Patient Education

Aspire Spine and Pain Center would like to be your partner in health care. Feel free to ask your questions and share your concerns with us. We will work with you to develop a wellness program for the care and treatment you need.

We welcome you to our practice and look forward to caring for you.

Aspire Spine and Pain Center provides a full range of medical services including the following:

Back Pain Prevention

At some point in their lives, the great majority of adults will suffer from significant low back pain, usually from an injury at work, at home or at play. Orthopedists, chiropractors, physical therapists, coaches and trainers all have helpful advice regarding back pain prevention. By following their directives, people can minimize the possibility of back injury, and keep themselves healthier in the process. ...

BOTOX® Injections for Migraines

Although known primarily as a treatment for facial frown lines and "crow's feet," BOTOX® Cosmetic, which is made from a type of bacteria known as Clostridium botulinum type A, also helps, according to the American Headache Society, to reduce the severity and frequency of migraine headaches. Migraines are often caused by reactions to certain triggers that stimulate the production of neurotransmitters in nerve cells, producing pain and other debilitating symptoms. ...

Pain Management

An estimated 70 million Americans suffer from chronic pain. Chronic pain is a major medical condition distinctly different from and more complex than acute pain. Whereas acute pain is a normal sensation triggered in the nervous system to alert the body to possible injury, chronic pain is a state in which pain persists, for many months or years, beyond the normal course required by healing. The effects, both economic and personal, associated with chronic pain can be significant. They include loss of income; debt from costly medical treatment; impaired mobility; and anxiety and depression. ...

Arthritis

Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is a common form of arthritis caused by the wearing down of the cartilage that protects the bones of a joint. Rheumatoid arthritis is an autoimmune condition caused by an inflammation in the lining of the joints. Both forms of arthritis cause pain, tenderness, and swelling, and may result in loss of movement in the affected joints. Over time, joints affected by arthritis may become severely damaged. Arthritis occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of a joint or after an injury. It can however, affect people of any age, including children. ...

Back FAQs

The spine is the main support for the human body and provides protection for the spinal cord. It is comprised of 33 vertebrae that permit the body to maintain an upright position as well as to bend. These vertebrae include not only the articulating bones of three regions of the spine, cervical (neck), thoracic (chest), and lumbar lower back), but also the stationary vertebrae of the sacrum and coccyx that make up the bottom of the spine. ...

Cervical Medial-Branch Block

A cervical medial-branch block is an injection administered to diagnose and treat neck, upper-back, shoulder and facial pain, and headaches. The procedure is designed to both relieve symptoms and diagnose their source. By deadening pain signals in the medial-branch nerves (which transmit pain signals from the facet joints to the brain), it is possible to determine whether a particular facet joint (which connects two vertebra) is the source of the pain. ...

Cervicogenic Headache

A cervicogenic headache is a headache that develops from structural abnormalities of the head, neck or spine. A cervicogenic headache may develop as a result of restricted blood flow through the neck and irritation to nerves along the path from the spinal cord to the brain. These abnormalities may be caused by head or neck injuries, infections, tumors or rheumatoid arthritis of the upper cervical spine. Similar to a migraine, this condition can vary in severity and is more common in women than men. ...

Comprehensive Pain Assessment

• Pain is a universal human experience. Millions of people experience pain because of surgical procedures, injuries, cancer, and other diseases. A certain percentage of people experience chronic pain without a known cause. Since assessing pain is the first step toward effective pain management, doctors need to have organized methods of evaluating pain in all of their patients, even if those patients are too young to have mastered spoken language, are uncommunicative, speakers of others languages, or hearing or cognitively impaired.

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  Chronic Pain Syndrome

  Chronic pain syndrome (CPS) is a complex condition, the causes of which are not fully understood. Unlike acute pain, which alerts the patient to a possible injury, infection, or disease, chronic pain persists in the absence of evident damage. While the patient may have suffered a traumatic injury or disorder, in patients with CPS, pain persists even after the injury is healed or the disease is cured, continuing to interfere with the patient's quality of life, or even creating serious disability. Patients are considered to have CPS when they continue to suffer pain well beyond the expected time needed for healing, typically more than 6 months or 1 year. ...

  
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  Corticosteroid Injections

  Corticosteroid injections have been used for decades to temporarily relieve pain and inflammation in joints and soft tissues, and to relieve systemic inflammatory reactions. The advantage to injecting corticosteroid medication rather than taking it orally is that it is delivered more quickly to the affected area and often has more effective results. Corticosteroid injections are routinely used to reduce the pain and swelling of bursitis, tendonitis and arthritis. In addition, they are helpful in treating lupus, scleroderma and severe allergic reactions. Corticosteroid injections are also very effective in reducing spinal or radiating limb pain (radicular pain) when injected into the epidural space, which is between the dura, the outer layer covering the brain and spinal column, and the spine itself. When used this way, they are referred to as epidurals, which are frequently used for labor pains during childbirth. ...

  
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  Complex Regional Pain Syndrome

  Complex regional pain syndrome, also known as reflex sympathetic dystrophy, is a form of chronic pain that often develops after an injury. The pain experienced is often long-term and intense, and tends to get worse over time instead of getting better. This condition often affects the arms, legs, hands or feet and can spread to nearby areas as it progresses. In addition to pain, patients may also experience swelling, redness and skin sensitivity. The exact cause of complex regional pain syndrome is unknown however it may be linked to emotional stress and a sympathetic nervous system. ...

  
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  Discogram

  A discogram is a diagnostic test performed to determine whether a patient's back pain is the result of a spinal-disc abnormality, and, if so, to pinpoint the disc causing the problem. A discogram is performed by injecting a special dye into the patient's spinal disc(s), and using fluoroscopy to view the area in greater detail. The injection creates pressure on the disc and, if the disc is damaged, causes pain. ...

  
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  Degenerated Discs

  Degenerated discs are a common back problem. The spinal discs, which are soft, gelatinous cushions that separate the vertebrae, wear down during the aging process. Because the discs function as between-the-bones shock absorbers, allowing the spine to bend and twist, this deterioration can result in serious back pain. As discs are damaged or wear away, the amount of space between the vertebrae gets smaller. As the space narrows, joints are placed under greater stress, resulting in further degeneration. ...

  
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  Epidural Steroid Injections

  By reducing inflammation, epidural steroid injections (ESIs) are used to temporarily relieve lumbar (lower back), cervical (neck), thoracic (mid-spine) and sciatic-nerve pain. ESIs contain cortisone and an anesthetic, and are delivered directly to the epidural space, which is the area between the spinal cord and the outer membrane that covers the brain and spinal cord (the dura). As a result, they provide more effective and faster pain relief than oral medications. ...

  
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  Facet-Joint Injections

  Facet-joint injections are both a minimally invasive treatment for back pain caused by inflamed facet joints, and a diagnostic tool for determining whether facet-joint inflammation is a source of pain. Four facet joints connect each vertebra to the vertebra above and below it. A facet-joint injection, administered into either the joint capsule or its surrounding tissue, combines a long-lasting steroid and a local anesthetic. ...

  
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  Fibromyalgia

  Fibromyalgia is a chronic condition that causes fatigue, as well as widespread pain and tenderness in the muscles, ligaments and tendons. People with fibromyalgia have specific tender points on their bodies that are particularly sensitive when pressure is applied. Fibromyalgia is also associated with sleep problems, headaches and trouble concentrating. Women are more likely than men to develop fibromyalgia, as are people between 40 and 60 years old. ...

  
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  Herniated Disc

  A herniated disc (also called a ruptured or slipped disc) is a damaged "cushion" between two bones in the spine (vertebrae). Normally, the gelatinous discs between the vertebrae hold the bones in place and act as shock absorbers, permitting the spine to bend smoothly. When a disc protrudes beyond its normal parameters, and its tough outer layer of cartilage cracks, the disc is considered "herniated." ...

  
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  Intravenous Ketamine Infusion

  An intravenous (IV) infusion of ketamine, an anesthetic, is typically used to treat chronic neuropathic pain disorders in patients who have not responded to other forms of pain management. Chronic neuropathic pain disorders often occur in patients who have experienced a stroke, undergone chemotherapy or spinal cord surgery, or have an existing health problem such as diabetes. Symptoms of neuropathic pain disorders include pains throughout the body, tingling and numbness. The main purpose of an IV ketamine infusion is to reduce the patient's overall pain. ...

  
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  Lumbar Epidural Steroid Injection

  A lumbar epidural steroid injection is a minimally invasive procedure for treating leg, buttock and lower back pain originating from the epidural space. The epidural space surrounds the dura, a membrane which protects the spinal cord and its nerves. The primary reasons for pain in this area are herniated or ruptured discs, stenosis, or sciatica all of which result in nerve compression. The pain may originate in any part of the lumbar region of the spine, including the coccyx, or tailbone, where it is referred to as caudal. ...

  
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  Knee Arthritis

  Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is the most common form of arthritis and it commonly affects the knees. Arthritis of the knee may develop as the cartilage protecting the bones of the knee joint wears down over time. Over the years, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. Arthritis of the knee occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of the knee joint or after an injury. ...

  
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  Lower Back Pain

  Lower back pain is the most common cause for a work-related disability and one of the main reasons for people staying home from work. The lower back is one of the most important parts of the body as it holds most of our body weight when we stand and is involved in movement when we bend or twist at the waist. Because of its pivotal role and frequent use, the lower back is susceptible to injury and chronic pain. Lower back pain is especially common in older adults who may have decreased bone strength and muscle elasticity. The spongy cartilage pads, called intervertebral discs, that allow for flexibility may wear away and weaken in an elderly person. ...

  
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  Lumbar Facet-Joint Injections

  Lumbar facet-joint injections are both a minimally invasive treatment for lower-back pain caused by inflamed facet joints, and a diagnostic tool to determine whether facet-joint inflammation is the source of the pain. Facet joints connect each vertebra to the vertebra above and below it. A facet-joint injection, administered either into the joint capsule or its surrounding tissue, combines a long-lasting corticosteroid with a local anesthetic. Although the anesthetic provides only very temporary pain relief, the corticosteroid reduces inflammation and can relieve pain for up to a few years. Enduring pain relief from the injection is diagnostically significant, indicating that the pain originates in the facet joint that received the injection. ...

  
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  Myofascial Pain

  Myofascial pain syndrome is a chronic condition in which trigger points (muscle knots) develop in certain muscles, usually ones that have been injured or overused. Jobs and recreational activities that involve repetitive motions, in which muscles repeatedly contract, are common causes. Trigger points can also be caused by stress and anxiety. Myofascial pain is most common in middle-aged adults, although people of any age may be affected. ...

  
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  Lumbar Percutaneous Discectomy

  A lumbar percutaneous discectomy may be performed to remove herniated disc material that is pressing on nerves or the spinal cord. The goal of a lumbar percutaneous discectomy is to decompress the nerves by removing deviated disc material and disc fragments. It is a minimally invasive procedure that involves making a very small incision and inserting a tiny surgical needle between the vertebrae, into the middle of the disc. Disc material is removed and as a result, painful nerve pressure is relieved. ...

  
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  Lumbar Sympathetic Nerve Block

  A lumbar sympathetic nerve block is administered to both diagnose and treat pain in the lumbar (lower) region of the spine. It is used to determine whether the lumbar sympathetic nerves, which carry pain impulses from the lower extremities, are the cause of the pain, and, in some cases, serves to eliminate that pain altogether. During the procedure, medication is injected into or around the lumbar sympathetic nerves on one side of the body. ...

  
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  Neuropathic Pain

  Neuropathic pain is a chronic condition caused by damage within the nerve fibers, resulting in the delivery of incorrect signals to the brain. Neuropathic pain, a response to injury to the central nervous or peripheral nervous system, usually causes tissue damage. What makes neuropathic pain so difficult to treat is that it is not only chronic and severe, but unresponsive to simple analgesic relief. ...

  
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  The mild® Procedure

  The mild® procedure is a minimally invasive technique for treating lumbar spinal stenosis (LSS) caused by ligamentum flavum hypertrophy (thickening ligaments). LSS is a narrowing of the lower spinal canal that can cause pain, numbness or tingling in the lower back, legs or buttocks, all of which can lead to difficulty in walking and standing. Study data about patients treated with the mild procedure "show that 79 percent of [LSS] patients experience a significant reduction in pain and significant increase in mobility." According to its manufacturer, Vertos Medical Inc., the mild procedure has received U.S. Food and Drug Administration approval for treating compression in the lower spine. ...

  
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  Neuropathy

  Neuropathy is a condition characterized by damage to a nerve or a group of nerves. It causes functional problems in the affected nerves, including a loss of sensation and difficulty with movement. Neuropathy can cause damage anywhere, as the peripheral nerves branch out from the brain and spinal cord to the muscles, skin and organs throughout the body. The nerves send messages to the brain about sensation and pain in each particular area, so if they are not functioning properly, complications can easily occur. ...

  
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  Pain Medication

  A number of different types of medications may be used to reduce pain in various parts of the body. Any of the medications described below may be helpful in relieving pain, depending on the medical condition of the patient and the severity of the pain being experienced.

  Over-the-Counter Medications

  Over-the-counter medications are frequently helpful in relieving symptomatic pain that is mild to moderate. Such medications may include analgesics such as acetaminophen and non-steroidal anti-inflammatory drugs, or NSAIDS, such as ibuprofen and naproxen. It is important for patients to consult with their physicians regarding appropriate dosages and to avoid possible interactions with prescribed medications or over-the-counter preparations they may be already taking. ...

  
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  Occipital Neuralgia

  Occipital neuralgia is a neurological disorder characterized by inflammation or injury to the occipital nerves. These nerves, one on either side of the head, span from the base of the neck to the scalp. This condition produces terrible headaches that are usually located on one side of the head. At times, the symptoms of these headaches may be similar to those caused by a migraine, so it is essential to undergo an examination that will determine their source. ...

  
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  Phantom Limb Pain

  Phantom limb pain is the feeling of pain or other sensations in a limb that has been amputated. The precise reason this occurs remains unknown, but apparently the brain of the amputee is continuing to receive messages from nerves associated with the amputated limb. Typically, there is the strong sensation that the amputated limb is still attached, and functioning as it was prior to the amputation. ...

  
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  Platelet-Rich Plasma Injections FAQs

  Certain elements within the blood, specifically the platelets, help tissues to heal by stimulating a repair and growth response. Platelet-rich plasma (PRP) injections promote accelerated healing by supplementing the platelet content of an area in which tissue has been damaged. ...

  
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  Piriformis Syndrome

  Piriformis syndrome occurs when the piriformis muscle, which runs from the lower spine to the top of the thigh bone, presses on the sciatic nerve. As a result, it causes pain, tingling and numbness in the buttocks and, often, down the back of the leg. The pain often worsens as a result of sitting for a long period of time, walking, running, or climbing stairs. While piriformis syndrome may occur for no apparent reason or develop after regular physical activity, it is sometimes caused by a a traumatic injury, such as a car accident or a fall. ...

  
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  Platelet-Rich-Plasma Injections

  Platelet-rich-plasma (PRP) injections use components of the body's own blood to stimulate healing. Platelets, which are usually associated with coagulation (clotting), are also, according to recent research, able to assist in mending and strengthening damaged tissue by increasing certain growth factors. During the normal healing process, the body uses platelets to promote new-tissue growth and repair injuries. By supplementing platelet content, the healing process is accelerated. There is ongoing research on the efficacy of PRP injections, and some medical professionals remain skeptical about their value. ...

  
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  Post-Laminectomy Syndrome

  Post-laminectomy syndrome is a condition in which a patient continues to experience pain and disability after a laminectomy, a type of spinal surgery. During a laminectomy, a piece of the layer of bone covering the back of the spinal cord (the lamina) is removed to eliminate compression on the spinal nerves. This surgery may be performed in conjunction with other back surgery, such as a discectomy, and is most often performed to relieve stenosis, a narrowing of the spinal column. The development of post-laminectomy syndrome is a complication of the procedure. Post-laminectomy syndrome is a type of failed back surgery, a broader category which includes chronic pain following any spinal surgery, including spinal fusion. ...

  
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  Radiofrequency Neurotomy

  Radiofrequency neurotomy is a treatment designed to provide relief from severe pain in the back or neck. It uses the heat generated by radiofrequency waves to interfere with the nerves' ability to send out pain signals. The heat generated by these waves is delivered to targeted nerve areas through special needles that are inserted, just above the spinal area, through the skin. ...

  
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  Sacroiliac Joint Dysfunction

  Sacroiliac joint dysfunction, also known as sacroiliitis, is the inflammation of one or both of the sacroiliac joints, the joints that link the pelvis and lower spine by connecting the sacrum to the iliac bones. Sacroiliac joint dysfunction may be caused by injury, pregnancy, osteoarthritis, degeneration of cartilage, or inflammatory joint disease. At times, a structural abnormality, such as legs of differing lengths or severe pronation, may put increased stress on the joint, resulting in this problem. Patients with sacroiliac joint dysfunction typically experience pain in the buttocks and lower back that worsens when running or standing. While a traumatic injury may cause this problem, it more often develops gradually over a long period. ...

  
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  Sacroiliac-Joint Steroid Injections

  Sacroiliac-joint steroid injections help to diagnose and relieve lower-back pain caused by problems with one or both of the sacroiliac joints, which connect the spine's base (sacrum) to the pelvis's ilium bones. If one or both of the sacroiliac joints is inflamed (sacroiliac-joint dysfunction), a patient can experience pain in the buttocks and lower back that worsens when running or standing. Sacroiliac-joint dysfunction can be caused by osteoarthritis, traumatic injury, pregnancy, inflammatory joint disease, or underlying structural abnormalities. ...

  
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  Sciatica

  Sciatica is an inflammation of the sciatic nerve, the longest nerve in the body. The sciatic nerve stretches from the spinal cord to the end of each leg and may become inflamed for a number of reasons, including age-related changes in the spine, obesity, or a sedentary lifestyle. Sciatica usually develops gradually as the nerve is compressed over time. This results in pain along the nerve pathway, as well as numbness, tingling and muscle weakness in the affected area. ...

  
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  Spinal Cord Stimulation (SCS)

  Spinal cord stimulation (SCS) typically involves implanting an electronic device in the body to help relieve chronic back and leg pain. The device, called a "spinal cord stimulator" or "dorsal column stimulator," sends electrical impulses through wires/electrodes placed near the spinal cord; the impulses block pain signals from reaching the brain. SCS does not cure chronic pain, but usually lessens it by 50 percent and more by replacing a patient's feeling of pain with a tingling sensation. Before implantation, a patient is asked to go through a trial period with an external device; this allows pain levels to be evaluated, and determine whether they decrease when the device is used. ...

  
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  Steroid Injections for Arthritis

  Arthritis is a condition that causes, pain, swelling and stiffness in the joints. Treatment for arthritis may vary, but the main goal is to reduce inflammation and pain. Most patients may try several different treatment options before finding a method that works best for their individual condition. Steroid injections are an advanced treatment option for patients with arthritis and other sources of joint pain, that have not responded well to other treatments such as exercise and oral medications. These injections deliver relief directly to the source of the pain and are considered safe for nearly all patients. ...

  
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  Spinal Stenosis

  Spinal stenosis is the narrowing in one or more areas of the spinal canal as a result of injury or deterioration of the discs, joints or bones of the spine. Most cases of spinal stenosis develop as a result of the degenerative changes that occur during aging. Osteoarthritis is the main cause of spinal stenosis, since this condition causes deterioration of cartilage in the area that leads to the bones rubbing against each other. As bones make repeated abnormal contact, bone spurs form, narrowing the spinal canal. ...

  
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  Sympathetic Ganglion Block

  A sympathetic ganglion block is a type of nerve block used in the treatment of severe or chronic pain. It involves the injection of an anesthetic medication that will numb the affected bundle of nerves, a cluster known as a ganglion. These nerves help the body react to stress and are responsible for the fight-or-flight response, a physiological reaction to situations perceived as being dangerous. If the nerves are damaged or compressed in any way, they can produce pain and other symptoms. ...

  
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  Toradol Injections

  Toradol, also known as Ketorolac, is a medication used to relieve acute short-term pain. It is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce swelling in order to promote healing. A Toradol injection, administered either intravenously or intramuscularly, is usually given to provide pain relief after a surgical procedure, followed by up to 5 days of oral administration. While not a narcotic and not addictive, Toradol is nevertheless not meant for use for longer than 5 days. Although a helpful medication for short-term pain relief, Toradol has a great many contraindications and potentially dangerous side effects. ...

  
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  Transforaminal Injections

  A transforaminal injection is an injection of a long-acting corticosteroid into a foramen of the spine, the place where a nerve root exits. The procedure is performed to relieve back pain and numbness in an attempt to avoid surgical intervention. The injection helps to reduce inflammation and swelling which not only relieves pain, but restores sensation and improves mobility. Transforaminal injections are most successful for patients with radicular back pain, or pain that radiates down the arms or legs. They do not work as effectively on other types of back or neck pain. ...

  
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  Trigger-Point Injections

  Trigger-point injections treat pain in areas that have developed trigger points, which are knots of muscle that form when muscles contract and but cannot relax. Trigger points are caused by injury to or overuse of the affected muscle; they can also be caused by stress and anxiety. They can irritate the nerves around them, which causes pain in other areas of the body. The chronic pain brought on by trigger points can also decrease the affected muscle's range of motion. ...

  
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  Ultrasound-Guided Joint Injections

  Joint injections are a minimally invasive treatment for relieving pain caused by inflammatory joint conditions such as rheumatoid arthritis, tendonitis, bursitis and gout. To reduce pain and inflammation from these conditions, medications such as corticosteroids and hyaluronic-acid preparations are sometimes injected into the problem joint. The medications affect only the targeted areas, and usually do not cause side effects. Joint injections are administered under local anesthesia, and cause only brief, mild discomfort. ...

  
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  Vertebroplasty

  Vertebroplasty is a minimally invasive procedure administered to treat vertebral compression fractures with an injection of bone cement directly into the injured tissue. Compression fractures commonly occur as a result of osteoporosis, spinal tumors or injury, and can cause severe pain and limited mobility. They can also lead to abnormal spine curvature and increase a patient's risk for serious spinal complications. When deemed a viable alternative to spinal surgery, a vertebroplasty presents many advantages. Unlike more invasive procedures, a vertebroplasty requires almost no recovery period and results in almost no scarring or bleeding and very little discomfort. In addition, a vertebroplasty can be a method of prevention as well as treatment, since the bone is very unlikely to refracture in the area in which it has been cemented. ...

  
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  Viscosupplementation

  Osteoarthritis is a degenerative joint disease that can affect the knee. It causes the surface layer of cartilage to break down and wear away, and the joint's synovial fluid to lose its ability to lubricate. This combination causes pain, stiffness, limited joint motion, and inflammation in the knee. Osteoarthritis of the knee is often initially treated with pain relievers such as acetaminophen, nonsteroidal anti-inflammatory drugs and corticosteroid injections. However, these methods are not always effective, and can have adverse effects such as gastrointestinal problems, allergic reactions or kidney damage. ...

  
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  Workers' Compensation

  Workers' Compensation is a federal program designed to cover costs for employees whose ability to work is compromised by an injury at the workplace or an occupational disease. Employees receive workers' compensation in exchange for relinquishing their right to sue their employer for negligence, an agreement known as "the compensation bargain." ...

  
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Back Pain Prevention

At some point in their lives, the great majority of adults will suffer from significant low back pain, usually from an injury at work, at home or at play. Orthopedists, chiropractors, physical therapists, coaches and trainers all have helpful advice regarding back pain prevention. By following their directives, people can minimize the possibility of back injury, and keep themselves healthier in the process. ...

BOTOX® Injections for Migraines

Although known primarily as a treatment for facial frown lines and "crow's feet," BOTOX® Cosmetic, which is made from a type of bacteria known as Clostridium botulinum type A, also helps, according to the American Headache Society, to reduce the severity and frequency of migraine headaches. Migraines are often caused by reactions to certain triggers that stimulate the production of neurotransmitters in nerve cells, producing pain and other debilitating symptoms. ...

Pain Management

An estimated 70 million Americans suffer from chronic pain. Chronic pain is a major medical condition distinctly different from and more complex than acute pain. Whereas acute pain is a normal sensation triggered in the nervous system to alert the body to possible injury, chronic pain is a state in which pain persists, for many months or years, beyond the normal course required by healing. The effects, both economic and personal, associated with chronic pain can be significant. They include loss of income; debt from costly medical treatment; impaired mobility; and anxiety and depression. ...

Arthritis

Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is a common form of arthritis caused by the wearing down of the cartilage that protects the bones of a joint. Rheumatoid arthritis is an autoimmune condition caused by an inflammation in the lining of the joints. Both forms of arthritis cause pain, tenderness, and swelling, and may result in loss of movement in the affected joints. Over time, joints affected by arthritis may become severely damaged. Arthritis occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of a joint or after an injury. It can however, affect people of any age, including children. ...

Back FAQs

The spine is the main support for the human body and provides protection for the spinal cord. It is comprised of 33 vertebrae that permit the body to maintain an upright position as well as to bend. These vertebrae include not only the articulating bones of three regions of the spine, cervical (neck), thoracic (chest), and lumbar lower back), but also the stationary vertebrae of the sacrum and coccyx that make up the bottom of the spine. ...

Cervical Medial-Branch Block

A cervical medial-branch block is an injection administered to diagnose and treat neck, upper-back, shoulder and facial pain, and headaches. The procedure is designed to both relieve symptoms and diagnose their source. By deadening pain signals in the medial-branch nerves (which transmit pain signals from the facet joints to the brain), it is possible to determine whether a particular facet joint (which connects two vertebra) is the source of the pain. ...

Cervicogenic Headache

A cervicogenic headache is a headache that develops from structural abnormalities of the head, neck or spine. A cervicogenic headache may develop as a result of restricted blood flow through the neck and irritation to nerves along the path from the spinal cord to the brain. These abnormalities may be caused by head or neck injuries, infections, tumors or rheumatoid arthritis of the upper cervical spine. Similar to a migraine, this condition can vary in severity and is more common in women than men. ...

Comprehensive Pain Assessment

Pain is a universal human experience. Millions of people experience pain because of surgical procedures, injuries, cancer, and other diseases. A certain percentage of people experience chronic pain without a known cause. Since assessing pain is the first step toward effective pain management, doctors need to have organized methods of evaluating pain in all of their patients, even if those patients are too young to have mastered spoken language, are uncommunicative, speakers of others languages, or hearing or cognitively impaired. ...

Chronic Pain Syndrome

Chronic pain syndrome (CPS) is a complex condition, the causes of which are not fully understood. Unlike acute pain, which alerts the patient to a possible injury, infection, or disease, chronic pain persists in the absence of evident damage. While the patient may have suffered a traumatic injury or disorder, in patients with CPS, pain persists even after the injury is healed or the disease is cured, continuing to interfere with the patient's quality of life, or even creating serious disability. Patients are considered to have CPS when they continue to suffer pain well beyond the expected time needed for healing, typically more than 6 months or 1 year. ...

Corticosteroid Injections

Corticosteroid injections have been used for decades to temporarily relieve pain and inflammation in joints and soft tissues, and to relieve systemic inflammatory reactions. The advantage to injecting corticosteroid medication rather than taking it orally is that it is delivered more quickly to the affected area and often has more effective results. Corticosteroid injections are routinely used to reduce the pain and swelling of bursitis, tendonitis and arthritis. In addition, they are helpful in treating lupus, scleroderma and severe allergic reactions. Corticosteroid injections are also very effective in reducing spinal or radiating limb pain (radicular pain) when injected into the epidural space, which is between the dura, the outer layer covering the brain and spinal column, and the spine itself. When used this way, they are referred to as epidurals, which are frequently used for labor pains during childbirth. ...

Complex Regional Pain Syndrome

Complex regional pain syndrome, also known as reflex sympathetic dystrophy, is a form of chronic pain that often develops after an injury. The pain experienced is often long-term and intense, and tends to get worse over time instead of getting better. This condition often affects the arms, legs, hands or feet and can spread to nearby areas as it progresses. In addition to pain, patients may also experience swelling, redness and skin sensitivity. The exact cause of complex regional pain syndrome is unknown however it may be linked to emotional stress and a sympathetic nervous system. ...

Discogram

A discogram is a diagnostic test performed to determine whether a patient's back pain is the result of a spinal-disc abnormality, and, if so, to pinpoint the disc causing the problem. A discogram is performed by injecting a special dye into the patient's spinal disc(s), and using fluoroscopy to view the area in greater detail. The injection creates pressure on the disc and, if the disc is damaged, causes pain. ...

Degenerated Discs

Degenerated discs are a common back problem. The spinal discs, which are soft, gelatinous cushions that separate the vertebrae, wear down during the aging process. Because the discs function as between-the-bones shock absorbers, allowing the spine to bend and twist, this deterioration can result in serious back pain. As discs are damaged or wear away, the amount of space between the vertebrae gets smaller. As the space narrows, joints are placed under greater stress, resulting in further degeneration. ...

Epidural Steroid Injections

By reducing inflammation, epidural steroid injections (ESIs) are used to temporarily relieve lumbar (lower back), cervical (neck), thoracic (mid-spine) and sciatic-nerve pain. ESIs contain cortisone and an anesthetic, and are delivered directly to the epidural space, which is the area between the spinal cord and the outer membrane that covers the brain and spinal cord (the dura). As a result, they provide more effective and faster pain relief than oral medications. ...

Facet-Joint Injections

Facet-joint injections are both a minimally invasive treatment for back pain caused by inflamed facet joints, and a diagnostic tool for determining whether facet-joint inflammation is a source of pain. Four facet joints connect each vertebra to the vertebra above and below it. A facet-joint injection, administered into either the joint capsule or its surrounding tissue, combines a long-lasting steroid and a local anesthetic. ...

Fibromyalgia

Fibromyalgia is a chronic condition that causes fatigue, as well as widespread pain and tenderness in the muscles, ligaments and tendons. People with fibromyalgia have specific tender points on their bodies that are particularly sensitive when pressure is applied. Fibromyalgia is also associated with sleep problems, headaches and trouble concentrating. Women are more likely than men to develop fibromyalgia, as are people between 40 and 60 years old. ...

Herniated Disc

A herniated disc (also called a ruptured or slipped disc) is a damaged "cushion" between two bones in the spine (vertebrae). Normally, the gelatinous discs between the vertebrae hold the bones in place and act as shock absorbers, permitting the spine to bend smoothly. When a disc protrudes beyond its normal parameters, and its tough outer layer of cartilage cracks, the disc is considered "herniated." ...

Intravenous Ketamine Infusion

An intravenous (IV) infusion of ketamine, an anesthetic, is typically used to treat chronic neuropathic pain disorders in patients who have not responded to other forms of pain management. Chronic neuropathic pain disorders often occur in patients who have experienced a stroke, undergone chemotherapy or spinal cord surgery, or have an existing health problem such as diabetes. Symptoms of neuropathic pain disorders include pains throughout the body, tingling and numbness. The main purpose of an IV ketamine infusion is to reduce the patient's overall pain. ...

Knee Arthritis

Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is the most common form of arthritis and it commonly affects the knees. Arthritis of the knee may develop as the cartilage protecting the bones of the knee joint wears down over time. Over the years, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. Arthritis of the knee occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of the knee joint or after an injury. ...

Lumbar Epidural Steroid Injection

A lumbar epidural steroid injection is a minimally invasive procedure for treating leg, buttock and lower back pain originating from the epidural space. The epidural space surrounds the dura, a membrane which protects the spinal cord and its nerves. The primary reasons for pain in this area are herniated or ruptured discs, stenosis, or sciatica all of which result in nerve compression. The pain may originate in any part of the lumbar region of the spine, including the coccyx, or tailbone, where it is referred to as caudal. ...

Lower Back Pain

Lower back pain is the most common cause for a work-related disability and one of the main reasons for people staying home from work. The lower back is one of the most important parts of the body as it holds most of our body weight when we stand and is involved in movement when we bend or twist at the waist. Because of its pivotal role and frequent use, the lower back is susceptible to injury and chronic pain. Lower back pain is especially common in older adults who may have decreased bone strength and muscle elasticity. The spongy cartilage pads, called intervertebral discs, that allow for flexibility may wear away and weaken in an elderly person. ...

Lumbar Facet-Joint Injections

Lumbar facet-joint injections are both a minimally invasive treatment for lower-back pain caused by inflamed facet joints, and a diagnostic tool to determine whether facet-joint inflammation is the source of the pain. Facet joints connect each vertebra to the vertebra above and below it. A facet-joint injection, administered either into the joint capsule or its surrounding tissue, combines a long-lasting corticosteroid with a local anesthetic. Although the anesthetic provides only very temporary pain relief, the corticosteroid reduces inflammation and can relieve pain for up to a few years. Enduring pain relief from the injection is diagnostically significant, indicating that the pain originates in the facet joint that received the injection. ...

Myofascial Pain

Myofascial pain syndrome is a chronic condition in which trigger points (muscle knots) develop in certain muscles, usually ones that have been injured or overused. Jobs and recreational activities that involve repetitive motions, in which muscles repeatedly contract, are common causes. Trigger points can also be caused by stress and anxiety. Myofascial pain is most common in middle-aged adults, although people of any age may be affected. ...

Lumbar Percutaneous Discectomy

A lumbar percutaneous discectomy may be performed to remove herniated disc material that is pressing on nerves or the spinal cord. The goal of a lumbar percutaneous discectomy is to decompress the nerves by removing deviated disc material and disc fragments. It is a minimally invasive procedure that involves making a very small incision and inserting a tiny surgical needle between the vertebrae, into the middle of the disc. Disc material is removed and as a result, painful nerve pressure is relieved. ...

Lumbar Sympathetic Nerve Block

A lumbar sympathetic nerve block is administered to both diagnose and treat pain in the lumbar (lower) region of the spine. It is used to determine whether the lumbar sympathetic nerves, which carry pain impulses from the lower extremities, are the cause of the pain, and, in some cases, serves to eliminate that pain altogether. During the procedure, medication is injected into or around the lumbar sympathetic nerves on one side of the body. ...

Neuropathic Pain

Neuropathic pain is a chronic condition caused by damage within the nerve fibers, resulting in the delivery of incorrect signals to the brain. Neuropathic pain, a response to injury to the central nervous or peripheral nervous system, usually causes tissue damage. What makes neuropathic pain so difficult to treat is that it is not only chronic and severe, but unresponsive to simple analgesic relief. ...

The mild® Procedure

The mild® procedure is a minimally invasive technique for treating lumbar spinal stenosis (LSS) caused by ligamentum flavum hypertrophy (thickening ligaments). LSS is a narrowing of the lower spinal canal that can cause pain, numbness or tingling in the lower back, legs or buttocks, all of which can lead to difficulty in walking and standing. Study data about patients treated with the mild procedure "show that 79 percent of [LSS] patients experience a significant reduction in pain and significant increase in mobility." According to its manufacturer, Vertos Medical Inc., the mild procedure has received U.S. Food and Drug Administration approval for treating compression in the lower spine. ...

Neuropathy

Neuropathy is a condition characterized by damage to a nerve or a group of nerves. It causes functional problems in the affected nerves, including a loss of sensation and difficulty with movement. Neuropathy can cause damage anywhere, as the peripheral nerves branch out from the brain and spinal cord to the muscles, skin and organs throughout the body. The nerves send messages to the brain about sensation and pain in each particular area, so if they are not functioning properly, complications can easily occur. ...

Pain Medication

A number of different types of medications may be used to reduce pain in various parts of the body. Any of the medications described below may be helpful in relieving pain, depending on the medical condition of the patient and the severity of the pain being experienced.

Over-the-Counter Medications

Over-the-counter medications are frequently helpful in relieving symptomatic pain that is mild to moderate. Such medications may include analgesics such as acetaminophen and non-steroidal anti-inflammatory drugs, or NSAIDS, such as ibuprofen and naproxen. It is important for patients to consult with their physicians regarding appropriate dosages and to avoid possible interactions with prescribed medications or over-the-counter preparations they may be already taking. ...

Occipital Neuralgia

Occipital neuralgia is a neurological disorder characterized by inflammation or injury to the occipital nerves. These nerves, one on either side of the head, span from the base of the neck to the scalp. This condition produces terrible headaches that are usually located on one side of the head. At times, the symptoms of these headaches may be similar to those caused by a migraine, so it is essential to undergo an examination that will determine their source. ...

Phantom Limb Pain

Phantom limb pain is the feeling of pain or other sensations in a limb that has been amputated. The precise reason this occurs remains unknown, but apparently the brain of the amputee is continuing to receive messages from nerves associated with the amputated limb. Typically, there is the strong sensation that the amputated limb is still attached, and functioning as it was prior to the amputation. ...

Platelet-Rich Plasma Injections FAQs

Certain elements within the blood, specifically the platelets, help tissues to heal by stimulating a repair and growth response. Platelet-rich plasma (PRP) injections promote accelerated healing by supplementing the platelet content of an area in which tissue has been damaged. ...

Piriformis Syndrome

Piriformis syndrome occurs when the piriformis muscle, which runs from the lower spine to the top of the thigh bone, presses on the sciatic nerve. As a result, it causes pain, tingling and numbness in the buttocks and, often, down the back of the leg. The pain often worsens as a result of sitting for a long period of time, walking, running, or climbing stairs. While piriformis syndrome may occur for no apparent reason or develop after regular physical activity, it is sometimes caused by a a traumatic injury, such as a car accident or a fall. ...

Platelet-Rich-Plasma Injections

Platelet-rich-plasma (PRP) injections use components of the body's own blood to stimulate healing. Platelets, which are usually associated with coagulation (clotting), are also, according to recent research, able to assist in mending and strengthening damaged tissue by increasing certain growth factors. During the normal healing process, the body uses platelets to promote new-tissue growth and repair injuries. By supplementing platelet content, the healing process is accelerated. There is ongoing research on the efficacy of PRP injections, and some medical professionals remain skeptical about their value. ...

Post-Laminectomy Syndrome

Post-laminectomy syndrome is a condition in which a patient continues to experience pain and disability after a laminectomy, a type of spinal surgery. During a laminectomy, a piece of the layer of bone covering the back of the spinal cord (the lamina) is removed to eliminate compression on the spinal nerves. This surgery may be performed in conjunction with other back surgery, such as a discectomy, and is most often performed to relieve stenosis, a narrowing of the spinal column. The development of post-laminectomy syndrome is a complication of the procedure. Post-laminectomy syndrome is a type of failed back surgery, a broader category which includes chronic pain following any spinal surgery, including spinal fusion. ...

Radiofrequency Neurotomy

Radiofrequency neurotomy is a treatment designed to provide relief from severe pain in the back or neck. It uses the heat generated by radiofrequency waves to interfere with the nerves' ability to send out pain signals. The heat generated by these waves is delivered to targeted nerve areas through special needles that are inserted, just above the spinal area, through the skin. ...

Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction, also known as sacroiliitis, is the inflammation of one or both of the sacroiliac joints, the joints that link the pelvis and lower spine by connecting the sacrum to the iliac bones. Sacroiliac joint dysfunction may be caused by injury, pregnancy, osteoarthritis, degeneration of cartilage, or inflammatory joint disease. At times, a structural abnormality, such as legs of differing lengths or severe pronation, may put increased stress on the joint, resulting in this problem. Patients with sacroiliac joint dysfunction typically experience pain in the buttocks and lower back that worsens when running or standing. While a traumatic injury may cause this problem, it more often develops gradually over a long period. ...

Sacroiliac-Joint Steroid Injections

Sacroiliac-joint steroid injections help to diagnose and relieve lower-back pain caused by problems with one or both of the sacroiliac joints, which connect the spine's base (sacrum) to the pelvis's ilium bones. If one or both of the sacroiliac joints is inflamed (sacroiliac-joint dysfunction), a patient can experience pain in the buttocks and lower back that worsens when running or standing. Sacroiliac-joint dysfunction can be caused by osteoarthritis, traumatic injury, pregnancy, inflammatory joint disease, or underlying structural abnormalities. ...

Sciatica

Sciatica is an inflammation of the sciatic nerve, the longest nerve in the body. The sciatic nerve stretches from the spinal cord to the end of each leg and may become inflamed for a number of reasons, including age-related changes in the spine, obesity, or a sedentary lifestyle. Sciatica usually develops gradually as the nerve is compressed over time. This results in pain along the nerve pathway, as well as numbness, tingling and muscle weakness in the affected area. ...

Spinal Cord Stimulation (SCS)

Spinal cord stimulation (SCS) typically involves implanting an electronic device in the body to help relieve chronic back and leg pain. The device, called a "spinal cord stimulator" or "dorsal column stimulator," sends electrical impulses through wires/electrodes placed near the spinal cord; the impulses block pain signals from reaching the brain. SCS does not cure chronic pain, but usually lessens it by 50 percent and more by replacing a patient's feeling of pain with a tingling sensation. Before implantation, a patient is asked to go through a trial period with an external device; this allows pain levels to be evaluated, and determine whether they decrease when the device is used. ...

Steroid Injections for Arthritis

Arthritis is a condition that causes, pain, swelling and stiffness in the joints. Treatment for arthritis may vary, but the main goal is to reduce inflammation and pain. Most patients may try several different treatment options before finding a method that works best for their individual condition. Steroid injections are an advanced treatment option for patients with arthritis and other sources of joint pain, that have not responded well to other treatments such as exercise and oral medications. These injections deliver relief directly to the source of the pain and are considered safe for nearly all patients. ...

Spinal Stenosis

Spinal stenosis is the narrowing in one or more areas of the spinal canal as a result of injury or deterioration of the discs, joints or bones of the spine. Most cases of spinal stenosis develop as a result of the degenerative changes that occur during aging. Osteoarthritis is the main cause of spinal stenosis, since this condition causes deterioration of cartilage in the area that leads to the bones rubbing against each other. As bones make repeated abnormal contact, bone spurs form, narrowing the spinal canal. ...

Sympathetic Ganglion Block

A sympathetic ganglion block is a type of nerve block used in the treatment of severe or chronic pain. It involves the injection of an anesthetic medication that will numb the affected bundle of nerves, a cluster known as a ganglion. These nerves help the body react to stress and are responsible for the fight-or-flight response, a physiological reaction to situations perceived as being dangerous. If the nerves are damaged or compressed in any way, they can produce pain and other symptoms. ...

Toradol Injections

Toradol, also known as Ketorolac, is a medication used to relieve acute short-term pain. It is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce swelling in order to promote healing. A Toradol injection, administered either intravenously or intramuscularly, is usually given to provide pain relief after a surgical procedure, followed by up to 5 days of oral administration. While not a narcotic and not addictive, Toradol is nevertheless not meant for use for longer than 5 days. Although a helpful medication for short-term pain relief, Toradol has a great many contraindications and potentially dangerous side effects. ...

Transforaminal Injections

A transforaminal injection is an injection of a long-acting corticosteroid into a foramen of the spine, the place where a nerve root exits. The procedure is performed to relieve back pain and numbness in an attempt to avoid surgical intervention. The injection helps to reduce inflammation and swelling which not only relieves pain, but restores sensation and improves mobility. Transforaminal injections are most successful for patients with radicular back pain, or pain that radiates down the arms or legs. They do not work as effectively on other types of back or neck pain. ...

Trigger-Point Injections

Trigger-point injections treat pain in areas that have developed trigger points, which are knots of muscle that form when muscles contract and but cannot relax. Trigger points are caused by injury to or overuse of the affected muscle; they can also be caused by stress and anxiety. They can irritate the nerves around them, which causes pain in other areas of the body. The chronic pain brought on by trigger points can also decrease the affected muscle's range of motion. ...

Ultrasound-Guided Joint Injections

Joint injections are a minimally invasive treatment for relieving pain caused by inflammatory joint conditions such as rheumatoid arthritis, tendonitis, bursitis and gout. To reduce pain and inflammation from these conditions, medications such as corticosteroids and hyaluronic-acid preparations are sometimes injected into the problem joint. The medications affect only the targeted areas, and usually do not cause side effects. Joint injections are administered under local anesthesia, and cause only brief, mild discomfort. ...

Vertebroplasty

Vertebroplasty is a minimally invasive procedure administered to treat vertebral compression fractures with an injection of bone cement directly into the injured tissue. Compression fractures commonly occur as a result of osteoporosis, spinal tumors or injury, and can cause severe pain and limited mobility. They can also lead to abnormal spine curvature and increase a patient's risk for serious spinal complications. When deemed a viable alternative to spinal surgery, a vertebroplasty presents many advantages. Unlike more invasive procedures, a vertebroplasty requires almost no recovery period and results in almost no scarring or bleeding and very little discomfort. In addition, a vertebroplasty can be a method of prevention as well as treatment, since the bone is very unlikely to refracture in the area in which it has been cemented. ...

Viscosupplementation

Osteoarthritis is a degenerative joint disease that can affect the knee. It causes the surface layer of cartilage to break down and wear away, and the joint's synovial fluid to lose its ability to lubricate. This combination causes pain, stiffness, limited joint motion, and inflammation in the knee. Osteoarthritis of the knee is often initially treated with pain relievers such as acetaminophen, nonsteroidal anti-inflammatory drugs and corticosteroid injections. However, these methods are not always effective, and can have adverse effects such as gastrointestinal problems, allergic reactions or kidney damage. ...

Workers' Compensation

Workers' Compensation is a federal program designed to cover costs for employees whose ability to work is compromised by an injury at the workplace or an occupational disease. Employees receive workers' compensation in exchange for relinquishing their right to sue their employer for negligence, an agreement known as "the compensation bargain." ...