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

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Dr. Rodolfo Gari Talks Kyphoplasty: Pain Management Without Surgery

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Interviewer: Our next guest has been here before, of course, talking about the innovative ways that he treats pain without surgery. We love the sound of that. We welcome back Dr. Rudy Gari from Florida Pain Relief Group who is here with another method and that is called – it’s got a funny name but I’ll try it right here – kyphoplasty.

Dr. Gari: Yes, yes.

Interviewer: Okay, so what is a kyphoplasty?

Dr. Gari: So, a kyphoplasty, basically, it is a way…we’re actually putting like a cement into your vertebral bodies. So, your spinal column consists of 31 different bones called vertebral bodies. Sometimes, usually as we get older or we fall and so-forth, that body can become fractured. It can have what’s called a compression fracture where the body actually shrinks. And we didn’t have a whole lot of methods before except to go on and put all kinds of fuses and rods in there to straighten it up. Now, what we can do, we can actually put medication, like a cement, into that vertebral body to make it stronger to try to really strengthen that bone, and the relief can be sometimes instantly.

Interviewer: That’s fantastic. Now, we’re talking about…you’re mentioning these vertebral bodies, it’s basically the vertebrae, right?

Dr. Gari: It’s the vertebrae, correct.

Interviewer: Okay, and so we’re talking about back and any part of the back that this kyphoplasty helps?

Dr. Gari: Well, this help patients that have had a fracture.

Interviewer: Okay. Specifically?

Dr. Gari: Specifically.

Interviewer: Okay.

Dr. Gari: They’ve broken their backbone, if you will, somehow and it’s a way to be able to give them strength of that vertebrae again, so that they can get back on their feet and be able to get things done.

Interviewer: And a lot of times people who have had these fractures, they start to shrink, don’t they? So does this prevent that from happening?

Dr. Gari: Well, what actually happens when we shrink it…well, first of all, it does align you a little bit more, but the reason why we shrink when we get older is not so much the bone, but there is actually this gelatinous tissue in between the bones…

Interviewer: That disappears.

Dr. Gari: …and that tends to get lower and lower. So, we can lose 1, 2, or 3 inches as we get older because it tends to dry out.

Interviewer: Yeah, I’ve lost an inch already. I used to be 6’3″, I’m 6’2″ now and I hate that. All right, so are we talking about permanent or temporary relief with this kyphoplasty?

Dr. Gari: Well, the kyphoplasty, you know, it’s a permanent thing. I mean, we put that in there and that vertebra is a lot stronger that what it’s been before.

Interviewer: That’s great.

Gari: And that stays in there.

Interviewer: Sure. Now, how does one know if they’re a candidate for this type of treatment?

Dr. Gari: Well, usually your…you know, most physicians know about this procedure. So, if you go to your primary care doctor or your orthopedic or whoever it may be, you know, they’ll diagnose that fracture and find a physician that is competent and skilled at performing these procedures.

Interviewer: Yeah. And you know, Doctor, a lot of people out there who are in pain, no matter what kind of pain it is, the first thing they reach for in the medicine cabinet is an anti-inflammatory or, worse yet, even an opiate. Why is that not a good idea?

Dr. Gari: They have side effects. Those anti-inflammatories…I’ve actually done a year of internal medicine and I’ve seen patients, actually, beat up and die from anti-inflammatories. You cannot be taking this and you should not be taking these on a daily basis. There’s a lot a lot of, I mean, a more mild and gentle anti-inflammatory drugs, but even they have side effects as well. They can affect your kidneys. There’s all kinds of different side effects from long-term medications and, of course, the opioid. We all know about the opioid addiction, the epidemic that goes on. They’re not meant to be taken in the long term. Some patients need long-term opioids. However, there’s a lot of things that can be done so that you don’t have to take all these medications with significant side effects.

Interviewer: Okay, and this being one of them and you have so many other treatments available.

Dr. Gari: Yes we do.

Interviewer: Dr. Gari, thank you so much. Now, Florida Pain Relief Group even schedules same-day appointments for you.

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Dr. Rodolfo Gari of Florida Pain Relief Group Talks How Failed Back Surgery Syndrome Works

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Cyndi: Anyone who suffers from chronic back pain knows they’ll try anything to get relief. Well, sometimes that means undergoing surgery. But what if that doesn’t actually work? Failed back surgery syndrome can sometimes be a result, and avoiding surgery is an important measure to stamping out FBSS. Dr. Rudy Gari is here from Florida Pain Relief Group to talk more about this, FBSS, Failed Back Surgery Syndrome.

Dr. Gari: Yes.

Cyndi: Okay. How common is it to see this?

Dr. Gari: It’s very common. So we have great neurosurgeons, they do fantastic work, but unfortunately, you know, it’s not 100%. And so we have some patients that, despite a great surgical procedure, the patient continues to have back pain afterwards. So we actually get a lot of referrals from our surgeons when they’ve done everything possible that they can and they still have that back pain.

Cyndi: Are there certain people, in particular, that are more prone to this?

Dr. Gari: That can really happen to just about anybody. The more surgeries that you have, it makes more sense, the more likely that you are… Because the first surgery has a high success rate, the second one is less, and the third one’s even less. So yes, our surgeons do everything that they can, but unfortunately there are some patients that, despite that, they still continue with pain. And that’s where we come in and we can help out.

Cyndi: I imagine, after going through all that, these patients that are coming to you are at their wit’s end because they’ve tried. They’ve gone through major surgery, and they still have pain. So what can you do for them?

Dr. Gari: Sure. So we can do a lot of things for ’em. The first thing we do is perform a thorough history and physical examination and see what’s going on, make sure there’s nothing else that we can do from a surgical point of view. After that, that’s medications. We can do nerve blocks, physical therapy, spinal cord stimulation, stem cell therapy. There’s a lot of different tools that we can have, and we learn more and more every day. It can be pretty debilitating. I’ve had some patients say, “Doc, I just wanna be able to go to the mall and go shopping. I mean, things that we take for granted, they can’t do that. But we can help them, and sometimes that’s a success, is different treatments to allow you to go shopping, to go do grocery shopping, you know, those kind of things.

Cyndi: Does it require a lot of visits to you to get this relief, or is it something that takes time because everyone wants it fixed, you know, yesterday? But obviously you have to assess what the matter is first and then start with the treatment. But is it ongoing treatment usually, or is it a treatment that’s one time and then you’re good?

Dr. Gari: It’s both. So we have some patients that all that they need is, perhaps, you know, two or three nerve blocks and physical therapy and then they’re good. And then, if they aggravate their back again, they come see us. We have other patients where, you know, they just have a lot of damage. They have a lot of scar tissue and different things where they do require more visits from us.

Cyndi: I hear a lot about people who have pain due to scar tissue. Why does that cause so much pain?

Dr. Gari: So what happens is that a scar can form around the nerve, so that nerve is constantly being squeezed. We actually have a procedure that’s called epidurolysis, and what that does is, is that we can actually go in and try to remove, if not loosen up, that scar tissue. And we do that without surgery. We do it through a needle and then a little bit of a catheter. We can go in there and try to loosen that scar tissue.

Cyndi: And that relieves that nerve.

Dr. Gari: Yes.

Cyndi: Ah, and stops the pinching.

Dr. Gari: It’s that squeezing on the nerves by the scar tissue that is formed around it.

Cyndi: Oh, sounds like some really good advice and good news for a lot of people that are out there right now that are going through this because they may think there’s nowhere else to turn. But there is, definitely.

Dr. Gari: Yes, there is.

Cyndi: Thank you, Dr. Gari. Florida Pain Relief Group even offers a same day appointment, so you can visit their website. It is floridapainreliefgroup.com, or give them a call right now, 844-KICK-PAIN. Dr. Rudy Gari, thanks again.

Dr. Gari: My pleasure.

Cyndi: We’ll be right back.

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