NEW! Micro-Dosing Intrathecal Pain Pump Therapy

Twin Cities Pain Clinic Offers New Pain Pump Micro-Dosing Treatment 


Twin Cities Pain Clinics have been experts in Intrathecal Therapy for years, but Micro-Dosing is a new option for this pain treatment. Micro-Dosing follows FDA guidelines and requires specific preparation prior to the treatment for safety and better results.

An intrathecal pain pump is an implantable device that provides constant delivery of medication into the space around your spinal cord (intrathecal space). This new therapy uses a low dose of medication in the pump to give patients better pain relief and a better quality of life. This can also minimize risks and side effects of opioids. 


What is Micro-Dosing?  Micro-Dosing is the use of small amounts of FDA approved pain medicine that is pump directly into the area that surrounds the spinal cord. Micro-Dosing is a very safe treatment option and only requires a small amount of medication. 

Is this right for me?

  • Are your medications giving you your life back or do they merely “take the edge off”?
  • Do you have side effects like constipation, nausea, or drowsiness from medications?
  • Are you concerned about addiction? Are you needing higher dosages of medications?

How do we use a low dose?  The goal of opioid medication is to improve your function and quality of life and provide more stable pain relief.

  • Low dose opioids in a pump allows us to deliver the medication more directly to the area of pain.
  • Using a pump gives you a consistent flow of medication so that you are not experiencing the “ups and downs” associated with oral medication.
  • Low dose intrathecal medication greatly reduces your risk of side effects. People with pumps typically report a decrease in symptoms like constipation or nausea.
  • Using low dose opioids decreases the risk of hyperalgesia and tolerance. 
    • Tolerance: your body needs more of the same drug to have the same relief
    • Hyperalgesia: opioids may cause “opioid-induce hyperalgesia.” What this means is that opioids cause chemical changes in your brain which actually make you more sensitive to pain. 

If you are interested in this new Micro-Dosing Intrathecal Therapy for pain please contact your Twin Cities Pain Clinic provider or call 952-841-2345

When To Seek Pain Management

When should I seek help for pain management? 

Patients suffering from chronic pain should not wait until their pain is so severe that it has begun to affect their lifestyle. Often patients who suffer from a post-surgical or traumatic injury are referred by their surgeon. When the pain persists for at least six months or becomes disabling, patients should consult a physician. If patients do not find relief through medication therapy or other more traditional methods, they should not ignore their pain. They should talk to a physician and ask for a referral to alternate treatment plans such as a pain management specialist. The sooner patients begin to manage their pain, the easier it will be to stay in control of it. 

What are the long-term effects of not managing pain?

Chronic pain and its associated treatment are often misunderstood. These misunderstandings often lead to incorrect assumptions about pain management. It is imperative that patients and employers understand the costly effect of chronic pain when it is left untreated. When it is not managed, it can lead to a series of physical, emotional and financial problems that negatively impact a patient’s quality of life. 

Pain often prevents a person from performing simple tasks such as exercise, housework or job-related tasks. According to the American Chronic Pain Association, pain accounts for $61.2 million per year in lost productivity for business.

When one area of a person’s life is out of control, it is likely that other areas will also be affected negatively. For instance, when a patient is no longer able to perform well at work, they may be absent frequently or may be less productive on the job. This leads to job loss and financial stress.

When an individual loses mobility, and is unable to function physically, they may experience weight gain, muscle atrophy and sometimes diabetes. While this has an obviously negative effect on the person’s physical health, it also has a negative impact on a person’s emotional health. This could lead to depression and anxiety disorders.

There is no reason for patients to suffer unnecessarily. There are treatments available through interventional pain physicians that can provide the patients with the relief they need to get back to leading a healthy, productive lifestyle. 

Improving Quality of Life with Fibromyalgia

People with fibromyalgia can improve how they feel. “This may seem out of reach when you’re feeling hopeless and depressed, but it’s true,” said Twin Cities Pain Clinic Nurse Practitioner and fibromyalgia specialist, Nancy Cleveland. “The first step is to rule out other more life-threatening diseases because the symptoms can be similar to so many other illnesses.” 

What is Fibromyalgia? Fibromyalgia (fi-bro-my-al-gee-uh) is a disorder that causes pain in your muscles, joints, ligaments and tendons. the pain is especially intense when pressure is applied to areas called “tender points.” Common tender points are the back of the head, the elbows, the shoulders, the knees, the hip joints, and around the neck.

Fibromyalgia affects around 3-6% of he population in the United States. This disorder might be hereditary, so you may have family members with similar symptoms. More women than men have fibromyalgia. 

What are the symptoms of fibromyalgia? Increased sensitivity to pain is the main symptom of fibromyalgia. Many other symptoms also occur in people with this disorder. Symptoms may come and go- here are a few of them:

You may have some degree of constant pain, but the pain may get worse in response to activity, stress, weather changes and other factors. You may have a deep ache or a burning pain. You may have muscle tightening or spasms. Many people have migratory pain (pain that moves around the body.)

Most people with fibryomyalgia feel tired or fatigued. This fatigue may be mild or very severe. You may also have trouble sleeping, which may add to the fatigue.

Depression or anxiety may also occur as a result of your constant pain and fatigue, or the frustrations you feel with the condition. “Depression is huge. No one can see your source of pain, but you know it’s real,” said Cleveland, who sees multiple patients a week with fibromyalgia. “Psychotherapy sessions can be a tremendous help. It’s an important step in getting over this huge hurdle and on your way to developing coping skills.”

The good news is that fibromyalgia does not cause any permanent damage to the muscles and organs. This is not a life-threatening disease, but it is chronic. Although there is no cure, there are many things you can do to feel better.

What can I do to relieve my symptoms? Find an exercise that gets all your body moving and do it consistently, according to Cleveland. Yoga classes, warm water therapy, swimming, and low-impact aerobic exercises are among the best things you can do. “The important lesson here is to not overdo it when you’re feeling good,” said Cleveland. “This can lead you to have several bad days. It is more important to find out how much you can exercise and remain consistent on good and bad days. You will want to strike a balance.” Many people find that a routine time to eat, sleep, and exercise helps to ease their symptoms.

You may need to begin at a very low level of exercise (5 minutes every day is helpful at first). Continue to increase the length and frequency of exercise until you are exercising for at least 30 to 60 minutes, 3 to 4 times a week. Once you reach this point you can consider switching to higher-impact exercise, like walking, jogging and tennis. A physical therapist experienced in treating fibromyalgia can help you develop an exercise regime to follow at home.

Because the symptoms of fibromyalgia are made worse by stress and poor sleep, it is important to cut stress out of your life whenever possible and to get as much sleep as you need. Since alcohol and caffeine can contribute to poor sleep, avoid these substances around bedtime. 

Is there any medicine I can take to help my symptoms? Several medicines can help reduce the symptoms of fibromyalgia. Many of these medicines are taken before bedtime and help reduce pain and improve sleep.

Your doctor may recommend treating your symptoms with acetaminophen (one brand: Tylenol) first. He or she may also prescribe another medicine for you to take, non-steroidal anti-inflammatory medicines are not usually effective in treating fibromyalgia when taken alone. 

“In addition to all these steps, you need to have the mental mindset to do the things that will help improve your pain symptoms,” said Cleveland. “That means choosing something even if you’re not feeling up to it and appreciating the good things, even if it’s just the weather. It goes a long way in improving your psyche.”

Depression and Chronic Pain

Unlearning Helplessness: Fighting Depression and Staying Optimistic When Dealing With Chronic Pain

In the medical and psychological communities, the idea that a sick person’s mental status and stress-coping mechanisms affect their body is hardly new. Years of studies have demonstrated the power of the mind in healing the body: keeping an optimistic attitude lessens chronic pain and speeds recovery. Some studies suggest that optimism boosts the immune system – preventing disease and helping the body recover from illness faster – and a recent Mayo Clinic study even shows that people with an optimistic outlook live 20 percent longer than those who see the glass half-empty.

For chronic pain patients, there are obvious health benefits to being optimistic – but is your personal attitude and outlook on life really something you can control? Can you actually turn years of pessimistic and depressed thoughts upside down during a time of such great challenges for your body and your mind? 


Many lifelong pessimists fall into a behavior pattern called learned helplessness – a sense of a complete lack of control over one’s life, or that one’s actions are futile and will have no effect on the outcome of a bad situation. In a way, the patient has “given up” on changing his or her situation. First theorized by psychologist Martin Seligman in the late 1960’s, learned helplessness is an all-encompassing life outlook that affects the way an individual copes with emotional as well as physical pain: uncontrollable bad events disrupt a person’s ability to adapt to stress, while controllable bad events can be changed or avoided (making them less stressful).

Chronic pain patients often fall into this pattern because they begin to see their pain as an uncontrollable event. Without the comfort or hope of relief, pain patients can easily fall into depression, reject the support of loved ones, or abandon their search for solutions. It’s important to stay positive by remembering that treatment centers – such as Twin Cities Pain Clinic – provide a wealth of innovative treatment options and programs for managing chronic pain. The “helpless” coping style is learned – and it’s possible to retrain your outlook by disputing your own views, building a support network, and actively looking for a solution to your problem.

Don’t let pain control your life – or define who you are.  

Eating Your Way to Reduced Pain

Food Tips for Chronic Pain Patients

With treatment from a pain specialist, physical therapy, and some other lifestyle alterations, chronic pain patients can help keep their pain under control. Research is showing that what we eat can also have an effect on the body’s pain levels – especially in fibromyalgia patients.

Many experts blame fibromyalgia pain on oversensitive nerve cells in the brain and spinal cord, and certain foods may stimulate the release of neurotransmitters that heighten this pain. While research in the area is young, specialists have compiled a list of healthy and helpful eating tips for patients with back pain, neck pain, fibromyalgia and other types of chronic pain. 

Eat more whole fruits and vegetables, legumes, and omega-3 fatty acids. Research shows that a diet high in fruits, vegetables, and omega-3’s increases inflammation in the body, increasing muscular and joint pain. A diet high in whole, fresh foods also helps control weight – and as overweight pain patients tend to report more severe pain, controlling weight can indirectly help control pain. 

Eat less refined, processed “junk food”. Heavily refined, sugary, and chemically processed foods are known to irritate muscles, disrupt sleep, and interfere with immune function – three things that can enhance chronic pain. Aspartame, a chemical sweetener used in diet soft drinks, has also been found to heighten pain sensitivity in some fibromyalgia patients.  

Avoid nightshade vegetables. While vegetables are a nutritious and important part of a pain patient’s diet, vegetables in the nightshade family – such as tomatoes, potatoes, and eggplants – can increase joint pain and arthritis symptoms in some individuals due to neurotoxins in the plants. While many will experience no difference, some sensitive patients will improve remarkably without nightshade vegetables.  

Preventing Knee Pain

Keeping your knees agile and pain-free!

Minnesotans are known for pushing themselves to the limit in order to make the most of our long summer days – golfing, tennis, water skiing, biking, and running can all take a toll on the knees, especially if you’re middle-aged. Almost one in three Americans older than age 45 report some type of knee pain, and it’s a common reason that people visit their doctors or the emergency room, according to the Mayo Foundation for Medical Education and Research.

Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Or, certain medical conditions, including arthritis, gout and infection, may be at the root of your knee pain. More serious injuries, such as a ruptured ligament or tendon, may require surgical repair. Many relatively minor instances of knee pain respond well to self-care measures.

Although every knee problem can’t be prevented – especially if you’re active – you can take certain steps to reduce the risk of injury or disease. Here’s how. 

Move More – “I know it sounds counter intuitive, especially if your knee is sore, but the most important thing for knee health is to be active,” says Leigh Callahan, Ph.D., an associate professor with the Thurston Arthritis Research Center at the University of North Carolina. “A knee that isn’t used stiffens; the muscles around it start to atrophy, and because these muscles would otherwise absorb some of the shock that moves up the leg with every step, a stiff knee has to take on more of the body’s weight than a supple one.”

Strengthen Your Thigh Muscles – In a recent study of 265 men and women with knee osteoarthritis, Mayo Clinic researchers found that those with the strongest quadriceps (thigh muscles) had less knee pain and better physical function than those with the weakest. But there’s a right way and a wrong way to build those muscles. If you’re an avid gym-goer, avoid the leg-extension machines, Kenny suggests. “They put far too much stress on the knee joint,” he says.

Stretch Regularly – Maintaining flexibility is important, especially in the muscles and tendons that connect directly to the knee, such as the hamstrings and the quadriceps. If these tissues become overly taut, they can pull the knee out of alignment. 

Lose The Weight –  Losing as little as 5 percent of your body weight can dramatically reduce your chances of developing knee arthritis, the most common cause of knee pain. 

If your doctor recommends surgery right away, seek a second opinion. Several major studying of arthroscopic surgery to remedy sore knees have found little or no benefit. Physical therapy, as well as anti-inflammatory medicines, can be just as effective – and less invasive.

Normally, the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Depending on your injury, training is likely to focus on the muscles in the back of your thigh (hamstrings), the muscles on the front of your thigh (quadriceps), and your calf, hip and ankle. You can do some exercises at home. Others require the use of weight machines, exercise bicycles or treadmills, which may mean visits to an athletic club, fitness center, or clinic. 


Botox Injections for the Treatment of Migraine Headaches

We’ve all heard of Botox, responsible for generations of smooth foreheads in Hollywood. But Botox has also brought relief to many people who suffer from chronic medical conditions. In 2018 Botox was approved for use with chronic migraine, and many patients are reporting success. What do you need to know before considering it?

What type of Headache Responds Best to Botox?

Botox is only FDA-approved for chronic migraines, which means headache on 15 or more days a month. Botox is not recommended for patients who experience fewer than 15 headache days a month.

What is Botox? 

Botox is a form of botulinum toxin, a neurotoxin produced by the bacteria that causes botulism. When the Botox botulinum is purified and used in tiny doses in specific areas, it temporarily reduces muscle contractions for approximately 3 months.

How Does Botox Work?

Botox is injected around pain fibers that are involved in headaches. Botox enters the nerve endings around where it is injected and blocks the release of chemicals involved in pain transmission. This prevents activation of pain networks in the brain.

Botox prevents migraine headaches before they start, but takes time to work. One treatment lasts for 10-12 weeks, and patients reported that two Botox treatments reduced the number of headache days by approximately 50%.

What is Treatment Like?

When you receive your first Botox treatment, expect to be in the office for about a half hour. Your Certified Nurse Practitioner uses a very small needle that feels like a pinprick. He or she injects small amounts of Botox into shallow muscles in the skin. Each treatment typically involves multiple injections in seven key areas of the head and neck.

The most common side effect from the Botox shots is a sore neck, and we recommend using an ice pack to reduce the discomfort.

It can take up to six months to see the maximum benefit from Botox. In the meantime, you can continue your regular medications with no risk of a drug interaction.



Article from American Migraine Foundation