Our practice is operated by board certified physiatrists. We are physicians that specialize in treating the whole person. We believe not only in treating pain, but doing it in a manner that helps you achieve your personal goals. Are you are having difficulty working due to pain? Maybe you can’t go to your grandchild’s game because of your pain. Are you unable to enjoy your hobbies like fishing, hunting, or golfing? Perhaps you are afraid to go grocery shopping or cross larger streets because you are afraid of falling.
Call us if you are having pain or weakness that is interfering with your daily life. We will diagnose and treat pain in your back, neck, joints such as knees, hips, and shoulders without surgery. We will help you attain your strongest self after a stroke, amputation, or spinal cord injury. It’s time to stop letting your pain or weakness run your life. It is time to start living again. Let us help you get your life back.
If you are over the age of 30, you may have notice some morning stiffness. You may not be able to bounce out if the bed like you used to. This achiness and stiffness that you feel in the morning is characteristic of arthritis.
Not all arthritis is caused by the same disease. There are actually several different causes of arthritis.
This is the type of arthritis that most of us will develop as we age. It occurs with destruction of the cartilage between 2 bones. If you have this condition, you may have pain and stiffness that has increased gradually over time. You may experience stiffness when first arising in the morning or after prolonged sitting (a symptom known as gelling). It may take you more than 30 minutes to get started in the morning. If this is you and the pain is interfering with your life, contact us for a thorough evaluation and a comprehensive treatment program.
In the past, this type of arthritis was referred to as crippling arthritis due to the devastating nature of destruction to the affected joints resulting in deformities, especially in the hands and feet. Individuals with this type of arthritis typically have pain in multiple joints that is worse in the morning. Patients with rheumatoid arthritis (RA), may take as long as 2 hours to loosen up in the morning from the stiffness. This condition is diagnosed by a thorough history and examination by an experienced clinician as well as blood testing. It is important to be diagnosed with this condition if you have it because the progression of the disease may be slowed with proper treatment.
This type of arthritis can affect individuals with psoriasis. About 5% of patients with psoriasis will go on to develop psoriatic arthritis. It typically affects the hands and feet, but can also affect other joints such as those in the spine. Proper diagnosis allows for better treatment, education, and outcomes for individuals with this condition. Please schedule an appointment with one of our providers for further assistance.
Arthritis in this condition typically occurs 1-4 weeks after a systemic infection like gastrointestinal (GI) infections. These can occur with bacteria such as Shigella, Salmonella, or Campylobacter. It can also occur after urinary tract infections (UTIs) with bacteria such as Chlamydia. Joint pain with the arthritis may occur with difficulty urinating or pain with urination, or eye irritation/pink eye. Treatment options involve proper diagnosis, treatment of underlying cause, as well as other conservative measures.
Injuries from falls, motor vehicle accidents, or contact sports can cause resultant ligament tears, sprains, and cartilage damage. Injuries may also cause dislocations and fractures. Do not wait for a scheduled medical evaluation if you have had an injury with severe pain and swelling, especially if you are unable to bear weight on a leg or arm. You should be seen urgently at the ER, urgent care, or your primary doctor’s office. If the symptoms persist after urgent treatment, you may require a more thorough evaluation. Please contact us if we may be of assistance to you.
This condition comes on suddenly in the form of an attack where an individual will have very severe pain in a joint such as the knee, toe, hand, or ankle. It is caused by a metabolic condition where a substance called uric acid is deposited into body tissues. Uric acid actually crystallizes in the joints into needle-like crystals that cause severe pain in the joint, swelling and inflammation. How did the uric acid get there? Uric acid is a byproduct of the breakdown of a substance called purines. Purines are found in a lot of different foods. Food that are high in protein are in general high in purines too. Food such as anchovies, gravies, kidneys, liver, sardines, and sweetbreads, and steak are particularly high. Other foods also cause higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fructose. This condition is diagnosed by clinical examination and sometimes aspiration of the joint.
Treatment requires both immediate intervention as well as sometimes preventative therapy. Please see one of our specialists if needed.
It is pain that radiates from your back down your leg. You can have numbness and weakness associated with it. Sometimes, people will have pain and numbness at the same time. The pain can be sharp, stabbing, shocking, and can be excruciating. Some of our patients will describe it as taking their breath away.
Sciatica is often worsened by coughing, sneezing, prolonged sitting, prolonged standing, or walking. It can start upon awakening in the morning or sometimes after a trauma. Some patients are unable to recall any inciting event.
The pain is from nerve compression in the back (lumbar spine). In between the lumbar vertebral bones there are discs. The discs act as shock absorbers for the bones and also maintain the space where the nerves exit out to supply your legs. In the case of sciatica, either the disc bulges back to compress the nerve, the disc leaks chemicals onto the nerve that irritate it, the bone develops some spurs from arthritis that compress the nerve, or rarely, a tumor can press on the nerve. Whatever the cause the nerve is either compressed or irritated and it responds by causing low back, buttock, thigh, and leg pain.
One of the main risk factors for this condition is age. As we age, we are more likely to develop arthritis. Our discs also lose quite a bit of water out of them leading to degenerative disc disease causing disc bulges and herniations.
Another risk factor is smoking. Smoking robs the discs of oxygen and they wear out faster leading to disc degeneration.
Repetitive lifting, especially with poor body mechanics, meaning bending at the waist instead of the knees can cause this condition.
Diabetes increases risk of all different types of nerve damage.
Obesity because the heavier you are, the more weight on the spine.
Trauma such as falls, car accidents or high impact sports put you at risk of this condition.
Genetic factors may also play a role. If other people in your family develop disc problems early in life, you may develop them also.
Certain occupations can put you at risk. Everyone knows that jobs that require a lot of constant lifting of heavy objects are not good for your back, but would it surprise you to know that desks jobs are equally bad for your back? It has to do with the mechanics of sitting. When you stand 100% of your body weight is placed on the spine, but when you sit, it could be as much as 140% your body weight even with proper posture. If you sit leaning forward as in working on a low computer or reaching, it could be closer to 200%. If you work at a desk job, it is important to stretch regularly, strengthen your core muscles and get up and walk when you can.
By changing the risk factors of which you have control.
Exercise regularly, especially exercises that strengthen your core muscles. Core muscles are the muscles around your midsection that support your spine while you are standing, walking, and sitting. If these muscles are weak, all of the support for these activities falls to your spine. We were not designed to work that way. Unfortunately, as human beings in this era, we do not usually strengthen them during daily activities, so you have to be very intentional about it.
You can also reduce your chance of developing sciatica by lifting with proper body mechanics (lift with your legs) and get help if an item is too heavy – try not to rush.
Most people who have sciatic will never go to the doctor. For most people, it resolves in 1-2 weeks. If it does not though, you should seek medical attention.
Initial treatment is supportive only with anti-inflammatories like steroids, muscle relaxers, heat/ice, or possibly stronger pain medication.
If it fails to improve after a couple of weeks or is accompanied with extreme weakness of the legs, urinary incontinence (wetting yourself) or bowel incontinence (soiling yourself), you should see a specialist to order testing like an MRI, EMG, or CT and provide further treatment.
More advanced treatments range from physical therapy to spinal injections to acupuncture, or as a last resort surgery. We at Comprehensive Rehabilitation and Pain Specialists, P.C. are here to help you.
If you battle with sciatica that is uncontrolled, discuss it with your family doctor or ask for a referral to see a spine specialist at our practice. There are a lot of treatments and education that we can prescribe to get you on the right path.
Gout is another common cause of foot pain. A person that has this will complain of a sudden intense pain usually in the big toe that may be severe enough to awaken them from sleep. The joint will become swollen, hot, and difficult to move. Sometimes just the sheet touching it will cause unbearable pain.
It is caused by the buildup of a substance called uric acid. Uric acid is present in all of us and is formed by the breakdown of meats such as steak, liver, and seafood. Other foods also cause higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fructose. Normally the kidneys get rid of this extra substance, but in some people either the kidneys can get rid of enough of it or they make they make too much uric acid.
The result is the uric acid builds up and accumulates in a joint, such as the big toe and causes these attacks that cause severe pain.
Gout is diagnosed with drainage of the joint and sending the fluid to a lab for evaluation. X-rays may be obtained to rule out other causes such as a stress fracture.
Treatment for gout is usually with NSAIDs (medications like ibuprofen and naproxen), a medication named colchicine, and sometimes with a steroid.
Some people will have one gout attack and never have another. Some people will have a few of these attacks per year. If you fall into the latter category, there are medications that you doctor can start you on to reduce the attacks.
Give us a call at (252) 333-1277 to schedule an appointment. A physician referral is required.
