Posted by admin on June 30, 2010 under Pain Treatment | 
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As a pain management specialist, Scott Glaser, MD, works to help patients with chronic pain restore quality of life, increase function and regain wholeness. He has worked with his Pain Specialists of Greater Chicago co-founder Ira Goodman, MD, for over a decade, treating syndromes ranging from common lower back pain to the severe pain associated with nerve damage. The doctors use various minimally invasive techniques to manage pain, including small joint injections, nerve blocks and medication infusion pumps.
Dr. Glaser graduated from the University of Notre Dame and Indiana University School of Medicine and completed his anesthesia residency and fellowship at Northwestern University in Chicago. He has worked as a pain management specialist in the private practice setting since 1990 and was named to the Becker’s ASC Review list of notable ASC physicians in 2009.
Through his work in pain management, Dr. Glaser has become invested in the struggle against controlled substance misuse. He lobbied to ensure passage of the NASPER bill, which aims to protect patients and physicians from substance misuse by setting up prescription monitoring programs. The bill was signed into law in 2005, and Dr. Glaser continues to work to implement a prescription monitoring program in Illinois. He also speaks to physician groups and other health providers about the risks of controlled substance abuse.
In 2008, Dr. Glaser was elected by his fellow specialists to serve as a director on the national board of the American Society of Interventional Pain Physicians. He also became a diplomat of the American Board of Interventional Pain Physicians —acknowledged to be the highest level of credentialing in his field — the first year it was offered.
Dr. Glaser is an instructor for the American Society of Interventional Pain Physicians, a society that provides training for interventional pain management specialists and promotes excellence in the field of pain management. He teaches other physicians minimally invasive procedures and lectures on continuing medical education at ASIPP meetings.
Posted by admin on June 29, 2010 under Pain Treatment |
ASIPP WebMD
Your back is throbbing and has been for weeks. You can barely move from your bed, but you are not getting any sleep because of the intense pain.
This is a pretty common scenario, explains David Neumeyer, MD, the associate director of the Sleep Disorder Center at the Lahey Clinic Medical Center in Burlington, Mass.
“Pain and sleep are integrally connected,” he says. “Chronic pain is very common in the population and even more common in people who have poor sleep, and it sort of becomes a vicious cycle.” Pain affects your ability to sleep, and the lack of sleep makes the pain seem worse.
The Link Between Pain and Sleep Problems
Exactly how the two conditions are connected varies from person to person. “You have to determine what is the chicken and what is the egg,” he says. “Is pain a manifestation of, or made worse by, a sleep disorder or is pain causing the poor quality of sleep?”
Charles Bae, MD, a neurologist in the Sleep Disorders Center at the Cleveland Clinic in Ohio, puts it this way: “Pain can be the main reason that someone wakes up multiple times a night, and this results in a decrease in sleep quantity and quality, and on the flip side, sleep deprivation can lower your pain threshold and pain tolerance and make existing pain feel worse.”
“If you have arthritis and roll or turn while you are sleeping, pain can wake you up,” says David S Kloth, MD, the founder, medical director, and president of Connecticut Pain Care in Danbury, and a past president of the American Society of Intervention Pain Physicians.
The first step is to figure out if the lack of sleep is causing pain or if the pain is causing a lack of sleep, and then you treat whichever came first, he says.
The Pain-Reducing Benefits of Better Sleep
Pain may not be the only problem interfering with your sleep. Some people may also have an underlying sleep disorder, such as sleep apnea. Neumeyer recommends an evaluation by a sleep specialist to be sure there is not underlying sleep disorder.
Once you’re correctly diagnosed, sleep experts say good treatment can significantly help those living with chronic pain.
Getting better quality sleep — and more of it — may improve your pain threshold so you will ache less, says Neumeyer.
“People in pain don’t sleep, and people who sleep have less pain,” agrees Michael Breus, PhD, author of Beauty Sleep and the clinical director of the sleep division for Arrowhead Health in Glendale, Ariz.
Treating Pain-Related Sleep Problems
Improving sleep in people with chronic pain such as low back pain, arthritis, fibromyalgia, and diabetic nerve pain is difficult because these individuals often don’t want to take any more drugs, says Breus.
These individuals are often already taking several medications to treat their pain disorder. What’s more, certain prescription sleeping pills may interact with their pain medications, so they couldn’t take them even if they wanted to, says Breus.
In essence, Breus becomes the Sherlock Holmes of sleep problems. He looks at each individual’s sleep habits and bedroom environment. “I have to investigate how old their mattress and pillows are, and make sure they are offer proper support,” he says. He asks about their diet and habits. Do they avoid beverages with caffeine after 2 p.m.? Do they exercise regularly? Do they use the bedroom only for sleep and sex? All these things may also help people in pain get their ZZZs.
The bottom line, according to Cleveland Clinic’s Bae, is “if you have chronic pain and trouble sleeping, bring it up to your doctor to see if anything can be done to help your sleep while getting your pain treated.”
Posted by admin on June 13, 2010 under Back Pain, Pain Treatment |
Common, but Treatable
If the mere thought of running out of ibuprofen sends you into a panic, you’re far from alone. One in four Americans—the majority of them women—get sidelined by an achy back, neck, head or joints. In a 2006 government survey, more than half of them reported their agony lasted three months or longer.
Chronic pain can affect our relationships and our job performance. But experts say there is no reason to wince through your days needlessly. “There are options available,” says Scott Glaser, M.D. of the American Society of Interventional Pain Physicians. “We are now able to find the source of the pain, treat it and control it, and give individuals back their quality of life.” Find out how to treat the most common pain complaints.
Back Pain
There are two main causes. The sponge-like discs and joints between spinal vertebrae become injured or degenerated with daily wear and tear. Or the spinal nerves become compressed and inflamed from injury or conditions like arthritis. Dr. Glaser says “ice and heat applications are time-honored therapies” for chronic pain.
Other options include chiropractic treatments, physical therapy, massage and biofeedback. Jacob Teitelbaum, M.D., author of Pain Free 1-2-3, recommends boswellia, willow bark and curcumin-based supplements, which have anti-inflammatory properties. If those methods don’t work, a pain specialist may suggest patches that deliver painkillers directly to area or medication injected into the joints between the vertebrae or the nerves. Heat treatments or electrical stimulation can also help. Back surgery should be a last resort because of long-term risks and the possibility of creating more pain.
Chronic Headaches
Everyone gets a headache now and then, but 15 percent of Americans get severe headaches, and they occur twice as often in women than men. Migraine, cluster and tension headaches are the three most common types, and they can be triggered by anxiety, stress or hormonal changes.
If you suffer from migraines, over-the-counter remedies such as Excedrin Migraine can help, says Dr. Teitelbaum, and daily doses of magnesium and vitamins B6 and B2 may help prevent them. Stronger drugs to treat migraine pain and relieve tension and cluster headaches are available by prescription. Inhaling pure oxygen, available in small canisters by prescription, can also relieve cluster headaches. And antidepressants can help prevent tension headaches.
A Sore Neck
The same factors that cause back pain contribute to neck pain—bulging spinal discs touch nerve endings, and suddenly shaking your head is next to impossible. Worse, upper neck pain can also trigger headaches, Dr. Glaser says. “The spine is simply a series of bones sitting on top of each other protecting the spinal cord and nerves,” Dr. Glaser says, “Every joint where these bones touch is capable of being a source of pain.”
If neck pain is associated with headache, chiropractic care can help release the muscles that cause most tension headaches. Medications used to treat the headache can also offer relief. As with lower back pain, minimally invasive procedures to deaden nerve endings or deliver medications are an option.
Facial Pain
Facial pain has many causes, from a toothache to more serious conditions like trigeminal neuralgia, when inflamed nerves cause shooting, stabbing pain in the face.
For simple tooth pain, over-the-counter pain killers can help until you can see your dentist. If the problem is in your jaw’s temporomandibular joint (TMJ), you can use ice packs and a bite guard at night that helps position the jaw correctly, relieving chronic pain. For trigeminal neuralgia, anticonvulsants and muscle relaxants are typically prescribed. In extreme cases, surgery to damage the nerve so it stops delivering pain messages may help, but often results in some facial numbness.
Fibromyalgia
People with fibromyalgia (mostly women) suffer fatigue, stiffness, joint tenderness, muscle pain and so-called “fibro fog” or memory problems. No one knows for sure what causes fibromyalgia, but some theories include traumatic events and repetitive injuries, as well as genetic factors.
Over-the-counter painkillers can help, as can antidepressants and drugs used to treat restless legs syndrome. Dr. Teitelbaum, who had fibromyalgia himself, recommends getting at least eight hours of sleep nightly; hormonal support to regulate thyroid, adrenal and reproductive hormones; treating infections, including anti-fungal treatments for infections such as Candida; proper nutrition and exercise.
Arthritis
The cartilage between joints erodes over time, causing pain that is the hallmark symptom of arthritis. There are two main forms of arthritis: Osteoarthritis, caused by aging and repetitive injury, and rheumatoid arthritis, an autoimmune condition that causes the body to attack its own healthy joints.
There’s no cure for arthritis, but anti-inflammatory painkillers like ibuprofen can help. Rheumatoid arthritis responds to anti-rheumatic drugs and corticosteroids. Exercise can also ease arthritis pain as it strengthens the muscles surrounding the joints and keeps the joints limber. Steroid injections into the joint or replacing the normal joint fluid with injections of medication also provide relief. Joint replacement surgery is also a popular treatment for severe arthritis in the hip and knee.
Seeking Treatment for Pain
All too often, people grin and bear it when it comes to pain, says Dr. Glaser, which can make it worse. “We tend to see patients a year after they’ve injured their back,” he says. “That makes it much harder to treat. Patients that come to me a month after they start hurting have a much higher success rate.”
If you’re in pain, talk to your primary care doctor. If conservative treatments aren’t working, Dr. Teitelbaum recommends seeking a pain specialist through the American Academy of Pain Management. “Pain is like the flashing red oil light on your dashboard,” he says. “It’s your body’s way of saying something needs attention.”
