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Back Pain: Spondylosis, Spondylolysis, and Spondylolisthesis

Have you read your MRI report recently and ended up more confused about your low back pain than before you began? If so, you are not alone.  The medical terms for low back problems confuse many medical professionals who don’t deal with these issues on a regular basis.  The purpose of this post is to help explain what is going on with your back, so that you can make a more informed decision on which treatments to choose.

The 3 main terms we are going to discuss are spondylosis, spondylolysis, and spondylolisthesis.  Each is defined below and a general discussion of treatment options follows.

Spondylosis refers to degenerative osteoarthritis of the spine – essentially the space between adjacent spinal vertebrae narrows. Because this condition commonly occurs in the zygapophysial (facet) joints or the intervertebral discs, it is often referred to as facet syndrome or degenerative disc disease.

Spondylolysis is a defect of a vertebra in the pars interarticularis – most typically a stress fracture that is caused by repetitive trauma done to the lumbar spine from strenuous sports such as football, weightlifting, cheerleading, or gymnastics.  Spondylolysis is also linked to certain inherited spinal anatomy (increased size and shape of the L4 superior articular process).

Spondylolisthesis is the displacement of a vertebra, most commonly occurring after a break or fracture.  There are 2 common forms of spondylolisthesis.

Isthmic (spondylolytic) spondylolisthesis is the most common form, with a reported prevalence of 5–7 percent in the US population. It usually progresses from spondylolysis over time.

Degenerative spondylolisthesis develops as a long-term result of progressive spondylosis. Facet arthritis and ligamentum flavum weakness may result in slippage of a vertebrae. Degenerative forms are more likely to occur in women, persons older than fifty, and African-Americans.

Symptoms:

Spondylosis, spondylolysis, or spondylolisthesis can cause stiffness and pain in the spine (lower back pain or neck pain), however, when severe, the narrowing may cause pressure or compression of the nerve roots.  Compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory disturbances, such as severe pain, weakness, or tingling in the neck, shoulder, arm, back, and/or leg, possibly accompanied by muscle weakness).

Treatments:

Treatment begins with conservative therapy including: physical therapy (including yoga and pilates), anti-inflammatory medications, epidural steroid injections, facet joint injections, radiofrequency ablation, massage therapy, acupuncture, and chiropractic care.  Often a back brace will help patients, especially those with spondylolisthesis to perform certain activities with less pain.

If there is nerve root irritation or nerve root compression causing radiculopathy that is not improved with conservative care, decompression surgery may be very effective in relieving the pain.  Fusion surgery is a poor option for the treatment of spondylosis, but may be considered for severe cases of spondylolisthesis.

Regenerative medicine has recently emerged for spondylosis and spondylolysis.  There are several reports of long-term successful treatment of low back pain with both PRP (platelet rich plasma) therapy or stem cell treatments.

For those interested, I have included a video with some excellent exercises for low back pain.

Fast facts: Are you at an Increased Risk for Back Pain?

An important question that is frequently put to our back pain management specialists here at the Capitol Pain Institute is whether there are certain jobs or lifestyles that increase the risk of back pain. The simple answer to this question is that it is not professions or lifestyles that influence back pain probability, but due to a wide specter of reasons. Statistics show that most adults would, at one time or another during their lifetime, experience a severe case of back pain, especially lower back pain. There is even evidence to show that a quarter of Americans may have a relapse of severe back pain once a quarter. These people come from different creeds, have different day-to-day routines and so forth, yet are united by this worrying statistic. Suffice it to say that back pain leads to more work missed than any other occupational disability.

Why does back pain occur?

Back Pain 225x300 Fast facts: Are you at an Increased Risk for Back Pain?As mentioned before, there are plenty of factors that can influence the appearance of back pain. There is the excessive strain put on muscles and ligaments, injury due to a car accident or workplace incident, nerve irritation and so on and so forth. A key point to remember about back pain is that it is not always a manifestation of something wrong with the back per se, as back pain can be a direct manifestation and symptom of other health issues. Back pain in itself is a very broad term that includes both the symptoms of various injuries and the elements of deeper health concerns. Neck and back strain, unusual physical activity, direct and indirect injury, shock, uncomfortable posture can all contribute to the formation of back pain.

What causes increased risk of back pain?

The non-exhaustive list above should provide some direction in terms of activities and occupations that may be closely linked with greater risk of back pain. There are, of course, ways to try and avoid this back pain. Our back pain doctor in Austin at the Capitol Pain Institute recommend abstaining from physical activity that is not at par with your usual level of strain on your muscles and ligaments. They also recommend taking it slow when pain does occur, as forcing yourself past the mild irritating pain can lead to much greater consequences. What our doctors stress, however, is that it is usually very difficult to pinpoint the exact reasons for a particular back pain incident. Given the interconnectivity and complexity of the human nervous system, most of the time no one factor can be attributed to increased back pain risk. Nerve entrapment, muscular injury, herniated disks, joint erosion are all named as possible causes of back pain, but caution is urged when trying to link the condition to just one of the aforementioned issues.

How we can help

No online chat or discussion can substantiate a visit to meet with our trained medical professionals in person. Diagnosis should never be given out online, and the materials you would find here are for informational purposes only, thus we encourage you to contact our doctors at the Capitol Pain Institute today to book an up and personal review of your individual situation.

Understanding Spine Basics: The Vertebrae, Discs and the Spinal Cord

Dealing with back pain is torture, but the more you know about spine basics, such as the vertebrae, discs and the spinal cord, the better you will understand your pain. Although it won’t lessen it, it can help you avoid making the situation worse.

A lot of strain is put on your spine; after all it is what holds up the heads, shoulders, and the entire body. It is the frame that supports your body and allows you to twist and bend. It also acts to protect your spinal cord by encasing it.

Understanding Spine Basics: The Vertebrae, Discs and the Spinal Cord

 To get a better understanding of your spine, let’s break down the components that hold it together.

Spine Basics – The Vertebrae

You have probably heard of “vertebrae”, which is the plural of vertebra, but do you have a firm understanding of what they are?

The vertebrae are the 33 individual interlinked bones that form your spinal column. They are broken down into five main groups that depend on where they are located on the backbone.

  • The base of your skull has 7 cervical vertebrae
  • 12 thoracic vertebrae in your upper back
  • 5 lumbar vertebrae in your lower back, below the curve.
  • Below your lower back are 5 vertebrae that are fused together to form the sacrum, which is part of your pelvis.
  • The last 4 vertebrae are fused together to make your tailbone.

The vertebrae in each region have unique features that help them execute their main functions.

Spine Basics – Discs                  

 Between each vertebra is what are medically called intervertebral discs, but are usually shorted to “discs”. The discs in your back Spine Basics 268x300 Understanding Spine Basics: The Vertebrae, Discs and the Spinal Cordconnect each vertebra to the next. They’re flat and round with a gel-like center, and are about a half an inch thick.

Discs are made of two components:

  • Nucleus pulposus: Is similar to jelly, and comprises the center of your disk
  • Annulus fibrosus: The flexible outer-ring of the disk, which consists of several layers similar to elastic bands and resembles the cross-section of an onion.

Discs are located in front of your spine, and are what give the torso the ability to move forwards, backwards, side to side, and rotate. They are also responsible for absorbing shock and pressure during activities such as running, walking and even sitting.

Spine Basics – The Spinal Cord

 Your spinal cord goes from your skull down to your lower back, and goes through the middle section of each vertebra. Nerves flow from your spinal cord to every muscle in your body, via openings in your vertebrae (foramen), and carry messages between your brain and muscles. Because of this anatomical set-up, injury or damage to your spinal cord can result in serious problems in other areas of your body including your limbs, muscles, skin and organs. Since your spinal cord is protected by vertebrae, disks, ligaments and muscles, you also have to be careful when you injure these areas of your back.

 Now you know the basics of your spine, its components, and also how they work together. If you’re dealing with back pain and want to know how our Austin pain doctors at the Capitol Pain Institute can help you, contact us by e-mail at help@capitolpain.com or call us at (512) 467-7246.

When is a Migraine headache really a Migraine?

When is a Migraine headache really a Migraine?

“My head hurts…It must be a migraine!” Is a common complaint amongst many patients in neurology clinics and Austin pain clinics alike. However, not all headaches have the same triggers, causes, or treatments. In specific, a migraine is a severe headache that may be commonly associated with nausea and/or light and sound sensitivity. This type of headache is distinctly different from cluster type headaches (pain behind the eye) and tension type headaches (pain across forehead) which may be discussed in more detail with your physician.

So when is a “migraine” really a migraine headache? The once popular ‘vascular theory of migraine’ purported that migraine headaches were a cause of dilatation and vasoconstriction of cerebral blood vessels is no longer considered mainstream [1-3]. More reflective of current research is the idea that migraines are caused by ‘cortical spreading depression’ or a wave of electrical activity sweeping across the brain.

This electrical wave activates a nerve system known as the ‘trigeminovascular system’ (TVS) which is a network of nerves that can irritate the pain-sensitive lining of the brain (the meninges). The TVS explains the distribution of migraine pain, which often includes the front and back of the head and the upper neck [4,5].The prolongation and intensification of migraine pain is propagated by the inflammatory response (neurogenic inflammation) triggered by the TVS [6].

What role does genetics have with migraine headaches? Migraine headaches are in most instances inherited. Subtle abnormalities, involving membrane channels, receptor families, and enzyme systems have been linked to migraine in certain groups and individuals. The importance of inheritance in migraine has long been recognized [7]. One early general population based study found that the risk of migraine in relatives of migraineurs was three times greater than that of relatives of non-migraine control subjects [8].

How common are migraine headaches? Migraine is a common disorder that affects up to 12 percent of the general population [8]. It is more frequent in women than in men, with attacks occurring in up to 17 percent of women and 6 percent of men each year [9,10]. Migraine is most common in those aged 30 to 39, an age span in which prevalence in men and women reaches 7 and 24 percent, respectively [10]. Migraine also tends to run in families. Migraine without aura is the most common type, accounting for approximately 75 percent of cases.

What is a migraine aura? About 25 percent of people with migraines experience one or more focal neurologic symptoms called the migraine aura. Auras are most often visual, but can also be sensory, verbal, or motor disturbances. Visual auras may either appear as a bright spot or as an area of visual loss or geometric shapes and zigzagging lines may often appear. [12]. Less common than the visual and sensory auras, is the language or dysphasic aura that causes transient language problems that may run the gamut from mild wording difficulties to frank difficult speaking [13]. Traditional teaching is that migraine aura usually precedes the headache [13]. However, prospective data suggest that most patients with migraine experience headache during the aura phase [14]. It may also occur without an associated headache.

Can I feel a migraine starting? A migraine prodrome (forewarning) occurs in up to 60 percent of people 24 to 48 hours prior to the onset of headache i.e. euphoria, depression, irritability, food cravings, constipation, neck stiffness, and increased yawning [10].

How does a migraine progress? Migraine is a disorder of recurrent attacks. The attacks unfold through a cascade of events that occur over the course of several hours to days. A typical migraine attack progresses through four phases: the prodrome, the aura, the headache, and the postdrome [11]. The headache of migraine is often but not always unilateral and tends to have a throbbing or pulsatile quality, especially as the intensity increases. As the attack severity increases over the course of one to several hours, patients frequently experience nausea and sometimes vomiting. Many individuals report sensitivity to light or sound during attacks, leading such migraine sufferers to seek relief by lying down in a darkened, quiet room.

What is a migraine postdrome — Once the spontaneous throbbing of the headache resolves, the patient may experience a postdromal phase, during which sudden head movement transiently causes pain in the location of the headache. During the postdrome, patients often feel drained or exhausted.

What precipitates or exacerbates a migraine? An evidence-based review concluded that stress, menstruation, visual stimuli, weather changes, nitrates, fasting, and wine were probable migraine trigger factors, while sleep disturbances and aspartame were possible migraine triggers [15]. All of the probable and possible migraine triggers except aspartame were also general headache triggers.

In a retrospective study of 1750 patients with migraine, approximately 75 percent reported at least one trigger of acute migraine attacks [16]. In order of descending frequency these included:

  • Emotional stress (80 percent)
  • Hormones in women (65 percent)
  • Not eating (57 percent)
  • Weather (53 percent)
  • Sleep disturbances (50 percent)
  • Odors (44 percent)
  • Neck pain (38 percent)
  • Lights (38 percent)
  • Alcohol (38 percent)
  • Smoke (36 percent)
  • Sleeping late (32 percent)
  • Heat (30 percent)
  • Food (27 percent)
  • Exercise (22 percent)
  • Sexual activity (5 percent)

Obesity has been associated with an increased frequency and severity of migraine [17-20].

Are there ways I can tell a tension headache from a migraine headache? While the features of migraine and tension headache overlap, the clinical features that appear to be most predictive of migraine include nausea, sensitivity to light, sensitivity to sound, and worsening of symptoms by physical activity [21, 22]. Food triggers are also more common with migraine than tension-type headache.

The International Headache Society (IHS) diagnostic criteria for migraine with and without aura are as follows [14]:

Migraine without aura — Migraine without aura is a recurrent headache disorder that fulfills the following criteria [14]:

  • Headache attacks last 4 to 72 hours
  • Headache has at least two of the following characteristics: unilateral location; pulsating quality; moderate or severe intensity; aggravation by routine physical activity
  • During headache at least one of the following occurs: nausea and/or vomiting; photophobia and phonophobia
  • At least five attacks occur fulfilling the above criteria
  • History, physical examination, and neurologic examination do not suggest any underlying organic disease

Migraine with aura — In migraine with aura, attacks include the transient appearance of focal neurologic symptoms that usually develop gradually over 5 to 20 minutes and last for less than 60 minutes. A headache that has the features of migraine without aura begins during the aura or follows the aura within 60 minutes.

Although too detailed for this overview, it is important to know that other types of migraines exist, including ‘Menstural migraines’  (a migraine headache that occurs in close temporal relationship to the onset of menstruation), ‘Basilar-type migraine’ (often present as difficulty speaking, ear ringing, double vision, decreased hearing then followed by a typical migraine headache), etc.

The purpose of this overview is for informational purposes only not as a tool for diagnosis, treatment, or management. If you experience any types of head pain, visual disturbances, nausea and vomiting it is imperative that you seek immediate consultation with a physician for treatment as many other diseases or injuries can cause similar signs and symptoms and may be life threatening. Consult with your physician regarding diagnosis, management, and prevention.

 

REFERENCES

  1. Charles A. Advances in the basic and clinical science of migraine. Ann Neurol 2009; 65:491.
  2. Charles A. Vasodilation out of the picture as a cause of migraine headache. Lancet Neurol 2013; 12:419.
  3. Amin FM, Asghar MS, Hougaard A, et al. Magnetic resonance angiography of intracranial and extracranial arteries in patients with spontaneous migraine without aura: a cross-sectional study. Lancet Neurol 2013; 12:454.
  4. Sessle BJ, Hu JW, Dubner R, Lucier GE. Functional properties of neurons in cat trigeminal subnucleus caudalis (medullary dorsal horn). II. Modulation of responses to noxious and nonnoxious stimuli by periaqueductal gray, nucleus raphe magnus, cerebral cortex, and afferent influences, and effect of naloxone. J Neurophysiol 1981; 45:193.
  5. Wise SP, Jones EG. Cells of origin and terminal distribution of descending projections of the rat somatic sensory cortex. J Comp Neurol 1977; 175:129.
  6. Sarchielli P, Alberti A, Floridi A, Gallai V. Levels of nerve growth factor in cerebrospinal fluid of chronic daily headache patients. Neurology 2001; 57:132.
  7. Lance JW, Anthony M. Some clinical aspects of migraine. A prospective survey of 500 patients. Arch Neurol 1966; 15:356.
  8. Merikangas KR, Risch NJ, Merikangas JR, et al. Migraine and depression: association and familial transmission. J Psychiatr Res 1988; 22:119.
  9. Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001; 41:646.
  10. Stewart WF, Shechter A, Rasmussen BK. Migraine prevalence. A review of population-based studies. Neurology 1994; 44:S17.
  11. Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007; 68:343.
  12. Charles A. The evolution of a migraine attack – a review of recent evidence. Headache 2013; 53:413.
  13. Kelman L. The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs. Headache 2004; 44:865.
  14. Cutrer FM, Huerter K. Migraine aura. Neurologist 2007; 13:118.
  15. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004; 24 Suppl 1:9.
  16. Hansen JM, Lipton RB, Dodick DW, et al. Migraine headache is present in the aura phase: a prospective study. Neurology 2012; 79:2044.
  17. Martin VT, Behbehani MM. Toward a rational understanding of migraine trigger factors. Med Clin North Am 2001; 85:911.
  18. Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia 2007; 27:394.
  19. Bigal ME, Liberman JN, Lipton RB. Obesity and migraine: a population study. Neurology 2006; 66:545.
  20. Bigal ME, Lipton RB. Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology 2006; 67:252.
  21. Bigal ME, Tsang A, Loder E, et al. Body mass index and episodic headaches: a population-based study. Arch Intern Med 2007; 167:1964.
  22. Smetana GW. The diagnostic value of historical features in primary headache syndromes: a comprehensive review. Arch Intern Med 2000; 160:2729.

New Diagnostic Criteria for Fibromyalgia

The Hunt for the Correct Diagnosis: Fibromyalgia vs Myofascial Pain Syndrome

A Glance at the Latest Breakthroughs in Diagnosis and Treatment

Although hard to believe, there was a time when Fibromyalgia was treated as a “catch all diagnosis” or a diagnosis applied to any patient in diffuse, widespread chronic pain without a clear cause. As there was no initial diagnostic criteria, and the condition was poorly understood, many patients would be mislabeled with the diagnosis of “Fibromyalgia” without a clear understanding of why or how this diagnosis was reached. Fortunately, there has been a great deal of headway in defining Fibromyalgia, learning about its cause, and separating this diagnosis from other similar pain conditions.

Fibromyalgia is regarded as a chronic condition that causes intense pain all over the body as well as causes a range of other symptoms. Doctors have classified Fibromyalgia as a syndrome, which means it is comprised of signs, symptoms, and characteristics that often go hand-in-hand. A few commonly reported characteristics include “hurting all over,” “feeling exhausted,” morning stiffness, poor or un-refreshing sleep, memory impairment, and abdominal cramps.  See the Centers for Disease Control Fact Sheet on Fibromyalgia.

The term Fibromyalgia was coined circa 1976. However, it wasn’t until 1990 that the American College of Rheumatology published the first diagnostic criteria. Historically, a patient was diagnosed with Fibromyalgia once other syndromes were ruled out, and was founded upon “tender points.” These tender points needed to be on both sides of the body, above and below the waist in 11 of 18 specific spots on the body (as the diagram below demonstrates). These tender points needed to persist for at least 3 months. A new paradigm in diagnosing Fibromyalgia has stirred the medical community in recent years and caught everyone’s attention – patients and physicians alike. The Widespread Pain Index (WPI) and the Symptoms Severity Scale Score (SS) were recently introduced as two novel methods of assessing for Fibromyalgia. In essence, a diagnosis of Fibromyalgia may be reached under this new paradigm via a minimum score combination of the WPI and SS.

The medical community’s understanding of fibromyalgia has not only led to novel methods of diagnosis, but also in treatment and understanding of cause. The current thought is that Fibromyalgia represents a ‘malfunction’ of the central nervous system or a ‘central sensitization’ so to speak. In other words, those stimuli that would be interpreted by the brain and spinal cord as “mildly unpleasant” may be misinterpreted or increased in amplitude to “very unpleasant / painful.” This amped up neural circuitry may explain why patients not only may feel pain throughout their body but also why it may affect many other body systems including the gastrointestinal tract and cognitive functioning. This forward progress is in-line with the FDA approving three drugs in the treatment of Fibromyalgia (Lyrica, Cymbalta, and Savella) all with direction action on the central nervous system and more focused research into future potential therapies. Moreover, improved sleep habits, regular exercise, and stress reduction are also regarded as beneficial for this condition.

Fibromyalgia should not be confused with Myofascial Pain Syndrome. Understanding the differences between these commonly confused conditions not only helps direct targeted therapy but reduces misdiagnosis.  Unlike the symmetric “tender points” once touted in Fibromyalgia, Myofascial pain syndrome is hallmarked by “trigger points” or focal, painful, taut muscle bands that may be felt on the physical exam.  These tender points or “knots” can be painful, especially when under direct pressure and may result from tissue trauma, inflammation/irritation, or stress. Others speculate these taut muscle bands represent regions of reduced blood flow. Patients with these trigger points may experience pain at these sites or referred pain resulting in headaches, poor sleep, or decreased range of motion in joints. The treatment for Myofascial Pain Syndrome is commonly regarded as physical therapy, medications including NSAIDs and tricyclic antidepressants, and trigger point injections which increase regional blood flow and decrease inflammation through the deposition of local anesthetic and steroids in these regions. Ultrasound guidance has allowed for enhanced safety and efficacy of these injections.

At Capitol Pain Institute, our expert Austin pain doctors are aware of nuances in these pain conditions, the latest diagnostic criteria, therapeutic modalities, and medications to treat each of these pain conditions. We invite you to engage our physicians and nurse practitioners to speak more about your pain condition and how we may be of help!

Capitol Pain Institute in the fight against ovarian cancer

Capitol Pain Institute is teaming up with the Be The Difference Foundation in the fight against ovarian cancer.  Over 22,000 women will be diagnosed with ovarian cancer this year, and more than 15,000 will die from the disease – it is the deadliest form of female reproductive tract cancer. The expected 5 year survival rate for ovarian cancer is well below 50%  and these numbers have not changed in over 30 years! Unlike breast cancer and uterine cancer, which can be detected early on,  there is no early detection or screening test available for ovarian cancer today.

The Be The Difference Foundation was formed by four ovarian cancer survivors in different phases of survivorship who all share the same passion, to Be the Difference and end the fight against ovarian cancer.  Their mission is to help women increase their chance of survival of ovarian cancer.  To achieve this goal, their efforts are focused on raising awareness and money to fund programs for women fighting ovarian cancer today and to provide research dollars for a cure.

Capitol Pain Institute is a proud sponsor of the Wheel To Survive, an indoor cycling fundraiser to fund programs for women battling ovarian cancer today and to provide research dollars for a cure. The event will be held at the Dell Jewish Community Campus on March 30, 2014 from 9AM to 3PM.  The event currently has over 100 registered riders and has already raised tens of thousands of dollars, all of which go directly to ovarian cancer research.  Dr. Matt Schocket, Dr. Raimy Amasha, and the rest of the Austin Pain Management doctors team will be riding in the event.  We invite you to join us in the fight against ovarian cancer.  You can contribute to the Capitol Pain Institute team by visiting the Austin Pain doctor’s fundraising page.

We still need more sponsors for the event to support the riders.  100% of all donations to the riders go to charity, so we need additional sponsors to help fund the cost of the event.  Please contact Kim Schocket @ kimbyintex@yahoo.com for sponsorship information.  All sponsorships are fully tax deductible.

You can learn more about ovarian cancer by visiting the Centers for Disease Control website: http://www.cdc.gov/cancer/ovarian/statistics/

Treating Pain with Pain Management Austin

Thousands of people in Austin and all across the country suffer from chronic pain. This chronic pain could take many different forms such as headaches, sciatica, and lower back pain. One study shows that chronic pain costs the country 635 billion dollars in health care a year. What is worse is that this hefty price tag, however, is when people continue to spend thousands of dollars on prescription medication treatments without any result. Pain management Austin clinic can help people with chronic pain conditions using treatments like epidural steroid injections.  Additionally, there are other steps that people can take to help them manage their chronic pain better.

PainManagementAustin 300x224 Treating Pain with Pain Management Austin

Chronic pain may require more than just prescription medication.

 Step One

One of the first steps to take when dealing with chronic pain is for people to understand what exactly chronic pain is.  A headache that lasts for a week is horrible for the sufferer but it is usually not considered chronic pain.  Instead, pain is generally labeled as chronic when it persists for 3 months or longer. Still, if anyone is experiencing pain that is lasting for longer than expected, it is best to go to a doctor or medical practitioner to talk about how to alleviate the chronic pain. A doctor may suggest going to a specialist who deals with pain management in Austin.

Options

Epidural steroid injections might be suggested to help alleviate certain forms of chronic back pain, like having a herniated disc or degenerated disc in the spine. With this procedure a small amount of corticosteroids is injected in the outer part of the lower spinal cord. The steroids are an anti-inflammatory agent that provides relief in inflamed spinal nerves. Even with this procedure from a pain management Austin specialist, there are other steps a person can do in conjunction with any current medical treatment help manage their chronic pain.

Non-Medical Approaches

Meditation is one such tactic that can be used to help manage chronic pain, along with additional medical treatments from a pain management Austin specialist. Meditation is easy to do, and does not require any special training or equipment to do. In order to meditate people only need to sit or lay comfortably where they will not be disturbed, close their eyes, and focus on their breathing. Some people may try to relax the muscles throughout their body by tensing and relaxing one muscle at a time. While meditation is not a permanent solution to chronic pain it can help people to take away focus from their pain. Even just a few minutes of meditation a day can help those who suffer from chronic pain.

Consult a Professional

People suffering from chronic pain should speak to a doctor about the course of action to take for treatment. The doctor might suggest the person see a pain management Austin specialist who may suggest a treatment for chronic pain like epidural steroid injections. People may also want to consider doing daily meditations to help with their pain management. No matter what type of pain a person is experiencing talking to a medical professional about chronic pain management can help find some relief from the pain.

 

Austin Pain Doctors are Trained to Help Chronic Pain Sufferers

For those suffering from chronic pain, every day can be a challenge to complete simple tasks, to attend school, go to work, or run a home and look after children. As chronic pain is so unique to the person, so too must the treatment approach to chronic pain management. It is important to find a doctor or medical team that will work with you to create an individualized treatment plan. If you live in Austin and central Texas, you are fortunate to have some of the best Austin Pain Doctors in your community.

What is Chronic Pain?

Chronic pain is suffered by millions of people worldwide. In its simplest terms, chronic pain is any pain that lasts for an extended period often more than six months – the degree of the pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating. The toll on the body is significant, ranging from physical, psychological and emotional stress. The causes of chronic pain are wide spread. For some people, it is a result of a trauma or significant injury. Others suffer chronic pain as a result of less obvious causes, many of them hard to diagnose. For almost everyone who suffers from chronic pain, the goal is to find a way to manage it and improve their quality of life. Dr. Juli Desai, a well-regarded Austin pain doctor, creates a treatment plan for each patient that provides both pain relief while focusing on improving overall quality of life.

The Capitol Pain Institute

The Capitol Pain Institute was founded by one of the expert Austin Pain doctors, Dr. Schocket. The focus of this organization is to AustinPainDoctor 300x206 Austin Pain Doctors are Trained to Help Chronic Pain Sufferersprovide a unique, individualized approach to pain management – providing progressive, comprehensive and innovative care in a multidisciplinary center. Each potential patient is required to schedule a face-to-face consultation with staff. During this consultation, the focus will be on discussing the form of chronic pain, the cause, if known, the impact to the person’s day-to-day life, and the expectations.

This initial assessment is significant to the whole treatment plan. Reviewing all historical medical documents and test results will allow our Austin pain doctors to render an effective diagnosis. We rely on careful assessment and precise diagnose to determine the best choice of treatment – understanding the cause of the pain, the progression of the pain and any significant changes in form, location or intensity will help address the immediate focus of treatment. A comprehensive treatment plan is then designed unique to the patient, identifying short term and long term goals and defining expectations towards an improved quality of life.

 Progressive Treatments used by Austin Pain doctors at the Chronic Pain Institute

One of the promises of the Chronic Pain Institute is to use progressive treatments to address pain management. One of these progressive treatments is known as Platelet Rich Plasma Therapy – plasma is extracted from your body via blood samples then injected into the damaged region to encourage healing. This as well as other progressive treatments are considered in the development of individualized treatment plans.

Contact Us

To learn more about how our Austin pain doctors at the Capitol Pain Institute can help you deal with chronic pain, contact us by e-mail at help@capitolpain.com or call us at (512) 467-7246.

Stem Cells-the Next Frontier is Here

by Guest Author Joseph Smith, PhD


stem cells Stem Cells the Next Frontier is HereOur very own stem cells may provide the key to return us to a high quality of life without chronic pain. Stem cells are undifferentiated biological cells that can develop into just about any specialized tissues.  No longer controversial as they need not be derived from embryos or cadavers, the modern therapy utilizes adult stem cells harvested from the patient’s own body, e.g., by tapping into the hip or leg bone.  This type of autologous harvesting involves the least risk as immune response is minimized and can often be non-existent.

The somatic stem cells circulate throughout the body and play an integral part in regenerating and thus healing organs and tissues at the cellular level.  What used to be the frontier of science fantasy is now available at innovative clinics and health centers where highly trained surgical teams use adult stem cell therapy to treat patients suffering from osteoarthritis, chronic pain, ligament or cartilage damages.

Adult stem cells are derived from the patient’s bone marrow.  Next, a unique solution containing platelet-rich plasma and the harvested stem cells is created in strict accordance with FDA guidelines. This healing elixir is then injected into problematic regions such as degenerated joints, ligaments, herniated discs, muscles, etc.  A cascade of self-repair activities at the cellular level commences as the patient’s own newly activated stem cells start to morph into the required cell types including osteoblasts (bone cells) and chondrocytes (cartilage cells).

Recent pilot studies as reported by researches in the science journals, Arthritis Research & Therapy and Transplantation, clearly suggest that injections of stem cells provides superior cartilage repair outcomes.  Patients showed rapid and progressive functional improvement with betterment of cartilage quality.  Specifically, this provides a “valid alternative treatment for chronic knee osteoarthritis” according to the scientists. Stem cell research may reverse the projected sevenfold increase in primary and revision knee replacements expected in the United States between 2005 and 2030 according to reports in the Journal of Engineering in Medicine.

What used to be the frontier of future medicine is now here.  Check with your community for the rare innovative, talented physicians who have embraced the new stem cell therapies.  They can provide their patients with additional alternative treatments to consider.  For example, instead of the old standard of  meniscectomy (a philosophy of tissue removal) that can often lead to increased risk of osteoarthritis, the better standard is the opposite – a philosophy of tissue regeneration by restoring the joint space and growing back cartilage to avoid the necessity of knee replacement.

References:
Nam H, Karunanithi P, Loo W, Naveen S, Chen H, Hussin P, Chan L, Kamarul T. The effects of staged intra-articular injection of cultured autologous mesenchymal stromal cells on the repair of damaged cartilage. Arthritis Research & Therapy 2013, 15:R129.

Orozco L, Munar A, Soler R, Alberca M, Soler F, Huguet M, Sentis J, Sanchez A, Garcia-Sancho J. Treatment of Knee Osteoarthritis with Autologous Mesenchymal Stem Cells: A Pilot Study. Transplantation. 2013 May 15.

Maclaine S, McNamara L, Bennett A, Dalby M, Meek R. Developments in stem cells: implications for future joint replacements. Journal of Engineering in Medicine. 2013 Mar;227(3):275-83.
 

Hiring mid-level practitioner

Capitol Pain Institute is looking to hire a FT or PT nurse practitioner, physician assistant, or clinical nurse specialist.  If you are interested, please contact the office at 512-467-7246 or email drschocket@capitolpain.com.