Posts Tagged ‘pain management’

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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Chiropractic Manipulation While Under Anesthesia

Tuesday, December 27th, 2011

Many patients achieve pain relief through treatment with a car Proctor, and for those who need supplemental therapy than simply the rehab and the adjustments in the office, a manipulation of anesthesia may do the trick. This is utilized when patients are not responding to normal treatment protocols, or could be having pain due to their degenerative condition that is just not getting relief.

The procedure that is specific for breaking up scar tissue along with adhesions in the neck, back, shoulder, a combination of short lever manipulations, along with some passive range of motion are utilized in the manipulation under anesthesia treatment.

Differing levels of anesthesia

There are three different methods of anesthesia used for this procedure, the first, the least “invasive”, involves manipulation after the patient has had certain anesthetic solutions injected into specific regions and tissues of the spine. During this type of treatment the patient is awake and alert as normal, but the area (s) being manipulated are in effect numbed so as to not cause the patient discomfort during the procedure. You may have heard of this type of anesthesia being referred to as a “local” or “local anesthesia” which means that it is confined to a specific area.

The 2nd type of anesthesia utilized during an MUA procedure is mild sedation. The patient remains awake but heavily sedated, that way the patient can feel relaxed and not feel significant pain during the manipulation. This method of anesthesia may be used along with local anesthesia. It is slightly more invasive than simply using local and with this patients are not allowed to drive themselves home afterwards and would need someone to come with them.

The next method of treatment involves general anesthesia where the patient is put completely “under” or unconscious. This method is used for the more advanced levels of treatment where the patient would not be able to tolerate the pain associated with the treatment due to their advanced condition. Only licensed specialists perform this treatment in a hospital or surgery center. This type of treatment requires special practice, training, and certification.

Choreographed Teamwork

Unlike a typical chiropractic adjustment, manipulation or anesthesia requires a team of individuals. There’s typically a chiropractor who has specialty training in the procedure, a physician who is either a D.O. or an M.D., and in the anesthesiologist. This procedure has been around for over 60 years and the American Medical Association recognizes its existence.

Candidates for the MUA procedure would be patients who do not respond properly the normal chiropractic therapy because of adhesions or scar tissue around the shoulder or spine.

The manipulation procedure can be utilized in conjunction with physical therapy or surgery. Usually this is a last resort prior to surgery and candidates would have typically undergone one to 2 months of conservative treatment. As with other treatments, successful very between patients and it has often been successful with the manipulation procedure.

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Pain Management Options When Your Pain Cannot Simply Be Fixed

Monday, December 26th, 2011

There certain situations as a pain management patient when your pain cannot be fixed permanently with either a a surgery or physical therapy. This could be due to either having had a previous surgery that did not get rid of all of your pain or potentially made it worse. It could also be due to a situation that is not amenable to surgery such as diabetic neuropathy or a different type of neuropathy that is simply something the patient has to live with.

If this situation exists and the individual simply needs to deal with their pain, what options exist to reduce the chronic pain? There are several options that can provide relief to the patient so they should not despair completely. The 1st thing to try is either physical rehabilitation or physical therapy.

These 2 options are very similar, with physical therapy being done by a physical therapist and the rehab option often being performed by chiropractors. They can both be extremely helpful in pain reduction along with increasing an individual’s function.

Along with these treatments the patient should be under the care of a pain management doctor who specializes in chronic treatment of pain. This way the doctor can treat the patient with medications that may include anti-inflammatories and potentially narcotics, potentially an antidepressant medication along with something like either Neurontin or Lyrica. The patient may also require muscle relaxant medications, so it’s best to be under the care of a specialist for these decisions.

When it comes to other treatments, a lot of it depends on what type of particular pain the patient is experiencing it was a coming from. Interventional pain management treatments may help substantially, for instance if the individuals dealing with pelvic pain a superior hypo-gastric plexus block may help reduce pain substantially.

This is just one example, another may be if a patient is having chronic pain in his neck or back from facet arthritis a radiofrequency ablation may help substantially.

The point is that if the patient is having a high pain issue along the spinal column interventional procedures can often help a lot. Along with the treatments, one last resort treatment that can help patients live with their chronic pain is a spinal cord stimulator. This is a treatment that is not going to cure anything, but it can reduce pain on a chronic basis.

The device has a paddle that is placed around the spinal cord in the epidural space and transmits electrical impulses that can depolarize the pain channels that go to the brain. This may modulate the pain the patient is experiencing and decrease it substantially.

The implants are placed on an outpatient basis and typically are preceded by a trial of an implant to make sure it’s going to work. The trial is left in place for 4 to 7 days, and if it works the patient receives a final implant. This involves placing the paddle as mentioned around the spinal cord and also involves attaching it to a battery that can be placed under the skin either in the abdominal area or on top of the buttock region.

With regards to the spinal cord stimulator’s overall results have shown an overall success rate of 62%. For a patient who has chronic pain and very few options for which to work with even a 60% success rate can be very welcoming, even if it only provides 50% relief in a terrible situation.

Want to find out more about Arizona pain doctors, then visit Preferred Pain Center’s site on how to choose the best Phoenix chiropractor for your needs.

What To Do When You Have Sciatica From A Pinched Nerve?

Sunday, December 25th, 2011

At times sciatica occurs from a herniated disc pushing on a nerve root. The sciatic nerve is actually a combination of multiple nerve roots including 2 lumbar nerves and the 1st sacral nerve root which come together.

This is why when the sciatic nerve is being compressed, in layman’s terms called a pinched nerve, it is termed sciatica. Typically depending on which nerve root of the sciatic nerve is actually being compressed up around the spinal column, is where the patient will have the pain in his leg anatomically. In order to avoid surgery from a herniated disc, what are the treatment options available in the acute phase of having sciatica?

One of the 1st things that should be tried is to seek treatment at a pain management center. Initially muscle relaxants along with physical therapy and probably some narcotic medications and anti-inflammatories will be started. Additionally, Tylenol can help. When anti-inflammatories are being utilized a gastric protection medication such as Zantac should be instituted as well.

Physical therapy can help a lot along with chiropractic treatments and may be spotty compression therapy to decompress the pensioner. The medications also may make life a lot more tolerable and allow patients to increase their function and a back= brace may help as well.

A lot of the time narcotic medications do not work very well for sciatica pain. If this is the situation then taking Lyrica or Neurontin can help with the nerve pain and can help modulate this type of pain.

Along with these medications interventional pain management injections may also help tremendously. This may include a series of epidural injections which consist of steroid medication injected under fluoroscopic guidance.

This will not fix the herniated disc, but it will bathe the region with steroid medication which can sue the area and provide pain relief by decreasing the inflammation.

Some people still think it is a good idea to spend time in bed when you have back pain and leg pain from a pinched nerve. Studies actually show that this is a bad idea as you can actually make the situation worse. Getting out of bed and ambulating along while trying to do most of your activities of daily living is much better in the long run.

So the combination of medications along with a back brace, physical therapy, chiropractic treatment and spinal decompression therapy, along with interventional pain treatments is the best combination of treatments that we have in this day and age to try and prevent the need for surgery.

Although a lumbar discectomy surgery has small risks, they do exist and it will be much better to avoid surgery if possible. We know that at one year after a lumbar disc surgery, if the patient was able to avoid the operation, the results are no different.

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US Drug Use Is On The Rise

Sunday, December 25th, 2011

Recently a survey on drug use in America was completed by the Substance Abuse And Mental Health Services Administration.

With regards to methamphetamines, the number of users over the age of 12 has been reduced by over half between the 4 years of 2006 to 2010. It was a whopping 731,000 users back then and as of 2010 only 353,000. It appears therefore that methamphetamine is falling out of vogue as it was extremely popular in the early 2000’s.

However all the survey results were not so great. Those surveyed over the age of 12 showed that over 22 million illicit drug users exist in America which is actually more than it was 2 years ago. Over 50 percent of individuals who are using prescription narcotics for reasons non-medical acquired those from either a relative or a friend who gave them to them.

Illicit drug use in the US rose 1.5% in those aged 18 to 25. Marijuana was the predominant reason for this increase. About 17.4 million people in the US use marijuana. The survey did not explain how much of the increase in marijuana was due to medical marijuana for those using it with a debilitating condition.

If we are going to see arise in one of the illicit drugs, marijuana is actually the least one to worry about. There are now 16 states plus the District of Columbia that have legalized it for medicinal use, and approximately 10 additional states are looking to do the same. Currently 80% of the American public approves of medical marijuana.

Cocaine use actually dropped by 40% from 2.6 million to 1.5 million between 2006 and 2010. Another encouraging trend was that teen drinking has dropped one percent between 2009 and 2010 along with tobacco use.

Certain trends in the survey are very encouraging, such as the large drops in methamphetamine and cocaine use along with less teen drinking. There are estimated to be 23 million Americans who need substance abuse help, but only 11% who actually receive it.

Effective treatments are available which are better than ever. A lot of illicit drug users remain in denial, and do not see their use as a real problem. This can be detrimental to the person’s long term health and family unit. People tend to think prescription medicines must be safe because a doctor wrote for them.

If that’s the situation that happened prescription medication be harmful? Well they are if abused and thankfully rehab centers and United States have less of a stigma than ever. Hopefully more individuals will utilize these options and get their lives back on track.

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With a Herniated Disk is Surgery Necessary?

Sunday, December 25th, 2011

Approximately 1% of the US population experiences pain from a herniated disc at any one point in time. About 25% of all people with back pain have a herniated disc, and over 90% of these occur in the low back.

What is the natural history of a herniated disc? Do individuals always need surgery or is it possible to get away with nonoperative treatment? Surgery is not absolutely necessary with a herniated disc. There are situations where it is deathly recommended such as with a neurologic deficit that is worsening from the disk pushing on a nerve root.

For instance if the patient has an L4-L5 herniated disc, the nerve root that is most commonly affected is the L5 nerve root. The L5 nerve root is essential in the patient’s ability to lift up the foot. So if it is effective enough, the patient may be unable to lift up the foot and have what is known as a foot drop. Watching this for too long to see if it gets better is not such a great idea therefore surgery may be indicated if this does not get better within a month or two.

Often times physicians are able to prescribe muscle relaxants, painkillers, or have the patient undergo a series of epidural steroid injections. In conjunction with physical therapy, chiropractic treatment, or maybe even a series of spinal decompression treatments, the patient may be able to avoid surgery and get back to being much more functional. These treatments are effective over 90% of the time for a herniated disk with sciatica.

Epidural steroid shots work well about 70% of the time, sometimes 80%. They do not fix a herniated disc problem, but they may be able to soothe enough with a Band-Aid type of pain relief while the body gets rid of the piece of disk pushing on the nerve. Studies have shown that individuals who have surgery for a disc herniation versus patients who undergo nonsurgical treatment at one year do about the same.

So unless it is an emergency, patients who are having sciatica from a disc herniation should undergo nonoperative treatment initially. If the person hs bowel or bladder dysfunction that is in effect an emergency and should be treated surgically right away.

If the person has another logic deficit that is getting worse, that becomes a relative indication for surgery to get relief quicker and to get motor function back. If the whole decision is being based on pain though it truly is a quality-of-life decision and should be only shifted in the surgery if the nonoperative treatments fail.

Want to find out more about pain doctors in Arizona, then visit Preferred Pain Center’s site on how to choose the best Mesa chiropractor for your needs.