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BEHAVIORAL INTERVENTIONS TO AID RECOVERY FOR ACUTE AND CHRONIC PAIN AFTER SURGERY Medical observers have long pointed out that the stronger a patient’s expectation for pain relief from an illness or surgery, the more likely such relief will occur. Nearly 50 years ago, research showed that patients who were educated with detailed information about their operations and expected pain intensity, their need for morphine pain medication was reduced. At one end of the spectrum, are anxious patients: ill-informed, with few social supports, lacking confidence in the persons or system caring for them, focusing upon their pain and their recovery. At the other end are patients who trust their families and health-care providers, expect a good surgical outcome, turn their attention away from their pain, and are motivated to return to their previous level of function. In addition to patient education, such interventions include:  -Hypnotic suggestion before a procedure -Cognitive behavioral techniques such as guided imagery  -Modifying attention, distraction, virtual reality, and music  -Relaxation, biofeedback and controlled breathing exercises Chronic Postsurgical Pain (CPSP) affects 10-20% of patients. The transition of acute postsurgical pain to CPSP is complex. Sensations are transmitted from damaged tissue to the brain, where psychological factors influence the experience of pain and individual pain responses. Psychological factors that predict CPSP include: -Depression -Anxiety -Posttraumatic stress disorder symptoms -Fear of surgery Evidence-Based Treatments to Prevent CPSP To date, there have been a few studies of cognitive-behavioral-based physical therapy which appears to hold promise as an integrated treatment. There is evolving evidence of the efficacy of mind-body interventions and hypnosis improving pain, disability, and mood in acute trauma and postoperative pain. Our medical team is dedicated to helping you achieve pain relief and assisting in the return to your previous level of function. We care about your outcome and strive to adopt multiple modalities, including such behavioral interventions, to achieve less pain, and more joy. Call us today for an appointment, or visit our website, www.primemedicalpain.com #pain #painrelief #chronicpain #behavioralintervention #postsurgical #lesspain #morejoy

Pain Management in Phoenix, AZ | Prime Medical Pain Management Centers

Treatment of Postsurgical Pain in Adults Pain relief after surgery is important for both well-being and comfort because it contributes to faster and better recovery. Multimodal Analgesia: Historically, postsurgical pain was treated with pain medications such as morphine, an opioid. Opioids are substances that act on opioid receptors to produce morphine-like effects, most often used medically to relieve pain. Although these opioids remain an important component in treating severe postsurgical pain, their use as a single therapeutic entity may cause problems such as sedation, constipation, nausea and vomiting. Evidence-based guidelines now recommend the use of combinations of two or more pain medications or techniques with different sites or mechanisms of action (“multimodal”). Advantages of multimodal analgesia include: • Improved pain relief • Decreased opioid requirements • Decreased adverse effects of opioids Current evidence supports the use, when feasible, of injectable medications (Lidocaine, Toradol, Cortisone, etc), or other local and regional modalities to help pain, including but not limited to trigger point injections. These are important within a multimodal approach. Different surgical procedures cause: Pain as a result of different mechanisms (muscle pain after orthopedic surgery or abdominal pain after abdominal surgery, for example), different severity, and different locations. Often, these circumstances require pain relieving approaches specific to each type of surgery and population. Acute Rehabilitation after Surgery: It is now clear that providing pain medication by itself is insufficient to improve postoperative outcome and recovery. However, multimodal protocols for enhanced recovery after surgery have been developed and address multiple dimensions of the recovery from surgery. Application of such protocols can facilitate shortened hospital stays and reduced rates of complications. A multiple disciplinary approach to pain management can help get you feeling better quicker, while minimizing adverse side effects and maximizing effectiveness of your treatment plan. Our providers are here to help! Call today to make an appointment or find more information on our web page, https://www.primemedicalpain.com #pain #painrelief #postoppain #PrimeMedicalPain #triggerpoints #painmanagement #painmedicine Reference:www.iasp-pain.org/GlobalYear

Pain Management in Phoenix, AZ | Prime Medical Pain Management Centers

Chronic Postsurgical Pain: Definition, Impact, and Prevention Chronic postsurgical pain (CPSP) - • pain lasting at least 3 months after surgery • pain not felt before surgery or different or higher in intensity • pain is at the area of surgery or a referred area • pain that is not due to (e.g., cancer recurrence, infection) CPSP has become a health priority- • occurs in 1 to 2 out of 10 surgical patients one or two of 10 surgical patients and is intolerable o In a large study, 2.2% of postoperative patients reported severe CPSP, 1 year after surgery The type of surgery influences the incidence and intensity of pain o 35% after chest or breast surgery o 20% after knee surgery o 10% after hip surgery Laparoscopic and minimally invasive procedures also account for chronic pain 70% of CPSP risk can be predicted by- • type of surgery • Age • physical and mental health • Existing pain prior to surgery Most common risks include- • emotional overload • pain before surgery • new pain after surgery • anxiety, or disturbed sleep Pain before surgery can be treated so as to minimize the likelihood of new pain after a surgery. Chronic pain should not be such that it becomes a barrier in your life. We can help. If you have been suffering from ongoing pain that has not improved, contact us today. Call today to make an appointment or find more information on our web page, https://www.primemedicalpain.com If you suffer from common risk factors such as anxiety, depression, or disturbed sleep, we recommend you speak with your primary care provider. #pain #painrelief #postoppain #PrimeMedicalPain Reference:www.iasp-pain.org/GlobalYear

FITNESS

As tolerated, we recommend an adjunct therapy to medicine pain management whether it be stretching, aerobic exercise, muscle strengthening, chiropractic therapy, massage, physical therapy, etc. Yoga has helped many pain sufferers to minimize their symptoms in a relatively short period of time and has been shown to be a credible adjunct therapy to pain medicine management. Recommend contacting your physician before attempting any of these exercises, or make an appointment with us today. We can help you feel better soon. #MoreJoy #LessPain #PrimeMedicalPain https://www.primemedicalpain.com/

ACUTE POST-OPERATIVE PAIN Decades of research have established that acute pain after surgery has a distinct pathophysiology that can impair functionality and often culminates in delayed recovery. Surgical tissue trauma leads to individuals suffering ongoing pain at rest and increased responses to stimuli at the site of injury. • Different surgical procedures involve distinct organs and specific tissue within and adjacent to them, creating a variety of patterns of sensation and differences in the quality, location, and intensity of postoperative pain. • Decreased tissue pH and oxygen tension, can remain at the surgical site for several days. These responses may contribute to pain following an incision. • Nerves may be injured during surgery and may account for pain that is present early in the postoperative period and can evolve into chronic neuropathic pain. Neuropathic pain is defined as chronic pain that results from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord). • Noxious input during and after surgery can increase the responses of the CNS (central nervous system) thereby amplifying pain intensity. The magnitude of this depends on location of the operative site and the extent of the injury. • Opioid pain medications modulate central sensations in complex ways, by decreasing involvement of pain pathways, thereby providing relief of pain. Reference:www.iasp-pain.org/GlobalYear If you have been suffering from ongoing pain symptoms that have not improved, contact us today. We can help! Call us by clicking on the "Call Now" tab, or find more information on our web page: https://www.primemedicalpain.com #PainRelief #PostopPain #PrimeMedicalPain

International Association for the Study of Pain (IASP)

Check back frequently for informative updates on pain after surgery. Less Pain, More Joy Prime Medical Pain https://www.primemedicalpain.com/

Pfizer's Dr. Freda Lewis-Hall Discusses Fibromyalgia -- Dr. Phil

Fibromyalgia can be quite debilitating. In addition to pain, symptoms can include anxiety, concentration and memory problems, fatigue, headaches, sleep problems, tender points, numbness, and tingling in hands, arms, feet, and legs. A healthy and active lifestyle may help decrease your Fibromyalgia symptoms. Studies show that second to medication, the actions most likely to help are light aerobic exercises (such as walking or water exercise to get your heart rate up). But always check with your doctor before you start any exercise program. Fibromyalgia can be managed and symptoms lessened. Contact us today for an appointment. Our caring and experienced medical team at Prime Medical Pain, can help you feel better. Click here for more information or to make an appointment: https://www.primemedicalpain.com/ Source: powerofpain.org/fibromyalgia/

American Pain Society

The American Pain Society is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.

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Exercise Can Keep Joints Strong Exercise helps keep joints flexible and strong. It can also help you lose weight, which takes pressure off aching joints. Every pound you lose takes 4 pounds of pressure off your knees and 6 pounds off your hips. If you have any joint issues, ask your doctor before starting a new exercise program, so you know what you can do safely. Warming Up Is Critical Warming up with gentle movements helps get your body ready for your workout. Gentle exercises such as side bends, shoulder shrugs, arm circles, overhead stretches, and bending toward your toes are all good warm-up exercises. Repeat each move 3-5 times. Remember, there should be no pain with exercise -- ease into your activity. Save the stretch-and-hold movements for after your warm-up or workout. Get Stronger Strengthening exercises such as weight training help you build the muscles that support your joints. You can use hand weights, resistance bands, or even a 1-liter water bottle. Start with weights that you can lift 12 to 15 times without slouching or poor form. Talk to a certified personal trainer to help design the best strengthening program for you. Lat Stretch Stand with your back straight and feet shoulder-width apart. With your arms overhead, hold one hand with the other. Pull upward while leaning straight over toward your left side. Keep your lower body straight. You should feel the pull along your right side. Hold 15 to 30 seconds. Do this 2 to 4 times on each side. Tricep Stretch Stand with your back straight and your feet shoulder-width apart. Bend your left arm and bring your elbow straight up so that it points to the ceiling. Hold your elbow with your right hand.Pull your elbow gently toward your head. You're stretchingthe back of your bent arm. Hold 15 to 30 seconds. Then switch elbows. Repeat 2 to 4 times on each arm. Calf Stretch Place your hands on a wall, back of a chair, countertop, or tree. Now step back with your right leg. Keep it straight, and press your right heel into the floor. Push your hips forward and bend your left leg slightly. You should feel the stretch in your right calf. Hold for 15 to 30 seconds. Repeat 2 to 4 times for each leg. Quadriceps Stretch You’ll feel this stretch along the front of your thigh. First, hold on to something sturdy and balance on your left foot. Bend your right knee, raising your ankle to your hand. Grab hold of your ankle, pulling your foot toward your butt to deepen the stretch. Keep your knees close together. Hold 15 to 30 seconds. Repeat 2 to 4 times for each leg. Hamstring Stretch Your hamstring muscles run down the back of your thigh. Stretch them by sitting up straight in a chair with one foot on the floor. Slowly raise the other leg, while keeping your knee straight. Support your leg with both of your hands. Hold this for 15 to 30 seconds, and repeat 2 to 4 times on each leg. Listen to Your Body Listen to your body and know your limits. Exercise should challenge you, but it shouldn't cause pain. If you have some mild muscle soreness after starting a new exercise, that’s normal. However, if it lasts more than a couple of days, ease up on your workout to give your body more time to get used to the new exercises. If you have any lasting pain, see your doctor. For more information on therapies to aide in pain relief, please contact us at Prime Medical Pain Management Centers, by phone or by visiting our website, www.primemedpain.com **Before starting any stretches or exercises, check with your doctor to ensure you are healthy enough to perform them.** Retrieved from www.webmd.com. 2016 July 30.

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Working With Your Doctor What can I expect from a visit with a Pain Management Doctor? Come to your appointment prepared. Some things you can do to prepare yourself for your appointment include: (1) Keep a pain journal. Note when your symptoms seem to be worse, what activities worsen your pain, and what helps your pain. Keep track of how much pain you are having on a scale of 1-10, 10 being the worst pain you have ever felt (use the Pain Scale included in this post). (2) Bring a record of what medications you have tried to help your pain. Make sure to include over the counter medications as well as medications you have been prescribed by other doctors. (3) Bring any previous x-rays, CT scans, and MRI films with you to the doctor. The doctor may request previous records from other doctors you have seen. (4) Bring a list of your current medications, even those which are not for your pain condition. Also include any over the counter medications, dietary supplements, vitamins, or minerals. (5) Think about how your pain affects your life; does it prevent you from participating in your regular activities? Is there anything you would like to be able to do that your pain currently prevents you from doing? (6) Bring a list of questions you may have for the doctor. The doctor will complete a history and physical exam. Your healthcare provider will ask about the location of the pain, the severity of the pain, activities which influence your pain, whether the pain is accompanied by weakness, and the type of pain (aching, burning, stabbing, etc.). Other symptoms the doctor may ask you about which seem related or unrelated to pain but may be a result of your condition may include sleep patterns and emotional status, recent infections, and stomach or bowel symptoms. After completing the history and physical exam, the healthcare provider may order additional tests such as radiographic images (including x-rays, MRIs, etc.) or blood tests. Chronic pain is a complex process that requires a combination of treatments in order to achieve the best results. A multimodal treatment plan tailored to the patient will be developed that may include medications, possible procedures, assistance with emotional aspect of pain, and physical therapy. Developing a treatment plan which is likely to provide the most benefit given your treatment options and preferences requires a joint effort between you and your healthcare provider. At Prime Medical Pain Management Centers, we encourage our patients to actively work with our medical providers to get better. The treatment of chronic pain requires a continuing and active effort from both the individual suffering from the chronic pain and the healthcare team. Visit our company website, call our office (602-497-2634), or stop by the office today. We can help you achieve LESS PAIN, and MORE JOY. http://www.primemedicalpain.com/ Source: https://theacpa.org/faqlisting.aspx. 26, 6 June.

CHRONIC KNEE PAIN Many Americans have resigned themselves to pain because they simply feel it’s a normal condition. According to a recent survey by the American Osteopathic Association (AOA), close to one in two Americans say pain is part of life, while another 41% believe pain is a standard part of the aging process. The AOA survey also found: Pain does not discriminate. Although many people think chronic pain is a normal part of aging, it can affect anyone – regardless of age. In fact, close to 65% of Americans ages 18 to 34 have experienced chronic pain or someone they care for has experienced chronic pain during the past year. Americans are keeping quiet. Almost 60% of Americans confess they might not talk to a medical professional if they were suffering from chronic pain. Second most common cause: Knee pain is the number two cause of chronic pain; more than one-third of Americans report being affected by knee pain. Sometimes knee pain may be the result of too much weight on the knee joint. Other times it may be due to injury or improper technique during activity. Rob Danoff, DO, an AOA board-certified family physician and a fellow of the American College of Osteopathic Family Physicians, explains common ways to treat chronic knee pain: 1) Try alternating between warm and cool treatments: While everyone is different and techniques that work for one person may not work for another, sometimes alternating between cool compresses and warm moist heat provides relief. Try using one or the other every four to six hours for 10 to 20 minutes at a time. Cool compresses may help to reduce inflammation while warm moist heat can relax and loosen tissues while stimulating blood flow to the area. Be careful to use moderate heat for a limited time – about 20 minutes – to avoid burns. Also, never leave heating pads/towels on for extended periods of time or while sleeping. 2) Incorporate strength and mobility training: The type of exercises you can perform will depend on the health of your knee. Aerobic exercise in a non-weight bearing environment – such as a pool – can help you lose weight and ultimately reduce the strain on your knees. Talk to your physician about other exercises that will help take direct pressure off the joint by building up the muscles that surround the knee. Check with your doctor before starting such exercises. 3) Stretch. Stretching the muscles and tendons surrounding the joint can help with some causes of knee pain. 4) Update your shoes. Shoes are meant to absorb the shock during movement, and when they don’t, the shock travels up to your knee. 5) Don’t give up on finding relief. When home remedies aren’t helping, seek medical advice from an experienced medical pain management provider. At Prime Medical Pain Management Centers, we take a comprehensive approach to care for our patients, and design an appropriate plan to help the patient get better and help them find pain relief. Along with a comprehensive review of your medical history, and complimentary treatments, such as stretching or physical therapy, pescription pain medication may be necessary. The important thing to remember is to consult your physician in order to come up with a treatment plan that is right for you. www.primemedpain.com Source: http://www.osteopathic.org. 12 June 2016.