Back Pain
Orofacial pain
OROFACIAL PAIN
Author:
Dr. Suhail Latoo
Dept. of oral and maxillofacial pathology
Govt. Dental College & hospital, Srinagar
Dr. Khalid Amin
Dept. Conservative dentistry and Endodontics
Govt. Dental College & hospital, Srinagar
Dr. Ravinder Kumar Baghat
Dept. Conservative dentistry and Endodontics
Govt. Dental College & hospital, Srinagar
Pt come to the dental clinic complaining from:
Pain
Swelling
Bleeding
Ulcer
Discolored mucosa
Pain: unpleasant emotional experience caused by injury to the body or mind.
Pain is difficult in diagnosis because:
- Due to the difference in the nature of pain:
It varies from one individual to another & has several forms as aching, throbbing, burning…
- Due to the difference in pain perception & sensation.
Neural mechanisms of pain:
Pain perception & pain reaction (arc reflex)
Any receptor in the tissue can be stimulated by painful stimuli these will generate nerve impulse that is transmitted through afferent neuron to cerebral cortex that interpret the stimuli and send a response through efferent neurons.
Pain perception: physicoanatomical process by which pain is received & transmitted to higher centers.
Pain reaction: the manifestation shown as a result of pain perception & interpretation.
Pain reaction differs according to:
Age (old, young)
Sex (male, female)
Emotional status à(modify the intensity & the personal behavior response to pain).
Religious factor
Health status
N.B.
Pain receptor (necoceptors or exteroceptors).
Pain threshold (trigger of stimulus which necessary to feel pain “variable”).
Sensory nerve supply to the orofacial structures:
Trigeminal
Facial
Glossopharyngeal
Vagus
Branches of cervical spinal nerve.
Hypoglossal
Types of orofacial pain:
- Somatic: coetaneous or mucosal pain due to noxious stimuli to pain receptor without any abnormality or change in the neural st. (normal neural st.)
Noxious stimuli could be:
Thermal changes (impression)
Mechanical (trauma)
Pressure (denture)
Chemicals (aspirin)
Bacterial, viral, fungal infection.
Systemic disease with oral manifestation.
Somatic pain can be:
Deep or superficial
Superficial:
Sharp, easy to be localized.
E.g. skin, mucus membrane (ulcers).
Deep:
Dull, diffuse, difficult to be localized.
E.g. pulpal pain, osseous pain as (abscess), muscular pain (stress & strainàischemiaàspasmàtresmus), ligament, & joints pain.
- Vascular: pain due to changes in the blood flow (pain due to noxious stimuli that affect the vascular tissue or perivascular tissue) some classify it as deep muscular pain.
E.g. migraine, cluster Headache, Milkerson Rosenthial syndrome.
Migraine:
Unilateral headache in the maxillary, frontal, occipital bone.
Female>male, start in 2nd decay of life.
Caused by contraction of the cranial blood vessels followed by dilatation causing changes in the cerebral blood flow.
It s usually associated with aura (photophobia, nausea & vomiting, fatigue).
It has familial history.
Predisposing factors:
- Allergy to food.
- Exercise.
- Stress.
- Excitation.
TXàergotamineàside effectsàhypertension & cardiovascular problem.
Cluster headache:
Unilateral headache start at evening (evening attacks).
Male>female, start in 2nd decay of life.
Chch by headache episodes for 20min in maxillary, temporal, & orbital bone followed by relief & repeat for about 1:30hour.
It s usually associated with watery discharge of the nose, nasal congestion, nostril blockage in the affected side, eye tearing, eye redness & edema of the eye led.
It has no familial history.
Can be treated with ergotamine.
Milkerson rosenthial syndrome:
Combination of:
Facial pulsy.
Bifid tongue.
Bilateral temporal headache.
Chelitis graulomatosa.
Vascular pain can be treated by analgesics.
- Neurogenic: pain occurring along the course of the nerve due to abnormality in the neural st. of the nerve itself.
Chch:
- Paroxysmal.
- Very sever & sharp “like electric shook”.
- Localized to the affected sensory nerve.
It may be 1ry (trigeminal, & glossopharyngeal) neuralgia, or 2ry neuralgia.
1ry neuralgia: (unknown cause)
Severe, sharp, paroxysmal pain along the course of the nerve but dose not cross the midline due to abnormality in the neural st. of the nerve it self but no pathological lesion present.
Pain resembles electric shock.
Trigeminal neuralgia:
Severe, sharp, paroxysmal pain along the course of the trigeminal nerve. (Sudden onset & disappear gradually).
Female>male, right>lift side, old>young age, maxillary > mandible >ophthalmic branch.
Etiology:
Unknown cause.
But there are 2 theories the 1st (most acceptable) says that pain is due to stretching & demylenation of the trigeminal nerve above the petrous part of the temporal bone which is larger in females, right side, old.
2nd says that pain is due to pulsation of the carotid artery above the gassarian ganglionàpressure.
Trigger zone: mild sensory stimuli (shaving, touch, brushing, washing) directed to this zone will result in the neuralgial attack. Between the attacks the zone becomes refractory (pt is pain free between the attacks).
Half inch sign or frozen face.
D.D.:
Post herpetic neuralgia.
Pulpal pain.
Tumors in the orofacial st.
Atypical pain.
To differentiate:
- Presence of atypical agent.
- Continuous not in attacks.
TX:
-medically by Tegratol (anticonvulsant) 200mg /3times per day
It shouldn’t exceed 800mg
Side effects (aplastic anemia, agranulocytosis, and GIT disturbance).
Or by phnytoin.
-surgically (cryosurgery, or surgical resection).
-injection of (LA, or alcohol along the coarse of the nerve).
Glossopharyngeal neuralgia:
Severe sharp paroxysmal pain along the course of the glossopharyngeal nerve.
Rare.
Trigger area:
Nasopharynix
Soft palate
Tonsil
Sides of the tongue.
Stimuli (coughing, yawning, swallowing, talking)
Pain:
- Otic.
- Pharyngeal.
- Shooting sever pain.
D.D.:
Tumors in the nasopharyngeal area.
Stone in the submandibular gland.
Eggle syndrome (elongated styloid process).
Tx:
As trigeminal neuralgia but surgical resection will change the taste sensation.
For diagnosis topical anesthesia application will relief pain.
2ry neuralgia: (well known cause) pathological changes alter the nerve st. & cause neuralgia.
e.g.
Post herpetic neuralgia: as complication of the herpes zoster infection chch by very severe knife cutting sharp pain that cannot be treated.
Antiviral & cortisones are given in these cases to prevent nerve fibrosis & scaring & the pt can be treated with tricyclic antidepressant…
Paget’s disease: osteoclastic activity followed by osteoblastic activity causing narrowing of the foramen, jaw & skull enlargementàcompression on the nerve.
Post traumatic neuroma: due to the accidental severing of the nerve, during healing, nurolemmal sheath create a neuroma that disturb nerve impulse. This cause severe sharp pain in the lip with increased T.
Coalgia: severe sharp lancating pain in the socket due to the sectioning of the peripheral nerve during extraction.
Neuralgia 2ry to malignancy: malignant tumor can invade the nerve causing neuralgia. E.g. Trroter syndrome àepidermal carcinoma in the lateral wall of the pharynx extending to the maxillary or mandibular division.
Maxillary àpain in cheek.
Mandibular àpain in tongue & lip parasthesia.
Eustachian tube àdeafness.
- Referred: pain felt at a distance from the pathologically affected area.
e.g.
-Coronary heart disease show a referred pain in the left shoulder & lower jaw (angle & teeth).
-pain in case of sinusitis referred to upper posterior teeth.
-pulpitis in the lower teeth referred to the upper teeth.
- Psychogenic (atypical facial pain): facial pain that dose not follow anatomical pathway, & has no organic cause.
Dull pain, spread widely, bilateral, poorly localized & the pt can’t determine the pain quality.
Female>male, young>old, maxilla>mandible, most common in the sides of the tongue, cross the midline.
Sometimes called psychogenic pain because it s common in pt with depression & usually seen in pt with abnormal behavior.
How to diagnose?
-Hx
-clinically & investigation (full mouth x-ray, vitality test, sensitivity test, GTT, CBC)
-pt behavior & attitude (it can be diagnosed mainly by exclusion)
Tx:
Multiple visitsàPt assuranceà to correct the behavioràreffer to a specialist.
- Mycofacial pain dysfunction syndrome (MFPD): chronic disorder chch by dull unilateral pain involving the side of the face, extending around the ear, periaurecular, frontal, occipital, sternoclidomastoid muscle…etc.
Male>female, old>young.
Pain on palpation of muscle of mastication.
Pt starts with pain & chch of clicking & trismus without any pathological abnormality in TMJ.
Possible causes:
Great VDOàover extension. E.g. high filling.
Short VDOàover contraction.
Clenching & bruxismàMuscle fatigue.
If untreated:
- After 1 yearàdeviation of the jaw to one side on opening.
- These defects cause rupture of the sarcoplasmic reticulum that release the inflammatory mediators & stimulate the pain receptors.
Tx:
-cause removal.
-moist heat application for 3min.
-topical anesthesia.
-muscle exercise (tongue attach the post. Part of the palate several times during the day).
Diagnosis of tha orofacial pain: (VIP)
Clinical history:
-detailed Hx of the pain complaint:
When pain start? (Onset sudden or gradual)
Where dose it start? (Anatomical location)
How long it takes to start (duration)
How long it takes to relief (duration)
Nature of pain (throbbingàabscess, dullàperiodontal, sharpàpulpal, lancatingàneurological)
Severity of pain (if interfere with sleeping, talkingàsever, if notàmild)
Localization
Associated symptoms
Is the pain associated with any systemic disease?
-Hx of the related disease (arthritis, muscular complaint, neurologic or psychogenic disorder).
Clinical examination of the teeth, their supporting & associated st. (vitality tests, percussion tests, x-ray, sinus x-ray).
Rapid cranial nerve evaluation:
Nerve
Test
1
Block one of the nostrils & check smell ability.
2,3
Pupil reaction to light (contraction).
4,6
Allow pupil to follow moving object without moving the head
5
Touch the skin with (sharp & blunt objects).
Check muscle of mastication.
Pt move mandible against pressure.
7
If affected the pt cannot raise his eye brow, close the eye lash, and blow his mouth on the affected side.
Also it causes dropping of the corner of the mouth.
8
Drop an object on the ground & ask about hearing.
9,10
Ask pt to say ahhhhhhhhhà uvula moving, gagging reflex.
11
Check sternoclidomastoid & trapezius muscle
Ask the pt to tilt the head against pressure.
12
Tongue protrusion.
TMJ disorders (imp. In late stage MPDS):
-functional or organic TMJ disorder.
-signs & symptoms.
-radiographic evaluation.
-Management.
_
Author:
Dr. Khalid Amin
Dept. Conservative dentistry and Endodontics
Govt. Dental College & hospital, Srinagar
Pt come to the dental clinic complaining from:
Pain
Swelling
Bleeding
Ulcer
Discolored mucosa
Pain: unpleasant emotional experience caused by injury to the body or mind.
Pain is difficult in diagnosis because:
- Due to the difference in the nature of pain:
It varies from one individual to another & has several forms as aching, throbbing, burning…
- Due to the difference in pain perception & sensation.
Neural mechanisms of pain:
Pain perception & pain reaction (arc reflex)
Any receptor in the tissue can be stimulated by painful stimuli these will generate nerve impulse that is transmitted through afferent neuron to cerebral cortex that interpret the stimuli and send a response through efferent neurons.
Pain perception: physicoanatomical process by which pain is received & transmitted to higher centers.
Pain reaction: the manifestation shown as a result of pain perception & interpretation.
Pain reaction differs according to:
Age (old, young)
Sex (male, female)
Emotional status à(modify the intensity & the personal behavior response to pain).
Religious factor
Health status
N.B.
Pain receptor (necoceptors or exteroceptors).
Pain threshold (trigger of stimulus which necessary to feel pain “variable”).
Sensory nerve supply to the orofacial structures:
Trigeminal
Facial
Glossopharyngeal
Vagus
Branches of cervical spinal nerve.
Hypoglossal
Types of orofacial pain:
- Somatic: coetaneous or mucosal pain due to noxious stimuli to pain receptor without any abnormality or change in the neural st. (normal neural st.)
Noxious stimuli could be:
Thermal changes (impression)
Mechanical (trauma)
Pressure (denture)
Chemicals (aspirin)
Bacterial, viral, fungal infection.
Systemic disease with oral manifestation.
Somatic pain can be:
Deep or superficial
Superficial:
Sharp, easy to be localized.
E.g. skin, mucus membrane (ulcers).
Deep:
Dull, diffuse, difficult to be localized.
E.g. pulpal pain, osseous pain as (abscess), muscular pain (stress & strainàischemiaàspasmàtresmus), ligament, & joints pain.
- Vascular: pain due to changes in the blood flow (pain due to noxious stimuli that affect the vascular tissue or perivascular tissue) some classify it as deep muscular pain.
E.g. migraine, cluster headache, Milkerson Rosenthial syndrome.
Migraine:
Unilateral headache in the maxillary, frontal, occipital bone.
Female>male, start in 2nd decay of life.
Caused by contraction of the cranial blood vessels followed by dilatation causing changes in the cerebral blood flow.
It s usually associated with aura (photophobia, nausea & vomiting, fatigue).
It has familial history.
Predisposing factors:
- Allergy to food.
- Exercise.
- Stress.
- Excitation.
TXàergotamineàside effectsàhypertension & cardiovascular problem.
Cluster headache:
Unilateral headache start at evening (evening attacks).
Male>female, start in 2nd decay of life.
Chch by headache episodes for 20min in maxillary, temporal, & orbital bone followed by relief & repeat for about 1:30hour.
It s usually associated with watery discharge of the nose, nasal congestion, nostril blockage in the affected side, eye tearing, eye redness & edema of the eye led.
It has no familial history.
Can be treated with ergotamine.
Milkerson rosenthial syndrome:
Combination of:
Facial pulsy.
Bifid tongue.
Bilateral temporal headache.
Chelitis graulomatosa.
Vascular pain can be treated by analgesics.
- Neurogenic: pain occurring along the course of the nerve due to abnormality in the neural st. of the nerve itself.
Chch:
- Paroxysmal.
- Very sever & sharp “like electric shook”.
- Localized to the affected sensory nerve.
It may be 1ry (trigeminal, & glossopharyngeal) neuralgia, or 2ry neuralgia.
1ry neuralgia: (unknown cause)
Severe, sharp, paroxysmal pain along the course of the nerve but dose not cross the midline due to abnormality in the neural st. of the nerve it self but no pathological lesion present.
Pain resembles electric shock.
Trigeminal neuralgia:
Severe, sharp, paroxysmal pain along the course of the trigeminal nerve. (Sudden onset & disappear gradually).
Female>male, right>lift side, old>young age, maxillary > mandible >ophthalmic branch.
Etiology:
Unknown cause.
But there are 2 theories the 1st (most acceptable) says that pain is due to stretching & demylenation of the trigeminal nerve above the petrous part of the temporal bone which is larger in females, right side, old.
2nd says that pain is due to pulsation of the carotid artery above the gassarian ganglionàpressure.
Trigger zone: mild sensory stimuli (shaving, touch, brushing, washing) directed to this zone will result in the neuralgial attack. Between the attacks the zone becomes refractory (pt is pain free between the attacks).
Half inch sign or frozen face.
D.D.:
Post herpetic neuralgia.
Pulpal pain.
Tumors in the orofacial st.
Atypical pain.
To differentiate:
- Presence of atypical agent.
- Continuous not in attacks.
TX:
-medically by Tegratol (anticonvulsant) 200mg /3times per day
It shouldn’t exceed 800mg
Side effects (aplastic anemia, agranulocytosis, and GIT disturbance).
Or by phnytoin.
-surgically (cryosurgery, or surgical resection).
-injection of (LA, or alcohol along the coarse of the nerve).
Glossopharyngeal neuralgia:
Severe sharp paroxysmal pain along the course of the glossopharyngeal nerve.
Rare.
Trigger area:
Nasopharynix
Soft palate
Tonsil
Sides of the tongue.
Stimuli (coughing, yawning, swallowing, talking)
Pain:
- Otic.
- Pharyngeal.
- Shooting sever pain.
D.D.:
Tumors in the nasopharyngeal area.
Stone in the submandibular gland.
Eggle syndrome (elongated styloid process).
Tx:
As trigeminal neuralgia but surgical resection will change the taste sensation.
For diagnosis topical anesthesia application will relief pain.
2ry neuralgia: (well known cause) pathological changes alter the nerve st. & cause neuralgia.
e.g.
Post herpetic neuralgia: as complication of the herpes zoster infection chch by very severe knife cutting sharp pain that cannot be treated.
Antiviral & cortisones are given in these cases to prevent nerve fibrosis & scaring & the pt can be treated with tricyclic antidepressant…
Paget’s disease: osteoclastic activity followed by osteoblastic activity causing narrowing of the foramen, jaw & skull enlargementàcompression on the nerve.
Post traumatic neuroma: due to the accidental severing of the nerve, during healing, nurolemmal sheath create a neuroma that disturb nerve impulse. This cause severe sharp pain in the lip with increased T.
Coalgia: severe sharp lancating pain in the socket due to the sectioning of the peripheral nerve during extraction.
Neuralgia 2ry to malignancy: malignant tumor can invade the nerve causing neuralgia. E.g. Trroter syndrome àepidermal carcinoma in the lateral wall of the pharynx extending to the maxillary or mandibular division.
Maxillary àpain in cheek.
Mandibular àpain in tongue & lip parasthesia.
Eustachian tube àdeafness.
- Referred: pain felt at a distance from the pathologically affected area.
e.g.
-coronary heart disease show a referred pain in the left shoulder & lower jaw (angle & teeth).
-pain in case of sinusitis referred to upper posterior teeth.
-pulpitis in the lower teeth referred to the upper teeth.
- Psychogenic (atypical facial pain): facial pain that dose not follow anatomical pathway, & has no organic cause.
Dull pain, spread widely, bilateral, poorly localized & the pt can’t determine the pain quality.
Female>male, young>old, maxilla>mandible, most common in the sides of the tongue, cross the midline.
Sometimes called psychogenic pain because it s common in pt with depression & usually seen in pt with abnormal behavior.
How to diagnose?
-Hx
-clinically & investigation (full mouth x-ray, vitality test, sensitivity test, GTT, CBC)
-pt behavior & attitude (it can be diagnosed mainly by exclusion)
Tx:
Multiple visitsàPt assuranceà to correct the behavioràreffer to a specialist.
- Mycofacial pain dysfunction syndrome (MFPD): chronic disorder chch by dull unilateral pain involving the side of the face, extending around the ear, periaurecular, frontal, occipital, sternoclidomastoid muscle…etc.
Male>female, old>young.
Pain on palpation of muscle of mastication.
Pt starts with pain & chch of clicking & trismus without any pathological abnormality in TMJ.
Possible causes:
Great VDOàover extension. E.g. high filling.
Short VDOàover contraction.
Clenching & bruxismàMuscle fatigue.
If untreated:
- After 1 yearàdeviation of the jaw to one side on opening.
- These defects cause rupture of the sarcoplasmic reticulum that release the inflammatory mediators & stimulate the pain receptors.
Tx:
-cause removal.
-moist heat application for 3min.
-topical anesthesia.
-muscle exercise (tongue attach the post. Part of the palate several times during the day).
Diagnosis of tha orofacial pain: (VIP)
Clinical history:
-detailed Hx of the pain complaint:
When pain start? (Onset sudden or gradual)
Where dose it start? (Anatomical location)
How long it takes to start (duration)
How long it takes to relief (duration)
Nature of pain (throbbingàabscess, dullàperiodontal, sharpàpulpal, lancatingàneurological)
Severity of pain (if interfere with sleeping, talkingàsever, if notàmild)
Localization
Associated symptoms
Is the pain associated with any systemic disease?
-Hx of the related disease (arthritis, muscular complaint, neurologic or psychogenic disorder).
Clinical examination of the teeth, their supporting & associated st. (vitality tests, percussion tests, x-ray, sinus x-ray).
Rapid cranial nerve evaluation:
Nerve
Test
1
Block one of the nostrils & check smell ability.
2,3
Pupil reaction to light (contraction).
4,6
Allow pupil to follow moving object without moving the head
5
Touch the skin with (sharp & blunt objects).
Check muscle of mastication.
Pt move mandible against pressure.
7
If affected the pt cannot raise his eye brow, close the eye lash, and blow his mouth on the affected side.
Also it causes dropping of the corner of the mouth.
8
Drop an object on the ground & ask about hearing.
9,10
Ask pt to say ahhhhhhhhhà uvula moving, gagging reflex.
11
Check sternoclidomastoid & trapezius muscle
Ask the pt to tilt the head against pressure.
12
Tongue protrusion.
TMJ disorders (imp. In late stage MPDS):
-functional or organic TMJ disorder.
-signs & symptoms.
-radiographic evaluation.
-Management.
About the Author
Oral And Maxillofacial Pathologist
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Comfort Dreams Lumbar Back Support 12-inch Twin XL-size Memory Foam Mattress $386.99 This specialty memory foam mattress is designed to help provide relief from low back pain and discomfort. This memory foam mattress features a premium stretch fabric cover. |
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Contoured Remedy Memory Foam Lumbar Support Cushion $9.99 This Contoured Remedy Memory Foam Lumbar Support Cushion provides ideal lumbar support to ease lower back pain. Made of molded, highly resilient memory foam. Features an orthopedic design that relieves tension and helps keep spine in proper alignment. |
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Stander Able Tray $132.22 Tray is perfect for your laptop, crafts or diningAssistive product is a must-have for anyone with impaired balance, back pain, or recent surgeryDaily living aid features a sturdy, ergonomically designed handle for balance |
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As seen on TV Spinal Stretch $89.99 SpinalStretch is an effective way to decompress the lower spine and provide an easy and quick back pain solution anywhere. SpinalStretch also makes a great alternative to traditional inversion equipment. |
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Bali Semi-waveless 8-inch King-size Water Mattress $598.99 The medical benefits of a water mattress include even weight distribution and reduced back pain. This semi-waveless waterbed offers a minimum of 50-percent motion reduction. |
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As Seen on TV Magnetic Lumbar Sacral Back Support and Healing Belt $34.99 This three-in-one Magnetic Lumbar Sacral Back Support and Healing Belt is designed for people who suffer from back pain. This wide belt securely supports the kidney zone, lower back and waist for comfort. |
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Bali Semi-waveless 8-inch Queen-size Water Mattress $559.99 Medical benefits of Queen water mattress include even weight distribution and reduced back painSemi-waveless waterbed offers minimum of 50-percent motion reductionQueen waterbed has removable top cover for easy cleaning |
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Memory Foam Strap Leg Spacer $19.99 A soft memory foam coupled with a soft velour cover highlights this leg spacer. A positioning strap will keep this leg spacer in place so your lower back pain can be relieved. |
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Back Cold Compression $32.04 Back cold compression therapy reduces back painHealth care product reduces pain caused by back strain, chronic back ache and injuriesCompression is especially useful after back surgery |
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The Truth About Back Pain (Paperback) $11.58 Two chiropractic doctors introduce a bold new approach to diagnosing and treating back pain based on the three distinct causes of the ailment–structural, emotional, and nutritional–and propose solutions that use noninvasive physical and simple mental… |
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Mind over Back Pain $10.08 This is the book that has given thousands of sufferers new hope–a gentle, effective way to find real relief from back pain, without painkillers, without surgery, without spending days on end in bed. Dr. John Sarno`s revolutionary appro… |
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Healing Back Pain $10.62 HEALING BACK PAIN offers relief from chronic back pain without drugs, surgery, or even exercise. Recognizing the connection between the mind and the body, Dr. John Sarno explains how back pain can be the end result of long-term emotional pain, par… |
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Healing Back Pain (Paperback) $6.92 A guide to overcoming back pain without drugs or surgery identifies psychological factors that can cause back pain, discusses Tension Myositis Syndrome and offers case histories and results from mind-body research. Reprint. |
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Healing Back Pain $14.41 HEALING BACK PAIN offers relief from chronic back pain without drugs, surgery, or even exercise. Recognizing the connection between the mind and the body, Dr. John Sarno explains how back pain can be the end result of long-term emotional pain, par… |
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Say Goodbye to Back Pain! (Paperback) $9.85 Almost all of us experience back pain at some point in our lives. Many people suffer far more than they need to and are looking for help. Chicken Soup for the Soul: Say Goodbye to Back Pain! offers that help with its inspiring and comforting st… |
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Mind over Back Pain $7.91 Description not available. |
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No More Back Pain (Paperback) $10.66 By the director of Muscle Pain Research at NYU School of Medicine, a revolutionary book about solving back pain without surgery and drugs. |
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Yoga for Back Pain (Paperback) $13.22 ?Stunningly innovative. . . . This is the first book in which thedifferent causes of back pain are identified and assigned appropriate yogaposes. Individuals of any age, even those unfamiliar with yoga, will be able tofollow Dr. Fishman`s simple ins… |
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Gentle Yoga for Back Pain (Paperback) $10.52 Citing high rates of back pain in the United States, a guide to using light exercise and yoga for relief outlines specific remedial postures and practices, in a guide that offers insight into the sources of back pain and how yoga can be incorporated as… |
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The Biomechanics of Back Pain (Hardcover) $78.37 Authored by experts of international renown, the new edition of The Biomechanics of Back Pain forms a bridge between the latest research and the effective clinical management of patients with back problems. Now published for the first time in… |
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Cure Back Pain With Yoga (Paperback) $12.09 An approach to alleviating back pain and sciatica through specific yoga techniques identifies nine common causes of low back pain, explaining how practitioners can identify and treat back problems through a focused yoga practice that can be customized … |
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Healing Back Pain Naturally (Paperback) $10.76 A holistic approach to dealing with back pain explains how to use an all-natural program that combines mind-body techniques, specific stretching exercises, breathing techniques, diet and nutrition, and mental pain-coping strategies. Reprint. |
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The 7-minute Back Pain Solution (Paperback) $11.41 Banish back pain forever!Are you one of the millions of lower-back-pain sufferers who is desperate for relief? Have you ever been stopped in your tracks by pain so excruciating you were afraid to move? Have you spent countless hours seeing me… |
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Back Pain Relief $12.81 |
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50 Things You Can Do Today to Manage Back Pain (Paperback) $9.22 A guide to the various types and many possible causes of back pain, and practical and holistic advice to help sufferers deal with it Looking at lifestyle changes, dietary manipulation, supplements, and D… |
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Management of Low Back Pain (Paperback) $51.07 Description not available. |
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Elaine Petrone Method – Stop the Back Pain (DVD) $17.75 Description not available. |
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Mayo Clinic Wellness Solutions – For Back Pain (DVD) $15.16 Description not available. |
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How to Deal Simply With Back Pain and Rheumatoid Joint Pain (Paperback) $10.07 Description not available. |
Tags: back, back pain, back pain between shoulder blades, back pain during pregnancy, back pain relief, back pain treatment, chiropractor, health, pain, wilcoxon