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Using Medical Marijuana Effectively in Clinical Practice

As regulatory approval of medical marijuana spreads in the US, practicing clinicians need to be apprised of cannabis-related indications, efficacy, and adverse effects.

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In an effort to develop viable standards for patient counseling and education, Jayesh Parmar, PhD, and colleagues from the school of pharmacy and health professions at the University of Maryland Eastern Shore in Princess Anne, Maryland, and colleagues reviewed 68 abstracts, summarizing common medical uses of cannabis-based medications and their safety in various disease states and populations. The study was published online September 16 in Research in Social and Administrative Pharmacy.

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“The overall purpose of this article was to provide clinicians with evidence-based counseling guidelines that can be strengthened as new clinical information becomes available,” lead author Dr. Parmar told Clinical Pain Advisor. “This is a starting point on developing counseling guidelines for the clinicians, subject to their review and modification.”

The study found that all 3 FDA-approved products (dronabinol, nabilone, and nabiximols), as well as inhaled and ingested marijuana products, are often used to treat neuropathic pain.

Other common uses for dronabinol included weight gain and chemotherapy-induced nausea and vomiting (CINV); nabilone is also used for CINV, while nabiximols is favored for spasticity in multiple sclerosis (MS). Smoked marijuana is also commonly used to treat glaucoma, and orally ingested marijuana is often used to improve sleep and seizure control in MS.

According to Barth Wilsey, MD, from the department of physical medicine and rehabilitation at the University of California Davis Medical Center in Sacramento, California, the key findings mirror those of a recent rigorous review involving 79 randomized trials with almost 6,500 participants.

“There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome,” Dr. Wilsey told Clinical Pain Advisor.

Moreover, cannabinoids were linked to an increased risk of short-term adverse events,” Dr. Wilsey pointed out. These were most commonly related to CNS, cardiovascular, and respiratory effects.

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Although medical marijuana may be beneficial for selected medical conditions, further research is warranted, Dr. Parmar said, noting that he and his team are currently reviewing data and developing guidelines for marijuana use in CINV and pain relief.

A number of legal and regulatory issues also need to be addressed before marijuana use can be established in clinical practice. Federal laws still view marijuana as an illegal substance, although enforcement is low in states that have approved access to cannabis-ingested products, Dr. Parmar noted.

Benefits of Marijuana Treatment Agreement

It is important that clinical practitioners communicate with patients regarding the goals of marijuana therapy and associated potential risks and benefits. Patients should be made aware that in contrast with recreational use, medical marijuana is intended for delivery in low, cumulative, therapeutic doses.

According to Dr. Wilsey, a treatment agreement might be the best way to convey treatment goals and improve patient understanding and compliance.3,4 As with prescribed opioids, written agreements between prescriber and patient can help deter misuse and abuse by delineating patient responsibilities with respect to dosing, random drug screens, and appointments.

Dosing Strategies Remain Unclear

Optimal dosing strategies for cannabis-based medications and ingested marijuana remain unclear, highlighting the importance of clinical counseling guidelines.

Wide variation exists in the reported dose of delta-9-tetrahydrocannabinol (Δ 9-THC) needed to produce CNS effects, Dr. Wilsey said. Two recent studies suggest that lower doses of THC provide pain relief similar to that of higher doses, yet decrease the risk for adverse events.5,6

A patient-specific, self-titrating model has therefore been suggested as a useful dosing paradigm for medicinal cannabis, allowing patients to take the lowest effective dose of THC.

“The use of flexible dosing has been previously performed for the treatment of neuropathic pain with nabiximols where patients self-titrated their overall dose and pattern of dosing, according to their response to and tolerance of the medicine,” Dr. Wilsey pointed out, noting that the delayed-onset associated with dronabinol and nabilone may make titration difficult.

Efficacy may vary with formulation

According to Dr. Wilsey, some experts have suggested that whole plant cannabis or ingested marijuana is superior to the FDA-approved cannabis-based medications. The concept may explain why long-marketed oral cannabinoids are not widely used in the US.

“Peak plasma concentrations occur 1 to six hours after ingestion, with a magnitude approximately 10% of that achieved with smoking. It has been postulated that the preference expressed by patients for herbal cannabis is a result of the faster onset and shorter duration of action, allowing titration of dose to the desired effect,” Dr. Wilsey said.

Dr. Wilsey and colleagues plan to compare the efficacy and safety of herbal cannabis and oral Δ 9-THC (dronabinol) directly in a clinical population.

“We plan on performing a randomized, controlled 8-week trial comparing the effectiveness of these two cannabinoid preparations in patients with neuropathic low back pain. In addition to studying efficacy and side effect profiles, we will also perform a driving simulation study to determine the real-world impact of these two cannabinoid treatments,” Dr. Wilsey concluded.

References

1. Parmar JR, Forrest, Benjamin D, Freeman, Robert A. Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs.Research in Social and Administrative Pharmacy. 2015. Published online September 16, 2015. doi:10.1016/j.sapharm.2015.09.002

2. Whiting PF, et al. Cannabinoids for medical use: A systematic review and meta-analysis. JAMA. 2015; 313 (24).

3. Ware MA, Ziemianski D. Medical education on cannabis and cannabinoids: Perspectives, challenges, and opportunities. Clin Pharmacol Ther. 2015; 97(6): 548-550.

4. Wilsey B, et al. The medicinal cannabis treatment agreement: Providing information to chronic pain patients via a written document. Clin J Pain. 2014.

5. Wilsey, B, et al. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain.The Journal of Pain. 2008; 9(6): 506-521.

6. Wilsey, B, et al. Low dose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain. 2013; 14(2): 136-148

Article written by Beth Gilbert. She has an undergraduate degree in chemical engineering from Lehigh University and a Master’s in biomedical engineering from Columbia University.

Article Source:

http://www.clinicalpainadvisor.com/treatments/using-medical-marijuana-effectively-in-clinical-practice/article/450820/

 

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Back Pain Control Medications

Suffering from back pain for a week, and then also you are not in a mood to take your problem seriously. This lack of care can bring you down to a much worse condition, compelling you to prolong your application leave that you took from your office. As long as your pain is controllable, it means that you still have options to get better on your own.

Mild pain medications are an option that will not stop degeneration, but will definitely help with pain control. Let’s explore these mild pain control medications!!

Aspirin

These are over the counter pain relievers that helps a lot in lower back pain alleviation. However, in any kind of state such as if a woman is pregnant then this medicine should not be opted. As it can cause stomach problems like ulcers, with or without bleeding. You should take medications, but if you are already in a state then you should first pay a visit to your doctor to see whether he prescribes you that medicine or not.

NSAIDs

Known as the Non Steroidal Anti-Inflammatory Drugs, comprises of pain relievers such as ibuprofen or naproxen. These medicines are found very effective in alleviating the pain associated with muscle strain, stress and inflammation. The inflammatory response in joints is blocked by these pain alleviators. However, NSAIDs can be harmful for older people as it can decrease the renal function. Furthermore, its excessive use can lead to the kidney problems.

Narcotic Pain Medications

Narcotics such as codeine and morphine are prescribed by your doctor in case the pain in back is severe. For the central nervous system the narcotic pain medication acts as a numbing anesthetic. In case of some side effects that might be observed such as nauseatic feeling, vomiting, constipation, sedation or drowsiness, the preventative measures that can be taken, such avoiding sleeping aids or antidepressants, avoiding alcohol, increasing fluid intake, eating a high fiber diet or using a fiber laxative to treat constipation. Remember, narcotics should be used in right proportion as excessive use can make you addicted to it.

Muscle Relaxants

Feeling fatigued, or difficult to move for your daily chores, depicts that you are having muscle spasms or muscle strains. In such a case muscle relaxants can help a lot in alleviating your pain. Keeping in consideration that they also have a risk of making you drowsy or depress you, they should be used for a limited amount of time. They are recommended for two or three days.

Antidepressants

People mostly are unaware of the fact that pain in the back can be a direct symptom of depression. To mildly treat this specific condition, there are antidepressants that can relieve the stress leading to the symptoms of back pain. Some kinds of antidepressants help in alleviating your pain and some provide a sound sleep. The latter are for those who, due to back pain have trouble in sleeping. Hence, they are prescribed by your doctor in order to get you back to a normal sleep routine.

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How To Treat Back Pain Non Surgically?

Surgery Is Not The Only Option For Back Or Neck Pain

Yes, this is true that, it is not necessary surgery will work out for everyone for removing the pain of neck or back, in fact, 95% people find relief from pain through undergoing non-invasive and non-surgical treatment and that non-surgical treatment comprises of medication, physical therapy, pain management and exercise. Those who come across neck pain first time, always ask themselves that will they be able to get better without opting for a surgery? The answer for this is that more than 95% of people experiencing pain in both neck or back do not have to undergo surgery, and they get the perfect treatment for their this specific pain through non-surgical options. Because of the latest advancement in the medical field these non-surgical treatment options are replacing traditional surgery option and having seen their natural healing capability people are opting for them. They give excellent results when it comes to getting rid of pain.

·        Non-Steroidal Anti-Inflammatories

NSAIDs work by eliminating inflammation and providing pain relief. Injured ligaments and joints may cause pain straight away or by nerves which get irritated as they leave the spine. NDAIDs should be taken on a regular basis at therapeutic dosing in order to have a true anti-inflammatory effect. NSAIDs consist of ibuprofen and Naprosyn and you must consult your physician if you wish to get a long-term therapeutic dosing of NSAIDs.

·        Physical Therapy Is The Best Alternative To A Surgery

During physical therapy, many different treatments just like applications of heat and cold, ultrasound and massage are mostly used for alleviating pain and stiffness. Therapeutic exercise is mostly prescribed in order to build a strength and good range of motion. Patients can learn about healthy posture and relaxation techniques. Gentle cervical traction can also be prescribed, if the doctor thinks that it will work for you.

·        Pain Management And Its Benefits

Pain Management is to prevent and treat your back pain and many other health problems by treating misalignments or subluxation in the spine. Manual Spinal Adjustment is the main part of proper pain treatment, and other therapies comprise of muscle stimulation, Tens “transcutaneous electric nerve stimulation, ultrasound or heat and ice therapy. Adding to this it may also consist of exercise, massage therapy and stretching.

Conclusion

In order to select the right non-surgical treatment option, going to the right place matters a lot and for that Pain Management Institute is the best option as you will find doctors and staff devoted to provide the best the non-surgical treatment to patients suffering from back pain. So, do not waste your time and call on this number (815) 464-7212 for an appointment.

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Five Must Ask Questions From Your Surgeon Before Back Surgery

Taking Surgery Decision Is Critical

Undergoing spinal surgery is a big decision, it means that you must understand its procedure and proper knowing of the doctor, who will perform this operation. Surgery has never been the first choice for any patient, and that depicts the seriousness of undergoing the spine or back surgery. Before undergoing any surgery, you must ask a few basic questions from your doctor and doing this will eventually lead to good results of surgery.

What Operation Are You About To Perform?

It is the duty of your doctor to explain you clearly that what surgical process, he/she will perform and what steps this specific surgical process includes. In some cases a procedure is performed in some different ways, and each one of them has different risks. So that is why your doctor has to explain all avenues, before getting ready to undergo surgery.

What Are The Risks Involved?

This is the most important question to consider and overlooking it will cause hazardous outcomes of a surgery. Although because of medical advances the surgery has improved a lot with the passage of time, but it has not yet detached surgery from risks. So learning about the complications of surgery and what symptoms you will look for after it is good.

What Nonsurgical Options Are Available?

Your doctor may inform you about all the non-surgical options, if you ask about it. You ask this question if you have serious reservations to undergo the back surgery. Ultimately, it is up to you that you want to undergo the surgery or not. A Doctor is only to inform about each and every non-surgical option and its chances of success, the rest depends on you whether you will opt for it or go to a surgery.

How Many Times Has Your Doctor Performed A Similar Operation?

This question relates to your own mental satisfaction, and asking this question from a doctor will help you in getting rid of stress caused by unexpected outcomes of a surgery. Asking this question will also help you to get your surgery performed by an experienced doctor.

What Should Be Expected After A Successful Surgery?

It is very important to discuss, that what you may come across after undergoing the surgery, and there are four basic questions regarding that, they are:

  • Will you have to stay overnight?
  • Will you have to have someone to take you home?
  • Will you need home-care for fewer days after a surgery?
  • When will you get back to your work after a surgery?

Conclusion

In order to meet an experienced doctor for a surgery, selecting the right clinic is very important and for that Pain Management Institute is the best place, where you will find all the desired treatments. So feel free to contact at (815) 464-7212 for an appointment.

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Five Ways To Relieve Your Carpal Tunnel Syndrome

While many of us do not spare a moment to think about our carpal tunnel, because we haven’t experienced the pain of carpal tunnel syndrome (CTS). Around 10 million Americans cannot even turn a page without a sharp pain shooting through their wrist sometimes all the way up to their arm.

CTS is quite a common problem for the office working people. However, sitting on a computer constantly is not the only reason you may develop it. Zaki Anwar MD, the pain management specialist at Pain Management Institute lists the following factors that can cause CTS:

  • Heredity
  • Fluid Retention
  • Diabetes
  • Rheumatoid Arthritis

Here are a few tips to help you keep your carpal tunnel pain at bay:

1.     Give a break to your wrists

Your hands need a little care as you work. So whenever you take a break to have some water or go to the washroom, bend both your hands upward from the wrist gently and hold this stretch for a few minutes. Then bend each hand downward and hold again for a few minutes. Flex and bend your fingers as well.

2.     Go easy when using force

You can work perfectly fine when you put swift strokes on your computer keyboard so don’t pound the keys. Neither would it make any difference if you hold the pen very tightly, it can work just fine if you go easy. Keeping your hands relaxed will help.

3.     Keep your posture in check

Don’t slump forward in your seat, it will put pressure on your hands and wrists. Keep your eyes level with the monitor and your feet on the floor flat. If your chair is tall, use footrest to keep your feet flat. Pick a chair that supports the curvature of your spine. Take a break every after every 40 minutes and walk for around 60 seconds in your office. Don’t sit cross legged for longer durations. Dr. Anwar suggests the best posture to keep your joints relaxed is to keep your hips, knees and ankles at 90 degrees.

4.     Don’t let your hands get cold

If you sit in a chilly atmosphere, your hands can get stiff and then sore. Give fingerless gloves a try. It may look odd at first, but your hands will stay pain free that way.

Try Yoga

Any exercise that builds your strength is good for joints. Yoga has been found successful in pain relief and keeping your hands flexible.

If your carpal tunnel syndrome worsens, reach out to Pain Management Institute where skilled medical staff can take immediate measures to relieve the symptoms

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Suffering From Pain? Opt For Medial Nerve Blocks!!

Kinds Of Nerve Blocks

You will come across many sorts of nerve blocks, which are able to provide better pain relief. Epidural nerve blocks are for neck, back and for your spine through stopping the nerve’s ability of sending pain signals, from that specific area to your brain, and on the other hand facet joint blocks help in determining, whether facet joints in your back are the real cause of your acute pain or not. But here we will focus on medial nerve blocks.

Let’s Find Out About Medial Nerve Blocks

A medial branch nerve block stops pain signals, which go to the brain from medial nerves. These nerves are situated close to facet joints; they are mostly used for relieving pain in two main areas such as the neck and spine. This is known as a very straightforward treatment. Those who suffer from back pain will be required to lie on their stomach, and those who suffer from neck pain are mostly positioned on their side. The skin is cleansed through local anesthetic, and then your doctor is to perform the injection procedure in the area, which houses the medial branch nerves. A very less quantity of anesthetic is inserted into the region, which helps pain relief to occur within minutes.

Is This Treatment Invasive?

Many patients come up with saying that their injection phase is painless; particularly if it is compared to the pain they are coping with on a daily basis. You may come across a light pinch in the area on which this injection phase is performed, as the needle breaks the skin, otherwise the procedure is painless.

Its Lasting Capability

This injection is great for providing short-term relief, and pain relief may last for hours or days or for a few months.

Who Are The Right Candidates?

Those who are not allergic to any specific sort of medications or they are not on blood thinners and those who do not have an active infection are the right candidates for this Medial Nerve Block. This specific treatment does not take much time and you are done with this treatment within few minutes.

Conclusion

The most important thing prior to acquire this specific treatment is to find the right pain management specialist and in this regard “Pain Management Institute” is the right option. This institute has been treating patients with medial nerve blocks for years and has all the facilities under one roof in order to make this particular treatment more successful. So do not waste time and contact on (815) 464-7212 for an appointment.

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Suffering From A Whiplash Injury? Get The Right Treatment For It

Do Not Overlook Whiplash

There are people, who think whiplash as minimal injury, but the fact is that whiplash is a very serious condition and it is also capable of making a way for many long-term pain conditions and confined mobility. If it is left untreated and ignored by a patient, then there are chances that it will damage other parts of the patient’s body. This specific injury is mostly caused by a car accident. It takes place as your head or neck forcefully jerks backward and forward. This sudden movement is the reason for ligament strain in the neck, and it causes pain and confined mobility of your head and neck. The more forcefully your head and neck heave during a car accident, the more the strain occurs on these ligaments, and that causes more damage. Whiplash may take place even by a minor car accident, as your neck and head are the most sensitive parts of your body and minor jerk may cause chronic neck pain.

The Symptoms Of Whiplash

  • Pain in neck
  • Neck stiffness
  • Injury of neck muscles or ligaments
  • Having painful Headache
  • Having a burning or prickling sensation
  • Shoulder and back pain

The Statistics About This Specific Injury

805,581 whiplash injuries get reported yearly and the cost of claims for this specific injury reaches to 8.8 billion each year. 66% of insurance bodily injury claims comes from neck injury. This shows that how much whiplash is affecting people, and treating it on time is the most important thing to avoid any further injury.

Few Tips On Avoiding Whiplash, While Driving

  • You have to make sure that head rest in the car is at proper height
  • Make sure you keep a decent gap between your car and the car which is ahead of yours. This will reduce the chances of an accident
  • Always sit upright on your seat
  • Fastening seat belts is the most important thing

During a car accident, all you have to do is to lean your head back onto the head rest and try to look straight. This will help in reducing any severe whiplash outcome.

Conclusion

Whiplash is the injury which may cause acute neck pain, and in order to treat this specific problem, the important thing is to find the clinic, which owns the vast experience of treating patients suffering from whiplash. Pain Management Institute in this regard is the best place to go for, as you get a chance to meet the experience doctors, and may avail the latest and advanced facilities to treat whiplash. So do not waste time and contact on this number (815) 464-7212 for an appointment.

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Coping With Head Injury!!

Head Injury And Its Kinds

The severity of head injury depends on how it happened, the way it took place. There are few head injuries that cause bleeding within your skull. Other injuries, damage the outside area of your head, resulting in the formation of bumps, or bruises and lacerations. Pain in the head is undoubtedly unbearable, sometimes een leadin you to nauseatic feeling and compelling you to hault your usual activities. Below are four kinds of head injury so read them thoroughly and we hope knowing about them will help you in many ways.

·        Closed Injury

This injury does not break your skull or penetrate brain tissue, but your brain can be vulnerable to bruising and swelling because of it.

·        Open Injury

Open injury is the one, which pricks your skull, and this damage can cause bleeding in your brain tissues. You may come across skull fracture because of it.

·        Concussion

This specific kind of injury takes place as your brain gets shaken, and it may cause consciousness and headache.

·        Scalp Wounds

Scalp is known as the skin that is to cover and protect your skull naturally. This injury makes you vulnerable to bleeding or tissue damage.

Its Causes

There are many causes behind the head injury, but we have jot down the names of the most common causes of head injury.

  • Injuries caused by Vehicle Accident
  • Skull wounds caused by Gun shot
  • The striking of your head by any heavy object

Diagnosis Of Head Injury

The pressure headache, tension headache that is felt before or after the ehad injury is diagnosed by doctors using y sorts of imaging in order to see bleeding in the skull or check any other damage in the brain. The imaging options comprise of CT, Scan, MRI, and X-ray.At the time of head injury, stabilizing your head, back and neck is important before taking you to the hospital, and it is very important to avoid any other injury.

Go To The Right Place For Your Head Injury

The treatment depends on what sort of head injury you have. Opting for the right treatment for head injury also depends on your overall health. The most important thing is to find the place where you can have the proper treatment for this specific injury, and in this regard “Pain Management Institute” is the best place, as it offers you the complete pain management solution. From medication to surgery, you will have all the treatment options for your specific injury at the institute. So do not waste your time, and immediately contact on this number (815) 464-7212 for an appointment.

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Suffering From Neck Pain?-Opt For An Effective Treatment

What To Know About Head Or Neck Pain?

Neck pain and head pain should not be taken so easy, as it may cause a severe headache, which

is sometimes very hard to tolerate.  Although both pains are common, but it is not necessary

that it will be normal, and you have to do something to get rid of pain, which occurred in your

neck or in head.

Neck And Head Are Connected To Each Other Naturally

The vertebrae of your neck help the weight of your head and all of its motions, which does not

seem like much-unless you feel that your head weighs similarly like bowling ball. As your neck

bones are not in natural position, it results in tightening of the muscles and causes irritation of

the nerves which are connected to your head. Below are the symptoms of pain associated with

your head and neck, so read about them, which will help you to take some preventing

measures regarding that.

1. Intense or dull pain or any sort of pain in neck

2. Having stiffness in the neck

3. Not having the ability to move your head properly

4. Headache

5. Pain in jaw and shoulder

Demand For Proper Pain Management

The ways of treating this kind of specific pain have totally changed, and now there are much

more advanced treatment options than going for traditional treatment options.  Safely

eliminating the neck and head pain is possible without causing any side effects, by opting for

proper pan management.  The stress on your neck muscles and irritation in the nerves can

naturally ease, by exploring the areas of misalignment in your neck and upper back, and then

restoring proper alignment.  If your muscles and nerves work normally, then your neck is not

vulnerable to acute stiffness and it also decreases your chances to have a headache.

Go To The Right Clinic For Your Pain

If you visit the right clinic for your pain, it means you have got on the right track, which will lead

you to good results, in terms of getting rid of this specific pain. For that Pain management

institute is the most right place, which has all the facilities under one roof for your neck pain,

and has doctors and staff, who have been treating that sort of pain for years and know how to

eliminate this acute pain in your neck permanently. So feel free to contact Pain Management

Institute at (815) 464-7212 for an appointment.

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Treat Back Pain Properly To Feel Young Again!!

Being in pain most of the time is the most disturbing feeling a person can ever have. A slight cut

on the toe, a bruise in hand may heal slowly and gradually. But in a condition when you feel

constant pain in back, just imagine what changes and issues it would bring to a person. They

indeed make a person frustrated and tensed. The person would even be reluctant to get up from

the bed as lying down will only be the time he/she will feel a bit better.

YOU START FEELING OLD…

Obviously, if you do nothing in chronic pain, and keep on following your home remedies

thinking that with the passage of time you will get better; you will start feeling old. It will be as

if, performing small task will require you to do a lot of rest because of the lower back pain that

you are feeling constantly.

Not doing anything in such an acute stage, is like driving a car without steering. You don’t know

where you are going, but the thing which is certain is that you are starting to feel years older,

even with minimal work, less or no engagement in activities etc.

THE POTENTIAL CONSEQUENCES OF BACK PAIN

According to a research, it is said that as compared to men, women have greater chances of

suffering from back pain and all the other diseases associated with it.

Some of the consequences that appear if the pain is left untreated include:

 Probelms while sleeping, eating, and mobility

 Impaired immune function

 Incontinence

 Irritability

 Lack of concentration and mental clarity

 Poor appetite and weight loss

 Sadness, anxiety, or depression

 Sexual dysfunction

 Skin ulcers

COME TOWARDS LIFE-FEEL YOUNG AGAIN!!

It is due to our own mishandling of the issues that we turn smaller problems into bigger ones by

not treating them well. In some cases it is also said that the lower back pain might be due to

some other problem. All it requires is proper and timely treatment so that the condition does not

turn into some bigger disease and bring a destructive change in your life.

A little positivity is all that is required. You need to look around, understand how becoming

dependent on others will create problems for your own self. And considering all this opt for the

treatments like exercise regularly, have physical therapy, take a balanced diet, follow a proper

pain medication prescription etc. As, one thing is for sure. The earlier the treatment is begun the

lesser the pain will have its impact in your day-to-day life.

Regarding nay help for involving the diagnosis and treatment of back pain feel free to contact

Pain Management Institute’s pain specialists at (815) 464-7212.

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