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An Overview of Topical Analgesics in Pain Medicine

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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.Arizona pain center

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.

Arthritis Treatment Phoenix

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

Pain Clinics Phoenix

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, Arizona PainCigna, 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!

6 Ways to Avoid Surgery for Spinal Stenosis

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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 Spinal Stenosis Treatmentcanal. 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,

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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 Pain Doctors in Phoenixnot 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. Phoenix pain clinic

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 Phoenix pain doctorsand 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!

Treatment of Post-thoracotomy Pain Syndrome

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When an individual has a thoracotomy, usually the incision is fairly large. The approach is often used for scoliosis surgery, tumor removal, or a spinal reconstruction in the thoracic spinal column.

Unfortunately, the end result may often be a successful spinal reconstruction, but the

Post thoracotomy syndrome treatment

Typical size of a thoracotomy incision.

patient ends up with considerable pain from the incision. Post-thoracotomy pain syndrome as a result of a neuralgia emanating from the intercostal nerves around the surgical approach. Usually a rib is removed during the approach and there are intercostal nerves that are around this rib that get irritated.

In one sense it is almost like a reflex sympathetic dystrophy reaction, or even a neuroma where the end of the nerves become chronically irritated and painful. Studies have shown between five and 20% of those who undergo a thoracotomy procedure end up with chronic pain due to the incision and surgical approach.

Treatment for post thoracotomy pain syndrome may involve a combination of pain management therapies. Initially, the individual may take oral NSAIDS along with topically Pain Clinics Arizonaapplied pain medication. Neural modulating agents such as Lyrica and Neurontin may help, along with narcotic medications.

Interventional procedures include trigger point injections, intercostal nerve blocks, epidural steroid injections, radiofrequency nerve ablation or cryoablation.

Physical therapy may be helpful with electrical stimulation, ultrasound and nerve stimulation treatments.

One of the latest treatment attempts involves spinal cord stimulator implants. Spinal cord stimulation does not fix a chronic pain problem, rather, it can mask the individual’s pain and therefore allow the need for less narcotics and allow the patient to be more active.

Implants are permanently placed with electrodes into the spinal canal emitting slight electrical impulses to change the way that the brain perceives pain signals. Hopefully, a larger study will be able to show the true effectiveness of spinal cord stimulation for postthoracotomy pain syndrome, and so far anecdotal case reports have shown effectiveness for the problem.

If you or a loved one has undergone a thoracotomy procedure and are continuing Pain Management Arizonato have pain, help is available. The Board Certified pain doctors at Arizona Pain Specialists have significant experience with complicated pain management problems such as post thoracotomy pain.

Call (602) 507-6550 for one number scheduling for help.