Category: Medical Minute

Medical Minute - Osteoarthritis
Medical Minute - Osteoarthritis
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You’ve probably heard of “arthritis”. You may have even been told by your doctor that you have arthritis, but have you ever wondered what that means?
There are many different types of arthritis. Simply stated, arthritis is inflammation of a joint. The word originates from the Greek “arthron” meaning “joint.” The suffix “-itis” simply refers to inflammation.
There are many different types of arthritis. Therefore, it is important to undergo a proper medical evaluation, with a medical professional, because the treatment may differ significantly based on your subtype of arthritis.
With that said, osteoarthritis is the most common subtype of arthritis. “Osteo-” comes from the Greek word for bone. Osteoarthritis (OA) is typically referred to as “wear and tear” type of arthritis. Cartilage will eventually wear out and may result in what is sometimes referred to as bone on bone. OA continues to worsen with time and thus far is a non-reversible process. Modern medicine is aimed at slowing this process but there is currently no consensus-accepted evidence that it can be reversed.
Important factors to consider regarding osteoarthritis are the impact on the patient’s function, severity of disease, radiographic evaluation, risks of medications and procedures, surgical candidacy, physical fitness, and even sleep and dietary habits. Some of these are factors within the patient’s control that may impact their pain and improve their function. Two very potent factors to improve pain in arthritis are smoking cessation and weight reduction. Excessive weight puts significant pressure and strain on load-bearing joints (e.g. spine, hips, knees, ankles) and any reduction in weight will improve pain and function. Also, smoking cessation has been demonstrated to improve circulation and healing. Both of these strategies should be strongly encouraged in all patients.
The first line therapies for osteoarthritis are non-steroid anti-inflammatories (NSAIDs) and acetaminophen. Patients are encouraged to speak with their physicians regarding dosing and judicious use of those medications. There are also several therapy modalities, such as physical therapy, cryotherapy, heat therapy, and ultrasound therapy that are beneficial. Secondary medications, including neuropathic agents, should also be considered. In addition, interventional procedures including steroid injections and in some cases Hyaluronic Acid injections, a joint lubricant used to reduce friction, have shown to improve functional status, but will require a referral to a pain medicine specialist. These interventional procedures also offer the advantage of not requiring incisions or long recovery periods.
Finally, a full surgical joint replacement is a last resort that should be considered if all else fails. This will require consultation with an orthopedic surgeon.
If you or someone you know is suffering from arthritis, it is important to schedule an evaluation with your doctor because the treatments differ for different types of arthritis. At El Paso Pain Center, our double board certified physicians can diagnose your arthritis and start you on the proper treatment plan. Please let us help! Call today to make your appointment (915) 598-PAIN (7246).

About The Author

Dr. Paolo Mimbella is a Pain Management Physician at El Paso Pain Center and is Double Board Certified in Physical Medicine and Rehabilitation and Pain Medicine. He completed his fellowship in Pain Medicine at Albert Einstein College of Medicine.

Medical Minute - Lower Back Pain
Medical Minute - Lower Back Pain
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Low back pain is one of the most common reasons for patients to seek care from a medical doctor. About 80% of people will have a low back pain episode in their lifetime. ¹ Frequently, back pain may be related to degenerative disc disease, arthritis, or problems of the muscles and ligaments surrounding the spine. Back pain that is associated with leg pain, numbness, or weakness can be due to a herniated disc commonly referred to as Sciatica or spinal stenosis. Rarely, back pain is associated with bowl or bladder dysfunction and may be caused by a potentially serious spinal condition, such as an infection, fracture, or tumor. If your back pain does not resolve after rest and conservative therapy you should seek medical attention from a Board Certified professional.

At El Paso Pain Center, we will identify the cause of your back pain and develop a treatment plan that is personalized for you. Using the latest technology we will help you determine your next course of action. Whether you need diagnostic imaging with X-Rays or MRI, physical therapy or interventional procedures w e are here to help. We are experts in a vast array of procedures including: epidural injections for Sciatica, medial branch blocks for Arthritis, or even Kyphoplasty for osteoporotic spine fractures. With our leading specialists, you can trust El Paso Pain Center to help!

About The Author

Dr. Vazquez is the Medical Director for El Paso Pain Center. He completed a Pain Management Fellowship at MD Anderson Cancer Center and is Double Board Certified in Pain Management and Anesthesiology.

Medical Minute - Peripheral Neuropathy
Medical Minute - Peripheral Neuropathy
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Peripheral Neuropathy

Peripheral neuropathy is a painful condition that is hard to describe by most affected individuals,
but is one that limits the function of many. The hard to describe sensation usually affects the extremities and can feel like burning, pins & needles, electricity, numbness, or can present as increased sensitivity or pain from stimuli that are typically not painful. Affected individuals may also notice that they are unable to feel changes in temperature, have a loss of normal muscle reflexes, or are likely to experience increased pain intensity at night or when they are sedentary.

So what are peripheral nerves? The peripheral nervous system (PNS) connects the nerves running from the brain and spinal cord to the rest of the body. The PNS includes the nerves from the arms, hands, legs, feet, joints, mouth, eyes, ears, nose, and even internal organs and skin. When damaged, this results in a pathologic process of injury to these peripheral nerves, frequently culminating in chronic pain. Nerve injury can stem from many sources including: physical trauma, surgery, chemical exposure, chemotherapy, infection, insufficient blood supply, vitamin deficiencies, autoimmune diseases, diabetes and unknown causes.

At best, this process is simply the result of an acute event and will improve on its own in four to six weeks. However, the pain can also continue to develop and change over days, weeks, or even years. Some individuals may even experience a temporary relief in pain symptoms before a return or worsening of their pain, while others experience a pause or plateau in their symptoms where pain no longer progresses but fails to improve. However, if the pain persists and/or intensifies, the process may become chronic which may require professional medical treatment.

Treatment depends on the type of neuropathy, location, and symptoms. Unfortunately, no treatment exists to cure all forms of neuropathy, but there are many forms of conservative therapy geared towards lifestyle modifications such as: exercise, diet/weight management, avoidance of toxins, maintenance of optimum blood sugar, and controlling culprit diseases that may help. In addition, there are medications in the neuropathic family such as pregabalin and gabapentin which are designed to stabilize the irritated nerve membranes and thus sooth the painful sensations. Unfortunately, many individuals may not tolerate these medications due to their side effect profile. Thankfully, there also exist alternatives to include serotonin and norepinephrine reuptake inhibitors in addition to tricyclic antidepressants and topical analgesics which have all shown benefit in sub populations affected by peripheral neuropathy. For refractory cases, we can also consider image guided interventional procedures targeting damaged peripheral nerves or enlist the use of cutting-edge technology involving dorsal column stimulator therapy. If you or someone you know is suffering from peripheral neuropathy, at El Paso Pain Center we can diagnose your condition and develop an individualized treatment plan for you. With our vast experience, we will provide you with specialists that care about you and desire to improve your health by limiting the grasp your chronic pain has over you. Let us help. Call (915) 598-7246 for your appointment today. It’s time to feel better!