Difference between revisions of "Ease Muscle Pain from Chikungunya"
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| − | Chikungunya is an infectious disease caused by a virus spread by the bite of mosquitoes. It is common in regions such as Africa, India and Southeast Asia. This disease is characterized by the abrupt onset of high fever (higher than 38.9 degrees C or 102 degrees F). The illness also causes severe incapacitating polyarthralgia (pain in multiple joints) or joint pain that is symmetrical. The distal joints such as wrists, hands, ankles and knees are affected, as opposed to the proximal joints such as the hips and shoulders. Chikungunya also causes a rash and severe myalgia, or muscle aches. The joint pain is particularly marked in that it is protracted and debilitating, perhaps going on for years, and sufferers may walk with a debilitating gait. In fact, the word “Chikungunya” means “ to walk bent over” in some east African languages.<ref>Pialoux, g Gauzere BA, Jaurequiberry, S et al , Chikungunya: An Epidemic Arbovirosis, The Lancet Infectious Disease 2007 May 7(5) 319-327.</ref> While there is no cure for the illness, you can take steps to ease pain and discomfort while you recover. | + | Chikungunya is an infectious disease caused by a virus spread by the bite of mosquitoes. It is common in regions such as Africa, India and Southeast Asia. This disease is characterized by the abrupt onset of high fever (higher than 38.9 degrees C or 102 degrees F). The illness also causes severe incapacitating polyarthralgia (pain in multiple joints) or joint pain that is symmetrical. The distal joints such as wrists, hands, ankles and knees are affected, as opposed to the proximal joints such as the hips and shoulders. Chikungunya also causes a rash and severe myalgia, or muscle aches. The joint pain is particularly marked in that it is protracted and debilitating, perhaps going on for years, and sufferers may walk with a debilitating gait. In fact, the word “Chikungunya” means “ to walk bent over” in some east African languages.<ref name="rf1">Pialoux, g Gauzere BA, Jaurequiberry, S et al , Chikungunya: An Epidemic Arbovirosis, The Lancet Infectious Disease 2007 May 7(5) 319-327.</ref> While there is no cure for the illness, you can take steps to ease pain and discomfort while you recover. |
| − | [[Category:Pain Management and Recovery]] | + | [[Category: Pain Management and Recovery]] |
== Steps == | == Steps == | ||
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#*There are ample laboratory tests to confirm that you have chikungunya. The most widely used is the RT-PCR (reverse transcriptase polymerase chain reaction), which checks for the virus. The disease leaves a huge viral load, so it is readily detected. This massive viral load is likely responsible for the patients feeling so terrible. | #*There are ample laboratory tests to confirm that you have chikungunya. The most widely used is the RT-PCR (reverse transcriptase polymerase chain reaction), which checks for the virus. The disease leaves a huge viral load, so it is readily detected. This massive viral load is likely responsible for the patients feeling so terrible. | ||
#Know how long the infection might last. The acute infection lasts from days to two weeks. During this time, you will likely be extremely fatigued with high fever and the extremely painful joints and muscles, almost incapable of walking. | #Know how long the infection might last. The acute infection lasts from days to two weeks. During this time, you will likely be extremely fatigued with high fever and the extremely painful joints and muscles, almost incapable of walking. | ||
| − | #*Then you will enter a subacute phase, which can continue for months to years. Sixty-three percent of patients still experience joint pain and swelling a year after the initial infection.<ref>Staples et al, 2009</ref> In the long term, you may experience a form of seropositive arthritis or rheumatism that has the HLA B27 antibody. This is similar to a more common post-infectious arthritis, known as Reiter’s syndrome.<ref>Current Diagnosis and Treatment of Infectious Disease,, Lange,McGraw Hill Publishing 2001</ref>, <ref>J Erin Staples, Robert Breiman, Ann M Powers Chikungunya: an Epidemiological Re-Emerging Infectious Disease, Clinical Disease Clinical Infectious Disease 2009 49 (6) 942-948.</ref> | + | #*Then you will enter a subacute phase, which can continue for months to years. Sixty-three percent of patients still experience joint pain and swelling a year after the initial infection.<ref name="rf2">Staples et al, 2009</ref> In the long term, you may experience a form of seropositive arthritis or rheumatism that has the HLA B27 antibody. This is similar to a more common post-infectious arthritis, known as Reiter’s syndrome.<ref name="rf3">Current Diagnosis and Treatment of Infectious Disease,, Lange,McGraw Hill Publishing 2001</ref>, <ref name="rf4">J Erin Staples, Robert Breiman, Ann M Powers Chikungunya: an Epidemiological Re-Emerging Infectious Disease, Clinical Disease Clinical Infectious Disease 2009 49 (6) 942-948.</ref> |
#Know that the illness is not fatal, but there is no treatment. Despite the terrible symptoms, the disease is not typically deadly. However, there is no treatment other than supportive care, similar to other viral illnesses. There have been trials with certain drugs to try treating the illness, but these drugs have not been shown to be efficacious. | #Know that the illness is not fatal, but there is no treatment. Despite the terrible symptoms, the disease is not typically deadly. However, there is no treatment other than supportive care, similar to other viral illnesses. There have been trials with certain drugs to try treating the illness, but these drugs have not been shown to be efficacious. | ||
===Soothing Muscle Pain During the Acute Stage of the Illness=== | ===Soothing Muscle Pain During the Acute Stage of the Illness=== | ||
| − | #Get as much rest as possible. There is no cure for chikungunya, so you will have to do what you can to support your body's natural healing abilities. One way to support your body's natural healing abilities is to get as much rest as possible.<ref>http://www.cdc.gov/chikungunya/symptoms/index.html</ref> Sleep as much as you can and take it easy during the day. | + | #Get as much rest as possible. There is no cure for chikungunya, so you will have to do what you can to support your body's natural healing abilities. One way to support your body's natural healing abilities is to get as much rest as possible.<ref name="rf5">http://www.cdc.gov/chikungunya/symptoms/index.html</ref> Sleep as much as you can and take it easy during the day. |
#*Make yourself as comfortable as possible with pillows and blankets. | #*Make yourself as comfortable as possible with pillows and blankets. | ||
#*Plan to rest for about two weeks, if not longer. | #*Plan to rest for about two weeks, if not longer. | ||
| − | #Stay hydrated. Muscle tissue is composed of 75% water.<ref>http://www.acefitness.org/fitfacts/pdfs/fitfacts/itemid_173.pdf</ref> When you have low hydration levels in your body, your muscles can be more susceptible to seizing up, cramping and other discomfort.<ref>http://www.everydayhealth.com/news/unusual-signs-of-dehydration/</ref> Chikungunya brings a high fever, which contributes significantly to dehydration, putting your muscles at further risk for cramping. | + | #Stay hydrated. Muscle tissue is composed of 75% water.<ref name="rf6">http://www.acefitness.org/fitfacts/pdfs/fitfacts/itemid_173.pdf</ref> When you have low hydration levels in your body, your muscles can be more susceptible to seizing up, cramping and other discomfort.<ref name="rf7">http://www.everydayhealth.com/news/unusual-signs-of-dehydration/</ref> Chikungunya brings a high fever, which contributes significantly to dehydration, putting your muscles at further risk for cramping. |
#*Drink plenty of water and other fluids to ensure you stay hydrated. | #*Drink plenty of water and other fluids to ensure you stay hydrated. | ||
#*If nausea is present, take small sips at frequent intervals, drinking water, Gatorade or electrolyte mixtures. Make your own electrolyte mixture with six cups of water, one cup of sugar and two teaspoons of salt. | #*If nausea is present, take small sips at frequent intervals, drinking water, Gatorade or electrolyte mixtures. Make your own electrolyte mixture with six cups of water, one cup of sugar and two teaspoons of salt. | ||
#*Be sure to [[Tell if You Are Dehydrated|monitor for dehydration]]. Patients with this illness are at risk of becoming dehydrated. It’s likely that the patient needs to be prompted to eat and drink due to lethargy and weakness as well as inability to care for oneself. Diarrhea and vomiting do not predominate in this illness, so these are not likely to be the main causes of dehydration. | #*Be sure to [[Tell if You Are Dehydrated|monitor for dehydration]]. Patients with this illness are at risk of becoming dehydrated. It’s likely that the patient needs to be prompted to eat and drink due to lethargy and weakness as well as inability to care for oneself. Diarrhea and vomiting do not predominate in this illness, so these are not likely to be the main causes of dehydration. | ||
#*If you are dehydrated, you may need intravenous fluids to rehydrate. | #*If you are dehydrated, you may need intravenous fluids to rehydrate. | ||
| − | #Take a fever reducer. Antipyretics, also known as fever reducers, may help you manage your fever. They can also be used to manage joint pain. Try taking some acetaminophen, ibuprofen, naproxen, or paracetamol to help reduce your fever and joint pain.<ref | + | #Take a fever reducer. Antipyretics, also known as fever reducers, may help you manage your fever. They can also be used to manage joint pain. Try taking some acetaminophen, ibuprofen, naproxen, or paracetamol to help reduce your fever and joint pain.<ref name="rf5" /> |
#*Make sure that you read and follow the manufacturer's instructions for use. Do not exceed the recommended dosage of any over the counter medicine. | #*Make sure that you read and follow the manufacturer's instructions for use. Do not exceed the recommended dosage of any over the counter medicine. | ||
#Try a heating pad. Holding a heating pad on your joints and other painful areas may bring some temporary relief for your joint pain. Try holding an electric heating pad on your joints for up to 20 minutes at a time. Make sure that you remove the heating pad after 20 minutes and give your skin a break for about an hour to avoid overheating or burning your skin. | #Try a heating pad. Holding a heating pad on your joints and other painful areas may bring some temporary relief for your joint pain. Try holding an electric heating pad on your joints for up to 20 minutes at a time. Make sure that you remove the heating pad after 20 minutes and give your skin a break for about an hour to avoid overheating or burning your skin. | ||
#*You can also use a hot water bottle if you do not have a heating pad. You can fill a plastic water bottle with hot water and wrap a paper towel or cloth around it. | #*You can also use a hot water bottle if you do not have a heating pad. You can fill a plastic water bottle with hot water and wrap a paper towel or cloth around it. | ||
| − | #*You may even want to try alternating an ice pack with a heating pad. Ice can help to numb pain in your joints while heat tends to increase blood flow and soothe muscles.<ref>https://health.clevelandclinic.org/2014/08/should-you-use-ice-or-heat-for-pain-infographic/</ref> Make sure that you wrap the ice pack with a paper towel and do not keep an ice pack on for more than 20 minutes at a time either. | + | #*You may even want to try alternating an ice pack with a heating pad. Ice can help to numb pain in your joints while heat tends to increase blood flow and soothe muscles.<ref name="rf8">https://health.clevelandclinic.org/2014/08/should-you-use-ice-or-heat-for-pain-infographic/</ref> Make sure that you wrap the ice pack with a paper towel and do not keep an ice pack on for more than 20 minutes at a time either. |
#Ask your doctor about narcotic pain medication. Discuss narcotic pain medication such as Norco for severe muscle pain. Norco combines hydrocodone and acetaminophen. Many cases of chikungunya are debilitating enough to warrant this type of medication. | #Ask your doctor about narcotic pain medication. Discuss narcotic pain medication such as Norco for severe muscle pain. Norco combines hydrocodone and acetaminophen. Many cases of chikungunya are debilitating enough to warrant this type of medication. | ||
#*The recommended dosage of Norco is 325 milligrams orally every four hours. | #*The recommended dosage of Norco is 325 milligrams orally every four hours. | ||
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===Using Supplements and Herbs=== | ===Using Supplements and Herbs=== | ||
| − | #Increase your intake of vitamin C. Enhance your body’s ability to fend off muscle pain by taking 1,000 milligrams of vitamin C twice daily.<ref>http://www.webmd.com/fitness-exercise/art-sore-muscles-joint-pain?page=2</ref> This will also help boost your immune system. It may be tough to get this much from food alone but fresh fruits and vegetables are always the best source if possible. You can also take supplements. Some of the most nutrient rich sources of vitamin C include: | + | #Increase your intake of vitamin C. Enhance your body’s ability to fend off muscle pain by taking 1,000 milligrams of vitamin C twice daily.<ref name="rf9">http://www.webmd.com/fitness-exercise/art-sore-muscles-joint-pain?page=2</ref> This will also help boost your immune system. It may be tough to get this much from food alone but fresh fruits and vegetables are always the best source if possible. You can also take supplements. Some of the most nutrient rich sources of vitamin C include: |
#*Oranges: 69mg of vitamin C per serving. | #*Oranges: 69mg of vitamin C per serving. | ||
#*Chili peppers: 107 mg of vitamin C per serving. | #*Chili peppers: 107 mg of vitamin C per serving. | ||
#*Red Bell Peppers: 190 mg of Vitamin C per serving. | #*Red Bell Peppers: 190 mg of Vitamin C per serving. | ||
| − | #Take vitamin D to help with chronic pain. Low levels of vitamin D have been linked to chronic pain.<ref>http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link</ref> In addition, vitamin D may help improve muscle fatigue and recovery time.<ref>http://wrightnewsletter.com/2013/04/03/vitamin-d-may-reduce/</ref> | + | #Take vitamin D to help with chronic pain. Low levels of vitamin D have been linked to chronic pain.<ref name="rf10">http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link</ref> In addition, vitamin D may help improve muscle fatigue and recovery time.<ref name="rf11">http://wrightnewsletter.com/2013/04/03/vitamin-d-may-reduce/</ref> |
#*Take 200 iu (two capsules) of vitamin D3 daily. Although you can get vitamin D from sunshine, you’ll be resting inside, so you’ll likely need to take supplements. | #*Take 200 iu (two capsules) of vitamin D3 daily. Although you can get vitamin D from sunshine, you’ll be resting inside, so you’ll likely need to take supplements. | ||
| − | #Drink green tea. Muscle pain can be in part caused by inflammation. Green tea is known to be an anti-inflammatory treatment that can help with muscle pain.<ref>http://breakingmuscle.com/nutrition/anti-inflammatories-green-tea-ginger-and-the-athlete</ref> Green tea also causes upregulation of the body’s natural killer cells that are responsible for targeting infectious agents. Therefore, green tea can help fight illness and enhance immunity. | + | #Drink green tea. Muscle pain can be in part caused by inflammation. Green tea is known to be an anti-inflammatory treatment that can help with muscle pain.<ref name="rf12">http://breakingmuscle.com/nutrition/anti-inflammatories-green-tea-ginger-and-the-athlete</ref> Green tea also causes upregulation of the body’s natural killer cells that are responsible for targeting infectious agents. Therefore, green tea can help fight illness and enhance immunity. |
| − | #*Drink at least one cup daily.<ref>Edwin Cooper, The Immune System and Complementary and Alternative Medicine Evidence -Based Complementary Medicine 2007 Sept 4 (supp 1) 5-8.</ref> | + | #*Drink at least one cup daily.<ref name="rf13">Edwin Cooper, The Immune System and Complementary and Alternative Medicine Evidence -Based Complementary Medicine 2007 Sept 4 (supp 1) 5-8.</ref> |
| − | #Take ginseng extract. According to experts, ginseng extract can facilitate the body’s immune response. It can also relieve exhaustion and muscle pain that you may experience with an illness that consumes a lot of your energy, such as chikungunya.<ref>http://wholehealthchicago.com/2009/05/19/siberian-ginseng/</ref> | + | #Take ginseng extract. According to experts, ginseng extract can facilitate the body’s immune response. It can also relieve exhaustion and muscle pain that you may experience with an illness that consumes a lot of your energy, such as chikungunya.<ref name="rf14">http://wholehealthchicago.com/2009/05/19/siberian-ginseng/</ref> |
| − | #*There is no medical consensus on dosing. Follow the product’s label for dosing instructions.<ref | + | #*There is no medical consensus on dosing. Follow the product’s label for dosing instructions.<ref name="rf13" /> |
| − | #Try aged garlic. Aged garlic supplements can help reduce muscle soreness and pain. The chemical allicin, which is contained in garlic, may contribute to this reduction.<ref>http://www.webmd.com/vitamins-supplements/ingredientmono-300-garlic.aspx?activeingredientid=300&activeingredientname=garlic</ref> Aged garlic can also help the body’s natural killer cells to activate immunity.<ref | + | #Try aged garlic. Aged garlic supplements can help reduce muscle soreness and pain. The chemical allicin, which is contained in garlic, may contribute to this reduction.<ref name="rf15">http://www.webmd.com/vitamins-supplements/ingredientmono-300-garlic.aspx?activeingredientid=300&activeingredientname=garlic</ref> Aged garlic can also help the body’s natural killer cells to activate immunity.<ref name="rf13" /> Try taking aged garlic supplements to help fight the infection. |
===Preventing Chikungunya=== | ===Preventing Chikungunya=== | ||
| − | #Use mosquito nets. If you are traveling or living in an area that has outbreaks of chikungunya, take precautions so that you minimize your risk of infection. Protect your sleeping area with a mosquito net treated with insecticide.<ref>http://www.who.int/mediacentre/factsheets/fs327/en/</ref> | + | #Use mosquito nets. If you are traveling or living in an area that has outbreaks of chikungunya, take precautions so that you minimize your risk of infection. Protect your sleeping area with a mosquito net treated with insecticide.<ref name="rf16">http://www.who.int/mediacentre/factsheets/fs327/en/</ref> |
| − | #*If you sleep with any part of your body pressed against the net, you may still be at risk of being bitten through the net.<ref>http://reliefweb.int/sites/reliefweb.int/files/resources/NE16-Chikugunya.pdf</ref> | + | #*If you sleep with any part of your body pressed against the net, you may still be at risk of being bitten through the net.<ref name="rf17">http://reliefweb.int/sites/reliefweb.int/files/resources/NE16-Chikugunya.pdf</ref> |
| − | #Use bug repellent spray. Use a product that contains DEET, picaridin, or IR3535 to protect yourself against bug bites. You might also try products that contain oil of lemon eucalyptus or para-menthane-diol. Reapply the spray according to the manufacturer’s instructions.<ref>http://www.cdc.gov/westnile/faq/repellent.html</ref> | + | #Use bug repellent spray. Use a product that contains DEET, picaridin, or IR3535 to protect yourself against bug bites. You might also try products that contain oil of lemon eucalyptus or para-menthane-diol. Reapply the spray according to the manufacturer’s instructions.<ref name="rf18">http://www.cdc.gov/westnile/faq/repellent.html</ref> |
| − | #*Make sure your bug repellent contains sufficient insecticide to kill mosquitos.<ref | + | #*Make sure your bug repellent contains sufficient insecticide to kill mosquitos.<ref name="rf17" /> |
| − | #*If you’re using sunscreen and bug repellent, apply the sunscreen first and then the bug repellent over it.<ref>http://www.cdc.gov/chikungunya/</ref> | + | #*If you’re using sunscreen and bug repellent, apply the sunscreen first and then the bug repellent over it.<ref name="rf19">http://www.cdc.gov/chikungunya/</ref> |
| − | #Wear long sleeves and pants. Cover up your body to prevent mosquitos from having access to your skin. Wear long pants and shirts with long sleeves.<ref | + | #Wear long sleeves and pants. Cover up your body to prevent mosquitos from having access to your skin. Wear long pants and shirts with long sleeves.<ref name="rf19" /> |
| − | #Don’t leave out open containers of water. Uncovered water catchments, cisterns and buckets are breeding grounds for mosquito larvae. Cover these up, especially if you have four or more catchments in a 10-meter radius of your dwelling.<ref | + | #Don’t leave out open containers of water. Uncovered water catchments, cisterns and buckets are breeding grounds for mosquito larvae. Cover these up, especially if you have four or more catchments in a 10-meter radius of your dwelling.<ref name="rf17" /> |
| − | #Be cautious around areas where there are outbreaks. Chikungunya is spread by getting bitten by an infected mosquito, “the vector” of the species Aedes, which has caused clustered outbreaks in areas surrounding the Indian Ocean. Outbreaks continue to be a risk until the public health issue of the mosquito problem is better controlled. <ref>Taubitz,W Cramer, JP, Pfeffer, M et al Chikungunya:Foreign Travelers:A Clinical Presentation and Course, Clinical Infectious Disease 2007 July 45 (1) e 1-4 epub 2007 e1-4 May 23.</ref> | + | #Be cautious around areas where there are outbreaks. Chikungunya is spread by getting bitten by an infected mosquito, “the vector” of the species Aedes, which has caused clustered outbreaks in areas surrounding the Indian Ocean. Outbreaks continue to be a risk until the public health issue of the mosquito problem is better controlled. <ref name="rf20">Taubitz,W Cramer, JP, Pfeffer, M et al Chikungunya:Foreign Travelers:A Clinical Presentation and Course, Clinical Infectious Disease 2007 July 45 (1) e 1-4 epub 2007 e1-4 May 23.</ref> |
== Tips == | == Tips == | ||
*Eat foods that are easy to tolerate. Soups and broths are good choices of foods to keep up your energy. If you can handle solid food, these can be eaten. As you fight the fever and infection, your body will be expending lots of calories with a high metabolic rate, so it is important to eat plenty of nutritious food as you recover | *Eat foods that are easy to tolerate. Soups and broths are good choices of foods to keep up your energy. If you can handle solid food, these can be eaten. As you fight the fever and infection, your body will be expending lots of calories with a high metabolic rate, so it is important to eat plenty of nutritious food as you recover | ||
