Strengthening the Doctor-Patient Relationship

Five easy steps to create a strong doctor-patient bond in the initial visit.

The relationship between doctor and patient continues to be the keystone in quality medical care. When a trusting healthy relationship is fostered initially, it is more readily maintained and set up for further growth. Quality relationships lead to an accurate description of symptoms, full medical history disclosure, and ultimately a more holistic view of the patient.

  1. Obtain Patient Consent

Obtain patient consent at every possible opportunity and work to maintain this mutual respect in which the patient feels autonomy over their own body. Frame things in a question as opposed to predetermined steps.

The simple act of asking permission rather than telling the patient what you are going to do immediately puts them at ease and makes them feel like a valued stakeholder in their own health.

2. Poker Face

Check your personal opinions at the door. While you may encounter patients that engage in unsafe or otherwise alarming behaviors it is not your job to pass judgment. Remain outwardly neutral as you explain the risks of a given activity and always appeal logically as opposed to emotionally. The moment you show your emotions on your face your patient will feel defensive and the trust that has been built in this short time will have already been broken.

3. Eye Contact

This one is easy! Keep your eyes on the patient as frequently as possible. If you are not engaged with your patient they will not engage with you. Eye contact is another way to help the patient feel valued and it reflects good listening skills when you are focused on your patient as they speak.

4. Assume Ability

Remember by now you know to check your judgments at the door so don’t stop at physical and mental ability. If you have a patient who appears to be differently abled, elderly, or young do not gloss over important questions you assume don’t apply to that patient. Your patient will notice, and the trust you have otherwise established will be damaged.

5. Simplify your Words

You have heard this one before; don’t spew medical jargon! While that is an important lesson let’s take it one step further and challenge you to be concise. If you lecture or over explain to your patient they will tune you out. Remember this is not your appointment this is about the patient. Making them feel important in their personal health will also motivate them to make healthy choices and continue to seek your input as well.

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What Physicians and Patients need to know about Prescription Drug Monitoring Programs

Pain Management and PDMPs

Safe and lawful prescribing of pharmaceuticals are the aim of Prescription Drug Monitoring Programs (PDMPs). However, a delicate balance must be struck. Learn more here.

What are PDMPs?

Prescription Drug Monitoring Programs (PDMPs) attempt to ensure the safe and lawful prescribing of pharmaceuticals through networked databases of physician practices, hospital systems and pharmacies that allow for automated controls on how controlled substances are prescribed to patients.

Typically these systems are implemented and maintained at the state-level, with 49 U.S. States, the District of Columbia and Guam currently operating PDMPs.

A key function of these systems is to combat issues surrounding the misuse of opioids. While proven an effective therapy for managing chronic pain, opioids have addictive properties and can be dangerous in large quantities, or when mixed with certain kinds of medication.

Benefits of PDMPs

As PDMPs become more ubiquitous throughout the U.S., and data comes in, encouraging statistics have emerged. According to the CDC, in Florida, opioid-related deaths fell 50% from 2010 to 2012, when pain clinic regulations and the establishment of a PDMP was put in place. The CDC also reported a 75% decrease in doctor shopping (seeking multiple prescriptions for opioids from different doctors) from 2012 to 2013, when New York began requiring prescribers to check the PDMP before writing painkiller prescriptions.

Major benefits of PDMPs include:

  • Reduction in overprescription of opioids
  • Reduction in doctor shopping
  • Avoid harmful drug interactions
  • Reduction in fraudulent prescriptions
  • Improved quality of care
  • Enhanced treatment and intervention for patients with or developing dependencies
  • Increased confidence in prescribing painkillers
  • Capturing geographic trends and other data points to improve population health

Concerns Among Physicians and Patients

With any disruptive integration of technology in medicine there are drawbacks, especially where there are potential legal consequences at stake. Physicians are becoming wary of being identified as over prescribers of opioid medicine, and may withdraw from using the therapy where it has a legitimate use. This is also known as “the chilling effect” which can lead to patients being underserved, or receiving alternative treatments that could have greater side-effects or are less effective. This is especially true of pain management providers who specialize in such therapies, and are relatively high prescribers of opioids.

Some other  potential drawbacks PDMPs pose are:

  • Fear of undue legal scrutiny for patients and physicians
  • Less effective pain management therapies
  • Reduction in precision care/increase in inadequate care
  • The wrongful identification of addicts or “pseudo-addicts”
  • Privacy concerns
  • Wrongful categorization as fraudulent prescribers
  • Increased time demands for physicians
  • Lack of ability to illegal drug use, such as heroin

What Pain Management Care Providers Need to Know

Because there is no accurate way to measure pain, other than what is reported from patients, physicians must rely on radiology, historical information, laboratory tests, and physical examination to make a judgment on the appropriate treatment.

This presents a fine line that pain management care providers must walk.

There is an element of accuracy that PDMPs can provide in determining the most effective intervention for either pain management or drug dependency by using their data. However, addiction from illicit drug use and dependence due to pain management can require different methods of intervention and treatment. Addiction treatments are currently largely geared more towards illicit drug users. This presents a challenge in striking an effective balance of curbing risks of drug dependency while not reducing effective pain treatment.

Being a part of a network can help alleviate some of the time and effort needed to navigate this complicated balance. PDMPs will likely expand in use and effectiveness over the coming years. As they do, so will the possibility of safely prescribing powerful medications while adequately treating pain.

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Holistic Therapy – What is It and How Can it Help?

At some time in our lives, we will all reach a low point and we will struggle.  Many seek professional help in the form of counseling to gain the experience and knowledge needed in order to cope and push through these difficult times.  Professional treatment is often times the last resort for individuals.  What many people do not know, is that individual therapy can help the beginning stages of disorders, addictions, depression, stress, anxiety, family issues, trauma, and so much more.  Counseling can be used as both a preventative measure and as a corrective measure to assist those in need and to get them back on track to a healthy mental and physical state.

Holistic counseling and therapy have been on the rise.  Holistic therapy takes the approach of treating the “whole” person, involving looking into their life experiences as well as spiritual, physical, and psychological aspects of the person, not just the issue they are struggling with.  Be sure to find a licensed counselor who uses a holistic approach rather than who “coaches” using holistic methods.   Holistic approaches and counseling involve treatment of the “entire” person, from the inside out.  The goal of holistic counseling is for the client to achieve an improved mental, physical, and spiritual state.

Holistic therapy and exercises are catered towards the three main components of a person.  Massage, yoga, and other bodywork techniques are used on the physical aspect of the person’s body in order to help relieve tension and promote a better awareness of trouble areas as they arise rather than suffering after an extended period of time have passed.  These trouble areas are signs of repressed emotions and stress that the person is struggling with.  The next set of exercises involves psychotherapy aspects to assist the individual with the emotions they are feeling as the tension is released from the body.  Further education, as well as discussion of emotions and the stressors in the person’s life, will help them understand and be able to develop coping mechanisms as their awareness is heightened.  The last part of holistic treatment is to identify with the spiritual aspects of the person.  Both therapist and client will explore the deeper meanings of the individual’s life and of the world in order to help heal the soul and mind.  Meditation is a favored form of therapy used to assist in addressing the soul as well as spiritual aspects of the person.

Holistic therapy is an excellent form or preventative therapy, also known as wellness therapy or practice.  A balance is sought in holistic treatment of the body, spirit, and mind.  Holistic therapy has proved beneficial to many that have tried and used it, as it also helps educate the person to be more attuned to their needs as well as stress factors.  By being able to identify negative emotions as well as cope with them, holistic treatment helps prevent further relapses and promote the growth of a person’s well-being.  Using holistic counseling will take more than a couple of sessions.  The treatment is geared towards longevity and increasing the strength of positivity within a person.

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Healthy and Natural Habits for Managing Chronic Pain

Many daily habits can cause, exacerbate, or ease the amount of pain you experience, and there are several tried and true methods for dealing with chronic pain with or without the aid of pharmaceuticals and/or corrective surgery.

In all cases you should consult a doctor, nurse practitioner or physical therapist about what natural remedies are right for you and your condition, and whether medical interventions are necessary.

The best way to deal with chronic pain is to discuss the issues you are having and what medical interventions you are comfortable with participating in- openly with your doctor. Pain management professionals will work with you to ensure a natural, holistic approach to easing the chronic pain is taken and ensure your lifestyle habits and preferences are fully taken into consideration.

Types and Methods of Natural Pain Relief

Low Impact Hobbies and Exercise

Taking your mind off the pain is proven to be highly effective and can be done with a hobby or activity that is enjoyable, and perhaps, time-consuming. Reading, knitting, building models are great examples of ways we can train our brains on something other than chronic pain.

When engaged in such activities the brain releases chemical such as serotonin and dopamine that can ease anxiety and mitigate the amount of pain that is perceived.

Relaxation and meditation of often recognized ways to manage pain which fall into this category. According to Clinical Health Psychologist Dr. William Deardorff, “the brain can learn how to manage and decrease the sensation of pain using a combination of deep focus, breathing, and imagery techniques.” Such techniques combined with avoiding idle time can help limit the perceived amount of pain.

Stretching and Yoga

Many instances of lower back pain and some joint pain can be soothed by different yoga poses and stretching techniques. Yoga helps to strengthen and loosen the connecting muscles to areas where soreness and inflammation start.

One of the best ways to get active in yoga is to search for a yoga studio or a gym near you. You can also look up poses that can help you get started at home. If your doctor agrees that you are in fit condition to perform yoga, you may find that over time you will feel more mentally and spiritually fit. According to an article from Harvard Health citing two separate sources, Yoga has shown to help improve symptoms associated with ailments such as fibromyalgia and osteoarthritis and can even improve mental wellbeing.

Using Hot and Cold Temperatures for Pain Relief

Also known as cryotherapy and thermotherapy, there may be some confusion as to when it is best to employ hot or cold to painful areas, so always consult with your healthcare professional. Generally, though, you use ice on injuries and heat on muscle pain, according to Painscience.com.

Cryotherapy or “icing” can be useful for bruising, inflammation and other superficial injuries. While the evidence supporting the effectiveness of cryotherapy for injuries is tenuous, it can provide some minor comfort where inflammation and swelling are involved.

Heat can be used for muscle spasms, tension, chronic pain and other situations associated with throbbing or aching feelings. Warmth can have a calming effect as well, which can sooth some of the emotional aspects associated with pain.

Be careful when using temperature-based therapies in treating pain, because there could be an opposite-to-the-desired effect. The rule of thumb is to do what feels good to you.

Herbal Remedies and Supplements

When considering supplements, as with all pain interventions and therapies you must consult with your healthcare provider. There are many on the market that can help with different types pain. WebMD offers a comprehensive article listing supplements that can ease different types of pain.

The following are some of the listed remedies:

  • For back and joint pain: turmeric, devil’s claw root, capsicum/capsaicin, comfrey, glucosamine and chondroitin
  • For a headache: white willow bark, boswellia, caffeine, feverfew and butterbur
  • For arthritis: SAM-e, glucosamine/chondroitin, and boswellia
  • Other remedies for inflammation: Omega 3 fatty acids, and probiotics

In all cases, consulting with your physician before starting natural and herbal interventions is the rule of thumb as some of these supplements may react adversely with others, or other medicines you are taking.

Alternative Medicine for Chronic Pain

When considering an “alternative” treatment for pain you may notice a re-reoccurring theme: Your doctor is always going to be your best guide, so have questions prepared. Also consider many treatments that were once deemed alternative, are now becoming mainstream such as acupuncture and marijuana.

It is important to keep in mind that treatments outside of the mainstream are there for a reason: They aren’t effective, or potentially harmful.

Sometimes the most natural method of pain relief is to abstain from bad habits or to engage in healthy ones. Minor lifestyle changes like exercise, avoiding substance abuse, proper diet and getting enough sleep can improve quality of life and by extension perceived pain.

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Fibromyalgia Pain Relief in Dallas

Fibromyalgia is defined as having chronic, widespread musculoskeletal pain. Researchers believe that the root of fibromyalgia could be related to overactive nerves in the central nervous system, which may lead to heightened pain sensations. However, as anyone with the condition can tell you, the disorder goes far beyond isolated episodes of physical pain. The condition can also produce debilitating psychological symptoms such as anxiety and depression.

Fibromyalgia can be triggered by physical or psychological trauma, or the condition may develop after major surgery. For many people, fibromyalgia seems to develop gradually with no discernible cause or trigger. This leads to frustration for many people, as they feel that the pain they’re experiencing is unexplained.

Fibromyalgia Symptoms

Fibromyalgia affects everyone differently. In general, women are more likely to experience fibromyalgia. The risk of fibromyalgia pain increases if you have a family history of the condition or if you have an autoimmune disease such as lupus or rheumatoid arthritis. People who struggle with fibromyalgia often have overlapping conditions such as irritable bowel syndrome (IBS), jaw pain such as temporomandibular disorder (TMJ), migraine headaches, and restless leg syndrome.

The most common symptoms of fibromyalgia include:

  • Fatigue
  • Insomnia
  • Lower abdomen cramping
  • Muscle spasms
  • Problems with memory and concentration
  • Widespread musculoskeletal pain

Fibromyalgia Treatment in the Dallas-Fort Worth Area

Because fibromyalgia can often develop without a clear cause, some people feel like there can be no clear treatment. Texas Pain Relief Group is here to tell you that treatment is available for this debilitating condition.

Chronic discomfort should not be a way of life, and our team of pain relief specialists is here to offer you a holistic treatment plan that focuses on both the physical and psychological aspects of fibromyalgia. From lifestyle modification and non-pharmacological treatments to pain relief injections, we offer a comprehensive range of fibromyalgia therapies.

Don’t struggle with chronic pain any longer. Get the help you need from pain specialists in the Dallas-Fort Worth area. Contact Texas Pain Relief Group today to schedule an appointment

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Injections for Joint Pain

Joint pain, also called arthralgia, can be a debilitating, frustrating condition. It can develop in any joint in the body, though the knees, hips, and shoulders are the most at risk because of a large amount of stress they handle on a daily basis. Degenerative conditions such as osteoarthritis and sports injuries are some of the most common causes of joint pain. Other causes include:

  • Rheumatoid arthritis
  • Degenerative disc disease
  • Bursitis
  • Gout
  • Lupus

For some people, joint pain goes away on its own over the course of several weeks. Treatments such as over-the-counter medication, stretching, and physical therapy are usually successful at mitigating joint stiffness and pain. However, other people experience chronic joint pain that persists for months or years. They may experience joints that are swollen, tender, stiff, or weak. Many people with chronic osteoarthritis also suffer from reduced range of motion in the joint. For these individuals, joint pain injections may be the right treatment choice.

How  Injections for Joint Pain Work

Joint pain injections offer a more targeted approach to pain that does not respond to more conservative treatments. However, many people with joint pain may not be ready for major surgery such as joint replacement. Most injections can be performed right in your doctor’s office and you can go home after the procedure.

  1. The doctor will use a needle to inject the joint with medication. To ensure accuracy, X-ray guidance is used to get the needle to the precise location of joint pain.
  2. A local anesthetic such as lidocaine is injected, along with a slow-release steroid (usually cortisone).
  3. The local anesthetic will numb the pain for several hours, but the steroid will take three to five days to take effect.
  4. Once the steroid reduces inflammation, pain relief may last for several weeks or months.

Find Injections for Joint Pain in Texas and Florida

“Joint pain” is an extremely broad term, and the condition affects everyone differently. At Physician Partners of America, we believe in listening to what you have to say about your pain and the treatments you’ve tried in the past so that we can thoroughly understand your condition and provide you with a customized treatment plan. No two people are alike, so why should pain relief plans be alike? We offer a range of pain relief therapies for osteoarthritis and sports injuries including injections for joint pain.

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The Anatomy of Sacrum Pain

When people refer to sacrum pain, they are usually talking about pain that affects the sacroiliac (SI) joint in the spine. The sacrum is a triangular bone at the very bottom of the spine, formed by five fused vertebrae. On either side of the sacrum are two wing-like bones that join via strong ligaments with the iliac bones of the pelvis. Unlike the other vertebrae of the spine that are connected by flexible discs, the sacrum itself and the SI joint have very little motion and flexibility. Instead, their primary roles are to support the spine and absorb shock.

Sacrum Pain Symptoms

Just like the other joints in the body, the SI joint can degenerate over time. The ligaments around the joint can stiffen, or they can develop tears and loosen the joint too much. Either scenario can cause the joint cartilage to wear away, leading to the sacral and iliac bones rubbing together and causing pain. This is also a synovial joint, which means it is filled with a lubricant called synovial fluid. Over time, the synovial fluid may become inflamed and cause further discomfort.

Sacrum pain caused by SI joint dysfunction can take many forms. Symptoms can include:

  • Groin pain
  • Muscle weakness in the legs
  • Pain in the lower back
  • Pain when moving standing after sitting for a long period of time
  • Pain when standing for long periods of time
  • Radiating pain in the hips, buttocks, and legs
  • Tingling or pins-and-needles sensations in the lower extremities

Treatment for Sacrum Pain in Tampa, Florida

Some of the most common causes of sacrum pain include osteoarthritis, rheumatoid arthritis, and osteoporosis, but the condition can also develop due to occupational injuries, auto accident injuries, and other activities that put repeated stress on the SI Joint. If you think you may be suffering from sacrum pain due to SI joint dysfunction, turn to the professionals at Physician Partners of America in Tampa.

Our team of pain specialists has extensive experience treating chronic pain using nonsurgical and minimally invasive methods so that you can get back to living the life you enjoyed before sacrum pain took over. At Physician Partners of America, we believe that all patients experience pain differently, which is why we take the time to understand your symptoms and ask questions about the pain relief techniques you’ve tried in the past. By getting to know you, the patient, we can then create a completely customized pain management plan that fits your unique needs.

Contact us today to schedule an appointment with a pain specialist in Tampa, Florida

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What is the Cause of Your Diabetic Leg Pain?

What is the Cause of Your Diabetic Leg Pain?

Do you ever experience a pins-and-needles sensation in your legs? How about numbness or weakness? If you’ve answered yes to either of these questions and you’re also suffering from diabetes, the culprit may be diabetic neuropathy. Diabetic neuropathy, also known as diabetic nerve pain, happens when nerves are damaged because of diabetic complications. With one in five diabetic individuals experiencing diabetic neuropathy, it is important to be tested for this complication.

What are Symptoms of Diabetic Leg Pain?

Depending on the nerves affected, the symptoms for diabetic nerve pain can vary. Typically, discomfort starts with tingling or numbness, but the sensation can escalate to throbbing, shooting, or burning pain. Though these sensations often begin in the legs and feet, they can spread to the hands and arms, often worsening at night.

Other symptoms of diabetic neuropathy can include:

  • Cramps
  • Increased sensitivity to touch
  • Muscle weakness
  • Decreased balance and coordination
  • Loss of reflexes, especially in the ankle

In more serious cases, diabetic neuropathy can lead to issues with your digestion, urinary tract, and cardiovascular health. Because of this, it is important to talk to your doctor or pain specialist as soon as you start experiencing symptoms.

Is Diabetic Leg Pain Treatable?

Though there is no known cure for diabetic neuropathy, slowing diabetes and associated neuropathy symptoms start with healthy eating, exercising regularly, and maintaining optimal blood sugar levels. Smoking and alcohol abuse can also contribute to the condition, so it’s important to stop those habits. Additionally, there is a number of alternative nerve pain management treatment options available that focus on slowing the progression of the disease, managing complications, and relieving the pain associated with nerve damage.

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Are Sacroiliac Joint Injections Right for You?

Sacroiliac joint injections are used to treat dysfunction of the sacroiliac, or SI, joint, located at the bottom of the spine, just above the tailbone. This joint has a large of responsibility. Not only does it absorb shock for the lower back, but it also connects the sacrum with the pelvis and helps to transmit movement to the pelvis and legs. Due to this constant stress, it is not uncommon for SI joint pain to develop as a result of osteoarthritis, overexertion, or long periods of immobility, as may occur if someone sits for long periods of time at a desk for work.

SI joint dysfunction symptoms can often mimic other symptoms that affect the lower back, such as sciatica or a herniated disc:

  • Dull or throbbing pain in the lower back
  • Radiating pain that moves down the buttocks and legs
  • Weakness in the lower back or legs

Before considering sacroiliac joint injections as a treatment option, it is extremely important for a doctor to accurately diagnosis the condition and make sure another degenerative spine condition or injury isn’t causing your back pain. An SI joint injection may initially be used for diagnostic purposes so that your doctor can pinpoint the source of your discomfort.

How Sacroiliac Joint Injections Work

A sacroiliac joint injection also called a sacroiliac joint block, involves a special type of X-ray called a fluoroscope to help the doctor guide the needle into the correct location in the joint. A numbing anesthetic such as lidocaine is usually injected into the joint. If this stops the pain, the doctor can confirm that the SI joint is the culprit. A steroid solution is also injected into the joint to reduce inflammation and pain.

The local anesthetic can help to relieve pain immediately but will wear off within a few hours. It is the slow-release steroid that can provide longer-lasting pain relief. The steroid begins to work within a few days of receiving the injections. Depending on the severity of your condition, your doctor may recommend sacroiliac joint injections every few months.

Sacroiliac Joint Injections in Florida and Texas

If you’re looking for pain relief specialists with extensive experience administering sacroiliac joint injections, turn to the experts at Physician Partners of America. Our pain clinics offer a compassionate, supportive environment where we will take the time to ask questions about your pain and learn what treatments you’ve already tried. Using this information, we can then formulate a targeted pain relief plan.

We know that SI joint pain can affect everything you do. You may feel like this chronic discomfort has put your life on hold. At Physician Partners of America, our goal is to become your partner for long-term pain management and healing. Contact us today to schedule an appointment.

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Nerve Block Treatment for Neck Pain – Is It Right For You?

We don’t realize how heavily we rely on our necks for everyday movements until we experience neck pain and immobility. Suddenly, even the smallest tasks such as reaching a high shelf or turning your head to check for oncoming traffic can seem excruciating.

For many people, acute neck pain in the cervical region of the spine will go away on its own with rest, physical therapy, and medication. However, chronic neck pain due to conditions like a pinched nerve, whiplash, or fibromyalgia may require a more targeted therapy such as nerve block treatment.

A nerve block treatment for neck pain may help to relieve:

  • Stiffness and reduced range of motion in the neck
  • Chronic headaches
  • Tingling in the shoulders and arms
  • Weakness in the upper extremities
  • Muscle spasms in the neck

How a Nerve Block in the Neck Works

A cervical nerve block may be used for both diagnostic and treatment purposes. A nerve block is performed by injecting a local anesthetic around a group of sympathetic nerves in the neck. The injection is guided by the use of a special X-ray called a fluoroscope to ensure accuracy and precision. The solution that is injected is usually a combination of an anesthetic and an anti-inflammatory steroid.

If the nerve block successfully eliminates or diminishes pain, your doctor may recommend repeating the nerve block injection about every other week. Local anesthetic and a calming sedative are usually all that is required for a nerve block in the neck. General anesthesia is not necessary and you can return home shortly after the procedure.

Neck Pain Treatment in Florida and Texas

Living with neck pain can affect everything you do, from working to exercising, to socializing. At Physician Partners of America, we know that it can feel as if your life has been put on hold when you’re struggling with neck pain and nothing is more frustrating than trying treatment after treatment without success.

We offer a comprehensive range of minimally invasive pain relief therapies including cervical sympathetic nerve blocks for patients in Florida and the Dallas-Fort Worth area. This type of targeted pain relief therapy has helped many patients get their lives back and may prevent the need for an invasive neck surgery. Our expert team of pain management doctors and medical professionals has extensive experience performing cervical nerve blocks.

Find out if a nerve block for neck pain is the right treatment option for you by scheduling an appointment at one of our pain relief clinics. We offer convenient locations throughout the Dallas-Fort Worth area, including Euless, Grapevine, Hurst, and Irving.

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