Sickle cell disease is a type of anemia that causes the red blood cells to develop improperly and prematurely causing the shape of the cells to be sickle, or half moon shaped. Most of us have heard the term anemia but the majority of people do not realize that anemia simply means a lack of red blood cells, and oxygen being delivered.
While there are many types of anemia, sickle cell anemia is a unique variation that disproportionately affects people of color, specifically those of African and Latin descent.
The most common symptoms of anemia include fatigue and weakness, however, sickle cell differs in that it is characterized by what is known as “sickle cell crises”. Sickle cell crises are painful flare-ups that can last several hours, to even days.
Why are sickle cell crises more painful, severe and longer lasting than other anemia-related flare-ups? The answer lies in the shape and composition of red blood cells. When a person has sickle cell anemia and the red blood cell does not grow to its full size because of a lack of hemoglobin.
Hemoglobin is responsible for
carrying oxygen through the blood and into tissues such as muscles and organs. The lack of hemoglobin causes the cells to be malformed and brittle, which leads to a disruption in the normal blood flow through vessels and arteries. When blood is pumped from the heart and travels through arteries to distal parts of the body vessels become smaller.
The narrowing of these vessels can cause sickled red blood cells to become clogged and coagulated at various junctions, leading to extreme pain. In addition to the cells becoming clogged in arteries, the immature red blood cells are also fragile leading to rupture. The pain is commonly felt in the muscles and bones and has been described as throbbing, stabbing, dull or sharp pains.
In sickle cell anemia there are three primary mechanisms of pain arousal; nociceptive, peripheral neuropathic and central neuropathic pain. Inflammation or mechanical tissue pain is the underlying cause of nociceptive pain and is generally characterized by local throbbing, sharp and pounding pain.
Nociceptive pain tends to respond favorably to NSAIDs and opioid medications. Damaged or dysfunctional peripheral nerves can cause neuropathic pain commonly described as burning, heaviness, and numbness.
Patients suffering from peripheral neuropathy respond positively to pharmacological therapies. Damage to central nerves in the spine and brain can result in altered pain processing, causing normal stimuli to trigger intense pain responses. Central neuropathies respond favorably to neuroactive medications that alter the levels of pain neurotransmitters released.
Symptoms of sickle cell anemia have been noted to have
begun as early as six months of age in newborns. Dactylitis or pain and inflammation of the fingers is a frequent presentation in children.
Other common complications associated sickle cell anemia is avascular necrosis of the hip and other joints, embolisms and even ulcers.
Knowing risk factors that increase the likelihood of flare-ups, such as stress, infections, and other chemical insults and minimizing exposure, sickle cell warriors can help to reduce the frequency and severity of crisis flares.
Dr. Kevin Kinney, board certified and licensed Chiropractic Physician featured on INSIDER.com, TheTodayShow.com & BlackDoctorsMatter.org. Connect with Dr. Kev at drkevinkinney.com or @DrDuval904
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