Mayo Clinic Health Letter, September 2012 Highlights: Treat Blood Clots in Lungs Promptly; Implantable Devices may Reduce Chronic Nerve Pain; Maintain Important Core Muscle Strength

ROCHESTER, Minn.--(BUSINESS WIRE)--Here are highlights from the September issue of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit www.HealthLetter.MayoClinic.com or call toll-free for subscription information, 1-800-333-9037, extension 9771.

Prompt Treatment Needed for Blood Clots in the Lungs

ROCHESTER, Minn. -- Pulmonary embolism occurs when critical blood flow to lung tissue is blocked in one or more arteries. It can be fatal without prompt treatment. The September issue of Mayo Clinic Health Letter explains this condition, common symptoms, risk factors and treatment options.

Normally, blood circulates freely through arteries and veins. When pulmonary embolism occurs -- blocking an artery -- it is usually due to a blood clot fragment from elsewhere in the body that travels through the bloodstream to the lungs. Most often, these dangerous clots form in the large veins of the leg or pelvis, a condition called deep vein thrombosis.

Symptoms: They can vary widely, depending on how much of the lung is affected and the size, number and location of the clots. People with underlying heart or lung disease are more likely to have symptoms that may include:

* Sudden breathlessness, during activity or at rest
* Sharp chest pain that may become worse with inhalation
* Light-headedness or fainting
* Wheezing
* Clammy or bluish skin
* Rapid or irregular heartbeat
* Excessive sweating
* Weak pulse

Some people have no signs or symptoms other than those linked to deep vein thrombosis. Those symptoms may include leg redness, swelling or pain.

Risk factors: The danger of pulmonary embolism increases with age, especially after 60. Risk also rises with:

* Long periods of inactivity, due to hospitalization, bed rest, or even prolonged sitting during travel
* Certain medical conditions, including trauma and bone fracture, neurologic disorders that impair leg use, autoimmune disorders, some cancers and previous deep vein thrombosis
* Surgery, particularly orthopedic procedures involving the hip, knee or pelvis; major neurosurgery and cancer surgery
* Excess weight and smoking

Treatment: Pulmonary embolism is considered a medical emergency, but it can be difficult to detect. Symptoms may be similar to those of a heart attack, heart failure or pneumonia. A physician may suggest blood tests as well as a computerized tomography pulmonary angiogram or an ultrasound to help confirm the diagnosis. Medications to thin the blood or dissolve the clot are the most common treatments.

Devices Help Reduce Severe, Chronic Nerve Pain

ROCHESTER, Minn. -- When severe chronic nerve pain doesn’t respond to medication, surgery or physical therapy, implanted devices may provide relief, according to the September issue of Mayo Clinic Health Letter.

In one type of device, electrical pulses are directed along a nerve to block or override pain impulses traveling along the same nerve. Medication pumps are another option, dispensing medication directly into the fluid around the spinal cord.

There are two types of electrical stimulation devices, and they may be used together. In spinal cord stimulators, a wire is placed within the spinal canal and connected to an electrical generator implanted beneath the skin in the abdomen. Approved by the U.S. Food and Drug Administration, spinal cord stimulators may improve pain from failed back surgery, peripheral neuropathy and complex regional pain syndrome, which results in leg or arm pain.

More targeted than spinal cord stimulators, peripheral nerve stimulators are placed along nerves that branch off from the spinal cord. They may be used to treat leg pain after back surgery, post-herpetic neuralgia and some types of headaches. This newer technology hasn’t been approved by the FDA.

Implanted medication pumps are most often used to relieve pain from cancer or chronic back pain. The drug delivery system consists of a small flexible catheter placed in the spinal fluid. The catheter connects to a drug infusion pump implanted in the lower abdomen. The adjustable pump is programmed to dispense medication. It can be refilled by injection through the skin into the device.

Drug delivery pumps are effective but have limitations. Patients may develop increasing tolerance to the pain medication. Most often, pain medication pumps are offered to patients with limited life expectancy or in other extreme situations.

Nerve stimulation devices and pain medication pumps are effective to reduce -- but not eliminate -- pain. Reducing pain by about half is a reasonable goal when using these technologies. But that may be enough to allow patients to function more normally, especially when combined with other pain-management strategies.

Core Muscle Strength -- Why it’s Important to Maintain

ROCHESTER, Minn. -- Core muscles -- located around the midsection and pelvis -- are critical to physical activities ranging from folding laundry and carrying groceries to serving a tennis ball or swinging a golf club. The September issue of Mayo Clinic Health Letter covers the importance of strengthening and maintaining core muscles.

Twenty-nine pairs of muscles make up the core. They are sometimes described as a muscular box. The roof is the diaphragm, the large muscle below the lungs. The base includes the pelvic floor and girdle of muscles around the hips. The abdominal muscles are the front of the core box. At the back are the paraspinal muscles that support the spine, and the large gluteal muscles.

This muscular box provides the foundation for moving the arms and legs. Core muscles support the body’s shift in balance, providing a stable foundation for daily activities and exercise. A well-conditioned core reduces the risk of low back pain and helps maintain good posture.

Exercises that focus on the body’s midsection can strengthen the core muscles. One option is simply balancing on one leg while keeping the back and pelvis stable. Pilates, tai chi and yoga involve many core-building movements. A personal trainer or physical therapist also can offer exercise suggestions. To get the most benefit and avoid injury, it’s wise to learn proper techniques.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 1-800-333-9037 (toll-free), extension 9771, or visit www.HealthLetter.MayoClinic.com.

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