Make Pain a Thing of the Past – Back Pain – Physician Partners of America

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Arachnoiditis Pain Causes and Treatment

PPOA Treatment Can Ease Back Pain from This Rare Disorder

Arachnoiditis has nothing to do with spiders, but its symptoms can be pretty scary. Difficult to diagnose and difficult to treat, this rare nerve inflammation can trigger excruciating lower back and leg pain. It is a progressive and debilitating disorder that can cause some people to become bedridden and unable to work.

What is Arachnoiditis?

The condition affects only about 11,000 people a year, according to the National Organization for Rare Disorders.  It is almost always caused by a medical procedure.

It starts in the web-like arachnoid membrane that protects the spine and brain. When the membrane becomes inflamed, it can cause the nerves to fuse together. This causes them to malfunction. The resulting scar tissue can press against the nerve roots that exit the spine, causing severe pain.

Arachnoiditis pain usually affects the lower back and legs and causes a variety of sensations.

  • Tingling or “creepy-crawly” feelings on the skin
  • Muscle cramps, twitching and spasms
  • Shooting, “electric shock” pain
  • Bowel, bladder and sexual problems

“It causes a number of symptoms and they can vary in the same individual,” said Dr. Abraham Rivera, chief medical officer of Physician Partners of America.

What Causes Arachnoiditis?

This condition has many causes. The majority are related to contaminants that accidentally get into the dura – the fluid surrounding the spinal column – during certain medical procedures like epidurals and spinal taps.  These contaminants include preservatives or impurities. Long ago, oil-based chemicals used in contrast dye tests, like myelograms, were blamed for some cases of arachnoiditis.

How is Arachnoiditis Diagnosed?

This disorder is so uncommon that most doctors rarely see it in their practices, making detection difficult. Fortunately, Physician Partners of America Pain Relief Group has the expertise to identify it and attempt to treat the pain.

The most helpful diagnostic tests are MRIs (magnetic resonance imaging) and CAT scans (computerized axial tomography). Another test, an EMG (electromyogram), uses electrical impulses to determine the extent of damage to nerve roots. PPOA specialists can perform this test.

What is the Best Arachnoiditis Treatment?

Unfortunately, there is no cure for this condition, but Physician Partners of America offers the hope of relief from arachnoiditis pain.   “One common treatment is oral pain medication, but it doesn’t tend to work well,” says Dr. Rivera. “The pain can be managed for some people with a spinal cord stimulator.”

Spinal cord stimulators are minimally implantable devices that send electrical signals to targeted areas of the spinal cord to treat specific pain conditions. It is a minimally invasive procedure that PPOA physicians perform routinely.

Stems cell therapy for arachnoiditis is only in the experimental stage and has not yet been proven helpful.

“We are keeping our eye on the latest research to treat this debilitating condition,” says Dr. Rivera. “Not every current treatment works for everyone, but we make every effort to treat the pain and help sufferers lead a more normal life.”

 

 

 

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Tiger Woods Back Surgery – How Does Golf Affect the Body?

He’s had four procedures in four years

Golf legend Tiger Woods’ back surgery saga has gained as much attention as his game and his personal life. His recent PGA Tour Championship performance marks his 80th win. It’s a stunning comeback after a five-year hiatus – and even more significant because he has undergone four operations for chronic pain.

Woods has suffered from pain in his lower back, known as the lumbar spine, and had discectomy surgery to relieve a pinched nerve in 2014. A discectomy removes a small piece of a vertebral disc that is pressing against pain-causing nerves.  This surgery does not affect range of movement.

One year later, he had to withdraw from the Wyndham Championship and undergo a second procedure to decompress another pinched nerve. One month after that, he has a third surgery to relieve pain from the second operation.

The golfer brushed it off as an occupational hazard. “It’s one of those things that had to be done,” he recently told People magazine.

Does Golf Cause Back Problems?

What is it about the game of golf that triggers back pain? Physician Partners of America pain management specialist Dr. Chad Gorman has a background in sports medicine and is a golfer himself.

“While golf is a beautiful sport that requires precision and eye coordination, strength, endurance and focus, there are many common injuries that golfers are prone to getting,” he said.

It’s well known that years of powerful swinging motions can cause tendonitis and “golfer’s elbow,” technically known as lateral epicondylitis.

Tiger Woods’ back surgery history shows that golfers are also prone to chronic lower back pain. “The amount of force that can be created while swinging a golf club puts golfers at increased risk of acute disc herniation, stress fractures and other common causes of back pain,” says Dr. Gorman, who practices in PPOA’s New Port Richey, Fla. location.

Disc herniation occurs when the soft center of a disc that separate spinal bones pushes out and presses against surrounding nerves. It can result in pain, numbness and weakness in an arm or leg.  Woods complained of severe leg pain after his third back surgery, and had to undergo a fourth in 2017. That specialized procedure, known as an interior lumbar interbody fusion, welds unstable vertebrae together so they heal into a single, solid bone.

Lower Back Pain Treatments

Woods recently told People that he is now pain-free, but has to make some adjustments to his swing. “He has had to change his spinal rotation significantly due to the fusion in his back,” Dr. Gorman observes.

For weekend golfers, surgery is not always necessary. Some benefit from aggressive physical therapy. Epidural steroid injections (ESI) and platelet-rich plasma and stem cell therapy can also help ward off surgery in some cases.

Physician Partners of America Pain Relief Group physicians offer ESI, regenerative medicine and other interventional treatments. In cases of pinched nerves or disc disease, the PPOA Minimally Invasive Spine Group offers laser-assisted procedures that can be done in one day with minimal downtime.

 

 

 

 

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Laser Spine Surgery Now Covered by Tricare at PPOA

Tricare makes pain relief affordable for active duty and veterans

Military members living with neck and back pain can now get affordable treatment with their military medical insurance. Physician Partners of America Minimally Invasive Spine Group accepts Tricare, including Tricare Prime, for laser spine procedures. This includes treatment for active duty, reserves and retired military.

Our laser spine surgeon, Dr. James St. Louis, is a U.S. Army veteran and has been treating fellow service members for 30 years. The surgical founder of Laser Spine Institute, he is pleased to extend this groundbreaking outpatient surgical option to patients at Physician Partners of America in Florida and beyond.

“Laser surgery allows patients to return to their activities within days or weeks instead of months, as is the case with open surgery – and that is in their best interest,” says Dr. St. Louis.

Causes of military back injury

The physical stresses of combat and the rigors of training – carrying weapons and heavy packs, running, jumping, marching and parachuting – can cause neck, back and musculoskeletal pain. Trips and falls are other common culprits. Left untreated, these and other spinal problems can lead to limited civilian job prospects and disability.

According to vetsnational.com, common back injuries associated with military service include:

  • Bulging and herniated discs
  • Compressed nerves
  • Intervertebral disc syndrome
  • Sacroiliac joint dysfunction
  • Cervical spine fracture
  • Misaligned vertebrae

Physician Partners of America can evaluate military patients for all of these conditions.

“I see a lot of herniated discs and compressed nerves in military patients,” says Dr. St. Louis. “Because they’re generally young and healthy, we can help them, in selected cases, without the need for spinal fusion.”

It also eliminates the need for opioid pain killers because it targets on the treatment area specifically without the side effects of oral medications.

What is laser spine surgery?

Minimally invasive laser spine procedures treat severe spine-related pain on an outpatient basis: no overnights in the hospital or weeks in bed recuperating. A small incision (less than one inch) and muscle-sparing surgical techniques are the key. Dilation tubes, about as wide as a magic marker, gently spread muscles instead of the cutting and tearing common with traditional open back surgery. The laser is used for ablations and removing tissue that presses on nerves.

Common procedures include laser facet ablation, laser discectomy, laminotomy and foraminotomy. These allow for decompression of nerves that exit the spinal canal.

The methods used in PPOA’s minimally invasive laser spine surgery​ allow for a fast recovery. Most patients are able to walk out of the surgery center the same day and resume activities in days or weeks, as opposed to months with traditional surgery. That – and the affordability that Tricare insurance offers – are a plus for military members.

“Military patients are the best patients,” says Dr. St. Louis. “They are motivated to get back to work. They’re generally healthy, have a good work ethic, and want to get back to a productive life.”

 

 

 

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PPOA Offers New Spinal Stenosis Treatment

Vertiflex procedure is minimally invasive and reversible

A new spinal stenosis treatment is allowing people to walk without pain for the first time in years – and without relying on opioids. Physician Partners of America now offers this minimally invasive procedure, known as the Superion Indirect Compression System, at its Texas Pain Relief Group and Florida Pain Relief Group locations.

This spinal stenosis treatment has even helped some patients leave their wheelchairs behind. That’s what recently happened for a patient of Christopher Creighton, M.D., Physician Partners of America’s pain management specialist in Richardson, Texas.  “It was truly remarkable,” Dr. Creighton says. “He came in in a wheelchair and walked out of the surgery center 100 percent pain-free.” Another patient who had hobbled for years had the same result.

Dr. Creighton calls the unique system “remarkable. I’ve never seen anything like it in my 26 years in practice.”

How does this spinal implant work?

Manufactured by Vertiflex, it is a one-inch titanium implant that slightly spreads the vertebrae, relieving pinched nerves. The implant “decompresses,” or widens, the spot that is compressing the nerve.  Once it is in place, the surgeon releases two “arms” on either side of the device to keep it secure.

The procedure takes about 30 minutes, causes little bleeding, and does not involve removal of bones or tissue. It is also completely reversible if the patient chooses a different procedure later on.

What is spinal stenosis?

Most often seen with age and wear and tear, stenosis is a narrowing of the spinal canal. It is usually associated with the lumbar, or lower, spine. The narrowing process squeezes on nerve roots that exit the spine, causing pain.

Spinal stenosis symptoms

The most common way to tell if a patient needs lumbar spinal stenosis treatment is when bending over feels better than standing straight. The bending motion opens up the space between the vertebrae, temporarily relieving the nerve compression.

What is spinal decompression?

Since it’s not comfortable to live life bent over, decompression surgery might be an answer. “Surgery,” in the case of Physician Partners of America, is always minimally invasive. That means an incisions that is one inch or less. While there are several ways to treat painful back conditions, Vertiflex shows much promise.

“It’s much faster to perform, it has less operative risk, and the results are immediate,” Dr. Creighton says.

Vertiflex procedure – an alternative to spinal fusion

This decompression device can also help people whose spines have become unstable from disc degeneration. This process releases proteins in spinal fluid, which can irritate sciatic nerves. A traditional treatment is spinal fusion, in which two or more vertebrae are permanently joined together with hardware into a single structure. The goal is to stop movement between the two bones and prevent back pain.

Fusion usually has a three- to six-month recovery time. Compare that with the days of weeks of recovery after a Vertiflex implant.

Patients in a clinical trial reported 73 percent improvement in back function after two years and 81 percent improvement after five years. Overall patient satisfaction with the implant stood at 90 percent after five years.

Ask your PPOA physician about the Vertiflex procedure as a disc degeneration and spinal stenosis treatment.

 

 

 

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The Anatomy of Sacrum Pain

When people refer to sacrum pain, they are usually talking about pain that affects the sacroiliac (SI) joint in the spine. The sacrum is a triangular bone at the very bottom of the spine, formed by five fused vertebrae. On either side of the sacrum are two wing-like bones that join via strong ligaments with the iliac bones of the pelvis. Unlike the other vertebrae of the spine that are connected by flexible discs, the sacrum itself and the SI joint have very little motion and flexibility. Instead, their primary roles are to support the spine and absorb shock.

Sacrum Pain Symptoms

Just like the other joints in the body, the SI joint can degenerate over time. The ligaments around the joint can stiffen, or they can develop tears and loosen the joint too much. Either scenario can cause the joint cartilage to wear away, leading to the sacral and iliac bones rubbing together and causing pain. This is also a synovial joint, which means it is filled with a lubricant called synovial fluid. Over time, the synovial fluid may become inflamed and cause further discomfort.

Sacrum pain caused by SI joint dysfunction can take many forms. Symptoms can include:

  • Groin pain
  • Muscle weakness in the legs
  • Pain in the lower back
  • Pain when moving standing after sitting for a long period of time
  • Pain when standing for long periods of time
  • Radiating pain in the hips, buttocks, and legs
  • Tingling or pins-and-needles sensations in the lower extremities

Treatment for Sacrum Pain in Tampa, Florida

Some of the most common causes of sacrum pain include osteoarthritis, rheumatoid arthritis, and osteoporosis, but the condition can also develop due to occupational injuries, auto accident injuries, and other activities that put repeated stress on the SI Joint. If you think you may be suffering from sacrum pain due to SI joint dysfunction, turn to the professionals at Physician Partners of America in Tampa.

Our team of pain specialists has extensive experience treating chronic pain using nonsurgical and minimally invasive methods so that you can get back to living the life you enjoyed before sacrum pain took over. At Physician Partners of America, we believe that all patients experience pain differently, which is why we take the time to understand your symptoms and ask questions about the pain relief techniques you’ve tried in the past. By getting to know you, the patient, we can then create a completely customized pain management plan that fits your unique needs.

Contact us today to schedule an appointment with a pain specialist in Tampa, Florida

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Osteoporosis Pain Relief

Osteoporosis, which is a disease that affects the strength and density of the bones, is extremely common. It is estimated that more than three million Americans are newly diagnosed with this condition each year, resulting in more than 50 million annual cases of osteoporosis.

While anyone can develop osteoporosis, certain risk factors greatly increase your chances of developing brittle, weak bones:

  • Being Caucasian or Asian
  • Being female
  • Being over the age of 60
  • Low body weight
  • Low sex hormone levels
  • Menopause
  • Small body frame
  • Smoking

Although osteoporosis is most common in older individuals, bone mass gradually starts to decrease – sometimes by as much as one percent each year – as early as the age of 30. Taking preventive measures when young, such as exercising and getting sufficient calcium and vitamin D, is an essential part of life-long bone health.

Osteoporosis Diagnosis & Symptoms

Unfortunately, many people don’t realize they have osteoporosis until a bone fracture occurs. Considered a “silent” disease, osteoporosis can develop over the course of many years without producing any noticeable symptoms. Being vigilant about potential signs of bone loss is extremely important, as taking measures to fend off osteoporosis early can help prevent dangerous fractures down the line. Talk to your doctor about your risk for osteoporosis if you notice:

    • Bone pain or low back pain
    • Spinal curvature
    • Height loss

A diagnostic test called a bone mineral density scan, or DEXA scan, is an X-ray specifically geared toward detecting loss of bone density. Images of your bones are compared to healthy bone benchmarks for someone of your age, gender, and ethnicity. Your doctor may order a DEXA scan if you are at an increased risk for osteoporosis or exhibit any of the symptoms listed above.

Osteoporosis Treatment in Texas and Florida

If you are diagnosed with osteoporosis, treatments will likely include calcium, vitamin D, specialized osteoporosis medication, physical therapy, and strength training. Treatment may vary if you are experiencing osteoporosis pain due to a bone fracture. Back pain due to a fracture of one of the spinal vertebrae can be especially debilitating and may require surgery. At Physician Partners of America locations across Texas and Florida, we offer osteoporosis pain treatment and vertebral fracture treatments such as vertebroplasty and kyphoplasty. These minimally invasive procedures can help heal a vertebral fracture caused by osteoporosis so that you can get back to living your life.

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5 Ways to Alleviate Back Pain

Alleviate Back Pain

Back pain is something that a majority of American adults will go through at some point in their lives. It can begin with something as simple as doing yard work or bringing groceries into your house.

Though back pain is common, it can cause a lot of frustration in your life. Even minor back pain can keep you from enjoying your daily activities, and more serious back pain could make it difficult to work or drive.

If you are struggling with back pain, you are likely ready to try whatever it takes to make it go away. Here are five strategies for getting some relief from your back pain:

Use Heat and Ice 

For pain relief, both heat and ice can help with your back pain. When you injure your back, begin with ice as a treatment for a couple of days. It will help reduce your swelling and start the healing process.

After two days, switch to heat for your pain relief. A heating pad can help your back loosen up and soothe your pain. However, if you find one more relieving than the other, that’s fine. Whatever works for you is the best method for your pain relief.

Get Moving to Alleviate Back Pain

When you are in pain, you may be tempted to stay in bed until you feel better. However, you should try to get back on feet within a few days if possible. Mild activity can help you feel better, even something as simple as walking can help.

It is important to work on things like improving your flexibility and strengthening your core over time, as these will help keep your back pain at bay. However, keep in mind that you should avoid strenuous activity until you are fully healed to avoid making your injury worse.

Be Aware of Your Body, Day and Night

You may not realize how much the way you carry yourself can impact the level of your back pain. During the day, work on improving your posture. Whether you are sitting or standing, good posture can make a big difference in improving your back pain.

Another thing to pay attention to is the position that you sleep in. An unsupportive mattress or bad sleep position can make your back pain worse. Try to avoid sleeping on your stomach, as that can aggravate your back. If you sleep on your side, try putting pillows in between your knees to keep your spine straight. If you sleep on your back, you can put pillows under your knees for relief.

Practice Healthy Habits

Healthy habits can be a huge help in alleviating your back pain. To start, if you are a smoker, you should quit as soon as you can. Smokers may be more likely to have back pain.

Other wellness techniques that might help your back pain include healthy eating habits and meditation. Since meditation focuses on breathing and relaxing, it can help your back loosen up.

See a Specialist to Alleviate Back Pain

Though all of these techniques can help your back improve, you still may need to see a specialist if you are in a lot of pain all of the time. Your medical professional can help you find the right path to getting your back healed and your pain alleviated.
Back pain does not have to ruin your life. Talk to a specialist and begin the healing process.

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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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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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