Monthly Archives: January 2013

Study Shows Smoking Cigarettes Not Great for Managing Chronic Pain

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Over 25% of Americans smoke, and it is common for those with chronic pain to use cigarettes as a coping mechanism to deal with it. A recent study published in the Journal of Pain look at whether or not smoking cigarettes is a good coping strategy for chronicPain Clinics Las Vegas pain management.

The study was performed out of the Oregon Health and Science University. Over 150 veterans were evaluated from the Oregon Veterans Medical Center.The participants were predominately male, white and middle-aged with the median age of 54 years.

They were asked two questions. One was whether or not they smoked, and the other was whether they smoked to help cope with pain.

Approximately 60% of the participants were smokers, and half of those smoked to cope with pain. When the researchers compared the groups, they found that those who smoked to cope with pain had worst outcomes than those in the other study groups.

Those who smoked but said they did not use it as a coping mechanism had the same pain related outcomes as non-smokers. Those who smoked to cope with chronic pain had worse outcomes in three categories. Pain levels overall were higher, functional abilities were lower, and that group tended to fear pain more.

Although the researchers found statistical significance that smoking is a poor way to cope with pain, they hypothesized on why those with pain use it to begin with. One of the Pain Management Las Vegasresearchers looked at it as a positive feedback loop with smoking being a risk factor for the development of pain and pain then serving to motivate smoking as a potential coping mechanism.

The researchers also thought that tobacco possibly desensitizes nicotine receptors which also may cause more pain sensitivity. This study is one of the first to show that smoking to cope with pain is not a great idea. Even though those who smoked not to cope with chronic pain had the same outcomes as non-smokers, there are still significant health risks with smoking, so it should be avoided if at all possible and Pain Management Doctors in Las Vegas discourage it.

If you live in the Las Vegas area and are suffering from acute or chronic pain, let the Nevada Pain Network help you. The Network connects those in pain with pain management Las Vegas and Henderson trust, simply fill out the form on the page or call (702) 323-0553 today.

Should you have your hardware removed after spine surgery?

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One question that patients who have had spine surgery often ask their Las Vegas Pain Management Doctors is whether or not they should go back to the surgeon for hardware removal. This is especially true when patients have residual pain after surgery.

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Notice the broken hardware. This often indicates failure of fusion and need for another surgery.

When a spine surgery is done as a fusion, instrumentation is placed to help hold the bones together while the fusion occurs. For a few months, fusion will slowly take place and the hardware is instrumental in keeping things stable during that process.

If the fusion occurs, the hardware is then not really doing anything. However, if the fusion fails, and the hardware is continuing to take a lot of stress it may eventually break.

It is very common after spine surgery for residual pain to continue. Unfortunately, it is the rare back surgery that eliminates 100% of a patient’s pain.

To evaluate for whether or not a hardware should be removed, x-rays and a CAT scan should be performed to see if the fusion took place. If the hardware is broken, and the patient is having a lot of pain, then it is reasonable to assume that there was a problem with the fusion and a surgeon should be consulted.

However, if the fusion is solid and hardware is intact, then a soft tissue injection should be performed in the area directly around the hardware by a Pain Management Doctor in Las Vegas. This may provide some helpful information as to whether or not it is the hardware potentially irritating some of the soft tissues and causing a problem.Pain clinics in Las Vegas

If this does not help substantially, it is probably not the best idea to have the hardware taken out. If it does take away a lot of pain, then it may be a good idea to go ahead and have the hardware removed. Keep in mind that having hardware removed does entail another incision and having the surgeon go right back through the soft tissue from the first time. Granted, a small incision can be used but nevertheless, it will entaill another trip to the operating room.

Another option is if the injection at a pain clinic in Las Vegas helps relieve pain around the surgical area, to see how long that pain relief lasts. It may be that a simple injection into Nevada Pain managementthis area every few months does the trick.

Deciding on whether or not to undergo a hardware removal after spine surgery is not a simple decision. With a proper workup, logical decision can be made for the decision with your Las Vegas Pain Doctor.

The Nevada Pain Network connects those in pain with the best pain providers in the Las Vegas and Henderson areas. For pain management Las Vegas trusts, simply fill out the form on the page or call (702) 323-0553 today!

Why is Lumbar Radiofrequency Ablation Such a Revolutionary Treatment?

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The amount of people in America who have chronic low back pain is well over 50 million. Over 90% of individuals in the US will experience back pain at some point in life, and Pain Clinic Las Vegasunfortunately about 10% of those will go on to have chronic back pain.

With low back surgery often having unpredictable results, nonsurgical Las Vegas pain management plays a vital role in allowing individuals to keep the baseline low back pain at a reasonable level while allowing people to work, play, socialize and not fall into depression.

Radiofrequency ablation is a revolutionary treatment for low back pain for a number of reasons. The first and most important reason is that radiofrequency lesioning has been shown to work exceptionally well for those with low back pain due to facet joint arthritis.

The low back has facet joints on both sides of the spine at every level. These joints have cartilage just like the hip and the knee, and are prone to arthritis as cartilage is slowly lost over time.Pain Management Las Vegas

There is no effective facet joint replacement procedure like there is for the hip or knee. So over time, Pain Management Doctors in Las Vegas have sought an effective method of relieving low back pain that has a low risk profile, can be performed as an outpatient, works well, and has a long duration of pain relief.

Studies looking at the effectiveness of radiofrequency ablation in the lumbar spine have shown over 75% good to excellent results. Not only that, but the duration of effective pain relief often lasts between six and 18 months!

There have also been studies looking at repeating radiofrequency procedures when pain Las Vegas Pain Management Clinicsrelief wears on. Amazingly, those studies have shown the repeat procedure produces results almost equivalent to the initial procedure.

Most injections with numbing medicine steroid last a few months. By increasing the duration of pain relief to an impressive 6 to 18 months, radiofrequency ablation has truly been a revolutionary procedure in pain management. The newest radiofrequency neurotomy machines allow multiple levels to be treated at one time. The procedure is performed as an outpatient at Las Vegas pain clinics and usually lasts between 30 and 45 minutes. Pain relief may be felt right away, or there is actually a small chance the patient may get slightly worse before getting better due to some muscle spasms.

The procedure heats up the area around the painful facet joints and deadens the tiny nerve endings that supply sensation and hence pain to those joints.

Over time, those tiny nerve endings may grow back and the pain may come back as well. A study looking at a repeat radiofrequency ablation procedure in that situation also showed excellent results.

An effective radiofrequency procedure may lessen the need for pain medications, and permit an individual to concentrate better, play with his or her kids, and return to work.Pain clinics in Las Vegas NV

Even though the radiofrequency procedure does not cure the arthritis problem, it is a huge leap forward for pain management. With the lengthy duration of pain relief and the ability to completely change a person’s life, radiofrequency ablation is one of the greatest inventions in pain management today.

Las Vegas pain management doctors perform radiofrequency procedures for neck and back pain along with headaches as well for the occipital nerves. Call Nevada Pain Network today at (702) 323-0553.

Does Smoking Help With Pain Management? New Research Discussed

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New research was recently conducted looking at whether or not smoking helps with pain control. A significant amount of people with chronic pain smoke as a coping mechanism. But does it really help? Hear David Greene, CEO of the Nevada Pain Network, describe the recent research.

If you live in the Henderson or Las Vegas area and are in need of pain treatment, contact the Nevada Pain Network. The Network connects those in pain with pain relievers. Call (702) 323-0553 for assistance today with Pain Management Las Vegas trusts.

What’s the Difference Between Facet Injections and Epidural Steroid Injections?

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The two main procedures performed in Pain Management Las Vegas today are facet injections and epidural steroid injections. They are not interchangeable procedures however. There are Chiropractor Las Vegascertain indications for one versus the other to help the patient with chronic or acute pain.

There are over 40 facet joints throughout the spine, starting at the neck and going all the way down to the sacrum. There are two at each level and they about the size of a thumbnail. Each joint maintains cartilage just like the hip or the knee, and is subjected to potential arthritis as individuals age.

When facet arthritis develops, it can lead to chronic pain in the area. Even though the joints are small, they can cause a lot of pain when injury and arthritis occurs.

Facet injections involve placing steroid and numbing medicine into the joint that is painful, along with possibly injecting numbing medicine around the joint itself. This does not involve placing the needle into the spinal canal, as the facet joints are located behind this area on the outside of the spinal column.

Epidural steroid injections are performed for different reasons and the needles placed into Facet Injectiona different area. The epidural space is located directly around the spinal cord. In this area compression of nerve roots can occur, which is commonly known as a pinched nerve.

If a nerve becomes pinched by a herniated disc, it is commonly known as a slipped disc. In addition, spinal stenosis often leads to pinched nerves. In the case of spinal stenosis, there may be several nerve roots compressed as arthritis overgrows bone and soft tissue diffusely and can compress multiple nerve roots.

Pinched nerves in the lumbar spine lead to sciatica down one or both legs, and in the neck region it causes radiculopathy with pain down one or both arms.Herniated Disc treatment

Epidural steroid injections involve placing steroid medication in the epidural space over the area of the pinched nerves with subsequent pain relief.

So facet injections involve treatment predominately for chronic neck and back pain due to facet arthritis, whereas, epidural steroid injection’s involved treatment around the spinal cord for pinched nerves causing sciatica or radiculopathy.

Both procedures have shown excellent success in pain management. Over 75% of individuals on average achieve excellent pain relief with epidural injections and approximately the same with facet injections. Individuals receiving epidural steroid injections may receive a series of injections one to two weeks apart for six weeks (3 injections), and both types of injections may be repeated every few months as necessary.

Both facet and epidural injections are performed as an outpatient and have very low risk profiles. This may include a slight risk of infection, bleeding, nerve injury or allergic reaction Nevada Pain Managementto the medicines used.

If you need pain relief for back, neck arm or leg pain in the Henderson or Las Vegas area, let the Nevada Pain Network help you. The Network works with Las Vegas Pain Clinics, chiropractors and physical therapists in the Las Vegas area.

Call (702) 323-0553 for pain management Las Vegas help today!

Radiofrequency Ablation Increasingly Being Used for Sacroiliac Joint Pain

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Radiofrequency ablationRadiofrequency ablation of spinal joints is one of the most technologically advanced procedures in pain management today. The procedure has been shown to provide excellent pain relief for those with arthritis of the lumbar spinal joints along with the mid back and neck.

Those joints are called facet joints and are about the size of a thumbnail. Research in the past has shown that radiofrequency ablation may provide 12 to 18 months of consistent pain relief, which is significantly longer than what a steroid injection typically provides. (Spine 28:16, 1877-1878)

Over the last couple years, the technology has been used by Las Vegas Pain Doctors also treat sacroiliac joint pain. Little-known fact by most people is that sacroiliac joint pain causes between 12 and 25% of low back pain. (Spine 2009, 34:1, 31-37) That has not been a considerable amount of research looking at how effective the technology is For SI SI joint pain treatmentjoint pain, however, a recent study was presented at this years American Academy of pain medicine meeting.

What that study did was evaluate 80 patients at the Cleveland cClinic who underwent the procedure. The study showed that over half of the patients in the study experienced over 50% pain relief for upwards of six months.

Studies in the lumbar spine have shown a longer duration of pain relief. Sometimes upwards of 18 months. However, future studies for SI joint pain with a larger number of patients may end up showing better and longer pain relief.

Dealing with sacroiliac joint pain can be tough. There’s no great surgical solution. Injections of steroid into the sacroiliac joint may bring significant pain relief for a few weeks to a few months. However, the joint is fairly irregular and sometimes difficult to achieve steroid placement in the complete arthritic area causing the pain. Chiropractic treatment along with physical rehabilitation and anti-inflammatory medication by mouth can provide significant pain relief as well.

One of the most difficult aspects of pain management is achieving lengthy blocks of time that pain can be relieved with existing procedures. This is one of the reasons why radiofrequency ablation has become so popular at Pain Management Las Vegas clinics, is that it provides a much longer time. The pain relief as compared to steroid injections. Thankfully a showing significantly beneficial results for sacroiliac joint pain.

SI joint arthritisFuture research will delineate the best methods of applying this technique and sacroiliac joint pain. When used in conjunction with existing pain management medications and therapies, it presents hope to those dealing with pain emanating from this joint.

Pain clinics in Las Vegas often provide RFA treatments, which are also known as radiofrequency lesioning. When looking for a Henderson or Las Vegas pain clinic, make sure RFA is offered.

Where Could Your Shoulder Pain be Coming From?

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At some point during life, two out of three individuals will experience shoulder pain. For a decent amount of those people who have shoulder pain, it is not actually coming from the shoulder. Where else could it be coming from?Pain Management Las Vegas

One of the most common areas of shoulder pain coming from outside the joint is from the neck. If an individual has either a herniated disc that is pushing on a cervical nerve roots or spinal stenosis that is pushing on one or multiple nerve roots, that can lead to referred pain in the shoulder that may masquerade as originating from the shoulder.

Another source of pain that refers to the shoulder is from the biceps tendon. The biceps itself has two origins, one in the shoulder and one actually outside it. If it’s gets inflamed and tendinitis is occurring, a person may complain of shoulder pain when actuality it is coming from the tendon and should be treated as such.

It is a little-known fact that carpal tunnel syndrome can cause pain that goes backwards into the shoulder. Another potential source of shoulder pain from outside the joint is from

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A cervical herniated disc may lead to pain in the shoulder.

the acromioclavicular joint, called the AC joint for short. This is the joint where the clavicle meets up with the acromion. It is a small joint, but can cause a lot of shoulder area pain if it is arthritic and inflamed.

There is a nerve called the suprascapular nerve that may become pinched in the spinoglenoid notch. This may cause pain and weakness in the shoulder, but the source of the pain is actually not in the joint at all.

A cardiac event can refer pain into the shoulder, specifically the left shoulder. This may cause pain that appears to emanate from the shoulder, but in actuality it is occurring from angina or an ongoing cardiac event.

For a physician working up shoulder pain, it is often evident on physical examination that the shoulder is not actually the source of the pain. It also may take a diagnostic Injection into either the joint or the subacromial space to see if that relieves the discomfort. if it does, the shoulder can be assumed as being the generation of the pain.

The most concerning external source of shoulder pain is obviously the potential for a cardiac event, so physicians should have a low threshold for getting this worked up emergently if suspected.

The bottom line here is that just because a person is having shoulder pain, does not mean

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Rotator cuff problems lead to shoulder pain.

that the shoulder is actually causing that pain. It may be coming from somewhere else and simply referring pain in.

If you live in the Las Vegas or Henderson area and are experiencing shoulder pain, a Pain Clinic in Las Vegas can help delineate whether or not your shoulder pain is actually coming from the shoulder. Pain Management Las Vegas Clinics have Board Certified doctors and Las Vegas Chiropractor doctors who are experts in the workup and treatment of shoulder pain.