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

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Dr. Rodolfo Gari Talks Best Posture and How It Helps To Avoid Back Pain

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Interviewer: We’ve heard it since we were kids, sit up straight. We all know slouching is bad for the back, but sitting up straight can also cause strain. Dr. Rudy Gari from Florida Pain Relief Group is here to help us find the happy medium. Hi Dr. Gari.

Dr. Gari: Hello.

Interviewer: So I think I’m sitting properly right now.

Dr. Gari: Yes, you are. Yes, you are.

Interviewer: Okay. But is there some ways that we can sit that we think we’re doing the right thing but we’re not?

 

 

Dr. Gari: Well, there is something that’s called the loss of lordosis. So people that have for example back pain. So your back should be curved. That’s called the lordosis. It means the curvature of the back that’s natural. And so, that actually allows us to have less back pain when we have that lordosis. Patients that have back pain for example can get muscle spasms and they lose that typical lordosis and now their back is flat. That flatness actually increases the pressure in nerve because our bodies were not designed to sit that way.

So while posture is very important, but often with the terms posture is also your core muscles. So strengthening your core muscles in many ways helps your posture, helps your pain and there is a lot of things that are done with physical therapy.

Interviewer: Yes, indeed. So bad posture can cause not only back pain but what else can that do?

Dr. Gari: Well, it can cause back pain and it can also cause you to pivot the wrong way. It can cause you to have a bad gait and it can lead to a lot of other problems in your back, in your neck, and other places.

Interviewer: I’m thinking neck and headaches from bad posture.

Dr. Gari: Absolutely. Absolutely.

Interviewer: Definitely. Okay. Should we get things for our chairs and…

Dr. Gari: Well, if you think about it, sitting in chairs is not natural.

Interviewer: Okay. So stop sitting?

Dr. Gari: So our bodies weren’t designed to sit but we do. So one of the things that people do is some very simple things. For example, sitting at that big medicine ball. That’s going to correct your posture because your body is gonna normally adjust, your core muscles are going to pick it up to make sure that you don’t fall, that you sit correctly.

Interviewer: So throw out that office chair and get the medicine ball?

Dr. Gari: Throw out the office chair and get that big medicine ball, sit on the medicine ball, stand up. Standing is much better for you than sitting.

Interviewer: All right.

Dr. Gari: And especially when it comes to that pressure on your lower back.

Interviewer: They do have those stand up desks now.

Dr. Gari: Those are pretty good.

Interviewer: Do you recommend that?

Dr. Gari: I absolutely do. High heels can cause some bad posture. I know that you know that though. Everybody likes high heels, we feel good about it but if you have back pain, that’s not…

Interviewer: Put those away.

Dr. Gari: You might wanna put those away for a while.

Interviewer: Too much strain. Let’s talk about picking things up wrong. What are we doing?

Dr. Gari: Well, the worst thing that you can do is to bend forward and pick something up.

Interviewer: Okay. Don’t do that.

Dr. Gari: If you must pick up, don’t use your back muscles to lift that object. You wanna make sure you maintain that lordosis, that curvature. Squat down and use your legs to lift up that object. Sometimes we have those back braces so you can put those on if you have to lift something because that’s gonna help your back. What you don’t wanna do though, you don’t wanna wear those on a regular basis because that will actually weaken your core muscles. We want our core muscles to be the ones doing the work of keeping posture and not get used to those back braces.

Interviewer: So the key to keeping that healthy is keeping this habit?

Dr. Gari: It’s all about the core muscles absolutely, Pilates.

Interviewer: Right, yeah, very well.

Dr. Gari: You know Pilates, right?

Interviewer: Mm-mmh.

Dr. Gari: Pilates was a physician who started that because he had back problems and he did all those exercises for himself.

Interviewer: All right. It might be time to try some of those. Dr. Gari, thank you very much. Florida Pain Relief Group even schedules same-day appointments. You can visit their website,  or give them a call. It is 844 (KICK-PAIN). We’ll be right back with more Daytime so don’t go away.

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Dr. Rodolfo Gari of Florida Pain Relief Group Talks Treatments for Weather-Related Joint Pain

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Cyndi: I’m sure many of you out there feel pain every single day, but just because you do, it doesn’t mean you can’t have it fixed. Even when it comes to a joint that often hurts, your knees, your hips, you name it. Dr. Rudy Gari from Florida Pain Relief Group joins us now to tell us what can be done about it. Dr. Gari, I think a lot of people at home are going, “That’s me, I’m half pain. When I bend down and do a knee bend, I can hear my knees. Is that normal?

Dr. Gari: No, it’s not normal. It’s something that’s called crepitus.

Cyndi: Crepitus?

Dr. Gari: Crepitus. And crepitus means that you have an inflammatory process, some sort of inflammation going on in those joints. It’s not a normal process. We have to examine and see what’s going on with it.

Cyndi: Can you help?

Dr. Gari: Yeah, absolutely.

Cyndi: Okay, good.

Dr. Gari: Yes, we can.

Cyndi: What about people who get symptoms of aches in their joints when there’s a weather system happening? What is happening there?

Dr. Gari: Well, what’s going on is that, I like to say that my patients are the best weather forecasters because they will tell me when it’s about to rain. Because they can actually sense, their pain increases, because the change in the atmospheric pressure affects the joint pressure that you have. We can sense that. So you know, normally we don’t, but if you have an inflammatory process in your joints anywhere, that becomes magnified significantly when the atmospheric pressure changes. So, humidity and a lot of that really tends to affect people that are in chronic pain a lot.

Cyndi: And you have some really innovative ways to help people with this inflammation, right?

Dr. Gari: Absolutely. What we do is, we first determine what’s going on, what’s causing that inflammation. We wanna get to the root of the problem. You know, what can we do? Sometimes it’s just arthritis, sometimes there may be some sort of a mass that can be removed, sometimes it’s trauma. But most of the times, almost always, it’s some sort of inflammatory process that’s causing that. And we get to that whether it’s through medication, through a pill, through an ointment, through a cream. Sometimes just a simple injection into the joint gets rid of it. Sometimes the joint in and of itself is so arthritic that we have to try to redevelop that joint. And one of the things that we perform as well is called regenerative medicine, where we can actually put stem cells, allografts, very innovative things, that can actually redevelop some of those tissues that you have in your joints.

Cyndi: That’s great. So it’s not necessarily a life sentence, it’s something that can be treated.

Dr. Gari: There’s a lot of exciting things that’s going on in medicine today, and it’s very exciting, what we can do.

Cyndi: What about for people who wake up in the morning with pain and stiffness in their joints, is there anything you can do for that or is it just a matter of getting up and stretching? Or is there more to it than that?

Dr. Gari: Well, the reason why you have joint pains in the morning is because your temperature drops. So when your temperature drops during sleep, and that also causes your joints and so forth to become a lot more stiff. So, when you get up, take a hot shower and so forth, that really increases, and you get less stiff and you have a lot less pain.

Cyndi: What about for people who have nagging, reoccurring pain? Is surgery ever the answer, or not?

Dr. Gari: Well, usually, the answer is no, but sometimes there might be something going on where you need an operation. But most of the times, you don’t need an operation. Most of the times, it could be something like physical therapy, a pill or medication, sometimes a little simple injection. Sometimes, there’s something that’s called the hydraulic membrane which, it’s like a lubrication into your knees that we can inject into your joints that can last several months. Sometimes there’s stem cells, there’s all kinds of different options.

Cyndi: Well, that’s good to hear because I know a lot of people would rather try every option before they have to go under the knife. Dr. Gari, thank you very much. You can contact the Florida Pain Relief Group to schedule your same-day appointment. We’ll be back with more “Daytime,” so don’t go away.

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Dr. Rodolfo Gari Talks Pain Relief Myths: Pills, Patches & What Works

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Interviewer: We see ads all the time for magic creams and patches for pain relief. There are so many ways that claim to treat pain, between pills, patches, injections, lotions. So how do we know what actually works? Dr. Rudy Gary from Florida Pain Relief Group joins us now to help us figure it all out. Dr. Gary, welcome back.

Dr. Gary: Thank you.

Interviewer: Now, how do we know if these things really work?

Dr. Gary: Well, the best answer to that is to find out exactly what that is. You know, you hear it on the radio, you know, these cure-alls.

Interviewer: Yeah, call now.

Dr. Gary: Yeah, unfortunately, sometimes some of those are just kind of like a placebo effect. You know, it may be just aspirin could be in there. Is it gonna help? Yeah, it’s going to help you. We can probably just give you just about any patch, and one-third of the patients are going to react positively. The problem is it doesn’t last long.

Interviewer: Right.

Dr. Gary: What we have to do is you have to go see a real physician, somebody what went to medical school, studied anatomy and physiology, pharmacology, and is going to establish a diagnosis on you, is going to treat you as a patient, is going to listen to what is wrong with you, actually perform a physical examination, laboratory examinations, radiology, find out what the problem is, make a determination of how that affects you, and then get a plan in place, whether it’s a pill, a patch, an injection, whatever it may be, and target that area.

Interviewer: Well, let’s talk about some of those options out there, because what would be the best way to alleviate pain? Would it be a pill, would it be a patch, an injection, a cream? I mean, there are so many choices?

Dr. Gary: So the answer is it depends.

Interviewer: Yeah.

Dr. Gary: Right? So it depends on number one, who the patient is. It depends on what the problem is. Sometimes, we can eliminate the pain with a simple injection, that’s what we take and your pain is gone. Other times, that’s not the best way and we’re going to try out some very low-level analgesics. Maybe like a muscle-relaxant, you know you might be having spasms. We’re going to determine the type of pain. So there are actually different types of pain. There is what’s called neuropathic pain which is a nerve pain, and there is something else that’s called nociceptive pain, which is more like a dull achy pain. And the medication and the treatment depends on the type of pain that it is. It’s coming from your nerves, your joints, some of the organs, and we have to target, and the physician that’s very keen to that type is going to give you much better results.

Interviewer: We’ve heard of those icy patches that you can buy at the pharmacy, and I’m wondering, do they work? There’s hot patches, cold patches.

Dr. Gary: Well, they work to the extent that… There was actually someone that won the Nobel prize for that, it’s called the gate theory. And what that does is that works about as good as… So if you’re…you may recall when you were little and you put your finger on the stove and boy that really hurts. So what does mom do? Mom comes by and she rubs your finger, and the pain is better. Well, the reason why the pain is better is because what you feel is the rubbing sensation and that blocks the pain sensation. So whether the ice packs, heat packs, you’re going to feel the heat or the cold instead of the pain.

Interviewer: Right.

Dr. Gary: It does work, so does massage and a lot of different things.

Interviewer: It’s a distraction more than anything.

Dr. Gary: Yeah, because again, it’s called the gate theory of pain.

Interviewer: Right.

Dr. Gary: So only a certain type of fiber can go to your brain for you to understand that, and then it will block the other sensation.

Interviewer: Okay.

Dr. Gary: We actually have a procedure called [inaudible 00:03:26] stimulation. And what that does is that people that are having severe low back pain, pain shooting down the legs, have had three or four back operations, we can put these tiny little electrodes so you feel a tingling sensation instead of this pain that you have. And you can control that in programming.

Interviewer: Oh, I’m sure a lot of people are happy to hear about that. Dr. Gary, thank you very much. Florida Pain Relief Group even schedules same day appointments. We’ll be back with more daytime, so don’t go away.

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Dr. Rodolfo Gari Talks Work Injuries And Ways To Avoid Them

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Cyndi: The daily grind of working in an office can cause pain that people often try to ignore, but sometimes that pain can affect your whole life and it should not be ignored. Dr. Gari from Florida Pain Relief Group joins us now with more. Dr. Gari, good to have you back.

Dr. Gari: A pleasure

Cyndi: A lot of people try to just ignore the pain, but if it’s really starting to bother them, and it’s affecting their whole life, why should they go see somebody like you?

Dr. Gari: Well because one of the things, for example, the reason why we as human beings have something called pain is because it’s a warning signal. Think of it like you’re driving your car and it starts to flash saying that the engine oil is low. You’re about to get into something really bad. So if you have pain, from whatever that may be, that’s your body telling you, “Hey you gotta go and get this checked out.” Because it can and normally does get worse if it’s not treated.

Cyndi: When you see people that work in an office environment, what kind of pain are they usually coming to you with?

Dr. Gari: Usually some sort of work-related injuries. Sometimes it’s a fall, you know. I get a lot of patients of mine that are workman’s compensation. For example that they get sent over because they are lifting boxes, they hurt their back. Sometimes they’re typing, they’re using a lot of computers, they get repetitive stress injuries like carpal tunnel. They get neck injuries, you know, from maybe reading, from having the head too low. Just about any type of activity can happen…if you sit for long periods of time, that can affect your lower back. In fact, one of the biggest pressures on your lower back is when you’re sitting down.

Cyndi: Really?

Dr. Gari: What I tell some of the patients…

Cyndi: I’ve got that. I’ve got it here, I’ve got it here. So and I tend to just think, you know, that’s just the cost of doing business. But I don’t have to live with this pain.

Dr. Gari: Well, you know, in a way it’s some of the things that we do, but there’s things that can be done. For example, if you sit a lot, you can sit on one of those medicine balls. That helps with your core muscles. Also, if you can stand, there’s a lot of these desks that you can actually raise up. And standing actually reduces the pressure on your lower back, and that helps quite a bit.

Cyndi: I’m looking into that. Back to the worker’s comp situation. How does that all work when somebody comes to you with that?

Dr. Gari: Well, the worker’s compensation was meant to help the injured worker. It’s a great program because people need help. What they’ll do is when someone gets injured, they’ll work with the worker’s compensation, they’ll get an adjuster. That adjuster can send the patient to someone like us to evaluate what’s going on. We can make a diagnosis on what’s happening, what’s causing the injury, and what we want to do is help them out and, you know, try to get them back to work.

Cyndi: Definitely. That’s the goal, right? You don’t want to have more time than you need. What about repetitive stuff like typing? I’m just thinking of everyone around me on our computers, just that alone. Do you see a lot of people coming in just with carpal tunnel?

Dr. Gari: We see a lot of that. We see a lot of people with pain. And our hands weren’t made to be typing all the time. It was meant to grab and doing things with it. So things that are not natural, they can cause a lot of injuries. And one of the things about the worker’s comp that you mentioned earlier is that if we can see that patient earlier…the studies have shown very significantly that the earlier that you treat that injured worker, the more likely that he is or she is to get back to work.

Cyndi: All right. Well Dr. Gari, thank you very much. You can contact Florida Pain Relief Group to schedule your same-day appointment. Visit their website or you can give them a call: 844-Kick-Pain. Dr. Gari, thank you again.

Dr. Gari: My pleasure.

Cyndi: We’ll be right back.

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Dr. Rodolfo Gari Talks Sciatica and Best Ways To Treat It

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Jerry: How familiar is this to you? Lower back pain that reaches down your legs. Well it’s something a lot of you could be experiencing right now. And a common cause of this, by the way, is something called sciatica. You’ve probably heard of that. Dr. Rudy Gari from Florida Pain Relief Group joins us now to explain what it is exactly. Welcome back to you, Dr. Gari.

Dr. Gari: Thanks, Jerry.

Jerry: So we hear a lot about sciatica. What is it? What causes it?

Dr. Gari: Sciatica basically is a shooting pain, shooting sensation that goes from your lower back and shoots often all the way down to your foot. The reason it’s called sciatica is because it often involves what’s called the sciatic nerve. A sciatic nerve is a large nerve. It’s your main nerve that goes through your leg and often is caused by some sort of an inflammatory process. A lot of times it’s a bulging disc. It’s a herniated disc. You twisted the wrong way. Something is pinching causing inflammation. And you get a very severe shooting sensation that can be very, very debilitating.

Jerry: So a lot of things can cause it but it’s generally related to some sort of a nerve issue?

Dr. Gari: What I tell people is, if you’ve hit what they call your funny bone.

Jerry: Yes.

Dr. Gari: When you push here it shoots down to your fingers, right? Well it’s the same thing that happens with sciatica.

Jerry: Oh got it.

Dr. Gari: Instead of pushing your elbow something’s pushing your lower back and shooting down to your foot.

Jerry: So how does this change people’s daily life?

Dr. Gari: Just last week I had a patient that came in with a severe sciatica. She came in in tears. She was hurting so bad she could not even sit. She basically had to lay down on the bed. She was just crying with so much pain that she had.

Jerry: That’s debilitating.

Dr. Gari: Yes.

Jerry: That says it all right there. All right. Let’s talk about treatment options then. How did you help this woman?

Dr. Gari: Well the first thing that I did, of course, was to make a diagnosis. After the history and physical examination I found that she had the classic symptoms. She had the shooting pain. The exam showed that she had decreased sensation, so forth. That’s indicative of some sort of a disc herniation pushing on that sciatic nerve. The definitive diagnosis I sent her for MRI. And sure enough it came back that she had a herniated disc between the fifth vertebrae and the first sacral vertebrae pinching on that nerve. We brought her in two days later. She was very heavily medicated because of the pain.

Jerry: Sure.

Dr. Gari: What we did for her, we gave her these injections that went close to that nerve root. Reduced the inflammation. The inflammation pretty much went away. She had two treatments, two injections, a week apart. This person was a marketing representative and she traveled a lot. She could not even go anywhere and she’s back at work.

Jerry: Isn’t that great?

Dr. Gari: I sent her to physical therapy to make sure she strengthens her core muscles. If she can take great care of herself, which I’m sure that she will, she can get back to a normal life.

Jerry: Which is fantastic. Is a treatment like that is it permanent or do you have to keep coming back for these injections?

Dr. Gari: This can be permanent if, and it’s a big if. For example, what caused that disc herniation to herniate in the first place: Normally it’s weak core muscles. We sit a lot. We do a lot of things. So it herniates. We get the inflammation. The inflammation ends up going away. Physical therapy, and that disc can actually shrink back. So it can be permanent.

Jerry: So you have to take care of yourself after you get the injections.

Dr. Gari: Yes you do.

Jerry: All right. Dr. Gari, thanks so much. You can contact Florida Pain Relief Group to schedule your same day appointment right now. We’ll be right back with more after this.

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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 Talks Why Arthritis Doesn’t Have To Rule Your Life and Treatment Therapies For It

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Cyndi: Everyone’s familiar with arthritis, but do you know that it does not have to be a life sentence? Arthritis is a life-altering form of pain for so many people, but Dr. Rudy Gari from Florida Pain Relief Group is here to help. Welcome back, Dr. Gari.

Dr. Gari: Thank you.

Cyndi: So we all hear about arthritis, we talk about arthritis, but really what is arthritis?

Dr. Gari: So arthritis, if you break down the word, so itis means inflammation, and arthro means joints. So arthritis is basically an inflammation of your joints. And of course, your joints are what keeps the bones together. So you have joints throughout the entire body. That’s what allows us to bend and do things. So that can cause a lot of wear and tear. That wear and tear leads to inflammation. There are nerve endings in those joints, and it can get pretty painful.

Cyndi: We’ve heard of different types of arthritis. What’s the most common?

Dr. Gari: The most common type of arthritis is osteoarthritis.

Cyndi: Osteo?

Dr. Gari: Yes. In fact, most of us get some sort of arthritis. Even our late 20s it begins, 30s and 40s.

Cyndi: Is it pretty much inevitable that we’re all going to get some form of arthritis?

Dr. Gari: Unfortunately, most of us as we get older, we are gonna get arthritis. It doesn’t mean that you have to know that you have it. You kinda get these aches and so forth throughout the day. But most of us go about our daily lives just, you know, living as if nothing’s going on.

Cyndi: But there are some people their arthritis affects their everyday life and it can really be hard for them to function. So what can you do for people who have arthritis, either in the early stage or quite gradual?

Dr. Gari: The first thing that we do is to determine the type of arthritis, and that helps us to determine what the outcome might be. So let’s just say osteoarthritis, for example, because that’s really common. A lot of times, osteoarthritis causes joint pain everywhere. Most of the pain tends to be low back, cervical region. Our necks hold the head up. Our lower backs help us bend back-and-forth. Those are the daily activities. So we tend to focus on those joints because that’s what’s gonna improve your daily living as much as possible. Things that we can do, we mentioned that’s inflammation of the joints, so what we do is go in there to reduce the inflammation. Some sort of injections goes into those joints, there’s no surgery that’s involved. Two or three of these, if it relieves inflammation, there’s even other things such as radiofrequency, rhizotomies that I’ve mentioned before, that can help burn the little nerve endings that only cause pain.

Cyndi: Wow. We’ve heard about taking turmeric and things like that, and adding more things to our diet to help with inflammation, but that’s not necessarily going to be enough, is it?

Dr. Gari: What happens when you eat something, whether it’s a pill or whatever, it goes in your mouth and through your stomach, and then from there it gets absorbed, goes through your liver, and 95% gets broken down. So a very tiny, tiny fraction of what you’re taking is actually going to those joints. By us delivering the medication straight to those joints, we bypass all that.

Cyndi: Is it always a type of medication that you recommend, or do you have different therapies for arthritis?

Dr. Gari: Different therapies. Sometimes, actually, just moving around. Physical therapy, moving. I ask them to go in the pool, just move your joints more. Sleep. If you can get better sleep, your joints are gonna absorb some more fluid. That’s going to help out as well.

Cyndi: Right, but if you’re finding that it’s really hard to function, you can help.

Dr. Gari: Yes, we can.

Cyndi: You can get right in there and take care of it.

Dr. Gari: Absolutely.

Cyndi: Good stuff. Dr. Gari, thank you very much. Contact Florida Pain Relief Group to schedule your same-day appointment. You can visit their website, it is floridapainreliefgroup.com. Or you can give them a call right now, 844-KICK-PAIN, and you too can be pain-free. Thank you, again.

Dr. Gari: My pleasure.

Cyndi: We’ll be right back.

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Dr. Rodolfo Gari Talks What a Rhizotomy Is and How It Can Relieve Joint Pain

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Interviewer: People who are in pain oftentimes don’t go to the doctor because they fear the worst. We all sometimes feel like that, right? But some pain can actually be treated without surgery. Dr. Rudy Gari from Florida Pain Relief Group is back to tell us more. And good to see you, doctor.

Dr. Gari: Good seeing you.

Interviewer: And specifically, we’re talking about something called a rhizotomy. Now, what is a rhizotomy and what does it do?

Dr. Gari: Certainly. So a rhizotomy, basically, what we’re doing is we’re finding ways to deaden the nerves in a permanent way. There are tiny little nerves that give sensation to your joints, and they’re just purely sensory nerve. They don’t do anything else other than just cause you to have pain if you have some sort of inflammatory process, which can happen a lot. So, people, if they have some sort of a chronic inflammatory process through the joints, those nerves are constantly reminding them. What we do is we first make sure that that’s the cause of the pain, and once we’ve diagnosed that, we do something that’s called rhizotomy. And what that does is, we place these needles right into those tiny little nerves. The needle tip heats up and it burns those little nerves off, and that relief can last several months, sometimes up to a year.

Interviewer: So it’s not a permanent relief but it is something that will give you relief for, like you said, a certain amount of time.

Dr. Gari: Yes. Unfortunately, a lot of those tiny little nerves tend to grow back, but I’ve had people who’ve had relief for over a year. And if you have pain on a daily basis, that’s a lifetime.

Interviewer: Yeah, no kidding. And it’s not too much trouble, then, to just come back when the pain flares up again, too?

Dr. Gari: Absolutely. We can repeat this. And the nice thing about it is that this is done through a needle, so we’re not cutting skin, it’s not a permanent operation and it’s a relatively benign procedure. We have a lot of safety measures in check.

Interviewer: So does it hurt at all? You mentioned needle. That’s the first thing I think of, “How much pain is involved to get pain relief?”

Dr. Gari: Yes. No, it’s actually fairly painless. We give a local anesthetic at the skin. We then go ahead and use some intravenous sedatives. And, in fact, just this morning I had four patients that had the rhizotomy done and they went home already.

Interviewer: So what areas does this benefit, primarily? Is it the knee? Is it the shoulder? Can it be any joint?

Dr. Gari: Well, the rhizotomy can occur in just about anywhere. The most common places happens to be at the neck and the lower back. The reason for that, most of the bending takes place at your neck and lower back, so that’s where a lot of the trauma and a lot of the pain comes from.

Interviewer: Now, what makes this kind of a good idea to do as a procedure to relieve the pain, as opposed to other treatments?

Dr. Gari: Well, what happens is, there’s not a whole lot of treatments that are available when you have chronic pain of your joints, for example. It’s usually medications, and those medications have significant side effects. Anti-inflammatories can cause an ulcer, can cause bleeding. You have opioids. We all know about the problems with opiate addiction. So this is an alternative to you having to take medications. Medications are not benign. They’re not mean to be taken on a long-term basis, but people have to take them that way. This is an option so that you don’t have to take these medications long-term.

Interviewer: You know, it’s funny you mentioned that because I know so many people who have their elderly parents actually hooked on opiates, and they don’t even know it. Because that’s what they’re prescribed, that’s what they take. So this is something that’s so much healthier and so much better for you.

Dr. Gari: Absolutely. I had an 81-year-old female today, a very nice lady, that was taking a lot of medications. And the problem with that, if they get a little bit groggy, and they fall and they break a hip, that can be lethal.

Interviewer: Absolutely. All right, Dr. Gari, great information. Now, Florida Pain Relief Group even schedules same-day appointments. Be sure to visit their website, floridapainreliefgroup.com, or give them a call, 844-KICK-PAIN. Simple as that. We’ll be right back.

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Dr. Rodolfo Gari Talks Fibromyalgia: Who Gets It and Treatments

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Interviewer: In some cases, widespread muscle and joint pain can point to fibromyalgia. It will not only affect physical pain, but it can involve mental pain as well. Dr. Rudy Gari from Florida Pain Relief Group joins us now, with some help. Dr. Gari, great to have you here.

Dr. Gari: Thanks a lot.

Interviewer: Let’s talk about what causes fibromyalgia in the first place.

Dr. Gari: Sure. So fibromyalgia, we’re not really sure the exact causes of it, but here’s what we do know. So if you break down the word fibromyalgia, fibro means fibrous, and myalgia means muscle, inflammation of the muscles. What we know is that it tends to affect predominantly women, we’re not really sure why it does, but it does. And it involves a process whereby your fibrous tissues and your muscles combine to cause inflammation, and it can be very debilitating in a lot of people. There’s different things that could be done, we know what can help. For example, we know what makes it worse is usually stress, tension, so the treatment for that is relaxation and techniques to lower that threshold.

Interviewer: Is this really common, among a lot of women in particular, that you see?

Dr. Gari: Yes, it’s very common. We have a lot of patients with fibromyalgia, and the way that we treat them is comprehensively, and that involves relaxation techniques, physical therapy. Sometimes we do these things called trigger point injections, and trigger points are actually like little muscle spasms that can develop in patients with fibromyalgia, throughout your body. It’s a pretty simple technique, we just go in there with a very small needle and break up these little trigger points. We also give them medications to help them relax, and we find that with that comprehensive approach, we can give them their life back.

Interviewer: Yeah, I was going to ask you, what kind of reactions are you getting from patients who you’re helping? Because I’m sure a lot of them, for a long time, they weren’t being diagnosed. And they kept saying, or people might have been saying, “Well, are you depressed?”, and they weren’t getting to the heart of what was wrong with them. So we mentioned physical, how it hurts, but how mentally it can be so hurtful, for so many people. So what are you finding from the people that you’re treating with this?

Dr. Gari: Sure, well one of the things that would happen the last…many years ago, the first thing that we tell them is that this pain is real.

Interviewer: And that’s half the battle for so many people, right?

Dr. Gari: Yes, this pain is real, and sometimes I tell patients that, and they begin to cry.

Interviewer: Yeah, because nobody has listened to them.

Dr. Gari: No, this pain is real, this is real pain. You’re having this pain, it’s not just in your head. You’re feeling this, but the good thing is we can help you with this. And that you’d be…it’s almost as if it’s like tons of weight off their shoulders, that somebody understands what they have and that we can do something about it.

Interviewer: Do you see gentlemen at all with fibromyalgia?

Dr. Gari: We do see men with fibromyalgia, not as common as women, but we treat them the same way. This happens in both, it’s not just unique to women, it also affects men.

Interviewer: So apart from finally having somebody listen to them, and saying “Yes, I’m validating that you’re feeling what you’re feeling,” how quickly can people start to feel some kind of relief?

Dr. Gari: I’ve had patients come into the office with significant pain, mostly from trigger points. We do the trigger point injections right in the office, and they come out a different person. You can just look at their face. I wish I could take a picture of their face before and after. So it can be immediate, but that’s just the immediate treatment of the trigger points. We then go more comprehensive with everything else and make it more long-term.

Interviewer: Well, I know this is really encouraging news for a lot of people that are watching right now because fibromyalgia does affect a lot of people, and they’re looking for help. Dr. Gari, thank you very much for joining us today. Florida Pain Relief Group even schedules same day appointments. Be sure to visit their website, floridapainreliefgroup.com, or give them a call right now 844-KICK-PAIN. Doctor, thank you again. We’ll be right back.

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Dr. Rodolfo Gari Discusses What Regenerative Medicine Is and How It Can Relieve Your Pain

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Jerry: Those of you who suffer from pain know that it can be extraordinarily debilitating, but imagine if you’re able to beat that through a minimally invasive procedure and still remain active. Dr. Rudy Gari from Florida Pain Relief Group joins us now to tell us how. Okay, this is gonna be music to so many people’s ears who are out there. And by the way, including mine, because I suffer from terrible arthritic pain in both my knee and my foot. And we’re not gonna make this all about me, we want it to be all about what this almost miracle treatment is that you’re offering. How are you, first of all?

Dr. Rudy Gari: Doing great, Jerry.

Jerry: How about that lead in, huh? That was quite a build-up.

Dr. Gari: That was great, Thank you very much.

Jerry: Of course. Let’s talk about what you do. I mean, we’re talking about regenerative medicine. Tell us exactly what that is.

Dr. Gari: Well, Jerry, regenerative medicine is actually one of the most exciting fields in medicine today. And so people talk about minimally invasive procedures. Pain management physicians, like myself, anesthesiologists, have been doing minimally invasive procedures before those words became common. And what that is, essentially is, what can we do short of surgery? In fact, 99% of what we do there is actually no cutting of the skin. It’s just an injection.

Jerry: Okay, injection of?

Dr. Gari: Injection of something that is gonna help you, and that kind of leads into regenerative medicine. So regenerative medicine is actually using your own body’s stem cells to regenerate your own tissues. So we’ve seen lots of stuff, for example, we can regenerate organs or we can also regenerate a lot of our own tissues. And some people hear stem cells, we still have stem cells. We just don’t have the same amount of stem cells that we had when we were babies. So as we get older, we have less stem cells. So regenerative medicine is, for example, through some things called allographs. And they are actually amniotic membrane that has been reconstituted, and it has these factors called stem cell retruding factors. What that does is we apply that with a needle, with an injection, into your joint, your back, or wherever it might be. It actually tells your body, “Hey, I need to have this fixed.”

Jerry: That’s great. So we’re talking about how many injections before you start feeling much better?

Dr. Gari: Well, it actually takes a while because remember your body is going to have to heal. So it’s anywhere from two to three different injections.

Jerry: Over a period of time?

Dr. Gari: Over a period of time, because this is not like anything foreign implanted. This is your body regenerating itself.

Jerry: What are we talking about in terms of down time?

Dr. Gari: There’s not a whole lot of down time. There might be like a little burning, something like that, because there’s a little inflammatory process that takes place while your body’s trying to heal. But in fact, one of the people that work with us actually had regenerative medicine in his knee and climbed Mt. Kilimanjaro a week later.

Jerry: A week later? Sign me up for this stuff. Okay, any pain at the site of the injection when it happens?

Dr. Gari: There’s a little burning, a little uncomfortable, for like a day or two, but that goes away. It’s an inflammatory process because your body is busy trying to heal itself.

Jerry: Okay. So why isn’t everybody doing this, and should they be?

Dr. Gari: Well, a lot of people are doing this. It’s a new science, we’re very excited at Florida Pain Relief Group because we have experts in that field, and it’s becoming more and more and more. This is the wave of the future.

Jerry: Excellent. Dr. Rudy Gari, thank you so much. Florida Pain Relief Group even schedules same day appointments. Be sure to visit their website floridapainreliefgroup.com, or call 844-KICK-PAIN. That’s easy enough. Thanks so much, doctor.

Dr. Gari: Jerry, it’s my pleasure.

Jerry: Nice to see you. We’ll be back with more Daytime right after this.

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