Dr. Rodolfo Gari Talks Pain Relief Myths: Pills, Patches & What Works

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Interviewer: We see ads all the time for magic creams and patches for pain relief. There are so many ways that claim to treat pain, between pills, patches, injections, lotions. So how do we know what actually works? Dr. Rudy Gary from Florida Pain Relief Group joins us now to help us figure it all out. Dr. Gary, welcome back.

Dr. Gary: Thank you.

Interviewer: Now, how do we know if these things really work?

Dr. Gary: Well, the best answer to that is to find out exactly what that is. You know, you hear it on the radio, you know, these cure-alls.

Interviewer: Yeah, call now.

Dr. Gary: Yeah, unfortunately, sometimes some of those are just kind of like a placebo effect. You know, it may be just aspirin could be in there. Is it gonna help? Yeah, it’s going to help you. We can probably just give you just about any patch, and one-third of the patients are going to react positively. The problem is it doesn’t last long.

Interviewer: Right.

Dr. Gary: What we have to do is you have to go see a real physician, somebody what went to medical school, studied anatomy and physiology, pharmacology, and is going to establish a diagnosis on you, is going to treat you as a patient, is going to listen to what is wrong with you, actually perform a physical examination, laboratory examinations, radiology, find out what the problem is, make a determination of how that affects you, and then get a plan in place, whether it’s a pill, a patch, an injection, whatever it may be, and target that area.

Interviewer: Well, let’s talk about some of those options out there, because what would be the best way to alleviate pain? Would it be a pill, would it be a patch, an injection, a cream? I mean, there are so many choices?

Dr. Gary: So the answer is it depends.

Interviewer: Yeah.

Dr. Gary: Right? So it depends on number one, who the patient is. It depends on what the problem is. Sometimes, we can eliminate the pain with a simple injection, that’s what we take and your pain is gone. Other times, that’s not the best way and we’re going to try out some very low-level analgesics. Maybe like a muscle-relaxant, you know you might be having spasms. We’re going to determine the type of pain. So there are actually different types of pain. There is what’s called neuropathic pain which is a nerve pain, and there is something else that’s called nociceptive pain, which is more like a dull achy pain. And the medication and the treatment depends on the type of pain that it is. It’s coming from your nerves, your joints, some of the organs, and we have to target, and the physician that’s very keen to that type is going to give you much better results.

Interviewer: We’ve heard of those icy patches that you can buy at the pharmacy, and I’m wondering, do they work? There’s hot patches, cold patches.

Dr. Gary: Well, they work to the extent that… There was actually someone that won the Nobel prize for that, it’s called the gate theory. And what that does is that works about as good as… So if you’re…you may recall when you were little and you put your finger on the stove and boy that really hurts. So what does mom do? Mom comes by and she rubs your finger, and the pain is better. Well, the reason why the pain is better is because what you feel is the rubbing sensation and that blocks the pain sensation. So whether the ice packs, heat packs, you’re going to feel the heat or the cold instead of the pain.

Interviewer: Right.

Dr. Gary: It does work, so does massage and a lot of different things.

Interviewer: It’s a distraction more than anything.

Dr. Gary: Yeah, because again, it’s called the gate theory of pain.

Interviewer: Right.

Dr. Gary: So only a certain type of fiber can go to your brain for you to understand that, and then it will block the other sensation.

Interviewer: Okay.

Dr. Gary: We actually have a procedure called [inaudible 00:03:26] stimulation. And what that does is that people that are having severe low back pain, pain shooting down the legs, have had three or four back operations, we can put these tiny little electrodes so you feel a tingling sensation instead of this pain that you have. And you can control that in programming.

Interviewer: Oh, I’m sure a lot of people are happy to hear about that. Dr. Gary, thank you very much. Florida Pain Relief Group even schedules same day appointments. We’ll be back with more daytime, so don’t go away.

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Dr. Rodolfo Gari Talks Work Injuries And Ways To Avoid Them

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Cyndi: The daily grind of working in an office can cause pain that people often try to ignore, but sometimes that pain can affect your whole life and it should not be ignored. Dr. Gari from Florida Pain Relief Group joins us now with more. Dr. Gari, good to have you back.

Dr. Gari: A pleasure

Cyndi: A lot of people try to just ignore the pain, but if it’s really starting to bother them, and it’s affecting their whole life, why should they go see somebody like you?

Dr. Gari: Well because one of the things, for example, the reason why we as human beings have something called pain is because it’s a warning signal. Think of it like you’re driving your car and it starts to flash saying that the engine oil is low. You’re about to get into something really bad. So if you have pain, from whatever that may be, that’s your body telling you, “Hey you gotta go and get this checked out.” Because it can and normally does get worse if it’s not treated.

Cyndi: When you see people that work in an office environment, what kind of pain are they usually coming to you with?

Dr. Gari: Usually some sort of work-related injuries. Sometimes it’s a fall, you know. I get a lot of patients of mine that are workman’s compensation. For example that they get sent over because they are lifting boxes, they hurt their back. Sometimes they’re typing, they’re using a lot of computers, they get repetitive stress injuries like carpal tunnel. They get neck injuries, you know, from maybe reading, from having the head too low. Just about any type of activity can happen…if you sit for long periods of time, that can affect your lower back. In fact, one of the biggest pressures on your lower back is when you’re sitting down.

Cyndi: Really?

Dr. Gari: What I tell some of the patients…

Cyndi: I’ve got that. I’ve got it here, I’ve got it here. So and I tend to just think, you know, that’s just the cost of doing business. But I don’t have to live with this pain.

Dr. Gari: Well, you know, in a way it’s some of the things that we do, but there’s things that can be done. For example, if you sit a lot, you can sit on one of those medicine balls. That helps with your core muscles. Also, if you can stand, there’s a lot of these desks that you can actually raise up. And standing actually reduces the pressure on your lower back, and that helps quite a bit.

Cyndi: I’m looking into that. Back to the worker’s comp situation. How does that all work when somebody comes to you with that?

Dr. Gari: Well, the worker’s compensation was meant to help the injured worker. It’s a great program because people need help. What they’ll do is when someone gets injured, they’ll work with the worker’s compensation, they’ll get an adjuster. That adjuster can send the patient to someone like us to evaluate what’s going on. We can make a diagnosis on what’s happening, what’s causing the injury, and what we want to do is help them out and, you know, try to get them back to work.

Cyndi: Definitely. That’s the goal, right? You don’t want to have more time than you need. What about repetitive stuff like typing? I’m just thinking of everyone around me on our computers, just that alone. Do you see a lot of people coming in just with carpal tunnel?

Dr. Gari: We see a lot of that. We see a lot of people with pain. And our hands weren’t made to be typing all the time. It was meant to grab and doing things with it. So things that are not natural, they can cause a lot of injuries. And one of the things about the worker’s comp that you mentioned earlier is that if we can see that patient earlier…the studies have shown very significantly that the earlier that you treat that injured worker, the more likely that he is or she is to get back to work.

Cyndi: All right. Well Dr. Gari, thank you very much. You can contact Florida Pain Relief Group to schedule your same-day appointment. Visit their website or you can give them a call: 844-Kick-Pain. Dr. Gari, thank you again.

Dr. Gari: My pleasure.

Cyndi: We’ll be right back.

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Dr. Rodolfo Gari Talks Sciatica and Best Ways To Treat It

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Jerry: How familiar is this to you? Lower back pain that reaches down your legs. Well it’s something a lot of you could be experiencing right now. And a common cause of this, by the way, is something called sciatica. You’ve probably heard of that. Dr. Rudy Gari from Florida Pain Relief Group joins us now to explain what it is exactly. Welcome back to you, Dr. Gari.

Dr. Gari: Thanks, Jerry.

Jerry: So we hear a lot about sciatica. What is it? What causes it?

Dr. Gari: Sciatica basically is a shooting pain, shooting sensation that goes from your lower back and shoots often all the way down to your foot. The reason it’s called sciatica is because it often involves what’s called the sciatic nerve. A sciatic nerve is a large nerve. It’s your main nerve that goes through your leg and often is caused by some sort of an inflammatory process. A lot of times it’s a bulging disc. It’s a herniated disc. You twisted the wrong way. Something is pinching causing inflammation. And you get a very severe shooting sensation that can be very, very debilitating.

Jerry: So a lot of things can cause it but it’s generally related to some sort of a nerve issue?

Dr. Gari: What I tell people is, if you’ve hit what they call your funny bone.

Jerry: Yes.

Dr. Gari: When you push here it shoots down to your fingers, right? Well it’s the same thing that happens with sciatica.

Jerry: Oh got it.

Dr. Gari: Instead of pushing your elbow something’s pushing your lower back and shooting down to your foot.

Jerry: So how does this change people’s daily life?

Dr. Gari: Just last week I had a patient that came in with a severe sciatica. She came in in tears. She was hurting so bad she could not even sit. She basically had to lay down on the bed. She was just crying with so much pain that she had.

Jerry: That’s debilitating.

Dr. Gari: Yes.

Jerry: That says it all right there. All right. Let’s talk about treatment options then. How did you help this woman?

Dr. Gari: Well the first thing that I did, of course, was to make a diagnosis. After the history and physical examination I found that she had the classic symptoms. She had the shooting pain. The exam showed that she had decreased sensation, so forth. That’s indicative of some sort of a disc herniation pushing on that sciatic nerve. The definitive diagnosis I sent her for MRI. And sure enough it came back that she had a herniated disc between the fifth vertebrae and the first sacral vertebrae pinching on that nerve. We brought her in two days later. She was very heavily medicated because of the pain.

Jerry: Sure.

Dr. Gari: What we did for her, we gave her these injections that went close to that nerve root. Reduced the inflammation. The inflammation pretty much went away. She had two treatments, two injections, a week apart. This person was a marketing representative and she traveled a lot. She could not even go anywhere and she’s back at work.

Jerry: Isn’t that great?

Dr. Gari: I sent her to physical therapy to make sure she strengthens her core muscles. If she can take great care of herself, which I’m sure that she will, she can get back to a normal life.

Jerry: Which is fantastic. Is a treatment like that is it permanent or do you have to keep coming back for these injections?

Dr. Gari: This can be permanent if, and it’s a big if. For example, what caused that disc herniation to herniate in the first place: Normally it’s weak core muscles. We sit a lot. We do a lot of things. So it herniates. We get the inflammation. The inflammation ends up going away. Physical therapy, and that disc can actually shrink back. So it can be permanent.

Jerry: So you have to take care of yourself after you get the injections.

Dr. Gari: Yes you do.

Jerry: All right. Dr. Gari, thanks so much. You can contact Florida Pain Relief Group to schedule your same day appointment right now. We’ll be right back with more after this.

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Dr. Rodolfo Gari Talks Kyphoplasty: Pain Management Without Surgery

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Interviewer: Our next guest has been here before, of course, talking about the innovative ways that he treats pain without surgery. We love the sound of that. We welcome back Dr. Rudy Gari from Florida Pain Relief Group who is here with another method and that is called – it’s got a funny name but I’ll try it right here – kyphoplasty.

Dr. Gari: Yes, yes.

Interviewer: Okay, so what is a kyphoplasty?

Dr. Gari: So, a kyphoplasty, basically, it is a way…we’re actually putting like a cement into your vertebral bodies. So, your spinal column consists of 31 different bones called vertebral bodies. Sometimes, usually as we get older or we fall and so-forth, that body can become fractured. It can have what’s called a compression fracture where the body actually shrinks. And we didn’t have a whole lot of methods before except to go on and put all kinds of fuses and rods in there to straighten it up. Now, what we can do, we can actually put medication, like a cement, into that vertebral body to make it stronger to try to really strengthen that bone, and the relief can be sometimes instantly.

Interviewer: That’s fantastic. Now, we’re talking about…you’re mentioning these vertebral bodies, it’s basically the vertebrae, right?

Dr. Gari: It’s the vertebrae, correct.

Interviewer: Okay, and so we’re talking about back and any part of the back that this kyphoplasty helps?

Dr. Gari: Well, this help patients that have had a fracture.

Interviewer: Okay. Specifically?

Dr. Gari: Specifically.

Interviewer: Okay.

Dr. Gari: They’ve broken their backbone, if you will, somehow and it’s a way to be able to give them strength of that vertebrae again, so that they can get back on their feet and be able to get things done.

Interviewer: And a lot of times people who have had these fractures, they start to shrink, don’t they? So does this prevent that from happening?

Dr. Gari: Well, what actually happens when we shrink it…well, first of all, it does align you a little bit more, but the reason why we shrink when we get older is not so much the bone, but there is actually this gelatinous tissue in between the bones…

Interviewer: That disappears.

Dr. Gari: …and that tends to get lower and lower. So, we can lose 1, 2, or 3 inches as we get older because it tends to dry out.

Interviewer: Yeah, I’ve lost an inch already. I used to be 6’3″, I’m 6’2″ now and I hate that. All right, so are we talking about permanent or temporary relief with this kyphoplasty?

Dr. Gari: Well, the kyphoplasty, you know, it’s a permanent thing. I mean, we put that in there and that vertebra is a lot stronger that what it’s been before.

Interviewer: That’s great.

Gari: And that stays in there.

Interviewer: Sure. Now, how does one know if they’re a candidate for this type of treatment?

Dr. Gari: Well, usually your…you know, most physicians know about this procedure. So, if you go to your primary care doctor or your orthopedic or whoever it may be, you know, they’ll diagnose that fracture and find a physician that is competent and skilled at performing these procedures.

Interviewer: Yeah. And you know, Doctor, a lot of people out there who are in pain, no matter what kind of pain it is, the first thing they reach for in the medicine cabinet is an anti-inflammatory or, worse yet, even an opiate. Why is that not a good idea?

Dr. Gari: They have side effects. Those anti-inflammatories…I’ve actually done a year of internal medicine and I’ve seen patients, actually, beat up and die from anti-inflammatories. You cannot be taking this and you should not be taking these on a daily basis. There’s a lot a lot of, I mean, a more mild and gentle anti-inflammatory drugs, but even they have side effects as well. They can affect your kidneys. There’s all kinds of different side effects from long-term medications and, of course, the opioid. We all know about the opioid addiction, the epidemic that goes on. They’re not meant to be taken in the long term. Some patients need long-term opioids. However, there’s a lot of things that can be done so that you don’t have to take all these medications with significant side effects.

Interviewer: Okay, and this being one of them and you have so many other treatments available.

Dr. Gari: Yes we do.

Interviewer: Dr. Gari, thank you so much. Now, Florida Pain Relief Group even schedules same-day appointments for you.

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Dr. Rodolfo Gari Talks Spinal Cord Stimulation and Its Benefits

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Interviewer: Surgery, it’s a word that patients hate hearing and one that keeps many away from the doctors’ offices. But there are ways to treat back pain without going under the knife. Dr. Rudy Gari from Florida Pain Relief Group is back to talk about one of those ways today, spinal cord stimulation. Okay, Dr. Gari, great to have you back.

Dr. Gari: Pleasure.

Interviewer: What is spinal cord stimulation?

Dr. Gari: So actually spinal cord stimulation is a technique where we place these tiny little electrodes into the back of your spine that helps…it blocks the pain levels. It’s actually based on a Noble Prize winning technique. If you think about it, when you were a little kid and you place your finger on the stove and it hurt, and mom came and rubbed it and it felt better. Well, the reason why it felt better is because the touch sensation actually went up your brain and blocked the pain going to your brain.

Interviewer: Interesting.

Dr. Gari: What spinal cord stimulation does, is these tiny little electrodes, they’re no more than epidurals when the ladies have the little epidural catheters for labor, it’s the same thing, but we place these little electrodes there and what it does is it replaces the back pain and the pain going down to the legs with a very gentle tingling sensation. So you feel a tingling sensation as opposed to having this constant back pain.

Interviewer: That sounds like a great thing for so many people. What kind of pain does it treat?

Dr. Gari: It treats basically back pain, low back pain, it treats any sort of nerve pain, diabetic neuropathy, any sort of nerve entrapment. Patients that have had…we get a lotta patients that have had two or three or four back operations. There’s nothing else that can be done. Those are very good candidates because, you know, they are constantly in pain, we can place that in there and get them some really significant relief, allow them to cut down on all these massive medications that they have to take just to live their everyday life.

Interviewer: Is this done through an outpatient kind of facilitation?

Dr. Gari: Outpatient procedure. You come in, we give you some sedatives to relax you, a little local anesthesia, it’s done [SP] through a needle. We place this electrodes through a needle and you go home the same day. Usually we do what’s called a trial period, where we have you go home with it for about a week, make sure that it’s gonna work for you. If it works for you, we can get it implanted. It’s a….very…it’s a tiny little incision that just goes right on the skin. It has a little thing called a generator which is the size of a half dollar, and the batteries’ rechargeable, so it last years.

Interviewer: Oh, so you don’t have to keep going into the office to get this put in, you can…

Dr. Gari: No, no.

Interviewer: …have put in and then you’re… Do you control it yourself, or?

Dr. Gari: Yes, there’s a lotta programs. So for example, you say, “Well, sometimes I get back pain, sometimes have pain down a leg, sometimes a combination.” We can program this to have different types of variances. So, if you have back pain, you hit number one, if you got leg pain number two, and so forth.

Interviewer: Why is this preferable to more traditional back treatments, like surgery?

Dr. Gari: Because a lotta times there are no other options. You have, for example, these chance of success after the first back operation is fairly high. The second one is not so high and the third one, you’re only talking maybe 15%. So after that, you’re almost…you’re pretty much out of options when it comes to surgery, but you’re not out of options when it comes to seeing us because we have a lotta different treatments.

Interviewer: Well this is a great alternative to surgery in the first place, right?

Dr. Gari: Absolutely.

Interviewer: All right. Dr. Gari, thank you very much. Florida Pain Relief Group even schedules same-day appointments. Be sure to visit their website right now, floridapainreliefgroup.com, or give them a call, 844-KICK-PAIN. Dr. Rudy Gari, thank you again very much.

Dr. Gari: My pleasure.

Interviewer: We’ll be right back.

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Dr. Rodolfo Gari Talks Pain From Sports Injuries And Best Treatment Therapies

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Cyndi: When you’re active and involved in sports, injuries can happen at any time. But that doesn’t mean you have to live with pain. Dr. Rudy Gari from Florida Pain Relief Group is back to tell us what they can do to help. Welcome back, Dr. Gari.

Dr. Rudy: Thank you very much.

Cyndi: Let’s talk about some of the common sports injuries that you see at the office.

Dr. Rudy: Sure. Common sports injuries are usually former athletes. We’ve had a lot of professional athletes as well.

Cyndi: We know they get injured a lot.

Dr. Rudy: A lot.

Cyndi: And they wanna get better fast. They don’t wanna be out for a long time.

Dr. Rudy: Yes, yes. You know, your body wasn’t meant to be taking that kind of abuse and punishment on a regular basis, and that tends to affect the joints, your muscles, some of the nerves. So it’s just a lot of chronic pain that can be endured from that.

Cyndi: Sure. Well, let’s just say I’m out there and I get injured. At what point do I have to stop icing it at home and come see you?

Dr. Rudy: Sure. So, you know, any time that your pain lasts longer than what it should…if it’s, you know, more than a typical bruise and that sort of stuff, like, you know how long it should last. If it lasts longer, you should come in and see someone like myself so that we can make sure that nothing more than a typical bruise has occurred.

Cyndi: Well, I’m a golfer and I know that I’ve had my share of aches and pains. What are some of the types of pain that you see in golfers that come see you.

Dr. Rudy: We see a lot of repetitive motion in golfers. So if you think about the action of the golfer, there’s a lot of lower back. So your lower back wasn’t meant to twist so much, so we see a lot of low back problems, joint problems and lots of low backache.

Cyndi: And how can you help somebody with that?

Dr. Rudy: Well, you know, we’ve talked before about inflammation, and it’s the same thing. So that constant abuse and that twisting causes inflammation of your joints, your spine and so forth. We can go in with techniques that do not involve surgery to reduce the inflammation of your lower back, which will help significantly and help you get your life back.

Cyndi: Is there anything we can do at home ourselves to prevent the pain?

Dr. Rudy: Sure. One thing you can do is, number one, make sure that you always use proper technique whenever you do any sort of exercise.

Cyndi: Easy for you to say.

Dr. Rudy: That’s true. And just take care of yourself, you know, regular exercises, core exercises.

Cyndi: Core. That’s so important. We you have to think about…

Dr. Rudy: Core is very important.

Cyndi: And when you say core exercises, it’s more than just getting on the ground and doing sit-ups, right?

Dr. Rudy: That’s correct.

Cyndi: What should we be doing to strengthen our core?

Dr. Rudy: Well, anything, like, for example, one of the things you can do is you can get on the horse. And that’s one of the most effective way to strengthen your core, is when you’re almost, like, very flat, that causes your entire core muscles to contract. Try doing that for 20, 30 seconds and then try to go up to about one, two minutes if you can.

Cyndi: So let’s say this method is not working, we’re still in a lot of pain. What’s the next step? What’s the consultation like when we come and see you?

Dr. Rudy: The next step is you wanna come in and see a physician like myself, because we’re gonna take a very thorough history and physical examination. And depending on what that shows, do some imaging studies, maybe an MRI, an X-ray, find out what’s going on. You might have something that’s a lot more that’s going on there that is gonna need some intervention.

Cyndi: Right. And it might not mean a whole lot of physical therapy. It might be a quick fix but it might be something that you have to do.

Dr. Rudy: That’s right. That’s correct.

Cyndi: Okay. Good stuff, Dr. Gari. If you want relief from back pain or any kind of pain, or you’ve had that tweak and you just can’t get rid of it, you can make same-day appointments at Florida Pain Relief Group. Be sure to visit their website. It is floridapainreliefgroup.com, or give them a call today at 844-KICK-PAIN. “Daytime” will be right back.

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Dr. Rodolfo Gari Talks Why Arthritis Doesn’t Have To Rule Your Life and Treatment Therapies For It

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Cyndi: Everyone’s familiar with arthritis, but do you know that it does not have to be a life sentence? Arthritis is a life-altering form of pain for so many people, but Dr. Rudy Gari from Florida Pain Relief Group is here to help. Welcome back, Dr. Gari.

Dr. Gari: Thank you.

Cyndi: So we all hear about arthritis, we talk about arthritis, but really what is arthritis?

Dr. Gari: So arthritis, if you break down the word, so itis means inflammation, and arthro means joints. So arthritis is basically an inflammation of your joints. And of course, your joints are what keeps the bones together. So you have joints throughout the entire body. That’s what allows us to bend and do things. So that can cause a lot of wear and tear. That wear and tear leads to inflammation. There are nerve endings in those joints, and it can get pretty painful.

Cyndi: We’ve heard of different types of arthritis. What’s the most common?

Dr. Gari: The most common type of arthritis is osteoarthritis.

Cyndi: Osteo?

Dr. Gari: Yes. In fact, most of us get some sort of arthritis. Even our late 20s it begins, 30s and 40s.

Cyndi: Is it pretty much inevitable that we’re all going to get some form of arthritis?

Dr. Gari: Unfortunately, most of us as we get older, we are gonna get arthritis. It doesn’t mean that you have to know that you have it. You kinda get these aches and so forth throughout the day. But most of us go about our daily lives just, you know, living as if nothing’s going on.

Cyndi: But there are some people their arthritis affects their everyday life and it can really be hard for them to function. So what can you do for people who have arthritis, either in the early stage or quite gradual?

Dr. Gari: The first thing that we do is to determine the type of arthritis, and that helps us to determine what the outcome might be. So let’s just say osteoarthritis, for example, because that’s really common. A lot of times, osteoarthritis causes joint pain everywhere. Most of the pain tends to be low back, cervical region. Our necks hold the head up. Our lower backs help us bend back-and-forth. Those are the daily activities. So we tend to focus on those joints because that’s what’s gonna improve your daily living as much as possible. Things that we can do, we mentioned that’s inflammation of the joints, so what we do is go in there to reduce the inflammation. Some sort of injections goes into those joints, there’s no surgery that’s involved. Two or three of these, if it relieves inflammation, there’s even other things such as radiofrequency, rhizotomies that I’ve mentioned before, that can help burn the little nerve endings that only cause pain.

Cyndi: Wow. We’ve heard about taking turmeric and things like that, and adding more things to our diet to help with inflammation, but that’s not necessarily going to be enough, is it?

Dr. Gari: What happens when you eat something, whether it’s a pill or whatever, it goes in your mouth and through your stomach, and then from there it gets absorbed, goes through your liver, and 95% gets broken down. So a very tiny, tiny fraction of what you’re taking is actually going to those joints. By us delivering the medication straight to those joints, we bypass all that.

Cyndi: Is it always a type of medication that you recommend, or do you have different therapies for arthritis?

Dr. Gari: Different therapies. Sometimes, actually, just moving around. Physical therapy, moving. I ask them to go in the pool, just move your joints more. Sleep. If you can get better sleep, your joints are gonna absorb some more fluid. That’s going to help out as well.

Cyndi: Right, but if you’re finding that it’s really hard to function, you can help.

Dr. Gari: Yes, we can.

Cyndi: You can get right in there and take care of it.

Dr. Gari: Absolutely.

Cyndi: Good stuff. Dr. Gari, thank you very much. Contact Florida Pain Relief Group to schedule your same-day appointment. You can visit their website, it is floridapainreliefgroup.com. Or you can give them a call right now, 844-KICK-PAIN, and you too can be pain-free. Thank you, again.

Dr. Gari: My pleasure.

Cyndi: We’ll be right back.

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Dr. Rodolfo Gari Discusses The Effects of Car Accident Injuries

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Interviewer: You don’t need me to tell you, car accidents can be a pain, literally, it can be a traumatic experience, of course, but that pain doesn’t have to become permanent. Dr. Rudy Gari, from Florida Pain Relief Group, joins us now once again to tell us how we need to make sure these injuries don’t go untreated. It seems like a simple thing, right? But most people are rushed right to the ER after an accident, aren’t they, Dr. Gari? Why is it important for them to see a pain relief doctor as well?

Dr. Gari: Well, what happens a lot in a car accident is you get what’s called a deceleration type of injury. Basically, you’re traveling 30 miles an hour and you come to a screeching halt very quickly. So that deceleration type of injury can cause injuries in and of itself. And normally it involves, it can be the joints, it could be your back, it could be your neck. And so that injury, again, a lotta what causes the pain is some sort of inflammation that is a direct result of that injury. So we take care of patients that have been involved in motor vehicle accidents. And whether it’s a disc herniation in the lower back, the neck, joint, wherever that might be. We even have some patients that, you know, they come and see us. And some of those patients, you know, because of a lot of patients that have been involved in a car accident, may have some sort of legal representation. They may not even have insurance. We will even take care of ’em because of that and we can work with their law firm if that’s what it takes. We just wanna make sure that this patient gets better.

Interviewer: Gets better. Now a lotta times you have a car accident and you might feel something, you’re not really sure if you feel something. How do you know when you should see someone when the pain might just be like a minor, temporary pain?

Dr. Gari: Well, what I tell my patients is if something is not normal, you know it Go see a doctor. Because it may be something a little mild…

Interviewer: Right now.

Dr. Gari: …right now, but it might be something a little, you know, deeper that’s going on. And we have to at least make a diagnosis, maybe physical therapy of something to make sure that you can get better, get back on your feet.

Interviewer: Is it typically…when people come and see after a car accident, is it a neck injury? I know you mentioned back, but neck is even more prevalent more than likely, right?

Dr. Gari: Well, one of the things that we see in car accidents a lot is what’s called a whiplash. So whiplash is when the back of your neck hits backwards and there are these nerves in the back of your neck that can cause a lotta inflammation there and you get what’s called an [inaudible 00:02:37], a really bad headache behind your head. We can help that quite a bit because, again, we just go in there, get that inflammation to go away. There’s different types of procedures we can do for that. So the neck injury is common because the head goes back and forth during that car accident.

Interviewer: Sure, yeah, it makes sense. And let’s talk about prevention because, you know, most people hopefully are wearing their seat belts. What other kinds of things can they do in their car because you never know when you’re gonna be hit from behind?

Dr. Gari: Well, some of the things that they need to be mindful of course is in this…you know, I’m not a driving instructor, but of course, you know, be defensive. If you anticipate something…in fact, there’s some car, I was driving my son’s car the other day and the car started slowing down. So these sensors are actually very helpful right now to try to prevent these injuries. Wear your seatbelt, make sure that your air bag is working, and brace yourself if you’re about to hit.

Interviewer: Okay, all right. Good advice. Thank you so much, Dr. Gari. Now you can contact Florida Pain Relief Group to schedule your same day appointment. You can visit their website, floridapainreliefgroup.com, or give them a call 844-KICK-PAIN, simple as that. Thanks again doctor, appreciate it. We’ll be right back with more “Daytime” right after this.

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Dr. Rodolfo Gari Discusses About Diabetic Neuropathy and Ways to Treat It

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Cyndi: Over 29 million people in the United States have diabetes, a disease that can lead to a variety of other problems, a common one being diabetic neuropathy. It can show itself in many different ways, which means it’s also hard to diagnose. Dr. Rudy Gari from Florida Pain Relief Group is back with more. Dr. Gari, good to have you here.

Dr. Gari: My pleasure.

Cyndi: Let’s talk about diabetic neuropathy, and why is this the most common form of neuropathy?

Dr. Gari: Certainly. Well, unfortunately, it’s the most common because there’s a lot of patients, a lot of people with diabetes. And what happens with diabetes is, your sugar goes up and down quite a bit. Well, that sugar is spread throughout the whole body, especially, it can affect the nerves. And over constant and constant misalignment of your glucose levels, your nerves get damaged, especially the very small nerves, and that can cause significant pain in patients that have diabetes. Their pain is usually manifested as a burning sensation, a sharp, stabbing constant, and it can be very debilitating to a lot of patients.

Cyndi: So it’s not just a pain that comes and goes, it can be there constantly?

Dr. Gari: It can be there constantly, to the point where it’s hard for you to function with your everyday life activities.

Cyndi: I’m thinking for somebody who has neuropathy from diabetes in their feet, that can be difficult for just getting around, right? It’s not only annoying but could it affect your walking ability?

Dr. Gari: Well, the unfortunate part is that it can cause both numbness and pain at the same time, if you can think about that, because of the different fibers that are affected. So, sometimes, we have diabetic neuropathy in people that, they don’t feel as much. They can get hurt more often, but then they always have a constant, stabbing, burning sensation that can be very debilitating.

Cyndi: Sounds like an awful, awful way to live. So how can you help people who are dealing with that kind of pain?

Dr. Gari: Sure. So for the first thing, it’s the obvious. We wanna make sure that your diabetes is well-controlled. So make sure you’re seeing your internist, your family practice doctor, making sure that your blood glucose is very stable, as much as it can be. Other things that we can do is medications. There’s different ointments or different creams. And if those don’t work, there are even more interventional techniques. We’ve spoken before about something called spinal-cord stimulation. And spinal-cord stimulation is one of those things that can actually replace that burning sensation of your diabetic neuropathy with a more mild, tingling sensation.

Cyndi: So even though you’re dealing with the spinal cord, it can affect all your extremities? Is that where it all comes from?

Dr. Gari: Well, diabetes tends to affect, normally, your extremities. Usually, your arms, your hands, your legs, your feet. And the extremities, the nerves that go to extremities originate in your spinal cord.

Cyndi: Right. So that’s why you can go in there and take care of that.

Dr. Gari: Correct.

Cyndi: I know there are a lot of people watching right now who are probably thinking, “This is me.” So what kind of message do you have for them right now? Because they’ve been living with this for a long time.

Dr. Gari: Well, the message that we have is that we have a lot of options for you. Besides medication, there are ointments, there are creams, making sure that your glucose is well-controlled. There is even different types of nerve blocks that we can do that can alleviate their pain. And if we have to, we can do a trial of a spinal-cord stimulator.

Cyndi: And just having somebody say, “Your pain is real,” I’m sure is music to so many people’s ears, because they’ve dealing with it for a long time and not getting anywhere.

Dr. Gari: Unfortunately, there’s a lot of illnesses that many doctors have. Pain is one of them. All that we do is take care of people in pain, so you’re the only thing that’s important to us, and your pain.

Cyndi: That’s great news. Dr. Gari, thank you very much. Florida Pain Relief Group even schedule same-day appointments, so be sure to visit their website, floridapainreliefgroup.com, or give them a call, 844-KICK-PAIN. Dr. Gari, thank you again.

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Dr. Rodolfo Gari Talks What CRPS Is, Where It Occurs and Treatment

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Cindy: Complex regional pain syndrome, it doesn’t that like something that anyone would want to deal with. It is also called CRPS.This chronic pain condition can wreak havoc on your body. Doctor Rudy Gari from Florida Pain Relief Group joins us now to fill us in on what this is. Great to have you back.

Dr. Gari: Thank you.

Cindy: Complex regional pain syndrome sounds awful. What is it?

Dr. Gari: Yes, it does. And the reason why it is called complex regional pain syndrome is because it’s just that, it’s complex. This is something that has been going on Cindy, for a very long time. In fact, this goes all the way back in the Civil War. We have documented case studies of soldiers who actually had so much pain in their arm that they wanted to cut their arms off.

Cindy: Oh, okay.

Dr. Gari: It used to be called something called causalgia, it was called the reflex sympathetic dystrophy. The term that is used right now is called complex regional pain syndrome and what that really is, if you think about it, think about if you get pain in your hand or your arms, anywhere. Normally, that pain shoots up your brain and it stops. What happens with complex regional pain syndrome is that it becomes a vicious cycle. So the pain keeps going in circles, keeps going in circles and it never stops.

Cindy: Any particular area of the body that you see it most often?

Dr. Gari: It usually affects the extremities. It affects the arms, it affects the legs, it can actually spread, but the good thing Cindy is there’s a lot of things that we can do to help complex regional pain syndrome. One of the first things is that the earlier that we see it the better. And so it often travels through these nerves called sympathetic nerves. So what we do is what we call sympathetic blockade. We want to stop that seizure and that pain constantly going in circles but it’s a certain specialized field in medicine they use, physicians like myself, I’m an anesthesiologist, I’ve been treating this for many, many years and I’ve actually had great success. So there’s blocks, there’s something called sponcra [SP] stimulators and the earlier that we treat this the better it is for our patients.

Cindy: How often do you see somebody coming in with complex regional pain syndrome?

Dr. Gari: I just saw a patient this morning.

Cindy: Really?

Dr. Gari: This patient has horrendous, horrendous leg pain and has all kinds of issues going on. Not just nerve pain it affects his vascular system and the pain is never ending. She’s has unfortunately, has this for many, many years.

Cindy: Oh gosh. Well, she doesn’t have to live with it for any more years, right?

Dr. Gari: No, no. We have her on a plan.

Cindy: What are you able to do for her? What are you going to do?

Dr. Gari: So what we do is we can give her some medications probably to help with that pain. We’re gonna go after and try to stop that seizure if you will of the pain syndrome, blocks and we’re considering a sponcro stimulator as well.

Cindy: So get to the source, right?

Dr. Gari: Absolutely, absolutely.

Cindy: Instead of just you know, treating the…

Dr. Gari: It can be cured.

Cindy: It can?

Dr. Gari: It can be cured, yes.

Cindy: Okay. So when is it time to come see you? When they feel like this is something that has been going on with them?

Dr. Gari: The sooner the better, the sooner the better. Have seen someone like myself because we can treat you in those things that we can do.

Cindy: So, usually fingers, legs, any…

Dr. Gari: Fingers, arms. It’s usually the arms or hands or legs. It usually begins as something as mild as just bumping into the wall somewhere that can cause, like, a seizure which will just continue, where we have to stop that vicious cycle.

Cindy: It goes on and on and on. Okay, good stuff Dr. Gari, that’s really good news for so many people. Florida Pain Relief Group has scheduled same day appointments so be sure to visit their website. It is floridapainreliefgroup.com or you can give them a call at 844-KICK-PAIN. Doctor, always good to see you. Thank you very much.

Dr. Gari: My pleasure.

Cindy: We’ll be right back.

Dr. Gari: Thank you.

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