Conditions

Treating patients with the following conditions

Arthritis/Osteoarthritis

Arthritis & Osteoarthritis

Overview

With osteoarthritis affecting over 27 million individuals world-wide, it is the most common cause of disability. Arthritis is defined as inflammation of a joint. There are many forms of arthritis however the most prevalent form is Osteoarthritis (OA).
Osteoarthritis is commonly referred to as wear-and-tear arthritis because it occurs when cartilage between joints wears down over time. Cartilage provides cushion between bones allowing for frictionless movement. If the cartilage wears down enough bone may rub on bone. OA most commonly affects joints in the neck, hands, lower back, knees and hips, but can damage any joint in the body.

 

Types
There are over 100 forms of arthritis. The three most prevalent types of arthritis are:
  • Osteoarthritis (OA)
  • Rheumatoid arthritis (RA)
  • Juvenile Arthritis (JA)
Symptoms
The symptoms experienced with OA generally develop slowly and worsen over time. Symptoms of OA include:
  • Pain
  • Stiffness
  • Tenderness
  • Grating Sensation
  • Loss of Flexibility
Diagnosis
A physical examination of the affected joint(s) will be done to check for swelling, tenderness, or redness. The joint’s range of motion may also be examined. If necessary, imaging and lab tests may be ordered by the physician. Imaging test will take a picture of the joint. These images are achieved through an X-ray or Magnetic resonance imaging (MRI).

 

Treatment
There is now cure for OA however there are treatments available to help relieve the pain associated with OA.
  • Medications i.e. Nonsteriodal anti-inflammatory drugs (NSAIDs),  acetaminophen or narcotics for severe pain
  • Cortisone shots
  • Lubrications shots
  • Osteotomy or realignment of bones for OA in knee joints
Links to additional resources
Back/Neck/Thoracic Pain

Back/Neck/Thoracic Pain

Types

  • Cervical (Neck) Back Pain
  • Thoracic (Mid-Back) Back Pain
  • Lumbar (Lower Back) Back Pain
Symptoms
  • Muscle aches
  • Limited range of motion or flexibility
  • Stabbing or shooting pain
  • Inability to stand up straight
Diagnosis/Test
Diagnostic tests are not usually necessary to confirm the cause of your back pain however a physical examination will be completed by a physician to assess your pain, flexibility, and range of motion.
If your physician suspects that there is a reason to determine the specific cause of your back pain, an X-ray, Magnetic Resonance Imaging (MRI) or a Bone Scan may be ordered. There is a chance however these tests may not determine the cause of your back pain however, back pain can be treated and improve even if the specific cause is unknown.

 

Causes
The pain often develops without a specific cause. The majority of individuals develop neck/thoracic/back pain due to poor habits. These poor habits include:
  • Poor Posture
  • Lifting, pushing, or pulling objects incorrectly
  • Overexertion
Conditions commonly associated with back pain include:
  • Arthritis
  • Osteoporosis
  • Ruptured or bulging disc
  • Ligament or muscle strain
  • Skeletal irregularities
Various Treatments often include:
  • Transcutaneous electrical nerve stimulation (TENS)
  • Acupuncture
  • Cortisone Shots
  • Anti-inflammatory medications note: medications should be taken as directed by your doctor
Cancer Pain

Cancer Pain

Pain management is particularly important for cancer patients. If you have pain, the severity and prevalence of your pain may depend on many factors, including the type and stage of your cancer, your treatment plan and your tolerance for pain. You may experience pain from the cancer itself, or as a side effect of cancer treatment. Those with advanced cancer are most likely to have severe pain.

Treatment options & care 

  • Prescription medication(s)

  • Implanted pain pumps

  • Nerve block therapy

Complex Regional Pain Syndrome

Complex Regional Pain Syndrome

Overview/Description

Complex Regional Pain Syndrome is a chronic pain condition involving damage or malfunction of the central and peripheral nervous systems which most commonly occurs around 40 years of age. The pain experienced generally only affects one of the limbs (hands, arms, legs or feet). The central nervous system is comprised of the brain and spinal cord while the peripheral nervous system involves nerve signaling from the central nervous system to the rest of the body.

Types

  • Complex Regional Pain Syndrome I (CPRS-I)
  • Complex Regional Pain Syndrome II (CPRS-II)

Symptoms

In the majority of cases, symptoms are mild and individuals recover over time however in more severe cases recovery may not occur and disability can occur. Common symptoms associated with Complex Regional Pain Syndrome include:

  • Persistent, excessive pain
  • Burning or “pins and needles” sensation
  • Swelling
  • Joint stiffness
  • Increased sensitivity of the affected limb
  • Constant or intermittent skin color or temperature changes of the affected limb

Diagnosis

An accurate diagnosis by a physician is beneficial in the creation of a treatment plan.  Diagnosis of CPRS is based on your individual medical history and signs and symptoms, as there is no single diagnostic test used to confirm CPRS. Magnetic Resonance Imaging (MRI) or Bone Scans may be used to identify bone metabolism changes that are characteristic to CPRS. Other test may be done to rule out other conditions with similar symptoms. A common distinguishing factor used to rule out other conditions is the notation of an injury to the affected limb.

Causes

Occasionally, CPRS develops without any known injury. The most common triggers for CPRS include:

  • Fractures
  • Sprains
  • Soft tissue injury i.e. burns, cuts, bruises

Treatment options & care 

  • Sympathetic Nerve Block
  • Spinal Cord Stimulation
  • Acupuncture
  • Anti-inflammatory medications note: medications should be taken as directed by your doctor
Degeneration Disk Disease (DDD)

Degenerative Disk Disease

Overview

Your spinal disks are made up of a soft inner core and a tough outer wall. The disks change in ways that may cause degenerative disk disease, such as drying out (due to aging) or cracking (due to stress of everyday movements or minor injuries). Degenerative disk disease is when normal changes that take place in the disks of your spine cause pain.

Symptoms

Common signs include pain that:

  • Is in your lower back, buttocks, or upper thighs
  • Comes and goes. It can be nagging or severe and can last from a few days to a few months.
  • Feels worse when you sit, and better when you move and walk
  • Feels worse when you bend, lift, or twist
  • Gets better when you change positions or lie down

In some cases, degenerative disk disease can lead to numbness and tingling in your arms and legs. It can also cause your leg muscles to become weak. This means the damaged disks may be affecting the nerves near your spine.

Diagnosis/Test
The doctor will look at your spine for signs of the condition, like pain in your lower back or neck. He may also ask you to walk or bend to see which movements cause pain.

Your doctor may order an X-ray or MRI to check for bone or nerve damage near your spine.

Various Treatments often include:

  • Transcutaneous electrical nerve stimulation (TENS)
  • Cortisone Shots
  • Medications- note: medications should be taken as directed by your doctor
Herniated Disk

Herniated Disk

Overview

The disks between your spinal vertebrae contain a gel-like substance in the center of them. The outer part of a disk is made up of fibrous cartilage that keeps the gel contained. When the outer part gets tears or splits, the gel can poke out. This is what it means for a disk to become herniated.

A herniated disk is also called a “ruptured disk” or a “slipped disk.” As you get older, the disks tend to break down and lose their cushioning.

Symptoms

Although they can occur in any part of your spine, herniated disks are most common in the lower part of your backbone (the lumbar spine), just above your hips. And the pain may spread from your back to your buttocks, thighs, even to your calves.

Discomfort from a herniated disk usually worsens when you're being active and lessens when you're resting. Even coughing, sneezing, and sitting can aggravate your symptoms because they put pressure on the pinched nerves.

Diagnosis/Test
The doctor will look at your spine for signs of the condition, like pain in your lower back or neck. He may also ask you to walk or bend to see which movements cause pain.

Your doctor may order a X-ray or MRI to check for bone or nerve damage near your spine.

Various Treatments often include:

  • Nerve Blocks
  • Cortisone Shots
  • Medications- note: medications should be taken as directed by your doctor
  • Surgery
Joint Pain (Shoulder, Hip, Knee)

Joint Pain

Overview
Joint pain is a generalized term to describe pain in or around your joint. Joint pain may arise from the joint itself or any of the muscles, ligaments or tendons surrounding the joint. Often times the pain worsens with activities that involve movement of your extremity. Joint pain may also arise from other structures in the body. This type of pain is termed “referred pain.”

Symptoms

Some signs associated with joint pain that indicate you should be seen by a doctor include:

  • Pain that lasts more than a few days
  • Pain  that occurs at rest or at night
  • Significant bruising or swelling surround the joint
  • Inability to raise extremity
  • Inability to carry objects or use extremity
  • Signs of injection: fever, redness, warmth

Diagnosis/tests

To diagnosis your pain, a thorough medical history and physical examination will be completed by a physician. Questions will be asked in regards to your general health, possible causes of your joint pain, and a description of your symptoms to help determine the source of your pain. The physical examination will aid in finding the cause of your pain. The physician will examine your joint for any abnormalities, swelling, weakness, and observe your range of motion. If necessary other diagnostic tests may be order to identify the cause of your pain. These tests may include an X-ray, Computed tomography (CT scan), Magnetic resonance imaging (MRI), Ultrasound, or arthroscopy.

Causes

Common causes for joint pain include:

  • Injury
  • Fracture
  • Dislocation
  • Bursitis
  • Heart attack
  • Arthritis
  • Tendinitis

Treatment options & care

  • Anti-inflammatory medications
  • Surgery
  • Activity changes
Neuralgia (Nerve Pain)

Neuralgia/Nerve Pain

Overview

With nerve damage there can be a wide array of symptoms. Which ones you may have depends on the location and type of nerves that are affected. Damage can occur to nerves in your brain and spinal cord. It can also occur in the peripheral nerves, which are located throughout the rest of your body.

Symptoms

  • Pain
  • Sensitivity
  • Numbness
  • Tingling or prickling
  • Burning
  • Problems with positional awareness

Diagnosis/Test
Diagnostic tests are not usually necessary to confirm the cause of your back pain however a physical examination will be completed by a physician to assess your pain, flexibility, and range of motion.

Often, the first goal of treatment is to address the underlying condition that's causing your nerve pain or nerve damage.

Various Treatments often include:

  • Cortisone Shots
  • Medications- note: medications should be taken as directed by your doctor
  • Transcutaneous electrical nerve stimulation (TENS)
Radiculopathy

Radiculopathy

Overview:

Radiculopathy is due to a compressed nerve where it exits the spinal column. The problem occurs at or near the nerve root along the spine. Typically pain or other related symptoms are not localized but radiate to areas of the body served by the compressed nerve. This condition typically resolves within 6 weeks to 3 months.

Types:

  • Cervical (Neck) Radiculopathy
  • Thoracic (Mid-Back) Radiculopathy
  • Lumbar (Low Back) Radiculopathy

Symptoms:

The symptoms associated with Radiculopathy will vary depending on which nerves are affected.

Typical symptoms include:

  • Pain
  • Tingling or numbness in legs or arms
  • Localized pain in neck or back
  • Sciatica

Some individuals may experience hypersensitivity to light touch where pain is felt or muscle weakness in muscles controlled by the affected nerves.

Diagnosis:

Initially, a medical history and physical will be completed by the physician. The medical history will address questions regarding the type and location of your symptoms, how long the symptoms have been present, what makes the symptoms better or worse, and if you have any other medical problems. During the physical examination the physician will test muscle strength, reflexes, and sensation to determine the severity of the issue.

In order to determine the source of the radiculopathy, the physician may order an imaging test such as an X-ray, Magnetic Resonance Imaging (MRI), Cat Scan (CT) or Electromyogram (EMG).

Causes

Radiculopathy is due to the mechanical compression or irritation of nerves as they exit the spinal column. This can result from:

  • Disc herniation
  • Thickening of surrounding ligaments
  • Osteophytes in individuals with Osteoarthritis
  • Tumor
  • Scoliosis
  • Diabetes

Treatment:

  • Anti-inflammatory medications
  • Epidural Steroid Injections
  • Physical Therapy or Chiropractic Treatment
Sacroiliac (SI) Pain

Sacroiliac Pain

Overview

There are two Sacroiliac (SI) Joints in your lower back, and they sit on each side of your spine. Their main job is to carry the weight of your upper body when you stand or walk and shift that load to your legs.

Causes

Arthritis can lead to the problem. A type that affects your spine, called ankylosing spondylitis, can damage the SI joint. You'll also hurt when the cartilage over the SI joint slowly wears away as you age.

Arthritis can lead to the problem. A type that affects your spine, called ankylosing spondylitis, can damage the SI joint. You'll also hurt when the cartilage over the SI joint slowly wears away as you age.

Symptoms

It could be a dull or sharp. It starts at your SI joint, but it can move to your buttocks, thighs, groin, or upper back.

Sometimes standing up triggers the pain, and a lot of times you feel it only on one side of your lower back. You may notice that it bothers you more in the morning and gets better during the day.

Diagnosis/Test
To diagnosis your pain, a thorough medical history and physical examination will be completed by a physician. Questions will be asked in regards to your general health, possible causes of your pain, and a description of your symptoms to help determine the source of your pain.
He may also ask you to walk or bend to see which movements cause pain.

Your doctor may order an X-ray or MRI to check for bone or nerve damage near your spine.

Various Treatments often include:

  • Nerve Blocks
  • Cortisone Shots
  • Medications- note: medications should be taken as directed by your doctor
  • Transcutaneous electrical nerve stimulation (TENS)
Sciatica Pain

Sciatica Pain

Overview

Sciatica refers to back pain caused by a problem with the sciatic nerve. This is a large nerve that runs from the lower back down the back of each leg. When something injures or puts pressure on the sciatic nerve, it can cause pain in the lower back that spreads to the hip, buttocks, and leg.

Causes

Symptoms

  • Lower back pain
  • Pain in the rear or leg that is worse when sitting
  • Hip pain
  • Burning or tingling down the leg
  • Weakness, numbness, or difficulty moving the leg or foot
  • A constant pain on one side of the rear
  • A shooting pain that makes it difficult to stand up

Diagnosis/Test
To diagnosis your pain, a thorough medical history and physical examination will be completed by a physician. Questions will be asked in regards to your general health, possible causes of your pain, and a description of your symptoms to help determine the source of your pain.
He may also ask you to walk or bend to see which movements cause pain.

Your doctor may order an X-ray or MRI to check for bone or nerve damage near your spine.

Various Treatments often include:

  • Nerve Blocks
  • Cortisone Shots
  • Medications- note: medications should be taken as directed by your doctor
  • Transcutaneous electrical nerve stimulation (TENS)
Spinal Stenosis – Neurogenic Claudication

Spinal Stenosis

Facts

The leading reason for spinal stenosis is arthritis, a condition caused by the breakdown of cartilage -- the cushiony material between your bones -- and the growth of bone tissue. Osteoarthritis can lead to disc changes, a thickening of the ligaments of the spine, and bone spurs. This can put pressure on your spinal cord and spinal nerves. Other causes include injuries, accidents, tumors, or Paget’s Disease.

Symptoms

Spinal stenosis usually affects your neck or lower back. Not everyone has symptoms, but if you do, they tend to be the same: stiffness, numbness, and back pain.

Diagnosis/Test
The doctor will look at your spine for signs of the condition, like pain in your lower back or neck. He may also ask you to walk or bend to see which movements cause pain.

Your doctor may order a X-ray or MRI to check for bone or nerve damage near your spine.

Various Treatments often include:

  • Nerve Blocks
  • Cortisone Shots
  • Medications- note: medications should be taken as directed by your doctor
  • Surgery
Spondylosis

Spondylosis

Overview

Spondylosis refers to degenerative changes in the spine such as bone spurs and degenerating intervertebral discs between the vertebrae. With age, the bones and ligaments in the spine wear.

Spondylosis changes in the spine are frequently referred to as osteoarthritis. Spondylosis can occur in the cervical spine (neck), thoracic spine (upper and mid back), or lumbar spine (low back).

Symptoms

Localized pain in the area of spondylosis, usually in the back or neck. Neck spondylosis can cause headaches. Shooting pain may occur.

Diagnosis/Test
The doctor will look at your spine for signs of the condition, like pain in your lower back or neck. He may also ask you to walk or bend to see which movements cause pain.

Your doctor may order an X-ray or MRI to check for bone or nerve damage near your spine.

Various Treatments often include:

  • Nerve Blocks
  • Cortisone Shots
  • Medications- note: medications should be taken as directed by your doctor
  • Transcutaneous electrical nerve stimulation (TENS)
Vertebral Compression Fractures

Vertebral Compression Fracture

Overview
Vertebral compression fractures occur when the vertebra of the spine become compressed due to trauma. The amount of trauma necessary to break the bones of the spine is usually substantial however in some cases such as individuals with cancer or the elderly, the bones of the spine are already fragile so they can break with minimal force. The lower back is the most common area for vertebral compression fractures however, they can occur in any portion of the spine.

Types

  • Wedge fracture
  • Bioconcave fracture
  • Crush fracture

Symptoms

  • Pain in the upper, middle, or lower back
  • Numbness
  • Tingling
  • Weakness
  • Incontinence
  • Urinary Retention

Diagnosis/Tests

To diagnose a Vertebral Compression Fracture, imaging tests are used on the spine. Possible imaging tests include:

  • X-rays
  • Computerized tomography (CT scan)
  • Magnetic resonance imaging (MRI)

Causes

  • Trauma
  • Osteoporosis
  • Pathogenic fracture

Treatment options and care

  • Rest
  • Pain medication (Non-steroidal Anti-inflammatory Drugs)
  • Cold compress
  • Prescription pain medications
  • Vertebroplasty
  • Kyphoplasty
Cancer Pain

Cancer Pain

Pain management is particularly important for cancer patients. If you have pain, the severity and prevalence of your pain may depend on many factors, including the type and stage of your cancer, your treatment plan and your tolerance for pain. You may experience pain from the cancer itself, or as a side effect of cancer treatment. Those with advanced cancer are most likely to have severe pain.

Treatment options & care 

  • Prescription medication(s)
  • Implanted pain pumps
  • Nerve block therapy