Lower back pain is one of the most common forms of discomfort faced by Americans. Whether through injury or age-related changes, most people will encounter some form of low back pain at some point in their lives. Individual cases can range in severity from mild tweaks due to physical exertion all the way to debilitating pain related to a spine condition. 

Even a minor backache can be a major inconvenience — and it can come with the risk of worsening. This is why it’s important for everyone to take steps to prevent lower back pain whenever possible, and properly manage and care for their condition if they are dealing with pain or discomfort. The following information can help you take control of your pain and achieve the best possible quality of life. 

 

Understanding Lower Back Pain and Common Causes

Lower back pain is a broad and general term describing any symptoms of discomfort occurring in the area of the back extending just below the ribcage to just above the hips and buttocks. This includes the lumbar, or lower, region of the spinal column as well as supporting muscles, tendons and ligaments. Lower back pain is an extremely common condition and affects millions of people of all ages, but becomes more common with age. 

Because the lower back and spine must support the weight of the upper body while remaining flexible enough for basic movement, this area is under tremendous stress on a daily basis. This is why injuries to this area are so common, and why the lower spine is so vulnerable to natural aging and degenerative conditions. 

Common causes of lower back pain include:

  • Muscle strains, especially from physical labor and strenuous exercise
  • Ligament sprains and tears
  • Conditions affecting the spinal discs, such as bulging and herniated discs
  • Osteoarthritis of the spine, also known as facet disease
  • Any condition that causes spinal stenosis, which is narrowing of the spinal column and resulting nerve compression

Lower back pain can be acute, lasting for a short period of time often due to an injury or strain, or chronic, lasting or recurring for months or longer. Chronic lower back pain is often related to degenerative spine conditions, but it can also be caused by repetitive injuries. Both acute and chronic lower back pain can range from mild to severe and debilitating. 

 

Can You Prevent Lower Back Pain? 

There is no way to completely prevent the occurrence of either acute or chronic lower back pain, but it is possible to significantly lower your risk of injury or developing age-related conditions. By understanding the most common risk factors and taking active steps to address them, anyone looking to avoid lower back pain can put themselves in the best possible position. 

Doctors and medical researchers have identified the following risk factors as having a high association with lower back pain: 

  • An overly sedentary lifestyle, which can lead to weaker supporting muscles and rapid breakdown of soft tissue structures in the spine
  • Being overweight or obese, which adds to the stress on the spinal column
  • Having a physical job that involves heavy lifting and/or repetitive motions
  • Smoking or tobacco use
  • Excessive alcohol consumption
  • A nutrient-poor diet high in saturated fats and processed foods

There are some factors, such as genetics, that are beyond anyone’s control, but by practicing a healthy lifestyle including getting regular exercise, practicing good posture, and eating a healthy diet, it is possible to lower the risk of lower back pain. 

 

Tips for Managing Everyday Discomfort 

A large number of cases of lower back pain are highly manageable and can improve with time. In these situations, there are a few steps that can help reduce discomfort and maintain an active lifestyle. Basic measures to manage lower back pain include: 

  • Performing gentle stretches every day, especially in the morning 
  • Using a heat source, such as a heating pad, in combination with an ice pack or other form of cold compression
  • Getting plenty of rest and avoiding overexertion
  • Staying hydrated
  • Taking over-the-counter medication, such as nonsteroidal anti-inflammatory drugs (NSAIDS)
  • Engaging in light exercise, such as walking for 10 to 20 minutes every day 
  • Getting a good night’s sleep 

If lower back pain is affecting sleep quality, make sure that you are sleeping on a supportive mattress. Older, worn out mattresses can worsen and exacerbate lower back pain. 

 

Treating Chronic Lower Back Pain

If lower back pain does not improve in a few days to a week, it is important to see a doctor or pain management specialist for diagnosis and treatment. Identifying the source of back pain through a physical examination, discussion of symptoms, and diagnostic imagery such as an MRI is essential to managing symptoms on a long-term basis. 

Chronic lower back pain can often benefit from more involved treatments and interventions, such as:

  • Physical therapy to help strengthen supporting structures, address postural issues, and improve range of motion
  • Spinal injections, such as lumbar epidural steroid injections, to reduce inflammation and pain on a medium-term basis
  • Assistance with lifestyle changes, such as quitting smoking
  • Nutritional counseling
  • Alternative treatments, such as massage therapy or acupuncture

Even non-reversible conditions such as arthritis or degenerative disc disease can be effectively managed through conservative therapies and interventional pain management

 

When to Consider Surgery for Lower Back Pain

For spine conditions, back surgery can start to become a serious option if weeks or months of conservative treatment has been explored without bringing the relief necessary for a good quality of life. In many cases, a minimally invasive outpatient procedure can help relieve nerve compression and achieve lasting relief of lower back pain. With muscle-sparing techniques and a very small incision, spine surgeons can help patients achieve a shorter recovery time with less risk of complication compared to traditional open spine procedures. 

 

From Basic Care to Minimally Invasive Spine Surgery, PPOA Can Help You Explore Your Options

No matter where you are on your lower back pain relief journey, from prevention to management to treatment, the compassionate team at Physician Partners of America (PPOA) is here to help. We can put you in touch with the providers who are right for your needs and help you develop an individualized treatment plan. You don’t have to live with lower back pain. Contact PPOA today and take control of your care.

Herniated discs are among the most common causes of lower back and neck pain — each year as many as 6.6 million people are diagnosed with a herniated disc in the United States alone. So if you are dealing with herniated disc pain, you are not alone. Although the symptoms can be debilitating and interfere with the ability to enjoy everyday activities and spend time with friends and family, herniated disc pain is very often manageable. 

This helpful overview will provide a detailed understanding of herniated disc pain, including the causes of herniated discs, the most common symptoms and effective treatments. By learning more about this condition, you can take charge of your care and start to achieve the quality of life you deserve. 

 

What Causes Herniated Discs and Herniated Disc Pain? 

A herniated disc occurs when the soft inner material of a spinal disc begins to push out through a crack or tear in the tougher outer layer. The spinal discs sit between the vertebrae, cushioning the spine and enabling basic movement such as bending, flexing and twisting. Over time, natural degeneration combined with everyday stresses can cause the discs to weaken and lose elasticity, making conditions such as bulging and herniated discs more likely. 

A herniated disc by itself is not necessarily painful and the condition often goes undiagnosed. Herniated disc pain typically occurs when displaced disc material irritates or puts pressure on surrounding nerves. Nerves affected by a herniated disc can include the spinal cord, branching nerve roots and small nerves on the disc itself. 

 

Herniated Disc Symptoms

Herniated disc pain can depend on the location of the herniated disc as well as the specific nerves affected by displaced disc material. For example, a herniated disc in the cervical, or upper, spine will generally cause neck pain and radiating symptoms in the upper extremities. A herniated disc in the lumbar, or lower, spinal region is usually a source of lower back pain and radiating symptoms in the lower body. Herniated disc pain can also occur in the cervical, or middle, spine but is less common due to the fixed nature of this region.  

Herniated disc pain can include, but is not limited to:

  • Localized pain, often described as a burning sensation, in the neck or lower back
  • Shooting pains in the hips, buttocks and legs, also known as sciatica, due to compression of the sciatic nerve by a herniated disc 
  • Radiating symptoms in the upper or lower extremities, including tingling, numbness and muscle weakness
  • In severe cases, herniated disc pain can result in a pronounced limp and foot drop 

Herniated disc pain can range in severity from mild to severe and debilitating. Untreated herniated disc pain can lead to long-term nerve damage and mobility problems that are more difficult to manage. This is why being proactive about seeking diagnosis and treatment is so important. 

 

Treating Herniated Disc Pain

Doctors and pain management specialists typically diagnose herniated discs through a discussion of symptoms, review of medical history, a physical examination and diagnostic testing such as an X-ray or MRI. 

For mild herniated disc pain, basic conservative treatments such as over-the-counter anti-inflammatory medication, hot and cold therapy and gentle stretches can often be effective. It is also important for anyone diagnosed with a herniated disc to commit to a spine-healthy lifestyle that includes eating a nutritious diet, practicing good posture, staying active and avoiding tobacco products and excessive alcohol consumption. 

Moderate to severe herniated disc pain may benefit from more involved therapies, including:

  • Physical therapy 
  • Interventional pain management treatments, including epidural steroid injections
  • Therapeutic massage
  • Alternative therapies such as acupuncture   

For herniated disc pain that does not respond to a full course of nonsurgical therapy, herniated disc surgery can be an effective course of treatment. Thanks to advancements in surgical technology and technique, minimally invasive spine surgery can now help patients find long-term relief from herniated disc symptoms on an outpatient basis. Surgeons can access the herniated disc and remove displaced material with a small incision and minimal disruption of soft tissue compared to traditional open spine procedures, helping patients achieve a shorter recovery time and less risk of complication. 

 

For Herniated Disc Pain Relief, Reach Out to Physician Partners of America Today

Whether you are exploring interventional pain management or considering surgery for herniated disc pain, Physician Partners of America (PPOA) can help. We work closely with patients from all walks of life to develop a highly individualized plan that fits anyone’s treatment goals. Our mission is to provide compassionate, evidence-based care that puts you on the path to wellness and a healthy, active lifestyle. 

To start your pain relief journey, contact us today to make an appointment. 

Facet disease affects millions of people in the United States and is a major source of aches, pains and limited mobility. If you’ve heard of this condition and are concerned about it one day affecting you, you are not alone. Like other conditions, while there is no way to completely prevent facet disease, there are steps anyone can take to significantly lower the risk of it developing. 

This informative overview will help you better understand facet disease and take action to promote a healthier spine and decrease the risk and severity of facet disease. 

 

Facet Disease Explained

Doctors typically define facet disease as a chronic condition where inflammation and degeneration of the facet joints in the spine cause pain, stiffness, and limited range of motion. Like other joints, the spinal facet joints have a coating of cartilage and joint fluid that helps to reduce friction and enable smooth movement. Anything that disrupts the function of joint cartilage and fluid in the facet joints can cause the development of facet disease through increased friction and inflammation. 

The most common contributor to facet disease is osteoarthritis of the spine. As cartilage dries and breaks down, it can cause increased bone-on-bone contact. The resulting inflammation, pain and stiffness cause the debilitating symptoms associated with facet disease. Other causes and contributors can include stress from frequent injuries and autoimmune conditions. 

 

Can Facet Disease Be Prevented?

Facet disease is a non reversible condition without a cure, but it is highly treatable. Because facet disease is largely caused by natural age-related degeneration, there is no way to completely prevent it from developing. The same goes for cases of facet disease related to post-injury trauma or autoimmune diseases. 

However, there are steps to limiting the risk factors associated with facet disease. In addition to age and genetics, which can’t be controlled, controllable risk factors for facet disease include weight, diet, tobacco use, activity level and posture. By understanding these risk factors and taking steps to counteract them, it is possible to substantially lower your risk of facet disease. 

 

Five Proactive Steps Anyone Can Take to Decrease Their Risk of Facet Disease

Everyone is different and no two plans for preventing and reducing the risk of facet disease will be the same. It is important to work with your doctor or pain management specialist to develop a plan that is right for you. Common steps for practicing a spine healthy lifestyle that lowers the risk of facet disease include: 

 

1. Staying Active and Keeping a Strong Body 

A sedentary lifestyle is strongly associated with spinal degeneration and facet disease. This is because the reduced cardiovascular health and muscle atrophy associated with being inactive can have negative effects on spinal tissue. The decreased blood flow of nutrients to the joints and discs in the spine combined with lack of support from surrounding muscles can speed up degeneration. 

When it comes to exercise, a little goes a long way. Even walking for 10 to 20 minutes every day can have a positive impact. Other spine healthy exercises include gentle stretching, planking and Pilates, but always check with your doctor for exercises that are right for you. 

 

2. Reducing Stress on Your Spinal Joints 

The spine is designed to withstand tremendous pressure while allowing for the flexibility and mobility needed to bend and flex, but there are still limits. Constantly placing stress on the spine, whether through high-impact exercise, poor posture or carrying extra body weight, can add up over the years. Take steps to reduce stress on the joints by avoiding activities that can potentially injure the spine, practicing good posture and maintaining a healthy weight. 

 

3. Eating a Healthy, Anti-Inflammatory Diet 

Inflammation is a major source of facet disease, and many people are not aware of how much food plays a role in the inflammatory process. Eating a diet high in saturated fats, processed grains, and refined sugar can all increase inflammatory markers in the body, also increasing the risk of facet disease or making symptoms more severe. To counteract inflammation, eat an anti-inflammatory diet rich in leafy greens, berries, unsaturated fats, whole grains and Omega-3 fatty acids such as salmon. 

 

4. Avoiding Unhealthy Lifestyle Choices

Tobacco use and excessive alcohol consumption are major risk factors for facet disease. Tobacco use, particularly smoking, can hurt cardiovascular health and decrease blood flow along with all the other negative health effects associated with it. Alcohol use can cause dehydration, organ damage and diminished blood flow. Anyone looking to cease or limit usage of either substance should work with their doctor or a behavioral health professional to develop an effective strategy. 

 

5. Working Closely with Doctors and Treatment Professionals

Along with the above, patients should always see their doctors for check ups and physical examinations on a regular basis. Identifying spine conditions or facet disease as early as possible can prevent them from becoming more severe down the road. Very often, basic conservative pain management treatments, including over-the-counter medication, anti-inflammatory injections, and hot and cold compression, can help effectively manage symptoms along with practicing a spine healthy lifestyle. The key is to be proactive and collaborative with your treatment team and commit to any treatment recommendations and lifestyle changes.  

 

Reach Out to the Caring Team at PPOA Today 

No matter where you are in your pain relief journey, from prevention to treatment, Physician Partners of America (PPOA) can help. We can work with you to develop a personalized treatment plan, including interventional pain management, that is right for your spine-healthy lifestyle and wellness goals. 

Contact us today to learn more or schedule your appointment. 

Failed back surgery syndrome (FBSS) can be one of the most devastating conditions anyone living with back pain can encounter. After dealing with chronic pain and other symptoms for years, patients can feel like they are at their lowest point if spine surgery isn’t effective or even makes the pain worse. Fortunately, there are effective treatment options and hope for anyone looking to overcome FBSS and achieve a better quality of life. 

 

What Is Failed Back Surgery Syndrome?

 

Failed back surgery syndrome describes complications or new symptoms that develop in the aftermath of a spine procedure. In some situations, patients may begin experiencing FBSS immediately after the procedure, or soon after recovery. In other cases, problems may not develop until weeks or months later, often making the condition difficult to diagnose and treat. 

FBSS may be more common than some realize. According to a 2023 study, failure rates may be as high as 25% for decompression procedures such as microdiscectomy and potentially up to 46% for lumbar fusions. 

 

Causes of Failed Back Surgery Syndrome

 

Failed back surgery syndrome is still being studied, and the causes are not fully understood. There can be a wide range of contributors and risk factors that can lead to the development of FBSS, including: 

 

  • Misdiagnosis: Not properly identifying the source of pain can lead to surgery on the wrong area or condition and the continuation of symptoms. 
  • Surgical error: Errors such as not fully removing damaged spinal tissue, nicking nerve tissue, or excessively damaging surrounding muscles and ligaments at the surgical site can cause increased pain or complications during recovery. 
  • Rejection of implants or failed fusion: In procedures involving surgical implants, the body may have an adverse reaction or the surgeon may not have implanted it properly, leading to potentially serious complications. And with some spinal fusion procedures, the vertebrae may not fully fuse, leading to a condition called pseudoarthrosis. 
  • Development of scar tissue: Whether due to surgical error, an increased risk of developing excessive scar tissue in the patient or long-term nerve damage, scarring in the surgical area can cause pain and is a key contributor to FBSS. 
  • Transfer of stress to a different level of the spine: Immobilizing one level of the spine in a spinal fusion can put more strain on the levels above and below. This can increase the risk of new pain and symptoms developing in these areas, especially if there is already degeneration present. 

 

Other risk factors can increase the likelihood of FBSS, including being overweight or obese, not following instructions during the recovery period, smoking and excessive alcohol consumption. Additionally, patients with mental health conditions such as depression and anxiety can be at an elevated risk for FBSS or experiencing more severe symptoms of the condition. 

 

Failed Back Surgery Syndrome Symptoms

 

Symptoms of failed back surgery syndrome can vary widely depending on the condition being treated, the procedure, and the cause or causes of the failed surgery. In some cases, FBSS pain may be the same symptoms from before the surgery, while in other situations, new or more severe pain may develop. Symptoms to watch for include:

 

  • Localized back pain
  • Severe shooting pain
  • Neuropathic symptoms such as tingling, numbness or muscle weakness
  • Development of a limp in the lower body 

 

Symptoms such as fever, chills, nausea or severe pain may be signs of an infection or other serious complication that constitutes a medical emergency. Patients should always err on the side of caution and contact their surgical provider or other health professional if something doesn’t feel right. 

 

Treatment Options for Failed Back Surgery Syndrome

 

As with symptoms, treatment can depend on the individual patient and diagnosis. In some cases, an immediate revision surgery may be required if there is a serious or life-threatening complication. In other situations, the best course of action will be to recommit to conservative treatment options including:

 

 

Followup surgery for FBSS is seen as a last resort treatment option. Especially because revision procedures for the same condition can have a decreased likelihood of success. But in some situations, minimally invasive surgery from a surgeon specializing in addressing FBSS may be the recommended course of action. 

 

Contact PPOA for Failed Back Surgery Syndrome Relief

 

If you’re living with FBSS or think you may have undergone an unsuccessful procedure, there is hope. The caring and dedicated team at Physician Partners of America (PPOA) specializes in helping people dealing with chronic FBSS pain find the treatment and relief they deserve. From nonsurgical pain management to FBSS surgery, we have the expertise to help you build an individualized treatment plan that is right for you. 

 

Contact us today to make an appointment and start your pain relief journey.  

Although tremendous strides have been made in the effort to reduce opioid misuse, dependance on prescription opioid pain medication remains a prominent challenge in the United States. Since 1999, overdose deaths related to opioids have quintupled according to the CDC, impacting millions of lives. Although a large number of these deaths are related to illicit and synthetic opioids such as fentanyl, traditional prescription opioids still represent a risk to many people. 

When used appropriately, opioids can be an essential part of the treatment and recovery process for chronic pain. But in the vast majority of situations, opioids are intended for temporary use. To ensure a successful transition to non-pharmaceutical pain management, doctors and patients can often benefit from working together to develop an opioid tapering plan

By learning more about this process, and how to find effective interventional pain management, anyone can safely stay on the path of effectively managing their pain. 

 

Understanding opioid tapering

 

Opioid tapering is the practice of gradually reducing dosage of prescription opioid medications so patients can begin to wean off of the drug and find alternatives for pain management. Opioids can be so dangerous because the body builds up a tolerance, meaning that higher and higher dosages are required to be effective. Eventually, doses can become so high that the risk of an overdose increases substantially. 

However, stopping opioids instantly can lead to severe withdrawal symptoms and an elevated risk of relapsing. This is why the most effective approach is for doctors to help patients gradually decrease their dosage and/or frequency of taking opioids, making it safer and easier to eventually stop altogether. 

According to the CDC, effective guidelines for opioid tapering include:

  • Personalizing tapering plans based on individual pain levels and length of prescription
  • Going slow and decreasing dosage by no more than 10% a week
  • Ensuring patients get additional psychological and behavioral support to deal with dependency
  • Collaborating with patients and other providers to get buy in and provide effective pain management alternatives

Patients who are taking prescription opioid medications and are interested in beginning an opioid tapering program should speak with their primary care doctor or pain management specialist.  With a positive attitude and support from providers and family members, it is possible to successfully taper and transition from prescription opioids to other forms of pain management. 

 

Transitioning to an effective pain management program

 

Depending on the source of symptoms and underlying condition, there are a wide range of opioid alternatives to help manage pain. The goal should be to address the root causes as much as possible while improving overall health. By combining a tapering program with comprehensive interventional pain management, many patients are able to find long-term relief while discontinuing prescription opioids. 

Effective pain management options that can coexist with opioid tapering include:

  • Over-the-counter medications — Pain relievers such as acetaminophen and nonsteroidal anti-inflammatories such as naproxen can have a reduced risk of being habit forming and while helping to relieve pain after opioid tapering. 
  • Physical therapy — Working with a physical therapist can help patients build a stronger and more flexible body. This can help with pain relief both directly and indirectly by reducing pressure on nerves and breaking up painful bundles of tissue. 
  • Lifestyle changes — Staying active and eating a diet rich in nutrients and anti-inflammatory foods can help increase overall health and reduce the body perceives and processes pain signals. 
  • Pain management injections — Injections ranging from nerve blocks to epidural steroid injections can reduce pain and inflammation in a targeted area for weeks at a time or longer. This can help many patients dealing with chronic pain complete steps such as physical therapy or lifestyle changes they may not be possible otherwise. 
  • Alternative therapies — Techniques ranging from acupuncture to massage therapy help a large number of patients find relief, especially when combined with other conservative pain management approaches. 

There is no one-size-fits-all approach to pain management, and it’s essential to find a pain management specialist who understands your unique needs and treatment goals. 

 

Continue your pain relief journey with PPOA

 

Physician Partners of America (PPOA) believes in individualized, expert-supported  compassionate care to help anyone overcome the pain treadmill. By working closely with everyone who comes to us, we help achieve meaningful relief through evidence-based therapies. If you are dealing with serious pain and do know where to turn next, PPOA can help. 

Reach out today to find a pain management specialist who can help you take the next step and get your life back.

Many terms related to the spine and back pain can sound scary — and facet disease is a great example. Going to the doctor and finding out that the source of your pain and other symptoms is a type of disease can bring a range of questions and concerns. How did it develop? Will it get worse? Is there a cure? 

While facet disease is a serious diagnosis, it is also a relatively common, usually age-related condition that affects the joints in the spine. And because it is a joint disease, another common question is whether facet disease is a type of arthritis. 

The short answer is that in most cases, facet disease is a type of arthritis that affects the joints in the spine. By learning more about this condition and how it relates to arthritis, you can make informed treatment decisions that are right for your needs and lifestyle. We hope the following guide can help. 

 

What Is Facet Disease?

 

Facet disease is a general term describing a condition when the joints in the spine become a source of chronic pain and mobility problems. The vertebrae that make up the spinal column are linked together by sets of joints, called facet joints, that enable the spine to bend, twist, and flex. Like other joints, the facet joints are covered in cartilage and lubricated by joint fluid. 

There are a wide range of causes that can cause these joints to become painful and inflamed, including natural degeneration of joint tissue that leads to bone-on-bone friction, post-traumatic stress related to injury, and other conditions such as ankylosing spondylitis. Symptoms of facet disease can include: 

 

  • Localized joint pain
  • Stiffness and reduced mobility
  • A grinding and popping sensation in the joints, called crepitus
  • The development of bone spurs 
  • Radiating pain due to nerve compression

 

Facet disease is not a reversible condition, with treatment usually focusing on managing symptoms and improving overall health. 

 

What Is Arthritis? 

 

As a whole, arthritis refers to persistent swelling and inflammation of one or more joints in the body that causes symptoms like pain and reduced range of motion. According to the Arthritis Foundation, arthritis actually encompasses more than 100 unique conditions that can impact joint health and cause health problems. 

By far the most common form of arthritis is osteoarthritis (OA,) which is inflammation in the joints caused by age-related breakdown of cartilage and the drying out of synovial joint fluid. Other types of arthritis include rheumatoid arthritis, psoriatic arthritis, and forms of metabolic arthritis such as gout. Symptoms and treatment can vary depending on the type of arthritis and the location, but the goal of any therapy is generally to reduce joint pain and stiffness related to inflammation. 

 

Is Facet Disease a Type of Arthritis? 

 

In nearly any case, facet disease refers to facet joint pain caused by or closely related to some form of arthritis. For many people, facet disease will specifically be caused by facet osteoarthritis, which is inflammation of the facet joints caused by breakdown of the protective cartilage surrounding the edge of each facet joint. 

Everyone is different, and the causes of neck and back pain can be very unique to each person. If you have facet disease and have questions about the exact cause of your condition, speak to your doctor or pain management specialist for more information or clarification. 

 

Treatment Options for Facet Disease

 

Although facet disease is not curable, there are many effective treatments for managing pain and improving joint function. A holistic care plan for facet disease can include:

 

  • Getting plenty of rest and limiting stress on the spine
  • Using hot and cold therapy, such as alternating a heating pad with an ice pack, to reduce inflammation and improve circulation
  • Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
  • Performing gentle stretches to help loosen stiff joints
  • Undergoing physical therapy to strengthen supporting muscles, improve posture, and increase range of motion
  • Receiving interventional pain management, such as facet joint injections 
  • Undergoing radiofrequency ablation, which can reduce nerve pain in an inflamed facet joint

 

Spine surgery is generally a last resort treatment for facet disease, and recommended in cases where there is narrowing and nerve compression related to bone spurs or seriously inflamed joints. 

If facet disease pain is seriously affecting your quality of life and ability to spend time with loved ones, it is possible to find relief. At Physician Partners of America (PPOA,) we are committed to helping people living with debilitating pain create personalized, compassionate treatment plans that deliver meaningful relief. 

Take your life back from pain. Contact the dedicated team at PPOA to start your treatment journey today. 

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. 

 

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. 

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.

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.