back pain
The Start of Baseball Season
The baseball season just opened and already players are calling off their first few games due to “tweaked knees” and “sore backs”. As the sun is starting to come out, and the snow is (FINALLY!) melting, many of us are anxious to get outside and start playing sports again. However, this is also a time
Smoking and Back Pain – is it related?
We all know that smoking is bad for you. In fact, since 1965, the Surgeon General’s Warning posted on every package of cigarettes says: Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy. But did you know that in addition to the myriad of illnesses that are related to tobacco and smoking, recent
Spinal Surgery for Lumbar Stenosis
A recent study was published in the Journal of the American Medical Association, analyzing spinal surgeries done on Medicare patients who were diagnosed with lumbar stenosis. Let’s rewind – what is lumbar stenosis? Lumbar refers to the lower part of the spine, where we would normally identify as low back. Stenosis refers to the narrowing
When Making Medical Decisions About Pain Relief, Is More Information Better?
In today’s world we are bombarded by information and ways to obtain it. Do you want to know how many steps you take a day? Just buy a device and it will calculate it for you. Care to know what your cholesterol levels are? Simply go get a kit at your nearest drug store. Is
When Making Medical Decisions About Pain Relief, Is More Information Better? Read Post »
Why Health Insurances Carriers Should Not Be For Profit Enterprises
In November, I read this article in The New York Times on How Medical Care Is Being Corrupted. In a nutshell — Insurance carriers have been incentivizing care for more than 20 years by selectively paying for some services whilst denying others. To successfully address a complicated problem, such as long-standing pain, more than one
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Rafael Nadal will receive stem cell therapy for back pain – Should You?
Earlier in November, Rafael Nadal, the 14-time Grand Slam winner, announced he would receive stem cell treatment to help heal his ailing back, the same type of treatment he received for his knee. His doctor in Barcelona, Dr. Angel Ruiz-Cotorro, who has been treating Nadal for 14 years, said, “Nadal’s back pain is ‘typical of
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Epidural steroids are not effective for spinal stenosis
I have been suggesting for many years that there is an overuse of spinal injections and surgeries for low back and leg pain, so it was no surprise when I read an article in The New York Times (NYT) that reported on a study recently published in the New England Journal of Medicine[1] about patients
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Stiffness is an important aspect of muscle pain
I recently saw George, a 48-year-old man, who suffered from pain, described as soreness in the thighs, neck, shoulders and arms, and tingling in his calves and shin. Sitting for more than two hours or sitting for more than 20 minutes would cause an increase in his pain. Bending over also brought on his pain.
Low Level Laser Therapy as promising treatment
Low level laser therapy (LLLT) is a promising new treatment for a variety of painful conditions which is believed to reduce inflammation and stimulate healing of wounds. Interest in the laser first developed when Endre Mester at Semmelweis University noticed that applying the laser to the backs of shaven mice caused hair to regrow faster
NSAIDs for pain relief
The next series of blogs is a brief discussion of different types of medications used for pain. NSAIDs Non-steroidal anti-inflammatory drugs (NSAIDs) are generally one of the first line of medications used in the initial treatment of pain. They are exactly what their name means – they are not steroid medications (like cortisone or prednisone)
Muscles as the source of pain
Muscles are the largest organ system in the body, accounting for approximately 50% of our body weight. We have different ways of categorizing muscles: how they look, how they move, and where they’re located. We are going to focus on muscles that move voluntarily, which means we tell the muscles to move, as opposed to
Back and neck pain that starts in one specific area often spreads locally and sometimes to other regions
A number of my patients who have been struggling with pain management for more than a year may report that although their pain began in one specific spot, over time, it began to spread. Sometimes, over time, neck pain would involve the lower back pain as well. Many of these patients were thought to possibly
Flouting guidelines: Worsening Trends in The Management and Treatment of Back Pain
The study published in JAMA today demonstrated that from 1999-2010 in 3 key areas, guidelines for the treatment of back pain are being ignored: Use of recommended NSAIDs and APAP as first line drugs decreased by ~35% whilst not recommended opioid use increased by ~50%. Not recommended referral from PCPs to specialists for back pain
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Many Back Surgeries Unnecessary
In the United States we are faced with the highest per capita health costs in the world. One would think that massive expenditures could provide the best care and treatment outcomes, but this is not the case. In many aspects the US is worse or no better than countries spending 50% of what we do
“Doctor, My Back is Killing Me!” – Chapter 1, Part 3 (#endbackpain)
In the last part of Chapter 1 from End Back Pain Forever, we turn to the story of “Stephanie”. Please review this blog for the complete chapters 1 and 2 from my book. “Doctor, My Back is Killing Me!”, Part 3 Take the case of a patient whom I shall call Stephanie. She is
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“Doctor, My Back is Killing Me!” – Chapter 1, Part 2 (#endbackpain)
Here is Part 2 of Chapter 1 from my book, End Back Pain Forever. Click here for Part 1. Chapter 1 “Doctor, My Back is Killing Me!”, Part 2 “I can put you on strong medication to dull the pain,” says the doctor. “It may be that your spine is the problem.” “Does that mean
“Doctor, My Back is Killing Me!” – Chapter 1, Part 2 (#endbackpain) Read Post »
“Doctor, My Back is Killing Me!” – Chapter 1, Part 1 (#endbackpain)
Where to begin? In the first two chapters of my book I explore a variety of issues related to the difficulties in evaluating and treating patients with back pain. I am posting these chapters as a means to share my perspective which developed over more than 40 years as a pain medicine physician in the
“Doctor, My Back is Killing Me!” – Chapter 1, Part 1 (#endbackpain) Read Post »
A discussion about back pain
Where to begin? In the first two chapters of my book, End Back Pain Forever, I explore a variety of issues related to the difficulties in evaluating and treating patients with back pain. I am posting these chapters as a means to share my perspective which developed over more than 40 years as a pain
End Back Pain Forever: Chapter 2, part 5 #endbackpain
In this next segment, I take Hans up on his offer to examine one of my patients. Read what happens next! Click here for the Part 4 segment. Chapter 2 You Are Not Alone: The Back Pain Epidemic (Part 5) Dr. Kraus and I met a week later at Lenox Hill. I had chosen
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