Make Pain a Thing of the Past – Health and Wellness – Physician Partners of America

Three Benefits of Therapeutic Massage for Chronic Pain

We all think of a nice massage as helping us relax and relieve tension after a tough work week or a hard workout, but did you know it can also be an effective part of a pain management treatment plan? By working with a licensed and experienced massage therapist, many people are able to experience improvements in their pain levels and increased range of motion. 

If you are exploring therapeutic massage as part of a broader pain management program, this informative guide can help you better understand the specific benefits for pain relief. 

 

What Is Therapeutic Massage?

Massage is any deliberate technique for manipulating the soft tissue in the body, including skin, muscles, tendons, and ligaments. Although any form of massage is intended to have therapeutic benefits, therapeutic massage is a discipline specifically designed to systematically identify sources of pain and discomfort and use specialized techniques to provide relief. 

Licensed massage therapists receive formalized training and education in massage therapy and credentialing from an organization such as the American Massage Therapy Association. Research is still ongoing, but there is a growing body of evidence to support the effectiveness of massage therapy as a clinical practice for patients dealing with pain and other issues. 

 

How Therapeutic Massage Can Relieve Pain

Doctors and researchers are still working to fully understand exactly how therapeutic massage relieves chronic pain, but the following benefits are believed to be important parts of the process.

 

1. Relaxes Tense Muscles and Soft Tissue

Many types of pain are associated with tension in the muscles and connective tissue. Even if the source of pain is not directly related to an injury, such as with neuropathic pain related to diabetes, feeling constant discomfort can cause muscles to involuntarily tense up. This in turn can cause pain to become subjectively worse. 

By finding muscles and connective tissue that are most affected by pain and using techniques to relieve tension, a trained massage therapist can help promote significant relief by encouraging a relaxation response.  

 

2. Relieves Mental Stress and Anxiety Around Pain

The emotional and mental health aspects of pain can be easy to overlook. But for many pain sufferers, the stress and anxiety that comes with the physical symptoms can be just as bad. In fact, there may even be a connection between mental health and the way some people subjectively experience pain. 

In addition to the physical benefits of massage therapy, the relaxation response from a massage can also have a soothing effect on the mind. By relieving stress and anxiety, therapeutic massage can help people more effectively manage their pain. 

 

3. Promotes Healthy Blood Flow to Fight Inflammation

Chronic pain and muscle tension can lead to painful bundles of tissue and the buildup of inflammatory toxins. If left untreated, these issues can worsen pain and reduce flexibility and mobility in the area. 

Regular massage therapy can break up these bundles of tissue, known as trigger points, and promote nutrient-rich blood flow to the area that helps to break up toxins. This reduced inflammation can help reduce painful sensation while increasing function and range of motion. 

 

Therapeutic Massage and Interventional Pain Management

If chronic pain is affecting your quality of life and you believe therapeutic massage may be an effective form of treatment, speak to your doctor or pain management specialist. Depending on your specific diagnosis, your doctor can help you decide if you are a good candidate for therapeutic massage. Different conditions may respond better to different approaches — someone with a lower back strain will need a different approach than someone dealing with fibromyalgia or nerve pain. Your doctor or specialist can also help you find a licensed and experienced massage therapist for pain relief. 

For many people, therapeutic massage is an effective part of a holistic interventional pain management program consisting of treatments that can also include: 

  • Physical therapy
  • Lifestyle changes, such as posture improvement and nutritional counseling
  • Therapeutic injections 
  • Spinal cord stimulation

Take control of your chronic pain. No matter where you are on your treatment journey, Physician Partners of America can help. Our compassionate experts can help you create an individualized pain management program that fits your condition and treatment goals. Contact us today to learn more. 

 

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Herniated Disc? Spinal Stenosis? Pinched Nerve? Understanding the Connections for Neck and Back Pain

Living with neck pain, back pain, or related symptoms like tingling or muscle weakness is difficult enough. But too often, an added source of stress is getting an accurate diagnosis and finding effective treatment for your pain. Understanding the sources of pain and what the underlying causes is can be a critical step on any pain relief journey. 

In many situations, after seeing a doctor or receiving an MRI report, patients can hear a veritable laundry list of terms and conditions. Among the most common of these include pinched herniated discs, pinched nerves, and spinal stenosis. It can be natural to have questions and wonder what the relationship is between these terms and how they vary. 

Every person is different and there can be a wide range of causes for neck or back pain, but very often these three conditions in particular are very closely related. If you are dealing with one or more of these problems, the following guide can help. 

 

What Is a Herniated Disc?

A herniated disc happens when a crack or tear develops in the tough outer layer of a spinal disc, causing the softer inner material to be pushed out. These flexible discs help the spine to bend and flex, but can begin to dry out and break down with age. 

A herniated disc is not necessarily painful, in fact, people can have this condition for years without knowing it. To cause symptoms, the herniated disc material must either irritate local nerves on the disc, or put pressure on surrounding nerve roots or the spinal cord. 

Herniated discs can occur at any level of the spine, but are most common in the upper (cervical) or lower (lumbar) regions due to the flexibility of these areas. Symptoms of a herniated disc include local neck or back pain, as well as tingling, numbness, and muscle weakness in the upper or lower extremities. 

 

What Is Spinal Stenosis? 

Spinal stenosis is a term for narrowing in the spinal column, particularly the narrow passages that the spinal cord and nerve roots travel through. This is generally an age-related condition that is caused by breakdown of connective tissue, joints, and discs in the spine. Specifically, underlying contributors to spinal stenosis can include:

  • Spinal arthritis
  • Bone spurs
  • Bulging and herniated discs
  • Degenerative disc disease
  • Spondylolisthesis, which is when a vertebra begins to slide out relative to the vertebra beneath it

Spinal stenosis is extremely common, and is another condition that may not necessarily be painful or symptomatic unless the nerves in the spinal column are affected. 

 

What Is a Pinched Nerve?

Pinched nerve is a general term for nerve compression. Although a pinched nerve can happen anywhere — think about the pins and needles you feel if you sit on your foot for too long — they are especially common in the spine. 

The spinal column needs to be rigid enough to hold up the body and protect the spinal cord but flexible enough to allow for movement. This combination means a very high amount of stress on parts, including the joints and discs, that also experience wear and tear from everyday movements. What’s more, the vital nerves in the spine are packed into a very tight space with extremely narrow openings. 

Added up, this means there are many things that can go wrong in the spine that can cause a pinched nerve, including displaced disc material like a bulging or herniated disc, spinal arthritis, bone spurs from bone on bone friction, and degenerative disc disease. 

 

What Is the Connection Between These Conditions?

These three conditions are often very closely related. For example, it is possible to have a herniated disc in the lower spine that contributes to spinal stenosis and causes a pinched nerve. In very many cases, a pinched nerve is the main cause of pain and symptoms. This means that effective treatment requires identifying the main factors causing nerve compression and taking steps to relieve this pressure. 

 

Diagnosing and Treating Your Neck and Back Pain

Whether you have received a diagnosis for a herniated disc, a pinched nerve, spinal stenosis, or all three, it is critical to work with your treatment team to positively identify the functional and physical causes of your pain. Diagnostic steps include a physical examination, movement tests, detailed questions about symptoms, diagnostic nerve blocks, and imagery such as an MRI or X-ray. 

Once the source of pain has been identified, patients should commit to a comprehensive plan of conservative treatment to relieve symptoms, improve mobility, and take pressure off of the affected nerve. Effective steps can include:

  • Improving posture
  • Undergoing physical therapy to strengthen supporting muscles and reduce painful movements
  • Using hot and cold compression therapy and over-the-counter pain medication
  • Eating a healthy, anti-inflammatory diet
  • Interventional pain management treatments such as epidural steroid injections to help reduce inflammation and pain around the pinched nerve

If a full course of conservative treatments are unable to effectively relieve nerve compression and related symptoms, minimally invasive spine surgery to remove displaced disc material that is narrowing the spinal column can become an option. 

No matter where you are in your treatment journey, the team at Physician Partners of America can help. We can assist in creating a personalized pain management plan that fits your treatment goals and lifestyle. You don’t have to let pain take you away from the quality of life you deserve. 

Contact us today to learn more. 

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Seven Common Causes of Neuropathic Pain

Our nerves play a key role in our body, sending sensory and motor information between the brain and other regions. Without nerves we would be unable to move at all or feel anything, whether it felt soothing or painful. Although pain is an unpleasant sensation, it is an important signal to our brain that something is wrong and should be taken care of. 

Neuropathic pain is a particularly difficult problem because it affects the nerves themselves, causing pain when there is no direct external cause. In many situations, people develop neuropathic symptoms, including shooting pains, tingling, and numbness, without knowing the source. 

This helpful guide will cover some of the most common causes of neuropathic pain and help you learn how to receive an accurate diagnosis and treatment for nerve pain. Although neuropathic pain can be debilitating and take you away from the people and activities you love, it is possible to find relief.  

 

What Is Neuropathic Pain? 

Neuropathic pain, also called neuropathy or neuralgia, is basically any pain, discomfort, or dysfunction caused by damaged or disrupted nerve tissue. This can include both the central nervous system, consisting of the brain and spinal cord, and the peripheral nervous system. The peripheral nervous system consists of all the other nerves throughout the body, including those in the arms, legs, hips, abdomen, chest, and face.

Disrupted and damaged nerves can cause pain signals to be sent to the brain when there is not a direct stimulus such as an injury. Common neuropathic pain symptoms include:

  • Shooting pain that is often described as an electric or burning sensation
  • Tingling, or a pins-and-needles sensation
  • Numbness
  • Muscle weakness
  • Sensitivity to heat or cold

Neuropathic pain can vary in severity, type, and location depending on the underlying cause. 

 

The Most Common Causes of Neuropathic Pain

Neuropathic pain can often be difficult for doctors and patients to find the cause of. There are hundreds of different injuries, diseases, and conditions that can damage both the central and peripheral nervous systems, resulting in neuropathic pain. Here are some of the most common:

 

1. Injuries

Serious brain injuries, spinal cord injuries, traumatic injuries, burns, fractures, and many other types of injuries can cause nerve damage that results in neuropathic pain. People with limb loss or amputations experience a particular form of neuropathy known as phantom limb pain. 

Even less severe injuries such as muscle strains and ligament sprains can potentially cause neuropathic pain, particularly if they are not allowed to heal properly or there are repeated reinjuries. 

 

2. Diabetes

It is estimated that as many as 30% of people with diabetes suffer from some form of neuropathic pain. This form of nerve pain, known as Diabetic neuropathy, can develop anywhere but often occurs in the hands and feet. The cause of diabetic neuropathy is not fully understood, but it is believed to be related to high levels of sugar in the blood damaging nerves throughout the body.

 

3. Multiple Sclerosis, Parkinson’s Disease, and other nervous system disorders

Multiple sclerosis (MS) is a condition where the body’s immune system attacks the protective layers of nerves. As a result, the nerves can become exposed, scarred, and damaged resulting in neuropathic pain. Parkinson’s disease is another nervous system disorder that often causes neuropathic pain, although researchers do not fully understand the relationship. Because of the effect they can have on nerves throughout the body, there is a risk of neuropathic pain for nearly any disorder affecting the central or peripheral nervous system. 

 

4. Trapped and compressed nerves

Nerves that become trapped or compressed by injury, repetitive motions, or even poor posture can eventually become damaged, resulting in chronic neuropathic pain. A prominent example is carpal tunnel syndrome, where the median nerve becomes trapped by an inflamed carpal tunnel in the wrist. 

Another frequent cause is sciatic nerve compression due to a bulging or herniated disc in the lower spine. If this nerve is compressed for too long without improving or being treated, it can cause neuropathic pain and dysfunction in the lower body. This can include limping, numbness, and shooting pains as well as pins and needles sensations in the toes. 

 

5. Viral infections

Along with the primary symptoms and health problems they cause, some viruses can attack the nervous system and cause neuropathic pain. People recovering from shingles often encounter a specific form of neuropathy called postherpetic neuralgia. Additionally, people diagnosed with HIV and AIDs can also encounter nerve damage and resulting neuropathic pain. 

 

6. Alcohol and substance abuse 

Long-term excessive alcohol consumption can cause a wide range of health problems, including organ function, cardiovascular issues, and nerve damage. Neuropathic pain can also affect people misusing medications that are designed to treat pain, including opioid pain relievers. Receiving counseling for excessive alcohol and substance abuse as early as possible after it is recognized can be key to preventing or limiting serious issues like nerve damage and organ failure. 

 

7. Cancer and cancer treatment

Many people living with cancer also deal with related neuropathic pain, particularly peripheral neuropathy. Although it is possible for the cancer itself to cause nerve damage, such as a tumor that compresses or traps a nerve, it is more common for cancer medications to cause neuropathic pain. Neuropathic symptoms related to chemotherapy drugs specifically are known as chemotherapy-induced peripheral neuropathy (CIPN) and require special care to ensure it does not cause further complications. 

 

Diagnosing and Treating Neuropathic Pain

People diagnosed with a serious condition or injury that has a risk of neuropathic pain are generally warned early and given education and guidance to prevent and manage symptoms. For other people, neuropathic pain can seemingly develop spontaneously without a clear cause. In these cases, a diagnosis means seeing a doctor for an examination and testing to identify the underlying source. Steps for diagnosing neuropathic pain include:

  • Reviewing medical history 
  • Discussing symptoms and how they are affecting mobility and quality of life
  • A physical examination with movement tests and hands-on examinations of painful areas
  • Undergoing testing, including nerve conductivity and blood tests
  • Receiving diagnostic imagery, such as an X-ray or MRI to identify a compressed or entrapped nerve

Treatment for neuropathic pain is often closely related to the cause. For example, successfully managing diabetes can improve circulation and reduce blood sugar levels that contribute to nerve damage and nerve pain. Effective sciatica treatment, especially early in the process can relieve nerve compression and prevent ongoing nerve damage. 

In other situations, permanent nerve damage may mean that the best course of action for treating neuropathic pain is by managing symptoms. Pain management options for neuropathic pain can include physical therapy, prescription and over-the-counter medication, acupuncture, and injections. 

 

Contact Physician Partners of America Today

No matter what the cause of neuropathic pain, it is possible to find long-term relief and return to an active lifestyle if these symptoms are impacting your life. The caring and dedicated team at Physician Partners of America can help you understand the causes of your neuropathic pain and create a personalized treatment plan that is right for your specific needs and wellness goals.

Contact us today to learn more and schedule an appointment with one of our specialists.

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Recognizing the Early Signs of Fibromyalgia

Fibromyalgia is one of the most devastating conditions anyone can deal with. In addition to the excruciating pain, loss of energy, and mobility problems that people with fibromyalgia often report, it can also be notoriously difficult to diagnose and treat. Too many patients trying to overcome fibromyalgia over the years have been told they are exaggerating or even making up symptoms.

The truth is that fibromyalgia is a very real condition that can have a significant impact on your quality of life. And while there is not currently a cure for fibromyalgia, it is possible to successfully manage symptoms — especially if you recognize the early warning signs and take action. If you are wondering if pain, fatigue, and other issues you are experiencing are fibromyalgia and how to know for sure, this guide can help you take the first steps. 

 

What Is Fibromyalgia?

Fibromyalgia is a pain disorder mainly characterized by widespread pain throughout the body accompanied by other symptoms. Doctors and medical researchers do not fully understand the causes of fibromyalgia, but it could possibly be related to genetic factors that affect the way the brain processes and perceives pain. 

Risk factors for fibromyalgia include:

  • Age, with older people being more likely to be diagnosed
  • Sex, with a higher percentage of women having fibromyalgia
  • Being diagnosed with an autoimmune condition such as rheumatoid arthritis or Lupus
  • Dealing with a traumatic event such as a car accident or serious injury
  • Recovering from a viral infection or other serious illness
  • Presence of conditions including irritable bowel syndrome, chronic fatigue syndrome, mental health disorders, and Temporomandibular joint disorders (TMJ) 

According to the Centers for Disease Control and Prevention (CDC,) about 4 million people in the United States live with some form of fibromyalgia. 

 

Is it Fibromyalgia? How to Recognize the Symptoms

There is a wide range of variation for how people develop fibromyalgia and how they experience symptoms. For some people, the onset of symptoms is sudden and severe, while for others it can be gradual and start out mildly. Similarly, some patients can identify a specific triggering event, such as an injury or surgery, but for others, there might not be a clear identifiable cause. 

While no two cases are exactly the same, the most commonly reported symptoms of fibromyalgia are: 

  • Pain throughout the body: People often describe fibromyalgia pain as a dull throb or ache without a clear or direct source. This pain can be present on the left and right side, as well as the upper and lower body, and typically persists for at least three months.
  • Migraines: While the exact relationship is unclear, severe headaches and migraines are very common for people with fibromyalgia. 
  • Mental problems: Fibromyalgia is widely associated with cognitive difficulties including brain fog, forgetfulness, and an inability to concentrate. There is also a high rate of overlap with mental health conditions such as anxiety and depression. 
  • Lack of energy: Many people with fibromyalgia report feeling chronic fatigue for no understandable reason, often despite adequate levels of sleep, exercise, and nutrition. 
  • Sleep disturbances: Pain and symptoms related to fibromyalgia can make it hard to get a good night’s sleep, creating a vicious cycle of increased pain and fatigue. 

While all of these symptoms don’t need to be present, experiencing more than one of these issues in addition to widespread pain can be a clear warning sign of fibromyalgia. 

 

Diagnosing Fibromyalgia

If you are dealing with potential symptoms of fibromyalgia, it is important to receive a clear diagnosis from a qualified physician, such as your primary care doctor or a pain management specialist. Doctors will usually take the following steps to diagnose fibromyalgia pain:

  • Review patient and family medical history
  • Discuss symptoms, including length, severity, and types
  • Perform a thorough physical examination that includes checking painful or sensitive areas
  • Order blood work to rule out certain conditions or confirm the presence of issues such as rheumatoid arthritis or Lupus that may be related

To be diagnosed with fibromyalgia, patients must generally be experiencing widespread pain in multiple areas of the body for three months or longer. Be weary of any physician or medical professional who does not take your symptoms seriously. Many fibromyalgia patients have to see multiple providers before finding an accurate diagnosis and effective treatment. 

 

How to Manage Fibromyalgia Pain

It is possible to successfully manage fibromyalgia pain. Most doctors recommend a combination of medication, nonsurgical interventions, and healthy lifestyle management. Effective options include:

  • Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen sodium
  • Anti-seizure medications, such as gabapentin or pregabalin, have been shown to be effective in reducing fibromyalgia related pain
  • Antidepressants and anti-anxiety medication can help manage mental health conditions and may also help regulate the way the brain processes pain signals
  • Physical therapy and occupational therapy along with regular exercise can help improve energy, strengthen the body and improve flexibility for people with fibromyalgia

Many fibromyalgia patients also find relief by working with a pain management specialist to explore interventional pain management therapies ranging from injections to electrostimulation. 

 

Take Control of Your Pain with Physician Partners of America

From diagnosis to treatment, if you are concerned about the impact of fibromyalgia pain on your life, Physician Partners of America (PPOA) can help. Our caring and dedicated team can work with you to create a personalized care plan based on your unique condition, lifestyle, and recovery goals. Don’t let chronic pain take over your life — take control and contact PPOA today to get in touch with a pain management specialist near you.

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Five Benefits of Exercise for Pain Relief

If you’re living with chronic pain, being active can feel like one of the hardest things in the world. No matter what the source of your pain is, decreased energy, mobility and lack of motivation almost always come with it. But even if it’s for just a few minutes a day to start with, exercise can offer surprising pain relief benefits. 

Although it won’t cure or reverse the causes of pain, a little exercise can go a long way. By integrating regular physical activity into a broader pain management plan, many people are able to noticeably improve their quality of life. 

 

How Exercise Can Help You Manage Pain

Here are five of the most important benefits that exercise can provide for nearly anyone living with chronic pain, and some practical tips for getting started. 

 

1. Increased Energy

Many chronic pain conditions, including arthritis, fibromyalgia, and lower back pain cause fatigue as a symptom. This can create a vicious cycle of sedentary behavior that makes your pain feel worse than it is. Research has shown that even very small periods of low-impact exercise can develop improved cardiovascular fitness and reduce fatigue. 

 

2. Stronger, More Flexible Muscles 

Another side effect of pain-related inactivity is muscle atrophy. When muscles and connective tissue weaken due to lack of use, it can increase certain kinds of pain, particularly conditions related to nerve compression. Low-impact exercises such as yoga, pilates, and even walking are a great way to reverse this process, rebuilding a stronger and more flexible body. 

 

3. Improves Your Mood

It’s well documented that chronic pain has a close relationship with mental health problems such as depression and anxiety. People with chronic pain are more likely to develop these problems, which can often cause a subjective increase in pain-related symptoms. However, there is evidence that regular exercise such as walking or running can boost mood and reduce the risk of depression and other problems, including for pain sufferers.

  

4. Reduces Inflammation

Inflammation is one of the most significant contributors to chronic pain. Inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and plasma viscosity (PV) in the blood can be associated with nerve irritation and increased pain signals going to the brain. Regular exercise can actually release anti-inflammatory cytokines that help reduce markers of inflammation and pain levels. 

 

5. May Increase Your Pain Tolerance

No two people experience pain the same way, and pain tolerance has a lot to do with this. What is excruciating pain for one person may be far less severe for another. Although there is only so much anyone can do to change their pain tolerance, exercising might be one of those ways. Studies have found that exercising may change the way the brain processes pain while also helping to regulate the release of natural pain-relieving chemicals. 

 

Tips for Exercising and Integrating Fitness into Treatment

If you’re dealing with chronic pain and interested in starting an exercise routine, the first thing you should do is speak to your doctor, physical therapist, or pain management physician. A qualified professional can help you understand your current level of fitness and take steps to lower your risk of overexertion or injury. 

General tips for exercising for pain relief include:

  • Start small and build, even if you just start by walking around your house for a few minutes a day, it can be a great start
  • Be consistent — try to exercise at least three times a week 
  • Stay hydrated 
  • Make sure you stay limber with gentle stretches
  • Don’t overdo it and get as much rest as you need
  • Get a good mix of cardiovascular exercises and strengthening exercises — this is why many people turn to yoga and Pilates

Regular exercise, a healthy anti-inflammatory diet, and interventional pain management options like anti-inflammatory injections and physical therapy help many people manage pain and live a healthy lifestyle on a long-term basis. If a full course of nonsurgical treatment and commitment to a healthy lifestyle does not bring the relief necessary for a good quality of life, surgery can become a consideration for certain conditions and patients. 

No matter where you are in your treatment journey, Physician Partners of America can help. From interventional pain management to minimally invasive outpatient surgery, our experts will work with you to create an individualized treatment plan that fits your goals and lifestyle. Contact us today to learn more.

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How Do You Manage Sciatic Nerve Pain?

Shooting pains in the buttocks and legs, difficulty walking, and not even being able to sit comfortably are just a few of the tell-tale signs of sciatic nerve pain. In the most serious cases, this condition, also called sciatica, can result in debilitating neuropathic symptoms and excruciating pain. Whether you have just been diagnosed with a condition causing sciatica or have been living with it for years, this guide will help you better understand this condition and take steps for effective long-term management and relief. 

 

What Is The Sciatic Nerve? 

The sciatic nerve is the largest nerve in the body, starting in the lumbar spine, traveling through the buttocks down the back of the legs and into the feet. This nerve, which is actually a group of smaller nerves, is essential to sending sensory and motor information to the lower body.

 

What Is Sciatica? 

Sciatica describes a collection of symptoms caused by compression or irritation of the sciatic nerve, including lower back pain, shooting pains down the buttocks and hips and neuropathic symptoms like tingling, numbness and muscle weakness in the legs and toes. In more extreme situations, sciatic nerve pain can cause a pronounced limp and foot drop in patients. 

Sciatica or sciatica-like symptoms can be caused by any injury or condition that disrupts or puts pressure on the sciatic nerve, including:

  • Herniated discs or bulging discs in the lower spine
  • Spinal arthritis, also called facet disease 
  • Injury of the piriformis muscle in the buttocks
  • Pressure on the sciatic nerve due to pregnancy.

 

Diagnosing Sciatic Nerve Pain

Sciatic nerve pain requires careful diagnosis, as it can be confused with other conditions. Anyone experiencing sciatica-like symptoms should see their primary physician or pain specialist for an in-depth diagnosis involving the following steps:  

  • Discussion of symptoms
  • Review of medical history
  • Movement tests and physical examination
  • Diagnostic imagery, such as an MRI
  • Diagnostic injections such as nerve blocks

It’s important to correctly identify the source of symptoms in order to effectively treat sciatic nerve pain. For example, a temporary injury such as a strained piriformis muscle will require different care than a longer-term chronic condition such as a herniated disc. 

 

Can You Fix Sciatic Nerve Pain?

The long-term outlook for sciatic nerve pain depends on the cause. Temporary causes like an injury or pregnancy-related sciatic nerve pressure should improve with time and can eventually go away. Chronic, age-related conditions that cause sciatica like spinal arthritis or degenerative spinal discs are non-reversible and can be much harder to manage. 

 

Practical Steps to Manage Your Sciatic Nerve Pain

Although no two cases of sciatic nerve pain are the same, and you should always work closely with a medical professional to create a personalized care plan, the following basic steps have helped many people find relief from sciatica. 

 

1. Practice Basic At-Home Treatments

For most milder cases of sciatic nerve pain, doctors will recommend basic conservative therapies. This will include:

  • Rest
  • Alternating cold compression, such as an ice pack, with heat therapy, such as heating pad
  • Gentle stretching in the lower back and legs
  • Taking over-the-counter medication, such as a nonsteroidal anti-inflammatory drug (NSAID) like naproxen or ibuprofen

 

2. Stay Active and Eat a Healthy Diet 

Certain lifestyle factors can increase the frequency and severity of sciatic nerve pain. This includes extra weight that puts pressure on the spine, being overly sedentary which causes weaker supporting muscles, and eating an inflammatory diet. Any sciatic nerve pain treatment plan should address these factors through regular low-impact exercise, an anti-inflammatory diet and other steps such as practicing good posture or quitting smoking. 

 

3. Try Physical Therapy 

Physical therapy is an effective, focused treatment program that can help reduce pain and improve function in the lumbar spine and lower body for people with sciatica. A licensed physical therapist can perform techniques such as manual therapy and provide instruction on therapeutic exercises that can strengthen supporting muscles, relieve pressure on the sciatic nerve and increase mobility. 

 

4. Explore Pain Management Injections 

Although exercise and physical therapy can be great ways to improve range of motion and take pressure off the sciatic nerve, for many, sciatica can be too severe to be active or complete a course of therapy. Pain management injections, such as an epidural steroid injection, can provide relief over a period of weeks or months to enable increased levels of activity. For many patients, a combination of lifestyle changes, pain management injections and physical therapy is an ideal combination to manage or even overcome sciatic nerve pain.  

 

5. Know When to Consider Surgery 

Surgery can become a serious option for sciatic nerve pain if there is an operable condition that has not responded to a full course of nonsurgical treatment. For example, if a herniated disc is putting pressure on the sciatic nerve and a full course of conservative therapy and interventional pain management has not improved symptoms, minimally invasive spine surgery may be able to help. Using muscle-sparing techniques, highly skilled surgeons can perform an outpatient procedure that removes displaced disc material and takes pressure off the sciatic nerve.  

 

Let PPOA Help You Manage Sciatic Nerve Pain 

No matter where you are in your sciatic treatment journey, Physician Partners of America can help. Our caring experts can assist you in creating an effective plan for long-term relief based on your lifestyle and specific diagnosis. From interventional pain management to minimally invasive spine surgery, our highly skilled medical professionals can help you get your life back. 

You can overcome sciatica, contact us today to learn more. 

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Acupuncture Versus Dry Needling — What’s the Difference?

Most people are familiar with acupuncture, even if they haven’t tried it, but less people have heard of dry needling — although that may be starting to change. If you have heard of both, it’s natural to wonder what the difference is, or if there even is a difference. After all, these two practices both involve carefully inserting small needles into the body, usually with the goal of relieving pain and improving function.

Despite these basic similarities, there are some key differences to understand. If you’re exploring options for pain management and want to know which may be right for you, learning more about acupuncture versus dry needling can help you make an informed and confident decision.  

 

What Is Acupuncture?

Acupuncture is a practice with roots in traditional Chinese medicine. During an acupuncture session, a specially trained practitioner carefully inserts thin needles in specific locations around the body. For hundreds of years, acupuncture has been used to treat everything from pain to infertility to allergies. 

According to many Chinese medical traditions, acupuncture helps to balance the flow of energy throughout the body, known as Chi or Qi. While modern medical researchers are still working to fully understand the mechanism, there is growing evidence that it may be effective for managing pain and relieving stress. Possible explanations for how acupuncture works include stimulation of pain-relieving endorphins, increasing blood flow and disrupting pain signals. 

 

What Is Dry Needling?

Dry needling is a more contemporary treatment rooted in modern physical therapy practices. It is actually more closely related to trigger point injections, which involve injecting anti-inflammatory medication into bundles of painful tissue, called trigger points, to break them up. Dry needling gets its name because it uses a needle without injecting any form of medication. 

The idea behind dry needling is that for certain trigger points and other problems affecting soft tissue, simply using the needle can stimulate blood flow and loosen tissue without additional injectable material. As a relatively newer practice, the body of research around dry needling is still growing, but it is a recognized treatment by the American Physical Therapy Association and other organizations. 

 

So, What’s the Difference?

The primary differences between acupuncture and dry needling include:

  • Medical tradition: Acupuncture is based in Chinese traditional medicine, while dry needling is a newer practice, generally originating in the area of physical medicine. 
  • Treatment areas: Acupuncture targets pressure points that are believed to be focal areas of the body’s natural energy. Dry needling usually targets trigger points, which are bundles of painful nerve and muscle tissue. 

There is also some debate about how different dry needling and acupuncture actually are. Some acupuncturists see dry needling as ultimately being rooted in acupuncture, and many practitioners use a blended approach with aspects of the two treatments. In contrast, many dry needling practitioners have an exclusive background in physical therapy or interventional pain management and see dry needling as firmly belonging to these disciplines.  

 

Deciding Which Is Right for You

Ultimately, the decision to undergo acupuncture, dry needling or both will depend on your diagnosis, your preferences as a patient and the advice you receive from your primary care doctor or pain management physician. When exploring any new treatment, it is important to research your prospective provider to ensure they are licensed to practice in your state. 

For example, acupuncture is licensed and overseen in Florida by the Board of Acupuncture, which has specific guidelines and requirements for practice. Dry needling is often licensed by physical therapy boards or chiropractic organizations. 

 

How Acupuncture and Dry Needling Fit with Pain Management Plans

Both forms of treatment can be part of an effective pain management plan that includes other options such as physical therapy, therapeutic massage, injections and other forms of interventional pain management. For most causes of chronic pain, it is also helpful to practice a healthy lifestyle that includes exercise, good nutrition and avoiding tobacco products and excessive alcohol consumption. 

For conditions including hip pain, back pain, neck pain and knee pain, if conservative and alternative pain management treatments have been explored without bringing relief, minimally invasive spine surgery or orthopedic surgery can start to become a consideration.  

 

Reach Out to Physician Partners of America Today 

Are you living with chronic pain and want to learn more about your options for relief? Physician Partners of America (PPOA) can help you learn more about the causes of your pain and help you develop a personalized plan to reclaim your life. 

Contact our dedicated team to learn more, or schedule an appointment to start your pain relief journey today. 

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Five Causes of Low Back Pain — And How to Find Relief

Affecting millions of people in the United States alone, everyone experiences some form of lower back pain at some point. While a stiff back after a morning of yard work or a slight tweak from a tough workout are normal and usually improve in a few days, chronic back pain can be a bigger problem. According to the National Institute of Health, about 8.2% of the population deals with persistent or chronic low back pain. 

At its most severe, chronic low back pain can be extremely debilitating, affecting your ability to do nearly any activity. People with lower back pain report decreased job performance, mental health problems and diminished quality of life. While it can feel hopeless, it’s important for anyone living with low back pain to keep a positive attitude and work with providers to learn as much about their condition as possible. 

 

Why Is Low Back Pain So Common, and What Are the Risk Factors? 

One of the reasons why lower back pain is so common is because of the sheer amount of stress this part of the body endures on a daily basis. The lower back is made to support the upper body while being flexible enough to bend, stretch and flex. To do this, the lumbar (lower) spine is made of five vertebrae linked by joints, discs, connective tissue and muscle. 

All of these individual parts are put under tremendous pressure while we walk, run, lift and even sit in our chairs. What’s more, the joints and discs in the spine are subject to the same age-related degeneration as other parts of the body, causing them to dry out and break down over time. This combination of pressure and aging makes injuries and conditions much more common in the lower back, especially when combined with the following risk factors:

  • Placing extra stress on the spine by being overweight 
  • Weak core muscles and supporting tissue due to lack of exercise
  • Smoking and tobacco use, which can decrease circulation 
  • Postural and mechanical issues that can cause uneven distribution of pressure

If you’re experiencing lower back pain, it’s important to receive a diagnosis from a qualified medical professional, such as your family doctor or a pain management specialist. Different causes of back pain cause a variety of symptoms and can require varying treatment. 

 

These are Five of the Most Common Causes of Low Back Pain

There are hundreds of injuries and conditions that can affect the lower back and spine, but here are five of the most frequent underlying causes of back pain. 

 

1. Strains, Sprains and Other Injuries

This is by far the most common cause of back pain overall. The lower spine is supported by an intricate arrangement of muscles, tendons and ligaments that help hold us upright and allow us to bend, lift, twist and perform other movements. It’s very easy to strain a muscle or sprain a tendon or ligament when exercising, working or doing other basic activities. 

While acute injuries should heal in a short period of time, repeated reinjuries or serious injuries can lead to chronic low back pain. This is why it is so important to rest and recover, even after a seemingly minor injury. Additionally, more serious injuries such as slip-and-falls or car accidents can result in chronic lower back pain, even when they don’t cause a fracture.

 

2. Arthritis of the Spine 

The facet joints that link the vertebrae in the spinal column are subject to the same age-related breakdown as other joints in the body. Over time, the protective cartilage and connective tissue of these joints dries out and wears down. This leads to increased friction between the joints that causes the inflammation, stiffness and pain in the joints that is diagnosed as spinal arthritis. 

Also called facet disease, spinal arthritis can also result in bone spurs due to the bone on bone contact between facet joints and swollen ligaments due to the inflammation. These and other problems can narrow the nerve pathways in the spinal column, resulting in radiating pain and nerve compression symptoms. 

 

3. Degenerative disc disease

Degenerative disc disease (DDD) is similar to spinal arthritis, but it affects the spinal discs that cushion the vertebrae in the spinal column. The spinal discs are made of a tough outer layer of cartilage and a softer inner layer. Over time, the discs dry out and become thinner, making them less flexible and able to support the spine. 

DDD can result in loss of disc height that makes the vertebrae rub together and narrows the nerve pathways in the spine, resulting in localized and radiating pain. Degenerative forces that affect the spinal discs can also make conditions like bulging and herniated discs more likely. 

 

4. Bulging discs

A bulging disc occurs when the outer layer of a spinal disc weakens and begins to bulge out of its normal place in the spinal column. The discs in the lower spine are more likely to develop bulges due to the increased pressure they experience. A bulging disc is not necessarily painful by itself, but like other conditions, it can cause lower back pain and radiating symptoms as a result of nerve compression. 

 

5. Herniated discs

A herniated disc happens when the softer inner material of the disc begins to push out through a weak spot, such as a crack or tear, in the tougher outer layer. Many herniated discs can start as a bulging disc and progress to partial or full herniation. The herniated inner disc material can irritate local nerves and also put pressure on the spinal cord and nerve roots that travel into the lower body, causing lower back pain and radiating symptoms such as sciatica. 

 

Finding Lower Back Pain Relief

Has low back pain taken over your life? You don’t have to let it. Untreated back pain can progress with time, even leading to mobility problems and long-term nerve damage. When you take control of back pain treatment, you can improve your chances of getting your life back.

If you have exhausted basic treatments like over-the-counter medication, ice packs and heating  pads, Physician Partners of America (PPOA) can help. The caring and dedicated PPOA team is committed to individualized back pain treatment plans that fit your needs and lifestyle. From interventional pain management options like epidural steroid injections to minimally invasive spine surgery, our expert team can help you develop an effective care plan for every stage of your treatment journey. 

Contact us today and let us help you take your life back from chronic back pain. 

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Pain Management Injections Explained—Types of Injections and How They Help

Chronic pain is an issue that millions of Americans deal with everyday, so if it’s affecting you, you are not alone. In fact, approximately 20% of the population deal with some level of chronic pain at some point. 

Unlike acute pain that you may experience from a minor injury or illness, chronic pain persists for weeks, months or even years and can have a negative impact on nearly every part of your life. Chronic pain can take you away from your job, your family and friends and even make it difficult to do your favorite activities and hobbies. 

Although it may feel hopeless if you haven’t found relief from basic treatments, there are effective therapies that can help you effectively manage chronic pain on a long-term basis. Interventional pain management is an approach to overcoming pain that involves a wide spectrum of treatments that work together to address the causes of pain, relieve symptoms and improve function. 

 

Understanding Pain Management Injections

One of the most common techniques for interventional pain management are injections that are designed to deliver pain relieving and anti-inflammatory medication to the treatment area. Although pain management injections are effective, the variety of types and terms can be overwhelming to someone exploring their options for relief. We’re sharing this guide to help patients understand the types of injections available and how they can help as part of a broader interventional pain management plan. 

 

Epidural Steroid Injections

This is one of the most common types of injections for people with lower back pain or neck pain.  Epidural steroid injections typically include a combination of a numbing agent, an anti-inflammatory corticosteroid and saline solution. The medication is injected into the epidural space that surrounds the spinal cord using precision guidance with X-ray fluoroscopy or other techniques. 

Epidural steroid injections provide relief over a period of weeks to months, enabling patients to increase activity and complete physical therapy that can help with spine conditions on a longer-term basis. 

 

Facet Joint Injections

Facet joint injections are another spinal injection that can provide relief for joint inflammation related to arthritis and other conditions. The facet joints link the vertebrae in the spine and are subject to the same stresses that cause inflammation and arthritis in other joints. Facet joint injections relieve the inflammation and stiffness that are a byproduct of arthritis. Like epidural injections, facet joint injections usually include a mixture of a numbing agent and an anti-inflammatory steroid. 

 

Trigger Point Injections

Trigger point injections are designed to treat knots that develop due to excessive muscle contraction, known as trigger points. In addition to causing localized pain, trigger points can also irritate surrounding nerves and cause pain and discomfort in other areas. For example a trigger point in the neck can cause people to feel symptoms in their arms and hands. 

Trigger point injections can help to relax the muscle tension in a trigger point and release and flush toxins from the area. These injections can include a numbing agent, anti-inflammatory medication such as a steroid.

 

Nerve Blocks

A nerve block is an injection that deactivates pain signals along a nerve or a group of nerves. X-ray guidance is generally used to help the provider place the injection in the precise location. 

Nerve blocks can be used for both diagnostic and pain relief purposes. When diagnosing the location of pain, a doctor can inject a nerve block into the area believed to be the source of pain, and if a patient feels relief, it can confirm the diagnosis. When used for pain relief, the injection can include pain relieving and/or anti-inflammatory medication. 

 

Injections as part of a larger treatment plan

Most doctors will recommend pain management injections as part of a broader treatment plan that includes physical therapy, massage, diet, exercise and alternative therapies such as acupuncture. The relief and improved mobility made possible through injections can enable patients to complete exercise programs and physical therapy that can strengthen supporting muscles and relieve pressure on joints and discs that are often the sources of pain.  

If weeks or months of interventional pain management methods do not bring the relief necessary for a good quality of life, surgery can become an option. Today, minimally invasive, outpatient procedures help promote a shorter and easier recovery period compared to traditional hospital-based surgeries. 

The caring and dedicated team at Physician Partners of America (PPOA) works with patients to create long-lasting, personalized pain management solutions that help patients get their lives back. Our options include short-term to long-term treatment plans that take an educational and collaborative approach for people from all walks of life. Talk to a PPOA specialist today to learn more about your options and start your pain relief journey. 

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Five Stretches for Neck Pain

Whether it’s a stiff neck, muscle strain or pain from a spine condition, everyone has to deal with neck pain at some point or another. In more serious cases, chronic neck pain can disrupt nearly every part of your life, from work to family time to hobbies. Fortunately, there are many effective treatments and methods to relieve neck pain and improve range of motion. 

One of the simplest ways to help with aches, stiffness and limited movement is performing neck stretches. Gently stretching on a regular basis can help manage symptoms of neck injuries and conditions such as a herniated disc, especially when combined with other treatments. 

 

How Do Stretches Help with Neck Pain?

When performed correctly, stretching provides multiple benefits for people dealing with neck pain, including:

  • Loosening stiff muscles and connective tissue
  • Increasing circulation and flow of nutrients to the area
  • Helping to improve posture by focusing on proper neck positioning

If you are dealing with neck pain that has lasted more than a few days to a week, always see a doctor for diagnosis and treatment. Before beginning any stretching or exercise routine talk to your doctor or other qualified health professional about your physical limitations and what stretches are right for you. 

 

Try These Easy Stretches to Relieve Mild to Moderate Neck Pain

The best stretches for neck pain depend on the individual cause of the injury or condition, but some of the most commonly recommended neck pain stretches by doctors and physical therapists include the following. 

 

1. Neck Rotation

Perform a neck rotation by keeping your head pointed forward, slowly turning to the right, holding for 10 seconds and returning to the forward position. Repeat on your left side. Perform anywhere from five to 10 repetitions. 

 

2. Forward Neck Extension

For this stretch, slowly tilt your head back while keeping your spine straight until you are looking straight up and hold for five seconds. Slowly tilt your head forward until your chin is pointing toward the sternum and hold for another five seconds before returning to the starting position. Perform five to 10 repetitions depending on your comfort level. 

 

3. Lateral Neck Extension 

Lateral neck extension involves using your hand as resistance to gently pull your head toward the shoulder. Begin by slowly tilting your head to the right side by pulling with your right hand until you feel a stretch. Hold it for five seconds and slowly return to center. Repeat this with your left hand, gently pulling to your left shoulder. Do this five to 10 times. 

 

4. Tilted Forward Neck Flexion

Slowly and gently tilt your head forward toward your chin. You can place your hands behind your head for added resistance depending on your comfort level. Hold for five seconds. While keeping your head tilted forward, slowly turn your head to the right and hold for another five seconds. Return to center and turn your head to the left, holding for five seconds. Perform five repetitions. 

 

5. Neck Glide

A neck glide starts with the head pointing straight ahead. Slowly point your chin forward while keeping your head upright and centered. Hold for five seconds and return to center. Repeat 10 times. 

 

Fitting Neck Stretches into Your Pain Management Treatment Plan

Neck stretches can be performed throughout the day as needed to keep the neck loose and prevent stiffness and awkward positions. Make sure to stay hydrated and focus on posture to get the most out of stretches. 

Performing neck stretches yourself can be a great supplement to physical therapy sessions and therapeutic forms of exercise such as yoga or Pilates. Ask your physical therapist or trainer how to integrate stretches into your treatment or workout routine. 

For neck pain that becomes serious or does not improve with basic treatments and a healthy lifestyle, more involved treatment may be necessary. Interventional pain management techniques, including injections and nerve blocks, help many patients overcome neck pain. For upper spine conditions that don’t respond to conservative therapies, minimally invasive spine surgery can provide lasting relief with an outpatient, muscle sparing procedure. 

Physician Partners of America is dedicated to helping people living with neck pain become pain free with personalized treatment plans that can help a wide range of conditions and levels of severity. Contact our caring team today.  

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