Pain Management Las Vegas | Nevada Comprehensive Pain Center

CALL US! 702.476.9999

Author Archive for Brett J

Does Cognitive Behavioral Therapy For TMD Work?

Temporomandibular disorders (TMD, also known as TMJ) affect the hinge joint that connects the lower jaw to the skull. This joint offers a full range of motion for daily activities including chewing or talking. There are multiple causes of TMD, which can include grinding or clenching the teeth, dislocation of the jaw, or even arthritis. For those who suffer from severe cases, it can lead to TMJ migraines and ear pain. Researchers are now suggesting that cognitive behavioral therapy for TMD could help pain sufferers.

How to treat TMD

The American Pain Society suggest several treatments for TMD. Patients were often prescribed non-steroidal anti-inflammatory drugs or NSAIDs to treat this pain. However, a study by the University Of Connecticut Health Center suggests that cognitive behavioral therapy (CBT) can also be effective in treating TMD.

The researchers discovered that many patients whose TMD was non-responsive to traditional treatments also suffered from symptoms of depression. These patients did not possess typical coping methods and, in spite of not presenting a joint pathology indicative of TMD, they still experienced the pain in their face.

The authors hypothesized that certain CBT treatment-related outcomes might be predictive of treatment non-response. These include:

  • Lower retention in treatment
  • Less adaptive changes in coping and self efficacy
  • Pain catastrophizing

Cognitive behavioral therapy treatments focus on the patients’ thoughts and feelings about certain situations in their lives. Then, it teaches them effective coping mechanisms for moving forward. The idea is to change negative behaviors that result from negative feelings into positive behaviors. Patients do this by actively changing the patient’s thought patterns.

Nonresponsive TMD patients may have success alleviating and eliminating their painful condition by engaging in behaviors that change the way they think about the pain they are experiencing. If the researchers’ findings are correct, this could change how healthcare professionals handle a number of similar conditions.

Do you think that some forms of TMD can be caused by depression and treated with cognitive behavioral therapy?

How Does Neuromodulation For Head Pain Work?

Headache pain is generally divided into four separate types: migraines, cluster-type headaches, tension-type headaches, and secondary headaches (as a result of another condition or as a side effect of treatment). Each of these can be severe enough to impact daily life, and each of them can benefit from a treatment called neuromodulation for head pain.

What is neuromodulation?

Neuromodulation can be a biological process in which the body emits chemicals that regulate neural activity (e.g., serotonin, the “feel good” hormone), but in some cases an interventional form of neuromodulation is needed.

Surgical neuromodulation uses devices implanted along the spine, in the skull, or near a group of pain-causing nerves that then emit mild electrical pulses to disrupt the pain signals. One example of this spinal cord stimulation.

With spinal cord stimulation (SCS), electrodes are positioned along the spine near the nerves that are the source of pain. A mild electrical impulse is then delivered to interfere with the body’s pain signaling. This interrupts their path to the brain and offering pain relief. This is called neuromodulation in that the pain signals to the brain are interrupted, the neural circuit broken.

How does neuromodulation for head pain work?

This neural disruption can be enacted directly in the brain itself with deep brain stimulation.  Electrodes are implanted in the brain areas that receive pain signals. This blocks the signals or corrects them to not signal pain. This technique has been used in the hypothalamus, the region from which tension-type and cluster headaches seem to stem. It lends credence to the idea that these types of headaches are a result of sleep disorders or disturbances.

This technique may also work to help with cluster and nasal headaches associated with the sphenopalatine ganglion (SPG). 68% of patients in a clinical trial found relief from pain when a microstimulator was implanted in this nerve, but the duration of pain relief is still uncertain, and the risk at this time may outweigh the benefits. Patients may lose sensation and experience sensory disturbances as a result of treatment, and there is the risk of infection and tissue damage during implantation.

TENS unit therapy

Less invasive forms of neuromodulation are called transcranial stimulation. The most common form of this is transcutaneous electrical nerve stimulation (TENS). During transcutaneous nerve stimulation, doctors place a cap or pads on the patient’s skull. They then deliver mild electrical current across the vagus nerve to trigger the release of pain-blocking signals. This has been a promising treatment for pain associated with migraine and cluster headaches.

Transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are two other less-invasive neuromodulation techniques. The first has been used with success in the treatment of chronic migraines and the second for episodic migraines. Both have very limited side effects and are promising treatments, but more research in larger clinical trials needs to be completed to truly judge their effectiveness.

Neuromodulation is a promising weapon in the arsenal against headache pain. Have you tried neuromodulation for head pain?

Raising Awareness During Migraine And Headache Awareness Month

Headaches and migraines are unfortunately common, but invisible to many. Over 42 million people in the U.S. suffer from headaches and migraines. During Migraine and Headache Awareness Month, the National Headache Foundations asks people to share their stories of suffering with head pain to show others that they aren’t alone.

Why is Migraine and Headache Awareness Month important?

On top of these sobering statistics, consider that:

  • Headaches and migraines are the leading reason that people use over-the-counter pain relievers
  • There is no absolute cure for migraine headaches since its causes are not entirely understood
  • Headaches may have a genetic component–a child has a 75% chance of suffering from headaches if both parents have them
  • Migraine-related work absenteeism and lost productivity can cost U.S. corporations at least $20 million a year

Since head pain related to headaches and migraines is so common, the National Headache Foundation (NHF) chose to rally supporters during the month of June to spread awareness about these conditions. Migraine and Headache Awareness Month this year is about sharing your story during the “You Are Not Alone” campaign to let others know about the effects of these pain conditions. The National Headache Foundation asks those who suffer from headaches and migraines to let others know that they are not alone.

How to show support

By standing up to spread awareness, the community can show that it is unified and strong as it moves towards better treatments and research.

As part of this, everybody is encouraged to “show purple” and send in photos while wearing purple or holding a sign in support of Migraine and Headache Awareness Month. This may mean standing in front of a well-known landmark or other space where you go when not suffering from head pain. It may mean sharing statistics on your social media accounts.

In this way, the Foundation hopes to put a face to the many people who suffer from headaches and migraines. They’ll be sharing these photos on their Facebook page throughout the month. You can share your story with the NHF or use the hashtag #MHAM.

They’ve also set up recognition days for raising awareness about different aspects of migraines and headaches, such as cluster headaches, pediatric headaches, and caregiver support.

When you’re suffering from a headache or migraine, it can feel like you are absolutely alone. However, there are others out there who understand and can sympathize with your pain. Every headache is different, but in finding a community who suffers from similar types of pain, you may begin to find strength to face your pain.

Share your story today with the National Headache Foundation here during Migraine and Headache Awareness Month.

Image courtesy of the National Headache Foundation 

Top 5 Benefits Of Acupuncture

Acupuncture can be used for a wide variety of conditions from sports injuries to help alleviate pain from cancer treatment. Consider these top five benefits of acupuncture. If your doctor at NVCPC thinks you’d be a good candidate for acupuncture, they’ll refer you to a trusted provider.

It’s an alternative treatment with very few side effects

Unlike some drug therapies to reduce symptoms of various conditions, there have been nearly no side effects reported with acupuncture treatments. It may be able to:

  • Reduce pain after surgery
  • Alleviate nausea
  • Help migraines
  • Improve arthritis symptoms
  • Eliminate severe menstrual cramps
  • Relieve low back pain

Provides stress relief

Some patients turn to acupuncture to help alleviate stress from their lives. Stress does more to your body physically than you may be aware. It can weaken your immune system, which can make you vulnerable to illness.

To help manage stress, and avoid the flu or colds associated with high stress levels, you may want to consider acupuncture to help you relax and strengthen your immune system.

Helps with depression

study out of the UK has indicated that along with a treatment of antidepressant drugs, acupuncture can be as helpful for reducing depression symptoms, along with counseling.

Aids in treating sports injuries

Rest is the most recommended treatment for a twisted ankle or tennis elbow. However, it has been shown that patients receiving acupuncture treatments after these types of injuries heal more quickly than those who do not.

As acupuncture helps stimulate the body’s natural energy flow, it unblocks those areas and allows for more natural healing to occur.

Benefits infertility treatments

You may not have thought about it, but studies have shown that couples going through infertility treatments have had significantly more success if they have utilized acupuncture as part of the process. Several months before starting in vitro fertilization or egg transfers, patients who have acupuncture treatments find that their results are more positive.

Are you still curious about acupuncture and how it can help you? At this point, it is important to speak with a licensed acupuncturist or your doctor. They can help you learn more about the practice and the benefits of acupuncture.

Have you had an experience with acupuncture that has affected your health in a positive way?

Are There Unsafe Supplements?

Food and dietary supplements can have big benefits for health and wellness. Unfortunately, however, there are more than a few unsafe supplements sold today.

Why are there unsafe supplements on the market?

In the U.S., dietary supplements themselves fall into a regulatory black hole. They’re not drugs, so they can’t be outright banned. They’re also not food, so they don’t receive any oversight from the Food and Drug Administration (FDA).

This lack of oversight means that supplements are often not tested to the same standards as prescription drugs. Adverse or side effects caused by the supplements are hard to monitor. Finally, no government agency has actually verified the accuracy of the supplement’s claims for health and wellness.

How to use supplements safely

Unsafe supplements cause many illnesses and deaths every year, though there are ways you can use them safely.

Supplements are, of course, often helpful. Pregnant women benefit from folic acid supplements. Vitamin supplements can boost the health of those with deficiencies. Eschewing supplements entirely isn’t the correct answer. Instead, using them requires a bit of knowledge and responsibility on your part.

Follow these guidelines when deciding whether to take a supplement:

  • Always talk to your doctor or another trusted healthcare professional about the supplements you wish to take
  • Ask your healthcare team for recommendations or talk to them about your concerns about its use
  • Avoid any supplements that you don’t actually need and look for supplements that contain only those ingredients that you need for health
  • Especially avoid supplements that promise weight loss or improvements in sexuality, as these are more likely to be dangerous to health
  • Research the supplement and active ingredients thoroughly–the National Center for Complementary and Alternative Medicine (NCCAM) has an extensive list of benefits, risks, and side effects of many common supplements
  • Be on the lookout for the dirty dozen, the Consumer Reports’ guidelines for the most dangerous ingredients that appear in supplements (these are: aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe)

By being a responsible, thoughtful consumer, you can help protect yourself from some of the more unsafe supplements on the market today.

How To Reduce Your Opioid Use

The misuse and abuse of opioid medications have a very real impact on all of our lives. This is true for chronic pain patients, family or friends of those with pain, or members of the community. Prescription opioids claim more than 46 deaths every day from overdoses. Because of these alarming statistics, many groups are coming together to combat the problem of opioid overuse and abuse.

Many states are now beginning to regulate the use and ability to prescribe opioid medications with prescription drug monitoring programs. Programs also penalize those who abuse these drugs. Many of these regulations also often incorporate a safe disposal method, such as Clark County’s Pain in the Drain program, in order to keep these drugs away from adolescents and other populations at risk for abuse.

How to manage chronic pain with less opioids

Pain doctors also have the capability to better monitor their own patients and prescribe these opioid medications thoughtfully. If you do need opioid medications to help you manage your chronic pain, there are many tools you can use in order to minimize your risk of misuse, such as:

  • Closely monitoring your own use of these drugs in cooperation with your pain management team
  • Finding ways to curb or minimize your use of opioids with the support of your doctor
  • Using mobile apps to help you better track and monitor your pain symptoms
  • Exploring alternative options for pain relief, such as epidural steroid injections or spinal cord stimulation

Finally, if you do find yourself in the grip of an addiction to opioid medications, do know that there is always help in the form of support groups and online resources. Remember, opioid medications are merely a tool. They can help you live a higher quality of life with less pain, but there are almost always ways to limit their detrimental effects. Empowered by knowledge, supportive family and friends, and a strong pain management team, you can live a full life with chronic pain.

Tell us your story about your pain and your journey using opioid medications below.

Opioids Can Exacerbate Mental Health Issues. Here’s How.

When faced with the need to medicate for chronic pain, patients need to feel comfortable asking questions and taking control of their care. Opioids are a common treatment for many pain issues. However, there are some risks with them and it is important to be aware of them. That’s especially true for those that have to do with your mental health.

Opioids and psychiatric problems

A study by Oregon Health and Sciences University showed patients given higher doses of opioids also experienced more psychiatric problems.

The study was published in the peer-reviewed Journal of Pain. It demonstrated that patients with additional psychiatric problems were prescribed opioids at a higher rate than patients without a history of mental health issues. It also showed that prolonged use of opioids correlated with increased mental health issues in these patients.

Abuse

In 2013 the Food and Drug Administration (FDA) expressed its concern about the overuse of prescription painkillers. This was especially true for opioids such as oxycodone and hydrocodone. A leading problem with the use of these medications is the development of dependent or addictive behaviors.

Another medical study from John Hopkins found that individuals with existing mental health issues were more likely to abuse these prescription painkillers. Researchers noted that:

“Individuals suffering from mood and anxiety disorders such as bipolar, panic disorder and major depressive disorder may be more likely to abuse opioids… They found that mood and anxiety disorders are highly associated with non-medical prescription opioid use.”

Medical professionals are becoming increasingly concerned about prescribing opioids for a variety of treatments. It is clear that other solutions need to be found in order to successfully treat chronic pain and mental health issues in patients.

Dr. Silvia Martins, lead author of the John Hopkins’ study, says:

“Additional studies are needed to examine the relationship between non-medical prescription opioid use and prescription opioid-use disorder with mood and anxiety disorders since they could co-occur due to shared genetic or environmental risk factors.”

Have you had a negative experience with opioid use and mental health challenges in your life? To get help reducing your opioids, contact us today at NVCPC

What Causes Pain After Back Surgery?

Back pain is often caused by simple things–poor posture, excessive sitting, excessive weight, or injuries from sports or repetitive movements. However, there is a category of causes that are a bit more ironic in their nature, but also possibly more dangerous. Back pain may occur after spinal surgery due to movements in the discs or muscles, or it can be caused by an infection. Pain after back surgery is relatively rare, however, it is important to know the risks before undergoing surgery.

How causes pain after back surgery?

Over 200,000 lumbar laminectomies and discectomies are performed every year in the U.S. While many patients experience pain relief following these procedures, others may have pain that persists after surgery. This pain may be dull or aching in the back, or sharp or stabbing in the back or extremities.

One of the more common causes for pain after back surgery is recurrent disc herniation. In this situation, removing one of the discs during surgery causes those around it to weaken. This can lead to another herniated disc in another portion of the spine. This pain is most often felt as a sudden return of pain after a period of relief following the surgery.

Likewise, the invasive act of surgery itself can lead to changes within the body that can lead to pain. Irritation from scar tissue after the surgery causes 20% to 36% of chronic pain after back surgery. Changes in the body’s muscular structures can lead to spinal muscular deconditioning in which certain weak muscles around the spine exacerbate pain. Other causes of pain from the surgery itself may come about from errors made during the surgery or continued smoking during the recovery period.

When to see a doctor

If you experience pain after a back surgery, talk to your doctor. If you’re in Nevada, contact us at NVCPC. Back pain after surgery combined with a fever, chills, or wound redness or tenderness may indicate a more serious spinal infection.

Although many preventative measures are taken to prevent infections during surgery, there are certain risk factors that can make a person more susceptible. These include:

  • Poor nutrition
  • Recent surgeries
  • Steroid use
  • Cancer
  • Obesity
  • Diabetes
  • An HIV infection

According to the North American Spine Society, approximately 4% of people contract an infection following surgery. If you notice any signs of fever, chills, wound redness, or weakness or tingling in the arms or legs following a surgery, call your doctor right away. They can do a series of tests to check for an infection and provide options for treating it.

Have you undergone back surgery? Did you have any pain following the surgery? 

4 Daily Activities That Burn Calories

Often we get so caught up in the right kind of exercise that we don’t notice the calorie burning activities that we do each and every day. If the thought of going to the gym sets you on edge, consider adding a few more of these everyday activities into your routine to boost your fitness regimen. Just a few normal, everyday activities can boost your calorie burning potential, so give them a try!

1. A trip to the grocery store

Pushing your shopping card from the cereal aisle to the frozen foods sections can burn calories–up to 243 in an hour! Take your time in the store and don’t rush from item to item on your list. Spend most of your time in the produce section and get to know some of the healthy food options. You can even bag your own groceries, take them to the car, and return the cart to the corral for bonus calories.

2. Dusting the house

Get out that duster and furniture polish! A half an hour of household dusting can burn 80 calories. Don’t settle for the surfaces. Open the china cabinet and dust everything inside. Don’t miss the mini-blinds. Once you’re done, go through the house again with the white glove test to see what you missed and burn a few extra calories in the process. Add vacuuming into your day and burn an additional 180 calories in an hour.

3. Folding your laundry

Not many people look forward to the chore of laundry, but if you know that you can burn 72 calories for a half an hour of folding it might be easier. Don’t fold the clothes in your closet or bedroom. Fold them in the laundry room or on the lowest level of your house so you can burn some additional calories carrying them up the stairs.

4. Start a garden

For a higher calorie burning count, try high impact gardening. Not only will you burn 230 calories in an hour but you can spend the day outside in the sun. Choose foods or flowers that make you happy so at the end of the day your work can reflect your mood. Don’t forget to wear sunscreen!

What household chores can you think of that can help you burn calories?

How To Lift Weights Safely

The benefits of weight lifting have been documented often over the years. However, beginners should exercise caution before lifting their first dumbbell. All of the fads over the years, including shake weights and some home gym systems, can’t replace good old fashioned weight training. Here are 10 tips how to lift weights safely.

Wear the right clothes and shoes

You don’t have to spend a lot of money on a weight lifting wardrobe, but it is also important to understand how the right clothes can actually help. Jeans, for instance, will restrict movement and potentially cause you to lift incorrectly. Wear loose fitting clothing that can give you a full range of motion.

Ask for help

Especially when you’re a beginner, don’t try lifting heavy weights by yourself. Work with a personal trainer or join a local lifting group. Others with experience can give you feedback on your form as well as help you if something goes wrong.

Make sure weights are secure

A major concern with weight lifting is a problem with the weights falling off the bars. It is easy to miss how secure the discs are when you’re just starting out. Learn how to use the equipment and always double check.

Always warm up

Not stretching before lifting can result in pulled muscles or more serious injuries. Spend just a few minutes before you begin lifting to stretch your legs, arms, and back.

Perfect form before lifting heavier weights

When you’re just getting started it may benefit you to start without any weights just to understand the proper techniques. Use a broom handle or a small hand held tool to mimic the basic shape of larger and smaller weights.

Use a safe lifting speed

Professional weightlifters understand how slowly or quickly to move at any part of the routine. If you create momentum you risk serious injury. An object in motion tends to stay in motion and this includes weights.

Practice situational awareness

When you are weight training at the gym or in public always be aware of your surroundings. Don’t lift too close to someone else and be careful when changing weights or moving around a machine. You don’t want to bring harm to someone else.

Stop if you feel dizzy

Always pay attention to your body’s clues. If you start to feel weak or feint, don’t keep going. Take frequent rests and drink plenty of water.

Don’t train in hot spaces

The air temperature will absolutely affect you. If you usually work out in your own home or garage, make sure you do so in the mornings or evenings before the temperature gets too hot.

Practice caution when alone

If you are alone be hyper aware of your surroundings and your equipment. Don’t push yourself too hard if you’re not in a place to receive help from someone else.

Are you interested in starting a weight lifting program in your fitness routine?