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.

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.

woman sitting with legs crossed enjoying the smell of her coffee

Stress Relief Tips for Chronic Pain

Stress and chronic pain are often close cousins. When you experience physical discomfort, it’s natural to feel emotional stress too, but even this normal stress can accelerate pain, resulting in a cycle that makes things worse both mentally and physically.

Here’s some advice about the relationship between pain and stress, and how to interrupt their circular connection.

Stress and the Body

Stress affects every system of the body, the American Psychological Association reports, including respiratory, nervous, musculoskeletal, and gastrointestinal systems. Tensed muscles often serve as a protective measure against injury and pain, but this continual tension can lead to other problems in every system, including headaches, digestive complications, and joint discomfort.

On a chemical level, stress can also release hormones that have a damaging, compound effect on the mind long term. “[I]ndividuals who are under this constant state of stress experience a decrease or damage of cognitive function to the brain, lowered IQ, and, as a result of the chemical response, the pain becomes more pronounced,” Loma Linda University Health reports. More pain yields more stress, and more stress yields more pain. For those with a chronic pain disorder, the cycle may feel impossible to break.

Coping with Pain and Stress

If either stress or pain could be avoided altogether, this problematic cycle would be easy to fix. But stressors (including pain) are part of everyday life. Fortunately, there are several healthy outlets that can help manage both your mental health and your chronic pain.

  • Exercise moderately and regularly. It may seem counterintuitive to exercise when you’re in pain, but even a short, low-intensity walk, yoga, or moderate stretching can provide benefits. Research shows, for example, that walking can help reduce arthritic joint stiffness, while also delivering a mood boost.
  • Focus on your sleep patterns. When stress or pain causes your mind to race at night, you aren’t getting the sleep you need to restore and repair. Avoid electronics at least 30 minutes before bed to combat this mind-racing, and do your best to maintain a regular sleep schedule.
  • Explore an anti-inflammatory (and anti-stress) diet. Eating health-consciously with enjoyment can help both your body and your mind. Choose anti-inflammatory foods that bring delight to your palate and your pain levels.
  • Delegate responsibilities. Chronic stress, and therefore unnecessary pain, sometimes stem from taking on too much. Can you delegate tasks at work or home to trustworthy others?
  • Reach out and touch loved ones. “Studies have shown that touch can lower stress levels, lessen anxiety, and help a myriad of other physical disorders,” Dr. Martha Lee, founder and Clinical Sexologist of Eros Coaching, told Bustle. “There are noticeable changes in mood and even health when we’re exposed to simple human kindness in the form of touch.” Even when you can’t physically connect, a phone call may help you unload problems and feel more connected.
  • Practice other stress outlets. Going for a drive, listening to music, reading a favorite book, journaling, playing with a pet, or experimenting with art are all ways to manage stress, and alleviate pain at the same time.

At Alliance Spine and Pain Centers, we are dedicated to finding solutions that aid your chronic pain, your mental health, and the relationship between the two. Schedule an appointment with us online or call directly at 770-929-9033 to discuss what solutions may be best for you.

lady holding her lower back in pain

When Should You See a Pain Specialist

While most people deal with pain in some capacity during the course of their lives, it can be difficult to know when it is time to talk to a professional about it. In a 2016 study, more than 1 in 5 adults were reported to have chronic pain in the United States, and about 8% of adults experienced “high-impact” chronic pain. The NCCIH defines chronic pain as that which “lasts longer than several months,” and persists past the timeline of “normal healing.”

Dealing with pain every day can become its own “normal,” but continual pain does not have to be brushed aside.  A pain specialist is trained to help people manage pain issues, particularly when chronic pain is affecting the following areas of your life.

When it Impacts Your Ability to Work

A 2017 study published in Family Practice found that employees with chronic pain reported an average of 5.4 hours per week of reduced productivity. This effect on overall performance can leave both employees and managers feeling frustrated.

If your pain is reducing your productivity at work, you may need to speak to a specialist for solutions.

When it Diminishes Your Mental Health

Living with chronic pain is both physically stressful and draining. But this continued pain is also often associated with mental health conditions such as anxiety and depression. According to Mental Health America, this is because daily pain can cause a change in the level of stress hormones and neurochemicals in your brain and nervous system.

Unfortunately, the anxiety caused by chronic pain may add to its intensity. “Sometimes pain and depression create a vicious cycle in which pain worsens symptoms of depression, and then the resulting depression worsens feelings of pain,” Daniel K. Hall-Flavin, M.D. at the Mayo Clinic acknowledges.

If your chronic pain is dampening your mood, causing frustration, depression, anxiety, or other negative emotions, a pain specialist can help.

When it Reduces Time with Loved Ones

Many people who experience chronic pain can find themselves having difficulty participating in social activities and engagements they would otherwise enjoy. According to a 2019 study published in the Journal of Patient Experience, patients with chronic pain had lower friendship quality, higher perceived rejection, and higher perceived hostility. Whether due to physical restrictions, emotional exhaustion, or a combination of both, many people with chronic pain often feel that they are not as connected to their family and friends as they want to be.

Talk to a specialist to relieve chronic pain, and get back to more quality time with loved ones.

When Other Treatments Have Been Unsuccessful

There are many different types of treatment for chronic pain available. If you have tried at-home or even doctor-prescribed methods only to have persisting pain, a specialist can help.

Postponing treatment for your chronic pain may lead to its worsening in the future, so consult a pain specialist sooner rather than later to access new, multidisciplinary treatment and help your body heal.

If you or someone you love are experiencing chronic pain, the experts at Alliance Spine and Pain can provide individualized solutions that can get you back to doing the things you love. You can schedule an appointment online or give us a call at 770-929-9033.

female athlete runner touching foot in pain

Exercises for Leg Pain

Nearly 59% of Americans are suffering from leg pain. But despite these numbers, the current status quo of pain management is not ideal for many.

Leg pain can range from annoying to absolutely debilitating. Fortunately, many cases of leg pain can be relieved by exercising the affected muscles.

Wherever you’re hurting, from your thighs to your ankles, we hope the following exercises can be helpful. Keep in mind that it is always important to start slow and build your skills, and as with all types of pain management, to listen to your body. If any exercise becomes painful, discontinue and seek advice from your pain specialist.

Quadriceps

For those with knee osteoarthritis, it is important to strengthen your quad muscles.

To do so with leg lifts, lie down on your back, lift your legs up one at a time, keeping the raised leg straight, and hold them in the air for five seconds. Another way to bolster your quad muscle strength is with a Bulgarian split squat: rest one foot on a bench or chair behind you, and lower your body in a squat with the other leg.

Hamstrings

A kettlebell swing requires a kettlebell, although it is possible to use a dumbbell instead. Begin in a standing position, holding the kettlebell between your knees. Keeping your back straight, hinge forward while shifting your hips back, bending your knees no more than necessary to allow the kettlebell to swing between your legs. Using your leg strength and core, return to an upright position while raising the kettlebell with extended arms in front of you, and then lower to the original position. This whole-body exercise stretches the glutes, hamstrings, hips, core, shoulders, and back.

The basic bridge is another excellent exercise for the hamstrings, and is easier on your body than others. You don’t have to arch your entire back into a curve — simply lie on your back with knees bent and feet on the floor, and focus on raising your hips to form a straight line from knees to shoulders.

Knee & Joint Strength

If you are struggling with knee pain, certain leg exercises may not be for you, as improper movement may exacerbate any injuries. However, there are several knee and joint exercises that can be low-impact and bring relief. These include leg raises, or seated knee extensions, and hamstring curls.

Lower Back & Hip

Supine side leg raises may be able to help you stretch and relax your lower back and hip. Lie down on your side, properly supporting your spine and abdomen, and slowly lift and lower one leg. Utilizing a mat can also give you extra support and comfort.

Calves

Calves are often neglected during exercise routines, and a standing calf raise may be quite beneficial to your knees, too. Stand upright, with your feet flat on the ground, and slowly lift your heels and shift your weight to your toes. Squats can also ease pain in your calves.

Ankles & Feet

The University of Michigan provides a selection of rehabilitation exercises if you are struggling with an ankle sprain. These include the towel stretch, during which you place a rolled-up towel at the bottom of your foot, outstretch your leg, and pull at each end of the towel.

There are also many exercises that can help with foot flexibility and mobility, such as the toe splay: Sit down and spread your toes apart without straining. Hold the position for 5 seconds before releasing.

What if the Exercises Aren’t Helping?

Since every body is different, and there are many different types of leg pain — including musculoskeletal, vascular, and neurological — not all of these exercises may work for you. Consult with your doctor or a pain specialist to custom-design an exercise program that is specifically designed for your leg pain. Visit us online to schedule a consultation, or call us at 770-929-9033.

Woman stretching her arms at her desk

Start the New Year with Less Pain

If you suffer from chronic pain, you may have already searched for ways to find relief. Though some medicines or therapies may help with immediate discomfort, they may not provide the promise of a long-term solution for the new year.

While finding the most appropriate and effective way to alleviate pain for an even fuller life may require close consultation with your doctor and pain specialist to determine the cause and eliminate any risks, there are several options available to you.

Dorsal Root Ganglion Stimulation

Lower body chronic pain can be difficult to treat. Dorsal root ganglion stimulation uses neurostimulation along the spinal nerve root to target specific areas of chronic pain, such as the hip, groin, knee, or foot.

The dorsal root ganglia (DRG) are composed of densely compacted sensory nerve cell bodies, which send sensations to the brain. Each DRG is associated with a different part of the body, and DRG stimulation targets these specific clusters to address the unique area of your individual discomfort.

“[DRG] could provide long-term relief for chronic back pain that has not responded to other treatments, including spinal cord stimulation,” a study from Rush University Medical Center asserts. “It could also help certain people who need a non-drug form of pain therapy.”

Regenerative Medicine

Regenerative medicine is an umbrella term used for a multitude of new procedures that amplify your own body’s healing powers. Because these treatments do not introduce new materials into your system or require surgery, recovery time may be reduced.

Platelet Rich Plasma

Platelet-rich plasma (PRP) therapy utilizes the growth factors that are in the platelet layer of centrifuged blood. These factors help your body naturally harness to treat inflammation, reduce pain, heal injuries, and promote tissue regeneration.

The process involves taking a sample of your own blood, and then separating out the platelet layer with a centrifuge. Your platelet-rich plasma is then reinjected where needed into injured tissue to release growth factors that stimulate and increase reparative cells.

According to the American Academy/Association of Orthopedic Medicine, “Research studies and clinical practice have shown PRP injections to be very effective at relieving pain and returning patients to their normal lives,” but we recommend consultation with your pain specialist to determine whether PRP injections are appropriate for you.

Bone Marrow Aspirated Concentrate

Like platelet-rich plasma, bone marrow aspirated concentrate (BMAC) also employs your body’s own natural healing power. But rather than using blood, BMAC retrieves bone marrow from your pelvic bone where stem cells are made. The cells are then concentrated from the marrow, and injected into a ligament, joint or vertebral disc that is causing pain.

Though further research is being conducted, clinical studies have shown that BMAC has “promising results” for those with osteoarthritis, and that the procedure involves minimal side effects.

Customized Treatment

There are several other methods that can be used to alleviate your chronic pain, including diagnostic facet nerve blocks, lumbar endoscopic discectomy, individual physical therapy sessions, and more.

We know that finding the most effective treatment for your chronic pain can be exhausting. So the care team at Alliance Spine & Pain Centers is dedicated to providing an accurate diagnosis and effective therapy to alleviate your discomfort with long-lasting results. To learn more about our treatments, and to book an appointment for 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.

Photo of a veteran wearing military uniform.

Pain Resources for Veterans

Originally celebrated after the end of World War I as Armistice Day in 1919, Veterans’ Day is a day of recognition and remembrance to honor all veterans — those who sacrificed their lives during wartime, and all those who have previously served. 

Alliance Spine and Pain Centers honors these remarkable men and women with some resources that can provide support and relief. 

Interventional Pain Management

Interventional pain management is designed to relieve patients of their pain using research-based solutions that go beyond medication. Specialists in interventional pain management take a multidisciplinary approach to address patients’ pain. This collaborative process can be particularly important for veterans who may experience more physical pain than nonveterans, as well as effects from the complex relationship between chronic pain and chronic stress

Physical Therapy

“Physical therapy is a profoundly important practice in caring for veterans,” the U.S. Department of Veterans Affairs asserts, because it provides an “alternative to surgery, prevents injury, increases mobility, reduces pain, and restores independence.” 

But the tie between veterans’ health and physical therapy has been strong from the beginning. The first school of physical therapy was established at Walter Reed Army Hospital in Washington, D.C., following World War I. 

Since then, physical therapists have provided medical care for the U.S. military across multiple deployments, including active combat. A study in the Physical Therapy and Rehabilitation Journal concludes that the versatility of physical therapy allows practitioners to accurately diagnose, treat, and rehabilitate a wide range of musculoskeletal injuries wherever soldiers are located — reducing the need to evacuate them. Physical therapists can also often be mobile, allowing them to work with patients privately in their hometowns upon return.

Mental Health

Mental health for every individual is complicated, but especially for veterans. According to a 2014 article published by the American Public Health Association, veterans have “disproportionate rates of mental illness, particularly posttraumatic stress disorder (PTSD) . . . depression, anxiety, and military sexual trauma.” 

These mental health complications can lead to high levels of substance abuse and homelessness in the veteran population, but also suicide, as a 2018 data report on national suicide by the U.S. Department of Veterans Affairs revealed.

In August of 2020, the U.S. Senate passed the Commander John Scott Hannon Veterans Mental Health Care Improvement Act, S. 785. This legislation focuses on improving mental health care for veterans through several provisions, including improved access to innovative care (art and animal therapy, and increased telehealth access for rural veterans, for example). Improved diagnostic tools, transitional care, increased VA program oversight, and specific mental health needs for female veterans are also included.

Sources of Support

The Department of Veterans Affairs provides several resources, including the VA Aid and Attendance benefit, described by Military Benefits.info as “available to qualifying low-income veterans (or their spouses) who are in nursing homes or who need in-home care help with everyday tasks like dressing or bathing.” 

Depending on your location, you may find independent sources of assistance, such as Friends in Service of Heroes (F.I.S.H.), the Cohen Veterans Network, or Forces United. Make the Connection can also help you locate resources based on zip code. 

These national organizations also provide support to veterans and their families:

Alliance Spine and Pain Centers is grateful for our veterans, and for the opportunities we have to assist them. For state-of-the-art therapies to address a wide range of pain, schedule an appointment online or call (770) 929-9033.