Make Pain a Thing of the Past – spinal cord stimulation – Physician Partners of America

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PPOA Treatment Can Ease Back Pain from This Rare Disorder

Arachnoiditis has nothing to do with spiders, but its symptoms can be pretty scary. Difficult to diagnose and difficult to treat, this rare nerve inflammation can trigger excruciating lower back and leg pain. It is a progressive and debilitating disorder that can cause some people to become bedridden and unable to work.

What is Arachnoiditis?

The condition affects only about 11,000 people a year, according to the National Organization for Rare Disorders.  It is almost always caused by a medical procedure.

It starts in the web-like arachnoid membrane that protects the spine and brain. When the membrane becomes inflamed, it can cause the nerves to fuse together. This causes them to malfunction. The resulting scar tissue can press against the nerve roots that exit the spine, causing severe pain.

Arachnoiditis pain usually affects the lower back and legs and causes a variety of sensations.

  • Tingling or “creepy-crawly” feelings on the skin
  • Muscle cramps, twitching and spasms
  • Shooting, “electric shock” pain
  • Bowel, bladder and sexual problems

“It causes a number of symptoms and they can vary in the same individual,” said Dr. Abraham Rivera, chief medical officer of Physician Partners of America.

What Causes Arachnoiditis?

This condition has many causes. The majority are related to contaminants that accidentally get into the dura – the fluid surrounding the spinal column – during certain medical procedures like epidurals and spinal taps.  These contaminants include preservatives or impurities. Long ago, oil-based chemicals used in contrast dye tests, like myelograms, were blamed for some cases of arachnoiditis.

How is Arachnoiditis Diagnosed?

This disorder is so uncommon that most doctors rarely see it in their practices, making detection difficult. Fortunately, Physician Partners of America Pain Relief Group has the expertise to identify it and attempt to treat the pain.

The most helpful diagnostic tests are MRIs (magnetic resonance imaging) and CAT scans (computerized axial tomography). Another test, an EMG (electromyogram), uses electrical impulses to determine the extent of damage to nerve roots. PPOA specialists can perform this test.

What is the Best Arachnoiditis Treatment?

Unfortunately, there is no cure for this condition, but Physician Partners of America offers the hope of relief from arachnoiditis pain.   “One common treatment is oral pain medication, but it doesn’t tend to work well,” says Dr. Rivera. “The pain can be managed for some people with a spinal cord stimulator.”

Spinal cord stimulators are minimally implantable devices that send electrical signals to targeted areas of the spinal cord to treat specific pain conditions. It is a minimally invasive procedure that PPOA physicians perform routinely.

Stems cell therapy for arachnoiditis is only in the experimental stage and has not yet been proven helpful.

“We are keeping our eye on the latest research to treat this debilitating condition,” says Dr. Rivera. “Not every current treatment works for everyone, but we make every effort to treat the pain and help sufferers lead a more normal life.”





Interviewer: Surgery, it’s a word that patients hate hearing and one that keeps many away from the doctors’ offices. But there are ways to treat back pain without going under the knife. Dr. Rudy Gari from Florida Pain Relief Group is back to talk about one of those ways today, spinal cord stimulation. Okay, Dr. Gari, great to have you back.

Dr. Gari: Pleasure.

Interviewer: What is spinal cord stimulation?

Dr. Gari: So actually spinal cord stimulation is a technique where we place these tiny little electrodes into the back of your spine that helps…it blocks the pain levels. It’s actually based on a Noble Prize winning technique. If you think about it, when you were a little kid and you place your finger on the stove and it hurt, and mom came and rubbed it and it felt better. Well, the reason why it felt better is because the touch sensation actually went up your brain and blocked the pain going to your brain.

Interviewer: Interesting.

Dr. Gari: What spinal cord stimulation does, is these tiny little electrodes, they’re no more than epidurals when the ladies have the little epidural catheters for labor, it’s the same thing, but we place these little electrodes there and what it does is it replaces the back pain and the pain going down to the legs with a very gentle tingling sensation. So you feel a tingling sensation as opposed to having this constant back pain.

Interviewer: That sounds like a great thing for so many people. What kind of pain does it treat?

Dr. Gari: It treats basically back pain, low back pain, it treats any sort of nerve pain, diabetic neuropathy, any sort of nerve entrapment. Patients that have had…we get a lotta patients that have had two or three or four back operations. There’s nothing else that can be done. Those are very good candidates because, you know, they are constantly in pain, we can place that in there and get them some really significant relief, allow them to cut down on all these massive medications that they have to take just to live their everyday life.

Interviewer: Is this done through an outpatient kind of facilitation?

Dr. Gari: Outpatient procedure. You come in, we give you some sedatives to relax you, a little local anesthesia, it’s done [SP] through a needle. We place this electrodes through a needle and you go home the same day. Usually we do what’s called a trial period, where we have you go home with it for about a week, make sure that it’s gonna work for you. If it works for you, we can get it implanted. It’s a….very…it’s a tiny little incision that just goes right on the skin. It has a little thing called a generator which is the size of a half dollar, and the batteries’ rechargeable, so it last years.

Interviewer: Oh, so you don’t have to keep going into the office to get this put in, you can…

Dr. Gari: No, no.

Interviewer: …have put in and then you’re… Do you control it yourself, or?

Dr. Gari: Yes, there’s a lotta programs. So for example, you say, “Well, sometimes I get back pain, sometimes have pain down a leg, sometimes a combination.” We can program this to have different types of variances. So, if you have back pain, you hit number one, if you got leg pain number two, and so forth.

Interviewer: Why is this preferable to more traditional back treatments, like surgery?

Dr. Gari: Because a lotta times there are no other options. You have, for example, these chance of success after the first back operation is fairly high. The second one is not so high and the third one, you’re only talking maybe 15%. So after that, you’re almost…you’re pretty much out of options when it comes to surgery, but you’re not out of options when it comes to seeing us because we have a lotta different treatments.

Interviewer: Well this is a great alternative to surgery in the first place, right?

Dr. Gari: Absolutely.

Interviewer: All right. Dr. Gari, thank you very much. Florida Pain Relief Group even schedules same-day appointments. Be sure to visit their website right now,, or give them a call, 844-KICK-PAIN. Dr. Rudy Gari, thank you again very much.

Dr. Gari: My pleasure.

Interviewer: We’ll be right back.

Lower Back Pain Relief : Millions of people suffer from lower back pain. In fact, according to the American Chiropractic Association, it is the leading cause of disability worldwide and is the second leading cause of missed work. Pain the lower back, or lumbar spine, can take a variety of forms. Acute, or short-term pain, may arise due to a ligament sprain, muscle strain, or overexertion. This type of back pain will usually subside after a few days or weeks with treatments like rest, stretching, and nonsteroidal anti-inflammatory medication.

However, chronic low back pain can persist for weeks, months, or years. This type of long-term pain is usually due to some type of degenerative condition such as degenerative disc disease, osteoarthritis, herniated disc, ankylosing spondylitis, bone spurs, or chronic pain syndromes. Inflammation or degeneration of the spine can exert pressure on nerve roots in the spinal canal and cause the following symptoms:

  • Radiating pain that begins in the lower back and travels down through the hips, buttocks, and legs
  • Muscle weakness or spasms in the lower extremities
  • Tingling or a pins-and-needles sensation in the lower back, legs, and feet

Anatomical problems such as bone spurs, herniated discs, and inflamed vertebral joints will usually press on the spinal nerve root on one side of the spine, which means that symptoms are usually unilateral (only affecting one side).

Getting a Lower Back Pain Diagnosis

Several different types of lower back conditions can give rise to similar symptoms, though each disorder should be treated differently. It is extremely important to get a diagnosis for your lower back pain from a medical professional. A doctor will likely perform a thorough physical exam, ask you about your symptoms, and review your medical history. Imaging exams such as an X-ray, MRI, or CT scan may also be necessary to pinpoint the exact cause of your lower back pain. While some spine conditions respond to conservative treatments such as physical therapy, low-impact exercise, and chiropractic work, severe lower back pain may require more targeted pain management techniques.

Lower Back Pain Relief in the Dallas-Fort Worth Area

Some people think that chronic lower back pain is a fact of life. However, when lumbar spine discomfort affects your quality of living, it’s time to seek treatment. At Texas Pain Relief Group, we offer a variety of nonsurgical pain management therapies for the lower back:

  • Facet joint injections
  • Lumbar epidural steroid injections
  • Lumbar sympathetic nerve blocks
  • Spinal cord stimulation
  • Transcutaneous electrical nerve stimulation (TENS)

If you’re ready to take the first step toward lasting pain relief, contact Texas Pain Relief Group to find out what lower back treatments may be right for you.