neck pain posts Archives

Golfers with back pain

A golfing patient I treated originally came to me with low back pain and later with shoulder pain and neck pain- all preventing his inner champion from blossoming. Like so many golfers he had come to accept the suffering as part of the game. He was amazed to find that he could get rid of the back pain that had plagued him for years. He wrote about it in his blog today bit.ly/9aluAt

Thank you for the mention in your blog.

~ Norman Marcus, MD
Norman Marcus Pain Institute, New York NY
 
Your New York City Pain Relief Doctor”
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Source of your back, shoulder and neck pain

A 35 year old executive complained of neck and shoulder pain radiating into his fingers along with difficulty using his fingers. His MRI showed bone spurs in his neck which were causing compression of the nerves going into his arm. A neurosurgeon had suggested that he have surgery to remove the spurs and to fuse the vertebra in his neck.

He was given cervical spine epidural steroids and after the 2nd injection his pain and difficulties in his hand were eliminated, but the pain in the region of his shoulder blade persisted. He felt that it was time to revisit the neurosurgeon, but I told him that pain only in the shoulder isn’t typical for a problem in the spine.
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If I get back pain will it go away?

Although Low Back Pain (LBP) is thought to affect around 80% of individuals, it is also thought to be self limiting and get better quickly (within weeks). Studies of patient populations however suggest that it is actually a more serious problem. Although most patients who experience back pain do not see a doctor, 60-80% of those that do are still reporting pain one year later and in those whose pain has disappeared, 20% will have a recurrence within months.
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Back Pain Treatment

Please refer back to the past two blogs to find the background material for todays blog. Although the number of CARF approved pain centers in the US halved, the number of outpatient pain centers mushroomed. The services provided however focused on two areas:

  1. Medication management
  2. Nerve blocks and other invasive procedures.

Although many patients could be helped with one or both of these approaches, many patients in need of physical therapy and psychological services that were integrated with the overall treatment plan, would no longer receive optimal treatment. Reimbursement would be the driver of care rather than the needs of the patient. Centers could not stay in business and provide care that insurance companies would not cover. The shift toward procedures became an accepted standard of care and new organizations of pain physicians were formed whose membership focused predominantly on invasive procedures.
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The Blog to Illuminate and Eliminate Chronic Pain

It is my wish to inform patients and colleagues about the possibilities of eliminating pain even when it is thought to be permanent (chronic) or require an invasive proceedure such as surgery, nerve injections, spinal cord stimulation or a morphine pump to achieve any relief.

Our story begins with the recogniton that the current standard of care doesn’t work very well. An article in the Jouranl of the American Medical Association (JAMA), in February, 2008, by Martin, Deyo, et al.. reported that even though the cost of neck and low back pain in the USA increased from $26 billion in 1997 to $86 billion in 2005, there was no improvement in treatment outcome. $86 billion is also the amount we spend on cancer.

Actually patients were reporting that they were more impaired by neck and back pain in 2005 than in 1997. It appears that the reasons that we frequently offer to explain low back pain such as herniated discs, degenerated discs, arthritis, and spinal stenosis, are frequently wrong since treating these so called causes results in no, or partial, temporary improvement. What is missing from the published diagnosis and treatment guidelines for common pain problems such as low back, neck and shoulder pain, is any approach which addresses muscles as the primary source of pain.

In future postings we will look at some reasons why muscles are ignored and what you can do about it.

~ Norman Marcus, MD
Norman Marcus Pain Institute, New York NY
 
“Your New York City Pain Relief Doctor”
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