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Sciatica is a common pain condition which is marked by pain, tingling and numbness which often begins in the buttock and extends down the leg, all the way to your foot. Sciatica is the result of irritation or inflammation of the sciatic nerve.

The sciatic nerve is a nerve which starts in the low back at the site of spinal cord, extends through the piriformis muscle in the buttock and further branches down the back of the leg and into our foot.

Sciatica pain can be acute or chronic. An acute episode of sciatica may last between one and two weeks and usually resolves itself in a few weeks. Acute sciatica may eventually turn into chronic sciatica which is a life-long condition and it doesn’t currently respond well to treatments.

Reasons of chronic sciatica pain

Some usual chronic sciatica pain causes are;

  • Degeneration

Degeneration of tissues present in the lumbar spine is one of the chronic sciatica pain causes. It can irritate or contract the sciatic nerve. Degeneration of the facet joints can also cause the synovial tissue in the joint’s capsule to inflame and increase in bulk. Degeneration of vertebral bone may cause abnormal bone growths. These abnormally bulky tissues in the lumbar spine may cause compression of one or more nerve roots of the sciatic nerve. Degenerated intervertebral discs may secrete inflammatory proteins, causing inflammation of the sciatic nerve.

  • Spondylolisthesis

Spondylolisthesis is also considered as chronic sciatica pain causes, it occurs when a small stress fracture causes one vertebral body to slip forward on another. Sciatica might result from nerve compression following the disc space collapse, fracture, and forward slipping of the vertebral body. Spondylolisthesis causes bilateral sciatica and is more common in younger adults.

  • Lumbar herniated disc

Research suggests that up to 90% of chronic sciatica pain causes is lumbar herniated disc. The herniated disc typically compresses one or more spinal nerve roots that form the sciatic nerve.

A lumbar herniated disc can cause sciatica in two ways:

Direct compression: Direct compression of the sciatic nerve can occur when a lumbar disc bulges or when the soft inner material of the disc leaks out or herniates through the fibrous outer core and presses against the nerve.

Chemical inflammation: An acidic chemical irritant from the disc material known as hyaluronan leak out and cause inflammation and irritation in the area around the sciatic nerve.

  • Lumbar spinal stenosis

Spinal stenosis is the narrowing of the spinal canal and it is chronic sciatica pain causes which is relatively common in adults older than age 60. Research suggests that lateral recess stenosis commonly causing sciatica in the elderly population.

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166

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The cancer pain is usually constant. Most patients with advanced cancer and up to 60% of patients with any stage of the cancer experience significant pain. A person with well-managed pain has better quality of life. They are likely to sleep well and have more energy during the day. Being as active as possible also minimizes the risk of ailments like pneumonia, blood clots and bedsores, which are associated with immobility. The foundation of cancer pain management is regular medication, including opioid and paracetamol drugs, chosen to suit each person and to minimize side effects.

Pain management choices for cancer pain

The type of pain experienced influences the choice of cancer pain management. Some of the factors that influence the choices include:

  • The location of the pain
  • The severity of the pain
  • The type of pain such as tingling, sharp, or aching
  • Whether the pain comes and goes or is persistent
  • Which activities or events make the pain worse
  • What events or activities make the pain better
  • Current medications
  • How much current medications are able to ease the pain
  • The impact the pain has on lifestyle, such as poor quality of sleep or loss of appetite

Relaxation techniques in cancer pain management

Physical exercises and mental relaxation are part of cancer pain management because it reduces anxiety and also helps a person to better cope with pain. Your doctor may recommend reputable therapists or contact the professional association for your chosen therapy.

Helpful therapies are;

Hypnotherapy is the use of imagery to induce a dreamy relaxed state of mind. Hypnotherapy is also useful to ease some of the side effects of cancer treatment, such as nausea.

Meditation is deliberate clearing of the mind to bring about feelings of calm and heightened awareness. Meditation offers many long-term health benefits, such as reduced stress and blood pressure when practice regularly.

Massage is also a part of cancer pain management. It works by soothing soft tissue and in turn encourages relaxation.

Tai chi is a Chinese form of non-combative martial arts which consists of gentle movements to clear the mind and relax the body.

Breathing and relaxation; correct breathing, using the diaphragm and abdomen, can soothe the nervous system and manage stress.

Yoga is an ancient Indian system of postures synchronized with the breath.

Other pain management for cancer

Other techniques that may be beneficial to ease pain include:

Acupuncture is the ancient form of Chinese medicine and it involves inserting and stimulating fine needles into specific points of the skin. Acupuncture is an effective treatment in some pain syndromes, but there is little research looking at cancer pain.

Transcutaneous electrical nerve stimulation (TENS) therapy is another cancer pain management technique in which a minute electrical current is passed through the skin via electrode s, prompting a pain-relieving response from the body.

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When the term spinal surgery comes into our mind, we naturally thought about large incisions, long recovery periods, and painful rehab. Fortunately, surgical advances like the microdiscectomy spine surgery procedure have improved the process.

Microdiscectomy spine surgery is a minimally invasive surgical procedure performed on patients with a herniated lumbar disc. During this surgery, a surgeon will remove portions of your herniated disc to relieve pressure on the spinal nerve column. It is also sometimes called microdecompression or microdiskectomy.

Who benefits from microdiscectomy surgery?

If you’re wondering that if you’re a candidate of microdiscectomy spine surgery or not then here are you answer. You are a candidate if you have any or more of the following symptoms;

  • Significant pain, numbness or weakness in your leg or foot
  • Leg pain (sciatica) worse than back pain
  • Symptoms that have not improved with exercise, physical therapy or any medication
  • Diagnostic tests (MRI, CT, myelogram) shows a herniated disc
  • Weakness in leg, loss of feeling in the genital area, and loss of bladder or bowel control (Cauda equina syndrome)

How surgery is performed?

As microdiscectomy spine surgery is performed through back so the patient lies face down on the operating table. Steps are as follow;

  • A 1 to 1½-inch incision is made in the midline of the low back.
  • The back muscles are lifted off the bony arch of the spine and moved to the side.
  • The surgeon is now able to enter the spine by removing a membrane over the nerve roots.
  • In some cases, a small portion of the inside facet joint is removed to facilitate access to the nerve root and to relieve any pressure or pinching on the nerve.
  • The surgeon may make a small opening in the bony lamina if needed to access the operative site.
  • The nerve root is then gently moved to the side.
  • The surgeon uses small instruments to go under the nerve root and remove the piece of disc material that have exude out of the disc.
  • The muscles are then moved back into place.
  • The surgical incision is closed and stereo-strips are placed over the incision to help hold the skin in place to heal.


Complications of microdiscectomy spine surgery

As with any other surgery, there are some risks and complications with microdiscectomy spine surgery which are;

  • Bleeding
  • Infection
  • Possible buildup of fluid in the lungs that may lead to pneumonia
  • Deep vein thrombosis, which occurs when blood clots form in the leg
  • Pain that persists after the surgery
  • Nerve root damage
  • Bowel/bladder incontinence

Success rate of microdiscectomy spine surgery

The success rate for microdiscectomy spine surgery is generally high, with one extensive medical study showing good or excellent results overall for 84% of people who have the procedure done.

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Kyphoplasty treatment is minimally invasive procedure used to treat vertebral compression fractures of the spine. These wedge-shaped and painful fractures can be caused by osteoporosis and an injury. If they left untreated, they can lead to a humped spine or kyphosis. Kyphoplasty treatment helps correct the bone deformity and relieves the pain associated with spinal compression fractures

Candidates for kyphoplasty

You are a candidate of kyphoplasty treatment if you have painful vertebral compression fractures from any of the listed conditions;

  • Metastatic tumor (a cancer which spread from another area)
  • Osteoporosis (a lowering of calcium in bones)
  • Vertebral hemangioma (benign vascular tumor)
  • Multiple myeloma (bone marrow’s cancer)

One thing you should keep in mind is that kyphoplasty treatment will not improve old and chronic fractures, nor will they reduce back pain associated with stooping forward and poor posture. Kyphoplasty is significantly effective when it is chosen as soon as the first week after a fracture.

How kyphoplasty is actually performed?

You need to lie down on your stomach before kyphoplasty treatment has been started. The area in which the needle will be inserted is cleaned and sterilized and local anesthetic may be injected in the same place. Surgeon will then perform the following steps;

  • The surgeon inserts a hollow needle called as trocar into your skin. With the help of fluoroscopy (a type of X-ray) they guide the needle through your muscles and into the correct position in your bone.
  • Next they will insert an inflatable balloon into the trocar. The balloon is inflated to create the space needed for the bone cement.
  • Once the space has opened up, the mixture is injected to fill it up. Imaging tests will help the surgeon to confirm that the mixture is distributed properly.
  • After the cement is in place, the needle is removed.
  • The area is bandaged. Stitches won’t be necessary.
  • Your IV and monitoring equipment are then removed.

Time of procedure is depending on how many vertebrae is going to be treated. Kyphoplasty treatment usually takes less than an hour for treating one vertebra.

Restrictions you should follow after procedure

  • No exhausting activity for the next 2 weeks including yard work and housework
  • Avoid lifting or twisting and bending your back for the next 2 weeks
  • For 2 weeks after surgery do not lift anything heavier than 5 pounds
  • Do not drink alcohol for 2 weeks after surgery or while you are taking narcotic medication
  • Do not drive for 2-3 days. Once the haziness from anesthesia wears off you can resume driving

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166

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BOTOX® is the name of a toxin which is produced by the bacterium Clostridium botulinum. When used in large amounts, botox toxin can cause a form of muscle paralysis known as botulism, which is often usually associated with food poisoning. Even though one of the most serious complications of botulism is paralysis, scientists have still discovered a way to use it to the human advantage. Botox treatments which use small, diluted amounts of botox can be directly injected into specific muscles, causing controlled relaxation of the muscles.

Applications of botox treatments

Botulinum treatments are predominantly used to reduce the appearance of facial wrinkles and fine lines.

Beyond aesthetic applications of botox treatments, Botox is used to treat a variety of medical conditions, including migraines, excess sweating, eye squints and leaky bladders.

Botulinum toxin is presently used to treat over 20 different medical conditions, with more applications under investigation.

Botox treatments are currently approved for the following therapeutic applications:

  • Blepharospasm (spasm of the eyelids)
  • Idiopathic rotational cervical dystonia (severe shoulder and neck muscle spasms).
  • Chronic migraine
  • Severe primary axillary hyperhidrosis (excessive sweating).
  • Strabismus (crossed eyes)
  • Post-stroke upper limb spasticity Trusted Source.
  • Detrusor (bladder wall muscle) over activity – causing urinary incontinence Trusted Source.
  • Overactive bladder
  • Hemi facial spasm
  • Glabellar lines which are frown lines between your eyebrows
  • Canthal lines (crow’s feet)

What happens during the procedure?

For the procedure of botox treatments, the patient is placed in a somewhat raised position and the areas to be injected are cleansed with a nonalcoholic cleanser. The Botox is then injected into the desired or affected areas. It is common for pressure to be applied if an injected area seems to be bleeding after the botox injection. While ice is sometimes applied beforehand for comfort reasons, direct pressure is much more effective or beneficial than ice in order to control the bleeding and bruising.


Complications of the treatment

Botox treatments can cause some unwanted effects which include;

  • Mild nausea
  • Temporary unwanted weakness/paralysis of nearby muscles
  • Temporary upper lid or brow ptosis (drooping)
  • Weakness of the lateral rectus or lower eyelid (a muscle controlling eye movement)
  • Dysphagia – trouble swallowing
  • Neck weakness
  • Mild pain, local edema (fluid buildup) and/or erythema (reddening of the skin) at the injection site
  • Numbness
  • Headache
  • Malaise – feeling generally unwell
  • Flu-like illness
  • Brachial plexopathy – a condition affecting the nerves either side of the neck and chest
  • Gallbladder dysfunction
  • Diplopia (double vision)
  • Bleeding
  • Blurred vision
  • Decreased eyesight
  • Swelling
  • Fatigue
  • Hives
  • Dry mouth

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166

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Spinal cord stimulation is a therapy which used to masks pain signals before they reach the brain by delivering low-level electrical signals to the spinal cord or to specific nerves to block pain signals to reaches to the brain.

Who is a candidate?

Patients selected for spinal cord stimulation usually have had chronic debilitating pain for more than 3 months in the lower back, leg or arm. They also commonly have had one or more spinal surgeries. You’re a candidate for spinal cord stimulation if you have;

  • Failed conservative therapies
  • You would not benefit from any additional surgery.
  • The pain is caused by a correctable problem and should be fixed.
  • You do not want further surgery because of the long recovery or risks associated with it. Spinal cord stimulation (SCS) sometimes can also be chosen over a large, complex spine surgery.
  • You are not suffering from untreated depression or drug addiction; these should be treated prior to having a SCS.
  • You have no such medical conditions that would keep you from undergoing implantation.
  • You have had a successful trial of SCS.

What happens during the SCS procedure?

During the procedure of spinal cord stimulation, a device that delivers the electrical signals is implanted in the body through a needle placed in the back near the spinal cord.  Then a small incision is made to place the pulse generator in the upper buttock. The patient may turn the current on and off or adjust the intensity of the signals.

Benefits of spinal cord stimulation technique

Potential benefits which spinal cord stimulation is offering are;

  • It improves the ability to participate in activities of daily living
  • Effective or beneficial for extremities, back, and/or leg pain relief
  • Gives power to manage your own treatment procedures


Risks of SCS

There is no surgery without risks. Specific complications associated with SCS are;

  • Battery failure and/or battery leakage
  • Cerebrospinal fluid leak
  • Persistent pain at the stimulator site or at the electrode
  • Allergic response to implant materials
  • Generator migration and/or local skin erosion
  • A pocket of clear fluid or seroma at the implant site. Usually seromas disappear by themselves but may require a drain
  • Lead migration, which often result in changes in stimulation and reduction in pain relief
  • Weakness, clumsiness, paralysis, numbness, or pain below the level of implantation

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166

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Patients who suffer from chronic low back pain and neck pain and who have not responded to common or usual pain management interventions such as medications and physical therapy may be candidates for radiofrequency lesioning.

The purpose of radiofrequency lesioning is to reduce or eliminate facet joint pain and related symptoms in the neck or low back. The procedure interrupts communication of pain between a specific medial nerve root (roots that supply the spine’s facet joints) and the brain.

Before RF is performed, the pain generating facet joint nerve is identified by means of a diagnostic injection, such as a facet joint or medial branch nerve block.  Other tests may include MRI.  Since the medial branch nerves do not control neck or low back muscles, it is not harmful to disrupt or turn off their ability to send pain signals to the brain.

Procedure of radiofrequency lesioning

Radiofrequency lesioning is done under fluoroscopic or X-Ray guidance to assist the precise needle placement. By using a special radiofrequency needle and microelectrode, the tissue at the site of pain is stimulated by a small radiofrequency current. That current will generate heat and blocks the pain pathways. Local anesthetic is used to numb the targeted area before the procedure begins.

Procedure can takes between 30 and 60 minutes depending upon the areas to be treated. The patient can go back to their home after the procedure.

Who benefits from radiofrequency lesioning?

The radiofrequency lesioning procedure is typically performed on patients with chronic pain caused by damaged peripheral nerves or sensory nerves and nervous tissue surrounding the central nervous system which is brain and spinal cord. Some particular conditions that fall under this category generally include:

  • Trigeminal neuralgia (chronic facial pain)
  • Occipital nerve neuralgia
  • Degenerative disc disease
  • Post-herpetic neuralgia
  • Complex Regional Pain Syndrome (CRPS), both type 1 and 2
  • Peripheral neuropathies
  • Coccydynia
  • Neck or back pain due to facet joint arthropathy

Advantages of radiofrequency lesioning

The radiofrequency lesioning disrupts nerve conduction like the conduction of pain signals and in turn it may reduce pain, and other related symptoms. Approximately 70-80% of patients among all will get a good block of the intended nerve. This should help relieve the part of the pain that the blocked nerve is controlling. Sometimes after a nerve has been blocked, it becomes clear that there is pain from the other areas as well.

Risks and complications

Possible side effects of radiofrequency lesioning are;

  • Infection
  • Low blood pressure
  • Headache
  • Allergic reaction to medication

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166


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Joints are those parts of our body where our bones meet. Joints let the bones of our skeleton to move. Joint pain refers to discomfort, soreness and aches in any of the body’s joints. Joint pain is a common complaint. General it doesn’t require a hospital visit.

Joint pain can be caused by injury affecting any of the ligaments, tendons or bursae that are surrounding the joint. Injury can also affect the bones, cartilage and ligaments within the joint.

Treatment options of joint pain

Joint pain treatment will depend upon the cause of pain.

  • Medications

For moderate to severe joint pain with swelling, an over the counter or prescription nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen or naproxen sodium can help to provide relief from pain. NSAIDs also have some side effects, potentially increasing your risk for gastrointestinal bleeding. If you’re suffering from milder pain without swelling acetaminophen can be effective.

If your pain is so severe so NSAIDs and Cox-2 medicines aren’t effective enough, your doctor might prescribe a stronger opioid medication.

  • Topical Agents

Capsaicin is a substance found in chili peppers which may use as joint pain treatment to relieve joint pain from arthritis and other conditions. Capsaicin blocks those substances which helps transmit pain signals, and it triggers the release of chemicals in the body called endorphins, which block pain. Side effects of capsaicin cream include stinging or burning in the area where it is applied. Another topical option is cream containing the ingredient, methyl salicylate.

  • Injections

For people who don’t find joint pain relief from oral or topical medications, the doctor can inject a steroid medication directly into the infected joint every three months to four months. The procedure is really effective but temporary.

  • Physical Therapy

Physical therapy is also considered as joint pain treatment as it strengthens the muscles around the joint, stabilize the joint, and improve your range of motion. The therapist will use techniques like heat or cold therapy, electrical nerve stimulation, ultrasound and manipulation.

If you are overweight then losing weight can relieve some of the pressure on your painful joints. Exercise is one effective way to lose weight but be careful to stick with low-impact exercises that won’t further irritate the joint. Bicycling and swimming are among the best exercises because both allow you to exercise your joints without putting impact on them. Swimming also relieves some of the pressure on your joints because water is buoyant .

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166

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Headache is said to be chronic if you have a headache for more than four hours on more than 15 days per month. Some people experience these headaches for a period of six months or longer. Headaches that can occur on daily or nearly daily basis include;

  • Hemicrania continua
  • Idiopathic intracranial hypotension
  • Cluster
  • Migraine
  • Tension type
  • Mixture of types ( commonly tension and migraine)

Causes of chronic headaches

Many possible reasons can contribute to chronic daily headaches which include;

  • Head injury
  • A previous history of migraine
  • Overuse of painkilling medications (see medication-overuse headache)
  • Obesity
  • Stressful life events
  • Being female

Types of chronic headache pain treatments:

So many options are available for chronic headache treatments and they all are depending on the diagnosis and type of headache you are suffering from.

Anti-seizure medications also known as anticonvulsants or antiseizure drugs are diverse group of pharmacological agents acts as mood stabilizers. Some of them are used as chronic headache treatment as they seem to prevent migraines and might be used to prevent chronic daily headaches, as well. Options include divalproex sodium (Depakote), gabapentin (Neurontin, Gralise), and topiramate (Topamax, Qudexy XR, and others)

NSAIDs some nonsteroidal anti-inflammatory drugs like naproxen sodium might be helpful, especially if you’re withdrawing from other pain relievers. They can also be used periodically when the headache is more severe.

Beta blockers such drugs are commonly used to treat high blood pressure. They are used as chronic headache treatment option when it comes to prevent episodic migraines. These include atenolol, metoprolol and propranolol.

Antidepressants such as nortriptyline like Pamelor can be used to treat chronic headaches. These medications can also help to treat the depression, anxiety and sleep disturbances that often accompany chronic daily headaches.

Some other antidepressants such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine might help in treating depression and anxiety, but these medicines not been shown to be more effective than placebo for headaches.

Botulinum toxin botox injections provide relief for some people and might be a viable option for people who don’t tolerate daily medication much well. Botox would most likely to be considered if the headaches have features of chronic migraines.

Some other alternatives of chronic headache treatments are;

Massage can promote relaxation and can reduce stress and relieve pain. It might be particularly helpful if you have tight muscles in the back of your head, neck and shoulders.

Electrical stimulation of the occipital nerve a small battery is surgically implanted near the occipital nerve at the base of your neck which sends continuous energy pulses to the nerve to ease pain.

Herbs some evidence suggest that the herbs feverfew and butterbur help prevent migraines or reduce their severity.

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166

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Intradiscal electrothermal therapy (IDET) or intradiskal electrothermal annuloplasty (IDEA) is a relatively new, minimally invasive treatment for spinal disc-related chronic low back pain and that persistent disc pain is thought to be caused by nerve fibers that have grown from their normal location in the outer layers of the disc and reaching into the disc interior. This is related to the breakdown or degeneration of the tough outer layers or annulus of the disc. Almost 70% of patients with chronic low back pain can get benefits from Intradiscal electrothermal therapy.

How does IDET works?

  • The intradiscal electrothermal therapy procedure is performed with a local anesthetic and mild intravenous sedation.
  • A hollow introducer needle is inserted into the painful lumbar disc space by using a portable X-ray machine for proper placement.
  • After that, an electrothermal catheter or heating wire is passed through the needle and positioned along the back inner wall of the disc (the annulus), the site believed to be responsible for the chronic pain.
  • The catheter tip is now slowly heated up to 90 degrees Celsius for 15-17 minutes
  • The heat contracts and thickens the collagen fibers making up the disc wall, thereby promoting closure of the tears and cracks. Tiny nerve endings within these tears are burned or cauterized to make them less sensitive.
  • The catheter along with the needle is then removed and, after a short period of observation the patient can go home.
  • A lumbar support is worn for 6 to 8 weeks which is followed by an appropriate course of physical therapy. Bending and lifting precautions are necessary during this time because it allows adequate healing of the disc.

What to expect after Intradiscal electrothermal therapy?

Pain relief after intradiscal electrothermal therapy is not immediate. Pain may first increase after couple of days from the procedure. Physical therapy is a necessary part of recovery. After first month of intradiscal electrothermal therapy plan to walk and do easy stretches as prescribed by your doctor. During the first 2 to 3 months, exercise as directed by your doctor, and avoid lifting, bending, and long periods of sitting. People who have had IDET are usually told to wait at least 5 to 6 months before resuming strenuous sports such as skiing, running, tennis and football.

Side effects of IDET:

Although risks or complications of intradiscal electrothermal therapy are relatively rare but there are some which include;

  • Disc damage
  • Nerve damage
  • Disc infection

Pain management institute is helping people to cure acute and chronic long term pain to resume a normal life style. PMI has provided many treatments like stem cell therapy and many others.

For more details call on 815.412.6166

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