The Real Pain Doc (2026)

29/09/2020

SI joint pain is a common diagnosis that many of you may have been given yourself.⁣⁣
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After treating sacroiliac pain for years, the reason for pain seems to me more mechanical than due to inflammation. ⁣⁣
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Steroid injections may help but the majority do not last for more than six months.⁣⁣
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The SI Fix system is a long-term treatment for sacroiliac pain that avoids a large surgery.⁣⁣
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This is the first step where the pin and dilators are placed. This safety check shows that the instrumentation is aligned and within the joint.

29/09/2020

Let’s go Bolts! Bring home a championship to Tampa Bay. Although triple overtime is exciting, some of us have work tomorrow haha. Wrap it up earlier lol ⁣
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27/08/2020

Quality of life is everyone’s goal. Especially those who suffer from chronic pain.⁣
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Interventional pain management provides a non-surgical option to treat the source of the pain.⁣
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Pain management components⁣
1 Correct diagnosis⁣
2 Directed nonsurgical treatments ⁣
3 Strengthening and maintenance ⁣
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This is a broad overview of managing chronic pain. Many patients by the time they have seen a pain physician have seen multiple other doctors beforehand.⁣
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A thorough physical exam and history allow to get the diagnosis correct. It can be challenging to differentiate as many anatomical structures are close together. This is where the expertise of musculoskeletal medicine and pain come into play.⁣
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Once you start to feel better to focus then changes to strengthening. Strengthening the muscles around a joint such as low back allow the body to protect it by absorbing most of the stress.⁣
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Yes this is a simplistic version but healing takes persistence in time. Patients can be in pain for years and it may take a while to reverse this process.⁣
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The goal is to get better day by day and improve your quality of life and function.

26/08/2020

Being safe when seeing the doctor is a top priority.⁣
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All of our staff wears a mask at all times. Patients are also asked to wear one within the office. ⁣
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At our office we sanitize high touch areas including clipboards, door k***s and pens for safety. ⁣
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We also continue to social distance in our lobby by spacing furniture out.⁣
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If the waiting room begins to get crowded we politely ask patients to wait in their car until there’s enough room to social distance.⁣
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All of these safety policies and procedures are also done at our surgery center. This allows for nonsurgical treatments to be completed in the safest possible way.⁣
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As we see our patient numbers rising, we will continue to do all that we can to make your safety our priority.

06/08/2020

Genicular is the medical term referring to the knee.⁣
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There are Three Genicular nerves. Two on the femur and one on the medial aspect of the tibia. ⁣
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These nerves have been found to be sensory fibers without motor function. Meaning that they are responsible for a pain in the knee but not for movement of the joint.⁣
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There is one diagnostic injection required. I use 3 mL of 0.5% Marcaine, a stronger numbing medication as it is a larger nerve. ⁣
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If it takes away greater than 50% of the pain then we can move forward to the radiofrequency (RFA) which is the medical term for applying heat next to the nerve.⁣
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This does not “burn” the nerve but rather makes it non-functional as it affects the proteins within the nerve. If the bridge between a painful knee and the brain is disrupted then the pain is significantly improved without changing the anatomy.⁣
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This procedure is a great option for those with medical issues that make it unsafe to undergo surgery. It can also be done in those who still have pain after a total knee replacement.⁣
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Reach out with any questions

30/07/2020

The radiofrequency is a non-surgical long-term treatment for back arthritis.⁣
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The facet joints are the small joints in the back that are aggravated over time with where in tear I can be inflamed after a trauma. The details of this have been outlined in a previous post.⁣
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The target is the medial branch which is the nerve that transmits pain from the facet joint. ⁣
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Most of the procedure is getting these probes in place. The radio frequency is using electricity to heat the tip of the probe to 90°C for 90 seconds. This makes the pain nerve non-functional and destroys the bridge between Back arthritis and the brain. ⁣
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The benefits to this procedure can last for a minimum of six months and can be as long as a couple years.⁣
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On average, patients with this issue have the procedure repeated at least once per year. It allows for improvement in pain as well as decrease in pain medication use.⁣
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Benefits ⁣
1 Non-Surgical⁣
2 Quick procedure. About 15 minutes ⁣
3 improvement in function ⁣
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Share with someone who has back pain @ Downtown St. Petersburg

28/07/2020

Beer bellies can be strong and abs can be weak.⁣
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Like Arnold said keep your mind on your muscles.⁣
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When it comes to low back pain, a strong core is important to take pressure off of the spine.⁣
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A strong core can also take out an excessive curve in the low back to improve our posture.⁣
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Examples of exercises⁣
-Planks⁣
-Yoga⁣
-Pilates⁣
-Kettle bells⁣
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Actually many exercises can become a core workout if you keep your mind on flexing your core and keeping stable in mind.⁣
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Other examples can include squatting while keeping your core tight as well as one legged balance exercises while keeping a strong core.

27/07/2020

Are epidurals what pregnant women get?⁣
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This is a common question I hear on a daily basis.⁣
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“Epidural” Refers to the SPACE around the spinal cord, disc and spinal nerves. ⁣
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The medicine being placed in this Epidural space can differ based on the diagnosis and treatment.⁣
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The most common substance injected is liquid steroid to decrease inflammation and pain after a herniated disc/pinched nerve. ⁣
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During pregnancy, an epidural is performed and many times a catheter is left behind. During childbirth, anesthesia medication is slowly infused through the catheter over hours to decrease pain from the waist down. ⁣
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However, in a pain procedure the total time is usually less than 10 minutes. Also the volume is significantly less, averaging about 5 mL of fluid.⁣
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Epidural injections with steroid are a common procedure and can quickly decrease severe pain and improve your quality of life and function.⁣
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If you are having tingling, numbness and burning down the legs reach out with questions or concerns.

22/07/2020

Do you or someone you know have tingling, burning and weakness in their hands?⁣
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This can come from either a pinched nerve in the neck or from carpal tunnel syndrome ( CTS). ⁣
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A pinched nerve in the neck can cause nerve pain into the elbow or hand. Depending on which nerve is being pressed on the presentation can differ.⁣
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Symptoms of a pinched nerve ⁣
1 neck pain ⁣
2 tingling into the arm going below the elbow ⁣
3 improvement in symptoms with holding your arm above your head⁣
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Carpal tunnel syndrome occurs when the canal where the median nerve runs through becomes narrow. The median nerve is responsible for both sensory and motor function of the thumb, pointer finger, middle finger and half of the ring finger.⁣
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Symptoms of CTS⁣
1 tingling, Numbness and burning in the hands. This is usually bilateral⁣
2 weakness especially with grip using the thumb and pointer finger⁣
3 waking up with tingling and numbness in both hands⁣
4 Improvement in symptoms when you shake your hands out ⁣
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And MRI of the neck and and electromyography (EMG) can provide all the information needed to make the right diagnosis.⁣
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Possible treatments?⁣
1 epidural injection in the neck⁣
2 steroid injection directly into the carpal tunnel⁣
3 possible surgery to open up the carpal tunnel to decrease median nerve compression⁣
4 physical therapy and medication management⁣
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DM for questions. ⁣
Share with someone who may benefit.

21/07/2020

Staying safe during this time is still the most important thing!⁣
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It is important to still say 6 feet away when in public and to wear your mask especially in closed spaces. ⁣
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I know it is hard to breathe in your own air and is definitely uncomfortable.⁣
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Wearing a mask is mostly to prevent transmission to those that are at risk like our older family members and members of our community. ⁣
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Stay safe!

20/07/2020

Elbow pain after reeling in the catch of the day?⁣
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Pain on the outside of the elbow is commonly called “tennis elbow” no matter what activity caused the pain to begin with.⁣
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The downward force is of a fishing pole cause us to contract the wrist extensor muscles to keep the rod steady. ⁣
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If you were lucky enough to have a big day fishing then this could cause some inflammation of the wrist extensor tendon‘s a.k.a. tennis elbow.⁣
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Best initial treatment when you are feeling it on Monday is ice and anti-inflammatories.⁣
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Most acute pain, meaning less than three weeks, goes away about 95% of the time with or without treatment.⁣
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If your symptoms last more than three weeks it would be appropriate to be assessed by your doctor.⁣
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Many times it is time efficient to go straight to the pain doctor to get your treatment faster and get back to what you love doing. ⁣
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We offer conservative as well as non-surgical treatments to help most aches and pains from head to toe.⁣
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Google “eccentric exercises” for the elbow to see video that can help you treat your elbow pain at home.⁣
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Comment or DM for questions⁣

17/07/2020

Chronic pain affects our Mind and Body. ⁣
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Our mindset can help to set the stage for how we get through those obstacles.

The Real Pain Doc

29/09/2020

29/09/2020

27/08/2020

26/08/2020

06/08/2020

30/07/2020

28/07/2020

27/07/2020

22/07/2020

21/07/2020

20/07/2020

17/07/2020

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