(1) What is a "Pain Clinic", and why do we need it ?
A Pain Clinic is a place where your chronic intractable pain is diagnosed and treated effectively, in a timely manner to avoid further long term problems. Pain is under recognized and under treated. As a result it costs Billions of Dollars to businesses & the Health care industry and causes long term pain related problems in patients. Some of these problems are : Weight Gain due to poor exercise endurance, Isolation leading to Depression, anxiety, Sleep Disorder, Economic deprivation, Sexual Dysfunction (due to pain or medications) leading to Marital problems. Other serious problems like Hypertension, Coronary Artery Disease, Diabetes Mellitus etc. may occur due to poor pain control.
(2) What kind of pain problems are being handled in a Pain Clinic ?
All but Chest Pain are handled in a Pain Clinic !!
(3) Who runs a Pain Clinic ?
Any Doctor now days could claim being a "Pain Management Specialist". Typically, the Pain Clinics are run by Anesthesiologists, who have a broad knowledge of Nerve Anatomy, good handle on needles for different procedures, appropriate Local Anesthetic use and side effects for the given procedure, Opioid use and abuse knowledge.
(4) What is an ideal Pain Clinic ?
An Ideal Pain Clinic is one where an Anesthesiologist, Neurosurgeon, Orthopedic surgeon, Physiatrist, Neurologist, Psychiatrist, Psychologist, Physical Therapist, Chiropractor, Occupational Therapist, Pharmacist, and Nurse specialized in Pain Management are working under one roof. They manage each complex case after thorough discussion among themselves. It is difficult to find an Ideal Pain Clinic at this time.
(5) What is Narcotic (Opioid) medication ?? Why are doctors afraid to prescribe it ?
Opioid is the appropriate term when it comes to medical treatment. It is a potent pain killer, if used appropriately. It does not work for all pain related symptoms. Examples: Headache. Headaches may get worse after inappropriate use of Opioid. It also causes lots of side effects like constipation, respiratory depression, disturbed sleep cycle, dependence, tolerance etc. It may help at first, but then the body gets used to the medication, therefore, it may require dose escalation to the Level where it would cause intolerable side effects. To avoid reaching that point, it should be prescribed appropriately by the physician who has experience and knowledge with that group of medication. Besides, the patient should get other modalities, i. e. "Nerve Block", Physical therapy, Biofeedback, Massage therapy, TENS application, etc to treat pain effectively and avoid opioid dose escalation. The doctors are afraid simply because some of them either do not have the required broad experience in prescribing these groups of medication or they do not have any other modality to offer for your pain along with the medication. There are also strict regulations and guidelines to prescribe the medication appropriately.
(6) What are different groups of Opioid ?
There are many subgroups of Opioid, but for the discussion purpose, I like to divide it into two groups. One is Short Acting Opioid and second is Long Acting Opioid. In Chronic pain condition, the pain symptom is continuous. Therefore, you need a medication which works round the clock to treat your pain continuously. The Long Acting Opioid is appropriate for that. The Short Acting Opioid is normally prescribed by your Primary Care Physician for minor pain. Opioid are addictive by nature. Short Acting Opioid is relatively more addictive then Long Acting Opioid, since it cause more euphoric effects. Besides, Short Acting Opioid almost always have Acetaminophen, which could cause Liver problem in the long run with high doses. In conclusion, Long Acting Opioids are a better choice for chronic pain treatment and are commonly being prescribed by pain management physicians.
(7) What do I need to do to get an appointment at your clinic ?
Advanced Pain Clinic accepts only those patients, who are referred by their health care provider. Therefore, you need to be referred on paper or verbally to get on the schedule. Moreover, you also need to submit your records pertinent to your pain symptoms, which will be reviewed by the doctor prior to your appointment at the clinic to make sure that the doctor can help your pain condition. That will save you time and money.
(8) What type of pain management procedures are being offered at Advanced Pain Clinic ?
(9) Does your clinic uses Fluoroscope to do "Nerve Blocks" ?
Yes. All two locations are equipped with fluoroscope. Use of fluoroscope enhances your results and improves safety from the procedure. I highly recommend its use for the pain management procedures.
(10) Do you do pain management related surgeries ?
Yes. I do certain pain management related surgeries. Please click here to visit " Advance Pain Treatment" section.
(11) What is the advantage of being a patient at Advanced Pain Clinic ?
Following advantages :
(a) Each patient will be interviewed by the same Doctor at each visit. There is continuity of care. The care is rendered with dignity.
(b) State of the Art technology is being used to diagnose and treat your pain conditions.
(c) The doctor is experienced in treating pain condition for more than 10 years. He is Certified by the American Board of Anesthesiologists and by the American Board of Pain Medicine.
(d) The clinic is located conveniently at three locations in Central Florida. Each clinic is equipped with fluoroscope to enhance safety and result of your pain management procedures. Doing those procedures in clinic makes it very economic for you and your insurance company.
(e) Only eligible patients are given appointments after thorough screening procedure to adequately accommodate truly needy patients and as a result it provides adequate attention to them.
Instructions to Avoid Low Back Pain:
1. Avoid sitting on sofas, recliners, Lazy-boy chairs, or rocking chairs. Use flat bottom chairs to sit on.
2. Avoid elevating your legs while sitting. Keep your feet on the ground while sitting.
3. Avoid reclining while driving or riding in cars.
4. When you go to restaurants, choose tables, not booths.
5. When lifting objects off the ground, do not lift from the waist, instead, use your knees.
6. Use a firm mattress with a 1” pillow top. If the mattress is not firm, place a sheet of plywood under the mattress.
7. Sit on a chair which has a flat bottom. Do not sit on chairs with curved/indented bottoms. If you sink into the chair while sitting on it, do not sit on it.
8. Daily stretching helps resolve inflammation.
Instructions to Avoid Neck Pain:
1. Use a medium-thickness pillow. Avoid using thick pillows.
2. Avoid watching TV while lying in bed or sitting on a recliner.
3. Maintain good posture. Adjust your computer monitor, keyboard, and mouse height to maintain a good, neutral position for you neck, shoulders, and arms.
4. Daily stretching helps resolve inflammation.
Things You Can Do To Make Yourself Better!!
While waiting for your pain to improve, you may be able to make yourself more comfortable if you:
Wear comfortable, low-heeled shoes.
Make sure your work surface is at a comfortable height for you.
Use a chair with a good lower back support that may recline slightly.
Walking is an excellent exercise since it is gentle on the back yet helps bring oxygen to the soft tissues in your back and stimulates a healing response.
If you must sit for long periods of time, try resting your feet on the floor or on a low stool, whichever is more comfortable.
Too high of a pillow or none at all is seldom recommended except in very unusual circumstances.
When sleeping on one’s back a pillow that provides gentle neck support is ideal.
If you must stand for long periods of time, try resting one foot on a low stool.
If you must drive long distances, try using a pillow or rolled-up towel behind the small of your back. Also, be sure to stop often and walk around for a few minutes.
If you have trouble sleeping, try sleeping on your back with a pillow under your knees, or sleep on your side with your knees bent and a pillow between your knees.
A gradual return to normal activities, including exercise, is recommended. Exercise is important to your overall health and can help you to lose body fat (if needed). Even if you have mild to moderate low back symptoms,
The following things can be done without putting much stress on your back:
Walking short distances.
Using a stationary bicycle.
It is important to start any exercise program slowly and to gradually build up the speed and length of time that you do the exercise. At first, you may find that your symptoms get a little worse when you exercise or become more active. Usually, this is nothing to worry about. However, if your pain is still severe, contact Advanced Pain Clinic, PA .
Once you are able to return to normal activities comfortably, We may recommend further aerobic and back exercises.