Options in Pain Management Alice Looney ANP-C Kreisberg Family Pain Management Center Saint Luke s Cornwall Hospital

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Options in Pain Management Alice Looney ANP-C Kreisberg Family Pain Management Center Saint Luke s Cornwall Hospital"

Transcription

1 Options in Pain Management Alice Looney ANP-C Kreisberg Family Pain Management Center Saint Luke s Cornwall Hospital To decrease pain To improve lifestyle To decrease the need for drugs (including narcotics and other potentially hazardous medicines/medications) Goals of Pain Management When is it appropriate to refer to pain management? Conservative Therapies Interventional Options Medical Management What s New in the Regulations Topics 1

2 Chronic long standing pain Acute radicular pain and/or weakness Failed conservative therapy Complex pain not adequately managed in the Primary Care setting Neuropathic Pain/Shingles Metastatic Disease Referral Acute Post Operative Pain Short term Pain lasting only a few days or few weeks New pain of unknown origin Pain requiring urgent intervention Not for Pain Management Lumbar/Cervical radiculopathy Facet disease Sacro Ileac Joint disease Neck, back or Hip Pain Migraine Headaches Poorly controlled Fibromyalgia Sickle Cell Disease Long term pain post trauma Chronic Regional Pain Syndrome Neuropathy/Neuralgia/Post Herpetic Neuralgia Chronic Pancreatitis/long standing abdominal pain Metastatic Disease Diagnoses??? 2

3 Don t jump the gun!!! Time: 50% of acute back pain Resolves in 2 weeks and 80% in 6 weeks with rest With conservative treatment. Where to start??? Physical Therapy 4-6 weeks Stretching Strengthening Modalities : Heat/Ice, Traction, Ultrasound, TENS Non-Narcotic Medications NSAIDS Lidoderm Patches Muscle relaxers Neurontin/Lyrica Cymbalta (SNRI) Compounded Topicals Savella (SNRI) Conventional Options Psychiatric Evaluation May be needed 3

4 Chiropractor Acupuncture Reikki Therapy Massage Therapy Cold Laser Therapy Meditation/Biofeedback Off the Grid Facet Disease/Osteo Arthritis Facet Injections Lumbar/Cervical Patience is a virtue Radiofrequency Ablation Lasts 6-12 months Radicular Pain Disc Herniation Post Laminectomy Syndrome Stenosis Epidural Transforaminal Epidural Interventional Pain Management Chronic Regional Pain Syndrome Stellate Ganglion Block Lumbar Sympathetic Block Blocks are temporary, used to decrease pain to allow more aggressive Physical Therapy and desensitization to decrease loss of function. Usually combined with medications. Migraine Headaches/Occipital Neuralgia Occipital Nerve Block Cervical Facet Injections Botox Injections Interventional Pain Management 4

5 Sacroilitis: Sacro Ileac Joint Injections Chronic Pancreatitis: Celiac Plexus Block Myofacial Pain/Fibromyalgia: Trigger Point Injections OA of the Hip: Intra-articular hip injection Bursitis of the Hip: Bursa Injection Piriformis Syndrome: Piriformis Injection Other Injections Case by case basis. Needs referral Strict screening criteria Exhaust Non Narcotic Options Prior to prescribing narcotic medications Start low and go slow Medical Management Complete History and Physical Review of all prior pain management records Review the radiology No prescription on the first visit Urine Drug screen NYS Prescription monitoring system ISTOP Screening Criteria 5

6 Patient Safety Legal Ramifications Prevent Diversion of medications Requires use of one Pharmacy, random drug screens, single source of medications Defines reasons the contract would be cancelled Narcotics Contract Prescriptions are forged, sold, shared or misdirected in any way Other physicians prescribe my chronic pain medication or any other pain medication for me I do not keep my appointments in Pain Management, Physical Therapy or Psychology without a justifiable reason This Contract will be cancelled if: The Pain Management Provider will slowly reduce and stop my medication Additional narcotic medication will not be provided When appropriate, Non-narcotic alternatives will be suggested If appropriate referral to Detox or Rehab will be facilitated If cancellation of contract occurs 6

7 Tramadol/Ultrcet Butrans Tylenol with Codeine Hydrocodone/Hysingla/ZyhydroER Oxycodone/Oxycontin Dilaudid/Exalgo Nucynta/Nucynta ER MS Contin/MS IR/Embeda Fentanyl Patch/Actiq/Fentora Commonly Used Narcotic Medications Dependence Constipation Difficult Urination Drowsiness Nausea Itching Poor breathing Reduced Sexual Function Side Effects If fiber, increased fluids, stool softeners and a laxative are not effective.. Consider Relistor or Movantik Constipation 7

8 ISTOP * VA/Federal Government do not participate *Batching *Doesn t cross State lines * Fines Tamper Deterrent Technology Regulations Strict Screen Criteria Frequent Drug Screens Interviewing Skills Physical Exam Random Drug Screens NYS Prescription Monitoring System Weeding out the Drug Seekers Huge Allergy List!!!! I m allergic to everything except Oxy Specific Requests The only thing That works for me is Oxy 30 and I need at least 6 a day. Doctor shopping and hopping Frequent ER visits at multiple sites Inconsistent stories during interview Red Flags 8

9 Calling early for refills Missing or lost prescriptions Requesting Narcotics for elders in their care who continue to complain of pain More Red Flags Questions????? 9

DIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN. Arnold J. Weil, M.D., M.B.A. Non-Surgical Orthopaedics, P.C. Atlanta, GA

DIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN. Arnold J. Weil, M.D., M.B.A. Non-Surgical Orthopaedics, P.C. Atlanta, GA DIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN Arnold J. Weil, M.D., M.B.A. Non-Surgical Orthopaedics, P.C. Atlanta, GA MEDICAL ALGORITHM OF REALITY LOWER BACK PAIN Yes Patient will never get better until case

More information

SPA PCP Treatment & Referral Guidelines Pain Management Developed June 1, 2003 Revised - (Format Revisions) November 13, 2006

SPA PCP Treatment & Referral Guidelines Pain Management Developed June 1, 2003 Revised - (Format Revisions) November 13, 2006 SUTTER PHYSICIANS ALLIANCE (SPA) 2800 L Street, 7 th Floor Sacramento, CA 95816 SPA PCP Treatment & Referral Guidelines Pain Management Developed June 1, 2003 Revised - (Format Revisions) November 13,

More information

Cervical Spondylosis (Arthritis of the Neck)

Cervical Spondylosis (Arthritis of the Neck) Copyright 2009 American Academy of Orthopaedic Surgeons Cervical Spondylosis (Arthritis of the Neck) Neck pain is extremely common. It can be caused by many things, and is most often related to getting

More information

Breast Cancer Surgery and Pain

Breast Cancer Surgery and Pain Breast Cancer Surgery and Pain Princess Margaret Information for women who have had breast surgery Read this pamphlet to learn about: Pain after surgery What you need to know about pain What you need to

More information

Herniated Cervical Disc

Herniated Cervical Disc Herniated Cervical Disc North American Spine Society Public Education Series What Is a Herniated Disc? The backbone, or spine, is composed of a series of connected bones called vertebrae. The vertebrae

More information

Opioid Analgesic Medication Information

Opioid Analgesic Medication Information Opioid Analgesic Medication Information This handout provides information about treating pain with opioid analgesics or narcotics. Please read this entire handout. We want to be sure that you understand

More information

Laser Treatment Policy

Laser Treatment Policy Laser Treatment Policy Pursuant to federal law 21 CFR 812.2(c)7 and 812.3(b), physician(s) at this pain center may advise and use unapproved laser s on patients under one or more of the following conditions:

More information

Taking Charge, Living Life: Managing Your Chronic Pain Common Questions & Answers About Chronic Pain Treatment

Taking Charge, Living Life: Managing Your Chronic Pain Common Questions & Answers About Chronic Pain Treatment Taking Charge, Living Life: Managing Your Chronic Pain Common Questions & Answers About Chronic Pain Treatment Contents What is Your Pain Like?...2 Goals of Pain Therapy...3 Treatments...4 One Provider

More information

Lumbar Spinal Stenosis

Lumbar Spinal Stenosis Lumbar Spinal Stenosis North American Spine Society Public Education Series What Is Lumbar Spinal Stenosis? The vertebrae are the bones that make up the lumbar spine (low back). The spinal canal runs through

More information

Managing Chronic Pain

Managing Chronic Pain Managing Chronic Pain Chronic pain can cripple the body, mind and spirit. Feeling broken? You may benefit from Cleveland Clinic s Section of Pain Medicine, which tailors comprehensive, innovative treatment

More information

Offering Solutions for The Management of Pain

Offering Solutions for The Management of Pain Integrative Pain Treatment Center Integrative Pain Treatment Center Offering Solutions for The Management of Pain ADACHES BACK AND NECK PAIN FIBROMYALGIA MYOFASCIAL PAIN ARTHRITIS SPINAL STENOSIS JOINT

More information

PAIN CLINIC THEN & NOW. JACKIE COLE Nurse Clinician Winnipeg Health Sciences Centre Pain Management Centre

PAIN CLINIC THEN & NOW. JACKIE COLE Nurse Clinician Winnipeg Health Sciences Centre Pain Management Centre PAIN CLINIC THEN & NOW JACKIE COLE Nurse Clinician Winnipeg Health Sciences Centre Pain Management Centre 1972 Dr Lionel Cruickshank founded the Health Sciences Centre Pain Clinic Dr Cruickshank pioneered

More information

Lora McGuire MS, RN Educator and Consultant lmcguire@jjc.edu. Barriers to effective pain relief

Lora McGuire MS, RN Educator and Consultant lmcguire@jjc.edu. Barriers to effective pain relief Lora McGuire MS, RN Educator and Consultant lmcguire@jjc.edu Barriers to effective pain relief Freedom from pain is a basic human right -WHO Pain is whatever the experiencing person says it is and exists

More information

Opioid Agreement for Center for Pain Management S.C.

Opioid Agreement for Center for Pain Management S.C. Opioid Agreement for Center for Pain Management S.C. Patient Name: DOB: I am the patient named above. I have agreed to use pain medication as part of my treatment for chronic pain. I understand that these

More information

IEHP UM Subcommittee Approved Authorization Guidelines Referrals to Pain Management Specialists

IEHP UM Subcommittee Approved Authorization Guidelines Referrals to Pain Management Specialists IEHP Policy: Based on a review of the currently available literature and community standards of practice, the IEHP UM Subcommittee will consider referrals to Pain Management Specialists medically necessary

More information

.org. Cervical Spondylosis (Arthritis of the Neck) Anatomy. Cause

.org. Cervical Spondylosis (Arthritis of the Neck) Anatomy. Cause Cervical Spondylosis (Arthritis of the Neck) Page ( 1 ) Neck pain can be caused by many things but is most often related to getting older. Like the rest of the body, the disks and joints in the neck (cervical

More information

Herniated Lumbar Disc

Herniated Lumbar Disc Herniated Lumbar Disc North American Spine Society Public Education Series What Is a Herniated Disc? The spine is made up of a series of connected bones called vertebrae. The disc is a combination of strong

More information

Low back pain. Quick reference guide. Issue date: May 2009. Early management of persistent non-specific low back pain

Low back pain. Quick reference guide. Issue date: May 2009. Early management of persistent non-specific low back pain Issue date: May 2009 Low back pain Early management of persistent non-specific low back pain Developed by the National Collaborating Centre for Primary Care About this booklet This is a quick reference

More information

Pain Management For Non-Surgical Treatment Of The Cervical Herniated Disc

Pain Management For Non-Surgical Treatment Of The Cervical Herniated Disc Pain Management For Non-Surgical Treatment Of The Cervical Herniated Disc Pain management has become very popular lately. What is pain management? Well, pain management is actually going to a physician

More information

PAIN MANAGEMENT AT UM/SYLVESTER

PAIN MANAGEMENT AT UM/SYLVESTER PAIN MANAGEMENT AT UM/SYLVESTER W HAT IS THE PURPOSE OF THIS BROCHURE? We created this brochure for patients receiving care from the University of Miami Sylvester Comprehensive Cancer Center and their

More information

Cervical Conditions: Diagnosis and Treatments

Cervical Conditions: Diagnosis and Treatments Cervical Conditions: Diagnosis and Treatments Mark R Mikles, M.D. Cervical Conditions: Diagnosis and Treatment Cervical conditions Neck Pain Radiculopathy Myelopathy 1 Cervical Conditions: Diagnosis and

More information

THE COMMONWEALTH OF MASSACHUSETTS Department of Industrial Accidents

THE COMMONWEALTH OF MASSACHUSETTS Department of Industrial Accidents THE COMMONWEALTH OF MASSACHUSETTS Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, Massachusetts 02114-2017 DEVAL L. PATRICK Governor PHILIP L. HILLMAN Director TIMOTHY P. MURRAY

More information

Interventional Pain Management Options Palliative Care C.M.E. Chatham, Ontario November 14, 2012.

Interventional Pain Management Options Palliative Care C.M.E. Chatham, Ontario November 14, 2012. Interventional Pain Management Options Palliative Care C.M.E. Chatham, Ontario November 14, 2012. Anita Borm B.Sc. (Hons) Clinical Programs and Research Manager Chronic Pain & Addiction Program, London

More information

7 Things You Should Know About Pain Management

7 Things You Should Know About Pain Management 7 Things You Should Know About Pain Management WHITE PAPER 1: WHAT ARE COMMON CAUSES OF PAIN AND IS THERE A CURE? Everyone will experience pain at some point in his or her life. Some pain is temporary,

More information

OUTLINE. Anatomy Approach to LBP Discogenic LBP. Treatment. Herniated Nucleus Pulposus Annular Tear. Non-Surgical Surgical

OUTLINE. Anatomy Approach to LBP Discogenic LBP. Treatment. Herniated Nucleus Pulposus Annular Tear. Non-Surgical Surgical DISCOGENIC PAIN OUTLINE Anatomy Approach to LBP Discogenic LBP Herniated Nucleus Pulposus Annular Tear Treatment Non-Surgical Surgical Facet Joints: bear 20% of weight Discs bear 80% of weight Neural Foramen

More information

Cervical Spine. New Patient Form

Cervical Spine. New Patient Form Cervical Spine New Patient Form Please mark the painful areas on the pictures below Use the following marks: stabbing pain ooo burning pain +++ aching pain pins and needles = = = numbness Right Right Right

More information

MEDICAL PROTOCOLS: INTRODUCTION

MEDICAL PROTOCOLS: INTRODUCTION MEDICAL PROTOCOLS: INTRODUCTION JANUARY 1, 1996 REVISIONS & UPDATES: JULY 1, 2012; JULY 1, 2013; APRIL 1, 2014; APRIL 1, 2015; AUGUST 15, 2015 CONTENTS BACKGROUND NEW EFFECTIVE DATES FUTURE UPDATES ACKNOWLEDGMENTS

More information

CLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF LOW BACK PAIN

CLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF LOW BACK PAIN CLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF LOW BACK PAIN Low back pain is very common, up to 90+% of people are affected by back pain at some time in their lives. Most often back pain is benign and

More information

Musculoskeletal: Acute Lower Back Pain

Musculoskeletal: Acute Lower Back Pain Musculoskeletal: Acute Lower Back Pain Acute Lower Back Pain Back Pain only Sciatica / Radiculopathy Possible Cord or Cauda Equina Compression Possible Spinal Canal Stenosis Red Flags Initial conservative

More information

Clinical Guideline. Low Back Pain Orthopaedics. Princess Alexandra Hospital Emergency Department. 1 Purpose. 2 Background

Clinical Guideline. Low Back Pain Orthopaedics. Princess Alexandra Hospital Emergency Department. 1 Purpose. 2 Background Princess Alexandra Hospital Emergency Department Clinical Guideline Orthopaedics Review Officer: Katherine Isoardi Version no: 1 Approval date: 18/03/2015 Review date: 18/03/2017 Approving Officer Dr James

More information

Pain Management after Surgery Patient Information Booklet

Pain Management after Surgery Patient Information Booklet Pain Management after Surgery Patient Information Booklet PATS 509-15-05 Your Health Care Be Involved Be involved in your healthcare. Speak up if you have questions or concerns about your care. Tell a

More information

Spinal Decompression

Spinal Decompression Spinal Decompression Spinal decompression is just one more tool we have to treat radiculopathy. With appropriate education and exercises, this modality has been proven to assist in the resolution of symptoms

More information

Why are antidepressants used to treat IBS? Some medicines can have more than one action (benefit) in treating medical problems.

Why are antidepressants used to treat IBS? Some medicines can have more than one action (benefit) in treating medical problems. The Use of Antidepressants in the Treatment of Irritable Bowel Syndrome and Other Functional GI Disorders Christine B. Dalton, PA-C Douglas A. Drossman, MD What are functional GI disorders? There are more

More information

What you need for Your to know Safety about longterm. opioid pain care. What you need to know about long-term opioid

What you need for Your to know Safety about longterm. opioid pain care. What you need to know about long-term opioid What you need to know about longterm opioid pain care. What you need to know about long-term opioid and the Safety of Others pain care. TAKING What you OPIOIDS need to know about long-term RESPONSIBLY

More information

Prevalence of Back Pain

Prevalence of Back Pain Prevalence of Back Pain Point prevalence 12-35% Lifetime prevalence 49-80% Annual prevalence in UK (OPCS surveys 1997) 37% (3.5 million/year) Male=female No regional differences Increases with age Prevalent

More information

Appendix A - Low Back Pain Scope

Appendix A - Low Back Pain Scope Appendix A - Low Back Pain Scope Low back pain: full guideline DRAFT (September 2008) Page 1 of 10 NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Low back pain: the acute

More information

Back & Neck Pain Survival Guide

Back & Neck Pain Survival Guide Back & Neck Pain Survival Guide www.kleinpeterpt.com Zachary - 225-658-7751 Baton Rouge - 225-768-7676 Kleinpeter Physical Therapy - Spine Care Program Finally! A Proven Assessment & Treatment Program

More information

Do you have Back Pain? Associated with:

Do you have Back Pain? Associated with: Do you have Back Pain? Associated with: Herniated Discs? Protruding Discs? Degenerative Disk Disease? Posterior Facet Syndrome? Sciatica? You may be a candidate for Decompression Therapy The Dynatronics

More information

MEDICAL PROTOCOLS: INTRODUCTION

MEDICAL PROTOCOLS: INTRODUCTION MEDICAL PROTOCOLS: INTRODUCTION EFFECTIVE JANUARY 1, 1996 REVISIONS EFFECTIVE JULY 1, 2012 UPDATED APRIL 1, 2014 BACKGROUND NEW EFFECTIVE DATES FUTURE UPDATES ACKNOWLEDGMENTS Workers Compensation Medical

More information

Evaluation and Management of Low Back Pain Patients

Evaluation and Management of Low Back Pain Patients Evaluation and Management of Low Back Pain Patients Muhammad A. Munir, MD Diplomat American Board of Anesthesiology and Pain Management Epidemiology of LBP 70-85% of Individual experience back pain during

More information

SPINE AND NECK SURGERY: MAKING A DECISION THAT S RIGHT FOR YOU

SPINE AND NECK SURGERY: MAKING A DECISION THAT S RIGHT FOR YOU 1. GET THE FACTS: Back and neck pain affects 8 out of 10 people at some point in their life. Acute back and neck pain comes on suddenly and usually lasts from a few days to a few weeks. Chronic back and

More information

Orthopaedic Approaches to Chronic Neck and Lower Back Pain

Orthopaedic Approaches to Chronic Neck and Lower Back Pain Orthopaedic Approaches to Chronic Neck and Lower Back Pain David C. Urquia, MD Augusta Orthopaedic Associates / Waterville Orthopedics Introduction We see many patients who have longstanding pain in the

More information

Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies

Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies 1 Journal of the American Osteopathic Association April 2005, Vol. 105, No. 4 supplement, pp. 16-22 David M. Biondi, DO FROM ABSTRACT:

More information

Abdominal Wall Pain. What is Abdominal Wall Pain?

Abdominal Wall Pain. What is Abdominal Wall Pain? Abdominal Wall Pain What is Abdominal Wall Pain? Abdominal Wall Pain is a syndrome (an experience) of abdominal pain that can occur at any time of life and is not unique to children. It is diagnosed by

More information

6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S.

6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S. High Prevalence and Incidence Prevalence 85% of Americans will experience low back pain at some time in their life. Incidence 5% annual Timothy C. Shen, M.D. Physical Medicine and Rehabilitation Sub-specialty

More information

Sample Treatment Protocol

Sample Treatment Protocol Sample Treatment Protocol 1 Adults with acute episode of LBP Definition: Acute episode Back pain lasting

More information

Spinal Injections. North American Spine Society Public Education Series

Spinal Injections. North American Spine Society Public Education Series Spinal Injections North American Spine Society Public Education Series What Is a Spinal Injection? Your doctor has suggested that you have a spinal injection to help reduce pain and improve function. This

More information

Lansing Area Consortium Emergency Department Chronic Pain and Dental Pain Practice Guidelines and Management

Lansing Area Consortium Emergency Department Chronic Pain and Dental Pain Practice Guidelines and Management Lansing Area Consortium Emergency Department Chronic Pain and Dental Pain Practice Guidelines and Management Goals: 1. Maximize patient safety. 2. Provide uniform practice in chronic pain and dental pain

More information

Lumbar Disc Herniation/Bulge Protocol

Lumbar Disc Herniation/Bulge Protocol Lumbar Disc Herniation/Bulge Protocol Anatomy and Biomechanics The lumbar spine is made up of 5 load transferring bones called vertebrae. They are stacked in a column with an intervertebral disc sandwiched

More information

OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES

OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES General Therapy Guidelines 1. Therapy evaluations must be provided by licensed physical and/or occupational therapists. Therapy evaluations

More information

SPINAL INJECTIONS N A S S P E S

SPINAL INJECTIONS N A S S P E S SPINAL INJECTIONS NORTH AMERICAN SPINE SOCIETY PUBLIC EDUCATION SERIES WHAT IS A SPINAL INJECTION? Your doctor has suggested that you have a spinal injection to help reduce pain and improve function. This

More information

New England Pain Management Consultants At New England Baptist Hospital

New England Pain Management Consultants At New England Baptist Hospital New England Pain Management Consultants At New England Baptist Hospital Pain Management Center Health Assessment Dear New Pain Management Patient, Welcome to the New England Pain Management Consultants

More information

There are four main regions of the back; the cervical (C), thoracic (T), lumbar (L), and sacral (S) regions

There are four main regions of the back; the cervical (C), thoracic (T), lumbar (L), and sacral (S) regions Low Back Pain Overview Low back pain is one of the most common disorders in the United States. About 80 percent of people have at least one episode of low back pain during their lifetime. Factors that

More information

Pain Questionnaire. Center for Interventional Pain 1000 Health Center Drive, Suite 106 Mattoon, IL 61938 217-238-4495

Pain Questionnaire. Center for Interventional Pain 1000 Health Center Drive, Suite 106 Mattoon, IL 61938 217-238-4495 Center for Interventional Pain 1000 Health Center Drive, Suite 106 Mattoon, IL 61938 217-238-4495 Pain Questionnaire Date First name Last name Middle initial Date of birth Sex Male Female Height Weight

More information

Review of Pharmacological Pain Management

Review of Pharmacological Pain Management Review of Pharmacological Pain Management CHAMP Activities are possible with generous support from The Atlantic Philanthropies and The John A. Hartford Foundation The WHO Pain Ladder The World Health Organization

More information

Spinal cord stimulation

Spinal cord stimulation Spinal cord stimulation This leaflet aims to answer your questions about having spinal cord stimulation. It explains the benefits, risks and alternatives, as well as what you can expect when you come to

More information

Whiplash and Cervical Spine Disorders: Evaluation and Management

Whiplash and Cervical Spine Disorders: Evaluation and Management Whiplash and Cervical Spine Disorders: Evaluation and Management Dr. Corrie Graboski Definition by Quebec Task Force Pain Generators an acceleration-deceleration mechanism of energy transfer to the neck

More information

Deuk Spine Institute s Guaranteed Spinal Surgery Outcomes

Deuk Spine Institute s Guaranteed Spinal Surgery Outcomes Deuk Spine Institute s Guaranteed Spinal Surgery Outcomes Ara Deukmedjian MD Deuk Spine Institute Surgery Center of Viera June 12 2015 Deuk Spine Institute Multispecialty Spine surgeons, orthopedic surgeons,

More information

Neck Injuries and Disorders

Neck Injuries and Disorders Neck Injuries and Disorders Introduction Any part of your neck can be affected by neck problems. These affect the muscles, bones, joints, tendons, ligaments or nerves in the neck. There are many common

More information

Hitting a Nerve: The Triggers of Sciatica. Bruce Tranmer MD FRCS FACS

Hitting a Nerve: The Triggers of Sciatica. Bruce Tranmer MD FRCS FACS Hitting a Nerve: The Triggers of Sciatica Bruce Tranmer MD FRCS FACS Disclosures I have no financial disclosures Objectives - Sciatica Historical Perspective What is Sciatica What can cause Sciatica Clinical

More information

Get Back to the Life You Love! The MedStar Spine Center in Chevy Chase

Get Back to the Life You Love! The MedStar Spine Center in Chevy Chase Get Back to the Life You Love! The MedStar Spine Center in Chevy Chase The MedStar Spine Center in Chevy Chase Relief from Pain, Restoration of Function Non-surgical, Minimally Invasive and Complex Surgical

More information

The Newest Breakthrough In Non- Surgical Treatment of Herniated or Degenerative Discs

The Newest Breakthrough In Non- Surgical Treatment of Herniated or Degenerative Discs The Newest Breakthrough In Non- Surgical Treatment of Herniated or Degenerative Discs The DRX 9000 is Your Answer To Persistent Back Pain To People Who Want To Be Rid Of Lower Back Pain But Think They

More information

INITIAL PATIENT ASSESSMENT AND HISTORY

INITIAL PATIENT ASSESSMENT AND HISTORY DATE INITIAL PATIENT ASSESSMENT AND HISTORY Thank you for choosing us to assist in your medical care. Please fill out this form completely to assist us with your visit. First Name MI Last Name Age: Marital

More information

Evaluation of Chronic Pain Patients for Narcotic Therapy: Cautions and Controversies

Evaluation of Chronic Pain Patients for Narcotic Therapy: Cautions and Controversies Evaluation of Chronic Pain Patients for Narcotic Therapy: Cautions and Controversies C. Marcus Cooper, Ph.D., D. N. H. Director Of Psychological Services Pain Medicine Associates Johnson City, Tennessee

More information

Medications for chronic pain

Medications for chronic pain Medications for chronic pain When it comes to treating chronic pain with medications, there are many to choose from. Different types of pain medications are used for different pain conditions. You may

More information

Mitchell Freedman, DO

Mitchell Freedman, DO The Treatment of Chronic lower back pain: The Good, the Bad and the Ugly Mitchell Freedman, DO Director of Physical Medicine and Rehabilitation at the Rothman Institute Associate Professor of Physical

More information

http://images.tutorvista.com/content/control5coordination/human5brain.jpeg!! 387

http://images.tutorvista.com/content/control5coordination/human5brain.jpeg!! 387 http://images.tutorvista.com/content/control5coordination/human5brain.jpeg!! 387! 388! http://my.fresnounified.org/personal/lygonza/gonzalez/neuron/neuron5synapse%20communication.png!! http://www.urbanchildinstitute.org/sites/all/files/databooks/2011/ch15fg25communication5between5neurons.jpg!!

More information

WOMENCARE A Healthy Woman is a Powerful Woman (407) Pelvic Pain

WOMENCARE A Healthy Woman is a Powerful Woman (407) Pelvic Pain Pelvic Pain WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 Many women have pain in their pelvic region at some point in their lives. Finding the cause of pelvic pain can be a long process.

More information

Pain Management. Practical Applications in Electrotherapy

Pain Management. Practical Applications in Electrotherapy Pain Management Practical Applications in Electrotherapy The TENS Advantage Deliver Immediate Pain Relief using a unique waveform designed to help prevent nerve accommodation. Manage Dynamic Pain by adjusting

More information

UNM Pain Center: Addressing New Mexico s Public Health Crises of Pain, Addiction, and Unintentional Opioid Overdose Deaths

UNM Pain Center: Addressing New Mexico s Public Health Crises of Pain, Addiction, and Unintentional Opioid Overdose Deaths UNM Pain Center: Addressing New Mexico s Public Health Crises of Pain, Addiction, and Unintentional Opioid Overdose Deaths Joanna G Katzman, M.D., M.S.P.H Director, UNM Pain Center Associate Professor,

More information

OPIOID CONVERSIONS. 2. Add a rescue doses (IR) of same opioid if possible should be~10 20% of total daily opioid dose

OPIOID CONVERSIONS. 2. Add a rescue doses (IR) of same opioid if possible should be~10 20% of total daily opioid dose OPIOID CONVERSIONS 1. Converting Short acting Long Acting (IR SR) when pain is well controlled *Use for : CHRONIC pain Pts on scheduled IR opioids pain that recurs before the next dose PP: Can use equianalgesic

More information

Questions and answers on breast cancer Guideline 10: The management of persistent pain after breast cancer treatment

Questions and answers on breast cancer Guideline 10: The management of persistent pain after breast cancer treatment Questions and answers on breast cancer Guideline 10: The management of persistent pain after breast cancer treatment I ve had breast cancer treatment, and now I m having pain. Does this mean the cancer

More information

BOTOX Treatment. for Chronic Migraine. Information for patients and their families. Botulinum Toxin Type A

BOTOX Treatment. for Chronic Migraine. Information for patients and their families. Botulinum Toxin Type A BOTOX Treatment Botulinum Toxin Type A for Chronic Migraine Information for patients and their families. Is Chronic Migraine the same as Migraine? Chronic Migraine is similar to migraine as sufferers experience

More information

Pain Clinic or Center Interventions Other Information

Pain Clinic or Center Interventions Other Information Pain Referral Resource Guide for Massachusetts * Created by the Massachusetts Pain Initiative (MassPI) Web site: www.masspaininitiative.org E-mail: info@masspaininitiative.org Disclaimer: The Massachusetts

More information

Controlling Pain Part 2: Types of Pain Medicines for Your Prostate Cancer

Controlling Pain Part 2: Types of Pain Medicines for Your Prostate Cancer Controlling Pain Part 2: Types of Pain Medicines for Your Prostate Cancer The following information is based on the general experiences of many prostate cancer patients. Your experience may be different.

More information

Dr. Thomas Williamson-Kirkland M.D.

Dr. Thomas Williamson-Kirkland M.D. 1 Presents Dr. Thomas Williamson-Kirkland M.D. Treatment of Chronic Pain Patients Pain Management Programs Work Conditioning and Work Hardening 2 Treatment of Chronic Pain Patients: Pain Management Programs,

More information

Corporate Medical Policy Automated Percutaneous and Endoscopic Discectomy

Corporate Medical Policy Automated Percutaneous and Endoscopic Discectomy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: percutaneous_discectomy 9/1991 5/2016 5/2017 5/2016 Description of Procedure or Service Traditionally, discectomy

More information

ANETTA ADAMS, MSN, APN, FNP-BC, RNFA CURRICULAM VITAE

ANETTA ADAMS, MSN, APN, FNP-BC, RNFA CURRICULAM VITAE CURRENT PRACTICE: Office: (775) 284-8650 Fax: (775) 284-8654 nvadvancedpain.com ANETTA ADAMS, MSN, APN, FNP-BC, RNFA CURRICULAM VITAE EDUCATION: 2007-2011 MSN/FNP Orvis School of Nursing University of

More information

Femoroacetabular (Hip) Impingement & Labral Tears

Femoroacetabular (Hip) Impingement & Labral Tears Michael J. Huang, MD Sports Medicine Colorado Springs Orthopaedic Group 4110 Briargate Parkway, Suite 300 Colorado Springs, CO 80923 (719) 373-8849 www.huangortho.com Introduction Hip pain can be caused

More information

NEW PATIENTS' INFORMATION SHEET

NEW PATIENTS' INFORMATION SHEET NEW PATIENTS' INFORMATION SHEET Please print clearly. Please complete all information so that your claim can be processed quickly and efficiently. Thank you! PATIENT INFORMATION (First) (MI) (Last) Name

More information

Neck Pain Overview Causes, Diagnosis and Treatment Options

Neck Pain Overview Causes, Diagnosis and Treatment Options Neck Pain Overview Causes, Diagnosis and Treatment Options Neck pain is one of the most common forms of pain for which people seek treatment. Most individuals experience neck pain at some point during

More information

Sciatica Yuliya Mutsa PTA 236

Sciatica Yuliya Mutsa PTA 236 Sciatica Yuliya Mutsa PTA 236 Sciatica is a common type of pain affecting the sciatic nerve, which extends from the lower back all the way through the back of the thigh and down through the leg. Depending

More information

Whiplash and Whiplash- Associated Disorders

Whiplash and Whiplash- Associated Disorders Whiplash and Whiplash- Associated Disorders North American Spine Society Public Education Series What Is Whiplash? The term whiplash might be confusing because it describes both a mechanism of injury and

More information

PREMIER PAIN CARE PA Carlos J Garcia MD 2435 W. Oak Street # 103 Denton, TX 76201 Phone 940-323-9404 Fax 940-323-9422 PATIENT REGISTRATION

PREMIER PAIN CARE PA Carlos J Garcia MD 2435 W. Oak Street # 103 Denton, TX 76201 Phone 940-323-9404 Fax 940-323-9422 PATIENT REGISTRATION PREMIER PAIN CARE PA Carlos J Garcia MD 2435 W. Oak Street # 103 Denton, TX 76201 Phone 940-323-9404 Fax 940-323-9422 PATIENT REGISTRATION Last Name First Name MI Mailing Address City Zip code Home Phone

More information

Dr. Kenneth A. Giraldo, MD, P.A. Patient Controlled Substance Agreement Informed Consent Form

Dr. Kenneth A. Giraldo, MD, P.A. Patient Controlled Substance Agreement Informed Consent Form Dr. Kenneth A. Giraldo, MD, P.A. Patient Controlled Substance Agreement Informed Consent Form The following agreement relates to my use of controlled substance for chronic pain prescribed by Dr. Kenneth

More information

Herniated Disk. This reference summary explains herniated disks. It discusses symptoms and causes of the condition, as well as treatment options.

Herniated Disk. This reference summary explains herniated disks. It discusses symptoms and causes of the condition, as well as treatment options. Herniated Disk Introduction Your backbone, or spine, has 24 moveable vertebrae made of bone. Between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep

More information

1st Edition 2015. Quick reference guide for the management of acute whiplash. associated disorders

1st Edition 2015. Quick reference guide for the management of acute whiplash. associated disorders 1 1st Edition 2015 Quick reference guide for the management of acute whiplash associated disorders 2 Quick reference guide for the management of acute whiplash associated disorders, 2015. This quick reference

More information

RENAL ANGIOMYOLIPOMA EMBOLIZATION

RENAL ANGIOMYOLIPOMA EMBOLIZATION RENAL ANGIOMYOLIPOMA EMBOLIZATION The information about renal angiomyolipomas on the next several pages includes questions commonly asked about the embolization procedure. Please take a few moments to

More information

UNDERSTANDING STRESS AND YOUR BODY

UNDERSTANDING STRESS AND YOUR BODY UNDERSTANDING STRESS AND YOUR BODY Life s demands create stress and although some stress may be good, too much can cause health problems. Most people equate stress with high blood pressure, a heart attack

More information

Patient Information Form Pain Management Center at Phoebe

Patient Information Form Pain Management Center at Phoebe Patient Information Form Pain Management Center at Phoebe Please complete the following form, so that we may facilitate your visit Occupation: or (circle) Retired, Disabled Homemaker, Full time student

More information

Objectives. Pain Management Knowing How To Help Yourself. Patients and Family Requirements. Your Rights As A Consumer

Objectives. Pain Management Knowing How To Help Yourself. Patients and Family Requirements. Your Rights As A Consumer Objectives Pain Management Knowing How To Help Yourself Jackie Carter, RN MSN CNS Become familiar with the definitions of pain Be aware of your rights to have your pain treated Become familiar with the

More information

Temple Physical Therapy

Temple Physical Therapy Temple Physical Therapy A General Overview of Common Neck Injuries For current information on Temple Physical Therapy related news and for a healthy and safe return to work, sport and recreation Like Us

More information

Electrodiagnostic Testing Electromyogram and Nerve Conduction Study

Electrodiagnostic Testing Electromyogram and Nerve Conduction Study Electrodiagnostic Testing Electromyogram and Nerve Conduction Study North American Spine Society Public Education Series What Is Electrodiagnostic Testing? The term electrodiagnostic testing covers a

More information

Spinal Pain: Diagnosis and Interventional Procedures

Spinal Pain: Diagnosis and Interventional Procedures Spinal Pain: Diagnosis and Interventional Procedures Dr Ilias Drivas MBBS FRANZCR Diagnostic and Interventional Radiologist Alfred Imaging Group Staff Specialist Royal Prince Alfred Hospital Overview Go

More information

Summary of Recommendations

Summary of Recommendations CHIROPRACTIC CLINICAL PRACTICE GUIDELINE Adult Neck Pain Not Due to Whiplash Summary of Recommendations November 2005 Note: This summary does not replace or supercede the content of the detailed technical

More information

PERIODIC TRIGGER POINT INJECTIONS UP TO 4 PER YEAR: Upheld

PERIODIC TRIGGER POINT INJECTIONS UP TO 4 PER YEAR: Upheld Case Number: CM13-0037615 Date Assigned: 12/18/2013 Date of Injury: 05/14/2001 Decision Date: 04/21/2014 UR Denial Date: 10/14/2013 Priority: Standard Application Received: 10/23/2013 HOW THE IMR FINAL

More information

STRESS. Health & Wellness The Newsletter About Achieving and Maintaining Optimal Well-being UNDERSTANDING AND YOUR BODY. www.neorthopt.

STRESS. Health & Wellness The Newsletter About Achieving and Maintaining Optimal Well-being UNDERSTANDING AND YOUR BODY. www.neorthopt. Health & Wellness The Newsletter About Achieving and Maintaining Optimal Well-being UNDERSTANDING STRESS AND YOUR BODY Life s demands create stress and although some stress may be good, too much can cause

More information