Before ultrasound became a revolutionizing staple in the field of pain medicine, some brilliant, forward-thinking doctors used X-Ray (fluoroscopy) to add vision to their pain injections. But with these tools came drawbacks. Firstly, while fluoroscopy is excellent for viewing bones and spread of contrast, they do not let us see the intricate detail of muscles, tendons and ligaments. Secondly, they emit radiation, which means that they should only be used on an ‘as necessary’ basis. In our effort to provided safe, accurate and effective injections, about 10-15 years ago our field began using ultrasound to make major improvements. Not only is it 100% safe, ultrasound immediately transformed pain medicine patient outcomes.
Way before I became I pain physician I was acutely aware of a particular maxim: an ounce of prevention is worth a pound of cure. Despite its triteness, in this expression I found unbounded wisdom: wearing knee pads while rollerblading averted nasty knee cuts and ripped jeans, while a napkin in my lap discouraged tomato sauce stains. Back in my own days as an athlete – a batting helmet defended my skull from menacing fastballs. These days, this aphorism’s weighs heavily on my shoulders when I am confronted by yet another patient who is an athlete with an injury resulting from poor to complete reckless abandonment of sports nutrition. Many such patients have suffered muscle injuries and/or severe cramping that has resulted from dehydration, electrolyte abnormalities and/or potassium and magnesium deficiencies. This is not just frustrating because these kinds of injuries are extremely avoidable through a proper sports nutrition-inspired diet, but also failure to acquire the full range of protein, carbohydrates, micronutrients and vitamins an athlete requires will severely limit the ability to reach maximum performance. To put it in laypersons terms, without sports nutrition athletes will increase the likelihood of debilitating injury and will also be actively hampering their ability to perform to their full potential.
If you are considering back surgery because of a pain issue, it might not even be the most expedient treatment for you as it will not always alleviate or mitigate pain. Unless your back issue is neurological or an instance of instability of the spine, surgery simply is not your best course of treatment. If you suffer from muscular or myofascial pain, lumbar facet arthropathy or lumbar disc herniation, amongst other back pain issues, your best bet is to treat your back pain without surgery. Read my blog for the full details of the non-surgical treatments I recommend.
Musculoskeletal Ultrasounds (MSUs) are my go-to when attempting to pin down an issue that we don’t believe to be bone related. That means they are perfect for diagnosing muscle, tendon, and ligament injury – as this dynamic investigative and explorable procedure tells us in seconds the make-up of your musculoskeletal system. We have found that MSU has been pivotal in helping diagnose sports injuries and others who find they are in pain when they move a joint. Traditional analysis like x-rays and MRIs take static images where MSUs create dynamic images in motion. Let’s explore that some more.
We’re living in unprecedented times. The spread of COVID-19 across the world means that healthcare facilities are under pressure like never before. Governments are doing everything they can to reduce this burden, including urging people to stay home unless it’s absolutely necessary to go out. But what does this mean for those of us who need access to a doctor?
Before ultrasound became a revolutionizing staple in the field of pain medicine, some brilliant, forward-thinking doctors used X-Ray (fluoroscopy) to add vision to their pain injections. But with these tools came drawbacks. Firstly, while fluoroscopy is excellent for viewing bones and spread of contrast, they do not let us see the intricate detail of muscles, tendons and ligaments. Secondly, they emit radiation, which means that they should only be used on an ‘as necessary’ basis. In our effort to provided safe, accurate and effective injections, about 10-15 years ago our field began using ultrasound to make major improvements. Not only is it 100% safe, ultrasound immediately transformed pain medicine patient outcomes.
Migraines – they’re a real headache. After a long week of working we deserve to have some time off; and whether that’s having a lie in, a series binge on Netflix, or jumping into your overgrown garden and getting stuck into some horticulture – we all need to switch off a bit at the end of the week. We should have some escapism. But there’s nothing worse than your tranquillity being intruded on by a throbbing head pain that gets gradually worse. There’s a banging on one side of your head, like a nail been driven by a hammer and you feel a slight nausea. So much for your down time. Again, migraines, they can be real headaches. But not to worry, I can sort that for you.
Medical science has transformed the usage of Nerve Blocks, which work a type of local anaesthetic, to treat migraines and headaches. The procedure is usually used for the treatment of pain, chronic pain, and complicated dental work.
Peripheral Nerve Blocks are a reasonable option for many patients with headache disorders. The injection is administered with a syringe and needle that is utilized to inject nerves on the outside of the skull. Alternatively, a soft and minimally invasive catheter will deliver numbing medicine to a target bundle of nerves via the nasal passages.
The goal of this procedure is to temporarily numb the nerves in the periphery and consequently reduce the pain signals travelling to and from the central nervous system, and of course –allow you to watch Netflix and drift off in peace.
Your physician will usually take a few minutes to administer the entire procedure. Depending on your physician and the location of the migraine the anaesthetic may be injected directly to where the pain is manifesting itself.
Thanks to this breakthrough procedure, no hair needs to be shaved – and all you will experience is a slight discomfort before your migraine completely breaks and you can enjoy the weekend you deserve. This procedure is especially beneficial for rescuing patients whose home medication has failed them.
If you are interested in Nerve Blocks to help you overcome a migraine, especially if your home medication is failing you, then make sure you contact your local physician. Alternatively, if you are local, you can find me at Mount Sinai’s Department of Rehabilitative Medicine’s Downtown office.
The word technology resonates with incompressible circuit boards, expensive gadgets, and the film i-Robot. Sometimes, we even consider it something to be feared (just think back to Y2K). But technology is defined as an application of knowledge for practical purposes – it doesn’t have to be complex machinery and computers. In fact, the best technologies aren’t the most complicated, but the ones that have the most impact. Touch Graphics is a perfect example of innovative technology that makes treatment accessible. These innovative revolutions are helping to reduce the impact of life-altering events, like losing sight.
Touch Graphics focuses on technologies that enable the visually impaired to draw through low-tech, accessible, and affordable means. The project is predicated on the idea that when drawing, sight is needed to give feedback to the artist. You must visualize where your pencil has been, and where it is going to go to complete a coherent piece. If the drawer cannot see or visualize at which point they are at, it becomes difficult to locate where the next stroke will go – and even mean that they cannot experience their project upon completion.
In the past, this has meant the visually impaired were unable to draw. The Touch Graphics project has revolutionized this principle by using tactile feedback. It is somewhat similar to braille. A person can learn to draw by using styli and paper – using feel to see their drawing – opposed to sight. As their instrument passes over the paper, the styli beneath raises, allowing the artist to explore their work and decipher the next point of contact without sight. They can visualize the piece, which empowers hobbyists and born-to-be artists to engage with art, in a way which was otherwise impossible.
Anyone with good motor skills in their fingertips can learn to use this set-up. In bringing tactile sensation to the perceptual foreground, vision becomes effortless. It has shown to become a highly refined skill with practice. The set-up is affordable due to materials being easily accessible for everyone. A perfect example of technology being intelligent innovation – and fit for purpose.
Touch Graphics, inc focuses on products that communicate spatial information through the sense of touch for use by visually impaired. They are featured on https://www.cooperhewitt.org/ an organisation which curates a myriad of designs that enable people in the artistic field. If you have a story to share, drop me a comment or retweet – I’d love to hear what you think.
