Conditions We Treat

What is arthritis?

Arthritis is marked by one of more joints experiencing swelling or tenderness for a sustained period of time. There are several types of arthritis but there are two that are most common. The first is the most common, osteoarthritis. Osteoarthritis occurs when the cartilage, which cushions the joint space between bones, is broken down from joint injury, infection, age, or repetitive wear and tear. Leading to bone rubbing against bone, this break down of cartilage contributes to pain and swelling in that joint. The second type of arthritis is rheumatoid arthritis. The mayo clinic states, “the body’s immune system attacks the lining of the joint capsule, a tough membrane that encloses all joint parts.” This leads to the swelling and inflammation, but can also lead to the destruction of the cartilage and the bone itself.

What are the treatment options?

Possible treatments for arthritis include Steroid injections into affected joints, Platelet Rich Plasma (PRP), Viscosupplements, Amniotic fluid injections, Radiofrequency Ablations (RFAs) of sensory nerves to alleviate pain in severe cases.

Learn more about arthritis pain  Contact Republic & Get Relief

What is carpal tunnel syndrome?

Carpal tunnel syndrome is caused by the compression of a nerve, which runs along the forearm into the hand, usually at the wrist. There is a tunnel of ligaments, which houses the median nerve, along with tendons, which are responsible for bending your fingers. When there is pressure or swelling in this area, numbness and weakness can occur in your hand or, reversely, into your arm. The first indication this is developing is often at night, with patients being woken up. Typically, tingling can be felt and symptoms will worsen until the hands and/or fingers feel swollen. While swelling is not visible, this will hinder movements and use. Symptoms will occur at work, but also at home while grasping items, driving, or even simply while sitting. There are a number of ways to diagnose carpal tunnel syndrome, most doctors relying on physical examinations and diagnostic testing in the office.

How can I treat it with Republic?

Republic Pain Specialists can work with you to find a treatment plan that avoids opioid prescriptions and works to combat the issues causing your carpal tunnel syndrome. Many patients respond well to yoga and exercise classes in order to strengthen their hands and arms to avoid this compression issue any further. Additionally, working on hand opening and closing can help alleviate symptoms. There are some injections that can help with pain relief, but unless the actions causing the pain are minimized, the pain will ultimately return. This is why speaking with an employer or recognizing your own need to adjust your work positioning will be vital to comfort in the future.

Learn more about Carpal Tunnel Syndrome  Contact Republic & Get Relief

Different Types of Back Pain

The back has a lot to do in holding your body and assisting with movement throughout your day. The back is made up of tendons, muscles, nerves, bones, and more to provide a wide range of activity. There are a number of causes for back pain. Trauma, such as an accident or sports injury can lead to issues, as can overburden, such as a repetitive movement or poor techniques. Another common cause of back pain is mechanics, when an individual moves, whether it be walking, running, lifting, or any other movement, in an incorrect pattern. Posture can lead to some back issues, as can mental or emotional disorders. Further, there are structural issues, like bulging or ruptured intervertebral discs, neural tension, or other components of your physical structure that, over time, can lead to ongoing back pain. Symptoms may range from pain anywhere in your back to pain extending to your hips, shoulders, or limbs, trouble sleeping or restlessness, inability to sit or stand, decreased range of motion, or more.

How Republic Pain Specialists Can Help

Republic Pain Specialists want to help you get to the root of your back pain. Sometimes the location of the pain is difficult to pinpoint. We seek to discover exactly where your pain is originating from to treat it as quickly as possible, instead of using a trial and error method. This means we have to value the input of our patients, asking them questions and listening to their answers as they describe their symptoms. From there, our procedure would differ depending on the patient. We may look at scans if we feel certain types of injury are likely. Other patients may benefit from injections to target sources of pain. We frequently recommend the prevention techniques from above to help patients avoid debilitating back pain in the first place. We are also equipped to refer our patients to a yoga specialist or other member of the health community to work on strengthening or to explore other options altogether.

Learn more about Chronic Back Pain  Contact Republic & Get Relief

Are there different types of headaches?

There are many different types of headaches including cervicogenic, cluster, migraines, tension and trigeminal headaches. How you treat a headache is dependent on what type of headache it is.

What Are the Causes of Chronic Migraines/Headaches

There are a number of possible different causes or triggers for migraines, especially ones that develop into chronic migraines. Some may notice hormonal fluctuations having an impact or changes in the weather. Stress, sleeplessness, and external stimuli may trigger a migraine response. There are certain foods, beverages, and additives many try to avoid, especially those high in caffeine or in chocolate products. There are some studies looking into possible genetic factors that come with an increased propensity for migraines and headaches.

Treatment Options

There are a number of non-medication techniques one can try. First, it is important to learn if there are any triggers, which may contribute to a migraine. If so, those factors should be eliminated or controlled as much as possible. By keeping a headache diary, you will be able to notice patterns and events that may impact your health more than you realize. Exercising, regular sleeping habits, and drinking plenty of fluids are important for everyone in the general population, but are even more important for those with migraines. Relaxation techniques and meditation can help as well, especially in regard to learning biofeedback to help diffuse physical response to tension and stress in life.

Other treatments include greater occipital nerve injections as a single injection or progressing to Radiofrequency Ablation (RFA) if needed. Typically the first line treatments for migraines or headaches are pharmacotherapy, stress reduction, and/or trigger identification. If we are unable to provide relief using these methods we then move on to stronger prescription medications, injections, intravenous therapy or nerve injections. RFAs and biofeedback therapies are also available treatment options if other options have not shown success.

Learn more about Chronic Migraines/Headaches  Contact Republic & Get Relief

What is Diabetic Neuropathy?

Diabetes causes a number of issues in the body of patients who have or develop diabetes. The higher levels of glucose, or blood sugar, and fats, like triglycerides, in the blood cause nerve damage. There are several different ways diabetic neuropathy presents. Peripheral neuropathy is the most common and, according to the National Institute of Diabetes and Digestive and Kidney Diseases impacts anywhere from one third to one half of patients with diabetes. This is marked by nerve damage, specifically in the feet and legs, but sometimes in the arms and hands as well. Focal neuropathy is similar, but usually affects a single nerve. Autonomic neuropathy damages the nerves of your internal organs. Proximal neuropathy usually triggers one side of the body and is centralized in the hip or thigh making movement painful.

How can Republic help?

Every pain presentation differs which is why a thorough consultation, with the attention of one of our pain specialists, is vital to your best chances for a reduction of pain. Once our team is able to evaluate the full range, location, and causes of your pain, we would work together to make a plan that makes sense for you. If not already working with a dietitian to address diabetic concerns, we work closely with a group we recommend for a number of pain management plans. Additionally, personal training or yoga therapy can help recover lost health or maintain current strength for some of our patients. The nerve component of the neuropathy may be addressed with nerve blocks or with therapeutic massage to give the best chances for recovered movement, feeling, and overall health.

Learn more about Diabetic Neuropathy  Contact Republic & Get Relief

What is Fibromyalgia?

Fibromyalgia is challenging to define. This condition is a long-term, or chronic, presence of pain in the muscles and bones and is often marked by general fatigue and cognitive disturbances. The symptoms can be very similar to other conditions, particularly autoimmune disorders. In addition to pain in multiple regions of the body, Fibromyalgia can impact the ability to remember relatively easy events or to concentrate on activity. This “brain fog” can be even more upsetting than the pain according to one study from Rheumatology International. Other aspects include an increased occurrence of IBS symptoms and painful periods in women.

Fibromyalgia Treatment Options

There are many options for treating this condition. While we would never recommend an opioid for conditions, in terms of Fibromyalgia, the recommendation is even stronger because numerous studies have proven them to be unsuccessful in treating or helping with symptoms. Instead, there are several courses of action we encourage those with this issue to explore. Acupuncture can help a number of our patients and can be paired with additional options. Many find relief with yoga and meditation, some forms of exercise, and even massage therapy. Additionally, because Fibromyalgia is so closely linked to mental health issues, particularly in regards to having “flare ups”, self-care like eating a balanced diet and pursuing counseling is an imperative part of treatment. Staying healthy and free from infection can help with symptoms as well because infection can lower the body’s ability to manage itself.

Learn more about Fibromyalgia  Contact Republic & Get Relief

What is a herniated disc?

In between the vertebrae of your spine there are cushion pads, also called discs. These discs are flat and round and provide the cushion your body needs for movement throughout your day. They act as the spinal column’s shock absorbers for all the work your body does. The disc is made of a jelly like nucleus and a fibrous outer ring. A herniated disc occurs when inflammation from sudden injury or improper repetitive movement causes an abnormal shape to the nucleus, putting pressure on the outer ring. Further damage can cause chemicals to be released causing pain or the disc can bulge to such an extent the pressure impacts nearby nerves or the spinal cord itself. Symptoms are frequently lower back pain, numbness or a tingling sensation in the leg or foot, sharp pain shooting down the leg, or, in some serious cases, loss of bladder or bowel control. A simple exam in office can detect a herniated disc most of the time with a small number of patients needing imaging to confirm or diagnose.

There are three types of herniated discs, cervical, thoracic and lumbar. Each of these types has different presenting symptoms which is why a thorough history and exam is needed prior to recommending a treatment plan.

What treatments are there?

Treatments for herniated discs include: PT, flexibility and strength training, chiropractor, diet, activity modifications, epidural steroid injections (ESI), amniotic tissue/fluid implantations, and in severe cases surgery is required. For minor cases, rest can allow the inflammation to decrease and for pain to be relieved. By allowing the body to completely rest for a day or two, you may be able to resume regular activities with controlled movements and rest breaks throughout your day. Pay particular attention to how items are lifted and your posture when sitting or standing. For repeat injuries, physical therapy, strength training, and some yoga activities can help strengthen weak muscles and train your body the proper way to move to decrease the amount of strain on the discs. Republic has several trusted groups we partner with to help evaluate if this option would work for you. Another non-surgical way we provide relief would be to consider an epidural injection to reduce inflammation and help the body heal.

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COVID Symptoms

There are a number of possible symptoms that come with COVID, and those symptoms could linger for quite some time after a patient recovers. Many have reported having feelings of brain fogginess and having a difficult time remembering things, loss of smell and taste, headaches, fatigue, chest and joint pain, and other flu like symptoms.

Treatment Options

With COVID-19 issues, we are relying heavily on a block we have a lot of experience with already. The Stellate Ganglion Block has been used in medical procedures for relieving pain for almost a century, and our team has increasing experience administering it and teaching this method to others. David Gaskin says this specific injection “blocks that sympathetic flow and allows the body to reset and start what it normally should do, which is autoregulation in a normal pattern.”

One of the most appealing parts of providing this treatment for patients is the fact that the block is proving effective for multiple symptoms, not just for pain related issues. Since the block hinders nerve transmission in the face, head, chest, and arms and is also commonly used for general pain syndromes, some patients have reported seeing relief with their loss of senses, the forgetfulness or fogginess that has lingered, and headaches.

Learn more about Parosmia  Contact Republic & Get Relief

What is Shingles?

Shingles is caused by the same virus that causes Chicken Pox. This virus lies dormant in your system, specifically in nerve tissue near your spinal cord and brain. Different factors trigger this dormant virus to become live again causing, in most cases, a rash or strip of painful blisters to appear. Some people also experience fever, headache, and fatigue, but the issue most people emphasize when discussing shingles is the pain. According to the Mayo Clinic, “depending on the location of the pain, it can sometimes be mistaken for a symptom of problems affecting the heart, lungs, or kidneys.” This is frequently found when an individual is experiencing the pain without observing or having the rash, which is not uncommon. Individuals over the age of 50, those with lowered immunity, those undergoing cancer treatment, and certain medications can increase your risk for this contagious disease.

Pain Relief

Shingles must be treated quickly (within 30 days from the outbreak) to return the virus to a dormant state. An epidural steroid injection (ESI) can be used and will in most cases return the virus to a dormant state within days. Severe or long-term cases may need a sympathic nerve block, intercostal nerve block or an Radiofrequency Ablation (RFA) to relieve the pain of shingles. There are a few options we can explore at Republic Pain Specialists to relieve any immediate or lingering pain from an outbreak of shingles. Due to the virus being so closely associated with the nerves of the body, having nerve pain, and occasionally, nerve damage, is not uncommon. Thus, we may explore options very similar to other nerve pain relief options in our clinic.

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Types of Injuries

You can theoretically injure any part of your body, including your jaw, eyes, nose, and ears, depending on the athlete and the sport being played. However, most sports related injuries are divided between the arms, the legs, and the back. According to healthline.com, the lower body is injured 42% of the time in sports related injuries and the upper body accounts to 30%. These may be strains, sprains, broken bones, and torn ligaments.

How we can help

In every pain related case, and sports injuries are no exception, we may treat you in a completely different way. Our first priority is to determine the cause and location of the pain. A comprehensive exam and discussion is vital in our treatment. In some cases, an injury may have even been caused by a weakness or emerging issues somewhere else in your body and we need to determine that. Once we have a better idea of what is happening in your body, we can make recommendations. Strengthening those parts of your body will be helpful for getting back on the field, court, or track, but many patients will need additional help. This help may come in the form of nerve blocks, massage treatments, or therapy of some sort. Only an appointment with us will be able to determine the best solution.

Learn More About Sports Related Injuries  Contact Republic & Get Relief