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 […]
The tragic occurrence of meningitis, stroke and death following use of infected steroids used for spine injections should make us more aware that this very common treatment for back pain may not be worth the risks. The use of epidural steroid injections (ESIs) to shrink an inflamed nerve thought to be causing back pain has not
Epidural Steroids- Are they worth the downside risk? Read Post »
“Thank you for treating me as someone struggling with pain and not as a former drug addict who could not be trusted with strong pain medication” – a note I recently received from one of my patients. A patient with a history of drug abuse may be fearful that their past will prevent adequate treatment
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
End Back Pain Forever: Chapter 2, part 5 #endbackpain Read Post »
This excerpt from my book End Back Pain Forever, is about my mentor and friend, Dr. Hans Kraus. He changed the way I viewed pain and the treatment of pain, and enhanced my life and ultimately my patients’ lives for the better. Chapter 2 You Are Not Alone: The Back Pain Epidemic (Part 4)
End Back Pain Forever: Chapter 2, part 4 #endbackpain Read Post »
This excerpt from my book End Back Pain Forever, provides a small summary of my early involvement in pain medicine. Chapter 2 You Are Not Alone: The Back Pain Epidemic (Part 3) In 1975, I became a staff physician in the Montefiore Department of Neurology’s Headache Unit, founded by Dr. Arnold Friedman. Two years
End Back Pain Forever: Chapter 2, part 3 #endbackpain Read Post »
I wrote End Back Pain Forever to open up a discussion on back pain and provide insights on effective treatments. I have posted the first two chapters of the book on my blog. Chapter 2 You Are Not Alone: The Back Pain Epidemic (Part 2) As a physician specializing in pain medicine, I know how
End Back Pain Forever: Chapter 2, part 2 #endbackpain Read Post »
Chapter 2 of End Back Pain Forever delves into the ever-increasing problem of the back pain epidemic. Please review this blog for Chapters 1 and 2 from my book. Chapter 2 You Are Not Alone: The Back Pain Epidemic If you suffer from back pain, you are not alone. The widespread failure by doctors to
End Back Pain Forever: Excerpts from Chapter 2 #endbackpain Read Post »
The NY Times on 4/9/2012 ran a story about the overuse and unintended negative consequences of strong (opioid) pain medication. They mentioned opposing views concerning the liberal use of opioids. I participated in a debate in 1995 about the inappropriate use of the diagnosis “Chronic Pain Syndrome”(CPS) in patients whose muscles had not been assessed
Why do we over-prescribe strong pain medication? Read Post »
A recent article revealed that 2/3 of patients who received opioids (drugs like morphine) for 90 days following surgery were still taking them one year later. It doesn’t make sense that there still is pain from the surgery one year later. Did these patients become dependent or addicted to the drugs? Did they really need
Strong pain medication after surgery – is there a downside? Read Post »
There may be more to your pain than you think. Pain affects how you feel and how you move your body. More often than not, these changes happen without you even realizing it. Consider a concept known as kinesiophobia, defined as a fear of movement associated with anxiety related to an injury. Just as stress
How do I know if kinesiophobia is a factor in my pain? Read Post »
There are three different mechanisms that affect your back pain when it is related to muscles- and that means most of the pain you will experience in your life. 1. Referred back pain patterns- Pain may be referred from one muscle to another when the nerves carrying painful sensations in a muscle stimulates the same
Why does back pain appear to move or change intensity? Read Post »
Two days ago I reported on a study that showed we are frequently doing a disservice to patients in inappropriately ordering imaging studies such as MRIs. Yesterday I saw a patient who could be the poster person for the study. This patient had a back injury one year ago when a fall onto the buttock
A bony abnormality of the hip called Femoral Acetabular Impingement Syndrome (FAIS), where the head of the femur (the thigh bone) is found to be irregularly shaped rather than its “normal” spherical shape, is sometimes treated with a surgical procedure to shave the head of the femur. FAIS can affect young individuals in contrast to
Osteoporosis in women is a growing public health challenge with an aging population. New approaches are needed to prevent and treat decreases in bone density and strength. Two recent articles present different and potentially complementary approaches. Diet: Lanou reviews the studies on soy diets for the prevention of osteoporosis and bone fractures. Although the results
A recent study of a simple resistance exercise program for the neck and shoulders, in office workers who complained of weekly headaches (HAs), showed an approximately 50% reduction in HA frequency vs. a weekly health education control group. The exercise groups were 2 minutes or 12 minutes of daily exercise. The remaining HAs were no
The body can sometimes heal itself in painful conditions. A study of patients with painful osteoarthritis of the knee showed that by mechanically separating the bones in the knee that were touching and causing pain, cartilage regrew and pain and function improved. No other treatment is available that can produce structural change in an existing
In our desperate wish for pain relief, we sometimes receive treatment that is harmful. One of those treatments may be botulinum toxin, frequently provided as Botox injections to tender muscles. A recent article showed how Botox could produce permanent damage in muscles with normal muscle fibers being replaced with fat cells.
A large study of army recruits demonstrated the protective effect of exercise on the development of knee pain. Male and female recruits who performed 4 stretching and 4 strengthening exercises for 7 weeks, were 75% less likely to develop anterior knee pain.
The patient mentioned in the blog posted in March, 2011 copied me on an email he sent: “I’ve been waiting for clearance from my surgeon who finally declared my fusion as failed (FBSS) in early March and offered no additional hope for pain reduction. At one-year post surgery I could be evaluated for an implanted
