The causes of migraine, including vestibular migraine, are not completely understood and symptoms can vary greatly. Evidence suggests that dietary factors may play a role in several of the triggering mechanisms. According to a review of studies, the most commonly reported foods and drinks that have been identified as migraine triggers include chocolate, cheese, nuts, citrus fruits, processed meats, monosodium glutamate (MSG), aspartame, fatty foods, coffee, and alcohol. While it is generally accepted that migraines are sensitive to diet and that diet may trigger migraine attacks, there is no definitive list of these foods. According to a study published in the journal Nutrients, the following foods have been noted in the scientific literature as potential contributors to migraine:

• Chocolate
• Citrus fruits
• Nuts
• Ice cream
• Tomatoes
• Onions
• Dairy products
• Alcoholic beverages
• Coffee
• Caffeine
• Monosodium glutamate (MSG): commonly found in fast food, chips and snack foods, seasoning blends, frozen meals, canned soups and soup and noodle mixes, processed meats, and condiments
• Histamine: found in alcohol and other fermented beverages and foods, like yogurt and sauerkraut, dried fruits, avocados, eggplant, spinach, processed meats, shellfish, aged cheese
• Tyramine: found in aged cheese, cured meats like salami and pepperoni, pickled and fermented foods, dried fruits, alcoholic beverages
• Phenylethylamine: found in chocolate, wine, natto, eggs, some nuts and seeds like almonds, walnuts, and flaxseeds, and some beans like soybeans, lentils, chickpeas, and green peas.
• Nitrites: added to foods such as cured deli meats, bacon, and sausage.
• Aspartame: artificial sweetener added to some sugar-free sodas, ice cream, gum, yogurts, dressings, etc.
• Sucralose: sweetener that may be found in packaged baked goods, beverages, chewing gum, frozen dairy desserts, etc.
• Gluten: found in beer, breads, cakes, candies, cereals, cookies, crackers, muffins, pancakes, etc.

Research has also suggested that it can take high amounts of some of these foods to trigger a headache, withdrawal from some of these foods, notably caffeine, or fasting. According to one systematic review, fasting was shown to be a migraine trigger for 44 percent of people. In addition, some diets, such as Atkins, Mediterranean, ketogenic, low-sodium, and low-fat have been reported to reduce migraine attacks.

There are no official dietary guidelines for vestibular migraines, but an elimination diet, where common trigger foods are removed from one’s diet, one by one, is often used. Using a food diary, people note how they respond to the removal of certain foods that they suspect may worsen their symptoms, and then slowly reintroduce these foods to determine those that may trigger migraines.

In addition to following an elimination diet, researchers are exploring the role of probiotics in the changing of the gut microbiome in people with migraine. Foods that are high in probiotics include olives, apple cider vinegar, yogurt, kefir, kimchi, miso, kombucha, and pickles. Note, however that several of these probiotic-rich foods appear on the common trigger food list for migraines.

Whichever dietary routes you try to lesson and prevent migraine headaches, it’s generally good advice to seek out a mostly whole foods diet rich in fruits, vegetables, whole grains, minimally processed meats, poultry, and fish, eggs, healthy fats and herbs and spices as a way to enjoy healthy, nutrient-rich foods as part of a healthy lifestyle.

Access our Free Guide for Headache Relief. 

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Bone spurs can also form at the edges of the bones that make up your spinal column, called vertebrae. Bone spurs of the spine may not cause any symptoms and you can’t see them or feel them. But, if they grow large enough they can cause two spinal conditions. If they squeeze (compress) the spinal cord, they can cause a condition called spinal stenosis. If they squeeze the nerves leaving the spinal cord that go to your arms and legs, they can cause a condition called radiculopathy.

What causes spinal bone spurs?

By far, the most common cause of spinal bone spurs is osteoarthritis. Osteoarthritis is the most common cause of joint pain, stiffness, and swelling. It is often called “wear and tear” arthritis because it occurs over time. Joints are protected at their ends by cartilage. As cartilage wear down and thins out over years of use, bones start to rub on bones. The bones try to make more cartilage for protection, but this often results in overgrowth of bone called an osteophyte or bone spur.

Because osteoarthritis occurs over many years, it is most common in people over age 60. An injury to the spine can speed up the process. Other risk factors include being overweight, not getting enough exercise, and having bad posture. Having a job that requires years of lifting and bending may also be a risk.

What are the symptoms of spinal bone spurs?

Spinal bone spurs are common and most people do not have any symptoms, although they may show up on an x-ray. If they get large enough and cause spinal stenosis or radiculopathy symptoms occur. The most common areas for symptoms are the neck and lower back.

• Spinal stenosis of the lower back causes burning pain and aching in the lower back and buttocks. Pain may extend down into the legs and get worse with walking or standing. There may also be weakness and numbness in the legs. Spinal stenosis of the neck causes similar pain, but the weakness and numbness occur in the arms, hands, and fingers.
• Radiculopathy causes symptoms in the areas supplied by the nerves leaving the spine that become compressed by spinal bone spurs. Symptoms include sharp pain in the neck, shoulders, back, or legs. Pain gets worse with activity. There may also be weakness, numbness, or “pins and needles” sensations.

What is the treatment for bone spurs on the spine?

Home care may include ice, rest, and over-the-counter pain and inflammation medications called NSAIDs, like Advil or Motrin. Losing weight and staying active are also important. Physical therapy may be prescribed by a health care provider. When OTC meds and home care are not helping, injections of numbing and anti-inflammatory medications into the vertebral spaces may help. As a last resort, spinal bone spurs may be removed surgically.

Learn more about bone spurs on your feet.

Exercises for spinal bone spurs

Exercises that strengthen the spinal muscles and increase flexibility may reduce bone spur symptoms. These stretching and strengthening exercises can be started safely in physical therapy and continued at home. Losing weight, maintaining a healthy weight, maintaining good posture, and staying fit and active are the best ways to prevent spinal bone spur symptoms.

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By age 70, for about 40 percent of people, the knee joint cartilage has started to thin or wear away. Bones are grinding on bones, the joint space gets narrower, and symptoms of pain and stiffness start to be a problem. There is no cure for osteoarthritis and it tends to gets worse over time, but there are some effective treatments. For about 10 percent of people with knee osteoarthritis, knee injections are part of the treatment.

American Academy of Orthopedic Surgeons (AAOS) Treatment Guidelines

According to the AAOS, the first treatments for osteoarthritis should include physical therapy and home exercise, nonsteroidal anti-inflammatory drugs (NSAIDs), weight loss if needed, and low-impact aerobic exercise. These treatments are called non-invasive treatments because they do not involve any injections or surgery. They can be managed with your primary care doctor. Non-invasive treatments can’t reverse damage done by osteoarthritis or prevent damage from getting worse, but they can slow down the disease and relieve symptoms. For many people, this is enough to make the disease manageable.

NSAIDs can include both over-the-counter medications like Advil or Motrin, and prescription strength NSAIDs from your doctor. Physical therapy may include exercise, heat or cold applications, as well as massage or low-voltage transcutaneous electrical nerve stimulation (TENS) to reduce pain. Low-impact exercises reduce joint stress and can include swimming or walking.

There is not much evidence to support alternative treatments. Some studies suggest a role for acupuncture to reduce pain. There is less support for joint supplements like glucosamine and chondroitin. Although many people seem to get relief, studies suggest this is probably a placebo effect. Omega-3 fatty acids in fatty fish or fish oil supplements have better evidence than other supplements for relief of pain and improving function.

The Role of Knee Injections

Knee injections are invasive therapies, usually given by an orthopedic specialist. According to two 2022 studies presented at the annual meeting of Radiological Society of North America; people who had steroid knee injections had more progression of osteoarthritis on knee imaging studies than people who had no injections. Steroid knee injections were also associated with more progression than knee injections using a substance called hyaluronic acid. Steroids work by decreasing swelling in the knee, so they do relieve pain and improve movement. Hyaluronic acid is a lubricant that may help protect the remaining cartilage in the joint.

These new studies do not prove that steroid injections make knee osteoarthritis worse, and they are not the first studies to suggest that steroids may be linked to worse long-term outcomes. It may be that the patients who get steroid injections just have worse arthritis. According to AAOS guidelines, steroid injections are reserved for people who have significant changes on their knee x-rays, severe pain, and have not responded to non-invasive treatments.

AAOS guidelines say steroids should be used for severe pain and inflammation because most studies show that these injections reliably relieve pain and swelling. AAOS does not recommend hyaluronic acid as a first treatment for severe osteoarthritis because the research does not support it. AAOS also says steroid injections should be limited to three or four times per year to reduce the risk of worsening joint damage over time.

The Role of Knee Surgery

Knee replacement surgery is recommended when all other treatments are not helping. Advances in knee replacement surgery have made it one of the fastest growing surgical options, even in people under age 60. The main reason is that replacing the knee with a meatal and plastic joint takes the pain away and returns basic function. In the hands of an experienced orthopedic surgeon, these results benefits are very reliable, and can last from 15 to 25 years.

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The Migraine Ice Hat

There is not much recent research to support the use of the ice hat, but the use of ice is a very popular remedy among migraine sufferers. In fact, it may be the first or second home remedy that people with migraines use when they have an attack. Along with getting to a quiet dark space, drinking lots of water, lying down, and closing your eyes, Mayo Clinic and the National Headache Foundation both recommend a cold compress or ice pack over your eyes and forehead.

Although there are no big clinical trials that compare the use of an ice cap to a placebo or another home remedy, there was one small study in 2006 published in the journal Evidence Based Complementary and Alternative Medicine. In this study, 26 women used a cold gel pack very similar to the ones being sold today. The cap was removed from the freezer and slipped over the head and ears. There was also a cover for the eyes. The women in the study used the cold gel pack at the start of a migraine attack for 25 minutes.

Before using the ice cap treatment, the women rated their pain from one to 10. They rated the pain again after the 25-minute treatment. The average pain score went from almost eight down to just below two. The researchers concluded that cold application may be effective for some patients suffering from a migraine attack. So, a modern-day ice hat may be a home remedy option for you, but you might get the same result with a simple cold cloth or ice pack wrapped in a towel, as suggested by the Mayo Clinic.

Relaxation Techniques

According to the National Institutes of Health’s National Center for Complementary and Integrative Health (NCCIH), relaxation techniques for migraine headaches can release the body’s natural relaxation response and this response may help during a migraine attack or may reduce stress that triggers and attack. Examples of relaxation techniques include meditation, progressive muscle relaxation, breathing exercises and mind body exercises. These techniques can be learned and used at home to relieve or reduce the frequency of migraine attacks. Examples of mind body exercise are Tai Chi and yoga. Tai Chi is a Chinese exercise that combines controlled breathing, meditation, and slow graceful movement. Regular aerobic exercise and yoga reduce tension and can help reduce migraine attacks, according to the Mayo Clinic.

Herbs Vitamins, and Minerals

Over-the counter (OTC) supplements made from herbs, vitamins, or minerals are other popular home remedies. Most of these remedies have little research to support their use, but a few have been effective in some small clinical trials:

• Butterbur is a plant extract available as a supplement. There was enough evidence for this supplement for the American Academy of Neurology to recommend it until 2015, when it became apparent that butterbur could cause serious liver damage. This option should be avoided unless you discuss the risks and benefits with your doctor, advises NCCIH.
• Coenzyme Q10 is a natural substance of the body that acts as an antioxidant. A review of six studies concluded that this supplement may shorten and decrease migraine attacks, but the benefits were small. This supplement has no serious side effects but may interfere with insulin or the blood thinner warfarin.
• Feverfew is an herbal supplement that has been studied for migraine and may be sold as a migraine supplement, but the studies are described as inconsistent and this supplement has several side effects, including rash and indigestion. It is not recommended by NCCIH.
• Magnesium is a mineral that is natural in the body and studies show that it may reduce the frequency of migraines but it needs to be taken in high doses for this effect, which can result in stomach ache, nausea, and diarrhea. Large doses of magnesium are not considered safe.
• Riboflavin is a B vitamin that has been studied for prevention of migraines. Some studies suggest it may help, and it is a safe supplement without side effects or interference with medications.
• Omega-3 fatty acids are healthy fats found in cold water fish like salmon and mackerel. Studies show that a diet high in these fats may reduce migraine frequency and severity, but the same benefits have not been shown in to occur in supplement form.

Lifestyle Changes

According to the American Migraine Foundation, there are some lifestyle changes that are strongly supported and can benefit anyone with migraine. The acronym SEEDS can help you remember these important changes:

• S is for sleep. Poor sleep is a common migraine trigger. You should get seven to eight hours of sleep every night and keep the same schedule for going to sleep and getting up in the morning. Have a bedtime routine and make sure your bedroom is quiet, dark, and comfortable.
• E is for exercise. Thirty to 50 minutes of moderate intensity exercise increases brain chemicals called endorphins that that reduce migraine attacks. Make exercise a daily priority.
• E is for eating. Eat a heart healthy diet and eat meals at regular hours. Avoid sugar added and processed foods. Don’t skip meals or try fasting diets. Hunger is a migraine trigger. So is dehydration, so drink plenty of water. Red wine may be a trigger for migraines and caffeine can dehydrate you.
• D is for dairy. There are many possible migraine triggers and different people may have different triggers. Keeping a headache diary is the best way to find your triggers and avoid them. Keeping track of the number of headaches you have, when they occur, and how long they last will help your doctor develop the best treatment plan for you.
• S is for stress. Stress is a universal trigger for migraine. Avoid stress when you can, and use your relaxation techniques when you can’t.

Finally, you should know that home remedies are no substitute for medical treatment. Most people with migraines will benefit most from medications. Fortunately, there are lots of options that include medications to relieve pain, stop an attack, and prevent or limit attacks. Work with your doctor to find the best treatment plan, one that includes medications, home remedies, and lifestyle changes.

To learn more, access our free special health report on headache relief. 

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A common cause of longer-term low back pain is a tear, bulge, or degeneration of a spinal cord disc. A bulging disc can push on a nerve leaving the spinal cord and cause pain that shoots down the leg, called sciatica. No matter what the cause is, sitting is not good for low back pain. It makes the pain worse, prolonged sitting can even be the cause of low back pain.

Why Is Sitting Bad for Back Pain?

According to Harvard Medical School’s Harvard Health, sitting puts more pressure on your spinal discs than standing. In fact, the best way to relieve back pain from sitting is to get up and move. Studies show that people who sit for work are at higher risk for low back pain. People who work in offices or work on the computer from home may spend more than five to seven hours of a work day sitting. Leisure time spent sitting in front of a TV or gaming on a computer screen also adds to sitting time.

People who work at call centers and answer phones may spend 95 percent of their work day sitting. A recent study in the journal Applied Ergonomics found that 75 percent of call center workers experienced low back pain. Workers who had less pain moved more, even while sitting. Changing position and stretching while sitting is called dynamic sitting. People who moved less, called static sitting, had more pain.

How to Sit When You Need to Sit

The first rule is get up and move about every 10 to 15 minutes, never sit for more than 30 minutes. While sitting, be dynamic not static. Change position and stretch your back and shoulder muscles in your chair.

Cleveland Clinic offers these tips for sitting with back pain:

• Get up every 15 minutes.
• As soon as you get up, do some stretching and then walking.
• Support the natural inner curve of your lower back – called the lordosis – while sitting. If your chair does not support your lordotic curve, place a rolled towel or cushion for support.
• Use a straight-backed chair with a firm seat and arm rests.
• Sit with your back supported and with your feet flat on the floor.
• Don’t cross your legs.
• Rest your elbows on the chair or desk and sit close enough so you don’t have to lean forward.
• The height of your chair should allow your thighs and your forearms to rest at a 90-degree angle from the rest of your body (straight out, not tilting up or down).
• Use the same rules for leisure sitting. Slouching in a soft chair will make back pain worse.

Other ways to prevent or reduce back pain are exercising regularly, adding exercises to stretch and strengthen back muscles, keeping good posture while walking, standing, and sitting, maintaining a healthy weight, and not smoking. Smoking ages your spine.

AAOS adds these tips for back pain:

Use heat or ice to reduce back pain and muscle spasms. Use over-the-counter pain relievers. Call your healthcare provider if back pain continues for a few weeks or gets worse. Get help right away if:

• You have loss of feeling or weakness in your lower body.
• You have back pain after an injury or with a fever.
• Your pain gets suddenly worse.
• You have loss of feeling or movement.
• You have loss of bowel or bladder control.

For more information, see our health report Managing Low Back Pain.

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Sciatica is different than low back pain. Low back pain causes pain only in the back. Sciatica is pain that follows the path of the sciatic nerve, so the pain is felt in the back, buttock, back of the thigh, and the calf. Pain that moves from one area to the other is called radiating pain. Sciatica usually affects only one nerve on one side of the body.

Sciatic pain can be described as mild, severe, aching, or burning. It may feel like a sudden shock of pain and it may be triggered by coughing, sneezing, straining, lifting, or twisting. Other common symptoms of sciatica may include weakness, numbness, or tingling (“pins and needles”).

Sleeping With Sciatica

Symptoms of sciatica may be worse at night and may wake you up or keep you from falling asleep. The exact cause and severity of sciatica is different for different people, so there is no single solution to sleeping with sciatica. There is no recommendation for a specific type of mattress or pillow.

According to Cleveland Clinic, the key to sleeping with sciatica is to find the most comfortable sleeping position for you. If you usually sleep on your back, it could be the best position. Some people have less pain when the spine is straight. If that works for you, place a small pillow under your head and another under your knees.

If you are used to sleeping on your side, that could also be the best position, since some people have less pain when the spine is bent slightly forward. If this position works for you, place a pillow under your head, behind your back, and between your knees. Sleep on the side opposite your sciatic pain. The good news is that sciatica usually goes away on its own without treatment, so you should only have to make it through a few nights.

Causes, Diagnosis, and Treatment for Sciatica

You may be at higher risk for sciatica if you are overweight and inactive. The most common age for sciatica is 30 through 50. After a bulging disc, the most common cause of sciatica is a bony growth on a vertebra – called a spur – that presses on the nerve. People with diabetes may have diabetic nerve damage that affects the sciatic nerve. Rare causes include a spinal blood clot, abscess, or tumor. You may also be at higher risk of you have bad posture or if you have a job the requires a lot of lifting or sitting. In most cases, sciatic pain will go away in a few days. If you have sciatic pain more than one week, pain that is getting worse, or pain that is causing weakness or numbness, let your doctor know.

If you are sitting at a computer most of the day, sitting with correct posture is important. © Maanas | Getty Images

To find the cause and best treatment, your healthcare provider will do a physical exam and may order imaging studies of your lower spine with x-ray or MRI. Treatment may include nonsteroidal anti-inflammatory drugs for pain and inflammation, physical therapy, and home care. In rare cases, surgery to remove a bone spur or repair a herniated disc may be needed.

Sciatica Treatment at Home

Home care for sciatica pain may include:

• A short period of rest followed by movement
• Physical therapy exercises at home
• Hot or cold compresses
• Maintaining good posture
• Avoiding heavy lifting

It is important to know that resting your back too long does not help sciatica get better. Your back needs to be moving to get blood flowing to your lower back area and to prevent stiffness and loss of muscle tone. Even if it is a little painful at first, movement is the most important part of home care.

Sciatica is not a medical emergency, but some conditions that cause sciatica may be, if the spinal cord is being compressed and nerves are being damaged. Get help right away if you have complete loss of feeling or severe weakness, or if you lose bowel or bladder control.

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Acetaminophen vs Ibuprofen

The other common OTC pain and fever reliever is acetaminophen, with the brand name Tylenol. Although acetaminophen and ibuprofen both reduce fever and pain, acetaminophen is not an NSAID, so it does not reduce inflammation. Inflammation is swelling, redness, and warmth caused by the body’s defense system, called the immune system.

Both acetaminophen and ibuprofen may work for pain and fever, but if you also have inflammation, ibuprofen is the better choice. Inflammation is your body’s response to an infection, injury, foreign body (like a splinter), or irritation from a chemical or toxin (like a bee sting). Inflammation is a sign that your immune system is active, but it can be uncomfortable because it causes swelling, pain, heat, and redness. It can also cause loss of body functions, like loss of smell if your nose is inflamed or loss of movement if a joint is inflamed.

Ibuprofen Side Effects

The most common side effect of ibuprofen and other NSAIDs is stomach and intestinal irritation that causes heartburn, nausea, gas, constipation, or a stomachache. If you take ibuprofen for a long time or at a high dose, you can have more serious and dangerous complications like developing a bleeding ulcer or kidney damage.

You may have read or heard that ibuprofen increases your risk of stroke or heart attack. This risk is not significant if you do not already have a history of heart or blood vessel (cardiovascular) disease. If you do have a history of cardiovascular disease, ask your doctor about taking ibuprofen. It may increase your risk of heart attack or stroke by about 0.1 to 0.2 percent.

Acetaminophen Side Effects

Acetaminophen side effects are less common than ibuprofen side effects, although a few people may have nausea, vomiting, or a headache. The most serious side effect of acetaminophen only occurs if you take an overdose of more than four grams or four thousand milligrams (4000 mg). This could happen if you take more than eight extra-strength Tylenol tablets at one time. At this dose Tylenol can be very toxic to your liver, and may even be life threatening. Taking high doses of Tylenol if you are also drinking alcohol can be even more dangerous because both Tylenol and alcohol can be toxic to the liver. If you have liver disease you should talk to your doctor about acetaminophen and limit the dose to 3000 mg per day.

Ibuprofen or Acetaminophen for Headache?

For pain without inflammation, like a headache, both ibuprofen and acetaminophen will work. Some studies say that ibuprofen is a little stronger. Both drugs last about the same time and can be taken every four to six hours. Pain caused by an injury or infection that causes inflammation responds better to ibuprofen. Examples would be a sprained ankle, toothache, or infection. For women, pain caused by menstrual cycles responds better to ibuprofen because it reduces menstrual cramps.

To avoid side effects, adults should not take more than 1200 mg of ibuprofen or 3000 mg of acetaminophen in a single day. Always use these medications at the lowest dose and shortest time that gives relief. Alternating ibuprofen and acetaminophen may reduce pain more than taking either one alone. New OTC pain relievers that combine both drugs are now available.

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NCCIH says that about 9 to 10 percent of Americans use chiropractic care every year for relief of back or neck pain, headache, general wellness, disease prevention, energy, strengthening the immune system, and improving memory and concentration. Spinal manipulation of the neck or back is used mainly to treat low back pain, neck pain, and headache.

It is normal to have some increase in pain after spinal manipulation. According to the Mayo Clinic, side effects of spinal manipulation can include increased pain, fatigue, and headache. These side effects should not be severe or long-lasting. Although the risks from spinal manipulation by a trained and licensed chiropractor are low, complications can include damage to the disc between spine joints (herniated disc) or damage to nerves leaving the spinal column. These complications may cause longer-lasting pain, numbness, tingling, or weakness.

A very rare but very serious cause of pain and weakness after neck manipulation is a tear in one of the arteries that pass through the spine of the neck to supply the brain. A tear in one or more of these arteries can cause a stroke. This injury is called a cervical artery dissection. It may also be caused by a sports or whiplash injury that suddenly and forcefully moves the neck. The symptoms are sudden pain and loss of movement.

Should You Get Spinal Manipulation?

According to NCCIH, there is moderate evidence in studies to support spinal manipulation for low back pain and weak evidence for headache or neck pain. A review of 15 studies on spinal manipulation for low back pain, involving about 1,700 patients, found that spinal manipulation can give moderate relief to people with low back pain.

A review of 51 trials on spinal manipulation for neck pain, involving over 2,900 patients found that evidence for relief for neck pain was weak. A review of studies on spinal manipulation for headache rated the evidence of improvement to be low.

According to a 2020 review of alternative therapies for pain, published in the journal Advances in Therapy, there is a lack of evidence to support the use of spinal manipulation for migraine headaches, although over 50 percent of chiropractors use this treatment for migraines. This review also found that evidence for relief of neck pain was weak and that spinal manipulation was a poor choice compared to other therapies.

NCCIH says spinal manipulation has been studied for many other conditions including fibromyalgia, pediatric ear infections, COPD, bedwetting, menstrual pain, asthma, and high blood pressure without evidence of relief or improvement in these conditions.

Recommendation for Spinal Manipulation

The best evidence for the use of spinal manipulation is for low back pain. Clinical practice guidelines from the American College of Physicians recommend spinal manipulation as one of the options for treating low back pain.

NCCIH says this treatment is relatively safe when performed by a trained chiropractor, physical therapist, or osteopathic physician. The most common side effect is temporary pain and stiffness. If you see a chiropractor for back pain, you should tell your chiropractor about any medical conditions you have and any dietary supplements you take. Mayo Clinic advises against spinal manipulation if you have

• Severe osteoporosis
• Back or neck pain that includes tingling, numbness, or weakness
• Cancer in your spine
• A diagnoses of any type of spinal abnormality
• An increased risk of stroke

According to the CDC, common stroke risks include a previous stroke or transient ischemic attack, high blood pressure, high cholesterol, heart disease, diabetes, and obesity. Mayo Clin notes that spinal manipulation does not work for everyone, so if you do not see any improvement after several weeks, it might not be the best option for you.

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Chronic Pelvic Pain Syndrome in Women

According to the National Institutes of Health National Library of Medicine, chronic pelvic pain in women is a common condition that affects up to one in seven women. There are many possible causes of pelvic pain. If the pain lasts for three to six months, the brain becomes overly sensitive to pain and feels even mild pain as severe pain. This type of pain is called centralized pain and CPPS is a centralized pain syndrome.

CPPS in women may start with causes of pain that can include endometriosis, inflamed bladder, physical trauma, irritable bowel syndrome, pelvic inflammatory disease, sexual abuse, and many other causes. Depending on the cause, the pain may be described as sharp, dull, crampy, burning, or shooting. Pain may get worse when urinating, having a bowel movement, or having sex. It may also get worse during menstrual periods.

See more: Chronic Pelvic Pain Syndrome in Women

CPPS in women can be hard to diagnose because the cause of pain may be gone even though the feeling of pain continues. Mild pain caused by normal sensations like a menstrual period or sexual intercourse may trigger severe pain. Blood tests, urine tests, and imaging studies can be done to look for the cause of pain, but sometimes these tests are normal. In many cases, the diagnosis is made based on the history and the symptoms. Stress, depression, and anxiety commonly contribute to CPPS.

Treatment of CPPS may start with treating the cause of pain if it is found. For example, if a woman has endometriosis or pelvic inflammatory disease, treating these conditions may reduce CPPS symptoms. In many cases, other treatments may also be needed to control CPPS, and finding the right treatment may require a team of health care providers. For these reasons, CPPS is often treated best in a pain rehabilitation clinic or center.

Some of the more common treatments can include:

• Over-the-counter pain relievers
• Hormone treatments or birth control pills for pain related to menstrual periods
• Antibiotics if an infection is suspected
• Antidepressants
• Physical therapy
• Spinal cord stimulation
• Pain control injections
• Psychotherapy

Chronic Pelvic Pain in Men

Chronic pelvic pain in men is unexplained pain in the pelvic area with pain when passing urine and pain in the groin, penis, or the area between the scrotum and anus, called the perineum. There may also be strong and sudden urges to pass urine and pain after ejaculation. This condition is also called chronic nonbacterial prostatitis. Like CPPS in women, this condition is often associated with stress and anxiety.

Possible causes of pain include inflammation of the prostate gland caused by aging or prior infection. Other possible causes include low testosterone and undetected infections of the prostate gland. In the United States, this condition is most common in men over age 50.

Diagnosis of male CPPS includes a rectal exam of the prostate gland, urine testing, prostate fluid testing, and blood testing. Tests are often negative and the diagnosis is made by the history and symptoms. Treatment options include:

• Antibiotics
• Over-the-counter pain medications
• Medications that improve prostate symptoms called alpha-adrenergic blockers
• Physical therapy
• Psychotherapy
• Antidepressant medication

See more: Chronic Pelvic Pain Syndrome in Women

Chronic Pelvic Pain Syndrome Home Remedies

CPPS can have a negative effect on the quality of life and mental health. Finding ways to reduce stress and anxiety may help. Some recommended home remedies include:

• Meditation
• Deep breathing
• Exercise
• Avoiding constipation
• Taking a warm bath

CPPS is a difficult condition to live with and it can take time to find the cause and the right treatment. Even if the cause is not found, which is not uncommon, working with a team of health care providers familiar with the condition frequently reduces symptoms and improves the quality of life.

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In the United States today, turmeric and curcumin may be used as dietary supplements to treat arthritis. Dietary supplements used as a medical treatment are called nutraceuticals.

“Turmeric works by reducing inflammation in the body. The mechanism of action is thought to be due to turmeric’s ability to modulate the body’s immune response,” says Daniel Powers, MS, founder of the Botanical Institute. “This is similar to how non-steroidal anti-inflammatory drugs (NSAIDs) work, but from a natural perspective.”

Studies on Turmeric and Curcumin for Arthritis

Research on the benefits of turmeric and curcumin for arthritis has focused on the most common type of arthritis, called osteoarthritis. Osteoarthritis becomes more common with older age because it is caused by the wear and tear of joints that occur over time. Other than NSAIDs to reduce pain and swelling, there are few treatments and no cure for osteoarthritis other than joint replacement surgery. NSAIDs have side effects like heartburn and can increase your risk for problems like kidney disease, high blood pressure, and cardiovascular disease, so a safe alternative would be welcome.

Studies have tested that around 1000mg of curcumin is a safe dose for osteoarthritis.

According to NCCIH, studies on curcumin and turmeric nutraceuticals have found them to be probably safe when used orally or topically on the skin. A 2015 review of available studies that included laboratory studies and a few human studies concluded that curcumin is effective for treating osteoarthritis.

In one of the few human studies that compared curcumin to a placebo for osteoarthritis, curcumin significantly reduced pain compared to the placebo, but it was a small study including only 120 people. Another human study compared curcumin to an NSAID for osteoarthritis pain and found that they worked equally well, reducing pain by about 50 percent. Curcumin had fewer side effects than the NSAIDs. However, this was also a small study of 139 people.

Should You Try Turmeric or Curcumin for Arthritis?

NCCIH recommends checking with your health care provider before using a nutraceutical to treat arthritis. These supplements are not regulated or tested by the Food and Drug Administration (FDA) and may have ingredients or contaminants not listed on the label.

“Turmeric can be very effective against arthritis however, it should not be overdosed because it contains large doses of oxalate, a chemical that can combine with calcium in the body, causing kidney stones,” says Daniel Boyer, MD at the Farr Institute. “In addition, the FDA also warned against the use of turmeric from Bangladesh due to their high concentration of lead mental, a great health hazard.”

The best dose for turmeric or curcumin to treat osteoarthritis has not been established. Research studies have used about 1000 milligrams of curcumin, which seems to be safe. Although rare, both curcumin and turmeric can have side effects that include mild diarrhea, nausea, or heartburn.

One of the problems with turmeric and curcumin is that not much is absorbed from your digestive system when you take it orally, called bioavailability. That is one of the reasons they have been difficult to study. Look for supplements that include some black pepper, which makes curcumin or turmeric more bioavailable.

These supplements have not been shown to be safe during pregnancy. One more potential risk is that turmeric and curcumin are mild blood thinners, so if you are already taking a blood thinner, adding one of these supplements could increase your risk for bleeding.

Bottom Line on Turmeric or Curcumin for Osteoarthritis

Neither turmeric or its active ingredient curcumin has been tested with the numbers and controls that are needed to approve medications by the FDA. That said, the little research we do have available in controlled human studies suggests that these nutraceuticals may have an anti-inflammatory effect that could benefit osteoarthritis. If you are interested in trying one of these supplements, start by discussing the risks and benefits with your health care provider.

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