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

Warwick Pain Center RI Blog

RSS Grab RSS Feed

Who is a Candidate for the Disc-FX Procedure?

Joseph Coupal - Thursday, August 16, 2018
Comprehensive Pain Management - Disc-FX Procedure in Franklin, MA

Patients with symptomatic, contained lumbar disc herniations that have not responded to conservative treatment, may experience relief from a Disc-FX procedure. 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.

Your doctor will evaluate and determine if you are a candidate for the Disc-FX procedure.

Potential Benefits of Disc-FX:

  • Minimal Access Procedure
  • Out-Patient Procedure
  • Minor Skin Incision
  • Rapid Procedure
  • Multiple Treatment Options
  • Local Anesthetic
  • Target Access to Damaged (Diseased) Area
  • Treat Multiple Disc Levels
  • Early Anticipated Return to Normal Activities

Disc-FX has been shown to:

  • Offer a safe and effective treatment option
  • Provide improvement in quality of life
  • Treat multiple disc levels with one surgical procedure

For more information on Disc-FX for treating chronic back pain, contact Comprehensive Pain Management in Warwick, RI.

How Spinal Cord Stimulation Works

Joseph Coupal - Thursday, August 02, 2018

In this basic overview, you'll discover how spinal cord stimulation (SCS) works, and why it can be such a promising therapy for chronic pain.

If you live with chronic pain, you know how all encompassing it can be. It robs you of the things you love to do, strains your relationships, and makes even small tasks unbearable.

One size fits all therapies don't give you the relief you need. Spinal Cord Stimulation is a safe, drug-free, FDA pain managaement therapy that is clinically proven to reduce chronic pain. And, your therapy can be personalized. SCS is designed to interrupt pain messages with a small device called a stimulator. To see how SCS works, watch the video below.

When patients can choose between multiple therapies with one device, they achieve better overall pain relief.

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

Spinal Cord Stimulation

Joseph Coupal - Thursday, July 19, 2018
Comprehensive Pain Management in Warwick, RI

Chronic pain is long standing pain that persists beyond the usual recovery period or that accompanies a chronic health condition. Because this pain is not protective and is not a result of an ongoing injury, it is referred to as "pathological" and is therefore treated as a condition, not as a symptom. Chronic pain may prevent people from working, eating properly, participating in physical activity or enjoying life.

Spinal cord stimulation (SCS) is a pain-relief technique that delivers a low-voltage electrical current continuously to the spinal cord to block the sensation of pain. SCS is the most commonly used implantable neurostimulation technology for management of pain syndromes. As many as 50,000 neurostimulators are implanted worldwide every year. SCS is a widely accepted, FDA-approved medical treatment for chronic pain of the trunk and limbs (back, legs and arms).

There are three SCS device types:

Conventional systems require little effort on the patient’s part for maintenance. However, a minor surgical procedure is required to replace the power source when it runs out. Radiofrequency systems are designed to sustain therapy over long periods at the highest output level. Because of its high power capabilities, the RF system is suitable for the most challenging cases in which there is complex, multi-extremity pain. With this type of system, the patient must wear an external power source to activate stimulation. Rechargeable systems are the newest type of SCS device. The patient is responsible for recharging the power source when it runs low. A rechargeable system typically lasts longer than a conventional system. Eventually a minor surgical procedure may be required to replace the power source if the time between recharges becomes impractical.

SCS Trial Procedure

If it is determined that the patient is a suitable candidate for SCS, often the first step is to implant a device on a trial basis. During the SCS trial phase, a lead or leads are implanted temporarily and are connected to a trial spinal cord stimulator. The trial stimulator is programmed with one or more stimulation programs customized to the specific areas of the patient’s pain. The trial phase can be beneficial for the following reasons:

  • It can help the patient/physician analyze whether SCS effectively relieves pain
  • It provides the patient/physician with an assessment period to determine which type of SCS technology works best
  • It enables the patient/physician to evaluate different stimulation settings and programs

SCS Implantation

If the SCS trial provides adequate pain relief, then a permanent system may be implanted. SCS is a reversible therapy, so even though it is called permanent, treatment can be discontinued at any time and the implanted parts turned off and/or removed.

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

aans.org

Radiofrequency Ablation for Chronic Hip Pain

Joseph Coupal - Thursday, July 05, 2018
Comprehensive Pain Management - Attleboro, MA

Many people with osteoarthritis and other degenerative diseases, including posttraumatic pain and rheumatoid arthritis, suffer from chronic hip pain. Conservative treatment approaches such as physical therapy and analgesia may result in significant cost or adverse effects while providing only short-term improvement, and minimally invasive techniques have been found to be ineffective or of temporary benefit.

Although total hip arthroplasty (THA) is often performed in patients with advanced disease, the procedure is associated with a 5% to 15% failure rate, high cost, and increased morbidity, mortality, and persistent postoperative pain. In addition, the life expectancy of hip implants ranges from 10 to 25 years.

There has recently been renewed interest in radiofrequency (RF) procedures for joint pain resulting from degenerative conditions.

Clinical studies have shown that RF treatment is more effective than conservative methods in reducing hip pain. It works by interrupting the sensory input from the femoral and obturator nerves that innervate the hip joint.

The most common indication for RF was osteoarthritis, and other diagnoses included vascular necrosis and persistent pain after THA. Participants had moderate to severe hip pain and limited ambulation, and previously demonstrated a lack of response to oral analgesics and other conservative approaches.

Hip pain is a common condition that is often seen in elderly patients with multiple comorbidities. Often, pain medications are ineffective or have too many side effects, and injections only provide little or temporary pain relief. In addition, surgery may not be an option because of unwillingness of the patient or an especially high risk for complications related to comorbidities. RF treatment may be a reasonable alternative in these circumstances, as well as in situations involving long wait times for THA or persistent pain after THA.

For more information on RFA, contact Comprehensive Pain Management in Warwick, RI.

clinicalpainadvisor.com

What is Radiofrequency Neurotomy and How Does it Relieve Back Pain

Joseph Coupal - Thursday, June 21, 2018
Comprehensive Pain Management in Warwick, RI

During this minimally invasive procedure, the physician uses heat from radio waves to treat painful facet joints in your lower back. It can treat pain that doesn't respond to medications or physical therapy.

You lie on your stomach and you are given medicine to make you feel relaxed. The skin and tissue of your back are numb.The physician inserts a tube called a cannula. A video x-ray device called a fluoroscope to guide the cannula to the medial branch nerves in your spine. These tiny nerves carry pain signals from the facet joints to the brain.

The physician inserts an electrode through the cannula. A weak electric jolt is used to test its position, if the jolt recreates the pain but does not cause any other muscular effects, then it is in the correct position.

Then the physician uses the electrode to heat the nerve. This disrupts the nerves' ability to transmit pain. Several nerves may be treated together if necessary.

When the procedure is complete, the electrode and cannula are removed and a small bandage is placed on your skin. You are monitored for a brief time before you are allowed to go home. The injection site may be a bit sore, and you may still experience back pain. If the correct nerves were treated, you will gradually experience pain relief as you heal. This may take many weeks, but your relief may last several months.

For more information on Radiofrequency Neurotomy to relieve back pain, contact Comprehensive Pain Management in Warwick, RI.

Who is a Candidate for Kyphoplasty?

Joseph Coupal - Thursday, June 07, 2018
Comprehensive Pain Management in Warwick, RI - Kyphoplasty

What is kyphoplasty?

A compression fracture or a break in one of your vertebra can be painful. It can also make it difficult to move freely. That’s because a break can result in bone fragments rubbing against each other.

Surgery can help treat such fractures. For example, kyphoplasty is a minimally invasive procedure that is often performed. Usually, it can be done without a hospital stay.

Kyphoplasty makes room for a cement mixture to be injected into the bone to give it strength. In this procedure, a doctor inserts and inflates a balloon to create an opening for the mixture. The balloon is removed after the cement is injected. Kyphoplasty is sometimes referred to as balloon vertebroplasty.

This procedure is more likely to be successful if done within two months of a fracture diagnosis. It can help relieve pain and improve mobility when other measures fail to provide relief.

Candidates for kyphoplasty

This procedure can be effective in treating people whose bones are weakened by cancer or whose vertebrae collapse due to osteoporosis, a disease that causes loss of bone density.

Kyphoplasty is used to mend recent fractures. However, it is not used as a preventive technique, even for osteoporosis. As well, it is usually not advised for herniated disks, back arthritis, or curvature of the spine due to scoliosis.

This procedure has not been extensively tested in younger, otherwise healthy people. The long-term effects of the bone cement aren’t known, so these procedures are generally reserved for older people. For more information on Kyphoplasty, contact Comprehensive Pain Management in Warwick, RI.

Source: healthline.com

Managing Chronic Pain at Work

Joseph Coupal - Thursday, May 24, 2018
Comprehensive Pain Management - Warwick, RI

More people are trying to stay on the job despite chronic pain. Find out how you can integrate your pain management plan into your workday.

Besides providing a way to make a living, working can be very important to people living with chronic pain and dealing with chronic pain management. Remaining on the job is a tremendous boost to the self-esteem of people with chronic pain. The challenges of work and the social interactions that take place on the job may even serve to distract you from your pain. Research has found that those who return to work enjoy greater success in their pain management.

A recent survey found that one of every four working people in the United States experiences chronic pain — an increase of nearly 40 percent from a decade earlier, yet nearly 9 out of 10 people living with chronic pain choose to remain on the job rather than stay home. Nearly all said only severe pain would keep them home from work.

Unfortunately, pain can keep you from being an effective employee. That same survey found that about half of chronic pain patients who remain in the workplace engage in "presenteeism" — they are present at work, but their chronic pain sometimes or often prevents them from performing their job.

Manage Pain in the Workplace

Pain management on the job is possible, but requires that employees with chronic pain take a proactive approach to the challenges they face. Effective coping skills include:

Advocate for yourself. Don't feel as though you have to manage pain in silence. Talk to your human resources department about accommodations that could help minimize your pain and maximize your productivity. If you feel comfortable, talk with your boss and co-workers about your pain so they can understand and possibly assist in your pain management practices.

Set priorities. Be aware of your limitations and your health, and don't push yourself in ways that will cause a setback in your pain management efforts. Say no when you need to.

Take breaks. Use regular breaks as a way to bring your pain management practices into the workplace. If getting up and stretching helps your chronic pain, be sure to do so. Some people find that taking a few minutes to meditate in a quiet place helps them manage pain. Others squeeze in a short walk during lunch to gain the benefits of additional exercise.

Adopt healthy habits. On or off the job, you can help your pain management efforts by eating well and exercising. Inquire about any wellness programs offered by your employer; these can be a valuable source of information about healthy living. And be sure to stay on top of taking your prescribed pain medications.

Tweak your workspace. Examine your work area for ways to minimize pain and make you more comfortable. Ergonomic tools like special office chairs, hand rests, foot rests, keyboard trays, and telephone headsets can be tremendously helpful, and many employers will provide these items for you, especially if they understand the benefits.

Be aware of pain management options. Ask your doctor about new ways to deal with your chronic pain and if sessions with an occupational therapist could help you make on-the-job pain management strategies more effective. A therapist also can provide exercises and coping skills tailored to your particular ailment.

Staying at or returning to work can be a helpful component of pain management. By following certain strategies, you can be more productive and experience less pain while benefiting from being around other people on the job. For more information on chronic pain management, contact Comprehensive Pain Management in Warwick, RI.

Source: everydayhealth.com

Common Nerve Block Procedures for Chronic Pain

Joseph Coupal - Thursday, May 10, 2018
Comprehensive Pain Management - Warwick, RI

What are some of the more common nerve block procedures for the treatment of chronic pain? What are some of the common side effects associated with these nerve blocks?

The vast majority of injections done for the diagnosis or treatment of chronic pain are performed on an outpatient basis. Some are performed on inpatients, who may be already hospitalized for other reasons. All of them may be performed under fluoroscopic (x-ray) guidance but are sometime performed in the office without x-ray. Below is a brief description of some of the more commonly performed nerve blocks by pain management specialists.

Epidural Steroid injection: Epidural steroid injection is an injection performed in the back or neck in an attempt to place some anti-inflammatory steroid with or without a local anesthetic into the epidural space close to the inflamed area that is causing the pain. These injections are generally done for pain involving the back and leg or the neck and arm/hand. They may be done under x-ray guidance. Epidural steroid injections may be placed in the lumbar (low back), thoracic (mid back), or cervical (neck) regions.

Facet Joint Injection: The facet joints assist with movement of the spine both in the neck and back. Injection into these joints can provide relief of neck and back pain; these injections are always performed under x-ray guidance. You will be on your stomach for this injection if it is done for back pain; however you may either be on your stomach or back if the injection is performed for neck pain, depending on the preference of the physician. This block is often a diagnostic block and a more long lasting injection may be indicated if you have significant pain relief from this injection.

Lumbar Sympathetic Block: A lumbar sympathetic nerve block is performed for pain in the leg that is thought to be caused by complex regional pain syndrome type I (or CRPS I). These injections are often performed under fluoroscopic (x-ray) guidance.

Celiac Plexus Block: A celiac plexus block is generally performed to relieve pain in patients with cancer of the pancreas or other chronic abdominal pains. A needle is placed via your back that deposits numbing medicine to the area of a group of nerves called the celiac plexus. This injection is often performed as a diagnostic injection to see whether a more permanent injection may help with the pain. If it provides significant pain relief then the more long lasting injection may be done.

Stellate Ganglion Block: A stellate ganglion block is an injection that can be performed for the diagnosis of complex regional pain syndrome of the arm or hand or for treatment of pain to that area. It can also be used to help to improve blood flow to the hand or arm in certain conditions that result in poor circulation of the hand.

For more information on treating chronic pain, contact Comprehensive Pain Management in Warwick, RI.

Source: asra.com

How to Conquer Chronic Pain

Joseph Coupal - Friday, April 20, 2018
Comprehensive Pain Management - Warwick, RI

If you struggle with chronic pain, the greatest pain relief usually comes when you combine therapies—an approach called comprehensive pain management. For instance, you might add hands-on care from a physical therapist or chiropractor to relaxation techniques, medication, and exercise (cardio soothes pain by pumping out endogenous opioids, your body’s natural analgesic drugs). Other less well-known options include:

Go OTC.

One non-prescription pill may not be enough for serious pain, and doubling up on anti-inflammatories like ibuprofen, naproxen, and aspirin increases your risk of heart problems, stomach bleeding, and other side effects.

But you can combine any one of them with acetaminophen (aka Tylenol), which works via an entirely different mechanism. In fact, a recent University of Pittsburgh study found an acetaminophen/ibuprofen pairing more effective than opioids for dental pain. Just stick to the recommended daily dosage on the label for each product. Meanwhile, scientists continue to study new and safer formulations, including an ibuprofen plus arginine supplement that mitigates the drug’s potential cardiovascular harms.

Try a different pill—or patch

The same meds you pick up at the drugstore come in prescription strengths and also in gels, creams, and patches to apply directly where it hurts. There’s also a range of other drugs — since similar brain chemicals underly pain and depression, antidepressants are effective for headaches, facial pain, fibromyalgia, nerve damage, low back aches, and other types of chronic pain. The anti-seizure drugs block the release of pain-provoking neurotransmitters and are also prescribed for fibromyalgia and nerve irritation from shingles, among other painful conditions. And if you have to take an opioid, ask about your options; you’re less likely to become dependent on a synthetic drug than on oxycodone.

Intercept the message.

Pain sensations travel from body to brain along nerves; doctors have an increasing array of tools to jam the signals. Nerve blocks—injections of anesthetics or steroids—relieve pain in the arms, legs, or other specific areas. Implanting electrodes allows doctors to deliver tiny electrical pulses to the spine, relieving back pain or the type of ache that occurs when nerves are damaged by injury or infection. Singing nerve tissue away with heat, a technique called radiofrequency ablation, relieves some cases of neck and back pain. And in severe cases—such as after cancer—surgery can cut nerves completely.

For more information on treating chronic pain, contact Comprehensive Pain Management in Warwick, RI.

Source: Mens Health

Chronic Pain Management, What is it?

Joseph Coupal - Friday, April 06, 2018
Comprehensive Pain Management in Warwick, RI

1. What does a pain management specialist do?

A pain management specialist is a physician with special training in evaluation, diagnosis, and treatment of all different types of pain. Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these. Pain can also arise for many different reasons such as surgery, injury, nerve damage, and metabolic problems such as diabetes. Occasionally, pain can even be the problem all by itself, without any obvious cause at all.

As the field of medicine learns more about the complexities of pain, it has become more important to have physicians with specialized knowledge and skills to treat these conditions. An in-depth knowledge of the physiology of pain, the ability to evaluate patients with complicated pain problems, understanding of specialized tests for diagnosing painful conditions, appropriate prescribing of medications to varying pain problems, and skills to perform procedures (such as nerve blocks, spinal injections and other interventional techniques) are all part of what a pain management specialist uses to treat pain. In addition, the broad variety of treatments available to treat pain is growing rapidly and with increasing complexity. With an increasing number of new and complex drugs, techniques, and technologies becoming available every year for the treatment of pain, the pain management physician is uniquely trained to use this new knowledge safely and effectively to help his or her patients. Finally, the pain management specialist plays an important role in coordinating additional care such as physical therapy, psychological therapy, and rehabilitation programs in order to offer patients a comprehensive treatment plan with a multidisciplinary approach to the treatment of their pain.

2. What should I look for in a pain management specialist?

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 and with whom you feel a comfortable rapport. Since many types of chronic pain may require a complex treatment plan as well as specialized interventional techniques, pain specialists today must have more training than in the past, and you should learn about how your pain physician was trained and whether he or she has board certification in pain management.

The widely accepted standard for pain management education today is a fellowship (additional training beyond residency which occurs after graduating from medical school) 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?

3. 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.

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

On your first visit to a pain management specialist, he or she 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 on chronic pain management, contact Comprehensive Pain Management in Warwick, RI.

Source: asra.com


Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Recent Posts


Archive