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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 Discusses About Diabetic Neuropathy and Ways to Treat It

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Cyndi: Over 29 million people in the United States have diabetes, a disease that can lead to a variety of other problems, a common one being diabetic neuropathy. It can show itself in many different ways, which means it’s also hard to diagnose. Dr. Rudy Gari from Florida Pain Relief Group is back with more. Dr. Gari, good to have you here.

Dr. Gari: My pleasure.

Cyndi: Let’s talk about diabetic neuropathy, and why is this the most common form of neuropathy?

Dr. Gari: Certainly. Well, unfortunately, it’s the most common because there’s a lot of patients, a lot of people with diabetes. And what happens with diabetes is, your sugar goes up and down quite a bit. Well, that sugar is spread throughout the whole body, especially, it can affect the nerves. And over constant and constant misalignment of your glucose levels, your nerves get damaged, especially the very small nerves, and that can cause significant pain in patients that have diabetes. Their pain is usually manifested as a burning sensation, a sharp, stabbing constant, and it can be very debilitating to a lot of patients.

Cyndi: So it’s not just a pain that comes and goes, it can be there constantly?

Dr. Gari: It can be there constantly, to the point where it’s hard for you to function with your everyday life activities.

Cyndi: I’m thinking for somebody who has neuropathy from diabetes in their feet, that can be difficult for just getting around, right? It’s not only annoying but could it affect your walking ability?

Dr. Gari: Well, the unfortunate part is that it can cause both numbness and pain at the same time, if you can think about that, because of the different fibers that are affected. So, sometimes, we have diabetic neuropathy in people that, they don’t feel as much. They can get hurt more often, but then they always have a constant, stabbing, burning sensation that can be very debilitating.

Cyndi: Sounds like an awful, awful way to live. So how can you help people who are dealing with that kind of pain?

Dr. Gari: Sure. So for the first thing, it’s the obvious. We wanna make sure that your diabetes is well-controlled. So make sure you’re seeing your internist, your family practice doctor, making sure that your blood glucose is very stable, as much as it can be. Other things that we can do is medications. There’s different ointments or different creams. And if those don’t work, there are even more interventional techniques. We’ve spoken before about something called spinal-cord stimulation. And spinal-cord stimulation is one of those things that can actually replace that burning sensation of your diabetic neuropathy with a more mild, tingling sensation.

Cyndi: So even though you’re dealing with the spinal cord, it can affect all your extremities? Is that where it all comes from?

Dr. Gari: Well, diabetes tends to affect, normally, your extremities. Usually, your arms, your hands, your legs, your feet. And the extremities, the nerves that go to extremities originate in your spinal cord.

Cyndi: Right. So that’s why you can go in there and take care of that.

Dr. Gari: Correct.

Cyndi: I know there are a lot of people watching right now who are probably thinking, “This is me.” So what kind of message do you have for them right now? Because they’ve been living with this for a long time.

Dr. Gari: Well, the message that we have is that we have a lot of options for you. Besides medication, there are ointments, there are creams, making sure that your glucose is well-controlled. There is even different types of nerve blocks that we can do that can alleviate their pain. And if we have to, we can do a trial of a spinal-cord stimulator.

Cyndi: And just having somebody say, “Your pain is real,” I’m sure is music to so many people’s ears, because they’ve dealing with it for a long time and not getting anywhere.

Dr. Gari: Unfortunately, there’s a lot of illnesses that many doctors have. Pain is one of them. All that we do is take care of people in pain, so you’re the only thing that’s important to us, and your pain.

Cyndi: That’s great news. Dr. Gari, thank you very much. Florida Pain Relief Group even schedule same-day appointments, so be sure to visit their website, floridapainreliefgroup.com, or give them a call, 844-KICK-PAIN. Dr. Gari, thank you again.

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