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

Attleboro, MA(508) 236-8333
Franklin, MA(508) 507-8818
South Kingstown, RI (401) 234-9677
Warwick, RI(401) 352-0007

Franklin, MA • (508) 507-8818
Warwick, RI • (401) 352-0007
South Kingstown, RI • (401) 234-9677

South Kingstown Pain Center RI Blog

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A Minimally Invasive Treatment Option for Back Pain

Joseph Coupal - Friday, January 26, 2018
Comprehensive Pain Management - Disc-FX System

Treating Contained Disc Herniations

In the past, patients with contained disc herniations have been treated with conservative care including rest, medications, injections and/or physical therapy. Unfortunately, this does not always provide relief. In the past, people who did not respond to conservative care were forced to live with the symptoms or consider major spine surgery. If they underwent surgery, it could take weeks or months to recover, causing a major disruption in their daily lives.

With Disc-FX, this is not the case. Disc-FX provides an option for those people who have failed conservative care, and are not yet ready for major surgery. It is a minimal access procedure performed on an out-patient basis. The patient will go home the same day as the procedure with only a small bandage on their back. Following manual removal of the offending herniation, the patented Disc-FX device is activated to help clean the disc and seal tears in the annulus. As a result, pressure in the disc is reduced, which eases symptoms.

Facts about Contained Disc Herniations:

  • 90% of low back pain is caused by pinched or irritated nerve in the back
  • There are 15 million office visits for low back pain each year
  • Low back pain is the most prevalent cause for people under 45 to visit their physician

Who is a Candidate for the Procedure?

Patients with symptomatic, contained lumbar disc herniations that have not responded to conservative treatment, may experience relief from the use of Disc-FX. Typical signs of a contained lumbar disc herniation is lower back pain or pain radiating down the leg accompanied by some lower back pain. Disc-FX® may not be beneficial for advanced degenerative disc disease or spinal fractures. At Comprehensive Pain Management, we will evaluate and determine if you are a candidate for Disc-FX.

Disc-FX System Overview

The Disc-FX System is an innovative, minimal access spine system designed to efficiently access the damaged disc without injury to surrounding disc anatomy. Disc-FX permits multiple treatment options compared to other ‘single treatment’ devices in the marketplace. In addition to manual decompression, Disc-FX can help to clean the disc and seal tears in the annulus.

For more information on Disc FX contact Comprehensive Pain Management in South Kingstown, RI.

Spinal Cord Stimulation FAQs

Joseph Coupal - Friday, January 05, 2018

Comprehensive Pain Management in South Kingston, RI When can I resume my usual activity?

For several weeks after the procedure you will be asked to restrict your physical activity. Once that period is over, your Spinal Cord Stimulation system is designed to help you lead a healthy and active lifestyle. However, you should always consult your doctor before resuming activity after surgery or before engaging in physical activities.

Will I be totally pain-free with Spinal Cord Stimulation?

People differ in the amount of pain relief they receive with SCS therapy. Many people experience a reduction in pain sensations. The trial procedure will help you determine the amount of relief you may receive.

Will Spinal Cord Stimulation allow me to be free of pain medications?

For some patients, SCS works well enough that pain medications are no longer needed. For others, it can mean a reduction in the amount of pain medication they need. Always consult your doctor before changing your dosage of any medications.

Can I control the stimulation therapy?

Yes, the cordless remote control allows you to turn stimulation on and off, increase and decrease the level of stimulation, and target different pain areas using settings or programs designed specifically for you.

Do I use my Spinal Cord Stimulation system 24 hours a day?

It’s up to you. These systems are designed for 24-hour-a-day use, should you wish. However, there are a few limitations, which your physician can describe. For instance, you should not turn on stimulation while driving or charge while sleeping.

Can one Spinal Cord Stimulation system help me with pain in multiple areas?

Yes, this system is designed to address multiple pain areas at the same time. You can use your remote control to adjust the amount of stimulation for each pain area.

Can I get diagnostic imaging with this system?

SCS patients have many imaging options. Commonly used methods such as X-Rays, CT Scans, PET Scans and Ultrasounds can image many different parts of the body, including soft tissue. In addition, the Precision Montage™ MRI System provides access to full-body MRI scans, under specified conditions, for patients who meet the eligibility requirements. SCS systems have varying limitations and conditions related to MRI scans. Talk to your doctor to find out which option is right for you.

Will I feel the implant? Is it visible to others?

The implant features a contoured oval shape and is small in size. Your doctor can position it in the most comfortable and convenient location in your body. Patients often report that they can feel the unit by pressing on their skin. In most cases, it isn’t visible to others.

How convenient is it to recharge the implant battery?

Recharging the implant battery is designed to be convenient and simple. The charger is lightweight, cordless and portable so you can charge on the go. Either an adhesive patch or soft cloth belt (included with the charger) can be used to recharge.

Is spinal cord stimulation safe?

Yes, spinal cord stimulation has been proven safe and effective and has been in use for decades. Over 400,000 people worldwide have been successfully treated with SCS therapy. You should review the risks of SCS with your physician.

For more information on Spinal Cord Stimulation contact Comprehensive Pain Management in South Kingstown, RI.

Source: bostonscientific.com

Who Can Benefit from Spinal Cord Stimulation?

Joseph Coupal - Thursday, December 14, 2017

Comprehensive Pain Management in Franklin, MAA two-step screening process is typically used to determine whether a person is a good candidate for spinal cord stimulation. The first step is based on the person’s medical condition and begins with a thorough assessment by the doctor.

Chronic Pain Conditions Treated with Spinal Cord Stimulation

A general condition known as failed back surgery syndrome is one of the most common reasons spinal cord stimulation is used. This relates to chronic pain after one or more back or neck surgeries fails to alleviate persistent low back pain, leg pain (sciatica or lumbar radiculopathy) or arm pain (cervical radiculopathy).

The therapy also has the potential to alleviate pain related to the following conditions:

  • Arachnoiditis, painful inflammation and scarring of the meninges (protective layers) of the spinal nerves
  • Chronic back pain with or without leg pain
  • Chronic neck pain with or without arm pain
  • Complex regional pain syndrome, a chronic progressive disease characterized by severe pain and swelling
  • Peripheral neuropathy, a constant burning pain of the legs caused by the most distant nerves dying off
  • Complex regional pain syndrome (reflex sympathetic dystrophy), a progressive disease of the nervous system in which patients feel constant burning pain
  • Refractory angina, which causes chest pain, shortness of breath, and fatigue

Spinal cord stimulation is recommended for an increasing number of painful health problems, this is not a comprehensive list of conditions the therapy may help.

If the person fits the criteria for spinal cord stimulation, the doctor will arrange a trial period—the second step in the screening process—to see how well the temporary therapy eases the individual’s pain.

For more information on spinal cord stimulation, contact Comprehensive Pain Management in South Kingstown, RI.

Source: Spine-Health

Osteoporosis is Serious

Joseph Coupal - Tuesday, December 05, 2017
Comprehensive Pain Management - Osteoporosis Treatment in South Kingstown, RI

Some 54 million Americans have osteoporosis or low bone mass, according to the National Osteoporosis Foundation. Yet, a disconcerting number of those who have experienced abnormal fractures – ones occurring after a fall from a standing position or less – do not equate these accidents to the state of their bone health.

“The findings from a recent Harris poll are especially worrisome. Ninety-six percent of the respondents who had not been diagnosed previously as having osteoporosis, but fell and broke a bone simply from a standing position, indicated they were never told by their physician that the problem may be due to bone disease.

Eight-two percent with abnormal fractures failed to identify them as potential signs of osteoporosis, which causes loss of bone mass and makes bones more fragile. Nearly half the respondents – both those diagnosed with osteoporosis and those not – blamed their fractures on clumsiness.

Osteoporosis is often called “the silent disease,” because it slowly weakens bones, especially in the hip, spine and wrists, without symptoms. Oftentimes, the problem is not diagnosed until a fracture has occurred. Although men can develop the disorder, postmenopausal women are more susceptible because of a decline in their estrogen levels. Estrogen plays an important role in maintaining bone density in women.

Besides gender, other osteoporosis risk factors include genetics and a family history of osteoporosis, advancing age, calcium and vitamin D deficiencies, smoking, certain disorders like rheumatoid arthritis, excessive alcohol consumption, low body weight and some medications, such as chemotherapeutic drugs.

Although patients worry more about cancer, heart disease and other serious health problems, osteoporosis can have a considerable impact on quality of life, causing pain, lost work time and disability. It can even lead to death.

There are statistics indicating as many as 30 percent of patients who sustain hip fractures due to their bone disease will require long-term nursing care; approximately 20 percent will die within a year due to complications indirectly stemming from the fracture.

Even more common than the broken hip bones are spinal fractures – often called vertebral compression fractures. Affecting some 700,000 patients annually, these fractures can be the first sign of osteoporosis. They occur when spinal vertebrae weaken from the bone disease, becoming flatter and more narrow and unable to withstand pressure. Even simple tasks like twisting or reaching for something can break these vertebrae in patients with osteoporosis.

Vertebral fractures result in sudden onset of back pain, especially when walking or standing; limited mobility; and even loss of height.

Vertebral compression fractures can be treated with a minimally invasive procedure called kyphoplasty, which can offer pain relief and halt the collapse of the spine of caught early. Patients can walk out after the procedure and feel immediate improvement. Most recommended approaches to treating osteoporosis involve lifestyle changes, which include weight-bearing exercises like walking and a balanced diet with foods rich in calcium and vitamin D; calcium supplements; and medications that either stop bone loss and increase bone strength or enhance bone formation.

Noting the adage, “an ounce of prevention is worth a pound of cure,” here are some tips to maintain healthy bones:

  • Improve your diet. Eat plenty fruits and vegetables and increase calcium by consuming calcium-rich foods like dairy and dark green vegetables. Avoid too many products high in animal protein.
  • Make sure you get sufficient vitamin D.
  • Limit caffeinated drinks and decrease consumption of salty, processed foods.
  • Exercise.
  • Stop smoking.
  • Smile. A 2015 study indicates older women with a strong sense of well-being have greater bone density than their unsatisfied counterparts.

For more information on treating fractures caused by osteoporosis, contact Comprehensive Pain Management in South Kingstown, RI.

Source: PR Web

Pain Management In Sports

Joseph Coupal - Friday, November 10, 2017
Comprehensive Pain Management in South Kingstown, RI

We praise athletes, at every level, for their ability to compete, to dazzle, to perform under pressure, to inspire and — maybe most importantly — to win.

And when they fall down, when they tear, break or injure themselves, they promise to pick themselves back up, come back stronger than ever and carry their team to victory — thus solidifying their seemingly superhuman performance.

But what goes into recovery? How do athletes get better? And then how do they stay healthy?

Often, recovery — and general pain management in sports — involves medication.

On game day, many NFL players find themselves lining up to receive a shot of Toradol, Bleacher Report reported earlier this year. Toradol, or ketorolac, is described as a stronger and faster-acting version of Advil or Aleve.

One player told Bleacher Report that he had received a shot of Toradol before every game for the past "four or five years."

Persistent use of such medication could have long term effects, and it's not just a problem in professional sports. In 2013, a University of Michigan researcher found that "male adolescent athletes who participated in competitive sports across the three-year study period had two times greater odds of being prescribed painkillers during the past year and had four times greater odds of medically misusing painkillers (i.e., using them to get high and using them too much) when compared to males who did not participate in competitive sports."

The researcher also found that by the time high school athletes became seniors, approximately 11 percent had used narcotic pain relievers such as OxyContin or Vicodin for nonmedical purposes.

For more information on pain management in sports or after suffering a sports related injury, contact Comprehensive Pain Management in South Kingstown, RI.

Source: NPR

Pain Management Specialist: What To Look For and What to Expect

Darren Kincaid - Friday, October 27, 2017
Comprehensive Pain Management in South Kingstown, RI

The most important consideration in looking for a pain management specialist is to find someone who has the training and experience to help you with your particular pain problem. You also need to feel comfortable with them. Many types of chronic pain may require a complex treatment plan as well as specialized interventional techniques.

The widely accepted standard for pain management education today is a fellowship (training beyond residency) in pain management. Most fellowship programs are associated with anesthesiology residency training programs. There are also fellowship programs associated with neurology and physical medicine and rehabilitation residency programs. The fellowship consists of at least one year of training in all aspects of pain management after completion residency training. When a physician has become board certified in their primary specialty and has completed an accredited fellowship, they become eligible for subspecialty board certification in pain management by the American Board of Anesthesiology, The American Board of Psychiatry and The American

Board of Neurology, or the American Board of Physical Medicine and Rehabilitation. These three are the only board certifications in pain management recognized by the American College of Graduate Medical Education.

In addition to learning about your pain physicians training and board certification, you also should ask whether they have experience with your specific pain condition and what types of treatments they offer. Do they only perform procedures or do they use a multidisciplinary approach to pain management?

Who do they refer to for other treatment options such as surgery, psychological support or alternative therapies? How can they be reached if questions or problems arise? What is their overall philosophy of pain management?

How can I be referred to a pain management specialist?

The best way to be referred to a pain management specialist is through your primary care physician. Most pain physicians work closely with their patients' primary care physicians to insure good communication, which in turn helps provide the optimum treatment for their patients. Patients are also often referred by specialists who deal with different types of pain problems. Back surgeons, neurologists, cancer doctors, as well as other specialists usually work regularly with a pain physician and can refer you to one.

What should I expect during my first visit to a pain management specialist?

On your first visit to a pain management specialist, they will get to know you and begin to evaluate your particular pain problem. This will usually involve a detailed history, a physical exam and review of tests that you have had performed. The questions you are asked and the physical examination will focus on your particular problem, but your pain physician will want to know about past and current medical history as well.

Often you will be given a questionnaire before your first visit that will ask detailed questions about your pain problem, and you will probably be asked to bring any imaging studies (such as X-rays, computed tomography [CAT] scans, or magnetic resonance imaging [MRI] scans) or other tests that have already been done. You should know before your first visit whether or not a procedure is anticipated. If so, you may need a driver to take you home.

Most importantly, this visit is an opportunity for your pain physician to begin to analyze all of this new information and discuss with you an initial assessment of your pain problem. He or she may know exactly what is causing your pain, or perhaps further diagnostic procedures will be needed. But no matter what type of problem you have, you should leave this first visit with a clearer understanding of your pain and the course of further evaluation and treatment that is planned.

For more information, contact Comprehensive Pain Management in South Kingstown, RI.

Source: ASRA

Pain Management Clinics: What to Know

Joseph Coupal - Thursday, October 19, 2017
Comprehensive Pain Management - South Kingston, RI

At least 100 million Americans and more than 1.5 billion people worldwide live with chronic pain.

Most Americans with it say it's tough for them to sleep well at night and concentrate during the day. They also say it affects their energy levels and their enjoyment of life.

If pain is regular part of your life, a pain clinic may be able to help you.

What Is a Pain Clinic?

Pain management clinics are health care facilities that focus on the diagnosis and management of chronic pain. There are two kinds. One focuses on procedures to deal with specific types of pain, like neck and back pain.

The other, sometimes called an interdisciplinary clinic, takes an approach that looks at the whole person.

Often, the pain managment team may include:

  • Nurses and doctors
  • Psychologists
  • Physical therapists
  • Occupational and vocational therapists
  • Nutritionists and dietitians

In addition to medications, these clinics can help you manage pain with physical, behavioral, and psychological therapies.

They also may teach you about your pain, coach you on lifestyle changes, and offer complementary or alternative medicine. These can include:

  • Acupuncture
  • Biofeedback
  • Cognitive behavioral therapy
  • Water therapy
  • Massage
  • Meditation

What’s the Goal?

The goal is to decrease your pain and raise your quality of life. Treatment at a pain clinic can give you the skills to manage your chronic pain on your own and allow you to function better, possibly so that you may return to work.

Do They Work?

Multiple studies say folks who have comprehensive pain management have less pain and emotional distress. Research says people suffering from pain can do their daily tasks easier.

How Do I Find a Pain Clinic?

Ask your primary care doctor or specialist for a referral to Comprehensive Pain Management in Franklin, Warwick or South Kingston, RI. You can also:

  • Call your local hospital or medical center.
  • Get help from a local pain support group.
  • Search The Center to Advance Palliative Care for a list of providers in each state.

What Should I Look For?

Look for a clinic with a specialist who knows about your kind of pain. Ask if the doctor has had special training and is board certified in pain management.

As with other doctors, you should also try to find someone you feel comfortable with. Your pain management specialist will treat your pain and coordinate other care, including physical therapy, rehabilitation, and counseling.

A good pain program will work with you and your family to create a plan based on your goals. It will monitor your progress and tell you how you’re doing.

What Else Should You Ask?

Be sure to ask what kind of therapies and treatments a clinic offers. You can also see if they organize support groups.

A pain clinic should focus on the person, not the pain.

For more information on comprehensive pain management, contact Comprehensive Pain Management in South Kingstown, RI.

Source: Web MD

Back Pain Treatment: Non-Surgical Options

Joseph Coupal - Friday, October 06, 2017
Comprehensive Pain Management in South Kingston, RI

Prior to starting any type of treatment, it is always important to see an appropriately trained doctor or pain specialist to develop an appropriate treatment program for your specific condition and medical history.

The main goals for managing back pain in the lumbar spine (lower back) usually include:

  • Providing enough pain relief to be able to actively participate with physical therapy and rehabilitation
  • Preventing further injury or stress to the spine through improved ergonomics and posture
  • Maintaining an ability to function enough at home and at work

Non-Surgical Back Pain Treatments

There are a wide variety of non-surgical options for back pain treatment of the lumbar spine. The more common treatment approaches include:

Pain medication. Typical pain medications used to treat the lower back pain include acetaminophen, NSAIDs, oral steroids, narcotic drugs, muscle relaxants, and anti-depressants. Each type of medication has strengths, limitations, and risks, and the patient’s particular problem in the lower back and overall health will determine which pain reliever, if any, is indicated.

Heat or ice. Application of a cold pack or heating pad can help relieve low back pain. Some people find that alternating between the two works best.

Manual manipulation. This treatment may be applied by a chiropractor, osteopathic doctor, or other qualified health professional. It is thought to help relieve lower back pain by reducing pressure on sensitive structures, increasing flexibility, improving blood flow and reducing muscle tension.

Therapeutic massage. Massage therapy is thought to improve blood flow, reducing muscle stiffness, and decrease stiffness.

Exercise. A program of back exercises and physical therapy will usually include a combination of strengthening, stretching, and low-impact aerobic exercise.

Epidural injections. An epidural injection into the spine delivers steroids that can provide lower back pain relief by decreasing inflammation in the painful area.

TENS units. These electrical devices are used to interfere with the transmission of pain signals sent to the lower back.

Lifestyle factors. Many lifestyle changes are also important in reducing lower back pain, such as quitting smoking, weight loss, activity modification, and improved ergonomics and posture.

For more information on treating back pain, contact Comprehensive Pain Management in South Kingstown, RI.

Source: spine-health.com

Safely, Quickly and Effectively Treat Herniated Disc and Other Disc Issues

Joseph Coupal - Thursday, September 21, 2017
Comprehensive Pain Management - Disc-FX System

Disc-FX System safely, rapidly and effectively performs minimally invasive discectomy procedures for contained lumbar spine herniations. The innovative, patented design combines simple, intuitive function with precise surgical results.

  • Less invasive compared to traditional discectomy procedures
  • Minimum annulotomy reduces risk of herniation
  • Multi-functional therapeutic options; debulking, ablation and modulation
  • Manual excision of herniated nucleus through 3.0mm portal
  • Ablation and denervation achieved with use of this device

Safely, Rapidly and Effectively Treat Discogenic Pathologies

  • Manual excision of herniated nucleus
  • Less invasive incision compared to traditional disc procedures
  • Reduces risk of reherniation
  • Multi-therapeutic options; nucleus decompression, nucleus ablation and annulus modulation

Multiple Treatment Options in one system:

  1. Nucleus Decompression/Discectomy
    • Grasping forceps are used to manually remove bulging nucleus material
    • Nucleus material can be collected and sampled for pathology. Doctors generally remove 1-2 grams of nucleus pulposus
  2. Nucleus Ablation
    • Nucleus Ablation can be performed by the device to further break down the nucleus, allowing free fragments to be removed manually via the grasping forceps
  3. Annulus Modulation
    • Due to the steerability of the device, the annular wall which contains pain receptors can be treated and annular fissures can be sealed

For more information on Disc FX to treat herniated discs, contact Comprehensive Pain Management in South Kingstown, RI.

Source: elliquence.com

Pain Treatment Options

Joseph Coupal - Thursday, September 07, 2017
Comprehensive Pain Management in Franklin, MA

Pain can be a debilitating condition, but there are ways to keep it under control. Learn about different pain management options.

Whether your pain is from arthritis, cancer treatments, fibromyalgia, or an old injury, you need to find a way to get your pain under control. What's the best approach to do that?

The first step in pain management is scheduling an appointment with your doctor to determine the cause of your pain and learn which pain management approach is often the most effective for it. There are many different pain management options available: You can find the right treatment combination to get the relief you need.

Before you try to treat your pain, it's important to understand how pain is defined.

The International Association for the Study of Pain came up with a consensus statement. Pain is an unpleasant sensory and emotional experience. That's extraordinarily important. When we focus only on the sensory aspect, we fail to appreciate the suffering component of the pain, which is important to recognize because pain is not what occurs at the periphery.

Pain is real and it's physical — there's no mistaking that. But pain is measured and specific to one person based on that person's perception of the pain, and that's why everyone's pain is different.

What the brain perceives is indisputably modifiable by emotions. That means that people who are fearful of pain, depressed, or anxious may experience pain differently and perhaps more severely, than someone who has pain but isn't experiencing those other emotions.

It is important to approach pain both physically and emotionally and to address people as entire human beings. So while chronic pain medication can be effective and important for pain management for many people, it isn't the only tool available when it comes to pain treatment and it shouldn't be the only tool that's used.

Medications. There are a lot of medications that are prescribed for pain, although opioids (narcotics) and benzodiazepines may not be the best options.

Types of chronic pain medication used include:

  • NSAIDs (non-steroidal anti-inflammatory drugs), including ibuprofen, naproxen, and aspirin
  • Acetaminophen (Tylenol)
  • Antidepressants, which can improve sleep and alleviate pain
  • Anti-seizure medications, which can be effective in treating pain related to nerve damage or injury
  • Steroids, like dexamethasone and prednisone, to alleviate inflammation and pain

Therapy. Therapy can be aimed at both the mind and the body. Therapies should not be purely physical or purely psychological — it should always be a mixture of both of those things.

Physical therapy is a very important part of any pain management program. Pain can be worsened by exercise that isn't done correctly (or interpreted incorrectly as pain rather than overuse), and a physical therapist can tailor the right exercise regimen for you. Proper exercise slowly builds your tolerance and reduces your pain — you won’t end up overdoing it and giving up because it hurts.

Cognitive-behavioral therapy allows people to learn and have a better understanding of what the pain is from, and what they can do about it. This therapy is really about understanding the role of pain in your life and what it actually means for you.

Other pain management options. A variety of approaches and modalities can help you deal with both the physical and emotional parts of pain:

  • TENS (transcutaneous electrical nerve stimulation) therapy
  • Meditation
  • Relaxation techniques
  • Visual imagery, as simple as picturing a peaceful scene, for example
  • Biofeedback, which teaches control over muscle tension, temperature, heart rate and more
  • Heat and cold therapy
  • Manipulation and massage

The bottom line: Seek help for your pain as soon as it becomes a problem in your life. We aren't guaranteed lives without pain. But when chronic pain starts to destroy your ability to function in the world, then it's a problem that needs to be addressed.

For more information on pain management, contact Comprehensive Pain Management in South Kingstown, RI.

Source: everydayhealth.com