APM Blog

Pain comes in many forms – and alternative pain treatment options do, as well. So . Should you seek acupuncture for low back pain? What about for fibromyalgia? And when are massage, relaxation and yoga warranted? At the beginning of September, the National Center for Complementary and Integrative Health – part of the National Institutes of Health (NIH) – went a long way toward answering this question, reviewing five decades of research to find the answer.

Overview of Research

The NIH review was published in Mayo Clinic Proceedings in September and contained data from 105 U.S. randomized controlled trials that were conducted over the past 50 years.[1] The trials covered a range of pain conditions, including low back pain, fibromyalgia, neck pain, osteoarthritis of the knee and migraine pain. It also looked at a variety of complementary treatment approaches, including acupuncture, massage, yoga, tai chi and dietary supplements, among others.

Although the review was wide-ranging and included a plethora of studies, there were some limitations. In some trials, the number of participants was small (with fewer than 100 individuals) and not very diverse, which could explain some of the conflicting results seen across the trials. However, throughout all trials, there were no serious side effects reported and very few mild side effects (like muscle soreness), meaning that overall, complementary treatments are a reasonably safe option for pain sufferers.

Back Pain

As one of the most common pain conditions, back pain has been the subject of many studies regarding complementary treatments. It may have something to do with the fact that people in the U.S. spend roughly $8.7 billion out-of-pocket each year on complementary approaches to manage their back pain, an amount which far exceeds any other condition.[2]

This review looked at back pain studies on acupuncture, massage therapy, osteopathic manipulative therapy, spinal manipulation and yoga. The NIH found that acupuncture and yoga, in particular, may be the most beneficial for patients with low back pain. There is also weaker, but still moderately positive evidence for: massage therapy, which may provide short-term relief; spinal manipulation, which can provide modest pain relief if performed often enough; and osteopathic manipulation, which may help improve pain, but has limited effects on function/disability.

Neck Pain and Knee OA

In terms of neck pain, the review looked at studies involving massage and spinal manipulation. They found that although spinal manipulation demonstrated no significant improvements in terms of pain and function, massage therapy did provide some benefits. If done often enough – say an hour 2 or 3 times a week – massage was able to help reduce pain and improve function in the short-term.

For osteoarthritis of the knee, the team reviewed studies regarding various dietary supplements, in addition to more active therapies. They found mixed results for glucosamine and chondroitin, but ultimately concluded there was little evidence to suggest these supplements were any better than taking a placebo. Tai chi, on the other hand, resulted in significant improvements for individuals with knee OA, and acupuncture was proven useful, as well.

Migraine Pain and Fibromyalgia

Studies regarding alternative treatments for severe headache and migraine pain were rare, with only one included for acupuncture, one for massage and two for omega-3 fatty acids. According to these studies, there is no benefit of acupuncture or massage in terms of pain severity, and the data for omega-3s is contradictory. Relaxation techniques, however, have been the subject of more research and have been shown to reduce both the frequency of headaches and the level of disability they cause. Even better results were achieved when relaxation was combined with another form of treatment, like medication or cognitive behavioral therapy.

The studies regarding complementary approaches for fibromyalgia have often been small and inconclusive, yet, according to this review, there is some evidence to suggest that mindfulness-based stress reduction can reduce stress and sleep disturbances associated with fibromyalgia and that tai chi may help reduce symptoms.

Multidisciplinary Approach

As the review found, many complementary approaches can be useful for the treatment of pain, but oftentimes more improvement can be seen when complementary approaches are paired with interventional ones. The physicians at Advanced Pain Management are dedicated to working with other practitioners to provide individualized and comprehensive pain relief. To learn more, call (888) 901-7246.

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[1] Nahin, Richard L., Robin Boineau, Partap S. Khalsa, Barbara J. Stussman, and Wendy J. Weber. “Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States.” Mayo Clinic Proceedings 91, no. 9 (September 2016): 1292–1306.

[2] Nahin, Richard L., Barbara J. Stussman, and Patricia M. Herman. “Out-of-Pocket Expenditures on Complementary Health Approaches Associated with Painful Health Conditions in a Nationally Representative Adult Sample.” The Journal of Pain 16, no. 11 (November 2015): 1147–62.


Thursday, 02 November 2017 10:48

How Injections Work to Alleviate Your Pain

The causes of chronic pain are undoubtedly diverse, from aging spinal discs and spinal stenosis to joint irritations and even failed back surgery. But there is one thing that many painful conditions have in common: inflammation.[1] Reducing that inflammation – the goal of a variety of injection procedures – can be a key component to achieving pain relief.

The Inflammatory Response

Inflammation is a natural reaction, part of the immune response our bodies enact to help themselves heal.[2] But inflammation, in addition to causing redness, swelling and even loss of function, can result in acute or prolonged pain.

According to the Institute for Quality and Efficiency in Health Care[2], various cells are involved in the inflammatory process. Tissue hormones cause your blood vessels to expand, allowing more blood to reach the injured tissue. Defense cells are brought along with that blood to assist with the healing. But these cells can irritate your nerves, causing pain signals to be sent to the brain. 

In chronic painful conditions, unlike acute cases of external injury or your body fighting against pathogens, this inflammation lasts from several weeks to several years. That means the related pain and sensitivity, instead of fading, continues on for the long-term.

Putting out the Fire

The goal of injections are to calm this inflammatory response – or “put out the fire” of inflammation. This is done by delivering combination of inflammation-reducing medications directly to the nervous system.[3] Typically, a local anesthetic (for short-term relief) and a steroid medication (for longer-term inflammation reduction) will effectively relieve pain for up to several months.

Injections can sooth the pain related to a variety of back problems, in addition to irritated shoulder, knee or hip joints, but in every case they work the same: The injected medications work to relieve inflammation, thus decreasing the firing of pain neurons within the nerves and spinal cord and helping to alleviate your pain.

Targeted Relief

At Advanced Pain Management, the physicians are specially trained in administering inflammation-reducing injections. To ensure that each injection of medication gets directly to the exact source of the pain, they utilize a specialized X-ray device called a fluoroscope during procedures.

Before injecting the medications, the physician uses an injection of dye, which shows up on the X-ray image, to verify that the needle is placed correctly. This extra step confirms that the medication is being injected exactly where it’s needed.

 Get Moving

The pain-reducing effects of injections can not only increase an individual’s tolerance for activity, but also their ability to undergo physical therapy. Advanced Pain Management’s comprehensive and individualized approach to pain management often includes a physical therapy component, which can help prolong and increase the pain-reliving effects gained from injections, in addition to preventing pain recurrence and re-injury.

Combined, physical therapy and injections can also help individuals decrease their reliance on opioid pain medications, reducing the risks associated with these powerful drugs.

Injections are a safe, low-risk way to treat pain at the source and get you moving again. To find out more about the injections APM offers, take a look these interactive animations or call (888) 901-PAIN (7246).


[1] Tal, Michael. "A Role for Inflammation in Chronic Pain." Current Review of Pain 3, no. 6 (November 1, 1999): 440-46.

[2] Institute for Quality and Efficiency in Health Care. "What Is an Inflammation?" PubMed Health. January 7, 2015. Accessed March 08, 2016. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072482/.

[3] "Patient Engagement Videos." ViewMedica. 2015. Accessed March 08, 2016. https://viewmedica.com/.

Published in Injections
Thursday, 02 November 2017 10:26

Intrathecal Pumps and Efficient Pain Relief

Oral opioids, by their very nature, are an inefficient – as well as a potentially dangerous – option for pain relief. That’s because opioids aren’t administered directly where they’re needed; after consumption, they work their way through the bloodstream before attaching to the opioid receptors in the brain, spinal cord and other organs.[1]

Fortunately, there’s a more efficient way to administer pain-relieving medications: directly where the pain signals travel. This method, called intrathecal pump implantation (or targeted drug deliver), delivers medication right to the intrathecal space, meaning pain relief can be achieved with roughly 1/300 of the dose of oral opioids.[2] For some chronic pain patients, this means more accurate pain relief with fewer of the side effects linked to oral opioids.

Overview of Intrathecal Pumps

An intrathecal pump consists of a pump, which can contain various combinations of medication, and a catheter. The device is able to provide targeted pain relief because the catheter is placed directly into the intrathecal space, the region surrounding your spinal cord. Pain signals travel along the spinal cord to the brain; the catheter delivers medication directly to that area, effectively preventing the pain signals from being perceived by the brain.[3]

The amount of medication released into the intrathecal space is controlled with an external programmer, which is pre-set with parameters and can be used by the patient to control breakthrough pain.

Intrathecal pumps are generally recommended for people with chronic pain who have utilized conservative treatments with limited success. It may also be used for people who have had surgery but are still experiencing pain, or people for whom surgery is not likely to help.[3]

Getting a Pump

The qualification process for a pump begins with a behavioral health consult for all patients. Patients who are experiencing depression, a lack of social support or a lack of motivation toward wellness do not do as well with implantable therapies. So during this mandatory step, a behavioral health professional will ensure that the patient is in the best possible position to achieve success with the implant.

After behavioral health clearance, the patient will undergo a reversible trial of the devise to ensure effectiveness of the therapy. This important step allows each patient to try the device and make sure it provides them adequate pain relief.

During the trial, the doctor administers local anesthetic then inserts a catheter through either a needle or a small incision into the intrathecal space. The catheter is then connected to an external temporary pump.[3] The patient will be able to try the system for roughly a week, and if the patient and the physician deem the trial successful, then a permanent device will be implanted.

During the permanent procedure, the patient will typically be put under local anesthetic. The temporary catheter will be removed and replaced with a permanent one. A permanent pump will be placed under the skin, usually in the abdomen, and connected to the catheter.[3]

Follow-up Care and Side Effects

After implantation, the patient will need to visit the doctor regularly so the pump can be refilled with medications. The pump itself contains a battery that will last several years. (The battery life will depend on which type of pump is utilized.)[3] After that time, a new catheter will be implanted.

There are may be some side effects related to the implant. For instance, mild discomfort and swelling at the incision site can occur after implantation. Over time, activity may move or damage the catheter, which would then require repositioning or replacement.

Learn More

For more information regarding intrathecal pumps, or to find out if one may be right for you, call (888) 901-PAIN (7246).

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[1] "What Are Opioids?" Drugabuse.gov. National Institute on Drug Abuse (NIDA), Nov. 2014. Web. 04 Aug. 2016.

[2] Lynch, Louise. “Intrathecal Drug Delivery Systems.” Continuing Education in Anaesthesia, Critical Care & Pain 14, no. 1 (September 4, 2013): 27-31.

[3] “ViewMedica Patient Engagement Videos.” Swarm Interactive. 2015. Accessed August 5, 2016. http://www.viewmedica.com/

Published in Pain-relief
Wednesday, 01 November 2017 04:13

Don’t Let Motorcycle Pain Slow You Down

Although, for some, riding a motorcycle is the epitome of summer fun (or spring or autumn), for others, it can be a pain – literally. From the muscle cramps and fatigue to the back aches, neck pain and wrist stiffness, pain can oftentimes ruin this quintessential warm-weather activity. But, fortunately, there are some steps you can take that will keep you going strong for the rest of the season.

Sitting Position

Your motorcycle type will go a long way toward helping – or harming – your pain levels. The best motorcycles to help prevent pain are standard ones that allow you to sit with your back straight, your feet directly below your body and your arms and hands straight in front of you.

Cruisers are the second best option for your body. On many of these bikes, your body will still be able to maintain a pretty straight posture, although your legs will be in a less favorable position, putting more of your weight on your butt and back – and therefore on your spine. Also, try to avoid bikes with “extreme ape” handlebars, which can both strain your shoulders and cause hand and arm pain.

In the least favorable category are sport bikes, on which you lean forward and oftentimes curve your back outward, putting your spine in a very unnatural position. These bikes also require you to have your feet behind you and your hands lower than your arms, creating more stress – and pain – in your arms and legs.

Core Strengthening

Even on bikes that allow for straight posture, many – if not most – riders still find themselves slouching. In this position, your shoulders will be arched forward, as will your back, putting increased stress on your spine, causing pain and leaving you more prone to injuries. The goal is to straighten your back and keep it that way throughout the ride. This takes core strength.

To achieve core strength, core strengthening exercises should be included as part of a regular exercise schedule. (Aerobic exercise is a critical element since it will help with weight loss, which will take excess weight off the spine.) A plank and modified plank (where you’re resting on your knees instead of your feet) are two good core exercises, as are lunges and squats. Other exercises include:

  • Abdominal Brace with Leg Extension: Lie on your back with your knees bent and abs tightened. Kick one leg out while keeping your back straight, then slowly lower it. Repeat this 10 times with each leg.
  • Superman on Bed: Lie face down with your arms at your sides and your head hanging off the bed. With your chin tucked, lift your head up until your back is straight. Pull your shoulder blades together and lift your arms off the bed. Hold for 5 seconds and repeat 5 times. Do this 2-3 times per day.
  • 4-Point Hip Extension: Start on your hands and knees with your abs tightened. Extend one leg behind you for a few seconds, then bring it back down. Repeat with the other leg.


Sitting in a single position while riding causes joints and muscles to stiffen. Stretching and movement – which relax the muscles and lubricate the joints – are therefore important components of a comfortable ride.

While it may not be possible to get off your bike to stretch and walk around every 30 minutes, try to do it as much as possible. Take advantage of rest stop breaks to do some simple arm, leg, back and neck exercises. You can also try to work movement into your ride: Raise and drop your shoulders, straighten your legs out for a few seconds (one at a time), or even move your elbows around briefly. If you have cruise control, use it on long stretches and take the opportunity to move your wrists and hands around.

Simple Adjustments

There are some other simple things you can do to reduce pain while on the road.

  • Hydration matters – no matter the temperature. Dehydration can cause slower reaction times and even cognitive impairment
  • Adjust your bike where possible. If your seat or handlebars are adjustable, take the time to make them as ergonomic as possible. Even a slight tweak could save you from pain in the future.

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Published in Motorcycles
Wednesday, 01 November 2017 03:03

Can Yoga Really Help Relieve Pain?

The search for nonpharmacological treatments for pain is on. Seemingly every day there are new promoters popping up, touting the benefits of one exercise or one herbal supplement that can cure all your ills – a modern-day snake oil, if you will. One such thing that’s often put forth as a be-all and end-all for pain is yoga. But what’s the truth behind these claims – and can it really be a useful avenue for the chronic pain population? Let’s find out.

Elements of Yoga

One of the main draws of yoga is that it is comprised of more than one component, since it incorporates physical postures, breathing techniques and relaxation/meditation elements.[1] There are many different kinds of yoga, each incorporating different poses, breathing and relaxation styles, but all rely on the interplay between these core elements.

The physical aspects of yoga are meant to increase strength, coordination and flexibility, while the breathing and meditation aim to help practitioners develop greater awareness and lessen anxiety. These mind and body aspects, when combined are meant to confer a greater quality of life.[2]

National Usage

According to the National Institutes of Health (NIH), “Pain is one of the leading reasons Americans turn to complementary health approaches, such as yoga, massage, and meditation — which may help manage pain and other symptoms that are not consistently addressed by prescription drugs and other conventional treatments.”[3]

The use of yoga for pain relief (along with tai chi and qi gong) is the third most common complementary modality used by American adults to treat pain (behind nonvitamin dietary supplements and deep-breathing exercises), but its use is growing. In 2002, only 5.1% of people practiced yoga. By 2012, that number had almost doubled, with 9.5% of people utilizing it.[4] This increase held especially true for the younger generation (age 18-44).

Proven Benefits

It’s been found that yoga can, in fact, be beneficial for certain types of pain. An analysis of eight randomized controlled trials on the benefits of yoga for lower back pain, for instance, found that yoga helped improve pain and functional disability by a medium to large degree.[1] Furthermore, the type of yoga practiced within the study had no effect on the outcome; they all seemed to produce benefits in terms of pain and function, suggesting (although more research is needed) that the poses themselves don’t matter as much as the interplay between the postures, breathing and relaxation.

Another such analysis of yoga for pain took into consideration a myriad of pain conditions, from low back pain and rheumatoid arthritis to headaches/migraines and renal disease.[2] All studies that were evaluated indicated a positive effect in favor of the yoga interventions; however, this effect was greater for back pain when compared with other conditions.

Reasons for the Success

There are several theories as to how and why yoga confers such benefits. It could be that yoga’s physical poses result in increased core strength and stabilization, which are good for the back. It could also help by slowly getting pain patients to move again, overcoming their fears of making the pain worse through physical exertion.[1] Moving, in turn, helps reduce stiffness by lubricating the joints and can also promote weight loss.

Catherine Bushnell, the scientific director of the National Center for Complementary and Integrative Health (NCCIH) at the U.S. National Institutes of Health (NIH) believes it goes further than that, though. Chronic pain affects the brain, causing emotional problems and impaired cognitive abilities, most likely through a reduction in gray matter. Yoga, Bushnell has found, has the opposite effect, bulking up gray matter and strengthening white matter connectivity, thus counteracting the effects of chronic pain on the brain.[5] This, in turn, leads to an increase in pain tolerance, says Bushnell.


Nonetheless, yoga has its drawbacks. Its positive effects on pain and functional disability have been shown to fade over time, conferring only a small benefit a few months after cessation – meaning a sustained commitment to the exercise is necessary.[1] But another study found that enthusiasm for yoga often fades over time, meaning it’s unlikely that participants will sustain an effective level of participation.[2]

Additionally, more research is needed into which conditions may actually be improved by yoga. Some studies, for instance, have found support for its use for rheumatoid arthritis,[2] while others have found little to no effect on pain and disability for RA.[6] Furthermore, for some people – like those with high blood pressure, glaucoma, sciatica or women who are pregnant – the NIH recommends modifying or avoiding various yoga poses – meaning they may not receive the same level of pain-relieving benefits as others. [7]

Going Further

“Chronic pain is not exclusively a physical condition, but a complex syndrome including physical, psychological and social processes,” concludes a review in The Journal of Pain.[2]  “With respect to the multifaceted causes, there is need for interdisciplinary procedures in diagnosis and pain management.” While yoga can be utilized as one facet of the treatment for pain, more are usually required.

That’s where pain management comes in. With the help of a pain management provider, who can effectively coordinate interventional procedures and complementary alternative treatments, like yoga, the various causes and effects of pain can be addressed in an efficient and methodical manner, meaning more effective pain relief and a quicker return to doing the things you love.

Want to learn more? Call (888) 901-PAIN (7246) to schedule a consultation.

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

[1] Beggs, R. Thomas, and Susan Holtzman. "Yoga for Chronic Low-Back Pain: A Meta-Analysis of Randomized Controlled Trials." Pain Research and Management 18, no. 5 (September/October 2013): 267-72.

[2] Büssing, Arndt, Thomas Ostermann, Rainer Lüdtke, and Andreas Michalsen. "Effects of Yoga Interventions on Pain and Pain-Associated Disability: A Meta-Analysis." The Journal of Pain 13, no. 1 (January 2012): 1-9.

[3] "NIH Analysis Shows Americans Are in Pain.” National Institutes of Health (NIH). August 11, 2015. Accessed May 19, 2016. https://www.nih.gov/news-events/news-releases/nih-analysis-shows-americans-are-pain.

[4] Clarke, Tainya C., Lindsey I. Black, Barbara J. Stussman, Patricia M. Barnes, and Richard L. Nahin. "Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002-2012." National Health Statistics Reports 79 (February 10, 2015).

[5] Bergland, Christopher. "How Does Yoga Relieve Chronic Pain?" Psychology Today. May 27, 2015. Accessed May 23, 2016. https://www.psychologytoday.com/blog/the-athletes-way/201505/how-does-yoga-relieve-chronic-pain.

[6] Cramer, H., R. Lauche, J. Langhorst, and G. Dobos. "Yoga for Rheumatic Diseases: A Systematic Review." Rheumatology 52, no. 11 (November 2013): 2025-030.

[7] "Yoga: In Depth." NCCIH. June 2013. Accessed May 24, 2016. https://nccih.nih.gov/health/yoga/introduction.htm.

Published in Yoga

“Don’t let winter stop you from gardening and enjoying your landscape,” says expert horticulturalist Melinda Myers. And don’t let pain stop you, either! Download APM’s new Weed out the Pain: Winter Home and Garden Edition for tips and ideas on maintaining your plants and your health during these cold winter months, as well as ideas on exciting pain-fighting recipes and crafts.

Brave the Outdoors

Winter is a difficult time in the Midwest, since the cold weather often keeps us indoors – and away from our gardens. It’s also a hard time for people with pain, since the frigid temperatures and difficult winter chores can often increase pain. But winter doesn’t have to mean the end of your hobbies – even gardening – and, if done right, your outdoor chores don’t have to be a source of pain. Melinda’s advice on winterizing your landscape, paired with expert injury prevention advice from pain management providers, can help you enjoy winter and reduce your pain in the process.

For instance, Melinda recommends that after it snows, people should shovel first, then use a plant-friendly deicing salt. This way, you use less salt, making it better for your budget and your landscape. And while shoveling, switch sides often in order to avoid muscle fatigue or strain. It’s better for your back and means less chance of injury.

Staying Inside

But you don’t even have to go outside to experience the benefits of gardening. “Whether it’s the plants you brought in for winter, a new houseplant or greens on a windowsill, gardening helps reduce stress and elevate our mood,” says Melinda.

Melinda suggests growing an array of microgreens as an easy and nutritious gardening project this winter. Radish, mustard and spicy microgreens can give a spicy zip to your meals, and sunflower and popcorn microgreens have a delectable nutty flavor. 

Speaking of delectable meals, winter’s the perfect time to stock up your pantry with foods that fight pain – like cherries, ginger and peppers – and add them to a warm slow-cooked meal. The winter toolkit provides nine unique, tasty dishes to curb your hunger and decrease your pain, like this slow cooker creamy chicken and mint curry from Food 52. The refreshing addition of mint can actually help reduce inflammation and decrease headaches and general aches and pains.

After you’ve eaten, try your hand at some of the exciting winter- and nature-themed crafts in the toolkit, which not only help you brighten your home during the dull winter months, but can also help you fight pain.

Learn More

To get these expert tips from Melinda and APM’s pain management professionals, in addition to an array of pain-fighting recipes and winter crafts – download the Weed out the Pain: Winter Home and Garden Edition now!

Published in Gardening

Winter in Wisconsin can be brutal – but there is a fun side. The outdoor activities that come with snowfall can make the winter months a bit more bearable. Skiing, especially, is an exhilarating winter pastime – but pain can often stop avid skiers from taking to the slopes. Here are six great tips to keep back and knee pain at bay so you enjoy your time on the slopes.

  1. Make sure your knees are in the correct position.

    Knee pain is one of the main types of pain associated with skiing. For those with current knee pain and those trying to avoid it, proper knee posture is a must. Many people’s knees drop inward during skiing; instead of being right above the feet, they’re leaning toward the inside. (To see if you do this, practice your skiing stance in the mirror.) This improper alignment puts more pressure on the knees, causing inflammation. To address this, practice bending and straightening your knees in front of the mirror, making sure your knee lines up with your second or third toe. Do 30 reps 3-4 times a day, then graduate to doing it without the mirror.1 Also be sure to balance your weight along your whole foot, not just your heels, to prevent pain around your kneecap.
  2. Strengthen your quads.

    Quad strength is vitally important when skiing; it’s what allows you to achieve the proper knee-bent, squatting position.[1] To get them into peak form, stand on a step with one leg up. Slowly bend the knee you’re standing on, then straighten it. (Make sure your knees are in the proper position above your toes and that your hips stay level.) During the off-season, keep your quads strong with cycling and squats or lunges. Also make sure your ski position doesn’t have your butt too low; this makes it more difficult for your quads to work like they should, and also puts more strain on your knees.[1]
  3. Improve your core strength.

    While skiing, the body’s core muscles – particularly those in the lower back and abdominals – help you maintain a proper skiing form, which, in turn, prevents you from aggravating painful sites or incurring new pain. (Strengthening core muscles can also help reduce existing back pain.) To improve your core, start with leg extensions, where you lie on your back with your knees bent and your abs tightened, then kick one leg out straight before returning to the starting position. (Do this 10 times with each leg.) After you’ve mastered that, move on to bridges (lie on your back with your knees bent and abs tight, then raise your buttocks and hold for five seconds) and modified planks (start on your knees and elbows and hold yourself up for a period, working up to 30-60 seconds). For more core-strengthening exercise, download our Stretching Exercises for Pain Reduction guide.
  4. Keep hydrated.

    Water makes a big difference when it comes to your muscles. Losing water through sweating has been shown to decrease muscle strength. Consuming water, on the other hand, helps your body build new muscle tissue. So to keep your muscles strong – which can help you maintain proper posture and limit the risk of pain – make it a point to stay hydrated. The American College of Sports Medicine recommends drinking about 17 ounces of water two hours before exercise, then at regular intervals during exercise to replace lost fluids.[2]
  5. Maintain your exercise habits throughout the year.

    Skiing is a great form of exercise, but just like any other type of exercise, it’s hard to jump into it without proper preparation and training. Try to maintain an exercise regime throughout the year, so you’re ready for the ski season when it comes. (It will also help reduce existing pain.) If, like many others, you find yourself out of shape come winter, try to begin an exercise and core-strengthening program at least six weeks before you begin skiing for the season.[3] This way, your body will be prepared and you’ll be less likely to injure yourself while on the slopes or experience lingering pain afterward. Also remember to ease yourself into skiing at the beginning of the season. Too much too quickly is a recipe for injury. Start with a limited ski trip, then gradually work up to longer periods.
  6. Stretch and ice after you’re finished.

    Skiing can often result in delayed onset muscle soreness, which results from small tears in the muscle during physical activity and causes muscle inflammation.[4] It’s most common when starting a sport back up again or increasing your intensity level and can happen for people of all activity and skill levels. Reducing this after skiing can help you get back to the ski slopes quicker. After you finish a run down the black diamond, take ibuprofen or acetaminophen, ice your knees and legs during the first 24 to 72 hours and be sure to stretch. Try to rest your legs for a few days to allow them to recuperate before going back out. If the pain lingers past a few days – or your existing pain is still stopping you from skiing – consider seeing a doctor or pain management specialist.

Download your free stretching exercises for pain reduction

[1] Macdonald, Lucy. “How to Avoid Knee Pain When Skiing.” February 15, 2013. Accessed November 3, 2016. http://www.coachmag.co.uk/exercises/sport-workouts/2183/how-avoid-knee-pain-when-skiing.

[2] Convertino, Victor A., Lawrence E. Armstrong, Edward F. Coyle, Gary W. Mack, Michael N. Sawka, Leo C. Senay, and W. Michael Sherman. “ACSM Position Stand: Exercise and Fluid Replacement.” Medicine & Science in Sports & Exercise 28, no. 10 (1996): i–vii.

[3] Hyde, Thomas E. “Skiing and Back Pain.” October 2, 2012. Accessed November 4, 2016. http://www.spine-health.com/conditions/sports-and-spine-injuries/skiing-and-back-pain.

[4] McNamara, Melissa. “How to Get Rid of Sore Legs from Skiing.” November 15, 2015. Accessed November 3, 2016. http://www.livestrong.com/article/535504-how-to-get-rid-of-sore-legs-from-skiing/.

Published in Knee Pain

Thanksgiving is a time of family, food and fun; it shouldn’t be a time of pain. While the joys of good food and good company may distract you in part from your pain levels, here are five other easy tips to make this Thanksgiving the best one yet.

  1. Travel in comfort. Managing pain while you travel to and from your destination is just as important as managing it during your festivities – if not more. No matter how you’re traveling – whether by car, plane or train – utilize lumbar support to ensure a proper sitting position. Using something as simple as a pillow between your back and the seat can help you prevent lower back pain.

    Additionally, make sure you are sitting on your “sitting bones” instead of your tailbone (which may require you to sit on a small cushion or a rolled up towel). If you’re driving, plan various stops along the way to get out, stretch and walk around. If you’re flying or traveling by other means, try to get up and walk around every so often when it’s safe to do so.
  1. Add some pain-fighting foods to the menu. Lessening the levels of inflammation in your body is an important component of controlling pain. So on a day dedicated to food, why not set about lessening your pain levels with anti-inflammatory ingredients. Cherries, ginger, mint and hot peppers, for instance, can be a great way to add a new kick to your traditional dishes – and reduce your inflammation. For ideas on pain-fighting Thanksgiving recipes, check out this article.

  2. Avoid the alcohol. Alcohol can be detrimental to your pain in various ways. For one, it wreaks havoc on your quality of sleep, which, in turn, can worsen you pain levels the next day. For another, alcohol can interfere with many medications, including opioids. Alcohol slows down your nervous system (including brain activity) and painkillers slow down your respiration (including breathing). When you combine the two, the effects are magnified, causing a dangerous slowdown of your systems that can actually hasten an overdose. In fact, alcohol is a factor in almost18.5% of opioid-related emergency room visits and over 21% of opioid-related deaths.[1]

    In case you need another reason not to drink, alcohol can actually promote inflammation. The liver’s process of breaking down alcohol creates dangerous by-products, which can not only damage liver cells, but also increase inflammation throughout the body and weaken the body’s natural defenses.[2]
  3. Replace your after-dinner nap with a walk. Instead of sleeping off the turkey-related tiredness, shake it off with a brisk walk. When sitting down for a long meal, it’s inevitable that your joints will stiffen, which can often cause joint pain. Moving around actually lubricates those joints, decreasing your pain levels. So throughout the day, try to get some family members to join you in a walk around the block. Your joints will thank you.

  4. Stop and stretch. Throughout the day, whether you’re cooking, eating, cleaning or watching the big game, take some time to loosen up your muscles, which get stiff just like your joints. Here are some simple suggestions.
    • Neck stretch: Sit on your right hand and slowly lower your left ear down to your left shoulder until you feel a stretch in your right shoulder. Hold the stretch for 20-30 seconds and repeat two or three times on both sides.
    • Mid-back stretch: Pinch your shoulder blades together for three to five seconds. Repeat five times. This stretch can be done every 10 to 15 minutes.
    • Low back stretch: In a chair, rock forward on your seat, arching your lower back forward as much as you can. Then rock back and curve your back, with your chest moving toward your knees. Repeat this five times.
    • Hamstring stretch: While sitting, extend one leg out straight, bend forward and reach toward your toes until you feel a stretch behind your knee. Hold for 20-30 seconds, then switch sides.

For more stretches to reduce pain, download Advanced Pain Management’s comprehensive stretching guide, which contains step-by-step instructions on a variety of back and neck pain exercises, along with expert tips on exercise and posture.

Download your free stretching exercises for pain reduction

[1] CDC. “Alcohol Involvement in Opioid Pain Reliever and Benzodiazepine Drug Abuse–Related Emergency Department Visits and Drug-Related Deaths — United States, 2010.” October 10, 2014. Accessed October 7, 2016. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6340a1.htm.

[2] National Institute on Alcohol Abuse and Alcoholism. “Beyond Hangovers.” September 2010. Accessed October 7, 2016. http://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.htm.

Published in Thanksgiving-recipes
Tuesday, 31 October 2017 18:25

5 Ways to Extend the Growing Season

Don’t let cooler temperatures and the impending winter season stop you from gardening. Take advantage of every nice day and use these five strategies to keep gardening and enjoying your landscape.


  1. Add a splash of color to your fall garden with the help of cool-season annuals. Plant pansies, sweet alyssum, ornamental cabbage and kale in the garden or containers for a colorful finale to the season. Planting in containers – especially when they’re placed on stools or ladders at waist level – is an easy way to avoid excessive bending and kneeling, which can aggravate back and knee pain.

    You can also double your gardening pleasure by growing cool wave and other winter hardy pansies. These will brighten your fall garden, survive winter and add color to your spring garden as the bulbs begin peeking through the soil. Be sure to use a padded kneeler or knee pad when planting, and avoid kneeling on both knees whenever possible. Your knees will thank you at the end of the day.

  2. Take advantage of fall plant sales and add a few trees, shrubs and perennials to your landscape. The soil is warm and the air is cool, making it less stressful for you and the plants. Once your plants are in the ground, make sure to water them thoroughly and whenever the top few inches of soil are slightly moist but still crumble in your hand.

    And hydrate yourself, as well. Even though it’s cooler out, have a water bottle nearby; being dehydrated can lead to fatigue, muscle weakness and even dizziness. To further help your body, reduce the strain on your muscles by using the proper tools when digging and planting. To avoid hand pain, for instance, look for tools with padded handles or take a DIY approach, bulking up the handles on your existing tools with a washcloth and tape.

  3. Tarp.smallProtect flowers and vegetables from frosty nights. The first few fall frosts are often followed by warm, sunny weather during which you can enjoy the beautiful flowers and produce from your garden. Floating row covers sold as ReeMay, Harvest Guard and Garden Fabric allow air, light and water through while protecting plants down to 24 degrees. This means you can leave your plants covered, day and night, as long as needed.
  4. Bring a few annuals indoors. You can move potted plants into a sunny window or start new plants from cuttings. I prefer the latter, since you can wash off any unwanted pests and the resulting smaller plants take up less window space. First, start by taking 4- to 6-inch cuttings from your favorite annuals such as coleus, geranium or annual vinca. Then root the cuttings in moist vermiculite or a well-drained potting mix. Once rooted, move them to a small container filled with potting mix. Just like outside, you can easily reduce pain by placing indoor potted plants on a waist-height table, stool or ladder, or by employing a homemade or store-bought wall garden.

    You can grow your new plant in either a sunny window or under artificial lights. Be sure to water it thoroughly and often enough to keep the soil slightly moist. With proper care and enough light, you will be enjoying a few flowers over the winter.
  5. Harvest and preserve some herbs for added flavor in your winter meals. Use garden scissors or pruners when harvesting them. Rinse the herbs, remove any damaged or dried leaves, bundle, and hang upside down to dry. A warm, dry, airy place out of direct sunlight works best. Store dried herbs in airtight containers in a cool, dark location. For pain-fighting properties, consider drying some mint. It’s a great ingredient to add to your tea in fall and winter, and can reduce inflammation and relieve general aches and pains.

    As you garden your way through fall, you’ll not only improve the beauty of your landscape, but also your emotional and physical wellbeing. Enjoy!

    Weed Out The Pain Toolkit Download
Tuesday, 31 October 2017 18:04

4 Tricks for Evading Halloween Pain

For many people, the scariest thing this Halloween won’t be the masks or the movies, it will be facing the laborious holiday projects and parties with chronic pain. Fortunately, though, pain’s disrupting effect can be minimized with a few Halloween tricks.

Trick or Treat with Ease

For those suffering from chronic pain, trick-or-treating can be a dreaded event – but it doesn’t have to be. With proper preparation, warmup and some minor modifications, trick-or-treating can quickly regain its sense of fun.

Start preparing a week or two beforehand with a basic walking program. Start off moderately with a few simple stretches and set yourself an achievable goal. A fitness app or pedometer can help measure your progress. Slowly increase your distance as you feel comfortable. Also remember to wear comfortable clothing and shoes and drink plenty of water to fuel your muscles and keep you energized.

On the day (or night) of your area’s trick-or-treating, make the walk easier for yourself by planning out the route beforehand, keeping in mind how far you can comfortably go. To reduce the distance, if your children are old enough have them walk to the door by themselves while you remain at the end of the driveway.

Keep Clear of Candy

While it may be tempting to raid your own candy bowl (or your kids’ trick-or-treating bags), it’s better for your pain if you refrain. Sugar, in all its varied forms, can actually increase the inflammatory markers in the body – and lead to weight gain. Just like simple carbohydrates and food additives (such as MSG, artificial sweeteners and preservatives), it’s best to decrease your sugar intake.

Instead of sugary items, opt for healthy or fun alternatives – and give them to neighborhood kids, as well. Not only could you help teach kids lasting healthy habits, you could also provide a much-needed option for those with allergies. For consumable items, try handing out fruit leather, mandarin oranges, or juice boxes with 100% fruit juice. To add more of a “trick” to their treating, consider handing out something simple, like silly putty, masks, bubbles, glow sticks or stickers.

Dress for Success

Selecting your ghoulish, ghostly or gut-busting garb can be one of the best parts of the season – but it can also spell disaster for those with chronic pain. To avoid painful predicaments, no matter what your Halloween plans, opt for a costume that’s comfortable and allows you to move and walk easily.

Avoid costumes that require high heels or awkward footwear, for instance. High heels can actually make your feet slide forward in your shoes, causing improper weight distribution. This imbalance causes your body to tilt forward, forcing your back to compensate by overarching and putting strain on your hips, knees and lower back. Instead, choose footwear that provides support to your whole foot, promoting proper posture.

You should also steer clear of outfits that put extra weight on your shoulders or legs, which can lead to increased neck pain, back pain and knee pain. For comfort and safety, also try to choose a costume that doesn’t constrict your legs when you walk, and that isn’t too hot or itchy.

Avoid Decorating Nightmares

Whether spooky or spectacular, Halloween decorations are key to getting into the holiday spirit. But for those with chronic pain, the effort required to decorate can be a real nightmare. To avoid pain, choose lightweight decorations that don’t require excessive bending or reaching to put up. If you must carry heavy decorations or heavy boxes, hold them close to your body as you walk and try not to twist or turn.

To put decorations on your roof, gutters or a similarly high area, use a ladder or step stool, which can reduce the neck strain that comes with looking up for long periods, as well as the shoulder and arm pain from reaching up.  

You could also consider a back brace, which provides back and abdominal support while you lift boxes and decorate your home. Back braces, along with wrist braces and knee braces, help support the weak or painful parts of your body and protect them from further injury.

Enjoy the Season!

Taken together, these four Halloween tricks can help you avoid pain so you can enjoy all the spooktacular things the holiday season has to offer. What creative techniques do you use to avoid Halloween-related pain?

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Published in Halloween
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