Make Pain a Thing of the Past – spine arthritis treatment – Physician Partners of America

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Interviewer: When you’re in pain and you head to the doctor, you already know what’s coming. Rate your pain on a scale of one to ten. But is that really the best way to gauge it, and if so, then what? Dr. Jorge Leal from Florida Pain Relief joins us now to talk more about this. Okay, Dr. Leal, what exactly is pain management?

Dr. Leal: Pain management, it’s a relatively new specialty that is basically charged with trying to diagnose and then manage the chronic pain.

Interviewer: Now, we hear about doctors all the time saying, “Rate your pain from one to ten.” Is that really an accurate benchmark, and does that really help you when I say, “I’m at a seven”?

Dr. Leal: Well, it’s the best that we have. As you well know, pain is subjective, meaning that only the individual that is experiencing the sensation is capable of rating it, so we try to keep it simple. So just a numeric rating system has been effective and has been validated statistically that it is as good as we can achieve, given the circumstances that it is a purely subjective experience.



Interviewer: Is medication usually the best way to treat pain, or are there better alternatives out there?

Dr. Leal: Well as you well know in our society, pills seem to be the first thing that we reach for, but perhaps that may not be the correct one. Due to the fact that pain has been relatively under-treated in the past, we became to rely heavily on pills to try to keep the pain under control. And then eventually we started to realize that indeed may be doing some harm and there may not be any benefit in the long run in trying to control some person…individual’s pain.

Interviewer: So what is the best way then to treat pain? Because there are a lot of people that are taking pills as we speak right not to try to just get through the day. So, from the Florida Pain Relief Group, how do you approach somebody who’s got pain?

Dr. Leal: Well, the most important thing is to try to find out what is causing the pain. And for that, we need to approach the problem in a comprehensive fashion to find out what caused the pain, what has been done in the past, what worked, what hasn’t worked, have there been any side effects? So all those things get taken care of…into consideration, and then we formulate a plan of therapy. And that could be from medications to interventional techniques to sometimes surgical approaches, and some rehabilitative techniques are available.

Interviewer: What are some non-invasive options that you have for people who are dealing with pain?

Dr. Leal: Well, the most important thing is to treat any underlying psychological difficulties or problems that the individual may be having. Not uncommon, it’s almost akin to the chicken and egg. Which comes first, the pain causing anxiety or anxiety aggravating the pain? So they are intricately related, so they must be addressed. So psychological counseling, psychological therapies, including also pharmacological therapies, are very important in the management of pain.

Interviewer: But the bottom line is you want your patients to be free of this pain. They don’t want them to live with it.

Dr. Leal: That is correct. The idea is to manage it and allow them a better quality of life.

Interviewer: All right, a lot of people will be happy to hear that. Dr. Leal, thank you very much. You can visit their website. It is, or you can give them a call, 844-KICK-PAIN to schedule your same-day appointment. There is relief out there. We’ll be right back with more Daytime, so don’t go away.


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.