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Definitions of Different Types of Doctors

People in pain often treat with different types of doctors. Some of the physicians they may treat are a:

Pain Management Doctor. According  to the American Society of Regional and Pain Medicine – “A pain management specialist is a physician with special training in evaluation, diagnosis, and treatment of all different types of pain. Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these. Pain can also arise for many different reasons such as surgery, injury, nerve damage, and metabolic problems such as diabetes. Occasionally, pain can even be the problem all by itself, without any obvious cause at all.”
“The best way to be referred to a pain management specialist is through your primary care physician. Most pain physicians work closely with their patients’ primary care physicians to insure good communication, which in turn helps provide the optimum treatment for their patients. Patients are also often referred by specialists who deal with different types of pain problems. Back surgeons, neurologists, cancer doctors, as well as other specialists usually work regularly with a pain physician and can refer you to one.”

https://www.asra.com/page/44/the-specialty-of-chronic-pain-management

Neurosurgeon. “A neurosurgeon is a physician who specializes in the diagnosis and surgical treatment of disorders of the central and peripheral nervous system including congenital anomalies, trauma, tumors, vascular disorders, infections of the brain or spine, stroke, or degenerative diseases of the spine.”

https://www.urmc.rochester.edu/highland/departments-centers/neurosurgery/what-is-a-neurosurgeon.aspx

Orthopedist. “An orthopaedic surgeon is a physician devoted to the diagnosis, treatment, prevention and rehabilitation of injuries, disorders and diseases of the body’s musculoskeletal system. This system includes bones, joints, ligaments, muscles, nerves and tendons. While orthopaedic surgeons are familiar with all aspects of the musculoskeletal system, many orthopaedists specialize in certain areas, such as the foot and ankle, hand, shoulder and elbow, spine, hip or knee. Orthopaedic surgeons may also choose to focus on specific fields like pediatrics, trauma, reconstructive surgery, oncology (bone tumors) or sports medicine.”

https://www7.aaos.org/member/directory/definition.htm

Physical Therapist. “Physical therapists can teach patients how to prevent or manage their condition so that they will achieve long-term health benefits. PTs examine each individual and develop a plan, using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.”

http://www.apta.org/AboutPTs/

Vocational Therapist. “Vocational rehabilitation counselors help individuals deal with the career-related effects of physical and mental disabilities, which may have resulted from accidents, illnesses, injuries, birth defects or disease. These professionals train clients to search and apply for jobs. They also support those who have lost their jobs or who are dealing with job stress or other issues. In creating a rehabilitation program, they may confer with other professionals assisting in the client’s care, including doctors, family members, occupational therapists, teachers and psychologists.”

https://learn.org/articles/What_is_a_Vocational_Rehabilitation_Counselor.html

Disclaimer

The information contained in this blog 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. If you’re experiencing pain, please phone our Langhorne, PA office at 215.741.7031.

We see patients from Bucks, Mercer, Montgomery,  and  Philadelphia Counties. We treat patients in the Delaware Valley including Levittown, Newtown, Langhorne, Doylestown, Southampton, Trenton, Richboro, and nearby locations

 

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What is Cauda Equina Syndrome

A recent article in Spine-Health discussed an emergency medical condition called cauda equina syndrome. The condition normally requires “urgent surgical intervention.”

If the condition is not treated quickly, patients can suffer:

  • Paralysis
  • Loss of bladder or bowel control
  • Problems walking
  • Other neurological or physical difficulties

Cauda equina syndrome may mature in weeks or months – but it also develop suddenly.

  • Symptoms of sudden onset include “severe low back pain and significant loss of bladder and bowel function.”
  • Symptoms of gradual onset include some loss of bladder or bowel function. The patient may suffer pain in the lower back, muscle weakness and/or numbness, and incontinence (both the bladder and bowel). Patients also develop sciatica in one or both legs.

Patients with sciatica or back pain may develop cauda equina syndrome. Others may develop the condition without any sciatica or back pain.

Cauda equina is Latin for “horse’s tail.” The name is used because the nerves at the end of the spine visually resemble a horse’s tail as they extend from the spinal cord, through the lumbar spine and over the sacrum, and down the back of each leg.”

Disclaimer

The information contained in this blog 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. If you’re experiencing pain, please phone our Langhorne, PA office at 215.741.7031.

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Medial Branch Block

What Are Medial Branch Blocks?

A medial branch block procedure is mainly diagnostic. If the procedure works (it gives the patient relief from pain) that it lets the doctor know what region caused the pain. It may let the doctor also know if the patient can benefit from any other pain procedures such as a radiofrequency neurotomy.

Medial Nerves

Each facet joint is connected to two medial nerves. The nerves are carriers of pain signals. The medial nerves can also control some muscles in the neck and back. Medial nerves are located in different parts of the spine including:  The neck: Cervical medial branch nerves are located in a bony groove in the neckThoracic medial branch nerves are located over a bone in the mid-back or upper backLumbosacral medial branch nerves are found in a bony groove in the low back.

How the Procedure is Performed

The doctor will use an X-Ray machine called a fluoroscopy to help guide the needle injections to the right spot of the body.  The procedure is an out-patient procedure which takes about 30 minutes. The patient will lie down on a  medical table. An anesthetic will be used along with the injection for each medial nerve. Contrast dyes are used to make sure the medicine goes to the   medial branch nerves.

The patient will be given another 20 to 30 minutes to recover from the procedure. The doctor will do some quick tests to see how well the procedure worked.

Risks

Risks are low. Complications are infrequent. Some of the risks include an allergic reaction to the X-Ray contract solution, bleeding and infection. Worsening of pain symptoms, discomfort where at the injection site are also possible. Nerve or spinal cord damage or  paralysis are rare but possible.

Results

Patients normally experience some relief within the first six hours after the procedure. Patients who do experience relief within this time frame may be eligible for radiofrequency neurotomy

Disclaimer

The information contained in this blog 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. If you’re experiencing pain, please phone our Langhorne, PA office at 215.741.7031.

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How Staying Active May Help with Neck Pain Management

Exercise helps the neck in three different ways.

A recent article in Spine-Health suggests that exercise can help with pain management. The first step though is to review your pain doctor whether you should participate in an exercise program. Some pain conditions create complications when people exercise.

  1. Exercise helps the neck muscles, according to the article. Exercise includes walking, swimming, biking, yoga, doing household chores, and even gardening. These activities help the neck muscles stay strong. They also help maintain neck flexibility. Different activities help put the “neck through a wide range of motions.” When you don’t move, the muscles get weaker. They also get tighter. Weak and tight neck muscles make the neck more likely to suffer sprains and strains.
  2. Exercise helps circulate the blood. Aerobic exercise (as opposed to exercise that focuses on strength) helps you breathe better. It’s also good for the heart because it increases your heart rate during exercise. Exercise helps the blood move to the neck and upper back. This movement is good for your general mobility and also helps the muscles relax. When you finish your exercise, the brain releases endorphins which can help with some types of pain. People who exercise generally have better moods and more energy. Doctors generally recommend people exercise about 5 times weekly – about 30 minutes each session
  3. Exercise is good for your posture. It may not seem like a lot – but bending forward “just 15 degrees,” nearly doubles the pressure on your cervical spine. Bad posture negatively affects the joints, soft tissues, and muscles of the neck – which increases pain. Exercise and activity helps with good posture. As with all exercise programs, overdoing exercise can reverse the advantages of exercising. You’re allowed to take breaks. You shouldn’t cram five days of activity into the weekend.

Disclaimer

The information contained in this blog 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. If you’re experiencing pain, please phone our Langhorne, PA office at 215.741.7031.

We see patients from Bucks, Montgomery, Mercer, and  Philadelphia Counties. We treat patients in the Delaware Valley including Levittown, Doylestown, Newtown, Southampton, Trenton, Buckingham and Richboro.

 

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Physical Therapy for Neck Pain

According to Spine Health, there are several types of non-aggressive physical therapy that may help with neck pain.  Some recommended types of therapy  (it’s always wise to check with your doctors first) include:

  • Cold and hot therapy. Ice packs placed where it hurts may help. Hot packs may be used to loosen muscles that are stiff and increase the flow of blood. Some patients alternate hot and cold treatments depending on their injuries.
  • Massage therapy. Massages are also good for relaxing muscles. Many patients with neck pain get massage on the back of their neck, their shoulders, and the back of their head.
  • Electrotherapy. Electrotherapy sends a soft electrical current through wires to the part of the body that hurts. There’s more than one type of electrotherapy. Examples include “altering pain signals, stimulating muscle contractions, promoting tissue healing, and sending pain relief medicine through the skin (iontophoresis). Using TENS (transcutaneous electrical nerve stimulation) is the most common type. TENS transports electrical pulses to nerves under the skin.
  • Ultrasound. With ultrasound, the health provider applies a cold gel to the area of the body that’s in pain. A handheld device sends “high-energy” soundwaves to the skin area. The soundwaves penetrate into the tissues. Ultrasound helps some patients experience less pain and muscle relaxation.

Disclaimer

The information contained in this blog 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.If you’re experiencing pain, please phone our Langhorne, PA office at 215.741.7031.

We see patients from Bucks, Mercer, Montgomery, and  Philadelphia Counties. This includes patients from Levittown, Langhorne, Doylestown, Newton, Bristol, Bensalem, and Richboro.

 

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Summer Pain Issues and Practical Tips

As the hot weather and long hours of summer approach, it’s a good idea to think about how the heat and summer affect chronic pain. Here are a few things to think about:

High humidity may affect joint pain such as arthritis. Some people with chronic pain complain that the heat makes their joints feel stiff and tight.  These uncomfortable sensations are due, possibly, to the fact that heat can cause muscles, tendons, and ligaments to expand which can irritate the joints. Fluid generally helps lubricate the joints.In the warm weather, many people fail to drink enough fluids to cool their body and lubricate the joints.

The warm weather is also known to affect people with fibromyalgia. Hot weather can increase inflammation which makes anti-inflammatory drugs less effective. You may need to consult with your pain management doctor about the correct summer dosage.

A few hot weather tips for managing pain in the summer

  • Stay inside where it’s cooler – if you  have air conditioning.
  • Exercise outdoors  in moderation. It may be enjoyable to walk or garden outside – but it’s wise to take breaks and to go back inside on occasion.
  • Consider using a de-humidifier to manage the high summer humidity
  • Stay hydrated. Drink plenty of fluids. Remember, fluids help keep the joints lubricated
  • Eat a healthy diet. Good nutrition helps reduce your weight and helps you feel your best
  • Wear appropriate clothing. Whites and light colors work best. Natural fabrics can help.

If you take vacations in the summer, prepare for long trips by having pillows  for your back and neck.

Getting enough  sleep can be harder in the summer because of the longer hours and heat and humidity. If you can afford it, use the air conditioning at night. Try to go to bed at the same time each night to stabilize your sleeping patterns.

Bring stadium cushions to the ballpark. If you go to summer festivals, arts shows, or amusement parks – be prepared. Bring plenty of water and know where you can sit. You might invest in a light portable fabric chair.

Disclaimer

This blog does not constitute medical advice

Speak with our office

We see patients from Bucks, Philadelphia, Mercer, and Montgomery Counties. We treat patients who live in Levittown, Richboro, Doylestown, Langhorne, Newtown, and the Delaware Valley region. For help, please contact us.

 

 

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How can PRP Help with Pain Management

PRP (platelet rich plasma) is a procedure that uses your own blood. It consists of a solution of platelet cells, proteins, and growth factors which are used for regeneration. The platelets are rich with materials that rebuild tissue as well as heal your body. Because PRP uses your own blood, no foreign chemicals or synthetic chemicals are used.  The risks of other side effects are minimal.The platelets are injected into parts of the body that are damaged to help them heal.

The procedure is being used with some success for patients with disc pain, joint pain,  and other types of pain. It also seems to help people with arthritis.

When PRP works, it provides long-term relief. How well the procedure works depends on a variety of factors including how severe your pain is. PRP treatments are not intensive.

Blood is drawn  (like a normal blood test) and prepared. This takes about a half-hour and is done wen you visit the office. A centrifuge is then used to separate the platelets from the red blood cells. The platelets are kept and then injected into the damaged area that is causing the pain. A fluoroscope is used to guide  the injection into the right spot.

Normally, 2 to 6 injections are needed. Many petitions experience relief after the first or second treatment.Normally, PRP treatments have minimal pain. If there is pain, then some medications, other than anti-inflammatory drugs, can help with the healing.

The benefits and risks of PRP

  • When PRP works, the repair is usually permanent.
  • The procedure is minimally invasive.
  • Patients often see results fairly quickly

After treatment, patients should avoid strenuous exercise until the body fully heals.

PRP is generally a safe procedure. Because you’re using your  own blood, you shouldn’t have an allergic reaction. Risks include bleeding, damage to a nerve, and infection.

PRP is normally not considered until it’s clear more traditional pain management techniques aren’t working.

Disclaimer

This blog does not constitute medical advice.

We see patients from Bucks, Philadelphia, Mercer, and Montgomery Counties. We treat patients who live in Levittown, Richboro, Doylestown, Langhorne, Newtown, and the Delaware Valley region. For help, please contact us.

 

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How Massages Can Help with Your Back Pain

Massages have both physical and psychological benefits.  They’re considered low risk for most patients  with back pain. According to Spine Health, there are numerous benefits to back pain patients who have their back massaged.

The key benefits of a massage

  • Helps the circulation and flow of blood. Blood flow provides nutrients to tissues and muscles.
  • Improves flexibility which help manage the pain of tight muscles. Flexible muscles can even help patients sleep better.
  • Increases endorphin levels. Elevated endorphins help improve your mood so you can live wit your  pain.

Massages can help with the following pain conditions

  • Muscle strains – in the neck, upper back, and lower back.
  • Osteoarthritis of the spine – caused by damage to the facet joints and cartilage between the facet joints. The damage is often due to joint degeneration which becomes worse as people age.
  • Fibromyalgia. This painful condition an affect the whole body and specific points. In addition to pain, patients often have difficulty sleeping and feel stiff. Massages can help fibromyalgia patients manage their pain.

Patients should work with massage providers recommended by their pain management doctors due to concern about the underlying  problems that are causing the pain. Doctors need to know about some conditions such as prior surgeries, rashes osteoporosis, and other conditions.

Types of massages

Patients should also review the different types of massages they can get.

  • Swedish massages use “long gliding strokes and kneading motions”
  • Neuromuscular therapy  can  help focus  on specific pain points. A common type of neuromuscular therapy is the Shiatsu massage. This type of therapy generally requires about four massage sessions over a six week period. It uses “alternating levels of concentrated pressure (10-30 seconds) on the areas of muscle spasm.”

For those who can’t find the time to meet with a massage therapists, hand-held massages and pillows are an alternative. There are also massage charges that try to simulate the various hands-on massage techniques.

Disclaimer

This blog does not constitute medical advice.

We see patients from Bucks, Philadelphia, Mercer, and Montgomery Counties. We treat patients who live in Levittown, Richboro, Doylestown, Langhorne, Newtown, and the Delaware Valley region.

Massage image by Thomas Wanhoff from Phnom Penh, Cambodia – From Rama Day Spa Frankfurt, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=2735045
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The Parts of the Spine-A Short Summary

The spine has three main parts:

  • The cervical spine. This is composed of 7 cervical vertebrae.
  • The thoracic spine. This is composed of 12 thoracic vertebrae.
  • The lumbar spine. This is composed of 5 lumbar vertebrae.Another small part is called the sacrum which is part of the pelvis

The vertebrae are bones.Each vertebrae, in turn, is made of the following parts:

  • The body. This part bears most of the weight. It includes the centrum and a posterior arch (also called a neural arch).
  • The  fibrous discs. These separate the vertebrae from other vertebrae. They are also called intervertebral discs.
  • Two pedicles.
  • Two laminae. These attach the ligaments of the spine.
  • Seven processes. There are two types: The spinous processes. This is the bone humans feel when they run their hands down their back.  The paired transverse processes. These run 90 degrees from the spinous  process. They attach the back muscles
  • Four facet joints – in two pairs. These help give the spine stability.

Disclaimer. This blog does not constitute medical advice.

Please contact us. We see patients in Langhorne, Upper Darby, Norristown, and Philadelphia. You can make an appointment by calling  215.741.7031.
We see patients who live in Bucks County, Montgomery County, Mercer County, and Philadelphia – including Doylestown, Levittown, and Newtown.

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Spinal Anatomy

The spine has three main parts:

  • The cervical spine. This is composed of 7 cervical vertebrae.
  • The thoracic spine. This is composed of 12 thoracic vertebrae.
  • The lumbar spine. This is composed of 5 lumbar vertebrae.

Another small part is called the sacrum which is part of the pelvis

The vertebrae are bones.Each vertebrae, in turn, is made of the following parts:

  • The body. This part bears most of the weight. It includes the centrum and a posterior arch (also called a neural arch).
  • The  fibrous discs. These separate the vertebrae from other vertebrae. They are also called intervertebral discs.
  • Two pedicles.
  • Two laminae. These attach the ligaments of the spine.
  • Seven processes.  There are two types: The spinous processes. This is the bone humans feel when they run their hands down their back.  The paired transverse processes. These run 90 degrees from the spinous  process. They attach the back muscles
  • Four facet joints – in two pairs. These help give the spine stability.

Disclaimer. This blog does not constitute medical advice.

Please contact us. We see patients in Langhorne, Upper Darby, Norristown, and Philadelphia. You can make an appointment by calling  215.741.7031.

We see patients who live in Bucks County, Montgomery County, Mercer County, and Philadelphia – including Doylestown, Levittown, and Newtown.

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