The Most Comprehensive Pain Center in the Valley Newsletter Issue 2 July/August 2010 Contents Maximizing Success with a Multi-Discipline Approach
Radiofrequency Ablation Can provide long term pain relief (6-18 mths) for patients experiencing back or neck pain. Spinal Decompression Therapy Strong evidence exists for this revolutionary treatment to alleviate Back, Neck, Arm and Leg pain. Why Drug Test? Pain Doctors frequently drug test patients for treatment compliance. Here’s why it’s important.
Preferred Pain Center 4 Contact Information and Satellite Locations Patients Routinely Seen Within 48 hrs
Preferred Pain Center in Phoenix, AZ offers a team of medical professionals from various backgrounds including traditional, alternative, and holistic training.
Treatments Offered at Preferred Include: • • • •
Physiotherapy Medication Management Interventional Pain Treatments Non-Surgical Spinal Decompression Therapy Chiropractic Naturopathic
The Center gets patients in very quickly, and has helped • • many patients regain their lives. Preferred Pain Follow us on Twitter Center… the Pain Stops twitter.com/PreferredPain Here!
Preferred Pain Center Mission Statement To alleviate pain in our patients through a multi-disciplinary approach that is superior quality, time efficient, respectful, committed, and cost effective. RISEing to the care of our patients: Respect…Integrity...Service…Excellence
It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience. - Julius Caesar
Meet our TOP DOCS 2010 Phoenix Health & Wellness Magazine Congratulations to these providers!
Ajay Narwani, MD Pain Management
Sky Moore, DC Rehab/Chiro
Kathy Kamin, NMD Naturopathic Medicine
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
1992 Graduate Bastyr University Seattle, WA hCG Weight Loss Specialist Bio-Identical Hormones Stress Management and Allergy Elimination
The Most Comprehensive Pain Center in the Valley Preferred Pain Center Phoenix, AZ
Radiofrequency Ablation, or “burning” of medial branch nerve endings, can provide long term pain relief to patients experiencing neck or back pain.
The Basics on Radiofrequency Ablation By David L. Greene, MD, CEO
Radiofrequency ablation, or RFA, is not an overly complicated concept but the words sure seem to be. The procedure is outpatient for treating lower back, neck, buttock, hip and groin pain emanating from spinal joints, called facet joints. Additional terms you may hear for the same procedure include lumbar facet thermal coagulation, nerve ablation, burning, or rhizotomy. Where is the Pain coming from that’s being treated?
medicine and/or steroid into the facet joint. This will provide both diagnostic and hopefully therapeutic benefit for a period of time. How long? It varies greatly from patient to patient (weeks to over a year). The theory behind RFA is to provide a longer term relief than a simple injection. It can be done at multiple levels usually if you have arthritis at one level you have it at numerous. The RFA Procedure
Facet joints connect the bones of the spine (vertebrae) and help guide the spine during movement. They are subject to arthritis and pain as we age. The facet joints are found on both sides of the spine and are about the size of a thumbnail.
The facet joints have a nerve supply which allows them to feel pain, these nerve endings are called Medial Branch Nerves. These are nerve endings, NOT nerve roots which are the large yellow things in the picture above. Pain emanating from an injured/arthritic facet joint may range from muscle tension to more severe pain to what's called referred pain into the buttock, groin, hip, etc. If you have a pinched nerve root, that is different than simple facet joint pain. That is treated with an epidural injection (interlaminar or transforaminal), not a facet joint treatment. In a patient with a diagnosis of facet joint related pain, typically the pain doctor will start with an injection of pain
During this procedure, radiofrequency energy (it gets heated up) is used to disrupt function of the medial branch nerves (deaden them), so that they can no longer transmit pain signals from the joint. The procedure is done under x-ray (fluoroscopy).
Patients often feel sore for up to 4 days after the procedure. Pain relief can last upwards of a year, but it will vary considerably. If it works and the pain comes back, then it can be repeated every 6 -12 months. The typical reason the pain comes back is that despite the fact the physician deadens those medial branch nerve endings, they come back to life eventually. More than 70% of patients treated with RFA experience significant pain relief. Considering the pain relief with RFA can last for such a lengthy period, it’s an extremely viable option for patients with pain in either the back or neck from facet joint origin.
The Most Comprehensive Pain Center in the Valley
Spinal Decompression Therapy
The Blog of Pain
By David L. Greene, MD, CEO
Spinal Decompression Therapy is Is It Painful? How Many a non-surgical treatment that can Sessions are Needed? effectively treat back, neck, arm, For the vast majority of patients, and leg pain. treatment is completely painless. The FDA cleared spinal Based on research and our decompression therapy in 1996. providers’ clinical experience, It’s extremely safe, affordable, and the best results are achieved revolutionary. with 20 sessions over a sixHow Does It Work? week period. To reduce inflammation and assist the The treatment is traction-based, healing process, supporting with gradual application and structures sometimes are release of traction forces designed treated with passive therapies to “trick” the para-spinal muscles (ice/heat/muscle stimulation), so they do not guard or spasm. chiropractic adjustments (when This creates a negative pressure indicated) and/or active on the spine, which then allows rehabilitation in order to increased blood flow bringing strengthen the spinal along substantial oxygen and musculature. nutrients. This allows the protruded or herniated disc to be How Much Does it Cost? pulled back within the normal The cost for 20 sessions at confines of the disc, which permits Preferred Pain is $1495, which is healing to occur. very reasonable considering the What Conditions Benefit from cost and potential adverse Decompression? outcomes associated with spine • Herniated Discs Neck & Back surgery. • • • • • • • •
Bulging Discs Degenerative Disc Disease Failed Surgery Sciatica Radiculopathy Spinal Arthritis Spinal Stenosis Facet Syndrome
The Bottom Line
Spinal decompression therapy has saved many people from spinal surgery. According to a recent study in the Journal of the American Medical Association, surgery is no more effective than non-invasive treatments, including chiropractic care, for patients with lumbar disc herniation causing sciatica.
Our mission for the Blog of Pain is to educate, discuss, and converse all subjects related to pain. Traditional, alternative, and holistic approaches to pain management are discussed. Essentially anything and everything related to PAIN. Recent topics: • • • • •
Chiropractic Care for Back Pain Review of Caudal Epidurals Drug Testing False Positives Marijuana and illicit drug use Effectiveness of Neck Injections
Recent Testimonial How fast Preferred Pain moved is what helped me get better. They got me in very quickly, and I started to feel better right away. The treatments have taken away the pain and numbness. I was supposed to be off work for 6 weeks, I was able to go back in only 3. To describe the treatment in one word -
EXCELLENT! -Jenica Tellez, ICU Nurse
Preferred Pain Center utilizes the Kennedy Decompression Table, which is the only one on the market allowing both prone and supine treatment.
The Most Comprehensive Pain Center in the Valley Preferred Pain Center Phoenix, AZ
Why Pain Doctors Drug Test Patients The Rising Epidemic According to a new CDC study, pain reliever abuse has increased 111% in the last 5 years. Non-medical use of narcotics has skyrocketed, and physicians can be placed in the awkward situation of having to decide whether or not a patient’s pain ! medication use is legitimate. !
with other medications. A urine drug test ensures patient compliance with the prescribed regimen and may prevent an unnecessary adverse event.
Protecting the Doctor
Even under the most humane and disease related indications, physicians face ! significant risks by prescribing controlled ! medications. Patients may divert their prescription, take too much, combine with Protecting the Patient illicit substances, etc. These risks are Imagine yourself waking up in pain mitigated by physicians subjecting ! every single day, and you are under the patients to urine drug screening. The vast ! care of a physician prescribing you pain majority of patients are compliant, medication. In order to ensure however a small few have necessitated the compliance and place confidence in the testing from resultant adverse events. patient-physician relationship, your 45&&,/6++0%'-#!"!#$%&&'()*+!,(!-!.$/%0)*(! The Bottom Line ! doctor may necessitate a urine drug 75&&*'8#&*"##9& test. This will guarantee that you are The pain doctors affiliated with Preferred ! taking the drugs prescribed and only *5&&&486)%'-#& Pain Center often require Urine Drug those medications. If you were to stray Screens along with Pain Agreements and & from the prescribed from those :5&&&;#0'& checking the AZ Pharmacy Board Website medications, you could be &placing your for compliance. It provides for the highest <5&&&*=')%-#"& level of patient safety while minimizing health at risk. Narcotic medications & can have significant cross-reactions the chance of prescription diversion. >5&&&!=6#)(?&@&AB+=&,+5&C&*'D#-E'/9&&&&&&&& & &&&&&&&&&&&&&&F=#'%G2'"+#"0H& & I5&&&!=6#)(?&@&JA)%&,+5&C&,=#'&
!"#$#""#%&!'()&*#)+#"! “A lot of diversion goes !"#$#""#%&!'()&*#)+#"& on for seemingly 1)02"')/#&3(0+! legitimate prescriptions,” stated • 433&!!.&!34K,! one of the study
doctors. Urine Drug
1K*3S:1KIM&4<TK4U& Screens can minimize the chance of
*1IK4U&7*7,U& prescription diversion. SK1T<:U&VS;4K4U& !
Preferred Pain Center Information – Call 4,,SW4KTU&IW<4T& (602) 507-6550 for appts X<,TU&4K:&4KY& Main Office Location
Satellite Offices A. Scottsdale B. Cave Creek C. Avondale D. Mesa E. Chandler
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F. Main office G. Surgery Center
! 2813 E. Camelback Rd Suite 430 Phoenix, AZ 85016 • 4Z&>.SK:4T1.K&
Surgery Center Location
N. 32nd Street • X.W[<W\,&*.;!& Phoenix, AZ 85028
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Phone (602) 507-6550 Fax (602) 759-1741 • ;<:1*4W<!
Most Insurance Accepted including! *'--&K6LM&FNOAH&POQRNPPO! Follow us on Twitter! Worker’s Comp & Personal! InjuryLLL5^"#$#""#%^'()/#)+#"5/6D! twitter.com/PreferredPain Patients Routinely Seen within 48 hours! !!
The Pain Letter Issue 2 July/August 2010 Preferred Pain Center, Phoenix, AZ Comprehensive Pain Managment Center newsletter with articles on...