Woman on couch with back pain

Bias in Women’s Pain

You may have already had this conversation with friends and family: Who is able to tolerate more pain, women or men? Some are certain women have higher pain tolerance, due to familiarity with pain during childbirth and menstrual periods. Others believe men are more adept at “toughing out” physical pain.

Scientific research shows that men and women do experience pain differently, but that gender bias may play a part in how it is treated or even measured. Here is a closer look at the complexity of this issue.

Biological & Psychological Differences

An increased number of scientific studies have been conducted to clearly establish the differences in men and women when it comes to chronic pain. “Women are more likely than men to experience a variety of chronic pain syndromes and tend to report more severe pain at more locations than do men,” the Journal of Bone & Joint Surgery reported in 2020, and many similar studies agree.

But a variety of factors may contribute to this difference, including anatomy, sex-hormone levels, inflammatory response, and even genetic predisposition. In a 2019 study, for example, women who developed chronic pain after a car accident were more likely to have an elevated series of specific RNA molecules encoded on their X chromosome — which women have two of, as opposed to men who have just one.

Psychological differences may also come into play. For example, Jennifer Kelly, PhD, of the Atlanta Center for Behavioral Medicine observed in 2010 that “Women tend to focus on the emotional aspects of pain . . . [and] may actually experience more pain as a result, possibly because the emotions associated with pain are negative.” Contrasting beliefs between the sexes about articulating or expressing pain could also challenge the ability (even for patients themselves) to gauge its severity.

How Gender Bias Intervenes

Nearly 20 years ago, authors Diane Hoffman and Anita Tarzian concluded in their paper “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain,” that “In general, women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively.” Further studies since have come to similar conclusions.

For example, in 2021, a report in The Journal of Pain “identifies a bias towards underestimation of pain in female patients, which is related to gender stereotypes.” Caregivers and medical professionals providers, the study concludes, “are more likely to recommend psychological treatment for females than males, and analgesics more frequently for males than females.” This means that women may not be receiving the prescriptive pain relief they need.

The gender of a care provider may not only influence treatment, but even a patient’s own articulation of her pain, as well. “I’ve noticed that women typically feel more comfortable discussing pain symptoms and being vulnerable with female health care providers,” Leia Rispoli, M.D., a pain management specialist and associate physician at Remedy Pain Solutions, told Glamour.

Inequity in medical research reinforces gender bias,” experts at Medical News Today explain. For many decades, women have been excluded from a variety of medical studies and clinical trials, leaving them out of the conversation regarding diagnosis and treatment altogether.

Individualized Treatment Can Make a Difference

Clearly identifying and articulating your pain, and advocating for your own best treatment may be the first and most effective step in finding the right pain solution to alleviate your own suffering — regardless of your gender. We are committed to finding solutions and relief for your chronic pain. Schedule an appointment with us online or call directly at 770-929-9033 to discuss what solutions may be best for you.

nurse working with senior patient experiencing shoulder pain

The Link Between Osteoporosis & Arthritis

Osteoporosis and arthritis are two conditions that can both affect your bones. While their causes, symptoms, and treatments are often different, they do share an important link, as having certain types of arthritis may make you more likely to develop osteoporosis. Let’s look more closely at their complex relationship, and how to navigate treatment for both.

What Are Osteoporosis and Arthritis?

In the case of osteoporosis, your overall bone density decreases, causing your bones to become more fragile and brittle. More than 53 million people in the U.S. are already affected, or are at risk for it due to low bone mass. According to the Bone Health & Osteoporosis Foundation, the condition develops when the body loses too much bone material, produces too little new bone to replace that loss, or a combination of both. Typically, a lifelong lack of calcium is the root cause.

Osteoporosis is often called a “silent disease,” as symptoms may not manifest until your bone mass has already begun deteriorating. Loss of height, and an increase of bone fractures are two common signs that the condition has already progressed.

Arthritis is an umbrella term for joint pain or a joint condition with symptoms such as swelling, stiffness, decreased range of motion, and general joint discomfort. There are more than 100 types of arthritis and conditions related to it, and it is the number-one cause of disability in the U.S. Two of the most common types are osteoarthritis, which is a gradual wear-and-tear degenerative joint disease, and rheumatoid arthritis (RA), an autoimmune inflammatory disease.

How Are Osteoporosis and Arthritis Linked?

While researchers are still investigating the precise cause, there is an established link between osteoporosis and inflammatory arthritis conditions. Specifically, people with inflammatory forms of arthritis such as RA have a greater risk of developing osteoporosis. The inflammation itself appears to increase the risk of osteoporosis and related fractures, especially in areas closest to the affected joints.

Rheumatologist Katherine Wysham, MD, adds that inactivity caused by RA can further increase osteoporosis risk. “Our patients are hurting,” she said to arthritis support group CreakyJoints in 2019. “They have pain, which prevents them from exercising. But we know that weight-bearing activity is really important to bones — they respond to that stimulus and become stronger. Without it, the body won’t increase muscle or bone.”

To further complicate matters, some of the medications used to treat RA can also lead to osteoporosis. While corticosteroids such as prednisone can very quickly reduce RA flares, they also pose a significant risk for weakening bones and suppressing their formation or repair. Corticosteroid-induced osteoporosis is the most prevalent form of secondary osteoporosis.

How Are Osteoporosis and Arthritis Treated?

Fortunately, it is possible to treat arthritis while protecting your bones. Lifestyle modifications for promoting bone health may include getting enough vitamin D and calcium in your diet or taking supplements, if needed. Vitamin D aids in the body’s process of absorbing calcium, thereby helping to renew bone material. Strength training and weight-bearing aerobic exercises can also strengthen your muscles and bones, while exercises designed to improve balance can help reduce your risk of fall-related fractures.

Outside of these home remedies, there are many pain treatment options that don’t involve the use of corticosteroids. Here at Alliance Spine & Health, we offer a range of state-of-the-art therapies to treat the cause of joint pain and deliver real relief. From radiofrequency ablation that relieves pain in the joint to platelet rich plasma (PRP) that promotes joint healing, our treatments can help restore your quality of life without the risk of increased bone loss.

To explore your options for relief from joint pain, schedule an appointment with our office by calling (770) 929-9033, or connecting with us online.

Person talking to doctor

How To Talk About Pain with Your Doctor

Living with chronic pain is an ongoing, daily stressor in itself. But it can also cause psychological and emotional stress that adds insult to injury — literally. Finding solutions with your doctor and pain specialists needn’t add to this discomfort.

At Alliance Spine and Pain Centers, we are committed to addressing your pain with open curiosity, kindness, and practical advice. Here are some tips for coordinating with your team to discover pain solutions together.

Ask Questions

You turn to your medical team because they have a lot of knowledge. But they don’t always know what you want to know. “Asking questions is one of the best ways to ensure you and your doctor are on the same page,” Dr. Ted Epperly, a clinical professor of family medicine at the University of Washington School of Medicine advised Time magazine. “And if your doctor doesn’t seem interested in answering, or you get a negative response, you need to find a new doctor.”

To be sure you are both communicating clearly, schedule an appointment specifically designed to address your pain questions, and provide thorough answers. For guidance, here are a few questions the U.S. News & World Report determined doctors wish their patients would ask:

  • How does my family history impact treatment?
  • What preventative care measures can I take?
  • What are other trusted sources of information I can utilize?
  • Do you have specific advice around prescriptions?
  • How does my sleep impact pain treatment?
  • Why are we conducting this test? What will the results reveal?
  • What do you do for your own health and well-being?

Take Note of Your Own Body

Outside resources may direct you toward successful pain management solutions, but starting with self-awareness might be the best way to empower you, and therefore your doctor.

“Think about the duration and quality of the pain,” advises REWIRE. “How you’d describe it if someone asked when it started. If anything has relieved it, and if anything has made it worse. Prepare an ‘elevator pitch’ of sorts. The more you can describe it, the better you’re going to be able to work with your physician.”

Climate, food consumption, over-the-counter pain medicines, and levels of physical activity may also impact your pain. Self-tracking these details even over a couple of weeks can paint a clearer picture of your condition, and help your pain management team craft a plan to alleviate it. Paying careful attention to how your pain impacts your work and personal life can also provide useful information.

Coordinate with Caregivers

Involving a trusted loved one — to take notes, ask questions, or provide private, thoughtful and honest feedback or support — may help you feel even more courage to speak up for yourself.

But coordinating conversations among all your caregivers may help even further. Can you (or your personal health advocate) bring your health team together in a conference call, or email chain? “When you’re seeing a whole bunch of different specialists,” Isabel Mavrides, a disability justice activist and organizer explains, “they don’t always talk, which can make the diagnostic process take much longer.” Finding a format that works best for you and your specialists (while keeping in mind HIPAA regulations to protect your privacy) can help ensure that everyone is clearly connected.

At Alliance Spine & Pain Centers, we’re here to advocate for and with you. Schedule an appointment online to discuss your pain management, and how we can work more specifically with you to find solutions. You can also call 770-929-9033 to set up a conversation.

illustrations of a human spinal cord

How Does Spinal Cord Stimulation Work?

Spinal Cord Stimulation (SCS) is a procedure you may have heard of if you have chronic pain. This process involves surgically inserting a device under your skin to send electrical signals to the brain, blocking pain responses.

Looking into SCS can provide hope, but it can also feel daunting. That’s why we’re here to break down the ins and outs of what you need to know.

What Causes Chronic Back Pain?

To understand how SCS helps chronic pain, it’s important to understand what first causes it. Glial cells are key contributors, as they send pain signals to the brain through the spinal cord. They can also contribute to pro-inflammatory responses, and inflame chronic pain sites.

These glial cell signals can be manipulated, however, with an SCS procedure.

How does Spinal Cord Stimulation Help?

An SCS system targets glial cells, modifying their pain signals to the brain. The procedure involves connecting a small device to thin wire leads that are implanted into a specific area in your back, continuously sending electrical pulses to the correct glial cells.

Even if it does not remove a pain’s source, research shows that 92.4% of patients who received SCS were satisfied with the results. While each patient experiences unique pain (and therefore a unique relief), SCS is considered successful when your pain is reduced at least by 50%.

How Patients Get Started

If you qualify for SCS, you will first undergo a trial procedure. During this phase, at least one insulated wire lead is placed through an epidural needle into your spinal canal. The needles are removed, leaving the wires in place and the wires are attached to an external battery — called a trial stimulator.

Once the leads and trial stimulator are connected, you and your physician will monitor your pain levels for about seven days. After this trial period, the lead is removed. If the relief is deemed sufficient, you may move forward with the permanent procedure.

The Permanent Procedure

The permanent procedure is not as daunting as it may sound. You can expect to go home the same day once these three steps are complete:

  1. Permanent leads are inserted into your spine. This is done with an epidural needle through a small incision.
  2. Another small incision is then made to insert the implantable pulse generator (IPG) beneath the skin, usually on the buttocks or abdomen. The leads are then connected to the IPG battery.
  3. Finally, a wireless electrical control unit programs the IPG’s electrical pulses. This way, you can turn the system on or off using the external control unit, or change its stimulation power.

After the Procedure

You may experience discomfort and swelling around the incision site for a few days. Once the incision has healed, you will be able to continue your daily activities, with less pain and discomfort.

Potential Risk

A 2011 retrospective review of SCS reported that hardware complications were the most common defaults in SCS procedures. Some patients (22.6%) experienced lead migration, where the wires shifted after time. Others (12%) experienced pain at the generator site.

Overall, SCS procedures are very safe, with few complications, and deaths or neurological deficits only rarely reported.

Who is Spinal Cord Stimulation Good For?

You may be a candidate for SCS if you have pain resulting from previous back or neck surgery,  diabetic neuropathy, or other chronic back, lower body, and arm pain.

Deciding the Best Spinal Cord Stimulator Device to Use

With the rapidly technology improvements for spinal cord stimulation, Alliance works closely with the top medical device companies as they advance their SCS systems. This industry’s innovative interventional pain management systems continuously improve to offer more benefits to a wider range of people needing this treatment.

Alliance physicians determine the type of SCS system for their patients based the patient’s type of pain and its source. Here are a few examples of the wide range of SCS treatment options that Alliance offers:

  • The HFX Solution treatment, the only spinal cord stimulation system approved by the FDA that uses high frequency stimulation to manage pain associated with diabetic neuropathy, or other chronic pain.
  • Nalu Neuromodulation training, a new device that will allow our physicians to help target pain through Peripheral Nerve Stimulation and Spinal Cord Stimulation using a generator that is ultra-small.
  • Medtronic DTM™ (Differential Target Multiplexed), a Spinal Cord Stimulation waveform to help treat patients with chronic, intractable low back pain.
  • Evoke® Spinal Cord Stimulation (SCS) System, a new investigational device designed to measure and record your body’s response to stimulation and makes millions of automatic, real-time adjustments to maintain a consistent level of pain relief.

If you are considering SCS, connect with Alliance Spine & Pain Centers. We understand the challenge of finding chronic pain relief, and our experts will help you find the answers. To schedule an appointment, Give us a call at 770-929-9033 or visit us online.

doctor with hands on patient's spine

What Is Post Laminectomy Syndrome?

Though the condition is not commonly known to the general public, those who suffer from post laminectomy syndrome (PLS, and also sometimes referred to as Failed Back Surgery Syndrome [FBSS]) likely know it all too well. When you’ve endured a high level of back pain, tried multiple forms of relief, and then undergone surgery — only to find it has caused you even more pain — the frustration is understandable.

As a 2015 study in São Luís, Brazil summarized: “PLS features intense levels of pain, reduced quality of life and greater physical and occupational disability.”

Therefore, concerned doctors and pain specialists are eager and determined to find solutions.

What is a Laminectomy?

A laminectomy, or decompression surgery, removes a part of the vertebrae (the lamina) to surgically create space for the spinal cord and associated nerves, relieving painful compression.

Spinal nerve compression can be caused by conditions including:

  • Spinal stenosis, or narrowing of your spinal canal
  • Herniated disc
  • Degenerative disc disease, or breakdown of the vertebrae
  • Vertebral injury
  • Tumors

A laminectomy is often considered when other forms of conservative treatments have been unable to relieve pain.

What are the Causes of Post Laminectomy Syndrome?

Unfortunately, the most common cause of post-laminectomy syndrome may involve a misdiagnosis of the area of nerve compression or pain source, as this 2016 study revealed: “Inaccurate diagnosing is a major factor leading to FBSS, with as much as 58% of FBSS resulting from undiagnosed lateral stenosis of the lumbar spine.”

Other causes of post-laminectomy syndrome can include:

  • Transfer of spinal pain to the site of surgery
  • Myofascial pain or inflammation
  • Nerve damage or infection caused by surgery
  • Recurrent underlying issues, such as spinal stenosis or disc herniation
  • Scar tissue that develops along the treated nerve
  • Epidural fibrosis after surgery
  • Further progressive disease

Individual patient risk factors can also greatly contribute to an unsuccessful laminectomy, including diabetes, obesity, smoking, and even depression prior to surgery.

What are Symptoms of Post Laminectomy Syndrome?

It’s normal to experience pain directly after surgery while your body begins the healing process, but if it persists for longer than a couple of months, you may want to discuss PLS with your doctor.

PLS symptoms vary based on the cause and each individual patient, but some of them include:

  • New or shooting, dull, or sharp back pain
  • Consistent, similar pain to that experienced prior to surgery
  • Radiating leg pain or numbness
  • Prolonged tenderness around the site of surgery
  • Difficulty sleeping due to pain
  • Difficulty conducting daily activities or going to work due to pain
  • Continued reliance on pain medication

Treatment Options for Post Laminectomy Syndrome

If you fear you may be experiencing PLS, the most important thing you can do is to schedule a thorough follow up examination with your doctor. An MRI or CT scan may be prescribed to get to the root of your pain — something that will be very important in order to treat it.

While the recommended solution will depend on this follow-up, PLS may be treated by:

Spinal Cord Stimulation: Electrical impulses are used to block pain signals to the brain.

Radiofrequency Ablation: Administered through a small needle, electric current heats nerve tissues and eliminates their ability to send pain signals.

Regenerative Medicine: Cutting-edge protocols harness your body’s own healing power to relieve pain.

If you’ve undergone a laminectomy or other back surgery and are still struggling with persistent pain, the specialists at Alliance Spine & Pain Centers offer personalized, state-of-the-art treatments. To schedule a consultation, visit us online or call (770) 929-9033.

person holding lower back in pain

Finding Relief from Lower Back Pain

Pain in the lower back is the leading cause of disability across the globe. In a 2012 National Health Interview Survey, more than 25% of surveyed adults reported experiencing lower back pain within the previous three months.

At best, lower back pain discomfort can be irritating. At worst, it can interfere with your daily life by disrupting your sleep and making it challenging to complete routine tasks.

But just because lower back pain is common doesn’t mean you have to suffer from its symptoms. Here’s a closer look at what causes this pain and what you can do about it.

Common Symptoms of Lower Back Pain

Lower back pain is experienced anywhere below the bottom edge of the ribcage. The discomfort can range from a dull ache, to shooting or stabbing sensations that become so intense they even interfere with the ability to stand.

Acute pain can come on suddenly — often after an injury or strain, such as one experienced during heavy lifting. Chronic pain, on the other hand, can have more subtle causes and persist for more than three months. Regardless of the source or intensity, it’s a good idea to seek professional care for any back pain that doesn’t subside within 72 hours.

Causes

There are many potential causes of lower back pain beyond direct injury to the muscles and ligaments in the back. These causes may include:

  •       Sciatica
  •       Spinal stenosis, or narrowing of the spinal column
  •       Ruptured or herniated disk
  •       Arthritis

New Treatment Options

Fortunately, there are nearly as many ways to treat back pain as there are causes. Instead of simply dulling pain with medications, patients now have access to innovative and personalized treatments that address the underlying causes of back pain. While the recommended treatment will depend on the cause of your back pain – which is why consultation with your doctor is recommended — here are several ways the condition may be treated:

  • Injections: Often used for low back pain that radiates down the leg, injections such as epidural steroids can alleviate swelling and inflammation to eliminate pain.
  • Facet blocks: Facet joints are located on either side at the rear of the spine. Facet block injections to this area can administer anesthetic and anti-inflammatory steroid medication to alleviate symptoms.
  • Radiofrequency ablation: Especially effective for pain in the lower back, during this treatment electric current is administered through a small needle, heating nerve tissues and eliminating their ability to send pain signals.
  • Neurostimulation therapy: Artificial nerve stimulators can be implanted under the skin to deliver targeted electrical impulses to affected nerves. This treatment blocks pain signals, and can provide long-lasting relief.

If you’re struggling with persistent back pain and have yet to find lasting relief, turn to Alliance Spine & Pain Centers. We understand the challenges of ongoing back pain and offer personalized, state-of-the-art treatments delivered by experienced pain management specialists to help you feel like yourself again. To schedule an appointment, call (770) 929-9033, or view our full list of treatment options.

Woman holding foot in pain

What is Painful Diabetic Neuropathy (PDN)?

Painful diabetic neuropathy is nerve damage that results from diabetes. The high blood sugar that frequently appears as a result of diabetes can cause permanent injury to nerves throughout your body, which causes the intense pain. PDN presents as a burning, excruciating, stabbing or intractable type of pain, or presents with tingling or numbness. Nerves in the legs and feet are most often damaged with this condition. The symptoms are often painful and debilitating. Diabetic neuropathy is a serious complication from diabetes and can affect up to 50% of people with diabetes. 

As a result of the nerves affected, painful diabetic neuropathy can produce pain and numbness in your legs and feet and lead to issues with your digestive system, urinary tract, heart, and blood vessels. 

The American Diabetes Association recommends that screening for diabetic neuropathy begin immediately after someone is diagnosed with type 2 diabetes, and five years after diagnosis for someone with type 1 diabetes. After that, screening is recommended annually.

Causes: 

There are four distinct types of diabetic neuropathy: peripheral neuropathy, autonomic neuropathy, proximal neuropathy (diabetic polyradiculopathy), and mononeuropathy (focal neuropathy). The exact cause of each type of neuropathy is unknown. 

Researchers think that, over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients.

Symptoms: 

According to Mayo Clinic, since there are four main types of diabetic neuropathy, symptoms depend on the type of diabetic neuropathy someone has and its degree of severity. Symptoms typically have a gradual onset, and many don’t notice they have a problem until they have experienced considerable nerve damage. 

Peripheral neuropathy

This type of neuropathy may also be called distal symmetric peripheral neuropathy. It’s the most common type of diabetic neuropathy. It affects the feet and legs first, followed by the hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include:

  • Numbness or reduced ability to feel pain or temperature changes
  • Tingling or burning sensation
  • Sharp pains or cramps
  • Increased sensitivity to touch — for some people, even a bedsheet’s weight can be painful
  • Serious foot problems, such as ulcers, infections, and bone and joint pain

Autonomic neuropathy

The autonomic nervous system controls your heart, bladder, stomach, intestines, sex organs and eyes. Diabetes can affect nerves in any of these areas, possibly causing:

  • A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)
  • Bladder or bowel problems
  • Slow stomach emptying (gastroparesis), causing nausea, vomiting and loss of appetite
  • Changes in the way your eyes adjust from light to dark
  • Decreased sexual response

Proximal neuropathy (diabetic polyradiculopathy)

This type of neuropathy — also called diabetic amyotrophy — often affects nerves in the thighs, hips, buttocks or legs. It can also affect the abdominal and chest area. Symptoms are usually on one side of the body, but may spread to the other side. You may have:

  • Severe pain in a hip, thigh, or buttock
  • Eventual weak and shrinking thigh muscles
  • Difficulty rising from a sitting position
  • Severe stomach pain

Mononeuropathy (focal neuropathy)

There are two types of mononeuropathy — cranial and peripheral. Mononeuropathy refers to damage to a specific nerve. Mononeuropathy may also lead to:

  • Difficulty focusing or double vision
  • Aching behind one eye
  • Paralysis on one side of your face (Bell’s palsy)
  • Numbness or tingling in your hand or fingers, except your pinkie (little finger)
  • Weakness in your hand that may cause you to drop things

Treatment: 

Since diabetic neuropathy doesn’t have a known cure, the goals of treatment are to slow the progression of the disease, relieve pain, and manage complications/restore function. 

To Slow Disease Progression: 

  1. To slow the progression of the disease, consistent management of blood pressure levels within a normal range will help. Blood sugar levels might need to be set on an individual basis. The National Diabetes Association recommends between 80 and 130 mg/dL, which is 4.4 and 7.2 millimoles per liter (mmol/L) before meals and less than 180 mg/dL (10.0 mmol/L) two hours after meals. 
  2. Mayo Clinic encourages slightly lower blood sugar levels for most younger people with diabetes, and slightly higher levels for older people who may be more at risk of low blood sugar complications. Mayo Clinic generally recommends the following target blood sugar levels before meals: between 80 and 120 mg/dL (4.4 and 6.7 mmol/L) for people age 59 and younger who have no other medical conditions and between 100 and 140 mg/dL (5.6 and 7.8 mmol/L) for people age 60 and older, or for those who have other medical conditions, including heart, lung or kidney disease

Pain Relief: 

Prescription drugs represent another possible therapy for diabetes-related nerve pain. Potential options for pain relieving prescription medication are: 

Anti-seizure drugs: 

The American Diabetes Association recommends pregabalin (Lyrica) and Gabapentin (Gralise, Neurontin) as options. Side effects can include drowsiness, dizziness, and swelling. 

Antidepressants: 

Antidepressants can alleviate nerve pain, even if you aren’t depressed. Tricyclic antidepressants can help with mild to moderate nerve pain. Amitriptyline, desipramine (Norpramin) and imipramine (Tofranil) are all in this category of drug. Side effects can include dry mouth and drowsiness.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another class of antidepressant that may help with nerve pain and have fewer potential side effects. The American Diabetes Association recommends duloxetine (Cymbalta) as a first treatment. Another that may be used is venlafaxine (Effexor XR). Possible side effects include nausea, sleepiness, dizziness, decreased appetite and constipation.

Physicians may combine an antidepressant drug with an anti-seizure drug. These drugs can also be used with pain-relieving medication, including acetaminophen (Tylenol) or ibuprofen (Advil or Motrin IB) or a skin patch with lidocaine (a numbing substance).

HFX™ Spinal Cord Stimulation (SCS): 

It’s the only spinal cord stimulation system approved by the FDA to manage pain associated with diabetic neuropathy. 

The HFX™ Solution treatment system involves a minimally-invasive implant procedure, allowing the patient to go home the same day. The spinal cord stimulation device then delivers mild electrical pulses to the nerves, interrupting the transmission of pain signals to the brain, which reduces pain. 

Managing Complications and Restoring Function: 

The treatment a patient requires will depend on the neuropathy-related complication a person has. 

  • Urinary tract problems. Some drugs affect bladder function, so your doctor may recommend stopping or changing medications. A strict urination schedule or urinating every few hours while applying gentle pressure to the bladder area can help some bladder problems. Other methods, including self-catheterization, may be needed to remove urine from a nerve-damaged bladder.
  • Digestive problems. To relieve mild signs and symptoms of gastroparesis — indigestion, belching, nausea or vomiting — doctors suggest eating smaller, more-frequent meals. Diet changes and medications may help relieve gastroparesis, diarrhea, constipation and nausea.
  • Low blood pressure on standing (orthostatic hypotension). Treatment starts with simple lifestyle changes, such as avoiding alcohol, drinking plenty of water, and changing positions such as sitting or standing slowly. Your doctor may also recommend compression support for your abdomen. Several medications, either alone or together, may be used to treat orthostatic hypotension.
  • Sexual dysfunction. Medications taken by mouth or injection may improve sexual function in some men, but they aren’t safe and effective for everyone. Mechanical vacuum devices may increase blood flow to the penis. Women may find relief with vaginal lubricants.

If you have any more questions, the pain specialist experts at Alliance Spine and Pain are here to help. Reach out to any of our pain specialists by clicking here or by giving us a call at 770-929-9033.

Orthopedist examining patients back

Treatment Spotlight: Radiofrequency Nerve Ablation

Persistent pain in the back, neck, or joints is frustrating at best. At worst, it can interfere with your daily routine, making everyday tasks like standing, sitting, bending, and walking painful and exhausting. If you’ve tried home remedies and non-invasive treatments, but they’ve done little to alleviate your discomfort, radiofrequency nerve ablation could be right for you. Here’s everything you need to know before scheduling a consultation.

What Is Radiofrequency Nerve Ablation?

Also called radiofrequency neurotomy, radiofrequency nerve ablation (RFA) is a technique typically performed by pain management specialists with the goal of addressing chronic pain in the back, neck, hip, or knee. RFA is widely recommended by doctors for pain that:

  • Is localized to the back, neck, hip or knee and does not radiate
  • Intensifies while lifting or twisting
  • Feels better while lying down
  • Occurs on one or both sides of the back

In general, RFA helps patients with persistent pain caused by the degeneration of joints, usually from arthritis.

How Does RFA Work?

RFA uses heat generated by radio waves to disrupt the pain signals in the spinal nerves. Typically, the treatment will be performed while the patient is awake but mildly sedated, and will involve the following steps:

  • The injection area is numbed to minimize discomfort when the needle is inserted.
  • Under x-ray guidance, the doctor inserts a needle to the appropriate nerve branch. 
  • After the needle has been placed, an active electrode is inserted through the needle to emit a controlled electrical current. This will stimulate the nerve and may briefly create some discomfort, but allows the physician to confirm that they’ve targeted the proper treatment area.
  • Upon confirming the target nerve, the physician will use an ablation method (pulsed, water-cooled, or traditional radiofrequency) to create a heat lesion, which prevents the nerve from sending pain signals to the brain. If needed, the process will be repeated on other nerves.

The process takes 30 minutes, and patients can typically return home the same day. Common side effects include temporary discomfort at the injection site and numbness of the skin.

Most patients experience relief within one to three weeks after the treatment. During recovery, patients should allow their pain levels to guide their activities. Physical therapy may be advised to help patients regain strength and mobility if their pain has limited their activity range for some time.

Who’s a Good Candidate for Radiofrequency Nerve Ablation?

Although RFA isn’t considered a permanent fix for back or neck pain, it can provide lasting relief for anyone who wants to avoid or delay full back surgery but has had little success with other treatment options, such as physical therapy or lifestyle adjustments. It may be right for you if you’re experiencing chronic back or neck pain, or pain in the sacroiliac joint near the base of the spine and hip bones. Some patients experience pain relief that lasts years, and the treatment is considered a safe, well-tolerated treatment with few complications. Most people find that pain levels are much improved after the treatment.

If previous attempts to alleviate your back pain have done little to bring relief, turn to Alliance Spine & Pain. We understand the frustration of ongoing discomfort and offer state-of-the-art treatments delivered by experienced pain management specialists to help you feel like yourself again. To schedule an appointment, call (770) 929-9033 or reach out to us online.

Five Ways to Prevent Stiff Joints in the Morning

Ever wake up and feel so sore you’re not sure you can get out of bed? Morning joint stiffness is a common complaint among older adults, and several changes contribute to this symptom as we age.

One major cause of this pain is drying cartilage — the spongy cushioning that helps to absorb shock. A decline in production of synovial fluid can also mean joints are less lubricated. Additionally, stiff tendons and weak muscles become even tighter due to lack of activity during sleep. Finally, the symptoms of arthritis, a condition commonly associated with aging, can be more severe in the morning.

No matter what’s causing your morning pain, you don’t have to live with stiff, achy joints every day. Here are a few ways to get your joints going at the same time you do.

1. Stretch in Bed

Pop right out of bed upon waking up and you’re sure to feel like the Tin Man. Instead, try a few gentle stretches while you’re still lying down to gradually wake the joints up. Start by moving your neck from side to side, then stretching the upper body. Rotate hands and wrists in small circles, then activate the shoulders and elbows with similar gestures. Continue this circulation slowly down the body, including hips, knees, ankles, and toes in a way that feels good to you.

2. Take a Hot Shower

Make your way to the shower after climbing from bed. Turn the water temperature up to the highest comfortable setting, then allow your stiff joints to reap the soothing benefits of heat. Stay under the spray for at least 10 minutes to expose your joints to both water and the steam, which can help reduce inflammatory agents that contribute to arthritis.

3. Move Throughout the Day

Vigorous exercise may feel like the last thing you want to do with sore joints, but low-impact physical activity is one of the best treatments for joint pain. It strengthens supporting muscles, boosts bone strength, provides energy, and can help control your weight to reduce the strain on your joints. Regular movement also promotes restful sleep, giving your body the opportunity to repair overnight. Work with your care provider to come up with a plan that incorporates low-impact aerobic exercises, such as swimming or cycling, as well as stretching and strengthening moves.

4. Try an Anti-Inflammatory Diet

According to the Arthritis Foundation, following a Mediterranean-style diet can reduce inflammation that causes joint pain and stiffness. The dietary approach prioritizes inflammation-fighting agents, such as omega-3 fatty acids in fish and monounsaturated fats in nuts and seeds. It incorporates antioxidant-rich fruits and vegetables, as well as beans and whole grains. It also limits processed foods, which often contribute to inflammation.

5. Assess Your Mattress

While the right mattress can alleviate joint pain, the wrong one can aggravate it. If you’re getting the recommended eight hours of sleep, mattress quality becomes even more compelling, as you’re spending a third of your life there! The Sleep Foundation recommends models that provide both cushioning and support, prevent sinking, and keep the spine in proper position.

At Alliance Spine and Pain, we don’t just mask joint pain or stiffness with medication — we use individualized treatments to prevent or relieve them. To find out how we can ease your joint pain and stiffness, schedule an appointment online or by calling (770) 929-9033.

Woman stretching at desk

Why Your Spine Health Really Matters

Oftentimes, we don’t give much thought to our back health until something goes wrong. Perhaps it’s persistent neck pain, or a twinge in your back, but a sudden ailment can draw attention to the state of your spine. 

Caring for this central part of your body is just as important when you’re not experiencing any issues, however. Here’s why your spine deserves the same careful regard as any other aspect of your health.

The Spine’s Functions

Acting as the body’s main structural support system, the spine holds us upright. It connects all parts of the skeleton — head, chest, pelvis, shoulders, arms, and legs — and bears the weight of your entire upper body. 

In addition to its vertebral bones, the spine is also made up of elastic ligaments and spinal disks, which allow it to bend and twist. This flexibility also provides mobility throughout the whole body. Among its main key functions, the spine also serves as a balance system and shock absorber, thanks to its unique S-shape. 

The bones of the spine also protect a key component of the central nervous system— the spinal cord. The spinal nerve roots located there connect a series of peripheral nerves that branch off and extend to the extremities. To safeguard this critical nerve network, cerebrospinal fluid encases the spinal cord along with layers of protective membranes, all shielded by your vertebrae.

The Importance of Spinal Health

Keeping your spine healthy is one of the most important preventive health measures you can take. Certain spinal conditions can hinder your mobility, resulting in a loss of independence or a reliance on assistive devices. For example, the pain from a sciatica can be caused by degenerative disc disease or narrowing of the spinal column, and it irritates the sciatic nerve. This condition can cause immense pain while walking, standing, or even sitting. 

A stable spine has greater flexibility, meaning it allows you to move naturally and freely without pain. But an injured spine can make it challenging to lift, reach, stretch, or complete other everyday movements.

In fact, back and neck pain are the most common causes of physical pain in the U.S., and are responsible for the greatest number of doctors’ visits, outside the common cold. Back conditions are also the most common reason for disability in the U.S. 

Taking care of your back is therefore not just a matter of preserving long-term health, but of protecting your livelihood, too.

Tips for Maintaining a Healthy Spine

While we can’t always control whether we’ll develop spinal conditions such as osteoporosis or arthritis, there are plenty of things we can do to boost spine health. Here are a few to start practicing now.

  • Lift carefully. Keep objects close to your body as you lift them, and use your leg strength to bear the weight instead of your back.
  • Practice good sleep posture. Aim to keep your spine in its neutral alignment while you sleep. You may need to put a pillow between your legs if you’re a side sleeper, under your knees if you’re a back sleeper, or beneath your hips if you sleep on your stomach.
  • Maintain a healthy weight. Excess weight puts added stress on your spine. Follow a nutrient-rich diet and exercise regularly. As an added bonus, mixing strength, stretching, and aerobic activities will help keep your back more resilient against injuries.

Our team at Alliance Spine and Pain promotes spine health by addressing the root causes of back issues. We use state-of-the-art therapies to address a wide range of back issues. Schedule an appointment online or by calling (770) 929-9033.