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PAIN MANAGEMENT

Pain Management

Accident and Work Injury Clinic offers a comprehensive range of services for pain management. Below you will find detailed information pertaining to back, neck and knee pain. While back, neck and knee pain are the most common ailments people suffer from we can diagnose and treat a variety of symptoms and pain management issues. 


BACK PAIN

 

How Common is Back Pain?

While it is estimated that four out of five people will experience back pain at some point in their lives, back pain that lasts longer than a few weeks is not normal.

Back Pain Symptoms:

Back pain symptoms may include feelings of muscle ache, stabbing or shooting pain, stiff or limited flexibility in the back or lower back, inability to stand with proper posture and radiating pain down one or both legs.

Where is my back pain coming from?

Muscle Strains

Did you know that muscle related pain is one of the most common reasons for overall back pain? It is true. Muscle related pain can be caused by improper lifting techniques, overuse, poor posture or a sudden awkward movement or fall.

Bulging or Herniated Discs - Spinal discs are soft cushions between vertebra. Sometimes, the soft jelly like substance inside the disc can bulge out of place or rupture, putting pressure on the surrounding nerves causing back pain. Disc related pain can be caused by an injury. Interestingly, some people who have bulging or herniated discs will never experience any back pain.

Sciatica - Sciatica refers to pain that stems from the sciatic nerve, a large nerve extending from the lower back down the back of each leg. Sciatica is not a disorder, but a symptom of another underlying problem, such as a spinal stenosis, a pinched/irritated nerve in the lower back or a herniated disc. Learn more about sciatica.

Other Painful Conditions:

If you have spinal stenosis, degenerative disc disease, scoliosis, compression fractures, arthritis or osteoporosis you may also experience pain in the back. These conditions can be treated with conservative, minimally invasive procedures.

Risk Factors for Back Pain:

There are a few factors that can increase your risk of developing back pain, such as: smoking, obesity, age, physical labor, sedentary work and depression.

Preparing for Your Doctor Appointment:

Before you meet with your clinic doctor, take note of some important facts.

Is your back pain the result of an injury?

What movements increase or decrease your back pain?

What are the symptoms you have been feeling?

How long have you had this back pain?

What does your back pain feel like? Dull, aching, stabbing or shooting?

What type of work do you do?

What treatments or medications have you already tried to resolve your back pain?

Diagnosis Testing:

To help determine the cause of your back pain, your provider may ask you a lot of questions and ask for some diagnostic testing. 

Some common diagnostic imaging includes:

X-Ray – an x-ray shows the alignment of the bones in your spine and whether you have any broken or arthritic bones that may be causing pain. Always bring your x-ray images with you to an appointment to help your provider understand your full history.

Magnetic resonance imaging (MRI) or computerized tomography (CT) scans – These tests show images of bone, muscle, tissue, nerves, blood vessels, tendons and ligaments. These tests can show disc herniation, muscle tears, ligament problems and can help your provider understand your back pain. 

Nerve Studies – Electromyography (EMG) – Electromyography (EMG) is a test used to study nerve and muscle function. There are two parts to EMG testing; a nerve conduction study and a needle exam for muscle testing. The nerve conduction study involves stimulating the nerves at different points with small electric stimulation so their function can be measured. The needle exam involves inserting very fine needles into several muscles. These needles pick up both normal and abnormal electrical signals given off by a muscle. The EMG can provide information about the extent of nerve and/or muscle injury and can give some indication as to whether the damage is reversible. An EMG may be performed when the patient has unexplained muscle weakness to distinguish if the problem is in the muscle or if it due to nerve disorders. The EMG can detect abnormal electrical activity of muscles and nerves that can occur in many diseases and conditions, including muscular dystrophy, muscle inflammation, pinched nerves, damage to nerves in the arms and legs (peripheral nerve damage), multiple sclerosis and carpal tunnel syndrome.

Back Pain Treatment Options:

There are a number of treatment options that help reduce back pain, which include:

Epidural Steroid Injection

Discogram

Facet Joint Injection

Trigger Point Injection

Radio-frequency

Neuroablation

Minimally Invasive Posterior Facet Fusion

Sacroiliac Joint Injection.


NECK PAIN

 

Neck Pain Symptoms:

Neck pain can occur from the top of your shoulders to the bottom of your head. Neck pain symptoms may be mild to severe and may limit your range of motion.

Neck Pain Causes:

As we age, neck pain can be caused by the wear and tear of tissues and joints. Neck pain can have many causes, but most of these are not serious conditions. Neck muscles can be strained or pulled from poor posture or even from sleeping in an awkward position. Over time, normal wear and tear or arthritis can also lead to neck pain. Certain injuries can lead to neck pain as well as nerve compression in the area.

Risk Factors: 

The weaker or more degenerated the tissue or joints in the neck become, the more susceptible the neck is to injury.

Age-As you age, you are more likely to have increased wear and tear on vertebrae, discs, muscles and joints. This can often lead to neck pain and arthritis.

Occupation: 

If your job requires you to hold your head in the same position for prolonged periods (professional driver, computer work), you may increase your risk for neck pain. The good news is that simple stretching and strengthening exercises can help you reduce your risk for neck pain. Download some simple exercises now.

Testing: 

There are many diagnostic tests that can be performed to determine the cause of neck pain. These include facet joint injections, medial branch block and EMG testing. Imaging scans done by a specialist may be used to identify neck pain or rule out other conditions with similar symptoms.

Neck Pain Treatment Options:

There are a number of pain management treatment options that help reduce neck pain, which include:

Cervical Epidural Steroid Injection

Facet Joint Injection or Selective Nerve Root Block

Trigger Point Injection

Massage Therapy

Discography for Appropriate Surgical Evaluation

Neurostimulation Therapy

Pain Psychology

Acupuncture

Physical Therapy

Medication Management

Radiofrequency Ablation


KNEE PAIN

 

Knee Pain Symptoms:

Knee pain is a common complaint affecting people of all ages. This may be a result of an injury or due to medical conditions such as arthritis, gout and even infection. The knee joint is made up of bones, ligaments, tendons, cartilage and bursae. Injury or inflammation to one of these structures can lead to knee pain. Some signs and symptoms of knee pain include swelling and stiffness, redness and warmth, weakness, popping or crunching sounds or locking of the knee in the affected area.

Knee Pain Causes:

Knee pain can result from a number of different things including an injury, pulled or torn ligaments and tendons, damaged cartilage, gait, and even muscle and back injuries. Knee pain also may simply occur following years of wear and tear playing sports, working or from general leisure activities. Injuries to the knee can affect the cartilage, ligaments, tendons and the bursae (fluid-filled sacs) that support, stabilize and cushion the knee joint. Some common injuries to the knee include:

ACL injury – The anterior cruciate ligament (ACL) is one of four ligaments in the knee that provides stability to the knee. Most often this ligament is injured with sudden directional changes with the knee bending inward and forward, tearing the ligament. This is seen in football, basketball and skiing injuries frequently.

Torn meniscus – The meniscus is tough cartilage that acts as the shock absorber between the femur (thigh bone) and the tibia (shin bone). This also can be torn with sudden twisting injury to the knee.

Bursitis – There are small sacs of fluid filled cushion that surround the knee joint. When these become irritated and inflamed, pain occurs especially with movement. 

Loose body – An injury or general wear and tear can cause pieces of bone or cartilage to become loose and break off. The loose body can interfere with the normal movements of the knee and cause pain with movement.

Patellar tendinitis – This occurs when there is irritation or inflammation of the tendon around the patella (knee cap). Typically, runners, skiers, cyclists and sports involving heavy jumping and stress on the knees are prone to this injury. 

Patellar dislocation – The patella (knee cap) covers the front of the knee and glides through the normal range of motion. If the patella becomes dislocated pain occurs as there is excessive lateral, or side to side, movement of the patella.

Certain medical conditions also lead to knee pain. These include:

Osteoarthritis – This is the most common type of arthritis. This is usually the result of wear and tear injury where the cartilage breaks down over a period of years from use and with age. As the cartilage disappears, the cushion is destroyed and bone on bone grinding can occur, leading to knee pain.

Rheumatoid arthritis – This is an autoimmune condition that can affect many other joints in the body besides the knee. This is a chronic disease condition and the severity and impact on a patient is variable from mild to severe. 

Gout – This condition results from excessive uric acid crystal build up in the joints of the body. Typically patients have the big toe affected as well as the knee.

Pseudogout – This condition is similar to gout; however, there is a buildup of crystals of calcium pyrophosphate instead of uric acid. Knees are commonly affected by this condition.

Knee Pain Risk Factors:

A person may be more likely to experience certain types of knee pain and knee problems common to their age and sex group. Excess weight increases stress on the knee joints on a daily basis. Being involved in sports or having a previous knee injury also increases the chance of experiencing knee pain. Certain activities and sports tend to create more stress on the knees causing injury such as skiing, basketball and football.

Testing:

A physical exam by a doctor is often the first step to determine the source of knee pain. Following a doctor's assessment, imaging tests including x-rays, CT scans, ultrasounds and MRI’s may be necessary to help pin-point the cause of knee pain and determine the best knee pain treatment plan.

Knee Pain Treatment Options:

Advanced minimally invasive treatment options for knee pain have improved outcomes and can help you return to the activities you enjoy. There are a number of treatment options that help reduce knee pain, which include:

Steroid Injection

Percutaneous Tenotomy or Fasciotomy 

Nerve Blocks

Acupuncture

Massage Therapy

Physical Therapy

Medication Management

Pain Psychology