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All Posts in Category: Blog

2018-03-14 (1)

End you suffering with radio Frequency Lesioning

Patients who endure chronic back pain and cervical pain, who have tried several conventional treatments such as medications and physical workout sessions should once try radio frequency lesioning

Radiofrequency lesioning or RFL is a process that  takes advantage of electrical impulses to mask nerve transmission. RFL is mostly used on the to treat facet joint nerves, sacroiliac joint nerves and peripheral nerves. Radiofrequency Lesioning treatment provides long term relief from pain by masking the pain signals for 6 to 9 or even 18 months in some cases

The basic purpose of Radio frequency Lesioning

The Radio Frequency Lesioning does not harm the nerves instead retards their ability to transmit pain signals to the brain, providing a better and quality pain relief for up to 18 months

The procedure details

Radio Frequency Lesioning is carried under the fluoroscopic guidance to make sure that the needle reached the aimed point. By using the special Radio frequency needles and Microelectrode, the tissues and  nerves the pain site is accelerated by a low intensity current. This current produces heat and blocks the pain transmitters. Local anesthesia is used to numb the area before the procedure is initiated. At the pain management institute RFL is  done on an outpatient basis. The procedure takes only 30 to 60 minutes. The patient can go home soon after the procedure.

Almost 80 to 90%  of the patients get potential relief from the chronic back and neck pain with Radio Frequency Lesioningsays Dr. Zaki Anwar, MD

Though the pain relief is longer as compared to many other procedures, however it is not permanent. Sensory nerves reproduce over time and cause pain symptoms to reappear

Risks and complications

There are few risks associated with Radio frequency Lesioning involving pain and numbness, bleeding and allergic reactions on the treated area

Other rare complications include nerve damage, that may cause chronic inflammation and numbness

Conditions that can be well treated with Radio Frequency Lesioning

There are several conditions that are successfully treated with Radio Frequency Lesioning, including

  • Facet joint pain
  • Discogenic pain
  • Sympathetically generated pain

Final thoughts

A huge number of adults endure chronic pain conditions in the United States. The patients are not only a victim of physical agonizing also they are under emotional suffering if their pain doesn’t respond to the conventional treatments

Radio Frequency Lesioning is a slightly invasive method that is implied to effectively treat pain that has been chronic and unresponsive to other treatments. The procedure is generally safe and involves negligible risks if done by an expert physician

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2018-03-08 (1)

Your Pain Stops Here

A selective nerve root block is a slightly surgical procedure that is done to diagnose and treat cervical and lumbar pain and related pain suffering areas. The procedure includes injecting local anesthesia straight into the expected problematic nerve root of the spinal column to help recognize the cause of a patient’s pain also it helps to relieve pain for the shorter period

Symptoms of an irritated nerve root

The spinal pain happens when any of the spinal nerve becomes irritated, inflamed or compressed. The pain may spread in the upper and lower areas depending on the location of the nerves

If a nerve is damaged in the cervical region, the pain and other symptoms will be felt in the neck, shoulder and arms, whereas the nerve irritation in the lower spine causes numbness, tingling in the lower back, hips, buttocks and legs

Sometimes it becomes difficult for a physician to identify the exact nerve causing pain, at times MRI may not indicate the problematic nerve. In such condition a selective nerve root block is recommended to restrict the nerve root that is the source of pain

How a selective nerve root block is performed

A selective nerve block involves injecting a local anesthetic formulated with Corticosteroid to the targeted nerve root. The local anesthesia numbs the nerve sensation, while the steroids help in decreasing inflammation and the pain arising

The selective nerve root blocks are much the same as the epidural injections, however the medications are administered in the pain causing nerve root and not in the epidural space. The selective nerve root block results may vary from person to person as some nerve roots are difficult to reach and administer

What to expect after the procedure?

Many patients undergoing selective nerve root block can resume their routinely activities following the procedure. Some patients may report a sudden relief from the symptoms that is because of the numbness. The pain may reappear until the steroid shots initiate its effects. The relief of pain symptoms from a selective nerve root block depends on the levels of your pain and lasts from several days to several months

What will happen following the procedure?

Soon after a selective nerve root block, patients may experience incremental pain at the site of injection, pain while movement, lightheadedness, nausea, headache and vomiting all these symptoms will last in a day

Risks and complications

Risks related to selective nerve root block are very rare, including, infection, bleeding and allergic reactions with the medications applied during the procedure. Very rare and serious complications include, nerve damage and paralysis

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How helpful are the sympathetic nerve blocks

The sympathetic nerve spreads from the front exterior of the spinal column and not in the spinal canal with the nerves that allow sensation and strength to your legs. The sympathetic nerves are a component of the self-governing nervous system that controls functions such as blood flow and temperature adjustment on the arms and legs, sweating, heart rate, digestion and blood pressure
The self governing nervous system is responsible for regulating bodily function that is involuntary. However, the sympathetic nerve has no connection with the central nervous system. When regulation of the sympathetic nervous system is disturbed pain conditions occur, including; complex regional pain syndrome

How the sympathetic nerve blocks are done

A sympathetic nerve block counts in injecting numbing medicine around the sympathetic nerve in the low back or neck. With the injections the sympathetic nervous system in the corresponding area is for the time being is retarded for reducing and eliminating pain. If the pain is significantly relieved after the sympathetic nerve block, then the physician will move towards the diagnosis of the treated pain, the anesthesia injected may last longer than normally expected. The purpose of sympathetic nerve block is to bring the sympathetic nerve tone to its normal state of regulation. If the first block is successful, then further blocks may be administered if the pain continues to significantly reduce
What will happen to me during the procedure?
The procedure will be started with an IV and relaxation medication is given to ensure your comfort at The Pain Management Institute. You will be asked to lie on an X-ray table and the skin where the injections will be administered is cleaned with an antiseptic solution. Dr. Zaki Anwar, Medical Director at the Pain Management Institute will then numb the skin, which stings for a few seconds and guides the needle to to the sympathetic nerves to ensure that the medicine reaches the aimed location
What should I do and expect after the procedure?
A few minutes after the procedure, Dr Zaki will ask to mobilize your treated area to provoke usual pain. You may not feel improvements for the first few hours after the procedure. You might feel increased heat in the affected areas for a day after the sympathetic nerve blocks. If the injections are given in the neck you might notice slight drooping of the eyelids and redness in the eyes for a couple of hours. All these symptoms are normal and resolve within a day. Discuss any remaining pain and notice the pain relief every day so that Dr Zaki Anwar, MD get knowledge about your results and devise future tests, treatment plan if needed

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Is it possible to avoid surgery for spinal fracture?

Vertebroplasty is a treatment in which a specially formulated cement is injected into the fractured vertebra, with the goal of relieving your spinal pain and bringing back your mobility. Not all people with fracture vertebra are suitable candidates for this procedure, however, according to the studies conducted Vertebroplasty is more beneficial as compared to other conservative treatments, which include, bed rest pain relievers, muscle relaxants, back braces and physical therapy. Prior to considering for vertebroplasty you should consult with your physician about the risks and benefits. At the Pain Management Institute, Dr Zaki Anwar, MD only recommends the vertebroplasty treatment if;

  • When the conventional methods for treating back pain have failed
  • You endure chronic back pain and immobility
  • The fracture vertebra brought you serious consequences, including veins damage, osteoporosis, respiratory problems, muscle shortening, losing height and emotional distress

Risks and complications with Vertebroplasty

Generally vertebroplasty is easily endured, with a complication rate is 1 percent to 3 percent. In very rare cases, patients face risks such as

  • Hemorrhaging
  • Blood loss
  • Fractures of ribs or other nearby bones
  • Fever
  • Nerve root irritation
  • Infection
  • Cement flowing outside of the bone before it hardens

For a little while following the vertebroplasty procedure the pain may worsen as the cement hardens, but it only happens in very rare cases and does not last longer. You may experience complications depending on your condition, it is necessary to discuss with your doctor prior to any processing

How Vertebroplasty

Works Prior to the procedure

At the Pain Management Institute vertebroplasty is done, considering your comfort as the first priority. Dr Zaki Anwar MD Pain management Specialist and Anesthesiologists will conduct an X-ray and discuss your complete medical history with a physical examination to pinpoint the location and nature of your vertebral fracture. If needed Dr Zaki Anwar, MD might also use MRI or CAT scan. Must tell your doctor about any medications or other painkillers you are taking. Inform your physician if you have a history of bleeding disorders or if you are taking any blood thinning medications or other medications that hinders the clotting of blood

During the procedure;

Dr Zaki Anwar, MD will give you an IV sedation to relax and remain un bothered, in cases of sever pain local anesthesia might be used. A needle is placed using an x-ray guidance into the fractured vertebra, sometimes a second injection is also needed to completely fill the crack

What to expect after the procedure?

You will be asked to lie on your back for a couple of hours as the cement hardens in an observation room, you will experience pain relief after a day or two. Dr Zaki Anwer, MD will assess you for any complications and recommend wearing a back brace if needed

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My wrist pain has committed the daily tasks challenging for me

Carpal tunnel syndrome is an ailment in which the median nerve passing through the wrist is compressed. The median nerves control some of the nerves that hold the movement of the muscles in the thumb, also the median nerve is responsible to carry information to the brain about the sensation and feeling in your thumb and fingers

When the median nerve is compressed it causes pain and soreness, sensation and deadness in the suffering hand. Women are more prone to develop Carpal Tunnel Syndrome. Though the condition can affect people of all ages, irrespective of the gender, however, it’s more common in the middle aged and elderly people

Carpal tunnel syndrome brings pain, tingling and deadness either on one side or both of your hands, it happens to develop gradually, over a course of weeks. The symptoms are usually worse in the thumb, index finger and middle fingers, however, at some point it feels like your whole hand is affected. Also, you might feel pain spreading up the arm to your shoulder or neck.

The symptoms have a propensity to be worse at night and may disturb your sleep, you could also notice it most when you wake up in the morning. Hanging your hand out of bed or shaking will often reduce pain and sensation

You may not feel pain during the day, however, certain activities such as writing, typing, or  doing households can aggravate the symptoms. In the case where nerves are severely squeezed you may endure pain throughout the day. Your hand may feel weak, and your fingers numb. You would lose grip and activities involve the use of fingers, such as writing becomes a challenge. The median nerve is very easily offended by pressure, in most cases there is no obvious cause to carpal tunnel syndrome. Some of the most reported causes include

  • Any form of arthritis in the wrist carpal tunnel
  • Hormonal changes during pregnancy
  • An under active thyroid gland
  • Diabetes
  • Fracture of the wrist

Your chances of getting the Carpal tunnel Syndrome are greater if your job puts a heavy demand on your wrist, or if you are using vibrant tools. Not in all the cases the Carpal tunnel syndrome is progressive and can be healed without any treatment. If there is any particular underlying cause of your symptoms, then treatment may become necessary.

Simple treatments can often help, including:

  • A resting splint for your wrist
  • A working splint
  • Medications
  • Surgery
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Pelvic pain is now possible to treat with Dr. Zaki Anwer, MD

If you or a family member having a hard time with pelvic organ prolapse or loss of voluntary control? You’re not alone. The National Center for Health Statistics of the Centers for Disease Control and Prevention states that 25% of U.S. women live with one or more pelvic floor disorders

What are Pelvic disorders and What causes Pelvic Pain?

Pelvic floor disorders cause severe pelvic pain and affect a woman’s pelvic organs, as the uterus, vagina, bladder, rectum and the linked muscles. The most common condition that causes pelvic pain are; loss of voluntary control, and pelvic organ prolapse.

Women with weak pelvic muscles or tears in the connective tissue may have problems controlling their bladder and bowels. They usually experience urine leakage, bowels gas or stool leakage, a problem clearing the bladder, and constipation. Also, some women feel or see tissue bulging out of the opening of their vagina. It might be possible to experience one or several symptoms of pelvic floor dysfunction.

Treatment Options for pelvic pain

There is a wide range of pelvic pain treatment. However, it is equally vital, the patients must seek treatment that best suits their needs and lifestyle

“Many patients with pelvic pain can be treated successfully without surgery.” said Dr. Zaki Anwer, MD.
“Different strategies as behavior therapy, physical therapy and medications are typically first step in treating patients with pelvic pain

“I practice conservative methods first while treating my patients. However, for patients whose symptoms persist after non surgical treatment, surgery is considered to find relief.” said Dr. Zaki Anwer,MD at The Pain Management Institute  
The basic aim of the pelvic pain treatment is to reduce symptoms and improve the quality of life. Dr. Zaki Anwer first diagnose the cause of the pelvic pain. Once the cause is diagnosed the treatment will be focused on the cause of pain. Many patients get optimal relief from a combination of treatments


Considering your condition Dr. Zaki Anwer, MD will recommend you medication including

  • Pain relievers
  • Hormone treatments
  • Antibiotics
  • Antidepressants

Other therapies

Sometimes medications are not enough in such cases you can opt for other therapies

  • Physical therapy
  • Spinal cord stimulation
  • Psychotherapy


While all the other traditional treatments fail to provide relief, surgery can be an option. The approach can be ;

  • Laparoscopy
  • Hysterectomy
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What hurts my shoulder?

The shoulder is the body’s most mobile joint and enables the arm to have a wide range of motion. This mobility allows us to perform daily tasks like reaching for a coffee cup, showering and answering the phone. However, the repetitive stress can wear down the shoulder muscles, tendons and ligaments, leading to varying degrees of pain and discomfort.

You can sense pain handiest whilst you flow your shoulder, or all of the time. The ache can be brief or it is able to retain and require clinical prognosis and treatment. Dr. Zaki Anwer, MD, explains some of the commonplace and reasons of chronic shoulder ache

Chronic Shoulder pain may arise when any of these structures emerge as irritated, injured or inflamed. Minor muscle lines, repetitive use injuries and repeated overhead motions inclusive of swinging a tennis racket

What are the most common causes of shoulder pain?

Once in a while, it’s far hard to inform the exact nature or supply of shoulder pain, but there are some common causes.

Rotator cuff tears

One common motive of  chronic shoulder pain is a tear of the rotator cuff, that’s made of the muscular tissues and tendons that hold the arm bone in the vicinity in the shoulder joint. Whist the rotator cuff is damaged, you may experience a shoulder ache or weak spot when transferring your arm.

Shoulder injuries

Shoulder impingement syndrome occurs whilst there may be immoderate pressure on tendons within the shoulder from the bones of the shoulder. This may be caused by repeated overhead interest which includes painting, lifting, swimming, tennis and different overhead sports.

Frozen shoulder

Frozen shoulder is a situation that causes aches and boundaries the shoulder’s variety of motions. Although a sole reason of frozen shoulder has but to be decided, specialists suspect it develops whilst the joint turns into inflamed and scar tissue bureaucracy. When this takes location, tissues inside the joint decrease and harden, making the shoulder more difficult to transport.


Osteoarthritis happens when the cartilage that hold up the tops of the bones tears down. The damage of the shoulder causes swelling, chronic shoulder pain and sometimes the generation of bone spurs, when the bones at the end rub together

How long does shoulder pain typically last?

Chronic shoulder pain can last days, weeks, or even longer depending on the underlying cause. You might endure like a dull ache, or it may be sharp and jolting in a specific area. Pain may be restricted to your shoulder or perhaps spread down your upper arm. Applying ice, resting the shoulder and/or taking over-the-counter medications may provide potential relief from chronic shoulder pain

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How an Intrathecal Pain Pump can help with Chronic Pain

The FDA has recently approved an Intrathecal pain pump delivery method of medications that may eliminate or reduce the need for structured Opoids

The basics about the Intrathecal Drug Delivery System

The Intrathecal pain pump is an implantable pump that provides targeted delivery for chronic pain and severe spasm. The Intrathecal pain pump delivers medications straight to the fluid surrounding the spinal cord, which Dr. Zaki Anwer, MD, says, provides relief at minimal dosage as compared to the oral medications in sufferers with chronic pain and severe spasm

The pain pump is designed to ease therapy management by providing physicians with perceptible aid and intuitive workflows

The most suitable candidates for the Intrathecal pain pump are the chronic pain sufferers, unmanageable pain and severe muscle contraction, other treatments have failed to provide relief and have endured unbearable side effects with medications

Reducing or Eliminating Systemic Opioid Use

Dr. Zaki Anwer, MD, at The Pain Management Institute, Chicago, Frankfort saysWith continuous Opoid crises the ability to minimize the use of structured Opoid and efficiently manage my patients with pain is more important than ever.”

He adds “The pain pump aids in simplifying the therapy management, enabling me to focus on providing my patients with pain relief through the Intrathecal delivery of medications so that structured Opioids are reduced or eliminated entirely”

How it’s performed

An Intrathecal pump is surgically implanted under the skin by an expert physician. The pump is implanted in the abdominal area, is linked with the catheter, which digs under the skin to a specific area where the medication is required

The therapy has been proven to be safe and effective when used as directed

  • Does not involve permanent changes to the spinal cord or nerves
  • Can be adjusted to dispense medication according to your activity level and pain patterns
  • Lets you try the therapy for a short period of time before committing to long-term therapy
  • Is reversible the therapy can be turned off, or if desired, it can be surgically removed


In addition to the usual risk of surgery and anesthesia at the time of introducing the pain pump and catheter tubes a variety of side effect may occur directly associated to the pump, the catheter mechanism, the drugs and the refilling process at the time of surgery or following the surgery when the pain pump remains in the position, patients are notified of the infection, failure to control pain development of spinal headache, spinal cord or nerve injury, drug overdose, or adverse reaction to the drugs and equipment malfunction can all occur at, or around, the time of insertion.

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Botox can work wonders for chronic migraine sufferers

Botox isn’t just restricted to treat wrinkles. More than 10 percent of the world’s population endures migraine headaches, and they can seek alleviation with Botox treatment

Chronic migraines, involve 15 headache days in a month or more, can be exceptional weakening. For such conditions Botox is the treatment offering life-changing relief, proving, Botox isn’t just for cosmetic purpose any further

“It’s worth trying for people who are having a hard time living with pain,” said Dr Zaki Anwer, MD, at The Pain Management Institute, “Some patients have no other choice.”

Stephen Robert is a chronic migraine sufferer, his headaches are extremely weakening. I was stuck in bed for weeks and was unable to work, I lost jobs because of my severe agonizing and was not able to enjoy quality time with my children when they were toddlers; told Dr Zaki Anwer

He endeavored with a host of medications, but nothing comforted him until he came to visit The Pain Management Institute, Dr. Zaki Anwer, MD. He treated him with Botox and his life was exceptionally changed. “The results are incredible” Dr. Zaki Said

He explained that Botox works on migraines by paralyzing the muscles for the time being. When people have migraines or suffer headaches specifically the covering of the skull, get irritated or inflamed. Additionally, the muscles shrink in the sense and they pull on the scalp, giving rise to pain symptoms “With Botox, what it’s geared to do is alleviate that and help in terms of relaxing those muscles,” said Dr Zaki

Dr Zaki carries out the Botox with very fine needles on the forehead, in the temples and back of the head as well as across the shoulders. Patients can have injection after the intervals of three months

The Botox for a significant number of patients have, have changed their lives and returned them what I believe is a key to spending quality of life, said Dr Zaki Anwer

“I have an entirely different perspective on life now, I’m up. I have now more quality time to spend with my children, I am efficiently working, and don’t miss days from work any more” said  Roberts

As for risks Dr Zaki Anwer explained

Dr Zaki Anwer says he is mostly comfortable with Botox procedures. Even if the toxin spread between the nerve cells, its very rare that may bring complications far from the injected site

“Complications are rare and when they occur typically involve the local spread of the toxin to cause paralysis of unintended targets, for example, eyelid drooping,” he said.

“To make it less scary, all toxins have a limited life,” said Dr. Zaki. “For most patients, regardless of how Botox is used, it will eventually be destroyed by the body.”

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How microdiscectomy surgery saved Michael Porter Jr. and helped him get back to competition

Porter has failed to hit all this season because of a back injury to which he had no other option than a surgery to correct. The surgery was a Microdiscectomy of the spinal disc and the team at the Pain Management Institute explains that Porter would take a couple of months to recover

What is Microdiscectomy?

Microdiscectomy surgery is also known as the micro decompression, and is among the most practiced minimally invasive spine surgery procedures. The main target of Microdiscectomy surgery  is to reduce the pressure off your  nerves to relieve your back pain

Traditionally, discectomies are carried out with an open technique. Your surgeon might make a comparatively large incision, involving the cutting your back muscles so that the view of your spine becomes quite clear. While this technique may bring you benefits, it can cause significant muscle damage and recovery is usually painful and slows down. Microdiscectomy surgery has the same goals as invasive discectomies, it removes the part of your intervertebral disc that cause pressure on your nerve and cause you pain

However, the microdiscestomy spinal surgery procedure is minimally invasive and take advantage of special instruments and visualization tools that allows them to make small incisions to minimize the risk of injury to your back  muscles. The results are quicker and less painful recovering

Porter talks about his injury, he remembers the injury first occurred about two years ago while he was playing he jumped and was hit in the air and came down to the floor flat on his back. The injury became worse in a few weeks causing debilitating pain. Porter and his parents planned to travel Chicago, Frankfort to visit the Pain Management Institute, where after a complete physical examination, they were given multiple options by Dr Zaki Anwer, Pain Management Specialist and Medical Director. And it was eventually decided that Microdiscectomy spinal surgery is the best option. Because of my severe back pain “I had forgotten what it is like to play normal”. “That’s why I’m blessed to have visited Dr. Zaki Anwer and had Microdiscectomy as because of the surgery, I’ll be far better than I was playing without those limitations”.

The patients undergoing Microdiscectomy Spinal Surgery primary need physical therapy as a way to recover soon. Porter said his physical therapy  includes not sitting for longer periods. Porter said “He believes he will recover soon from the back surgery and eventually be 150 percent fine”.

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