Conditions Treated

Back Pain

Back pain affects 80% of Americans at some time in their lives. It comes in many forms, from lower back pain, middle back pain, or upper back pain to low back pain with sciatica. Common back pain causes include nerve and muscular problems, degenerative disc disease, and arthritis. Many people find relief from symptoms of back pain with pain medication or painkillers.

Neck Pain

Neck pain can occur anywhere in your neck, from the bottom of your head to the top of your shoulders. It can spread to your upper back or arms. It may limit how much you can move your head and neck. Neck pain is common, especially in people older than 50. Most neck pain is caused by activities that strain the neck. Slouching, painting a ceiling, or sleeping with your neck twisted is some things that can cause neck pain. These kinds of activities can lead to neck strain, a spasm of the neck muscles, or swelling of the neck joints. Neck pain can also be caused by an injury. A fall from a ladder or whiplash from a car accident can cause neck pain. Some less common medical problems can also lead to neck pain, such as:

• An infection in the neck.
• Narrowing of the spinal canal in the neck (cervical spinal stenosis).
• Rheumatoid arthritis.

Shoulder Pain

The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from one or more of the following causes:

• Strains from overexertion
• Tendonitis from overuse
• Shoulder joint instability
• Dislocation
• Collar or upper arm bone fractures
• Pinched nerves (also called radiculopathy)

Pinched Nerve

The term pinched nerve describes one type of damage or injury to a nerve or set of nerves. The injury may result from compression, constriction, or stretching. Symptoms include numbness, "pins and needles" or burning sensations, and pain radiating outward from the injured area. One of the most common examples of a single compressed nerve is the feeling of having a foot or hand "fall asleep." Pinched nerves can sometimes lead to other conditions such as peripheral neuropathy, carpal tunnel syndrome, and tennis elbow. The extent of such injuries may vary from minor, temporary damage to a more permanent condition. Early diagnosis is important to prevent further damage or complications. Pinched nerve is a common cause of on-the-job injury.

CRPS-Type I / II

Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome, is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems.

CRPS is most common in people aged 20-35. The syndrome also can occur in children; it affects women more often than men. CRPS most likely does not have a single cause but rather results from multiple causes that produce similar symptoms. Some theories suggest that pain receptors in the affected part of the body become responsive to catecholamines, a group of nervous system messengers. In cases of injury-related CRPS, the syndrome may be caused by a triggering of the immune response which may lead to the inflammatory symptoms of redness, warmth, and swelling in the affected area. For this reason, it is believed that CRPS may represent a disruption of the healing process.

Cancer Pain

The majority of people with cancer will experience pain at some time or another. The pain can result from the cancer itself, or from the cancer's treatment. In addition, some people who have been cured of their cancer can continue to suffer from pain. Cancer pain, or the discomfort that stems from cancer and its treatment, can be controlled most of the time. There are many different medicines and methods available to control cancer pain. People who have cancer and are feeling pain need to inform their doctor immediately. The earlier pain treatment is started, the more effective it is.

Headaches

According to the National Headache Foundation, over 45 million Americans suffer from chronic, recurring headaches and of these, 28 million suffer from migraines. About 20% of children and adolescents also have significant headaches.

What Types of Headaches Are There?

There are several types of headaches - 150 diagnostic headache categories have been established!

• Tension headaches: Also called chronic daily headaches or chronic non-progressive headaches, tension headaches are the most common type of headaches among adults and adolescents. These muscle contraction headaches cause mild to moderate pain and come and go over a prolonged period of time.
• Migraines: The exact causes of migraines are unknown, although they are related to blood vessel contractions and other changes in the brain as well as inherited abnormalities in certain areas of the brain. Migraine pain is moderate to severe, often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually occur 1 to 4 times per month. Migraines are associated with symptoms such as light sensitivity; noise or odors; nausea or vomiting; loss of appetite; and stomach upset or abdominal pain. When a child is having a migraine they often look pale, feel dizzy, have blurred vision, fever, stomach upset, in addition to having the above listed symptoms. A small percentage of pediatric migraines include recurrent (cyclic) gastrointestinal symptoms, in which vomiting is most common. Cyclic vomiting means that the symptoms occur on a regular basis -- about once a month. These types of migraines are sometimes called abdominal migraines.
• Mixed headache syndrome: Also called transformed migraines, this is a combination of migraine and tension headaches. Both adults and children experience this type of headache.
• Cluster headaches: The least common, although the most severe, type of primary headache, the pain of a cluster headache is intense and may be described as having a burning or piercing quality that is throbbing or constant. The pain is so severe that most cluster headache sufferers cannot sit still and will often pace during an attack. The pain is located behind one eye or in the eye region, without changing sides. The term "cluster headache" refers to headaches that have a characteristic grouping of attacks. Cluster headaches occur one to three times per day during a cluster period, which may last 2 weeks to 3 months. The headaches may disappear completely (go into "remission") for months or years, only to recur.
• Sinus headaches: Sinus headaches are associated with a deep and constant pain in the cheekbones, forehead or bridge of the nose. The pain usually intensifies with sudden head movement or straining and usually occurs with other sinus symptoms, such as nasal discharge, feeling of fullness in the ears, fever, and facial swelling.
• Acute headaches: Seen in children, these are headaches that occur suddenly and for the first time and have symptoms that subside after a relatively short period of time. Acute headaches most commonly result in a visit to the pediatrician's office and/or the emergency room. If there are no neurological signs or symptoms, the most common cause for acute headaches in children and adolescents is a respiratory or sinus infection.
• Hormone headaches: Headaches in women are often associated with changing hormone levels that occur during menstruation, pregnancy, and menopause. Chemically induced hormone changes, such as with birth control pills, also trigger headaches in some women.
• Chronic progressive headaches: Also called traction or inflammatory headaches, chronic progressive headaches get worse and happen more often over time. These are the least common type of headache, accounting for less than 5% of all headaches in adults and less than 2% of all headaches in kids. Chronic progressive headaches may be the result of an illness or disorder of the brain or skull.

Myofacial Pain

Most people have muscle pain from time to time. But myofascial pain is a kind of ongoing or longer-lasting pain that can affect the connective tissue (fascia) of a muscle or group of muscles. With myofascial pain, there are areas called trigger points. Trigger points are usually in fascia or in a tight muscle.

When you put pressure on a trigger point, you not only feel pain at the trigger point but you may also feel it in muscles in another area. For example, pressure on a trigger point in the neck may cause pain in your arm. This is called referred pain. Myofascial pain often goes away with treatment. Experts don't know exactly what causes myofacial pain syndrome. It may start after:

• Strain or injury to the muscles, ligaments, or tendons.
• Overuse, such as from typing on a computer or writing at a desk.
• Using a muscle after you haven't used it for a while, such as after a stroke or after having a broken bone.

Post Laminectomy Syndrome

Failed back syndrome (FBS) refers to chronic back and/or leg pain that occur after back (spinal) surgery. Multiple factors can contribute to the onset or development of FBS. Contributing factors include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression, anxiety, sleeplessness and spinal muscular deconditioning. An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease. Smoking is a risk for poor recovery from such an operation.

Common symptoms associated with FBS include diffuse, dull and aching pain involving the back and/or legs. Abnormal sensibility may include sharp, pricking, and stabbing pain in the extremities. Failed Back Syndrome should be evaluated and treated with an interdisciplinary approach with a group of healthcare professionals from varied fields working together toward a common goal for the patient. The therapeutic approach to FBS may range from non-surgical to surgical intervention. The term “post-laminectomy syndrome” is used by some doctors to indicate the same condition as failed back syndrome.

Shingles and Postherpatic Pain

Shingles is an infection caused by the same virus that causes chickenpox, the varicella-zoster virus. Shingles results in a rash that can be mildly itchy to intensely painful. The rash appears as raised dots that develop into blisters, then dry out and crust over.

Shingles occurs in people who had chickenpox previously; in cases of shingles, the dormant (inactive) varicella-zoster virus becomes active again. Shingles generally affects the elderly, but it can appear in younger people or in people who are immunodeficient (lacking the proper immune defenses to fight off illness)

Occupational Injuries

Mention "repetitive strain" or "repetitive motion" injury, and most people think of carpal tunnel syndrome, the debilitating condition arising from long-term computer use. But according to the Occupational Safety and Health Administration (OSHA), 60% of all work-related musculoskeletal disorders (MSDs) actually occur in manufacturing and so-called manual handling jobs. So even though such jobs account for just 28% of America's workforce, OSHA's new ergonomics proposal is worded specifically to apply to these workers so that employers know they must be covered.

Who are these workers? By OSHA's definition, manufacturing includes not just piecework on an assembly line but also product inspection and packaging, operation of heavy machinery, and activities like commercial baking, cabinet making, and building tires. Manual handling covers everything from bagging groceries and delivering packages to lifting and caring for a patient undergoing physical therapy. (Agriculture, construction, and maritime jobs, which have a much higher rate of turnover, are not covered as of yet, although the agency intends to address those areas of work in future regulations.)

Auto Accidents

The collision that usually causes the least amount of damage is called a low speed impact crash. A low impact crash is generally defined as one that takes place at speeds under 10 miles per hour (mph). Insurance companies believe since these impacts are at such low speeds that damage should be very little. Insurance companies also would like to convince you that at such low speeds that bodily injury is not possible.

A motor vehicle might be built to take a 5 or 10 mph crash your body’s soft tissue is not. The neck and back are the areas usually most affected. The chest and ribs can also sustain injury. The motor vehicle can take the force of the collision but it needs to push the inertia somewhere and it that turns out to be the occupants a lot of the time. At first glance low impact accidents might seem to mean low injury or damage but it can be different if you look below the surface.

Injuries from side impacts are most often head, neck, dislocations, chest, arms and legs. This is in addition to cuts, bruises and soft tissue damage. If a head injury has occurred there also might be headaches, dizziness, blurred vision and neurological issues. This is one reason the insurance industry would like to see more side airbags installed into vehicles. With a side impact collision the insurance company receiving the claim can be paying a lot of money out not just for totaled cars but also because of the bodily injury that has been sustained.

Frontal collisions cause injuries that are much more severe than those in a low impact accident. Injuries may involve many body parts or even fatal wounds. Some possible injuries are to the neck, back, chest, ribs, head, arm and legs. There are also the possibility of internal injuries, concussions and various cuts and abrasions. This is a lot of bodily injury for insurance companies to worry about. This is also why cars with extra safety features allow you a discount with your insurance company. That air bag deploying can cut your injuries in half and thus the insurance bodily injury payout is lessened.

Rollover crashes are also a type of impact accident. Most rollovers occur when a vehicle runs off a road and turns over on it sides or continues to flip over once. Rollover collisions might involve one vehicle or more. They are very serious crashes that result in a high number of fatalities.

Injuries in a rollover accident can be quite serious. It is believed that the best way to prevent or limit rollover injuries is to use the seat belt and avoid aggressive or erratic driving. Taking a turn at a high rate of speed, over-correcting a swerve or leaving the even roadway are all conditions that can lead to a rollover. The injuries that arise from this type of impact depend on the severity of the roll, the amount of times the vehicle roll, the terrain on which the vehicle overturned and if the occupants can dislodge themselves from the vehicle without assistance.

The worst injuries will occur to a passenger that was not wearing a seat belt and was ejected from the vehicle. The injuries can be head, soft tissue, neck, chest, arms, legs, ribs and internal bleeding. One would be lucky to come out of a rollover accident with only cuts, scraps and bruising. Rollovers scare not only the occupants but the insurance industry as well. They know but the vehicle and bodily injury claims are certain to be very high.

The low impact collision, the side impact, the frontal impact, rear impact and rollover can be all serious accidents for the people involved. It can take as little as a 10 mph crash to cause continual neck or back pain. Different vehicles absorb energy in different ways.

TMJ Dysfunctions

The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull. Temporomandibular disorders (TMD) occur as a result of problems with the jaw, jaw joint, and surrounding facial muscles that control chewing and moving the jaw.

This joint is immediately in front of the ear on each side of your head. The joints are flexible, allowing the jaw to move smoothly up and down and side to side and enabling you to talk, chew, and yawn. Muscles attached to and surrounding the jaw joint control its position and movement.

The cause of TMD is not clear, but dentists believe that symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself. Injury to the jaw, temporomandibular joint, or muscles of the head and neck such as from a heavy blow or whiplash can cause TMD. Other possible causes include:

• Grinding or clenching the teeth, which puts a lot of pressure on the TMJ
• Dislocation of the soft cushion or disc between the ball and socket
• Presence of osteoarthritis or rheumatoid arthritis in the TMJ
• Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth

Myofacial Pain

Most people have muscle pain from time to time. But myofascial pain is a kind of ongoing or longer-lasting pain that can affect the connective tissue (fascia) of a muscle or group of muscles. With myofascial pain, there are areas called trigger points. Trigger points are usually in fascia or in a tight muscle.

When you put pressure on a trigger point, you not only feel pain at the trigger point but you may also feel it in muscles in another area. For example, pressure on a trigger point in the neck may cause pain in your arm. This is called referred pain. Myofascial pain often goes away with treatment.

Experts don't know exactly what causes myofacial pain syndrome. It may start after:

• Strain or injury to the muscles, ligaments, or tendons.
• Overuse, such as from typing on a computer or writing at a desk.
• Using a muscle after you haven't used it for a while, such as after a stroke or after having a broken bone.

Sacroiliitis

Sacroiliitis is an inflammation of one or both of the sacroiliac joints, which connect your lower spine and pelvis. With sacroiliitis, even the slightest movements of your spine can be extremely uncomfortable or even painful for you. Sacroiliitis can be difficult to diagnose, and it may be mistaken for other causes of low back pain, including sciatica, herniated disks and strained muscles. Sacroiliitis may be associated with a group of diseases called spondyloarthropathies, which cause inflammatory arthritis of the spine. Treatment for sacroiliitis may involve a combination of you resting, receiving physical therapy and taking medications.

Joint Pain

Joint pain is discomfort that arises from any joint — the point where two or more bones meet. Joint pain is sometimes called arthritis or arthralgia. Joint pain can be mild; causing some soreness each time you move your joint. Or joint pain can be severe, making it impossible to use your joint. Joint pain is rarely an emergency. Most cases of mild joint pain can initially be managed at home.

Spinal Injuries

In 1995, actor Christopher Reeve fell off a horse and severely damaged his spinal cord, leaving him paralyzed from the neck down. From then until his death in 2004, the silver screen Superman became the most famous face of spinal cord injury. Most spinal cord injury causes permanent disability or loss of movement (paralysis) and sensation below the site of the injury. Paralysis that involves the majority of the body, including the arms and legs, is called quadriplegia or tetraplegia. When a spinal cord injury affects only the lower body, the condition is called paraplegia.

Christopher Reeve's celebrity and advocacy raised national interest, awareness and research funding for spinal cord injury. Many scientists are optimistic that important advances will occur to make the repair of injured spinal cords a reachable goal. In the meantime, treatments and rehabilitation allow many people with spinal cord injury to lead productive, independent lives.

Fibromyalgia

You hurt all over, and you frequently feel exhausted. Even after numerous tests, your doctor can't find anything specifically wrong with you. If this sounds familiar, you may have fibromyalgia.

Fibromyalgia is a chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points — places on your body where slight pressure causes pain.

Fibromyalgia occurs in about 2 percent of the population in the United States. Women are much more likely to develop the disorder than are men, and the risk of fibromyalgia increases with age. Fibromyalgia symptoms often begin after a physical or emotional trauma, but in many cases there appears to be no triggering event.

Disk Herniations and Bulges

A herniated disk can affect how you're able to perform everyday tasks and can cause severe pain that influences almost everything you do. You and your doctor will make decisions about how to best treat your herniated disk (herniated disc), sometimes also called herniated disc, ruptured disk or slipped disk.

No single treatment choice is best for everyone. Your decisions will be based on a number of factors, including:

• The nature of your condition
• The degree to which it's affecting your lifestyle
• The level of pain you're experiencing

Think of yourself and your doctor as partners in making decisions about how to treat your herniated disk. You'll want to carefully consider all your options and the risks and benefits of each in relation to your lifestyle and what's important to you. The information here is intended to help you understand the various treatment options and decide which treatment may be best for you. This guide also frames key questions to help you in this important decision-making process.

This guide is designed for you if you're diagnosed with a herniated lumbar disk, but not a herniated cervical disk. Lumbar disk herniation occurs in the lower (lumbar) region of the spine and occurs more frequently than does neck (cervical) herniation.

Sciatica / Leg Pain

The sciatic nerve is the longest nerve in your body. It runs from your spinal cord to your buttock and hip area and down the back of each leg. The term "sciatica" refers to pain that radiates along the path of this nerve — from your back down your buttock and leg.

Sciatica isn't a disorder in and of itself. Instead, sciatica is a symptom of another problem involving the nerve, such as a herniated disk. Depending on the cause, the pain of acute sciatica — which you may find considerably uncomfortable — usually goes away on its own in four to eight weeks or so.

In the meantime, self-care measures may help you ease sciatica. Sometimes, your doctor will suggest other treatment.

Diabetic Neuropathy

Many people with diabetes eventually develop some form of nerve damage, a condition known as diabetic neuropathy. High blood sugar can injure nerve fibers throughout your body, but nerves in your legs and feet are damaged most often.

Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal.

Diabetic neuropathy is the most common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.

Peripheral Neuropathy

Peripheral neuropathy, in its most common form, causes pain and numbness in your hands and feet. The pain typically is described as tingling or burning, while the loss of sensation often is compared to the feeling of wearing a thin stocking or glove.

Peripheral neuropathy can result from such problems as traumatic injuries, infections, metabolic problems and exposure to toxins. One of the most common causes of the disorder is diabetes.

In many cases, peripheral neuropathy symptoms improve with time — especially if it's caused by an underlying condition that can be resolved. Medications initially designed to treat other conditions, such as epilepsy and depression, are often used to reduce the painful symptoms of peripheral neuropathy.