Telemedicine pain clinic

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Physician Partners of America Offers Telemedicine Option

For patients worried about leaving home to see their pain management doctor, Physician Partners of America (PPOA) is offering a solution: telemedicine. It allows patients to talk to their regular PPOA physician and order prescription refills.telehealth pain clinic

“We understand some people are under stay-at-home orders, and others are too high-risk to venture out, so we are using technology to bring our doctors to them,” says Josh Helms, COO of PPOA.

Some chronic pain patients may carry a higher risk of contracting the virus. For others, the dry cough associated with COVID-19 may aggravate some neck and spine pain. Patients should consult a primary care physician for testing and diagnosis. Current PPOA pain patients seeking guidance or medication management are encouraged to use our telemedicine option.

PPOA’s telemedicine service is simple to use. There is no complicated software to install. All that’s required is a telephone. Our scheduling team will handle all the details and paperwork through the HIPAA-compliant electronic medical records (EMR) system, just as they do for office visits. A team member will contact patients to confirm their phone call with the doctor, and the doctor will call at the pre-arranged time.

“Our telemedicine service can take the place of an in-office visit in many cases,” says Helms. “It’s an easy and HIPAA-compliant way to ensure our patients are getting what they need to ease their pain during this uncertain time.”

Visit our home page, click on Schedule Appointment, or call  888-412-6958, and set your telephone appointment today.

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Managing Pain During Coronavirus

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During this unsettling time where the Coronavirus (COVID-19) is a major global issue, fear and uncertainty can take over. For people who are already suffering from chronic pain, contracting the virus, or even seasonal allergies, can be the cause of more pain.

Many of PPOA’s patients have chronic pain in relation to their back and neck. Due to this, if the patient has a sore throat, excessive coughing- which is a symptom of the Coronavirus, may worsen their pain. This is because of the strain the coughing is putting on the back, making it contract more than usual. Although the virus has to run its course, reduction of the cough will help the patient find some relief. Along with a cough, the Coronavirus can bring its own aches and discomforts, adding to the patient’s already chronic pain.

For those who haven’t suffered from chronic back pain until contracting the virus, there is a possibility the amount of coughing has put strain on the patients back. Excessive coughing can cause conditions such as:

To help prevent these conditions or to not cause a flare up in previous conditions or chronic pain, follow these steps when coughing.

  • Keep a natural form in your back instead of hunching forward when coughing.
  • Keep shoulders down and away from your ears.
  • If available, put your hands down on a surface when you cough to help to prevent the back from compressing.

If you are experiencing symptoms of the Coronavirus, please call your primary care doctor. If you are experiencing chronic pain, we can help you find relief. Contact us today.

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Dr. Thomas Heil Performs SI Joint Fusions

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Dr. Thomas Heil grew up and earned his medical degree in West Virginia. He began a residency in General Surgery at the Mayo Clinic in Rochester, Minn., but later decided his passion lay in helping patients relieve their pain. After working in pain management for 20 years in Charlotte, NC., Dr. Heil decided to take his talents to Texas, where he now works at our Keller location.

While there is a wide range of conditions he treats, 50-75% of Dr. Heil’s patients come to seek relief from lower back pain. About 20-40% of these patients coming in for lower back pain treatment will find out their pain is stemming from their sacrum, therefore, their SI (sacroiliac) joint.

“Pain in the sacrum is a lot more common than most people would think and probably a lot less frequently diagnosed than it should be.” –Thomas Heil, M.D.

The Sacrum and SI Joint

The sacroiliac (SI Joint) can be found in the pelvis, right between the ilium and sacrum. It is also the lowest part of the spine and sits right above the tailbone. This joint is very important because it transfers energy from the upper part of the body to the lower part and is an essential component for shock absorption during activities such as walking.

Symptoms of Pain in the Sacrum

Some symptoms of SI joint pain can include:

  • Generalized pain in lower back/buttock region
  • Sharp or stabbing pain when movement occurs
  • Pain in sleeping positions and the changing of sleeping positions
  • Pain or stiffness when sitting for a long period of time

Conditions Related to Pain in the Sacrum

More often than not, pain the sacrum is caused by a joint aggravation or irritation triggered by overuse. Many times, strenuous exercise activities such as cross fit can contribute to this type of pain. With age also comes the degeneration of the fluid within the joint called synovial fluid. Your joints need this because when it begins to wear, your bones rub together. In the minority of cases, pain in the sacrum is related to another generalized inflammatory arthritic syndrome such as lupus or rheumatoid arthritis.

The Treatment

There have been a lot of different ways to treat pain in the SI joint over the years.

The first step to making sure the sacrum pain is coming from the SI joint is a diagnostic block. This is where your physician will put Novocain and some contrast agent down in the joint to ensure the right target is hit.

If the joint numbs up and feels great, sometimes just a steroid injection or two will clear it up well enough. But probably about 50% of the time those steroid injections are temporary. “Some people get several months of relief at a time but others only get several weeks,” Says Dr. Heil. “You certainly don’t want to keep getting injections that often.”

In the past, very large orthopedic procedures were done. During this time, the procedure would take probably 4-5 hours and patients would be in the hospital for a couple of weeks while in recovery. Over the past decade or so, new surgical techniques have been developed that are less- aggressive and minimally invasive. The most recent treatment option being offered is an SI Joint fusion that is about a 20-30 minute procedure that involves a very small incision- no more than the size of your thumbnail. Your physician will insert a little expander device into the SI joint and take out a small piece of the joint that is irritated and replace it with a bone graph. Usually within 4-5 days patients are starting to get over the soreness of the procedure and it is very effective as a long term treatment.

If you are Suffering from Pain in the Sacrum

Dr. Thomas Heil suggests anyone suffering from pain in the sacrum just takes it easy. If this is a new concern, try to reduce whatever you’re doing that is causing the irritation. Anti-inflammatories and rest can greatly reduce the pain. If the irritation persists, the next step would be to see a pain specialist to see if there’s something that can be done to more quickly resolve the problem so it doesn’t become a long term lingering issue.

“What we really want to do is start treating these problems aggressively early on in the process so people are not placed on these narcotics and opioids that have all of the side effects of addiction with it. So the earlier the patient can come in to see us the better off they’re going to be.” Thomas Heil M.D.

Dr. Heil is located at 4364 Heritage Trace Parkway, Suite 112A Fort Worth, TX 76244. We have 35 locations in Florida, Texas, and California that consist of trained specialists. If you are experiencing pain or would like more information, call us today to schedule a consult (888) 616-5110.

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Physician Partners of America Now Offers SI Joint Fusions

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The sacroiliac (SI Joint) can be found in the pelvis, right between the ilium and sacrum. It is also the lowest part of the spine and sits right above the tailbone. This joint is very important because it transfers energy from the upper part of the body to the lower part and is an essential component for shock absorption during activities such as walking.

About 25% of patients lower back pain stems from the SI joint. This is because although activity is good for you, it can also lead to more pressure and strain on these specific joints.

 

“If it can be established that pain is originating from the sacroiliac joint, there are new, minimally invasive treatment options that can be employed on an outpatient basis to provide lasting pain relief,” says Keith Girton, M.D. with Physician Partners of America’s Melbourne, Florida location.

 

The SI joint fusion and iFuse Implant System Is intended for use during a minimally invasive sacroiliac joint fusion. The actual procedure itself is performed in an operating room, with either general or spinal anesthesia. The iFuse Implant System requires a small incision (about one to two inches long), along the side of the buttock. The whole MIS SI joint procedure takes about an hour, and recovery time is significantly less than open surgery.

 

 

This procedure can be beneficial to someone who has chronic pain and discomfort within the SI joints and has not been successful with more conservative treatments such as physical therapy and injections. The SI joint fusion provides stability to the SI joint. With our minimally invasive technique, triangular shaped implants will be inserted to provide maximum protection to surrounding tissues.

 

Benefits of SI Joint fusions include:

  • Minimal down time
  • Small incisions
  • No hospital stay
  • Regain quality of life

 

We have quality doctors certified in the iFuse Implant System. If you think this might be a procedure that fits your needs, please contact us to find out if you’re a candidate.

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Finding Migraine Relief Through an Unlikely Source

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Dr. Edrick Lopez Treats Migraines with Botox-

We all know Botox– or botulinum toxin – to be a beautifying procedure. However, a second purpose has come to light and people everywhere are finding relief for their chronic pain. Doctors have found that for a person suffering from chronic back pain, neck pain, facial pain, or even migraines, a visit to Botox specialist can provide quick and effective relief from pain that just doesn’t respond well to other treatments.

Dr. Edrick Lopez, a Harvard-trained intervention pain management specialist with Physician Partners of America’s (PPOA) McKinney, Texas location, takes a multidisciplinary approach to pain relief ranging from neck, back, and joint injections to Botox for migraine headaches and regenerative medicine.

How Does it Work?

Botox is used for multiple purposed and to many, is viewed as one of modern medicine’s most fascinating treatments. A protein produced by certain types of bacteria, botulinum toxin, in its natural form, is one of the most toxic substances known to man. The toxin itself works by blocking a neurotransmitter called acetylcholine, which forces muscles to relax; in large doses Botox causes parts of the body to shut down completely, but when administered in small doses by a trained professional, it relaxes muscles safely and locally to smooth out wrinkles and to target muscular sources of chronic pain. Decades of research and careful refinement of the toxin has allowed scientists to start using this substance for good, and today Botox is used safely in millions of procedures, both medical and cosmetic.

What Conditions Can Botox Treat?

Because it relaxes muscles, pain management doctors at PPOA’s clinics, along with Dr. Lopez, find that Botox is particularly effective at treating chronic pain that is muscular in origin. Botox can be especially helpful when treating conditions such as whiplash, TMJ, and lower back pain. In these cases, Botox forces the muscles to relax, allowing joints to return to their natural position without pain.

“Botox is a great alternative for patients who suffer from chronic migraines,” says Dr. Lopez. “It can significantly enhance the quality of life of these patients by reducing the intensity and the frequency of their migraine headaches.”

Botox is also FDA approved as a treatment for chronic migraines. Regular injections at specific sites around the head and neck can create long-term relief for patients who suffer migraines more than 15 days out of the year, and for patients who have tried and failed at least 2 different preventative medications.

Injections to treat chronic migraines are usually administered once every 12 weeks, and, as with other Botox-treated pain, patients usually start to feel positive effects within a few days.

“I love that we can offer this therapy that can so markedly help our patients with chronic migraines.” – Dr. Edrick Lopez

Contact us today to see if you might be a good candidate for Botox.

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Complex Regional Pain Syndrome (CRPS)

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Complex Regional Pain Syndrome (CRPS) is a nervous system malfunction and a chronic condition where a person feels pain in one or more of their limbs after an injury.

If you have recently had an injury and find that you are having pain in one or more of your limbs, there is a chance you are at risk for CRPS.

CRPS usually affects the arms or legs after injury or incident. These two specific extremities are the typical areas that CRPS could impact. It most often occurs after an injury or incident like stroke, heart attack or surgical procedure.

“They way that I explain this to my patients is that when you touch the stove, you get a little shock that goes from your finger to your brain that tells you to stop, your about to burn your finger,” says Dr. Rodolfo Gari, “with CRPS, instead of telling you to stop, the pain goes into a loop from your finger to your spinal cord and becomes constant.”

 

Treatment is Crucial

As time goes on untreated, you will be at an increased risk of not putting CRPS into remission. Receiving treatment as soon as possible will give you better chances of treatment. Pay attention to your symptoms and do not ignore the signs of Complex Regional Pain Syndrome.

 

Symptoms of CRPS

As soon as you recognize CRPS symptoms, seeking help right away is essential for treatment and recovery. A specialist can help you manage the symptoms, relieve the pain and keep the condition from getting worse.

“With some patients,” says Dr. Gari, “even breathing or a slight touch to the skin can be so painful.”

The symptoms may include:

  • Constant feeling of burning or throbbing in the affected limb, typically your leg, arm, foot or hand
  • Swelling in the affected limb
  • Your limb may change temperature from hot to cold and back
  • The limb may be sensitive to old temperatures or being touched
  • Your joints may swell or feel stiff
  • Difficulty moving the affected limb
  • Your skin tone may change, turning mottled or shades of red or blue
  • Your skin may also have texture changes, becoming thinner, more tender or shiny
  • The affected limb may have changes in nail and hair growth
  • You may experience muscle spasms or atrophy

Keep in mind, symptoms can vary depending on the affected person, but the sensitivity and pain may occur first. The important thing is to seek help from a doctor as soon as possible.

 

Why Fast Treatment is Critical

If treatment is not given within a certain amount of time after the injury, changes in skin color may occur at a point when your condition has become irreversible.

There is a possibility of CRPS going away on its own if the pain and symptoms are not too severe and do not worsen. However, CRPS could possibly spread from the affected limb to another part of your body, such as another limb.

CRPS pain could worsen with signs of stress, so even if the condition has you feeling stressed, try to stay calm and simply get the help you need.

The medical team at Physician Partners of America can help you find the right treatment plan, and get your CRPS symptoms under control before they get worse.

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Our View on the Backlash to the Opioid Crisis

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Window sign was unauthorized, untrue

Physician Partners of America (PPOA) as an organization is sensitive to the current backlash to the opioid crisis and the new prescribing laws that have resulted. We recognize a growing movement of law abiding chronic pain patients who rely on long-term “maintenance” doses of opioid pain medication.

In particular, we would like to address a sign that was placed in the window of one of our practices on May 14, implying that we will cease prescribing opioid medication to patients as of May 31, 2019.

Patients are and will continue to be titrated down according to CDC guidelines; however, there is no cut-off date.

This sign was brought to our attention through social media. It was in no way authorized or approved by management, and its message is untrue. It resulted from an employee’s misinterpretation of our goal to reduce opioid dependence.

At its foundation, PPOA uses interventional pain management modalities to treat pain at its source instead of masking it with medication. Our physicians come to our organization with a variety of backgrounds and use many modalities to treat chronic pain. They are medical pioneers like Dr. Phillip Kravetz, researchers like Dr. Neil Ellis and Dr. Michael Lupi, and inventors like Dr. Lesco Rogers.

Treatments may include Stimwave, trigger point injections, nerve blocks, minimally invasive spine procedures with and without laser assistance, Botox injections for migraines, neuromodulation and regenerative medicine. Physicians may also utilize a variety of medications – including topical, oral and intrathecal – to reduce pain.

We use pharmacogenomics to determine the safest dosage and medication type based on each patient’s genome, and intraoperative neuromonitoring

We have championed remedies to the opioid crisis in public forums, in the media, in televised town halls and at medical conventions. PPOA physicians strictly follow the prescribing laws of the states in which they operate.

We recognize the opioid crisis backlash. As an organization, we sympathize with the plight of people who rely on, but who do not intentionally abuse, prescription opioid medications to manage their chronic pain. We aim to show them what we consider a better, safer way to reduce or eliminate pain.

We will continue to engage in serious, thoughtful discussions toward finding a middle ground that balances patient concerns, federal guidelines and state laws.

We thank the public for input on this sensitive topic and invite you to learn more about who we are and what we do on our website.

 

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Dr. Jorge Leal Offers Compassionate Interventional Pain Management in Tampa

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Dr. Jorge Leal is double board-certified in Pain Medicine in Anesthesiology. He is a longtime pain management specialist with Physician Partners of America at its flagship Tampa location on Habana Avenue. He treats all neck and back pain conditions in a direct yet caring manner and is fluent in both Spanish and English.

Dr. Leal (pronounced lee-AL) uses a wide spectrum of pain relief treatments including injections, spinal cord stimulation, intrathecal pain pumps and minimally invasive procedures using special lasers when needed. Overall, he has more than 30 years of experience managing all pain conditions.

His patient-focused care, interest in the mind-body connection and extensive experience have earned him a loyal following.

Patient J. says: “Science-based doctor. He’s been seeing the most difficult patients for his entire career. This is the guy to see for real treatment. Go elsewhere if you want to be told what you want to hear instead of what’s real.”

Patient M.P. tells Google Reviews: “Dr. Leal is GREAT, very frank and to the point. Willing to listen, try new approaches and change if something isn’t working. I recommend Dr. Leal to everyone with back pain.”

Patient J.T. writes: “Dr. Jorge Leal is a fine physician. He is kind, easy to talk to, smart and knows his stuff. ”

Patient A.B. writes: “Dr. Jorge Leal was well worth the wait in the office. He took his time with me and helped me get on the right meds… I would definitely recommend him to anyone in chronic pain.”

M.H., a Spanish-speaker, writes: “Le doy 5 estrellas al dr Leal. Es un dr muy dedicado a sus pasientes y a mi me ha ido muy bien con su tratamiento.”

An anonymous patient writes on RateMDs.com: “Before Dr. Leal, I was in severe pain; it was impacting my quality of life. I needed help to get out of bed each morning due to pain. After going to two other doctors and being made to feel like a junkie off the street or a pincushion from so many epidurals… I finally found Dr. Leal. He was able to help me live again!”

Another patient, who has been treated by Dr. Leal for more than 13 years, writes on vitals.com: “I recommend everyone I know who has chronic pain or a condition that causes pain (i.e., lupus, fibromyalgia, migraines, rheumatoid and osteoarthritis, and complex regional pain syndrome) to Dr. Leal’s practice — I won’t recommend anyone else!”

Dr. Leal got his start in pain management when he completed his residency in anesthesiology at the State University of New York before continuing his career in Florida. He has held several appointments in anesthesiology and pain management.

Make an appointment today at his office, 4730 N. Habana Ave., Tampa, FL 33614 by calling (813) 437-1621 or visiting the location website.

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Dr. Mauricio Orbegozo Offers Personalized Pain Care in Tampa

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Dr. Mauricio Orbegozo, interventional pain management physician in Tampa, has appeared in Tampa Bay Metro magazine’s Doctor of Distinction issue. Dr. Orbegozo prides himself on being able to connect on a personal level with each of his patients. Indeed, he earned 2018 Patients’ Choice and Compassionate Doctor Recognition awards from vitals.com.

“I have always been proud of the fact that if a patient’s name comes up in a question I am able to recall who that patient is, the therapy the patient is undergoing and also who they are personally,” he says. “I believe that to treat pain you have to know as much of the patient as possible not only physically but mentally [and] socially.”

Dr Mauricio Orbegozo Patient reviews

Dr Mauricio Orbegozo patient reviews

His compassion shines through. Here’s what some of his patients say:

C.V. tells Google reviews: “Dr. Orbegozo takes his time to listen to me. He genuinely cares. I’m glad I’m in his care. I wouldn’t change him at all. That’s why I drive from Winter Haven, because he is the best. This is excellent patient care at its best.”

J.L. writes: “A wonderful doctor. He gets a 10 in every area!”

D.S. writes: “One of the best doctors visits I have ever had. He took his time, listened to my concerns and answered all my questions. Very satisfied.”

D.P. writes: “He listens, he explains, and most of all he has plenty of patience to explain why you are in pain and what he will do to fix it…  He makes sure you leave that office knowing what is the next step to feeling better.”

Dr. Mauricio Orbegozo Tampa Bay Metro

Courtesy – Tampa Bay Metro, Doctors of Distinction

A second-generation physician from Colombia, Dr. Orbegozo earned his medical degree from Colegio Mayor de Nuestra Señora del Rosario in Bogota. He completed a residency at Loyola University and his fellowship at Texas Tech University at Lubbock. he specializes in treating all chronic pain conditions using a wide array of modalities, including laser procedures and neurostimulator placement.

He is a veteran of the United States Air Force and has contributed to such medical journals as the Journal of Clinical Anesthesiology.

Patients can schedule appointments with Dr. Mauricio Orbegozo at the Fletcher Avenue location near the University of South Florida campus, 3450 E. Fletcher Avenue, Suite #350A, Tampa, FL, 33613. Click the location page or call (813) 437-1636.

He also sees patients at the PPOA Westchase office, 10903 Sheldon Road, Tampa, Fl 33626. Schedule an appointment by clicking the Westchase location page or calling (813) 437-9499.

His offices accept Medicare and most insurance.

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Dr. Jose Medina-Sanchez Offers Compassionate Pain Management in Brandon FL

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Dr. Jose Medina-Sanchez in our Brandon, Fla., location specializes in a few different areas of pain management including the rehabilitation of musculoskeletal, neuromuscular injuries, traumatic brain and spinal cord injury, and stroke patients. Laser-trained, he uses interventional methods to target pain rather than relying on opioids to mask it.  He is also actively involved in providing rehabilitation in skilled nursing facilities.

Dr. Medina-Sanchez puts his patients first and every day looks forward to providing his patients with solutions.

C.W. writes: “Dr. Medina-Sanchez is very a compassionate doctor. During my initial visit I began having spasms while he was examining me and he was very sympathetic and reassuring. I thought he was going to cry. I’m joking about him crying, but he was very concerned about my pain. Obviously I was impressed. ”

J.B. writes: “They care about your pain. Dr. Medina-Sanchez has gotten my pain under control and for years 15 years I was not able to get out of bed or walk. Now I’m able to fly home for my sister’s birthday. It’s been 6 years. I am happy to say that he has given me hope to have a normal life again. I highly recommend Physician Partners of America/Florida Pain Relief Group. The staff is great. If you’re having back pain, he can fix it !!!! Give them a call and hope your experience is as good as mine. Thank you.”

Another patient tells Google Reviews: “Dr Medina was AMAZING!!! So sweet. So kind. He listened & didn’t prejudge my situation. He and I worked together to come up with a long term plan, after he asked me what my goals were. I’ve already recommended him to 2 people & I just had my 1st appointment yesterday. He & his staff are so great!! It makes going to the doctor, which is normally full of anxiety for me, rewarding & something I do not mind doing. I’m so glad I found him & his staff.”

Born and raised in Puerto Rico, Dr. Jose Medina-Sanchez is a graduate of the University of Connecticut. He completed his residency at Marianjoy Rehabilitation Hospital  in Wheaton, Ill., as Chief Resident. He also then completed a fellowship in Interventional Spine and Pain Management. That focus in spine and pain management had an impact of his extensive knowledge of non-surgical spinal procedures.

His office is located at 427 S. Parsons Ave., Suite #112, Brandon, FL 33511. Call (813) 285-5335 for an appointment. Same-day appointments are also available. The office accepts Medicare and most insurance.

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