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Practical Suggestions for Reducing Pain

Practical Suggestions for Reducing Pain

Here are some tips for managing your pain. As always, the best advice is to review your pain issues with a respected and trusted pain management doctor.

  • Quit smoking.  Tobacco is not only bad  for your lungs and general health. It also increases the sensation of pain, slows the healing process, worsens  circulation, and can even increase the possibility of damage to the disc.
  • Exercise. While exercise may seem to be the last thing  you want to do if your are in pain, the right exercises can actually strengthen muscles and joints. Exercise can also help you eat less and feel better. Consult with your pain management doctor about the types of exercises that may be right for you.
  • Meditation. Meditation helps reduce stress, relieves tension, and helps you relax. It can take your mind off your pain and even help to reduce your pain.
  • Maintain a healthy diet. Excess weight makes dealing with pain much harder. Healthy foods do more than just keep the weight off. Good foods give you the energy you need to fight your pain and fight disease.
  • Keep a journal. Document what parts of your body are causing you pain, how severe the pain is, and how often it occurs. The more your doctor understands your symptoms and complaints, the better he/she can manage your pain.
  • Stay involved. It’s easy to withdraw from others when you’re in pain. But being involved with other people and continuing the activities you enjoyed, even at a reduced rate, helps take your mind off your pain. Participating in life helps give you the incentive to fight and work through your pain.

Other practical suggestions include:

  • Try yoga. It’s a low-stress form of exercise
  • Be vocal. Let others know what is bothering you so they can help you. You might even bring a relative/friend who  knows your pain issue with you when you see your pain doctor.

For help with any pain issues, please call our Langhorne, Pennsylvania office at 215.741.7031. We help patients throughout Bucks County, Montgomery, Mercer, and Philadelphia, We see many patients from Levittown, Langhorne, Newtown, Doylestown, Fairless Hills, Richboro, Bristol and Bensalem

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Guest article by Doctor, JOHN SZOSTEK

  • Swede Street Chiropractic
  • 611 Swede St, Norristown, PA 19401
  • (610) 277-7520

According to the Insurance Institute for Highway Safety, Highway Loss Data Institute, the IIHS conducts a number of tests to determine the severity of different types of  collisions. One of the most common types of vehicle accidents is a side-car crash which accounts for 25% of vehicle occupant fatalities in the United States. It is hard to protect occupants from side car accidents because the sides, unlike the front and rear of the car, have little ability to absorb the impact of a crash. Side airbags and making the sides strong with better materials are helping.

Side airbags are supposed to help protect the occupant from striking other occupants and from being struck by outside objects. The side airbags help spread the impact of any energy so one part of the body doesn’t take the brunt of the impact

IIHS Testing

In 2003, IIHS started testing the impact of side impact collisions. Their tests included SUVs and pickup trucks as well as standard cars so that impact with higher vehicles could properly be assessed. The size of the test dummies was also changed to better reflect the size of women and children.  In the IIHS test, a 3,300 pound SUV-like barrier strikes the driver side at 31 mph. The test-driver dummy is the size of a small woman and the size of the passenger dummy is a 12-year old child.

The IIHS Rating Criteria

The test engineers looked at the following measures to determine how well the vehicles performed side-impact collisions:

  • Injury criteria. The impact to the head, neck, chest, pelvis, femur, and chest of both front passenger dummies was assessed.
  • Head protection. Greasepaint was applied to the heads of the dummies. The aim of the test is to see which part of the barrier came into contact with the head-paint. Ideally, if the car has airbags, the pain should end  up on the airbags. Where the paint ended up along with high-speed film tests helped show how severe the impact to the head was – or might be if the occupant was slightly taller or shorter.
  • Structural integrity. The amount the barrier (the simulation of the other vehicle striking the test car)  intruded into the occupant’s area also helped determine how structurally sound the vehicle was.

The IIHS Ratings Results

Driver ratings were used as follows:

  • Good.The driver (in a left-side) crash is 70% less likely to die than a driver of a poorly rated car.
  • Acceptable. The driver is 64% less likely to die
  • Marginal. The driver is 49% less likely to die.

The IIHS tests only studied vehicles  that had standard side airbags. The tests showed that just having airbags alone doesn’t help protect the occupants.

The most significant part of the test results was the showing that the structure of the vehicle and the airbags work in combination. “ If the occupant space remains largely intact, then the safety belts and side airbags have time to control the motion of the crash test dummies and keep injury measures low. That’s less likely to happen if the side of the vehicle is significantly crushed.”

Side impact tests could be done with different types of vehicles and different weight categories because the key test component is the weight and speed of the moving barrier (the simulated vehicle). In 2003, when IIHS begin side-crash tests, only about 20% of vehicles earned a “good” rating. Most of the others were not acceptable nor marginal – they were mostly all poor. As airbags have become standard equipment and occupant structures have become stronger, most vehicles now have “good” ratings.


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Pain Management for Diabetic Neuropathy

Diabetic Neuropathy

Diabetes can cause painful nerve damage. There are four different types of nerve damage that all stem from the fundamental problem of high blood sugar levels for long periods of time. Part of the solution to diabetic neuropathy is to manage the underlying blood sugar level. Another part of the solution is treat manage the nerve pain directly

1. Peripheral Neuropathy. This nerve damage affects the legs and feet. It may also affect the back, abdomen, and arms. Symptoms include numbness, a burning sensation, tingling, and pain. Patients should make sure they wear footwear that fits, keep their feet moisturized and be aware of the sensations in their lower extremities daily.

2. Autonomic Neuropathy

  • Autonomic neuropathy in the digestive tract.This nerve damage affects the stomach and other parts of the digestive tract. Symptoms include constipation, bloating, nausea, heartburn, and diarrhea. Patients often feel full even if they haven’t eaten much. There are some medications that can help. A nutritious diet can also help.
  • Autonomic neuropathy in blood vessels. Symptoms include dizziness, low blood pressure, a fast heartrate, blackouts, nausea and vomiting. Special socks may help. Patients should avoid standing up too quickly.
  • Autonomic neuropathy in the urinary tract. Symptoms including bloating, difficulty emptying one’s bladder, incontinence, and frequent bathroom trips. Possible treatments include medications, insertion of a catheter, and surgery.Men and women may have problems with their sexual organs. Treatments can include a penile implant or injections for men and vaginal estrogen creams and lubricants for women.

3. Proximal Neuropathy. This nerve damage causes pain in the hips, thighs, and buttocks – usually just on one side of the body. Initial pain treatments include medications and physical therapy.

4. Focal Neuropathy. This nerve damage can affect specific nerves almost anywhere in the body including the head, body, and extremities. Pain and muscle weakness are common symptoms. Other symptoms include double vision, Bell’s palsy (a paralysis of one side of the face), chest and abdominal pain.

Additional solutions

Other nonsurgical pain management solutions include:

  • Stop smoking. Smoking impairs blood circulation. Better blood circulation decreases pain.Get more Vitamin D. This nutrient may reduce pain.
  • Try a Vitamin B12 complexTry a warm bath. The warm water can boost circulation as well as soothing you.
  • Get some exercise. Exercise can help reduce blood sugar levels and can slow down damage to the nerves.
  • Take care of your feet. Clean them and inspect them for cuts and scratches each day.
  • Try relaxation techniques. Yoga, massages, and meditation can help.

For help with any pain issues, please call our Langhorne, Pennsylvania location at 215.741.7031. We help  Bucks County, Mercer, Philadelphia, and Montgomery County patients. We see many patients from Langhorne, Newtown, Levittown, Doylestown, Newtown, Fairless Hills, Bristol, Richboro, and Bensalem

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About a half-million spinal surgeries are performed yearly. About 100,000 of these surgeries fail to correct the patient’s pain – requiring exploration of additional medical treatments. One such alternative is spinal cord stimulation. Spinal cord stimulators are indicated for chronic pain management if any of the following conditions are present:

  • Failed Back Surgery Syndrome (FBSS). A medical term that refers to patients who have not had success with back or spine surgery – they still have chronic pain after the back or spine surgery.
  • Radicular pain syndrome or radiculopathies. Radicular pain spreads along the spinal nerve root into the lower extremity.
  • Post-Laminectomy Syndrome. A laminectomy is surgery that removes the back part of the vertebra (called the lami-na) that covers the spinal canal. A laminectomy is also called decompression surgery. It enlarges the spinal canal to relieve stress on the spinal nerves or spinal cord.
  • Prior surgeries. Patients who have had numerous back operations or an unsuccessful disk surgery may indicate the a spinal cord stimulator should be considered.
  • Degenerative Disk Disease (DDD). DDD is a medical term, not really a disease, that describes changes in your spinal discs as you get older. The discs are shock absorbers for the spine. DDD is most prominent in the lower back (lumbar region) and the neck (cervical region).
  • Peripheral causalgia. Causalgia is related to partial peripheral nerve injuries. It is a rare pain disorder. The peripher-al nerves extend from the central nervous system of the brain and spinal cord to the limbs and organs.
  • Minor causalgia is similar to Reflex Sympathetic Dystrophy (RSD). Both are indicators for spinal cord stimulation. Scar tissue formation. After back surgeries, scar tissue formation, also known as Epidural fibrosis, can cause chronic pain.
  • Lumbar adhesive arachnoiditis. Adhesive Arachnoiditis is an incurable inflammatory condition affecting the middle (arachnoid) layer of the meninges – the membranes surrounding the spinal cord.
  • Diabetic neuropathy. Diabetes can cause painful nerve damage. Part of the solution to diabetic neuropathy is to manage the underlying blood sugar level. Another part of the solution is treat manage the nerve pain directly –such as by the use of spinal cord stimulation.As with all medical procedures, there are contraindications, warnings, and precautions that should be taken by the medical healthcare team. Diathermy should not be used on patients who already have a spinal cord stimulator implant. Spinal cord stimulation should not be used on woman who are pregnant or anyone under the age of 18. If a patient uses narcotics, the patient should be detoxified before spinal cord stimulation is considered. All risks should be reviewed along with a full review of the stimulator product information, before spinal cord stimulation is considered

Please Contact Us If you have questions about Spinal Cord Stimulation Implants or any pain issues, please contact us at 215.741.7301 Our office is located near the Oxford Valley Mall.


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What is Regenerative Medicine

What Is Regenerative Medicine?

Regenerative medicine is a branch of medical research that is helping doctors treat patients who don’t respond to current treatments. Current medical treatments often don’t treat the root causes of diseases, injuries and congenital problems. Many times, treatments can only help reduce the symptoms.

Regenerative medicine is the process of engineering, replacing, and regenerating human tissues, cells, and organs so they can function normally. This approach helps the body use its own repair mechanisms to help heal these previously irreparable body parts. In addition to using the body’s repair mechanisms, regenerative medicine includes helping grow tissues and organs in a laboratory and then implanting them in the human. The aim and hope is to use a person’s own cells to grow the necessary tissues and cells thus addressing the shortage of organ donation problem.

Regenerative medicine is fairly new. It includes many other scientific fields and professionals including:

  • Genetics
  • Robotics
  • Computer science
  • Biology
  • Chemistry

Regenerative medicine has been used for some time. Classic examples are bone marrow and organ transplants. New sciences and technologies are now helping speed up the solutions regenerative medicine can apply to help patients.

Different types of regeneration

Regeneration can be thought of in several different ways:

  • Rejuvenation. A classic way to help patient’s in pain is the body’s own ability to heal itself such as when skin heals after a cut. Now scientists are working to use some of the body’s cells such as those for the nerves, heart, and lungs to foster self-healing.
  • Replacement. This is the use of healthy organs, tissues, or cells from a living or deceased donor to replace the ones that are damaged. Liver and heart transplants are now fairly common. Regeneration aims to help improve the ability to do transplants including minimizing the possibility of organ rejection.
  • The new regeneration. Here, cell-therapy is used to deliver certain cells or related products to diseased areas of the body where the cells will restore those tissues and organs.

The role of stem cells

Stem cells are a key component of regenerative medicine, as they open the door to new clinical applications.According to the Mayo Clinic.“Stem cells have the ability to develop — through a process called differentiation — into many different types of cells, such as skin cells, brain cells, lung cells and so on.

There are different types of stem cells including adult stem cells and embryonic stem cells. There are also “progenitor cells, such as those found in umbilical cord blood, and bioengineered cells called induced pluripotent stem cells.” Other sources of adult stem cells include fat, blood, bone marrow, skeletal muscle, and dental pulp. “Each type has unique qualities, with some being more versatile than others.”

New rejuvenation strategies and methods are continually being researched, tested, and implemented to help people of all ages, especially seniors, get medical to alleviate many types of painful medical problems.

For help with any pain issues, please phone our Langhorne, Pennsylvania office at 215.741.7031. We see patients in pain in Bucks County, Montgomery County, and Philadelphia – including Bristol, Langhorne, Levittown, Newtown, Richboro, Bensalem, Doylestown, Trenton, Fairless Hills, and Southampton.

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How to Treat Sciatica


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.

A herniated disc 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.

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.

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.

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.


The information contained in this post 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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Sleeping with Back Pain

Here are a few suggestions for sleeping with back pain. Each person’s suggestion is unique. As with all pain management issues, the best course of action is to talk with your pain management physician

  • A pulled back muscle. While the symptoms of a pulled muscle can last for a few days, it can be hard to sleep until the symptoms resolved. While no sleeping position is fool-proof, sleeping on your side can help. It’s better to sleep with your body slightly elongated than in a curled up fetal position. A small pillow placed between your knees may help. A medium sized pillow can help so the neck doesn’t bend at an odd angle. For some patients, a heat wrap may also help.
  • Listen to calming radio. When you try to fall asleep, it’s easy to concentrate on your pain and the issues of the day. Soothing music or sounds can help you relax so you can fall asleep. Classical music, relaxation podcasts and audio books can help you relax.
  • Use or buy a quality mattress. If your mattress sags or isn’t firm, you should consider buying a good mattress that supports your back. Some tips on buying a mattress are:
  • Get one that supports the natural curve of your spine
  • Try out different mattresses at the mattress store.
  • If you sleep with someone, make sure the mattress is big enough for both of you

For help with any pain issues, please call our Langhorne, Pennsylvania office at 215.741.7031. We see patients in pain in Bucks County, Mercer, Philadelphia, and Montgomery Counties. We see many patients from Langhorne, Doylestown, Newtown, Fairless Hills, Levittown, Bristol, Richboro, and Bensalem


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What is a Fluoroscope?

The fluoroscope, discovered in 1985, was the first X-Ray machine. X-Ray  machines let physicians view the body’s interior greatly increasing the ability to diagnose and treat diseases. The fluoroscope has evolved into sophisticated technology that is now a cornerstone of interventional pain management.

Now, fluoroscopes give interventional pain medicine doctors practitioners the ability to use continuous, real-time x-ray imaging to guide interventional procedures. These procedures can target the sourceof physical pain with much more accuracy and safety.

In its simplest form, a fluoroscope consists of an X-ray source and a fluorescent screen, between which a patient is placed. However, since the 1950s most fluoroscopes have included X-ray image intensifiers and cameras as well, to improve the image’s visibility and make it available on a remote display screen. For many decades fluoroscopy tended to produce live pictures that were not recorded, but since the 1960s, as technology improved, recording and playback has become the norm.

Fluoroscopy is similar to radiography and X-ray computed tomography (X-ray CT) in that it generates images using X-rays. The original difference was that radiography fixed still images on film whereas fluoroscopy provided live moving pictures that were not stored. However, today radiography, CT, and fluoroscopy are all digital imaging modes with image analysis software and data storage and retrieval.

The use of X-rays, a form of ionizing radiation, requires that the potential risks from a procedure to be carefully balanced with the benefits of the procedure to the patient. Because the patient must be exposed to a continuous source of X-rays instead of a momentary pulse, a fluoroscopy procedure generally subjects a patient to a higher absorbed dose of radiation than an ordinary (still) radiograph. Only important applications such as health care, bodily safety, food safety, nondestructive testing, and scientific research meet the risk-benefit threshold for use.

For help with any pain issues, please call our Langhorne, Pennsylvania office at 215.741.7031. We help patients throughout Bucks County, Mercer, Philadelphia, and Montgomery Counties. We see many patients from Langhorne, Doylestown, Newtown, Fairless Hills, Levittown, Bristol, Richboro, and Bensalem

Sources. Wikipedia and https://accessanesthesiology.mhmedical.com/Content.aspx?bookId=1158&sectionId=64175538


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Upper Back Pain

Upper Back Pain

Most people who have pain related to the spine have the pain in the neck or lower back. The neck and lower back are designed for motion. The upper back is designed for stability and just limited movement.

The two main causes of upper back pain are:

1. Irritation of the muscles – called myofascial pain

2. Dysfunction of the joints

The upper back is known as the thoracic pain, the neck is known as the cervical spine, and the lower back is the lumbar spine.

Upper Back Anatomy

•The thoracic spine is made up of 12 vertebrae in the spine’s middle and the ribs that are attached to the vertebrae.

• Each vertebra is attached to a rib. The ribs are attached to the vertebra in the back and the breastbone, called the sternum, in the front. The combination of vertebra, ribs, and breastbone create the thoracic cage that protects the heart, lungs, and liver

• The top 9 ribs join at the front of the chest. The bottom 3 ribs do not join at the front. The bottom 3 ribs (and vertebra) allow for slightly more motion than the top 9.

• The joints in the thoracic cage also allow the body to twist from side to side.

Usually a diagnostic test; such as an MRI or CT scan will not suggest that surgery is needed for the upper back.

Some of the causes of upper back pain are:

• A sudden injury

• Strain over time such as working at a computer for long stretches of time.

Muscular Irritation

The upper body also has a number of large muscles that attach to the shoulder blade and the rib cage.

Common causes of muscular irritation in the upper back are a lack of strength, repetitive stress, auto accidents, sports injuries, and other causes.Treatments for muscular irritation of the upper back include:

  • Acupuncture
  • Massages
  • Chiropractic manipulation
  • Strengthening and stretching exercises
  • Physical therapy
  • Muscular pain can also respond to anti-inflammatory medications.

Joint Dysfunction Causing Upper Back Pain

The thoracic spine vertebra connect with the ribs by the joints. If the joints are damages, upper back pain can result

Treatments include:

  • Spinal manipulation – by a chiropractor, an osteopathic doctor
  • Treatment by a trained physical therapist
  • Home exercise to stretch and strengthen the back
  • Anti-inflammatory medicines can help
  • A local trigger point injection may help

For help with any pain issues, please call our Langhorne, Pennsylvania office at 215.741.7031. We help patients throughout Bucks County and neighboring counties.

We see many patients from Langhorne, Newtown, Doylestown,  Fairless Hills, Levittown, Bristol, Richboro, and Bensalem


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The opioid epidemic/crisis is the rapid rise in the use of prescription and non-prescription opioids in the United States and Canada in the 2010s. The crisis began with the over-prescription of these powerful pain relievers in the 1990s resulting in opioids being the most prescribed class of medications in the United States. In the 1990s, about 1/3 of the country or 100 million Americans were diagnosed with chronic pain. Opiate prescriptions were an all too common treatment.

Opioids are a class of strong painkillers drugs and include Percocet, Vicodin, OxyContin and Fentanyl which are synthetic to resemble opiate drugs such as opium derived morphine and heroin. According to the Drug Enforcement Agency, overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels. Nearly half of all opioid overdose deaths in 2016 involved prescriptions. As of 2016, 289   million opioid prescriptions are written yearly. In 2016, 62,000 Americans died from overdoses as compared to 16,000 in 1999.

Not only has the number of prescriptions dramatically increased, the potency of the opioids has also gotten worse. Many drug users are now being prescribed opioids that are more powerful than morphine.

When people continue to take opioids beyond what a doctor prescribes, whether to minimize pain or to enjoy the euphoric feelings, it can mark the beginning stages of an opiate addiction.

In the U.S., addiction and overdose victims are mostly white and working-class.   Geographically, those living in rural  areas of the country have been the hardest hit as a percentage of the national population.

Prescription drug abuse has been increasing in teenagers. 12- to 17-year-olds were one-third of all new abusers of  prescription drugs in 2006. Teens abuse prescription drugs more than any illicit drug except marijuana, more than cocaine, heroin and methamphetamine combined, according to the Office of National Drug Control Policy’s 2008 Report Prescription for Danger.

Pennsylvania ranks 21st for the number of opioid prescriptions per 100 people. There are wide variances in opioid prescriptions per state because of a lack of uniform standards and because of different medical opinions on how well opioids manage pain. Some doctors claim that there is little evidence that opioids help with anything other than cancer pain.

To help address, the lack of standards and the rising opioid epidemic, in 2016, the CDC published its “Guideline for Prescribing Opioids for Chronic Pain”, recommending opioids only be used when benefits for pain and function are expected to outweigh risks, and then used at the lowest effective dosage, with avoidance of concurrent opioid and benzodiazepine use whenever possible.


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