APM Blog

Friday, 17 November 2017 10:21

Tackle Pain and Up your Garden Game

Gardening is a great form of exercise, working multiple muscle groups as well as burning calories. It makes sense, then, that just like any other exercise or sport, there should be some rules to keep you – and your garden – in fighting form.

Before and After

Warmups and cool downs aren’t just for runners. Take the time to loosen up your body with some quick stretches and a brisk walk before digging in. And make sure to take frequent time-outs, with plenty of water, says Melinda Myers, an expert horticulturalist who works with Advanced Pain Management to provide tips on seasonal gardening and safety. Afterward, cool down with a few more stretches, and ice any sore areas.

Switch it Up

Whether it’s practicing tennis or watering hydrangeas, doing the same thing for extended periods of time can result in injury. Switch up your activities, and your position, to avoid stiffness and work a range of muscle groups. “I may go from weeding down on my knees to digging with a shovel or raking,” says Myers. “I often take a break from these more strenuous activities to water, so I’m moving and stretching my legs.”

There’s No ‘I’ in Garden

Share the load with a gardening round-robin, suggests Myers. Not only will it decrease your own load, but it’s a great way to catch up with friends – and boost your gardening know-how. “With busy schedules,” she says, “I find it’s a great way to take on overwhelming tasks, like spring cleanup and winter pruning, and enlist help, but make it fun.”

Learn More

For more tips on getting a leg up on gardening pain, visit Melinda Myers at the We Energies Energy Park stage during the Wisconsin State Fair Aug. 6-16, where she will be presenting “The Livable Landscape” at 10 a.m. and 2 p.m. daily. And don't forget to download your free Gardening Toolkit.

Weed Out The Pain Toolkit Download

Published in Gardening

Has managing your pain become a challenge when it comes to settling down for a restful night’s sleep? While sleep plays a critical part in our overall well-being, the good news is that even if you suffer from pain, there are many ways you can improve habits to help get the quality sleep your body needs. Before counting sheep, consider these easy tips:

1. Eat Healthy Throughout The Day:  Eating healthly throughout the day can be an important factor in how well you sleep at night. If you are someone who experiences hunger before bedtime, eat a small serving of carbohydrates and fat (berries and nuts) about 15 – 30 minutes before you go to bed. Be sure to avoid heavy, rich foods, alcohol and fatty foods 2 -3 hours before bed as these can cause indigestion and insomnia.

2. Nap Strategically: If you need to make up for lost sleep at night, it is ok to take short naps during the day rather than sleeping in late in the morning. This prevents disruption to your natural sleep – wake pattern. If insomnia is a problem for you, consider eliminating naps altogether.

3. Keep To An Evening Routine: Setting a bedtime and going to bed at the same time each night may prevent tossing and turning. If you must change your schedule on the weekends, try doing it in small increments. If you change your bedtime, help your body adjust by changing in small daily increments, such as 15 minutes earlier or later each day. It is also beneficial to incorporate relaxing rituals in the evening prior to going to bed such as taking a bath, reading or meditating. 

4. Exercise Most Days:  Physical activity, especially cardiovascular workouts, are known for improving the length and quality of your sleep. That said, it’s best not to exercise within 4 hours of going to bed because body temperature elevates. As you cool down, your brain receives signals to produce sleep-inducing melatonin.

5. Pay Attention To What You Drink: Watching what you drink in the late afternoon and evening hours has a number of implications on your ability to get a good night’s rest. Drinking too much before bed can cause disruptive, middle-of-the-night trips to the bathroom. Caffeine should be limited as it can keep you awake 10 to 12 hours after drinking it. After lunch, cut back on your overall intake or consider avoiding caffeine altogether. Be cautious when drinking alcohol as well – it can take hours to wear off and wreak havoc on your quality of sleep. 

6. Get Comfortable:  Create a comfortable room that is cool, dark and quiet. When sharing a bed with someone else, make sure it is big enough and at the comfort level for both of you. Set limits on how often children or pets share your bed or encourage they use their own beds most, or all of the time.

What tips do you have to help improve sleep?

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Published in Sleep-and-Pain

The start of the New Year is a great time to make changes to lifestyle habits such as diet and exercise – both of which play a significant role in our ability to manage pain. Being overweight or obese adds stress on joints, as they must carry a greater load. Managing weight, eating a healthy diet and exercising all contribute to pain reduction.

After the holiday season, it may seem like a difficult task to get back on track with healthful eating. Changing our diet can be as simple as taking a look at what is currently in your kitchen and identifying healthy foods that will help fight inflammation, block pain signals and help heal underlying disease.

“Eating more fruits and vegetables alone will not alleviate your pain,” says Advanced Pain Management (APM) physician Michael Jung. “But if you commit to a healthy eating plan that includes less processed foods and more fresh foods, you will likely see positive results.”

We’ve identified six easy-to-find foods that are known to help ease pain. In moderation, these recipes fit into a healthy diet so you can kickoff your New Year’s resolutions with a delicious start. Cheers to a happy, healthy 2015!

describe the imageCherries:

Cherries’ high amounts of antioxidants are the foundation to their pain-fighting power. These antioxidants block inflammation much the same way that an aspirin or other NSAIDS would. In a U.S. Department of Agriculture study, participants who ate 45 Bing cherries a day for 28 days reduced their inflammation levels significantly.

Curried Chicken Salad With Cherries, Mango and Pecans

3 tablespoons light mayonnaise

1 1/2 teaspoons curry powder

2 cups cubed cooked chicken

1 cup fresh cherries, pitted and sliced

1 small ripe mango, peeled, pitted and diced

1/4 small red onion, diced

2 tablespoons minced cilantro


Freshly ground black pepper

1/2 cup chopped roasted pecans


In a large bowl, mix the mayonnaise and the curry powder.

Fold in the chicken, cherries, mango, onion and cilantro. Season to taste with salt and pepper.

Sprinkle with the pecans and serve.

Link to recipe: http://www.aarp.org/food/diet-nutrition/info-03-2011/pain-fighting-foods.5.html


describe the imageCoffee:

Many over the counter cold and headache medicines contain caffeine for a reason – its known pain-lowering powers. If you are not a regular coffee drinker, you may see some benefit from drinking a cup or two when pain strikes as caffeine helps narrow the dilated blood vessels that often cause headache pain. However, too much caffeine can exacerbate pain.

One-Bowl Chocolate Cake

3/4 cup plus 2 tablespoons whole-wheat pastry flour, (see Ingredient Note)

1/2 cup granulated sugar

1/3 cup unsweetened cocoa powder

1 teaspoon baking powder

1 teaspoon baking soda

1/4 teaspoon salt

1/2 cup nonfat buttermilk, (see Tip)

1/2 cup packed light brown sugar

1 large egg, lightly beaten

2 tablespoons canola oil

1 teaspoon vanilla extract

1/2 cup hot strong black coffee

Confectioners' sugar, for dusting


Preheat oven to 350°F. Coat a 9-inch round cake pan with cooking spray. Line the pan with a circle of wax paper.

Whisk flour, granulated sugar, cocoa, baking powder, baking soda and salt in a large bowl. Add buttermilk, brown sugar, egg, oil and vanilla. Beat with an electric mixer on medium speed for 2 minutes. Add hot coffee and beat to blend. (The batter will be quite thin.) Pour the batter into the prepared pan.

Bake the cake until a skewer inserted in the center comes out clean, 30 to 35 minutes. Cool in the pan on a wire rack for 10 minutes; remove from the pan, peel off the wax paper and let cool completely. Dust the top with confectioners’ sugar before slicing.

Link to recipe: http://www.eatingwell.com/recipes/one_bowl_chocolate_cake.html


describe the imageGinger:

Historically used as a digestive aid, anti-nausea and sea-sickness remedy; ginger is also an effective painkiller. Almost two-thirds of patients with chronic knee pain reported less soreness upon standing after taking a ginger extract, according to a six-week study from the University of Miami. Much like the cherry, ginger can be beneficial in reducing inflammation , particularly offering relief from migraines, muscle pain and arthritis.

Roasted Winter Vegetables with a Maple-Ginger Glaze

1/2 lb. parsnips, peeled and cut into 2x1/2-inch sticks

1/2 lb. carrots (about 3 or 4), peeled and cut into 2x1/2-inch sticks

1/2 lb. turnips (about 2 medium or 1 large), peeled and cut into thin wedges

1/2 lb. Brussels sprouts, stems trimmed and any wilted leaves pulled off; large sprouts halved

2-inch piece fresh ginger, peeled and sliced into very thin matchsticks (about 1/3 cup)

3 Tbs. unsalted butter, melted

Kosher salt and freshly ground black pepper

1 tsp. grated fresh ginger

1-1/2 Tbs. pure maple syrup


Heat the oven to 425ºF.

Spread the vegetables and the ginger matchsticks in a large, low-sided roasting pan or a heavy rimmed baking sheet.

Drizzle with the butter and season with salt and pepper. Toss to evenly coat the vegetables and spread them so that they're just one layer deep.

Roast the vegetables, tossing a couple of times, until tender and golden brown in spots, about 30 minutes.

Combine the grated ginger and maple syrup. 

Drizzle the vegetables with the maple-ginger mixture, toss, and roast for another 5 minutes. The vegetables should be very tender and browned in spots.

Serve warm.

Link to recipe: http://www.finecooking.com/recipes/ginger_roasted_winter_vegetables.aspx



Fish contain omega-3 fatty acids that not only help keep your heart in top shape, but may also reduce the pain and inflammation of arthritis, migraines and neck and back pain. Omega-3s help improve blood flow by reducing inflammation in blood vessels and nerves. A study published in Pain, the Journal of the International Association for the Study of Pain, suggests that omega-3s provide benefit as an alternative therapy for joint pain and inflammation.  

Aim for two to four meals a week of fatty fish such as salmon, Atlantic mackerel, sardines, or trout — all top omega-3 sources. Halibut, light tuna, snapper, and striped bass are good, too.

Black Bean & Salmon Tostades

8 6-inch corn tortillas

Canola oil cooking spray

1 6- to 7-ounce can boneless, skinless wild Alaskan salmon, drained

1 avocado, diced

2 tablespoons minced pickled jalapeños, plus 2 tablespoons pickling juice from the jar, divided

2 cups coleslaw mix (see Tip) or shredded cabbage

2 tablespoons chopped cilantro

1 15-ounce can black beans, rinsed

3 tablespoons reduced-fat sour cream

2 tablespoons prepared salsa

2 scallions, chopped

Lime wedges (optional)


Position racks in upper and lower thirds of the oven; preheat to 375°F.

Coat tortillas on both sides with cooking spray. Place on 2 baking sheets. Bake, turning once, until light brown, 12 to 14 minutes.

Combine salmon, avocado and jalapeños in a bowl. Combine cabbage, cilantro and the pickling juice in another bowl. Process black beans, sour cream, salsa and scallions in a food processor until smooth. Transfer to a microwave-safe bowl. Cover and microwave on High until hot, about 2 minutes.

To assemble tostadas, spread each tortilla with some bean mixture and some salmon mixture and top with the cabbage salad. Serve with lime wedges, if desired.

Kitchen tip: Look for convenient pre-shredded cabbage-and-carrot “coleslaw mix” near other prepared vegetables in the produce section of the supermarket.

Link to recipe: http://www.eatingwell.com/nutrition_health/nutrition_news_information/foods_that_fight_pain?page=3


describe the imageMint:

Menthol in peppermint is known for helping with headache and back pain symptoms, in addition to treating muscle spasms. Wintergreen’s methyl salicylate adds an additional pain-fighting boost that blocks the enzymes that cause inflammation and pain. Try making mint tea to help with headaches and general aches and pain. 

Cucumber Salad With Mint & Feta 

1 lb thin skinned, mild (non bitter) cucumbers, such as Persian, Armenian, or Japanese cucumbers, thinly sliced. You might also try it with English cucumbers.

1/4 red onion, thinly sliced and cut into 1-inch long segments

2 or 3 red radishes, thinly sliced

10 mint leaves, thinly sliced

White vinegar

Olive oil

1/4 pound feta cheese

Salt and freshly ground pepper


In a medium sized bowl, gently toss together the sliced cucumbers, red onion, radishes, mint leaves with a little bit of white vinegar and olive oil, salt and pepper to taste.

Right before serving, sprinkle on crumbled bits of feta cheese. 

Serve immediately.

Link to recipe: http://www.simplyrecipes.com/recipes/cucumber_salad_with_mint_and_feta/


describe the imageHot Peppers:

Capsaicin, an ingredient in hot peppers, can help reduce pain. In fact, you may notice that many topical creams contain this as a pain-fighting ingredient. Capsaicin helps alleviate pain in part by depleting your body's supply of substance P, a chemical component of nerve cells that is involved in transmitting pain signals to your brain. It also works by de-sensitizing sensory receptors in your skin.

Hot Pepper Relish

1/2 pound hot green peppers (such as jalapeños or serranos), stemmed, seeds removed for a more mild relish

1/2 pound hot red peppers (such as fresnos or cherry peppers), stemmed, seeds removed for a more mild relish

1/2 pound yellow onions, roughly chopped

1 tablespoon kosher salt

1/2 cup cider vinegar

1/4 cup white sugar


Place peppers and onions in bowl of a food processor fitted with steel blade. Pulse until peppers and onion are finely chopped. 

Transfer pepper mixture to a fine mesh strainer set inside a bowl. Stir in salt and let sit for 2-3 hours. Rinse under cold water and strain, pushing vegetables against side of the strainer using a rubber spatula to remove as much water as possible.

In a medium saucepan, bring vinegar and sugar to a boil over medium high heat, stirring to dissolve to sugar.

Add in pepper mixture, reduce heat to medium-low, and simmer for 10 minutes, stirring occasionally. Remove from heat and let cool to room temperature.

Transfer relish to an airtight container and store in refrigerator up to a month.

Link to recipe: http://www.seriouseats.com/recipes/2013/05/hot-pepper-relish-recipe.html 

What other foods do you incorporate into your daily / weekly diet to help manage pain? Share your diet success stories and healthy recipes on our Facebook page: https://www.facebook.com/advancedpainmanagement

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Published in Pain-fighting-recipes

Did you know that eating certain foods increases the inflammatory markers in our bodies, while eating others can decrease signs of inflammation? People with acute and chronic pain often have a high amount of inflammation in their joints, muscles and blood. Changing your eating habits can decrease inflammation in your body, increase your energy, help you maintain a healthy weight and allow you to feel better both physically and emotionally.

There are three important dietary improvements you can make today that can help you reduce pain.

Limit Sugar

Sugar, AKA corn syrup, high-fructose corn syrup, dextrose, fructose, maltose and sucrose. You know that you can find sugar in cookies and brownies, but did you also know that sugar is hiding in many foods that are advertised as “healthy”? These include granola bars, instant oatmeal, juices, crackers, prepackaged meals and more. Think like a detective, and be sure to carefully read foods labels on everything you eat, paying close attention to grams of sugar.

Limit Simple Carbohydrates

Simple carbohydrates include “white” foods, like: white pasta, white breads, white crackers and anything made with white flour. Why should you limit these foods? Simple carbs quickly break down into forms of sugar, which we know to be inflammatory and related with weight gain, cardiovascular diseases and cancers. Studies have shown that eating a diet lower in carbs and higher in healthy fats and proteins also reduces inflammation in the body.

Limit Food Additives

Try to limit food additives in your meals, particularly MSG and artificial sweeteners and preservatives. These additives are found in several “low fat” and “diet” products, as well as prepackaged foods and processed meats.

What Should You Eat More?

You might be worried that abiding by the above recommendations that you will be limiting your foods choice but that isn’t true! Foods shown to be especially anti-inflammatory and good in all sorts of other ways include: berries, cherries, spinach, kale, sweet potatoes, olives and olive oil, fish (especially salmon, halibut, sardines, tuna, trout, whitefish, cod and oysters), avocados, green tea and nuts including walnuts, hazelnuts, almonds and sunflower seeds.

Another Tip: Try seasoning your foods with seasonings that have anti-inflammatory benefits such as with ginger, cinnamon, basil, cloves, mint, turmeric, thyme and chili pepper. Moderation is key in life, but being informed and making changes to help manage your life and your pain is important. What changes can you make today? Do you have pain fighting foods or recipes you might suggest to our readers?

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Published in Acute and Chronic Pain
Friday, 17 November 2017 04:43

Superfoods for a Fiercer You

When searching for pain relief, look no further than your own backyard – or your local farmer’s market. These four foods fresh from the garden – or pot – pack super pain-relieving and anti-inflammatory power.


Infusing mint into your tea or ice water can refresh and rejuvenate – and relieve your headaches and general aches and pains. Gardening expert Melinda Myers suggests growing this vigorous perennial herb in a container so it won’t overtake your other plants. It’s also easy to grow indoors near a sunny window.

Hot Peppers

Capsaicin, the spicy element in chili, jalapeno, habanero and cayenne peppers, is a great pain-fighting tool and is often used in topical creams to help treat backaches, arthritis and muscle pain. “Plant hot peppers after the soil and air warm, usually around Memorial Day,” advises Myers. They will be ready to harvest in late July and early August. Try drying some to enjoy year round.


Muscle pain and inflammation beware! Cherries contain a heavy punch of antioxidants, and can block inflammation and inhibit pain enzymes in much the same way as aspirin and other NSAIDs. Although it takes several years for cherry plants to start producing fruit, according to Myers, sour cherries grow well in Wisconsin. Just make sure to cover the plants with netting so the birds don’t eat your harvest.


Ginger can help reduce inflammation and combat migraines, muscle pain, arthritis and post workout (or post-gardening) soreness – all on top of its nausea-fighting power. Although it’s a tropical plant, says Myers, “enthusiastic gardeners have had success rooting the rhizomes (the part you eat) and starting new plants.” Try growing it indoors like a houseplant in winter and then move it outdoors for the summer.

Learn More

For more tips, including pain-fighting recipe ideas, download your free Gardening Toolkit at www.apmhealth.com/Melinda.

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Published in Superfoods
Thursday, 16 November 2017 07:40

18 Simple, Healthy Habits To Reduce Back Pain

Are your bad habits the cause of your back pain and neck pain? Oftentimes, reducing back pain and neck pain can be as simple as making a few changes to how you sit, stand and sleep. For instance, maintaining a good posture can help stop back pain by keeping your natural spinal curves in their normal position, taking painful pressure off your spine. Consider implementing these simple solutions to help manage chronic pain and get you back to enjoying work and life.

Back Pain and Sleep

There's no doubt that a good night's sleep is important. But back pain and sleep don't often go well together. While a restful 6- to 9-hour sleep can help your body and muscles recover, upper and lower back pain makes it harder to sleep, reducing your body’s ability to heal. Here are some easy solutions to help you sleep better with back pain. 

  1. Avoid sleeping on your stomach to help reduce back pain. 
  2. The best sleeping position for back pain is on your side. Keep your body straight and resist the urge to curl up into a ball. This position keeps the spine in alignment from the neck down, reducing the chance of pain. 
  3. Lessen the risk of back pain insomnia while sleeping on your side by putting a pillow between your knees, keeping your body in alignment. Pillows can help back sleepers reduce pain, as well. Simply place one or more under your knees to help prevent lower back pain caused by your spine arching too much. 
  4. In addition to altering your sleep position, back pain can be reduced with the help of a firm mattress and a supportive pillow.

Avoid Back Pain While Sitting

Back pain during long periods of sitting is a common phenomenon. Sitting actually puts more stress on your spine than walking or standing. But, thankfully, there are some easy fixes for back pain, neck pain and shoulder pain that occur while sitting.

  1. Poor sitting posture is to blame for a lot of upper back pain and lower back pain while sitting, as well as neck pain and shoulder pain. Good posture means less pain. To reduce pain when sitting, sit up straight, with your ears, shoulders and hips in line. Place both feet flat on the ground, with thighs parallel to the floor.
  2. Avoid back pain while sitting by sitting on your "sitting bones," not your tailbone. This might mean you have to add a blanket or cushion underneath you to ensure your knees aren't higher than your hips.
  3. To maintain proper sitting posture, buy a good chair with a firm, flat seat and plenty of lower back support. A chair with good lumbar support can help you avoid a sore back. If your chair doesn't have lumbar support, avoid back pain by putting a small pillow or rolled up towel between your lower back and the chair. 

Stand Without Back Pain

Do you experience back pain from standing too long? Many people do. Fortunately, there are some easy solutions to help deal with it. 

  1. If you are standing for long periods, be sure to give your back a break. You can manage your back pain at home by bending forward and to the sides to a comfortable stretching position.
  2. Don't forget that supportive shoes reduce the risk of back pain and knee pain
  3. Proper posture can also help limit back pain while standing. Keep your ears, shoulders and hips aligned to help prevent pain. Also try to pull in your stomach and chin, while tilting your pelvis forward.
  4. Change your position often to lessen back pain and knee pain while at work or during long periods of standing in line. If possible, use a stool or block to rest one foot on.
  5. A back brace can help you maintain proper posture, providing back and abdominal support. It provides support for prolonged periods of standing or walking.

Reduce Back Pain When Walking

If you're wondering how to walk with back pain, consider these simple tips.

Walking can be a great form of excercise, but it may be difficult to figure out how to walk with back pain. These tips can help you get started.

  1. Like in every other area, posture matters. You can exercise with back pain by holding your head high, tucking in your chin and pointing your toes straight ahead. 
  2. Comfortable shoes are a must. Pick ones with an arch support to help reduce back soreness and leg soreness the next day. 
  3. To avoid back pain after your workout, stretch when you return home. And don't forget to hydrate. Water can even help keep your spine healthy, since it's an important component of spinal discs. 

Drive Comfortably Without Pain

Driving to work and on errands can be a pain - literally. Back pain while driving can make routine trips unbearable. Consider these tricks to lessen driving back pain.

  1. To reduce back pain while driving, apply the advice for sitting without back pain: Keep your back upright, sit on your "sitting bones" and make sure your knees aren't higher than your hips.
  2. Keep your shoulders back and put both hands on the wheel to reduce the chances of back pain and arm pain.
  3. If you need help to keep your back straight or your arms straight, consider a brack brace or a wrist brace. They reduce pain by providing support and limiting movement, which can be especialy helpful for herniated discschronic lumbar instability, degenerative disc disease, post-operative rehabilitation or severe sprains or strains.

Do you have any other additions to our list? Let us know in the comments!

If you have additional questions about your back pain, consider the benefits of seeing a pain management physician. Click the link below to download our free comprehensive Back Pain Guide, with expert information, facts and advice to help you relieve your back pain. 

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Published in Back Pain
Thursday, 16 November 2017 08:44

How Does Back Pain Affect Sleep?

If you suffer from acute or chronic pain, especially back pain, the thought of a good night’s rest may be only a dream. Most adults need 7 to 9 hours a night for the best amount of sleep, although some people may need as few as 6 hours or as many as 10 hours of sleep each day. Oftentimes, individuals who suffer from pain associated from back conditions experience additional issues with insomnia and sleeping disorders. According to the National Sleep Foundation, pain and sleep problems are significant. In the adult population, about 15% of those surveyed reported experiencing chronic pain. In older adults, the number increases to over 50%. Among those with pain, 2/3 reported poor or disrupted sleep.

Sleep is one of the most critical ways that we renew our mental and physical energy on a daily basis. While there are many conditions and environmental factors that cause sleep problems, disturbances in sleep can intensify many conditions – including back pain. If you suffer from chronic pain or acute back pain and it is effecting the quality of your sleep, it is essential that you incorporate effective strategies and a treatment plan that will aid sleep deprivation from interfering with work, driving and social activities. 

Pain and Sleep Facts:

  • Each year, at least 40 million Americans suffer from chronic, long-term sleep disorders, and an additional 20 million experience occasional sleeping problems.
  • 2/3 of chronic pain sufferers have sleep problems.
    • Sleep deprivation accounts for an estimated $16 billion in medical costs each year, while the indirect costs due to lost productivity and other factors are much greater.
    • Sleep complaints and related daytime symptoms occur in 54–70% of adult rheumatoid arthritis patients.
    • One study estimated that the prevalence of sleep disturbance among people with low-back pain is 58.7%.
  • 75% of patients with fibromyalgia complain of sleep disturbances.

Causes Of Sleep Problems When You Are In Pain

If you live with pain, you know that sometimes your only relief is when you are asleep. However, some people’s pain prevents them from finding a way to become comfortable – oftentimes leading to the development of sleep problems. These problems not only result in overtiredness, but may cause pain to worsen. Here are a few conditions that may trigger a sleep problem to develop:

  • Anxiety and depression can make it hard to fall asleep or stay asleep. Consequent sleep loss can lead to increased pain. Anxiety and depression may also increase a person’s sensitivity to pain.
  • Some breathing related sleep disorders are associated with obesity – and obesity is also linked with back pain. Sleep disorders like sleep apnea interfere with normal sleep patterns, leading to insufficient sleep and poor sleep quality.
  • Limb movement disorders, such as restless legs syndrome, might further disrupt the normal sleep pattern.
  • Fibromyalgia can cause pain throughout the body. It is also linked with fatigue, anxiety and sleep problems.
  • Many prescription medications can impair the quality of your sleep. For instance, medications for conditions such as high blood pressure, epilepsy and ADHD may also cause sleep problems.

If you'd like more information on sleep and pain, take a look at the best sleep positions for back and neck pain.

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Published in Sleep-and-Pain

describe the image

Did you know that back pain is the leading cause of disability in the United States with more than one-half of all working Americans experiencing symptoms each year? In fact, experts say that as many as 80% of the population will experience a back problem at some time in our lives. The good news is that most causes of back pain are not related to serious conditions or incidents such as infection, sports or accident-related fractures or cancer. Most often, symptoms occur from causes that can be prevented or modified such as arthritis, poor posture, obesity, stress and more. When an individual experiences back pain, any one, if not all of the following factors may come to mind:

What is causing my back pain?

The back may be one of the most complex structures in our body and it sustains a tremendous amount of wear and tear with each of the activities we do everyday. In many instances, back pain is the result of overuse or injury. It is not uncommon for pain to arise from poor posture, standing or sitting for long periods of time, smoking, trauma from a fall and much more.

How do I go about diagnosing and treating my back pain?

Diagnosing the cause of back pain can be complicated and should be conducted by an experienced medical professional. Your medical provider will lead you through a series of important questions related to your pain intensity, lifestyle factors and more. A large variety of interventional treatments and minimally invasive procedures will likely be available for most people experiencing back pain, allowing patients to return to work and to their active lifestyles.

What are some ways to keep my back healthy?

Back pain prevention methods at work and home are important steps to understand and keep top of mind to avoid injury and chronic pain. Exercising, eating healthy, practicing good posture and proper lifting techniques are just a few of the ways you can prevent the onset of back pain.

How do I cope with my back pain?

Unfortunately for some, pain management is a part of day-to-day life for the long-term. However, there are many techniques that can be implemented to eliminate pain or at the very least, keep it at a tolerable level. Proper medication compliance, lifestyle factors, exercise and strength, stress and activity level all play a significant role in pain management.

The expert team at Advanced Pain Management is committed to identifying the source of back pain and finding the right treatment options for each individual patient. Understanding and protecting the spine is important to everyone’s wellbeing.

What steps are you taking to prevent back pain or treat symptoms associated with work and lifestyle factors?

Explore each area of diagnosis, treatment and prevention in much greater detail by downloading our newly expanded Back Pain Guide.

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Published in Back Pain
Thursday, 02 November 2017 13:12

The Benefits of Radiofrequency Neuroablation

Nerves play an important part when it comes to pain. They’re responsible for transmitting pain signals from the painful areas of your body to the central nervous system (i.e. the spinal cord and brain). It makes sense, then, that nerves can also play an important part when it comes to treating that pain. That’s where radiofrequency neuroablation comes in.

Background and Uses

Radiofrequency ablation (RFA) – also called radiofrequency rhizotomy and radiofrequency neurotomy – was first used to treat back pain in 1975 by CN Shealy.[1]  In a paper regarding the topic the following year, Shealy concluded that in properly selected patients, 82% experienced partial to total pain relief with no neurologic complications.[2]

 RFA is used to treat pain stemming from the facet joints, both in the spine (lumbar and thoracic) and neck (cervical). Facet joints are where each vertebra connects with the vertebrae above and below it. These joints both stabilize the spine and limit excessive motion.[3]Normal wear and tear, injury and disc degeneration can all cause issues with the joints, resulting in back or neck pain. In a systematic review in the journal Pain Research and Management, five out of six studies found that in cases of chronic back pain resulting from such facet issues, performing RFA resulted in statistically significant reductions in pain.[1]

The procedure is ideal for pain that hasn’t responded to conservative therapies, such as physical therapy or medication. Before the procedure, physicians will typically perform a diagnostic nerve block to ensure that the patient is a good candidate for the procedure.

How it Works

During an RFA procedure, heat from an electrode is used to cauterize one or more nerves, thus disrupting pain signals to the brain.

To begin, after the patient has received medicine to help them relax and the area around the injection site has been numbed, the physician inserts a small tube called a cannula into the spinal area and guides it to the right nerve with the help of an X-ray device. An electrode is inserted through the cannula and its position is tested with a small jolt before the nerve is heated.[3]

To heat the nerve, a high frequency electrical current is administered, which causes molecule movement and produces thermal energy.[1] This, in turn, creases a small lesion within the nerve, disrupting its ability to transmit pain signals. The doctor may treat several nerves, if necessary.

Following the Treatment

After an RFA procedure, pain relief may not be immediate. The injection site will be sore and back or neck pain may still persist, but, if the correct nerves were treated, the pain will gradually decrease over several weeks.

Partial or total pain relief from radiofrequency can last for several months. Nerves do grow back, however, so the procedure may need to be repeated. But, unlike invasive surgeries or long-term medication usage, there are few serious side effects to the procedure, allowing you to get back to a better quality of life.

More Information

To learn more about radiofrequency neuroablation, or to schedule an appointment with a pain specialist to discuss treatment options, click here.

Get moving. Call (888) 901-PAIN (7246) or click to schedule a consultation now.

[1] Leggett, Laura E., Lesley Jj Soril, Diane L. Lorenzetti, Tom Noseworthy, Rodney Steadman, Simrandeep Tiwana, and Fiona Clement. "Radiofrequency Ablation for Chronic Low Back Pain: A Systematic Review of Randomized Controlled Trials." Pain Research and Management 19, no. 5 (September/October 2014): 146-E153.

[2] Shealy, C. Norman. "Facet Denervation in the Management of Back and Sciatic Pain." Clinical Orthopaedics and Related Research, no. 115 (March/April 1976): 157-64.

[3] “ViewMedica Patient Engagement Videos.” Swarm Interactive 2016. Accessed May 5, 2016. http://www.viewmedica.com/.

Thursday, 02 November 2017 13:05

The Truth Behind Failed Back Surgery Syndrome

Back surgery doesn’t always mean the end of pain. In fact, a large portion of people still experience back and leg pain despite undergoing various types of spinal surgery, a condition universally called failed back surgery syndrome (FBSS). Fortunately, for those suffering from FBSS and for whom repeat surgery is not indicated – which is often the case – there are options to reduce the residual pain so sufferers can get back to a more normal quality of life.

Prevalence and Overview of FBSS

The true prevalence of FBSS isn’t entirely known, and estimates place the number anywhere between 5-50% of patients who undergo spinal surgery.[1] What is known is that the condition can come about from various types of surgeries and may be the result of removing bone (laminectomy or foraminotomy) or disc material (discectomy) or even a fusion of spinal segments.[2]

Failed back surgery syndrome doesn’t necessarily mean a failure on the part of the surgeon or that the pain is worse after surgery. FBSS simply refers to pain that persists after surgery – whether that pain is worse, unchanged or even slightly improved. In the case of FBSS, the outcome of the surgery just doesn’t meet the pre-surgical expectations of the provider and patient.[1]

Possible Causes

It’s thought that several factors can play into the development of FBSS.[2] Issues before surgery that can affect the outcome include spinal instability or anomalies in clinical images, in addition to preexisting conditions like diabetes, autoimmune disease and peripheral vascular disease.[3]

Psychological issues, like depression and anxiety, also play a role and patients with them are more likely to have unsatisfactory outcomes from surgery. [4]  Complications after surgery, like excessive inflammation leading to the development of fibrotic tissue, [2] can also result in unfavorable outcomes.

Treatment Options

Repeat spinal surgery is actually less likely to succeed than the primary surgery.[5]This means that oftentimes additional treatments provided by a pain management physician are needed to address the residual pain after spinal surgery.

Depending on the condition, pain management specialists have various options when it comes to managing FBSS pain. Oftentimes, they will utilize minimally invasive treatments such as epidural steroid injections, blocks or radiofrequency neuroablation. These, paired with physical therapy and other comprehensive treatments, can often lead to improved pain levels and overall quality of life.

Other times, physicians may turn to spinal cord stimulation, or SCS, a treatment that’s been proven more effective for FBSS than repeated surgery.[6] SCS delivers low voltage electricity to the spinal cord, interrupting pain signals before they reach the brain. With SCS, patients are able to try the system before permanent implantation and, once they receive the permanent version, are often able to reduce their reliance on opioids. Intrathecal pumps, which deliver medication directly to the spinal cord to block pain signals, may also be considered.

Preventing FBSS

However, as researchers note, preventing FBSS is much easier than treating it.[3] Preventing FBSS comes down, in large part, to proper patient selection for surgery,  meaning that for many, surgery may not be the right option. But for patients for whom spinal surgery is not indicated – or those who are hesitant to undergo such a serious surgery – there are other, less invasive treatment options. These may include some of the same options utilized to treat FBSS – like injections, blocks and radiofrequency – among others.

Learn More

If you’re looking for treatment options for FBSS – or are considering alternatives to spinal surgery – call (888) 901-PAIN (7246) to learn more today.

Download your free opioids and pain in-depth guide

[1] Taylor, Rod S., and Rebecca J. Taylor. “The Economic Impact of Failed Back Surgery Syndrome.” The British Journal of Pain 6, no. 4 (November 2012): 174-181.

[2] Russo, Marc. “Failed Back Surgery Syndrome: Pain That Persists after Surgery in a Subset of Patients.” International Neuromodulation Society. April 2002. Accessed August 30, 2016. http://www.neuromodulation.com/assets/documents/Fact_Sheets/fact_sheet_fbss.pdf

[3] El-Sissy, Mohamad H., Mohamad M. Abdin, and Amr M.S. Abdel-Meguid. “Failed Back Surgery Syndrome: Evaluation of 100 Cases.” The Medical Journal of Cairo University 78, no. 2 (March 2010): 137-144.

[4] Bordoni, Bruno, and Fabiola Marelli. “Failed Back Surgery Syndrome: Review and New Hypotheses.” Journal of Pain Research 2016, no. 9 (January 12, 2016): 17-22.

[5] Thomson, Simon. “Failed Back Surgery Syndrome – Definition, Epidemiology an Demographics.” British Journal of Pain 7 no. 1 (February 2013): 56-59.

[6] North, Richard B., David H. Kidd, Farrokh Farrokhi, and Steven A. Piantadosi. "Spinal Cord Stimulation versus Repeated Lumbosacral Spine Surgery for Chronic Pain: A Randomized, Controlled Trial." Neurosurgery 56, no. 1 (2005): 98-106.

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