At Pain Specialists of America (PSA), we are thrilled to welcome Dr. Chris Massey to our team of dedicated professionals. Dr. Massey brings a wealth of expertise and a compassionate approach to pain management, enhancing our mission to provide exceptional, outcomes-based care to those suffering from chronic pain.
Dr. Chris Massey, MD, MPH, DABA, is a native Texan excited to return to his home state after completing his extensive training in pain medicine. Dr. Massey's journey in medicine began at Texas Tech University Medical School, where he graduated with distinction. His passion for healing and dedication to patient well-being blossomed early in his career, setting the stage for his specialization in
anesthesiology.
Dr. Massey completed his residency at the prestigious Cedars-Sinai Medical Center, mastering the intricacies of pain management and perioperative care. Driven by an unwavering commitment to address pain at its core, he pursued a Pain Medicine Fellowship at Rush University. During his fellowship, Dr. Massey engaged in innovative research and adopted a holistic, patient-centric approach to pain management, emphasizing the importance of treating the root causes of pain and empowering patients with the tools to take control of their health.
Dr. Massey's philosophy extends beyond merely alleviating symptoms – he believes in empowering patients through education and lifestyle changes. By fostering a compassionate and understanding environment, Dr. Massey ensures that his patients feel heard and supported throughout their healing journey. His dedication to transparent communication and strong patient relationships aligns perfectly with PSA's mission to provide personalized, comprehensive pain management solutions.
Dr. Massey will be practicing at multiple PSA locations, including the Onion Creek Clinic and the PSA Surgery Center of South Austin, as well as the Austin Central James Casey Clinic and The Pain Relief SurgiCenter. Outside of Austin, James Cassey also practices at the San Marcos PSA Clinic.
His presence at these locations will significantly enhance our ability to provide advanced, patient-centered care to the central Texas community.
At Pain Specialists of America, we believe that for every pain, there is a plan. Our 13 locations and 3 state-of-the-art surgery centers throughout central Texas are dedicated to helping patients return to a functional and fulfilling life. Here’s what you can expect when you visit us:
PSA is committed to mitigating pain through exceptional, outcomes-based comprehensive pain management care. Our vision is to create an innovative, integrated healthcare ecosystem that provides the highest quality of care through a comprehensive pain management approach. We aim to break the stigma of pain management and improve the quality of life for our patients, their families, and the community.
Dr. Massey will be available to see patients at the following locations:
We invite you to schedule an appointment with Dr. Massey and begin your journey toward a pain-free life. With his expertise and our comprehensive care, feeling strong again is closer than you think. At Pain Specialists of America, we are dedicated to helping you live an active, healthy, and happy life.
Migraine attacks and headaches are often confused, but they are distinct conditions. A headache refers to general head pain and can vary in intensity and duration. Migraines, however, are a specific neurological condition characterized by severe, throbbing pain usually on one side of the head, and are often accompanied by symptoms like nausea, vomiting, and sensitivity to light and sound.
While patients commonly refer to all head pain as headaches, those experiencing frequent, prolonged, debilitating episodes likely suffer from migraines. As a migraine specialist dealing with chronic headaches, it is crucial to differentiate between the types, allowing for targeted treatment plans and collaboration with neurologists to improve patient outcomes.
Migraine attacks and headaches are often confused, but they are distinct conditions. A headache refers to general head pain and can vary in intensity and duration. Migraines, however, are a specific neurological condition characterized by severe, throbbing pain usually on one side of the head, and are often accompanied by symptoms like nausea, vomiting, and sensitivity to light and sound.
While patients commonly refer to all head pain as headaches, those experiencing frequent, prolonged, debilitating episodes likely suffer from migraines. As a migraine specialist dealing with chronic headaches, it is crucial to differentiate between the types, allowing for targeted treatment plans and collaboration with neurologists to improve patient outcomes.
Headaches come in various forms, each with distinct characteristics and causes:
Condition Specific: Some patients may also experience headaches due to sinus inflammation or TMJ. While the cause is something else, such as TMJ, pain can manifest as headaches.
Migraines can occur with or without aura. An aura includes visual disturbances, sensory changes, or speech difficulties preceding the headache.
A Simple Migraine, often referred to as a common migraine, does not include an aura but has the typical throbbing headache and associated symptoms like nausea and light sensitivity. Understanding these types helps in accurately diagnosing and effectively treating migraine attacks.
Some other classifications of migraines include:
Migraines typically progress through four stages, each with distinct symptoms:
Understanding these stages allows patients to better predict and manage their migraines, potentially reducing the severity and duration of attacks.
Migraines are highly individualized, and most patients have their own specific triggers. Consulting a migraine specialist can help identify these personal triggers and develop strategies to avoid them. Embracing self-management and education is key. Understanding and owning one's chronic illness can prevent it from taking over one's life. While it varies by individual, some common migraine triggers include:
There are several treatment options available for managing migraines, often involving a combination of pharmacologic and non-pharmacologic approaches. At PSA, we work closely with neurologists to devise a pharmacological treatment plan, as they have extensive knowledge of the medications used for both chronic and acute migraine attacks.
At PSA, we take a conservative and multimodal approach to chronic pain management, ensuring all non-invasive treatment options have been exhausted before moving on to other options. Nerve blocks and ablations can play a huge role in relieving chronic headaches and migraines, and have no adverse effects regardless of age. Additionally, stress management and lifestyle changes can play a huge role in migraine pain relief. Each patient is unique, requiring individualized treatment plans, but some common options include:
Treatment effectiveness varies, with some patients needing periodic nerve blocks (e.g., three times a year) and others benefiting from annual ablations. These procedures typically have minimal adverse effects, making them suitable for patients of all ages. While migraines may not be completely cured, these treatments can significantly improve the quality of life by reducing the frequency and severity of attacks.
Migraines, like many chronic illnesses, are surrounded by myths that can hinder effective treatment and management. Here are three common myths about migraine attacks
When people start experiencing headaches, they often dismiss or justify them (I’m dehydrated or I didn’t sleep well), thinking they are not a serious issue. However, headaches, especially migraines, are a chronic illness that can significantly impact one's quality of life. Recognizing and understanding your headache patterns is crucial for effective management. Migraines should be taken seriously, just as much as other conditions like diabetes or chronic back pain.
A prevalent myth is that if migraines are common in your family, you’re also stuck with them. While there can be a genetic predisposition to migraines, it doesn't mean you have to suffer without relief. There are many treatment options available, and seeking help from a migraine specialist, such as interventional pain physicians who run headache programs, can lead to effective management and improvement in quality of life.
Another common misconception is that managing migraines requires constant use of opioids. This is not true. There are many non-opioid treatments available, including preventive medications, nerve blocks, and other non-pharmacologic therapies. It's essential to consult the right migraine specialist who can provide evidence-based, effective treatment options without relying on opioids. Education and appropriate intervention can help patients manage their migraines effectively without the risks associated with long-term opioid use.
These myths can prevent individuals from seeking proper treatment and managing their condition effectively. By debunking these misconceptions and promoting science-based interventions, we can help each other achieve better health outcomes.
If you're seeking relief from migraine and chronic headache pain, PSA, with our comprehensive pain management programs, offers hope and solutions.
Dr. Pankaj Mehta, a distinguished expert in pain management, spearheads these efforts across multiple locations, including Temple, Killeen, and Georgetown, as well as at The Pain Relief SurgiCenter and PSA Surgery Center of Killeen. You can also find other migraine specialists near you by browsing our locations.
With a focus on personalized medicine, advanced treatment modalities, and cutting-edge research, Dr. Mehta and the team at PSA provide tailored strategies to address various pain conditions. PSA is dedicated to improving your quality of life and helping you find lasting relief from migraine and chronic headache pain.
Post-surgical nerve pain, also known as neuropathic pain, can be a challenging aspect of the recovery process for many individuals. Whether you've undergone spinal surgery, joint replacement, or other procedures, understanding the causes and management strategies for nerve pain is crucial for optimizing your recovery and quality of life.
Nerve pain after surgery can stem from various factors, including:
Neuropathic pain involves abnormalities in the nervous system, particularly sensitization of spinal nerves and the spinal cord. Simply put, it's like your body's pain signaling system going into overdrive, often leading to chronic pain. This phenomenon, known as central sensitization, can cause sensory abnormalities such as allodynia (non-painful stimuli perceived as painful), hyperalgesia (exaggerated pain response to painful stimuli), and radiating pain (shooting, burning, or electric-like sensations spreading from the surgery site to other areas of the body).
One of the more common types of post-surgery neuropathic pain is post laminectomy syndrome – otherwise known as pain after back surgery – but neuropathic pain can occur anywhere in the body.
Navigating post-surgical challenges involves understanding various factors contributing to nerve pain. Incomplete nerve recovery, scar tissue formation, structural alterations, recurrent disc herniation, and postoperative spinal instability all play roles in persistent discomfort, underscoring the complexity of postoperative nerve pain management.
Surgery, particularly in nerve-rich areas like the spine, can sometimes leave nerves not fully healed. These nerves act as communication wires between your body and brain. Surgeons aim to relieve pressure on them during the operation, especially if they were compressed before. But if they don't fully recover, they can continue sending pain signals to your brain, even after the initial issue is fixed. This ongoing pain is what we call nerve pain after surgery.
After surgery, scar tissue can form around the operated nerves. This scar tissue acts like a tight band, putting pressure on the nerves and causing irritation. Despite the initial problem being fixed, this ongoing irritation can lead to the nerves sending pain signals to the brain. So, in essence, nerve pain after surgery can occur because of the continued irritation caused by scar tissue pressing on the nerves.
After spine surgery, the healing process can sometimes alter the structure of your spine. Think of your spine like a stack of building blocks. If one block shifts, it can affect the stability of the entire stack. Similarly, after surgery, your spine may not return to its original shape, which can put pressure on nearby nerves. This pressure on the nerves can cause pain. So, when we mention "structural changes in the spine," we're referring to alterations in the spine's shape post-surgery, which can lead to nerve pain due to changes in nerve positioning or pressure.
Imagine your spine is like a tube filled with jelly, with layers of tough rubber bands around it to protect it. Sometimes, a part of the rubber band layer can bulge out, like a jelly donut squishing out when you press on it too hard.
Now, if you've had surgery to fix this bulging part and it happens again, it's called recurrent disc herniation. It's like the jelly squishes out again even after you've fixed it once. This can happen because the tough rubber bands might not be as strong after surgery, or because the pressure on your spine hasn't been relieved enough.
Think of your spine like a tower made of building blocks. After surgery, sometimes these blocks may not be as sturdy as they were before, which can lead to what's called postoperative spinal instability.
This instability can happen if the bones or structures in your spine aren't holding together as well as they should after surgery. It's like if some of the blocks in your tower become loose or shift out of place. This instability can put pressure on the nerves in your spine, causing pain.
Effective management of nerve pain after surgery requires a comprehensive approach tailored to individual needs. Here are some strategies to consider:
Medications: Certain medications, such as anticonvulsants, antidepressants, and neuropathic pain medications, can help alleviate nerve pain. Should be a last resort and used conservatively.
Nerve pain after surgery can significantly impact your quality of life, but with the right approach, it's possible to manage and reduce your symptoms effectively. By understanding the underlying causes of neuropathic pain and exploring various treatment options, you can take proactive steps towards a smoother recovery and improved well-being.
Remember, you're not alone in this journey.
Find a PSA location near you to receive individualized guidance and support, and don't underestimate the power of self-care and resilience in overcoming post-surgical challenges.
In the realm of chronic pain conditions, fibromyalgia syndrome stands out as a complex and often misunderstood disorder. Through the insights of dedicated healthcare professionals like Maheen Arastu, we gain a clearer understanding of fibromyalgia and the empathetic care provided to those grappling with its challenges.
Whether you personally are affected by fibromyalgia, know someone who is, or generally want to understand more about the illness, keep reading to learn valuable insights about the diagnosis, treatment, and realities of fibromyalgia.
Maheen Arastu, a dedicated Family Nurse Practitioner-Certified (FNP-C) based in Round Rock, brings a wealth of experience and compassion to the field of pain management. Her professional journey, transitioning from the operating room to specializing in interventional pain management, underscores her unwavering dedication to delivering personalized and empathetic care to her patients.
Furthermore, Arastu’s background in women's healthcare has provided her with valuable insights into the unique challenges faced by women, especially considering the higher prevalence of fibromyalgia among women. This perspective enhances her ability to address the specific needs of her patients with sensitivity and understanding.
Fluent in Hindi and Urdu, Arastu places a strong emphasis on culturally sensitive approaches in her practice, ensuring that every patient feels respected, understood, and supported regardless of their cultural or linguistic background.
As we commemorate Fibromyalgia Awareness Day, let us recognize Arastu’s commitment to raising awareness about this condition and providing compassionate care to those affected by it.
Fibromyalgia presents as a complex condition characterized by widespread pain, persistent fatigue, cognitive impairments, and disturbances in sleep patterns. Its prevalence is notably higher among women and frequently coexists with other ailments like irritable bowel syndrome, headaches or migraines, and mood disorders such as anxiety or depression. The triggers for fibromyalgia vary widely, encompassing genetic predispositions, infections, as well as physical or emotional traumas.
Symptoms typically manifest in diverse ways: individuals experience chronic body pain persisting for three or more months, often migrating across various regions such as the back, neck, and shoulders. Despite normal blood test results, individuals may grapple with profound fatigue, hindering their ability to engage in daily activities. These symptoms can arise following a specific triggering event, whether physical or psychological in nature, or may gradually accumulate over time without a discernible inciting incident.
Fibromyalgia can significantly impact daily life in various ways, often presenting a multitude of challenges for individuals living with the condition. Persistent pain can impact simple tasks – standing, walking, or sitting for extended periods, can become exceedingly difficult and exhausting.
Fatigue is another hallmark symptom of fibromyalgia, often accompanied by disrupted sleep patterns and cognitive difficulties commonly referred to as "fibro fog." The combination of pain, fatigue, and cognitive impairments can impair concentration, memory, and overall mental clarity, affecting productivity and daily functioning.
Moreover, fibromyalgia can impact emotional well-being, leading to feelings of frustration, anxiety, depression, and social withdrawal. The unpredictability of symptoms and the chronic nature of the
Diagnosis can be challenging because most patients have coexisting conditions. The illness is diagnosed out of exclusion, so running thorough testing and bloodwork is critical.
At Pain Specialists of America, we first work with rheumatology to rule out autoimmune disorders such as rheumatoid arthritis (RA) or lupus. We also run blood tests, sleep studies, cervical MRIs, and tender point assessments to get a complete picture. Collaborating closely with patients' primary care physicians (PCPs), we strive to gain a comprehensive understanding of their medical history.
While the diagnostic journey for fibromyalgia may be lengthy and intricate, the process of eliminating other potential illnesses empowers patients with clarity regarding their health status. With Arastu’s expertise and insight, patients can navigate this journey with confidence, knowing they are in caring and capable hands.
Diagnosis can be challenging because most patients have coexisting conditions. The illness is diagnosed out of exclusion, so running thorough testing and bloodwork is critical.
At Pain Specialists of America, we first work with rheumatology to rule out autoimmune disorders such as rheumatoid arthritis (RA) or lupus. We also run blood tests, sleep studies, cervical MRIs, and tender point assessments to get a complete picture. Collaborating closely with patients' primary care physicians (PCPs), we strive to gain a comprehensive understanding of their medical history.
While the diagnostic journey for fibromyalgia may be lengthy and intricate, the process of eliminating other potential illnesses empowers patients with clarity regarding their health status. With Arastu’s expertise and insight, patients can navigate this journey with confidence, knowing they are in caring and capable hands.
Arastu adopts a conservative approach to treatment, prioritizing strategies that are both gentle and sustainable for her patients. One such recommendation she offers is the "5-minute rule," advising patients to take a brief, 5-minute walk for every hour they spend sitting. By setting attainable goals, Arastu aims to foster habits that can be maintained over the long term, avoiding the pitfalls of overly strenuous exercise routines that may exacerbate symptoms.
In line with this philosophy, she often suggests aqua therapy or water aerobics, recognizing the potential strain conventional physical therapy may place on the body. Chair yoga and acupuncture also emerge as gentle yet effective modalities for alleviating tension and managing pain. Arastu also acknowledges the benefits of achieving healthy, sustainable weight loss in reducing pain for patients with a high BMI.
Arastu explores pharmaceutical options for patients only after exhausting other avenues of treatment. She emphasizes the importance of starting conservatively and using trial-and-error to ensure that any medication regimen aligns with the patient's preferences and needs.
Beyond medical treatments, Arastu underscores the vital importance of addressing mental health considerations and adopting healthy lifestyle habits. Though any illness may see an overlap between chronic stress and pain, this relationship is even more prevalent in those with Fibromyalgia. As an illness that affects the mind and body, it is critical that patients seek mental health support.
Cognitive-behavioral therapy (CBT), support groups, and mindfulness practices play integral roles in managing symptoms and promoting overall wellbeing. By nurturing a supportive environment and fostering open communication, Arastu empowers her patients to navigate their journey towards healing and resilience.
Additionally, getting adequate, restorative sleep is essential for those managing fibromyalgia. Arastu emphasizes the importance of prioritizing quality sleep to optimize health outcomes. Hydration is also key for overall health, and Arastu stresses the importance of staying adequately hydrated, especially for individuals with fibromyalgia.
Lastly, she advocates for a balanced diet rich in whole fruits, vegetables, and lean meats, while also acknowledging the value of occasional indulgences. Arastu’s approach to nutrition emphasizes enjoying food without undue stress, embracing a healthy relationship with eating, and savoring life's simple pleasures. Eat what you can, don’t stress, and enjoy the dark chocolate, she says.
Despite advancements in understanding fibromyalgia, skepticism persists regarding its legitimacy as a medical condition. Arastu emphasizes the tangible impact of chronic pain on individuals' lives, highlighting the importance of comprehensive evaluations and evidence-based treatments. Through education and advocacy, she works to dispel misconceptions surrounding fibromyalgia and validate the experiences of those living with this condition.
One inspiring success story shared by Arastu involves a patient who initially sought relief for chronic low back pain, despite her young age of 34-years. After exhausting conventional routes, including consultations with surgeons and rheumatologists, the patient embarked on a journey toward holistic healing. Arastu guided her through incremental steps, addressing each concern methodically.
Starting with manageable lifestyle changes like weight loss, the patient gradually progressed to exploring innovative treatments such as a lower back stimulator, specifically a peripheral nerve stimulator targeting the lower back to buttocks region. Remarkably, this comprehensive approach culminated in the patient achieving freedom from lower back pain, experiencing only occasional flare-ups that are managed effectively with medication. This narrative underscores the transformative power of personalized care and perseverance in overcoming the challenges posed by fibromyalgia.
As we commemorate Fibromyalgia Awareness Day, let us recognize the complexities of this condition and the invaluable efforts of healthcare professionals like Maheen Arastu in providing compassionate care. Through a holistic approach encompassing medical interventions, lifestyle modifications, and emotional support, we can empower individuals living with fibromyalgia to reclaim their lives and thrive despite the challenges they face.
Find a pain management location near you to start your pain relief journey. PSA is here to help.
As an advanced nurse practitioner at PSA James Casey in Austin, Kaycee Frederick specializes in administering injections to the shoulders, knees, and other areas of the body, addressing trochanteric bursae, migraines, and more. She works closely with Dr. Gutierrez, attending to patients with acute conditions, many of whom experience high levels of stress.
With nine years of experience specializing in pain management, Frederick has become well aware of the intersection of pain and stress. As we make our way through National Stress Awareness Month, Frederick shares invaluable insights into the relationship between pain and stress, and how to find healthy, evidence-based ways of managing both.
Both pain and stress can precede and follow one another, Frederick says. Prolonged fight or flight response, can disrupt the body's ability to maintain equilibrium, leading to a cascade of physiological and psychological responses. This disruption can exacerbate both pain and stress, creating a cyclical pattern that challenges the body's resilience and adaptive capacity.
Stress and anxiety, for example, may prompt muscle tension, such as in myofascial pain syndrome (MPS) or pelvic pain conditions, where stress-induced tension in muscles in the back, pelvic floor, or elsewhere intensifies pain, perpetuating a cycle of stress and discomfort.
Alternatively, the sudden onset of intense pain can be, not only physically challenging, but also disruptive to one's daily life, thereby inciting high levels of stress.
To manage chronic stress and pain, it's crucial to equip patients with coping mechanisms that address both the physical and mental aspects of their condition. Highlighting the interconnectedness of pain, mental health, and stress can promote a holistic approach to management.
Frederick notes how important it is to learn to monitor situational factors that trigger our own stress individually. Once an individual has identified their own unique stressors and found healthy coping mechanisms that work for them it may be easier to identify an individualized management plan.
Encouraging individuals to monitor their personal stress triggers fosters self-awareness, while evidence-based strategies like cognitive behavioral therapy (CBT) offer effective mind-based tools to navigate stressors and their associated thoughts and actions.
Accessing therapy, whether individually or in group settings, can provide valuable support, helping individuals understand the persistence of pain and mitigate related fears and anxieties.
Additionally, professionals should offer explanations and interventions grounded in evidence to empower individuals in managing their pain and stress effectively. By incorporating education on pain and stress reduction methods, individuals can gain greater control over their symptoms and improve their overall quality of life.
One study compared the effectiveness of Mindfulness-Based Stress Reduction (MBSR), Cognitive Behavioral Therapy (CBT), and usual care for adults with chronic low back pain. The trial involved 342 participants aged 20 to 70 who were randomly assigned to receive either MBSR, CBT, or usual care. MBSR and CBT sessions were conducted over 8 weeks, while usual care involved the participants receiving their regular treatments.
Results showed that both MBSR and CBT were effective in improving functional limitations and reducing back pain at 26 weeks. These improvements persisted at the 52-week follow-up. Therefore, the study suggests that both MBSR and CBT could be a beneficial treatment option for individuals with chronic pain and stress.
In a separate study, researchers explored the impact of combining pain neurophysiology education, or education about why the pain is happening, with therapeutic exercise for chronic low back pain (CLBP). Fifty-six participants with CLBP were randomly assigned to either receive therapeutic exercise alone or therapeutic exercise supplemented with pain neurophysiology education conducted in groups.
Results at the 3-month follow-up revealed a significant reduction in pain intensity, with a large effect size observed in the group receiving the combined intervention. Secondary measures, such as disability questionnaire scores and pain catastrophizing, also showed moderate improvements.
These findings suggest that integrating pain neurophysiology education with therapeutic exercise offers a promising approach for effectively managing CLBP, addressing both physical and cognitive aspects of the condition to improve patient outcomes.
A third study affirms the need to combine multiple modalities to treat pain and stress most effectively. The systematic review highlights the superiority of multidisciplinary interventions and emphasizes the need for a holistic approach to pain and stress management/ By integrating evidence-based practices like cognitive behavioral therapy (CBT) with comprehensive education on pain neurophysiology and stress reduction, individuals can gain better control over their symptoms and improve their overall quality of life.
Success with a holistic, mind and body approach to healing stress and pain is not just found in these studies – but in the very walls of PSA James Casey.
One inspiring story involves a patient who faced a life-altering injury, resulting in significant stress and upheaval in their life. Seeking support, they joined a dedicated support group and engaged in individual cognitive behavioral therapy (CBT). Alongside these interventions, they received comprehensive care from PSA James Casey, including neuropathic medication for nerve pain, physical therapy, and interventional therapy such as neuromodulators, or injections.
Alongside these interventions, they received comprehensive care from PSA James Casey, including neuropathic medication for nerve pain, physical therapy, and interventional therapy which included injections and peripheral nerve stimulator.
As a result of this multifaceted and holistic approach, the patient experienced a remarkable improvement in their well-being. They now thrive, finding solace and empowerment in the support group where they can share their journey with others facing similar challenges.
All in all, it’s important to recognize the impact stress can have on our overall health – not just our mental wellbeing, but also our physiology and physical wellness.
This means we can expect to manage pain significantly better when we also learn to effectively manage stress levels, which calls for an individualized, holistic approach. Evidence-based practices like cognitive behavior therapy (CBT) and patient education provide effective tools to navigate stressors.
Success stories from PSA James Casey further highlight the effectiveness of a comprehensive approach, where patients receive holistic care and support. By implementing integrated and evidence-based strategies, individuals can gain control over their symptoms, find empowerment, and enhance their quality of life despite life-altering challenges. If you’re ready to start your journey to lowering stress and chronic pain, simply request a new patient appointment on our website. We’re ready to welcome you with compassionate care.
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