Make Pain a Thing of the Past – laser pain procedures – Physician Partners of America

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Interviewer: Well, when the weekend finally rolls around, besides everybody saying, “Woo-hoo,” we all want to do activities we usually enjoy before heading back to work on Monday, but some of those activities, as you might experience, golfing, tennis, even gardening, can cause you pain. Dr. Abraham Rivera from Florida Pain Relief Group joins us now with a solution for all you weekend warriors out there. Now, Dr. Rivera, welcome.

Dr. Rivera: Thank you.

Interviewer: Let’s talk about what kind of pain that we’re zeroing in on here: bursitis, tendinitis, arthritis, all of the itises.

Dr. Rivera: Correct, correct. I mean, this is like you say, the weekend warriors. They go out there. They have very sedentary occupations. Now, it’s the weekend. They want to go out and play 18 holes of golf.

Interviewer: Right.

Dr. Rivera: Or they want to play a couple tennis matches. Of course, they come and see me Monday or Tuesday because they are sore, you know, to be expected. Now, many times when I talk to these patients, I find out that there is a problem with their technique. They have the wrong grip on the tennis racket or they have the wrong clubs. Often, they have shoulder disease, and they’re trying to hit that ball like when they were 22, and they’re 50 now. You can no longer hit that ball that way. So just believe it or not, by going over their technique, many times you solve the problem right there.



Interviewer: So I assume you’re a good golfer?

Dr. Rivera: Heavens no, but I do play with quite a few, and I see when they pay the price the next day.

Interviewer: So how do you fix, say, for instance, shoulder pain because a lot of people do like to get out there and hit the tennis ball around or play a round of golf. How do you treat them so they can go back to work without the pain?

Dr. Rivera: Yeah, many times, it’s just a case of acute tendinitis. They’re rubbing the tendon that goes over the shoulder joint against a spur that they have in their shoulder, and we typically diagnose that. We can prescribe some topical medication. We can give them some anti-inflammatory. Sometimes we have no resort but to inject the joint with cortisone. It’s something we can do in the office very quickly.

Interviewer: Now that’s something because I’ve had… I have rheumatoid arthritis in my knee, and I’ve had cortisone shots in my knee, but I was told you have to stop them after a while. Is this correct?

Dr. Rivera: Yeah, cortisone is a very seductive drug because it works.

Interviewer: Yes.

Dr. Rivera: You can only get so many of these so many times a year.

Interviewer: Right.

Dr. Rivera: It can have side effects. It can weaken the tendons. It can cause osteoporosis.

Interviewer: So what’s the next level then after that? I’m asking for myself.

Dr. Rivera: Yeah, I hear you. I hear you. You know when patients have disease in their joints, the thing I try to tell them, make them clear they understand, is they cannot travel that joint. By traveling that joint to the full range of motion, they’re wearing it out more. So try not to move it.

Interviewer: Yeah, hard to do. I’m a very active individual, but I was told that stem cell therapy might actually help.

Dr. Rivera: Well that certainly holds a promise. It is… the data is very promising, very tantalizing. It is an alternative. Unfortunately, it’s not covered by most insurances, but it’s certainly an alternative.

Interviewer: And real quickly for the gardeners out there, what can you do about their sore, stiff hands after they’re out there on a Saturday or Sunday?

Dr. Rivera: Preventive. I tell those patients to, number one, take an anti-inflammatory up front, a simple aspirin, Glucosamine, something over the counter. There is a lotion they can put on that contains some anti-inflammatories, and finally, I tell them to avoid impact. Okay, hammers, things that wack.

Interviewer: Right.

Dr. Rivera: Don’t want vibration.

Interviewer: Yeah, don’t hammer your flowers into the ground. Only if they’re dead. Okay, Dr. Rivera thank you so much. If you need to see Dr. Rivera or any of the other great doctors at the Florida Pain Relief group, just hit up their website  or give them a call, 844-KICK-PAIN to schedule your very same day appointment, which is very, very good to be able to get in there right away, right, when you have the pain? All right, Dr. Rivera, thanks again. We’ll be right back.


Cindy: Nobody wants their everyday activities to be limited because of pain, but shoulder pain can do just that if it goes untreated. Dr. Rudy Gari from Florida Pain Relief Group joins us now to talk more about shoulder pain and, my gosh, this is my life right here, shoulder pain, constant. What causes this, and is it degenerative?

Dr. Rudy Gari: Well, that’s one of the types of shoulder pain, is degenerative. Other types are traumatic. Example, my son, he thinks he’s Superman, and he was working out at the gym, and he hyper-extended his arms, and he dislocated his shoulder. We actually took him to one of the best surgeons in the country, who said, “Well, maybe he needs surgery.” He had a little bit of a tear there. Instead of having surgery, we actually brought him back to our facility and put in some stem cells into his shoulder, and he’s young enough, it actually allows it to regenerate that tear.

Cindy: So, even a tear can be fixed without surgery. That’s the first I’ve heard of that.

Dr. Rudy Gari: We’ve actually seen MRI evidence, before and after. And because stem cells regenerate tissue, we’ve seen the little mice with an ear growing out of his back, okay? That’s regenerated tissue. That’s the future of medicine, and so we’re doing a lot of treatments for joint pains through stem cells, allografts, what’s called now, regenerative medicine.

Cindy: That’s great because I know somebody who recently had shoulder surgery, and the recovery is worse than what he was going through before the shoulder surgery. It’s a long time.

Dr. Rudy Gari: It’s a big operation. Some patients need it, but it really is a big operation. It’s a very long…months, it can be, through recovery period.

Cindy: Definitely. Now let’s talk about arthritis. We think of it as being in our knees, and maybe in our hands, but can we get it in our shoulders?

Dr. Rudy Gari: We get arthritis in every joint, not only in our knees, and shoulders. We actually see a lot of arthritis in your back. Your back has 31 different bones. Each one of those bones is mounted together through these little joints, and they’re called facet joints. You get inflammation in any of the joints, shoulders, neck, anywhere, and that can cause pain, but the good thing is that it can be treated. We have to go after the source. It’s usually some sort of inflammatory process, like in the back, for example. You have pain in the back from inflammation, and once we make that diagnosis, there’s a procedure that’s called radio frequency, actually burns these tiny little nerves that cause pain from those joints. We can do it down the back, in the hip joints, knee joints, just different places.

Cindy: So, for people who are living with chronic arthritis, this could be the relief that they’re looking for?

Dr. Rudy Gari: Absolutely, and we help a lot of people with that.

Cindy: Okay, so should anybody come that’s got shoulder pain, and they think that it’s going to take more than just…like, they’ve gone for the massage and it’s not working, so they come to you? So what do you do then?

Dr. Rudy Gari: The first thing that we’re going to do, Cindy, is make a diagnosis. So, we’re going to take a good history, examination, probably send this patient for an MRI, find out whether it is a tear, arthritis, something else going on, because you have to make a diagnosis first, before you can actually go with a treatment.

Cindy: Right, and your goal is to try to find a way to treat that without having to go through the surgery?

Dr. Rudy Gari: Surgery should be the last option on everybody. Sometimes, you need it.

Cindy: Right.

Dr. Rudy Gari: But, you know, once you get it, it’s a long recovery process, so we want to do everything possible to avoid that.

Cindy: Good stuff. All right, Dr. Gari, thank you very much. You can visit their website, to schedule your same-day appointment, or give them a call right now, 844-KICK-PAIN. Dr. Rudy Gari, great to see you.

Dr. Rudy Gari: My pleasure.

Cindy: We’ll be right back.