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.
Connect with Kaycee Frederick on Facebook and Instagram to get helpful tips on managing chronic pain!
Pain medicine has changed quite a bit over the last 20 years. We’re in a much more advanced space now, with new therapies becoming available every day. However, these new options create challenges for both the patient and the provider. Which therapy will best serve each unique case? As these therapies become more and more complex, how do doctors teach patients about the reasons why some choices are better than others? There are also patients who have received treatment but are unclear why certain decisions were made.
This blog is designed to educate our patients and to bridge the gap of knowledge between what our physicians and advanced practice providers now know and what patients may currently believe.
Along with this education comes the ability to advocate—for yourself as well as your family members—so when you’re faced with a decision, you can make the best decision.
Many people in pain management—patients and providers alike—believe in this paradigm:
A caused B, therefore fixing A will lead to the resolution of B
In this paradigm, A is generally some type of injury or event, and B is either pain or change in function. Maybe something has been twisted or overused. This then leads to feeling pain. But the assumption here is that the problem is one-dimensional and there’s nothing else that may be contributing to the problem.
By the time they reach us, most patients have tried some sort of other therapy. They may have tried home care, with rest, ice, or heat. They may have been evaluated by their primary care physician or a chiropractor. From there, they may have tried over-the-counter medications or therapy, but they’ve continued to experience pain or disability. After all of this, they’re sent to a spine or pain specialist in order to diagnose and treat the chronic pain.
The journey from the initial onset of the pain to a visit to PSA will often take about three to six months. Along the way, patients may learn to adapt to their pain and change the way they walk, sit, stand, lift, or do any number of other normal activities. Now, we’re not just talking about the initial injury or cause and the resulting pain, but all of the behaviors that have developed as a result.
Pain medicine is a field. This means that those of us in the field don’t just focus on the treatment, we’re just as concerned with the diagnosis.
There are roughly 46 possible causes for lower back pain. In order to accurately diagnose—and therefore treat—any case, we have to look at the patient’s entire story: How did this story evolve? How does the patient describe the pain?
Along with the patient’s story, we conduct an examination and take a close look at the body: How does it move? How do the tendons and the musculature feel? Plus, we conduct studies like CT scans and MRIs.
From the story, examination, and study, we can begin to create a picture of the problem. But even then, with all of this work done, there may still be several causes for the pain. At this point, we may try different approaches to see how the pain responds—or doesn’t respond.
One approach is to try some form of injection, which patients often mistakenly call “shots.” Injections performed by a pain physician aren’t like flu shots, which are blindly injected into the muscle or skin.
Rather, these are diagnostic and therapeutic tools. They’re targeted injections that are specifically placed and contain two components: Local anesthetic and steroid.
With our findings as our guide, we may put a local anesthetic on a specific nerve. If the pain is reduced, we know we’ve found the source. But even if the pain isn’t reduced, we’ve still made progress in our search for the source and possible treatments of the pain.
With the steroid, we’re able to reduce inflammation, promote tissue healing, and allow the nerve to reboot.
Many patients wonder if their treatments will be effective and how long they’ll last. Unfortunately, there’s no way to predict the outcome of any treatment because every patient is different. While we do expect treatments to be effective and last for some time, the reality is that most pain journeys have their ups and downs.
In many ways, the pain journey is about breaking the pain cycle and peeling away the layers of pain. By the time a patient comes to our offices, three to six months after the pain was first discovered, there are so many other factors contributing to it, like altered biomechanics.
Similarly, when people talk about chronic pain in the back, the focus is mainly on the specific points in the back where the pain is felt. In reality, there’s much more to it and things like lymphatics, nerves, and muscles could also contribute to the problem.
As interventional pain physicians and diagnosticians, we feel it’s our responsibility to diagnose and treat what we believe is the primary source of your pain. We also feel it's our responsibility to treat any additional sources of pain. By keeping you appraised of all of this information, we can teach our patients about what they’re experiencing and how we’re managing it.
This means that as you make your way through the pain journey, you can make educated decisions you feel confident about.
Pain management doctors – physicians who specialize in the evaluation, diagnosis, and treatment of pain – have advanced training that qualifies them as your best source of treatment if you are experiencing any type of pain due to illness or injury.
After a general residency, these physicians undergo an additional one-year fellowship in pain management, and they are board-certified in a specialty, such as sport injuries or cancer pain.
However, most pain management doctors devote their time and expertise to helping chronic pain patients whose needs can sometimes be hard to diagnose and take months or years to treat using multiple therapies.
Pain management doctors most often see patients with pain in the low back, knee, head, hip, and neck. Common conditions treated is these physicians include: arthritis, fibromyalgia, migraines, sciatica, and more.
For one thing, they diagnose the specific cause of your pain and the underlying conditions that lead to it. Take back pain, for example. It could be caused by many conditions ranging from poor posture at your work desk to a herniated disc to a degenerative condition like arthritis.
Once a pain management doctor diagnoses your pain, he or she can find the therapy that works best for you based on their specialized training and the latest research. In fact, pain management doctors often conduct their own trials and studies on patients who haven’t responded to conventional treatments.
Pain doctors often use a wide range of nonsurgical, interventional treatments – along with complementary therapies – as a way of reducing the amount of medication you need to take or to avoid the need for surgery. These may include massage, a weight loss regimen, acupuncture, exercise, yoga, meditation, physical therapy, dietary changes, or chiropractic care.
They may also prescribe pain-killing medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or antidepressants. Depending on the severity of your specific condition, they may also recommend epidural steroid injections, nerve blocks, joint injections, radiofrequency ablation, spinal cord stimulation, or neuromodulation. If none of these methods are effective in alleviating your pain, surgery may be an option of last resort.
In any case, your pain management doctor will coordinate treatment between multiple doctors and healthcare professionals. In addition, he or she will continue ongoing care for any physical or mental concerns you may have. In that role, your pain management doctor acts as an advocate dedicated to relieving your symptoms.
To learn more about how a pain management doctor can help you overcome your pain issues, talk to the experts at Pain Specialists of Austin and Central Texas Pain Center. We help patients like you every day. Get the discussion started by calling (855) 876-7246 for an appointment today or request an appointment online.
Living a life with chronic pain can be complicated. Pain not only affects you, but it can also affect your friends and family, and potentially your work productivity. It can impact every aspect of your life, from difficult physical exertion to common tasks, like tying your shoes.
If you’re experiencing chronic pain, you’re not alone. As many as 100 million Americans deal with some form of chronic pain.
The beginning of a new year is almost always seen as a renewal, a fresh start, a sense of hope for something better. You can take your life back from daily chronic pain. You may have started and stopped many times in your pain management journey, that’s ok. Sometimes it’s necessary.
Here are a few tips to begin or continue your pain management journey in 2022.
Set up a system, not a resolution or goal
The goal or resolution to live a healthier life can be better achieved through establishing a system. A system makes your goal attainable. It’s concrete. It gets you moving in the right direction. A system is something you do on a regular basis. It might look like:
Drink more water. Whatever you are drinking now, double it if it is less than 40 oz per day. Dehydration can make chronic pain worse. Make sure you stay hydrated by drinking an adequate amount of water. Avoid caffeinated drinks, like coffee and tea, as well as alcohol since these beverages will actually make you more dehydrated.
Move more. Analyze how much you sit and how much you move. Adjust accordingly—even if it’s a small amount.
Find support in fellow pain warriors. Stay connected with others who might share the same battle. Holding space for your pain flare ups with an understanding friend might help you go through those moments with less grief.
Create a sleep routine. One-third of Americans don’t get enough sleep on a regular basis, according to the CDC. The Sleep Foundation offers these tips to build a better sleep routine: decide on bedtime, leave electronics alone, have a light snack or bedtime tea, take a warm bath, listen to music, stretch & breath, practice meditation, read a good book, write down a to-do list or journal and prep your bedroom. Pick 1-2 changes you can start implementing today.
Research your pain management options
It’s common that most people do not know the difference between conventional pain management and interventional pain management. Conventional pain management includes medication treatments and over-the-counter medication to manage pain flare-ups. Essentially any type of treatment that does not invade the body in order to alleviate pain. It does not address the root of the problem; it simply band-aids. Interventional pain management (IPM) focuses on finding the root cause and interrupting the pain cycle. IPM is an ideal treatment for both acute and chronic pain and can be used to alleviate even the most complex source of pain. Interventional pain management doctors partner with you to establish a comprehensive treatment plan that addresses your specific needs. Pain sufferers are aware of the opioid epidemic that plagues our nation. Interventional pain management doctors are at the forefront of making a change to better the lives of pain sufferers through comprehensive treatment plans.
[maybe more on what an interventional pain doctor does?]
IPM doctors start with a thorough evaluation of your pain and overall health. With this data, the doctors consider all of the available, relevant treatment options and create the plan that best addresses the causes of pain. For a more complete look at IPM, read our blog from last month.
Everyone's pain is different and there are many factors that cause flare-ups. Stress, depression, anger, anxiety or fear, intrusive thoughts, isolation, underdoing, or overdoing can create more pain signals in the body. Taking back your life by putting yourself in charge of your day helps you manage chronic pain better.
The goal of interventional pain management is to help you find the best function and quality of life possible.
If pain is disrupting your life, there’s hope. Our interventional pain management team can help you take control of your health by providing you with information and treatment options. It’s time to get your life back. There’s no reason for you to suffer. Your first step is to click or call. Our Care Team is ready to walk you through your recovery, step by step. We provide expert pain care, close to home.
According to Dr. Pankaj Mehta, our Chief Medical Officer, “The priority of interventional pain management (IPM) is finding the root cause and interrupting the pain cycle. IPM is an ideal treatment for both acute and chronic pain and can be used to alleviate even the most complex source of pain.”
To describe what we do as “pain management” would be true, but it wouldn’t tell the full story. Yes, we provide pain management, but it goes much further than that.
We provide a variety of interventional treatment modalities to help manage your pain by creating a personalized plan —no matter what the cause or source.
As Dr. Mehta says, “We partner with patients suffering from pain. We help them optimize pain control, enhance daily functionality, and improve physical and psychological well-being.”
What’s the difference? Conventional pain management includes medication treatments and over-the-counter medication to manage pain flare-ups, essentially any type of treatment that does not invade the body in order to alleviate pain. It does not address the root of the problem; it simply band-aids.
Patients frequently come to us with multiple “pain generators,” which are sites of illness or injury that contribute to pain and suffering and detract from your quality of life.
Pain not only affects you, but it can also affect your friends and family, and potentially your work productivity. It can impact every aspect of your life, from difficult physical exertion to common tasks, like tying your shoes.
First, we believe it’s critical to listen to the patient; to go beyond the traditional doctor-patient relationship, and create a partnership. Plus, no two people experience pain the same way, so personalized plans are critical.
Our approach to interventional pain management begins with a conversation. We listen to your concerns and your needs; how pain is affecting your life.
“This is why a partnership is important,” says Dr. Mehta. Because if you don't individualize the pain treatment for each patient, the outcome may not be as effective.
Along with our Care Team, we thoroughly process the information, imaging, and diagnostic testing to determine a diagnosis. The diagnosis helps us determine the range of treatment methods to address your pain. We take the “S.A.V.E.” approach to your course of treatment: Surgery At the Very End. There are many less invasive options to help you regain a functional life.
We create a “pain management ecosystem,” a complete program of the specialists, therapies, and other elements needed to reach your goals. A vital part of this ecosystem is your involvement.
According to Dr. Mehta, “We educate you on the non-opioid therapies available. This education not only empowers you on the choices you have but can help with your peace of mind.”
Our goal is to create a comprehensive approach to treat your suffering, to allow you to enjoy the quality of life you want.
We’re not limited to back and neck pain. We treat all kinds of pain, from headaches down to foot pain and neuropathy—and all points in between.
If pain is disrupting your life, there’s hope. Our interventional pain management team helps you take control of your health by providing you with information and treatment options. It's time to get your life back. There’s no reason for you to suffer. Your first step is to click or call. Our Care Team is ready to walk you through your recovery, step by step. We provide expert pain care, close to home.
The U.S. Centers for Disease Control and Prevention estimates as many as 100 million U.S. adults suffer from chronic pain. More alarming was that 8 percent of U.S. adults (19.6 million) reported having high-impact chronic pain directly proportional to suffering. Clinicians at Pain Specialists of Austin and Central Texas Pain Center have helped thousands of patients by identifying and treating the source of their chronic pain.
Chronic pain, as explained by Dr. Pankaj Mehta (MD, DABA, DABPM), a nationally renowned interventional pain doctor and Medical Director at Pain Specialists of Austin and Central Texas Pain Center, is pain that persists for at least three months, despite treatment, with an intensity that disrupts normal physical function and sleep patterns, reduces strength, limits daily activities and negatively impacts one’s ability to work and recreate with family and friends.
According to Dr. Mehta, chronic pain is generally the result of damaged, inflamed or dysfunctional nerves resulting from structural deterioration associated with aging, physical injury or trauma, muscle strain and disease. Conventional pain management (CPM) treats pain with medications and prescription drugs. Medication temporarily alleviates pain symptoms but does not fix the cause of the pain. There’s a better method for treating chronic pain with interventional pain management (IPM). IPM focuses on identifying the underlying structural cause of the pain and interrupting nerve transfer of pain signals at their source. We don’t just treat the pain symptoms; we treat the structural cause of your pain.
“Pain almost always has an underlying pathology, a structural deficit that in many cases can be treated effectively with advanced IPM,” he explained. “If you have chronic pain, there has to be a nerve or a group of nerves involved, which a local anesthetic block can diagnose.
This approach to addressing the underlying cause of your chronic pain is a concept Dr. Mehta calls “dampening the bad electric signals,” which he does through therapies such as nervous system stimulation or correcting spinal nerve compression via minimally invasive advanced spine therapies.
Pain does more than hurt physically,” he added, “it can impact physical, emotional and psychological well-being preventing individuals from being able to live a full and happy life.”
Dr. Mehta has found that many pain sufferers assume that they have no choice but to live with debilitating discomfort. Many times, they become discouraged after less effective treatment options do not work.
“Many people believe pain is an inevitable consequence of getting older, a lingering injury or a hereditary condition that runs in their family. Some hope the pain will just go away. Others don’t want to be perceived as complaining to their family and friends, so they just suffer in silence.”
Unfortunately, “a primary barrier to pain sufferers seeking treatment is a fear that they will be prescribed, and then become addicted to, opioid drugs.” That’s due to a public perception that “pain management treatment can only be accomplished with opioids,” he said, which, ironically, can be both an attraction and a repellent to people seeking pain treatment. “We’ve had people tell us that we don’t care about them because we won’t prescribe opioids, however, our unwillingness to allow them to become dependent on opioids shows how much we do care about them. We seek a long-term solution and not a quick, short-lived medicative numbing approach for their chronic pain.”
To learn more about Pain Specialists of Austin’s and Central Texas Pain Center’s multi-disciplinary, interventional pain management treatment options and how the science of pain management can change your life, please visit their website www.psadocs.com.