pain clinic florida

Home  /  FAQs on Intervertebral Herniated Discs – from Florida Pain Network  /  pain clinic florida

FAQs on Intervertebral Herniated Discs – from Florida Pain Network

October 30, 2012 , , , , , , , , ,
PrintPinterestTumblrDiggShare

One of the most common problems seen by pain management clinics is a person experiencing pain from an intervertebral disc herniation. Here are some commonly asked questions regarding disc herniations.

What are other names for a disc herniation?

Additional terms for a disc herniation include slipped disc, pinched nerve, lumbar disc herniation if it’s in the Sciatica Treatmentlow back, ruptured disc, or cervical disc herniation if it occurs in the neck.

How common are disc herniations?

It’s a very common problem. At any one point in time, one percent of the population is experiencing sciatica from a disc herniation. Sciatica occurs when a disc herniation actually pushes on a nearby nerve root,  creating inflammation and pain in that nerve root that goes down a person’s leg.

So one percent of the American population is over 3 million individals. There are an additional amount of people who have a disc herniation but are not experiencing sciatica. If the disc herniates and does not push on a nearby nerve root, sciatica may not result.

An individual may have back pain but not leg pain, so essentially there may be another 1% of people experiencing issues with a disc herniation and not sciatica, so the overall amount is between one and 2%.

How does a disc herniation occur?

The healthy intervertebral disc is composed of 80% water and the remaining 20% is a combination of collagen and proteins known as proteoglycans. The disc acts as a great shock absorber and allows significant Pain clinic Miamirange of motion when it is healthy. Due to advancing age, trauma or for genetics, the person may experience degeneration of the disc and loss of water content.

 

The disc itself is best analogous to a jelly donut. The inner jelly is called the nucleus pulposus and the covering to the donut is called the annulus fibrosis. The annulus is the only part of the disc that experiences pain because it does have some nerve endings there. Due to disc degeneration, the annulus can experience a tear which can lead to back pain along with some of the inner jelly squeezing out.

This is known as a disc herniation. If the jelly that squeezes out then compresses on an adjacent nerve root, that is called in layman’s terms a pinched nerve. This can then spark up inflammation and sciatica consisting of a burning, electrical type pain down the leg, numbness and possibly muscle weakness.

What are the symptoms of a disc herniation?

It is possible to have a disc herniation and have no pain whatsoever. A significant amount of the American population has disc degeneration and no back pain whatsoever. If a person has a tear in a disk and some of the disc squeezes out, the pain that is experienced is due to an inflammatory reaction. So if that inflammatory reaction does not occur, pain will not typically ensue.

Pain Clinic OrlandoIf it does, symptoms may consist of just back pain, or a person may have no back pain at all but simply sciatica. Back pain usually spreads out to one or both sides of the low back, an individual may also have substantial muscle spasms as a protective effect. The pain may also radiate into the buttock area or around to the hip or groin.

Sciatica pain usually feels like a burning or electrical type sensation along with some numbness or pins and needles. The area of the pain typically correlates with whichever nerve root is being pinched.

It may go down the back of the thigh into the foot, or on the front of the thigh, or on the front of the shin. The pain is not usually constant, it will vary with positioning and then come and go depending on the time of the day.

How is a herniated disc diagnosed?

In most cases, there is an established method for making the diagnosis. Usually a person’s history will raise suspicion for a herniated disc. If the person walks right out of a textbook, he or she will describe pain that goes down the leg in a pattern that correlates with a nerve root.

There are some specific physical examination signs that can tip off the doctor including a straight leg raise test if it is positive for tension signs.

X-rays are not helpful in the diagnosis of a herniated disc, it is an MRI that typically will show the disk herniation nicely and how large it is. There’s not a great correlation between the size of the disk herniation and the amount of symptoms experienced. It may be a very small disc herniation, yet produce very big symptoms.

What are my treatment options with a herniated disc?

Most of the time, treatment options for a herniated disc to come a quality of life elective decision. Only if it leads to significant neurologic symptoms should surgery be considered either emergently or as a relative indication.

Without motor weakness or bowel or bladder symptoms it truly is a quality-of-life decision.  If the person is experiencing mild to moderate pain, then anti-inflammatory medications, Tylenol and maybe some ice and heat might suffice.

For more significant symptoms, the person may need physical therapy, chiropractic treatment, or maybe spinal decompression therapy as well.

A TENS unit may help, which is a device about the size of an iPod that can be placed on the belt and be very mobile. You can help tire out the muscles around the back and relieve muscle spasms and also help change the way the brain perceives pain signals.

Back pain treatment OrlandoTreatment with a pain management doctor may consist of medication management along with interventional treatment. This may consist of short-term narcotics along with some muscle relaxers. With regards to interventional treatments, the gold standard is there are multiple different ways of performing the injections, and a series of 1 to 3 procedures may be necessary depending on how well they work. Injections usually work over 75 to 80% of the time for significant pain relief.

 

If substantial conservative treatment for over six weeks is ineffective, then surgery should be considered. If neurological deterioration occurs before then, then surgery should be considered sooner but it is best to make that decision in conjunction with your doctor.

 

What are my chances of needing surgery?

The vast majority of those experiencing sciatica symptoms will not end up needing surgery Over 95% of those with sciatica symptoms are able to achieve adequate pain relief with the above mentioned treatments. This is really good news considering there are some small but real risks associated with herniated disc surgery.

The Florida Pain Network connects those in pain with pain relievers around the state. This includes pain clinics in south Florida, pain management Orlando clinics, Tampa pain management and more. The pain doctors are Board Certified and offer comprehensive treatments including medication management and injections. Chiropractors offer manipulations, physical rehabilitation and spinal decompression therapy.

Visit THIS page to find the pain clinics closest to you, or just call (877) 877-8556 for assistance.


When it Comes to Pain Prescriptions, Race May Have an Influence

May 20, 2012 , , , , , , , ,
PrintPinterestTumblrDiggShare

A new report published in the American Journal of Public Health has shown that racial bias may affect doctor’s decisions on their prescribing habits.

This study was performed at the University of Washington and asked 87 pediatricians to complete online tests that were designed to look at unconscious attitudes towards race. Over 80% of the participating physicians were caucasian. The pediatricians were then asked to formulate treatment decisions for patients who were hypothetical, some were white and some were black.

These hypothetical patients had disease conditions of urinary tract infections, asthma, ADHD or pain problems.  The study showed no link between the urinary tract infections, asthma or ADHD. However, the study showed that pediatricians had an unconscious  Caucasian bias when it came to treating with ibuprofen versus oxycodone.

They were more likely to prescribe oxycodone to the hypothetical black patients after surgical procedures.  While the study showed an increased tendency for treating African-Americans with narcotic medication, a 2010 study out of the Journal of Pain showed that in the University of Michigan health system, pain clinic patients that were African-American were taking about half the number pain medications compared with similar Caucasian patients. 

Because the results of the University of Washington study were in theory because the doctors were in a hypothetical patients, it is unclear whether reality would also show racial bias. Most likely racial bias does exist in some fashion especially when correlated with the 2010 results showing the disparity between pain management prescriptions.

One question that I actually have is which way does the bias tilt because the theoretical study results are in the opposite direction from the University of Michigan results. Further research is needed to delineate the disparity. 

If you live in Florida and need pain management treatment, the Florida Pain Network can help. The network includes  Florida Pain Clinics throughout the state, and has clinics it took about interventional as well as medication management listed in the directory.  The website is geographically targeted, and if you put in your ZIP Code on THIS page, the pain clinics closest to you will pop up immediately.For instance, if you need Orlando pain management simply put in your zip code or type in Orlando. If you need options for pain clinics in Jacksonville Florida do the same.

You do not have to live in pain, contact a pain management practice for help today.


FAQs on Radiofrequency Ablation in Pain Management

May 16, 2012 , , , , , , , ,
PrintPinterestTumblrDiggShare

When looking at the most modern treatments available for helping reduce low back pain and neck pain, radio frequency ablation is on the cutting edge. It is also referred to as radiofrequency neurotomy, medial branch rhizotomy, and radiofrequency lesioning.

What exactly is Radiofrequency Ablation?

Radiofrequency procedures involve electro-magnetic waves traveling at the speed of light. It forms heat energy coming from the generator of the machine that is operating at very high frequencies.

This heat energy is utilized by pain management doctors in Florida to be delivered exactly to the area of nerve endings that are bringing sensation and pain to arthritic joints.The procedure blocks those nerves from working by deadening them which may last from a few months upwards of a couple years.

Pain clinics Florida

Radiofrequency Neurotomy

Why is a Radiofrequency Neurotomy performed?

An RFA procedure can give a lot longer pain relief than steroid injections. Typical pain relief from steroid injections into arthritic low back joints lasts from a few days to a few months. This is vastly different than what can be achieved with a radiofrequency ablation procedure and pain relief may last for 1 to 2 years.

The condition most commonly treated by radiofrequency ablation is called facet arthritis. Facet joints are the small thumbnail size joints on either side of the back and neck. These joints have cartilage and are subjected to potential arthritis just like any other cartilaginous joint in the body. This arthritis may be due to normal wear and tear in the body, or it may be a result after a car accident or another kind of traumatic injury. This may also include the result of whiplash causing damage to those joints.

Who is a candidate for a radiofrequency ablation?

The procedure is not typically a first line treatment. Typically patients who are dealing with facet arthritis undergo a diagnostic injection prior to the RFA utilizing numbing medicine and possibly steroid. If this work

s and then wears off, insurance companies will often approve a radiofrequency ablation. These diagnostic blocks are called medial branch blocks. 

One new indication for a radiofrequency ablation procedure includes sacroiliac joint arthritis, which has actually been showing excellent results with radiofrequency ablation.

Another pain management problem that is receiving excellent results from radiofrequency ab

pain management Orlando
pain management Sarasota

RFA

lation is occipital neuralgia. If an occipital nerve block helps with the patient’s pain initially, a radiofrequency neurotomy may then provide long-term pain relief for this diagnosis.

How does the radiofrequency procedure provide pain relief?

The heat that is generated from the radiofrequency procedure is placed around the area of the nerve endings that provide the pain sensation to arthritic joints. The heat kills those nerve endings, providing pain relief in the process. The distinction between a nerve ending and a nerve root is very important to understand, as the pain doctor does not want any of the heat to reach an actual nerve root.

Overall, radiofrequency ablation procedures in pain management have been providing anywhere from 50 to 95% pain relief in research studies. The procedure is one of the most successful in pain management today.

How is a radiofrequency ablation procedure performed?

The procedure is performed as an outpatient in an office procedure room or an Outpatient Surgery center. It is often done with IV sedation, but it is not absolutely necessary and can actually be done under numbing medicine if desired. 

Patients are placed in the prone position, which is stomach down, on a table that allows x-rays to go through it. The pain doctor will numb up the skin after sterilizing it, and place needles down to the areas of the arthritic joints being treated. This procedure is done under a real-time form of x-ray, call fluoroscopy. Once the Florida pain clinic  doctor is satisfied with the placement of the needles, the needle itself is removed and the catheter is left in place which allows the heat to be generated from the radio requency machine.

The next step is for the pain doctor to perform a motor nerve stimulation check. This make sure the catheters or not close to an actual nerve root. Assuming this test is passed, it’s time for the physician to go ahead and administer the heat energy. The amount and duration of heat energy utilized is different for the various parts of the body. Once this is accomplished the procedure is complete and bandages are applied. The patient goes home the same day, and usually is monitored in the recovery room for 30 to 60 minutes.

How well does a radiofrequency neurotomy procedure work?

The procedure has been studied extensively in research projects. Although the effectiveness varies, it is usually between 50% and 95% effective with the duration of pain relief lasting anywhere from 6 to 24 months. There was one study that showed average pain relief of over 470 days which is closing in on a year and a half. The small nerve endings that are eliminated during the procedure will actually grow back eventually at which time the procedure may simply be repeated with excellent results again.

What are the risks of the radiofrequency procedure?

The typical risks of a procedure such as this include a small risk of infection along with bleeding. If the patient is on blood thinners these should be stopped approximately 5-7 days before the procedure, and your doctor can tell you exactly the timeframe.

Patients often experience muscle spasms after the procedure for a couple weeks which is normal. This may mean the patient has more pain after the procedure than before, which is vital to a patient’s understanding so they do not get overly concerned. This does not necessarily mean that the procedure is not going to work, it may just mean that the heat generated sparked up some muscle spasms and those just need to subside.

There’s also actually a small risk that the nerve endings treated were only partially deadened and that may increase pain  for a few months afterwards. Patients may have some numbness over the skin for the procedure was performed and an unusually rare risk is damage of an actual nerve root.

The Florida Pain Network connects those in pain with pain relievers around the state. Clinic listings include Sarasota pain management, pain management Orlando clinics, pain clinics in Fort Myers, and others throughout the state.

The site is geographically targeted, those in need can simply put in their zip code HERE and the closest clinics will show up first.


What are Facet Injections and How are They Administered?

May 10, 2012 , , , , , , ,
PrintPinterestTumblrDiggShare

The spaces between the vertebrae of the back are facet joints. These are instrumental in allowing movement of the spine as each vertebra moves against the one above or below it. Inflammation due to degenerative disease, injury, or mineral deficiencies can cause a great amount of discomfort to the facet joints. Chronic pain from facet joints is called facet syndrome.

Facet injections relieve the swelling and inflammation and, in most cases, can address the pain associated with it. While most pain is centralized to the spine, some can be projected to other parts of the body, including the arms, legs, and other areas near the backbone.

Who is a Candidate for Facet Injections at Florida pain clinics?

Not everyone with back pain is a candidate for facet injections, but arthritis sufferers or patients with thickened facet joints may benefit from this treatment. It is the most common procedure performed by pain doctors in America because the problem is so common. If X-rays indicate the presence of inflammation and a person is suffering from chronic pain in the back or neck, facet injections are beneficial much of the time.

Traumatic injuries to the back or neck often lead to facet joint pain. Whiplash is one of the more common injuries that cause facet related pain, and truly the most common reason for pain is the wear and tear of degenerative facet arthritis.

Usually, facet injections are not the first form of treatment for spinal injuries. Physical therapy and chiropractic treatments are more apt to be attempted before resorting to the needle.

The Process of Facet Injections

A typical session of facet injections only takes ten to twenty minutes at a pain management Tampa clinic. The medication itself contains steroids and anesthetics and is administered by a needle that goes deep into the tissue. This causes some pain, which is offset by the use of local anesthetics.

Facet Joint Injections

Facet Joint Injections

Patients typically lie on their stomachs while they receive facet injections. This decreases the likelihood that a sudden movement might cause a problem with the treatment and allows for more separation between vertebrae. Neck or cervical facet injections may require patients to be placed in different positions.

The number of facet injections a patient receives is based on the extent of discomfort and how soon the condition causing the pain can be addressed in other ways. These injections are performed by pain management Delray Beach FL clinics and many others around the state.

The Florida Pain Network has pain clinics and doctors around the state to help. The website has geographically targeted listings which show those closest to your zip codes. or you may simply call (877) 877-8556 for assistance.


What to Expect with a Pain Management Medial Branch Block

May 5, 2012 , , , , , , , ,
PrintPinterestTumblrDiggShare

The medial branch block is a diagnostic procedure often performed at Florida pain clinics to determine if a specific facet joint is causing a patient’s discomfort. During the injection procedure, the shot is administered to block the nerves that are potentially bringing the pain sensation to the facet joint.

A medial branch block procedure is performed as an outpatient. Patients lay on their stomach on a special table that allows a real-time x-ray called fluoroscopy to work through it. If the metal on the table obstructed the physician’s view, it would be difficult to be accurate with needle placement. A local numbing medication is placed just underneath the skin and through the soft tissues down to the area of the medial branch. Pain clinics in Orlando and others throughout the state often perform this procedure as an outpatient.

At this point the doctor places the needle through the anesthetized track and injects contrast dye so that he or she can see and make sure that the needle is in the appropriate anatomic position. Once this is accomplished, numbing medicine is injected around the nerves to block those pain signals from reaching the brain.

Medial Branch Block

Medial Branch Block

The numbing medicine works within just a few minutes so patients should receive some relief very soon. If no significant relief is achieved, another level may be treated to see if that is the source of the pain. It may be the one level gets partial relief and since the patient may have arthritis in the second level treatment of that may help significant. Sometimes doctors will also inject steroid medication along with the numbing agent, and this can help with prolonged pain relief.

The medial branch block procedure may provide pain relief for simply a few weeks, or there have been studies showing it can provide 3 to 5 months of excellent pain relief.  Once the procedure is completed, patients usually go home within about an hour after spending a little time the recovery room.

If the procedure works and then wears off, often times the next step is a radio frequency ablation procedure which may provide up to two years of pain relief for facet joint related pain.

Patients seeking treatment for neck or back pain may seek relief at one of the pain clinics in Florida listed with the Florida Pain Network such as a pain management Fort Myers clinic or pain management Boca Raton clinic. The listings are geographically targeted so those closest to you will pop up, or simply call (877) 877-8556 for assistance.


1 2   Next »