Monthly Archives: May 2014

5 Things You Should Know About – Complex Regional Pain Syndrome

By | Blog | No Comments

What is CRPS?

Complex regional pain syndrome (CRPS) is where chronic pain presents itself in the following locations: an arm, hand, foot, or leg). This occurs after the area had been injured or there has been trauma. There is damage or malfunctioning of the peripheral and central nervous centers with a CRPS diagnosis. This means there will potentially be brain and spinal cord involvement as well as the nerves of the body. What results is pain that is prolonged and unbearable, with changes in the skin color, temperature, and possible swelling in the affected extremity. Symptoms are variable in the duration and the severity of CRPS.

•    There are two kinds of CRPS—CRPS-1 and CRPS-2. They both have similar symptoms but CRPS-II is noted to have confirmed nerve injury. The disorder can occur at any age or gender, however, rare in children under the age of 10 and the elderly. The average age is 40 years old.

•    The key symptom that shows the practitioner that CRPS is the problem is prolonged pain that will not go away. It will feel like “pins and needles” or something has their limb in a vice. The pain may spread beyond the initial area or travel to the opposite extremity. Allodynia, or increased sensitivity in the affected area, can cause extreme discomfort when even the lightest touch is unbearable.

•    Early treatment of complex regional pain syndrome is important to avoid more Pain clinic Las Vegasdisabling signs and symptoms, such as tissue wasting and contractures. If you are not moving a limb as much because it hurts to move it, your bones and muscles will not be stimulated enough. This will cause them to weaken and deteriorate. Your muscles will tend to tighten as well and you will have difficulties getting your extremities to straighten and bend as they should.

•    There is no single test that will diagnose CRPS, but there are a few procedures that will give the doctor a clue to whether complex regional pain syndrome. Physical and medical histories are important as well as radiological and other types of tests. A bone scan will detect any bone changes. A thermography is used to measure skin temperature and see how much blood flow is going through your limbs. An x-ray is useful to identify any mineral loss from bones. Magnetic resonance imaging (MRI) may show tissue changes that may be caused by CRPS.

There are effective treatments to help alleviate the pain from chronic regional pain syndrome. A sympathetic nerve block relieves the pain of CRPS by injecting an anesthetic in the area of the spine to block the communication of sympathetic nerves. It also improves blood flow.

Pain center Las VegasPain Management Doctors in Las Vegas performs sympathetic nerve blocks as an outpatient procedure. Numbing medication is used to alleviate any pain at the injection site. Intravenous sedation may be used.

Pain Clinics Las Vegas typically uses fluoroscopy which aids in the best needle placement. Contrast dye is used so that nerves are visible in the x-ray. Numbing medication will be injected and phenol that will deaden the sympathetic nerves to reduce pain sensations.

Make an appointment at the leading pain clinic in the area. Nevada Pain accepts over 50 insurances. Let Nevada Pain Clinics In Las Vegas help. With board-certified physicians and state-of-the-art treatment options, success rates are over 95% with the combination of medical and other therapies used
Call (702) 323-0553 for more information.

FAQ’s About Arthritis Of The Foot And Ankle

By | Blog | No Comments

As a person grows older, he or she may experience more pain and stiffness in their feet and ankles. This could be attributed to arthritis developing. People tend to ignore the pain until it becomes unbearable. If it isn’t treated in a timely manner, this can compromise a person’s quality of life where it is difficult to walk and do the normal things in daily life. With early treatment, arthritis can be managed so that a patient can continue to live life at the fullest.

 

What is Arthritis?

Arthritis is a condition that refers to the deterioration of the parts of the joint. Osteoarthritis is the most common type and results from the wearing down with use and is associated with increasing age. When the joint wears down, the area will become inflamed. It will be evident by the swelling, redness, and pain around the joint. Common places that people experience this is in the neck, back, shoulders, knees, and hands, but the feet and ankles can be affected as well.

Rheumatoid arthritis is another type of arthritis that occurs. It is caused by an irritation of the lining of the joint called the synovium. Rheumatoid arthritis will develop in the foot and ankle in people who has had the disease for 10 years or more.

Gout, ankylosing spondylitis,psoriatic arthritis andlupus are other kinds of arthritis.

Who Is At Risk?

There are more than 100 types of arthritis and this condition affects over 46 million adults in the U. S. Elderly people are more susceptible since aging plays a factor in osteoarthritis development. The fact that about 50% of the 60-70 year old age group has arthritis in their feet and ankles without symptoms should be noted. This age bracket will need to be evaluated so that arthritis is found early on before problems arise.

How Do You Treat It?

With the varying types of arthritis, one treatment does not help each one. There is a need to treat the different types by the cause of the arthritis, so proper diagnosis is essential. Proper treatment to the foot and ankle is imperative to prevent any deformity from arthritis.

After taking a complete medical history and physical examination, a patient will have x-rays and laboratory tests done to check to see what type of arthritis is found. A bone scan, CT scan, or MRI may also be used to evaluate the joints.

If it is confirmed that there is arthritis present, anti-inflammatory medications may be given. An injection of steroid, physical therapy, and/or orthotics (like have pads put in the shoes or custom-made braces) could also be part of the treatment for foot and ankle arthritis. If the arthritis is severe, surgery may be needed. This would entail having the joint cleaned or replacing the joint altogether. Rehabilitation would be needed after surgery, and a special shoe or cast may be worn for a while after the cast is removed.

It is important to see a pain management doctor right away if pain is experienced in the foot or ankle, hindering movement and walking. The earlier arthritis is treated, the better the outcome.

What To Expect From Physical Therapy

By | Blog | No Comments

A Nevada Pain doctor may prescribe a few weeks of physical therapy for certain patients along with other treatments recommended. Many people do not see the value of physical therapy and see it as a chore to go to multiple appointments every week. However, physical therapy is an important tool in helping patients which their highest potential of reaching normal functioning after surgery or injury. A physical therapist can be the best ally in enabling the body to reach its fullest potential when recovering from an injury, surgery, or illness.

What is Physical Therapy?

Physical therapists are professionals that help their patients improve their mobility and Chiropractormake movement as pain-free as possible. It is their goal to get their patients moving and able to perform daily activities the best as they can. Patients come to them in pain or the inability to move properly. Surgery may have made it impossible to move limbs that had become atrophied from non-use. Physical therapists identify the problems that can hinder optimal movement and work with their patients to improve the motion. It does take several visits to reach the goals set by the doctor and the therapist.

Reasons to Have PT:

•    To avoid surgery and/or medication.

•    Learn more about taking care of your body.

•    Protecting your joints to avoid reinjuring them.

•    Manual therapy.

•    Making your home safe.

•    Using assistive devices such as crutches.

•    Performing your daily tasks safely.

•    Doing home exercises designed specifically for the individual.

The physical therapist is essential to help patients rehabilitate from any major injury or surgery, but evidence shows that PT may be an equally effective alternative to surgery or strong pain medication. It is cheaper and less invasive than either of the options and the patients’ outcomes are much more positive in many cases. Conditions such as back pain to osteoarthritis of the knee can be treated with physical therapy.

Manual therapy is what physical therapists do to promote relaxation, alleviate pain, and increase flexibility. This cannot be done by the patient but by the licensed therapist.

Massage is one of the techniques used where pressure is applied to muscles to help increase the blood flow and ease the pain in the affected areas. Mobilization of the bones and joints entails twisting, pulling, or pushing them in short, precise movements to increase flexibility and encourage alignment. Joint manipulation is used to put pressure on the affected joint and the controlled force can help move it back in place or make it move better for the patient.

Specialized treatments

Some physical therapists specialize in other kinds of treatment. Vestibular rehabilitation (for people with problems with vertigo) and decongestive lymphatic drainage are among treatments available to patients. Patients with cancer may develop problems with movement where PT can help. Urinary incontinence and pelvic pain can be prescribed exercises and treatment from a physical therapist as well. Wound care for people with diabetes is something a trained physical therapist can treat.

As one can see, physical therapy is more than just for athletes. Physical therapy is useful for any patient seeking relief from pain and discomfort.

Pain center Las VegasThe Nevada Pain of Las Vegas accepts over 50 insurances and offers the best in pain treatment in the metropolitan area. Call (702) 323-0553 for more information and scheduling with the best board-certified pain physicians. For more information, please visit – Pain Specialists Las Vegas.

FAQ’s About Platelet-Rich Plasma (PRP) Therapy

By | Blog | No Comments

The treatment that has people talking when it comes to its therapeutic healing is Platelet-Rich Plasma, or PRP. This type of therapy is targeted to facilitate healing in the joints where blood flow is not as it is in other parts of the body. The treatment has been shown to be effective in speeding the healing process because of the growth factors in blood platelets. The concentration of the growth factors in the injured area stimulates

Platelet Rich Plasma Las Vegas

PRP has growth factors for regeneration and also calls in stem cells.

healing and has been shown to accelerate the process. This is important to athletes who experience tennis elbow or other injuries with tendon involvement.

What Is Platelet-rich Plasma (PRP)?

Blood contains plasma, red blood cells, white blood cells, and platelets. The platelets contain growth factors which are essential in healing injuries. In order to get a rich supply of PRP, blood is drawn from the patient. The vial of blood is placed in a device called the centrifuge where it is spun at a high velocity. The platelets will separate from the rest of the blood components and will be concentrated so that it is between 5-10 times greater than normal. This will be the PRP preparation that will be injected to the injured area.

How does the PRP preparation work?

PRP, with local anesthetic, will be carefully injected into the affected area where there is evidence of swelling. It usually takes several weeks before the patient starts to improve, whereas pain subsides. In the first couple of weeks, pain may even get worse before it gets better.

What type of injuries can be treated with PRP?

There are many injuries that can be treated with a PRP injection. Achilles tendonitis is a common injury that runners experience, as well as tennis players and other athletes. The heel cord in the foot can get twist or pulled, causing swelling and inflammation, causing it to be difficult to walk on. PRP will be helpful to address this by injecting it into the tissue. If the heel cord is torn where surgery is needed, PRP can be useful to speed up the healing as well.

The PRP would be prepared in a different way by allowing it to be stitched into the torn tissues during the surgical procedure.

Injuries such as tennis elbow, which is an injury of the tendons on the outside of the elbow, and jumper’s knee (inflammation of the tendon in the knee) are also treated with PRP injections. Tendon injuries respond best with these treatments though muscle and ligament injuries may be treated as well. Research continues to be done on the effectiveness of PRP for knee arthritis, fractures, muscle and ligament injuries, and surgical interventions. A factor that seems to impact the efficacy of platelet rich plasma treatment is the area of the body being treated. The overall health of the patient with the Pain center Las Vegasinjury is also a consideration. The injury heals best if it is treated as early as possible, so a chronic injury that has been developing over time will not respond as favorably.

The Board Certified Las Vegas pain management doctors at Nevada Pain offer cutting edge treatments such as Platelet Rich Plasma injections.

With over 50 insurances accepted at Nevada Pain, call for an appointment at (702) 323-0553.

 

An overview of Botox treatment for migraines

By | Pain Management | No Comments

A migraine refers to a specific type of headache: this headache is a unilateral (one sided), pulsating, or throbbing headache that lasts anywhere from two to four hours, and can be associated with an “aura” of associated symptoms, such as nausea, vomiting, photophobia Migraine specialist Las Vegas(sensitivity to light), and transient neurological symptoms.

This pain is typically recurring, and can be associated with specific triggers that the patient can identify. The headache from migraine is also aggravated by external stimuli, such as loud sounds, bright lights, and physical activity.

Migraine affects a significant portion of the global population, going as high as 15 percent in some estimates. The prevalence among women (19 percent) is significantly higher than that among men (11 percent).

The cause of migraine has many theories. Some researchers point to the increased excitability of the cerebral cortex and abnormal firing of pain neurons in the trigeminal nucleus. Changes in serotonin levels have also been observed, and these can cause spasms and dilations of tMigraine Headachehe blood vessels in the brain, causing the headache. Hormonal changes, food, environment, and emotional stressors have also been implicated in triggering migraine.

Typically, migraine is managed using medications, such as painkillers. There is a stepwise progression in painkillers, with non-steroidal anti-inflammatory drugs (NSAIDs) being prescribed prior to opioid analgesics. Prophylactic medication with topimarate, propranolol, metoprolol and sodium valproate have been shown to reduce the frequency and severity of attacks for those with chronic migraine.

One of the more recent novel interventions for treatment of migraine is the injection of Botulinum toxin type A, or “botox” as it is colloquially known. Botox is a purified form of neurotoxin that is produced by the bacterium Clostridium botulinum, which works by interfering in the transmission of signals between the nerve and muscle. Botox causes local muscle paralysis, and its use in dermatologic procedures to smooth out wrinkles is widely Pain center Las Vegasknown.

Researchers have found that injections with Botulinum toxin are effective in reducing the frequency of headaches, as well as significantly improving the patient’s quality of life. This seems to be the best application for Botox, as it has not been shown to be better than placebo in the treatment of acute headaches.

The FDA has approved Botox injections for chronic migraine treatment. This provides the ability to reduce the frequency and severity of migraine headaches. The injections take about 20 minutes and involve 30 injections. They can be repeated every few months, and the results are typically excellent.

The injections have been proven to be generally well tolerated by patients, with neck pain appearing in 9 percent of patients. Other side effects of the injections include itching, pain in the injection site, as well as muscle aching, tightness, or spasms.

It is still not understood how botulinum toxin provides effective reduction in the frequency and severity of migraines. There have been several theories offered, and these include:

  • Botulinum toxin causes local muscle paralysis. This relaxation of the muscles around the head may reduce blood pressure within the brain. It may also decrease muscular spasm, a possible cause of the headache.
  • Botulinum toxin may interfere with the ability of the nerves to send pain signals
  • Botulinum toxin may directly interfere with the transmission of signals that triggers an attack of migraine

Botox works is still not suggested as a first-line therapy. It should be reserved until initial therapy with oral medications has failed.

The Board Certified Las Vegas pain management doctors at Nevada Pain offer cutting edge treatments including radiofrequency ablation, spinal cord stimulator implants, several types of epidural injections along with the Botox injections.

Over 50 insurances are accepted at Nevada Pain and there is both a Las Vegas pain clinic and a Henderson pain management center. Call (702) 323-0553 for more information and scheduling with a headache clinic Las Vegas trusts!

FAQS on Vertebroplasty and Kyphoplasty from a Las Vegas Pain Center

By | Blog | No Comments

Vertebroplasty and Kyphoplasty are two very similar, minimally invasive procedures for repairing fractured vertebrae by means of medical grade bone cement (polymethymethacrylate), a type of adhesive filler used to facilitate healing of bone fractures.Pain Clinic Las Vegas

What conditions are treatable with Vertebroplasty and Kyphoplasty?

Vertebroplasty and Kyphoplasty are both procedures for repairing fractured vertebrae caused by injury or more often, osteoporosis (An evidence-based analysis of vertebroplasty and kyphoplasty 2013)..

What can a patient expect when they receive a Vertebroplasty or Kyphoplasty?

If a patient receives a Vertebroplasty or Kyphoplasty to repair a fractured vertebra they can expect to have nearly immediate results of a successful repair as the procedures are very effective and the cement used is fast drying. Often with fractured vertebra caused by osteoporosis the patient does not experience pain.

Often times they may not even be aware they have a fracture vertebra due to the slow degradation process of osteoporosis. If left untreated often the fractured vertebra will heal without treatment, however this is not always the case. Before the Vertebroplasty and Kyphoplasty this was standard practice, to allow the fractures to heal themselves, but this could take several months of bedrest (Current concepts of percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures: evidence-based review 2013).

Las Vegas Pain instituteVertebral fractures, even if not painful, may cause problems later, often causing the nearby vertebrae to also fracture due to the added stresses on them. This can eventually lead to conditions that are painful if bone fragments contact the disc or nerves or the vertebrae becomes so deteriorated that it collapses and contacts the associated nerves.

If left unattended vertebral fractures can become a very serious issue so addressing these fractures early is very important. Although cement is only used in the most serious cases, if used it can restore the vertebral height and provide pain relief in as little as ten minutes after the procedure has been completed.

How are the Vertebroplasty and Kyphoplasty performed?

Las Vegas pain managementThe two procedures are very similar; however a Vertebroplasty is a slightly more simple procedure. In the Vertebroplasty, the patient is sedated, but awake, and the cement is injected under pressure into the fractured vertebra. The cement hardens in about ten minutes and stability is restored to the vertebra.

The Kyphoplasty is slightly more involved; in the Kyphoplasty procedure, the patient is put under general anesthesia, although it can be done with just a local. A small incision, approximately one inch is made and a balloon catheter is inserted into the fractured vertebra (Balloon kyphoplasty: an evidence-based analysis 2004).

The balloon is expanded restoring the vertebra to its normal position and then withdrawn. After the vertebra has been restored to its normal position the bone cement is injected under low pressure into the vertebra.  In ten minutes it hardens and stability is restored. This procedure is used when the vertebra is badly damaged or collapsed.

How long do the Vertebroplasty or Kyphoplasty procedures last?

The repair made by Vertebroplasty and Kyphoplasty are permanent, although with Pain Clinics in Las Vegasosteoporosis more vertebra can fracture so along with the repair of the fractured vertebra steps must be taken to try to avoid further fractures. Often calcium supplements are all that are required.

What risk or side effects are associated with Vertebroplasty or Kyphoplasty?

Risks are potentially significant, although typically rare. A patient may have discomfort, bruising, and bleeding at the incision site and rarely infection can occur. Leakage of the cement before fully hardening may occur, if this happens it could potentially leak into the spinal canal and cause compression of a nerve resulting in increased pain levels.

The most serious risk is also the rarest; this is most possible when the cement is injected Pain center Las Vegasunder high pressure. If the cement leaks it is possible for it to be absorbed into the surrounding veins and embolizing the lungs. Embolization of the lungs is potentially fatal.

How successful are Vertebroplasty or Kyphoplasty for the relief of pain?

Patients suffering pain from a fractured vertebra have a 90% chance of experiencing relief from their pain.

Bottom line on Vertebroplasty or Kyphoplasty?

The procedures have been used with great success to repair fractured vertebra and relieve patients’ pain.

Nevada Pain has the top pain management clinics in the greater Las Vegas and Henderson areas. The Las Vegas pain management doctors are Board Certified and Award Winning, offering both medical and interventional pain management. The pain relief success rates are very high at the practice, with over 50 insurances being accepted.

Call (702) 323-0553 for more information and scheduling today!