Pain After Back Surgery

Get Relief from Pain After Back Surgery

When making the decision to go forward with back surgery, the hope is that by having the procedure done it will reduce or eliminate pain.

The reality is that back surgery can be unsuccessful and ultimately leave you with the same level of pain, or even greater pain, than when you first had the procedure.

The issue has become so common that it has a name: Failed Back Syndrome. Tampa pain specialist Dr. Jorge Leal with Physician Partners of America has this first-hand in his patients over the years.

“Sometimes the pain can occur immediately after the surgery.The pain you feel does not get better,” Dr. Leal said. “Sometimes it’s a period of days or weeks after the initial surgery.  The pain goes away but then it comes back.”

Symptoms of Failed Back Syndrome are varied. However, typically a patient will feel pain in their back and usually down one or both of the lower extremities.

“A patient could feel numbness in their legs, tingling sensations and also muscle atrophy,” Dr. Leal said. “If the nerves have been damaged, there could be a loss of reflexes, depending on the degree of residual damage.”

Physician Partners of America offers patients pain relief without surgery.

Treating failed back syndrome can be done using conventional measures such as physical therapy and anti-inflammatory medication. Another option is nerve blocks if they have not been tried in the past.

“If no further surgical treatment is required or desirable, then we look at implantable devices like spinal cord stimulation or a morphine pump,” Dr. Leal said.

The prognosis for someone with Failed Back Syndrome varies widely based on the kind of surgery that was performed and where the pain is coming from. Sometimes the pain will subside with treatment, but it is not a guarantee.

“What we can do is, through various diagnostic nerve blocks, we can identify the pain generator,” said Dr. Leal.  “From there we can concentrate on it and determine the best course of treatment for such a pain generator.”

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Pain from a car accident

Get relief from pain caused by a car accident

Tampa pain specialist Dr. Rodolfo Gari with Florida Pain Relief Group recently appeared on News Channel 8’s program “DayTime” to talk about pain from a car accident.

In the event of a car accident a person can experience a number of different injuries, from whiplash to broken bones and more.

At Florida Pain Relief Group our physicians have years of experience treating several types of pain that are the result of a car accident.

Our pain specialists can successfully diagnose, treat and relieve your pain at any of our Tampa pain relief center locations.

Watch the video to learn more.

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Pain Free Minute: Regenerative Medicine

In this week’s edition of the Pain Free Minute, Tampa pain specialist Dr. Rodolfo Gari talks about the benefits of regenerative medicine for treating chronic pain in Tampa.

In the video, Dr. Gari talks about regenerative medicine treatment in Tampa. It is one of the most exciting new ways that doctors can treat chronic pain.

At Florida Pain Relief Group our goal is to treat people using the most minimally invasive procedures available. These procedures include injection of your own body’s stem cells to regenerate tissue.

Watch the Pain-Free Minute to learn more about regenerative medicine treatments available at our Tampa pain relief centers.

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Spinal Cord Stimulation Treatment in Tampa

Get treatment for back pain in Tampa

Tampa pain specialist Dr. Rodolfo Gari of Florida Pain Relief Group recently appeared on WFLA’s mid-day program to discuss the benefits of spinal cord stimulation.

Spinal cord simulation is a procedure that treats patients with chronic back pain in Tampa. For patients whose chronic pain is not controlled through medication or other techniques, spinal cord stimulation can offer real pain relief.

In the video below, Dr. Gari, medical director of the Tampa pain relief center locations in East Tampa, North Tampa and Carrollwood discusses the benefits of spinal cord stimulation and the types of conditions that can be treated with it.

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Tampa Sciatica Pain Clinic

Got sciatica pain and nowhere to go?

Well, now you do. Physician Partners of America has pain clinics in Tampa to make sure sciatica pain relief is always just moments away.

Let’s talk a little bit about sciatica real quick.

The sciatic nerve runs from your lower back (lumbar region), down through your hips and buttocks and down each leg branching out into the feet. Half of your body can feel pain when this nerve suffers compression at any point.

This compression, or pressure on the nerves, is usually due to either: bone spurs, abnormal growths (cysts or tumors), herniated/slipped discs, or a disorder called spinal stenosis where the spinal canal is narrowed.

Symptoms of sciatica may be shooting pains down one leg, tingling sensations or numbness.

Tampa Sciatica Pain Relief Treatments

Treating your sciatica pain at our Tampa clinics can be done through minimally invasive surgeries or procedures using medication, or through non-pharmacological therapies where a more natural approach is taken. Our clinics offer a well-rounded, complete pain management environment where a variety of pain relief treatments can be utilized to get you better faster.

Depending upon the underlying cause for your sciatica pain, our doctors will discuss the best treatment options for you.

Selection of Sciatica Treatments

Lumbar Epidural Steroid Injection – Epidural steroid injections deliver medication directly (or as close as possible to) the source of pain generation.

Lumbar Sympathetic Block – A lumbar sympathetic block is an injection in the lower back that targets the lumbar sympathetic nerves, a series of nerves that carry pain signals from the lower extremities.

Nerve Block – A nerve block is an anesthetic or anti-inflammatory injection into a particular nerve or group of nerves for pain relief. The aim is to block pain signal(s) coming from a specific location in the body and/or decrease inflammation in that area.

Non-Pharmacological – A more organic and natural approach to healing with non-drug treatments, we offer such therapies as acupuncture, acupressure, aromatherapy, physical therapy, massage, guided symbolism, pet therapy and more. Used in conjunction with our other methods, these procedures do very well to keep pain managed over time.

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Get Pain Management in Tampa

Self-medicating isn’t always the answer.

In fact, popping Advil and Tylenol every couple of hours to numb the pain is potentially really bad for you. Sure, once and a while a headache or sore shoulder can be helped by OTC meds, but for the chronic, lasting, recurring pain it’s much better to seek professional pain management from the specialists like ours right here in Tampa.

We offer minimally invasive procedures specifically designed to manage your pain that allow you to live a normal life instead of living in pain. We’ll list some below with links so you can explore several pain treatments that can make your life much more enjoyable.

Tampa Pain Management Treatments

Celiac Plexus Block – Celiac plexus blocks are injections of pain relief solution that soothes stomach pain caused by disease or incessant pancreatitis.

Facet Joint Injections – A facet joint injection is a fairly straightforward procedure performed by using an x-ray (fluoroscopy) to guide and place the needle while avoiding potential nearby nerve harm or injury.

Nerve Blocks – A nerve block is an anesthetic or anti-inflammatory injection into a particular nerve or group of nerves for pain relief. The aim is to block pain signal(s) coming from a specific location in the body and/or decrease inflammation in that area.

Lumbar Epidural Steroid Injection – Epidural steroid injection (ESIs) are a typical treatment alternative for some types of low back pain and leg pain. The injections deliver medication directly (or as close as possible to) the source of pain generation.

Morphine Pump Implants – A spinal infusion pump implant, commonly known as a morphine pump, is a specialized device that delivers concentrated amounts of medication into the spinal fluid space through a small catheter.

Regenerative Medicine – A true advanced medicine of tomorrow available today, regenerative medicine promotes self-healing through using your body’s own stem cells which can be altered into healthy cells for any organ in the body, thus replacing the damaged ones. Additionally, the platelet-rich plasma in the blood can be used for inflammation and pain relief.

Pain Relief Through Proper Management

Our Tampa pain doctors at Florida Pain Relief Group are the among the best pain management doctors in Tampa area for good reason: Unmatched expertise and experience. Trust your pain relief to the team that specializes in it every day.

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Regenerative Medicine for Sports Injuries

With rising temperatures and more hours of sunlight, it is no wonder why we see a big increase in injuries every spring. Whether you’re a star athlete on a college baseball team, a freshman trying out for high school track and field, or simply enjoy the daily round of golf at your local course, sports injuries can result in serious damage if left untreated. That’s where regenerative medicine comes in, offering an alternative form of pain relief from some of the most common sports injuries.

Game Changing Pain Management for Sports Injuries

Common sports injuries, such as a torn ligament or joint pain, can leave the body unable to repair itself adequately, which can lead to ongoing pain and disability. Regenerative techniques involve boosting the body’s natural ability to heal itself or to deliver targeted cells and cell products to support tissue and organ function. Three forms of treatment for runner’s knee, tennis elbow, and other sports injuries that we offer at Physician Partners of America are:

  • Stem Cell Therapy – Stem Cell Therapy involved the harvesting, concentration, and purification of Stem Cells for injection into areas where you suffer chronic pain. They tend to have a powerful healing and rejuvenating effect!
  • Platelet Rich Plasma Therapy – Platelets are a natural reserve of growth factors that facilitate blood flow and strengthen cartilage. In this therapy, platelets are separated from a sample of the patient’s blood using a centrifuge and then injected into the site of injury, often yielding excellent results.
  • Allograft/Adhesive Barrier – We use highly advanced surgical techniques to graft donor tissue and minimize any scarring with the most advanced adhesive barriers.

No matter which treatment we recommend, our pain management physicians will walk you through each step, from the initial stages of consultation right through post-procedure recovery. Although much of our work depends on resolving injuries that are a direct result of playing sports, we never discourage our clients from taking part in healthy physical activity! We work with clients to help them modify their behavior so as to minimize the risk of any injury in the future.

Whether you’ve sustained an ankle sprain or a torn Achilles Heel, our pain management doctors are ready to assist! Give us a call to schedule an appointment at the pain management clinic nearest you.

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Risk Factors for Knee Pain

The knee connects the thigh bone (femur) with the shin bone (tibia) and consists of many parts including the knee joint, knee cap (patella), ligaments, tissues and more. It’s a very complex part of the body and, due to it’s location and job, is prone to injury.

Anything that increases the already-present possibility of injury is considered a risk factor. Some risk factors for knee pain are listed below.

Risk Factors for Knee Injury

 

  • Obesity. If it seems like everywhere you turn you’re told that being overweight increases your chance of injury it must mean something, right? Extra and undue stress on your knee joints adds pressure and causes the knee to work that much harder to do otherwise normal everyday tasks. It also increases the amount of wear and tear the knee undergoes, eliminating the vital cartilage that cushions the bones. This could lead to osteoarthritis.
  • Low muscle strength. If the muscles surrounding the knee are weak and lack flexibility, they aren’t able to support the knee or absorb enough of the stress exerted on the joint throughout the day.
  • Sports & physical activity. Sports and physical activities that call for the repeated twisting and/or pounding of the knees through constant running or jumping causes stress on the joint and can cause pain and injury.
  • Existing injury. A previous knee injury or a current one that is still healing can put you at risk for additional injuries if the knee is made to sustain pressure or stress.

Get knee pain relief in Tampa.

Our pain specialists deal with concerns like knee joint pain and manage it for countless others on a daily basis. Like them, we want you to become pain-free and be able to enjoy life again without the constant discomfort.

Contact us today to talk about your knee pain and discuss the treatment options available.

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Treating Chronic Back Pain in Tampa

Finding relief from chronic back pain in Tampa can be a long journey of trial and error. Some doctors who are not specialists may simply recommend an over-the-counter (OTC) treatment plan.

Others will take a dramatically different approach and suggest an invasive surgical procedure to determine the cause of the chronic back pain condition.

For many people, however, neither solution is the right one to help achieve lasting relief from chronic back pain.

In a recent appearance at the WFLA “DayTime” program, Dr. Rodolo Gari, medical director of Florida Pain Relief group in Tampa, FL, explained how a procedure called a Kyphoplasty is a viable non-surgical option for achieve lower back pain relief in Tampa.

Watch the video below to learn more:

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Neuropathic Pain Relief in Dallas

People suffering from neuropathic pain know that their options for immediate and long-term relief are not many.

However, Dr. Robert Nocerini with Physician Partners of America in Dallas has experience treating patients suffering from neuropathic pain.

Among the more popular treatments is a procedure known as spinal cord stimulation.

In this article, Dr. Nocerini goes into detail about what spinal cord stimulation is, who would be a good candidate, what patients should expect and more.

What is Spinal Cord Stimulation?

Spinal Cord Stimulation (SCS) devices are used to treat several different kinds of chronic pain. Spinal Cord Stimulation is FDA approved and has been in use for over 40 years. A spinal cord stimulator consists of one or more thin wire leads and a small battery generator that looks similar to a pacemaker. The leads are placed in the spinal epidural space and deliver a low-level electrical current to interfere with the sensation of pain. SCS is used to treat pain in the arms, legs or trunk. It is mainly used to treat neuropathic type pain, meaning pain that is generated and maintained by a problem with the nerves themselves, as opposed to pain from joints or muscles.

Who is a Candidate for Spinal Cord Stimulation?

Candidates have had chronic neuropathic pain for greater than 6 months, and they have been treated unsuccessfully with physical therapy, medications (over the counter and prescription, such as non-steroidal anti-inflammatory medications, neuropathic medications, opioids), steroid injections, and sometimes surgery.

What are the Conditions Treated by Spinal Cord Stimulation?

Radiculopathy

SCS is indicated for the treatment of intractable pain in the back and legs that is caused by nerve impingement or irritation, known as “radiculopathy.” This may result from arthritis or a herniated disc that affects the spinal nerve roots.

Post-laminectomy or Failed Back Surgery Syndrome

Some people continue to have pain after spine surgery. The terms “Post-laminectomy Pain Syndrome” or “Failed Back Surgery Syndrome” are names that have been used to describe this type of chronic pain condition. Better outcomes are more likely if SCS is initiated less than three years after surgery.

Painful Peripheral Neuropathy

There are many different causes of Painful Peripheral Neuropathy (PPN), but commonly this condition is due to diabetes. SCS may be indicated if standard pain medications for PPN are ineffective or have intolerable side effects.

Complex Regional Pain Syndrome (CRPS)

Complex Regional Pain Syndrome, formerly known as Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition that sometimes develops in the arms or legs after trauma. SCS is indicated if pain is refractory to physical therapy, medications, or injections. Like Failed Back Surgery Syndrome, better outcomes are associated with a shorter time period between diagnosis of CRPS and initiation of Spinal Cord Stimulation.

Post Surgical Scarring

Scarring that occurs after spine surgery may sometimes lead to Arachnoiditis or Epidural Fibrosis, two conditions that may lead to chronic pain. The scarring occurs around the spinal nerves causing irritation and pain.

Multiple Sclerosis

Studies are limited, but patients with pain due to multiple sclerosis may benefit from spinal cord stimulation.

Does spinal cord stimulation cure chronic pain?

Spinal Cord Stimulation interferes with the ability to perceive pain. It does not heal or cure the underlying cause of the pain.

What are the Benefits of Spinal Cord Stimulation?

Successful outcomes are associated with:

  • Reduction in pain, generally greater than 50%
  • Reduced use of opioid pain medications
  • Increased function and quality of life

What are the Limitations of Spinal Cord Stimulation?

Spinal Cord Stimulation cannot treat all types of pain. It is less successful at treating pain due to spinal cord injuries, phantom limb pain, intercostal neuralgia, and post herpetic neuralgia. In some patients, pain relief may diminish over time, possibly due to movement of the leads, new tissue growth around the leads, changes in the nature or location of the pain, or they may develop uncomfortable stimulation. Also, there are mechanical limitations of the equipment, which may need to be replaced over time. Newer technology can mitigate some of these limitations.

What are the Risks of Spinal Cord Stimulation?

Spinal cord stimulation is generally a safe procedure, but there is the possibility of complications. Like any injection, procedure, or surgery involving the spine, risks include bleeding, infection, nerve injury, or a spinal headache.

What is the evaluation process for spinal cord stimulation?

Patients should have had chronic pain for more than 6 months, have an objectively identifiable source of pain, conservative measures have failed, and surgery is not indicated. Patients should have an education period, have their questions and concerns addressed, and they should also be able to discuss their expectations. All patients should go through a psychological evaluation to determine if depression or other psychiatric illness is present, which may decrease the likelihood of a successful outcome.

Contraindications are pregnancy, severe spinal stenosis, presence of a pacemaker, or active substance abuse. Each patient is unique, and the decision whether to proceed with a stimulator trial ultimately is based on the specific medical history of each patient.

How is the procedure performed?

An advantage of spinal cord stimulation over other surgeries is that patients may go through a reversible trial period of stimulation to see if it works for them. The trial procedure is performed much like an epidural steroid injection, using fluoroscopy to visualize and guide one or more stimulator leads through a hollow needle and into the epidural space. Test stimulation is performed to find the location that best reduces pain. The leads are secured and then attached to an external generator that the patient wears on a belt. The trial period then takes place at home, and lasts from 3-5 days. If pain reduction or functional improvement is adequate during this period, the patient and physician can discuss implanting a permanent system.

The permanent procedure is similar to the trial, except a small battery generator is implanted under the skin after attaching it to the leads.

What does Spinal Cord Stimulation Feel Like?

Spinal Cord Stimulation typically creates what is called a paresthesia. Patients may describe a tingling or massaging sensation, or they may feel nothing at all. A newer type of SCS, called High-Frequency SCS, has no paresthesia associated with it.

Is Spinal Cord Stimulation Permanent?

The stimulator leads placed in the initial trial period can be easily removed in the doctor’s office without the need for sedation or anesthesia. Even though implantation of a spinal cord stimulator is referred to as “permanent,” the system is reversible, and in most cases it can be removed. This requires a short minor surgery.

What are New Advances in Spinal Cord Stimulation?

Advances in hardware and software programming are improving the effectiveness of spinal cord stimulation. Another significant recent advance is the development of High-frequency Spinal Cord Stimulation, which works without the paresthesias of traditional systems.

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