As much as we would love to take a vacation from our pain the reality is that our chronic pain will vacation with us.
Here are are few suggestions for those suffering from severe, persistent or chronic pain while preparing for your summer vacation.
- Check out the digs before you go. Sleeping on a hotel or guest bed is trying for anyone; however, for those dealing with chronic pain this could mean the difference between sleeping at all and being able to walk the next day. Prepare yourself by calling ahead find out about the size, age and quality of the mattress you’ll be sleeping on. If need be bring your own mattress topper (you can buy a Tempur-Pedic mattress topper online for the price of one nights stay in a hotel) and remember your own pillow if you suffer from neck pain.
- Find out where the local urgent care, internal medicine, PT and/or massage therapist is at your destination. You may need to make a visit to one of these providers so having their contact details on-hand will avoid wasted time in the event you may need their services. You may wish to call each of these places to check their office hours and keep in mind that booking a mid-vacation visit to the local massage therapist before you get on the road might be necessary if they are popular.
- If you’re travelling long distances be sure to prepare your vehicle for optimum comfort. There is nothing worse than feeling the onset of that pinched nerve or nagging sciatica when you’re only 1 hour in to a 5 hr drive.
- If you are travelling by car bring a cooler with an ice-pack ready to go and any topical pain relievers you may wish to use. Plan out your route and take time at rest stops to stretch and move around,
- If you are travelling by air be sure to pack light / use a rolling bag to avoid any unnecessary lifting and request an aisle seat so you can get up when and if you need to move around.
Either way you travel taking a warm bath right before you leave the house can help relax your muscles and prepare you for a long trip too.
Trigeminal Neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve in the face.
The Trigeminal nerve carries sensation from the face to the brain. It is a progressive pain condition meaning it can start out as random mild attacks and develop into bouts of extreme pain. For patients experiencing trigeminal neuralgia putting on make up brushing teeth or washing your face can become extremely painful. Studies have found that this condition is more common in women and people over 50 years of age.
The disruption of nerve functioning, also known by the name tic douloureux, is often caused by contact between the nerve and a vein or artery; however, multiple sclerosis and tumors have also been known to cause this type of pain.
How is it treated?
It is always best to come prepared when visiting your pain specialist. Make note of what triggers your pain and where on your face the pain occurs. You may be referred to pain management following a visit with a neurologist.
Our interventional pain management specialists have successfully performed trigeminal nerve ganglion blocks to reduce TN pain. Call your nearest pain clinic to learn more.
In severe cases your pain specialist may refer you to a neurosurgeon for further treatment, such treatments may include:
- Stereotactic radiosurgery (includes Cyberknife)
- Microvascular decompression
5 misconceptions about Pain Management
We asked our Doctors to set the record straight and clarify 5 common misconceptions about Pain Management, pain medicine and what we do. Here’s what they had to say:
1) It just entails a doctor writing for pain medications:
Most people have the misconception that pain management specialists primarily and solely write for pain medications as their means of treating acute/chronic pain. This couldn’t be farther from the truth. In fact, it is our goal to keep people from requiring chronic dosing of pain medications as this in itself has long term side effects and changes how our bodies work.
Our intention is to start with an accurate diagnosis of the cause of a patient’s main source of pain and to then implement interventional procedures that can either treat or moderate a patient’s pain. The idea is to either resolve or, at the least, temporize a patients level of chronic pain so that they have more tolerance to physical therapy and require less daily pain medication in the future.
Another common misconception is that a Pain Physician’s use of the term “pain medication” refers to controlled narcotic substances. It is always our initiative to use a combination of different types of medications which are not necessarily narcotics.
As Pain Physicians we avoid the initiation of these pain medications as narcotics carry inherent risks and can become a long term burden on the patient.
There are certain cases where patients have causes of pain that cannot be treated with interventional procedures, and in these few cases we then explore different types and combinations of medications.
We reserve the use of narcotics, for a short time, for cases where procedures do not provide adequate relief, however, hoping not to introduce controlled substances on a long term basis.
2) It’s only for people with neck and back problems:
When people think of pain management, they usually first think of neck and low back pain limited to the spine. Although this can describe a majority of our patients, we also treat many other sites and sources of pain such as chronic headaches, knee, shoulder, abdominal, pelvic pain and facial pain.
We can also treat peripheral neuropathic pain such as that caused by diabetes and chemotherapy or postherpetic neuralgia as a result of having had shingles.
3) It’s a last resort:
Unfortunately, most people come to pain management after having dealt with chronic pain for a long time and seeing physicians whose therapies might be limited to pain medications. Chronic pain along with prolonged use of narcotics causes multiple changes in the body such as changes in normal levels of circulating hormones and sleep cycles. Therapeautic interventions work best the sooner we see a patient as these other physiologic changes have not yet occurred and there is less to reverse.
These chronic physiologic changes can cause mood changes along with how our bodies perceive pain, sometimes making us more sensitive to painful sensations. In short, seeking a consult with a pain specialist as soon as pain persists is the best way to manage your pain in the long term.
4) Pain procedures are only a short term fix and only mask the pain until it returns:
In many cases this statement is actually true. Our goal in interventional pain management is to alleviate or minimize the pain that a patient feels on a daily basis so that they can be more functional and participate in modalities such as physical therapy. Our purpose in pain management is to prepare a patient’s body for building strength so that there are less acute and severe painful episodes.
Although sometimes we are unable to relieve pain completely, we can provide intermittent episodes of relief and eliminate the need for surgery if the patient is a poor surgical candidate or chooses not to undergo surgery.
The longevity of the pain relief a patient experiences depends on the cause of their pain and available therapies that can be offered to the patient. Although some of our therapies do not give prolonged relief, some do.
It is all on a case by case basis, and depends on the age and pathology of a patient’s pain. It is important that patients get assessed by an interventional pain physician to determine if there is a long term relief option for their source of pain.
In many cases, the earlier a patient seeks treatment for their pain the longer their pain relief experience may be.
5) All pain management specialists are the same, if you’ve tried one, there is no use exploring your options with another:
As with any specialty, outcomes are based on a physician’s individual skill and training. Because pain management is an evolving specialty, there are many new procedures that could be introduced to patient’s treatment plan.
Sometimes patients have a failed procedure or had a bad experience and assume that any future interventions will continue to be unfruitful. This is not usually the case. Therefore, it is important to do your research.
Seeking a more interventional driven pain physician who might have more skill or experience in different therapies may be an option to better treat your pain.
Do you or a loved one suffer from chronic pain? What can you do to celebrate your love without triggering a painful episode?
For people who suffer from chronic illnesses going out to dinner to celebrate the holiday of love is rarely an option especially when getting in the shower can be a major feat some days.
The common gift of chocolate is also not always an option as the processing of such foods can include inflammatory triggers and cause bouts of additional pain.
So, how do you express your love to the chronic pain sufferer in your life? Here are few ideas:
Massage or Spa day: Give your spouse a gift certificate for a massage. You could even opt to do the spa day or massage at home. Some masseurs do home calls and you can run a bubble bath with candles, a soothing soap and serve their favorite drink all yourself. There is nothing like a good relaxing session to show your special someone how much you care.
Pay for cleaners: For some people with chronic back or neck pain and especially those with fibromyalgia daily chores can become an impossibility. Everyone loves a clean home and a gift certificate for a cleaning service could help relieve a mind-load of stress for your chronic pain warrior.
Tickets to a comedy show: Endorphines do wonderous things and laughter really is the best medicine some times. So buying tickets to a comedy show or planning a trip to your local comedy club could be just the ticket to express your valentines day wishes. Word of warning you may want to plan ahead and be flexible on your dates as pain flare ups can happen at anytime. To avoid disappointment select a few dates you and your loved one can chose from.
Hand make a gift: Nothing says “I love you” like a hand made gift. Some knitted socks or a hat a bath towel with their initials and message embroidered on it.
Lastly, you may wish to get them something that will make their day-to-day life easier. There are a number of clever knick-knacks out there our favorite is the Sock Aide. For people who have trouble bending particularly those with back or knee pain the sock aide is simple genius.
Wishing all those who suffer from chronic pain a wonderful pain free Valentine’s day.
Newbridge Spine & Pain Center
What is interventional pain management?
Interventional pain management or interventional pain medicine is a sub-specialty of pain management. Interventional pain specialists are devoted to the use of minimally-invasive techniques such as facet joint injections, nerve blocks, radiofrequency ablation, vertebral augmentation, and neuromodulation (implantable drug delivery) therapies.
Finding long lasting relief can be difficult for many suffering from chronic pain. Interventional pain procedures offer new hope for patients presenting with any variety of persistent and severe pain conditions. In addition these procedures can help prevent patients from being tied to a long-term medication schedule.
Interventional pain specialists are highly trained in a myriad of pain procedures that treat the underlying source of pain, these procedures play a pivotal part of a multi-disciplinary approach to relieving pain.
These treatments offer pain relief for a wide range of conditions from headaches, pain in the neck, back or spine, to stomach, shoulder, pelvic, hip, knee or foot pain.
Patients often comment that seeking interventional pain management at the early stages of their diagnosis and treatment speeds up their recovery time and ability to pursue daily activities.
Is interventional pain management right for me?
These techniques, performed by qualified anesthesiologists, provide relief and improve the quality of life of many patients. To determine if a particular procedure or combination of procedures is right for you talk to your doctor, or make a new patient appointment. Our anesthesiologists will review your MRIs, Xrays, medical history and any records from your referring physician to determine a) the root cause of your pain and b) if you are a candidate for a procedure and c) what procedure you may benefit most from.
Interventional procedures are out-patient procedures performed in our office or ASC (ambulatory surgical centers) most of these procedures take less than 45 minutes from the time you enter the procedure room and require minimal recovery time. For patients who are anxious or in severe pain our office is equipped to offer monitored anesthesia care (sedation) to help you relax during your procedure.
Genicular Nerve Block & RF Ablation
The genicular nerve block and RFA are a proven and popular procedure to combat knee pain. The specialist interventional pain management physicians at Newbridge Spine & Pain Center perform this innovative new procedure for treating patients with knee pain without surgery. Genicular Nerve Block or Genicular Radiofrequency Nerve Ablation can be done before if the hopes of preventing surgery or after knee surgery to offer pain relief.
This state-of-the-art procedure relieves pain in patients experiencing knee pain due to any of the following conditions:
- Chronic Knee Pain
- Degenerative Joint Disease (of the knee)
- Osteoarthritis (OA) of the knee
- Prior to or following a total knee replacement
- Prior to or following a partial knee replacement
- Patients unfit for knee replacement
- Patients who wish to avoid a knee replacement
The procedure is performed in 2 stages:
- Diagnostic Genicular Nerve Block – this procedure consists of placing a small amount of a local anesthetic, on the genicular nerves. This tests the patient’s response and determines if there is sufficient pain relief in the knee to justify performing a therapeutic neurotomy
- Genicular Nerve Ablation – during this therapeutic portion of treatment, your pain management physician will perform a radiofrequency ablation (RFA) of the genicular nerves, restoring function of the knee and alleviating pain.
If you or someone you know is experiencing knee pain or suffers from any of the above conditions give us a call at any one of our four convenient locations in Maryland and Virigina to discuss what our interventional pain management procedures can do to relieve your pain.
We’ve been getting a number of questions regarding pain treatment for scoliosis lately. We thought we’d elaborate a little on what scoliosis is and what we can do to help manage pain associated with this condition.
What is Scoliosis?
Scoliosis is an abnormal (usually sideways) curving of the spine. The spine might look like the letter “C” or “S.” An inward curving of the spine is called lordosis.
What causes pain in Scoliosis patients?
As the spine twists it effects the supporting musculature and can affect heart and lung function if severe enough. The imbalance of the spine causes trouble with posture and puts stress on joints that wouldn’t otherwise see so much weight.
How can a pain management specialist help scoliosis patients?
In the setting of scoliosis our pain specialists would make sure the scoliosis is not severe enough to require surgery. If the scoliosis is not severe we can deal with the stress of the curved spine on the joints of the spine and the pain due to pinch nerves where the spine bends and puts strain on the supporting muscles on each side.
Treatment includes facet blocks, epidurals, trigger points for myofascial pain, muscle relaxants, nerve pain medications, gait supporting accents such as canes and foot insoles.
In cases where surgery is required our pain management physicians will refer the patient to an Orthopedic spine surgeon. Following surgery and orthopedic treatment a pain specialist can continue to help manage pain associated with scoliosis and would do so in coordination with a patient’s Orthopedic specialist.
Dr. Sana Shaikh is a Pain Management Specialist in Frederick MD
Sana Shaikh, MD is one of the newest additions to the Newbridge pain management and anesthesia teams. Dr. Sana Shaikh is an experienced pain management provider and ABA board-certified Anesthesiologist, read Dr. Sana Shaikh’s bio. We asked Dr. Sana Shaikh about the practice of pain management, her philosophy and the treatment of chronic pain. Here is her response:
What can a pain management specialist do for pain?
A common misconception about pain management is that it is primarily pain medication management. As pain specialists we are actually are able to treat many kinds of chronic pain by doing x-ray, fluoroscopic and ultrasound guided procedures in hopes of minimizing the need for pain medications and injections. These minimally-invasive procedures allow people to return to their daily activities without being tied to a medication schedule.
Why is it important for patients to see a pain specialist at the earliest opportunity?
As a pain management physician, I find patients come to me after years of dealing with their pain and having seen many physicians but having minimal improvement in their symptom. As the source of pain becomes a chronic problem, it starts to affects other aspects of a your health. The social, emotional and psychological impacts of chronic pain start to play a role in the perception of your pain and thus start adding to the impact of pain in a persons daily life.
Limiting activity, restricting social engagements and the stress and barriers that severe pain imposes starts to change a patients outlook on improvement and hope for a pain free future. There are actually documented physical and chemical changes that occur in a patient with chronic pain. Changes are seen in circulating cortisol levels, along with other normal transmitters involved with sleep cycles and mood.
I am a great believer in treating pain as early as it starts as I find we can prevent pain from progressing into a debilitating hindrance for many patients. Once a patient’s pain has already become chronic, I always make sure the treatment is a multimodal plan, involving interventional techniques that treat the initial source of the pain along with the incorporation of physical rehabilitation and psychosocial therapies to help get the patient back to the quality of life they strive for.
Healthy sleep behaviors are also significantly impacted by chronic pain. Typically patients experience frequent awakening at night and unrestful sleep. Patients with fibromyalgia, a disorder which causes chronic pain have documented changes seen in their sleep EMG studies. The lack of deep sleep in these patients has been linked to decreased levels of healthy neurotransmitters which affect the way a patient’s body copes with and perceives pain.
The chronic pain patient starts to experience a hindrance to their daily life, work, financial ability as well as their interpersonal relationships due to the many ways chronic pain affects the human body. As healthcare develops and our patient population ages, it is important to effectively treat acute pain as soon as possible before it takes such a great toll on people’s lives.
What happens when pain becomes chronic?
Once pain becomes chronic, the treatment changes as well. Although we start by focusing on the main source of the pain, it becomes important to also address the other aspects of a patient’s health that have been affected. Chronic pain patients typically avoid behaviors and movements that trigger their pain, however, these adjustments in a patient’s behavior & movement often leads to further muscle wasting and usually leads to additional myofascial pain.
Because of this, a multimodal / multidisciplinary care plan for treating pain, such as we provide at Newbridge Spine & Pain, is often crucial in long term pain management. Developing a care plan that includes physical therapy and rehabilitation are crucial to changing learned behaviors that may have contributed to a patient’s pain.
As part of my pain management care plans I also assess how pain has affected my patient’s coping skills and objectivity. Typically there is also a level of depression that accompanies the changes seen with chronic pain. Many times, incorporating behavioral and psychological therapy can help patients change their perspective and outlook on their pain allowing them to be more positive and proactive towards improvement.
Chronic pain is defined as a pain lasting more than 3-6 months. It happens to be a great source of healthcare cost per year and affects 100 million adult Americans as reported in 2011 by the Institute of Medicine. On February 2014, it even got the attention of USA Today News which highlighted the prevalence, impact and missed treatment options throughout the nation.
Pain Specialist Harris Shaikh, M.D.
Now seeing patients in Frederick, Maryland
Frederick, Maryland – September 29, 2014 – Newbridge Spine & Pain Center, a leading Maryland medical pain management practice dedicated to the treatment of chronic pain, has recently added two new physicians to its team of pain management providers in Frederick MD.
Harris Shaikh, MD joins the pain management team at Newbridge Spine & Pain Center in Frederick after completing his fellowship in Pain Management from The Manhattan Center for Pain Management at Mount Sinai St Luke’s-Roosevelt in New York. Dr. Shaikh, like most of the physicians at Newbridge Spine & Pain Center, has multiple board certifications including Anesthesiology and Internal Medicine.
Sana Shaikh, M.D.
Joining him in the move to Frederick is his spouse Dr. Sana Shaikh, also a board certified Anesthesiologist fellowship trained in pain management. Sana Shaikh, M.D. practiced pain management in New York prior to moving to Frederick to join the team at Newbridge Spine & Pain Center.
Harris Shaikh, M.D.
When asked what prompted them to make the move from New York to Frederick the Shaikh’s stated that the move to Frederick was a clear choice, “it was important for us to find a community that is family oriented and has values similar to ours we’re confident we’ve found that here in Frederick” said Dr. Harris Shaikh.
Regarding the choice to join the Newbridge practice he sates,
“I chose Newbridge Spine & Pain because they have a pain management philosophy which is consistent with mine; namely, using a multimodal, multidisciplinary approach that helps chronic pain patients return to the activities they love most.”
While Newbridge Spine & Pain Center brand has been in business for over five years and is conveniently located on Thomas Johnson Drive the physicians of Newbridge Spine & Pain Center, in particular founder and medical director Dr. Jay Gonchigar, have a long history of treating chronic pain in Frederick County and the surrounding area going back to 1997. With a team of fellowship trained pain management specialists Newbridge Spine & Pain is one of the few pain practices equipped with the expertise and resources to provide patients with sedation during pain management procedures, an offer that is especially welcomed by patients experiencing severe pain and anxiety.
Majid Ghauri, M.D., one of Newbridge Spine & Pain’s lead physicians, is enthusiastic about the additional pain providers, “Dr. Shaikh is a wonderful addition to our team his emphasis on and experience in multidisciplinary care is consistent with the Newbridge philosophy and his passion for chronic pain patients is a true asset to us. Additionally, we have the benefit of Dr. Sana Shaikh’s experience as a pain provider and anesthesiologist. Frederick is lucky to have them both.”
Chronic pain is one of America’s largest health challenges and can have a devastating impact on a person’s ability to do every-day-things. This fact makes Dr. Shaikh’s goal all the more promising as he hits-the-ground-running taking the Frederick practice under his wing,
“my goal is not only to help reduce pain but to help optimize our patient’s ability to perform their daily activities, pursue their hobbies and basically live a happy, active lifestyle.”
Newbridge Spine & Pain offices are located in Waldorf, Prince Frederick and Frederick, MD and now in Leesburg VA.
About Newbridge Spine & Pain Center
Newbridge Spine & Pain Center has helped thousands of patients experience effective, long-lasting relief from acute and chronic pain. By incorporating powerful, sophisticated pain-relieving treatments into customized plans of care, our pain management experts provide patients with the ability to return to living an active and healthy lifestyle. Some of the many conditions we successfully treat include back and neck pain, spinal cord disorders, cancer pain, auto & work injuries, fibromyalgia, arthritic pain and many other painful conditions.