Pain Management

Physical therapy is a type of treatment you may need when health problems make it hard to move around and do everyday tasks. It helps you move better and may relieve pain. It also helps improve or restore your physical function and your fitness level.

The goal of physical therapy is to make daily tasks and activities easier. For example, it may help with walking, going up stairs, or getting in and out of bed.

Physical therapy can help with recovery after some surgeries. Your doctor may suggest physical therapy for injuries or long-term health problems such asarthritis or chronic obstructive pulmonary disease (COPD). Physical therapy may be used alone or with other treatments.

Prolotherapy treatment in our office
What is Prolotherapy?

Invented in the 1950s by George Hackett, prolotherapy is based on the theory that chronic pain is often caused by laxness of the ligaments that are responsible for keeping a joint stable. When ligaments and associated tendons are loose, the body is said to compensate by using muscles to stabilize the joint. The net result, according to prolotherapy theory, is muscle spasms and pain. Prolotherapy treatment involves injections of chemical irritant solutions into the area around such ligaments. These solutions cause tissue to proliferate (grow), increasing the strength and thickness of ligaments. In turn, this tightens up the joint and presumably relieves the burden on associated muscles, stopping muscle spasms. In the case of arthritic joints, increased ligament strength may allow the joint to function more efficiently, thus reducing pain.

CONDITIONS TREATED BY PROLOTHERAPY:

A balance disorder is a disturbance that causes an individual to feel unsteady, for example when standing or walking. It may be accompanied by feelings of giddiness or wooziness, or having a sensation of movement, spinning, or floating. Balance is the result of several body systems working together: the visual system (eyes), vestibular system (ears) and proprioception (the body’s sense of where it is in space). Degeneration of loss of function in any of these systems can lead to balance deficits. When balance is impaired, an individual has difficulty maintaining upright orientation. For example, an individual may not be able to walk without staggering, or may not even be able to stand. They may have falls or near-falls. When symptoms exist, they may include:

A sensation of dizziness or vertigo.
Lightheadedness or feeling woozy.
Problems reading and difficulty seeing.
Disorientation.

Some individuals may experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. Some reactions to the symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period.

Cognitive dysfunction (disorientation) may occur with vestibular disorders. Cognitive deficits are not just spatial in nature, but also include non-spatial functions such as object recognition memory. Vestibular dysfunction has been shown to adversely affect processes of attention and increased demands of attention can worsen the postural sway associated with vestibular disorders. Recent MRI studies also show that humans with bilateral vestibular damage undergo atrophy of the hippocampus which correlates with their degree of impairment on spatial memory tasks.

Disc Disease
Bulging Disc
A bulging disk is a condition related to the spine, usually the lumbar, or lower back, that occurs when a disk bulges through a crevice in the spine. Disks are the soft, gelatinous material that cushions the vertebrae of the spine. A bulging disk occurs when the disk shifts out of its normal radius and most often occurs simply as a result of age.

Herniated Disc
A spinal disc herniation (prolapsus disci intervertebralis) is a medical condition affecting the spine due to trauma, lifting injuries, or idiopathic causes, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc (discus intervertebralis) allows the soft, central portion (nucleus pulposus) to bulge out beyond the damaged outer rings. Tears are almost always postero-lateral in nature owing to the presence of the posterior longitudinal ligament in the spinal canal. This tear in the disc ring may result in the release of inflammatory chemical mediators which may directly cause severe pain, even in the absence of nerve root compression.

Torn Disc
A torn disc is more severe than a bulge because the membrane that encloses the jelly-like interior of the disc becomes ripped open, allowing the gel to leak out. This creates pressure on the spinal nerves, which generates pain and numbness.

Cervical Radiculopathy (Pinched Nerve)
Some people have neck pain that may radiate into the shoulder and arm. This type of pain is often caused by an injury near the root of a spinal nerve. A nerve root injury is sometimes referred to as a “pinched” nerve. The medical term for this condition is cervical radiculopathy.

Lumbar Radiculopathy
Radicular pain is often secondary to compression or inflammation of a spinal nerve. When the pain radiates down the back of the leg to the calf or foot, it would in lay terms be described as sciatica. This type of pain is often deep and steady, and can usually be reproduced with certain activities and positions, such as sitting or walking.

Degenerative Disc Disease
Degeneration of one or more intervertebral disc(s) of the spine, often called “degenerative disc disease” (DDD) or “degenerative disc disorder”, is a condition that can be painful and can greatly affect the quality of one’s life. While disc degeneration is a normal part of aging and for most people is not a problem, for certain individuals a degenerated disc can cause severe constant chronic pain.

Joint Disease
Arthritis of the Spine
Spinal arthritis occurs in the facet joints (also called vertebral joints). These joints connect vertebrae together and are located in the posterior (rear) portion of the spine.

Facet Joint Syndrome
Facet syndrome is a syndrome in which the zygapophysial joints (synovial diarthroses, from C2 to S1) cause back pain.55% of facet syndrome cases occur in cervical vertebrae, and 31% in lumbar. Facet syndrome can progress to spinal osteoarthritis, which is known as spondylosis. Pathology of the C1-C2 (atlantoaxial) joint, the most mobile of all vertebral segments, accounts for 4% of all spondylosis.

Viral Disease
Herpes Zoster (Shingles)
Herpes zoster (or simply zoster), commonly known as shingles and also known as zona, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. The initial infection with varicella zoster virus (VZV) causes the acute (short-lived) illness chickenpox which generally occurs in children and young people.

Postherpetic Neuralgia
Postherpetic neuralgia (PHN) is a nerve pain due to damage caused by the varicella zoster virus. Typically, the neuralgia is confined to a dermatomic area of the skin and follows an outbreak of herpes zoster (HZ, commonly known as shingles) in that same dermatomic area. The neuralgia typically begins when the HZ vesicles have crusted over and begun to heal, but it can begin in the absence of HZ, in which case zoster sine herpete is presumed (see Herpes zoster).

Nerve Damage
Reflex Sympathetic Dystrophy
Complex regional pain syndrome (CRPS), formerly Reflex Sympathetic Dystrophy or Causalgia, is a chronic progressive disease characterized by severe pain, swelling, and changes in the skin. It often affects an arm or a leg and may spread to another part of the body and is associated with dysregulation of the autonomic nervous system resulting in multiple functional loss, impairment, and disability. Though treatment is often unsatisfactory, early multimodal therapy can cause dramatic improvement or remission of the syndrome in some patients. The International Association for the Study of Pain has proposed dividing CRPS into two types based on the presence of nerve lesion following the injury.

Causalgia
A burning pain often associated with trophic skin changes in the hand or foot, caused by peripheral nerve injury. It may be aggravated by the slightest stimuli or it may be intensified by the emotions. It usually begins several weeks after the initial injury and the pain is described as intense, with patients sometimes taking elaborate precautions to avoid any stimulus that they know could cause a flare-up of symptoms.

Phantom Limb Pain
A phantom limb is the sensation that an amputated or missing limb (even an organ, like the appendix) is still attached to the body and is moving appropriately with other body parts. Approximately 60 to 80% of individuals with an amputation experience phantom sensations in their amputated limb, and the majority of the sensations are painful. Phantom sensations may also occur after the removal of body parts other than the limbs, e.g. after amputation of the breast, extraction of a tooth (phantom tooth pain) or removal of an eye (phantom eye syndrome). The missing limb often feels shorter and may feel as if it is in a distorted and painful position. Occasionally, the pain can be made worse by stress, anxiety, and weather changes. Phantom limb pain is usually intermittent. The frequency and intensity of attacks usually declines with time.

Other Conditions Ischemic Pain
Unpleasant, often excruciating pain associated with decreased blood flow caused by mechanical obstruction, constricting orthopedic casts, or insufficient blood flow that results from injury or surgical trauma. Ischemic pain caused by occlusive arterial disease is often severe and may not be relieved, even with narcotics. The individual with peripheral vascular disease may experience ischemic pain only while exercising because the metabolic demands for oxygen cannot be met as a result of occluded blood flow. The ischemic pain of partial arterial occlusion is not as severe as the abrupt, excruciating pain associated with complete occlusion, such as by an embolus or thrombus.

Failed Back Syndrome
Failed back syndrome (FBS), also called “failed back surgery syndrome” (FBSS), refers to chronic back and/or leg pain that occurs after back (spinal) surgery. It is characterized as a chronic pain syndrome. Multiple factors can contribute to the onset or development of FBS. Contributing factors include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression, anxiety, sleeplessness and spinal muscular deconditioning. An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease.

Myofascial Pain Syndrom
Myofascial pain syndrome is a chronic pain disorder. In myofascial pain syndrome, pressure on sensitive points in your muscles (trigger points) causes pain in seemingly unrelated parts of your body. This is called referred pain.