ADDITIONAL PAIN MANAGEMENT RESOURCES

Back pain & proper lifting

Today I want to briefly go over number 1 cause of pain in the country. It is lower back pain. We will talk about prevention only today. Later we’ll address treatment options.

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Back pain home treatments

Today we’ll expand on the previous topic of lower back pain. What to do?

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Back pain advanced treatments

We’ll talk about what can be done when conservative therapy fails. You typically get referred to a pain specialist. What are the options?

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Spinal cord stimulation

Let`s go over number 1 cause of pain in the country. It is lower back pain. We will talk about prevention only today. Later we’ll address treatment options.

Read more

Kyphoplasty/Vertebroplasty for Spinal Fractures

It happens primarily in older people due to osteoporosis or trauma but it can happen in younger population as well. 

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1664 E 14 street, Suite 3B, Brooklyn, NY 11229 

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Tel: 347-763-9793
Fax: 318-232-6585 / 347-428-2099

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Back pain and proper lifting

Today I want to briefly go over number 1 cause of pain in the country. It is lower back pain. We will talk about prevention only today. Later we’ll address treatment options. Majority of cases involve injuries from lifting, pulling, twisting etc. However, there are many cases where pain starts spontaneously without any apparent inciting event. Most cases resolve on their own within 1-3 weeks. So, first, what can be done to minimize the chance of that happening? As we know, an ounce of prevention is worth a pound of cure. The steps below are widely known but time and again, people disregard them.

Always be mindful of how you lift or pull heavy objects. Tighten you abdominal muscles, utilize your legs not just the back. Never twist your body, always turn entire body. Stretch throughout the day to keep your muscles happy. Do activities that strengthen your core musculature which helps to stabilize and unload your spine. Wear back support when anticipating heavy lifting. If anyone has questions, I’ll be more than happy to answer them during an office visit.

Back pain home treatment

Today we’ll expand on the previous topic of lower back pain. What to do? First of all, warning signs that make a trip to the doctor or ER absolutely necessary are new onset of weakness in your legs, dragging the foot, loss of control of your urine or bowels or inability to urinate. These must be evaluated ASAP. If you are over 60 imaging should be done with new onset of pain even if no apparent trauma happened. For everyone else:

  • try placing alternating ice and heat pack 20 min each a few times a day;
  • take either Advil or Aleve for 2-5 days provided there are no contraindications;
    do gentle stretching, specific exercises can be reviewed if people interested;
  • rest for a day or 2, but not more, otherwise your muscles will start to weaken. After this pain typically subsides. 

 

If pain persists for over a months or there is numbness and burning, make a trip to either pain management specialist or at least your primary doctor. Next time we’ll talk about other treatment options which are beyond home remedies.

Back pain advanced treatment

Today we’ll talk about what can be done when conservative therapy fails. You typically get referred to a pain specialist. What are the options? There is a plethora of interventions that exists for various aches and pains but we’l concentrate on most common ones for the lower back due to most common problem which is disc herniation. First of all what is a disc herniation? It’s a cushion which supports the bones of your spine. With or without trauma, these cushions can get displaced or rupture causing internal material to leak out and cause pain by creating pressure and irritation around nerves which then send pain signals.

As mentioned before, most of these problems resolve on their own. It is very common to develop a muscle spasm as body tries to compensate for an acute problem. If pain is primarily muscular, a simple trigger point injection which is injection of local anesthetic like novocaine into the painful area often does the trick. It is the needle and not so much the medication that provides the relief.

This always should be coupled together with physical therapy. If the problem relates more to the nerve pain, you may be offered an infamous epidural injection. This implies placing local anesthetic and anti-inflammatory steroid in the space just before the spinal cord called epidural space, hence the name epidural injection. There are multiple epidural injection types available depending on where and what nerves are involved. Some times one type will work whereas another one won’t.

Another option is selective nerve block this implies approaching an involved nerve as it is out of the spine and blocking it to provide pain relief if for some reason epidural space cannot be reached. If nerve compression relates to arthritis or fluid in the joints of the spine called facets, you may be offered a facet joint injection or medial branch block if pain is more in the back itself. If the medical branch block is successful, you can be offered a radio-frequency ablation for a longer term relief. We will expand further next time with more involved techniques.

Spinal cord stimulation

Today we’ll give an introduction to spinal cord stimulation. It is intended for people with significant back and neck pain and pain in arms and legs which really doesn’t respond to other modalities. What is a spinal cord stimulator? It is a small device connected to to special electrodes that get inserted under the skin next to the spinal cord. It provides electric impulses that interrupt pain signaling. The idea is similar to when you hit something and then you rub the area and pain subsides. This is due to rubbing activating different nerves that compete with pain fibers. There are 2 stages involved. First, a trial stage. You need to make sure this is right for you.

You go to the doctor and they will place electrodes through the skin under sedation and then a technician will tweak the electric impulses to cover the exact area of pain. This is usually done in the office or ambulatory surgical setting. In our case, we do it in the office. You go home with this for a week and see how it works. If pain is well controlled, second stage is implantation of leads and battery. This also can be done in the office or surgical center of the hospital. The decision where to do it is usually made based on type and size of electrodes. Patient has control and can increase and decrease intensity of the electric current.

Kyphoplasty/Vertebroplasty for Spinal Fractures

We’ll talk today about fracture of spine bones called vertebra. It happens primarily in older people due to osteoporosis or trauma but it can happen in younger population as well. First thing is always to make sure the fracture is not related to cancer. If not and if patients qualify, they can undergo a procedure called kyphoplasty or vertebroplasty. The procedure is done in either office or ambulatory surgery setting. In our case we do it in the office.

The procedure is minimally invasive, done through specialized needles which are placed into the fracture site. Then specialized cement is placed into the fracture to restore the bone to normal height. The procedure takes about 45 min to 1 and a half hours depending on complexity and size and number of fractures. Patient goes home in about 30 minutes after procedure is done. The pain relief is usually nearly instantaneous and quite dramatic.

Cancer pain

Cancer pain is pain in the body related to cancer invasion. Typically, treatments with interventions and medications can be administered to significantly improve pain. 

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Post operative pain

Post operative pain is classified as pain not resolving after surgery within certain time period. Treatment options vary depending on type of surgery performed and areas affected.

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Meralgia Paresthetica

Meralgia paresthetica is a particular nerve disorder from excessive pressure on the nerve around the hip. It can be treated with a simple injection if conservative treatment fails.

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Various Neuralgias

Neuralgias are broadly defined as disease of nerves and can affect various body parts. Typically, burning and tingling pain can be managed with medications and interventional options.

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Complex Regional Pain Syndrome

Complex Regional Pain syndrome which come as Type 1 and Type 2 is a rare debilitating condition usually affecting one limb with significant disability. While very difficult to treat, you can come to New York Interventional Pain Management Center to understand your options.

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Arthritis pain

Arthritis pain can occur almost anywhere in the body but particularly large joints and fingers. There are several treatment options for this debilitating condition. Please come to New York Interventional Pain Management Center to explore potential treatments. 

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Trigger finger/contractures

Trigger finger and contractures are related to tendon disorders of the hand. To understand your treatment options, please contact us. 

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Coccyx pain

Coccyx pain or coccydynia is pain localized to the tailbone. It is often very painful when sitting or using the toilet. To explore your treatment options, please come to New York Interventional Pain Management Center.

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Sacroiliitis

Sacroiliitis is pain in lower back and buttock localized to a particular area where spine joins pelvis usually due to arthritic changes and can mimic sciatic pain.

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Piriformis Syndrome

Piriformis syndrome is often a one sided buttock and hip pain particularly with sitting and certain movements. There are several treatment options that we can offer for this condition.

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Myofascial pain syndrome

Myofascial pain syndrome is a collection of muscle related pain without specific underlying cause. It is usually characterized by pain in specific muscle bands. For acute and chronic cases of myofascial pain syndrome, please give us a call.

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Nerve entrapment

Nerve entrapments happen when bands of tissue or muscle wrap around or press on the nerve causing pain. This can happen spontaneously or after surgery. To explore your options, please come to New York Interventional Pain Management Center.

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Rib fracture pain

Similar to spinal fractures, outside of trauma, there are conditions that can cause rib pain with and without fractures. There are several treatment options available if you suffer from pain in the ribcage. Please come to New York Interventional Pain Management Center to understand your options.

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Spinal fracture pain

Outside of trauma, spinal fractures can occur due to osteoporosis (weak bones) and due to medical conditions that can infiltrate and weaken bone matrix. It is very important to maintain proper bone health. If you encounter a spinal fracture which manifests in debilitating pain, please come to New York Interventional Pain Management Center to explore your options.

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Post herpetic neuralgia/Shingles

Shingles is a viral infection that lives in nerve roots and can become active at any time causing severe burning pain even with light touch. While the most important thing to prevent postherpetic neuralgia and shingles is vaccination, if you develop shingles related pain, contact us to explore various treatment options.

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Diabetic neuropathy

People with long standing diabetes often develop painful sensation in feet, lower legs and hands. While main treatment is to get diabetes under control, unfortunately, the pain does not disappear on its own. If you believe you are experiencing pain from diabetic neuropathy, please contact our center.

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Neuromas

Neuromas are aberrant bundles of nerves that can cause pain and disability in various areas of the body. They need to be identified to be effectively treated. If you have post surgical scar pain or foot pain, give us a call.

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Golfer’s and Tennis elbow

Main problem with either Golfer or Tennis elbow is overuse injury. If pain does not improve with conservative treatment in 1-2 weeks, contact our center.

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Carpal tunnel/Cubital tunnel /Tarsal tunnel

Carpal, Cubital and Tarsal tunnel syndromes are similar in that there is entrapments and pressure on the nerve in wrist/elbow/ankle leading to pain and significant decrease in function and at times to muscle loss. Carpal tunnel is most common and frequently caused by prolonged typing or writing.

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Shoulder/elbow/wrist/hip/knee/foot pain

Small and large joint pain can develop from acute trauma as well as chronic wear and tear from sports or even ordinary lifestyle. Not uncommonly, inflammatory fluid accumulates leading to profound pain and loss of function. For acute and chronic cases of joint pain, please come to New York Interventional Pain Management Center.

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Spinal stenosis

Spinal stenosis is generally a progressive condition that can affect any area of the spine. Mainly time related wear and tear produce changes in the bones and cushions of the spine leading to various degrees of narrowing causing pain and loss of quality of life.

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Back pain

One of the leading causes of disability and missed work is acute or chronic lower back pain. Other than trauma, wear and tear of every day life leads to development of bulging discs and arthritis in supportive joints of the spine. Various treatment options are possible to address particular problem areas.

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Neck pain

Neck pain is a common issue that affects up to 75% of the world’s population at some point during their lives. Causes may include trauma, poor posture and arthritic changes However, real problem happens when a nerve is pinched and a person experiences severe pain, weakness and disability. We can offer treatment options to avoid surgery and restore function.

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Headaches

There is a wide variety of various types of headaches that exist. Not all headaches are migraines or tension. It takes detailed history and physical exam to render appropriate and maximally effective treatment. While some types of headaches can be managed medically, others respond mainly to pinpoint injections.

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