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Copyright 2011  Arizona  Pain  Specialists

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Arizona Pain  Monthly  |  April  2011


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Arizona Pain  Monthly  |  April  2011

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Welcome to  Arizona  Pain  M Welcome  to  the  April   issue  of  Arizona  Pain   Monthly!  There  are  so   many  great  outdoor   activities  this  time  of   year  that  we  hope  you   have  a  chance  to  get   out  and  explore!

This month  we  have  chosen  to  focus  on  one  of  the  most  com-­‐ mon  ailments  facing  patients  in  the  United  States:  Back  Pain.     Let’s  start  by  defining  the  scope  of  the  problem.    85%  of  the   population  will  suffer  from  back  pain  at  some  point  in   their  lives.    Back  pain  is  the  second  leading  cause  for  medi-­‐ cal  office  visits,  following  only  the  common  cold.  In  addition,     back  pain  is  the  leading  cause  of  disability  in  those  under   the  age  of  45.    Finally,  the  impact  on  the  healthcare  system  is   enormous,  with  $50  billion  spent  each  and  every  year  to  treat   low  back  pain.   At  Arizona  Pain  Specialists  we  see  the  impact  this  type  of  pain   can  have  on  our  patients’  lives.    Simple  activities  like  shop-­‐ ping  for  groceries,  sitting  through  a  movie,  picking  up  a  child   or  merely  walking  the  dog  can  be  challenging  and  frustrating   for  someone  suffering  from  pain. Our  mission  is  clear:  help  educate,  empower  and  heal  our   patients  who  are  suffering  from  this  all  too  common  ailment.     By  providing  individualized  treatment  plans  we  aim  to  help   our  patients  get  back  to  doing  the  things  they  enjoy  with  the   people  they  love. Our  focus  word  this  month  is  EXPLORE  .    In  this  issue  we  will   explore  the  common  causes  of  back  pain,  the  diagnostic  tools  

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Arizona Pain  Monthly  |  April  2011


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n Monthly  Magazine used  to  identify  the  source  of  the  problem,  and    provide  easy  exer-­‐ cises  to  help  reduce  your  back  pain.  If  you  are  suffering  from  pain,   we  would  like  to  provide  the  tools  to  help,  inspire  and  motivate  you   to  get  your  life  back.    Don’t  accept  that  you  have  to  suffer,  as  many   people  do.    You  deserve  to  live  your  life  on  your  terms,  and  to  explore   all  the  wonderful  things  life  has  to  offer.   We  hope  that  this  issue  is  educational  and  informative.    We  thank   you  for  your  continued  loyalty  if  you  are  a  long-­‐standing  patient,  and   welcome  you  to  the  Arizona  Pain  Specialists  family  if  you  are  a  new   patient. Until  next  time,  remember  at  Arizona  Pain  Specialists,  we  believe   you  can  be  pain  free.  Blessings  to  you  and  your  family, Dr.  Tory  McJunkin  &  Dr.  Paul  Lynch Please  contact  us  at Newsletter@ArizonaPain.com  if  you  have  questions  or  comments.  

Arizona Pain  Monthly  |  April  2011

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Ask the  Expert With  Dr.  Patrick  Hogan:   What tools do physicians use to diagnosis my chronic pain?

X-­Ray X-­‐Rays are  a  form  of  ionizing  radiation  able  to  produce  images  of  the  body.    A  concentrated  amount  of  X-­‐Ray   ‡Ž‡…–”‘•ƒ”‡ƒ‹‡†ƒ–ƒ•’‡…‹ϐ‹…„‘†›’ƒ”–ǡ™Š‡–Š‡•‡‡Ž‡…–”‘•’ƒ••–Š”‘—‰Š–Š‡„‘†›–Š‡›”‡…‘”†ƒ‹ƒ‰‡Ǥ These  images  lack  precise  detail  and  are  mainly  used  for  the  diagnosis  of  abnormal  anatomy  associated  with  the   bones  such  as  osteoarthritis.

Computed Tomography  (CT  and  CAT)  uses  numerous  x-­‐ray  beams  and  x-­‐ray  detectors  to  produce  a  cross  sectional  image.    These  rotate   around  a  body  part  while  it  is  moving  through  the  scanner  making  a  spiral  path,  producing  “slices”  of  the  body.     CT  images  best  depict  bone,  organs,  and  soft  tissues  making  them  useful  for  the  diagnosis  of  fractures  and  ab-­‐ normalities  of  the  anatomy.  

Magnetic Resonance   Imaging (MRI)  is  the  most  common   diagnostic  test  in  pain  manage-­‐ ment  and  does  not  use  ionizing   radiation.  Through  a  strong   ƒ‰‡–‹…ϐ‹‡Ž†ƒ†ƒ•‡”‹‡•‘ˆ radio  frequency  pulses  MRI  pro-­‐ duces  detailed,  cross  sectional   images  or  “slices”  of  bones  as   well  as  soft  tissues  not  seen  on   other  diagnostic  studies.    These   include  tendons,  ligaments,   muscles,  nerves  and  vessels.     MRI  is  best  for  diagnosing  dis-­‐ orders  such  as  herniated  discs,   tumors,  nerve  compression. degenerative  disc  disease  and   spinal  fractures.  

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Arizona Pain  Monthly  |  April  2011


Spinach and  Cheddar  Rice Serves  2 Ȉʹ–„•’…Š‘’’‡†•…ƒŽŽ‹‘• Ȉ͵‘—…‡•—…‘‘‡†”‡‰—Žƒ”Ž‘‰ grain  rice Ȉʹ–•’ƒŽŽǦ’—”’‘•‡ϐŽ‘—” Ȉʹ–•’”‡†—…‡†ˆƒ–ƒ”‰ƒ”‹‡ Ȉ͵ȀͶ‘œ•Šƒ”’Ž‘™ˆƒ–Š‡††ƒ”Ȉ cheese,  shredded ȈͳȀͶ…—’–Šƒ™‡†ˆ”‘œ‡…Š‘’’‡† spinach Combine  1  ¼  cups  of  water  with   the  scallions  in  a  saucepan.  Cover   and  cook  over  high  heat  until  mix   comes  to  a  boil.  Stir  in  the  rice.   Turn  heat  to  low,  cover,  and  allow   to  simmer  until  the  rice  is  tender   and  liquid  immersed.  This  should   take  approximately  15  minutes. While  the  rice  is  cooking,  take  a   small  nonstick  pan  and  melt  the   margarine  over  high  heat.    Slowly   ’‘—”ϐŽ‘—”‘˜‡”ƒ”‰ƒ”‹‡ƒ†•–‹” promptly  for  approximately  1  min-­‐ ute.  Next,  mix  in  the  milk.  Lower   heat  to  medium  and  stir  until  the   mixture  thickens.  This  should   take  close  to  5  minutes.  Mix  in  the   shredded  cheese  and  cook  until   melted.

Cranberry Chicken

Banana Pops

ȈΦ„‘––Ž‡Ž‘™ˆƒ–ƒ–ƒŽ‹ƒ†”‡••‹‰ Ȉͳ’ƒ…‡–‘‹‘•‘—’‹š Ȉͳ…ƒ™Š‘Ž‡…”ƒ„‡””‹‡• ȈͶǦ͸„‘‡Ž‡••ǡ•‹Ž‡••…Š‹…‡ breasts Preheat  oven  at  350  degrees. Mix  Catalina  dressing,  onion  soup   mix,  and  cranberries  in  a  bowl.  Light-­‐ ly  pound  chicken  with  a  meat  mallet,   —–‹Ž…Š‹…‡‹•”‘—‰ŠŽ›Φ‹…Š–Š‹…Ǥ Place  chicken  in  a  deep  baking  pan   and  pour  mixed  ingredients  over  the   chicken.   Bake  the  chicken  for  approximately   20-­‐30  minutes,  or  until  no  longer   pink  in  the  middle.  Remove  chicken   and  serve.

Ȉ͸ϐ‹”ǡ’‡‡Ž‡†„ƒƒƒ• ȈŽƒ–‡‘ˆŠ‘‡› ȈŽƒ–‡•‘ˆ…Š‘’’‡†—–•ǡ•Š”‡††‡† Ȉ…‘…‘—–ǡƒ†…‘‘‹‡…”—„• Ȉͳʹ’‘’•‹…Ž‡•–‹…•

Serves 4-­‐6

Serves 12

Cut  each  banana  in  half  crosswise.   Insert  popsicle  stick  into  the  cut   end  of  each  banana.  Brush  honey   over  bananas.  Roll  each  banana   over  nuts,  coconut,  and/or  cookie   crumbs.   Arrange  on  plate  and  cover  with   plastic  wrap.  Store  in  freezer  until   ready  to  serve.

Add the  spinach  to  the  rice  mixture   and  stir.  Lastly,  pour  the  cheese  mix   over  the  spinach-­‐rice  mixture  and   stir.  This  will  be  ready  to  serve.

Arizona Pain  Monthly  |  April  2011

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Unable to  explore  the  outdoors  because  you  are   stuck  at  your  desk  all  day?   Here  are  some  quick  exercises  that  will  help  to   relieve  neck  and  upper  back  pain  attributed  to   prolonged  sitting.     Neck  pain  has  a  number  causes.  The  most  com-­‐ mon  cause  of  neck  pain,  without  an  incidence  of   trauma,  is  poor  posture  while  sitting.    Living  in   a  modern  society  the  majority  of  people  that  are   working  on  the  computer,  or  driving  for  pro-­‐ longed  periods  of  time,  sit  with  terrible  posture.     The  ideal  posture  while  sitting  feels  somewhat   unnatural  and  militant.  Ideally,  there  should  be  a   straight  line  between  the  ear,  the  shoulders,  and   hips  while  sitting  and  working  on  a  computer.     The  top  of  the  monitor  should  be  at  eye  level   with  your  thighs  level  to  the  ground.  The  human   Page  8

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body is  designed  to  move,  rather  than  to  sit  in   a  chair  all  day.    As  technology  has  advanced,  we   put  ourselves  in  anatomical  positions  that  create   pain  and  pathology.         When  you  slouch,  your  head  and  shoulders   round  forward.    This  puts  mechanical  stress  on   cervical  facet  joints  and  interverbral  discs  in  the   neck  as  well  as  the  upper  back  and  neck  muscles.     Here  are  the  three  most  important  exercises   that  can  be  done  at  your  desk  to  counteract  the   effects  of  prolonged  sitting.    Although  these  ex-­‐ ‡”…‹•‡•Ž‘‘•‹’Ž‡ǡ‘•–’‡‘’Ž‡Šƒ˜‡†‹ˆϐ‹…—Ž–› performing  them  because  they  utilize  muscles   that  are  weak  and  uncoordinated.      If  you  need   more  assistance  or  instruction  with  these  exer-­‐ …‹•‡•ˆ‡‡Žˆ”‡‡–‘…ƒŽŽ‘—”‘ˆϐ‹…‡–‘•…Š‡†—Ž‡ƒ appointment.     Arizona  Pain  Monthly  |  April  2011


Try each  exercise  once  or  twice  an  hour  throughout  the  day.  Build  up  to   performing  each  one  three  times  consecutively.      As  you  master  each  of   these  exercises,  you  can  multi-­‐task  and  combine  them  into  one!  This  is  a   “—‹…ƒ†‡ˆϐ‹…‹‡–™ƒ›–‘•–”‡‰–Š‡›‘—”—’’‡”„ƒ…ƒ†‡…Ǥ‘—ƒ› ϐ‹†„‡––‡”…‘•‹•–‡…›‹’‡”ˆ‘”‹‰–Š‡‡š‡”…‹•‡•„›•‡––‹‰ƒŠ‘—”Ž› reminder  on  Outlook.    Remember  not  to  push  through  pain,  only  take  it  to  a   point  where  you  feel  your  muscles  working.  The  goal  is  to  offset  the  stress   you  are  putting  on  yourself  while  sitting.    If  you  are  having  increased  pain   stop  and  seek  further  medical  evaluation  with  your  doctor.    

Cervical neck  retraction  (Chin  tuck) Sit  up  straight,  keep  your  nose  and  eyes  LEVEL,   pull  the  chin  straight  back.    The  back  of  your  neck   should  feel  long.  The  highest  point  of  your  body   should  be  the  top  back  of  your  head.  Hold  for  10   seconds.     You  should  feel  like  you  are  sliding  your  head  backwards  over  the  neck,   ending  with  the  chin  tucked  in.  The  sliding  back  motion  is  minimal,  but  you   will  feel  a  pull  in  the  upper  part  of  your  neck.  The  tucking  of  the  chin  will   create  a  ‘double  chin’  effect.  

Brugger’s relief  position Sit  at  the  edge  of  your  seat.  Your  knees  apart  with   your  feet  under  the  knees.  Arch  your  back.  Rotate   your  arms  outward,  so  your  palms  face  forward.   ‡’ƒ”ƒ–‡›‘—”ϐ‹‰‡”•ƒ†’‘‹–›‘—”–Š—„•„ƒ…-­‐ ward.  Hold  this  position  while  breathing  deeply  in   through  your  belly.    Hold  for  10  seconds.    This  can   be  combined  with  the  previous  exercise,  cervical   neck  retraction.

Scapular retraction Sit  at  the  edge  of  your  seat.  Your  knees  apart  with  your  feet  under  the   knees.  Arch  your  back.    Focus  on  pulling  your  shoulder  blades  down  to-­‐ ™ƒ”†•–Š‡ϐŽ‘‘”–Š‡–‘—…Š–Š‡–‘‰‡–Š‡”Ǥ ‘Ž†ˆ‘”ͳͲ•‡…‘†•Ǥ•›‘— start  to  master  this  exercise,  incorporate  Brugger’s  position  and  the  chin   tuck  for  the  ultimate  posture  exercise. -­Chance,  Moore,  D.C.

Arizona Pain  Monthly  |  April  2011

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Arizona Pain  Monthly  |  April  2011


Low back  pain  is  the  most  com-­‐ mon  musculoskeletal  problem  that   requires  medical  attention,  and  is   –Š‡ϐ‹ˆ–Š‘•–…‘‘”‡ƒ•‘ˆ‘”ƒ physician  visit.  Explore  the  follow-­‐ ing  most  common  causes  of  low   back  pain.  

Muscle Strain The  most  common  cause  of  acute   low  back  pain.  The  strain  can  occur   immediately  after  some  type  of   strenuous  activity  or  can  be  de-­‐ layed  and  occur  a  few  hours  after   physical  activity.    The  back   is  supported  by  a  large   number  of  muscles,  but  the   most  common  muscles  to   be  strained  are  the  paraspi-­‐ nous  muscles,  located  next   to  the  spine.

vertebral disc.    The  intervertebral   disc  provides  support  to  the  spine   and  helps  cushion  stress  placed  on   the  vertebrae.    The  center  of  the   disc  is  a  gel-­‐like  substance  called   the  nucleus  pulposus.  The  outer   †‹•…”‹‰‹•‘”‡ϐ‹„”‘—•ƒ†‹• …ƒŽŽ‡†–Š‡ƒ—Ž—•ϐ‹„”‘•—•Ǥ• a  person  ages,  each  disc  loses  its   strength  and  elasticity.  There  are   several  types  of  disc  herniations.

Similar to  a  muscle  strain.     A  ligament  attaches  one   bone  to  another  bone  to   form  a  joint.  A  strain  of  a  lig-­‐ ament  occurs  when  the  liga-­‐ ment  is  stretched  beyond  its   normal  range.  Both  strains   can  vary  in  symptoms  from   dull  to  sharp  pain,  or  an   aching  feeling.  

Lumbar Spondylosis Degenerative  Disc                 Disease  (DDD)

Also known  as  disc  break  down,   is  a  natural  part  of  aging,  and  most   people  will  exhibit  some  disc  de-­‐ generation  over  time.    With  age,  the   ‹–‡”˜‡”–‡„”ƒŽ†‹•…•Ž‘•‡ϐŽ—‹†ǤŠ‹• ϐŽ—‹†Ž‘••…ƒ†‡…”‡ƒ•‡–Š‡‹”ƒ„‹Ž‹–› to  absorb  shock  and  they  become   Herniated  Disc Ž‡••ϐŽ‡š‹„Ž‡Ǥ –ƒŽ•‘…ƒ—•‡•–Š‡†‹•… to  shrink,  making  the  distance  be-­‐ Called  many  different  things,   tween  the  vertebrae  shorter.    All  of   including:    bulging  disc,  disc  extru-­‐ these  changes  can  produce  chronic   sion,  “slipped  disc,”  and  seques-­‐ low  back  pain.    Degenerative  disc   tered  disc.  The  spine  is  comprised   disease  can  occur  anywhere  in  the   of  24  individual  bones  called   spine  but  most  commonly  occurs   vertebrae.    Between  each  vertebrae   in  the  lumbar  spine,  or  lower  back.     there  is  a  cushion  called  an  inter-­‐ Arizona  Pain  Monthly  |  April  2011

Spondylolisthesis Žƒ••‹ϐ‹‡†ƒ•™Š‡‘‡‘”‘”‡ vertebrae slip  forward  causing  the   spinal  column  to  be  misaligned.   This  is  usually  due  to  degenerative   disc  disease  or  can  be  genetic.    This   leads  to  chronic  low  back  pain  and   instability  with  pain  that  is  in-­‐ creased  with  activity  or  bending.

Central Spinal   Stenosis

Ligamentous Strain

A type  of  arthritis  that  occurs  in   the  facet  joints.  This  is  also  called   lumbar  facet  syndrome  and  can   be  associated  with  degenerative   disc  disease.    When  one  vertebrae   begins  to  rub  on  another,  the  joints   connecting  them  can  become  ir-­‐ ”‹–ƒ–‡†‘”‹ϐŽƒ‡†ǡŽ‡ƒ†‹‰–‘„ƒ… pain.        

Š‡Ž‘••‘ˆϐŽ—‹†‹–Š‡†‹•…•…ƒ lead to  small  tears  or  cracks  in  the   disc,  and  can  increase  the  risk  of   disc  herniation.

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A narrowing  of  the   center  part  of  the  spinal   canal.    The  vertebrae  pro-­‐ tect  the  spinal  cord  and/ or  nerve  roots  located  in   the  spinal  canal.  Central   spinal  stenosis  occurs   when  the  spinal  canal   narrows,  and  is  typically   found  in  middle-­‐aged  or   elderly  people.    When  the   spinal  canal  narrows  it   begins  to  compress  nerve   roots  or  the  spinal  cord   near  the  narrowing.    This   leads  to  back  pain  that   often  travels  to  the  but-­‐ tocks  and  legs.    Patients   may  also  have  numbness   or  weakness  in  their  legs.     Generally,  the  pain  is  worse  with   standing  or  walking  and  improves   by  bending  forward.

Neuroforaminal Stenosis A  narrowing  of  the  side  part  of  the   spinal  canal  where  the  nerve  roots   exit  the  spinal  column.  Neurofo-­‐ raminal  stenosis  occurs  when  the   neuroforamen  or  the  nerve  exiting   area  is  narrowed.  At  each  of  the  24   vertebrae  a  nerve  root  branches   off  the  spinal  cord  and  exits  the   spinal  canal  between  the  vertebrae.   When  this  area  narrows  it  begins  to   compress  nerve  roots  that  are  exit-­‐ ing  the  spinal  canal  near  the  nar-­‐ rowing.    This  can  lead  to  pain  that   Page  11


travels to  the  buttocks  and  legs.    Patients  may  also   have  numbness  or  weakness  in  their  legs.

Vertebral Compression  Fracture   (VCFs) Occurs  when  a  vertebrae  breaks  or  collapses.    Se-­‐ vere  trauma  could  cause  a  compression  fracture  in  a   healthy  adult.    However,  elderly  patients  with  osteo-­‐ porosis  can  have  vertebral  compression  fractures   with  minimal  or  no  trauma.    Osteoporosis  occurs   when  the  bone  weakens  and  becomes  less  dense,   thereby  increasing  the  risk  of  fracture.     Compression  fractures  produce  local-­‐ ized  pain  at  the  site  of  the  fracture,  with   pain  that  radiates  across  the  back  and   around  the  trunk.

Sacroiliac Joint  Pain

Infection of  the  Spine An  infection  in  one  of  the  vertebrae  that  makes  up   the  spine.    The  source  of  infection  is  usually  from   a  urinary  tract  infection,  an  abscess  on  the  skin,  an   epidural  catheter,  or  from  intravenous  drug  abuse.     This  can  occur  at  any  age  and  the  infection  is  com-­‐ monly  located  in  the  lumbar  spine  or  sa-­‐ crum.    The  infection  causes  sharp  pain,  fever,   tenderness  over  the  infection,  and  may  cause   weakness  or  decreased  range  of  motion.  

Cancer in  the  Spine

Can be  a  source  of  low  back  pain,  al-­‐ though  the  sacrum  is  below  the  lumbar   vertebrae.    The  last  lumbar  vertebrae   connects  to  the  sacrum  which  is  a  fused   •‡‰‡–ƒ†‡—’‘ˆϐ‹˜‡„‘‡•ǤŠ‡•ƒ-­‐ crum  connects  to  the  iliac  bones,  which   connect  to  the  hips.    The  sacroiliac  joint   is  a  large  joint  on  either  side  of  the   sacrum  that  transmits  the  weight  from   the  lumbar  spine  to  the  legs.

Anklyosing Spondylitis ‡Žƒ–‡†–‘ƒ•’‡…‹ϐ‹…‰‡‡ǡ‡ƒ‹‰‘•–’ƒ–‹‡–• will  have  a  family  history  of  this  disease.    A  chronic   ‹ϐŽƒƒ–‘”›†‹•‡ƒ•‡‘ˆ–Š‡•’‹‡ǡ•ƒ…”—ǡƒ†–Š‡

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sacroiliac joints,  this  disease  may  cause  the  patient   to  start  exhibiting  symptoms  as  young  as  age  15.     Symptoms  of  this  disease  include  morning  stiffness,   aching  pain,  decreased  range  of  motion  in  the  back   and  tenderness  over  the  sacroiliac  joints.  

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Malignancies (cancers)  can  have  an  initial   source  in  the  vertebral  bodies,  or  more  likely   are  from  another  source  which  metastatic   cancer  has  spread  to  the  spine.    Breast,  lung,   prostate,  kidney,  and  thyroid  cancer  are   the  most  common  cancers  to  spread  to  the   spine.    The  pain  is  often  described  as  a  dull   or  throbbing  pain,  which  progressively  gets   worse  over  time.    Pain  can  be  increased  by   lying  down  or  coughing.    There  may  also  be   some  tenderness  over  the  affected  vertebra  as  well   as  neurologic  problems  like  weakness,  decreased   ”‡ϐŽ‡š‡•ǡƒ†—”‹ƒ”›‘”•–‘‘Ž‹…‘–‹‡…‡Ǥ

Arizona Pain  Monthly  |  April  2011


Arizona Pain  Specialists  patient   Jeff  Grabosky  is  making  incred-­‐ ible  headway  as  he  runs  across   America.

from the  citizens  in  each  town.   Grabosky  exercises  the  use  of   Having  made  it  into  Oklahoma   mind  over  matter  to  get  through   Whether  people  stop  to  ask  him   his  purpose  for  his  run  or  invite   in  early  March,  Jeff  sped  through   each  day.   him  to  share  a  meal,  Jeff  is  grate-­‐ Texas,  running  nearly  50  miles   ful  for  the  support.   per  day!  Fighting  nasty  weather   Not  only  has  Jeff  remained   mentally   s trong,   b ut   h e   h as   such  as  dust  and  wind  storms,  it   In  Jeff’s  most  recent  blog  post,   is  amazing  how  far    Jeff  has  been   found  encouragement  on  the   he   gives  thanks  for  the  prayers   road.  Jeff  continues  to  receive   able  to  travel. or   k ind  words.  “Thank  you  for  all   prayer  requests  which  help  to   your  prayers  for  my  safety  and   keep  him  motivated.  Posted  in    Despite  the  remarkable  dis-­‐ health.    I  feel  I  am  on  my  way   his  blog,  Grobosky  states  “Re-­‐ tance  Jeff  has  run,  he  notes  in   back  to  getting  healthy  again   ceiving  messages  and  prayer   his  blog  that  he  is  beginning  to   and  am  looking  forward  to  the   intentions  from  people  is  an   feel  the  effects  of  his  journey.   miles  ahead.” “Unfortunately,  the  pain  around   awesome  blessing  that  I  really   treasure  and  it  helps  keep  me   my  lower  right  ankle  and  shin   Jeff  has  continued  to  update  the   going.”  Jeff  believes  strongly  in   became  unbearable  today”   staff  at  Arizona  Pain  Specialists   Grabosky  states  on  March  6th.  “I   the  power  of  prayer  and  knows   during  his  run.   ƒ•—’‡”ˆ”—•–”ƒ–‡†„—–™‹ŽŽϐ‹† the  messages  he  receives  will  get   a  way  to  keep  pressing  on  if  it  is   Š‹–‘–Š‡ϐ‹‹•ŠŽ‹‡Ǥ Visit  ArizonaPain.com  and   in  any  way  physically  possible.” click  on  the  “Jeff  Runs  America”   In  addition,  Grobosky  has   ‰”ƒ’Š‹…‘–Š‡Š‘‡’ƒ‰‡–‘ϐ‹† shared   that  he  is  humbled  by  the   This  is  exactly  what  Jeff   Jeff. encouragement  he  has  received   has  done.    Although  in  pain,   Arizona  Pain  Monthly  |  April  2011

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Arizona Pain  Monthly  |  April  2011


Leila is  the  director  of  Mountain  View  Surgery  Center.  She  is   dedicated  to  helping  her  patients  become  pain  free,  and  safety  is   always  her  number  one  concern  ! See  what  you  have  in  common  with  Leila!  

Meet Leila M., Surgery Center Director

Favorite activities:‡ƒ†‹‰‘Ǧϐ‹…–‹‘ǡŠ‹‹‰ǡ‹‰ǡ•‘™„‘ƒ”†‹‰ǡ ”—‹– Ninja  and  Angry  Birds. Favorite  TV  shows:  I  Love  Lucy,  Tosh.O,  Curb  Your  Enthusiasm,  the  nightly   news Favorite  sports  team:  Pittsburgh  Steelers Favorite  food:  Authentic  Mexican  .   Favorite  movie:  Toss  up:  Casino  and  Goodfellas.   Favorite  location  in  the  world:  Someday  soon,  I  hope  to  answer  Greece.   Favorite  location  in  Arizona:  The  I-­‐8  on  my  way  to  San  Diego.   Favorite  thing  about  Arizona:  The  heat!  You  can’t  shovel  sunshine!   Favorite  bands:  Five  Finger  Death  Punch,  System  of  a  Down,  The  Beatles  and   Patsy  Cline     Favorite  book:  Last  Lecture  by  Randy  Pausch   Famous  person  you  would  like  to  meet,  dead  or  alive,  and  why?   I’m  never  “star  struck”,  but  I  could  use  Cesar  Millan’s  (The  Dog  Whisperer)   assistance  right  now.     Unknown  fact  about  you:  I  prefer  the  labels  in  my  pantry  and  fridge  facing  the   same  direction.   Unknown  talent:  I’m  artistic  and  have  been  known  to  paint  freehand.     What  celebrity  do  people  say  you  look  like:  Tina  Fey,  Sarah  Palin  and  Velma   from  Scooby  Doo!  

A  big  thanks  to  my  staff  for  supporting  me  and  one  another,   each  of  you  make  my  work  day  such  a  pleasure!

Employee of  the  Month  at  APS Stacie  began  at  Arizona  Pain  Specialists  ten  months  ago,  working   in  our  patient  concierge  group.  Due  to  her  compassion  and  great   attitude,  Stacie  now  works  directly  with  our  patients  at  the  front   desk.  She  is  a  patient  favorite  and  greets  everyone  with  a  warm   smile.     Every  month  managers  struggle  to  select  just  one  employee  from   the  excellent  staff  at  Arizona  Pain  Specialists.  This  month,  a  patient   did  the  work  for  us!  A  happy  patient  returned  to  our  Scottsdale   ‘ˆϐ‹…‡™‹–Šƒ„‘—“—‡–‘ˆϐŽ‘™‡”•ˆ‘”–ƒ…‹‡„‡…ƒ—•‡–Š‡›™‡”‡•‘ •ƒ–‹•ϐ‹‡†™‹–Š–Š‡…ƒ”‡•Š‡’”‘˜‹†‡†ǤŠ‡’ƒ–‹‡–ƒ†‡ƒ’‘‹–‘ˆ telling  staff  what  a  great  employee  we  have.   We  are  thankful  for  Stacie’s  kindness  and  attention  to  detail.  It  is   our  greatest  wish  that  every  patient  leaves  Arizona  Pain  Special-­ ists  this  happy  with  the  service  they’ve  received.  

Arizona Pain  Monthly  |  April  2011

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Arizona Pain Monthly April 2011  

Arizona Pain Monthly April 2011, our one year anniversary issue. In this issue we explore the causes of back pain and tools used to diagnos...

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