Peppe Pema

A physician will consider a patient’s lifestyle, severity of pain, and medical history when recommending a medication. To avoid potential side-effects and interactions, patients should always tell their health care provider about any drugs and vitamins/supplements they take.

Medications typically recommended for spinal osteoarthritis pain are described below.

Opioid medications are rarely prescribed because they carry an increased risk of misuse, abuse, and addiction. They are typically reserved for carefully selected patients whose back pain is acute or has not responded to other treatments. Other potential risks include cognitive, gastrointestinal, and other organ-related side effects.

See Pain Medications for Arthritis Pain Relief

Therapeutic massage can help reduce osteoarthritis pain, 2 Nelson NL, Churilla JR. Massage Therapy for Pain and Function in Patients With Arthritis: A Systematic Review of Randomized Controlled Trials. Am J Phys Med Rehabil. 2017 Sep;96(9):665-672. doi: 10.1097/PHM.0000000000000712. Review. PubMed PMID: 28177937. improve circulation, and reduce muscle tension and spasms. It is preferable to find a physical therapist or massage therapist who is trained in treating spinal arthritis joint pain.

This type of non-invasive therapy uses small amounts of electricity to reduce the sensitivity of nerves around the spine. Patients typically feel only a gentle vibration or tingling during TENS treatment. Not all patients using TENS experience pain relief. 3 Escortell-mayor E, Riesgo-fuertes R, Garrido-elustondo S, et al. Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain. Man Ther. 2011;16(1):66-73. doi: 10.1016/j.math.2010.07.003 , 4 Johnson M, Martinson M. Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: a meta-analysis of randomized controlled trials. Pain. 2007;130:157-165. , 5 Kroeling P, Gross A, Graham N, et al. Electrotherapy for neck pain. Cochrane Database Syst Rev. 2013;(8):CD004251. TENS therapy may be done in a medical office or the TENS unit may be prescribed to the patient and taken home with instructions regarding its proper use.

Read more about Transcutaneous Electrical Nerve Stimulation (TENS) on Spine-health.com

Limited evidence suggests acupuncture can help treat osteoarthritis pain, back pain, and headaches. 6 Sherman KJ, Coeytaux RR. Acupuncture for Improving Chronic Back Pain, Osteoarthritis and Headache. J Clin Outcomes Manag. Author manuscript; available in PMC 2010 May 4. Published in final edited form as: J Clin Outcomes Manag. 2009 May 1; 16(5): 224–230. PMCID: PMC2863344 , 7 Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018;19(5):455‐474. doi:10.1016/j.jpain.2017.11.005 , 8 Chou R, Deyo R, Friedly J, et al. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166(7):493-505. doi: 10.7326/M16-2459

Dating back thousands of years, acupuncture is based on the notion that the body contains patterns of energy flow, and that proper energy flow is necessary to good health. During a treatment session, ultra-fine needles are inserted at specific points on the skin in an attempt to correct and/or maintain a normal energy flow. This treatment is considered generally safe and may even be covered by insurance.

See Acupuncture and Reiki Healing for Arthritis

Commonly recommended supplements include turmeric, ginger, omega-3 fatty acids (such as fish oil), glucosamine, chondroitin sulfate, and vitamin D. Whether these supplements effectively reduce osteoarthritis symptoms is a matter of ongoing research, 9 Sodha R, Sivanadarajah N, Alam M. The use of glucosamine for chronic low back pain: a systematic review of randomised control trials. BMJ Open. 2013;3(6):e001167. Published 2013 Jun 20. doi: 10.1136/bmjopen-2012-001167 , 10 Vaishya R, Vijay V, Lama P, Agarwal A. Does vitamin D deficiency influence the incidence and progression of knee osteoarthritis? - A literature review. J Clin Orthop Trauma. 2019;10(1):9–15. doi:10.1097/RHU.0b013e3181b08f20 , 11 Bragazzi NL, Watad A, Neumann SG, Simon M, Brown SB, Abu Much A, Harari A, Tiosano S, Amital H, Shoenfeld Y. Vitamin D and rheumatoid arthritis: an ongoing mystery. Curr Opin Rheumatol. 2017 Jul;29(4):378-388. doi: 10.1097/BOR.0000000000000397 and experts agree more studies are needed.

Supplements are considered generally safe, but side-effects, adverse health events, and drug interactions are possible, so people are encouraged to talk to their doctor or pharmacists before taking one.

See Dietary Supplements for Treating Arthritis

A physician may recommend injection therapy if other nonsurgical medical treatments fail to reduce osteoarthritis pain in the back or neck pain. Injection therapy may also be an option for individuals who are sensitive to oral pain medications.

These injections treat pain stemming from a specific facet joint. The injection is typically delivered through the capsule that surrounds the two facets, into the joint itself. Examples of facet joint injections include:

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Premature ejaculation is the opposite of delayed ejaculation. The media attention of the latter is much greater than the attention of the former. Premature ejaculation is a topic that is covered in many articles, from tantra to training the penis itself.

There are many advertisements for clinics and treatments that try to solve the problem, but not many about delayed ejaculation.

Delayed ejaculation is a pathology that can take a long time to arrive or never arrive.

It is estimated that between 2% and 4% of men suffer from this pathology, which makes it very difficult for them to have an orgasm. There could be between 460,000 and 1,400,000 men in our country with this problem.

85% of the male population suffer from delayed ejaculation, which prevents them from reaching orgasm through penetration alone.

Most of us have to masturbate to get to the climax.

Although lasting a reasonable time having sexual intercourse without having an uncontrolled orgasm is something desirable to enjoy sex and have time to satisfy our sexual partner, the delay produced by this pathology is excessive, especially if the orgasm never comes, which it ends up producing a lot of frustration in both members of the couple.

There is no exact measurement of time, but it could be said that you suffer from delayed ejaculation if you need 30 minutes or more of stimulation to reach orgasm. This is an indication.

If the time it takes to climax negatively affects your sex life or that of your partner, then you have to measure that.

Delayed ejaculation is caused by three factors.

Delayed ejaculation has a high psychological component that can have very different origins.

It is possible that the education we received as a child made it more difficult for us to orgasm.

There is excessive pressure in the relationship. We can't concentrate on reaching our own pleasure because we are so focused on satisfying our partner.

From stress to excessive masturbation, the origins can be very different.

Neurological, circulatory or any other type of problems that affect us when it comes to orgasm are possible.