Category Archives: Pain Management

Long Term Study Shows High BMI a Risk Factor for Low Back Pain

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An 11 year study recently completed showed that being overweight or obese are predisposing factors for the development of chronic low back pain. The study was revelation in that those who developed low back pain did not have the presence of the pain at the beginning of the study. This means the extra weight lead to the back pain, which is a breakthrough finding.Pain Clinic Chandler

The researchers out of Norway were able to show definitively that a high body mass index was a risk factor for low back pain. They had a very high number of participants, over 25,000, and were able to use statistical analysis to rule out other risk factors.

The study population was extremely large and had over 14,000 women in over 11,000 men aged 30 to 70 years old. The risk factors that were also looked at included age, smoking, blood pressure, work status, education and physical activity. Not only was there a strong correlation between high body mass index and low back pain, there was also a correlation between recurrent low back pain among women.

In previous studies, it was unclear which problem came first. It could’ve been either low back pain causing a person to develop a high body mass index or vice versa. By studying such a large amount of patients for over a decade, they were able to definitively show that it is in fact the high body mass index that leads to low back pain and the recurrence of that pain.

If you are suffering from low back pain, let Arizona Pain Specialists help you. The Phoenix pain clinics offer comprehensive treatment including medication Pain doctors in Phoenix management, interventional pain management, acupuncture, chiropractic, spinal decompression therapy, physical rehabilitation and more. Over 50 insurance plans are accepted.

Call (602) 507-6550 today.

Key Points on Facet Syndrome – from an AZ Pain Center

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The lifetime prevalence of back pain is 84%, and for neck pain it is 67%. This means that most Americans will suffer from one or both during his or her lifetime.Arizona pain doctor

Low back pain is the number one reason that individuals seek medical treatment and is also the number one cause of disability. In 2006, procedures for facet syndrome represented 37% of all pain management interventional treatments according to Medicare. In the 10 years from 1997-2006, this represented a 624% increase in these procedures.

Interestingly, the true diagnosis of facet syndrome cannot be made by history, physical exam or radiology findings. The most reliable diagnostic method is with a medial branch block or a facet joint block.

Medial Branch Block

Medial Branch Block

One question that pops up a lot is what amount of pain relief is necessary for the patient to be a candidate for a subsequent radiofrequency ablation?

Multiple studies have actually looked at the difference in results between 50% versus 80% relief for the medial branch block as a prerequisite for an ablation. None of these have found any difference in results with a subsequent radiofrequency neurotomy.

In addition, some insurance companies require two successful medial branch block or facet joint procedures prior to a radiofrequency denervation. Interestingly, multiple studies looking at this also failed to find a difference in success rates between one versus two diagnostic procedures.

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Radiofrequency Ablation

When it comes to corticosteroid injections into the facet joint, there are multiple studies that have found intermediate length pain relief. However, there have not been any large studies showing the benefit to be better than medial branch blocks.

There is substantial evidence favoring the medial branch blocks for both diagnostic and therapeutic purposes. Medial branch blocks can provide up to three months on average of pain relief. So not only can the injections tell the Arizona pain doctor whether or not the facet joint is the cause of pain, but can also eliminate that pain for months.

If a subsequent radiofrequency ablation is performed, the pain relief from that can be anywhere from six months to 18 months, which is incredible. Studies have also looked at repeating the radiofrequency ablation if the pain relief wears off. Those have shown results just as good as the first time.

Arizona Pain SpecialistsIf you are suffering from chronic neck or back pain, Arizona Pain can help. They have 4 locations around the Valley, including a pain management Glendale AZ location along with one in Phoenix, Scottsdale, and Chandler in the east valley.

Over 50 insurance plans are accepted including BCBS, Aetna, Humana, United, Cigna, Banner, Medicare, Medicaid, Personal Injury, Worker’s Compensation and many more.

Treatments offered at the AZ pain clinics include pain management, stem cell injection treatments, chiropractic, acupuncture, physical rehabilitation, spinal decompression therapy and more. Call (602) 507-6550 for more information and scheduling.

Herpes Zoster Pain Management and Post Herpetic Neuralgia

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Herpes zoster is the medical term for shingles. It is a viral infection that typically causes acute pain in most patients who are affected with it. One of the main problems with herpes zoster is that even when the virus settles down a bit it can still leave substantial residual pain in a lot of patients. This is called postherpetic neuralgia.

Herpes zoster results after a chickenpox infection which is the same virus. Even when chickenpox resolves, the virus still stays in the body in a latent fashion. It can become reactivated in adults for any number of reasons.Post herpetic neuralgia

About 1 million people annually are affected by herpes zoster, with a lifetime incidence of 20 to 30% of the population. It is especially common in those who have immunosuppression such as those who have organ transplants, HIV and certain cancers.

The presentation of pain with herpes zoster is variable. Usually there is some pain over the skin which comes on before a rash appears on one side of the body. 50 to 70% of zoster cases take place in the thoracic region. 10 to 20% occur in the cervical and lumbar region and about 8% occur in the sacral area.

At times, an individual may have the severe pain without a rash appearing. There can be additional issues besides just a rash and severe pain. Individuals can sustain a stroke, complications with the eyes, motor neuropathy, transverse myelitis and glaucoma.

Treatment of herpes zoster

Antiviral medications should be given as first-line treatments to those with herpes zoster who are age 50 or older. Even in those younger if severe rash or pain is present, then a medication such as Acyclovir and others in the same family can help to heal the rash, decrease the pain and prevent postherpetic neuralgia.AZ pain center

About 20% of those over the age of 50 with zoster pain end up with continued pain for six months after their rash heals despite taking antiviral medications. Opioid medications are often added to the mix, and some doctors will use Neurontin as well because in some smaller studies that showed benefit.

Multiple studies have looked at epidural steroid injections for the treatment of zoster pain. One study showed acute pain relief during the zoster phase but did not reduce the risk of developing postherpetic neuralgia. Other studies have looked at multiple epidural injections or continuous epidural infusions which have shown a reduction of the incidence of Pain clinic Phoenixpostherpetic neuralgia.

First-line treatment should definitely be antivirals plus opiates. It is unclear if the addition of an oral corticosteroid is beneficial. If these are not quite managing the pain, then the AZ pain management doctor can perform epidural injections.

The actual definition of Post Herpetic Neuralgia is defined as pain that lasts for at least six months after the onset of the rash. Unfortunately, the condition can last for years and lead to a significant reduction in a person’s quality-of-life. The pain can wax and wane is typically described as being sharp and stabbing along with burning.

When it comes to treatment for postherpetic neuralgia, first-line therapy should consist of tricyclic antidepressants and maybe Neurontin, Lidocaine patches, opiates, Tramadol and maybe a capsaicin patch.Pain Management Mesa AZ

Unfortunately, a significant number of patients will not respond well to medication management for postherpetic neuralgia. Interventional pain management for the problem may consist of sympathetic nerve blocks. These are often very effective for temporary relief but not so great for longer lasting relief. Studies looking at spinal cord stimulation showed long-term benefits in over 80% of patients with postherpetic neuralgia. The study included 28 patients and was very promising.

Arizona Pain Specialists has been providing successful relief for chronic pain conditions for years, and recently received its 5th Consecutive Patient’s Choice Award. The Pain Management doctors work closely with Phoenix chiropractors at the clinics to provide comprehensive relief options.Pain Clinics AZ

If you or a loved one is suffering from chronic pain due to post herpetic neuralgia or a condition such as failed surgery, help is available at Arizona Pain. Call (602) 507-6550 today for treatment with the best pain management doctors in Arizona.