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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Migraine vs Headache | Migraine Specialists in Dallas

Migraine vs. Headache: What’s Causing Your Pain?

From pounding forehead pain and sinus inflammation to light sensitivity and nausea, a headache can put a halt to any day. Or…is it a migraine? Sometimes it’s not so easy to distinguish exactly what type of chronic headaches you are suffering from. Being able to identify a migraine headache from one of the other various types of headaches that exist can help you find the chronic pain relief that you need.

A Closer Look at the Different Types of Headaches

Painful Pressure of the Head: The Tension Headache

Causes: Stress, squinting, poor posture, clenching or grinding of the teeth, dehydration, and starvation

Symptoms: Forehead and upper neck pressure, feeling similar to having a band wrapped tightly around the head

Timeframe: Pain typically lasts anywhere from a few hours to a few days, with its severity ranging throughout that span of time

Cyclical Pain in One Area: The Cluster Headache

Causes: The causes of cluster headaches are unknown, but medication may trigger attacks

Symptoms: Severe pain behind one eye or on one side of the head, occurring at specific times of the day or of the year

Timeframe: Pain is often experienced in “clusters,” felt in and out throughout the span of a few days

Stuffiness, Runny Nose, and Pounding Pain: Sinus Headaches

Causes: Sinus headaches are caused by inflammation or infection of the sinuses, often a result of a cold or virus

Symptoms: Pain in the cheekbones, forehead, or nose, usually accompanied by a runny nose, congestion, or fever

Timeframe: A sinus headache generally lasts for as long as the sinuses are inflamed

Pain After Medication: The Rebound Headaches

Causes: Sensitivity to or overdose of a medication or painkiller

Symptoms: Pain typically feels similar to a tension headache, occurring a few hours after taking medication

Timeframe: Generally, pain is felt for as long as you take the medication that is causing them, and may continue for a few days after the medication is stopped

Reoccurring Throbbing, Sensitivity, and Nausea: Migraine

Causes: What causes migraine headaches remains unknown, although they are often associated with heredity or a sensitivity to light or smell

Symptoms: Throbbing pain in the head, sensitivity to light, nausea, blurred vision, and light-headedness

Timeframe: Migraine headaches can last anywhere from a few hours to a few days, many experiencing them at very specific times of day

There is no denying that any one of the above headaches can be undeniably painful, destroying your ability to enjoy any day. Fortunately, there are pain treatments available for each! Our skilled headache and migraine specialists in Dallas can help you identify what is causing your pain and offer alternative pain management solutions that will offer relief.

Discover what kind of a headache you may be suffering from and successfully manage its associated pain by scheduling an appointment with our headache and migraine specialists throughout the Dallas-Fort Worth area! You may also contact us online or call us to find the pain management clinic nearest you.

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Dallas Pain Doctors

We’ve Got the Dallas Pain Experts for You.

Migraines. Neck pain. Shoulder pain. Elbow pain. Carpal tunnel. Low back pain. Knee pain. Have we listed your pain yet? If not, that’s just a small sample of the chronic pains people deal with all the time and what our Dallas pain doctors at Texas Pain Relief Group treat on a daily basis.

Causes of Chronic Pain

Ever wonder why your pain just won’t go away? Below is a list of chronic pain causes that may help explain why what you are dealing with isn’t ordinary, everyday pain. It’s something else entirely.

  • Age. Over time, the body ages and parts begin to wear down. Degenerative diseases, like degenerative disc disease, can develop and cause serious pain and lead to further medical concerns.
  • Poor posture. Over the years, slouching, stooping, slumping and hunching overtake a toll on your spine, weakening it and causing potentially permanent damage to the vertebrae. Additionally, the muscles, ligaments, and nerves up and down your spine are affected and can be strained and compressed causing damage and pain.
  • Improper lifting. Picking up heavy objects without bending your knees can injure your back. You’ve been told for years to “lift with your knees” and if you didn’t listen, you may have to pay the price.
  • Obesity. Extra, unhealthy weight puts undue strain on the spine, spinal muscles and on your knees. It also merits mentioning that obesity and being overweight is a trigger for many health concerns and diseases. A proper calorie-focused diet and regular exercise go a long way to keep your weight down and your body healthy.
  • Genetics. Inherited abnormalities like the curvature of the spine, in addition to predispositions to illness and disease, can lead to any number of medical conditions.
  • Injury. A traumatic event such as a car wreck or sports accident can produce lasting pain.
  • Fashion. Wearing clothes that are far more fashion than function, and that provide little support and even less comfort like high heels can be causes of chronic foot and ankle pain.

Contact the Premier Pain Doctors in Dallas

The items listed above are all possible triggers for your chronic pain, and depending upon where the pain is, perhaps we’ve answered a question or two for you. To have all your pain relief questions and concerns addressed, don’t hesitate to contact the pain relief doctors in Dallas at Texas Pain Relief Group today. We’re unparalleled in pain management and have the treatment and care you need.

Don’t live in pain if you don’t have to.

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R.I.C.E. For Pain Relief

Treating Your Injury with RICE

So you’ve just sprained your ankle, twisted your knee or slammed your elbow. You’re in pain and need immediate relief. We want you to always remember one thing above all else in situations like these: RICE. No, not the little white or brown grains you eat with grilled salmon, but the mnemonic device known as RICE. (R)est. (I)ce. (C)ompression. (E)levation.

We’re not taking away from the healing power of rice though. Heated up in a sock in the microwave, rice can be a great muscle relaxer and create some serious bloodflow. However, when injured you need to follow this simple technique to make sure your minor injury doesn’t turn into something major.

There’s no need to call the doctor and order advanced treatment just yet, especially if you can quickly get RICE going. So you know, here’s the rundown:

  • Rest. Stop what you’re doing and rest. Stop moving the injured area and keep it still. Slowing it all down to relax the injured area a bit is very important. Also, take deep breaths to calm yourself down if need be.
  • Ice. A cold rag or ice wrapped in a paper towel will help to reduce any pain and swelling. Keep the area cold for at least 20-30 minutes before moving forward. The next day you can switch it up and use a heating pad – or that rice sock – to loosen the muscles if the pain persists.
  • Compression. Keep pressure on the injury (compression) using some sort of bandage wrap to help reduce swelling and apply some stability to the area.
  • Elevation. Keep the injured appendage raised up to, or above, the level of your heart to help further reduce swelling. Stacking pillows usually works the best to help elevate arms and legs.

That’s pretty much the crash course of RICE. It’s not difficult to remember, and it’s certainly not that difficult to perform. We definitely recommend that you follow this procedure for any minor muscle or joint injury you get. That said, if the injury is serious you need to get to the ER as soon as possible. If the pain persists and lingers, then you need to come see us.

At Physician Partners of America, we know a thing or two about pain relief. It’s quite literally our middle name. Contact us today for more information.

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Non-Surgical Pain Relief in Tampa

https://www.physicianpartnersofamerica.com/health-news/pain-management/rice-for-pain-relief/Tampa pain specialist Dr. Rudy Gari recently appeared on WFLA New Channel 8’s program “DayTime” to discuss non-surgical and non-invasive options available to patients with chronic pain.

Dr. Gari is the Medical Director of Florida Pain Relief Group. With three Tampa locations on Habana Ave., Fletcher Ave., and in Carrollwood, Dr. Gari has the latest in non-invasive and non-surgical pain relief techniques available to him in Tampa.

Dr. Rodolfo Gari has practiced interventional pain management in Tampa for more than 20 years and has experience successfully treating any kind of chronic pain.

Watch the video here:

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Chronic Pain Treatment in Tampa

Recently Dr. Rodolfo Gari, a pain specialist in Tampa, FL, appeared on Studio 10 Live! in Tampa to discuss treatment options available to patients in chronic pain.

Dr. Gari has more than 20 years of experience treating chronic pain patients in Tampa.

At Florida Pain Relief Group he has the latest treatments and procedures available to him to treat any kind of chronic pain.

Watch the video here:

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Treatment for Arthritis

Millions of people across the country experience pain from arthritis every day. The pain can range from mild discomfort to debilitating.

Effectively treating arthritis depends in large part on the severity of the condition and any related conditions.

Pain specialist Dr. Alik Saidov of Physician Partners of America in Arlington, TX, treats patients with varied arthritis-related conditions on a regular basis.

Below he provides some insight into treatment options and how best to prevent becoming arthritic.

 

Question: I take over the counter medication for my arthritis, but it’s not effective. What are other treatment options are there?

Dr. Saidov: “First, the pain should be evaluated by a specialist to determine the cause of arthritis. It could be from most common type “wear-and-tear” osteoarthrosis or a part of underlying pathology (e.g. rheumatoid arthritis, psoriasis, etc). The treatment options may vary from simple OTC medications to very strong pain and anti-inflammatory medications and injections into joints.”

Q: Are there specific things I can do in my daily life to reduce arthritis pain?

Dr. Saidov: “This depends on the type of arthritis. Recommendations could range from physical therapy to increase range of motion, to cold/warm applications, braces and more.”

Q: Since I know I have arthritis, are there any other conditions I should keep an eye out for?

Dr. Saidov:  “It could be from most common type “wear-and-tear” osteoarthritis or a part of underlying pathology (e.g. rheumatoid arthritis, psoriasis, Lupus, avascular necrosis, etc). It is important to be evaluated by a specialist first.”

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Stop Suffering From Neck Pain

Millions of people suffer from mild, moderate or severe neck pain every year. Many of them are enduring chronic, lasting pain and try in vain to combat it with run-of-the-mill OTC medicine like aspirin or ibuprofen. Needless to say, the relief is fleeting, if anything at all. That’s not how to treat neck pain.

Let’s back up and talk about what neck pain is. When the neck muscles are strained from poor posture from leaning over your computer, hunching over your desk at work, sleeping in awkward positions, a car accident, a sports injury or anything that caused stiffness and discomfort – that’s neck pain. Next, let’s take a look at some symptoms up close.

Neck Pain Symptoms

You know you have neck pain when you experience any of the following symptoms:

  • Muscle tightness and spasms in your neck
  • Decreased head range of motion
  • A headache that extends into the neck

Now, these symptoms may be a one-time thing and perhaps an ice pack or heating pad will take care of it. However, if you’re finding that this pain keeps coming back it may be chronic, and in that case, you need to move on to more advanced medical treatments.

Neck Pain Treatment

  • Physical therapy. Posture correction, neck-strengthening exercises, and alignment techniques can help ease your discomfort and potentially stop future pain.
  • Transcutaneous electrical nerve stimulation (TENS). This technique employs the use of electric currents produced by a device to stimulate the nerves for therapeutic purposes.
  • Steroid injections. A procedure where steroids are injected into the nerves of the neck to stop their ability to send pain signals to the brain. This is an effective way to gain immediate pain relief through minimally invasive means.

Get Neck Pain Relief Today

Don’t wait another painful day. Contact Physician Partners of America now or schedule an appointment to be connected with a pain expert who can help manage your condition and get you back to living a full, active life.

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How Health and Fitness can Prevent Chronic Pain

For many adults who experience chronic pain on a daily basis, their symptoms are exacerbated by a poor diet and little or no daily exercise.

Being proactive in maintaining a health and wellness routine can pay off

down the road when you are older.

Pain management specialist with Physician Partners of America offers a few tips for getting on the right track to living a healthy life and minimize the risk of pain from poor health.

 

Question: What kind of exercises should I be doing on a regular basis?

Dr. Michels: “It’s important to find fun exercises that get you moving every day. Things like walking a dog, riding a bike or going for a swim. The goal is to progress to strength training two or three times per week. Some great strength training exercises are push-ups, pull-ups, bodyweight squats and planks.”

Question: Eating well is hard to do. What kind of advice can you give me?

Dr. Michels: “Have three moderate-sized meals per day with healthy snacks in between, The goal is to never actually be hungry. Don’t overindulge. Some healthy snacks are raw almonds; vegetables such as carrot sticks, broccoli and celery; and whey protein shakes with almond milk, fresh spinach, and dark berries. When at the grocery store, shop the perimeter of the store. That’s where you will find fresh fruits, vegetables, and meats. Don’t forget about whole grains, too.”

Q: What kinds of foods should I avoid?

Dr. Michels: “Steer clear of processed foods, sugary drinks such as soda, candy, and food containing high fructose corn syrup. Also stay way away from flours and processed grains.”

Q: How much water should I drink every day?

Dr. Michels: “Start every day with an 8-ounce glass of water to re-hydrate. You should drink half your body weight in ounces per day. We often confuse thirst for hunger. Before running to food, drink an 8-ounce glass of water and see how you feel.”

Q: What kinds of goals should I set for myself?

Dr. Michels: “Start small and set easily attainable goals. Build off of the momentum of success. Write your goals down and put them somewhere you can see them daily. Once you have accomplished a goal, set a new one. Remember, show yourself grace. If you fail, pick yourself up and start again.”

Q: I hear people talk about “cheat days” – what are those? Are they OK?

Dr. Michels: “Allow yourself to experience the joy of accomplishing a goal. All yourself to have “cheat days” where you can enjoy something that may not be the best for you (i.e. birthday cake at a party, pumpkin pie at Thanksgiving.) Live by the 80-20 principal – 80% of the time eat healthy, 20% of the time eat what you want.”

Q: How can I stay focused on healthy living?

Dr. Michels: “Create a vision board: if you can see it, you can be it. A picture is worth a thousand words. Change the ‘way’ of thinking about diet and exercise – it’s not punishment, it’s reward. Think of how much better you are going to feel, look and be. By committing to a healthy lifestyle, it will enable you to finally start living. Have a “can-do” attitude. Consider healthspan vs. lifespan. It’s not the length of your life, but the quality of your life that matter.”

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Whiplash Treatment in Tampa

Suffering From Whiplash?

You’re headed home in typical Tampa rush hour traffic. People are getting out of work and piling into their cars to get home like everyone else. The light turns red and you stop. Suddenly… another car rear-ends you while sitting at the light. Of course you weren’t expecting this, so your head violently jerks forward and back as your car is pushed several feet into the middle of the intersection.

Dazed. Confused. You slowly get out of your vehicle and look back at the other driver who’s already panicking. Surprisingly, you’re not in any pain right now, but once the shock and adrenaline wear off, you may begin to feel severe neck pain, stiffness, and headaches. That’s called whiplash and it’s serious.

How to Tell If You Have Whiplash

As we said, the warning signs for whiplash probably won’t show themselves right away. The adrenaline rush and shock must first subside before the pain of the injury can show itself. Some of this warning signs – or symptoms – can be:

  • Neck pain and stiffness
  • Painful neck movement
  • Range of motion decreases in the neck
  • Headaches
  • Shoulder pain and/or tenderness
  • Tingling down the arms

Our Pain Experts in Tampa Can Treat Whiplash

Of course our example was a car wreck, but a person can get whiplash from a variety of events such as a sports injury or traumatic accident. You should contact the pain experts at Physician Partners of America if you begin to experience any of the listed symptoms above in addition to any other neck pain after any injury you may have received. Getting a prompt diagnosis – and treatment if whiplash is the case – is vitally important to restoring full mobility of your neck and to eliminate the pain.

Remember, you may not feel the pain right away. Don’t dismiss the fact that the injury occurred and the effects are on the horizon. Better safe than sorry, right? With that in mind, even if you’ve been injured, but don’t think it’s whiplash, let our pain management team here at Physician Partners of America take a look.

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