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The Most Comprehensive Pain Center in the Valley Newsletter Issue 4 NOV/DEC 2010

The PAIN Stops Here!

Contents Lumbar Epidural Steroid Injections 86% of patients with sciatica received excellent pain relief in a recent Pain Physician Study. Degenerative Disc Disease DDD is a very common problem. Here are seven ways to avoid surgery with it. Just the Facts: Radiofrequency Ablation

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Five facts on RFA and how it works. Preferred Pain Center 4 Contact Information and Locations. Patients Routinely Seen Within 48 hrs

Treatments offered at Preferred Pain Center

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Interventional Pain Management Medication Management PT/Rehab Physiotherapy Spinal Decompression Treatment Chiropractic Treatment Naturopathic Treatment Acupuncture Meet our TOP DOCS 2010

Comprehensive Pain Management Preferred Pain Center offers a team of medical professionals from various backgrounds including traditional, alternative, and holistic training.

Pain is only valuable once you know that you’ve learned from it.

-Anonymous

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Ajay Narwani, MD Pain Management

Sky Moore, DC Rehab/Chiro

Double Board Certified Pain/Anesthesia ABMS Interventional Pain Management Diplomate American Board Anesthesia Anesthesia Residency U. Texas-Houston Pain Fellowship U. Texas-Galveston

Rehabilitation and Chiropractic Specialist Doctoral Degree National College in Chicago Certified in NonSurgical Spinal Decompression Therapy Certified in Manipulation Under Anesthesia

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The Most Comprehensive Pain Center in the Valley Preferred Pain Center Phoenix, AZ

Epidural Injections are the most commonly performed procedure in the US for managing chronic lower back pain.

Epidural Injections for Chronic Back Pain By David L. Greene, MD, CEO Lumbar epidural injections are very commonly performed in the US for the management of chronic back and lower extremity pain due to spinal problems.

Patients were all given epidural injections under fluoroscopy, and randomized to whether or not they received steroids plus local anesthetic versus solely local anesthetic.

A recent study in Pain Physician showed the effectiveness of epidural injections for these issues to be significantly effective.

Outcomes for the study overall showed that patients can experience significant pain relief and functional status improvement with lumbar interlaminar epidural injections.

The underlying mechanism of how local anesthetic and steroid injections work in the epidural space is not well understood. The study was randomized, double blinded, and controlled looking at patients with chronic low back and lower extremity pain secondary to disc herniation or radiculitis in providing long lasting pain relief. Outcomes were evaluated at 3, 6, and 12 months posttreatment.

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Significant pain relief was defined as over 50% pain relief. In the group that received solely local anesthetic, 74% of patients achieved significant pain relief with average of 10 months success. In the group that received injections with steroid medication and local anesthetic, pain relief was seen in 86% of patients also averaging 10 months. With regards to functional status, over 80% of the group receiving steroid and local anesthetic improved their functional status scores by over 50%.

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(602) 507-6550


The Most Comprehensive Pain Center in the Valley

7 Ways To Avoid Surgery With Degenerative Disc Disease

By David L. Greene, MD, CEO Degenerative Disc Disease (DDD) is a diagnosis that may cause extreme disabling low back pain on a daily basis, or it may simply be an incidental finding. Over 40% of people over the age of 40 have MRI findings of degenerative disc disease, but remain asymptomatic. If disc degeneration is deemed to be the source of back pain, the best option obviously is to avoid surgery. Seeing as how only 20% of back surgeries are truly successful after two years, what are the best ways to accomplish the successful non-surgical approach. Here are seven ways: 1) Live With the Pain - Doesn't sound great but at the end of the day it is a quality of life decision. If a patient can avoid painful activities and remain somewhat active, able to work and interact socially and with family and live happily, this may in fact be the best option. With the results of surgery having at best a 70% success rate and usually it's a roll of the dice, all options should be exhausted and this may be the last option standing. 2) Lower Your Body Mass Index - Being overweight equals extra weight on the degenerative disc. It does not take a rocket scientist to know that if the disc is painful from degeneration and the body weight is pushing down on the painful region then extra pressure can easily exacerbate the problem.

The Blog of Pain http://blog.preferredpaincenter.com

The Blog of Pain educates and discusses all subjects related to pain. Recent topics: • • •

Will Spine Surgery Get Rid Of All My Back Pain? What is Sciatica? Spinal Decompression Can Help You Get Your Life Back

Recent Testimonial 3) Quit Smoking - Besides the general health benefits of not smoking including lowering the risk of cancer and avoiding emphysema, avoiding nicotine can help with blood flow. Nicotine is a vasoconstricting drug, and can decrease the blood flow which is needed to bring in healing oxygen and nutrition. 4) Core Stabilization and Lumbar Strengthening - Physical therapy can strengthen the muscles surrounding the spine, thereby reducing pressure on the painful degenerative disc. 5) Spinal Decompression -This is a revolutionary treatment that can dramatically decrease the pain from degenerative disc disease and help a patient avoid surgery. 6) Chiropractic Treatment - Treatment from a chiropractor can be very beneficial to decreasing the back pain from disc problems.

I’ve had back trouble for 30 years. It would take me 45 minutes just to get out of bed in the morning. I became depressed. I had severe back pain, no range of motion and I was afraid I was going to injure myself. Being in sales, I need a positive confident exterior and it was totally exhausting working through the pain. I didn’t have the luxury of having a nervous breakdown! My treatments at Preferred Pain Center consisted of PT, TENS, and Interventional Pain treatments with Dr. Narwani. Those helped, and the final treatment was a Manipulation Under Anesthesia which seemed to fix my problem for good.

All I can say is I feel absolutely freaking amazing! My pain went from an 8 to a 0, and Life is Good.

7) Interventional Pain Management - If there is associated facet arthritis, a facet block can assist with pain reduction. If a facet block then wears off, a radiofrequency ablation may help with pain relief for one to two years.

- Lisa Wolfe, Advertising Executive

There is no magic bullet or gimmicks to surgery avoidance when dealing with degenerative disc disease. The above options may help individually or in combination to allow one to live comfortably and avoid an operation.

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The Most Comprehensive Pain Center in the Valley Preferred Pain Center Phoenix, AZ

Just the Facts: Radiofrequency Ablation Radiofrequency ablation is a commonly upwards of two years. However one thing commonly seen is pain exacerbation performed procedure for facet related immediately after the procedure. This back or neck pain. typically resolves over a few days to An important advantage of RF current weeks and relief begins. (over previously used low frequency AC or pulses of DC) is that it does not 3) Pain relief from the RFA (rhizotomy) may last one to two years. The tiny nerve directly stimulate nerves and can endings that are causing the pain in the therefore often be used without the facet joints are deadened with the need for general anaesthetic. Patients sometime receive IV sedation for pain procedure. These will eventually regenerate, and then the procedure may be relief during the procedure. repeated. Here are 5 RFA facts. 1) It has nothing to do with listening to 4) A diagnostic injection is necessary the radio - the current utilized is in the prior to proceeding with an RFA - In order to receive insurance approval for the same wavelength as radio signals, however the current is focused into the procedure, it is necessary to show that an specific problem area. Radiofrequency injection helped over 50% for pain relief. If it works and then wears off, an RF machines do not have FM radios procedure is indicated. attached to them. 2) It can actually hurt more right afterwards than before. RFA procedures can provide pain relief for

5) It is the most modern treatment available for facet related pain. RFA remains the newest, best option available for long term pain relief

“Back or Neck Pain relief with Radiofrequency Ablation may last for TWO years.”

Preferred Pain Center Information – Call (602) 507-6550 for appts A Offices A. Scottsdale B. Main Office C. Surgery Center D. Laveen E. Mesa F. Chandler

Main Office Location

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2813 E. Camelback Rd Suite 430 Phoenix, AZ 85016

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Surgery Center Location

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10255 N. 32nd Street Phoenix, AZ 85028

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Most Insurance Accepted including Worker’s Comp & Personal Injury Patients Routinely Seen within 48 hours! Page 4

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Phone Fax

(602) 507-6550 (602) 759-1741

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Preferred Pain Center Newsletter Issue 4 2010