social activity and it also impeeds their progress at the work environment.

ETS – Endoscopic Thoracic Sympathectomy:
A medical term used to describe a surgical procedure in which the sympathetic chain is being destroyed, cut or clamped. In the past sympathectomy used to be done through different open methods which were associated with a long term morbitity (pain, discomfort, scar, loss of time from work)

Flushing:
This is a subjective feeling that some patients describe when they talk about heat sensation in their head area. Many times this is being confused with blushing which is redness of the face. Flushing is not an indication for sympathectomy since its a mere subjective feeling without any physical manifestation.

Ganglia:
A mass of nerve tissue or a group of nerve cell bodies. In sympathectomy terms it relates to the place over the ribs where connections from one sympathetic cell to another are being made.

Gustatory Sweating:
One of the side affects that patients can develop after sympathectomy. Here there will be appearance of facial sweating after eating sour or spicy foods. This affects about 15% of the patients who have had the ETS procedure. The majority of those are on a mild to moderate level.

Hemothorax: A medical term used to describe a situation where there is free blood within the chest cavity. This can happen either in trauma or during an operation. Usually the insertion of a chest tube takes care of this problem. In massive cases of bleeding opening of the chest cavity is needed.

Horner Syndrome:
Horner’s syndrome is one of the complications that can result from sympathectomy. When the sympathectomy was done in the open technique it used to happen more than at present time when sympathectomy is being done endoscopically. When sympathectomy is done endoscopically the rate of these complications should be less than .1%

The horner’s syndrome is characterized by mild drooping of the upper eye lid (ptosis), narrowing of the pupil (myosis), and mild dryness of the eyeball. Again this is a very rare possibility to have happen.

Why it happens:
If the sympathectomy is carried out to a higher level (T1) then the stellate ganglion can be damaged resulting in horner’s syndrome.

Hyperhidrosis
Excessive perspiration in the face, hands, and feet defined as sweat that exceeds what is necessary to regulate the bodies temperature.

Hyperhidrosis Surgery
Hyperhidrosis Doctor Rafael Reisfeld provides a detailed site relating to the ETS surgery with the only full explanation of the surgery we have seen.

Kuntz Nerve:
In the twenties sympathectomies were done for vascular problems of the hands. In those instances there was a high failure rate. Doctor A Kuntz tried to find the reason for this high failure rate. He found a nerve which was going within the spinal canal and he blamed that nerve for the failure. This nerve was only found in cats. Somehow this name found its way to the sympathectomy literature and is blamed for failures or recurances in cases when sympathectomy is done for hyperhidrosis.

Lumbar Sympathectomy
Lumbar Sympathectomy can be done now for patients who suffer from severe plantar hyperhidrosis (Excessive Foot Sweating). This can present either as a primary problem or in those patients where the thoracic sympathectomy did not help for the feet problem. The operation can be performed endoscopically or with the open method which basically give the same results, very short hospital stay (1 day) and good cosmetic results. The fear from retrograde ejaculation in the male population was shown to be not of a major concern as long as the sympathectomy is performed below level L2.

Neurotransmitters:
A chemical structure within the body that is secreted upon certain nerve stimuli and acts as a catalyst to the next step in any biochemical or nerve action.

Nerve Graft:
A medical term used in cases where nerves are severed accidentally or cut intentionally and then a nerve graft is applied between the missing segment. In the sympathectomy literature this term is used to describe a procedure where a nerve graft is taken from the ankle region to replace the missing sympathetic trunk in those cases where the sympathetic trunk was cut or destroyed. This is relatively a new procedure and final data are still yet to come.

Palmar Hyperhidrosis:
Also known as excessive sweating of the hands. The pathology here lies with an overactive sympathetic segment located in the upper chest cavity. The term of hypersympathetic activity can also be applied because in many occations it is associated also with rapid heart rate, anxiety etc. For treatments available click here.

Parasympathetic:
The nervous system has two major components, voluntary and involuntary. The voluntary composed of somatic nerves (sensory or motoric nerves) and the involuntary is made of the sympathetic and the parasympathetic system. The sympathetic and the parasympathetic system is also called the autonomous nervous system.

Perspiration:
A physiological mechanism in which the body regulates heat exchange. Here sweat is produced and by evaportation there is loss of heat causing cooling of the body surfaces.

Plantar Sweating:
The same process as in palmar sweating but here there is excessive sweating in the feet. Usually it comes together with palmar hyperhidrosis in about 85% of the cases. Many cases treated by sympathectomy will also report reduction of plantar sweating. Now lumbar sympathectomy is offered as a surgical solution for those cases with severe plantar hyperhidrosis or plantar foot sweating. Recent evidence from different centers in the world showed that this operation is very effective to treat excessive foot sweating. This operation can be done separately from the Thoracic Sympathectomy but necesitates somewhat longer hospitalization, possibly 1 to 2 days.

Pneumothorax:
A medical term used to denote the presense of air within the chest cavity, in between the lung and the chest wall. Can happen in traumatic cases (knives bullets or broken ribs) or can happen during an operation when the lung is injured. Most of the time it can be treated with a chest tube.

Robinul
A medication which has an anticholinergic action. Acetylcholine is a neurotransmiter that stimulates the sweat glands. Robinol can help in mild cases of palmar hyperhidrosis.

Rosacea:
A pathological skin condition in which the texture and the quality of the facial skin is damaged due to problems with broken blood vessels in the facial area. Can range from mild to severe. For more information see Dr. Nase’s website.

Sympathetic:
A part of the autonomous nervous system. This is made of sympathetic cells originating in the spinal cord and forming a chain ganglia connected to eachother and runs within the chest cavity on top of the ribs. To learn more about Endoscopic Thoracic Sympathectomy click here.

T2 T3 T4 levels:
Used by ETS surgeons to denote the level of the sympathetic chain that is being cut, coagulated, or clipped. T2 stands for second rib level, T3 for third rib level etc.

Titanium Clips:
Small titanium clips or clamps applied on blood vessels or nerves in order to stop bleeding or cease nerve stimuli. Titanium clips are made of a inert material that does not cause infection or alergic reaction. Also the small size prevents interference in certain x-ray examination.

Related: Excessive Sweating Treatments

Hand Sweating / Sweaty Palms

Hand Sweating / Sweaty Palms

Excessive hand sweating or as its known as palmar hyperhidrosis is the most common form of excessive sweating. Those who suffer from it start having the symptoms at a young age usually grade school. Its intensity can vary among people. It does have a genetic relation and about 50% of the patients have a family history with the condition. Recently the exact genetic location was found but a practical treatment with these new findings is still a long ways off. It can affect a person on a functional, emotional, and social level.

This condition is primarily a physiological issue but it can be agravated by emotional stimuli. Physiological meaning that the person can not control the level of sweating or timing of it. Attempts to control this condition are numerous and they range from lotions, pills, herbal medications, bio feedback, electric currents (iontophoresis), accupuncture, to surgery (See Navigation Bar On The Left). It should be emphasized that patients who suffer from severe excessive hand sweating should try at least some of the conservative approaches before any decision is made to go ahead with surgery.

In the past surgery meant a very extensive and invasive approach to get to the sympathetic nervous system located in the chest cavity. This particular fact prevented the operation to be done on a large scale. The improvements in the surgical approach (endoscopic surgery) and the surge of information available on the Internet have made it easier for patients to know, learn, and receive surgical treatment.

It is common now a days that the endoscopic thoracic sympathectomy (ETS) is performed on a outpatient basis which means the operation is carried out in a relatively short period of time and the patient can go home or to their hotel a few hours later. Also the amount of pain and discomfort is limited. Most of the patients can go back to their normal life (work, school, etc) within a very short time.

Additional Hand Sweating Resources:

  • Sweaty Palms – Leading Los Angeles Surgeon Dr. Reisfeld and The Center for Hyperhidrosis.
  • Sweaty Hands Treatment – Learn about the surgical treatment for hand sweating.

Related: Foot Sweating / Plantar Hyperhidrosis