Acupuncture (a branch of traditional Chinese medicine, or TCM) is a practice 3,500 year older than traditional Western medicine. This Cam Therapy works by applying needles, heat, and pressure to specific points on the body. The theory is that invigorating these points releases or redirects the body’s natural energy known as chi or qi because illness and pain come from blockages or imbalances of this vital life force.
Does It Work?
According to the National Institute of Health (NIH), many studies suggest that acupuncture works particularly well on chronic pain such as back and neck pain; osteoarthritis/knee pain; and headache. It often reduces the incidence and severity of tension headaches and may prevent migraines. “Therefore,” the NIH concludes, “acupuncture appears to be a reasonable option for people with chronic pain to consider.”
A review article that appeared in Practical Pain Management found that pain relief with acupuncture comes from inactivating the source of pain by modulating endorphin levels. These authors also reported on the benefits of acupuncture for temporomadibular joint disorder (TMD).
Often patients will see their acupuncturist on a regular basis, simply to maintain a feeling of general wellbeing. Even though the procedure is performed by inserting hair-thin needles into various parts of the body, acupuncture is considered non-invasive and gentle.
Focuses on alternative techniques such as meditation, yoga, or biofeedback for mitigating pain. Alternative medicine is a term that describes medical treatments that are used instead of traditional (mainstream) therapies. Some people also refer to it as “integrative,” or “complementary” medicine. About 40% of adults in the United States say they use some form of alternative medicine. But exactly what types of therapies are considered alternative? The definition changes as doctor’s test and move more of them into the mainstream.
- Energy Therapies
- Herbal Medicine
- Ayurvedic Medicine
- Massage Therapy
- Creative Writing
Chronic pain often starts after poorly healed trauma, failed surgery, or because of certain advanced diseases. When no other treatments can be offered to provide relief, medications may be necessary, alone or in conjunction with other interventions. Each patient’s case will be reviewed and appropriate treatment with Belbuca or opiates initiated for those that meet the criteria.
Belbuca is newly FDA approved Buprenorphine based medication for the treatment of chronic pain that was found to be effective in most conditions that require opiates. The advantages are lower side effect profile and diversion potential. You will need to be weaned off opiates to be switched to Belbuca and we offer an external device to help with withdrawal symptoms during the transition.
Opiates. Long-acting formulations could be prescribed to most compliant patients that meet criteria for chronic pain management and within the current daily limit of 90 MME or less. For patients who are currently on high daily dose opiate taper and usage of adjunct interventions will be offered as an alternative to switching to Belbuca.
Chiropractic is a healthcare concept that holds that the structure of the body, particularly the spine, affects the function of every part of the body. Chiropractors try to correct the body’s alignment to relieve pain and improve function and to help the body heal itself.
While the mainstay of chiropractic is spinal manipulation, chiropractic care now includes a wide variety of other treatments, including manual or manipulative therapies, postural and exercise education, ergonomic training (how to walk, sit, and stand to limit back strain), nutritional consultation, and even ultrasound and laser therapies. In addition, chiropractors today often work in conjunction with primary care doctors, pain experts, and surgeons to treat patients with pain.
Most research on chiropractic has focused on spinal manipulation for back pain. Chiropractic treatment for many other problems—including other musculoskeletal pain, headaches, asthma, carpal tunnel syndrome, and fibromyalgia—has also been studied. A recent review concluded that chiropractic spinal manipulation may be helpful for back pain, migraine, neck pain, and whiplash.
The body can be amazing in healing itself. But sometimes with generalized inflammation as in chronic conditions, efficiencies break down. To accelerate recovery, sympathetic stimulation achieved through cold shock induced stress can reset the system while producing excess amounts of very functional and productive hormones and proteins to do the job. The healing effect is multiplied when the body’s circulation is at a highly productive level with full transport and delivery to all extremities.
Cryotherapy triggers two very prominent systemic responses. “Cold Shock” (dropping the skin temperature on a whole-body scale, and primarily around the core, sends distress signals to the brain. This results in the following:
First, the Hypothalamus directs the endocrine system to release endorphins in vast amounts quickly. Additionally, shock protein (norepinephrine) is released in the brain (said to be twice the average producing levels). Norepinephrine acts as a powerful anti-inflammatory protein which inhibits TNFa production (an inflammatory cytokine produced by the immune system in response to injury, foreign bodies, chronic inflammation conditions and such). Endorphins are the feel-good hormones, responsible for elevating mood, and in this case, blocking pain reception signals. This Central Nervous System response we get with whole body cryotherapy allows patients to experience improved range of motion with pain reduction almost immediately.
Additionally, the brain senses rapid heat transfer (hypothermic simulation) due to extreme skin temperature change, thus creating a parasympathetic (Autonomic Nervous System) reaction with circulation. Blood draws from the extremities to the core to protect from heat transfer. This occurs within 30-seconds to one minute of exposure. Blood pooled to the core oxygenates and is enriched with nutrients. Upon exit of the chamber, as the skin temperature rapidly rewarms, the brain releases the blood supply back to the extremities with a vasodilation estimated to be 3:1. This process flushes areas of injury of toxic waste and bad cells replenishing with good blood to stimulate cellular regeneration. This is the systemic circulation benefit dealing with underlying condition (Regen). It should not be thought of as comparable to ice-cold water immersion because ironically, over the short duration exposure, there is little change in core temp. It does not have a gradual metabolic effect, it has a rapid thermogenic and peripheral effect with the added chemical release mentioned above.
T.E.N.S. are used by hundreds of thousands of people all over the world for the relief of physical pain. TENS stands for (Transcutaneous Electrical Nerve Stimulation). which are predominately used for nerve related pain conditions (acute and chronic conditions). TENS machines work by sending stimulating pulses across the surface of the skin and along the nerve strands.
The stimulating pulses help prevent pain signals from reaching the brain. Tens also help stimulate your body to produce higher levels of its own natural painkillers, called “Endorphins”.
Tens units have different adjustable settings to control amplitude (intensity) of stimulation by controlling the voltage. Current, and pulse width (duration) of each pulse. Electrodes are placed at specific sites on a user’s body depending on the physical location of their pain. The current travels through electrodes and into the skin stimulating specific nerve pathways to produce a tingling or massaging sensation that reduces the perception of pain. When a Tens Unit is used as directed a T.E.N.S. is a safe, noninvasive, drug-free method for pain management. A Tens Unit is used to offer a better quality of life for people with pain. There are two ways to explain how a T.E.N.S. successfully decreases or eliminates pain.
One of these theories is called The Gate Control Theory and is the most advanced explanation. The gate-control theory suggests that there’s a neural mechanism in spinal cord that acts as a kind of gate, shutting down or opening the flow of signals from the periphery to the brain. Whether the gate is open, closed or partially closed depends on what sort of signal it receives from the brain to change the perception of pain in the user’s body. These frequencies interfere with the transmission of pain messages at the so spinal cord level and help block their transmission to the brain.
Another theory is called The Endorphin Release, which suggests that electrical impulses stimulate the production of endorphins and enkephalins in the body. These natural morphine-like substances block pain messages from reaching the brain, in a similar fashion to conventional drug therapy, but without the danger of dependence of other side effects.
Shoulder, Hip and Knee Injections help relieve pain caused by inflammation and can hence, improve joint movement. They may be very useful to allow you to engage in physical therapy sooner and to further extend and therefore speed your recovery. Blossom Pain Management will offer steroid and topical anesthetic injections to selected patients.
Ketamine infusion is safe and can be provided on an outpatient basis. It helps manage pain symptoms from complex regional pain syndrome (CRPS) and some other pain disorders. Many patients affected by neuropathic pain do not experience the desired benefits from opioid use, and can develop physical dependency or addiction. CRPS produces a burning pain that can worsen over time. It becomes a central nervous system disorder that can affect the entire body.
Ketamine infusion therapy works to treat CRPS by addressing the transmission and perception of pain in the nervous system. Ketamine is a NMDA receptor antagonist which can interact with receptors involved with pain transmission and central sensitization. The medication has analgesic properties that also affect the production of nitric oxide, which is also involved in pain perception. Most patients achieve 3 months of pain relief after completing a full series of infusions. The number of ketamine infusions required depends on the type of problem the patient is experiencing. We observe responses with the trial infusions. Up to ten infusions are recommended depending on response to trial infusions.
It is established that one-third of patients with depression do not respond to medication treatment. Patients managing depression and have not benefitted from traditional treatments have an alternative solution with ketamine. Depression is a state of mind that can place difficulties on the affected patient. Their symptoms can include feelings of fatigue, agitation, and difficulties with concentration.
Ketamine has become popular for treating depression. It is used in numerous emergency clinics and hospitals for treating depressed patients considering thoughts of suicide. The drug works by blocking brain receptors known as N-methyl-D-aspartate (NMDA). The rapid effects and improvements in depression make them favored by patients with suicidal tendencies.
Some patients can experience significant improvements that result in them no longer being classified as depressed. The dramatic turnaround in well-being patients experience has led to additional adoptions of ketamine at clinics and hospitals.
Ketamine does have side effects that may be undesirable for patients. It can interrupt blood supply to the brain and reduce concentration. Some pharmaceutical companies are developing variants of the ketamine drug that maintains its antidepressant effects but removes its symptoms and side effects.
Is known to be unresponsive to opioid medications. Those suffering from neuropathic pain have limited options for treatment. Neuropathic pain can include damage to nerve fibers or tissues, characterized as a burning sensation. There is no definite overall cause for neuropathic pain, but it is associated with several conditions such as chemotherapy, diabetes, and shingles. Some success has been observed with non-steroidal anti-inflammatory drugs such as ibuprofen, but some conditions may be too severe to respond to even these medications.
Recent research has shown that ketamine can help alleviate the pain caused by neuropathic conditions. But this is also a popular recreational hallucinogenic drug, which means its use has some risks. Ketamine is generally administered as a topical gel. The anesthetic dulls the nervous response and nerves associated with pain.
The effects of ketamine can include hallucinations and psychotic episodes, it is a low-safety option for treating ongoing pain management. Ketamine infusions have increased in availability for patients experiencing chronic pain. The drug is administered in a monitored setting. Additional boosters are required after the initial dose to ensure the medication provides the complete effect.
Acute Pain Management
For acute management, ketamine should be administered in lower doses to improve the quality of pain relief. Smaller doses will also reduce the amount of opioid required and decrease side effects such as nausea and vomiting.
All part of Multidisciplinary Evaluation (MDE)that involves a comprehensive assessment of the patient’s injury by a trained Nutritionist, psychologist, and physical therapist. A treatment recommendation is developed after current physical, functional, and psychological barriers to rehabilitation reviewed.
Functional restoration programs are interdisciplinary, outpatient pain management programs for patients experiencing sub-acute or persistent pain. They include coordinated treatment with a pain physician, psychologist, and physical therapist. The programs are coordinated to meet individual patient needs. Functional restoration describes the process by which a patient acquires the knowledge to enhance their quality of life and restore optimal function.
Proper nutrition can be a powerful tool in relieving one’s pain, specifically if caused by chronic inflammatory condition. Evaluation of and adjustment of one’s diet and eating habits, addition of supplements and micronutrients can have a noticeable impact on quality of life in a chronic pain sufferer. Lifestyle coaching will focus on developing strategies to discourage behaviors that result in pain and adopting ones that will foster recovery.
No matter the cause of chronic pain, it impacts on one’s quality of life and often becomes a psychological burden of a long-term adjustment to now new limitations in quality of life. This may lead to depression, anxiety and other maladaptive behaviors that impact recovery or diminish its success. Hence, reliance on the drugs only as a quick fix for the problem along with using other substances to mask or avoid facing the issue, leads to the evolution of wrong and often unhealthy coping mechanisms, that ultimately worsen the condition. These circumstances make patients deal with symptoms that cannot be resolved or bettered with high-quality medical care or pharmacotherapy only. Psychotherapy is a different approach that can be successful in helping patients manage pain. It is designed to help patients adjust and overcome living a life with pain by addressing the mental component of the condition, ultimately improving one’s quality of life.
Therefore, at Blossom, we recommend it to all patients dealing with chronic pain.
Key features of psychotherapy for managing pain include:
- Developing behaviors that limit the effects of pain in daily life
- Reducing anxiety and raising the mood of the patient
- Establishing better control of the patient’s body
Psychotherapy goal is to reduce the need to use drugs and to rely solely on the medication only, achieved by regular interaction with a mental health professional. The patient develops techniques to change unhealthy behaviors or emotions and improve their physical and mental well-being.
Blossom Pain management provides group or individual therapy sessions focused on your individual needs and goals.