17.08.2013

Treating severe pain without medication

Here in Florida, I see horse after horse whose bars have not been trimmed at all, some for years. Unfortunately, this horse was in so much pain the first time I saw him that I could barely trim him, much less get photos. People report a specific incident where they rolled their ankle and then developed pain and swelling. Osteoarthritis is a form of arthritis that affects the joints and the cartilage of the joints, it impacts flexibility and can result in painful bone spurs.
The general symptoms of this type of arthritis are stiffness, pain and swelling of the affected joints is also common.
X-rays and MRI scans can confirm a diagnosis. Sometimes called degenerative joint disease, osteoarthritis cannot be cured, however, pain can often be relieved without the need for invasive surgery. Supartz injections are specifically designed to help osteoarthritis of the knee joint. Supartz is a solution made of purified sodium hyaluronate. At Newbridge we perform local anesthetic and corticosteroid nerve block procedures to reduce swelling and inflammation for patients presenting with pudendal nerve pain. Neck pain is the second most common complaint among our patients second only to lower back pain of course. There are myriad reasons that pain in the neck can occur. Sometimes the cause is obvious, a patient has had an accident or injury resulting a physical trauma that causes pain in the neck or cervical region.
Injury, inflammation and a range of abnormalities to any of the above can cause neck pain and stiffness. Pain going down your neck through your shoulders or arms is called radiating neck pain or cervical radiculopathy. Cervical radiculopathy is commonly associated with an injury near the nerve root and is often called a “pinched nerve”.
Degeneration of the disc, where the space between the individual vertebrae becomes smaller and the disc becomes less spongy and therefore less capable of absorbing shock, is also a very common cause for neck pain. If you are experiencing neck pain that persists your pain management specialist can order Xrays and MRIs to discover the root cause of this pain and develop a multi-modal treatment plan to combat pain and help you regain your quality of life. Trigeminal Neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve in the face. 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. Our interventional pain management specialists have successfully performed trigeminal nerve ganglion blocks to reduce TN pain. Interventional pain management or interventional pain medicine is a sub-specialty of pain management.
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.
These techniques, performed by qualified anesthesiologists, provide relief and improve the quality of life of many patients. 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.
Diagnostic Genicular Nerve Block – this procedure consists of placing a small amount of a local anesthetic, on the genicular nerves.
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. In the setting of scoliosis our pain specialists would make sure the scoliosis is not severe enough to require surgery. 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.
In cases where pelvic pain becomes chronic and does not respond to medication you may be referred to a pain management specialist by your urologist, OBGYN, Oncologist or Internist. Chronic pelvic pain may be treated with medication or an appropriate minimally invasive and non-surgical procedure.
The hypo-gastric plexus is a group of nerves near the end of the spinal cord by blocking these nerves a pain specialist can prevent patients from experiencing pain sensations. This type of non-surgical procedure is an injection of anesthesia medication plus a steroid and usually takes about 30 minutes.
Down both sides of the spinal column are nerves that exit through holes in the bone of the spine these are called nerve roots. Radiculitis, Radiculopathy, and Radicular Pain are not a diagnosis exactly but a description of a pain sensation caused by a pinched, compressed, inflamed or otherwise irritated nerve root. It is common for radicular pain to be felt in the buttocks and legs as a shooting pain sensation, however radicular pain is not always due to problems in the lumbar spine or lower back.
Radicular pain is also extremely common in the cervical spine, known as cervical radiculopathy, this pain, due to pinched nerves in the neck, is sometimes caused by herniated or degenerative discs in the neck area resulting in pain, tingling or prickling sensations in the hand and down the arm. Spasm,  low trauma car accident such as a fender bender can result in damage to the nerve root causing radiating pains.
In severe cases a patient may require surgery, if this is discovered during a procedure the patient will be referred to an appropriate surgeon. Facet Rhizotomy is used in the treatment of chronic back pain or degenerative disc disease.
The rhizotomy takes about one 30 min to one hour, depending on the number of levels (within the spine)  to be done.
The area is cleaned with an antiseptic solution and the skin over the injection site is numbed. Your pain management provider will thoroughly brief you on all pre-procedure requirements and provide you with instructions when you book your procedure. Please tell your doctor before the procedure is scheduled if you are taking any blood thinning medication.
Newbridge Spine & Pain Physicians are seasoned Anesthesiologists sub-specialty certified in pain management.
Doctors try to treat back pain without using surgery, through drugs, exercise and physiotherapy, but sometimes back pain becomes so severe, or spinal damage becomes so bad that the only option left is surgery. Minimally Invasive Spinal FusionIn spinal fusion surgery, two bones in the spine (vertebrae) are fused together. You should seek independent professional advice before acting upon any information on the BackPainExpert website. What Is a Urinary Tract Infection?About half of women will get a urinary tract infection, or UTI, at some point in life. American Congress of Obstetricians and Gynecologists.American Journal of Epidemiology, October 2004. HM 63 old lady Rheumatoid and hypertensive underwent Left Total knee replacement in October 2003 . Previously these patients remain bedridden as no further surgery could be done but with the development of better surgical skills and implants (Mega Prosthesis) we were able to operate this patient and make her mobile once again. Total Hip Replacement SM 53 years old gentleman presented to our hospital with pain in right hip following RTA. RM 60 old gentleman presented to us with pain and stiffness in both the hip joints since 30 years. Total Hip Replacement DP 55 years old gentleman presented with pain and limp right lower limb.
Raj Rani 72 years lady suffering from pain in the both knees from last 10 yrs with severe limitations of activities .


Kamala Devi 57 Years old lady presenting with pain and inability to bear weight on right lower limb.
63 yrs old lady presented to us with complains of pain around Left hip with difficulty in walking. If they remember the injury, they will report that the ankle rolled outward (in contrast to a low ankle sprain when the ankle rolls inward).
Newbridge physicians offer injections of corticosteriods which have proven to help inflammation of swollen joints, however, additional options are also available and are commonly used to relieve knee pain. Hyaluronan is a chemical naturally found in the joint tissues and the fluid that fills your joints. The genicular nerve block procedure is performed to both diagnose the source of pain ascertain effectiveness of an RFA treatment.
It carries sensation between the genitals as well as motor supply to various pelvic muscles.
However, other times you may not be able to pin point a specific incident or don’t understand what happened to actually cause the pain you are experiencing.
The cervical spine (the upper vertebrae of the spine) goes from the skull to the torso between each vertebrae are discs that act as shock absorbers between the bones.
If you experience this you may be suffering from either a cervical herniated disc  spinal spinal stenosis or degenerative disc disease. In these cases trigger point injections can help by encouraging blood flow to the region by igniting the body’s inclination to self heal.
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. 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.
Interventional pain procedures offer new hope for patients presenting with any variety of persistent and severe pain conditions. To determine if a particular procedure or combination of procedures is right for you talk to your doctor, or make a new patient appointment. 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.
The specialist interventional pain management physicians at Newbridge Spine & Pain Center perform this innovative new procedure for treating patients with knee pain without surgery. We thought we’d elaborate a little on what scoliosis is and what we can do to help manage pain associated with this condition. 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. 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.
Pelvic pain may come from the male and female reproductive systems, the colon, bladder or lower intestines. It should come as no surprise that treatments for pelvic pain vary depending on the cause a severity of the pain. Common conditions that result in radicular pain include sciatica, lumbosacral spondylosis, degeneration of the lumbar spine and spinal stenosis. Nerve blocks are an injection of steroids and anesthetics that help heal the nerve and restore normal function. When a nerve block is successful in offering relief your specialist may suggest the longer lasting radiofrequency procedure. Practicing a conservative approach to pain management our physicians treat all chronic pain. What are the Advantages of Minimally Invasive Surgery?In traditional back surgery, surgeons may have to cut though muscles and blood vessels, or operate around nerves. This is used in spinal stenosis (narrowing of the spine), injury, fracture, spinal weakness after infection or cancer, spondylolisthesis (slipping vertebrae) or abnormal curvature, e.g.
It happens when germs infect the system that carries urine out of the body -- the kidneys, bladder, and the tubes that connect them.
It is intended for general informational purposes only and does not address individual circumstances.
One month later she sustained fracture supracondylar femur which was managed by open reduction and plating. He had right Total Hip Replacement 10 years back and was walking comfortably before trauma. Revision Total Knee Replacement(TKR) done with RHK (Rotating Hinge Knee) to substitute for deficient collateral ligaments. Patient developed intraoperative supracondylar fracture of the femur during Total Knee Replacement(TKR) in Feb 2011 . She is a operated case of bipolar Talwalkar prosthesis for fracture neck of femur done 4 years back. A successful nerve block procedure generally qualifies a patient for radio-frequency ablation (RFA) of the same nerve this treatment has proven to be an extremely popular and effective long term pain solution.
Neuropathic pain in the perineum, genital and ano-rectal areas may come as a result of entrapment. Foraminal stenosis is the narrowing the cervical disc space due to the enlargement of a joint in the spinal canal. Studies have found that this condition is more common in women and people over 50 years of age.
In addition these procedures can help prevent patients from being tied to a long-term medication schedule.
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. 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. If the pain becomes chronic you should request a referral to a specialist pain management provider. The nerve roots are susceptible to changes or damage to the spine, such damage results in the sensation of, sometimes severe, pain.
It is important to discuss your expectations for this and any procedure with your pain relief physician prior to under going the procedure. It may take as long as 2 to 6 weeks for patients to notice any pain relief after this procedure.
Because of this, recovery can take a long time and require extended time off work or studies.
It is not a substitute for professional veterinary advice, diagnosis or treatment and should not be relied on to make decisions about your pet’s health. We found several common characteristics: (1) no obvious history of trauma, insect bite, or bruising, (2) accumulation of a small amount of rose-wine– or straw-colored serum in the hypodermis but above the perichondrium, determined by puncture aspiration, (3) most often located between the antihelix and concha, (4) no sign of marked inflammation or severe pain, and (5) disappearance without marked disfigurement. X-rays revealed fracture of the pelvic bone (Acetabulum) with posterior dislocation of the acetabular component. Patient developed infection of the right side knee in 2010 which was managed by aspiration and prolonged antibiotics. She was found to be having osteoarthritis of the both knees resulting in Severe Varus deformity with bone loss.
4 days later Open Reduction Internal Fixation with Retrograde Intramedullary Nailing was done. Specialists in pain management are uniquely trained and equipped to handle pain and understand that medication is not the only option.
Minimally invasive spinal surgery (MISS) has potential to reduce both pain and recovery time, shorten operation times (and so reduce the amount of anaesthetic needed), cut down on complications, and reduce blood loss, as well as resulting in smaller scars.
In minimally invasive spinal fusion, the surgeon only needs to make an incision of two to three centimetres and can stabilise the vertebrae using a screw, a bone graft from the hip or using donor bone, or a protein called BMP (bone morphogenetic protein) that promotes bone growth.
Never ignore professional veterinary advice in seeking treatment because of something you have read on the WebMD Site. We advocate treating auricular seroma as an independent disease entity apart from other auricular swellings such as hematoma and pseudocyst.


Fixation of acetabulum fracture with screws followed by revision of the acetabular component with uncemented cup was done .
She had a history of fall 5 months back following which whenever she tried to walk the knee would give way. Due to his disease he has become bedridden and was not able to do his normal daily activities.
Implant removal and revision Total Hip Replacement was done (Uncemented acetabulum and cemented femoral stem). After this type of surgery, patients could be out of hospital after as little as 24 hours and could be back at work between a few days and a few weeks, depending on the type of surgery. Minimally Invasive DiscectomyThe vertebrae in the spine are separated by cushions known as discs, and these keep the spinal column flexible. We have performed bilateral Uncementd Total Hip Replacement (with use of femoral head autograft to lateralize the cup) and bilateral adductor tenotomy. Because of the trauma the ligaments which give stability to the joint had been completely damaged. We did Re- Revision Total Hip Replacement with special implant (Continum cup for acetabulum and Wagner stem for femur). Large volume centres like Delhi Institute of Trauma and Orthopaedics (DITO) at Sant Parmanand Hospital get lot of patients with these deformities. Minimally invasive surgery isna€™t suitable for all patients, and the surgeon will be able to advise on the best type of operation.How Does Minimally Invasive Surgery Work?Minimally invasive surgery is usually guided using X-rays. If the disc bulges out of the spinal column, this is known as a slipped or herniated disc, and it can press on nerves and cause pain in the back or leg.
Now the patient presented to us with fracture supracondylar femur with broken implant and dislocated knee. This patient underwent Right Total Knee Replacement with special implant (Rotating Hinge Knee). Because of advancement in technology new stems are now available in the market which allow patient to undergo multiple repeat surgeries if needed without compromising on the quality of life. Distal Femoral Locking Plate was removed and Revision Total Knee Replacement with Rotating Hinge knee was done. The surgeon tunnels between the muscles and muscle fibres (known as muscle dilation), rather than cutting them away. In a discectomy, the surgeon cuts away a small part of the vertebra and then removes the protruding part of the disc.In a traditional discectomy, often known as an open discectomy, the surgery involves an incision of around seven or eight centimetres that cuts through muscles. With this special implant we have relieved her of pain as well as given her a good range of movement of the knee.
Previously such patients were advised a knee fusion in which patient is unable to move the knee. A hollow tube in inserted, followed by a very small endoscopic camera, and the surgeon then carries out the surgery using specialist small tools. A bladder infection is generally not a medical emergency -- but some people have a higher risk for complications. This patient underwent Left Total Knee Replacement with special implant (Rotating Hinge Knee).
On the left side we used LCCK with wedge augment and the right side we built up the tibial condyle with bone from distal femur cut and then used LCCK with wedge augment .
Part of the disc can then be removed through the small incision.Minimally Invasive Lumbar LaminectomyIn some people, back pain is caused by a narrowing of the spinal canal (the gaps in the spinal column) and this is known as spinal stenosis. This includes pregnant women, the elderly, and men, as well as people with diabetes, kidney problems, or a weakened immune system.
With this special implant we have relieved him of pain as well as given him a good range of movement of the knee. Removing bone and bony spurs from the vertebrae can relieve pressure on nerves and so reduce back pain. UTI or Something Else?Although burning during urination is a telltale sign of a UTI, it can  also be a symptom of a vaginal yeast infection or certain sexually transmitted diseases (STDs). In minimally invasive lumbar laminectomy, the surgeon can remove these using specialist tools, through an incision only one to three centimetres long.
Yet a cystoscopy , a thin tube and camera that is inserted into the bladder can help doctors diagnosis it.  Honeymoon CystitisFew things can ruin a honeymoon like a UTI.
But this is so common, it has its own name -- "honeymoon cystitis." The reason is that sexual activity can push bacteria into the urethra.
But pregnant women, some children, and recipients of kidney transplants should be treated to avoid a kidney infection. UTI ComplicationsThe main danger associated with untreated UTIs is that the infection may  spread from the bladder to one or both kidneys. When bacteria attack the  kidneys, they can cause damage that will permanently reduce kidney function. There's also a small chance that the infection may enter the  bloodstream and spread to other organs.
How Do UTIs Begin?Many types of bacteria live in the intestines and genital area, but this is not true of the urinary system.
Typically, bacteria travel up the urethra to the bladder, where an infection can take hold. When it does happen, it's often related to another underlying medical condition, such as a kidney stone or an enlarged prostate.
Diagnosing UTIsThe first step in diagnosing a UTI is usually a simple urine test called a urinalysis.
Your health care provider may recommend drinking lots of fluids and emptying your bladder frequently to help flush out the bacteria. But severe kidney infections may require hospital care, including a course of intravenous antibiotics. If you have three or more a year, talk to your doctor about how to prevent or minimize these infections. UTIs and PregnancyDuring pregnancy, there are several factors that boost the risk of UTIs, especially a kidney infection. Hormones cause changes in the urinary tract, and the uterus may put pressure on the ureters or bladder or both -- making it more difficult for urine to pass from the kidneys to the bladder and out. Untreated UTIs can contribute to preterm labor, so be sure to alert your doctor if you suspect you have an infection. UTIs and MenopauseEstrogen has a protective effect in the urinary tract, but levels of this hormone drop off significantly during menopause.
UTIs and Hospital StaysA hospital stay can put you at risk for a UTI, particularly if you need to use a catheter. This is more often a problem for older adults who require prolonged hospital stays or who live in long-term care facilities. Agitation, delirium, or other behavioral changes may be the only sign of a UTI in elderly men and women. Their muscles may not relax enough later to fully empty the bladder and flush away any bacteria. A small number of children have a structural problem that obstructs urine flow or lets urine flow back from the bladder to the kidneys, triggering chronic kidney infections. Other children may scream or cry when taken to the potty, as a way of rebelling against the process. Some studies suggest it can prevent, but not treat an infection, and is more effective in young and middle-aged women.



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