The next day, the patient can return to regular activities, with care. The neck or back is often very sore over the next one to four days, caused by muscle spasm and irritability while the targeted nerves are dying from the heat damage over the next one to two weeks. Resting for a few days before resuming normal activities is normal, with painkilling medication given as appropriate.
Archive for the 'Pain Management' Category
Radio frequency denervation is performed under fluoroscopy (a form of live x-ray). It is important to be sure that the placement of the needle is accurate, to damage the correct small nerve and avoid unintended consequences.
Patients are advised to avoid driving and strenuous activities for the day of the procedure, and to continue taking their normal medications except aspirin or other blood-thinning medications.
An intravenous line is inserted so that relaxation drugs can be given as required and the patient asked to lie face down on the x-ray table.
A local anesthetic is given to the area of skin where the procedure is to be performed. Fluoroscopy, which is live x-ray guidance, is used to place the needle alongside the medial or lateral branch nerves. A small electrical charge is passed through the needle to check it is in the right area next to the nerve. This stimulation should bring on the patient’s typical pain and make the back muscles twitch.
The target nerves are then anesthetized to minimize the pain while the lesion is being made, and repeated as often as the number of nerves to be treated. The whole thing takes from 30-90 minutes.
What is Pilates
Published July 10th, 2007 in Physical Medicine & Rehabilitation and Pain Management. 0 CommentsPilates is an exercise program that focuses on the core postural muscles that help keep the body balanced and are essential to providing support for the spine. In particular, Pilates exercises teach awareness of neutral alignment of the spine and strengthening the deep postural muscles that support this alignment, which are important to help alleviate and prevent back pain.
The Pilates exercise program
Pilates is an exercise system named after its originator, Joseph Pilates. Mr. Pilates developed this system in the early 1900’s to improve his health and to support the health of fellow World War I internees. Later, he incorporated the resistance of springs into rehabilitation programs for hospitalized patients, and then translated the use of springs into machines and created the unique equipment now used in the exercise system.
Important principles of the Pilates exercise program include:
· Use of mental focus to improve movement efficiency and muscle control
· Awareness of neutral spine alignment, or proper posture, throughout the exercises
· Development of the deep muscles of the back and abdomen to support this posture
· Use of breath to promote mental focusing and centering
· Creating length, strength, and flexibility in muscles
Electrodiagnostic Studies (EMG & NCS)
Published July 7th, 2007 in Physical Medicine & Rehabilitation and Pain Management. 0 Comments
Electrodiagnostic tests generally have two components: An electromyogram (EMG) and a nerve conduction study (NCS). These tests evaluate the physiology and functioning of the nerves and muscles and give information that complements the findings provided by x-rays and other scans. They cannot measure the pain that you may be experiencing but do give information about past or current damage to nerve fibers and how that damage affects muscles.
When is an Epidural Injection Typically Recommended?
Published July 2nd, 2007 in Epidural Injections and Pain Management. 0 CommentsEpidural steroid injections for rehabilitation
In general, an epidural steroid injection is used to help provide pain relief to enable patients to progress with their rehabilitation. Individuals who have less back pain and feel more comfortable are generally able to work on the active therapies—such as stretching, strengthening/pain relief exercises and low impact aerobic conditioning—that are critical in rehabilitating the lower back and helping prevent (or minimize) future episodes of low back pain.
Several common conditions—including a lumbar disc herniation, degenerative disc disease, and lumbar spinal stenosis—can cause severe acute or chronic low back pain and/or leg pain. For these and other conditions that can cause chronic pain, an epidural steroid injection may be an effective non-surgical treatment option.
Cervical, Thoracic and Lumbar Facet Injection Information Continued
Published June 27th, 2007 in Pain Management. 0 CommentsWhat will happen to me during the procedure?
Cervical, Thoracic and Lumbar Facet Injection Information
Published June 25th, 2007 in Pain Management. 0 CommentsWhat are the cervical facet joints, and why are facet joint injections helpful?
WHAT IS PROLOTHERAPY?
Prolotherapy is a non surgical treatment for musculoskeletal pain (neck, back and joint pain). It enables your body to produce new cells that will strengthen tendons and ligaments. Prolotherapy consists of injections of proliferents to create growth of normal cells. The injections consist of a solution, which stimulates growth factor production. Growth Factors are proteins that stimulate growth or healing of tissues. Prolotherapy regenerates NORMAL tissue.
WHAT DOES PROLOTHERAPY TREAT?
Prolotherapy is an effective treatment for arthritis, back and neck pain, sports injuries, joint aches, fibromyalgia, carpal tunnel, frozen shoulder, TMJ, rotator cuff injury, plantar faciitis, herniated discs, sciatica, and many, many others.
HOW ARE LIGAMENTS INVOLVED?
Most musculoskeletal pain is caused by ligament dysfunction. Ligaments are structures that hold bones and joints together. When ligaments are injured (car accident, falls, repetitive trauma) joints become dysfunctional and cause pain and muscle spasm. Dysfunctional joints and muscle spasm cause pain and radiating symptoms.
ARE YOU A CANDIDATE FOR PROLOTHERAPY?
Prolotherapy stimulates the body to repair the painful area. For the patient who has localized areas of pain or the person who has had a recent injury from an accident, Prolotherapy is a very effective treatment to strengthen those specific areas and eliminate the pain. Realize, however, that Prolotherapy starts the growth of new healthy, strong tissue. Your body—your own immune system—grows the tissue. For the person who has terrible digestion, chronic fatigue, irritable bladder, and a host of other chronic nutritional, hormonal and/or allergic problems, these deficiencies and illnesses should be corrected so the body will be able to respond to Prolotherapy.
The ideal Prolotherapy candidate has the following:
• Pain originating from a ligament or tendon
• Strong immune system
• Willingness to improve and receive follow-up visits
• Healthy diet
• Positive mental outlook
Quite often leg pain or foot pain is not caused by a problem in the leg or foot, but rather by a condition in the lower back. Diagnosis of leg pain and other lower extremity symptoms should focus not only on the legs and hips, but should also include examination of the low back. In fact, with many low back problems, there is actually little or no low back pain. Instead, there may be leg pain, foot pain, and/or lower extremity numbness or weakness.
Benefits of Epidural Injections
Published June 18th, 2007 in Epidural Injections and Pain Management. 0 CommentsPatients will find that the benefits of an epidural steroid injection include a reduction in pain, primarily in leg pain. Patients seem to have a better response when the epidural steroid injections are coupled with an organized therapeutic exercise program.
While the effects of an epidural steroid injection tend to be temporary—providing relief from pain for one week up to one year—an epidural injection can be very beneficial for patients during an episode of severe back pain. Importantly, it can provide sufficient pain relief to allow the patient to progress with their rehabilitation program.
Epidural steroid injection success rates
An epidural steroid injection is generally successful in relieving pain for approximately 50% of patients. If a patient does not experience any back pain or leg pain relief from the first epidural injection, further injections will probably not be beneficial. However, if there is some improvement in back pain or leg pain, one to two additional epidural steroid injections may be recommended.
