Stem Cell Clinic of California.

Pain Clinic

Managing Chronic Pain Without Pills

Chronic pain is a major medical condition characterized by pain lasting beyond six months or the normal time required to heal from an injury. Unlike acute pain, which is a normal, healthy process, the signals of chronic pain can remain active in the nervous system for months or even years. This can take a physical and emotional toll, adding to the pain and increasing emotional stress. About a quarter of Americans suffer from chronic pain ranging from mild to excruciating. It may be episodic or continuous and incapacitating.

What causes chronic pain?

The causes can be complicated and not always obvious. The most common types of chronic pain are headaches, joint pain, pain from injuries and chronic back pain. Then there is pain from congenital conditions, cancer and arthritis. Chronic pain may have no clear cause. When there is no clear cause for pain, it can be difficult to treat. Chronic pain management requires a multidisciplinary approach designed to help patients reach their greatest potential and highest level of functioning and independence.

There are many chronic pain conditions ranging from mild to incapacitating. These include:

  • Cancer pain
  • Chronic back pain
  • Fibromyalgia pain
  • Chronic pain in women

Since each patient’s pain is unique, treatment plans at our anesthesia clinic must be tailored to address individual needs.

Cancer Pain

Cancer Pain Treatment in Pasadena

Each year, approximately 14 million people learn the disheartening news that they have cancer. In many cases, cancer itself can cause pain, but in other cases it could be caused by the treatment or the tests done in order to obtain the diagnosis. Whether you experience any pain is mostly dependent on the type/stage of cancer you have and your pain tolerance level. Most pain occurs when a tumor presses on bones, nerves or body organs, and people with advanced cancer will typically experience more pain and accompanying issues.

Cancer pain treatment

Some options normally available are:

  • Over-the-counter and prescription-strength pain relievers – aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin, etc.)
  • Weak opioid medications, such as codeine
  • Strong opioid medications – morphine, oxycodone, hydromorphone, fentanyl, methadone or oxymorphone

When drugs aren’t enough

We offer you many options when medications don’t relieve your pain. These include:

  • Radiation Therapy: This reduces pain by shrinking the tumor. A single dose of radiation therapy may be enough to decrease pain significantly and efficiently in most patients.
  • Nerve Blocks/Implanted Pump: Certain nerve blocks may help relieve some pain. Nerve blocks are local anesthetics injected around or into a nerve, which prevents pain messages from reaching the brain. An implanted pump may also be an option for relief.
  • Neurosurgery: Nerves (typically ones found in the spinal cord) are cut to relieve pain.

Why some people live with cancer pain instead of seeking cancer pain treatment

Talking to a knowledgeable doctor or specialist about cancer pain can help reduce your stress. Cancer pain is often undertreated because of people’s reluctance to talk about the pain they are experiencing. Many patients forget that they are the experts when it comes to their own pain. So why don’t patients ask their doctors about the pain they are experiencing?

Patients are often reluctant to discuss their pain because they don’t want to “burden” their doctors. Not every doctor specifically asks about pain at an appointment, but cancer patients should be asked at every appointment for better assessment. If your doctor doesn’t know enough about proper cancer pain treatment, he or she should refer you to a cancer pain treatment specialist.

Some patients fear that they will end up addicted to pain medication. The truth is, addiction typically doesn’t happen when you take medications as prescribed for pain. Most people who become addicted continue taking pain medications when they are no longer in pain just to “get high.” When taken properly, medication has far greater benefits than negative side effects.

Many people fear feeling sleepy, unable to communicate with friends and family, acting strangely or being seen as dependent on drugs. Some patients are afraid that taking medications like morphine may shorten their life. Recent evidence shows that good pain control may actually help you live longer.

Always share what you are experiencing, your pain level and any side effects, with your healthcare team. Think of your pain using a rating system of 0 to 10, where 0 means no pain and 10 means the worst pain imaginable. This will help your team better assist you. You and your doctor will set goals and work as a team. The primary goal is making you feel comfortable. We have a strong pain management program and we believe we can help you!

We can ease your pain significantly with the proper care and treatment of pain disorders. We are dedicated to meeting your individual needs.

Chronic Back Pain

Help for Chronic Back Pain

Millions of Americans suffer from severe chronic back pain, which has many causes. Four out of five Americans will experience back pain sometime in their lives. Low back pain is the leading cause of disability in the United States. It’s the most common reason why people miss work and the reason most often cited when people ask for a doctor’s appointment. Your back is a complex system of bones, ligaments and muscles, and it supports your entire body.

There are many simple ways to reduce your risk of developing chronic back pain. Maintaining a healthy weight and staying active throughout your life significantly reduces your risk of developing many ailments, and chronic back pain is no exception. Avoid long periods of inactivity, like spending days bedridden, if you can. Stretching is crucial to maintaining a healthy back, especially before you engage in physical activities such as sports, cleaning, gardening or even taking walks. Quit smoking. Smoking will reduce your blood flow and deprive your back of the oxygen and nutrients necessary to sustain your muscles and bones.

Causes of back pain

Chronic back pain can be caused by injuries, acquired conditions and diseases, infections and tumors, mechanical problems or from the way you move or position your spine that is uncomfortable. Spinal injuries, from sprains and pulled ligaments to fractures, can all cause short-term and long-term spinal issues. Osteoporosis can weaken bones and make them susceptible to painful fractures.

Genetic conditions and diseases such as scoliosis and arthritis can also cause severe chronic back pain. For many of these diseases and conditions, treatment is the only way to effectively manage pain. Movement-based or mechanical problems result from wear and tear. Intervertebral disc degeneration occurs when the spongy discs between vertebrae break down due to age or injury.

Chronic back pain can also be caused by tumors and infections. A small percentage of chronic back pain patients have cancerous tumors or unchecked infections that develop elsewhere in the body and spread to the spine where they cause you serious pain.

Diagnosing & treating your back pain

We employ a variety of diagnostic tests to pinpoint your pain and tailor your treatment:

  • Lumbar Radiofrequency Neurotomy and Spinal Cord Stimulator: Minimally invasive procedures that can help effectively manage your chronic back pain. Both affect the pain signals that travel from your spine to your brain. Lumbar radiofrequency neurotomy disrupts the signals via electrodes, while spinal cord stimulator implants use mild electrical impulses.
  • Medial Branch Block: Similarly interrupts pain signals from an affected area to the brain, but instead uses a numbing anesthetic. Medial branch blocks can treat just about any back pain. They also treat headaches, shoulder, buttock and hip pain, and upper, middle or lower chronic back pain. This is also a neck pain treatment for neck pain relief.
  • Vertebroplasty: Can be especially helpful to patients who have endured cancer; a minimally invasive treatment in which we inject bone cement into the spine to stabilize areas weakened by osteoporosis.

Lower back pain relief procedures

  • Caudal Epidural Injections and Lumbar Epidural Steroid Injections: Options for patients who have herniated discs, radiculopathy or spinal stenosis. Caudal epidural Injections alleviate lower back pain, spine pain and lower back-related leg pain via a steroid injected into the lumbar region to treat spinal nerve pain caused by inflammation or swelling. Lumbar epidural steroid injections use an anti-inflammatory medication for lower back pain relief and leg pain.
  • Facet Joint Injections: These are both diagnostic tests and treatments that relieve lower back and spinal pain. Does your pain come from the facet joints in your back? If so, we administer a numbing anesthetic and anti-inflammatory steroid to relieve pain and inflammation caused by facet syndrome or spinal arthritis.
  • Lumbar Epidural Steroid Injections and Sacroiliac Joint Steroid Injections: Other options that can relieve the pain and inflammation of sciatica. Lumbar epidural steroid injections use anti-inflammatory medication on the outer membrane of the lumbar region to provide sciatic nerve pain relief. Sacroiliac joint steroid injections use a local anesthetic and a corticosteroid on the sacroiliac joints (they connect the spine to the hip bones) or the surrounding ligaments. Sacroiliac joint steroid injections are also used to treat injuries or disease in the sacroiliac joint.

Upper chronic back pain & neck pain relief procedures

Thoracic Epidural Steroid Injections and Thoracic Transforaminal Epidural Steroid Injections: These help combat pain in the upper back. Thoracic epidural steroid injections are outpatient procedures, a quick, easy method of dealing with pain in the upper back. Thoracic transforaminal epidural steroid injections treat pain caused by pinched nerves in the thoracic spine while relieving rib and abdominal pain.

Chronic back pain doesn’t have to be a life sentence. Any of the above procedures could start you on your way to a pain-free life. They can provide long-term lower back pain relief and neck pain relief from neck pain treatment and a better life experience that doesn’t put you at risk for dependence on drugs.

Fibromyalgia Pain

Effective Treatment for Fibromyalgia Pain

Many diseases limit a person’s ability to fully engage in and enjoy their lives, but none are quite like the pain and suffering a person endures because of fibromyalgia.

Fibromyalgia affects an estimated 5 million people, 80% to 90% of whom are women. It’s a serious disease with no cure, no known cause and very few options for long-term relief. Fibromyalgia patients suffer inexplicable widespread pain, fatigue and psychological distress, headaches, trouble sleeping and cognitive problems with concentration and memory. Though most are diagnosed around middle age, anyone in any age group could be diagnosed with fibromyalgia. Though children born to parents diagnosed with fibromyalgia are more likely to develop it, and there is some evidence that traumatic events can spark the disease, around 40% of cases appear randomly without any clear cause.

Fibromyalgia is the most common musculoskeletal affliction after osteoarthritis. Sufferers endure constant, crippling full body aches and fatigue and sensitive spots that may be painful to the gentlest touch. Sometimes it feels as if the muscles have been pulled or overworked; or you may experience a deep, stabbing pain or tingling, twitching and burning muscles. The pain seems to come from nowhere, unprovoked by physical activity, and can be randomly more or less severe on any given day.

Typically, people diagnosed with fibromyalgia take off work an estimated 17 days per year to deal with their pain. Most who suffer from fibromyalgia report a low quality of life, as the pain limits their ability to enjoy time with their families, be productive at work and engage in activities that make them happy. According to studies, 70% experience a loss of intimacy with their partner; 85% miss significant experiences in their lives and see their relationships suffer directly due to fibromyalgia.

Fibromyalgia patients are three times more likely to develop depression. Because fibromyalgia can isolate those diagnosed with it, it creates many social stresses and general anxiety that causes people to become more withdrawn. It also limits people’s ability to be physically active, even for short periods of time. Though it is unclear whether or not fibromyalgia leads to depression, some studies suggest that depression may just be another symptom. Whichever is the case, these two are indisputably linked, which makes the disease even more challenging to adequately manage.

Treatment options

Fibromyalgia is a complex disease with a lot of different symptoms that must be individually assessed. Finding the best method of treatment for each individual with the disease will require a unique solution.

Interventional anesthesia is a superior treatment option because it helps the interventional pain anesthesiologist fully understand the patient’s needs and form a specific, customized treatment plan that pinpoints the exact areas of pain and helps the patient manage that pain on their own special terms. Treatment options can include epidural steroid injections, nerve blocks, radiofrequency ablation, spinal cord stimulator, facet joint injections, lumbar sympathetic plexus blocks and trigger point injections. These are minimally invasive procedures that isolate and attack specific areas where the pain is the worst. If you a good fit for interventional anesthesia, we may suggest that you undergo a specific combination of outpatient treatments that will best help you manage your pain.

An Interventional pain anesthesiologist could be a better choice for people who suffer from fibromyalgia because he or she offers an alternative to drugs, which can dull the senses and leave you feeling as fuzzy as you would with untreated fibromyalgia. Our goal is to provide you with the most comfortable, best-suited pain management program. Helping you choose the right procedures is much better than simply prescribing drugs. We are here to listen, help you prioritize and find the treatment option that will give you the best relief possible.

Tips for dealing with fibromyalgia

Take time for yourself. Even if it’s just sitting still, listening to music, do whatever makes you happy and:

  • Avoid caffeine. The constant wide-awake feeling that persists after you’ve consumed a lot of caffeine will not help you, especially if you already struggle with sleep. Remember that coffee isn’t the only product that contains caffeine; soda, chocolate, tea, etc. should all be on your radar to avoid.
  • Do not work out before you go to bed. Exercising before bed may keep you wired and awake when you finally lie down to rest.
  • Create a safe space. It doesn’t matter where or what it is, devote one area completely to yourself, and outfit it with things that make you comfortable. Find a super-comfortable chair that you can lounge in.
  • Take sleep seriously. If you need to take naps in the day and it won’t affect your sleeping through the night, do it. Wind down before bed with a warm bath. Practice slow breathing exercises to calm your racing thoughts before bed.
  • Get enough vitamin D. A deficiency may worsen the pain in your muscles and bones. Take time to get some sunlight every day.
  • Give occupational therapy a shot. If you are overwhelmed by the pain you feel doing everyday tasks, occupational therapy can help you perform those tasks in ways that limit your pain.
  • Eat plenty of omega-3 fatty acids. Random as it sounds, studies have shown that after a diet high in omega-3 fatty acids, patients reported less pain.
  • Ask for help. Depression often accompanies fibromyalgia. Talking to someone about the mental anguish you’re experiencing may help you deal with the physical pain. Don’t face depression alone.

No matter what treatment you choose, we are also always here to help. If you are suffering from fibromyalgia and thinking about seeking treatment, please call us to talk about a consultation.

Learn more about fibromyalgia

Chronic Pain & Women

Nearly all women experience intense pain in their lives as a part of their genetic makeup, whether through childbirth, menstruation or other common female health ailments. Men and women don’t experience pain the same way, nor do they always have the same ideas about which pain is bearable or unbearable. Our aim is to help improve your quality of life.

According to studies, women tend to experience more spinal pain than men. The Clinical Journal of Pain states that about 40% of women experience spinal pain at some point in their lives. This ranges from ligament strains common among mothers who are constantly lifting or otherwise attending to young children. If you’ve already lived through these years, they can still cause you back pain or other issues later in your life. If you haven’t, you can reduce the strains by learning good lifting techniques and strengthening habits that will help you maintain a healthy spine.

Osteoporosis commonly affects women over 50. Osteoporosis occurs when the body loses too much bone tissue, or doesn’t make enough, or a combination of both. This leaves your bones extremely thin and vulnerable to fracture, even from simple actions such as sneezing or accidentally bumping into a coffee table. You can limit your vulnerability with aquatic therapy, which will help you loosen stiff joints and promote general bone health. Diet and lifestyle changes may help, as well. Spinal injections, either to block the pain or inject bone cement to strengthen your spine, may also be extremely beneficial.

Fibromyalgia is another disease that’s heavily prevalent among women. Fibromyalgia is characterized by widespread bodily pain in the muscles, bones and soft tissue. It is a frustrating disease with no cure and is often accompanied by depression. Those who are diagnosed don’t just experience bodily pain; it affects nearly all areas of life, including their social, family and marital life with their partner. There are many ways you can reduce the pain of fibromyalgia. We also offer several procedures that can help your worst pain.

Pelvic pain is another common issue for women. About 15% of women aged 18 to 50 experience chronic pelvic pain. This is a conservative number because the majority of chronic pelvic pain goes undiagnosed. Endometriosis and interstitial cystitis are two conditions that commonly cause pelvic pain. If the pain has lasted for more than six months, if traditional pelvic pain treatment techniques don’t work, if you’re experiencing sleep-related problems, poor appetite or depression, if your ability to engage in normal physical activities is severely limited, please consider pelvic pain treatment using interventional pain management to curb your pain. If pelvic pain goes untreated, it can evolve into more serious health issues and diseases.

Migraines are also more common in women: Of the 36 million people in the United States who suffer from chronic migraines, 27 million are women. What isn’t commonly known is that migraines are actually a syndrome, a collection of symptoms that arise from a common cause. Women who experience migraines may also have vomiting, nausea, dizziness, sound and light sensitivity and a variety of other painful symptoms. Women may experience migraines at any time, but they are especially common during menstruation, pregnancy, menopause or when using hormonal contraception. There are many interventional pain management methods to consider.

Our goal is personalized care; we understand that you have suffered long and may be desperate for relief. We are going to do everything we can to help you find it. We offer minimally invasive procedures that are tailored to you. With our specific diagnosis, we will target your pain at its source. We can’t guarantee to cure you. In some cases, there simply aren’t cures for certain conditions. However, if you schedule a consultation, we can help you determine your best options.

What to Expect

What to Expect During Diagnosis & Treatment of Pain Disorders

If you decide to see an interventional pain anesthesiologist, you should know that we cannot guarantee you a cure. But we can offer your best shot at managing your pain. It’s important to have the right expectations. Our goal is to give you a clear plan to control the pain and explain exactly what’s going on and what will happen when we try to reduce your pain via whichever procedure best fits your situation. Pain to us is a disease just as much as diabetes and arthritis, so we treat it as such.

Your first visit

The first time you visit us, we’re going to do a lot of listening. We will collect your medical history, information about medications you take and detailed information about your pain. When did you first notice it, how often does it occur, is it worsened by any activity? We’ll ask questions like these, and we will run a pain assessment test to understand how severe your pain is. We may treat you in your first visit or we may simply run tests to best understand what is going on with your body. Be as thorough and precise as possible because every detail helps us make a better diagnosis and thus form a better treatment plan.

Bring all your recent medical records, MRIs, X-rays, CT scans, etc. You’ll also need an insurance card as well as a means of paying your insurance co-pay and deductibles if you are covered by an insurance plan. If you plan on making payments yourself, feel free to call ahead for an estimate. Wear comfortable clothing that doesn’t restrict movement; we may test your range of motion, etc.

Waiting for your diagnosis

Making the correct, exact diagnosis to fit your specific situation may take time. After the first consultation, we may only be able to give you potential causes for your pain. The first visit simply functions to rule out the majority of causes of your pain. If we aren’t ready to make a precise diagnosis after your first visit, please be patient. We need to form a map pinpointing the most probable sources of your pain, along with other factors we’ll need to take into consideration as we craft a plan to combat it. This may take some time, but we must have it in order to provide you with an accurate and efficient diagnosis that makes the highest quality of care possible.

It is also common for us to request further testing. We need to understand your pain and all issues relevant to treating it on a very intimate level so we can make a treatment plan that is realistic and appropriate to your needs. Once we understand exactly what’s going on, we will outline ways we could go about helping you.

Tailoring your treatment

This is not a one-sided process. We want to hear all of your concerns, questions, opinions and suggestions so that our plan will actually work for you. If something makes you uncomfortable, we want to know. This is about you getting your life back. Two people with the same condition may require different methods of treatment, simply because they have different concerns and different needs. Our goal is combining treatment methods to best suit your lifestyle needs. We will also take your needs into consideration when we determine how often you need treatments.

Before you undergo treatment, we will explain how your body may react and how you can adequately prepare and take care of yourself following treatment. Depending on the procedure, you may have to bring someone along to supervise you or drive you home. It’s common for patients to return to work the day following treatment. Depending on what kind of work you do, we may ask you to take additional time off for your recovery.

After your treatment

If you have an invasive treatment, you may experience minor pain or sensitivity at the site of the treatment. This is no cause for alarm and will resolve itself in a few days. In the meantime, you can use common pain medications such as ibuprofen until the pain dissipates. In order to secure your eventual success, we need full communication with you during your post-treatment time. If you have questions about your treatment routine or if there are any changes you want to make or causes for concern, keep us well-informed.

If you have endured chronic, debilitating pain, the most frightening thing about fighting back is hope. We understand that pain may have changed your quality of life, relationships with the people you love and the way you function, but we are here to help. We don’t just prescribe medication and leave the rest up to you. Managing your pain will be a joint effort. Our only goal is your comfort and a better life for you.