Posts Tagged ‘pain management’

Looking at Some of the Myths of Pain Management

Saturday, January 14th, 2012

In the next dates, pain management is a very large business. There are over 100 million people in America suffering every year from chronic pain, and the cost of this exceeds $500 billion annually. Multiple misperceptions exist in the field of pain management, and here are a few of them described.

1. Narcotics are always a terrible medication. Annually over 15,000 fatalities occur from narcotic overdoses and there’s a lot of bad press every week regarding pill mill practices. So is only natural that a significant amount of America looks at narcotics as being always a terrible thing to prescribe.

However, they definitely have their place in the management of pain. In the patient with cancer for instance, they can make the end-of-life much more tolerable than living last few months in horrific pain.

In patients who do not have a surgical option for their chronic pain, narcotics other types of pain management along with can allow patients to work, and enjoy functional lives play with their children.

So opiates do actually have a place in the treatment of those dealing with acute pain and some forms of chronic pain as well.

2. An MRI always gives a definitive back pain diagnosis. Even with the most highly trained medical specialists, only 50% of the time is impossible to tell a patient definitively what their diagnosis is further back pain.

This include patients who have had a complete musculoskeletal workup which includes a history, physical examination, x-rays, and even an MRI. So an MRI is not always the go to trustworthy part of the workup.

3. Back surgery fixes most back pain. A significant amount of time there is not really a true cure for a person’s lumbar pain. Spinal fusion surgeries and United States have increased 15 fold over the last 10 years and the population in America has not gone up nearly that much. So it is a fact that with all these surgeries being performed the results have not improved substantially and in fact they remain moderate at best.

4. Only 3 steroid injections are permitted per year. Pain management specialist are not in agreement with, injections are definitively allowed annually. This is because research has not shown what is the best number. So some individuals say 4 injections per year and others say a lot more than that is okay.

With the steroid being injected into one particular area, medicine is able to stay in that region and only a tiny bit of it actually seeps into the bloodstream. So truly more than 3 steroid injections can be administered annually but we actually don’t know the definitive number that is okay.

5. All pain management involves opiate prescriptions. This is definitely a myth. The most modern types of pain management involve a comprehensive approach. This includes multiple pain doctors from different specialties collaborating and may include physical therapy, interventional pain management, or chiropractic treatment. Injections may include trigger points, epidural injections, or facet injections. This comprehensive treatment approach allows patients a lot of pain relief and tries to minimize the narcotics necessary.

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Pain Management With Tens Stimulation

Wednesday, January 11th, 2012

TENS, What is that there are they have other work for pain relief? To begin with tens stands for transcutaneous electric nerve stimulation. They have 4 small pads with connections consisting of electrodes or small wires, which are placed right on the skin close of the area that is painful.

Individuals with a tens unit often feel the sensation of pins and needles which is not typically painful but it can irritate the skin. If this occurs, patients should receive hypoallergenic patents. Tens units are typically utilized to treat many different painful conditions such as arthritis, sciatica, back sprains or strains, or pain from scoliosis.

How TENS Work

The tens unit for the patient receives a programming that relieves pain but remains comfortable. The tens unit is programmed to administer small electrical impulses the skin which goes down to nerve fibers. The patient is able to change the settings at will. Tens units work by jump starting the bodies and or fenced to help alleviate pain.

TENS have also been used on stroke patients, and have been known to help give stroke survivors feeling in their limbs again. What the doctors use are called NESS L300, and they attach to the patients brace (wherever that may be), and they detect whether the patient has their limb in the air, or on the ground. They then send an electrical current to the patient’s peripheral nerve that helps activate their muscles and corrects their gaits.

Lovely Benefits

They are mainly used to though to help relieve pain, and strengthen the muscles by reducing muscle spasms. The electrical therapy also helps increase circulation and can increase range of motion as well. For stroke patients, higher electrical impulses utilized which may improve a persons walking abilities, increase blood flow, and increase walking speed.

In addition to being used for stroke patients, tens units have also been used for dramatic brain injury patients, cerebral palsy patients, multiple sclerosis patients, and the typical patients with pulled muscles and stiff joints.

Considerations Before Use

It is recommended that a tens unit be received under a doctor’s supervision such as a chiropractor because there are some small risk associated. You should not use a tens unit if you have a malignancy, a pacemaker, or are pregnant. Tens unit should not be placed on your head, your job, or very close to metal implants.

It is also not recommended to use them if you have a heart monitor or sleep apnea. A TENS unit is not designed to cure pain it is simply designed to subdue it.

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Frequently Asked Questions About Facet Injections For Pain Management

Tuesday, January 10th, 2012

What is a facet joint injection exactly?

Facet joint injections consists of steroid also known as cortisone being injected into the small joints of the spine that are causing pain. They’re about the size of a thumbnail and there is one of bilaterally at each level of the spine.

What purpose does the facet injections serve?

The facet joints develop arthritis just like any other joint in the body, and arthritis is one of the biggest problems in America today. As people age arthritis develops or it may develop after a traumatic incident, and if arthritis develops in one facet joint typically it develops in multiple.

That the patient is dealing with pain in a facet joint, surgery is not a great option sense no procedure exists yet which can replicate the facet joint range of motion. Facet injection may provide pain relief analogous to when patients get an injection into their hip, shoulder or in knee.

How long does a facet injection take?

Typically when a person is getting a facet joint injection they are receiving it into more than one arthritic joint. Each joint may only take a few minutes to inject, but when you add up the multiple joints being injected the procedure may take about half an hour.

What exactly is being injected with a facet injection?

When a facet injection is done numbing medicine such as lidocaine is typically included along with the cortisone. There are numerous steroids that pain management doctors utilize and usually comes down to what is the doctor’s personal preference. Options include methylprednisolone, triamcinolone, or Celestone.

Does a facet injection hurt?

A needle has to be placed through the skin to do a facet injection. So there may be some discomfort along with that however most pain doctors will play some numbing medicine just underneath the skin and soft tissues going down to the joint. So the injection should not be too painful. Patients may also receive IV sedation which may help them not even remember the procedure.

Is anesthesia necessary for a facet injection?

Mostly, individuals do not need sedation to receive a facet joint injection. However if the individual has anxiety problems, maybe claustrophobia, not having the sedation may cause problems with the procedure. Rather than giving the patient and IV, a good middle of the road idea is to give patients value him by mouth prior to the procedure by about 30 min.

How’s the injection performed?

The vast majority of the time people are placed prone for the procedure. Typically a fluoroscopy is used which is a real-time x-ray machine to help ensure needle placement accuracy.

The area overlying the injection is sterilized and typically vital signs were monitored during the procedure especially if IV sedation is used. After the procedure, the patient is watched for a time. Then they are allowed to go home and usually the patient will need a ride to get home.

Can patients go back to work the next day?

The vast majority of patients will be able to go back to work the following day after a facet injection. If IV sedation is not used, the patient could actually go back to work the same day if desired.

How long will the pain relief last after a facet injection?

Pain relief with an injection into the facet joints is extremely variable. It may last a few months, or may only last a few days. There really is no great way to predict the duration of pain relief.

Can a procedure be repeated if the pain relief wears off?

The answer is yes. If the medication wears off after a few months and the pain comes back. Along with this, the patient may benefit from a radiofrequency ablation procedure which can triple the amount of pain relief and that could be well over a year.

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Chiropractic Treatment Does Not Have To Be A Lifelong Commitment

Saturday, January 7th, 2012

Chiropractors are doctors who heal by spinal manipulation and put into practice the art of healing by spinal alignment. The underlying philosophy lays with the thought that a healthy functional spine allows the nervous system to perform at an optimum capacity, therefore controlling every aspect of your body in a better and more efficient way.

Total Healing Vivacity

A full range of motion is very vital to a healthy body for functionality and overall health. When pain is a diversion of energies, it drains the body and can mask more threatening, or relevant, needs. Pain puts stress on a body, and long term stress can really takes its toll on every vital organ in the body including the heart and brain. One doctrine of chiropractic work is that is a recharging process and reconnection of the mind with the body to achieve a total healing vivacity. Once recharged, patients may enjoy life again with renewed vitality.

they patients believe wrongly that treatment with a chiropractor needs to last forever. Chiropractors trained for 7 years to learn their trade and most of the time treatment is wellness based. If the acute pain you are seeking treatment for is relieved with chiropractic care then it is not necessary to continue treatment for years.

If you want to make sure that the mind-body connection stays in balance and no underlying illness surfaces, you may want to see a chiropractor for a yearly tuneup. This would be analogous to vehicle maintenance but much less expensive. Unlike receiving of vehicle maintenance, there were obviously not be a manufacturer guarantee.

Global Views

There are quite a few countries were patients receive routine checkups with their chiropractor, similar to a dentist or an annual physical with the family practice doctor. Children and pregnant women are also encouraged to see a chiropractor as there are safe treatments and significant wellness can be achieved with them. Prior to undergoing spinal surgery, it is recommended to see a chiropractor for first-line treatment for back and neck pain.

The unknown can be a little bit scary, but chiropractic treatment is a choice perceiving treatment that is unknown that has a long history behind it and it has been shown to be extremely safe. The best route in life is transfixed the underlying cause of the problem you are facing and that is the basic philosophy of chiropractic treatment.

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The Basics of Mechanical Spinal Decompression Treatment

Thursday, January 5th, 2012

Is spinal decompression therapy and effective treatment for low back pain? The theory is that distractive forces applied to the low back will create a negative pressure in the middle of the disc space.

This negative pressure that is created is of creating a vacuum that reduces pressure on inflamed nerves and allows water and nutrients in blood flow to come in to the void that has been created. Once the spinal decompression is finished, this extra fluid including the nutrients relieves pain from compressed vertebrae.

Normally, discs in the spine are known to have extremely poor circulation, and the spinal decompression allows for a reversal of this. This increased blood flow in the nutrients and brings can help heal some spinal problems and relieve pain from sciatica, disc herniation’s and bulges, disco generation, and spinal studios us. It has been shown in multiple reports that patients who have failed significant pain management treatment can receive excellent pain relief from spinal decompression.

Origination of Spinal Decompression Treatment

The original creator of spinal decompression treatment is a gentleman from Canada, Dr. Alan Dyer. This prototype was created back in the early 1990s and he claim to be pain-free after using it, this was known as the VAX-D table. This table utilized a pneumatic pump to apply and release lumbar traction.

In 2004, the system was upgraded to include computer control of an electrically driven system, which replaced the pneumatic pump. Other doctors and inventors have come forth to created similar devices that follow the same general theory. IDD (intervertebral differential dynamics) is a similar product.

How Effective is Mechanical Spinal Decompression

As with anything that doesn’t have a long history of use, there are conflicting views of how much good comes from the use of the Vax-D and other inventions of a similar type. One study shows better than a 68% success rate, but the results were on a very limited number of individuals. Other studies have not been nearly as conclusive.

In both 2004 and 2005, reviews of the Vax-D and other powered traction devices did not indicate that they were effective in treating lower back pain for any of the known causes.

In 2006 there was a study published looking at numerous years of spinal decompression for decades and showed that its effectiveness could not be proven. The report called for larger studies to hopefully show statistically significant effectiveness.

While some patients claim they have had vast improvements in their physical situations, the scientific community as a whole does not currently embrace this assumption. For those who have experienced an improved condition, it is promising that further studies will reveal more positive information.

Because the studies have inconclusive, the implementation of improved standards for measuring results is warranted since the anecdotal success rates have been so high with the treatment. Once larger studies show definitive results, insurance companies may be inclined to start covering the treatment.

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Ways That Chiropractors Treat Back Pain

Tuesday, January 3rd, 2012

So you hurt yourself at work, lifted something too heavy, went to the E.R. and now you’re sitting in the waiting room of your local chiropractor’s office. All will go well, and you’ll be feeling better in no time.

Individuals are typically sent over to chiropractors when infections, fractures or cancer are ruled out at the hospital. At times pain may not be critical soap might be the just a couple treatments and some diet changes might do the trick.

Most chiropractors utilize a hands-on technique. They do not write for prescription medications and attempt to treat patients nonoperatively and avoid spine surgery. The basic concept on chiropractic treatment is to fix an individual spinal alignment and to heal the patient without surgery by fixing the root cause of the problem.

Spinal manipulation is mainly used to ensure mobility for your joints that have been pinched from tissue injuries or repeated stress. The most common of these reasons is having poor back support. It’s creates a lot of stress on your lower back, and usually lends to spots being pinched.

Once at your local chiropractors office, they will look up your medical history and perform a physical comprehensive examination, and also look at lab tests and imaging studies that have been performed. Chiropractic can begin the work once they have figured out because of your back pain.

Your chiropractor may utilize ultrasound to help relax tight muscles. In addition, electrical stimulation may be utilized to tire out these muscles and achieve pain relief. The tens unit which provides electrical stimulation has tiny little pads that go on your skin and this can often alleviate pain tremendously.

The most common method that chiropractors utilized to relieve back pain in patients is spinal adjustments. This technique utilizes abrupt force and a short lever arm to manipulate joints back into place.

After spinal adjustments, patients typically have increase range of motion and decreased pain in the affected area. At times the chiropractor may place a small heel lift in your shoes to stabilize and off-balance pelvis and improve the posture of your back.

Once all of your muscles and joints have been popped back in the place, your chiropractor will relay instructions on a home-based exercise program to performed preventively to hopefully avoid further injury.

They can also prescribe a variety of basic home modifications that include your diet, coping strategies, and how you take care of yourself to decrease the risk of chronic back pain being a long term problem.

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Treating Neck Pain With Chiropactic Therapy

Saturday, December 31st, 2011

A lot of people with neck pain seek out the services of a chiropractor. Chiropractors can fix throbbing and twinges, and often get to the root of the pain and fix it. Both neck and back pain are treated similarly by chiropractors, as both require controlled forces to push the joint past is typical range of motion for pain relief.

The most common reason that individuals seek treatment for their neck pain is poor posture, when people slouch, it applies significant pressure on the spinal cord area, which leads to swollen joints and hence, pain. 2nd most common reason for neck pain is extreme trauma injury such as with a motor vehicle accident. Chiropractors do their manipulations with the goal of loosening up your poorly moving joints that have reached that point due to damaged or scarred tissue.

Chiropractic doctors utilize cervical adjustments To loosen up the vertebrae in the neck and relieve pain from muscle spasms or pinched nerves. Chiropractors carefully manipulate the neck, and during this typically there is a pop as the vertebrae shifts into alignment. This helps relieve pain, increase blood circulation for healing, and stimulates the nervous system in a good way.

Additionally, chiropractors use other methods of neck pain relief. One of these is electrical stimulation, which incorporates low electrical impulses to help stimulate the muscles around the neck. This is very good if you have muscle pulls around the shoulder region and can help in determining whether surgery would benefit the patient. Therapeutic massage can also help relieve neck pain and this is not only obtainable at your local chiropractor but also at numerous spas in any metropolitan area.

Chiropractors may also use ultrasounds to relax your muscles. Ultrasounds are similar to the electrical stimulation, but instead of electricity, they send sound waves that deliver heat deep into your tissues to reduce stiffened muscles. This method also helps increase your blood circulation, usually reliving you of your stiffness, muscle spasms, and any swelling you may have occurred.

Once all is said and done, often times icing the area can control inflammation and decreased pain as well. This is for simple anyone can do it anywhere, and can provide significant pain relief throughout the day. Chiropractors often recommend a diet and exercise plan to increase further wants range of motion and help strengthen the muscles around the neck as a prophylactic maneuver to reduce the incidence of pain in the future. If the pain does not get better with chiropractic treatment, typically patients are referred to a further specialist.

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Back Pain Relief With Facet Injections

Thursday, December 29th, 2011

Facet injections provide temporary pain relief that has resulted from facet joint inflammation. It is not fully understood how the pain is generated in the facet joint, but it is thought to result from several causes which could be arthritis, injury, degeneration, which can produce back pain symptoms potentially similar to that of disc degeneration.

A facet injection’s benefits only last temporarily; from a mere day up to a year as it is a minimal procedure. Facet injections are usually used in conjunction with physical therapy and/or other forms of treatment such as chiropractic spinal manipulation.

Dual purpose

The injection introduces a long-acting corticosteroid, along with a numbing medicine into the painful joint. This is injected either into the joint capsule or potentially alongside the joint period the injection may also serve a diagnostic purpose in addition to a therapeutic pain relieving purpose.

The facet injection blocks pain signals sent to the brain by numbing the nerves in that area, patients that benefit from these injections may be candidates for facet rhizotomy, which is a procedure in which the nerve endings in the affected area are deadened by use of an electric current that destroys the nerves and prevents them from signaling the brain for pain.

Facet injection candidates are individuals who are suffering from either, or maybe some for pain into the shoulders or legs coming from joint inflammation. Facet injection is a natural progression for neck or back pain for patients who did not get relief with anti-inflammatory drugs, PT, rest, or back bracing.

Facet injections may be used for treating such diagnoses as arthritis, spondylosis, spinal stenosis, herniated disc, sciatica, or pain from postoperative period those who are pregnant or have a bleeding problem or an active infection are not candidates for the procedure. In addition, those who have uncontrolled diabetes or high blood pressure should use caution as the procedure may temporarily raise blood sugar levels or blood pressure levels.

Speedy pain relief

These injections are given in an outpatient setting by either radiologists, anesthesiologists, desire trysts, or pain doctors utilizing a fluoroscopy machine. This is a real-time x-ray device that allows the physician to see the needle and can help assure proper needle placement. Typically the patients feel a pressure sensation but not too much pain as long as the area is injected with numbing medicine prior to putting in the longer needle.

Certain patients they may need a Valium or some other antianxiety drug to help for the injection. Most individuals are able to walk right after the injection but most will end up needing a ride home. The patient should notice pain relief within a few days to maybe a week after the procedure if only minimal pain relief is achieved then a 2nd region of 3rd infection may be necessary. If the 1st 2 injections do not work as a 3rd may end up being necessary. Over 70% of patients get excellent relief from the facet injection and the procedure may be repeated 2 to 3 times annually.

Lower risks

There are some small but real risks associated with these injections, which may include but are not limited to bleeding, infection, nerve damage, or allergic reaction,. In addition, the patient may experience some side effects including hot flashes, fluid retention, interrupted sleep and an elevation in blood sugars. Diabetics should watch their levels carefully around the time of injection. In addition, patients who are on blood centers should make sure to stop these in conjunction with when their physician tells them to do so.

Facet blocks are an excellent choice in pain management to try up prior to an invasive spinal surgery. They have less chance of complications and a lower risk profile than surgery.

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What Is The History Of Chiropractic Treatment?

Thursday, December 29th, 2011

History or Chiropractic Medicine

Substantial debate exist with regards to how chiropractic treatment 1st came about. Generally it is thought to have started in 1895 with an individual who had up back injury and eventually became deaf. A person named Daniel David Palmer heard about the individuals problem and performed the 1st chiropractic adjustment in history on him.

Palmers Legacy

Palmer reasoned that if a back injury was the reason for the deafness then repairing the damage in the back should cure it. So he then manipulated 1 cervical vertebra whereupon the man claimed to have recovered hearing. And so chiropractic was born.

In 1913 1st licensed chiropractors came into existence and by the 1930s 39 states were licensing chiropractors. At this point there are over 60,000 chiropractors in the United States. All of the US states and territories officially recognize chiropractic as a profession.

A number of other countries recognize chiropractic therapy as a medical specialty including Mexico, Great Britain, Australia, Switzerland, Japan, and Canada.

Chiropractic Theory

How it works, chiropractic theory is that in order for the body to be healthy everything must be in tune. When the spine becomes misaligned, whether through accident, birth defects, or poor posture, chiropractic techniques are applied to realign and maintain alignment of the vertebrae.

With spinal misalignment happening, there can be pressure placed on the bodies nerve roots with pain resulting.

For example, if there is a misaligned vertebrae and pressure is being placed on the sciatic nerve, the individual may end up with sciatica and have difficulty walking.

This misalignment of vertebrae is referred to as subluxation, which in definition means the partial dislocation of a joint or organ, and is corrected by the manipulation of the spine either by the application of pressure by hand or by various mechanical methods. Chiropractors may also suggest a specified exercise regimen for the patient to do at home to help maintain proper alignment.

Risk Factors

There are opponents to chiropractic that say there is no evidence that proves chiropractic actually does anything. And further, there is evidence to suggest that unnecessary treatments do more harm than good. There is evidence that shows that neck manipulation may pose a small risk of stroke as the carotid artery may be damaged during treatment.

One extremely rare risk with chiropractic neck adjustments is paralysis. The risk of this is about one in 1 million. There have been some cases of paraplegia and quadriplegia from improper neck manipulation. So just like anything else in the healthcare field you might try, know that there are some slight risks associated with the benefits, and make sure you check out the reputation of the chiropractor you are thinking about seeing.

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Patients in Chronic Pain Have Increased Due to the Economy

Tuesday, December 27th, 2011

The incidence of pain in the United States is at an all-time high these days. Over 110 million Americans are currently dealing with chronic pain, which is one third of the population. A significant amount of these individuals on a yearly basis would normally qualify for some type of surgery to relieve the pain. This may range anywhere from a joint replacement surgery, to a spinal fusion surgery, or maybe a decompression surgery for simply a herniated disc.

Surgery in this country is not free. A lot of patients these days have higher insurance deductibles, along with large co-pays which means when you add up the total patient responsibility this is often economically not feasible in an elective situation. With the current economy, a lot of folks are opting to delay their elective surgeries and opt for nonoperative pain management.

When individual undergo surgery they may need significant time off from their appointment. In this faltering economy a lot of individuals are scared to lose their jobs as a result of this time off. So a lot of people just not having the surgery and doing pain management which would only necessitate a few hours off from work as opposed to a few weeks.

With the current state of the economy and individuals have dropped their health insurance due to financial problems. Without it, it may be possible to pay out-of-pocket for pain management but not for the high cost of surgery.

Many patients in the early 60s will soon be on Medicare. If they are trying to decide whether to undergo surgery, they may just wait to the polar bear on Medicare so that their financial responsibility will be a lot less.

With unemployment hovering around 9% nationally, this is a common decision to try and avoid surgery at all costs. In some parts of the country, unemployment is over 20% when you take into account those who have been out of work so long they’re not even included in the 9% total.

What we’re seeing now in numerous reports regarding the medical industry is that there is truly a “new normal” that is being seen. This involves all aspects of medical care such as patients asking more and more about what things are going to cost, all the way up to the medical device companies who are having to downgrade their economic projections when it comes to the amount of surgeries they can expect to be performed over the next 1 to 2 years.

Research out of J.P. Morgan have shown that office visits this past year have dropped significantly almost 10% from a year ago. Most analysts do feel that once the economy bounces back that the amount of surgical procedures will increase.

For instance joint replacements have been shown to be some of the best quality of life procedures in the world. So at some point an individual will have the procedure when their economic situation improves.

Most individuals look at medicine is being recession proof. This is no longer true as the new normal in the economy has shifted patients into avoiding elective surgery and increasing the amount of pain management patients dramatically in America.

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