Comprehensive Pain Management
(Formally known as Franklin Pain and Wellness and Warwick Pain)

Attleboro, MA(508) 236-8333
Franklin, MA(508) 541-0004
South Kingstown, RI (401) 234-9677
Warwick, RI(401) 352-0007

Franklin, MA • (508) 541-0004
Warwick, RI • (401) 352-0007
South Kingstown, RI • (401) 234-9677

Attleboro Pain Center MA Blog

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Kyphoplasty: What it is and How it Works

Darren Kincaid - Thursday, January 17, 2019
Comprehensive Pain Management  - Kyphoplasty in Attleboro, MA

Kyphoplasty injects special cement into your vertebrae — with the additional step of creating space for the treatment with a balloon-like device. Kyphoplasty can restore a damaged vertebra’s height and may also relieve pain.

Doctors might recommend kyphoplasty for cancer-damaged vertebrae or certain spinal fractures. In most cases, a weakening of the bones (osteoporosis) has caused the vertebrae to compress or collapse, causing pain or a hunched posture.

How Kyphoplasty Works

Before the procedure:

  • Your doctor will examine you, possibly drawing blood for testing and using X-ray or magnetic resonance imaging (MRI) to locate the fractures.

During the procedure:

  • An anesthesiologist will deliver medicine through an IV to either relax you and relieve your pain or put you to sleep.
  • With X-ray guidance, your doctor will insert a needle through your skin and back muscles into the bone, then inflate a balloon to help the vertebra regain its normal shape.
  • Your doctor will inject the cement while checking X-rays to ensure it’s going into the right place.
  • Your doctor will remove the needle, with no stitches needed.
  • The entire procedure will probably take less than an hour, though it may last longer if more vertebrae are treated.

After the procedure:

  • You will spend time in a recovery room. You could go home the same day, but your doctor may want you to stay overnight.
  • It’s possible that you can start walking an hour after the procedure. You may feel some soreness where the needle entered your back, but this lasts no more than a few days. You may quickly notice that you have less pain than you did before the surgery.
  • Talk with your doctor about whether you should avoid any activities after the procedure.
  • Your doctor may suggest taking certain vitamins, minerals and medications to help strengthen your bones and prevent additional spinal fractures.

For more information on Kyphoplasty, contact Comprehensive Pain Management in Attleboro, MA.

New Year's Resolutions for a More Pain Free 2019

Joseph Coupal - Friday, December 28, 2018
Comprehensive Pain Management in Attleboro, MA

The New Year is almost here – and with it comes all the New Year’s resolutions. But instead of the typical resolutions, consider setting some achievable goals that will not only lead to a happier you in 2019, but a more pain-free one, too!

Weed out the negative people in your life.

If the people in your life are demanding and not very supportive, then it could actually make things worse. Make your goal this year be to surround yourself with those who understand your situation and support you unconditionally. Whether this is friends, family members or even a support group dedicated to others in the same boat, seek them out and accept the support they offer. A strong support network can often make it much easier to cope with chronic pain.

Banish pessimism.

Negative thoughts – like “this pain is stopping me from living my life” or “I feel useless when I’m in so much pain” – don’t do anyone any good, especially you. Don’t let your negative thoughts and emotions overcome you in 2019. Make it a point to focus on the positive things happening in your life. One way to achieve this is to write a list of all the positive things happening in your life. Enjoy the company of your new grandchild? Write it down. Looking forward to a new movie or TV show this year? Add it to the list. Go over and add to the list every morning, or whenever you’re feeling down.

Find little ways to incorporate activity.

The problem with a lot of weight-related resolutions is that they’re too big. Something like “lose 30 pounds this year” is such a tall order that many people give up before they even really try. So start small; small changes can result in big outcomes. Make small resolutions for yourself – like working out three times this week, parking farther away from the store on two trips or taking the stairs instead of the elevator four times. These small goals – which are easier to accomplish – will result in a sense of accomplishment and will go toward helping you achieve your larger health and weight goals.

Focus on your relationships.

Oftentimes, those in pain become fixated on their pain. That’s all they talk about, think about, focus on. Their world becomes smaller and smaller and they have little time or attention for other people in their lives. This can lead to a myriad of relationship difficulties, especially amongst families. So in 2019, break the cycle. It starts with communication; tell your partner, friends and family what you need and encourage them to do the same. Just like your weight goals, set small relationship goals like two date nights or family game nights a month during which you won’t talk about your pain. If you’re still having difficulty, consider seeing a specialist, who will be able to help you refocus your attention away from your pain and toward the people and things that really matter.

Adopt a new hobby.

There are times when your pain is all you can think about. But putting all your energy into thinking and worrying about it won’t help you feel better. Although it might seem difficult, try to refocus your attention away from the pain. That’s where a new hobby comes in. Pick something that’s all-consuming and will capture and hold your attention for long periods. Choose an activity that leaves no room in your brain to focus on your pain. Getting your brain off of it is often one of the best ways to deal with it – it may also help you bond with those you love and improve yourself and your skill set in the process.

Get help.

Knowing that you are doing all you can to reduce you pain is a comforting feeling. But many people have become so frustrated at doctors and treatments and the lack of successful outcomes that they’ve given up. This isn’t helpful – for you or your pain levels. Make it your goal in 2019 to get some answers – and get some relief. There are new, innovative treatment options for many complicated and chronic pain conditions; talk to your doctor about pain management or contact Comprehensive Pain Management in Attleboro, MA.


Avoiding Back Pain During the Holidays

Joseph Coupal - Thursday, December 13, 2018
Comprehensive Pain Management in Attleboro, MA

Did you know that 80% of the population will have back pain at some point in life.

Activities like hanging Christmas lights and lifting heavy luggage make the holidays a treacherous time when you can injure your spine.

The most common injuries happen when people fall from ladders or strain when lifting boxes and suitcases. However, pain can frequently happen doing almost anything you aren’t used to: sleeping in a guest bed, standing a long time or picking up a kid who grew in the last year.

It's just about proper mechanics when you want to lift up a child. If you bend at your hips, and left them straight up, that can create a problem versus bending down, keeping your spine in an upright, vertical alignment and bending down in your knees and then picking them up from that standpoint.

The core is key to preventing back pain. Core muscles in the belly and the back is the biggest thing to try and prevent these things from happening. Because the stronger your muscles are, the stronger your core, the less likely you are to have these types of injuries.

Since your core strength is crucial in preventing back pain, also remember holiday weight gain can hurt your back, too.

Another simple exercise for a normal, back-pain free life is practicing good posture with everyday tasks like driving.

If it's too late, ice and heat can help with most injuries. The main treatment is anti-inflammatories, like ibuprofen.

For more information on preventing and treating back pain, contact Comprehensive Pain Management in Attleboro, MA.

Source: NBCDFW

How to Protect Your Spine With Osteoporosis

Joseph Coupal - Friday, November 30, 2018
Comprehensive Pain Management in Attleboro, MA

In some cases of osteoporosis, one or more vertebral bones can become so weak that they cannot fully support their load and develop tiny cracks. This type of fracture, called a vertebral compression fracture, can be painful and sometimes leads to worsening symptoms, such as tingling, numbness, weakness, or spinal deformity (kyphosis). Fortunately, you can take steps to lower your risk for vertebral compression fractures, as well as seek treatment if one occurs.

Although osteoporosis does not cause back pain, it can weaken the spinal vertebrae and make them prone to painful fractures. Read What You Need to Know About Osteoporosis

Visit your doctor regularly

If you’re dealing with a chronic condition, such as osteoporosis, it’s especially important to have regular checkups to monitor how you’re doing and whether the treatment plan needs to be adjusted. For example, your doctor might recommend certain medications for osteoporosis, such as bisphosphonates, which may reduce the risk for a vertebral compression fracture.

Eat healthy and quit bad habits

Everyone needs to get plenty of calcium for bone health. If you have osteoporosis or low bone mass, your doctor might also recommend calcium supplements. In addition, it is important to get plenty of vitamin D, which helps the body absorb calcium into the bones.

If you smoke, try to quit. Smoking is known to weaken bones and can worsen osteoporosis.

Regularly drinking lots of soda and/or alcohol may also contribute to weaker bones. If you are in the habit of drinking soda or alcohol every day, try to quit or cut back.

Consult with your doctor to find a balanced diet that works best for you. While it’s important to get enough calcium for bone health, too much calcium can also potentially cause problems, such as kidney stones.

Stay active but use good judgment

The phrase “use it or lose it” is especially true when it comes to your bones. Weight-bearing activities help to build and maintain bone mass. On the other hand, being inactive allows the bones to thin and weaken.

In general, it is good for people to stay active and exercise regularly. If you’ve been diagnosed with osteoporosis or low bone mass, check with your doctor regarding which activities may or may not be right for you. A supervised physical therapy program that focuses on safe resistance exercises may be recommended to help build muscle strength and bone density. Research continues to show that resistance training can strengthen both muscles and bones, even in older people, which may also lower the risk for osteoporotic fractures.

Most people with osteoporosis are encouraged to do some form of weight-bearing exercise as a way to better maintain bone mass, but some activities may be discouraged. For example, your doctor might advise against heavy lifting, doing sit-ups, or bending over to touch the toes, which could put undue stress on the spine.

Don’t ignore a compression fracture

Any time you have back pain that lasts more than a week or two, it is important to see the doctor. Ignoring back pain and potential vertebral compression fractures may lead to bigger problems down the road, such as increased pain, tingling, numbness, weakness, and severe spinal deformity.

Most vertebral compression fractures are treated nonsurgically, such as with rest, pain medications, or applying ice and/or heat while the fracture eventually heals on its own. If the pain cannot be successfully managed with nonsurgical treatments, surgery may be considered. A couple of surgical options for vertebral compression fractures include:

Vertebroplasty. This minimally-invasive procedure involves carefully placing a needle through the back and into the compression fracture, delivering bone cement to fill the cracks and re-stabilize the vertebra. See Vertebroplasty After a Painful Spine Fracture

Kyphoplasty. This procedure is similar to vertebroplasty, except that a small balloon is inserted and expanded into the compression fracture to help restore the collapsed vertebra closer to its original height before injecting the bone cement.

Some studies have found that both vertebroplasty and kyphoplasty have been effective at reducing pain from vertebral compression fractures, especially when done within 2 months of sustaining the fracture.

By following these tips, you’re well on your way to protecting your spine and successfully managing osteoporosis.

For more information, contact Comprehensive Pain Management in Attleboro, MA.

Cortisone Shots for Osteoarthritis

Joseph Coupal - Thursday, November 15, 2018
Comprehensive Pain Management - Attleboro, MA

There are a number of medical treatments that can be used for osteoarthritis, one of which is cortisone shots.

Cortisone shots, sometimes called corticosteroid injections, can help with osteoarthritis pain relief by targeting inflammation in the joint affected by osteoarthritis, the most common type of arthritis.

The effects of cortisone shots are only temporary, and if you take them too often, you may be at risk of side effects.

Osteoarthritis Pain Relief: What Are Cortisone Shots?

Cortisone shots are injections of synthetic corticosteroids, hormones that your body naturally produces in your adrenal gland which are essential for a number of your body processes.

When you experience stress, corticosteroids are released, minimizing inflammation. The corticosteroids in cortisone injections are manmade, but are very similar to the corticosteroids produced in your own body.

Cortisone shots help relieve inflammation. In addition to osteoarthritis pain relief, cortisone injections are commonly used to treat tendinitis, tennis elbow, and carpal tunnel syndrome.

When your doctor injects the medication into your inflamed joint or joints, the cortisone minimizes inflammation in and around the joint, providing significant osteoarthritis pain relief. It may take a few days to feel the effects of your cortisone injection; the pain relief will eventually wear off, usually after several weeks.

Osteoarthritis Pain Relief: Recommended Injection Schedule

Because of these risks, it is recommended that people not receive cortisone shots more than two to four times per year. And it is best that you schedule your injections at least three months apart.

In addition, talk with your doctor about the risks of getting cortisone shots if you:

  • Have septic arthritis (an infection in a joint)
  • Have a skin infection where you received a previous injection
  • Have had an allergic reaction to a previous cortisone shot
  • Use blood thinners
  • Are injured — a recent head trauma or broken bone, for instance
  • Are a competitive athlete

Obviously, cortisone injections can do a lot of good, but, if overdone, can create some serious problems. It’s wise to understand the pros and cons of these shots before receiving your first one.

For more information on cortisone shots contact Comprehensive Pain Management in Attleboro, MA.


Interventional Pain Management for Chronic Pain

Joseph Coupal - Thursday, November 01, 2018
Comprehensive Pain Management - Attleboro, MA

For a lot of people living with chronic pain, searching for pain relief can be challenging. Patients report using a trial and error approach while searching for a pain treatment that really works. Here we will explain the importance of interventional pain management and how it can help those with chronic pain.

Interventional Pain Management can help patients cope with chronic pain. Some pain management treatments involve using prescription medications to help deal with your pain. However, what differentiates an Interventional Pain Management approach from the traditional use of pain medications are effective techniques such as Radiofrequency Rhizotomy and the use of various injections to address the specific pain source.

Several conditions that Interventional Pain Management techniques are applied include neck pain, bone or muscle pain, lower back pain, chronic headaches, face or mouth pain.

There are times that these techniques play a large part in a multi-disciplinary approach to relieve pain and most symptoms. These diagnostic procedures can be used in conjunction with emotional and mental therapies as well as prescription medications.


These injections are also known as nerve blocks, which work to offer temporary to long-term pain relief. They work by sending powerful medications like anesthetics, steroids, and opioids near or directly on the nerve for pain relief. One of the common injections is an epidural steroid injection. This, minimally invasive, injection sends steroids and a numbing agent directly to the inflamed nerve space. Some common injections are sacroiliac joint injections, single nerve root block, and facet joint injections. Most patients require two to three injections for optimum benefits. Some patients who have received these injections have reported pain relief which can last for several years.

Electrical Stimulation

Electrical stimulation is a kind of neuromodulation. Through this procedure, a stimulator device is implanted sending pulses directly to the area causing pain while blocking pain signals from reaching the brain. Electrical stimulation may also be used for specific spinal and nerve conditions including diabetic peripheral neuropathy, epilepsy, and Parkinson’s disease. The patient is able to turn the current on and off or adjust the intensity of the signals.

Radiofrequency Rhizotomy

With the use of x-ray guidance and a tiny insulated needle (probe), the doctor can heat the affected nerve without destroying the nerve pathway. Radiofrequency Rhizotomy temporally turns off the nerve’s ability to send pain signals to the brain. Some names for radiofrequency rhizotomy are neuroablation and radiofrequency ablation. For many patients, this kind of procedure may offer pain relief ranging from 9 months to 3 years. However, during pain-free months, the doctor will recommend physical therapy. Physical therapists may help you address the underlying physical issues that cause pain.

Interventional Pain Management – Is It an Option for You?

You may need to try different Interventional Pain Management techniques or incorporate a combination of various methods as part of a comprehensive pain management plan. These techniques can offer pain relief to boost your quality of life. Remember though, these Interventional Pain Management procedures also have particular risks, so it’s important to discuss with your doctor whether interventional pain management is a good choice for you.

For more information contact Comprehensive Pain Management in Attleboro, MA.

Migraine Headache Pain Treatment

Joseph Coupal - Thursday, October 18, 2018
Comprehensive Pain MD - Migraine Headache Pain Treatment

Migraine is a complex and often debilitating disorder. There are different types of migraines, and several treatment options. Migraine treatment approaches can be classified as acute treatments, which aim to reverse or stop the migraine symptoms, and preventive treatments, which aim to reduce the frequency and severity of migraines. Many people with migraine need both types of treatment. Another treatment strategy is to identify and avoid personal triggers.

To help figure out the best treatment approach, it’s helpful to start with a migraine journal. Keeping an accurate, complete diary of every migraine attack and all of your symptoms will help a pain specialist make a correct migraine diagnosis. The record of your pattern of pain will also assist the doctor in determining which treatment might work best for your situation.

The goal of migraine treatment

The U.S. Headache Consortium lists the following goals of long-term migraine treatment:

  • Reduce attack frequency and severity
  • Reduce disability
  • Improve quality of life
  • Prevent headache
  • Avoid headache medication escalation
  • Educate and enable patients to manage their disease

In addition, the U.S. Headache Consortium has established the following goals for successful treatment of acute migraine attacks:

  • Treat attacks rapidly and consistently without recurrence
  • Restore the individual’s ability to function
  • Minimize the use of back-up and rescue medications
  • Optimize self-care
  • Be cost-effective
  • Minimize side effects

Types of migraine treatments

Migraine treatments can be divided into various classifications: acute or preventive, as well as prescription or over-the-counter (OTC). Acute medications are those used when a migraine attack is currently happening. They are also known as abortive medications. Preventive medications are used on an ongoing basis, even when an attack is not occurring, in the hope that they will prevent or reduce attacks. Preventive medications are also called prophylactic medications.

Prescription migraine treatments

Examples of prescription drugs used as abortive medications for acute symptom relief include:

  • Calcitonin-gene-related peptide (CGRP) blockers
  • Triptans
  • DHE 45
  • Ergotamine

Examples of preventive or prophylactic prescription medications include:

  • Beta blockers
  • Calcium channel blockers
  • Antidepressants
  • Neuronal stabilizing agents or anticonvulsants


OTC medications for acute symptoms relief include:

  • Excedrin for migraine
  • Ibuprofen, which is sold under the brand names Advil and Motrin
  • Naproxen, sold under the brand name Aleve
  • Aspirin
  • Acetaminophen, sold under the brand name Tylenol
  • Nerve Stimulators

In addition to medications two nerve stimulators may be used in certain people with migraines who have not gotten relief from other methods.

The Cerena Transcranial Magnetic Stimulator is a device that is approved for people 18 years of age and older who have migraines with aura. It is held to the back of the head and delivers a pulse of magnetic energy.

A vagus nerve stimulator has also been approved for use in adults with migraines, as well as episodic cluster headaches. The hand-held device is placed over the vagus nerve in the neck where it releases a mild electrical stimulation to reduce pain.

Complementary and Alternative Medicine

Some people with migraines also use complementary and alternative medicine approaches to get relief from their migraine symptoms. Complementary and alternative medicine includes any medicinal products or practices that are not part of mainstream medicine given by medical doctors and allied health professionals, such as nurses or physical therapists. Alternative medicine is also defined by its use as an alternate to traditional medical care. Complementary medicine is used in combination with traditional medicine. These types of treatments include:

  • Natural remedies, such as herbal treatments, vitamins, minerals and other supplements
  • Mind-body medicine, such as meditation, biofeedback, yoga, acupuncture, tai chi and hypnotherapy
  • Manipulative and body-based practices, such as chiropractic spinal manipulation and massage therapy

As always, the best source for advice on treating your migraine is your own migraine pain specialist. For more information on treating migraine pain, contact Comprehensive Pain Management in Attleboro, MA.


What Is Shingles?

Joseph Coupal - Thursday, October 04, 2018
Comprehensive Pain Management in Attleboro, MA

Shingles is a disease that affects your nerves. It can cause burning, shooting pain, tingling, and/or itching, as well as a rash and blisters.

You may recall having chickenpox as a child. Shingles is caused by the same virus. After you recover from chickenpox, the virus continues to live in some of your nerve cells. It is usually inactive, so you don’t even know it’s there.

In fact, most adults live with the virus in their bodies and never get shingles. But, for about one in three adults, the virus will become active again. Instead of causing another case of chickenpox, it produces shingles. We do not totally understand what makes the virus go from inactive to active.

Having shingles doesn’t mean you have any other underlying disease.

What Are the Symptoms of Shingles?

Usually, shingles develops only on one side of the body or face and in a small area rather than all over. The most common place for shingles is a band that goes around one side of your waistline.

Most people have some of the following shingles symptoms:

  • Burning, tingling, or numbness of the skin
  • Feeling sick—chills, fever, upset stomach, or headache
  • Fluid-filled blisters
  • Skin that is sensitive to touch
  • Mild itching to strong pain
  • Depending on where shingles develops, it could also cause symptoms like hiccups or even loss of vision.

For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze.

Long-Term Pain and Other Lasting Problems

After the shingles rash goes away, some people may be left with ongoing pain called post-herpetic neuralgia or PHN. The pain is felt in the area where the rash had been. For some people, PHN is the longest lasting and worst part of shingles. The older you are when you get shingles, the greater your chance of developing PHN.

The PHN pain can cause depression, anxiety, sleeplessness, and weight loss. Some people with PHN find it hard to go about their daily activities, like dressing, cooking, and eating. Talk with your doctor if you have any of these problems.

There are medicines that may help with PHN. Steroids may lessen the pain and shorten the time you’re sick. Analgesics, antidepressants, and anticonvulsants may also reduce the pain. Usually, PHN will get better over time.

Some people have other problems that last after shingles has cleared up. For example, the blisters caused by shingles can become infected. They may also leave a scar. It is important to keep the area clean and try not to scratch the blisters. Your doctor can prescribe an antibiotic treatment if needed.

See your doctor right away if you notice blisters on your face—this is an urgent problem. Blisters near or in the eye can cause lasting eye damage or blindness. Hearing loss, a brief paralysis of the face, or, very rarely, swelling of the brain (encephalitis) can also occur.

Our pain specialists will take your medical history and symptoms into account to create a treatment plan aimed at minimizing your pain.

For more information, contact Comprehensive Pain Management in Attleboro, MA.


Trigger Point Injections

Joseph Coupal - Thursday, September 20, 2018
Comprehensive Pain Management in Attleboro, MA

A trigger point injection is an outpatient procedure designed to reduce or relieve the back pain caused by trigger points. These small knots can form in muscles or in the fascia tissue leading to myofascial pain.

This outpatient procedure is designed to reduce or relieve the pain of trigger points. These small tender knots can form in muscles or fascia, which is the soft stretchy connective tissue that surrounds muscles and organs.

The trigger point injection procedure takes only a few minutes to complete. The physician squeezes and presses the skin to find the trigger point. Once identified a topical anesthetic may be used. The physician inserts a needle through the skin and into the trigger point.

An anesthetic mix is injected into the trigger point. This causes it to relax. If the trigger point doesn't relax completely after the first injection, the physician may reposition the needle for one or more injections. A small bandage is placed over the injection site and the patient is encouraged to stretch and move afterwards.

For more information on trigger point injections, contact Comprehensive Pain Management in Attleboro, MA.

Comprehensive Pain Management Patient Testimonials - Attleboro MA

Joseph Coupal - Thursday, August 30, 2018

Comprehensive Pain Management Patient Testimonials.

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