Picking a Pain Specialist

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Chronic pain can be an all-encompassing experience. Once you’ve determined that you have a problem with chronic pain, the next step is to determine what to do about it.

Even a cursory search online reveals numerous pain physicians who seemingly offer the same services. How can you tell who is trustworthy and experienced, and who is not?

This is something that Dr. Nocerini, pain specialist with Physician Partners of America in Dallas, TX, has had experience answering patient questions about.

Below he offers some insight into what to consider when choosing a pain doctor.

 

Question:  I’m in pain, but I’m not sure if I need to see a specialist. How will I know?

Dr. Nocerini: “A pain specialist can evaluate your pain and tell you what types of treatments may be the most effective. Most pain is temporary and self-limiting. It will improve in a short amount of time with basic measures, such as over the counter medications and rest. Other treatments may include prescription medications and physical therapy, but sometimes pain is resistant to these basic measures. If you have tried basic treatments without relief, it may be a good idea to see a pain specialist. Pain specialists provide more advanced medication management and interventional procedures, such as nerve blocks, joint injections, epidural injections, and other procedures such as spinal cord stimulation. If you have seen a spine surgeon or orthopedic surgeon and you were told that you were not a surgical candidate, a pain specialist may be able to help. If you’re currently under treatment for any type of pain without improvement, a pain specialist may be able to help.”

Q: What does a pain specialist do?

Dr. Nocerini: “Pain specialists treat pain in multiple ways. Pain can be treated by medications, procedures, such as injections or nerve blocks, physical therapy, and psychological counseling. Pain specialists can assist in localizing the source of pain. Pain specialists treat chronic back pain, neck pain, shoulder, knee and hip pain, headache, chronic pelvic pain, and abdominal pain. Not all pain specialists will treat all types of pain, but they can refer you to a pain specialist who focuses on your specific type of pain.”

Q: What should I look for when researching a pain doctor?

Dr. Nocerini: “When researching a pain specialist, be sure that your doctor has had fellowship training specifically in pain management. A fellowship is extra time spent after residency to obtain additional specialized training. Make sure it is an ACGME accredited fellowship. ACGME stands for the Accreditation Council for Graduate Medical Education, a non-profit organization that reviews and accredits graduate medical education programs in the United States. Also look for board certification in pain management. Board certification is evidence that your pain physician has met an additional level of standards after fellowship training. Look for a pain doctor that treats pain with multiple modalities, not just medications. Pain can be treated most effectively with a combination of therapies, such as injections, physical therapy, counseling, and occasionally referral to other specialists when indicated.”

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Dr. Rodolfo Gari Talks Rheumatoid Arthritis: Who It Affects and Ways To Treat

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Interviewer: Arthritis is something you usually think about only dealing with later in life, but rheumatoid arthritis can affect people of all ages. Your body’s immune system starts attacking its own joints, and that can obviously be incredibly painful. Dr. Rudy Gari from the Florida Pain Relief Group joins us now with more on this. And I got to tell you I know from experience Dr. Gari, I have rheumatoid arthritis in both my right knee and my foot that started developing I’d say about 15 years ago when I was in my 40s, my early 40s. So, what are we talking about here?

Dr. Gari: So, rheumatoid arthritis is one of the subsets of arthritis. So, arthritis, the definition is, itis is inflammation and arthro means joint, so inflammation of joint, and the most common one be osteoarthritis, which we get normally. But rheumatoid arthritis is a condition where your body’s own immune system begins to attack the soft tissues of the joints. There’s something called rheumatoid factor that we can perform on a laboratory exam to determine that. So, the way that that’s treated is twofold. One is the rheumatologist or the doctor that specializes in this can give you medications to actually try to combat that immune system response at your joints.

We get a lot of referrals from rheumatologists because there’s only so much they can do with that, but then you have the pain coming from the inflammation. So, we work in conjunction with rheumatologist so that they can work with the actual underlying rheumatoid factors, and we’re gonna work at the inflammation of those joints that’s an outcome of the rheumatoid arthritis.

Interviewer: Yeah, because for my knee, for instance, and I can relate to this. They’ve given me several cortisone shots, but then they say, “We can’t give you any more.” So what, you know, what do I do now?

Dr. Gari: Well, there’s different things you can do.

Interviewer: And a lot of people probably ask that same question.

Dr. Gari: Yeah. There’s a lot of things can be done. So, the reason why cortisone tends to work because cortisone reduces inflammation, all of this is about inflammation. So, besides cortisone injections, there is also sometimes the lining of your joints, it’s almost what they called bone on bone. So we can actually put in material there that lubricates, like long lasting lubricants, that can lubricate those joints. We can actually even go in and put in some stem cells. We’ve got the medicine right into the joints and try to regenerate some of that tissue that’s been destroyed, whether by normal arthritis or by an attack from your immune system such as rheumatoid arthritis.

Interviewer: Now, let’s talk about some other ways of treating this. A lot of people will take an aspirin. Is that smart? Will that take care of the pain?

Dr. Gari: Aspirin is going to help because aspirin is an anti-inflammatory just like steroids. The problem with aspirin, and like a lot of pills, if you take a pill by mouth, it goes into your stomach, and it goes into bloodstream. It affects your entire body. And only a small portion of that actually gets those joints that are inflamed.

Interviewer: Let’s talk about eliminating medicine altogether and alleviating this pain just through exercises. Is that possible?

Dr. Gari: Exercise is a good thing when you have arthritis, because what exercise does is it actually increases the hydration into the joints. People should try to get a good night’s sleep, because when we go to bed, the fluid tends to rehydrate the joints, and you feel better.

Interviewer: All right. And any preventative measures, fairly quickly here, in order to prevent arthritis from happening?

Dr. Gari: I think eat healthy, try to stay through with normal weight, exercise, good night’s sleep, and, you know, just those conservative measures.

Interviewer: And if those things don’t work, come see you.

Dr. Gari: Come see us, and we’ll help you out.

Interviewer: All right, Dr. Gari, thank you so much. And you can visit his website  to schedule your same day appointment, or give him a call, 844-jKICK-PAIN. Thank you so much, Dr. Gari.

Dr. Gari: Pleasure.

Interviewer: All right. We’ll be right back with more Daytime right after this.

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4 Home Back Pain Remedies

Home Brewed Back Pain Help

If you’re suffering with acute (short-term, minor) back pain, then help is only as far away as the mirror. You’re the best person to consult to get relief from the temporary aches and discomfort of regular, run-of-the-mill, I didn’t lift that box properly back problems.

Before we continue, let us say that for chronic, lasting and debilitating pain, we’re the team for you. Don’t try to self-medicate serious back pain on your own, but instead trust a pain specialist to get it managed and get you back on track. Now, with our disclaimer out of the way, let’s continue.

4 At-Home Back Pain Remedies

  1. Cold & Heat Treatment. Ice blocks pain signals and reduces swelling. Wrap an ice pack in a towel and hold it where it hurts for about 10-30 minutes, depending how much downtime you have. Next, heat it up a bit to stimulate blood flow and reduce potentially painful spasms. Working with ice to initially stem the tide of pain, then working in some heat with a warm rag after a few hours to loosen up the muscles and ligaments can work wonders.
  2. Stand up straight. Lots of people hunch when they walk and stoop when they sit. Standing up straight with your shoulders back is something your mom told you to do all your life growing up. It’s time to listen. Plus, hovering over your keyboard doesn’t do any favors for your neck, spine and back muscles. Sit back, relax and use that chair back to help straighten you up.
  3. Stretch. Maybe this will be a throwback to the old gym class days, but stretching before any physical activities wasn’t just something the coach liked to make you do for fun. Loosening the muscles and ligaments in your back helps them perform better and lessens the chance of them sustaining an injury during kickball or whatever sport you happen to be playing later.
  4. OTC is OK. For common, everyday aches and pains, over the counter medicines and rubs can certainly help reduce pain and discomfort. The only issue is that these can become metaphorical crutches for some and possibly even lead to addiction. If your pain gets to the point that you feel it all the time, it’s probably chronic and needs to be treated by pain doctors, not just pain pills.

This simple collection of 4 back pain remedies is something you can do to relieve current discomfort today and use to prevent further possible pain down the road. Again, this list is intended for normal aches and pains in your back. If you’re in major pain most of the time, contact us to speak with a specialist.

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4 Causes of Low Back Pain

Are you suffering with low back pain?

The back is the workhorse of the human body. The muscles and spine in the back are forced to twist and turn, bend and stretch all sorts of angles throughout the day. Depending on your job, your back may be pulling double-duty at times if constantly lifting heavy objects is involved. Add to this that most people don’t properly lift heavy items correctly, and there’s a recipe for potential future low back pain.

So what is low back pain?

Low back pain is muscle tension and/or stiffness in the area below the costal margin and above the inferior gluteal folds. Put plainly, it is pain experienced anywhere below the ribs and above the legs. One form of low back pain you may be familiar with is sciatica, but this condition can extend further down your leg.

4 Common Causes of Low Back Pain

Pain in the lower back area can be associated with issues of the lumbar spine, vertebral discs, spinal ligaments, or the spinal cord itself. But, it doesn’t stop there. The muscles and nerves of the lower back, as well as the organs located wherein, can also be a contributor, if not the source, of pain.

Considering the several moving parts of the back, there are numerous reasons you could be experiencing low back pain from a sports injury, car accident, fall or an existing medical condition that puts you at further risk of additional disorders.

Four common causes of low back pain are:

  1. Overuse. As the workhorse, the back is constantly put at potential risk for pain with constant, repetitive twisting of the spine and surrounding muscles. It only takes one wrong move to bend or twist too far, or lift a heavy object improperly, for an injury to occur.
  2. Aging. This one is universal. Everyone gets older and their body ages along with them. Through constant overuse as previously mentioned, coupled with the fact that wear-and-tear over the years, cartilage loss, and flexibility loss – to name a few – can severely limit what the body can do. Age takes it’s toll and the back may not be as forgiving as it once was.
  3. Herniated disc. A herniated disk refers to a problem with one of the rubbery discs between the vertebrae that stack up to make your spine. It is often called a “slipped disc.”
  4. Arthritis. If you’re suffering with painful inflammation and stiffness of the joints, this condition can spread into your lower back and cause problems there as well.

Lower Back Pain Relief at Texas Pain Relief Group

If you’re experiencing lower back pain, our advanced pain management treatments can help. Contact us now or schedule an appointment to see our pain specialists at Texas Pain Relief Group today!

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CRPS Symptoms and Treatment

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CRPS: Recently Dr. Rodolfo Gari, Medical Director of Florida Pain Relief Group in Tampa, appeared on WFLA’s mid-day program called “DayTime” to talk about the symptoms and treatments related to CRPS, or Complex Regional Pain Syndrome.

Dr. Gari discusses the history of of the syndrome, going back to documented instances of chronic pain experienced by soldiers during the Civil War.

What makes CRPS unique is that the condition is a vicious cycle of chronic pain never reaches the brain and ends; rather, it goes in circles and never stops.

The pain specialists in Tampa with Florida Pain Relief Group have years of experience successfully treating patients who suffer from Complex Regional Pain Syndrome. You can schedule an appointment at our Tampa pain relief center locations in Tampa today.

Watch the video here:

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About Spinal Cord Stimulation

Spinal Cord Stimulation: For patients who suffer from chronic pain in their limbs, neck and trunk, the options for pain relief can be limited. For some, pain medication works. But for others the effect is negligible and more aggressive treatment is required.

Among those treatment options that are available is what’s called Spinal Cord Stimulation.

“The spinal cord stimulator is an invasive implantable device for the treatment of chronic intractable pain in the limbs, neck Spinal Cord Stimulation,” said Dr. Jorge Leal, a Tampa pain specialist with Florida Pain Relief Group.

The Spinal Cord Stimulator process, a form of neurostimulation, is done by applying an electrical current to the source of pain creating a tranquil sensation that blocks the brain’s ability to sense perceived pain.

“I tell the patients that it works by ‘fooling’ the brain into believing that there is no pain,” Dr. Leal said. “First, a trial is performed and if successful, a permanent unit is implanted.”

This procedure is one that is commonly done for patients suffering from failed back surgery or Complex Regional Pain Syndrome.

“It is a last resort effort designed to treat pain that has not responded to conventional therapies, nerve blocks, etc. It is commonly described as a ‘pacemaker’ to the spinal cord,” Dr. Leal said.

In order to qualify for the procedure, a patient must first undergo a psychological evaluation.

Our Tampa pain specialists at Tampa pain relief center locations in East Tampa, North Tampa, and Carrollwood are experienced with the effective use of spinal cord stimulation to treat chronic pain. Schedule an appointment today.

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