Comprehensive Pain Management
(Formally known as Franklin Pain and Wellness and Warwick Pain)

Attleboro, MA(508) 236-8333
Franklin, MA(508) 507-8818
South Kingstown, RI (401) 234-9677
Warwick, RI(401) 352-0007

Franklin, MA • (508) 507-8818
Warwick, RI • (401) 352-0007
South Kingstown, RI • (401) 234-9677

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Comprehensive Pain Management Patient Testimonials - Attleboro MA

Joseph Coupal - Thursday, August 30, 2018

Comprehensive Pain Management Patient Testimonials.

Botox for Migraines and for Treating Other Ailments

Joseph Coupal - Friday, August 24, 2018
Botox Injections for Migraine Headaches

What began as a treatment option for muscle spasms soon morphed into a cosmetic procedure that offered a multitude of health benefits.

Indeed, the continue to expand beyond its ability to reduce fine lines and wrinkles.

While many pursue it for cosmetic purposes, the benefits of Botox span far beyond. It wouldn’t surprise us if that number continues to grow.

If you’re plagued with constant headaches and migraines, Botox may be able to bring some of the joy back to your life. And the list goes on.

Botox targets excessive sweating, muscle stiffness and twitching, incontinence, and more. Let’s take a closer look, shall we?

Where Did Botox Begin?

Interestingly enough, Botox is derived from a bacterium! Clostridium Botulinum was developed to treat muscle spasms, given its ability to freeze them.

Many patients were finding this particularly useful in the treatment of eye spasms. Soon enough, people started discovering Botox’s ability to reduce crow’s feet and fine lines.

Let’s explore the many benefits of Botox.


Of course, we have to start with the first, most obvious, benefit of Botox. It’s FDA-approved and sought by many for the reduction of wrinkles, particularly on our faces. Migraines

Botox has also proven to help people suffering from migraines. The great thing about this course of treatment is that it doesn’t require any medication which, as we all know, often carry dangerous side-effects.

Persistent headaches and migraines are often difficult to treat, and Botox doesn’t do much to de-mystify the plague of headaches.

So, while it’s unknown exactly how Botox relieves migraines, medical experts suspect it has to do with a blockage of the sensory nerves that send pain messages to the brain.

Botox also relaxes muscles, helping to relieve the nagging pain of frequent tension headaches. The treatment of persistent headaches or migraines is unarguably one of the most glorious benefits of Botox.

Excessive Sweat

Sweaty palms, anybody? Or, yeah, let’s go there. Sweaty armpits, anybody? If persistent sweat plagues your everyday life, Botox could be the answer.

Hyperhidrosis, or excessive sweating, is often combatted with prescription-strength antiperspirants. Sometimes that works, sometimes it doesn’t.

And, even if you haven’t been diagnosed with hyperhidrosis, how does stress sweat affect your life? The trouble with stress sweat is that it’s often a bit more potent than regular sweat.

If you meet your doctor for one round of Botox today, it could reduce your sweat issues for several months. Imagine only needing a Botox injection every couple months to finally rid your clothes of all those horrid sweat stains?

Bells Palsy

Bells palsy results from damage or trauma to facial nerves. This causes the surrounding muscles to weaken and one half of the face to droop.

This is, of course, a tough break, as it can be quite noticeable. It’s also one of the shining moments for the many benefits of Botox.

Botox can be administered either to the affected side of the face, relaxing those facial muscles that have tensed up, or to the unaffected side of the face, creating a better balance.

While Bells Palsy often needs time to completely go away, Botox can take some of the edge off the disappointment or pain brought on by this condition.

Enlarged Prostate

Studies continue to favor Botox’s ability to provide relief to men with enlarged prostates. By injecting Botox right into the prostate gland, some men experience relief that lasts up to a year.

In turn, this can alleviate the frequency of urinary tract infections, as well as the need for frequent urination. With long-lasting results that don’t require prescription drugs, many men are considering this course of treatment.


Similar to the relief it provides men with enlarged prostates, Botox may be able to help those suffering from incontinence, or the leakage of urine from an overactive bladder.

If you can imagine the terrible stress of a sudden urge to urinate, you’ll know this is a great treatment option for many. Perhaps all those poorly-timed urges even brought on stress sweat!

Muscle Stiffness & Twitching

Botox is being used to help adults facing upper limb spasticity. It can treat the stiffness in elbow, wrist, and finger muscles.

Likewise, Botox may also prove beneficial for those facing lower limb spasticity in their ankles and toes.

And, of course, we can’t forget where it all began. Anyone suffering from eye twitching or spasms can benefit from a Botox injection.

Although each of these pains or inconveniences are things we tend to adapt to, it’s certainly a big benefit knowing a brief appointment with your doctor can provide long-term relief.


Imagine using your lunch break to find some relief for your muscle spasms or headaches? Administering Botox is relatively quick and easy.

Also in terms of speed, the results tend to appear pretty quickly. Some patients report relief within a day or two. Others say it can take up to a week. Like many procedures, individual results will vary.


We waited until the end to get to the inevitable fine print. Fear not! As of now, very few jaw-dropping side-effects have been reported.

You should probably prepare for a little bit of pain around the injection area. You may also experience numbness or a slight headache immediately after.

Along the temporary lines, you may experience a little bit of weakness from the nearby muscles.

But, like any other condition we try to diagnose online, the results can appear horrifying.

So, we’d recommend having a nice sit down with your trusted physician before reading all the worst-case scenarios.

Many people have gone through the procedure with minimal discomfort and tremendous success.

One of the prime benefits of Botox continues to be its ability to remove certain prescription medications from your life, as those certainly have cumulative effects on our bodies.

Many Afflictions are Targeted by the Benefits of Botox

Whether you’d like to bring some body confidence back to your life or need some pain relief, you may want to consider knocking on Botox's door.

For more information on botox for treating Migraines, contact Comprehensive Pain Management in Attleboro, MA.

Source: USA Today

About Chronic Pain and How to Treat It

Joseph Coupal - Thursday, August 09, 2018
Comprehensive Pain Management - Warwick, RI

One thing about pain — you know it when you have it. And if you suffer from constant chronic pain, over time it wears you down — physically, mentally, emotionally. However, you may not know what kind or what category of pain you have.

There are 2 main categories of pain — both of which can be mild, moderate, or severe:

Acute pain: Occurs immediately after an injury and lasts no longer than 2 months when treated properly.

Chronic pain: Any type of pain that lasts 6 months or longer. Chronic pain is often difficult to treat, because the cause can be hard to determine. It can also vary from one person to the next — individuals with seemingly the same kind of chronic pain may need different treatments.

Managing Chronic Pain

The treatment option that will work best for you depends on your type of pain, how severe it is, and how you respond to pain treatment. The fact is, only a physician can determine if you are a good candidate for various pain treatment options. Pain Management Specialists are physicians who specialize in treating chronic pain. These physicians receive years of advanced, specialized training in pain management and focus on treating patients with severe pain.

There are 3 levels of pain, and each may have different forms of treatment. Usually, your physician will follow a treatment plan that begins with basic therapies (like resting and nutrition) and progresses to more aggressive solutions, depending on the type and severity of pain. The treatment plan also depends on how you respond to any particular treatment.

Basic Pain Treatments:

  • Rest and diet changes
  • Exercise and physical therapy
  • Anti-inflammatory drugs (ex: ibuprofen)
  • Cognitive and behavioral modification

Mid-Level Pain Treatments:

  • Transcutaneous electrical nerve stimulation (TENS)
  • Opioids (Prescription painkillers)
  • Nerve blocks (injection of an anesthetic, steroid, and/or anti-inflammatory into the pain area)
  • Thermal procedures (extreme heat or cold delivered through needles or probes)

Advanced Pain Treatments:

  • Spinal Cord Stimulation (SCS)

    SCS, also known as nerve stimulation, uses electrical signals to mask the perception of pain traveling from the painful area to the brain. In place of pain, patients feel a mild tingling sensation called "paresthesia." SCS may provide long-lasting pain relief and can be used with other therapies. Patients are able to control the intensity of the therapy, as well as turn it on and off, using a wireless remote control.

  • Surgery

    Surgical treatments may range from minor outpatient procedures to brain and spinal procedures. Surgery may be needed when structural problems occur within the spinal column often caused by injury or disease.

  • Implantable drug pumps

    Pumps deliver pain medication directly to the space surrounding the spinal cord. Direct application reduces the amount of opioids needed to relieve painful symptoms.

  • Neuroablation

    Often used as a last resort when other therapies fail, Neuroablation is a surgical technique that destroys nerves and tissue, permanently blocking nerve signals to the brain.

Is Spinal Cord Stimulation for You?

It very well could be. If you suffer from chronic pain, a Spinal Cord Stimulator (SCS) System may be the right choice. SCS therapy is often considered when medications or surgery are not an option or when the side effects of your current therapy are impacting your quality of life.

Evaluate your pain now. Then talk with a Pain Management Specialist to discuss if Spinal Cord Stimulation may be right for you, contact Comprehensive Pain Management in Attleboro, MA.

Source: Boston Scientific

Treating Herniations in the Lumbar Spine

Joseph Coupal - Friday, July 27, 2018

The Disc-FX System safely, rapidly and effectively performs minimally invasive procedures for herniations in the lumbar spine. This treatment combines simple, intuitive function with precise surgical results. This procedure is:

  • Less invasive compared to traditional discectomy procedures
  • Minimum annulotomy reduces risk of herniation
  • Multi-functional therapeutic options; debulking, ablation and modulation
  • Manual excision of herniated nucleus through 3.0mm portal
  • Ablation and denervation achieved with use of Trigger-Flex®

For more information on treating herniations in the lumbar spine, contact Comprehensive Pain Management in Attleboro, MA.

Why am I having Persistent Pain?

Joseph Coupal - Thursday, July 12, 2018
Comprehensive Pain Management - Warwick, RI

Most of the time pain goes away after an injury heals. However, if pain persists more than a month or two, it can become chronic pain. Sometimes pain becomes chronic because the underlying problem does not heal. For instance, arthritis causes long term inflammation and damage to the joints, and it may hurt as long as the inflammation lasts. Unfortunately, chronic pain may also occur despite healing and with no obvious injury to tissues. This may be the result of damage to the nerves that transmit pain (neuropathic pain), but chronic pain also affects the entire nervous system, sometimes in a permanent way.

When any type of pain lasts a long time there can be changes in the spinal cord and the brain that change how we perceive painful sensations. These changes may result in severe pain with little or no painful stimulus. Some chronic pain can be very difficult to treat and can become so frustrating for patients that it is often accompanied by depression or other emotional problems. It is this type of pain that represents some of the most challenging problems a pain management specialist can face.

For more information on chronic pain, contact Comprehensive Pain Management in Attleboro, MA.


Don't Let a Back Injury Ruin Your Golf Game

Joseph Coupal - Thursday, June 28, 2018
Comprehensive Pain Management in Attleboro, MA

Simply avoiding the exacerbating repetitive task may alleviate pain, however, giving up your golf game is not practical.

Frequent rounds of golf may cause a number of painful conditions from chronic overuse of the muscles and tendons. Back pain resulting from improper form is one of the more common complaints in orthopedics. First and foremost, having a golf pro will help avoid injuries and improve your game. Despite how hard you try, you may fall victim to a back injury just like the golf professionals. When injuries occur there are non-surgical and minimally invasive treatments to alleviate discomfort.

Simply avoiding the exacerbating repetitive task may alleviate pain, however, giving up your golf game is not practical. NSAIDs and RICE (rest, ice, compression, elevate) provide temporary relief but do not necessarily address the primary reason for discomfort.

The key to preventing back injury is working with your golf pro to optimize the mechanics of your swing. Muscle strains can be caused by an over-powerful swing or incorrect weight shift on the follow through, thus causing lower back pain. When this happens, and if the condition is beyond the assistance of RICE and anti inflammatories, there are non-surgical treatments to get you back in the game.

Some of the many options are:

Radiofrequency Ablation, otherwise known as RFA, is a safe, effective means to treat pain from arthritic joints in the neck and low back. The procedure uses heat to disable only the sensory nerves that transmit pain impulses in the spine. Benefits may last up to a year and sometimes longer.

Epidural injections are used to reduce inflammation and pain from nerve root compression in the neck and low back. In many cases this provides immediate relief and may provide relief lasting up to a year.

For more information on these non-surgical treatments, contact Comprehensive Pain Management in Attleboro, MA.


How to ease pain with Less opioids?

Joseph Coupal - Thursday, June 14, 2018
Spinal Cord Stimulation Works - Attleboro, MA

It’s no secret that the nation has been strongly affected by the opioid crisis.

While there are many contributing factors, the reason most people become addicted to, or overdose from opioids is pain — as in the need to relieve it.

To combat both opioid dependence and chronic pain, an increasing number of physicians are now specializing in the growing field of interventional pain management.

Interventional pain management specialists — many of whom are anesthesiologists — use nonnarcotic protocols to target the spots where patients are feeling pain, and then block the pain signals from traveling to the area.

This can be done in a variety of ways: injections, nerve blocks, topical and oral medications, and minimally invasive, outpatient surgical procedures.

Interventional pain management helps prevents addiction to narcotic pain medication.

For those suffering from chronic pain, these are just a few of the treatment options available that don’t include opioid medication.

For more information on pain management, contact Comprehensive Pain Management in Attleboro, MA.


Chronic Neck Pain is A Pain in the Neck

Joseph Coupal - Thursday, May 31, 2018
Comprehensive Pain Management - Spinal Cord Stimulation in Franklin, MA

We casually refer to a minor annoyance in life as a “pain in the neck,” but as anyone with neck pain will tell you, it’s far from minor and much more painful and debilitating than an annoyance.

Currently, one third of us suffer from chronic neck or shoulder pain, and this figure is predicted to increase as computer work, cell phones, and the myriad of other gadgets we now use force us to crane our necks forward for much more of each day than ever before. We will literally be in a world of hurt.

Historically, neck and shoulder pain have been an older person’s complaint, but clinics are experiencing a rise in younger patients with neck and shoulder complaints. The impact that poor posture during tablet computers and smart phone use are having on small children and teenagers is an increasing health problem and one that more parents need to be aware of and manage.

Because many cases of neck pain are related to posture, it can be difficult to distinguish which is which. People may come in with shoulder pain when they really have a neck problem. The reporting system of the body (and patients) can be unreliable so neck and shoulder pain commonly overlap. We can add in neck pain’s connection with headaches, too, to the mix of suffering that’s hard to tease apart.

Understanding some of the basics of the body helps us manage our conditions and treatments more effectively.

By a beautiful design in nature that allows us to turn our head and see in all directions, our neck is engineered to be a bit unstable. Perhaps to balance this, the muscles in the neck are some of the fastest, most forceful muscles in the body, and have some of the greatest endurance of any muscles. The muscles of the head and neck control important, everyday tasks such as facial expressions, talking, chewing and swallowing and even the movement of the eyes.

The neck and shoulders are structured in such a way that they are entirely dependent on alignment and balance between the muscles and fascia that bind them together while allowing for movement.

All this depends on proper posture.

Causes of neck pain

With so many of us gazing into computers or staring down at our smart phones most of the day, it’s no wonder data from the Centers for Disease Control and Prevention reports that nearly 20% of us have experienced neck pain within the past three months.

Poor posture: Today, poor posture is often called nerd or text neck because so many of us spend hours looking down at our devices now. One recent study showed that 79% of those between the age of 18 and 44 have their cell phone on them almost constantly with only two hours of the waking day spent without the cell phone. Looking down at your phone or tablet has unavoidable consequences. In order to protect themselves from the constant strain of poor posture, muscles harden into tough bands, causing fatigue, spasms and hot, chronic pain along the ridge of the shoulder blades and neck.

The tendency toward poor posture in the upper back from slumping and rounding the shoulders is easy enough and important enough to correct. When we slouch our shoulder blades slide away from the spine and overstretch and weaken muscles, particularly the pectoralis muscles.

Good posture requires conscious correction for only a short time and once the brilliance of adaption has occurred, a good habit is formed and it’s one more area of wellness that we’ve mastered and one less reason for pain.

Here’s what you can do on your own to prevent and treat text neck:

Make sure your work environment allows you to look forward at any screens you use, not down. Hold your phone up in front of your face whenever you can to avoid looking down at it. Take frequent breaks from your devices and walk around every 20 minutes, at least.

Soft tissue injury/Trauma: Muscles, tendons and ligaments in the neck and shoulder area are prone to injury from whiplash and other impact injuries. These conditions can range in severity and be acute or become chronic.

Degenerative diseases/arthritis/degenerative disc disease: Inflammation in joints is painful and restricts movement and mobility, however, it’s important to employ exercise as medicine with arthritis, and degenerative disc conditions, research says. Joints need the flexion caused by proper exercise to remain healthy, but improper movement is painful, so arthritis sufferers tend to err on the wrong side and reduce movement by too much and the stiffness worsens.

Pinched Nerves / Radiculopathy / Thoracic Outlet Syndrome: The pain, numbness and tingling from a nerve being compressed and irritated can be caused by physical overexertion or one of several medical conditions, so establishing cause by a doctor may be helpful. This condition responds well to physical therapy and exercise – see our post on thoracic outlet syndrome.

Fractures: Also called a broken neck, this occurs when one of the seven cervical vertebrae are fractured usually the result of a high-energy trauma such as car accident or a fall. These accidents can have serious consequences because the nerves running through the neck can be impacted or damaged. The first thing to do if you suspect a fracture is to immobilize the neck until x-rays can be reviewed by a physician. Treatment can range from wearing a cervical brace for 60 weeks to spending three months in a rigid cast or some combination of those options. Afterwards, physical therapy and bodywork will aid a full recovery.

Medical conditions: It’s rare, but possible for a medical condition to refer pain up into the neck and shoulder area. Talk to your doctor if no other cause of neck and shoulder pain is identified.

Neck Pain Relief or Prevention?

What’s even better than neck pain relief? Not having pain in the first place! We shouldn’t be sedentary for more than half an hour at a time. Positioning yourself in a certain way for an extended period increases pressure on your spine and decreases mobility. If you require the use of technology all day, take “micro breaks” every 15-20 minutes. Lift your head up and stretch, in order to get your neck and shoulders moving.

Studies have shown that people who take these micro breaks are 21% less likely to suffer from neck and shoulder pain. Help yourself to maintain the health and well-being of your spine and help prevent further postural issues arising. Address any ergonomic issues whether at work with your desk, at home, or in your study.

The body is designed for motion, much like a car. When we leave our car idle in the garage for several days, what happens? The battery needs to be charged. So it is with the body, and zones in the body that are often idle for hours at end, such as the neck and shoulders. So, “Get up and move!”

Finally, if your shoulders and back are tight, you’ll have a hard time eliminating neck pain because your back muscles will be pulling on your neck. The body is an integrated system and we need to treat the whole body when we run into trouble.

For more information on relieving chronic neck pain, contact Comprehensive Pain Management in Attleboro, MA.


Chronic Pain has a Massive Impact on the Workforce

Joseph Coupal - Thursday, May 17, 2018
Comprehensive Pain Management - Attleboro, MA

Chronic pain, which is any physical discomfort lasting for at least six months, affects over 50 million Americans, most of whom work full time. Common forms of chronic pain include headaches, backaches, arthritis, respiratory conditions, and ailments caused by sports injuries or other traumas, such as car accidents.

There have been several studies to examine the role of chronic pain on work factors such as job stress, employee performance and organizational profitability. It was found that social stigmas and job fears help mask the true size of the problem.

"Generally speaking, chronic pain and other physical and mental disorders have been categorized as 'silent disorders' in the workplace simply because most employees are afraid of the consequences if employers find out." - study author

The research indicates that chronic pain at work has a significant effect on both the worker and the organization. For example, higher levels of chronic pain are associated with:

  • More conflict on the job
  • Less-effective communication
  • An inability to focus on tasks that require sustained concentration
  • Less enthusiasm for the job
  • Fewer favorable interactions with coworkers and supervisors
  • Less support from the organization
  • More job tension
  • Higher levels of depressed mood (feeling "blue" on the job, etc.)

The authors of the studies were also interested in gauging the bottom-line consequences of chronic pain for sufferers.

"For those experiencing even moderate levels of chronic pain, the financial consequences are staggering." study author.

In one study, more than 2,000 employees were asked to report the number of hours per week that pain caused them to be ineffective.

The results indicate that chronic pain accounts for over five hours per week of lost productivity. When projected over the course of the year, this means more than $5,000 per employee.

This result does not take into consideration indirect costs, which can double or triple the amount.

An inability to be productive also affects customer retention and increases bottlenecks caused by not keeping up with others, as well as the costs associated with absenteeism, tardiness and ongoing medical treatment.

A proactive approach by employers may help minimize some of these undesirable effects.

First, education and communication can go a long way in reducing the stigma of chronic pain as a weakness. Also, organizational support, even if it is only in the form of empathy, may help sufferers get through the roughest days.

For more information on chronic pain management, contact Comprehensive Pain Management in Attleboro, MA.


The Cause of Musculoskeletal Disorders at Work

Joseph Coupal - Thursday, May 03, 2018
Comprehensive Pain Management - Franklin, MA

The root cause of Musculoskeletal Disorders (MSC) is exposure to MSD risk factors – both work-related risk factors and individual-related risk factors.

Work-related Risk Factors Workplace design plays a crucial role in the development of an MSD.

When a worker is asked to do work that is outside his body’s capabilities and limitations, he is being asked to put his musculoskeletal system at risk.

There are three primary ergonomic risk factors.

High task repetition. Many work tasks and cycles are repetitive in nature, and are frequently controlled by hourly or daily production targets and work processes. High task repetition, when combined with other risks factors such high force and/or awkward postures, can contribute to the formation of MSD. A job is considered highly repetitive if the cycle time is 30 seconds or less.

Forceful exertions. Many work tasks require high force loads on the human body. Muscle effort increases in response to high force requirements, increasing associated fatigue which can lead to MSD.

Repetitive or sustained awkward postures. Awkward postures place excessive force on joints and overload the muscles and tendons around the effected joint. Joints of the body are most efficient when they operate closest to the mid-range motion of the joint. Risk of MSD is increased when joints are worked outside of this mid-range repetitively or for sustained periods of time without adequate recovery time.

Exposure to these workplace risk factors puts workers at a higher level of MSD risk. It’s common sense: high task repetition, forceful exertions and repetitive/sustained awkward postures fatigue the worker’s body beyond their ability to recover, leading to a musculoskeletal imbalance and eventually an MSD.

Individual-related Risk Factors

Human beings are multi-dimensional. Limiting ourselves to a singular cause of Musculoskeletal Disorders will limit our ability to create a prevention strategy that addresses the multi-dimensional worker.

We need to address both workplace risk factors and individual risk factors.

Individual risk factors include:

Poor work practices. Workers who use poor work practices, body mechanics and lifting techniques are introducing unnecessary risk factors that can contribute to MSDs. These poor practices create unnecessary stress on their bodies that increases fatigue and decreases their body’s ability to properly recover.

Poor overall health habits. Workers who smoke, drink excessively, are obese, or exhibit numerous other poor health habits are putting themselves at risk for not only musculoskeletal disorders, but also for other chronic diseases that will shorten their life and health span.

Poor rest and recovery. MSDs develop when fatigue outruns the workers recovery system, causing a musculoskeletal imbalance. Workers who do not get adequate rest and recovery put themselves at higher risk.

Poor nutrition, fitness and hydration. For a country as developed as the United States, an alarming number of people are malnourished, dehydrated and at such a poor level of physical fitness that climbing one flight of stairs puts many people out of breath. Workers who do not take care of their bodies are putting themselves at a higher risk of developing musculoskeletal and chronic health problems.

Exposure to these individual risk factors puts workers at a higher level of MSD risk. Just like workplace risk factors, individual risk factors are common sense: when a worker uses poor work practice, has bad health habits, doesn’t get adequate rest and recovery and doesn’t take care of their bodies with a good nutrition and fitness regimen, they are at greater risk for fatigue to outrun their recovery system. Having a poor overall health profile puts them at greater risk of developing a musculoskeletal imbalance and eventually an MSD.

For more information on preventing Musculoskeletal Disorders at work, or for treating Musculoskeletal Disorders, contact Comprehensive Pain Management in Attleboro, MA.


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