Blog Archives - Page 13 of 33 - Pain Management Institute

Jul 10 Comments Off

Solution for chronic back pain found!

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Whether you have been percieving pain for two weeks or two decades, Pain Management Institute will work with you and your insurance provider to deliver valuable treatment at the source of pain instead of highlighting the symptoms.

Below is an outline of an pioneering measure, how doees it work and the types of patients who may be candidates to make sure you understand the benefits and risks associated with the process of Racz Epidural Neurolysis.

RACZ caudal neurolysis is an injection method which is frequently used to cure leg and back pain as a consequence of scar tissue as result of a prior surgery. This scar tissue can compress the spinal nerves and send burning pain all the way through the legs and causes unbearable pain in the lower back.

Pain Management Institute specializes in accurately diagnosing and treating the cause of painful conditions to stop them from coming back. It provides adapted treatments and integrative medicine to find the cause of your pain rather than just treating the pain symptoms.

Racz Epidural Neurolysis can evade the necessity for spinal surgery among the patients who are suffering chronic back pain and sciatic pain. This process invloves passing the Racz epidural catheter into the epidural space and injecting medicine directly at the place of nerve injury or adhesion to reduce the pain and break up adhesions generally in patients who have already had surgery.A catheter is positioned in the epidural space through which a solution of medication and local anesthetic can give profound analgesia. It is most favorable to place the epidural catheter close to the patient’s painful dermatome as possible.

The procedure is carried out with the patient lying face down with a cushion placed underneath the stomach. Back pain is intricate and has many causes. Experience of interventional pain therapy for chronic back pain has revealed that the pain is time and again due to a build up of scar tissue either from injury, disc herniation, or previous back surgery. This can be weakening, relentlessly limiting your aptitude to execute physical activity and trims down your aspiration to live your life to its fullest. The objective of the physicians and team at Pain Management Institute is to treat the source of your pain so that you can get back to living!

Prior to the procedure, your pain physician will evaluate your MRI in order to recognize which nerves are likely affected and are accountable for your pain. This injection process has the possiblity to provide instant and considerable long term liberation from chronic pain and discomfort in the lumbar spine. The process normally takes between 30 and 60 minutes. It can be done once, or in a series of up to three injections in a twelve-month period.

Taken as a whole, this method is safe. Nonetheless, with any procedure there are risks, side effects, and the possibility of complications. Luckily, the serious side effects and complications are rare. The immediate effect is generally from the local anesthetic that was injected. This effect will more often wear off in a few hours. The cortisone usually starts working in about 3 to 7 days and the effect can last for several days up to a few months.

Jul 05 Comments Off

Is back pain bothering you?

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Millions of adults in the United States experience a variety of different types of chronic pain conditions. The pain related to these conditions can be ruthless and can have a damaging impact to an individual’s personal and professional lives. Additionally, chronic pain has a significant impact on the U.S. economy, resulting in improved healthcare utilization, including rehabilitation and decreased worker efficiency.

Patients distressing along chronic pain are time and again treated with a combination of medication, physical therapy, as well as epidural steroid injections and other conservative treatment options. On the other hand, not all patients sense relief from pain through these treatment methods. Radiofrequency lesioning is a minimally invasive procedure that may be used to treat chronic pain that has been unresponsive to conservative measures.

Let’s know what Radiofrequency lesioning is.

Radiofrequency lesioning is a process in which special needles are used to generate lesions along chosen nerves. The needles heat the nerve to 80°C (about the temperature of hot, not boiling, water). When this heat is enforced upon the nerve for about 2-3 minutes, the nerve stops shipping pain signals to the brain. The body aims to re-grow nerves that are blocked in this conduct but that process can take up to a year or longer.

Before advising radiofrequency ablation, diagnostic local anesthetic nerve blocks need to be implemented to make sure that the patient is an ideal applicant. An analytical nerve block involves injecting a local anesthetic into the region of the nerve that is assumed to be causing the patient’s pain. The local anesthetic in effect for the time being numbs the area and should result in reduced pain symptoms. The efficiency of radiofrequency lesioning can be predicted from a patient’s response to the impermanent nerve block procedure.

Radiofrequency lesioning is accessible to patients with certain types of low back or neck pain (predominantly pain from the facet joints). You must have responded well to analytical local anesthetic blocks to be a candidate for Radiofrequency lesioning. The effectiveness of Radiofrequency lesioning will depend on how well you retort to the “temporary” or diagnostic block.

The course of action disrupts nerve conduction (such as conduction of pain signals), and it may in turn into lesser pain than before, and other related symptoms. An estimate of 70-80% patients will achieve a good block of the intended nerve. This should help relieve that part of the pain that the blocked nerve controls. Sometimes after a nerve is blocked, it becomes clear that there is pain from the other areas as well. Based upon the areas to be treated, the process can take from about 30 minutes to an hour.

In view of the fact that nerves cannot be seen on x-ray, the needles are situated using bony landmarks that designate where the nerves usually are. Fluoroscopy (x-ray) is used to identify those bony landmarks. After needle placement, very little voltages are applied to the needle to test for proper placement. After verification of the needle tip position, a small amount of local anesthetic is injected. After the nerve is adequately numbed, higher radiofrequency voltages are applied and the nerve heats to the desired temperature.

Jul 04 Comments Off

Are you searching for back pain reliever?

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The spinal cord is the foremost collection of nerves carrying nerve impulses to and from the brain to the rest of the body. Rings of bone, called vertebrae, are located around the spinal cord. These bones make up the spinal column or back bones.

Spinal cord injury can be a result by direct trauma to the spinal cord or a consequence of compression, damage from inflammation, infections, bleeds or clots, neoplasms, or spinal arthritis.

Spinal cord damage results in a failure of function, such as mobility or sensation. In majority of the people who have sensitive, traumatic spinal cord injury, the spinal cord is not fully detached but is bruised or torn. Spinal cord injuries may be an outcome of falls, diseases like polio, motor vehicle accidents, sports injuries, industrial accidents, gunshots and physical assaults, among many other causes. If the spine is fragile because of another condition, such as arthritis, slight injuries can cause spinal cord trauma. A lot of pain is suffered by the body when issues related to spinal cord arise.

Spinal cord stimulation is a remedy that masks pain signals before they reach the brain. A small device, similar to a pacemaker, is fixed in the body to transport electrical pulses to the spinal cord. It aids patients towards better management of their chronic pain symptoms and decrease the use of opioid medications. It may be an option if you suffer chronic back, leg or arm pain and have not found relief with other therapies like surgeries. Spinal cord stimulation is recommended when other treatments have not been successful, when surgery is not likely to help, or when surgery has failed. However, the device is not for everyone; consult with your doctor to see if the procedure is right for you.

Spinal cord stimulation does not eradicate the source of pain, it merely interferes with the signal to the brain, and so the amount of pain relief varies for each person. Also, some patients find the tickly sensation obnoxious. For these comprehensions, trial stimulation is carried out before the device is permanently fixed. The objective for spinal cord stimulation is a 50-70% decrease in pain. Nevertheless, even a minute amount of pain diminution can be noteworthy if it helps you to execute your daily activities with less pain and reduces the amount of painkillers you take.

Spinal cord stimulation does not work for everyone. If unsuccessful, the implant can be removed and does not damage the spinal cord or nerves. Some patients may find the sensitivity unpleasant. In other cases it may not cover the entire pain area. With trial stimulation, the experts can sense whether or not, this method is working for the patient. If the procedure proves to be a failure, the trial wires can be detached, causing no damage to the spinal cord or nerves.

Jul 02 Comments Off

Are you going through severe back pain? Now NO more!

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Resolving a single structure within the spine as the source of pain can prove to be a diagnostic challenge due to the complexity and complication of the structures involved in the spinal column. Additionally, discrete anatomical structures can clinically present with related symptom patterns and no physical examination finding can be specifically ascribed to any one structure. To further complicate this dilemma, multiple structural abnormalities noted on imaging studies are frequently found to be painless.

Selective nerve root blocks are based on the assumption that delivering a small amount of medication to a specific target can precisely point out the source of pain and provide information that could affect or predict their surgical outcome. At the Pain Management Institute, we offer cervical nerve root blocks under fluoroscopy guidance. Dr. Zaki Anwar is very experienced in these procedures and has a very meticulous approach and safety record.

When a nerve root becomes condensed and swollen, it can cause back and/or leg pain. Occasionally, an imaging study (e.g. MRI) may not clearly illustrate which nerve is causing the pain, therefore selective nerve root block injection is performed to assist in separating the source of pain. Adding more to its diagnostic function, this type of injection for pain management can also be used as a treatment for a far lateral disc herniation (a disc that ruptures outside the spinal canal).

The rate of success differs depending on the primary diagnosis and whether or not the injections are being used primarily for diagnosis. Those who are facing the symptoms of herniated disc, sciatica or swelling or irritation are the appropriate candidates for selective nerve root block. The following patients should not undergo this treatment:

If you have an allergy of any medication which is needed to be injected
If you use medication for blood thinning for instance (Coumadin injectable Heparin)
If you have an infection currently you are suffering from

During a Selective Nerve Root Block, your doctor will target exact condensed or irritated nerves in your neck, upper back, or lower back, injecting an anesthetic, anti-inflammatory corticosteroid or a mixture of these two medications into the space immediately surrounding the nerve or nerves.

Jun 27 Comments Off

Sympathetic Nerve Block, good solution?

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A sympathetic nerve block is firmly believed upon by many pain health specialists to be an efficient method for controlling chronic pain. However, there is not a great deal of medical evidence to show whether these blocks are actually helpful. This therapy targets the sympathetic nervous system. The sympathetic nerves are a group of nerves that are found along the front side of the spinal column that help control several involuntary functions of the body. The involuntary actions are referred as the actions you have no control over. These include blood flow, digestion, and sweating.

A sympathetic nerve block is an injection that can be used to treat pain which is a consequence of Complex Regional Pain Syndrome (CPRS), Raynaud’s syndrome, and some types of abdominal pain. This injection involves injecting local anesthetic in the area where several nerves meet. The target is to reduce or abolish the pain signals being sent to the brain.

The location of your pain typically determines where you’ll receive the nerve block. Your sympathetic nerves come together outside your spine area in thick networks of nerves called ganglions. If you have pain in the upper part of your body, you may get pain relief from blocking the stellate ganglion in your neck area. If you have pain in the lower part of your body, a ganglion near the lower spine may be targeted with a lumbar sympathetic block.

An experienced pain physician will locate the exact position of the target nerves using x-ray or fluoroscopic guidance to guarantee procedure’s truthfulness. Once the exact area of nerve pain has been located, the physician will inject an anesthetic solution. The procedure typically takes less than 30 minutes and patients are able to leave shortly after their procedure is complete.

Precautions:

Complications are exceptional, but can include infection, bleeding, spinal or epidural block and injection into a blood vessel. The procedure cannot be performed if:

You have the flu, cold or fever
High blood pressure or if you are on blood thinners.
If you have consumed solid food or fluids after midnight a day before the procedure is to be held.
If you are a diabetic patient

A sympathetic nerve block is a relatively safe procedure. You can usually go home afterwards and return to your normal activities after a day of rest. If you had IV sedation, you’ll probably need to have someone drive you home. Sympathetic blocks don’t work for everyone. Also, the pain relief they give may lessen over time. But for some, a sympathetic block may provide weeks or months of pain relief.

Jun 25 Comments Off

Feeling of Discomfort Around the Hip?

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The hip is a ball and socket joint that attaches the leg to the torso of the body. In the hip joint, the head of the femur (thigh bone) swivels within the acetabulum, the socket, made up of pelvic bones. While many causes of hip pain can arise from the joint itself, there are numerous structures surrounding the hip that can also be the source of pain.

Trauma is often the cause of hip pain, but any source of inflammation may cause pain in the hip area. Pain is one of the symptoms of inflammation, along with swelling, warmth, and redness; together these are signs and symptoms that a problem may exist. Hip pain is a common complaint among women of the population. The precise location of your hip pain can provide valuable clues about the underlying cause.

Problems within the hip joint itself tend to result in pain on the inside of your hip or your groin. Hip pain on the outside of your hip, upper thigh or outer buttock is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround your hip joint. Hip pain can sometimes be caused by diseases and conditions in other areas of your body, such as your lower back. This type of pain is called referred pain.

Causes of Hip Pain

These are some of the conditions that commonly cause hip pain:

Arthritis
Hip fractures
Muscle or tendon strain
Cancers
Avascular necrosis

Treatment:

If your hip pain is caused by a muscle or tendon strain, osteoarthritis, or tendinitis, you can usually relieve it with an over-the-counter pain medication such as acetaminophen or a nonsteroidal anti-inflammatory drug such as ibuprofen or naproxen. Rheumatoid arthritis treatments also include prescription anti-inflammatory medications such as corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate and sulfasalazine, and biologics, which target the immune system.

Another way to relieve hip pain is by holding ice to the area for about 15 minutes a few times a day. Try to rest the affected joint as much as possible until you feel better. You may also try heating the area. A warm bath or shower can help ready your muscle for stretching exercises that can lessen pain.

If you have arthritis, exercising the hip joint with low-impact exercises, stretching, and resistance training can reduce pain and improve joint mobility. For example, swimming is a good non-impact exercise for arthritis. Physical therapy can also help increase your range of motion. When osteoarthritis becomes so severe that the pain is intense or the hip joint becomes deformed, a total hip replacement (arthroplasty) may be a consideration. People who fracture their hip sometimes need surgery to fix the fracture or replace the hip.

Call your health care provider if your pain doesn’t go away, or if you notice swelling, redness, or warmth around the joint. Also call if you have hip pain at night or when you are resting. Treatment for hip pain depends on the diagnosis, but pain that’s caused by overuse or sports injuries is often treated with heat, rest, and over-the-counter anti-inflammatory medication. To prevent injuries, it is important to stretch before exercising and wear appropriate clothing, especially good shoes when running.

Jun 21 Comments Off

Is Carpel Tunnel Sysndrome a normal Condition?

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Carpal tunnel syndrome is a prevailing condition that causes numbness, tingling and other symptoms in the hand and arm. Carpal tunnel syndrome takes place when the nerves of the hand (also known as the median nerve) are constricted and compressed as it travels through the wrist along the carpal tunnel. The carpal tunnel protects the median nerve and flexor tendons that bend the fingers and thumb. A carpel tunnel is a narrow passageway on the palm side of the wrist. The carpal tunnel protects the median nerve and flexor tendons that bend the fingers and thumb.

In most patients, carpal tunnel syndrome gets worse over time, therefore an early diagnosis and treatment is necessary. Over time, the obstruction of the carpel tunnel exerts abnormal pressure on the nerves which results in pain, numbness, tingling, and weakness in the hand. The early symptoms can often be relieved with simple measures like wearing a wrist splint or avoiding certain activities. But, in case when the condition lasts too long, a surgery to take pressure off the median nerve may be recommended for some patients in order to avoid permanent damage. Carpal Tunnel rarely causes permanent nerve damage. Permanent, irreversible nerve damage is possible with Carpal Tunnel Syndrome. However, Carpal tunnel syndrome usually isn’t very serious. With treatment, the pain will typically go away and you’ll have no lasting damage to your hand or wrist.

Carpal tunnel syndrome symptoms usually start gradually. The first symptoms often include numbness or tingling in your thumb, index and middle fingers that comes and goes. Carpal tunnel syndrome may also cause discomfort in your wrist and the palm of your hand. These symptoms often occur while holding a steering wheel, phone or newspaper. The sensation may wake you from sleep. Many people “shake out” their hands to try to get rid of the numbness, but this feeling may become constant over time.

The most common causes include:

Anatomic factors
Sex
Nerve-damaging conditions
Inflammatory conditions
Obesity
Alterations in the balance of body fluids
Other medical factors
Workplace factors

Prevention Majors:

Reduce your force and relax your grip
Take frequent breaks
Watch your form
Improve your posture
Change your computer mouse
Keep your hands warm

Visit the doctor if you you observe persistent signs and symptoms suggestive of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Permanent nerve and muscle damage can occur without treatment hence, making it more worse!

Jun 14 Comments Off

Is it the growl of your back pain or punch?

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The growl of low back pain is often more excruciating than its punch. The pain most of the times make it worse than it actually is

MRI and X-ray for lower back pain and astonishingly deceptive, because conditions such as bulging disc is not that harmful and most of the back pain is relieved on its own. Muscle spasms are very common and can be critically intense, but aren’t serious.

What are the conditions when back pain becomes a scary part of your life?

There are cases of low back pain that have critical cases, but it occurs less often. Meanwhile, back pain is a warning sign of cancer, autoimmune disease, infection and a bundle of other scary offenders. Above the age of 55, almost one in twenty cases diagnosed with fracture and one in hundred is more sinister. The more you are far from 55 the better your condition is.

But how will you know about your back pain? It can be quite tricky, here we have brought you to the friendly guide to the red flags that need better safe than sorry investigation with your physician. This article will help you distinguish between the dangerous and just painful as smoothly as possible

The ordinary back pain is excruciating and debilitating, but not always alarming. Its growl is often much louder than its punch

Chronic low back pain is alarming, but rarely sinister

Back pain can absorb your happy days or even weeks, months and years. It is for sure very serious, even if it is not sinister. “I have dealt many doubtlessly tragic chronic low back pain patients, and a huge part of their savings ends up dealing with back pain. However, your critical case of chronic low back pain, as excruciating as it can be has never killed anyone,”Says Dr Zaki Anwar, MD Pain Management Specialist and Anesthesiologist. Founder of the Pain Management Center

Low back pain is sinister when it is caused by something that can handicap or kill you. Such cases occur less often, but bad things do happen, even the best doctors can overlook

Possible causes of sinister back pain and symptoms

These causes are not very common and usually brings serious symptoms that are easy enough to be alarmed. Some of the causes remain silent in the early stages, but not for too long

*Cause*	*Description*	*Symptoms*
Cancer	A tumor develops in or around the spine	The pain increases consistently, position and activity does not influence. Worsens at night and brings other symptoms as well
Spinal infection	Infections in or around the spine	Remains hidden for longer periods. The spot of infection is tender, with excruciating ongoing pain and immobile spine, along with fever and illness
Abdominal Aneurysm	Swelling in the artery adjacent to spine	Pain may be throbbing and pulsating. Often happens to people with the risk of heart disease, smokers and diabetic patients
Ankilosing Spondylitis	Rheumatic arthritis of spine and the pelvic region	Chronic back pain started in middle age and increase slowly. Relieves with activity but not rest and may spread to other areas

Jun 02 Comments Off

What causes a spinal disc herniation?

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The vertebral column is also called the spinal column is comprised of 33 bones. Each vertebrae is detached from the adjacent vertebrae by an intervertebral disc a, along with ligaments and the facet joints, which help each vertebrae to maintain the spine’s normal alignment and curve meanwhile also facilitating movement

In the middle of the spinal column there is an open carrier called the spinal canal. The spinal cord and the spinal nerves rests in the spinal canal, where they bath in the spinal fluid sheltered in the small spinal column

Herniated disc

A herniated disc happens when the fibrous outer part of the disc ruptures or is torn and the jelly like inner material is forced out. When the herniated disc exerts pressure consequently it gives rise to a pinched nerve condition that cause pain, numbness, tingling and weakness in the arms and legs. The inner squeezed substance in addition to pinching the nerve also give rise to inflammation and severe pain

Bulging disc

A bulging disc happens when the outer protective layer of the disc is depleted, but isn’t torn and pinches outwards. A herniated disc may evidently start as a bulging disc, eventually the outer wall is then torn by a potential amount of pressure

Disc herniation can arise in the cervical, thoracic and lower spine. The spot of pain is contingent to the location of the herniated disc. If the herniation arises in the cervical area, it can cause pain that spreads into the shoulder and the arm, it it arises in the lower back, the pain generated can spread into the hips and legs.

Hallmarks

A cervical herniated disc may cause pressure on the cervical nerves and can give rise to triggers like pain, pins and needle sensation, numbness or weakness in the shoulder, neck and arm. A potential disc herniation in the cervical spine may pinch the spinal cord within the spinal canal and cause numbness, stiffness and immobility in the legs and conceivably some complications in bowel and bladder control

A thoracic disc herniation may give rise to severe pain in the back, if the disc herniation travels through the forearm. The pain and the numbness may spread near the rib cage from the back to the front of the chest and the upper abdomen.

A lower herniated disc may cause the following symptoms;

Intermittent or continuous back pain
Spasm of the back muscles
Sciatica
Muscle weakness in the legs
Numbness in the leg or foot
Decreased reflexes at the knee or ankle
Changes in bladder or bowel function
Difficulty walking

The symptoms of the disc disease may mask other medical conditions and medical problems. You must consult a physician for a complete diagnosis

May 19 Comments Off

What is causing you uneasiness in the hip?

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The hip joint is strong enough to bear repeated movements and a substantial amount of wear and tear. The hip joint is comprised of the ball and socket is known to be the body’s largest fixed together in a manner that facilitate for fluid movement

Whenever we use the hip, such as for running, walking a cushion of cartilage helps avoid friction as the hip bone rotates in its socket

In spite of its persistence, the hip joint isn’t non perishable. With age and constant use, the cartilage can deplete and becomes damaged. Muscles and tendons in the hip can also get excessively used, bones can break during a fall or other injury and any of these situations can cause hip pain. If your hips are inflamed, here is a run through of what is causing you uneasiness, also it may help you know the quick tips to get relief from hip pain

Reasons for hip pain

There are some common conditions that can augment hip pain;

Arthritis

Osteoarthritis and rheumatoid arthritis are known to be the most common cause of hip pain particularly in older adults. Arthritis brings the inflammation of the hip joint and damages the cartilage that supports your hip bone. The pain eventually gets severe. People with arthritis also encounter immobility and tightness in the joints

Hip fractures

As we age our bones become weak and porous. Weakened bones are at a higher chance to fracture during certain injuries

Bursitis

The bursae are pockets filled with fluid placed between tissues such as bone, muscles and tendons. These small pockets are responsible to ease friction from these bony areas while working together. When bursae get inflamed they provoke the pain receptors, causing severe pain. Inflammation of the bursae has been often because of excessive activities of the hip joint

Tendonitis

Tendons are the thick bands of tissues that surrounds the bones to muscles. Tendonitis is the soreness and uneasiness of the tendons

Strained muscles

Strain on the muscles, tendons and ligaments that support the hips is caused by certain sudden movements and injuries. These muscles get pinched putting a substantial amount of pressure on the nerves restricting the normal hip functioning

Hip Pain Relief

Using over the counter medication, non steroidal anti inflammatory drugs, heat and ice therapy, plenty of rest along with physical therapy and exercising can help you achieve potential relief from your hip pain and increase range of motion

However, any deformities caused by arthritis or fracture may need to be dealt with surgeries such as total hip replacement or partial hip replacement

All Posts in Category: Blog

Precautions:

Causes of Hip Pain

Treatment:

What are the conditions when back pain becomes a scary part of your life?

Chronic low back pain is alarming, but rarely sinister

Possible causes of sinister back pain and symptoms

Herniated disc

Bulging disc

Hallmarks

Reasons for hip pain

Arthritis

Hip fractures

Bursitis

Tendonitis

Strained muscles

Hip Pain Relief