Category Archives: Pain management

Toothache symptoms and Root Canal Treatment

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Most of us have experienced some form of toothache, and some time in a very excruciating way.
But what are the main causes and what is the right treatment?

When a tooth is decayed, the vital part of it, called dental pulp, becomes inflamed. The level of inflammation depends on how deeply the caries has advanced into the tooth. A superficial cavity causes minor symptoms, such us increased sensitivity to hot, cold and sweet stuff. It is important not to underestimate this mild discomfort, which is a sign of an initial pathology of the dental pulp: a reversible pulpitis. Most of the times a simple filling will resolve the problem. If left untreated the process progresses toward the next stage, the irreversible pulpitis. Here the real trouble starts: toothache, throbbing pain, not well localized, often unbearable. It is due to a dramatic increase of the blood pressure into the dental pulp, a final attempt of the body to get rid of the bacteria, recruiting all the immune system defenses in the affected area. Unfortunately the tooth is like a rigid box and cannot expand. The increased amount of blood compresses the nervous fibres that are part of the dental pulp itself. At this stage the dental pulp cannot be saved but needs to be eradicated trough a procedure that we call  ROOT CANAL TREATMENT. The first step, often performed as an emergency, includes getting the tooth numb, accessing the deepest part where the vital tissue is located, and removing the fraction that is easily accessible. The tedious part is what gives the name to the procedure: removing the tiny pieces of tissue that are inside each root.

If Root canal is not performed, the dental pulp eventually dies, but this infected tissue harbour a lot of bacteria and toxins that gradually tend come out of the roots and colonize the surrounding bone. At a one point they can trigger another acute conditions, a periapical abscess, with severe symptoms and pus formation in the bone. Usually we have no sensitivity to cold or hot but a well localized tenderness to pressure on the affected tooth, and various degree of toothache. When the pus find a way out of the bone in the soft tissue, we can notice the typical swollen gum, or swollen face, according to the tooth involved and patient anatomy. Again a Root Canal Treatment is the therapy of choice.

It is important to look for the advice of a dentist as soon as possible in presence of even minor symptoms, or even better to get regular check ups in absence of problems, to identify possible trouble at an early stage.

Back or neck pain: Osteopath or Chropractor?

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Due to the very high number of hours we all spend in sedentary activities, and the increasing level of daily stress we have to cope with, the health issues related to back and neck pain are becoming epidemic. After an initial short term fix based on regular use/abuse of painkillers and anti inflammatory drugs, most patients start searching for a more durable approach at treating what are often chronic conditions. Invariably they end up visiting a Chiropractor or an Osteopath, with no clear idea of what is the difference and who suits them best.

Here are few hints about differences and common grounds.

Both disciplines require a degree level qualification and are regulated. In UK Osteopathy and Chiropractic are both governed by their own act of parliament and each have their own regulatory body – General Osteopathic Council (GOC) or General Chiropractic Council (GCC).
Both treat musculo-skeletal/biomechanical problems (i.e. backs, necks, feet, hips, knees etc) and the underlying causes. This requires thorough evaluation of the whole skeletal frame and it’s posture, using orthopaedic and neurological examination skills, similar to those of traditional medical practitioners. Both osteopaths and chiropractors use manual medicine to treat a person. This means they will use predominantly hands-on techniques or external electrical therapeutic machines like ultrasound, interferential therapy or laser therapy . They will all teach patients a variety of exercises to be carried out at home to reinforce their care between treatment sessions.

Although Osteopaths and Chiropractors are very similar, they are each derived from independent schools of thought and the main differences lie in treatment styles.

Osteopaths, having completed a thorough examination and arrived at a diagnosis, use a range of techniques including gentle soft tissue techniques (massage, stretching, muscle energy, inhibition etc) through gentle joint mobilisation, through to the more powerful manipulation known as high velocity thrust or HVT. There is also cranial osteopathy which is a very different subtle and gentle technique. Each session with an osteopath would typically be 45 minutes for the first treatment and consultation and 30 minutes for each follow up. In addition to treatment there will aslo be advice on lifestyle issues, injury avoidance, posture and exercises given.

Chiropractors tend to use quick thrust, short lever spinal manipulation techniques. Chiropractors like to term this, an adjustment. This means to click your lower back the would place their hands on that spot where movement is needed. Osteopaths and certain physiotherapist trained in post-graduate manipulation techniques will do the same.
Chiropractors might also use what are termed low force techniques with an instrument spinal manipulation tool like the activator. The aim is still to provide the quick thrust movement with a lower force than used with a hands on manipulation. You won’t hear the typical joint clicking sound with this type of manipulation.
Chiropractors are trained to take and read x-rays which may be appropriate in cases such as trauma or pathology.

Anyway, the most important aspect is to find a practitioner you trust and feel comfortable with, because a positive the doctor/patient relationship is the base of any healing process.