Medial Branch Blocks

Your back pain doctor may order a medial branch block as a diagnostic tool to find the cause of your back pain. Medial branch nerves are small and they radiate from the facet joints in your spine. They are important because they carry pain signals to the brain. Your back pain doctor can use this block procedure to help find the problems that you are having with your back. If you notice an immediate reduction in pain, then the doctor will know that the source of your pain is with the facet joint.

The procedure involves an injection of anesthetic into an area close to the suspected joint. In most cases, the doctor will inject several areas at the same time to help determine exactly which joint is causing the problem. It should be noted that a medial branch block is used mostly to diagnose the source of the pain. Treatment, once the problem is identified, may involve a medial branch radiofrequency neurotomy, also known as ablation.

If the medial branch block confirms that a facet joint is involved, the ablation procedure may be considered for long-term relief from pain. In the ablation procedure, a certain type of injection is used that forms a lesion on the affected nerve that is carrying pain signals out to the patient’s brain. The goal is to stop this signal but to keep the nerve functional in its others purposes.

Medial Branch Block Procedure:

Your back pain doctor will perform the block using fluoroscopy, which is real-time x-ray, to Pain Management Doctorsguide the injection needle to the proper nerves. When the needle is in place, contrast dye is injected to ensure that the medial branch nerve is covered with the medicine. At this point, anesthestic is injected into the nerve area. The whole procedure is usually completed within thirty minutes.

Once the procedure is finished, your back pain doctor will have you rest for a few minutes. You will be asked to do a few movements that would cause the pain. If the procedure was successful, no pain will result from these motions.

Risks of Medial Branch Blocks:

The risks associated with this procedure are few. They include: allergic reaction to the meds used; bleeding (which is very rare); infection, which is also very rare.

Your back pain doctor will need to know before ordering the block if you are on any type of medication, especially blood thinning meds. You will also need to report any active infections that you may have as this may cause the doctor to postpone your block until the infection is cleared up. Also, if you have any type of allergies, you must report that to the doctor.

If you have been suffering from back pain, you should visit a back pain clinic as soon as possible. Many back pain problems only get worse as time goes by, and early diagnosis and treatment by an experienced back pain doctor is always your best option. You do not have suffer with back pain!


What You Need To Know About Headaches

Ask any pain management clinic what type of problem they see often and they will tell you headaches bring in a lot of patients. While virtually everyone knows something about headaches, many people do not know much about the different types of headaches. Your local pain management clinic wants to share the following information with you so you will be prepared to understand what may be causing your headache.

General Headache Information:

Pain management clinic personnel would define headaches as pain that is continuous and located in the head or neck. There are different kinds of headaches, and many require their own special treatments. It has been estimated that more than 45 million people in the US have some form of chronic headaches.

The Tension Headache:

Every year, pain management clinics across America see patients complaining of tension headaches. In fact, the tension headache is, perhaps, the most common type of headache Back Pain Doctor Los Angelesthat people suffer from. This headache is often caused by muscle contraction and may stay with a person over a long period of time. Generally, the pain is on both sides of the head and in the front and back of the head. Tension headaches are not made worse if the person does activities, and there is usually no other symptoms.

It is important that the patient see someone at a local pain management clinic so the headache can be treated properly.

Temporal Headaches:

This is also known as temporal arteritis, as caused by inflammation in the large arteries which supply the head area and temple area. This type of headache is felt in the temples and patients complain of a continuous, aching pain that varies in intensity. Generally, these headaches occur in individuals who are 60 years old or older. Other symptoms may be present as well such as jaw pain, night sweats, weight loss, and depression. Those who have this type of headache should visit a pain management clinic for diagnosis as soon as possible.

Sinus Headaches:

Sinus headaches are another common type of headache. They are caused by sinus inflammation, which is often the result of some form of allergic reaction. Sinus headache pain can be constant and felt in the cheekbones, bridge of the nose, and forehead. A diagnosis should be made by a pain management clinic doctor and may require certain tests and procedures. Use of antibiotics and decongestants are first line treatments of sinus headaches. Antihistamines may also be needed. Pain management clinic personnel do not recommend the people self-diagnose or self-treat this type of headache as taking the wrong type of medication can make the condition worse.


There are other types of headaches, namely migraine and cluster headaches, as well. In all cases, headaches are painful and cause people to change their lifestyles because of this pain. Working with an experienced pain management clinic is one of the best ways to get relief from this pain and to identify what the problem is in the first place. If you suffer from headaches, make an appointment with your pain management clinic today.

Chronic Vs. Acute Pain Management

While pain can come in many different types in different parts of the body, one of the main distinctions that must be made is between acute, or short-term, and chronic (or lasting) pain. They tend to have different types of causes, and need different pain management strategies no matter what the cause may be.

Diagnosis: Whether the problem is acute or chronic, the first thing that needs to be dealt with is determining what’s causing it. Generally, treatment of this underlying cause is important to treating the pain, which can’t always be considered as a separate condition. Acute pain is generally a direct symptom of a specific injury.

Chronic pain that has lasted for months eventually becomes a medical condition of its own. In some cases, it may have started from an injury that has now long since healed. In others, the might be no apparent cause. Not having an underlying problem to deal with can make treatment more difficult. However, there are other times when the pain does not go away, and this can be a symptom of an undiagnosed illness – sometimes a severe one.

Pain Management Santa MonicaShort-term treatment: In this type of treatment, most often the key is simply to keep it under control until the underlying injury is healed. This is sometimes most easily done with medication. Muscle relaxants, over-the-counter or prescription pain relievers, or corticosteroid injections can be used, depending on location and severity.

Long-term treatment: With chronic pain, the effects of longer-term treatment need to be considered. Many medications are not intended for use over extended periods of time. In some cases, the effects of this use have not been well studied. Eventually, it’s generally best to look at other options.

Surgery is often considered for lasting back conditions, particularly with spinal disc injuries. While this is considered somewhat drastic and is often a last resort, it can get good results.

Another treatment used in more severe cases is electrical stimulation, which connects an implanted wire from a pulse generator directly to the nervous system. The generator is then turned on for a certain amount of time each day. This is often done for severe nerve pain, or for back problems that were not resolved by surgery.

When no apparent organic cause for chronic pain is found, adjusting movement and behavior can help to mitigate symptoms. In many cases, it’s important to avoid straining nearby muscles that could become overworked in compensation.

Many people also turn to less conventional therapies, such as acupuncture or chiropractic treatment. While not always recommended, these have been reported to produce good results.

Strategies used in both: For many types of joint or muscle pain, physical therapy is recommended. This can help prevent stiffness or other difficulties with the healing of acute injuries, and keep them from developing into chronic conditions. Similar stretching and strength exercises are also sometimes recommended to improve movement over the longer term.

Especially for lower-level pain, whether chronic or acute, massage therapy can help to relieve muscle tension that may be making it worse. Massages can also help ease strains.

See Your Back Pain Doctor If…

There are some types of back pain that can be treated at home, but there are other types of back pain that simply must be treated by your back pain doctor. Knowing when to see your doctor for your back pain can be very important.

Here are some signs and symptoms that should alert you to going to your doctor for treatment:

Back Pain with Fever:

If your back pain is accompanied by fever, you should see your doctor as soon as possible. The presence of a fever may indicate that you have some form of infection which will need treatment by health care professionals. Your doctor will be able to tell if the fever is caused by infection or not, and will be able to treat the infection if need be.

Back Pain Doctor Los Angeles

Back Pain and Trauma:

Anyone who experiences back pain because of trauma should see a doctor, but those who are over 50 years of age simply must see a doctor. It is not uncommon for even simple Pain Management Los Angelesfalls or other types of trauma to cause small fractures in older people. Your back pain doctor may want to take X-rays to rule out any fractures. If no fractures are detected, pain management can be achieved with various types of medication.

Back Pain with Tingling (or Numbness):

Many people will ignore the symptoms of tingling or numbness that goes along with their back pain. This is a mistake because tingling or numbness can indicate nerve damage or nerve irritation. Some conditions, such as spinal stenosis, can put pressure on nerves causing these sensations. In all cases of numbness or tingling with back pain, consultation with a back pain doctor is called for in order to track down the problem and treat it properly. Some conditions, when left untreated, can advance into permanent damage.

Back Pain at Night:

For those who feel fine during the day but experience severe back pain when they lay down at night, something serious may be afoot. When night pain occurs it can be a signal that the person has some form of disc degeneration or some other serious problem that requires professional medical assistance. Those who have night pain should see a back pain doctor promptly in order to have the problem diagnosed and treated. Blood tests and MRI’s may be needed to track down the cause of the pain and to rule out tumors or infections.

Chronic Back Pain:

If your back pain has not gone away within six weeks, you should see a doctor as soon as possible. The vast majority of back pain episodes go away within this time period. If your pain has not gone away, then your doctor will want to look into why it has not.

The above are just some of the issues you need to know about when it comes to back pain. The best advice is to always see your doctor when you have a sudden bout of back pain, especially if it was caused by any type of trauma. Seeing your doctor is the best way to ensure that you are not having a more serious problem than what you think you are having.


Drugs For Migraine Prevention: What You Need To Know

Those suffering from migraines already know how excruciating the pain can be at times. For some people, certain types of drugs may help prevent episodes from coming on.

One of the more common drugs used to help prevent migraines are beta-blockers. These drugs help to relax blood vessels which can be helpful in stopping a migraine in its tracks.

The calcium channel blockers can be used to help decrease the amount of constriction that takes place with the blood vessels. Narrowing of blood vessels often brings on headaches.

Some types of antidepressants have been seen as being effective in helping stave off migraines. Amitriptyline and nortriptyline are two such drugs.

Botox, also known as botulinum toxin, has helped some people. The drug is injected into the face and parts of the scalp. It does not work with everyone, however.

Who Should Use Migraine Prevention Medications:

If you fall into one of these categories, your doctor and you may wish to consider adding pain management and preventive drugs to your regime:

•    Those whose headaches are disabling or headaches that interfere with life or work

•    Those who have 3 or more headaches (moderate to severe) per month

•    Those whose migraines affect their quality of life

•    Those who take other pain management drugs often with no relief

•    Those who suffer from adverse side-effects to their current pain management medications

•    Those who wish to try preventive measures as a part of their pain management program

Pain Management Santa Monica•    Those who are able to take medication on a daily basis

•    Those who have unusual symptoms such as auras

Preventive Drugs for Migraine Should NOT Be Used:

•    By those whose symptoms are controlled and not disabling

•    By those who do not have 3 or more moderate to severe headaches per month

•    By those who are having success with other drugs

•    By those who are not having adverse side-effects with their current medications

•    By those who have medical conditions that would preclude them from taking preventive drugs

•    By those who cannot adjust to the side-effects of preventive drugs

•    By those who would prefer non-drug therapies as part of their pain management program

As is true for any type of pain management program whether it is for migraines or some other health issue, consult with your doctor first. He or she will be able to share the latest medical news with you that will pertain to your condition. It is never advisable to start a medical program on your own as some signs and symptoms may be indicative of serious health conditions that require professional medical assistance.

In addition to the above preventive drugs for migraines, there are also many non-drug pain management therapies available. These include such things as relaxation exercises, biofeedback, and certain devices that can help to lessen the pain or, at least, help you to cope with it when it hits. Again, your doctor is your best source of information when it comes to finding those medical actions and medications that can work with you and your personal health issue.


What You Need To Know About Rheumatoid Arthritis

Rheumatoid arthritis, which is also known as RA, usually affects the smaller joints in the feet and hands. It is a chronic disorder that causes painful inflammation in the affect area. RA can cause both joint deformities as well as erosion of bones. Those who suffer from this disease process often seek help from pain management doctors.

Rheumatoid arthritis happens when the body’s immune system begins to attack body tissue which it should not be doing. This is known as an autoimmune disorder. RA can also affect other parts of the body such as the lungs, skin, blood vessels, and eyes. As one might imagine, it can become a serious health problem.

Many people believe that RA only occurs in the elderly. This is not true; it can occur at any pain management los angelesage, but is most often seen in those over 40. Women are more at-risk than men. Pain management doctors treat this disorder with certain medications that can help control symptoms as well as helping to prevent further damage to joints.

RA Signs and Symptoms Include:

Joint stiffness in the morning

Swollen joints that are warm to the touch and sensitive

Nodules under the skin of the arms

Weight loss, fever, and fatigue

Most pain management doctors who work with RA patients agree that in the early stages RA affects small joints such as those found in the fingers and toes. As RA progresses, it can begin to affect other areas such as hips, knees, shoulders, elbows and ankles. Generally, symptoms will appear on both sides of the patient’s body and in the same joints.

Pain management doctors also agree that the symptoms of RA may come and go. In some cases, over time, deformity of the affected joint may occur. At present, doctors are not entirely sure what actually triggers the process.

There are certain risk factors that may make a person more susceptible to rheumatoid arthritis. These include:

Gender: Females develop RA more so than men

Family: Those who have family members with RA seem to be more at-risk

Age: Usually occurs in those over the age of 40, but can occur at any age

Rheumatoid arthritis can also increase a person’s chances of having other health Pain Management Doctors Los Angelesproblems. These include the added risk of developing osteoporosis, developing carpal tunnel syndrome if the RA affects the person’s wrists; heart problems can develop if the arteries become hard or blocked or if the sac surrounding the heart becomes inflamed; and lung disease is also possible if lung tissue becomes scarred.

The good news is pain management doctors have made great strides in helping people deal with their RA symptoms. It should be noted, however, the best medical course of action takes place when the patient sees a doctor early on. If you believe you may have RA, or be in the process of developing it, seek out medical advice as soon as possible. The earlier you begin treatment the more successful your treatment may be in the long run.


What A Diagnosis Of Adult Scoliosis Could Mean For You

Scoliosis is a condition which causes a curvature of the spine. When scoliosis occurs in childhood, the individual may experience rotation of the spine that results in damage to the spine and to various organs in their bodies. Traditionally, the only treatments used for scoliosis were wearing braces or having surgery in which a metal rod is placed inside the spinal column to hold it in place. Not all children with scoliosis advance with the same severity that requires surgical intervention. Those who have mild to moderate cases are often treated by pain management doctors who also work to prevent the curvature(s) of the spine from increasing.

Adults typically believe that if they did not have scoliosis as a child, they will not have it as adults. In reality, scoliosis can occur during adulthood when degenerative arthritis causes a breakdown of the facet joints so that the spine begins to shift to one side, resulting in the Pain Management Los Angelessame “S” curvature that results in early-onset scoliosis.

How Adult Scoliosis is Diagnosed

Some adults who develop scoliosis do not have pain from the condition and never seek treatment from pain management doctors to learn their diagnosis. Some may experience pain as a direct result of the condition or they may be experiencing pain from something else when the scoliosis is discovered. Scoliosis is easily viewed on an X-ray so that diagnosing the condition may be as simple and accidental as taking a chest X-ray to confirm Pneumonia and detecting the spinal curvature.

Differences Between Adolescent and Adult Scoliosis

When children develop scoliosis, it has no known cause. While those with mild forms may not recognize their condition at the time it occurs, others will advance severely so that they will experience damage to other areas of the body as a result. Many will visit pain management doctors to monitor their conditions and provide any needed treatment while they are still young.

Degenerative scoliosis, on the other hand, has a known cause. As adults age, the facet joints deteriorate and cause the curvature of the spine. Adults with degenerative scoliosis will often experience pain from the inflammation of the joints, not the curvature of the spine. Another incorrect assumption about adult scoliosis is that the condition does not advance. While it progresses slowly, the curve will continue to increase over time. It is just at a much slower rate than that which occurs with adolescent scoliosis. Therefore, the treatment they receive is for their pain, not for the condition itself.

Degenerative scoliosis occurs in aging adults in the same way that osteoarthritis can impact bones. The cartilage which protects the joints is worn away, causing the bones to rub together and cause inflammation and pain to occur. This usually occurs gradually over time with symptoms usually being the most severe in the mornings. Standing and walking are often difficult, sometimes causing pain from lumbar stenosis, a constriction of the lumbar spinal canal that result from the enlargement of the facet joints. For most adults with degenerative scoliosis, treatment is sought from pain management doctors as an elective choice to improve quality of life.


How To Identify Migraine Headaches

Nothing can disrupt your activities faster than the onset of a migraine headache. The large number of people who suffer from migraines know the severe and debilitating pain that accompanies them. For many, once a migraine takes hold, the only thing they can do is lie in a dark room where there is no light or noise to cause greater pain and nausea symptoms to occur.

More than 10% of the people in this country suffer with migraines, often seeking help from pain doctors when their condition becomes unbearable or home treatment methods are ineffective. People who suffer from migraines for the first time during their adult years may not realize that they have a migraine instead of a different type of headache. Some of the signs and symptoms that set migraines apart from other types of headaches are:

•    Throbbing pain which often occurs on one side of the head around the temples, eyes and forehead

•    Sensitivity to light and/or sound

•    Nausea or vomiting

•    Blurred vision

Some people experience warning signs before they ever feel the first pain from a migraine. Their mood may change or they may see auras as flashing lights or lights in waves or dots. Some people may detect an odd taste or smell. Sudden intense fatigue may signal a migraine as can increased muscle tension. Any of these signs may occur hours or even days before a headache occurs. As a result, some pain doctors have put a stronger emphasis on preventing migraines before they occur. Preventive measures may include:

•    Prescription Medication

•    Acupuncture

•    Hormone Therapy

•    Massage

•    Injections – Including the injection of medications which block nerve action where migraines are believed to occur

Although the exact cause of migraines is still not known, sufferers are fortunate that pain Pain Doctors Los Angelesdoctors have an increasing number of effective treatment options available to alleviate their pain and prevent the headaches from occurring. Some people with migraines have headaches as a result of triggers that they can learn to recognize. Some types of lights, watching TV, experiencing high levels of anxiety or stress and a lack of food or sleep are some common triggers. Some migraine sufferers recognize food triggers as causing their headaches, with a few foods being the most common triggers. They include cheese, soy sauce, chocolate, monosodium glutamate (MSG, an additive found in many foods), red wine and processed meat. Knowing what triggers your migraines will make it easier to prevent them from occurring.

Migraines and Women

More women suffer from migraines than do men and, as might be expected, their headaches are connected to their menstrual cycles. During the time of their cycle when estrogen levels decline, typically immediately prior to or during their menstrual periods, migraines will occur. In some women, hormonal therapy may alleviate migraine symptoms while others will experience more severe symptoms when taking hormones. Pain doctors must treat migraine patients on an individual basis to learn what the most effective treatments are for each person. Keeping a journal of what you experience before and during a migraine and including any potential triggers could help your doctor find the right treatment for your migraines faster.

Pain Management For Your Back

Many Americans suffer with moderate to severe back pain every day of their lives. Chronic back pain and the symptoms that often accompany it can greatly reduce the quality of life. There are a number of conditions which lead to pain in the neck and spine including:

•    Spinal Stenosis

•    Degenerative Disc Disease

•    Sciatica

•    Radiculopathy

•    Herniated Discs

Spinal decompression is a method of pain management to give patients relief from chronic neck and back pain. One of the most significant reasons for its increasing popularity is that it provides an alternative to dangerous back surgery that often doesn’t work. Spinal Pain Management Doctors In Los Angelesdecompression is a non-invasive therapy that involves using intermittent spinal traction, a procedure that has been cleared by the FDA and which is significantly less expensive than spinal surgery.

The process works by using motorized traction to gently stretch the spine. It changes the way the disks of the back are positioned and provides relief by alleviating the pressure that has previously been placed the gel-like structures that sit between the vertebrae of the spinal column. As many as 85% of patients who try this method of treatment find that it helps reduce the impact of herniated or bulging disks and increases the flow of nutrients to their location to aid in healing.

Incidence of Lower Back Pain

Another reason for the popularity of spinal decompression as a treatment for lower back pain is the incidence of the condition. An estimated 60% to 80% of all adults in the United States have lower back pain. Symptoms of pain and stiffness of the area send 13 million people to doctor’s offices each year for treatment. Although a significant portion of these patients will end up with either temporary or permanent disabilities, the majority of those who have back pain do not require surgery. Instead, they will rely on a variety of treatments that will reduce their pain and discomfort but which are not likely to eliminate the problem altogether.

Types of treatment available for lower back pain include:

•    Drug Therapy – NSAIDs such as ibuprofen or naproxen or stronger pain relief medications including opiates. Muscle relaxants and steroids are also used in some patients.

•    Corticosteroid Injections – used to reduce inflammation

•    Heat and/or Cold Therapy

•    Physical Therapy

•    Alternative Therapies

•    Chiropractic Manipulation

•    Exercise – Yoga and Pilates, along with other specific exercises for improving strength and stability of the joints and strengthening the core

Spinal decompression is used in combination with other treatment methods to attain the best results for the individual patient. Most patients will undergo approximately 20 treatments over a 6 to 7 week period during which time they will also receive chiropractic treatment and exercises as part of a multi-modal approach to treatment. Combining the high percentage success rate of spinal decompression with that of other non-invasive methods of treatment results in an approach that will give the patient needed relief to enjoy a better quality of life without the risks associated with surgery or the potential for a failed procedure.

Using Corticosteroid Injections For Back And Leg Pain

Corticosteroids are a class of medications that are related to a steroid called cortisone. They are effective in reducing pain in soft tissues and joints. Cortisone is produced naturally in the body in the adrenal gland. It places a role in the body when it is under stress; stress causes an increase of cortisone in the bloodstream as a result. The cortisone used in inject able cortisone is made synthetically and goes by many trade names like Kenalog or Celestone.

They are produced to be as closely like natural cortisone, however, the differences are:

1) the synthetic cortisone is not injected into the bloodstream,

2) it is much more potent, and

3) it lasts much longer than natural cortisone. This is helpful in the way that the inflammation will be kept at bay longer.

This offers extended relief to patients that suffer from inflammatory conditions. Tendons, bursa, and joints can be relieved of pain quickly through cortisone injections. Since Back Pain Doctor Los Angelescorticosteroids have such strong anti-inflammatory properties, they are very effective when administered by an expert.

Is a cortisone injection a quick fix for pain relief?

Corticosteroids are anti-inflammatory agents, not pain relievers. However, as the result of the reduced inflammation, this will tend to help relieve pain. Corticosteroid injections can work for many months or even years if it is given properly. They can permanently resolve some diseases where the problem is tissue inflammation such as bursitis or tendonitis.

How is it used for back and leg pain?

There are three main types of cortisone injections for back and leg pain. Doctors will prescribe epidural steroid injections to relieve back and leg pain where it will act on inflamed nerve endings. It is injected into the dura, a membrane that houses the spinal cord and spinal nerves.

This is to reduce the swelling of spinal nerves and hopefully decrease the pain associated with the inflammation. Epidural injections in the lumbar region are done under X-ray guidance or what they call fluoroscopy. These injections are effective in cases of sciatica and other back issues that involve inflammation.

What are the advantages of cortisone injections?

Doctors will prescribe epidural steroid injections to relieve back and leg pain where it will act on inflamed nerve endings. When there is inflammation, cortisone will work very quickly to reduce it. Cortisone injections work in the local area of the inflammation so that it is focused in one region of the body whereas oral medication works all over the body, even where it isn’t needed. It is much more powerful than traditional anti-inflammatory medications, such as aspirin or ibuprofen.

Oral analgesics like aspirin can cause stomach irritation as well. Cortisone injections can Back Pain Treatment Los Angelesbe done at the doctor’s office so it doesn’t require a hospital visit. The best assets of cortisone shots are the dependability of the medication, the quick onset, and the minimal side effects.

If a patient is the breadwinner of the family, this can be a great treatment that will allow that patient to get back to work sooner and without debilitating pain. Low, intermittent doses of cortisone injections pose little risk of side effects like oral anti-inflammatory.