Regenerative medicine is finally becoming a reality in pain management, with initial studies for platelet rich plasma therapy and stem cell injections showing promising results.

By using the patient’s own blood and placing it into a special machine that spins the collection at a high rate of speed, which separates the platelets from the blood

Platelets are great at calling in stem cells for injury repair.

components, Arizona pain management doctors are able to help heal an injured or arthritic joint.  The platelets from the person’s blood releases growth factors that improve natural healing of tissue that is damaged or injured.

The platelets are tiny cells in the blood that are critical to healing.  They are the body’s main source of tissue growth factors, as the platelets contain thousands of growth factors, necessary for healing.  Some of the growth factors that platelets contain include:

• Connective tissue growth factor
• Epidermal growth factor
• Insulin growth factor
• Platelet derived growth factor
• Vascular endothelial growth factor

These are just some of the growth factors contained in the body’s platelets.  The platelets along with the growth factors work together to naturally heal the body in response to injury or degenerative wear-and-tear.  When a person’s growth factors are highly concentrated and then re-injected into the body (at the site of injury), a powerful healing response is seen.

Why Use Your Own Stem Cells?

Platelet rich plasma therapy is often used with a fibrin matrix to bridge the gap in extremely damaged tissue, ligaments or tendons.  This process allows for new collagen to form and create a matrix along the damaged site.  When a person’s own stem cells are used, regeneration occurs and even the most severely damaged tissue can be initiated to heal.

In a person’s own blood there are concentrates of fibrin, platelets and mesenchymal stem cells.  Bioactive growth factors are also present in high concentration, but scattered throughout the blood.  The key component of platelet rich plasma therapy (PRP) is to spin the concentration of blood so that the growth factors can be separated.

Research shows that using PRP promotes the production of new collagen and rebuilds joint cartilage as well as strengthens injured tendons and ligaments.  The rebuilding comes from the introduction of a person’s own stem cells being introduced into the injury site.

PRP Therapy calls in stem cells for regenerative healing.

The concentrated platelets do a great job of “calling in” the body’s stem cells to initiate repair.  The new collagen becomes naturally incorporated into the patient’s existing cartilage, ligaments and tendons.  The process makes the injury site stronger, thicker, more viable and elastic.

If you have questions regarding how effective it is to use your body’s own stem cells for the healing of damage or injury, seek answers from your stem cell specialist today.

The Arizona Pain Stem Cell Institute offers regenerative medicine treatments including research projects with amniotic derived stem cells, bone marrow derived stem cells and platelet rich plasma therapy. The projects are non-randomized, meaning all patients receive the regenerative medicine treatments. Treatments are industry subsidized and typically cost 40% less than what is typically seen with stem cell treatments.

All treatments at the Institute are performed by Award Winning, Board Certified Scottsdale pain management doctors.

To find out more about the Arizona Pain Stem Cell Institute and potential treatments available to help with your back, neck or extremity pain, call today (602) 507-6550.

The Arizona Pain Stem Cell Institute is now open and seeing patients!

Arizona Pain Specialists understands that patients want nonsurgical options for pain that are cutting edge and represent the latest in pain management for relief.

The Institute’s mission is to alleviate pain in those suffering by offering regenerative medicine with the hopes of repairing injured tissue rather than simply suppressing pain.
In order to be able to offer the regenerative medicine procedures to as many patients as possible, the Arizona Pain Stem Cell Institute has teamed up with industry to subsidize research studies.

What this means is that in order to receive stem cell injections, patients can expect to pay approximately 40% less for their procedures than elsewhere.

Research Studies with Stem Cell Injections

Initially, the Stem Cell Institute is beginning two prospective studies with two more to follow.  Study #1 = The initial study will be evaluating amniotic derived stem cell rich injections into spinal joints for treating back and neck pain.

Pilot studies have shown that treating facet arthritis with stem cell injections works well.

Arizona Pain Stem Cell Institute offers research projects and other regenerative medicine treatments.

However, this study will include larger numbers with the material to obtain statistical significance.

The material being used in this study is amniotic fluid derived and obtained from consenting donors. It is processed at an FDA regulated lab and cryogenically stored until the injection.

The study will not be randomized, so every patient will receive the regenerative medicine substance. Follow-up will be for six months and all of the procedures are being performed at the Scottsdale location of Arizona Pain Specialists.

Study #2 = The second research study being started at the Arizona Pain Stem Cell Institute is also with the amniotic derived stem cell rich injection substance, but this study involves stem cell injections into extremity joints.

The study will evaluate the effect of the stem cell injections on arthritis pain in the shoulder, hip, knee and sacroiliac joint. Study parameters are very similar in that the follow-up is six months, and the study is being industry subsidized so patients can expect to pay out-of-pocket approximately 40% less than in other places.

Additional Procedures at the Stem Cell Institute

Bone Marrow Derived Stem Cell Injections

Additional procedures being offered at the Stem Cell Institute include bone marrow derived stem cell injections. These are performed as an outpatient and involve harvesting bone marrow from the patient’s iliac crest. The bone marrow is then spun in a centrifuge and then injected into the target area at the same setting.

Platelet Rich Plasma Treatment (PRP Therapy)

Platelet rich plasma therapy has been shown to help considerably for numerous musculoskeletal conditions such as knee arthritis, tennis elbow, rotator cuff tendonitis, achilles and ligament injuries. This involves a simple blood draw just like in the lab and the blood is then spun in a centrifuge. The result is a heavily concentrated solution of platelets and growth factors which are injected into the target area.

The Arizona Pain Stem Cell Institute is preparing a similar Platelet Rich Plasma Therapy study evaluating the treatment for both spinal arthritis for the back and neck along with extremity injections for arthritis pain. This will also be a non-randomized, industry subsidized study. Patients can expect to pay 40% less than typically charged at other clinics.

Studies to date with bone marrow derived stem cell injections and platelet rich plasma therapy have  shown impressive outcomes in small reports. Three professional sports leagues have approved the use of PRP and many athletes have received the treatments including Tiger Woods, Troy Polamolu, Hines Ward and Dwight Howard to name a few.
All the procedures at the Arizona Pain Stem Cell Institute are performed by Board Certified pain management doctors in Arizona.

To find out more information about the Arizona Pain Stem Cell Institute and if treatment can help your pain, or your loved ones, call (602) 507-6550 today!

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.

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 management, interventional pain management, acupuncture, chiropractic, spinal decompression therapy, physical rehabilitation and more. Over 50 insurance plans are accepted.

Call (602) 507-6550 today.

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.

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

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.

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.

If 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 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.

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.

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 postherpetic 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.

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.

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.

When pain medicines are taken by mouth, there can be adverse events associated. This may include common side effects such as constipation. However, once in a while something more serious may happen such as an ulcer or an overdose.

Topical analgesics that are applied to the skin are an excellent method of achieving pain relief with a lower side effect profile. When a medication is applied topically, it often provides substantial relief while having only little bit even enter the bloodstream.

There are three types of topical pain relievers often prescribed at Arizona pain clinics. One are numbing agents, another involves actual analgesic pain medication, and the third is counter-irritants.

The first, numbing agents, are designed to simply numb locally. This may include Lidocaine patches over a painful region. The medication seeps in a bit, and very little actually enters the bloodstream. One great application for Lidocaine patches is post-surgical around the incision.

Voltaren is the brand name for Diclofenac

Another medication that does well with local administration is diclofenac gel. Diclofenac by mouth is an NSAID that works well, however, there are instances of GI problems and potential kidney issues with chronic use. However, the topical route has been shown to be much safer and is FDA approved in a 1% solution. Studies have shown it is significantly more effective than placebo and great for arthritic pain (Drugs. 2009).

The second type of topical analgesics are actual medications that you want to get absorbed in the bloodstream. This includes fentanyl, clonidine, nitroglycerin, testosterone and more. These come in a gel form or a patch. The fentanyl patch for instance, stays on for a couple days and the medication gets into the bloodstream for systemic pain relief. One note here – Lidocaine patches can be trimmed to fit the area of treatment. A fentanyl patch should not be cut as all the medication will leak out.

Because of the serious potential adverse events with opiates or anti-inflammatory drugs taken by mouth, the topical analgesics are often used because there are minimal systemic side effects. You don’t have the risk of ulcers or kidney problems or fatalities due to respiratory depression (except with a drug meant to achieve systemic penetration like Fentanyl).

When it comes to counter-irritants, one very common one is known as capsaicin. This is a compound derived from chili peppers that desensitizes painful areas through repeated

Capsaicin is available over the counter.

doses. This could be very useful on a painful knee, shoulder or any extremities. This medication has extremely low side effects and may reduce pain nicely.

There also counter-irritant’ that are hot and cold products that have menthol or camphor as the active ingredients. Most of these are over-the-counter products such as Icy Hot or BenGay and the like. Another type of counterirritant includes topical products that have salicylates or benzyl nicotinate in them.

Overall, topical analgesics are an excellent way to reduce the need for oral medications and reduce side effects. There are various methods of increasing penetration through the skin for some of them, such as iontophoresis. This is a method kind of like ultrasound that pushes cortisone deeper into the skin that it would otherwise go.

Arizona Pain Specialists offers comprehensive Phoenix pain management at 4 locations that span the East & West Valley along with Phoenix itself. The Arizona pain doctors are Fellowship Trained, Board Certified and Award Winning. There are also physical rehabilitation doctors, acupuncture and chiropractic treatments offered.

The pain doctors accept Medicare, Major Medical like BCBS, Aetna, United, Cigna, Humana and many more. They are APIPA doctors in Phoenix along with Mercy Care and PHP. Workers Compensation and Personal Injury claims are accepted as well. Call today at (602) 507-6550 for more information and scheduling!

Trigeminal neuralgia causes extreme facial pain that can be disabling. It is the most common form of facial pain in those over the age of 50. In nine out of 10 cases the symptoms of the problem began after the age of 40.

Interestingly, women are affected more often than men at a ratio of 1.5 to 1. It is unclear what causes trigeminal neuralgia. Is thought that the nerve may be pinched near the origin of the brainstem.

The painful symptoms that go along with trigeminal neuralgia entail shooting pains on one side of the face. The pain is described as being sharp, shooting and almost like an electrical shock. Everyday normal activities can bring on the pain such as shaving, washing or eating.

Physical examination is not usually extremely helpful in most patients with trigeminal neuralgia. All the cranial nerves should be tested to make sure their function is intact, facial expressions are normal, the tongue works fine and things like that.

When trigeminal neuralgia is present, the patient should have an MRI scan to rule out tumors or multiple sclerosis. Also, the MRI can sometimes show compression of nerves by blood vessels. Having said that, there’s not enough evidence to support whether or not blood vessels actually cause symptomatic nerve compression.

The International Headache Society has come up with multiple criteria to make the diagnosis of trigeminal neuralgia. The first is that the individual should have pain that lasts anywhere from a few seconds to a few minutes and occurs along the branches of the trigeminal nerve. The second is that the pain should be intense, sharp or static in nature. Another is that there should be no signs of other neurologic disorders.

When it comes to treatment for trigeminal neuralgia, the medication of choice is carbamazepine. Studies have shown this medication can reduce the symptoms in about 70% of patients. Additional medications that may have efficacy include Neurontin, baclofen, pregabalin and Lyrica.

When it comes to interventional treatments, there are a few options that pain management doctors in Arizona can choose from. Percutaneous balloon microcompression involves percutaneous introduction using a needle into what is called Meckel’s cavity. There is some data to back up this technique, with the advantage being that it treats the first branch of the trigeminal nerve selectively.

Another injection that can be performed involves glycerol being introduced into the area around the trigeminal nerve. This can be performed, or the Phoenix pain doctor can do a radiofrequency treatment on the area and attempt to obtain longer pain relief. There are no large-scale studies showing the long-term outcomes of this procedure. For really difficult cases, a surgical microvascular decompression and be performed which separates blood vessels from the nerves.

One of  the problems seen with medication management for trigeminal meralgia is the side effects associated with chronic medication use. What comes to treatment recommendations looking at all the options available, multi-modality treatment is most likely best. This includes medication management along with potentially glycerol injections and then maybe radiofrequency ablation.

The risks of these treatments are very low. In older patients radiofrequency ablation is recommended, and that younger patients microvascular decompression is to provide the longest term relief.

Arizona Pain Specialists has Award Winning pain doctors in Scottsdale, Phoenix, Chandler & Glendale who have extensive experience in effective facial pain treatment including TMJ and trigeminal neuralgia. Call (602) 507-6550 today for more information and scheduling.

Arizona Pain has opened a new pain clinic in Phoenix, making this their fourth office in the Valley. The office is accepting new patients and is located close to Desert Ridge just off the Hwy 101.

Under one roof, the new Phoenix pain clinic offers a Fellowship Trained pain management doctor providing medication management and interventional procedures, spinal decompression therapy, chiropractic manipulations, physical rehabilitation and acupuncture as well.

Over 50 insurances are accepted. Dr. Anderson is a BCBS pain doctor in Phoenix who also accepts Aetna, Humana, Cigna, Medicare, United, Worker’s Comp, Personal Injury and many more. Also Dr. Anderson accepts Medicaid (AHCCCS) plans too.

Here is a video of the new clinic:
If you or a loved one is suffering from acute or chronic pain in the greater Phoenix area, call Arizona Pain today at (602) 507-6550. With pain clinics in Chandler, Phoenix, Scottsdale, and Glendale, there is bound to be a location convenient for you!

As people age, pain can result in the legs due to spinal stenosis. This refers to spinal arthritis over growing areas and pinching on spinal nerves as they tried to leave the spinal canal. It’s one of the most common diagnoses as an individual in the 50 to 85 age range develops pain in the lower extremities.

Once the diagnosis is made and is deemed not to be a vascular issue, the question is how to avoid surgery for symptomatic spinal stenosis. The surgery that is done to relieve the pain is called a laminectomy and is purely an elective procedure.

Here are the 7 most effective ways to treat stenosis to avoid going under the knife.

1. Over-the-counter anti-inflammatories and Tylenol. This sounds very simple and it is. These medications are low risk when taken according to manufacturer’s recommended dosing. In addition, they can be extremely effective for mild to moderate symptoms of spinal stenosis. As a nerve roots gets pinched from the overgrown tissue with arthritis, inflammation can result, which is what the anti-inflammatories can reduce.

2. Physical therapy. PT can be extremely helpful for reducing stenosis pain,

Physical therapy can be great for spinal stenosis symptoms.

strengthening up the muscles in the back, along with core strengthening, flexibility and relieving pressure on nerves. In addition, there are treatments including electrical stimulation and ultrasound which may also relieve symptoms.

3. Chiropractic treatment. While not a permanent solution, spinal stenosis can be helped with Phoenix chiropractor manipulations. This may temporarily decompress nerve roots and hence reduce pain.

4. Spinal decompression therapy. This treatment became FDA cleared back in the late 1990s and involves intermittent spinal traction. Continuous spinal traction has been shown not to be helpful for spinal stenosis or degenerative disc disease. However, individuals with spinal stenosis often can obtain 3 to 6 months of pain relief with a series of decompression therapy.

The treatment is noninvasive and most individuals fall asleep during the treatments as it is not painful.

5. Additional medications. Pain management doctors in Arizona may treat stenosis with medications including nerve membrane stabilizers such as Lyrica or Neurontin. It is unclear how these medicines work, but they can help a lot with sciatica type pain from stenosis. For periods of acute exacerbation, narcotics may be indicated to relieve bad symptoms. Over the long-term, the risks start to outweigh the benefits however.

6. Epidural steroid injections. These have long been a gold standard treatment for spinal stenosis treatment. The injection places cortisone medication around the inflamed nerve roots.

Modern Arizona pain management involves the usage of fluoroscopy, which is a real-time form of x-ray for increased accuracy. There are multiple different ways of performing epidural injections, including intralaminar epidurals, transforaminal epidurals or caudal injections. A person may need a series of injections to obtain maximum pain relief, and this can be repeated every few months.

If you or a loved one is experiencing spinal stenosis type symptoms, help is available. Arizona Pain Specialists offers comprehensive pain treatments for spinal stenosis, which are performed by an Award Winning team of Board Certified pain management doctors and chiropractors. There are 4 locations throughout the Valley, including a new Phoenix pain clinic.

Arizona Pain accepts over 50 different insurances. The clinics have Arizona pain doctors accepting Medicare, Medicaid, major medical, Personal Injury, Worker’s Compensation and self pay. For more information and scheduling, call (602) 507-6550 today!

Arizona Pain Specialists now has a new location… in Phoenix AZ! The best pain clinics in Phoenix, Scottsdale now has the Valley covered with an East Valley pain management clinic, Scottsdale pain clinic, Phoenix and the West Valley location in Glendale.

The new Phoenix pain management clinic is being staffed by Dr. Jack Anderson. Dr. Anderson is an MD who graduated from the U. of Oklahoma and recently completed the Arizona Pain Medicine Fellowship. His expertise is in both pain medication management and interventional pain management.

In line with the Award Winning team of pain doctors and chiropractors at the AZ pain clinics, Dr. Anderson is compassionate, caring and highly skilled.

Arizona Pain accepts over 50 insurance plans, including BCBS, Aetna, Humana, Cigna, United Healthcare, Medicare, Medicaid, Lifeprint, Banner, Personal Injury Liens, Workers Compensation, APIPA, Mercy Care, PHP and more including self pay.

The Phoenix location offers pain procedures on site along with chiropractic, spinal decompression therapy, physical rehabilitation, acupuncture and more. See this video for some pictures of the new Phoenix pain clinic!

Call (602) 507-6550 to schedule at the newest location for Arizona Pain Specialists – right off the Highway 101 at Desert Ridge!