The Five Different Kinds of Nerve Pain And How To Treat Them

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Nerve pain, or neuropathy, is a debilitating condition that can wreak havoc on your daily life. Whether caused by an underlying disease or previous injury, pain without reason can wear down someone’s physical and mental wellbeing. After a few months of chronic nerve pain, even the most resilient patients can become depressed and anxious. Treating nerve pain should be the first priority for these patients, so they can go back to enjoying life free of constant pain. 

Symptoms and Causes of Neuropathy

Nerve pain is often caused by an underlying medical condition. Diabetes is the most common, but it can also be caused by HIV, cancer, shingles, or degenerative bone diseases. Nerve pain is also a common symptom of spinal and skeletal injuries that put pressure on the nerves. Symptoms can range from mild pain and tingling at the damaged site to debilitating daily pain. Some of the common sensations include: 

  • Burning or tingling sensations
  • Pinpricks at the tips of fingers and toes
  • Sudden shocks throughout the body
  • Aching pain

Patients with nerve pain also suffer from varying side effects including higher rates of sleep problems, anxiety, and depression. The constant pain can limit mobility and daily activity, leaving sufferers limited in their lives until the pain is treated. 

The Five Types of Neuropathy

  • Peripheral neuropathy – This is the most common type of nerve pain, and includes damage to any nerve in the extremities. Pain and tingling are felt in the fingers, toes, hands, feet, arms, and legs, which can lead to mobility and dexterity issues.
  • Proximal neuropathy – Proximal neuropathy is another common type of neuropathy, defined by nerve damage in the thighs, glutes, and hips. Proximal neuropathy typically begins in one side of the body but can spread to both if left untreated. 
  • Autonomic neuropathy – This type of nerve pain involves the involuntary nerves connected to musculature and organs such as the heart, sweat glands, bowels, bladder, and sex organs. Like the other types of neuropathy, it can be caused by an underlying condition or can be a side effect of certain medications. 
  • Cranial neuropathy – Cranial neuropathy involves damage to the nerves connected to the brainstem. This results in conditions such as Bell’s palsy; microvascular cranial nerve palsy; third, fourth, and sixth nerve palsy; and multiple cranial neuropathies. 
  • Focal Neuropathy – Focal neuropathy is the damage of a single nerve, often found in the extremities but possible throughout the body. Though this type of neuropathy is not as widespread, it can be just as debilitating as other types of neuropathy. 

How To Treat Neuropathy

No matter what type of neuropathy you experience, seeking treatment is the right first step toward a better quality of life. No one should have to live in constant pain, and with the help of a pain specialist, you can regain your life, mobility, and happiness through a variety of pain management options. 

For medical conditions such as diabetes and cancer, treating the underlying condition can help eliminate or reduce the pain. People experiencing nerve pain due to alcohol addiction may also find relief through rehabilitative programs and detox. However, sometimes treating the disease or condition is not enough. Treatments including medications, physical therapy, and surgical intervention in the case of orthopedic injury may help alleviate neuropathy symptoms and help you get your life back on track. 

Talk to your local PPOA clinic to find treatment options and procedures that can help with your specific diagnosis. We believe that everyone can live a pain-free and medication-free life, and provide a variety of long-term treatment options that will get you back on your feet in no time. 

Schedule an appointment with your local PPOA physician today to learn more.

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What causes a pinched nerve?

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Are you worried about pain in your joints, spine, or another tender area of the body? You may have a pinched nerve. In this guide, we’ll help you determine whether or not your pain is a pinched nerve and when to seek a doctor for pain relief solutions. 

A pinched nerve is a compressed nerve in your spine or peripheral nervous system that causes pain, numbness, tingling, and other unusual sensations out of the blue. Experiencing a pinched nerve can be scary, as you never know if or when the pain will go away. At PPOA, we take these conditions seriously and want to help you find the right solutions for nerve pain. 

Pinched nerves are unfortunately widespread, with 85 in every 100,000 U.S. adults experiencing one in their lifetime. People 50 and older are more likely to experience them due to arthritis and degenerative bone diseases, but they can happen to anyone at any time. 

While most pinched nerves occur in the spine, they can originate in the joints or other areas of the body. So if you’re experiencing unusual pain or numbness in one of these areas, it could very well be a pinched nerve. 

What Causes A Pinched Nerve?

Herniated disks most commonly cause pinched nerves in the spine. When the disk between vertebrates slips, it can cause pain down the spine and into the legs. However, this is not the only cause of pinched nerves. They can occur due to: 

  • Rheumatoid arthritis
  • Sudden or repetitive injuries in the spine or joints (such as lifting heavy objects or repetitive wrist movement
  • Aging
  • Obesity
  • Diabetes
  • Pregnancy (swelling and weight gain during pregnancy can put more pressure on the joints)

Do I Have A Pinched Nerve?

Frequently patients delay visiting a physician for their pinched nerve because they believe it isn’t bad enough to warrant a doctor’s visit. However, these symptoms can worsen over time, so if you experience any of them, you should seek help: 

  • Sharp or dull pain in the spine or joints
  • Muscle weakness
  • Tingling 
  • Numbness 
  • A frequent or unexplained “falling asleep” sensation

When To See A Doctor

If your nerve pain is mild, you may delay going to the doctor for three to four weeks. Rest and over-the-counter pain relief medication may help to allow the nerve to heal on its own. However, if the pain does not go away, you need to seek a doctor. This can turn into chronic pain or, worse, permanent nerve damage. 

PPOA offers comprehensive pain management treatments, including physical therapy, targeted medications, and surgical interventions to ensure your pain goes away for good. We want to help you lead a pain-free life without debilitating everyday pain killers, which is why our physicians go over a variety of options to comprise your treatment plan. To learn more about our options for nerve pain, contact your local PPOA office today. 

 

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Who hurts more? Men, women and pain…

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Pain is a highly individualized experience that affects everyone differently. However, one factor in your biology plays a significant role in the experience of pain – sex and gender. Many of us think we have it worse than the opposite sex, but is it true? In this article, we’ll explore the differences in how males and females experience pain and what you need to know when it comes to your pain conditions. 

Who Experiences More Chronic Pain?

Research shows that women, on average, experience chronic pain more frequently, more intensely, and for more extended periods than men. In addition, many chronic pain conditions – from fibromyalgia to rheumatoid arthritis, migraines, and IBS – are predominantly diagnosed in women. 

Studies also show that women are more likely to experience simultaneous diagnoses and experience pain more intensely during injuries or other single-event health crises. This affects women’s healthcare experience and can negatively affect mood and psychological health. Women are more likely to be diagnosed with depression and anxiety, with chronic pain being one of the myriad reasons for this unfortunate statistic. 

Biology Plays a Part in Pain Response

The differences in pain levels between men and women aren’t merely psychological. The neural pathways that signal pain are structured differently in men and women, leading women to become more attuned to physical pain. Women also have more nerve fibers per square centimeter of skin, heightening sensory perception and greater pain sensitivity. 

Hormone differences also play a significant role in pain perception. Studies show that testosterone can aid in lessening the pain response, while estrogen generally heightens pain sensitivity. Coupled with the pain associated with the menstrual cycle, it is no wonder that women experience more pain throughout a lifetime and are more hyperfocused on pain when it occurs. 

Psychological Differences of Experiencing Pain

Heightened pain sensitivity plays an essential role in reporting chronic pain in men and women. Still, psychological and social factors may also indicate differences in how men and women experience pain. Women are thought to be more attuned to their bodies because, from a young age, they must be aware of their menstrual cycle. In addition, the added responsibility of pregnancy makes women more likely to notice changes in their bodies, including pain. 

Women also describe their pain in more emotional detail, indicating that women are impacted by pain from a social and psychological stance. According to an NIH study, Women used “more graphic language than men, and typically focused on the sensory aspects of their pain event. Men used fewer words, less descriptive language, and focused on events and emotions.”

Some believe the differences in chronic pain diagnosis stem from social differences, where men are conditioned to “act tough” and not show pain, while women are more likely to speak up. However, other reports indicate that women also feel pressured to ignore their chronic pain to be present for their families. They feel guilty for not juggling work responsibilities, child care, marriage, and caring for aging parents. 

What This Means For Both Men and Women

While men and women experience different pain levels, all of our patients must receive the care they need to treat chronic pain. We encourage male patients to speak up when they notice chronic pain because nobody should have to toughen up for it. And we want to help our female patients regain their lives and make their pain more manageable.

If you or a loved one is experiencing chronic pain, visit one of our pain management clinics to learn about your options. 

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Resolving to Fight Pain

Almost three-quarters of Americans will make New Year’s resolutions for the burgeoning year 2022. These resolutions run the gamut of activity from money to love to careers, but the most prevalent area to which Americans direct their aspirations is health. While many health-related resolutions pertain to diet and exercise, Physician Partners of America suggests making tiny everyday lifestyle changes to dramatically decrease your vulnerability to chronic pain.

Unlike other resolutions, preventing chronic pain can involve changing your environment instead of your behavior. For the majority of American workers who work in offices, this starts with arranging your desk and seat to put minimal stress on your body. Even though sitting and typing is a low-effort activity, a poor workplace setup can damage your neck, wrists, shoulders, elbows, and knees over time.

Resolve to follow these three tips to avoid chronic pain:

  • Computer monitors should be placed with their top edge at eye level, allowing you to maintain a natural head angle that avoids unnecessarily stressing your neck. Keyboards should allow your arms to fall naturally with your forearms at right angles to the upper arms.
  • Office chairs should allow you to rest your feet flat on the floor while providing the necessary back to support good posture. Armrests should likewise be positioned to facilitate good typing practice.
  • Even the best setup can be detrimental to your health if you remain sedentary, however. Be sure to get up and walk around every half hour or so; this will improve your circulation and keep joints loose.

Chronic pain is frequently the result of years of small misalignments, so using these tips can save you serious pain. Don’t be like the half of Americans who don’t keep their resolutions; learn more about avoiding chronic pain in 2022 and beyond at our website https://www.physicianpartnersofamerica.com/.

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Don’t Let the Holidays Hurt

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The winter holidays should be a source of joy, not pain, yet they are too frequently a source of injury. The added activity associated with the holidays can result in slips, falls, strains, and other unpleasant memories – certainly not the reason for the season.

Let’s examine the risks associated with a common holiday activity: putting up decorations. According to the United States Consumer Product Safety Commission, there are about 200 decorating-related injuries each day during the holiday season, with about half of the incidents involving falls. During the 2018 holiday season alone, about 17,500 people were treated in emergency rooms for holiday decorating-related injuries. In 2019, six people died from those injuries.

Improper ladder use is frequently to blame. Remember to read and follow all safety labels – don’t stand on the top step of a ladder, or the stabilizing platform if there is one. Make sure the ladder is near enough to where you’re hanging the lights or decorations that you don’t have to stretch to reach, which could cause the ladder to become unbalanced and you to become seriously injured.

If you’re hanging lights, don’t use them if you see frayed wires or broken bulbs. In addition, use extension cords wisely. Too often they can turn into dangerous tripping hazards, so make sure they’re clearly visible and taped down. 2,000 people end up with lacerations and sprains every winter from tripping over extension cords – don’t be one of them!

If you observe Christmas and erect a tree, do it safely. Trees can be heavy – not to mention the boxes of ornaments – so remember to practice safe lifting. Use your legs, not your back, to lift heavy loads, and ask for help if you have to strain to carry something. A pulled back muscle is not just painful; it may well prevent you from doing any more decorating!

Finally, if you live in an area that experiences ice, take the proper precautions. Wear stable shoes, don’t carry too much when walking over potentially icy terrain, and simply watch where you’re going. During the holidays it’s easy to become distracted by scenery, obligations, and crowds, but all of those can make it easier for you to slip, fall, and end up with a painful and debilitating injury.

Strains and sprains are the second most common type of holiday injury. Inconvenient and painful, they’re the opposite of what you want during the season of good cheer. Following the above tips will help keep you and your family safe, but should you find yourself in need of treatment please connect with PPOA via social media or your local clinic.

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Save your shoulders with these five easy tips…

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You use your shoulders for almost every movement, whether you realize it or not. From hitting a fastball to drinking your morning coffee, your shoulders are involved constantly. Because their normal function is so ubiquitous, it can be easy to forget how important having healthy shoulders is. But just ask anyone who’s suffered a shoulder injury – that ubiquity is a double-edged sword. As easy as healthy shoulders are to forget, injured shoulders are impossible to ignore. In addition, once you hurt a shoulder once, it becomes more likely you’ll reinjure it in the future.

Thankfully, you don’t have to stay idle to keep your shoulders healthy. Here are five easy things you can do to make sure you maintain full range of pain-free motion:

1. Use good posture.

Your mother was right! Bad posture is a very common source of chronic pain. Habitual slouching and hunching puts unnatural stress on your shoulder joints, fatiguing them and making them more susceptible to injury and pain. When you type, make sure your hands rest naturally on the keyboard so your shoulders can relax in a neutral position.

2. Stretch.

Whether for exercise or just daily flexibility, regular stretching will keep your shoulders loose and healthy. When muscles are in one position for too long, they stiffen, exposing you to injury if you have to make a sudden or unorthodox movement. A good place to start is practicing chest-opening exercises that stretch the pectoral muscles and pull the shoulder blades together. For those who go to the gym, make sure you’re stretching both before and after exertion.

3. Strengthen.

The stronger your muscles are, the more resilient your joints are. Muscles like your rotator cuff and lats provide support and control for your shoulders, so strengthening them will make it harder for the joint to become stressed or dislocated. Consider exercises like rowing or seated pulldowns to build strength.

4. Listen to your shoulders.

If you develop soreness, don’t ignore it. Resting the joints and icing them will reduce the kind of stress and inflammation that makes for annoying, long-lasting pain. If pain persists, see a doctor.

5. Sleep comfortably.

Side sleepers can be especially vulnerable to shoulder pain if their mattress, pillows, or particular sleeping position are putting undue stress on the joint. If you’re waking up stiff, evaluate your sleeping arrangement. Consider alternating sides, changing your pillow shape or firmness, or stretching before bed – sleep should help heal your joints, not damage them.

Following these tips will help keep your shoulders healthy and functional so you can go about your daily activities pain-free. For more information on keeping healthy joints, as well as treating joint pain, please connect with us on social media or at your local PPOA location.

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What is Neuromodulation?

Research suggests that more than 20% of American adults suffer from chronic pain. Despite its prevalence, however, the pain remains challenging to treat, especially in the long term. Every patient’s pain is difficult to quantify and as unique as their nervous system. Treatments for chronic pain have traditionally included pharmaceutical and surgical interventions. Unfortunately, neither is perfect; pain medication can be dangerously addictive or carry uncomfortable side effects, and surgical procedures can be imprecise, eliminating all sensations in the affected area.

Neuromodulation presents an effective alternative. The International Neuromodulation Society defines it as “the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.” It involves minor surgery – many procedures are minimally invasive – to place a small device near one’s spinal cord that electrically or pharmaceutically stabilizes the nervous system like a pacemaker stabilizes heart rhythms.

The applications of neuromodulation are extensive – it can be used to treat chronic pain and incontinence, Parkinson’s Disease, and ischemic disorders. Neuromodulation can even treat deafness via cochlear implants, which, instead of regulating existing nerve activity, actually create a response where none had existed.

The first neuromodulating device was implanted in a patient in 1967, and the field has multiplied since. The technology has demonstrated its safety and effectiveness in the ensuing decades, and the worldwide neuromodulation device industry is worth more than $10 billion. Recent advances have made the devices smaller, more efficient, more precise, and easier to implant.

Chronic pain remains a primary application of the technology, as it carries none of the risks of potent analgesics such as opioids. Neuromodulation replaces painkillers in many patients, and in others, it can prevent dependency and toxicity by delivering much smaller doses directly to the nervous system. Instead of a constant regimen of pills with their attendant health risks and side effects, patients undergo a minor procedure and may experience significant relief within days or hours.

Physician Partners of America includes neuromodulation in our array of treatments for chronic pain and other neurological conditions, especially for those whose pharmaceutical intervention has proved ineffective. For more information, please talk to your doctor or call one of our local clinics.

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Interventional Radiology: Finding more with X-Rays

As technology improves, surgical intervention has become ever more precise and effective. On the cutting edge of that trend is Interventional Radiology (IR), a technique whereby minimally invasive surgery is guided by live imagery, including x-ray fluoroscopy and MRI. As a result, surgeons can now treat diseases like cancer through pinhole-sized incisions, reducing the margin of error, the risk to the patient, and recovery time.

Here are five things to know about IR:

1. It functions with a variety of internal imaging systems.

Technological advances have provided physicians with tools that allow them to see into a patient during surgery, allowing them to guide tiny surgical instruments to their exact areas of need with heightened precision. The imaging type depends on the patient’s condition; a cancerous tumor might be targeted with MRI, whereas a bone concern would be imaged with x-ray fluoroscopy. The range of imaging tools has grown rapidly over the recent decades and includes CT scanning and ultrasounds.

2. It confers a significant benefit to the patient.

Surgeries performed using IR have significant advantages over those without. Conventional surgery requires the doctor to reference still images taken before the procedure, using cameras or visual cues to guide intervention. In IR, however, the surgeon can “see” into the patient in real-time, eliminating ambiguity and surprises. This lets the clinician operate precise tools through tiny incisions, which is better for the patient. Such procedures lower the risk of unnecessary blood loss and complications, which shortens hospital stays and recovery times, thereby lowering the patient’s costs.

3. It has particularly effective applications for cancer treatment.

Cancer remains a hard-to-treat illness in many cases. Part of the difficulty stems from the fact that many cancer treatments are the surgical equivalent of blunt instruments. Radiation therapy and chemotherapy target the entire area affected by cancer, meaning that healthy tissue is frequently affected along with cancerous cells. IR lets oncologists deliver such interventions directly to those cancerous cells, dramatically reducing patients’ experience of side effects. Doctors can even cut off a tumor’s blood supply during surgery, starving it as they treat it.

4. It can be used on patients of all ages.

Because IR can be used to treat so many conditions, IR patients cover the entire spectrum of age and medical needs. For example, IR can effectively treat vascular conditions more common in the elderly, like pulmonary embolism and deep vein thrombosis, by targeting specific problem spots with medication or equipment like stents. It can also treat major bleeding from things like sports, violence, or childbirth, which are more common in younger people.

5. It is an effective diagnostic tool.

While IR has numerous treatment applications, it can be used just as effectively to help doctors diagnose a condition. For example, taking a biopsy of a diseased or suspicious area can be a complicated procedure. IR makes it much simpler by enabling doctors to use smaller, more precise tools, allowing them to take a sample from their exact preferred location.

Physician Partners of America’s doctors are fully trained and equipped to perform IR on various conditions. To find out if you are a candidate for IR, please visit our website or call your local PPOA clinic.

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Expanding on the East Coast

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PPOA has grown significantly since our founding in 2013. We began with a single office and only three employees, but have since grown to a strong 500+ employees and over 30 locations across Florida, Texas, and California. We have always had a strong presence in Florida. We’re planning to expand that presence even further by adding to our surgery centers along the east coast of Florida from now until 2023. 

PPOA is expanding our ambulatory surgery centers in Orange Park, West Palm Beach and several other cities across the coast. This expansion marks not only progress for our organization, but the expanse of pain solutions for patients in need. Florida was one of the earliest states affected by the opioid epidemic and continues to be at the forefront of fighting prescription drug abuse through legislation and preventative care measures. 

By adding services across Florida, we hope to help fight the increase in opioid overuse and overdoses. Since COVID-19, studies have found a 31% increase in non-prescribed fentanyl use, as well as significant increases in illicit drug usage. With patients not being able to see doctors as regularly, coupled with restrictive lifestyle options and increased isolation, many patients are turning to opioids to curb pain and lessen emotional stress. 

PPOA offers a long-lasting solution for patients who have been given no other options. Our advanced surgical and pain management plans can give patients a real opportunity to live healthy lives unrestricted by constant pain. We care not only about our patient’s pain but what makes their pain debilitating. Were they active parents before an accident made it hard to walk their kids to school? Were they an active runner who now can’t make it out of bed some mornings due to muscle and spine damage? These details are important to our patients, which makes them important to our staff. We want to know what makes your life meaningful, so we can fight harder to bring these moments back to you.

The expansion of our clinics can help the retired population in Florida find innovative solutions for leading an active lifestyle pain-free. Florida is one of the top places in the country for retirees to live, and many want solutions to chronic pain that can facilitate their ability to travel, fish, visit with grandkids, and enjoy their later years without physical burdens. We offer minimally invasive options for our patients to ensure quicker recovery times and reduced pain after surgery. This provides Floridians with the solutions they need for enjoying coastal living to the maximum. 

These expanded surgery centers, along with our established locations across Florida, Texas, and California will make a lasting difference in the lives of thousands. 

To learn more about the opening of our new Florida locations, or to stay up to date on PPOA news, follow us on Facebook and LinkedIn.

 

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Facet Joint Arthritis – A Common Cause of Low Back and Neck Pain

What is Facet Joint Arthritis?

Facet joint arthritis is a very common cause of low back and neck pain in adults.  It is a condition in which the small joints, called facets, in the back of the spine become arthritic and painful, similar to the way arthritis in the knee or hip is painful. Facet joint arthritis is also known as facet arthropathy or spondylosis.

What are Facet Joints?

Facet joints connect the vertebral bodies, or bones, in the spine to one another and help keep the spine stable with normal movement. Facet joints are lined with cartilage, contain a small amount of joint fluid, and are encased in a joint capsule. There is a pair of facet joints at each level, and they are named for the vertebral bodies they connect. For example, the L4/5 facet joints connect the lumbar 4 and lumbar 5 vertebral bodies.

How does Facet Joint Arthritis develop?

Each facet joint is lined with cartilage, and over time the cartilage may thin and wear out. As a result, the joint will become inflamed and develop bone spurs, enlarging the joint.  This is also called facet joint hypertrophy. These changes can be due to a variety of factors, but typically anything that puts greater strain on the facet joint over time, such as manual labor, obesity, lack of exercise and deconditioning, will lead to degenerative changes in the joint. Genetic factors may also play a role even in the absence of these factors.

Where does Facet Joint Arthritis occur?

Facet joint arthritis commonly occurs in the low back or lumbar spine. It also occurs in the neck, or cervical spine, and to a lesser extent in the upper back, or thoracic spine. The lower lumbar facet joints, such as L3/4, L4/5, and L5/S1, are the most common location of facet arthritis because they carry the greatest weight compared to other areas of the spine.

What are the symptoms of Facet Joint Arthritis?

In the lumbar spine, the symptoms are typically lower back pain, which may be accompanied by radiation of the pain to the buttocks or the back of the thighs. In the cervical spine, the symptoms are typically neck pain, which may be accompanied by radiation to the shoulders, upper back or to the back of the head. Leaning back and rotating the spine typically worsens the pain. Decreased spinal flexibility and muscle spasm frequently accompany the pain.

How do you diagnose Facet Joint Arthritis?

A proper history and physical exam may suggest facet arthritis. X-ray, CT scan or MRI may confirm the presence of arthritis; however, facet joint arthritis is just one potential cause of low back or neck pain. If interventional treatments are planned, diagnostic injections with local anesthetic are required to confirm that the source of the pain is the facets.

What are the initial treatment options for Facet Joint Arthritis pain?

Anti-inflammatory pain medications, muscle relaxers or other pain medications, activity modification, weight loss, physical therapy, and regular exercise all may be helpful at reducing pain.

What are the options if conservative treatments fail?

Because back and neck pain may have multiple causes, first one must confirm that the facet joints are the source of pain. To determine if the facet joints are causing pain, a diagnostic injection of local anesthetic can be performed, either into the facet joint, or around the nerves that sense pain in the facet joint. These nerves are called the medial branch nerves. If pain is reduced by this diagnostic injection, then a procedure called a rhizotomy is performed. A rhizotomy uses radiofrequency energy to heat the facet joint nerves so that they can no longer sense pain. In cases where an enlarged arthritic facet joint is causing nerve compression or spinal stenosis, referral to a spine surgeon may be indicated.

How do you keep Facet Joint Arthritis pain from returning?

Intermittent flare-ups are common with chronic back and neck pain. The best long-term pain management strategy consists of regularly participating in exercises that restore spine health and stability. With the assistance of a Physical Therapist, participating in a home exercise program that focuses on increasing strength, endurance and flexibility will be the best defense against chronic pain.

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