Top Knee Arthritis Treatment at San Diego Pain Clinic

Top Knee Arthritis Treatment In San Diego Pain Clinic

Arthritis is a known cause of knee pain. Arthritis is defined as an inflammation of one or more joints. The most common symptoms related to arthritis are pain, stiffness and swelling. There are various types of arthritis that can affect the knee joint; however, treatment may vary depending on the condition that causes these symptoms.
The most common is Osteoarthritis also known as wear and tear arthritis or degenerative joint disease. It is involves continuous wearing away of the cartilage in the joint. Once the cartilage is completely worn away, the bone become exposed, and the knee become very swollen and quite painful. This condition affects people as they age. The most common one being those who are overweight. Also, knee arthritis is said to be genetic meaning that it can be passed down the family tree.
Some other factors that may lead to knee arthritis include; torn cartilage, injuries to the knee as well as fractures to the bone around the joint.

What are the Symptoms of Knee Arthritis?

Symptoms of arthritis to progress gradually as the condition worsens but the conditions may become even worse due to minor injury or overuse. Some patients may experience prolonged episodes of mild systems, accompanied by sudden changes that may increase the severity of their symptoms. Generally, the pain develops gradually over time. Other common symptoms of knee arthritis are;
• Joints become stiff and swollen and the person experiences difficulty bending and straightening the knees.
• Vigorous activity may cause severe pain
• Severe pain may cause a feeling of weakness in the knee.
• Loose cartilage fragments and other tissues can interfere with the smooth motion of the joints.
• People with arthritis may experience increased joint pain with a rainy weather.

What are the Causes of Knee Arthritis?

There is no proven cause of knee arthritis specially Osteoarthritis. Though, studies have shown that aging and women are prone to being diagnosed with arthritis. The risk factors associated with knee arthritis include;
• Genetic where arthritis runs in the family
• Obesity
• Severe trauma which involves fractures and removal of the supporting cartilages of the knee.

What Tests show you have Knee Arthritis?

Pain Doctors San DiegoKnee arthritis can be diagnosed by a San Diego pain clinic by use of X-ray which can be taken with the patient standing up where it diagnoses the condition with great accuracy. The pain doctors San Diego will also need to take a thorough history when performing a physical examination.

What are the Treatment Options for Arthritis?

Treatment of arthritis should start with the basic steps at a San Diego pain clinic and proceed to the more severe and invasive state even to an extent of surgery. For those patients with mild arthritis, the arthritis can be managed with simple things like an ice rest-activity or joint injections.
When it comes to surgery cases, there are two kinds of joint replacement surgeries:
• Partial knee replacement
• Total knee replacement surgery can be done using a minimally invasive quadriceps sparing approach that helps to shorten the recovery and decrease the pain after surgery.
Other treatment that works well with knee arthritis include;
Weight Loss, physical therapy, walking aids, activity modification, anti-inflammatory medication as well as cortisone injections.
To learn more about treating knee arthritis, contact a pain doctors San Diego today.

Pain Management San Diego

FAQ’s on Pain Medication Management

What is Pain Medication?

Pain medication is one of the most used forms of treatment in instances where a patient is experiencing symptoms of pain from one or more conditions. Many patients will already be familiar with the concept of pain medication, as they likely will have encountered it first hand at their local pharmacy or supermarket. With a number of medications tailored to specific purposes, pain medication can be helpful in the treatment for nearly every cause of pain.

What is the purpose of Pain Medication?

Pain Clinics San DiegoWhile the administration of pain medication will not cure the patient of any ailment, it will provide a large step forward in obtaining relief for the present condition. Pain medication can be given for a number of reasons. For some, relief is temporary with strong medication and a short duration, such as with surgery. The relief can also be long-lasting from medication taken daily, such as for those who have been prescribed a multiple-day treatment following an injury.

While great for the management of symptoms, the root cause of pain must still be treated in order for the patient to obtain permanent relief. It is normal for pain medication to only be given as long as is needed to maintain relief until this casue3 can be corrected.

What kinds of Pain Medications are used?

Patients will be given one of four medication types in order to treat their specific conditionsPain Medication Management San Diego. These medications range from simple over-the-counter (OTC) medications, to prescription-strength versions of these given to patients who have been diagnosed by a physician. The other two medication types are composed of corticosteroids and opioids.

Over-the-counter medications as a whole are household names that many patients will already be accustomed to using due to their availability. These medications largely consist of either NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) or acetaminophens. While each can be beneficial to a patient in providing relief, the method of how they function differs significantly.

NSAIDs such as ibuprofen and naproxen function by lowering the body’s production of prostaglandins, which are pain causing hormone-like substances. Acetaminophens however work by blocking the signals of pain sent to the brain. Aspirin-free Excedrin and Tylenol are the most commonly taken acetaminophens. One important note is that while both of these medications will help provide relief to a patient, acetaminophen based medications will not affect the presence of inflammation nor help provide relief for it.

The next tier comes in the form of prescription-strength medication. While these can be improved versions of the OTC medications, this tier houses both corticosteroids and opioids among other medications such as antidepressants. Corticosteroids are given to patients who are suffering an asthmatic or allergen based condition to help reduce both the inflammation present and the pain being experienced.

Opioids are given only to patients with severe cases of pain. While still technically a prescription drug, they are also classified as a narcotic and are heavily monitored by both physicians and by the government. Common examples of these include morphine and oxycodone.


Pain Medication Management San DeigoHow well does Pain Medication work?

The extent of medication success will be based on a number of factors, including both the dosage given and how well the patient follows their medication instructions. Other factors that may affect the success of medication include the severity of the pain-causing condition and on the patients’ individual susceptibility to medication. For many, pain medication is a very successful tool that helps provide relief for their condition.

What are the risks of Pain Medication?

Provided that the patient follows their individual medication instructions, the risks associated are very minimal. Potential risks will vary by medication and may include nausea, tiredness, or inability to focus. The largest risk present with medication is that it will not be effective for the patient.

San Diego pain management clinics serve Oceanside, La Jolla, Carlsbad, Encenitas, El Cajon, Escondido, Chula Vista, La Mesa, National City and surrounding areas.

Let the California Pain Network help connect you with the best pain management San Diego offers. Simply fill out the contact form on the page or call (619) 500-1573 for assistance!

Failed Back Surgery Syndrome: What Treatment Comes Next?

Failed Back Surgery Syndrome: What Treatment Comes Next?

For many patients with severe back problems, surgery is a promising treatment option. Procedures can include removing part or all of a damaged disc, or relieving pinched nerves. However, in some cases surgery isn’t helpful and chronic pain persists. This is known as failed back surgery syndrome. This may lead to problems with further treatment, especially when you’ve resorted to surgery only when less intrusive treatments weren’t effective. There are still options for back pain relief, though.

What causes it? There are a few basic categories of failed back surgeries.

First, the surgery performed might not have originally been the best option for the particular problem.Second, the operation may have been carried out in an inadequate way. For example, the surgeon might have missed an extruding disc fragment. Nerve injuries or Back Pain San Diegodisc herniation can be difficult to pinpoint and detect, particularly in cases of heavy scarring. In some cases, nerves can be damaged during the surgery itself. Sometimes, though, the cause of continued pain is unclear.

Prevention: This plays an important role in back treatment strategy. One way to avoid failed back surgery syndrome is using diagnostics to be more careful about which operations are done in the first place. For example, with herniated discs, surgery is more likely to be successful when a specific pressure point has been identified. In certain patients, psychological factors can also create risks for surgical recovery.

Medication: Painkillers are often early first-line treatments for this type of problem. Methadone, typically used to help treat opioid dependence, can also be an effective painkiller and is often considered helpful in avoiding other types of strong opioids, although correct dosage can vary widely. In some cases antidepressants can be effective.

Physical therapy:Stretching and other exercise early after surgery can limit the development of scar tissue which can cause pain by binding nerve roots. Later physical therapy is sometimes helpful in freeing up nerves or otherwise increasing range of motion. Proper rehabilitation is important after any back surgery, and in some cases symptoms will eventually improve with the prescribed regimen. Back pain sometimes persists after surgery due to lack of follow-up.

Minor nerve blocks:In some cases of nerve pinching or scarring, nerve block injections may be used to help pinpoint pain sources or to relieve pain. These procedures include numbing agents and corticosteroids.

Spinal cord stimulators: Implanted electrodes, connected to a unit that can be controlled by the patient, areused as a last resort for hard to treat back pain.This stimulation is thought to help disrupt pain signals being sent to the brain. After temporary electrodes are inserted and tested to see how the patient will respond to a spinal cord stimulator, the doctor will determine the pulse strength and an amount and frequency of time that it should be used. This can relieve symptoms for patients whose surgery hasn’t helped.

Reevaluation:In most cases, further surgeries tend not to be helpful without new diagnostic information coming to light. This is especially true in patients who’ve already had multiple failed surgeries. However, new evaluation of the underlying problem causing the original back pain can improve the odds of success for any form of additional treatment.

Because these situations can be quite unique, it’s important to work closely with a back pain expert to help determine what the specific problem is and what new or existing techniques might help.

Treating Whiplash From Car Accidents

Treating Whiplash From Car Accidents

Car accidents can lead to a variety of injuries. One of the more commonly diagnosed is whiplash, a general category of soft-tissue injury to the neck and shoulders.

In many cases, this type of injury can take a while to develop symptoms. Stiffness and soreness may gradually develop over the next day or two after the accident. It’s important to get medical attention as soon as possible for these symptoms, since they will likely continue to get worse and can develop into chronic pain if left untreated.

How is it caused? Many car accidents, especially rear-end impacts, will cause the head to snap forward and back suddenly. This leads to strain and overextension in the muscles and ligaments of the neck, even at relatively low speeds.

What are the symptoms? Along with affecting the neck itself, pain may radiate into the Neck Pain San Diegoupper back or down the shoulders or arms. It is sometimes accompanied by numbness and a tingling or pins-and-needles feeling.

In some cases whiplash is associated with headaches. Concussion-like cognitive symptoms, such as confusion, distractibility, and irritability, sometimes develop, and can be associated with poorer prognosis.

How is it treated?

Physical therapy:Whiplash used to be commonly treated with immobilization, usually using a neck brace. However, this is more recently thought to be less helpful, since it can lead to problems with stiffness and atrophy, and to slow long-term healing. Strain from heavy physical therapy may get in the way of recovery, especially if it leads to psychological anxiety, but early rehabilitation is important to promote full recovery. Therapy typically includes stretching and rotation exercises to increase range of motion. This has been shown to promote faster and more complete healing, and to lower chances of chronic pain.

Spinal decompression therapy:Spinal decompression, or mechanical traction, uses a specially designed chair or table to position the patient in a way that stretches out the spine. This is thought to help relieve compressed nerves and to promote healing by improving circulation around the injury. There are varying types of positioning that may be used.

Facet blocks: The facet joints are the connections between vertebrae in the spine, which allow flexibility. Facet block injections of corticosteroids in these joints can be used to numb strain from whiplash injuries. This is done as an outpatient procedure using fluoroscopy, or x-ray imaging, to guide the needle into the joint after local anesthetic has taken effect.Numbing agents injected along with the corticosteroids can provide nearly immediate pain relief. Over the next few days and weeks, physical therapy is generally used as part of longer-term treatment.

Epidural steroid injections: Compressed nerves in the epidural space around the spine are sometimes involved in whiplash pain. Steroid injections in the area of the nerve problem may ease the inflammation that develops.

Trigger point injections: In severe cases trigger points, or knots, may form in the neck muscles. Local anesthetic or corticosteroids are sometimes injected into trigger points to relieve pain from these spots.

Although medical evaluation and definition can be hard to pin down for whiplash, these types of symptoms can be relieved if evaluated and treated right away. An expert in neck pain can help you determine what might work well for you.

Arthritis Of The Spine: Pain Management Doctors In San Diego Offer Treatment Options

Arthritis Of The Spine: Pain Management Doctors In San Diego Offer Treatment Options

If you have arthritis of the spine, you are not alone. This condition is essentially a degenerative joint disease where the protective cartilage of the vertebrae wears down, causing pain and swelling. Bone spurs may result as well.  This can cause weakness and pain in your arms and/or legs.

What contributes to arthritis of the spine?

Age has a lot to do with the development of arthritis, and the spine is no exception. The Pain Management Doctors In San Diegoname osteoarthritisis given for arthritis of the spine. Younger people may end up with it because of an injury to the joint or a genetic defect in the cartilage. If a person is overweight, this can add stress and wear the cartilage down. Wear and tear from jobs or sports that are repetitive in nature can also bring about osteoarthritis.

What are the symptoms to look for?

One of the more common symptoms that arise from osteoarthritis is neck and back stiffness as well as accompanying pain with it. There can be weakness and/or numbness in the legs and arms. It is severe, it may affect the spinal cord and its nerves as well. Depending on the severity, a person may live with the condition without problems, but if it is bad enough, it could disable a person.

How Can Pain Management Doctors in San Diego Help?

Ultimately, the treatment of osteoarthritis is focused on relieving the pain associated with it and working to increase the person’s ability to function. It is important to pain management doctors in San Diego to help a person have the best quality of life.

Medication

Medication is one of the steps to treating osteoarthritis. The medication prescribed initially will be non-steroidal anti-inflammatorydrugs (NSAIDS) such as ibuprofenornaproxen. The drugs are good for reducing inflammation of the joints. If the inflammation is reduced, this will alleviate the pain associated with the swelling. Medication can take the edge off of the pain so that people can do their daily activities with less discomfort.

Physical Therapy

Your pain management doctors in San Diego may recommend physical therapy along with a regimen of medication. Studies have shown that regular exercise helps relieve some pain. Moving the joints prevent them from becoming stiff. Good examples of exercise are walking, strength training, and low-impact aerobics.

Other treatments

Other types of treatment interventions offered are TENS units and joint injections. TENS units help pain by sending light electrical impulses into the affected area. This is effective in many patients with osteoarthritis.

Joint injections are targeted to the area of pain in people with osteoarthritis. The injections contain a corticosteroid drug that is effective in reducing inflammation in the joint. This type of treatment alleviates the pain quickly and the patient gains more range of motion and mobility than before the injection. In many cases, they are administered in conjunction with physical therapy and NSAIDS. This provides the ultimate pain control in the arthritis sufferer.

 

Pain Clinics in San Diego Work With Fibromyalgia Patients To Manage Pain

Pain Clinics in San Diego Work With Fibromyalgia Patients To Manage Pain

Fibromyalgia is a physical and emotional condition. Each condition needs to be treated in order to treat the patient with fibromyalgia effectively. It is best to have doctors who know how to address both aspects of the disease so that care is coordinated as needed. The pain clinics in San Diego have pain management specialists who treat fibromyalgia patients on a regular basis. They are experienced in treated both emotional and physical symptoms so that their patients have the best outcome in treatment.

Goals of Treatment

Fibromyalgia patients say that pain is the number one problem that affects their livelihood. Therefore, pain is the ultimate goal of treatment. Pharmacological intervention plays an Painimportant role in pain control for these patients. The following are common medication groups used to help with fibromyalgia:

•    Antidepressant medication

•    Neurogenic medications

•    Sleep aids

•    Pain relievers

•    Muscle relaxants

•    Acetaminophen

Sleep in one of the most important issues to address when treating a person with fibromyalgia. They are known to suffer from insomnia, interrupted sleep, and chronic sleep disturbances. When one cannot sleep normally, pain can be exacerbated.

It is important to help the patient be able to carry out daily activities with as little pain as possible. There are many interventions to improve a patient’s mobility and physical motion.

•    Heat application therapy

•    Physical therapy

•    TENS unit

•    Trigger point injections for pain

•    Acupuncture

•    Massage

•    Water therapy

•    Exercise and stretch therapy

•    IV Therapy Treatment

Medications

The following three medications that are FDA-approved for fibromyalgia:

•    Cymbalta (duloxetine): This antidepressant is a serotonin and norepinephrine reuptake inhibitor (SNRI). Studies have found that this medication helps with many types of symptoms with fibromyalgia, including pain. The increased levels of the neurotransmitters are suspected to reduce the feelings of pain.

•    Lyrica (pregabalin): Lyrica is the drug of choice to help with nerve pain in fibromyalgia patients. It seems to calm the overly sensitive nerve cells that are responsible for sending pain signals. It has been shown to be very effective in reducing fibromyalgia pain.

•    Savella (milnacipran):Savellaworks in a similar way as Cymbalta and is another SNRI that is used for fibromyalgia. It helps in relieving pain and reduces fatigue in patients.

Other antidepressants are used to relief fibromyalgia patients of pain.

•    Tricyclic antidepressants.Tricyclic antidepressants increase the neurotransmitters in the brain (serotonin and norepinephrine) that can help by relaxing painful muscles and facilitate the production of the body’s own painkillers.

•    Selective serotonin reuptake inhibitors (SSRIs).SSRIs prevents serotonin from being taken up again in your brain, so this type of medication may help pain and fatigue.

Alternatively, the following medications can be prescribed to enhance pain relief:

•    Local anesthetics.Local anesthetics are injected into the tender areas of the patients. Though these type of medication can provide much needed relief, it usually only lasts for about 3 months.

•    Anticonvulsants. It is unclear how these type of medications work but they have been found to be effective in reducing pain and anxiety for many fibromyalgia patients.

•    Muscle Relaxants.Muscle relaxants are good for muscle strain or spams that cause pain.

Let your pain clinic help you get on your feet again by treating your fibromyalgia.

What You Need To Understand About Managing Pain

What You Need To Understand About Managing Pain

Pain is something that people often get wrong when asked to define it, and many people also associate pain with something like an injury. However, what pain really is can best be described as electrical impulses that go from one part of the body to the brain, and that is when people experience pain. When people have pain that does not go away, they need to consult experts on pain, and these medical professionals are called pain management doctors.

Injection Treatments For Chronic Pain Management

The first time that patients meet up with pain management doctors, there are a lot of questions that may come to mind, and some people actually write some of them down on San Diego Pain Managementa piece of paper to take with them. People may also need a notepad handy with them because they may have questions, but they also might want to write down questions they have about the treatments that the doctors and nurses might discuss with them, and here is more information on injection treatments that doctors might want to try to help their patients with chronic pain:

•    Epidural steroid injections: These are a series of three injections that are given in the lower back. For some people with chronic pain, the pain-relief can be for a few months all the way up to one year.

•    Lumbar epidural steroid injections: For people who have a pinched nerve, there can be a lot of pain in the lower body. A way to treat the pain is with this lumbar injection. The steroid is injected in an area of the lower back called the epidural space, using a surgical procedure, and after two weeks, if the pain has not subsided, then there may be a need for a second injection.

•    Facet joint injections: Also known as Z joints, these joints are located on either side of the vertebrae. To get an injection, a patient will have to undergo a minor medical procedure that will be use X-ray and a fluoroscope. With the injection, pain relief is instant, and people will have no pain for at least six months to one year.

•    Sacroiliac joint infections: Problems with the sacroiliac joints can cause people to have a lot of pain in the lower section of the back, the buttocks, and the legs. Typically, it is only one joint on one side of the body causing problems. Using x-rays, the injection is given into the sacroiliac joint, and it does provide long term pain relief.

Understanding pain is the first step in treating it, and pain management doctors San Diego San Diego Pain Managementhelp their patients understand what it is. Also, people tend to have a lot of questions they want to ask their doctors, and it is always a good idea to have a paper with these questions written down. Some of the most common questions are about pain treatments used especially the variety of injection treatments that are available. There are other treatments that people can use in addition to the shots, and the combination may be the perfect mixtures to finally find the relief they are looking for.

 

Pain Clinics Deal With Back Injuries

Pain Clinics Deal With Back Injuries

Some people try and deal with pain on their own, and do not even think about the fact that their medical doctor can help them. It is not surprising that people may have misgivings about going to a doctor for pain, and there is the fear that something seriously is wrong with them. However, once people get the courage to go to their doctor, that medical professional is going to recommend that their patients go seek out a pain clinic and make an appointment to have a talk with the employees that work there so the mystery of their constant pain can be solved.

Pain Clinics Offer Various Treatments For Back Injuries

A pain clinic is a special facility that specializes in figuring out why people have chronic pain, do testing to see if the problem can be found, and then treat that pain with various methods. While not every pain can be completely resolved, some people do have Pain Management Doctors In San Diegotreatments that make the pain much more manageable. Here is more information one of the treatments that a pain clinic will have available to treat pain from a back injury and it is called a spinal infusion pump implant:

•    What is a spinal infusion pump implant?: Anyone that has ever had major surgery, woke up to find that they had a small device in their hand that was connected to a machine that had a needle in it filled with a pain numbing drug such as morphine. Whenever they had pain, all they had to do was push the button, and a drop or two of the morphine went into their IV tube. A spinal infusion pump implant is similar to that contraption, and the fact that the implant is actually put into their bodies via a small catheter.

•    Who is eligible for a spinal infusion pump implant?:When people have back pain, a pain facility is going to do everything they can to help relieve it. However, when all other pain treatments have failed, then it is recommended that the patient have this pump implanted into their bodies. People with conditions such as failed back syndrome, osteoporosis, and arthritis, are often the ones that are eligible for this pain-relief implant.

•    How long does the spinal infusion pump implant procedure take?: Once inside the operating room, the procedure to place the spinal infusion pump implant takes between 45 minutes to one hour to place the device into the intrathecal space.

•    How successful is the use of a spinal infusion pump implant to control pain?: After the healing time, people with this implant have reported to their physicians that their pain is relieved, and in the cases of those with severe pain, their pain was a lot less and more tolerable. The pain medication in the implant can last from three to six months, and then it is refilled via a tiny needle that is inserted into the device.The batteries within the device can last up to five years, and once the batteries are gone, the entire device must be removed and replaced.

People in constant pain need to talk to their doctor about it because they can find relief if that doctor recommends they go to a pain clinic San Diego. At one of these pain facilities, Pain Management Doctors In San Diegoa patient can talk about their pain, get evaluated, examined, and then there are many treatment options that people have to help control their pain. Together, patient and doctor can discuss the ways to treat their chronic pain, and it may take more than one treatment method in order to get effective pain relief.

 

Shoulder Pain

FAQ’s on  Shoulder Pain

Shoulder pain San DiegoThe shoulder is one of the most mobile joints of our body. The wide degrees of mobility come from its ball-and-socket configuration. This allows rotation and movement in different directions. The shoulder is made up of the humerus (upper arm bone), scapula (shoulder blade) and clavicle (collarbone).

The head of the humerus is a round protuberance that fits into the glenoid (socket that is located in the scapula). This joint is stabilized by the tendons and muscles of the rotator cuff (namely the supraspinatus, infraspinatus, teres minor and subscapularis).

What can cause shoulder pain?

Shoulder Pain Clinics San Diego

A wide variety of conditions can cause shoulder pain. However, most shoulder injuries can be classified as fractures, arthritis, instability or tendinopathies. These are mostly injuries to the tissues of the joint, and the particular presentation of each will vary.

  • Tendinitis – tendons connect the muscle to the bone. Inflammation of the tendons occurs after repeated injury or wear and tear over time. Activities that cause stress on the shoulder joint can cause acute tendinitis, or chronic tendinitis. The rotator cuff tendons are the most commonly affected by this condition.
  • Tendon tears – the tendons can be torn from acute injury, or after progressive degeneration due to aging, wear and tear, among others. The tear can be partial, but sometimes can completely split the tendon. The rotator cuff tendon is commonly at risk for this injury
  • Impingement – this occurs when the shoulder joint is unstable, and soft tissues are pinched by the acromion (top of the shoulder blade). This repeated irritation can cause tendinitis or bursitis over time, and can even lead to tears.
  • Instability – partial or complete dislocations occur when the humeral head is displaced from the glenoid socket. This causes pain and damage to the tissues of the shoulder particularly that of the rotator cuff. Those who suffer dislocations are more at risk for subsequent dislocations
  • Arthritis – there are many kinds of arthritis, but the most common is osteoarthritis, which results from progressive wear and tear, and is associated with aging. If left untreated it may even lead to stiffness and loss of range of motion.
  • Fracture – this is usually after acute trauma to the shoulder joint. They often cause severe pain, swelling and bruising around the shoulder.

How is shoulder pain diagnosed?

Shoulder Pain Management San DiegoThe diagnosis of shoulder pain is made after a complete medical history and physical examination. Particular attention will be given to the details of the pain, including triggering events, aggravating movements, and others. You may also be asked to perform several clinical exams assessing the range of motion and the stability of the joint. Additional imaging studies may be requested, such as X-rays, Computerized Tomography (CT) scans, and Magnetic Resonance Imaging (MRI) scans.

How is shoulder pain treated?

Treatment of shoulder pain will depend on the condition and its severity. Mild injuries can be treated with conservative options, such as oral anti-inflammatory and analgesic medications, or physical therapy and rehabilitation. Other options include minimally invasive procedures such as steroid injection, nerve blocks, or platelet-rich plasma therapy. Major open surgery is usually indicated only for severe injuries, or injuries that do not respond to conservative measures.

References

Adey-Wakeling Z, Crotty M, Shanahan EM. Suprascapular nerve block for shoulder pain in the first year after stroke: a randomized controlled trial. Stroke. 2013 Nov;44(11):3136-41. doi: 10.1161/STROKEAHA.113.002471.

Gill TK, Shanahan EM, Taylor AW, Buchbinder R, Hill CL. Shoulder pain in the community: an examination of associative factors using a longitudinal cohort study. Arthritis Care Res (Hoboken). 2013 Dec;65(12):2000-7. doi: 10.1002/acr.22082.

Hanvold TN, Wærsted M, Mengshoel AM, Bjertness E, Stigum H, Twisk J, Veiersted KB. The effect of work-related sustained trapezius muscle activity on the development of neck and shoulder pain among young adults. Scand J Work Environ Health. 2013 Jul;39(4):390-400. doi: 10.5271/sjweh.3357.

Jowett S, Crawshaw DP, Helliwell PS, Hensor EM, Hay EM, Conaghan PG. Cost-effectiveness of exercise therapy after corticosteroid injection for moderate to severe shoulder pain due to subacromial impingement syndrome: a trial-based analysis. Rheumatology (Oxford). 2013 Aug;52(8):1485-91. doi: 10.1093/rheumatology/ket149. 

Sacroiliac Joint Pain

FAQ’s on Sacroiliac Joint Pain

What is sacroiliac joint pain?

Sacroiliac Joint Injection Treatment San Diego

The sacrum is the triangle-shaped bone that is found above the coccyx, or tailbone. This is connected to the iliac bones that make up the pelvis. Thus, the sacroiliac joint (SI joint) connects the spine to the pelvis. The joint is held together by a collection of strong ligaments, and there is very little motion around this joint. It serves primarily a support purpose, bearing the entire weight of the upper body during erect posture.

Dysfunctions in the SI joint can cause low back pain, or leg pain. Risk factors for SI joint function include older age, history of degenerative diseases such as arthritis, pregnancy, previous history of trauma or spinal surgery, among others. The progressive wear and tear of the protective cartilage in the SI joint causes the bones to rub against each other, leading to inflammation and pain. Circulating hormones from pregnancy cause the ligaments in the pelvis to relax in preparation for childbirth: this can lead to increased motion, and thereby, wear and tear on the SI joints. Malignant and metastatic conditions can also cause SI joint pain. The clinical presentation of SI joint pain will vary depending on the exact underlying cause. It may be chronic (greater than 6 months) or acute (less than 6 months).

How is sacroiliac joint pain diagnosed?

Sacroiliac Joint Injections San DiegoSI joint pain can be caused by a multitude of conditions that include, but are not limited to, osteoarthritis, malignancy, misalignment, or surgery. The exact cause will be determined by the physician through a complete medical history and physical examination. Additional imaging studies are usually requested, and these include X-rays, Computerized Tomography (CT) scans, Magnetic Resonance Imaging (MRI) scans, as well as ultrasonography.

SI joint pain can also be diagnosed with SI joint injections of local anesthetic and corticosteroids (strong anti-inflammatory medications). These are injected near the affected area under fluoroscopic (X-ray) guidance to improve accuracy, although the use of ultrasound and magnetic resonance imaging to guide the procedure have shown promise in providing pain relief and restoring function to patients. Relief of symptoms after this procedure positively identifies that SI joint as being involved in chronic pain. This is becoming an increasingly common procedure, and can be done by specialists in physical medicine and rehabilitation.

How is sacroiliac joint pain treated?

Sacroiliac (SI) Joint

Treatment will depend on the underlying pathology. The options can range from conservative, non-surgical management like oral anti-inflammatory medications, to minimally invasive techniques such as radiofrequency ablation and neurolytic nerve blocks, to open surgery.

Medications and physical therapy are usually the first line of treatments advised by physicians. If the pain is unresponsive to these interventions, then techniques such as nerve blocks should be considered. Nerve blocks can be done through local anesthetics and corticosteroids, or through more permanent methods like radiofrequency ablation or neurolysis.

These procedures have been shown to have good outcomes, and are normally well tolerated by patients. Since there are always risks associated with surgical procedures, open surgery is often kept as a last option. Surgery carries with it the risk of infection, bleeding, or damage to surrounding muscles, nerves or soft tissues.

References

Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013 Jan;13(1):99-116. doi: 10.1586/ern.12.148.

Nebreda C, Vallejo R, Aliaga L, Benyamin R. Percutaneous sacroplasty and sacroiliac joint cementation under fluoroscopic guidance for lower back pain related to sacral metastatic tumors with sacroiliac joint invasion. Pain Pract. 2011 Nov-Dec;11(6):564-9. doi: 10.1111/j.1533-2500.2010.00439.x.

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Stelzer W, Aiglesberger M, Stelzer D, Stelzer V. Use of cooled radiofrequency lateral branch neurotomy for the treatment of sacroiliac joint-mediated low back pain: a large case series.

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