Make Pain a Thing of the Past – r.i.c.e. relief – Physician Partners of America

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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,, or give them a call, 844-KICK-PAIN. Dr. Gari, thank you again.

Treating Your Injury with RICE

So you’ve just sprained your ankle, twisted your knee or slammed your elbow. You’re in pain and need immediate relief. We want you to always remember one thing above all else in situations like these: RICE. No, not the little white or brown grains you eat with grilled salmon, but the mnemonic device known as RICE. (R)est. (I)ce. (C)ompression. (E)levation.

We’re not taking away from the healing power of rice though. Heated up in a sock in the microwave, rice can be a great muscle relaxer and create some serious bloodflow. However, when injured you need to follow this simple technique to make sure your minor injury doesn’t turn into something major.

There’s no need to call the doctor and order advanced treatment just yet, especially if you can quickly get RICE going. So you know, here’s the rundown:

  • Rest. Stop what you’re doing and rest. Stop moving the injured area and keep it still. Slowing it all down to relax the injured area a bit is very important. Also, take deep breaths to calm yourself down if need be.
  • Ice. A cold rag or ice wrapped in a paper towel will help to reduce any pain and swelling. Keep the area cold for at least 20-30 minutes before moving forward. The next day you can switch it up and use a heating pad – or that rice sock – to loosen the muscles if the pain persists.
  • Compression. Keep pressure on the injury (compression) using some sort of bandage wrap to help reduce swelling and apply some stability to the area.
  • Elevation. Keep the injured appendage raised up to, or above, the level of your heart to help further reduce swelling. Stacking pillows usually works the best to help elevate arms and legs.

That’s pretty much the crash course of RICE. It’s not difficult to remember, and it’s certainly not that difficult to perform. We definitely recommend that you follow this procedure for any minor muscle or joint injury you get. That said, if the injury is serious you need to get to the ER as soon as possible. If the pain persists and lingers, then you need to come see us.

At Physician Partners of America, we know a thing or two about pain relief. It’s quite literally our middle name. Contact us today for more information.