Chronic pain can be a relentless burden, affecting every aspect of your life. If you've tried traditional treatments without success, you may be searching for alternative solutions. At Pain Specialists of America, we offer innovative therapies like peripheral nerve stimulation (PNS) to help you find lasting relief.
To understand how PNS works and its potential benefits, we need to first understand the nervous system.
Dr. Jerry Gutierrez explains the nervous system in a way that's easy to understand: "It's divided into central and peripheral.Central refers to the brain and spinal cord... The peripheral nervous system is all the little nerve branches that are an extension of the central nervous system."
Think of it like a tree, he says. "They typically start with nerve roots that turn into branches, that turn into peripheral nerves, that turn into other peripheral nerves. So it's like a tree trunk that has several branches and then little twigs..."
This intricate network of nerves extends throughout your body, carrying signals that control movement, sensation, and organ function.
When these peripheral nerves are damaged or diseased, they can send faulty pain signals, leading to chronic pain. PNS therapy offers a targeted approach to addressing these issues, focusing on the specific "twig" or "branch" that's causing the problem.
A peripheral nerve stimulator is a small, minimally invasive device that is implanted near a specific peripheral nerve. These nerves extend outside of your brain and spinal cord, carrying signals to and from your limbs and organs. When these nerves are damaged or diseased, they can send faulty pain signals, leading to chronic pain.
PNS works by delivering mild electrical impulses to the affected nerve, effectively blocking these pain signals from reaching your brain. Think of it like a "mute" button for your pain. Dr. Gutierrez, a pain management specialist at PSA, explains that PNS devices can operate in two modes: one that produces a tingling sensation and another that alleviates pain without any sensation at all.
PNS is highly effective in treating various types of chronic pain, particularly those associated with nerve damage. Some conditions that can benefit from PNS include:
PNS can be particularly helpful for peripheral nerve stimulator implant knee pain after surgery or due to nerve damage. It's a less invasive option for patients who may not be ideal candidates for surgery or those who want to avoid the risks of general anesthesia.
Before receiving a permanent PNS implant, you'll undergo a trial period with a temporary device. This allows you to experience the therapy and assess its effectiveness for your pain.
The implantation procedure itself is minimally invasive, typically performed as an outpatient procedure. Recovery time is generally short, with most patients able to return to their daily activities within a few days.
The longevity of a peripheral nerve stimulator (PNS) depends on several factors, including the type of device, the settings used, and the individual's pain condition.
In some cases, PNS is used as a short-term treatment to "reset" or correct nerve activity and provide long-lasting relief. Dr. Gutierrez explains that "sometimes we can change the course of nerve pain by stimulating it for 60 days, and it might go back to normal and not return." He's observed patients experiencing pain relief for up to two years, or even permanently, after just a 60-day treatment with a temporary PNS system.
For those with more chronic pain, a permanent PNS implant may be recommended. These implants typically have a battery life of several years, depending on the device and usage. When the battery eventually runs low, a minor procedure is required to replace it, similar to replacing a pacemaker battery.
Interestingly, Dr. Gutierrez notes that PNS often provides a "lingering effect," where patients continue to experience pain relief even after the stimulation is turned off. This extended relief is attributed to the way PNS can "alter the behavior of a nerve." This means that with PNS, you may not need to have the stimulator on constantly to experience pain relief, which can prolong the battery life of your device.
Ultimately, the lifespan of a PNS system is influenced by individual factors and the specific device used. Your doctor can provide more personalized information about what to expect based on your condition and treatment plan.
While both PNS and transcutaneous electrical nerve stimulation (TENS) use electrical stimulation, they differ in key ways. TENS units are external devices with electrodes placed on the skin, providing temporary pain relief. This pain relief is also more specific to the musculoskeletal system.
PNS, on the other hand, involves a more targeted and long-term approach, targeting the specific nerve causing pain. The stimulator can be either external or implanted under the skin, with leads placed close to the affected nerve. This allows for far more precise and continuous stimulation.
While both PNS and spinal cord stimulation (SCS) use electrical impulses to relieve pain, they target different areas of the nervous system. Dr. Gutierrez explains the difference using a helpful analogy: "Think of the nervous system like a tree. SCS is like treating the trunk, while PNS is like treating a specific branch or twig."
"A peripheral nerve stimulator would be good for somebody that has maybe just a certain twig or small branch that's injured," says Dr. Gutierrez. "You can really get a PNS in intimate proximity to that one nerve that we've identified as being the culprit... and just get that one focal area."
This means that PNS is ideal for treating pain that originates from a specific nerve, while SCS is more effective for widespread pain.
PNS offers several advantages over traditional pain management methods:
Improved quality of life: By reducing pain, PNS can help you regain your mobility, participate in activities you enjoy, and improve your overall quality of life.
While PNS is generally safe and effective, it's essential to be aware of potential considerations:
Your doctor will discuss these factors with you in detail and address any concerns you may have.
At PSA, we're committed to providing comprehensive and patient-centered PNS therapy. Our experienced pain specialists, like Dr. Gutierrez, will guide you through the process, from the initial consultation to the trial period and, if appropriate, the permanent implant. We're dedicated to helping you achieve the best possible outcome with PNS.
If you're struggling with chronic pain and want to explore whether PNS is right for you, contact PSA today to schedule a consultation. We're here to answer your questions, address your concerns, and help you find lasting relief.
Living with chronic pain can significantly impact your quality of life. It can limit your ability to work, enjoy hobbies, and spend time with loved ones. If you're searching for pain management in Temple, TX, Pain Specialists of America is here to help. We offer comprehensive, patient-centered pain management with a focus on improving your overall well-being.
At PSA, we understand that pain is a complex and personal experience. That's why we take a multidisciplinary approach, combining cutting-edge treatments with compassionate care to address your unique needs. Our team of experienced pain specialists is dedicated to helping you find lasting relief and reclaim your life from pain.
We're fortunate to have Dr. Andrés Gutiérrez Robles as part of our team in Temple. Let's take a closer look at the services he and the PSA Temple team provide to help the community find lasting relief.
Dr. Gutiérrez Robles brings a wealth of knowledge and experience to PSA. He completed his medical studies at Ponce Health Sciences University and a residency in Physical Medicine and Rehabilitation at Memorial Healthcare System. He further honed his skills through a fellowship in Pain Medicine at Oregon Health Science University.
Beyond his impressive credentials, Dr. Gutiérrez Robles is known for his compassionate approach and dedication to patient care. He's passionate about helping people overcome pain and improve their quality of life. This commitment was evident in his volunteer efforts during Hurricane Maria, where he provided much-needed medical assistance to those affected by the disaster.
Fluent in both Spanish and English, Dr. Gutiérrez Robles is a valuable asset to the Temple community, providing culturally sensitive care to a diverse patient population.
305 Clinite Grove Blvd, Temple, TX 76502
P: (254) 401-5250
As a compassionate pain specialist in Temple, we believe in a personalized approach to pain management. Dr. Gutiérrez Robles and his team take the time to understand your unique needs and develop a treatment plan that targets the root cause of your pain. We believe in accurate diagnoses and individualized treatment strategies to help you achieve the best possible outcomes.
Some of our interventional pain management services in Temple include:
When you choose PSA for your pain management needs, you can expect:
Pain Specialists of America is committed to providing high-quality, compassionate pain management care to the Temple community. With experienced specialists like Dr. Gutiérrez Robles and a focus on personalized treatment, we're here to help you find lasting relief and reclaim your life from pain.
If you're ready to take control of your pain, we encourage you to schedule an appointment with Dr. Gutiérrez Robles at PSA Temple.
"I can play with my kids again!" "I can go shopping without pain!" These are the kinds of victories Dr. Asim Aijaz, a pain management specialist at Pain Specialist of America in Bastrop, hears from his patients who have found relief using a spinal cord pe for diabetic neuropathy.
Diabetic neuropathy, a common complication of diabetes, can cause debilitating nerve pain, often starting in the feet and legs. As Dr. Aijaz explains, "It's a pretty brutal pain. It's described as pins and needles, burning sensations, numb but hurting at the same time, just not feeling quite right." This pain can make everyday activities like walking, playing with children, or even sleeping a constant struggle.”
While medications are often the first line of treatment, they don't always provide sufficient relief and can come with unwanted side effects. "A lot of patients might get on medication," says Dr. Aijaz, "it might help a little bit, but the side effects outweigh the benefits."
That's where spinal cord stimulation comes in.
Diabetic neuropathy, a common complication of diabetes, causes nerve damage, often leading to chronic pain in the feet and legs. This pain can be burning, tingling, or numb, and it can significantly impact a person's quality of life. While medications and lifestyle changes can help manage symptoms, they don't always provide sufficient relief.
Spinal cord stimulation (SCS) is emerging as a promising treatment option for diabetic neuropathy. It involves implanting a small device that sends electrical impulses to the spinal cord, effectively disrupting pain signals and providing relief.
"The spinal cord stimulator is a home run," says Dr. Aijaz, "mostly because we're able to treat it mechanically without necessarily needing medication." This means fewer side effects and a greater chance of long-term relief.
"We don't have to worry about continuing to repeat procedures," Dr. Aijaz explains. "Usually the patients are happy long term." Studies have shown that a spinal cord stimulator can significantly reduce pain, improve sensation, and enhance the quality of life for people with diabetic neuropathy.
Spinal cord stimulators offers a range of benefits for those with diabetic neuropathy:
Better Quality of Life: SCS can significantly enhance your quality of life. Patients often report being able to participate in activities they previously enjoyed, spend more time with loved ones, and experience a greater sense of freedom from pain.
Dr. Aijaz typically recommends spinal cord stimulators to patients who have tried medications without success or who are experiencing intolerable side effects.
While certain factors, such as poorly controlled diabetes, may require addressing before considering the procedure, the majority of patients with diabetic neuropathy are good candidates for SCS.
"If somebody's A1C is too elevated, that's a patient I probably wouldn't want to do surgery on," he explains. However, he notes that many patients are motivated to improve their health and gain better control of their diabetes when they see the potential benefits of a spinal cord stimulator for neuropathy..
The good news is that SCS technology has advanced significantly in recent years, making it even more effective and accessible. "These things are much more beneficial than they used to be," says Dr. Aijaz. "The batteries are smaller, they work better, they last longer. The way that they stimulate is different than it used to be."
One of the biggest improvements is the ability to provide pain relief without the tingling sensation that was common with older systems. "Today, we're able to just not have the pain and not have an alternative sensation there," Dr. Aijaz explains. Furthermore, with modern spinal cord stimulator systems, there are essentially no permanent restrictions on your activities, allowing you to live your life to the fullest.
It's important to note that insurance coverage for spinal cord stimulation for diabetic neuropathy has evolved significantly. In the past, it was often difficult to obtain coverage for this treatment. However, as Dr. Aijaz points out, 'Insurance is actually coming on board now.' This means that spinal cord stimulation is becoming more accessible to patients who may have been unable to afford it in the past."
If you're struggling with diabetic neuropathy, don't lose hope. Spinal cord stimulation may be the solution you've been searching for. Contact PSA today to schedule a consultation and learn more about life-changing treatment for diabetic neuropathy.
As Dr. Aijaz reminds us, "There is a treatment option there that might work really well for you... Just letting them know that there's something out here for you if you're willing to try it."
Spinal cord stimulators (SCSs) have revolutionized the way we manage chronic pain. By delivering mild electrical impulses to the spinal cord, these devices can effectively interrupt pain signals, providing relief and improving quality of life for many individuals.
At Pain Specialists of America, we're committed to helping our patients achieve the best possible outcomes with their SCS therapy. Spinal cord stimulators have minimal impact on your daily activities, with almost no permanent restrictions, but it’s important to know how to address any concerns, such as overstimulation.
In this blog post, Dr. Ryan Michaud sheds light on spinal cord stimulator overstimulation. Dr. Michaud is a leading pain management specialist at PSA with extensive expertise in SCS therapy. He practices at our pain management clinic in Seguin. Dr. Michaud has been practicing interventional pain management for over 14 years and has witnessed firsthand the transformative power of SCS in helping patients overcome chronic pain.
"In simple terms," explains Dr. Michaud, "SCS overstimulation is any unpleasant sensation that a patient might experience from their spinal cord stimulator." This can range from tingling or buzzing sensations to feeling stimulation in unintended areas, and in rare cases, even a mild shock-like sensation
Overstimulation can occur for various reasons. In some cases, it may be due to the initial programming of the device, where the electrical current is set too high. However, overstimulation can also develop over time, even after the SCS has been successfully implanted.
"One of the main reasons we used to see overstimulation was due to the older types of SCS systems," says Dr. Michaud. "These systems were more voltage-driven and often caused a tingling or vibrating sensation because of where the leads were placed in the epidural space."
Fortunately, newer SCS systems have addressed this issue. "With the newer sub-threshold systems," Dr. Michaud explains, "patients typically don't experience any tingling or vibration. These systems are more sophisticated and can be adjusted to provide optimal pain relief without causing uncomfortable sensations."
Over time, it's not uncommon for scar tissue to develop around the leads of a spinal cord stimulator. Think of it like the body's natural way of healing and encapsulating a foreign object. This scar tissue, while part of the normal healing process, can sometimes lead to complications. It might compress the leads, changing their position or contact with the nerves.
It can also alter the electrical field generated by the stimulator, making the stimulation less effective or causing it to spread to unintended areas. These changes can lead to uncomfortable sensations or even overstimulation, where the tingling or buzzing feels too intense or occurs in places it shouldn't.
Just as every person is unique, so is the anatomy of their spine. Variations in the epidural space, such as a naturally narrower space or the presence of bone spurs, can affect how the electrical current from a spinal cord stimulator is distributed.
Think of it like electricity flowing through a wire; if the wire is narrower in some places, the current might be more concentrated there. Similarly, in a narrower epidural space or one with bone spurs, the electrical current from the SCS might be more focused, potentially leading to overstimulation in those areas, especially with certain movements or positions that further compress the space.
This is why personalized programming and adjustments are so important to ensure the stimulation is delivered effectively and comfortably for each individual.
A lead is a thin, insulated wire with electrodes at the tip. It's surgically placed in the epidural space (more on that below) near your spinal cord. The lead connects to the pulse generator, which is a small device implanted under your skin, usually in your abdomen or buttock. The pulse generator sends electrical signals through the lead to your spinal cord, which helps to block pain signals.
Think of the lead as an extension cord carrying electricity from the power outlet (the generator) to the appliance (your spinal cord).
The epidural space is the area between the outer covering of your spinal cord (dura mater) and the bones of your spine (vertebrae). It's filled with fat, blood vessels, and nerve roots. This is where an epidural injection is administered, and it's also where the leads for a spinal cord stimulator are placed.
Imagine the epidural space as a protective cushion surrounding your spinal cord.
Placing the leads in the epidural space allows the electrical signals from the SCS to reach the spinal cord effectively, modulating pain signals without directly affecting the spinal cord itself.
Imagine your spinal cord as a highway with pain signals traveling along it. The epidural space is like the roadside next to the highway. The SCS lead is like a device placed on the roadside that emits signals to disrupt traffic (pain signals) on the highway, making the pain less intense or even disappear.
One of the most exciting aspects of spinal cord stimulation is the continuous evolution of technology aimed at improving patient outcomes and minimizing side effects like spinal cord stimulator overstimulation. Modern SCS systems have incorporated several key advancements to enhance the therapy experience.
Closed-loop systems represent a significant leap forward. These intelligent systems constantly monitor the electrical impedance of the tissues surrounding the spinal cord. By sensing changes in impedance, which can occur with movement or changes in body position, the system can automatically adjust the stimulation parameters to maintain optimal therapy. This "feedback loop" helps to prevent overstimulation by ensuring that the electrical current is delivered consistently and effectively, even as your body moves and changes throughout the day.
Another important innovation is sub-threshold stimulation. This technique delivers electrical impulses at a level below your perception threshold, meaning you won't feel any tingling or sensation from the device. While some patients find the tingling sensation helpful, others may find it uncomfortable or distracting. Sub-threshold stimulation offers a paresthesia-free alternative, allowing you to experience pain relief without any noticeable sensation.
Finally, burst and frequency modulation are examples of newer waveforms used in SCS therapy. These waveforms deliver electrical impulses in a more targeted and controlled manner, mimicking the natural patterns of nerve activity. This can result in more effective pain relief while minimizing the risk of overstimulation. These advanced waveforms also allow for greater personalization of therapy, as the stimulation patterns can be tailored to your specific needs and preferences
If you suspect you're experiencing spinal cord stimulator overstimulation, it's crucial to contact your doctor or the PSA care team promptly. "Reprogramming the device is often the first step in addressing overstimulation," says Dr. Michaud. This involves adjusting the device settings to optimize the electrical field and reduce or eliminate uncomfortable sensations.
Your physician and the device representative will work together to manage the SCS device and address any issues like overstimulation. The device rep has specialized knowledge of the device's technology and programming, while your PSA physician understands your overall condition and pain management needs.
Oftentimes, reprogramming can be done remotely using wireless technology. This allows for more convenient adjustments and may reduce the need for in-person appointments.
In some cases, physical therapy may be recommended to help manage any muscle tightness or imbalances that may be contributing to overstimulation. If conservative measures are not effective, surgical intervention may be necessary to reposition the leads or address other underlying issues.
Dr. Michaud emphasizes the importance of open communication between patients and their healthcare providers. "If you're experiencing any unusual sensations or changes in your pain, it's crucial to let your doctor know," he advises. "We're here to help you troubleshoot any issues and ensure your SCS is working effectively."
At PSA, we're committed to providing comprehensive and compassionate care for all our patients. We believe in empowering our patients with knowledge and support, so they can actively participate in their pain management journey.
While the primary goal of spinal cord stimulation is to reduce pain, many patients experience additional benefits that extend beyond pain relief. Some of these positive effects include:
Improved sleep quality: By reducing pain and promoting relaxation, SCS can help improve sleep patterns, leading to more restful nights and increased energy levels during the day.
Spinal cord stimulation is a valuable tool for managing chronic pain, and overstimulation, while potentially bothersome, is very manageable. With the right adjustments and support, you can treat spinal cord stimulator overstimulation and continue to experience the benefits of SCS therapy to enjoy a more fulfilling life.
It's important to remember that overstimulation is not a common occurrence, especially with newer SCS systems. As Dr. Michaud reassures us, "It can happen, but... that's why your physician and care team is there to help you."
If you have any questions or concerns about your spinal cord stimulator, don't hesitate to contact your PSA care team. We're here to help you every step of the way.
November is National Family Caregivers Month, a time to recognize and celebrate the millions of individuals who provide invaluable support to loved ones facing chronic pain or other health challenges. Did you know that more than 1 in 5 Americans (21.3%) are caregivers? That's a significant portion of the population who dedicate their time and energy to caring for others. At Pain Specialists of America, we understand the vital role family caregivers play in the pain management journey. We witness their unwavering dedication, compassion, and resilience every day.
This month, we want to honor these unsung heroes and shed light on the challenges and rewards of caregiving, while also emphasizing the importance of self-care and providing helpful resources.
Family caregivers are the backbone of support for those living with chronic pain. They provide physical assistance, emotional support, manage medications, and handle countless other tasks, often while juggling their own responsibilities.
Caregiving can be incredibly rewarding, fostering deep bonds and a sense of purpose. However, it can also be physically and emotionally demanding.
Caregivers spend an average of 26 hours per week providing care, often while juggling their own work, family, and personal responsibilities. Many caregivers are also part of the "sandwich generation," meaning they are caring for both children and aging parents simultaneously. This can lead to significant physical, emotional, and financial strain.
Caregivers often face:
It's essential to acknowledge these challenges and provide caregivers with the support and resources they need to thrive.
It's essential to acknowledge these challenges and provide caregivers with the support and resources they need to thrive. Caregiving can take a toll on caregivers' health and well-being. 41% of caregivers report low overall well-being, and nearly half have experienced increased anxiety or depression. That's why prioritizing self-care is crucial for caregivers to avoid burnout and maintain their own health and happiness.
Here are some essential self-care tips for caregivers:
Seek Professional Help: If you're struggling with stress, anxiety, or depression, don't hesitate to seek professional counseling.
There are many resources available to support family caregivers. Here are a few:
These organizations offer information, support groups, respite care services, and other resources to help caregivers navigate their journey.
At PSA, we understand that family caregivers are an integral part of the pain management team. We believe in a family-oriented approach, recognizing that chronic pain affects not just the individual but also their loved ones. Our commitment to supporting caregivers is woven into every aspect of our care.
We strive to support caregivers by:
Encouraging open communication: We believe in collaborating with caregivers to ensure the best possible care for our patients. We value your insights and perspectives and encourage you to be active participants in the treatment process.
Our focus on patient-centered care and comprehensive pain management extends to caregivers as well. By addressing the patient's pain comprehensively, we aim to:
At PSA, we believe that supporting caregivers is an essential part of providing compassionate and effective pain management. We're committed to working together with patients and their families to achieve the best possible outcomes.
To all the family caregivers out there: Thank you. Thank you for your unwavering dedication, your compassion, and your strength. You are truly making a difference in the lives of your loved ones.
If you're a caregiver for someone with chronic pain, please know that you're not alone. Reach out to PSA to schedule an appointment for your loved one. We're here to help.
November is International Nerve Pain Awareness Month, a time to shed light on this often debilitating and misunderstood condition. Led by the International Pain Foundation, this campaign aims to raise awareness about the causes and symptoms of nerve pain, offer support to those who live with it, and encourage early diagnosis and treatment.
At Pain Specialists of America, we understand the profound impact nerve pain can have on individuals' lives. We're committed to providing compassionate care, innovative treatments, and personalized support to help our patients find relief and reclaim their lives.
Nerve pain, also known as neuropathic pain or neuralgia, is a unique type of pain caused by damage or dysfunction in the nervous system. Unlike other types of pain that result from tissue injury, nerve pain originates from within the nerves themselves. Imagine faulty wiring in your home's electrical system—the pain signals get mixed up, leading to sensations that are often described as burning, tingling, shooting, or electric-like.
Nerve pain can stem from various sources, including:
The impact of nerve pain extends far beyond physical discomfort. It can disrupt sleep, limit mobility, affect work and relationships, and lead to anxiety and depression. The emotional and economic toll can be significant.
Nerve pain often presents with distinct symptoms, including:
If you experience any of these symptoms, it's important to consult with a healthcare professional. Early diagnosis and intervention are crucial for managing nerve pain effectively.
Diagnosing nerve pain often involves a collaborative effort between you and your doctor. They will want to hear a detailed description of your symptoms, including the type of pain, its location, and any triggers that worsen or improve it. Your medical history, including any past injuries, illnesses, or medications, is also crucial in understanding the potential causes of your nerve pain.
A physical exam may include tests of your reflexes, sensation, and muscle strength to assess nerve function. In some cases, your doctor may recommend nerve conduction studies and electromyography (EMG) to measure the electrical activity of your nerves and muscles. Imaging tests, such as MRI or CT scans, can help rule out other conditions that may be causing your pain.
Once a diagnosis is confirmed, your doctor will work with you to develop a personalized treatment plan. This plan may involve various approaches including nerve blocks, which are injections that can temporarily interrupt pain signals.
For more severe or persistent nerve pain, spinal cord stimulation or peripheral nerve stimulation may be an option. These non-invasive treatments involve implanting a small device that delivers electrical impulses to the spinal cord or peripheral nerves, disrupting pain signals and providing relief. Throughout your treatment journey, your doctor will monitor your progress and adjust your plan as needed to ensure you're receiving the most effective care.
Living with nerve pain can be challenging, but there are ways to manage your symptoms and improve your quality of life. One of the most important things you can do is to take an active role in your care. This includes working closely with your doctor, following your treatment plan, and being open and honest about your experiences.
In addition to medical treatments, adopting a healthy lifestyle can make a significant difference. Managing stress through relaxation techniques like deep breathing, meditation, or yoga can help reduce pain flare-ups.
Prioritizing sleep hygiene and aiming for 7-8 hours of quality sleep each night is also essential. Regular exercise, a balanced diet, and avoiding smoking and excessive alcohol can further support your overall well-being and help manage pain.
Finding support through online communities or local support groups can provide a sense of connection and empower you on your journey with nerve pain. Remember, you are not alone. With the right support, treatment, and self-care strategies, you can navigate the challenges of nerve pain and live a fulfilling life.
International Nerve Pain Awareness Month is a reminder that nerve pain is a real and debilitating condition that affects millions worldwide. By raising awareness, we can reduce stigma, encourage early intervention, and support those living with nerve pain.
If you're struggling with nerve pain, please know that you're not alone. Reach out to PSA for compassionate care and personalized treatment options. We're here to help you find relief and reclaim your life.
Driven by a relentless pursuit to alleviate pain, Dr. Massey's journey began in his home state of Texas, where he graduated from Texas Tech University. His passion for anesthesiology led him to California for residency, during which he encountered the debilitating effects of chronic pain, particularly Complex Regional Pain Syndrome (CRPS). Recognizing the profound impact CRPS has on individuals' lives, Dr. Massey dedicated himself to finding solutions. He furthered his expertise through a fellowship in pain management at Rush University, where he had the privilege of learning from two professors who were instrumental in creating the Budapest Criteria, the gold standard for diagnosing CRPS.
Today, Dr. Massey stands as a beacon of hope for those grappling with CRPS. His commitment to providing compassionate and comprehensive care is evident in his approach. He believes in fostering open communication, ensuring patients feel heard and understood throughout their journey to pain relief.
Complex Regional Pain Syndrome (CRPS) formerly known as causalgia, is a chronic pain condition characterized by an overactive nervous system response. It typically affects one or more limbs, often following an injury, surgery, or even seemingly minor events like a flu shot. Dr. Massey explains, "Essentially, it's an overreaction of the nerves due to damage, leading to inflammation and persistent pain signals."
The precise cause of CRPS remains elusive. However, it's widely believed to involve a combination of factors, including:
Diagnosis of Exclusion: CRPS is often diagnosed when other potential causes of the patient's pain have been ruled out.
CRPS Type 1 (formerly RSD): This type is characterized by an overactivity of the nervous system, often leading to symptoms like swelling, changes in skin color and temperature, and tremors. The key distinction is that there is no identifiable nerve injury in CRPS Type 1. It often occurs after trauma or crush injuries where multiple minor nerves are damaged, making it difficult to pinpoint the exact source of the pain.
Reflex sympathetic dystrophy (RSD) is an older term that was once used to describe CRPS Type 1. While the terminology has evolved, the underlying condition remains the same.
CRPS Type 2 (formerly causalgia): This type also involves an overactive nervous system response, but it is distinguished by the presence of a clear nerve injury. The pain and other symptoms can often be traced back to the specific damaged nerve.
CRPS diagnosis often involves a process of elimination, ruling out other potential causes of the patient's pain. While there's no single definitive test, a skilled pain specialist like Dr. Massey can reach an accurate diagnosis through a thorough evaluation of medical history, physical examination, and potentially additional tests like bone scans or nerve conduction studies. The Budapest Criteria, a set of clinical diagnostic guidelines, further aids in confirming CRPS. Early diagnosis is crucial for effective treatment and better outcomes, emphasizing the importance of seeking help promptly if you suspect you may have CRPS.
CRPS often progresses through three distinct stages, each with its own typical timeframe and set of symptoms:
Recognizing these stages and their typical time frames is critical for guiding appropriate treatment and minimizing the long-term impact of CRPS. Early diagnosis and intervention are key to managing symptoms and improving quality of life.
CRPS manifests in a variety of symptoms that can significantly impact a person's daily life. These symptoms can vary in intensity and may change over time. They include:
In some cases, CRPS can spread beyond the initial site of injury or affected limb. This phenomenon, referred to as "spreading CRPS," can involve the opposite limb or even distant areas of the body. While the exact mechanisms behind CRPS spreading are not fully understood, it is believed to involve a complex interplay of the nervous system and immune system. Early recognition of spreading symptoms is crucial for timely intervention and management.
If you notice new pain, swelling, or other CRPS symptoms in areas beyond the original site, it is essential to inform your healthcare provider promptly. They can assess the situation and adjust your treatment plan accordingly to address the spreading CRPS and help manage your pain effectively.
At PSA, we believe in a personalized approach to CRPS treatment. Dr. Massey emphasizes, "We start with the most conservative therapies and gradually escalate if needed. The goal is to find the most effective treatment plan for each individual patient."
A multidisciplinary team is often involved in the treatment of CRPS. At PSA, you'll have access to a dedicated pain specialist like Dr. Massey, who will create a comprehensive treatment plan tailored to your specific needs.
In addition to professional treatment, self-care plays a crucial role in managing CRPS. This can include gentle exercises, stress management techniques, maintaining a healthy lifestyle, and following any recommendations provided by your healthcare team.
Unfortunately, one of the most common misconceptions Dr. Massey encounters is the belief that CRPS isn't a real condition. "Some physicians don't know about CRPS and don't see it as a true pathology," he says. This lack of awareness can lead to delayed diagnosis and treatment, which can significantly impact patient outcomes.
Another misconception is that CRPS always involves a clearly identifiable nerve injury. "While this is true for CRPS Type 2, in CRPS Type 1, the affected nerves may be too small to be easily identified with current technology," Dr. Massey clarifies.
However, advancements in medical imaging and diagnostic techniques offer hope for the future. "We're constantly improving our ability to visualize and understand the nervous system. With increased awareness and research, we'll be able to identify and treat CRPS more effectively," Dr. Massey assures us.
"While I've seen the devastating impact CRPS can have, I want the world to know that it is treatable," Dr. Massey emphasizes. "The earlier we intervene, the better the chances of achieving complete remission. If you're experiencing persistent pain after an injury or surgery, don't hesitate to seek help from a pain management specialist."
Dr. Massey shares a particularly inspiring success story about a young nurse who developed CRPS after receiving a flu shot. "She was in excruciating pain and couldn't even pick up her children," he recalls. "After undergoing spinal cord stimulation at PSA, she experienced remarkable relief and was finally able to embrace her kids again. It's moments like these that make my work so rewarding."
At Pain Specialists of America, we're committed to helping you overcome the challenges of CRPS and reclaim your life. Contact us today or find a pain specialist near you to schedule a consultation with Dr. Massey and our team of experts. We're here to support you every step of the way.
October is Bone and Joint Health Awareness Month, and at Pain Specialists of America, we're dedicated to providing comprehensive care and empowering you to take control of your musculoskeletal health.
As we age, it's common to experience aches, pains, and stiffness in our bones and joints. While some discomfort may be a natural part of aging, it's important to understand how to maintain optimal bone and joint health throughout life, and to seek expert care when needed.
Dr. Jason Lo, a pain management specialist at PSA, brings a unique perspective to this topic, not only as a physician but also as someone who has personally experienced injury and recovery.
Our bones and joints provide the framework for our bodies, allowing us to walk, run, lift, and simply enjoy daily activities. When these systems are healthy, we experience less pain and greater mobility. However, conditions like arthritis, osteoporosis, and injuries can significantly impact our quality of life. Spinal health is also a critical component of overall bone and joint health. Learn more about prioritizing your spine health in our dedicated World Spine Day post.
"Joint pain is incredibly common," says Dr. Lo. "Think of your joints like the tires on your car. Over time, they experience wear and tear." This wear and tear affects the cartilage that cushions the bones within a joint, leading to friction, inflammation, and pain. This is the hallmark of osteoarthritis, a common cause of joint pain, especially as we age.
But it's not just about aging. Several other factors can contribute to joint pain:
Early warning signs that you may be developing a joint condition like arthritis include:
If you experience these symptoms, it's important to seek medical advice to determine the underlying cause and receive appropriate treatment early on.
If you're experiencing widespread joint pain, it's essential to seek medical advice to determine the underlying cause. This type of pain can be a sign of a more systemic issue affecting multiple joints throughout the body. Some possible causes include:
It's crucial to consult with a healthcare professional to pinpoint the exact cause of your widespread joint pain. At PSA, our experienced physicians will conduct a thorough evaluation, considering your medical history, symptoms, and lifestyle factors to arrive at an accurate diagnosis and develop an effective treatment plan.
Dr. Lo emphasizes the crucial role muscles play in supporting and protecting our joints. "Healthy muscles act as shock absorbers and help keep our joints aligned," he explains. "If you have weak muscles around a joint, it can accelerate wear and tear and lead to pain." This is because strong muscles help to stabilize the joint, reducing the strain on the ligaments and cartilage. When muscles are weak, the joint becomes less stable, making it more susceptible to injury and the development of conditions like osteoarthritis.
He explains that many factors can contribute to muscle weakness and inflammation, which in turn compromises joint support. These factors include:
Maintaining strong and healthy muscles is essential for optimal joint health. This can be achieved through regular exercise, including strength training and flexibility exercises, as well as a balanced diet and healthy lifestyle choices.
The good news is that there's a lot you can do to improve and maintain your bone and joint health. Dr. Lo recommends a proactive approach that incorporates these key elements:
Calcium and Vitamin D: These are the cornerstones of bone health. Ensure you're getting enough through your diet or supplements.
Vitamin K: Found in leafy greens, broccoli, and Brussels sprouts, vitamin K helps with calcium absorption.
Omega-3 fatty acids: These healthy fats, found in oily fish and flaxseed, can help reduce inflammation.
Protein: Adequate protein intake is crucial for muscle health and repair. Include lean meats, poultry, fish, beans, and lentils in your diet.
Weight-bearing Exercise: Activities that force you to work against gravity help strengthen bones.
Low-impact Activities: These are gentler on your joints while still providing benefits.
Flexibility and Range of Motion: Stretching and exercises that improve your range of motion help keep your joints flexible and reduce stiffness.
Maintain a Healthy Weight: Excess weight puts extra stress on your joints, especially your knees and hips.
Avoid Smoking: Smoking impairs blood flow and can contribute to inflammation and joint damage.
Limit Alcohol Consumption: Excessive alcohol intake can weaken bones and increase the risk of osteoporosis.
By taking these steps, you can actively contribute to your bone and joint health, reducing your risk of pain and maintaining mobility as you age. Remember, it's never too early (or too late) to start prioritizing your musculoskeletal health.
At PSA, the approach to bone and joint pain is comprehensive and personalized. "We start with a thorough evaluation to understand the root cause of your pain," says Dr. Lo. "Then, we create a customized treatment plan that may include physical therapy, injections, or other interventions."
Dr. Lo's personal experience with pain recovery after being hit by a truck has given him valuable insight into the challenges patients face. "I can relate to the post-operative and rehabilitation process," he shares. "I even gave myself a knee injection once to understand what my patients experience!"
Dr. Lo's main takeaway? "The best treatment for pain is prevention. Stay active, eat a healthy diet, and don't ignore early signs of discomfort."
Bone and joint pain can significantly impact your quality of life, but it doesn't have to be a life sentence. PSA is dedicated to helping you reclaim your life from pain. Contact us today to learn how our comprehensive approach to pain management can help you find lasting relief and get back to doing the things you love.
World Spine Day, observed annually on October 16th, serves as a crucial reminder of the global burden of spinal pain and disability. This year's theme, "Support Your Spine," highlights the importance of adopting healthy habits and preventative measures to maintain spinal health throughout life. With low back pain affecting hundreds of millions worldwide and projected to increase, it's imperative that individuals, communities, and doctors collaborate to raise awareness and promote proactive strategies for a healthier spine.
At PSA, we understand the profound impact that spinal pain can have on individuals and society. We are dedicated to providing comprehensive, personalized care that empowers our patients to overcome their pain and reclaim their lives.
Dr. Mehta is a highly accomplished and respected interventional pain specialist with an impressive background. His training at Harvard Medical School, Massachusetts General Hospital, and the Cleveland Clinic has laid the foundation for his expertise in treating chronic pain.
Dr. Mehta is a leading figure in the field of pain management, combining his extensive training, research expertise, and passion for helping patients to provide innovative and effective care. His focus on personalized medicine, minimally invasive techniques, and alternative approaches to chronic pain makes him a valuable resource for those seeking relief from persistent pain conditions.
Dr. Mehta points out that while general aging and degeneration are common culprits behind spinal issues, the specific conditions and their causes can vary depending on age and lifestyle. In younger individuals, poor posture, especially the infamous "text neck," can lead to early-onset back pain. As we age, the spine naturally undergoes wear and tear, with discs losing their shock-absorbing capacity and joints becoming arthritic. It's a "time-based cascade of aging," Dr. Mehta explains.
If you’re an athlete or if degenerative diseases such as arthritis run in the family, you may also be at an increased risk for spinal conditions and back pain.
Dr. Mehta's proximity to Fort Hood in Killeen, the largest Army base in Texas, means he frequently treats patients whose active lifestyles or military service have impacted their spinal health, regardless of age.
Think of your spine as a flexible column made up of individual bones called vertebrae. Between each vertebra are discs, which act as cushions, allowing your spine to bend and twist. Over time, these discs can lose shock absorption and become less flexible, much like a jelly donut going stale. This can lead to pain and stiffness, and in some cases, a herniated disc where the inner part of the disc bulges out and presses on nerves. Additionally, the joints between the vertebrae can wear down, causing friction and discomfort.
At PSA, we understand that every pain in the body originates from the spine, and we're here to address the root causes of your discomfort.
Dr. Mehta stresses that many patients rely on "Dr. Google" and may have misconceptions about why they have back pain or spinal pain. Some common misconceptions include:
It's crucial to seek professional guidance from a qualified spine or pain management specialist to ensure proper diagnosis and treatment. Moreover, it’s critical that patients research their caretakers and find a physician who is willing to solve the root cause, and not just slap a bandaid on the symptoms.
Thankfully, advancements in technology have revolutionized the field of spine care, offering less invasive and more effective treatment options. As Dr. Mehta often hears from patients, "What does a pain management doctor do?" The answer lies in the evolution of the field. Much like cardiology, where procedures have shifted from open-heart surgery to minimally invasive techniques, spine care has also seen a remarkable transformation. Rather than relying solely on medications or steroid injections, at PSA, we are equipped with advanced training and technology to identify and address spinal degeneration early on. This proactive approach allows us to utilize cutting-edge therapies like pain pacemakers, SCS (spinal cord stimulation), and SI joint interventions, providing targeted relief and potentially delaying or even preventing the need for more invasive procedures.
PSA offers a range of treatment options for back and spine pain, including:
Our focus is on providing lower back pain and spinal pain relief through less invasive techniques that target the underlying cause of the pain.
Dr. Mehta emphasizes the importance of seeking professional help when experiencing persistent back pain or other spinal issues. PSA distinguishes itself as a comprehensive spine care provider, acting as the "PCP of the spine." Our team of specialists is trained to evaluate your condition, recommend the appropriate treatment, and guide you through your journey to recovery.
Maintaining good posture, engaging in regular stretching and exercise, and adopting healthy lifestyle choices are vital for supporting your spine. Dr. Mehta encourages everyone to be proactive about their spinal health and avoid falling into the trap of "benign neglect," where minor aches and pains are ignored until they become major problems.
Muscles form a large composition of the body, and if we don’t use them, they will eventually stop working properly and start to hurt. Simple activities like going for walks and stretching for 15-20 minutes a day can make a significant difference in maintaining a healthy spine by supporting the muscular system around the spine and throughout the body.
Additionally, avoiding “text neck” by minimizing time spent looking down at your phone and ensuring a proper workspace can reduce strain on the neck and spine.
On this World Spine Day, Dr. Mehta's message is clear: "You don't have to suffer and live in pain." Seek help early, find an individualized treatment plan, and understand the anatomy of your spine so you can make informed decisions about your health. If you're experiencing back or spine pain, don't hesitate to seek help from a qualified spine specialist near you. At PSA, we are committed to providing cutting-edge therapies and compassionate care to help you achieve a pain-free life.
Remember: Don't let pain control your life. Reach out to a PSA pain specialist near you and take the first step toward a healthier, happier you.
In honor of National Pain Awareness Month, let's challenge the pervasive misconceptions surrounding chronic pain and illuminate the path toward a brighter future.
Too often, individuals suffering from chronic pain face dismissive attitudes and outdated beliefs. They may hear phrases like, "It's all in your head," or "You don't look sick." These misconceptions can be incredibly isolating and discouraging, leading patients to believe they have no choice but to endure their pain.
But the reality is far different.
Dr. Bennjamin Fronk isn't just a physician; he's a passionate healer and educator, driven by a deep-seated desire to empower his patients through knowledge and compassionate care. Embracing the true meaning of the word "doctor" - Latin for "teacher" - Dr. Fronk is dedicated to fostering an environment of continuous learning, not only for himself but also for his patients and staff. He understands that informed patients are empowered patients, capable of making the best decisions for their health.
This dedication to education manifests in his patient interactions, where he takes the time to explain complex medical concepts in layman's terms, ensuring that each individual feels heard, understood, and equipped to navigate their treatment journey.
He also extends this passion for teaching to his staff, recognizing that a well-informed team creates the best possible environment for patient care. By sharing his knowledge and expertise, Dr. Fronk cultivates a culture of continuous improvement, where everyone is encouraged to grow and learn, ultimately leading to better experiences and outcomes for his patients.
This commitment to lifelong learning, combined with his compassionate approach, makes Dr. Fronk a true advocate for those suffering from chronic pain, providing not only cutting-edge treatment but also the knowledge and support necessary for a brighter future.
The landscape of pain management has undergone remarkable transformations in the past decade, fueled by relentless advancements in medical science and technology. Once dominated by invasive procedures and limited options that weren’t always effective, the field now boasts a growing array of less invasive, more effective treatments. From minimally invasive surgeries and targeted neuromodulation to endoscopy and more, these innovations are revolutionizing the way we approach pain relief, prioritizing precision and minimizing disruption to the body.
As science and technology continues to develop, we can anticipate even more groundbreaking developments on the horizon, further expanding the possibilities for those seeking lasting relief from chronic pain. The future of pain management is bright, promising a new era of personalized, effective, and accessible care for all. The experts at PSA, including Dr. Fronk, are committed to continually learning about new practices and technologies that can better serve our patients.
Dr. Fronk and his colleagues at Pain Specialists of America adopt a patient-centered, holistic approach to pain management, prioritizing the identification and treatment of the root cause of pain rather than simply addressing symptoms. They understand that lasting relief comes from understanding the underlying issue, not just masking the discomfort.
This starts with a thorough evaluation, going beyond just reviewing medical records or imaging results. The focus is on the individual's experience of pain, their lifestyle, and how it affects their daily life. They believe in educating patients about their condition, empowering them to make informed decisions about their treatment.
It's not uncommon for patients to come in with preconceived notions about their diagnosis or treatment needs, often influenced by previous experiences, online information, or other healthcare providers. While Dr. Fronk appreciates their initiative, he stresses the importance of a comprehensive assessment to pinpoint the true origin of the pain.
This approach often reveals that the most obvious issue, such as a disc abnormality on an MRI, may not be the actual culprit behind the pain. By focusing on the individual's specific pain patterns and lifestyle factors, the team can develop a targeted treatment plan designed to address the root cause, not just the symptoms.
The ultimate goal is not just to alleviate pain, but to empower patients to regain control of their lives. By understanding their condition, making informed choices, and actively participating in their treatment, patients can move beyond pain management and get back to doing what they love. This commitment to lasting relief and improved quality of life sets Dr. Fronk and Pain Specialists of America apart, creating a welcoming environment for our patients
Chronic pain often carries an invisible burden. Unlike a visible injury, it can be difficult for others to understand the depth of suffering a patient experiences. This invisibility can lead to a sense of isolation, as family and friends may unintentionally doubt the severity of the pain, further compounding the patient's distress.
The stigma and misconceptions surrounding chronic pain can create a sense of hopelessness. Patients may feel trapped, believing that if one treatment doesn't work, they're doomed to a life of pain. They might resign themselves to the idea that there are no options, that they simply have to "live with it."
This is where Dr. Fronk's approach shines. He understands the emotional toll of chronic pain, the frustration of feeling unheard, and the despair that can accompany a seemingly endless search for relief. He listens. Not just to the physical symptoms, but to the patient's entire story – their fears, their hopes, and their struggles.
Dr. Fronk's compassionate approach helps break down the stigma surrounding chronic pain. He validates his patients' experiences, offering them a safe space to express their concerns without judgment. By actively listening and acknowledging their pain, he instills a sense of hope and empowers patients to actively participate in their journey towards recovery. He reassures them that they are not alone, that there are options, and that together, they can find a path towards a better quality of life.
If you're living with chronic pain, remember:
You have a voice. Advocate for yourself and seek out compassionate healthcare professionals.
At Pain Specialists of America, we understand the unique challenges of chronic pain – the invisible struggle, the doubts from loved ones, and the fear that there's no way out. We're here to tell you: there is hope. With a compassionate approach, cutting-edge treatments, and a dedication to uncovering the root cause of your pain, we empower you to reclaim your life. Don't settle for a life limited by pain.
Schedule an appointment today and let Dr. Fronk and the expert team at PSA guide you on the journey to a pain-free, fulfilling life. Remember, for every pain, we have a plan.
Dr. Fronk is currently accepting new patients at the following Pain Specialists of America locations:
7003 Woodway Drive, Suite 313, Waco, TX 76712
(254) 401-4403
305 Clinite Grove Blvd, Temple, TX 76502
(254) 414-2243
2701 East Stan Schlueter Loop, Suite 100, Killeen, TX 76542
(254) 415-7673