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Physical Medicine and Pain Management

A study by the Centers for Disease Control and Prevention revealed that chronic pain affects around 20% of U.S. adults.1

Pain has a knock-on effect on your physical and mental health.2 So, it's important to address it early on to prevent deterioration.

Being in constant physical pain is debilitating and stressful. It affects your ability to go about your daily life, and your general health and well-being.

Back pain, sciatica, and neck and shoulder pain are all common conditions that are often affected by our work and lifestyle.3,4 Pain management doctors can assess your pain, rule out serious underlying causes, and put in a treatment plan to keep you moving, reduce your pain, and in some cases reduce dependence on over-the-counter painkillers.

Here are some common conditions handled by pain management doctors.

Sciatica

  • Sciatica is the pain caused by pressure on the sciatic nerve, which runs from your hip, and down your leg.
  • It can present as sharp or dull pain, tingling, or numbness. In severe cases, sufferers struggle to walk or even stand.
  • An estimated 40% of all people will suffer from sciatica in their lifetime.5
  • As you age, you are more likely to be affected by flare-ups of the condition.
  • In mild cases of sciatica, treatment can involve bed rest and anti-inflammatory drugs such as ibuprofen, and you should recover within a matter of hours or days.
  • If you're suffering from persistent pain in your sciatic nerve, treatment in the form of steroids or pills may also be an option.
  • If your pain is frequent, debilitating, and/or is affecting your daily life, sciatica pain treatment in the form of surgery could also be an option. Since sciatica is often caused by a slipped or ruptured disc, the operation would involve paring back the vertebrae that is pinching the nerve root.
  • The second part of your sciatica treatment plan is to get moving as soon as you are able. Gentle exercise and specifically prescribed light physical exercises may lead to a speedier recovery and help to prevent future flare-ups.

Neck and shoulder pain

We're a nation of smartphone users. Many of us work for hours sitting at our desks, and our posture suffers as a result. Young people are also increasingly affected by this pain that was previously mostly associated with older patients.

  • 50% of 55-64 year olds live with chronic shoulder pain.6
  • A depressed mood, a high body mass index, and low social support are also risk factors associated with neck and shoulder pain in adolescents and young adults.7
  • Neck pain treatment varies depending on the cause. While neck pain is commonly caused by poor posture, if it is a result of injury and is particularly severe and persistent, or if you experience numbness, or if the pain spreads down your arms or legs, you will need urgent medical attention.8
  • Shoulder pain treatment can be administered at home in many cases. Hot and cold compresses, anti-inflammatory painkillers such as ibuprofen, and gentle stretching should all help alleviate the pain.9
  • With both neck and shoulder pain, treatment at home is only effective if the pain is mild and occasional. If your movement is impeded, if you are consistently/repeatedly affected, or if you feel weak, consult your doctor.

Back pain

The common causes of back pain differ from those of neck and shoulder pain.

  • Heavy lifting, repeated movement, or sudden and awkward movement can lead to muscle or ligament strain or slipped/herniated disks of the vertebrae.10
  • In these instances, your doctor will conduct tests to ascertain the underlying problem and prescribe back pain treatment accordingly. Bed rest, muscle relaxants, physical therapy, and surgery are all possible treatment options that your doctor may discuss with you.
  • General lower back pain is also a common form of chronic pain and is commonly a result of workplace factors; for example, heavy lifting, pushing, pulling, standing for long periods of time.11
  • If you are experiencing lower left back pain, talk to your doctor to rule out problems with your internal organs. Pain in your lower left back could be a symptom of problems with your kidneys or pancreas, or a gynecological disorder.12

Knee pain

Whether your knee pain is a result of a sports injury, or if you have arthritis, the same general rules apply for knee pain relief:

  • You may already be familiar with RICE: Rest, ice, compression, elevation. Rest your knee, use ice to reduce any inflammation, use a bandage to compress it, and elevate your knee above your heart.
  • Consider using a walking aid to take the strain off of your knee when you're in pain from arthritis or recovering from an injury.
  • Keep using your knee as much as advised by your doctor. When we're in pain, sometimes all we want to do is rest, and completely stop using the part of our body that is in pain. However, though it may seem counterintuitive, you need to use your knee. Choose low-impact exercises that don't put a lot of strain on your joints. Swimming, aqua aerobics, and exercise bikes are all great options.
  • Consider your weight. Being overweight puts more strain on your joints. Discuss a dietary/exercise plan with your doctor that is safe and takes your knee pain into consideration.13

Here at BronxDocs

Our board-certified anesthesiologists devote their time to the treatment of chronic pain.

They will assist you in both managing your immediate pain, and, once the cause of your pain has been determined, our physicians will put into action an effective course of treatment so that you can keep moving and improve your overall well-being.

Depending on the cause of your pain, treatment options may include:

  • Spinal steroid injections, which are an effective form of lower back pain treatment, sciatica treatment, and neck pain treatment.
  • Radiofrequency ablation, a procedure in which radio waves are used to heat up nerve tissue and reduce sensitivity. It is used as back pain treatment, and its pain-reducing effects can last for many months and even years.14

We also treat chronic pain with a variety of pain medicines, such as anti-inflammatory medicines and muscle relaxants.

We do not use opioids as part of our pain management programs. America is in the midst of an opioid epidemic, and men in the Bronx are over 50% more likely to die of opioid overdose than the average man in the U.S.15 There are effective alternatives.

Physical therapy, acupuncture, and surgical treatment options are also available through a referral within the group.

Citations

1. Dahlhamer J, Lucas J, Zelaya, C, et al. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults” United States, (2016). MMWR Morb Mortal Wkly Rep 2018;67:1001–1006. Doi: 10.15585/mmwr.mm6736a2

2. Sheng J, et al. “The link between depression and chronic pain: Neural mechanisms in the brain.” Neural Plasticity. 2017; 19 June 2017. Doi: 10.1155/2017/9724371

3. Mayo Clinic Staff. “Back pain” (2018) Retrieved from: https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906 Oct. 2019.

4. Pribicevic M. “The Epidemiology of Shoulder Pain: A Narrative Review of the Literature.” InPain in Perspective (2012) Intech doi: 10.5772/52931

5. Harvard Men's Health Watch. “Sciatica: Of all the nerve” (2016) Harvard Health Publishing Retrieved from: https://www.health.harvard.edu/pain/sciatica-of-all-the-nerve Oct. 2019.

6. Pribicevic M. (2012)

7. Yeun, Young Ran and Han, Suk-Jung. “Factors associated with neck/shoulder pain in young adults” Biomedical Research (2017) Vol. 28, Iss. 16 Retrieved from: https://www.alliedacademies.org/articles/factors-associated-with-neckshoulder-pain-in-young-adults-8224.html Oct. 2019.

8. Mayo Clinic Staff. “Neck pain.” (2018) Retrieved from: https://www.mayoclinic.org/diseases-conditions/neck-pain/symptoms-causes/syc-20375581 Oct. 2019.

9. Iftikhar, N, MD “Treating and Managing Shoulder Pain” (2018) Retrieved from: https://www.healthline.com/health/shoulder-pain-remedies Oct. 2019.

10. Mayo Clinic Staff. “Back Pain” (2018)

11. Wáng, Yì Xiáng J et al. “Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review.” Quantitative imaging in medicine and surgery vol. 6,2 (2016): 199-206. doi:10.21037/qims.2016.04.06

12. Alexander, L. “Lower Left Back Pain from Internal Organs.” Veritas Health 2019. Retrieved from: https://www.spine-health.com/conditions/lower-back-pain/lower-left-back-pain-internal-organs Oct. 2019. 

13. WebMD “11 Knee Pain Dos and Don'ts” (2018) Retrieved from: https://www.webmd.com/pain-management/knee-pain/knee-pain-dos-and-donts#1 Oct. 2019.

14. Cleveland Clinic. “Radiofrequency Ablation” Retrieved from: https://my.clevelandclinic.org/health/treatments/17411-radiofrequency-ablation Oct. 2019.

15. LiveStories (statistics taken from CDC Wonders.) “Bronx County Opioid Death Statistics.” Retrieved from: https://www.livestories.com/statistics/new-york/bronx-county-opioids-deaths-mortality Oct. 2019.