215.741.4410 Two Convenient Locations in: Langhorne, PA

Oxford Valley Pain & Spine Center's Blog

Stem Cell Therapy and Pain Management

 

 

Bone Marrow  Cells

Will Stem Cell Therapy be an Option for Back Pain?

Stem cell research is actively taking place to hopefully help people with many different diseases such as heart disease and Parkinson’s. The question then rises – will stem cells be able to help people with back pain?

Stem Cell Research

Stem cells have the ability to repair internal systems and also help other cells in the body. Ideally, they could be used to help repair bones, muscles, tissues, bloods, and all the internal body pieces that affect someone’s pain.

Stem cells can be taken from a person’s bone marrow such as the rear of the hip. The theory is to then inject these cells into the damaged tissue or anatomy with the hope and goal of regenerating the damaged tissue or anatomy.

There are concerns and dangers in using stem cells. One risk is that the cells may cause cell mutations which could lead to tumors. So far, the risk of cell mutation has not been a realized danger with bone marrow stem cells.’

Stem cells may, in time, be used to treat disc degeneration which often occurs due aging or injury. Disc degeneration can lead to degenerative disc disease and disc herniation, both of which can be quite painful.

Current interventional techniques such as injections do help but there are some limitations with injections. Injections don’t repair the underlying problem though they do help with pain relief. The use of stem cell therapy to treat pain is currently be explored

Disclaimer. This blog is for informational purposes only and does not create a doctor/patient relationship.

For questions about  pain management, please call our office at 215.741.7031. Our office is  in Langhorne, PA. We see patients from throughout Bucks County including Levittown, Newtown, Richboro, Bensalem, and Doylestown. We also see patients from Philadelphia, Montgomery County, and Mercer County.

 

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Some Easy Steps to Improve Spinal Pain

Many people with spinal pain can benefit from the following three measures. If you have any questions or concerns about these steps, please call our office.

Walk

A daily walk helps to strengthen the main muscles the support the spine. A walk helps improve flexibility, gets essential nutrients and oxygen to the spine, and helps support your spine’s bone structure.Walkers should walk with their head held high and their shoulders straight. Walkers should build up slowly by taking short walks and then working towards one good long healthy walk. The weather is getting warm. So now is an ideal time to add a walk to your routine.

Eat a nutritious health diet

Eating healthy for spine improvement is, in many ways, similar eating healthy to improve your heart. The basics are plenty of vegetables, fruits, and whole grains. Try to avoid processed foods and limit the amount of your sugar intake.Eating healthy not only directly improves your spine, it helps you lost weight. Excess weight puts more pressure on the back and the spine.

Consider using a standing desk

While most people know the benefits of exercise and nutrition, there is one newer strategy that can help your spine. Sitting puts a lot of pressure on the spinal discs. Standing can help reduce that pressure. Today, there are many office stores that offer standing desks that allow you to do your work while standing. These desks can be adjusted to allow you to work at a comfortable level while you’re standing. Many people who use standing desks start slowly and then build up the number of tasks they do and the amount of time they spend standing.

Disclaimer.

The information is for educational purposes only. Please make an appointment so we can formally review your medical condition.

For medical help, please phone us at 215.741.7031 to schedule a consultation. We see clients from Langhorne, Levittown, Newtown, Richboro, Bensalem, Doylestown, and across Bucks County. We also see patients from appointment. We see clients in Bucks, Montgomery, Philadelphia, Mercer, and neighboring counties. Our office is in Langhorne, PA

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What is Cervical Radiculopathy

Cervical radiculopathy occurs when a nerve root (near thevertebrae in the neck) is compressed. Cervical is a medical word for neck. Harm to these cervical roots can cause pain in the neck and in the upper parts of the body.

What are the Causes?
Some of the causes of cervical radiculopathy are arthritis, degenerative disease to the bones, a disc that ruptures or other nerve root injuries.

Older patients tend to suffer from  degenerative diseases. Younger people suffer nerve root damage in  the neck through a rupture or some trauma such as injury. A car accident or lifting something heavy can cause cervical pain.

What are the Symptoms?
The principal symptom is pain or  inflammation in the neck, shoulders, arms, chest, shoulders and the upper part of the back.
Other symptoms include weakness of the muscles, numbness and even tingling. You may also notice a lack of coordination – especially in the hands.
Pain extends to the areas served by the nerve. This is why cervical radiculopathy can also affect the arms and upper body as well as the neck

What is the Diagnosis?
Your doctor will perform a physical examination and take your medical history. The doctor may also take some medical images.

What is the Treatment?
Treatments typically include medications and therapy. In some cases surgery may be used to relieve the pain.
Medications include anti-inflammatory drugs (called corticosteroids) and non-steroidal pain medications like ibuprofen (Motrin or Aleve).
Steroids may be given either orally or through an epidural injection. Epidural injections are so-called because the injection is into the space above the “dura.” The dura is the membrane that surrounds the spinal cord.
Physical therapy techniques include  cervical traction (like that shown at right) and exercises to strengthen the affected area.
Surgery can be an option if the nerve compression is too severe.

Disclaimer

The information is for educational purposes only. Please make an appointment so we can formally review your medical condition. This blog does not create a doctor/patient relationship.

For medical help  please call our office at 215.741.7031 to schedule  an  appointment. We see clients in Bucks, Montgomery, Philadelphia, Mercer, and neighboring counties. Our office is in Langhorne, PA

Posted in Chronic Pain, Diagnosis, Neck Pain, Pain Management | Leave a comment

5 Mistakes people in chronic pain make

5 Things You May Not Be Doing Right to Cope with Pain

Everyone with pain has a tough time dealing with their pain. Many people try to take short-cuts or fail to take the necessary steps to manage their pain. Here are five points to consider.

1. Failing to see an experienced pain management doctor. If you have acute pain or if you have chronic pain that has lasted for a while, seek a consultation with a pain management doctor. The doctor will take your history, suggest appropriate tests to determine the source of your  pain, and answer you questions. The doctor will then explain your problem and review the various treatment options.

2. Ignoring the emotional side of pain. Be aware that pain and depression can go hand and hand. People with pain often get easily frustrated doing daily activities. They worry will the pain ever go away, how can they work with the pain, or can they take care of parents or children if they have pain. A key step in managing pain is being aware that you should talk to others about your pain so you fully understand what can be done about the pain. The more you can correct or manage your pain, the more you will be able to cope with the anxieties and fears that  pain brings.

3. Not getting enough sleep. Many people with people have problems sleeping due to the physical and emotional parts of  the pain. Lying on one’s back may be difficult. The stress of dealing with pain can make it  hard to get to sleep. Sleep  is crucial though to managing pain. Patients should try to sleep at normal hours instead of catching 15 minutes here and there. Pillows, beds, and the room environment including the temperature should be as conducive as possible to sleeping as long as possible.

4. Not getting exercise. Physical therapy may help make muscles stronger so that the pain is not as severe. Exercise during the day also helps patients sleep better at night. There are exercises that have minimal stress such as chair yoga that you can review with your pain management doctor.

5. Not following the doctor’s advice. Experienced pain doctors understand which treatments and medications work. They also understand that adjustments may be needed. Once you’ve reviewed your medical condition with your doctor, work through the recommended treatments. If the treatments are not helping, then make another appointment with your pain management physician.

If you are in pain, please do not hesitate to call Oxford Valley Pain and Spine for an appointment. We see patients who live or work in Bucks, Mercer, Montgomery, Philadelphia, and other nearby counties. Call 215.741.4410 for an appointment.

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Sciatica

Overview

The sciatic nerve is made of the nerve roots from the spinal cord into the lower back. These nerve roots affect the back, lower buttocks, the back of the leg, the ankle and the foot. Sciatic pain includes physical pain, numbness and tingling of these nerve roots.

Causes

A herniated disc (please see our herniated disc brochure) is the most common cause of sciatica. Other causes include spinal stenosis (a narrowing of the spinal canal), bone spurs often caused by arthritis of disc degeneration, and pinched nerves (nerve root compression). The problems can arise through an injury or through wear and tear. Some non-spine causes include tumors and sometimes a pregnancy.

Symptoms

Pain in the areas affected by the sciatic nerve often appear in the back and buttocks and also the leg and even the foot. Pain can include numbness, tingling, pins and needles and weakness.

Activity such as walking, lying down and anything that extends the spine can generate some relief. Movements that contract the spine such as sitting or standing for a long period of time can contribute to the discomfort.

Diagnosis

As with most medical conditions, a physical exam and medical history are the starting points. X-Rays and MRIs( magnetic resonance imaging) may also be recommended.

Treatment

Medication and physical therapy are the starting points for treatment. Acetaminophen (Tylenol) and NSAIDS (non-steroidal anti-inflammatory medications) such as ibuprofen (Advil) or naproxen (Aleve) may be prescribed. Physical therapies to extend the spine will be recommended and positions that contract the spine will be discouraged.

Some heat treatments such as a heating pad on a low or medium setting or an ice pack for 15 to 20 minutes every 2 or 3 hours can help. An occasional warm shower and single-use heat wraps that last up to 8 hours can also help.

A lot of the treatment advice depends on determining the exact cause of the sciatica. Stronger medications and even surgery may be recommended for severe cases.

Disclaimer

The information contained in this brochure is for educational purposes only. Please make an appointment so we can formally review your medical condition. This brochure does not create a doctor/patient relationship.

Please contact us

For help with any pain management issues  including sciatica, please contact our  office in Langhorne, PA at 215.741.4410. We see patients from Bucks County, Montgomery County, Mercer County, and Philadelphia  – including Levittown, Newtown, Richboro, Yardley, and Doylestown.

 

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Migraines

Migraines

Migraines are headaches that usually cause intense throbbing or a pulsing sensation in one area of the head. The pain can be very severe and can last hours or even days.

Causes

Genetics and environmental factors appear to play a role. Common migraine triggers include:

  • Hormonal changes in women.
  • Foods. Aged cheeses, salty foods and processed foods may trigger migraines. Skipping meals or fasting also can trigger attacks.
  • Food additives. The sweetener aspartame and the preservative monosodium glutamate (MSG) are known to trigger migraines.
  • Drinks. Alcohol, especially wine, and highly caffeinated beverages
  • Stress.
  • Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds.
  • Unusual smells: Such as perfume, paint thinner, secondhand smoke
  • Changes in wake-sleep patterns.
  • Physical factors. Intense physical exertion, including sexual activity, may provoke migraines.
  • Changes in the weather
  • Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.

Symptoms

Migraines often start in childhood or early adulthood. There are different stages of a migraine headache. You may experience some or all of these.

  • Prodrome: These are the early signs of a migraine. They include constipation, depression, food cravings, hyperactivity, irritability, neck stiffness, and uncontrollable yawning
  • Aura: These are symptoms of the nervous system such as flashes or light, sensory, motor or verbal disturbances. They typically build up gradually and can last for an hour. Examples include vision loss, pins and needles, and language problems.
  • Attack: Migraines often last for a few hours to several days. They can occur several times monthly. Symptoms include pain, sensitivity to light and sound, nausea and vomiting, lightheadedness or fainting and blurred vision.
  • Postdrome: Here, you feel washed out though some people mildly euphoric.

Diagnosis

Tests include blood tests, CT Scans, and MRIs,. Often a pain management doctor will work with a neurologist to determine the proper diagnosis.

Treatment

Doctors will work to manage your condition because Migraines can’t be cured. Medications fall into two (2) categories. Some medications aren’t recommended for pregnant women or if a mother is breast-feeding. Some medications aren’t appropriate for children.

Pain-relieving medications:

Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms that have already begun. The types of drugs and amounts vary on your condition. Some of the common drugs a qualified doctor may prescribe are:

  • Pain relievers such as aspirin or NSAIDs
  • Triptans
  • Ergots
  • Anti-nausea medications
  • Opioids
  • Glucocorticoids

Preventive medications:

These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines. You may be a candidate for preventive therapy if you have four or more debilitating attacks a month, if attacks last more than 12 hours, if pain-relieving medications aren’t helping, or if your migraine signs and symptoms include a prolonged aura or numbness and weakness.

These medications include:

  • Cardiovascular medications,
  • Antidepressants,
  • Anti-seizure drugs, and
  • OnabotulinumtoxinA (Botox).

Disclaimer

The information contained in this brochure is for educational purposes only. Please make an appointment so we can formally review your medical condition. This brochure does not create a doctor/patient relationship.

To speak with one of our caring doctors, please call 215.741.4410 to schedule an appointment. We see clients throughout Bucks  County including Langhorne, Newtown, Doylestown, Richboro, and Levittown. We also see  clients from Philadelphia, Montgomery County, and Mercer County

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Lumbar Epidural Steroid Injection

Why Is it Used

An epidural steroid injection (ESI) is used to relieve the pain from lumbar spinal stenosis

What is It?

An epidural steroid injection (ESI) consists of two main parts:

1. A corticosteroid. These are strong anti-inflammatory medications. They can help relieve swelling and reduce inflammation which in turn can reduce nerve and soft tissue issue pressures. Reducing these pressures reduces pain. They take longer than the anesthetic to provide relief.

2. A local anesthetic pain relief medicine. This medicine is aimed to provide immediate pain relief. It doesn’t reduce the inflammation.

An ESI is injected into the space around the spinal cord (within the spinal canal) and nerve roots (epidural space).

Before the ESI is performed, MRI(magnetic resonance imaging) tests and CT (computed tomography) scans are often done to help identify the exact location where nerve roots are being squeezed. During the injection, an X-ray machine (fluoroscope) is often used to guide placement of the needles so the injection can be properly targeted.

Results

Epidural steroid injections (ESIs) are used for leg and hip pain rather than back pain from lumbar spinal stenosis.

These injections can help relieve pain and reduce inflammation for a short period of time. They are not a long-term cure.

Side Effects/Other Considerations

As with all medical procedures, there can be side effects. If side effects cause you pain, consult your doctor. Complications, though rare, can include infection, bleeding, nerve damage, and leaking of the fluid that surrounds the brain and spinal cord.

Because steroid injections can cause soft tissue damage, they are usually given only three or four times in the same spot in any one year.

The procedure is an out-patient procedure that normally takes about a half an hour. You will be monitored for another 15 to 20 minutes and then told to rest at home.

Women who may be pregnant should be sure to tell their doctor before considering this procedure.

Disclaimer

The information contained in this brochure is for educational purposes only. Please make an appointment so we can formally review your medical condition. This brochure does not create a doctor/patient relationship.

 

 

 

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Radiofrequency neurotomy

Modern Flouroscope

Radiofrequency Neurotomy of the Cervical Facets

Overview

Radiofrequency neurotomy is a radio wave procedure to reduce back and neck pain. The radio waves create heat. Needles are inserted through the skin (above the spine). The doctor will use image scans to make sure the delivery of the radio waves is precise.

Why It Is Done

The procedure is done by physicians who specialize in pain management. The aim is to reduce chronic pain that hasn’t responded to other more conservative treatments. It is sometimes recommended to treat neck pain caused by whiplash and back pain that extends to the buttocks and thighs.

Risks

The main concerns (side effects) for this treatment are pain at the site (where the needles are inserted) and
temporary numbness.

More serious but rarer side effects include nerve injury, bleeding, infection, long-term numbness and paralysis.

Treatment

Radiofrequency neurotomy takes about an hour. It’s an outpatient procedure, which means you’ll arrive and go home on the same day.

The patient will lie on an X-Ray table and wear a hospital gown. Before the procedure the skin will be numbed with medicines. A fluoroscope (an X-Ray machine) will be used so the needles accurately target the affected nerves. An IV (intravenous) line will make sure you get the right drugs during the procedure.

After the procedure, you’ll be taken to a room to rest. Any soreness in the area where the needles were inserted usually goes away in a day or so. You can use an ice pack to help relieve any pain. Baths and heating pads should be avoided for one to two days. A warm shower is OK after a 24 hour waiting period.

Disclaimer

The information contained in this brochure is for educational purposes only. Please make an appointment so we can formally review your medical condition. This brochure does not create a doctor/patient relationship.

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What are Nerve Blocks?

What Are Nerve Blocks?

A nerve block is an injection of a nerve numbing drug into a group of nerves that creates pain to a specific body are or organ. The group of nerves are known as a plexus or ganglion.

How Are Nerve Blocks Used?

Different nerve blocks are used for different problems. They can be helpful in avoiding surgery or making surgery more effective.

  • · Therapeutic nerve blocks have local anesthetics that are used to attack acute pain areas. They are used to treat painful conditions.
  • · Diagnostic nerve blocks are used to help determine the real sources of the pain. These blocks usually also contain an anesthetic.
  • · Prognostic nerve blocks are used to determine what further steps, such as surgery, might be helpful to the patient.
  • · Preemptive nerve blocks are meant to prevent subsequent pain from a procedure that can cause problems including phantom limb pain.

Side Effects and Risks

  • · Bleeding
  • · Elevated blood sugars
  • · Rash
  • · Itching
  • · Weight gain
  • · Extra energy
  • · Soreness
  • · Death (in rare cases)

 

Nerve blocks work best when the pain is localized to a set of nerves.

Nerve Blocks

Types of Nerve Blocks

Various areas of pain require different nerve block types.

  • · Neck and Back: Cervical epidural, thoracic epidural, and lumbar epidural block
  • · Shoulder and Upper Neck: Cervical plexus block and cervical paravertebral block
  • · Shoulder, arm, hand, elbow and wrist: Brachial plexus block, elbow block, and wrist block
  • · Abdomen and Pelvis: Subarachnoid block and celiac plexus block
  • · There are also nerve blocks that target the face, eyelids, scalp, forehead, jaw, nose and palate.

 

Other Nerve Blocks

Sympathetic nerve block: Used to see if there is damage to the sympathetic nerve chain (a network of nerves extending the length of the spine). These nerves manage control of some of the involuntary functions of the body.

Stellate ganglion block: Used to see if there is damage to the sympathetic nerve chain supplying the head, neck, chest, or arms and if it is the source of pain in those areas. The primary usage of this nerve block is diagnostic though it may also give some temporary help.

Facet joint block: Please see our brochure on facet joint injections. Facet joints help with spine mobility.

 

Disclaimer

This information is for educational purposes only. Please make an appointment so we can formally review your medical condition.

 

We are located in Langhorne, PA. We see patients throughout Bucks County and patients from Philadelphia, Mercer, and Montgomery County including Newtown, Levittown, Doylestown, Hamilton, and other locations. You can reach us at 215.741.4410

 

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When to Consider Lumbar Steroid Injections

Signs that a Lumbar Epidural Injection May Be Worth Considering

There are many reasons why low back pain occurs or sciatica occurs. Some of these conditions can benefit from a steroid injection. Our doctors may recommend lumbar epidural injections if you have:

  • A lumbar disc herniation. A herniated disc happens when the soft, spongy, material that cushions (shock absorbs) the bones of the spine (vertebrae) slips out of place, breaks open or becomes damaged. It’s also called a slipped or ruptured disc. You can have a herniated disc in any part of your spine. The most common place for a herniated disc is the lumbar spine (the lower back).
  • Degenerative disc disease (DDD). Spinal discs act as shock absorbers for the spinal vertebrae. They separate the vertebrae bones and allow the spine to bend, move, and twist. DDD can happen through injury or through aging. DDD isn’t really a disease—it’s a change in the condition of your discs. The most common pain areas are the lower back and the neck. DDD can impinge on the nerves.
  • Vertebra compression fractures
  • Facet joint or nerve root cysts
  • A torn disc also called an annular tear.

When a Lumbar Steroid Injection is Not a Good Idea

Injections for back pain or sciatica pain should be posted if the patient:

  • Has a current infection
  • Is pregnant
  • Has bleeding problems. Patients who are on the Coumadin medication may need to go off the medication until the bleeding is under better control
  • Might have a tumor of the spine

For help with any pain issues, please call our Langhorne, Pennsylvania office at 215.741.4410. We help patients throughout Bucks County, Mercer, Philadelphia, and Montgomery Counties. We see many patients from Langhorne, Newtown, Fairless Hills, Levittown, Bristol, Richboro, and Doylestown.

 

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