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Poor Posture and Pain

27 September, 2024
Back Pain, Pain Management, Posture
Poor posture often results from occupational activities that involve spending substantial amounts of...
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Primary Care Physicians vs. Pain Management (pain clinic)

25 September, 2024
Pain Management
Primary care physicians and pain specialists address pain management in different ways. Some physici...
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Narcotics for pain management 

13 September, 2024
Pain Management, Pain Treatments
Narcotics are generally administered to those patients who are suffering from severe chronic pain. T...
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Minimally Invasive Treatments for Back Pain

30 July, 2024
Back Pain
Are you ready to be pain free? Back pain is a common ailment that affects millions of people in New ...
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What is diabetic neuropathy?

Posted on October 4, 2024 - 10:55 am by

Diabetic neuropathy is damage to nerves in the body that occurs due to diabetes. This condition develops when blood sugar levels dramatically increase and is a common complication among people with diabetes [1]. Approximately 30% of individuals who are hospitalized are diabetes patients suffering from neuropathy [2]. Nerves that may be affected due to diabetic neuropathy include: nerves in the spinal cord, skull, heart, intestines, stomach, and bladder [2]. When nerves in these parts of the body are injured an individual may experience digestive problems such as trouble swallowing, heartburn, dizziness upon standing, nausea, diarrhea, or constipation and tingling or burning sensations in the arms and legs.

The first signs of nerve damage may be serious pain in the legs, feet, and toes [3]. However, some people who have this condition do not experience physical symptoms and may suffer from unexpected injuries in the feet due to a loss of feeling. Once nerve damage has occurred, individuals may begin to have troubling feeling and manipulating objects. They may also start to lose the ability to properly judge temperature. For this reason, people with diabetes should be screened annually for neuropathy as foot ulcers and amputations are common causes of disability and even death in people who develop this condition [3, 4].

Treatment of diabetic neuropathy involves properly managing one’s diabetes and maintaining healthy blood sugar levels. Returning high blood sugar levels to normal slows the progression of nerve injuries, but does not reverse the damage [5]. Antidepressants such as despramine, tramadol, gabapentin, amitriptyline, venlafaxine, capsaicin, and bupropion or anticonvulsants may also be prescribed to treat the pain and discomfort caused by this condition [1, 2]. Early diagnosis and treatment of symptoms related to diabetic neuropathy is one of the best ways to prevent and delay the onset of this condition.

*These are not medical diagnosis or suggestions for any specific individuals.  They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group.  If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group.  We will be happy to assist you.

Diabetes, Sugar-intake, Dieting, and Effects on Pain and Treatment 

Posted on October 2, 2024 - 11:30 pm by

Diabetes has not only been described as an epidemic, but also as a ‘silent killer’, since the symptoms associated with it are not seen as being sudden or dramatic. But did you know that diabetics can experience dramatic and debilitating pain?

As a chronic disease that arises when a person’s blood sugar levels are unacceptably high, diabetes occurs when insulin is either not sufficiently produced or is incapable of acting on the cells of the body that release glucose into the bloodstream. Fortunately, diabetics can effectively manage this by controlling their blood glucose levels by regulating what and when they eat, and through medication.

Unfortunately, between 34% and 70% of diabetics can develop painful nerve disorders, called neuropathies (1-4). Although properly regulating blood glucose levels is the best way to control diabetic neuropathic pain, this condition can deteriorate over time (3). Neuropathic pain begins to significantly affect many organs of the body, promotes muscle wasting, and leaves behind symptoms of numbness, and a loss of feeling in the legs, arms and feet (1, 3, 5).

In addition, chronic neuropathic pain was shown to be a significant barrier to the self-management of diabetes-related symptoms in as many as 60% of patients (6). Those suffering from diabetes therefore suffer a ‘one-two punch’ when it comes to chronic pain; first the neuropathic pain, and then the inability to effectively manage blood sugar levels and proper dieting.

These compounding effects underscore the importance of controlling both blood sugar levels and the diabetic neuropathic pain experienced by the patient. There are a number of opioids and other pain-relieving drugs that significantly reduce chronic diabetic neuropathy (7, 8). Studies have shown that effective pain management helps diabetics adhere to better self-care practices, such as regulating blood glucose levels (7). This allows them to proactively help resolve the disease, and significantly boost their quality of life.

If you or a family member are diabetic, and would like information on managing chronic pain or diabetic neuropathy, please contact one of our offices. The New York Pain Management Group is experienced in controlling chronic neuropathic pain associated with diabetes.

*DISCLAIMER: These are not medical diagnoses or suggestions for any specific individuals. They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group. If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you.

Switching From Methadone to Tapentadol for Cancer Pain

Posted on October 1, 2024 - 11:30 pm by

Controlling cancer pain is an important part of cancer treatment and management. Of the variety of medications available to treat cancer pain, methadone has proven to bean excellent option for combating moderate-to-severe pain. Methadone is an effective, long-lasting opioid medication that is inexpensive and relatively safe [1]. Methadone is the only long-lasting opioid medication available in liquid form. Therefore, it is the easiest opioid medication to administer because it can be given to a patient orally, intravenously, through the rectum, a skin injection or a stomach tube. Since methadone provides long-lasting pain relief (its half-life is anywhere from 16-60 hours), this type of medication can accumulate in the body and potentially cause overdose [1]. To prevent this from happening, it is important for all patients to be monitored by a qualified physician and to start the medication slowly and at lower doses [1].

Even though methadone is an effective long-lasting pain medication, some patients cannot tolerate it well. The only other long-lasting pain medication on the market is tapentadol: a centrally acting analgesic medication that provides up to 12 hours of pain relief. The FDA approved tapentadol in 2009. It is an effective medication to treat moderate-to-severe osteoarthritis, diabetic neuropathy, or low back pain [2]. To date, there is no research published on the effects of tapentadol for the treatment of cancer pain. There is only one case report about the successful switching from methadone totapentadol by a cancer patient [3].

Choosing to take tapentadol to treat cancer pain should be discussed between patient and physician. If it is determined that no other medication is effective to treat the pain experienced by the cancer patient, tapentadol can be considered. However, it is important to know that there is no research published investigating either the effectiveness or the side effects of tapentadol in cancer patients [2].

*DISCLAIMER: These are not medical diagnoses or suggestions for any specificindividuals. They are an overview of various conditions, treatments and topics discussedby New York Pain Management Group. If you would like to discuss your symptoms ingreater detail, do not hesitate to contact the New York Pain Management Group. To learnmore about treatment options for this and other pain conditions, contact us today atwww.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you

Poor Posture and Pain

Posted on September 27, 2024 - 12:00 pm by

Poor posture often results from occupational activities that involve spending substantial amounts of time in an awkward position, or doing a repetitive motion without taking breaks. These activities tend to cause musculoskeletal complications, such as skeletal alignment problems and uneven muscle development, which in time lead to poor posture. 

Poor posture is a typical cause for neck, shoulder and back pain. Muscles in these body regions tend to tense up and compress the surrounding nerves, especially in occupations that involve a lot of standing, sitting, or using of a computer. Poor posture and the resulting pain are typically treated with a combination of workplace ergonomics, lifestyle changes and medications.

Improving ergonomics is one of the key methods to reduce and prevent posture problems in the workplace. Ergonomics aims to reduce stress and pain caused by bad posture, repeated motions, and overuse of muscles. Improving ergonomics can include anything from using a back support or a proper office chair, to taking frequent breaks and learning to keep your body in proper alignment when working. Taking frequent breaks and stretching your muscles is one of the easiest and cheapest ways to prevent poor posture and the pain associated with it. Allowing your muscles to relax and stretch regularly can reduce muscle tension and imbalance.

Certain lifestyle changes can also help reduce or revise posture problems. Regular exercise can strengthen your muscles and prevent the poor alignment that results from imbalanced and overused muscles. Stretching helps return your muscles to their proper length, reduce muscle tension, and prevent nerve compression.

Anti-inflammatory pain medications are another option for managing the pain caused by poor posture. However, pain medications don’t treat the underlying condition that causes poor posture. Thus, medications should only be used as a temporary solution to reduce pain.

If you suffer from chronic pain and posture problems, it is essential you seek professional help before the problem becomes too debilitating. The earlier you intervene and correct the factors that cause poor posture, the better chance you have for a full recovery.

*DISCLAIMER: These are not medical diagnoses or suggestions for any specific individuals.  They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group.  If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you.

Primary Care Physicians vs. Pain Management (pain clinic)

Posted on September 25, 2024 - 10:00 am by

Primary care physicians and pain specialists address pain management in different ways. Some physicians treat pain as if it is a symptom of an underlying condition and assume that if the condition is diagnosed and treated that the pain will go away. However, this form of pain treatment does not work for each individual and some people will continue to suffer from chronic pain. According to Institute of Medicine, approximately 100 million adults in America suffer from chronic pain, which is higher than the number of people affected by cancer, diabetes, and heart disease combined.

Doctors who specialize in treating pain include neurologists, anesthesiologists, neurosurgeons, and even psychiatrists. Anesthesiologists, in particular, usually work along with other health care professionals (e.g., nurse practitioners, physical therapists, orthopedists) when a team of specialists may be necessary to manage pain over time. One general difference between these types of specialists and primary care physicians is that pain specialists are knowledgeable in inflammation, pain, and specific treatments. More specifically, they are highly trained in the diagnosis, treatment, and rehabilitation of chronic pain. This means that in certain cases a pain specialist may be best able to determine the cause of an individual’s pain.

The Institute of Medicine suggests that steps should be taken to improve pain treatment by managing pain care according to each individual’s personal experiences and educating individuals about self-management. The institute also suggests that primary care physicians should collaborate with pain specialists if the initial treatment plan appears to be ineffective. Some hospitals have also started to incorporate the help of anesthesiologists by asking them to develop standardized procedures. The primary focus, however, is understanding that individuals experience and handle pain differently and that standardized protocols should be based on an individual approach. Suggestions such as these imply that individuals should quickly consider seeking pain management from a trained specialist when experiencing chronic pain. This may help reduce the need for taking unnecessary medication or undergoing treatment that is ineffective. Receiving proper pain treatment in a timely manner can also decrease recovery time.

*DISCLAIMER: These are not medical diagnosis or suggestions for any specific individuals.  They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group.  If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you.

What is Diabetic Neuropathy?

Posted on September 23, 2024 - 6:00 am by

Diabetic neuropathy is damage to nerves in the body that occurs due to diabetes. This condition develops when blood sugar levels dramatically increase and is a common complication among people with diabetes. Approximately 30% of individuals who are hospitalized are diabetes patients suffering from neuropathy. Nerves that may be affected due to diabetic neuropathy include: nerves in the spinal cord, skull, heart, intestines, stomach, and bladder. When nerves in these parts of the body are injured an individual may experience digestive problems such as trouble swallowing, heartburn, dizziness upon standing, nausea, diarrhea, or constipation and tingling or burning sensations in the arms and legs.

The first signs of nerve damage may be serious pain in the legs, feet, and toes. However, some people who have this condition do not experience physical symptoms and may suffer from unexpected injuries in the feet due to a loss of feeling. Once nerve damage has occurred, individuals may begin to have troubling feeling and manipulating objects. They may also start to lose the ability to properly judge temperature. For this reason, people with diabetes should be screened annually for neuropathy as foot ulcers and amputations are common causes of disability and even death in people who develop this condition.

Treatment of diabetic neuropathy involves properly managing one’s diabetes and maintaining healthy blood sugar levels. Returning high blood sugar levels to normal slows the progression of nerve injuries, but does not reverse the damage. Antidepressants such as despramine, tramadol, gabapentin, amitriptyline, venlafaxine, capsaicin, and bupropion or anticonvulsants may also be prescribed to treat the pain and discomfort caused by this condition. Early diagnosis and treatment of symptoms related to diabetic neuropathy is one of the best ways to prevent and delay the onset of this condition.

*DISCLAIMER: These are not medical diagnosis or suggestions for any specific individuals.  They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group.  If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you.

What is Fibromyalgia?

Posted on September 19, 2024 - 1:00 pm by

Fibromyalgia is a medical condition that is characterized by chronic pain and a painful response to pressure.  Symptoms can include fatigue, joint pain and insomnia.  Approximately 3% of the population suffers from this often debilitating disorder, with female sufferers outnumbering men 9 to 1.  

The cause of fibromyalgia is unknown.  Some doctors consider it a disease of the musculoskeletal system, while others consider it to be a neurological condition. There is, as of now, no cure for fibromyalgia; however, symptoms can be relieved by means of medications, exercise or lifestyle changes.

If you think you are suffering from fibromyalgia, your first step is to see a doctor.  There is no specific test to diagnose this disease, however the doctors at New York Pain Management can rule out other conditions that might be causing your symptoms.  After obtaining these results, our medical professionals will offer a diagnosis.

After determining that fibromyalgia is the root of your symptoms, Dr. Cean and Dr. Hunter will help you develop an individualized treatment plan.  Because the symptoms and severity differ from person to person, there is no set treatment for this condition.  Your treatment plan will include exercise, medications, stress reduction techniques and education.

Education is an important first step in the treatment of fibromyalgia.  It is important to know as much as possible about the disease to be able to cope with the wide variety of symptoms.  Low impact exercise can help relieve pain in many patients.  Dietary changes have also been shown to be effective at relieving symptoms.  You will want to avoid alcohol and caffeine, especially if you have trouble sleeping.  Other changes in diet, depending on symptoms, can be extremely helpful at reducing pain or other issues you may be suffering from.

Our doctors may also prescribe an antidepressant, as these give relief to many fibromyalgia sufferers.  Several pain relief medications, such as NSAIDs and narcotic pain medications have not proven to be helpful for the pain experienced from fibromyalgia.  

You can find relief from this painful and often debilitating disease.  New York Pain Management’s doctors can help you develop a treatment plan that works for you.

*DISCLAIMER: These are not medical diagnosis or suggestions for any specific individuals.  They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group.  If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you.

Benefits and Risks of Lumbar Epidural Steroid Injections

Posted on September 17, 2024 - 11:00 am by

Chronic pain can be a debilitating condition that affects the overall quality of your life by reducing your ability to work and be active. Lumbar epidural steroid injection (LESI) is one of the available nonsurgical treatments for chronic low back and leg pain caused by inflamed or injured spinal nerves. LESI is proven to be an effective way to manage pain and thus, its popularity has been steadily increasing since 1998, making it one of the most common treatments for managing chronic spinal pain in the United States.

LESI contains a combination of a local anesthetic pain medicine and an anti-inflammatory corticosteroid. The treatment is performed by injecting these medicines directly into the epidural space that surrounds the spinal cord and nerve roots. This provides an effective, long-term pain relief that can last for weeks or even years. Corticosteroids offer especially effective treatment for spinal nerve conditions due to their ability to reduce pain, swelling and inflammation of the nerve roots.

The benefits of epidural steroid injections have been evaluated by several clinical trials. In general, the procedure is found to be an effective treatment for chronic low back and lower extremity pain caused by conditions such as spinal stenosis, disc herniation and sciatica. Participants of several scientific studies reported reduced pain and increased quality of life that lasted for up to a year after receiving the injection.

However, as with any treatment, LESI is also associated with a few risks. Potential risks include bleeding, infection, nerve damage, and a spinal headache. Corticosteroids can also lead to weight gain, mood swings, insomnia, and elevated blood sugar levels in diabetic patients. LESI should not be used on patients who are pregnant, have an infection, or suffer from bleeding problems.

Lumbar epidural steroid injection can be an effective treatment method, especially in cases when other nonsurgical treatments have failed to manage or treat spinal pain. If you suffer from chronic pain, you should talk to your doctor about the benefits and risks of LESI, and whether it is the correct treatment choice for you.

*DISCLAIMER: These are not medical diagnosis or suggestions for any specific individuals. They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group. If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you.

What is Sciatica?  

Posted on September 15, 2024 - 10:35 am by

Sciatica can be defined as a medical condition caused by an injury to the lumbar region and results in a sensation of pain that radiates throughout the lower region of the body, and is felt primarily in the legs, buttocks and lower back. The intensity of this pain can range from mild discomfort to absolutely excruciating.  The pain is caused by the irritation of the sciatic nerve that is located in the lumbar region of the spinal cord by a damaged or injured spinal disc that lies in close proximity to the nerve itself. Sciatica can originate from a number of back-related injuries but the ones that are commonly diagnosed are due to herniated discs or degenerative disc disease. 

  There are a significant number of individuals affected by sciatica and it is detected primarily in adults. Diagnosis of sciatica is contingent on a medical examination along with the symptomatic information provided by the patient. Confirmation of sciatica diagnosis is obtained with one or more of the following tests: x-ray, CT or MRI imaging of the lower spine.  The treatment modalities offered to the patient depend on the cause of the sciatica and whether it is an acute or chronic condition.  

Current treatments for acute sciatica involve one or a combination of the following: application of ice to the affected region, prescribed bed rest, administration of mild painkillers, physical therapy and/or an exercise regimen. However, treatment in the chronic cases of sciatica is much more invasive and involves injections of steroids which provide temporary relief or possible surgical intervention to relieve the pain. There are a number of clinical trials that are underway to investigate the therapeutic benefits of novel drugs in patients with more chronic forms sciatica. 

It is imperative that if an individual experiences any degree of lower back pain for a prolonged amount of time that they seek immediate medical attention in order to prevent a worsening of the condition. Sciatica is a painful condition that if left untreated can debilitate and interfere with the quality of life.  Back injuries are not to be taken lightly.  

*DISCLAIMER: These are not medical diagnosis or suggestions for any specific individuals.  They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group.  If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you. 

Narcotics for pain management 

Posted on September 13, 2024 - 10:22 am by

Narcotics are generally administered to those patients who are suffering from severe chronic pain. The aim of this type of treatment is to provide temporary relief from the intense pain associated with the medical condition. Narcotics typically consist of pharmaceutical compounds known as opiates (pain relievers) and are either synthetic or semi-synthetic in nature.  The potency of the narcotic as well as its effectiveness generally depends on the type of ingredients that are combined to produce the drug.  

Narcotics are available in the following forms: pills, liquid form, or intravenous (IV) solutions, which are directly injected into the vein. Some common medical conditions that are treated by the administration of narcotics include: cancer pain, arthritis, and post-injury pain. These narcotics can have a long or short-term effect on the patient’s sensation of pain.  

A few examples of low potency narcotics are tramadol, codeine, and propoxyphene. Hydrocodone and oxycodone are frequently prescribed and are a more potent form of narcotic.  Oxymorphone, morphine, and fentanyl are the most potent forms and are used to relieve the most severe cases of chronic pain. There are also new narcotics that are currently being tested for pain management in clinical trials. 

Narcotics work by anesthetizing the parts of the central nervous system where the pain originates. However, long-term use of narcotics can potentially lead to drug addiction and/or drug tolerance. Drug tolerance simply means having to take a higher dosage of a drug in order to experience the same effect that a lower dosage had when the narcotic treatment began. 

Although there are adverse effects associated with the use of narcotics, when it is used with caution it can be an effective tool in pain management. Furthermore, the proper use of narcotics is crucial for sufferers to resume the quality of life that they had prior to the onset of debilitating pain. 

*DISCLAIMER: These are not medical diagnosis or suggestions for any specific individuals.  They are an overview of various conditions, treatments and topics discussed by New York Pain Management Group.  If you would like to discuss your symptoms in greater detail, do not hesitate to contact the New York Pain Management Group. To learn more about treatment options for this and other pain conditions, contact us today at www.nopainny.com or call at 1-888-789-NOPAIN! We will be happy to assist you. 

References 

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