Chronic neck pain, or cervical pain, can occur for a number of reasons—whiplash after an auto accident, arthritis, degeneration as people age, traumatic injuries, etc.  Severe neck pain can be disabling and can affect daily routines. 
The specialists at Nexus Paincare help our patients to understand exactly what type of pain they’re dealing with.  We create individual treatment plans for each patient that may include any of the following: diagnostic testing, treatment procedures, chiropractics, physical therapy, massage therapy, etc.
We believe that a multi-disciplinary approach is the most effective method of helping our patients recover from neck pain.   

Back pain is one of the leading reasons that people visit the doctor.  In fact, according to the American Pain Foundation, 70-85 percent of Americans will suffer from back pain at some point in their lives.

When is back pain serious enough to do something about it?  Many people put off going to the doctor until occasional back pain becomes part of daily life.  For those who randomly suffer from back pain, there are many self-help treatments that can help.

Exercise is one of the best ways to treat occasional back pain.  A light, aerobic activity, such as walking, can stimulate the release of endorphins.  Endorphins are a natural pain reliever as well as a natural stress reliever.  Exercise can also strengthen weak muscles that may be the cause of back pain.  Exercise may be a cure-all for those who have occasional back pain.

When exercise alone isn’t enough, over-the-counter medications such as aspirin and anti-inflammatory agents are acceptable for treating minimal back pain.  However, long-term usage, especially of large doses, can result in liver or kidney damage.

At some point, when exercise and aspirin have not helped and the pain is still persisting, many back pain sufferers have turned to massage therapy, physical therapy or chiropractics to find an answer.  These types of therapy can reduce pain and increase function.  This is an important part in the early treatment of back pain.

Oftentimes, however, these therapies are still not enough to help with chronic back pain.  When pain limits activities and modifies behavior, it is time to take a more aggressive treatment approach.  Pain that either lasts for more than six consecutive weeks, or is severe enough to limit daily functions early on, needs to be addressed by a medical doctor.

The idea that surgery is the only way to completely relieve back pain has become a social norm.  But what the general public does not know is that there are many less-invasive options to help most patients with back pain.

Family practice doctors are a good place to start.  They can order tests and help to evaluate exactly how serious the problem is.  A general practitioner, such as a family practice doctor, treats basic ailments.  But serious back pain requires a specialist.  General practitioners can direct referrals to specialists who can then offer additional options to patient who suffer from back pain.
               
The next step after the family practice doctor is to see a pain specialist.  Pain management doctors treat acute and chronic pain as well as musculoskeletal disorders.  They treat a wide range of problems from sore shoulders to spinal cord injuries. 

A pain management doctor is the first place to turn for people with back pain.  They are able to treat back pain with minimally invasive procedures that can often prevent spinal surgery.  Because this specialty is fairly new to the medical community, many people are not aware of the treatment options that are available.  Many doctors don’t even know all of the treatments available by pain physicians.

A female patient was in a car accident several years ago, which resulted in a few herniated discs.  She was told by her doctor that she’d have to have surgery.  She had heard of so many other people that had undergone surgery and still did not feel relief from the pain.  This option just didn’t give her enough promise of improvement and she opted not to have surgery. 

For years, she lived with the pain.  Besides surgery and narcotic drugs, she thought her only option was to live in pain.  Three years ago she heard about a Provo clinic called Nexus Paincare.  She decided she had nothing to lose by scheduling an appointment to see what they could do for her.

Nexus Paincare is a unique, multi-disciplinary practice that believes no one should have to live with pain.  The medical staff at Nexus Paincare includes five medical doctors who specialize in treating chronic headache, neck and back pain.  They believe in using a variety of treatment options for their patients.  The comprehensive team also includes two physician assistants, a nurse practitioner, two psychologists, a physical therapist, a chiropractor, a medical massage therapist, and several medical assistants.

It is through a combination of all these specialties that Nexus can accurately diagnose the problem, create an appropriate treatment plan and help the patient return to a functional life again.

The patient received state-of-the-art radiofrequency lesioning treatments.  This advanced technology uses high frequency electrical current to target the pain generating nerve.  The fibers in the nerve that cause pain are de-activated and the pain is stopped at its source.  Radiofrequency lesioning treatments can effectively stop pain for 12-18 months or longer.

Dr. Richard Rosenthal of Nexus Paincare, said “Many conditions can be treated by simply targeting the painful nerve and treating it with our radiofrequceny procedures.  Thanks to these medical advances, we can offer effective treatments without the risk and recovery time of surgery.”

Radio frequency treatments can reduce the pain enough that patients can then more effectively participate in physical therapy.  This provides the patient with more long-term improvement.

The patient suffered back pain for many years before she learned that there was another option.  She is not alone.  Many general practitioners are not aware that treatments such as radiofrequency lesioning are available.  Pain management specialists can help eliminate pain, resulting in less need for narcotic drugs and surgery.

“My pain is now manageable,” said the patient.  “I am capable of doing the same things much more comfortably because of the persistence and dedication of the doctors at Nexus.” 

After six weeks of exercise, over-the-counter medications, chiropractics and massages, continuous back pain needs to be addressed by a trained medical doctor.  The specialty of pain management is becoming better-known, but it is still widely overlooked by many referring primary care physicians because the advances and technology are so new. 

A disease of the nerves, peripheral neuropathy mainly affect s the feet and legs.  Patients often describe neuropathy pain as tingling, burning, or electric shock-type pain.  While many physicians simply treat neuropathy with opiate medications, our physicians try to find the source of the pain—and are often able to effectively stop the pain at its source. 
Neuropathic pain is caused for a number of reasons—a result of cancer pain, a lingering effect of shingles, diabetes, traumatic injuries, etc.

RSD (or reflex sympathetic dystrophy), often called Complex Regional Pain Syndrome, is a painful, chronic condition that can affect skin, muscles, joints, and bones.  This syndrome is usually on-set after a traumatic physiological incident, such as a broken bone, a sprain, or surgery.  Sometimes the initial cause of RSD is unknown.

Shingles is a sudden outbreak of a painful rash caused by the re-activation of the chickenpox virus.  Most people are exposed to chicken pox during childhood.  Unfortunately, the virus that causes chicken pox (herpes zoster virus) can stay in the body in a dormant state, waiting for any weakening of the immune system to become active again.  This can occur after any physical or emotional stress.  When the virus comes out of dormancy, it causes an outbreak that is different than chickenpox.  The reactivated virus travels through a nerve to cause a burning, painful skin rash.  The symptoms of shingles are more severe than those of chickenpox.  Prior to the development of the rash, the patient notices an itching, burning sensation in the skin of the affected area.  A red, irritated rash follows this—usually only on one side of the body.  Seventy-five percent of shingles cases affect the chest, head, or neck. 

The rash usually resolves within two to four weeks, but the pain can continue to occur for the remainder of the victim’s life.   If the pain continues once the rash has resolved the person is suffering from post herpetic neuralgia.  It is said to be the second most painful condition known to man, second only to tic douloureux (trigeminal neuralgia).  Few people under the age of fifty will develop this devastating complication, however, the incidence increases with each decade of life over the age of fifty.

The usual treatment for post herpetic neuralgia involves medication to kill the virus and treat the pain.  A recent study1 (*Prevention of Post herpetic Neuralgia, 2000), however, looked at the results of medication treatment and compared them to treating the patient with local anesthetics (numbing medicine) administered right onto the painful nerve. 

Specifically, the study observed six hundred adults over the age of fifty-five who had experienced a rash for less than seven days in duration.  Half of the group received intravenous anti-viral medication and oral steroids.  The other half received administration of local anesthetics directly onto the painful nerve.  The results at one year showed that only 1.6% of the patients in the group receiving treatment with local anesthetics had continued pain.  22.2% of the group treated with IV anti-viral medication and steroids were still in pain at one year. 

This dramatic difference in results suggests that every patient with the painful shingles disease should be treated with the local anesthetic option.  However, there are only a few physicians in the state of Utah with the proper training to administer this treatment.  They are usually listed in the telephone book under pain management physicians.  Nexus Paincare is one of the few offices with four physicians capable of providing this service.  It is recommend that  treatment for shingles be implemented as early as possible in patients at risk for developing post herpetic neuralgia.

The physicians at Nexus Paincare can help those suffering from shingles.  Our specialized professional team is committed to finding the source of pain, providing effective treatment and helping patients on the road to recovery.

1. A. Pasqualucci et al, “Prevention of post-herpetic neuralgia: acyclovir and prednisolone versus epidural local anesthetic and methylprednisolone”, Acta Anesthesiologica Scandinavica 2000, 44: 910-198

Also known as degenerative arthritis, osteoarthritis is caused by the breakdown and eventual loss of cartilage.  Cartilage is the soft tissue that acts as a cushion in joints.  When cartilage wears away, the joint is often left with bone rubbing directly on bone.  Osteoarthritis is the most common of all the types of arthritis— affecting millions of Americans.  It is most commonly caused by the natural aging process.

Using state-of-the-art treatments, our physicians are able to help many patients find relief from the pain associated with osteoarthritis.