References: 1. Goucke C R, The Management of Persistent . Clinical Update MJA If you’re experiencing pain 2003; 178: 444-447 2.Dominick C et al, NZMJ 2011; 124: 63-75 3.National Pain Strategy. Pain Australian 2011; 1-104 4. Chronic Pain Health Report. 2014; 3-19 5.Helping people Talk to your doctor about how they can help you get cope with chronic non-malignant pain, BPJ 2014;63: 29-38 6. Chronic Pain: Symptoms, relief from your pain. It is usually possible to manage it so Diagnosis, & Treatment. NHI Research Spring; 2011: 7.Living with Pain – Snapshot Survey Report, Chronic Pain Australia, 2014: 1-30 8. Osteoarthritis Understanding your you can undertake your daily activities more easily and condition. http://www.move.org.au/page/osteoarthritis. Accessed 11 December 2017 9. Ambizas EM et al. Diabetic . How can we help our patients? get on with living your life. Pharmacist; 2016;43(3):8-15 10.Van Tulder, et al. Sciatica:what the rheumatologist needs to know. Nature Reviews Rheumatology 2010; 5: 139-145 11.Valat JP et al Remember Sciatica. Best Practice & Research Clinical Rheumatology 2010;24: 241-252 12.Koes BW et al Diagnosis and treatment of sciatica. BMJ 2007; 334: 1313-1317 13.Medline Talk to your doctor about whether your medications Plus 2013 14. Deyo et al. What can the History and Physical Examination Tell us About Low ? JAMA 1992; 268( 6): 760-765 15.Spine Health Sciatica Symptoms are providing relief, if you’re experiencing any side https://www.spine-health.com/conditions/sciatica/what-you-need-to-know- effects and to what extent you can undertake your daily about-sciatica Accessed Dec 17. 16.Bulging Disc Defi nition, Causes, Symptoms and Treatments. http://spinecare.luminhealth.com/conditions/bulging-disc. Accessed activities. 27 Dec 2017 17. Assessing diabetic peripheral neuropathy in primary Care BPJ 2014; 61: 36-46 Are you

Healthy body ©Pfi zer New Zealand, Level 1, Building B, 8 Nugent St, Grafton 1023 Auckland. Living with pain often means people become less active. ©Pfi zer TAPS NA9798. PP-CEL-NZL-0043. 02/18. SPITFIRE J001129. However, it is important to stay as active as possible to in pain? maintain a healthy lifestyle. In addition to seeing your doctor, the holistic management of nerve pain may involve:

Occupational therapists Diabetic nurse educators Physiologists Psychologists Rehabilitation counsellors

Healthy mind Relaxation techniques may help you to cope better with your pain. Not all relaxation techniques will work for all people, so talk to your doctor about what may be best for you.

You’re not alone It is important to see your doctor regularly to monitor your progress and response to treatments. They may help you take better control of your pain.

You should also talk to your family and friends as they can also provide a great support network to help manage your pain.

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J0011320-Pain-Leaflet-A4-Tri-Fold_v4.indd 1-4 8/03/18 4:21 PM ARE YOU IN PAIN? HAVE YOU SOME EXAMPLES OF CAUSES AND How is neuropathic pain diagnosed? Discs occupy the space between vertebrae in the spine; Nerve pain needs to be diagnosed by your doctor or over time these discs can become damaged with BEEN IN PAIN FOR A LONG TIME? CONDITIONS ASSOCIATED WITH general wear and tear. – YOU’RE NOT ALONE CHRONIC PAIN other health care professional (HCP). If your doctor/ HCP suspects you may have nerve pain, they will ask Pain is a very personal experience; it may be JOINT PAIN – OSTEOARTHRITIS specifi c questions about the nature of your pain such as If a disc protrudes from the spine and puts pressure on short-lived or chronic (long-lasting). When it symptoms, intensity, duration and location. Some doctors the , it can cause the symptoms associated sticks around for a while we often learn to put up Osteoarthritis occurs most often in the knees, hips and use special screening questionnaires to help determine with sciatica. with it. Pain is considered “chronic”, “persistent” or spine. The symptoms of osteoarthritis can vary from one “long lasting” if it continues for more than three person to the next; one of the most common symptoms if you could have nerve pain. Your doctor/HCP will then months. Chronic pain is surprisingly common is joint pain. The pain has been described as being like a perform a physical examination and may order special and is believed to affect up to one in six grinding, rubbing or crunching sensation. diagnostic tests to determine the nature of your pain. New Zealanders. Osteoarthritis progresses slowly and develops over Your doctor will discuss the most appropriate options Pain is subjective; many people who experience many years and is usually diagnosed by symptoms and for managing your nerve pain with you. If prescribed chronic pain also experience other symptoms physical examination of the affected joint or joints. any medication, taking this properly is an important such as poor sleep and depression. part of managing your nerve pain. There are additional things you can do to help improve the likelihood of your Chronic pain may arise from an initial injury treatment being successful. such as a back strain or from a health condition such as osteoarthritis. Chronic pain may limit movement, which can reduce fl exibility, strength TYPES OF NEUROPATHIC PAIN and stamina. This can make it diffi cult to carry out Sciatica important and enjoyable activities. Sciatica is a group of symptoms, rather than an actual disease. It is named after the sciatic nerve – a large nerve that starts at the spinal cord in the lower back and DIABETIC PERIPHERAL NEUROPATHY TREATING LONG-TERM PAIN travels to the lower limbs. Sciatica occurs when pressure is put on this nerve. As a result, people with sciatica Diabetic peripheral neuropathy is one of the most Chronic pain may occur in different parts of the body. commonly experience pain in their lower back that common long-term complications of . It’s important you work closely with your healthcare radiates through the buttock, downward into their legs, Peripheral neuropathy refers to nerve damage in professionals to identify the causes of your pain in order feet and toes. the peripheral nervous system, which are the nerves to fi nd the best way to manage it. The following treatments outside of the brain or spinal cord. Diabetic peripheral are among some of the ways to manage pain: What does sciatica feel like? neuropathy (DPN) refers to damage that can occur to Causes of osteoarthritis nerves as a of diabetes. The pain associated with sciatica often feels like a sharp Many different factors contribute to developing pain or a burning sensation. Pain usually starts in the osteoarthritis including: It isn’t exactly known how diabetes causes damage to lower back and continues down one leg, following the nerves, but it is believed to be the result of high blood Medications Joint injuries (sports, work place) path of the sciatic nerve. Sciatica usually affects only sugar (called “hyperglycaemia”). Research suggests Increased age one side of the body. The pain in the leg can feel worse that lifestyle factors such as and alcohol Family history than the pain felt in the lower back and may worsen with consumption may also contribute to nerve damage. Being overweight or obese coughing. Sciatica may result in other symptoms such as muscle weakness, impaired refl exes, numbness or pins It is diffi cult to know exactly how many people have and needles. NEUROPATHIC PAIN (NERVE PAIN) neuropathies, however it is estimated to affect up to 50% of people living with type 2 diabetes and 10 – 20% Neuropathic pain is often described as feeling like What causes sciatica? Massage therapy burning, freezing, stabbing, shooting or electric shocks. of these will experience troublesome symptoms requiring Sciatica involves damage to nerves (“neuropathic” This pain can be constant or may come and go. The pain treatment. or nerve pain). This is most commonly the result of usually worsens at night causing sleep disturbances. a herniated disc (sometimes called a slipped disc).

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