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.
Using Nerve Blocks to Extinguish Headaches and Migraines
Dealing With Migraines So You Can Relax This Weekend
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.
Enter: Nerve Blocks
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.
How Does the Procedure Work?
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.
Pregnancy Related Musculoskeletal Pain
How To Deal With Pregnancy Related Muscle Pain
Pregnancy is an exciting time for any woman or family, but it brings with it many anatomic and physiological changes that can hinder a woman’s quality of life. During pregnancy, many women suffer from musculoskeletal pain due to the intense changes the body endures throughout the process, this includes but is not limited to: arthralgias, back pain, separation of the pelvis, transient osteoporosis, and tendonitis. This month, we’ll explore how we can manage the pregnancy-related pain while limiting the use of oral medications.
Women usually gain in the range of 25-35 pounds during pregnancy. A shift occurs in the woman’s centre of gravity. Hormonal and biomechanical alterations strain the axial skeleton and the pelvis which are pivotal in maintaining good posture. The body’s adaptions can overload a normally well-designed system, which causes acute pain and possibly chronic pain. Symptoms vary from person to person, but commonly patients experience pain, fatigue, and sleep disturbances.
Traditionally, treatment includes some oral medications including nonsteroidal anti-inflammatories (NSAIDs). Patients who have trouble sleeping are often provided medications that modulate sleep and pain. However, during pregnancy, the uses of oral medications is often limited as many medications can cross the blood-brain barrier and affect the foetus.
Specialized physical therapy programs can focus on stretching, strengthening, bracing and the use of modalities such as heat, ice and massage to ease the pain. We can also use the same ultrasound technology your obstetrician uses to see the baby to diagnose many of musculoskeletal disorders that arise during pregnancy. We also utilize this same technology to provide accurate guided injections to provide relief for moderate to severe pain.
We’ll focus treatment on limiting oral medications, working mainly with the right physical therapy and offering an ultrasound-guided (non-radiation) approach to interventions when necessary.
Reclaiming Your Life From Knee Injury
How Can Medical Science Put A Stop To Knee Arthritis?
Arthritis in the knee is caused by an inflammation of one or more joints around the femur, patella, and tibia. The joint will become painful, and gradually get worse if not attended to. This medical problem can be down to your genetics or lifestyle – long periods of not moving or heavy loads on the knees being the most common culprits. Patients tend to struggle with mundane tasks like walking up the stairs and bending the knee. Thankfully, with progressions in medical science, we have a promising treatment for knee arthritis - stem cell injections.
Stem Cell procedures consist of taking cells from your own body and using them to create more cells. Cells live in all tissue and can be poised to fix existing damages to the body. A top cure for arthritis is to renew the cartilage that separates the bones, which will (often alongside physiotherapy) bring you back to fighting fit health – alongside preventing any more troubles this lingering problem will cause.
But what exactly is knee arthritis? The knee is cushioned from impact by smooth and slippery substances called cartilage. This substance acts as a shock absorber and stops the bone from eroding. Arthritis is a condition in which the cartilage begins to wear away – a biological “wear-and-tear” – reducing the space between the bones. The result is painful, reduces the capacity of the knee, and chips away at surrounding bone, producing bone spurs.
Arthritis in the knee is a symptom of lifestyle, genetics, or a combination of both. You could be unlucky and have it hereditarily, or develop the problem from things you do. Playing sports and working jobs that have a heavy impact on the knees are often the genesis of this problem. Surprisingly, arthritis in the knee often worsens from lack of knee activity alongside an overload of activity – like heavy squats. Sitting with the knee in one position for prolonged periods of time can cause the arthritis to form, or worsen underlying issues.
As the symptoms get worse, it gets gradually more difficult to walk up the stairs, play sports; and can have a detrimental effect on your work and your quality of life. Imagine, every time you use your knee – you are causing more damage to it, as the bones continue to wear away at each other. Knee arthritis can be a slippery slope, once it begins – it can worsen to extreme situations where the cartilage completely erodes.
Thankfully, medical science can rescue us from this predicament.
Cells are harvested from the body – usually from a vein in your arm, and a sample of bone marrow will be taken (usually from the hip). The cells are then separately prepared before being re-injected into your body. Regeneration of the cartilage will mean you can resume sports, start walking normally again and give you the ability to reclaim your life.