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

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Interviewer: Surgery, it’s a word that patients hate hearing and one that keeps many away from the doctors’ offices. But there are ways to treat back pain without going under the knife. Dr. Rudy Gari from Florida Pain Relief Group is back to talk about one of those ways today, spinal cord stimulation. Okay, Dr. Gari, great to have you back.

Dr. Gari: Pleasure.

Interviewer: What is spinal cord stimulation?

Dr. Gari: So actually spinal cord stimulation is a technique where we place these tiny little electrodes into the back of your spine that helps…it blocks the pain levels. It’s actually based on a Noble Prize winning technique. If you think about it, when you were a little kid and you place your finger on the stove and it hurt, and mom came and rubbed it and it felt better. Well, the reason why it felt better is because the touch sensation actually went up your brain and blocked the pain going to your brain.

Interviewer: Interesting.

Dr. Gari: What spinal cord stimulation does, is these tiny little electrodes, they’re no more than epidurals when the ladies have the little epidural catheters for labor, it’s the same thing, but we place these little electrodes there and what it does is it replaces the back pain and the pain going down to the legs with a very gentle tingling sensation. So you feel a tingling sensation as opposed to having this constant back pain.

Interviewer: That sounds like a great thing for so many people. What kind of pain does it treat?

Dr. Gari: It treats basically back pain, low back pain, it treats any sort of nerve pain, diabetic neuropathy, any sort of nerve entrapment. Patients that have had…we get a lotta patients that have had two or three or four back operations. There’s nothing else that can be done. Those are very good candidates because, you know, they are constantly in pain, we can place that in there and get them some really significant relief, allow them to cut down on all these massive medications that they have to take just to live their everyday life.

Interviewer: Is this done through an outpatient kind of facilitation?

Dr. Gari: Outpatient procedure. You come in, we give you some sedatives to relax you, a little local anesthesia, it’s done [SP] through a needle. We place this electrodes through a needle and you go home the same day. Usually we do what’s called a trial period, where we have you go home with it for about a week, make sure that it’s gonna work for you. If it works for you, we can get it implanted. It’s a….very…it’s a tiny little incision that just goes right on the skin. It has a little thing called a generator which is the size of a half dollar, and the batteries’ rechargeable, so it last years.

Interviewer: Oh, so you don’t have to keep going into the office to get this put in, you can…

Dr. Gari: No, no.

Interviewer: …have put in and then you’re… Do you control it yourself, or?

Dr. Gari: Yes, there’s a lotta programs. So for example, you say, “Well, sometimes I get back pain, sometimes have pain down a leg, sometimes a combination.” We can program this to have different types of variances. So, if you have back pain, you hit number one, if you got leg pain number two, and so forth.

Interviewer: Why is this preferable to more traditional back treatments, like surgery?

Dr. Gari: Because a lotta times there are no other options. You have, for example, these chance of success after the first back operation is fairly high. The second one is not so high and the third one, you’re only talking maybe 15%. So after that, you’re almost…you’re pretty much out of options when it comes to surgery, but you’re not out of options when it comes to seeing us because we have a lotta different treatments.

Interviewer: Well this is a great alternative to surgery in the first place, right?

Dr. Gari: Absolutely.

Interviewer: All right. Dr. Gari, thank you very much. Florida Pain Relief Group even schedules same-day appointments. Be sure to visit their website right now,, or give them a call, 844-KICK-PAIN. Dr. Rudy Gari, thank you again very much.

Dr. Gari: My pleasure.

Interviewer: We’ll be right back.

Cindy: Everyone experiences back pain at some point in their life, whether it be strained muscles, a pinched nerve, or something much more serious. Dr. Rudy Gari from Florida Pain Relief joins us now to talk about why it happens and what we can do to stop it. Hi, Dr. Gari.

Dr. Gari: Hi Cindy, how are you?

Cindy: I’m well and thankfully pain-free right now, but I’ve had back pain and I think everybody that’s watching right now at some point in their lives has had it if they’re not having it right now. What can we do, first of all, to prevent this back pain?

Dr. Gari: Well the first thing that you can do is to make sure that your core muscles are intact. One of the biggest reasons for problems with back pain is that as we get older, our muscles and our core tends to loosen up, and those are really the protectors, and when they loosen up, it gets everything else loose and allows you to maybe twist the wrong way for you to get hurt.

Cindy: Yeah, I’ve done that.

Dr. Gari: Yeah.

Cindy: What about pinched nerves? We hear about that a lot. What can your organization do to help people who have pinched a nerve in their back?

Dr. Gari: A pinched nerve is actually a nerve that’s inflamed. What we can do is first identify exactly which nerve it is. Then if it doesn’t go away with typical physical therapy, medication, and so forth, very mild, we can go ahead and put some medication right exactly into that nerve with a very local anesthetic and something to take away the inflammation. If we take the inflammation, that pain goes away.

Cindy: Because a lot of times when people have back pain, it prevents them from doing any kind of activity, and then that’s a ripple effect for their whole health, isn’t it?

Dr. Gari: Absolutely, because if you think about it, your back is the core of your locomotion. You can’t walk, you can’t do anything, you can’t bend. It’s debilitating.

Cindy: Yeah, it can affect every aspect of your life.

Dr. Gari: Absolutely.

Cindy: What’s the most common back pain people come in complaining of?

Dr. Gari: The most common that we see is either some sort of a strain, or it’s some sort of a herniated disk, which is actually where your spine consists of the 31 different vertebrae, like bones, that hold us up, and there are these little shock absorbers in between. That little shock absorber gel, if it protrudes out it can hit a nerve, cause inflammation, and that can be very debilitating.

Cindy: What’s the option for somebody with a herniated disk? My mom had that.

Dr. Gari: Yeah, the option is to see if it goes away with physical therapy and just rest. If it doesn’t, then before you go and get operated, we can go in right like we talked about earlier, go in and take care of that inflamed nerve. It’s an outpatient procedure.

Cindy: Great.

Dr. Gari: Take away and reduce the inflammation, allow you to get back on your feet again, and eventually that inflammation goes away so that we can try to avoid you from getting surgery.

Cindy: Isn’t that nice? A lot of people will be happy to hear about that. What can people do at home and how can exercise play a role in really protecting our backs and preventing damage?

Dr. Gari: The exercise that you can do is, again, core exercises, especially your abdominal area. Want to make sure that you find ways not to have more extra pounds than you need to. You have to be careful with your exercises because you don’t want to hurt yourself either.

Cindy: Right.

Dr. Gari: But anything that strengthens your abdominal area and your back muscles, that’s the first line of defense before it ends up hitting your spine, which is where some of the problems tend to occur.

Cindy: What about yoga and Pilates? Do you think those are good?

Dr. Gari: Those are very good, absolutely. Stretching, and that all causes a lot of core exercises, yoga and Pilates. They’re very good. In fact, Pilates was actually started by a doctor, Dr. Pilate.

Cindy: Yes, of course.

Dr. Gari: Yes, and Dr. Pilate started this Pilates exercises because he suffers from back pain.

Cindy: See?

Dr. Gari: And he wanted to actually find some exercises where he could actually treat himself, and he treated himself with Pilate exercises.

Cindy: All right, well Dr. Gari, thank you very much. For relief of any kind of pain, you can make the same day appointment today at Florida Pain Relief. Be sure to visit their website,, or give them a call. 844-KICK-PAIN. We’ll be right back.