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

Tag Archive for: Pain Medications


Interviewer: There are so many different types of pills out there. Pain pills, vitamins, blood pressure medicine, depression medication, the list goes on and on. There’s a good chance that you probably take a few of those. But have you thought about what they could possibly be doing to your organs? Dr. Rudy Gari from Florida Pain Relief Group is back to shed some light on this. Dr. Gari, great to have you here, and this is a really important topic.

Dr. Gari: Yeah, absolutely it is. And so one of the problems with pain pills is that, if you think about it, when you take a pill through your mouth, it has to travel first to your stomach. It gets absorbed. From there it goes to your liver…90% plus gets broken down, and then it gets spread from head to toe.

Interviewer: Okay, so what if you are taking multiple medications and they’re all going into your liver? What’s that doing to your organs?

Dr. Gari: Well, that can have a significant effect in your organs, especially those… So let’s talk about some of the pain pills. A lot of the pain pills have acetaminophen. Acetaminophen is a very good analgesic, but it wasn’t meant to be taken in very high dosages. So it’s metabolized by the liver, and we know that taking too much acetaminophen can affect your liver. So that’s a big problem with taking pills. We see a lot of that when patients come in. One of the things that we do is we want to give them their medications, but we want the medications to be absorbed right directly to where the problem is.

Interviewer: Yeah.

Dr. Gari: So we like to use some different ointments and creams. For example, if you have low back pain, we might apply some of that right exactly into the back or to the joints to get absorbed through the skin. You don’t have to take this pill that gets to your stomach, liver, and then goes head to toe and only a small fraction gets to the problem area.

Interviewer: Yeah, if you can bypass those organs and keep them as clean as possible, then…

Dr. Gari: Absolutely. So like a perfect example, let’s just take morphine, which is a medication. I can inject a tiny fraction of morphine, let’s say, into your back…maybe one-tenth of a milligram. A half a milligram. That’s actually a lot more powerful than if you take a hundred milligrams of morphine by mouth.

Interviewer: Wow. I don’t know why everyone wouldn’t say, “That’s the better method.”

Dr. Gari: Well, and what happens is when you take a very small portion and you put it to the area that’s painful, that’s the only place that it goes. When you have to take, for a hundred milligrams to get to equal one, you have to take a lot of it and it goes from head to toe. Liver, all your organs get affected that don’t really need to be affected by that medication.

Interviewer: When we see ads on TV, we see pills being advertised, and they are a cure-all for everything. It’s not, right?

Dr. Gari: Well, unfortunately, no it’s not. You know, you all want to take a pill and have it go away. But a lot of times, and what’s exciting now is that we target exactly where that problem area is and go right to it and use the smallest amount of medication necessary to get that taken care of.

Interviewer: How can medication affect you mentally as well as physically?

Dr. Gari: Well, what happens, if you think about it, our bodies and our selves can become dependent. So if you have to take a pill, it almost becomes a reflex.

Interviewer: Right.

Dr. Gari: We don’t want you getting into that habit of having to take pills all the time. So let’s say, like a patch. We can place a patch on you that’s good for seven days. We can do some ointments and creams that you don’t have to worry about taking a pill four times a day. So people get very dependent on that.

Interviewer: And we’ve all heard of people dying because of it too, because of overdosing.

Dr. Gari: And the problem is when you take it, sometimes you become…and we don’t know exactly how it’s going to work. We do a lot of different things like pharmacogenomics to determine your metabolism of that, but still, even with that, there’s side effects.

Interviewer: Okay, Dr. Gari, important stuff here. Thank you very much. Visit their website, to schedule your same-day appointment or you can give them a call.  We’ll be right back with more Daytime, so don’t go away.


Cindy: Complex regional pain syndrome, it doesn’t that like something that anyone would want to deal with. It is also called CRPS.This chronic pain condition can wreak havoc on your body. Doctor Rudy Gari from Florida Pain Relief Group joins us now to fill us in on what this is. Great to have you back.

Dr. Gari: Thank you.

Cindy: Complex regional pain syndrome sounds awful. What is it?

Dr. Gari: Yes, it does. And the reason why it is called complex regional pain syndrome is because it’s just that, it’s complex. This is something that has been going on Cindy, for a very long time. In fact, this goes all the way back in the Civil War. We have documented case studies of soldiers who actually had so much pain in their arm that they wanted to cut their arms off.

Cindy: Oh, okay.

Dr. Gari: It used to be called something called causalgia, it was called the reflex sympathetic dystrophy. The term that is used right now is called complex regional pain syndrome and what that really is, if you think about it, think about if you get pain in your hand or your arms, anywhere. Normally, that pain shoots up your brain and it stops. What happens with complex regional pain syndrome is that it becomes a vicious cycle. So the pain keeps going in circles, keeps going in circles and it never stops.

Cindy: Any particular area of the body that you see it most often?

Dr. Gari: It usually affects the extremities. It affects the arms, it affects the legs, it can actually spread, but the good thing Cindy is there’s a lot of things that we can do to help complex regional pain syndrome. One of the first things is that the earlier that we see it the better. And so it often travels through these nerves called sympathetic nerves. So what we do is what we call sympathetic blockade. We want to stop that seizure and that pain constantly going in circles but it’s a certain specialized field in medicine they use, physicians like myself, I’m an anesthesiologist, I’ve been treating this for many, many years and I’ve actually had great success. So there’s blocks, there’s something called sponcra [SP] stimulators and the earlier that we treat this the better it is for our patients.

Cindy: How often do you see somebody coming in with complex regional pain syndrome?

Dr. Gari: I just saw a patient this morning.

Cindy: Really?

Dr. Gari: This patient has horrendous, horrendous leg pain and has all kinds of issues going on. Not just nerve pain it affects his vascular system and the pain is never ending. She’s has unfortunately, has this for many, many years.

Cindy: Oh gosh. Well, she doesn’t have to live with it for any more years, right?

Dr. Gari: No, no. We have her on a plan.

Cindy: What are you able to do for her? What are you going to do?

Dr. Gari: So what we do is we can give her some medications probably to help with that pain. We’re gonna go after and try to stop that seizure if you will of the pain syndrome, blocks and we’re considering a sponcro stimulator as well.

Cindy: So get to the source, right?

Dr. Gari: Absolutely, absolutely.

Cindy: Instead of just you know, treating the…

Dr. Gari: It can be cured.

Cindy: It can?

Dr. Gari: It can be cured, yes.

Cindy: Okay. So when is it time to come see you? When they feel like this is something that has been going on with them?

Dr. Gari: The sooner the better, the sooner the better. Have seen someone like myself because we can treat you in those things that we can do.

Cindy: So, usually fingers, legs, any…

Dr. Gari: Fingers, arms. It’s usually the arms or hands or legs. It usually begins as something as mild as just bumping into the wall somewhere that can cause, like, a seizure which will just continue, where we have to stop that vicious cycle.

Cindy: It goes on and on and on. Okay, good stuff Dr. Gari, that’s really good news for so many people. Florida Pain Relief Group has scheduled same day appointments so be sure to visit their website. It is or you can give them a call at 844-KICK-PAIN. Doctor, always good to see you. Thank you very much.

Dr. Gari: My pleasure.

Cindy: We’ll be right back.

Dr. Gari: Thank you.