Managing Flares in Your Chronic Pain

Chronic Pain is pain that persists for more than a few months. Temporary increases or flares in chronic pain are expected. A chronic pain flare is not a new pain – it is more severe occurrence of the already existing pain. This does not mean you have a new injury. It is important to remember that flares are going to happen, and in most instances will resolve on their own. Twin Cities Pain Clinic provides you with tools you may use when your pain flares up. 

Rest – take breaks when needed, and get adequate sleep. Avoid activities that are likely to trigger your pain. Reduce your exercise routine slightly, but don’t completely stop it. It is important to keep moving during this time. Mobility is a key part of managing your pain and lack of movement can actually make your pain worse. 

Hot Showers or Baths – a hot shower or bath will help dilate the blood vessels, promote blood flow, and help sore and tightened muscles relax.  

Ice Packs or Heating Pads – use ice or heat, whichever feels the most comfortable for you. unless this is a band new injury, it is ok to use heat. Some people find it helpful to alternate the two – ice for 20 minutes, followed by 10 minutes of heat. (Do not ice for more than 20 minutes at a time and do not fall asleep with the heating pad on).

Distraction – watch TV, read a book, play a game or try to go for a walk. Think of an activity that will help to take your mind off of the pain.   

Deep Breathing – find a quiet place to rest and breathe in and out slowly and rhythmically for 10-15 minutes. 

Yoga – yoga helps our bodies relax, which can help muscle spasms. 

Massage – massage therapy relaxes muscle tissue, which reduces painful contractions and spasms. 

Please schedule an appointment with your provider if the pain does not start to improve after 1-2 weeks, if you have new symptoms, or if you have a change in the function of your arms or legs. 

“Besides pain killers, I tried shots, nerve burnings, triggers, and multiple injections, but I was still in agony. I couldn’t vacuum or walk. I just sat in a chair. Now I can finally go shopping again and do the things I want to do.” – Tami

Targeted drug delivery is an alternate route of delivering pain medication at a fraction of the typical oral dose. The therapy is proven, safe, and effective for managing chronic pain. An implantable pump is filled with pain medication. The pump is connected to a thin, flexible tube called a catheter. The system continuously delivers the drug directly into the fluid surrounding the spinal cord, in an area called the intrathecal space. That means much less pain medicine and fewer side effects. Oral pain pills must be digested, enter the bloodstream, and cross the central nervous system to reach pain signals. Targeted drug delivery works directly at the source to stop nerves from sending pain messages. 

Potential Benefits of Targeted Drug Delivery

• Improved ability to function and participate in day-to-day activities
• Effective pain relief
• Less or no need for oral pain medication
• Fewer side effects compared to oral medication
• Patient satisfaction
• Personalized – you can manage your own pain therapy by delivering a dose of medication within your doctor’s pre-set limits
• Surgically reversible

A key advantage of Targeted Drug Delivery is that you can try it first and experience how the therapy may work for you!

Like test driving a car, the screening trial allows you to “test drive” targeted drug delivery before committing to long-term therapy. The screening trial allows you to assess how targeted drug delivery may relieve your pain during daily activities, experience how it feels to receive pain medication targeted to the intrathecal space and decide if you want to go ahead with an implant. 

Ongoing Care

The pump needs to be refilled periodically with your medication. Refills are important for providing you with continuous pain therapy. Your doctor may also adjust the dose so you receive the best pain relief possible. Be sure to make and keep your refill appointments! Missing a refill appointment could result in:

• Underdose (too little medication), which could lead to withdrawal symptoms
• Loss of pain relief therapy, or a change in your therapy
• Pump damage that could require pump replacement surgery 

To read more about Intrathecal Pain Pumps please visit http://twincitiespainclinic.com/services/intrathecal-pain-pump/ or call 952-841-2345 to schedule an appointment with one of our experts!

References:

http://www.medtronic.com/us-en/healthcare-professionals/therapies-procedures/neurological/targeted-drug-delivery/education-training/about-the-therapy.html

Do you have chronic, debilitating pain that has lasted longer than 3 months?

Have you tried and failed conservative therapies?

Don’t want to pursue surgery due to risks and long recovery?

Spinal Cord Stimulation might be an effective treatment for you! Let’s break down the different parts of a Spinal Cord Stimulator:

The Generator – A small device that sends out mild electrical pulses, which contains a battery. This is implanted in your body.

The Leads – Thin insulated wires that carry the electrical pulses from the generator to your spinal cord. These are placed in your body along your spinal cord.

The Patient Controller – A handheld “remote control” that allows you to adjust the strength and location of stimulation or even turn stimulation off. Twin Cities Pain Clinic offers all of the leading SCS brands. Ask your provider today to help determine the right device for you!

Click here to read more about Spinal Cord Stimulation.

Click here for SCS Frequently Asked Questions.

If you have chronic pain, you may be wondering how you will be able to manage the holidays. Getting together with family and friends is great, but all the events and obligations can make the season exhausting – and painful. Twin Cities Pain Clinic offers our top strategies for a less stressful, more comfortable Thanksgiving!

1.  Make a list of your priorities

Before the holidays approach, think about what you really enjoy about this time of year. Make a list of your favorite activities. If a longtime tradition has become more of a chore than a celebration, take it off your list.

If you are suffering from chronic pain, you may need to make a few changes to your holiday plans that require a lot of standing, bending or lifting. If you love to cook a big family meal, for instance, see if a friend or family member would be able to stop by and help so you aren’t bending over a hot oven by yourself.

2.  Let others help

“If there’s anything I can do, let me know!” We have all heard this before. This is the time of year to have your answer ready! Whether it is shoveling the sidewalk, picking up the ingredients for a pumpkin pie, or bringing in the Christmas tree. Make a detailed list of your holiday duties that could add to your pain – and leave yourself off the list. See if there is a family member or friend that could help you out with the more difficult tasks.

Setting priorities and doing less can be difficult, especially if you’re someone who usually takes care of everyone else. By planning ahead and delegating duties you are making a very important commitment to your health and well-being.

3.  Keep moving

Climbing a ladder to put the star on the top of the tree should be avoided, but don’t abandon your exercise routine. Stretches and gentle aerobic exercises, such as walking, can help improve your outlook by producing endorphins, the body’s natural pain reliever.

Exercise can help counteract depression, which has the potential to develop alongside chronic pain. Swimming or doing water exercises in a warm pool can be a soothing health break from the holiday rush.

4.  Get it delivered

Many of your local restaurants and retailers offer delivery services. Call your favorite restaurant or grocery store or check on its website to learn about delivery options. Some places offer economical dinner packages for a group. Avoiding the bending, lifting and twisting involved in shopping and cooking for a large group is probably worth the cost of the meal.

5.  Travel Pain Free

Traveling during the holidays can aggravate your pain. Make sure to consider your pain while scheduling flights or long car rides. Try to book a direct flight when possible, the less time spent cramped in the air the better. Bring a back support cushion, back roll, or even a couple of pillows to support your back, keeping pain at bay.

Pack light- a heavy bag can be more than just an inconvenience, it can cause or aggravate back pain by straining muscles and joints. To avoid unnecessary strain, it’s best to use a light suitcase with wheels and a handle for rolling it. Instead of stuffing one large suitcase full, it’s often better to use a few smaller bags. 

Ask the Professionals

Still have questions? Don’t hesitate to contact your provider at Twin Cities Pain Clinic for tips, tricks, or resources that align with your particular diagnosis or pain situation. Be thorough in your travel plans to ensure we can best meet your needs.

From the Twin Cities Pain Clinic family to yours, we wish you safe travels and a wonderful Thanksgiving Holiday with your loved ones.

Joint Injections: Instant & Long-Term Pain Relief

Injection of pain-relieving medication is a commonly known treatment option for those suffering with back pain. Did you know that other sites such as, shoulder, hip and knee pain can also benefit from an injection? It’s true, knee pain, hip pain, and shoulder pain can all be successfully treated with a joint injection!

How Does It Work?

A joint injection is a procedure used to help treat inflammatory conditions of the hip, shoulder, or knee. A long acting anti-inflammatory medication (steroid) mixed with a local anesthetic (numbing agent) is injected into the joint. The steroid helps to decrease the inflammation that causes swelling which should reduce the pain. These injections may contain various medications; a physician will determine what is appropriate based on your particular condition.

The Procedure

The injection is done by a physician under fluoroscopy (x-ray) or ultrasound. You will be brought into the procedure room and placed in position for the injection. If you are receiving oral or IV sedation, this will be administered prior to the procedure. Your skin will be cleaned at the injection site. The fluoroscope (x-ray machine) or ultrasound will be used to help visualize the needle as it is guided to the appropriate site and the numbing medication mixed with steroid is then injected. After the needle is remove, the site may be covered with a small bandage.

We recommend that you take it easy for the remainder of the day. You may resume normal activities the next day. You may experience tenderness or aggravated symptoms for several days after the injection. You may use ice packs to help with this pain. Patients usually feel relief after a few days; however, it may take 10-14 days to take effect.

Results?

Pain relief using join injections is expected to last several months or longer. If needed, the injections may be repeated a few times during the year. Although the injections do not change the underlying condition, they can break the cycle of pain and inflammation and allow time for exercise or physical therapy to strengthen muscles and get the joint moving again in order to decrease ongoing problems. This innovative procedure promotes healing and the potential for permanent improvement.

Learn more about Bursa Injections, Epidural Steroid Injections, Sympathetic Nerve Blocks, and Radiofrequency Neurotomy for the treatment of pain. 

Short-term relief from nicotine brings long-term problems.

It is no secret that smoking can wreak havoc on your health, but did you know that this bad habit may have a surprising connection with your back pain? In many recent studies, smokers seem to be more likely than nonsmokers to suffer with sore backs. This trend holds true for men and women, manual laborers and white-collar workers. These investigations raise many new questions about the root causes of pain. It also gives smokers a new motivation to pursue a healthy and pain-free lifestyle by “putting out” their old habit. (2)

According to many pain management specialists, smoking and nicotine use may worsen your pain over time. Did you know, smokers are nearly three times as likely to get lower back pain? About 18 percent of people in the United States are smokers, according to the Centers for Disease Control and Prevention. Yet smokers make up more than 50 percent of patients who seek pain treatment. (1)

Smoking is more than a bad habit.

The nicotine in tobacco can trick the body into feeling good – at first. It triggers the release of chemicals, like dopamine, which give off a satisfying, “reward” sensation. It’s what makes smoking so addictive.

But that same tobacco also impairs the delivery of oxygen-rich blood to bones and tissues. Decreasing blood and nutrient flow can cause degeneration, particularly in discs of the spine, which already have more limited blood flow. The result can be lower back pain and sometimes osteoporosis.

Physicians also link smoking with fatigue and slower healing, factors that make painful conditions more prominent. Researchers are exploring even more physiological reasons why smoking makes people with fibromyalgia, arthritis and other chronic pain hurt more. (1)

Quit Today

Giving up cigarettes will dramatically lower the risk of serious conditions such as heart disease and cancer. Kicking the bad habit may also help diminish your back pain!

Twin Cities Pain Clinic has some suggestions on how to help you quit smoking:

·        Schedule your “quit day”

·        Ask your doctor about medication or nicotine replacement products.

·        Get support from family and friends, or join a support group.

·        Avoid alcohol and other triggers

·        Take a walk whenever you feel the urge to smoke.

Our bodies are made up of many remarkable systems. When we make healthy lifestyle choices, it has the opportunity to run like a well-oiled machine. Smoking cessation, healthy diet, and exercise are all decisions that will help you live your life with less pain! 

References:

(1.) https://health.clevelandclinic.org/2017/08/why-smoking-will-worsen-your-chronic-pain/

(2.) https://consumer.healthday.com/encyclopedia/back-care-6/backache-news-53/back-pain-and-smoking-645336.html

Palmer, K.T. et al. Smoking and musculoskeletal disorders: Findings from a British national survey. Annals of the Rheumatic Diseases. January 2003. 62: 33-36.

Goldberg, M.S. et al. A review of the association between cigarette smoking and the development of nonspecific back pain and related outcomes. Vol.25 (8): 995-1014.

Deyo, R.A. and J.N. Weinstein. Primary care: Low back pain. New England Journal of Medicine. Vol. 344 (5) 363-370.

Mikkonen, P, et al. Is smoking a risk factor for lower back pain in adolescents? A prospective cohort study. Spine. March 1, 2008; 33(5): 527-32.

Did you know that 8 out of 10 people suffer from back pain at some point in their lives? Both women and men are prone to posture and back problems. Whether you’re in the midst of fighting the ache or just want to prevent it, here are some quick-and-easy ways to keep your back healthy and strong!

Keep Moving: An exercise routine that combines stretching, strengthening, and aerobic activity will keep your body and mind healthy! 

Eat Your Veggies: Proper nutrition is key to a healthy and active lifestyle! Try to choose whole foods like fruits, vegetables, whole grains and lean proteins.

Say no to Smoking: It is no secret that smoking has negative effects on your overall health, but did you know that smokers experience more spine pain and heal more slowly than nonsmokers?

Catch some ZZZ’s:  Getting proper rest is vital to your overall health. Choose a mattress and pillow that are comfortable and keep your head and spine aligned during your beauty rest.  

Stand up Straight: By practicing good posture you are promoting a strong and healthy spine! When you slouch or stoop, your muscles and ligaments strain to keep you balanced – which can lead to back pain.

Bottoms Up: Drinking more water throughout your day is a simple preventative step to protect against developing back pain and can even help reduce existing back pain.

Lighten Your Load: If your backpack or purse tips the scales at more than 10% of your weight, it’s too heavy! When choosing a bag try to find one with a long strap that is positioned across your chest, like a messenger bag!

Strengthen That Core: Having strong abdominal muscles can help protect your back from injury.

Dr. Will is the first in Minnesota to implant the new Proclaim DRG Neurostimulator system by Abbott!

On October 18^th at Twin Cities Surgery Center, Dr. Andrew Will implanted the first Proclaim DRG Neurostimulator system in Minnesota! Dr. Will continues to be at the forefront of his specialty, offering the most advanced treatment options.

According to Abbott, the new Proclaim platform is the only system that is FDA-approved to stimulate the dorsal root ganglion (DRG), an effective therapy that provides precise relief for patients suffering from focal chronic pain of the lower limbs due to CRPS. The Proclaim DRG Neurostimulator is the most advanced technology for patients’ convenience and comfort.  

At Twin Cities Pain Clinic, we have made it our mission to help patients get back to living their life with less pain. Dr. Will and his team of trained professionals combine compassion with extensive medical knowledge and the most recent technology to give their patients the best treatment in pain management possible. 

Click here to read more about DRG Stimulation.

Dr. Will remains at the forefront of his specialty of Pain Management. On October 2nd, he had the opportunity to speak at the Pain Management Roundtable at the Capitol in St. Paul. Dr. Will provides his professional insight on pain management therapies and the increasing amount of technology available to combat the opioid crisis.

Local medical device companies joined forces with local lawmakers to tackle the opioid addiction crisis. The focus of the roundtable, hosted by Medical Alley Association, was to bring up new alternatives that do not involve using prescription opioids for the treatment of chronic pain. Dr. Will and the medical community wanted to shine the spotlight on other treatment options to curb the opioid addiction.

“Opioids are not cheap even though they may look like it at first glance,” said Dr. Andrew Will, medical director of the Twin Cities Pain Clinic. “Some of them honestly are expensive right at first glance, Sometimes they’re over $1,000 a month just for the medication. Some of the other procedures we’re talking about, even though they have a bigger upfront cost, pay for themselves in two years.”

Intrathecal Pain Pumps, Injections, Spinal Cord Stimulators and physical therapy are some of the alternatives. It is important to note that there is no one therapy that will work for everyone. Chronic pain is unique to every individual, and treatment plans need to be individualized to each patient.

The summit on October 2nd is the first of a series of roundtable meetings hosted by Medical Alley Association.

Given the national crisis involving opioid abuse, it’s more important than ever for the millions of patients suffering from chronic pain to have access to new non-opioid treatment options. Twin Cities Pain Clinic and Twin Cities Surgery Center is the first facility in Minnesota and the Midwest to offer the Intellis™ platform including the world’s smallest implantable spinal cord stimulator (SCS) for the management of certain types of chronic intractable pain.

Chronic pain is a debilitating condition that can negatively impact all aspects of a person’s life – relationships, work productivity and activities of daily living, yet it remains under-recognized and undertreated.¹ Chronic pain is challenging to manage and neurostimulation has been proven to provide effective long-term pain relief and improve quality of life, in addition to being a treatment option for patients interested in trying a non-drug alternative.^2-6

Access to a new cutting-edge treatment option should offer new hope to Minnesota residents struggling with debilitating pain, like William “Bill” Kuehl. Bill was one of the first in Minnesota to receive the new Intellis™ SCS device. Bill’s pain started as a result from meningitis and a hip replacement. Since then he has struggled with severe pain in his back and lower limbs. When asked about how his new SCS has affected his quality of life and overall health he responded with, “When the SCS is turned on, life is great! I cannot imagine living without it.”

Bill enjoys nature and considers himself to be a true outdoorsman. He is a wonderful photographer, and with the help of his Spinal Cord Stimulator his is able to continue his passion by catching unique perspectives of wildlife and landscapes. He enjoys spending time with his family, and traveling with his wife, Marilyn. Bill is truly excited for his new Intellis Spinal Cord Stimulator and all of the user-friendly adaptions it has to offer. When asked if he would recommend the treatment option of spinal cord stimulation to others he responded with, “All I can say is, WOW!”

William Kuehl is willing to share his motivating, first-hand experience to help others and Dr. Will also welcomes the opportunity to further discuss chronic pain and treatment options. If you have a question regarding Spinal Cord Stimulation or our treatment options, do not hesitate to call our clinic at 952-841-2345.

Chronic pain has a significant personal impact and the fact that Spinal Cord Stimulation may provide pain relief is extremely important as Minnesota and the nation prepares to combat the opioid crisis. Spinal Cord Stimulation fights pain with technology and is a revolutionary non-opioid therapy.

References:

¹ Mekhail N, Wentzel DL, Freeman R, Quadri H. Counting the costs: case management implications of spinal cord stimulation treatment for failed back surgery syndrome. Prof Case Manag. 2011;16(1):27-36.

² North RB., Kidd DH., Farrokhi F, et al. Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial. Neurosurg; 56: 98–106 (2005).

³ Kumar K., Taylor RS., Jacques L, et al., Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicenter randomised controlled trial in patients with failed back surgery syndrome. Pain; 132: 179–188. (2007).

⁴ Kemler MA., De Vet HCW., Barendse GAM et al., The effect of spinal cord stimulation in patients with chronic reflex sympathetic dystrophy: two years’ follow-up of the randomized controlled trial. Ann Neurol; 55: 13–18 (2004).

⁵ Taylor RS, Spinal cord stimulation in Complex Regional Pain Syndrome and Refractory Neuropathic Back and Leg Pain/Failed Back Surgery Syndrome: results of a systematic review and meta-analysis. J Pain Symptom Manage; 31: S13–S19 (2006).

⁶ Cameron T, Safety and efficacy of spinal cord stimulation for the treatment of chronic pain – a 20 year literature review. J Neurosurg Spine; 100: 254–267 (2004).