1. Board Certified or Fellowship Trained Doctors
SI joint area pain may or may not be actually coming from the SI joint. It may be strictly situated in this area (the buttock) or it may radiate down the leg somewhat. It may be confused with myofascial type pain in the paraspinal muscles, piriformis, or gluteal muscles. Other patient problems that can mimic SI joint pain include intervertebral discs that have tears in the outer portion (annulus), or potentially arthritic and painful facet joints that have pain that radiates into the buttock region.
Options for spinal pain include traditional medications like over the counter analgesics or opioids, and also in between medications that are different from the traditional on-label medications. One of those medications includes gabapentin, which works well for neuropathic pain. Initially it was designed for epilepsy, but it is often used off-label for pain. Some antidepressants are often used for neuropathic pain issues.
Narcotics are the most popular method for treating chronic pain. In the decade 1997 to 2006, there was a narcotic usage percent increase of 347 percent in the US (Dartmouth Medicine Magazine). This has lead pain management doctors to begin asking the question “Is such a huge use of narcotics effective?” Narcotics are an easy option for doctors, but a better treatment option for increasing function is mixing in holistic treatments. One may not be able to eliminate pain, but the more important overall outcome is to improve function.
In a state that legalizes medical marijuana, is it considered a medication? Not really since the FDA approves medications for a specific indication. Natural marijuana does not have an approved indication by the FDA and is classified by the DEA as a schedule 1 narcotic. So even while being legal in 15 states, it remains federally illegal and cannot be prescribed and considered a true medication according to an FDA definition.
Patients dealing with neuropathic pain have a rough time with their pain. The reason is there is no surgical answer to the problem since “neuropathic” pain comes from a problem that is intrinsic to the nerve (inside it). If the problem was coming from something pinching on the nerve, then it may have a surgical answer such as just removing the offending agent.
As of 2011, pain management has entered into a completely new level of social and monetary awareness. A recent study from NIH shows that the total cost of care in the US is over $500 billion for pain and over 100 million Americans suffer from chronic pain of some type.
TENS are small machines, battery powered, that deliver electrical current by way of surface electrodes to the skin. These machines are safe, noninvasive, and inexpensive (usually less than $100).
Let’s begin with an interesting proposal. Say you had half a billion dollars and had 2 choices: 1) Buy a pro sports team or 2) Pay for a drug to get through FDA approval fully and then own that drug’s rights – which would you go for? The typical person doesn’t understand that these two proposals cost the same.
Low energy lasers came into existence in the 1960’s in Europe and Russia. the clinical effects are not from heating up of tissues but come from the low intensities of irradiation.