PAIN SYNDROMES TREATED

Patient Reviews

Ironman Triathlete Lisa Bentley

Abdominal Pain

Virtually any organ and structure within the abdomen may be a cause of abdominal pain. It is of utmost importance to make a proper diagnosis and treat potentially lethal disease early. Abdominal pain that lasts for weeks requires detective work by systematically addressing every possible organ and structure. Gallbladder, pancreas, liver, esophagus, kidneys, and intestines all need to be evaluated. Muscles covering the abdomen have also been implicated in abdominal pain. Prior abdominal surgery may cause internal adhesions and scar tissue, leading to pain. At times, abdominal scars may trigger pain in certain individuals. Broken or injured ribs need to be evaluated as possible causes. Irritable bowel syndrome, ulcerative colitis, and Crohn’s disease are conditions involving the intestines. All of which may present you with abdominal pain. Abdominal masses and cancer should be ruled out. Antineuropathics and opioids may be used to help with pain. Your doctor may recommend certain procedures that may help with diagnosis. If pain improves after injecting the sympathetic chain with local anesthetics, then the pain is assumed to be of sympathetic origin. Future treatment plans may include therapy. Learn more…

Anal Rectal Pain

Rectal and anal pain could be devastating for patients. This pain may be due to several causes, including trauma, infections, hemorrhoids, surgery, and colonoscopies. At times, after exhaustive work-up, no reason can be found. Medications, acupuncture, and nerve blocks could be used to treat the pain. Learn more…

Ankle Pain

Ankle pain refers to any type of pain or discomfort in your ankles. This pain could be caused by an injury or by a medical condition, such as arthritis. The most common cause of ankle pain tends to be from a sprain, which is an injury where the ligaments in your ankle tear or stretch.  As a result of a previous injury, or just the wear and tear of everyday life, your ankle may be suffering from arthritis, particularly rheumatoid arthritis. When inflamed, rheumatoid arthritis may limit your ability to do your everyday routines and activities.

Immediate care for ankle pain would be to stay off of your feet and keep ice on the area of discomfort. If swelling does not go down, the use of anti-inflammatory medication is suggested. If symptoms continue to persist, medical attention may be needed. Learn more…

Ankylosing Spondylitis

Ankylosing spondylitis (pronounced ank-kih-low-sing spahn-dill-eye-tiss), is a form of arthritis that primarily affects the spine, although other joints can become affected by the condition, including shoulders, hips, ribs and heels, as well as the joints in hands and feet.  In rare cases, the eyes, heart, and lungs can also be affected by AS. AS causes inflammation of the vertebrae that can lead to severe, chronic pain and discomfort that often comes in acute, painful episodes followed by temporary periods of remission.

Ankylosing spondylitis is a chronic, or life long disease. The severity of AS has nothing to do with age or gender. Learn more…

Anterior Cutaneous Nerve Entrapment Syndrome

Anterior cutaneous nerve entrapment syndrome (ACNES) is a condition that causes chronic pain of the abdominal wall. Treatment consists of injection treatment, and in some severe cases, surgery is needed. Learn more…

Arachnoiditis

Arachnoiditis describes a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. The arachnoid can become inflamed as the result of direct injury to the spine. It can also become inflamed because of an irritation from chemicals, infection from bacteria or viruses, chronic compression of spinal nerves, or complications from spinal surgery or other invasive spinal procedures. Inflammation can sometimes lead to the formation of scar tissue and adhesions, which cause the spinal nerves to “stick” together. If arachnoiditis begins to interfere with the function of one or more of these nerves, it can cause a number of symptoms, including numbness, tingling, and a characteristic stinging or burning pain in the lower back or legs. Some people with arachnoiditis will have debilitating muscle cramps, twitches, or spasms. It may also affect bladder, bowel, and sexual function. In severe cases, arachnoiditis may cause paralysis of the lower limbs.

Arachnoiditis remains a difficult condition to treat, and long-term outcomes are unpredictable. Most treatments for arachnoiditis are focused on pain relief and the improvement of symptoms that impair daily function. A regimen of pain management, physiotherapy, exercise, and psychotherapy is often recommended. Surgical intervention is controversial since the outcomes are generally poor and provide only short-term relief. Clinical trials of steroid injections and electrical stimulation are needed to determine the efficacy of these treatments.

Arachnoiditis appears to be a disorder that causes chronic pain and neurological deficits and does not improve significantly with treatment. Surgery may only provide temporary relief. Aging and pre-existing spinal disorders can make an accurate prognosis problematic. The outlook for someone with arachnoiditis is complicated by the fact that the disorder has no predictable pattern or severity of symptoms. Learn more…

Arthritis

Rheumatoid arthritis is a disease that affects the joints. It causes pain, swelling, and stiffness. If one knee or hand has rheumatoid arthritis, usually the other does too. This disease often occurs in more than one joint and can affect any joint in the body. People with this disease may feel sick and tired, sometimes developing fevers.

Some people have this disease for only a few months, or a year or two. Then it goes away without causing damage. Other people have times when the symptoms get worse (flares), and times when they get better (remissions). Others have a severe form of the disease that can last for many years or a lifetime. Severe arthritis can cause serious joint damage.

Doctors don’t know the exact cause of rheumatoid arthritis. They do know that with this arthritis, a person’s immune system attacks his or her own body tissues. Researchers are learning many things about why and how this happens. Rheumatoid arthritis is treated by a rheumatologist. If pain is severe, then NSAID’s and opioids may be of help. At times, selected joint injections, nerve blocks, and epidurals may be indicated. Learn more…

Back Pain

Back pain is the most common reason why people see a doctor. It affects everybody at some point in their life and it can happen with no warning. Typically, back pain is the result of a muscle sprain from lifting and carrying heavy objects incorrectly or repeatedly. Having your back in a bent position for a long period of time may also cause strain. Other causes of back pain may include damage to the discs between the vertebrae, osteoporosis, and osteoarthritis, which can eventually lead to spinal stenosis.

Fortunately, most cases of back pain will heal itself within a few weeks with the proper care. Diagnosis of the pain can be difficult to pinpoint, so having a doctor look at it should be the first step towards recovery. Learn more…

Cancer Pain

Cancer may be painful for several reasons. The tumor or its growth into nearby nerves, organs, and tissue may all be responsible. A growing tumor may cause pain by putting pressure on nerves, bones, or other organs. Cancer may also destroy the tissues after invading them, which is particularly painful when involving bones and nerves. Tumor spread or metastases could be painful for the same reasons explained.

Cancer therapy, such as chemotherapy, radiation, and surgery, may leave painful sequelae (an abnormal condition resulting from a previous disease). After surgery, recovery may be slow and painful. Radiation may burn skin and other tissues. Chemotherapy can cause many potentially painful side effects, including mouth sores, diarrhea and nerve damage. Peripheral neuropathy after chemotherapy could be difficult to treat. There are many different ways to treat cancer pain. Pain medications can usually control the pain. Most commonly used are NSAIDs, such as ibuprofen (Advil); as well as opioid medications, such as codeine, morphine, oxycodone, fentanyl or methadone.

Severe cases may need nerve blocks, epidurals, and morphine pumps. We may recommend a continuous delivery of medication (epidural, spinal or intravenous) and arrangements could be made to receive these at home, hospice, or the hospital. Learn more…

Central Cord Syndrome

Central cord syndrome is a form of incomplete spinal cord injury (in which some of the signals from the brain to the body are not received), characterized by impairment in the arms and hands and, to a lesser extent, in the legs. The brain’s ability to send and receive signals to and from parts of the body below the site of trauma is affected, but not entirely blocked. This syndrome, usually the result of trauma, is associated with damage to the large nerve fibers that carry information directly from the cerebral cortex to the spinal cord. These nerves are particularly important for hand and arm function. Some symptoms may include paralysis and/or loss of fine control of movements in the arms and hands, with relatively less impairment of leg movements. Sensory loss below the site of the spinal injury and loss of bladder control may also occur, with the overall amount and type of functional loss dependent on how severely the nerves of the spinal cord are damaged.

There is no cure for central cord syndrome, nor is there a standard course of treatment. Drug therapy, surgery, and rest are often part of the treatment program.

The prognosis for individuals with central cord syndrome varies. Patients who receive medical intervention soon after their injury often have good outcomes. Many people with the disorder recover substantial function after their initial injury, and the ability to walk is recovered in most of these cases, although some impairment may remain. Learn more…

Central Pain Syndrome

Central pain syndrome is a neurological condition caused by damage to, or dysfunction of, the central nervous system (CNS), which is made up of the brain, brainstem, and spinal cord. This syndrome can be caused by stroke, multiple sclerosis, tumors, epilepsy, brain trauma, spinal cord trauma, or Parkinson’s disease. The character of the pain associated with this syndrome differs widely among individuals partly because of the variety of potential causes. Central pain syndrome may affect a large portion of the body or may be more restricted to specific areas, such as hands or feet. The extent of pain is usually related to the cause of the CNS injury or damage. Pain is typically constant, may be moderate to severe in intensity, and is often made worse by touch, movement, emotions, and temperature changes, especially cold temperatures. Individuals experience one or more types of pain sensations, the most prominent being burning. Mingled with the burning may be sensations of “pins and needles;” pressing, lacerating, or aching pain; and brief, intolerable bursts of sharp pain similar to the pain caused by a dental probe on an exposed nerve. Individuals may have numbness in the areas affected by the pain. The burning and loss of touch sensations are usually most severe on the distant parts of the body, such as the feet or hands. Central pain syndrome often begins shortly after the causative injury or damage, but may be delayed by months or even years, especially if it is related to post-stroke pain.

Pain medications often provide some reduction of pain, but not complete relief of pain. Tricyclic antidepressants such as nortriptyline or anticonvulsants such as neurontin (gabapentin) can be useful. Lowering stress levels appears to reduce pain. Learn more…

Cheiralgia Paresthetica

Cheiralgia Paresthetica is a condition characterized by numbness or tingling in the back of hand and wrist. Cheiralgia Paresthetica is also known as Wartenberg’s Syndrome. It is most often caused by repetitive motion or overuse over time. Rest is an important element in treatment as well as methods such as massage therapy to reduce muscle and tendon irritation. Learn more…

Chronic Pain

While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap (sprained back or serious infection) or there may be an ongoing cause of pain (arthritis, cancer, or ear infection), but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), and psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system). Learn more…

Chronic Tension-type Headache

Occasional tension-type headaches sometimes progress to daily attacks. The pain involves both sides of the head and the back of the head and neck. It’s often described as a dull ache or a tight band of pressure around the head. The pain may fluctuate throughout the day or be steady for days, weeks, or even years at a time. Learn more…

CRPS

Complex regional pain syndrome, formerly known as regional pain syndrome, is a constellation of symptoms usually involving extremities. The hallmark of the condition is pain and inflammation that may progress to complete loss of function of the limb. It may be caused by a minor injury like an ankle twist or a more severe one like bone fractures. Surgery, nerve injury, burns, and intramuscular injection have all been implicated with this condition. The initial injury may be so small that it goes unnoticed by the patients. CRPS could be difficult to diagnose and may go unrecognized until evaluated by the trained specialist. At times, it is confused with early infection and time is wasted with antibiotic therapy. Symptoms are exaggerated in relation to the suspected injury. Therapy can be equally challenging for this. Tricyclic antidepressants and anti-neuropathics are among the initial medications used. To help with diagnosis, sympathetic blockade injections (neck or back) are given. If injections are effective, it helps in supporting the diagnosis. If pain is difficult to control and medications and injections have failed to help, then further therapy may include spinal cord stimulator and intrathecal pumps. Learn more…

Diabetic Peripheral Neuropathy

Diabetic Peripheral Neuropathy is a progressive and painful condition of peripheral nerves, typically in the arms and legs. High levels of circulating sugars in blood are thought to cause injury to nerves. The most important treatment is to maintain normal levels of glucose in blood. Some medications considered to be beneficial include anticonvulsants and antidepressants. These include tricyclic antidepressants like amitryptilin, nortryptiline and desipramine. The most widely used anticonvulsant is gabapentin, more commonly known as Neurontin. These medications may have side effects including dizziness, difficulty concentrating, somnolence, and loss of balance. These effects will subside with time. Learn more…

Discogenic Pain

The vertebral disc cushions in between two spine vertebrae. Disruption of its normal anatomy may cause pain. Discomfort will be felt in the lower back and occasionally in the legs. It is important to promptly diagnose discogenic pain to avoid unnecessary procedures and delay of treatment. Epidural injections may be tried; if not effective, then your doctor may recommend a diagnostic procedure that consists of placing a needle inside the disc and directly assessing the status of the disc under fluoroscopy. Other therapies may include IDET and nucleoplasty. Both procedures are performed by a pain specialist and at times surgery may be avoided. A needle is placed in the disc and small pieces are taken out or the disc is subjected to heat. Your doctor will determine if you may be helped by these procedures. Ultimately, surgery may be the only option. Learn more…

Emergency Medical Conditions

Emergency medical conditions are those in which the immediate onset of symptoms, including severe pain, leads a prudent layperson acting reasonably to believe that immediate medical attention is needed to avoid serious impairment or bodily harm. South Lake Pain Institute offers a walk-in headache clinic for the treatment of severe headache and migraine pain.

Eye Pain

Several conditions may be associated with eye pain, such as infection, trauma, surgery, cancer, and unknown causes. Different structures within the eye may contribute to pain including the eye globe, eyelids, nerves, arteries, and muscles. Identifying the cause of pain becomes paramount in treating the condition. Therapy is tailored to the cause. Your doctor may choose a regimen including medications that treat neuropathic and nerve pain, opioids, or antidepressants. In selected cases injections may be of benefit. Stellate ganglion blocks, or nerve blocks, may be offered. Learn more…

Face Pain

Several conditions may be associated with face pain. Nerves, muscles, tendons, and bones may be implicated. Infections, herpes, trauma, nerve damage, stroke, and surgery may be a cause. Identifying the problem will help delineate therapy. Your doctor may choose a trial period of antineuropathics, opioids, or antidepressants. If medications fail some injections may be of benefit; including stellate ganglia, trigger point, and selected nerves such as facial, trigeminal, supraoptical, etc. As well as epidurals, TMJ, and facet joints. Learn more…

Facet Arthropathy

Facet joints help keep two vertebrae together. As other joints, the facets coordinate movement of the spine. Pain is achy, sore, tender, and diffuse. It may be worse in the morning, also presented with stiffness. As the joints warm up, pain decreases and by the end of the day, after sitting and standing for too long, pain exacerbates. In certain cases, pain may be felt radiating to the front and back of the legs. This pattern may be confused with sciatica. The importance of being evaluated by a trained pain specialist cannot be stressed enough. Treatment is aimed to decrease inflammation of the joints, promote mobility, and increase function. Physical therapy, coordinated exercise, NSAID’s, and the new COX 2 inhibitors (Celebrex) are all cornerstones of therapy. Severe cases may need injections into the nerve and/or facet rhizotomy (RFA). Learn more…

Fibromyalgia

Fibromyalgia is a very complex medical condition; ignored by some, misunderstood by others. At times, patients are not diagnosed and suffer for years. Tender muscles, sleep disruption, morning fatigue, and multiple other diffuse symptoms hallmark fibromyalgia. Diagnosis is based on tenderness over specific muscle areas and exclusion of other conditions. Therapy should be multidisciplinary including physical therapy, reconditioning of fatigued muscles, psychological support, control of depression, and other associated psychiatric symptoms. Medications that may be useful include: tricyclic antidepressants, antineuropathics, muscle relaxants, sleep aid, and trigger point injections. In some instances opioids may be used, but rarely as a first option. Learn more…

Headaches

There are four types of headache: vascular, muscle contraction (tension), traction, and inflammatory. The most common type of vascular headache is migraine. Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach, and at times, disturbed vision. Women are more likely than men to have migraine headaches. After migraine, the most common type of vascular headache is the toxic headache produced by fever. Other kinds of vascular headaches include “cluster” headaches, which cause repeated episodes of intense pain, and headaches resulting from high blood pressure. Muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles. Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection. Like other types of pain, headaches can serve as warning signals of more serious disorders. This is particularly true for headaches caused by inflammation, including those related to meningitis, as well as those resulting from diseases of the sinuses, spine, neck, ears, and teeth. Learn more…

Hemicrania Continua

Hemicrania continua is a relatively rare type of chronic daily headache. The pain occurs on one side of the head and varies in intensity without ever disappearing completely. The pain is usually moderate, but may include jolts of severe pain that last less than a minute. The flare-ups of severe pain may be accompanied by tearing or redness of the eye on the affected side, swelling or drooping of the eyelid, and a stuffy or runny nose. You may experience nausea, vomiting, and sensitivity to noise and light. Sometimes auras such as blind spots or flashing lights in your visual field or sensations of numbness or tingling are present as well.

The causes of chronic daily headaches are not well understood. For primary chronic daily headaches, possible factors may include:

• Medication overuse (Tylenol, opioids)
• Muscle tension or tissue inflammation
• Abnormal function of brain structures that suppress pain
• Changes in the nervous system due to frequent headaches
• Stimulation of the central nervous system due to stress, infection, or trauma
• Injury of the upper spine
• Vasculitis
• Tumors
• Infection
• Obstructive sleep apnea

Chronic daily headaches are more common in women than in men. Various factors may increase the chance of having headaches, including:

• Anxiety
• Depression
• Sleep disturbances
• Obesity
• Snoring
• Overuse of caffeine
• Overuse of pain medication

When headaches occur three or more times a month, preventive treatment is usually recommended. Drug therapy, biofeedback training, stress reduction, and elimination of certain foods from the diet are the most common methods of preventing and controlling migraine and other vascular headaches. Regular exercise, such as swimming or vigorous walking, can also reduce the frequency and severity of migraine headaches. Drug therapy for migraine is often combined with biofeedback and relaxation training. One of the most commonly used drugs for the relief of migraine symptoms is sumatriptan. Other drugs used to prevent migraine include methysergide maleate, which counteracts blood vessel constriction; propranolol hydrochloride, which also reduces the frequency and severity of migraine headaches; ergotamine tartrate, a vasoconstrictor that helps counteract the painful dilation stage of the headache; amitriptyline, an antidepressant; valproic acid, an anticonvulsant; and verapamil, a calcium channel blocker. Another antidepressant such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine, commonly known as Prozac, may occasionally be an effective alternative for some people. Muscle relaxants such as tizanidine, or Zanaflex, may help some people manage chronic daily headaches.

Injections may be of benefit in certain conditions. Trigger point injections in tender muscles, nerve blocks (trigeminal, facial, supraorbital), or epidural steroid injections have been used effectively. Severe cases can be managed as in-patients in multidisciplinary clinics. Learn more…

Herniated Disc

The intervertebral disc is a soft tissue, cushioning in between vertebral bones of the spine. Trauma, age, and arthritis may cause it to be herniated (squeezed out of its capsule). Spinal nerves exit the spine in close proximity to the disc and can be pinched by the squeezed disc. This creates a local inflammation and irritation of the nerve. Spinal nerves give origin to the large nerves of the leg, the most talked about being the sciatic. From here derives the term “sciatica.” Treatment consists of alleviating pain while allowing the herniation to heal. Studies have shown that a disc herniation may resolve by itself. Physical therapy, chiropractor care along with NSAID’s, muscle relaxants, and antineuropathics may be of benefit. Some patients may need opioids. If this initial therapy fails, the epidural steroid injection may be needed. Epidural injections will deliver anti-inflammatory medications very close to the nerve and in turn decrease the pain. Very severe cases may need surgery.

Hip Pain

Hip pain is often the result of some sort of trauma, although any source of inflammation may create pain in the area. Inflammation will cause the hip joint to fill with fluid or blood, stretching the hip capsule lining and resulting in pain. Hip pain is a common complaint that can be caused by a wide variety of problems, depending on the location of the pain. Pain on the outside of your hip, upper thigh or outer buttock is usually caused by problems with muscles, ligaments and tendons that surround your hip joint. While it can sometimes be caused by conditions in other areas of your body, such as your lower back or your knees. Most hip pain can be controlled with self-care at home. Having a doctor diagnose the problem will aid in the correct treatment of the pain.

Joint Pain

Joint pain refers to discomfort, aches, and soreness in any of the body’s joints and is a common complaint that does not typically require a hospital visit. Arthritis is a frequent cause of joint pain, most commonly osteoarthritis, as the cartilage in the joint breaks down. Using topical pain relievers and anti-inflammatories, as well as stretching and staying active will help manage the discomfort. Other causes of joint pain are injury, overuse, bursitis, tendonitis, and osteoporosis. In these cases, taking a non-prescription anti-inflammatory, stretching, warm baths, and getting plenty of rest should take care of the problem. Seeing a doctor if you have persistent joint pain is recommended to determine the cause of the pain.

Knee Pain

Knee pain is a common complaint that affects people of all ages. It may be the result of an injury, such as a ruptured ligament or torn cartilage, but may also be caused by arthritis or infection. Diagnosis will usually consist of a physical evaluation and x-rays. You will be asked about your pain level, knee flexibility, and general mobility.

In extreme situations, surgery may be required to repair the damage caused by injury. Although, in most cases, self-care and using a knee brace for support will help relieve pain. Physical therapy may also be recommended. Call a doctor if your knee “gives out” or you can’t put any weight it.

Low Back Pain

“Low back pain” is a very generalized term to characterize a group of conditions that produce back pain. Several structures of the back may be implicated in generating pain. These include muscles, tendon, joints, nerves, and spinal discs. It is important to recognize the affected structure and minimize unnecessary testing and therapy. Treatment can be as easy as muscle relaxants and anti-inflammatory therapy. Well defined syndromes (and structures causing pain) have been described: most commonly discogenic pain, facet arthritis, myofascial pain, herniated discs, sciatic neuralgia, sacro-iliitis, piriformis syndrome, and vertebral compression fractures.

Meralgia Paresthetica

Meralgia Paresthetica is a condition associated with pain on the lateral aspect of the upper leg. It presents itself with numbness and burning/shooting pain. Injury to the lateral femoro-cutaneous nerve is considered to be the cause of this syndrome. Obesity, wearing a heavy belt, and trauma has been implicated in injuring the nerve. Treatment includes physical therapy, weight loss, and NSAID’s. In selected cases, injections to the nerve with local anesthetics and depo-medrol may be effective. If that fails, your doctor may recommend epidural injections.

Migraine

Migraines range from moderate to severe pain. Many migraine headache sufferers feel pain on only one side of their head, while some experience pain on both sides. Migraines feel like pulsating or throbbing sensations and may worsen with physical activity, hindering regular daily activities. Nausea with or without vomiting is common. Also, sensitivity to light and sound is present.

Myofascial Pain

Diffuse aching, sore, and burning pain, which may be throughout the body or confined to a small group of muscles. This condition may be present by itself or associated with other syndromes like fibromyalgia and arthritis. Treatments consist of muscle relaxants, trigger point injections, and physical therapy. Opioids are rarely effective with myofascial pain.

Ilio-lumbaris, paravertebral, and multifidus are some of the examples of muscles located on the low back. Spasm and injury of these and other muscles may be severe enough to send patients to emergency rooms and primary care doctors. Physical therapy, chiropractor adjustments, stretch exercises, and muscle relaxants are part of treatment. It is important to be evaluated by trained pain MD’s to avoid unnecessary tests and procedures.

Neck Pain

Neck pain is a common condition treated at South Lake Pain Institute.

Causes of neck pain include:

  • Abnormalities in the bone or joints
  • Trauma
  • Poor posture
  • Degenerative diseases
  • Tumors
  • Muscle strain

Treatment of soft tissue neck pain often includes the use of anti-inflammatory medication such as ibuprofen or naproxen. Pain also may be treated with a local application of moist heat or ice. Exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary.

Nerve Pain

Nerve pain can take many forms like burning, tingling, stiffness, or spasms. Because nerves are involved with everything the body does, there can be many causes for the pain. Some of those causes include (but are not limited to): compression or trauma to a nerve, autoimmune diseases, diabetes, and nutritional deficiencies. Oftentimes nerve damage is progressive, so it is important to consult a doctor when you first notice symptoms in order to reduce the likelihood of permanent damage.

Physical therapy, nutritional changes, and medication may be recommended, depending on the cause of pain. Acupuncture may also help relieve nerve pain.

Neuropathic Pain

Neuropathic pain is a chronic condition that leads to persistent pain symptoms. For many patients, the intensity of their symptoms can wax and wane throughout the day. Sufferers of this describe the pain as a burning, shooting, or tingling sensation. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers. Some common causes of neuropathic pain include diabetes, spinal surgery, shingles, and problems in the back, knee, or hip. Having a doctor diagnose the pain to determine its origins is crucial in deciding the correct path of treatment. Unfortunately, neuropathic pain often responds poorly to standard pain treatments and may get worse instead of better over time. For some people, it can lead to serious disability.

New Daily Persistent Headache

New daily persistent headaches begin abruptly in people without a history of headaches. Sometimes the headaches are triggered by an infection, surgery, or stressful life event; but often there’s no recognized trigger. The pain is often described as throbbing, dull, achy, stabbing or burning, or as pressure or tightness. The pain continues unabated throughout the day. Some new daily persistent headaches go away within several months. Others persist for years or even decades.

Occipital Neuralgia

Occipital Neuralgia is a common cause of headache. It involves the occipital nerves — two pairs of nerves that originate near the second and third vertebrae of the neck. Pain typically starts at the base of the skull by the nape of the neck and may spread to the area behind the eyes and to the back, front and side of the head.

Occipital neuralgia may occur spontaneously, or as the result of a pinched nerve root in the neck (from arthritis, for example), or as the result of prior injury or surgery to the scalp or skull.

Occipital neuralgia can be diagnosed—and temporarily treated—by an occipital nerve block.

Pancreatitis

Pancreatitis is the inflammation of the pancreas. When acute, it should resolve on its own and pain medications are rarely needed. Cancer and chronic disease may come with constant severe pain. Opioids and antineuropathics should initially help this. If the pain is severe and is not responding to the medication, epidural injections or sympathetic blocks may be needed. If all else fails, spinal pumps and epidural catheters may be placed to provide with constant potent medications directly to the spine and near the pancreas.

Piriformis Syndrome

Aching, sore, or shooting pain in the buttocks may be due to spasm of the piriformis muscle. The sciatic nerves run through the muscle and may be irritated by the muscle spasm. This condition may be confused with sciatica and spinal nerve/disc herniation. It is important that it is properly diagnosed to avoid unnecessary therapy, tests, and pain. Pain specialists are trained to recognize this condition. Therapy consists of stretch exercises, muscle relaxants, and injections into the muscle. The muscle is located deep in the buttocks and x-rays (fluoroscopy) should be used to confirm proper injection.

Post-chemo Pain

Although it is an effective treatment for many types of cancer, chemotherapy often causes side effects. Although specific side effects may be predictable for certain classes of treatment, each person’s experience with chemotherapy is unique. Chemotherapy can cause pain for some people, including headaches, muscle pain, stomach pain, and pain from nerve damage, such as burning, numbness, or shooting pains. Post-chemo pain usually goes away over time, but some people may have symptoms for months or years after chemotherapy has finished due to permanent damage to the nerves. Doctors can manage pain by treating the source of the pain; changing the perception of pain, usually with pain-relieving medications; or interfering with pain signals sent to the brain through spinal treatments or nerve blocks.

Post-radiation Pain

The side effects from radiation treatment varies from person to person and with the type and location of cancer, the treatment dose, and the person’s health. Side effects associated with radiation therapy occur because the high doses of radiation used to destroy cancer cells can also damage healthy cells and tissues located near the treatment area. However, major improvements in radiation technology have made it more precise, leading to fewer side effects. Pain may develop after radiation therapy and go away on its own. It can also develop months or years after treatment, especially after radiation therapy to the chest, breast, or spinal cord. A few patients need help managing post-radiation pain. Unless directed by your doctor, do not use heat or cold to relieve pain in any area treated with radiation. Talk to your doctor or nurse and describe the location and type of pain in as much detail as possible. Keep working with your cancer team until you are able to get it under control.

Post-surgery Pain

Post-surgery pain is normal but several factors determine how much pain you will have. For instance, different types of surgeries and surgical incisions produce different types of pain afterward. A longer and more invasive surgery, besides causing pain, can “take more out of you.” Recovering from these other effects of surgery can make it harder to deal with the pain. Not to mention, each person feels and reacts to pain differently. Good pain control, allowing you to get up and move around, is important because it lowers your risk of blood clots in your legs or lungs, as well as lung and urinary infections. Also, you will have a shorter hospital stay so that you go home sooner, where you are likely to recover more quickly. It is your responsibility after surgery to tell your doctors and nurses when you are having pain and if the medicines you are receiving control your pain.

Sacroiliitis

This joint is formed by the sacrum and pelvis. Pain is felt in the lower back, legs, and groin. Standing for too long and going from a sitting to a standing position usually triggers pain. Physical therapy, stretch exercises, and chiropractor adjustments may be beneficial. Muscle relaxants and NSAID’s are commonly used. Injection directed by fluoroscopy (x-rays) into the joint may help relieve pain.

Scar Pain

The cause of scar pain is damage to a small skin nerve, or when a nerve is squeezed by the scar tissue. With scar pain, which can occur after an operation, there is a neuroma formation at the end of a damaged skin nerve. After some interventions, such as inguinal hernia, lung, heart, kidney, and shoulder operations, as well as breast amputations, scar pain is more common. Patients with scar pain typically complain of neuropathic pain, during which continuous pain is present, alternating with spontaneous attacks of stabbing pain in the scar area.  This pain can sometimes occur after a complaint-free period lasting some months postoperatively.

Shoulder Pain

The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from any number of things: dislocation, a pinched nerve, overexertion, tendonitis from overuse, joint instability. X-rays and MRIs are typically needed to help your doctor get a better idea of just what is causing the shoulder pain.

With most cases, shoulder pain will go away by itself in time. Anti-inflammatory medications can help relieve the pain, as well as exercise and stretching. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary. Your doctor can tell you which is the best course of treatment for you.

Sports Injuries

Injury is a very common occurrence in sports, due to the physical nature of each sport. Different sports tend to bring about different injuries. For example, a contact sport such as football and wrestling usually creates traumatic injuries: contusions, sprains, bone fractures, concussions, and spinal damage. While other sports such as baseball and tennis tend to create injuries from overuse: rotator cuff, tendonitis, runner’s knee, and tennis elbow.

Exercising and staying in shape help to prevent sports injuries. Warming up and stretching before doing any sports activity are crucial in the prevention of injury. South Lake Pain Institute is highly experienced in treating all manner of sports injuries.

Tendonitis

Tendonitis (or tendinitis) is an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle, that is most often caused by repetitive, minor impact on the affected area, or from a sudden more serious injury. It also commonly occurs from overuse after a period of non-use. Anyone can get tendonitis, but it is more common in adults, especially those over 40 years of age. As tendons age they tolerate less stress, are less elastic, and are easier to tear.

Tendonitis can occur in almost any area of the body where a tendon connects a bone to a muscle. The most common places are elbows, shoulders, knees, hips, and achilles tendons. Initial treatment of tendonitis includes resting the affected area, applying ice to the area, taking anti-inflammatory medication, and avoiding activities that aggravate the problem.

Vertebral Fractures

Vertebral fractures are caused by trauma or bone weakening from osteoporosis. They are extremely painful and at times very difficult to treat. Potent opioids may be necessary to control the pain. A relative new procedure places a needle into the bone, and under close vigilance with fluoroscopy, cement is injected. When dry, the cement will act as a cast inside the bone. Also, by filling the vertebrae with cement, the normal anatomy may be restored.

Wrist Pain

Wrist pain is a common complaint and it varies, depending on what’s causing it. The most common cause of wrist pain is carpal tunnel syndrome, which occurs when the median nerve gets compressed at the wrist because of swelling. This usually happens when you do repetitive movements with your wrist, such as typing on a computer keyboard, using a computer mouse, sewing, painting, writing, or using a vibrating tool. Arthritis (osteoarthritis and rheumatoid) is another common cause of wrist pain, swelling, and stiffness.

Treatment for wrist pain includes wearing a wrist brace or splint to reduce swelling and ease wrist pain, applying hot or cold compresses, and taking anti-inflammatory drugs. In more severe cases, surgery may be required.