Chronic Prostatitis is Chronic Pelvic Pain Syndrome

Chronic prostatitis is pelvic or perineal pain without evidence of urinary tract infection lasting longer than three months. The National Institutes of Health (NIH) classifies prostatitis into four syndromes. This article discusses the four prostatitis syndromes listed in the medical research and by the NIH.

Prostatitis affects half of all men 

Prostatitis is a common condition affecting  almost half of all men during their lifetimes.  Prostatitis accounts for over two million outpatient visits every year. One percent of all primary care visits in the United States is for prostatitis.

Prostatitis – the “wastebasket of clinical ignorance”

Prostatitis has been called the “wastebasket of clinical ignorance.”

Stamey, Thomas Alexander, 1989, “Pathogenesis and Treatment of Urinary Tract Infections,” Lippincott, Williams and Wilkins
3D Man with prostate pain, dyspareunia
3D Man having some pain down there. Dyspareunia. Prostatitis

Historical confusion – the many names of Prostatitis 

Prostatitis is referred to by several different names, some are proper and some describe slightly different conditions such as:

  • pelvic pain,
  • anorectal pain,
  • levator ani syndrome,
  • unspecified anorectal pain,
  • proctalgia fugax,
  • interstitial cystitis,
  • bladder pain syndrome,
  • chronic prostatitis,
  • chronic pelvic pain syndrome,
  • prostatitis,
  • proctalgia, and
  • prostatodynia.
Graph symptoms of office worker syndrome
Office syndrome infographic. Prostatitis and hemorrhoids are listed as signs of office worker syndrome.

 Physicians tend to manage patients with prostatitis based on a patchwork of what they learned during residency, experience, the last paper on the subject they read, and perhaps a touch of evidence.

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Chronic Pelvic Pain (CPP) in Women and Men

Chronic pelvic pain (CPP) occurs in women and men. The American College of Obstetricians and Gynecologists’ (ACOG) definition applies to women. The European Association of Urologists (EAU) revised their guidelines beginning in 2009 to include women and men in their definition of chronic pelvic pain. Chronic pelvic pain is a bladder pain syndrome that occurs in women and men. Urological pain syndromes in men include Chronic Prostatitis / Chronic Pelvic Pain Syndrome (CPPS).

Chronic pelvic pain has two different definitions:

Historically, chronic pelvic pain (CPP), was defined by the American College of Obstetricians and Gynecologists (ACOG) and applied to women.

In 2009, the European Association of Urology (EAU) published EAU Guidelines on Chronic Pelvic Pain.  Their stated objective was “to revise guidelines for the diagnosis, therapy, and follow-up of CPP patients.”

The European Association of Urologists (EAU) guidelines distinguish between gynecological, gastrointestinal and musculoskeletal pain syndromes in women and men.  

Pelvic pain doctor holding digital tablet
PELVIC PAIN – Doctor holding digital tablet

In the revised guidelines published by the European Association of Urology (EAU) on Chronic Pelvic Pain, they included chapters on chronic prostate pain and bladder pain syndromes, urethral pain, scrotal pain, pelvic pain in gynecologic practice and others. 

ACOG’s Definition of Chronic Pelvic Pain  (CPP)  

The American College of Obstetricians and Gynecologists (ACOG) definition of  chronic pelvic pain.

“Pain lasting for six or more months that localizes to the anatomic pelvis, anterior abdominal wall at or below the umbilicus, the lumbosacral back, or the buttocks and is of sufficient severity to cause functional disability or lead to medical care.  Chronic pain can come and go or it can be constant.” (1)

American College of Obstetricians and Gynecologists, 2011

Chronic Pelvic Pain Continues after a Hysterectomy

“Approximately 12 percent of hysterectomies are performed for pelvic pain and 30 percent of patients who seek treatment at pain clinics have already had a hysterectomy.” (2)

Novak’s Textbook of Gynecology, 12th Ed, 1996

EAU’s Definition of Chronic Pelvic Pain  (CPP)  

The European Association of Urology (EAU) includes both women and men in its definition of chronic pelvic pain and defines chronic pelvic pain as follows (Ref. 2013):

“Chronic or persistent pain perceived in structures related to the pelvis of either men or women.  The pain must be continuous or recurrent for at least six months.” (3) 

European Association of Urology, 2013

Urological Pain Syndromes-Women / Men

When the pain is localized to a single organ, some specialists may wish to consider using an end organ term such as “Bladder Pain Syndrome.”  Urological pain syndromes include bladder pain syndrome, which is often termed as interstitial cystitis.

Angry cartoon bladder
Angry cartoon bladder showing Pelvic Pain

Urological Pain Syndromes in Men

Urological pain syndromes in men include Prostate Pain Syndrome, which is often termed Chronic Prostatitis / Chronic Pelvic Pain Syndrome according to the National Institute of Health (NIH) classification of chronic prostatitis. 

Chronic Prostatitis / Chronic Pelvic Pain Syndrome – NIH Classification

Many researchers use the term Chronic Prostatitis/Chronic Pelvic Pain Syndrome according to the National Institute of Health (NIH) classification of chronic prostatitis.

The National Institutes of Health (NIH) classifies prostatitis into four syndromes.

Prostatitis Syndromes:

  • Acute bacterial prostatitis; 
  • Chronic bacterial prostatitis (CBP) 
  • Chronic nonbacterial prostatitis (CNP) also called Chronic Pelvic Pain Syndrome (CPPS); 
  • Asymptomatic Inflammatory Prostatitis (formerly known as Prostatodynia)

The greatest number of cases of prostatitis have no known cause, despite chronic inflammation (1). 

Meares EM. Prostatitis and Related Disorders.

Chronic Pelvic Pain Syndrome (CPPS)

When the pain is localized to more than one organ site, the term Chronic Pelvic Pain Syndrome (CPPS) should be used.

Chronic Pelvic Pain Syndrome(s) (CPPS) in Women 

business woman pressing on stomach in pain
Close up of young business woman having Chronic pelvic pain in office.

In women, Chronic Pelvic Pain Syndrome (CPPS) includes the following:

  • Vulvar Pain Syndrome (a/k/a vulvodynia)
  • Vestibular Pain Syndrome
  • Clitoral Pain Syndrome
  • Dysmenorrhea
  • Endometriosis 
  • Associated Pain Syndrome 
  • Irritable Bowel Syndrome 
  • Pelvic Floor Muscle Pain Syndrome

The most common musculoskeletal pain syndrome in women is pelvic floor muscle pain syndrome.

Chronic Pelvic Pain Syndrome(s) (CPPS) in Men

3D man with chronic pelvic pain
Chronic Pelvic Pain Syndromes in Men

In men, Chronic Pelvic Pain Syndrome (CPPS) includes the following urological pain syndromes:

  • Scrotal Pain Syndrome
  • Testicular Pain Syndrome
  • Epididymal Pain Syndrome
  • Post Vasectomy Scrotal Pain Syndrome
  • Penile Pain Syndrome
  • Urethral Pain Syndrome 

Many research articles refer to the above-mentioned CPPS syndromes as: 

  • Chronic Orchialgia or 
  • Chronic Scrotal Syndrome  

Prostate Pain Syndrome/Chronic Prostatitis and Chronic Scrotal Pain/Chronic Orchialgia are the most common syndromes male patients complain of.

References

  1. The American College of Obstetricians and Gynecologists (ACOG 2011);
  2. Berek, J., “Novak’s Textbook of Gynecology,” 12th ed., 1996;
  3. European Association of Urology (EAU 2017)

Tips to Minimize Risk of Back Pain|Buttpillow.com

Do you suffer from back pain? Check out these tips from the medical literature to minimize your risk of back pain while sitting, bending, lifting, or during prolonged periods of standing.

Prevalence of Low Back Pain

Lower back pain is becoming a growing problem in industrialized countries  accounting for up to $50 billion spent per year in the United States alone (2000).  Ninety percent of the budget is spent on 10 percent of patients who have persistent chronic pain lasting longer than three months (1). 

Chronic back pain, often with associated leg pain, is the most common medical complaint in developed countries, (Bigos, et al. 1994).  Headache is its only peer (Lawrence, 1977).  A complaint of back pain is the most common reason for early Social Security disability in the USA.  The disability issues are so important that several countries and many organizations have convened to examine the problem, (Anderson, 1996). (2)

Tips to Minimize Risk of Back Pain – While Standing:

Posture techniques that help avoid lower back pain while standing: 

  • Maintain good abdominal tone;  keep abdomen flattened while standing.
  • When prolonged standing is necessary, place one foot on a step for a few minutes.
  • Wear cushion-soled shoes for prolonged standing.
Correct standing posture to minimize back pain
Correct standing posture on height adjustable desk to minimize risk of back pain.

While Bending, Lifting, or Carrying:

Posture techniques that help avoid back pain while bending, lifting or carrying:

  • Bend at the knees, not at the waist.
  • Lift with the thighs (keep heavy objects centered close to abdomen).
  • Flex knees while bending.
  • When carrying heavy objects, turn with the feet, not by twisting the trunk.
Lifting can cause hemorrhoids
Heavy lifting can cause hemorrhoids and back pain

While Sitting and Lying:

Posture techniques that help avoid back pain while sitting and lying:

  • Sit on a straight-backed, firm, supportive chair.
  • Sit only for short periods.
  • Sleep on your back with your knees bent, or on your side on a firm mattress.
  • Avoid prolonged standing, prolonged sitting, and improper lifting (1).
Correct ergonomic position while sitting
Correct sitting posture at computer to minimize risk for back pain.

Classifications of Low Back Pain with or Without Sciatica

“Transient– Self-limited; duration is hours to days; comes to medical attention when an episode of pain occurs.

“Acute– Self-limited, but protracted; duration is days to weeks; often seen by physicians; treatment is symptomatic; most recover spontaneously; evaluation and treatment required for severe symptoms.

“Persistent– Lasts more than 3-6 months; does not relent with time; high correlation with degeneration of the spine (spondylitis disease); surgical intervention occurs mostly in this group.

“Chronic Pain Syndrome– Lasts more than 6 months; worsens with time; associated with major co-morbidities (other conditions that also cause the same problem). ” (2)

Full woman patient body from back showing areas of sciatic nerve leg pain
Full woman patient body from back showing areas of sciatic nerve leg pain.

Classifications of Low Back Pain

“Acute low back pain– generally defined as pain which lasts from a few days to a few months.  Back pain with or without leg radiation is common (sciatica).

“Persistent low back pain– Progressively leads to the chronic state, defined by preoccupation with pain, depression, anxiety, and disability.”  (2)

Management of chronic back / leg pain:

  • Adequate analgesia.
  • Weight loss.
  • Restore flexibility.  
  • Restore strength:  Along the spine first.  
  • Restore general conditioning.  
  • Teach posture and body mechanics. (2)  
Woman doing yoga in a chair to minimize risk of back pain
I love yoga. Woman on a white background doing exercises on a chair.

References:

  1. Kelley’s Textbook of Internal Medicine, Fourth Edition, 2000, “Approach to the Patient with Back Pain,” written by Glen S. O’Sullivan, U.S.A.
  2. Textbook of Pain, 4th Edition, 1999, “Chronic Back Pain,” written by Donlin M. Long, U.S.A.

Musculoskeletal Disorders (MSDs) have many names |Buttpillow.com

Musculoskeletal disorders (MSDs) are also known as Cumulative Trauma Disorders (CTDs) and Repetitive Motion Disorders (RMDs) and overuse syndromes as well as repetitive strain injuries (RSIs). Learn more now about some of the most common MSDs seen in office workers which can be called by any of the names mentioned in this article.

MSDs are common in office workers

The U.S. Department of Labor Occupational Safety and Health Administration defines musculoskeletal disorders (MSDs) as “injuries and disorders of the soft tissues (muscles, tendons, ligaments, joints and cartilage) and nervous system.  They can affect nearly all tissues, including the nerves and tendon sheaths, and most frequently involve the arms and back.”  

Up to 85 percent of the population will suffer from musculoskeletal pain.  

Pretty woman in glasses
Anka waring glasses and a shirt with the Buttillow™ logo

Musculoskeletal disorders (MSDs) are known by many names, such as cumulative trauma disorders (CTDs).

MSDs are also called repetitive motion disorders (RMDs),  overuse syndromes,  repetitive strain injuries, and “office syndrome.”

Whatever the name, you’ll feel the pain.

“A rose by any other name would smell as sweet.”

William Shakespeare, Romeo and Juliet
Graph of symptoms and causes of musculoskeletal disorders
Office syndrome infographic. Symptoms and causes of musculoskeletal disorders.

Poor ergonomic posture can cause MSDs  

When workers sit or stand in a posture that is not ergonomically correct, they can experience musculoskeletal pain.

Because musculoskeletal pain and musculoskeletal disorders (MSDs) are a major source of suffering, health care, and utilization of compensation, there is a definite need for prevention (2).

OSHA – MSDs have a variety of names

Ergonomics:  The Study of Work, OSHA 3125, page 2, states “Occupational safety and health professionals have called these disorders a variety of names, including cumulative trauma disorders, repeated trauma, repetitive stress injuries, and occupational overexertion syndrome.”

To view OSHA’s discussion of musculoskeletal disorders (MSDs): “Ergonomics:  The Study of Work – OSHA 3125,” click here: https://www.osha.gov/Publications/osha3125.pdf

Cumulative Trauma Disorders (CTDs) defined by PEOSH:

“Cumulative trauma disorders (CTDs) are injuries of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces) or sustained or awkward positions.  Cumulative trauma disorders are also called repetitive motion disorders (RMDs), overuse syndromes, regional musculoskeletal disorders, repetitive motion injuries, or repetitive strain injuries.”

Public Employees Occupational Safety and Health Program, New Jersey Department of Health and Senior Services, “PEOSH Cumulative Trauma Disorders in Office Workers” December 1, 1997

Musculoskeletal Disorders in office workers:

Carpal Tunnel Syndrome – a compression of the median nerve in the wrist that may be caused by swelling and irritation of tendons and tendon sheaths.

Tendinitis – An inflammation (swelling) or irritation of a tendon. It develops when the tendon is repeatedly tensed from overuse or unaccustomed use of the hand, wrist, arm, or shoulder.

Tenosynovitis – An inflammation (swelling) or irritation of a tendon sheath associated with extreme flexion and extension of the wrist.

Low Back Disorders – These include pulled or strained muscles, ligaments, tendons, or ruptured disks. They may be caused by cumulative effects of faulty body mechanics, poor posture, and/or improper lifting techniques.

Synovitis – An inflammation (swelling) or irritation of a synovial lining (joint lining).

DeQuervain’s Disease – A type of synovitis that involves the base of the thumb.

Bursitis – An inflammation (swelling) or irritation of the connective tissue surrounding a joint, usually of the shoulder.

Epicondylitis – Elbow pain associated with extreme rotation of the forearm and bending of the wrist. The condition is also called tennis elbow or golfer’s elbow.

Thoracic Outlet Syndrome – a compression of nerves and blood vessels between the first rib, clavicle (collar bone), and accompanying muscles as they leave the thorax (chest) and enter the shoulder.”

Cervical Radiculopathy – A compression of the nerve roots in the neck.

Ulnar Nerve Entrapment – A compression of the ulnar nerve in the wrist.

Gamer girl in bikini top with headphone and playing computer games
Musculoskeletal disorders can happen to gamers and office workers.

Symptoms of MSDs or CTDs

The following symptoms may involve the back, shoulders, elbows, wrists, or fingers.  If symptoms last for at least one week or if they occur on many occasions a doctor should be consulted. 

  • Numbness,
  • Decreased joint motion,
  • Swelling,
  • Burning,
  • Pain,
  • Aching,
  • Redness,
  • Weakness,
  • Tingling,
  • Clumsiness,
  • Cracking or popping of joints

MSDs can be caused by work and non-work activities

These disorders can result from work and other than work activities that involve repetitive motions or sustained awkward postures, such as sports or hobbies. 

14 different types of gamers in a variety of postures
Posture is important to relieve and prevent musculoskeletal pain and musculoskeletal disorders (MSDs) while gaming.

“These painful and sometimes crippling disorders develop gradually over periods of weeks, months, or years. . .Work and non-work activities may together contribute to cumulative trauma disorders.  These disorders can also be aggravated by medical conditions such as diabetes, rheumatoid arthritis, gout, multiple myeloma, thyroid disorders, amyloid disease and pregnancy.” 

“PEOSH Cumulative Trauma Disorders in Office Workers” December 1, 1997

REFERENCES:

  1. Public Employees Occupational Safety & Health, State of NJ, 1997.
  2. Textbook of Pain, 1998, “Prevention of Disability due to Chronic Musculoskeletal Pain,” written by Steven James Litton
  3. U.S. Department of Labor Occupational Safety and Health Administration, OSHA 3125 2000 (Revised), “Ergonomics:  The Study of Work”

Dyspareunia or Painful Sex in Women & Men | Buttpillow.com

Dyspareunia is defined as genital pain that occurs before, during or after intercourse. This is a common sexual problem. Dyspareunia can occur in women and men. Some sources estimate dyspareunia occurs in two-thirds of all women. The medical literature does not quantify the number of men with this condition. Vaginal infections or infections of the prostate are the most common successfully-treated causes of dyspareunia.

Dyspareunia – Painful Sex in Women & Men 

Couple, man and woman, ripping the same paper showing the word "SEX."
Sex problems, dyspareunia, impotence, prostatitis, or sexually transmitted disease can cause relationship problems.

What is Dyspareunia?

Dyspareunia can be defined as difficult mating.  It is  not a well understood condition.  This problem  can be lifelong or acquired.   Dyspareunia usually occurs ten years after the start of sexual activity unless it has always been present.  Causes can be an infection, a skin problem, trauma, dryness, male factors, such as prostatitis as well as other physical and psychological factors.

“I hold it true, whate’er befall;

I feel it when I sorrow most;

Tis better to have loved and lost

Than never to have loved at all.”

Alfred Lord Tennyson

“Dyspareunia (difficult mating) is defined as genital pain that occurs before, during, or after intercourse.  The repeated experience of pain during intercourse can cause marked distress, anxiety, and interpersonal difficulties, leading to anticipation of a negative sexual experience and eventually to sexual avoidance.” 

American Psychiatric Association, 4th ed. 1994
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Hemorrhoids are a pain in the butt | Buttpillow.com

Hemorrhoids are much more prevalent in the Western World as compared with Third World Countries. Hemorrhoids are associated with constipation, heavy physical work and the effects of erect posture. Hemorrhoids are common during pregnancy. In addition to hemorrhoids, industrialized countries are at an increased risk for colorectal cancer. If you suspect you have hemorrhoids, always talk to your doctor. Do not self-diagnose!

Hemorrhoids

Hemorrhoids are one of the most frequent problems people in westernized countries face.  An estimated 50 percent of those over the age of 50 years require some type of conservative or operative therapy.  (4)

There are estimates of up to 75 to 90 percent occurrence rates of hemorrhoids in the U.S. population (1, 2, 3, 4, 5).

The cost to the community, both financial and in lost work days, is great; and by any standards, this condition must be considered a major health hazard (7).

The thinker sitting on a cactus - representing people with hemorrhoids
It’s hard to think when you sit on your hemorrhoids. Sit Better, Feel Better.

Hemorrhoids have plagued men and women for centuries, inflicting pain equally on individuals at all levels of society and of all occupations: Emperors (Napoleon); U.S. Presidents (Jimmy Carter); baseball sluggers (George Brett); judges; policemen; truck drivers; cab drivers; and jockeys (6).  It has been said that Napoleon’s hemorrhoids were troubling him during the battle of Waterloo (7, 9).

“I saw a sign one time that said ‘Hemorrhoids awareness week’ at the doctor’s office.  Let me tell you, if you got hemorrhoids, I am sure you are aware of it.  You don’t need a sign to tell anybody about it.”

Larry the Cable Guy

What are hemorrhoids?

A hemorrhoid is defined as “a mass of dilated, tortuous veins in the ano-rectum involving the venous plexuses of that area.”

Taber’s Cyclopedic Medical Dictionary, Edition 18
Info-graph of Hemorrhoid symptoms and treatments
Hemorrhoids line icon Infographics. Symptoms, Treatment. Vector signs for web graphics.

There are internal hemorrhoids and external hemorrhoids.  Internal hemorrhoids are higher up in the rectum and cause rectal bleeding.   External hemorrhoids protrude into and beyond the anal opening and cause itching, swelling, bleeding and pain.  People with external hemorrhoids seek relief from products such as “Preparation H.”  

Hemorrhoids in The Western World 

Today, hemorrhoids are considered to be one of the most common ills of men and women, a judgment made by those with vision limited to the Western World (7).

Hemorrhoids in “Third World Countries”

The high rate of hemorrhoids in westernized societies contrasts sharply with Third World countries.   Only about one in 25 to one in 30 individuals is thought to have hemorrhoids compared to one in two individuals in Westernized societies. One doctor recounted in 30 years’ practice in Africa, one of the only two patients he saw with severe hemorrhoids was a prince taking a semi-European diet (5, 7).

What causes hemorrhoids?

Hemorrhoids are thought to be caused by, or associated with, increased intra-abdominal pressure resulting from:

  • chronic straining to pass constipated stools,
  • heavy physical work, or
  • the effects of erect posture (3).

If constipated, hemorrhoids tend to worsen.  Try not to strain when you have a bowel movement.  Eat a diet high in fiber; and, if necessary take a fiber supplement daily with a lot of water.  

Dalmatian dog with red glasses on toilet reading newspaper - hemorrhoids
Dalmatian dog sitting on a toilet seat with digestion problems or constipation that could lead to hemorrhoids if human.

Pregnancy is a risk factor for hemorrhoids

“About 40 percent of pregnant women develop symptoms they attribute to hemorrhoids (Simmons, S. C. 1972).” 

Pregnancy may predispose women to hemorrhoids because of:

  • a) increased intra abdominal pressure from the pregnant uterus, 
  • b) constipation, 
  • c) hormonal venous dilation (hemorrhoidal tissue contains high levels of estrogen receptors, Saint-Pierre, A., et al., 1982), and 
  • d) increased circulating blood volume (3).
Pregnant woman holding back in pain
Pregnancy Pain. Pregnant Woman Feeling Back Pain, Discomfort.

Hemorrhoid problems are more common in pregnancy.  The large uterus can compress veins which return blood from the legs and rectum promoting swelling.   Also labor and delivery generates tremendous stress on hemorrhoids.  Manage hemorrhoids the best you can before and after labor and delivery of your baby.

Hemorrhoids are common among driving workers  

External compression from poorly designed seating concentrates forces on small areas of the body. This results in high localized pressure. 

The pressure can compress nerves, vessels, and other soft tissues, resulting in tissue-specific damage. These changes may themselves result in disease or predispose other tissues to damage.

Medical studies have shown a high rate of hemorrhoids among truck drivers, cab drivers, and even police officers.  This could be due to the additional ergonomic risk factor of vibrations during driving.  

Trucker Standing in front of a Truck. Driving and hemorrhoids, prostatitis.
Driving is a risk factor for hemorrhoids and prostatitis.

Heavy lifting, standing in the cold and medications can aggravate hemorrhoids

Heavy lifting aggravates the problem.  Try to avoid it.  

Standing out in the cold with insufficient clothing causes you to shiver and tense your abdomen, which is considered to be straining by some doctors.  The recommendation is to stay bundled up when standing out in the cold.

 Also medications, such as codeine, can cause constipation which could cause a hemorrhoidal flair up.

Lifting can cause hemorrhoids
Heavy lifting can cause hemorrhoids and back pain

Minimize external compression to reduce risk factors for hemorrhoids

Preventative measures to reduce risk factors for the development of hemorrhoids should be taken before it is too late.  It is important to minimize external compression from poorly designed seating as much as possible. 

Defective chair upholstery being repaired
Poorly designed seating can cause hemorrhoids

Standing can cause hemorrhoids to swell

“Also, when you are standing, the pressure in your hemorrhoids increases, and they tend to swell more.  Periods of rest — sitting and especially lying down — can be very beneficial if you are suffering with hemorrhoids.” 

Joseph R. Duba, M.D., “Understanding Hemorrhoids”
Toilet paper guy surprised standing is a risk factor for hemorrhoids while holding a roll of toilet paper.
Toilet paper guy is surprised standing is a risk factor for Hemorrhoids.

Hemorrhoids are the most common cause of rectal pain and/bleeding

The term hemorrhoids can be misleading because patients often attribute all rectal complaints to hemorrhoids.  Rectal pain and/or bleeding are common complaints among the general population.  Hemorrhoids are the most common cause of these complaints.  

Discuss hemorrhoidal symptoms with your doctor

The public and some members of the medical profession deem these symptoms, which are commonly attributed to hemorrhoids, harmless.  However, the same set of symptoms can herald serious colorectal disease.    Feelings of embarrassment or apprehension about treatment may make individuals reluctant to discuss rectal symptoms with their physician (4). 

Do not be embarrassed to discuss rectal problems with your care-giver because if it is discovered to be colorectal cancer, and it is detected early, there is an 85 percent cure rate (2).

Industrialized Countries at Increased Risk of Colorectal Cancer

Industrialized countries are at a relatively increased risk (for colorectal cancer) compared to less developed countries that traditionally had high fiber/low fat diets.  

“This point is exemplified by the fact that persons from a low risk country who migrate to the United States over time develop colorectal cancer rates similar to those among native U.S. citizens.”

Fry, R., et al., 1989;  Levin K., et al., 1991

Smoking Increases Risk of Colorectal Cancer

“Cigarette smoking and alcohol consumption have been reported to increase the relative risk of an individual to develop colorectal cancer, (Kune, G., et al. 1992; Martinez, M., et al., 1995).” 

Complaints that can be Confused with Hemorrhoids

“Anorectal disorders represent some of the most common yet poorly understood conditions in primary care.” (2)  Patients often attribute all anorectal complaints to hemorrhoids.

Cartoon man with pained expression holding his low back & butt
Cartoon man holding holding his lower back and butt with a pained expression

Other conditions include:

  • Anal fissures (tares);
  • Anorectal abscesses (infection);
  • Fistula (channel) ;
  • Incontinence;
  • Pruritus ani (itching and burning of the anal skin);
  • Infectious proctitis (rectal inflammation);
  • Hidradenitis suppurativa (disease of sweat gland);
  • Condyloma acuminatium (genital warts); 
  • Anal carcinoma (cancer).

Anal fissures

Anal fissure – A fissure is a crack or tear in the anal mucosa usually caused by the passage of a hard stool.  “Nearly half of the patients present with the complaint of hemorrhoids,” (Mazier, WP, 1994).

Anorectal abscess

Anorectal abscess – An anorectal abscess results from cellulitis or infection  (Stahl T.H., 1992).  Anorectal abscesses usually are obvious, producing diffuse swelling, redness, and pain around the anus.  Most abscesses are aggravated by sitting, coughing, sneezing and defecation (Goligher, J., et al., 1984).

Anal fistula

Anal fistula – A tract from the rectum to the surrounding skin that bowel contents can escape from.  Anal fistulas are predominantly found in middle aged men. (Goligher J. et al., 1984)

Anal incontinence

Anal incontinence – Loss of control of flatus and feces.  Young patients with incontinence may suffer enlargement of the colon from chronic constipation or trauma to the anal sphincter apparatus (Goligher, J. Et al. 1984).

“Older women are particularly at risk for incontinence due to progressive denervation (loss of nerves) of the pelvic floor musculature (muscles) from prior birth-related injury.”

Toglia, M.R., 1996

Pruritus ani 

Pruritus ani – intense itching and burning discomfort of the perianal skin.

Excessive cleaning of the anal area with soap and water can cause big problems if you are suffering with hemorrhoid pain / irritation because you remove the natural oils from the area.  The area should be kept lubricated with Vaseline if necessary.  

  When you are having external hemorrhoid pain/irritation, make sure that you use toilet tissue with added lotion, (for example Puffs Plus).

Guy holding toilet-paper making ok gesture
Toilet paper guy says it will be okay. With luck, your Hemorrhoids will go away.

Proctitis 

Proctitis – an inflammation limited to the distal 10 cm of the rectum (Centers for Disease Control and Prevention, 1993).

Hidradenitis suppurativa

Hidradenitis suppurativa – a chronic inflammatory disease of the sweat glands of the skin (Goligher, J. Et al., 1984).   It is usually common in people with oily skin.

Anal condylomas 

Anal condylomas – warts are caused by the human papilloma virus (HPV).  It is known that HPV is linked to cervical cancer in women. “Anal warts appear to be most common in young men especially those engaging in anal intercourse,” (Tedesco, F., et al., 1980).

References:

1. Primary Care, Volume 26, Number 1, March, 1999, “Hemorrhoids,” by Joy N. Hussain, M.D., Cairns Base Hospital, Australia.

2.  Family Medicine Principles & Practices, 1998, Fifth Edition: Chapter 91, “Diseases of the Rectum and Anus,” by Thomas J. Zuber; 2b.

3. Family Medicine Principles & Practices, 1998, Fifth Edition: Chapter 92, “Colorectal Cancer,” written by Gregory L. Brotzman and Russell G. Robertson.

4. MJA, Vol. 167, July, 1997, Clinical Practice, “Hemorrhoids: A Clinical Update,” written by Adrian L. Polglase, M.S., FRACS, Clinical Associate Professor and Colorectal Surgeon, Australia.

5. American Family Physician, September 1, 1995, “Non-surgical Treatment Options for Internal Hemorrhoids, written by John Pfenninger, M.D., and James Surrel, M.D.

6.  Surgical Clinics of North America, Vol. 65, No. 6, December, 1988, “Hemorrhoids, Non-operative Management,” written by A. R. Dennison, M.D.; D.C., Wherry, M.D.; and D.L. Morris, M.D., Ph.D.

7.  Southern Medical Journal, Vol. 81, No. 5, May, 1988, “Alternatives in the Treatment of Hemorrhoidal Disease,” by Emmet F. Ferguson, Jr., M.D., University of Florida, School of Medicine, Jacksonville, F.L., U.S.A.

8.  Postgraduate Medical Journal, September, 1975, 51, 631-636, “Hemorrhoids – Postulated Pathogenesis and Proposed Prevention,” written by D. P. Burkitt, C.M.G., M.D., F.R.C.S., F.R.S., and C.W. Graham-Stewart, MS, F.R.C.S.

9.  The American Journal of Proctology, Vol. 21, No. 3, June 1970, “An Epidemiological Investigation of Hemorrhoids, written by John Philpot, Ph.D., Rutgers, The State University, New Jersey, U.S.A

10.  “Napoleon’s Hemorrhoids and Other Small Events that Changed,” History by Phil Mason

Woman laughing holding Buttpillow™ at beach
Anka holding Buttpillow™ at the beach when we had photoshoot for “How to Become an Inventor” by Mr. Daniels

A 5,000 year History of Seating | Buttpillow.com

“A History of Seating in the Western World,” is a research paper written by Kim Gurr, who was seeking her Postgraduate Diploma in Ergonomics Research under the supervision of Leon Straker, Physiotherapy and Phillip Moore, Social Sciences; however, Ms. Gurr died before completing her ergonomics research. This research paper covers the 5,000 year period beginning with the Egyptian Era through today’s modern ergonomists.

A History of Seating in the Western World

“A History of Seating in the Western World,” is a research paper based on the Postgraduate Diploma in Ergonomics Research project performed by Kim Gurr under the supervision of Leon Straker, Physiotherapy, and Phillip Moore, Social Sciences, at the Curtin University of Technology in Perth, Western Australia.

Unfortunately, Kim died before finalizing her research.

History of Seating is Important for Ergonomics

Seating is an important issue for contemporary ergonomics. Its frequent use by humans and its association with musculoskeletal disorders are just some of the reasons for its importance.

To understand the place of seating in modern Western societies, it is useful to understand its history.

This paper presents an overview of the ancient history of seating and the modern history of Western seating with particular emphasis on the design influences over the past 5,000 year period.

History of Seating begins with the Egyptians

The history of supporting sitting or seating has a long and colorful history beginning, at least, with the Egyptians some 3,000 B.C.

The historical knowledge summarized here is distilled from a great variety of texts, for it seems our fascination with the chair is as alive today as it was in ancient times.

It should be noted that despite the huge amount of information documented on seat types, only three types of distinctly different seats developed.

These were:

  • the stool (both fixed and folding);
  • the bench, and
  • the chair
Continue reading “A 5,000 year History of Seating | Buttpillow.com”

Buttpillow™ – Patented Ergonomic Seating Cushion

The Buttpillow™ “Patented Ergonomic Seating Cushion” has a hidden wave-form cut-out that elevates the peri-anal area for individuals suffering with hemorrhoids, vaginal pain, dyspareunia, and prostatitis. The Buttpillow™ has an ergonomic wedge shape to help sitting individuals maintain the natural curve of the spine (lordosis) to minimize risk factors for low back pain, and pelvic pain. It is made with medium density open-cell foam for maximum buttock envelopment and pressure-reduction to minimize risk factors for the development of pressure sores, DVT, varicose veins, and sciatica.

Is All This Sitting . . . A Pain in the Butt?

The Buttpillow™ is designed to relieve and prevent pain and problems while sitting.  

Pretty woman sitting on a Buttpillow™
Anka (Ergo-Woman™) on a Buttpillow™-Ergo Giraffe

Sit on The Buttpillow™ . . .  Patented “Ergonomic Seating Cushion”

Patent drawing of Ergonomic Seating Cushion
Image of Patented Ergonomic Seating Cushion from Google Patents

The Buttpillow™ “Patented Ergonomic Seating Cushion” features:

  • The Buttpillow™ reduces sitting surface pressures.  
  • It is made with medium density open-cell foam topped with soft, convoluted foam for maximum buttock envelopment and pressure reduction to minimize risk factors for the development of pressure sores, DVT, varicose veins, and sciatica.
  • The Buttpillow™ elevates the peri-anal area with its patented hidden “wave” peri-anal and tailbone cut-out to relieve and prevent pain associated hemorrhoids, vaginal pain, pain after childbirth, dyspareunia, and prostatitis.
  • The Buttpillow™ has an ergonomic wedge shape to maintain the natural curve of the spine while seated (lordosis) to reduce risk factors for low back pain caused by sitting.

Relieve and Prevent Pain & Problems While Sitting!

  • Low Back Pain
  • Tail-bone Pain
  • Sciatica
  • Hemorrhoids
  • After surgery
  • After childbirth
  • Prostate Pain
  • Erectile dysfunction
  • Pelvic/vaginal Pain
  • Varicose veins
  • Pressure sores
  • Deep vein Thrombosis
Woman standing next to No Life Guard On Duty sign
“No Life Guard on Duty” Sit at your own Risk! Minimize ergonomic risk factors to prevent future pain.

Back Pain Causes, Categories, Risk Factors & Red Flags|Buttpillow.com

Prevalence of Back Pain

Up to 75 percent of the population experiences low back pain lasting more than one week at some point in their lives. By the age of 50 years old, about 85 – 90 percent of adults will have degenerative changes in their vertebral discs, and these changes begin to occur in the third decade (in their 30’s) of life.

Office worker with back pain from office syndrome
Office syndrome Infographics. 

In a one year period, the estimate of people with an episode of back pain is about 17 percent. Also the estimate of the people 18 to 24 years having back pain in a one year period is 13 percent.

Continue reading “Back Pain Causes, Categories, Risk Factors & Red Flags|Buttpillow.com”

The Ergonomics of Neck Pain | Buttpillow.com

Neck and shoulder pain are common among younger and younger men and women. Neck and shoulder pain can be caused by musculoskeletal disorders of the upper extremities. Preventative measures should be taken to minimize risk factors for neck and shoulder pain before you are in pain. The risk factors for and causes as well as preventative measures for the development of neck and shoulder pain outlined in the research are listed here.

Neck pain is a very common condition that affects nearly 50 percent of people over the age of 50 years at some point in their lives.  With the increased use of computers and other stationary-designed workplaces, more and more younger persons are faced with this problem.

There are many structures in the neck that can cause pain. There are also multiple sites, when problematic, that can cause referred pain to the neck.

It is important to note the following:  Whether pain is felt outside the neck; whether pain is felt in the shoulders, whether pain is felt down the arms, or whether pain is felt in the hands.

Incorrect and correct positions for talking ergonomically via phone
Incorrect and correct positions for talking via smart phone. Neck and shoulder pain.

Signs to Seek Medical Attention for Neck Pain

Signs to seek medical attention as soon as possible include the following:

  • Numbness,
  • Weakness,
  • Tingling of the upper extremities,
  • Severe headaches,
  • Visual changes,
  • New neck pain lasting more than three weeks,
  • Persistent neck pain.  

The Anatomy of the Neck 

The anatomy of the neck is made up of the cervical spine which, in turn, is composed of seven vertebrae (bones) which are joined by intervertebral discs. These discs are made up of a gel-like material that absorbs increased pressure. During the fourth decade of life (40’s), progressive degeneration of these discs occurs. The end result is a decreased ability of the discs to absorb shock and pressure.

Two Common Causes of Neck Pain 

Two common causes of new or persistent neck pain are bulging discs and bone spurs.

Bulging Discs

As the disc loses some of its shock absorbing ability, it grows; and at times will bulge on the structures surrounding it.

Bone Spurs

It is also common for the vertebrae themselves, which are made of bone, to grow additions called bony spurs. The spurs may grow in such a way as to compress nerves in the neck.

Bulging Discs and Bone Spurs May Cause Neck Pain to be Referred

Both May Cause Neck Pain to Be Referred

People with either condition may experience pain that can be referred to any level of the back of the neck. 

Muscle Spasms may Cause Neck Pain

Also, spasms of any of the many muscles of the neck are common causes of neck pain.

Try to Date When Your Neck Pain Began

It is helpful to date when the neck pain began. Once a specific activity can be linked to neck pain, treatment is easier.  Most people with neck pain have no objective findings on physical exam.    The history of the neck pain is an important tool for you and your health care provider to use to diagnose the cause of each pain.

Bending your head forward can cause Neck Pain / Spasm

Prolonged sitting with the neck flexed (bent forward) in one position, such as work on computers, is a common occupational cause of neck pain. A sustained position (without moving regularly) can cause spasm of the neck muscles and resulting pain.

Prolonged sitting with the neck bent forward (for example, on social medial, looking down at your phone) increases your risk for twisting injuries which may not hurt for 24 – 48 hours after the incident.

Bending your head back can cause Neck Pain

Prolonged neck extension (bent backward, looking up) is another common occupational situation that can give rise to neck pain in people doing overhead work.

The physical exam of the neck demonstrates that most people can easily place their chin on their chest, touch both shoulders with the chin and bend sideways to touch ear to shoulder on both sides.

Sitting woman doing neck exercises to minimize risk of "computer syndrome"
woman doing exercises to minimize risk of neck and shoulder pain, office worker syndrome, computer syndrome

Normally, the neck can be extended so a person is looking up at the sky.  Sometimes, slight neck extension causes pain and this could be caused by disc degeneration, which is common.

Studies show that degenerative changes in the spine of the neck (cervical spine) in people without complaints are evident in over 90 percent of people over 50 years old.

Treatment for Neck Pain 

Treatment of the neck differs if the neck needs to be immobilized with a collar. If this is you, you most likely will know who you are.

If your neck hurts, the first treatment is:

  • aspirin (as long as you are not pregnant) or Tylenol-related products;
  • and — believe it or not — performing as much of your daily activities as possible.

Muscle Relaxants May Be Prescribed

If neck pain lasts for more than three to four days, a course of muscle relaxants prescribed by your physician may be helpful.

People may seek manipulation therapy for neck pain. Be aware that the value of this type of treatment is uncertain.

Workplace Design is Critical to Minimize Neck Pain

One of the most important treatments is one of the least recognized. It is observation of your surroundings to determine what may be causing the pain.  Workplace design and body motion are critical elements that can worsen pre-existing conditions or create / prevent new ones.

Workplace Design can minimize Ergonomic Risk Factors 

The study titled, “Physicial Risk Factors for Neck Pain”  concluded that there is a positive relationship between neck pain and the duration of sitting and twisting or bending of the trunk.

“It was concluded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors:

  • Neck flexiom,
  • arm force,
  • arm posture,
  • duration of sitting,
  • twisting or bending of the trunk,
  • hand-arm vibration,
  • workplace design.”

If you feel you may need to see a doctor, check out these links:

The American Academy of Orthopaedic Surgeons: https://orthoinfo.aaos.org/en/diseases–conditions/neck-pain/

WebMD:  https://www.webmd.com/pain-management/guide/neck-shoulder

Spine-Health:  https://www.spine-health.com/conditions/neck-pain/chronic-neck-pain-what-condition-causing-my-neck-pain

The Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/neck-pain/symptoms-causes/syc-20375581 

References with Quotes:

1.  Physical Risk Factors for Neck Pain

“Ergonomic risk factors for different types neck and shoulder disorders, such as:  —  

– Cervical spondylosis;

– cervical syndrome a/k/a cervical disc disease;

– thoracic outlet syndrome;

– shoulder joint osteoarhorosis;

– rotator cuff tendinitis;

– tension neck syndrome  a/k/a “tendomyotic pressure pains in shoulders and neck”    —    can be minimized.

Scandinavian Journal of Work and Environmental Health, 2000; 26(1):7-19, “Physical Risk Factors for Neck Pain,” by Geertje A.M. Ariens, Msc; Willem van Mechelen, PhD.; Paulien M. Bongers, PhD; Lex M. Bouter, PhD; and Gerrit van der wal, PhD.

2.  Risk Factors for Musculoskeletal Disorders Among Newspaper Employees

“A total of 973 workers completed the survey.  The one-year period prevalence rate for any musculoskeletal disorder of the upper extremities was 41 percent.  Neck symptoms (26 percent) were the most frequently reported, followed by hand or wrist (22 percent), shoulder (17 percent), and elbow (10 percent) symptoms.”  

Scandinavian Journal of Work and Environmental Health, 1994; 20:417-26, “Job Task and Psychosocial Risk Factors for Work-Related Musculoskeletal Disorders Among Newspaper Employees,” written by Bruce Bernard, M.D.; Steven Sauter, PhD; Lawrence Fine, M.D.; Martin Petersen, PhD, and Thomas Hales, M.D.

3. Ergonomics Method for Prevention of the Musculoskeletal Discomforts Among Female Industrial Workers:

“Five main factors were associated with musculoskeletal discomforts: 

1) Lack of worker selection and lack of appropriate training to prevent occupational hazards or work-related diseases;

2) Poor ergonomic design of the workplace and tasks, including organization;

3) Poor working posture;

4) Lack of task variation;

5) Insufficient rest breaks.”  

Journal of Human Ergo., 1993: 22:95-113, “Ergonomics Method for Prevention of the Musculoskeletal Discomforts Among Female Industrial Workers: Physical Characteristics and Work Facts,” written by P. Chavalitsakulchas and H. Shahnavaz, Center for Ergonomics of Developing Countries, Luled University, Sweeden.

4. Workplace Ergonomic Factors and the Development of Musculoskeletal Disorders of the Neck and Upper Limbs

“The rise in frequency of these (musculoskeletal) disorders is believed to be associated with the advance of automation and specialization in work (National Occupational Health and Safety Commission, 1988).  Much faster work rates and the redesign of jobs often require that a production worker or data entry clerk do a single task or a very limited number of tasks repeatedly, commonly tens of thousands of times per day.  Although new technologies have generally reduced the workload and fewer jobs entail heavy lifting, the repetitiveness of today’s ‘light work’ concentrates the work load on fewer, smaller muscle groups.”  

American Journal of Industrial Medicine. 1991; 19:87-107, “Workplace Ergonomic Factors and the Development of Musculoskeletal Disorders of the Neck and Upper Limbs: A Meta-analysis,” written by Susan Stock, M.D.:

5.  Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups 

Cervical Spondylosis

“Cervical Spondylosis – degenerative arthritis (osteoarthritis) of the cervical vertebra and related tissues.  If severe, it may cause pressure on nerve roots with subsequent pain or paraesthesia (numbness and tingling) in the arms.  

Cervical Syndrome (cervical disc disease)

“Cervical Syndrome (cervical disc disease) . . .for data entry operators the diagnostic criteria was; a) neck pain radiating to one or both arms; and b) numbness in the hands in addition to:  c) limitation of neck movement and radiating pain provoked by test movements.  Pain in the neck radiating to the arm with a segmental distribution was our concept of Cervical Syndrome. 

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Thoracic Outlet Syndrome

“Thoracic outlet syndrome – a symptom complex caused by conditions in which nerves or vessels are compressed in the neck or under the axilla (underarm).  Anatomically, the cause is compression by structures, such as the first rib pressing against the clavicle (collar bone).”   

Tabers Medical Dictionary 

Shoulder Joint Osteoarthrosis

“Shoulder Joint Osteoarthrosis – our concept of shoulder joint osteoarthosis is that of a reduction in the articular cartilage height (cushions between the bones) and sclerosis (degeneration) in the structures of the glenohumeral joint (shoulder joint).  

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Rotator Cuff Tendinitis

“Rotator Cuff Tendinitis Shipyard welders, plate workers, and male office workers  had the following the criteria for this condition:  localized shoulder pain and tenderness of the humeral head (top of the arm bone).  

Tension Neck Syndrome

“Tension Neck Syndrome- A constant feeling of one or more subjective symptom.  

“For example neck pain or headache in addition to signs of at least two tender spots or palpable hardening (feeling hard bumps in your neck muscles), or both, plus muscle tightness in neck movements — were the diagnostic criteria of Tension Neck Syndrome for the Finnish studies of slaughterhouse workers, data entry operators, assembly line packers, shop assistants, and female office workers.

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Tension Neck Syndrome a/k/a tendomyotic pressure pains

“For the Swiss, data entry operators, ‘conversational terminal operators,’ typists, and office workers, the medical finding listed as ‘tendomyotic pressure pains in shoulders and neck’ was regarded as Tension Neck Syndrome.”  

Tension Neck Syndrome is most common shoulder-neck disease

“It should be noted that Tension Neck Syndrome had the highest rates of all shoulder-neck diseases studied and women tended to have higher rates of Tension Neck Syndrome than men.”

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A