Keeping Your Lawn Green and Your Back Pain-Free

Keeping Yourself Warm and Pain-Free This Winter

As winter comes into full swing, our attention turns to snow, ice and, winter activities. Here are a few tips to keep you pain-free this winter season. The winter environment can be great fun, but is also unforgiving.

  1. Be careful and pay attention – The most common causes of injuries in the winter include slips and falls. Make sure you wear proper footwear and take the extra time to walk slowly and to be aware of your surroundings. It only takes a small patch of ice to change a safe winter into a miserable painful one. Get an ice tip for your cane if you use one.
  2. Work safer -When shoveling snow, use proper equipment. Find a comfortable shovel to avoid repetitive injuries. Always wear gloves to protect your hands and boots to protect your feet and to prevent falls when clearing snow. Consider using an ergonomically designed shovel. The extra $5-10 in cost may save a lot of co-pay dollars. When operating a snow blower, wear protective goggles. Never put your hand in the chute to clear a jam with the machine off or on. Otherwise, plan on collecting your fingers when they come out the other side!
  3. Play safer—Helmets, Helmets, Helmets! – Use proper equipment when participating in winter activities. According to the American Association of Neurological Surgeons, in 2009 there were 16,948 winter sports (skiing, sledding, snowboarding, and snowmobiling) head injuries treated in emergency rooms. There were an additional 8,145 hockey related head injuries. When snowmobiling, skiing or snowboarding, always wear a helmet. When skiing, make sure you use proper fitting equipment that has had the bindings checked. Use proper technique to take some pressure off your back, knees, and other joints. Get a lesson for your safety and the safety of others! A very close call reminded me of this just last weekend. A little prevention can save you from a painful winter season.
  4. Take a break – Often we become so engrossed in our activities that we fail to take a much needed break. On your break, avoid consuming alcohol as it will impair your judgment and increase your heat loss. Repetitive motions are a common source of injury. Keep a timer and take a break every thirty minutes. Remember most ski injuries occur later in the day, especially on the third day of skiing or riding.
  5. Know your limits – Every individual is unique and there is no single regimen that will fit all. Know yourself. We tell our patients that they know their bodies better than anyone else does. If something feels wrong, just stop doing it. Know your limits! Most importantly, if you do injure yourself, don’t wait too long to seek medical advice. Often seemingly minor strains and sprains, if left untreated, can lead to more serious issues later on. With some attention and care, you can make your winter experience pain-free.

New York Pain Management has board certified pain physicians working for you. We have locations in Clifton Park and Queensbury and more information can be found on our website at https://www.nypainfree.com.

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Chronic Back Pain Q&A

Chronic Back Pain Q&A

Sam asks: “I have had two back surgeries and still have pain. The first surgery was great, but I popped another disc requiring a second operation. The second surgery helped at first but now one year after the pain has returned. What would you suggest?

Sam, as with Jim and Alicia, you need a full history and exam by a trained and certified pain specialist. Because of our experience in treating many patients like you, I would suggest an up-to-date imaging of your back as a starting point. The most common causes of recurrent pain are recurrent herniated discs, scar tissue build up, and narrowing or stenosis in various areas of the spine. Your treatment will vary depending on what is found. Often, non-invasive modalities listed above may be all that is required to take care of your pain. Unfortunately, the answers to this problem are often complex. You may require more invasive treatment options such as an x-ray guided steroid injection, image guided nerve lesioning, or spinal cord stimulation depending on the severity of your pain, history, physical exam, and imaging studies.

For additional questions on this subject or other chronic pain questions, and how we can possibly help you, please feel free to contact Dr. Gordon via e-mail info@nypainfree.com or call us directly at the number below.”

New York Pain Management has Board Certified Pain Physicians working for you. We have locations in Clifton Park and Queensbury and more information can be found on our website at https://www.nypainfree.com

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Finding a Board Certified Physician

Finding a Board Certified Physician

Susan asks: “How important is it to find a physician that is board certified in pain management and what does it mean?”

Hello Susan. Given the volume and breadth of medical knowledge, most physicians choose to specialize in a particular field of medicine and undergo additional training in a residency and/or fellowship. The American Board of Medical Specialties (ABMS) which is comprised of roughly twenty-four individual medical specialty boards, oversees medical education and medical training. The ABMS requires high standards of training and performance and ensures them by rigid initial and periodic examinations. Applicants that successfully meet these standards receive diplomas and are considered “board certified.” Finding a physician that is board certified in pain medicine ensures that your physician has undergone the highest level of training and possesses the most up-to-date knowledge to address your pain needs. You can always check the credentials of your physician by logging on to the ABMS website at www.abms.org to see if your physician is indeed board certified in their particular field of practice.

For additional questions on this subject or other chronic pain questions, and how we can possibly help you, please feel free to contact Dr. Gordon via e-mail info@nypainfree.com or call us directly at the number below.”

New York Pain Management has Board Certified Pain Physicians working for you. We have locations in Clifton Park and Queensbury and more information can be found on our website at https://www.nypainfree.com

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FAQ Spinal Cord Stimulators

FAQ Spinal Cord Stimulators

Coping with Chronic pain can be one of life’s greatest challenges. Optimum pain control with fewer side effects is our goal at New York Pain Management. There are many modalities that are common in treating chronic pain (such as neck and back pain). Treatments may include physical therapy, oral medications, chiropractic care, injections, such as epidural steroids, lysis of adhesions, facet joint injections and radiofrequency procedures.

When treatments such as these fail to provide relief, surgery may or may not be an option. When surgery is not an option, there are specialized modalities that have been developed that can be used to help control pain.

Simple implanted devices called “Spinal Cord Stimulators” can be extremely effective in diminishing and controlling pain. The device controls pain by gently stimulating specific nerves, diminishing painful sensations and ultimately gives the patient control over how much or how little stimulation he or she receives.

Details can be found at here.

This advanced approach to pain management is useful in treating multiple pain syndromes including sciatica, post laminectomy syndrome, nerve pain such as diabetic neuropathy, neuralgias and reflex sympathetic dystrophy or ischemic pain.

FAQ on Spinal Cord Stimulators

How do I know if spinal cord stimulation will work for me?
When evaluated by New York Pain Management’s board certified physicians, you will undergo a full history and physical exam. If your diagnosis is one that will benefit from spinal cord stimulation AND we find that ALL available less invasive treatments have been tried and failed, we will recommend you for trial stimulation.
What is a trial spinal cord stimulation?
At New York Pain Management, a trial spinal cord stimulator is done with temporary leads. The leads are inserted under x-ray guidance and left in place for a few days. This procedure takes approximately one hour and is done under light sedation. The trial gives the patients the opportunity to experience what stimulation feels like and to determine if it is beneficial for them. They are easily removed in minutes once the trial is done.
What are the risks involved? Is Spinal Cord Stimulation Safe?
Spinal cord stimulation has been safely used for over two decades in accredited facilities by trained board certified physicians. The U.S. Food and Drug Administration (FDA) has approved spinal cord stimulation for use with multiple types of pain. Risks can include hematoma, infection, failure of the stimulator and isolated nerve injury.

For additional questions on this subject or other chronic pain questions, and how we can possibly help you, please feel free to contact Dr. Gordon via e-mail info@nypainfree.com or call us directly at the number below.”

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Acupuncture and Integrative Medicine

Acupuncture and Integrative Medicine

I had the pleasure of returning to Shanghai recently, on a physician exchange program, to learn and study from pain physicians at the main city hospital and medical university. As the landscape of China itself has changed dramatically over the last ten years since my last visit, with new towering skyscrapers abutting 500 year old pagodas, so too have Chinese medical practices. Now, state of-theart PET scanners and tiny endoscopic cameras share space with herbal pharmacies and acupuncturists along hospital corridors. What is most remarkable is that despite the rapid influx of complex technological equipment, it has not supplanted ancient Chinese healing modalities including acupuncture, meditation, and herbal remedies. If anything, acupuncture, herbal remedies, Chinese massage and other modalities play an increasingly important role in Chinese medicine. During my month long stay, it was not unusual for a patient suffering from back pain to leave a doctor’s office with a prescription for an MRI and the newest anti-inflammatories, as well as a prescription for acupuncture and herbal treatments. This integrative approach to medicine incorporates elements of complementary and alternative medicine into comprehensive treatment plans along with orthodox methods of diagnosis and treatment. I found this model of healthcare is widespread in China and is becoming increasingly popular in the United States as well.

A 2007 study by the NIH (National Institute of Health) and CDC (Centers for Disease Control) showed that greater than 40% of all patients have tried some form of alternative or complementary medicine in the last year and that greater than 40 billion dollars are spent annually on alternative and complementary treatments. The popularity of alternative treatments is easy to understand. As medical students, our textbooks focused on disease diagnosis and treatment. However, patients, unlike diseases, ask challenging questions and present challenging issues. Patients have their own needs and priorities beyond treating disease including improved quality of life and exploring drug, and surgery, free approaches for their problems. By offering complementary approaches such as acupuncture and a host of other modalities in conjunction with the most advanced pain management options at NY Pain Management, we are able to fulfill this integrative model. We can shift the focus from the disease to the patient and multiply the number of strategies available to treat pain. An integrative approach provides increased options, symptomatic assistance, and hope to those in pain and suffering. In the upcoming months, we will talk more about specific complementary treatments including acupuncture and how it can help with pain as well as a host of other ailments.

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Chronic pain sufferers hit hard by the spiraling economy

Chronic pain sufferers hit hard by the spiraling economy

For the millions of Americans who suffer from chronic pain, popping an aspirin just doesn’t do the trick. They might have tried acupuncture, surgery, massage and physical therapy, but the pain won’t subside.

Then, they’re laid off. Health insurance benefits run out and they can no longer afford medication or treatment. Depression sets in, and the pain continues.

In today’s dire economic climate, chronic pain sufferers face this very real scenario all the time, local health experts say.

“The financial downturn is going to hit the chronic pain population harder,” said Dr. Gordan N. Kuhar, medical director of Saratoga Hospital’s Pain Management Center.

According to Dr. Charles Gordon, of New York Pain Management in Clifton Park, recent statistics report there are 40 million doctor visits per year due to chronic pain, and more then 500 million work days are lost from these visits.

“There’s more competition for jobs now,” Gordon said. “It makes it harder to take off lots of work,” due to chronic pain and injury.

When pain is combined with stressful psychological factors like losing a job, a home, a car or a spouse, the condition worsens and forms a cycle of causation from pain to stress and back again.

Depression

Health experts have varied responses when estimating how many chronic pain sufferers are clinically depressed, but they overwhelmingly agreed that depression and anxiety perpetuate the vicious cycle of pain, stress and dysfunction that their patients endure.

Kuhar estimates that two-thirds of chronic pain sufferers are clinically depressed, while Gordon said about half of his patients are on anti-depressant or anti-anxiety medication.

In a recent poll commissioned by the National Council on Aging, 30 million Americans age 65 and older have at least one chronic health condition. Half of them reported feeling depressed or angry as a result of their condition.

Both Kuhar and Gordon said everyone has different thresholds for pain and stress, and that threshold is affected by lots of factors: the environment, family and health history are just a few. When outside factors like financial hardship step in, they cause the already existing depression to snowball.

“We can all hold a certain amount of stress on our plate before the plate tips over,” Gordon said. “If you tend to be a downbeat person, pain and stress push you further in that direction.”

Some people are more likely than others to get caught in the cycle. Construction workers, athletes who do contact sports, youth, the elderly and the obese may have less efficient physical shock-absorbing systems, which can put them on the fast track to degenerative spine problems, Kuhar said. The majority of his non-cancer patients complain of back and neck soreness related to spinal problems, he added — and they are among 22 million Americans who suffer from persistent neck and back pain.

Financial obstacles

Gordon and Kuhar agree that the rising costs of insurance, co-pays and medicine have caused their patients to delay check-ups and testing.

“To some extent, people aren’t coming because they may not have insurance or can’t afford the co-pays,” Gordon said, adding he’s noticed the trend since late last fall, when the economy took a nose dive.

The National Council on Aging’s poll also found that one quarter of more than a million respondents said they had delayed getting health care or neglected to fill a prescription because of financial concerns. The problem seemed more pronounced among Latinos (49 percent) and Baby Boomer women (39 percent). Low-income individuals were more likely to delay care, but 22 percent of people who made $50,000 or more a year also put off doctor visits.

Others have a hard time buying brand name medications. Kuhar said he sometimes calls drug companies to negotiate for his patients’ needs and makes it a part of his daily routine to round up their first-choice medications.

“In a general sense, I can say that the cost of medication has gone up and the burden on patients as far as co-pays has generally gone up as well,” Kuhar said.

According to him, many third-party insurance payers are shifting more and more financial responsibility onto patients, who end up bearing the brunt of the cost. And, as the unemployment rate climbs, so does the number of people who can’t afford the medication they need.

An article published by HealthDay News in March states that as the economic recession deepens and more Americans lose their employer-based health insurance, health officials are worrying that people with chronic conditions will keep delaying treatment, ultimately making their condition worse.

Getting treatment, finding hope

As clinical social worker Caroline Russell Smith sees it, what’s so discouraging to many of her clients is “turning on the news to see an oppressive sense of doom” day after day. “So far it’s mostly people saying, ‘I’m having a hard time not thinking about what could happen or what may happen,’ ” Smith said.

Her weekly yoga and meditation class at One Roof holistic health center in Saratoga Springs combines mind and body exercise to alleviate people’s pain and psychological stress. Class members include people on disability assistance and those referred from local doctors and therapists, she said. Some are wheelchair- bound. Some are seeking a way to better their health despite issues they can’t control, like cancer, relationship troubles or workplace problems.

“While the reasons people come in vary, everybody there is complaining of some physical pain and psychological stress,” Smith said. “It’s a cost benefit for (insurance) companies and us, so people don’t have to go on medication or go to the hospital.”

The class is part of the Saratoga Stress Reduction program, and is taught four times a year by Smith and clinical psychologist Dr. Selma Nemer. The fee is $500, but One Roof offers a sliding scale for those whose health insurance won’t cover the cost.

Smith said “we’d make it work” for anyone who wants to take the class.

In his 15 years of practicing medicine, Kuhar said he can count on two hands the times he’s actually made a patient’s pain go away completely.

Typical treatment methods include epidural steroid injections, discography and joint injections to minimize people’s pain.

Anything suggested as a treatment method has a risk and a benefit, he said, citing some alternative methods patients have asked him about in the past, such as reiki and acupuncture. No matter how out-of-the-box they may sound, he usually finds them worthy of consideration.

“I embrace alternative ways of dealing with mental health and physical health issues,” Kuhar said. “My goal is to take that pain that dominates your day … and make it a nuisance.”

By MAREESA NICOSIA, The Saratogian

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