Pain We Treat

A herniated disc can occur in one of the three areas of the spine: cervical, lumbar or thoracic. In each of these areas, the disc which is the pillow-like cushion between each vertebrae begins to press on the nearby spinal nerves. Common references to a herniated disc include a pinched nerve, or a ruptured or slipped disc. Pain and symptoms vary based upon the location of the herniated disc in the spine. Treatment options may range from conservative modalities such as rest, physical therapy, or epidural steroid injections to surgical intervention. 

Cervical Radiculitis is a term that describes a spinal nerve root that is inflamed instead of being compressed. Examples of the pain associated with radiculitis include pain that radiates from the point of irritation. It is a well-known cause of shoulder pain, neck, and arm pain, which may only affect one side of your body. Additional symptoms may include finger numbness or tingling, or motor problems such as loss of reflexes or lack of coordination due to muscle weakness.

The often used term of Sciatica describes nerve pain that starts in the lower back and travels deep through the buttock and down into one leg. This constant burning sensation, numbness or shooting pain of sciatica is caused by irritation and/or compression of the sciatic nerve. A person with sciatica may feel the symptoms worsen when seated, trying to stand, lying down, or bending forward. Sciatica is most common in people 30 to 50. 

Degenerative Disc Disease is less of a disease and more of a condition experienced by persons typically over the age of 40. As a body ages, the discs that serve as cushions between the vertebrae on the spinal column may wear out. When this deterioration happens, pain can range from mild to severe with pain primarily in the neck and lower back which may extend to the arms and hands and also to the buttocks and thighs. The pain may become more severe when sitting or after lifting, twisting or bending. 

Spondylosis is a general term often describing degenerative conditions in the spine, with specific reference to arthritis in the facet joints. Facet joints are positioned between vertebral segments of the spine and provide stability and support. The facet joints can become worn out due to aging, trauma from accidents, repetitive wear and tear, or an abnormal posture. Inflamed facet joints may cause pain, stiffness, and soreness, often from a long period of sitting or standing too long. Based on the area of the spine where the inflamed joints are located, the pain may be felt in the upper back at the base of the skull, neck, or shoulders, mid-back, or in the buttocks, hips, groin, or thighs. Treatment options exist for facet joint syndrome, and your PCA physician will consult with you on the appropriate plan for your pain.

Spine surgery may eliminate the severe pain caused by compressed nerves or an unstable joint. However, some patients may continue to experience pain even after surgery. When patients with Post Laminectomy Surgery Syndrome come to PCA, we consult based on the whole back pain history and come to a treatment plan intended to provide relief without additional surgery. A consultation with a PCA physician will determine the most appropriate treatment, ranging from physical therapy to an interventional procedure.

In a battle with cancer, pain will likely occur. And because of the pain and the depressive state that often is present, working together on a treatment plan specifically for cancer-related pain is vitally important. Pain is often present due to the cancer or tumor itself but can often appear as a result of the necessary cancer treatments including radiation, chemotherapy, surgery, and others. There are many interventional procedures you can discuss with your physician in order to relieve your pain so that you can focus more on recovery.

Postherpetic Neuralgia (PHN) is nerve pain, often debilitating, that is associated with the aftermath of Shingles caused by the chickenpox virus. PHN may occur in the areas where the shingles rash and blisters appeared even after they have disappeared. The pain can last for years with severe effects on daily living and emotional and psychological health. PCA can develop a treatment plan with you to alleviate the pain and help you resume your normal activities again. 

While a cervicogenic headache is often a steady, non-throbbing pain at the back and base of the skull or sometimes behind the brow and the forehead, it actually is due to a problem in the cervical spine. The pain may extend down into the neck and between the shoulder blades. There are several reasons for a cervicogenic headache including a damaged disk, cervical osteoarthritis (spondylosis), or whiplash.

Ultimately, the cause of a cervicogenic headache is usually related to excessive stress to the neck. Treatment for cervicogenic headache should target the cause of the pain in the neck and vary based on the individual patient. Treatment options may include nerve blocks, medications, physical therapy, and exercise.

Arthritis is an inflammation of the joints which may affect only one or many joints. It is a painful condition that may worsen with age and activity. Arthritis can also affect young adults or children. People living with arthritis experience pain and stiffness, swelling, and a decreased range of motion in the affected joints. The pain might be moderate or severe, and it might even come and go. Severe arthritis can be debilitating with chronic pain reducing your ability to climb stairs or manage daily activities. Of the many types of arthritis or joint disease, the most common are osteoarthritis and rheumatoid arthritis. Osteoarthritis causes breakdown of cartilage, the tissue that covers the ends of bones at a joint. Rheumatoid arthritis is a different condition in that the immune system begins to attack the joints. A treatment plan begins with a proper diagnosis, and your PCA physician will work with you on the best option to alleviate arthritis pain.

SI Joint Syndrome is also called sacroiliitis. Your sacroiliac joints are located where your hips connect to your spine and are key in supporting your back and also absorbing the impact of walking and lifting. The sacroiliac joints can wear down due to aging or may be aggravated by child-birth or injury. SI joint syndrome is an inflammation of those joints and can cause pain in your lower back or buttocks and can travel down one or both of your legs. Symptoms of sacroiliitis may be similar to other causes of low back pain such as a herniated disc, spinal stenosis, or facet joint syndrome. There are numerous interventional procedures which your PCA physician will discuss with you in a consultation. Other terms for SI joint pain include: SI joint dysfunction, SI joint syndrome, SI joint strain, and SI joint inflammation.

Degenerative Joint Disease is also known as Osteoarthritis, the most common of arthritic conditions which causes inflammation in the joints due to cartilage breakdown. Osteoarthritis can occur in virtually any joint but is most common in hands, fingers and knees. Pain includes tenderness when pressure is applied, stiffness, inflammation, and swelling. Advanced cases can cause disruption in daily activities or work.

Because this condition is related to the general wear and tear of the cartilage protecting the joints, aging is the most common cause of Osteoarthritis. Women over 50 are the most at risk. Osteoarthritis also can be brought on by accidents involving ligament injuries, dislocated joints, or torn cartilage. Your PCA physician will discuss symptom management during your consultation.

Complex regional pain syndrome (CRPS) is a form of chronic pain in the arms, legs, hands or feet that can develop after surgery, or an injury, and sometimes a stroke or heart attack. CRPS is uncommon as the person’s pain is usually out of proportion to the severity of the initial injury or incident. It causes intense pain, usually in the arms, hands, legs, or feet. It may happen after an injury, either to a nerve or to tissue in the affected area. Rest and time may only make it worse. Proper diagnosis of CRPS involves tests to rule out other possible causes of the pain and the sooner diagnosis and treatment begins, the better the chances of recovery. 

Neuropathic pain – otherwise known as nerve pain – is a complex type of chronic pain that occurs when nerves in the central nervous system become injured or damaged. It often is accompanied by tissue injury. Causes can be attributed to damage caused by surgery, trauma or the progression of disease including diabetes, cancer or infection, after shingles. With neuropathic pain, the nerve fibers themselves might be injured resulting in sending incorrect signals to other pain centers. You might describe your pain as burning, electric-like, raw, shooting, or a deep and dull ache. 

Occipital neuralgia is a very distinct type of headache that may show with a piercing, or electric shock-like pain felt one side of the back of the head, behind the ear, or in the upper neck for a few seconds or several minutes. Usually, this pain might begin in the neck and then spread upwards onto the head. The scalp is often extremely sensitive to even the lightest touch, causing issues with hair washing or resting the head on a pillow. Specialists have found that occipital neuralgia can affect people with other headache conditions such as migraines. 

Trigeminal neuralgia is a chronic condition which can cause searing facial pain, most often in the lower face and jaw and around the nose, ears, eyes, or lips. This nerve disorder of the face is noted as being twice as common in women than men, often after the age of 50. With unpredictable attacks followed by increasingly brief periods of remission, many in the medical field have acknowledged trigeminal neuralgia as the most painful condition in existence. The attacks of intense stabbing or burning pain may be short-lived for a few minutes, usually one side of the face. If you have trigeminal neuralgia, even mild stimulation of your face may trigger a jolt of excruciating pain. The trigger for the painful episodes can be from simple everyday tasks such as brushing your teeth, putting on makeup, or even talking or feeling a cool breeze. Many people with this condition might seek initial help from a dentist assuming the pain is caused by nerves associated with the teeth. If left untreated, this disease tends to worsen over time. 

Spondylolisthesis is a condition of the spine, generally affecting the lower vertebrae, which happens when one of the vertebrae slips onto the bone beneath it. It happens when one of your vertebrae moves more than it should and slips out of place. It usually happens at the base of the spine. The pain is most often felt in the lower back or legs and the buttocks, and is felt when standing or walking, which worsens with activity. 

A fracture in the spine that is typically caused by osteoporosis, but may also result secondary to trauma or cancer. Soft and weakened bones caused by osteoporosis cause these small tiny cracks that add up and cause a vertebrae to collapse, thus becoming a compression fracture.  Persons with severe osteoporosis can experience compression fractures with simple coughing or sneezing. As compression fractures increase, the spine’s actual shape can change your posture and you may lose several inches in height. A compression fracture can be treated with a minimally-invasive procedure called vertebroplasty/balloon kyphoplasty.