Make Pain a Thing of the Past – dr. prasad – Physician Partners of America

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Jerry: How familiar is this to you? Lower back pain that reaches down your legs. Well it’s something a lot of you could be experiencing right now. And a common cause of this, by the way, is something called sciatica. You’ve probably heard of that. Dr. Rudy Gari from Florida Pain Relief Group joins us now to explain what it is exactly. Welcome back to you, Dr. Gari.

Dr. Gari: Thanks, Jerry.

Jerry: So we hear a lot about sciatica. What is it? What causes it?

Dr. Gari: Sciatica basically is a shooting pain, shooting sensation that goes from your lower back and shoots often all the way down to your foot. The reason it’s called sciatica is because it often involves what’s called the sciatic nerve. A sciatic nerve is a large nerve. It’s your main nerve that goes through your leg and often is caused by some sort of an inflammatory process. A lot of times it’s a bulging disc. It’s a herniated disc. You twisted the wrong way. Something is pinching causing inflammation. And you get a very severe shooting sensation that can be very, very debilitating.

Jerry: So a lot of things can cause it but it’s generally related to some sort of a nerve issue?

Dr. Gari: What I tell people is, if you’ve hit what they call your funny bone.

Jerry: Yes.

Dr. Gari: When you push here it shoots down to your fingers, right? Well it’s the same thing that happens with sciatica.

Jerry: Oh got it.

Dr. Gari: Instead of pushing your elbow something’s pushing your lower back and shooting down to your foot.

Jerry: So how does this change people’s daily life?

Dr. Gari: Just last week I had a patient that came in with a severe sciatica. She came in in tears. She was hurting so bad she could not even sit. She basically had to lay down on the bed. She was just crying with so much pain that she had.

Jerry: That’s debilitating.

Dr. Gari: Yes.

Jerry: That says it all right there. All right. Let’s talk about treatment options then. How did you help this woman?

Dr. Gari: Well the first thing that I did, of course, was to make a diagnosis. After the history and physical examination I found that she had the classic symptoms. She had the shooting pain. The exam showed that she had decreased sensation, so forth. That’s indicative of some sort of a disc herniation pushing on that sciatic nerve. The definitive diagnosis I sent her for MRI. And sure enough it came back that she had a herniated disc between the fifth vertebrae and the first sacral vertebrae pinching on that nerve. We brought her in two days later. She was very heavily medicated because of the pain.

Jerry: Sure.

Dr. Gari: What we did for her, we gave her these injections that went close to that nerve root. Reduced the inflammation. The inflammation pretty much went away. She had two treatments, two injections, a week apart. This person was a marketing representative and she traveled a lot. She could not even go anywhere and she’s back at work.

Jerry: Isn’t that great?

Dr. Gari: I sent her to physical therapy to make sure she strengthens her core muscles. If she can take great care of herself, which I’m sure that she will, she can get back to a normal life.

Jerry: Which is fantastic. Is a treatment like that is it permanent or do you have to keep coming back for these injections?

Dr. Gari: This can be permanent if, and it’s a big if. For example, what caused that disc herniation to herniate in the first place: Normally it’s weak core muscles. We sit a lot. We do a lot of things. So it herniates. We get the inflammation. The inflammation ends up going away. Physical therapy, and that disc can actually shrink back. So it can be permanent.

Jerry: So you have to take care of yourself after you get the injections.

Dr. Gari: Yes you do.

Jerry: All right. Dr. Gari, thanks so much. You can contact Florida Pain Relief Group to schedule your same day appointment right now. We’ll be right back with more after this.

It might start as an upset stomach. Nothing to get too worried about – people experience this on a regular basis. It could be you are nervous about something, or your last meal did not agree with you.

The next day the abdominal pain remains. It hasn’t gotten better despite the over-the-counter medications you have taken. By the third day, it becomes clear that something might be wrong. And at the end of the month, you’re still dealing with the abdominal pain. Something may be wrong.

“Abdominal pain that lasts for more than three months is called Chronic Abdominal Pain or CAP,” said Dr. Prasad, a pain specialist with Texas Pain Relief Group in Frisco, TX.  “Pain can vary in location, intensity, and character. Pain can be brief, lasting for a few minutes, or it may persist for several hours and longer. Associated symptoms can be diarrhea, bloating, indigestion.”

About 2-3% of adults at any time suffer from chronic abdominal pain. The causes of chronic abdominal pain can vary greatly.

“CAP can be caused by conditions affecting the organs in the abdomen and pelvis,” Dr. Prasad said. “Stomach and intestines; organs like liver, pancreas, kidneys, urinary bladder; female reproductive organs like ovaries and the uterus.”

Treating CAP depends on the severity and location of the abdominal pain. Often it will involve consultation and evaluation with other specialists, such as gastroenterologists, urologists, surgeons, gynecologists and any other specialist relevant to the condition.

“Treatment options for CAP can be conservative treatment with just medications,” Dr. Prasad said. “When medication alone fails to provide relief, procedural treatments may be considered including injections to block nerves. For resistant cases, the doctor may even consider spinal cord stimulation or pain pumps.”

Procedures such as nerve blocks, spinal cord stimulation, and pain pumps do not require hospitalization and are often performed on an out-patient basis. Most are done under sedation so the patient does not experience any discomfort associated with the procedure.

Dr. Prasad is currently seeing new patients at his office locations in Frisco and Euless.