Thursday, March 07, 2013
Determining the reason for pain

By Dr. Anthony Policastro
We often do things repeatedly and sometimes forget that fact. The repeated efforts can result in muscle and joint pain from overuse injuries. When we get the muscle and joint pain, we do not associate it with the repeated movements. Last year, I developed pain in my left upper back. It was in an unusual location so it did not appear to be related to an acute event. It continued for a period of time. I went on vacation for a week. The pain improved. I returned home. The pain got worse. That led me to question what was different about the home activities versus the vacation activities. One thing that was different was the form of exercise that I did. At home I used a treadmill. On vacation I walked outside. I realized that on the treadmill, I was holding on to the bar with my left hand. I switched to my right hand. The pain in my left shoulder improved. However, I then developed the same pain on my right side. I slowed the speed down and stopped holding on. The pain disappeared. We often develop pains and aches from the activities that we do on a daily basis. However, we do not go through the effort to find the cause. What we do instead is take pain medication. Alternatively, we take medication for inflammation. Some individuals take over the counter remedies to strengthen their cartilage. The problems with this approach are several. One is that we are taking medication that we do not need. A second is that we might have side effects from the medication. A third and most important reason is that we will continue doing the activities that cause the pain. The result will be that the pain will not go away. The principles to approach pain from repeated movement are simple. The first is the fact that a new pain that we have not had before usually has a cause for it. While it might be the onset of arthritis, it is more likely related to something we do on a regular basis. A second principle is related to the location of the pain. Something that occurs on only one side of the body is more likely to be related to a repeated movement with that side of the body. I once developed a bursitis in my upper back. I tried a variety of treatments. I finally figured out that it was from lying on my left side and supporting my head on my left elbow. I changed positions and the pain went away after months of trying other treatments. A third principle is related to the course of pain. Most acute injuries get better with time. Pain from repeated injuries will worsen over time. A fourth principle is related to new activities. If you have never had pain before, then a new pain might be related to something new that you are doing. The bottom line is to never assume that pain is due to something you cannot control. When pain occurs that is getting worse and lasts for a long time, you need to play detective. You need to trace your steps. You may need to try different changes to your routine. However, if you find the cause and eliminate it, your body will be very happy when the pain disappears.

Community Health Promotion awards The Governor's Council on Health Promotion & Disease Prevention announces a call for submissions for Recognition of Community Health Promotion. The goal is to recognize the efforts of municipalities that are championing the health and well being of their local residents. Recipients will be communities that have demonstrated effective planning and implementation of best practice and/or creative and visionary programs to improve physical activity, nutrition/healthy eating, tobacco-free lifestyles, healthy environments; promote healthy lifestyles and integration of the needs of individuals with limited mobility and disabilities. All applicants must represent an incorporated municipality located within the State of Delaware and must focus on policy and practice changes related to improving the overall health of its respective community members. For more information and an application, contact Dr. Milton Delgado at or 302-444-9142. The deadline to submit an application is April 12. Upon submission, all applications will be reviewed by a subcommittee of the Governor's Council on Health Promotion & Disease Prevention.

Increased risk for chronic wounds Delaware's diabetes prevalence is higher than the national average. 9.7% of adults report that they have been diagnosed with diabetes, and the disease is more common among the African American population in our state. Diabetes has several side-effects that can be very serious for patients with wounds. Diabetes patients may experience a range of disease-related side-effects. Nerve damage may cause a patient not to feel a cut or wound until it has grown infected. Diabetes can weaken the immune system, and wounds can become infected more easily. Narrow arteries may restrict blood flow to the legs, preventing a wound from healing. "Patients do not have to live with serious wounds," said Julie Willey, RN, clinical coordinator of the Wound Care Center at Bayhealth. "We offer advanced wound care technologies and a collaborative approach to treat underlying conditions such as edema or diabetes." While not every paper-cut or scrape means a trip to the Emergency Department, Willey encourages people to take precautions to prevent wounds and also seek medical care for skin irritations or redness. Performing daily foot inspections is a good habit to start. Exercise also can combat the negative consequences of carrying extra weight. For more information on the treatment of chronic or infected wounds, contact the Bayhealth Wound Care Center at 302-744-7500.

Creative Couture Fashion & Art Show The Auxiliary of Bayhealth Milford Memorial Hospital invites you to a Creative Couture Fashion & Art Show on Thursday, March 21, at Abbott's Grill in Milford.

The event opens at 11:30 a.m. with a Meet the Artists reception, featuring various artists from the Mispillion Art League of Milford. Each artist is donating a small work which will be placed on each table and taken home by a lucky person seated at the table. Cards by each of the artists will also be available for sale, and three artists will be offering to do commission work. The boutiques Coolspring Cottage of Coolspring, Twilla's of Lewes and Jane and Georgie of Rehoboth will have models for the fashion show. Tickets for a 50/50 raffle will be for sale, as well as drawings for a $50.00 gift certificate to Abbott's Grill and a $150 gift certificate from Jane and Georgie. Abbott's Grill will offer a buffet lunch at noon for all to enjoy. Cost is $35 per person. Tickets may be purchased at Reflections Gift Shop at Milford Memorial, through any member of the Milford Memorial Hospital Auxiliary Board or by calling Cynthia Jones at 270-1842. All proceeds benefit Bayhealth Milford Memorial.

2013 Walk MS dates The Delaware Chapter of the National Multiple Sclerosis Society has announced the 2013 Walk MS dates and is inviting all Delawareans to join the movement. Each year thousands of loved ones, friends, and neighbors throughout Delaware  from Wilmington's Riverfront to Sussex County's Baywood Greens  lace up and step out in solidarity, with hopes of creating a world free of MS. Last year, over a quarter million dollars was raised to help out the 1,550 Delawareans living with multiple sclerosis. The Twilight at Heritage Shores walk in Bridgeville will be held on May 31 and the walk at Baywood Greens will be held on June 7. To register, visit or call 302-655-5610.

End-of-Life Coalition awards dinner Rita Landgraf, secretary of the Delaware Department of Health and Social Services, will be the keynote speaker at the Delaware End-of-Life Coalition's 5th Annual Excellence Awards Dinner on Thursday, March 21. This event honors the outstanding professionals throughout the state who make a significant difference in the care of individuals dealing with end-of-life issues. The dinner costs $65 and will be held at the Deerfield Country Club, Newark. These awards recognize physicians, nurses, certified nurse assistants, counseling professionals and community organizations for their significant contributions to the betterment of patients and their families at the end-of-life. Sponsorship packages are available and nominations are still being accepted, visit Plan to attend the celebration and meet Crystal Rush, Miss Delaware International. To register visit

Alzheimer's Caregiver Support Group Cadia Rehab Renaissance near Millsboro is hosting and facilitating an Alzheimer's Association Caregiver Support Group that meets the fourth Tuesday of each month at 6 p.m. All meetings are open to the public and interested parties are invited to attend. Alzheimer's disease is the sixth leading cause of death in the United States. One person out of eight who reaches the age of 65 will develop Alzheimer's, as will one person out of every two who reaches the age of 85.

CPR classes offered Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child, or infant who is choking and use of the AED. This classroom-based, video, and instructor-led CPR course offers families, friends, and community members the opportunity to learn CPR and receive a course completion card. Classes are open to participants ages 12 and up. The target audience is those who have a duty to respond to a cardiac emergency because of job responsibilities or regulatory requirements. Cost is $45. Payment and registration is required by no later than five business days prior to the class. Late registrations may be accepted if seating is available. To register and obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

Walk for Autism is April 20 As a statewide agency whose mission is to create better lives for people with autism, Autism Delaware is expanding to provide the range of services needed by all Delawareans living with autism spectrum disorders over their lifespans. To this end, the nonprofit agency relies on volunteers, donations, and fundraising. "Our next big fundraiser in southern Delaware is Walk for Autism on April 20 at Cape Henlopen State Park," says Lisa Albany, the committee chair. "Our goal is to raise as much as possible to provide services through Autism Delaware that benefit individuals with autism spectrum disorders. We need volunteers to help run the event plus business and corporate leaders to sponsor it." "The need for autism services and support is rising rapidly," adds Autism Delaware Executive Director Teresa Avery. "The CDC now says that one in 88 children is identified with an autism spectrum disorder. In 1991, the Delaware Department of Education reported 152 public school students with autism  and 982 in 2010. That's a 546 percent increase over 19 years. For more information, visit