Everyone is troubled by pain from time to time, but for many of the patients we treat at Long Island Spine Rehabilitation Medicine pain has become a constant presence that interferes with their quality of life. Fortunately, we can help you live a more pain-free life and have a long track record of doing so.
Our doctors are physiatrists, specializing in and dedicated to the alleviation of pain. If pain has become what seems to be an unstoppable force in your life, contact one of our Long Island offices to receive compassionate, effective care and a broad range of therapeutic options.
Our patients are often amazed to find that, in addition to the traditional and complementary forms of treatment our doctors provide, simple measures in their daily routine can make an enormous difference in relieving their pain and preventing its recurrence. Such measures may include: altering their diets, exercising regularly, learning how to move and rest in more comfortable positions, and practicing some form of meditation.
In order to understand how our pain treatments and some changes in your habits can relieve your pain, you have to understand the origins of pain and how it affects the body and mind. For this reason, we will explore these subjects, as well as many types of pain management, both with medication and without.
What causes pain?
In the vast majority of cases, ongoing pain results from one of the following causes:
- Injuries due to accidents (e.g. trip and falls, car accidents, sports activities)
- Repetitive motions at work or during leisure time (e.g. typing, throwing, knitting)
- Medical conditions, like arthritis, cancer, back or neck problems, neuromuscular disease
- Surgical procedures
- Assaults
- Animal attacks
Types of Pain
Pain is categorized as either acute or chronic. Acute pain is a natural response to injury or disease. Usually, it starts suddenly and resolves within a limited period of time. Chronic pain, on the other hand, continues beyond the time frame during which normal healing is expected to take place, and generally lasts longer than 3 months.
Pain can be experienced as a dull ache, a sharp stab, a burning sensation, or a feeling of extreme pressure and can range from mild to extreme (typically described on a scale of 1 to 10). Pain can be felt in one localized area or can be widespread and is sometimes “referred” from its place of origin to some other part of the body.
What makes us feel pain?
Pain is a useful mechanism to protect us from danger and harm, raising our awareness that trouble is afoot. Here’s how it works:
We have two kinds of pain receptors in our nerves, one that sends messages of sharp, sudden pain and one that sends messages of dull, throbbing pain. We all know from experience that some areas of the body have more pain receptors than others. For example, the palm of the hand is very sensitive.
In most cases, pain receptors in the skin give a precise indication of the location that is injured or diseased; pain receptors in our internal organs may be less exact or, in some places, nonexistent, keeping patients, for example, from feeling a cancerous tumor growing within their intestinal tract. Ordinarily, pain travels from receptors to the spinal cord and then to the thalamus, a part of the brain.
At times, you may notice that your body reacts before you consciously feel the sensation of pain (for example, by jerking your hand away from a hot stove). This is an involuntary reflex to protect you from further harm. It is interesting to note that the thalamus is also the part of the brain that contributes to mood and arousal. No wonder our emotions play a part in how and when we experience pain.
How Emotions and Pain Interact
There is a complicated relationship between emotions and pain that can play a key role in having a pain-free life. As physiatrists, we know that ongoing pain can have a significant impact on mood and behavior. Chronic pain often makes those affected by it anxious, frightened, angry, or depressed, sometimes all at the same time. It also can make you feel misunderstood or unappreciated when those around you can’t seem to comprehend the intensity of what you’re experiencing.
The feeling that one must endure pain indefinitely has its own troubling effect on the body.
The stress it provokes can give rise to headaches, digestive problems, sleep disorders, loss of appetite, decreased libido, and fatigue. In other words, chronic pain can be self-perpetuating if the cycle is not interrupted.
Homework for Pain Management to Live a Pain-Free Life
Some of the home remedies you’ve used for sudden injuries can also be beneficial for chronic pain. Hot or cold packs, sometimes used alternately, can minimize pain. Depending on the circumstances, stretching, strengthening, walking, and even aerobic exercises can be helpful in elevating your mood as well as relieving stiffness and improving flexibility, thereby lessening pain.
Of course, moderation is key. Overdoing exercise can result in a new injury and make the situation worse. Still, doing something to alleviate chronic pain almost always feels better than curling up in a ball. Our doctors have multiple ways to help you and will plan a program of home care to keep you comfortable between visits.
How Long Island Spine Rehabilitation Medicine Helps You Lead a Pain-free Life
Many factors affect the way pain is treated, including:
- Cause
- Location
- Intensity
- Patient’s preexisting medical conditions
- Patient’s lifestyle
- What medications the patient is taking
- Patient’s age and general level of health
Because pain has such a powerful effect on your quality of life, our doctors have a wide range of methods to address it, including:
- Customized physical therapy with or without electrical stimulation
- Acupuncture to reduce pain & inflammation ( now recognized as effective)
by prestigious groups, such as NIH and Memorial Sloan-Kettering Cancer Center
- Platelet-rich plasma (PRP) therapy to promote healing
- Corticosteroid injections to relieve pain and inflammation directly at the site
- PEMF (Pulsed Electromagnetic Field) therapy to accelerate healing with
short pulses of low-intensity, low-frequency electromagnetic energy.
- Pain medications (analgesics)
- Assistive devices (e.g. canes, braces) to allow injured areas to rest
- RFA (Radio Frequency Ablation) to deaden nerves causing the pain
- Fluoroscopy-guided spinal injections to relieve back and nerve root related pain
Well aware of the body/mind connection, we also recommend that our patients consider, in addition to our diverse treatments:
- Relaxation techniques
- Stress management training
- Cognitive-behavioral therapy (CBT)
to alter the perception of, and reactions to, pain
- Meditation/yoga/tai chi
- Support groups for people in pain
- Massage therapy for soft tissue pain
- Psychological counseling that addresses pain
At Long Island Spine Rehabilitation Medicine, we believe that pain management works best when patients are fully convinced of its possible efficacy, so we will always include you in the decision-making process in terms of which therapeutic treatments are most appealing and comfortable for you.
Accurate Diagnosis Is Essential
Our physiatrists are excellent diagnosticians as well as pain management doctors and know that an accurate diagnosis is necessary for proper treatment. For this reason, when you come to us in pain, we will give you a thorough physical examination and use one or more of the following diagnostic tools to pinpoint the problem:
- Imaging tests: X-rays, CT scans, MRIs, ultrasound
- Electromyography (EMG) and nerve conduction studies
- Ultrasound-guided injections
- Diagnostic medical branch block (if we suspect your pain originates in the facet joints of your spine)
- Discography to determine which spinal discs are causing your pain
Treating Pain with Medication
Almost everyone uses pain medication from time to time, and over-the-counter medications can be of great help in keeping pain at bay. Of course, for severe injuries, after surgery, and as part of treating serious illnesses, prescribed medications may be necessary. Medication may not be the answer to living a pain-free life, however.
Following is a list of common pain medications:
- Acetaminophen (Tylenol) or aspirin to relieve short-term pain
- NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen (Advil) to relieve pain and reduce inflammation (often a cause of pain)
- Local anesthetics (drops, sprays, creams, or patches)
- Opioid medicines — e.g. codeine, morphine, and oxycodone —used less frequently and ideally for acute or severe pain.
- Some antidepressants and anti-epilepsy medicines that are effective against pain
Because almost any medication can have side effects, our physiatrists will think carefully before prescribing one. At Long Island Spine Rehabilitation Medicine, we take a holistic approach so before prescribing we will consider not only your symptoms, but your age, any medical conditions, allergies, or known susceptibility to addiction you may have, and what other medications you may already be taking.
Safe Is Better than Sorry When It Comes to Pain Medications
When you are desperate for relief from pain, you will do just about anything to make it stop. Still, as your doctors, we have to be cautious, always weighing the benefits and risks. Though pain medications can be remarkably helpful, their side effects can sometimes lead to more pain than they alleviate.
Many of the side effects mentioned below are rare, usually occurring when analgesics are taken at high dosages for long periods of time, often against medical advice. Side effects from painkillers include:
- Acetaminophen — skin rash and liver damage
- Aspirin — nausea, vomiting, indigestion and stomach ulcer, tinnitus, asthma, kidney damage, and bleeding
- NSAIDs — headache, nausea, stomach upset, heartburn, skin rash, tiredness, excessive bleeding or bruising, dizziness, tinnitus, elevated blood pressure, worsened heart or kidney failure, increased risk of heart attack, angina, and stroke
- Opioids (e.g. morphine, oxycodone, and codeine) — drowsiness, confusion, poor balance and coordination, nausea, vomiting, constipation, slowed breathing
*Most importantly, opioid use can lead to addiction, overdose, and death
To prevent unpleasant and dangerous side effects from pain medication, you should:
- Never self-medicate during pregnancy (this may harm the fetus)
- Be especially careful if you are a senior or taking care of an elderly person since older individuals can be at increased risk of side effects
- Make sure to inform doctors and pharmacists about interactions of pain medications with other medicines or supplements you are taking
- Also, check with pharmacists when buying over-the-counter pain medicines or supplements to check about possible interactions
- Don’t take more than one over-the-counter medicine at a time without consulting with your doctor or pharmacist; many have overlapping ingredients.
How Your Behavior and Mindset Can Help You Toward a Pain-Free Life
Lifestyle changes can have a profound effect on decreasing pain and improving quality of life. There are several alterations to your daily routine that can make you feel much better, especially when you know that your pain issues are also being addressed by our pain treatment specialists. This may be particularly true if you are suffering from conditions like arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia.
Because no single lifestyle change will make a substantive difference for everyone, being open-minded and trying several options gives you the best chance of finding a key to improving your own health. The following lifestyle changes, alone or in combination, can be invaluable in reducing your level of pain and giving you an improved sense of well-being:
- Lose excess weight
- Exercise regularly
- Eat a healthier diet with more fruits and vegetables and fewer sugars and fats
- Find ways to reduce and/or deal more effectively with stress, by altering your schedule, learning to avoid certain situations, finding ways to self-soothe
- Improve sleeping habits (e.g. retiring at the same time every night, having a good mattress and comfortable pillow, not eating for 2 or more hours before going to bed)
- Stop smoking and excessive alcohol consumption
Contact Our Knowledgeable Long Island Physiatrists to Help Reach a Pain-free Life!
No matter what the medical cause of chronic pain, pain itself is exhausting and debilitating. At Long Island Spine Rehabilitation Medicine, our doctors are specialists in treating the vicious cycle of chronic pain. When you come to us, we will evaluate your condition with care and precision, determining (with your input) the best therapies to use in your particular case.
If you have been in pain for a long time, it is easy to begin to feel hopeless which only contributes to your suffering. Contact our highly skilled pain specialists now. We have a long record of successful outcomes and will open the window to a wide range of traditional and innovative treatment options. We, like you, are focused on one goal: helping you to live a healthy, pain-free life.