Make Pain a Thing of the Past – Fibromyalgia Risk Factors – Physician Partners of America

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Interviewer: Pain, anywhere on your body can really put a damper on your life and your activities. But when it’s somewhere that’s constantly in use, like your pelvis, it can truly be debilitating. Dr. Rudy Gari from Florida Pain Relief Group joins us now with more about this. Dr. Gari, good to have you back.

Dr. Gari: My pleasure.

Interviewer: So many women that I know have pelvic pain. And it really is awful for them and they do not know where to turn. How many times do you have somebody come through your office door and they say, “The pelvic pain is driving me crazy”?

Dr. Gari: Just about every day.

Interviewer: And what in the world can be causing this?

Dr. Gari: Well, pelvic pain can be caused by a host or a variety of different factors. Sometimes these women may have some sort of endometriosis. They may have adhesions, they may have a different…some sort of a strain. So there’s all kinds of different disorders that can be causing this and unfortunately, most of the treatments that out there are just not very good. A proven example is the adhesions. If you have adhesions,..

Interviewer: What is that?

Dr. Gari: So adhesions are kinda like a… almost like a spider web if you will, but it’s your own body spider web.

Interviewer: Okay.

Dr. Gari: So like a little scaring sometimes inside, but it’s inside your abdomen, your pelvis. So, it can be pulling on a nerve or pulling on one of the organs there and can be causing pain. So what a surgeon can do is go in there and actually through what’s called a laparoscopy, go in there with a scope and remove those adhesions, and you feel much better. Here’s the problem, most of the times it comes right back.

Interviewer: Okay.

Dr. Gari: So it becomes a futile event to continue doing that. So, we have make sure that, “Hey, you know, has everything been done that can be done?” And then let’s look for some alternatives to doing the same thing that hasn’t been working. And some of the things, for example, that we’ve done, there’s nerve block called a superior hypogastric plexus block.

Interviewer: That sounds very scientific.

Dr. Gari: Yeah. So basically your pelvis has a bundle of nerves called the superior hypogastric plexus and that’s where you get the pain sensation. So some things very simple that we can do is go in there and actually put… place a long acting local anesthetic and a little bit of steroid into the ganglion to help calm it down. And there’s a whole bunch of techniques like that that we can do. There are other things that we can do for patients that are their wits end, there’s nothing that can be done, We’ve actually performed spinal cord stimulation at the… that stimulates the pelvic area.

Interviewer: Really?

Dr. Gari: So instead of pelvic pain, you have a much more comfortable sensation.where it doesn’t bother you anymore.

Interviewer: I’m thinking there are women out there right…listening that are thinking, “Well, what kind of a time commitment is that for me? Do I have to come back every week to get this stimulation so that I feel better?”

Dr. Gari: No, this actually…for the first week of the trial, see if it’s gonna work for you. So you’ll have the little trial for about a week, make sure that it’s some you’re comfortable with, that it helps you. And if it does help you, we can get that implanted. It’s a tiny little electrode, maybe the size of a string. It goes in, into the back of your spine, it stimulates those nerves, and then there’s a little generator that gets implanted under the skin about the size of a half dollar…

Interviewer: Wow.

Dr. Gari: And that battery lasts several years. You can program that in different ways and you have a lot of control over yourself.

Interviewer: So, lots of options out there?

Dr. Gari: Absolutely.

Interviewer: Okay, Dr. Gari. Thank you very much. You can contact Florida Pain Relief Group to schedule your same-day appointment. Stop living with pain, you don’t have to. You can visit their website. It is or give them a call, 844 KICK PAIN. We’ll be right back with more Day Time, so don’t go away.

A headache following concussion will usually clear within a few minutes to days following trauma.

Longer lasting headaches are known as post-traumatic headache. (PTHA) There is a wide variety of symptoms and frequency of headache.

The most difficult presentation is the individual who develops chronic headaches following mild injury. It is important to obtain an accurate history of the patient as well as examination and imaging if appropriate.

Obtaining an accurate history from the headache patient can be challenging. Did the patient have any headaches prior to injury? What additional symptoms do they have-nausea, vomiting, blurring or loss of vision, light, smell or sound sensitivity? Problems with memory? Changes in behavior observed by close friends or family? Tinnitus (ringing in the ears) or dizziness?

Clinical features may range from mild aching over entire head or unilateral (one side) headache, frequency and severity . Often the pain of headaches and the inability to function cause anxiety, depression, and libido impairment.

Changes in mental function may be seen with difficulty in concentration, decreased work efficiency, difficulty maintaining attention and memory loss. Burst of anger or bouts of crying may also be seen.

Treatment of post traumatic headache as well as other symptoms is usually symptomatic. There is no medication that will alter the disturbances that may have occurred in the brain. “Wait and watch” is a frequent term used by clinicians and may be frustrating to the patient, especially the young previously healthy individual.

Appropriate diagnosis is essential. What might the extent of the traumatic brain injury (TBI) be? Are there other injuries which may be effecting the patient’s pain such as jaw or neck injury?

PTHA (post traumatic headache)-major types

  • Tension headaches
  • Cervical/cervicogenic headaches
  • Musculoskeletal headaches
  • Temporal Mandibular Joint Dysfunction


  • Physical Therapy
  • Medications
  • Stress Management
  • SPG Blocks
  • Occipital Nerve Blocks
  • Botox

NCAA Guidelines for return to play after concussion:

  • Light aerobic exercise such as walking, swimming, or stationary bike. If asymptomatic then;
  • Mode, duration and intensity-dependent exercise based upon sport. If asymptomatic then;
  • Sport specific activity with no head impact. If asymptomatic then;
  • Non-contact sport drills and resumption of progressive resistance training. If asymptomatic then;
  • Full contact practice. If asymptomatic then;
  • Return to play. Medical clearance determined by treating provider or athletic trainer in consultation with team provider

If at any time the athlete becomes symptomatic, return to previous level of activity. Final determination ultimately resides with the team provider.

Determining Fibromyalgia Risk Factors

It’s estimated that more than 3 million people suffer from fibromyalgia in the United States. Fibromyalgia can cause chronic fatigue, disrupt sleep patterns, affect the memory, and alter the mood. It is marked by persistent widespread muscle pain in various parts of the body and is often debilitating.

There is no cure, but the chronic pain associated with the disorder can be managed with proper treatments and therapies right here in Tampa, Florida.

3 Risk Factors for Fibromyalgia

  1. If you’re a woman, then your chances of a fibromyalgia onset are greater. This painful disorder is diagnosed in woman far more often that men for physiological reasons (ie. the differences in human male and female bodies.)
  2. If another family member has fibromyalgia, you are more likely to suffer from it at some point as well. Genetic predispositions and inherited traits put some people at a higher risk of the disorder’s onset.
  3. If you have rheumatoid arthritis you may be more likely to develop fibromyalgia due to already being prone to painful nerve disorders.

Get Fibromyalgia Help in Tampa

Fibromyalgia is a tricky health concern. It is believed that repeated nerve stimulation causes the brains of those suffering with fibromyalgia to change, leading to an abnormal increase in levels of neurotransmitters (the chemicals in the brain that signal “pain.”) Over time, it is thought that the brain’s pain receptors seem to develop a “memory” of the pain and become more sensitive, often overreacting to pain signals in the future.

Over-the-counter (OTC) medicine like aspirin can offer a brief respite, but the pain will return and you don’t want to become dependent on painkillers, the OTC or prescription-kind. There are alternatives to managing the chronic pain of fibromyalgia. Non-pharmalogical therapies can be a great way to reduce the pain without surgery or medication.

Our pain management experts at Florida Pain Relief Group can help relieve the awful pain that fibromyalgia causes. Get on board with us today to make fibromyalgia pain walk the plank!