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

Attleboro, MA(508) 236-8333
Franklin, MA(508) 541-0004
South Kingstown, RI (401) 234-9677
Warwick, RI(401) 352-0007

Franklin, MA • (508) 541-0004
Warwick, RI • (401) 352-0007
South Kingstown, RI • (401) 234-9677

Franklin Pain and Wellness Center

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Comprehensive Pain Management Patient Testimonials - Franklin MA

Joseph Coupal - Thursday, August 30, 2018

Comprehensive Pain Management Patient Testimonials.

Spinal Cord Stimulation FAQs

Joseph Coupal - Friday, August 10, 2018
Comprehensive Pain Management in Franklin, MA

Frequently Asked Questions

Have questions about Spinal Cord Stimulation? We've got you covered. Below are some of the top questions.

Is Spinal Cord Stimulation (SCS) safe?
Yes. SCS therapy has been proven safe and effective. Hundreds of thousands of people worldwide have been treated with SCS. SCS Systems are FDA-approved.

Q: Can one SCS system help me manage pain in more than one area?
SCS Systems are designed to cover several pain areas at the same time if needed. You can use your wireless remote control to adjust the amount of stimulation for each pain area.

Q: Will I be totally pain-free with Spinal Cord Stimulation?
People differ in the amount of pain relief they receive with SCS therapy. The trial, or test drive, may help you determine the amount of relief you will receive. SCS is generally considered effective if your pain is reduced by at least 50%.

Q: Will SCS allow me to be free of pain medications?
Every person differs in how effective SCS therapy is for them. For some patients, SCS therapy may work well enough that pain medications are no longer needed. For others, success with the therapy can mean using less pain medication.

Q: Will it be visible under my skin?
No. You will not be able to see your device under your skin. Unless you tell someone you have it, they'd never know. Our SCS Systems feature contoured, oval shapes and are small.

Q: Will my insurance cover SCS?
SCS is covered by most health insurance plans, including Medicare, commercial payers, and most workers' compensation programs. Your clinic or physician will need to get approval first. Insurance providers generally require pre-authorization for SCS. After determining that you are a candidate for SCS, your physician and his/her office staff will provide your insurance company the necessary documentation needed to complete the pre-authorization.

Your physician's office and your health insurance provider/program are the best resources for coverage questions and can provide you specific detail regarding your coverage benefits and out-of-pocket cost for SCS.

Q: Can I actually control the SCS therapy?
Yes. Our SCS System's wireless remote control lets you turn stimulation on and off, increase and decrease the level of stimulation, and target different pain areas using settings or programs customized by your physician specifically for you.

Have more questions? Contact Comprehensive Pain Management in Franklin, MA.

Source: Boston Scientific

Balloon Kyphoplasty for Treating Spinal Fractures

Joseph Coupal - Friday, July 27, 2018
Comprehensive Pain Management  - Kyphoplasty in Franklin, MA

The adult spine is a column of 33 bones that protects the spinal cord and enables us to stand upright. Each bony segment of the spine is referred to as a vertebra.

Having a spinal fracture means that one of the vertebra has either cracked or collapsed. Like other bones in the body, the extent of the break can vary, from a hairline fracture to a complete collapse of the vertebral body.

When a bone breaks, localized swelling can occur, and pain is common. In the spine, swelling and misalignment can irritate adjacent tissue and nerves. Damage to even one vertebra can alter the alignment of your spine, upsetting the distribution of weight along the spinal column and setting the stage for another fracture.

Balloon Kyphoplasty is a minimally invasive procedure that can repair spinal fractures. It takes about an hour per fracture level to treat a fracture with balloon kyphoplasty, and the procedure can be done on an outpatient or inpatient basis.

Balloon Kyphoplasty can reduce or eliminate your back pain from a spinal fracture, as well as restore vertebral body height and proper alignment of your spine. Early and effective treatment (fixing the broken bone) may reduce the consequences of spinal fractures, especially those associated with other treatments, for example, prolonged bed rest or use of analgesics.

Other benefits include sustained improvement in mobility, improvement in ability to perform activities of daily living, and improved quality of life. Although the complication rate with Kyphon Balloon Kyphoplasty has been demonstrated to be low, as with most surgical procedures there are risks associated with the procedure, including serious complications. This procedure is not for everyone. For a full discussion of risks and whether this procedure is right for you, contact Comprehensive Pain Management in Franklin, MA.


What Does a Pain Management Specialist Do?

Joseph Coupal - Friday, July 13, 2018
Comprehensive Pain Management - Franklin, MA

A pain management specialist is a physician with special training in evaluation, diagnosis, and treatment of all different types of pain. Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these. Pain can also arise for many different reasons such as surgery, injury, nerve damage, and metabolic problems such as diabetes. Occasionally, pain can even be the problem all by itself, without any obvious cause at all.

As the field of medicine learns more about the complexities of pain, it has become more important to have physicians with specialized knowledge and skills to treat these conditions. An in-depth knowledge of the physiology of pain, the ability to evaluate patients with complicated pain problems, understanding of specialized tests for diagnosing painful conditions, appropriate prescribing of medications to varying pain problems, and skills to perform procedures (such as nerve blocks, spinal injections and other interventional techniques) are all part of what a pain management specialist uses to treat pain. In addition, the broad variety of treatments available to treat pain is growing rapidly and with increasing complexity.

With an increasing number of new and complex drugs, techniques, and technologies becoming available every year for the treatment of pain, the pain management physician is uniquely trained to use this new knowledge safely and effectively to help his or her patients.

Finally, the pain management specialist plays an important role in coordinating additional care such as physical therapy, psychological therapy, and rehabilitation programs in order to offer patients a comprehensive treatment plan with a multidisciplinary approach to the treatment of their pain.

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


Possible Solutions to Chronic Pain

Joseph Coupal - Friday, June 29, 2018
Comprehensive Pain Management - Warwick, RI

Previous columns have discussed chronic pain and some of the first steps that sufferers, guided by their physicians, should explore to seek relief.

Exercise, physical therapy, cold and heat, massage, acupuncture, Transcutaneous Electrical Nerve Stimulation, chiropractic manipulation, or non-opioid medications such as ibuprofen and other NSAIDS can make pain levels tolerable for many.

For others, however, the relief from these measures is inadequate. If you have "tried everything and nothing has worked,” it might be time to ask your physician if Interventional Pain Management would be a suitable avenue to explore.

Most specialists in this field are anesthesiologists, but some additionally have fellowship training in image-guided spine intervention.

Several local pain management clinics and practitioners offer these interventions. Your primary care physician should be able to help you determine if you are a good candidate for these procedures and to make a referral to the practitioner whose training and expertise is best suited to your needs.

There are various treatment options that can be performed by interventional pain management specialists.

While initially the placement of injections was based mostly on educated guesswork, the more recent use of fluoroscopy to guide precise needle placement has allowed much higher success rates.

Fluoroscopy is a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie, so a needle or wire can be guided to exactly the right spot.

Different interventions treat different types and locations of pain and have varying lengths of effectiveness.

Facet joint injections

These treat pain in the facet joints which support the spinal column and allow it to flex, extend, and rotate.

In older adults trauma and arthritic changes can contribute to the development of facet syndrome. Frequently a deep, dull aching pain is referred to the groin, buttocks, hip, or side and back of the thighs.

Facet point injections have two purposes. Diagnostically they can pinpoint the location of structures causing pain. The small amount of local anesthetic and steroid is injected directly into the facet joint.

If the pain is improved, then a longer-lasting procedure like radiofrequency ablation can be performed for longer-acting relief. The short-term relief facet joint injections can provide also can make a patient comfortable enough to participate in restorative physical therapy.

Epidural steroid injections

These can be given in the neck (cervical), mid-spine (thoracic) or low back (lumbar) sections of the spine. They can also be used for diagnosis as well as short-term pain relief.

To reduce inflammation and pain in the nerves as they exit the spine, a mix of local anesthetic and steroid is injected into the epidural space, just outside the membrane that covers the spinal cord. Without the use of fluoroscopic x-ray for precise placement, 25 percent of procedures will result in incorrect placements.

Sometimes one or two more injections are needed, every three or four months apart. They can provide temporary relief in about 50 percent of patients for back pain, sciatica, and neck pain with shooting arm pain.

Epidurals are a common treatment option for many forms of low back pain and leg pain. Fifteen percent of the U.S. population suffers from low back pain and incidence increases with age.

While the pain relief effects are temporary — a week to a year — injections early in an acute attack can be very beneficial in preventing chronic pain.

Sacro-iliac joint injections

These deliver anesthetic and steroid to the place where the pelvic and tailbone meet, resulting in increased mobility and less pain. Some pain management practitioners feel that combining the S-I joint injections with rehabilitative exercise and chiropractic release of the joint yields the best result.

Radiofrequency ablation

This can be used for longer-term relief of neck pain, back pain, and headaches from facet joint arthritis. Using fluoroscopic x-ray, heat generated by radiofrequency waves can be delivered precisely to damage small nerves, disturbing the transmission of pain signals from the spinal column to the brain. The effects usually last several months.

Pain intervention techniques

Muscle as well as joint pain can be treated in this way. Trigger points — tender, irritable spots in muscles that are painful to the touch — can be treated by injecting a mix of cortisone and a local anesthetic such as lidocaine or bupivacaine into painful muscle tissue, usually in the neck or back.

Spinal cord stimulators

These are somewhat like an implanted Transcutaneous Electrical Nerve Stimulation unit. The SCS is indicated for those who have chronic neuropathic pain and are not candidates for surgery but for whom other treatments and injections have not been effective.

Initially wires are implanted to the affected area with the generator for the electrical current worn externally. If this treatment helps to lessen pain, the SCS can be implanted by a surgeon.

Intrathecal pain pump implantation

This allows targeted drug delivery to help with intractable chronic pain. Since medication is delivered directly to the intrathecal area surrounding the spinal cord, a smaller dose can be used than if it were given by other means, there are fewer side effects such as sleepiness, upset stomach and constipation, as when medication is taken orally, and the pain relief is often dramatic.

If a trial shows a pain improvement of 50 percent or greater, the patient may be considered a candidate for implantation.

These interventions are definitely not appropriate for everyone, but if the more conventional methods of pain relief are not working, they should be discussed and considered.

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


Spinal Cord Stimulation to Treats Back Pain

Joseph Coupal - Friday, June 15, 2018
Comprehensive Pain Management in Warwick, RI

Walking down the sidewalk may seem simple, but a year ago, Michael Holtz was in too much pain to walk.

To help ease the pain, he would use opioids for pain relief.

He had nerve damage along the leg and had been in chronic pain. He was at the end of his rope.

Holtz has degenerative disk disease and has had more than 20 surgeries for chronic pain, taking a variety of prescription drugs including opioids.

Struggling with depression, and desperate for pain relief, Holtz tried everything.

Holtz was like many patients who are hitting a wall to manage their chronic pain.

He had tried cortisone injections, epidurals, acupuncture, physical therapy, a number of different blocks, radiofrequency ablation is a spinal nerves and continued to be quite dysfunctional with the pain.

But, spinal cord stimulation provided relief for Holtz.

Here's how it works: a small device consisting of wires and a battery is surgically implanted in a patient, controlling pain by delivering electrical impulses to the spine to block pain signals.

This therapy also gives the patient an opportunity to control the sensation, the stimulation, the intensity of what they’re getting themselves, vis a vi a bluetooth device.

Now six months later, Holtz controls his own pain.

The device is helping thousands of patients like Holtz suffering from chronic pain, get off medications, and avoid opioids

It does not involve a drug. It avoids the issues with dependence on medications and certainly with over treatment and undertreatment and withdrawal.

A spinal cord stimulator has a average life span of ten years. It’s remotely charged through the Bluetooth device. It’s a one-time surgery. You can swim and go on an airplane with it.

For more information, contact Comprehensive Pain Management in Franklin, MA.


Radiofrequency Ablation for Treating Arthritis Pain

Joseph Coupal - Friday, June 01, 2018
Comprehensive Pain Management - South Kingston, RI

Radiofrequency ablation (or RFA) is a procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.

Which Conditions Are Treated With Radiofrequency Ablation?

RFA can be used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis.

How Long Does Pain Relief From Radiofrequency Ablation Last?

The degree of pain relief varies, depending on the cause and location of the pain. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years. More than 70% of patients treated with RFA experience pain relief.

Is Radiofrequency Ablation Safe?

RFA has proven to be a safe and effective way to treat some forms of pain. It also is generally well-tolerated, with very few associated complications. There is a slight risk of infection and bleeding at the insertion site. Your doctor can advise you about your particular risk.

For more information on Radiofrequency Ablation for treating back pain, contact Comprehensive Pain Management in Franklin, MA.

Source: WebMD

Managing Pain in the Workplace

Joseph Coupal - Friday, May 18, 2018
Comprehensive Pain Management - Franklin, MA

Pain is the top cause of adult disability in the United States, costing the workforce as much as $334 billion each year in lost productivity costs, according to a 2012 study. While the musculoskeletal “pain points,” such as back pain and carpal tunnel, are well known and their direct costs well-documented, there has been less emphasis on—or awareness of—the secondary or mental health effects of pain: anxiety, depression, unclear thinking and memory loss.

Even what someone might consider mild discomfort or irritation can cause these secondary effects and can affect everything from sleep to diet to exercise. As a result, these conditions can—and often do—impinge on the workplace, with symptoms manifesting themselves in form of diminished employee morale, focus and performance.

There is also a “compounding effect”—the more pain persists, the more of an impact it can have. It may become a vicious cycle, as discomfort in one area causes problems in another. Employees who are suffering and unable to work miss out not only on the income, but also the sense of meaning, purposefulness and belonging that can be gained from a job. Initial distress may lead to chronic anxiety and even depression.

Those who are able to work may only be there in body, unable to focus and perform as expected. This is known as presenteeism and it can be an even greater drag on productivity than absenteeism. In fact, according to a recent report, the cost of presenteeism to businesses is 10 times higher than that of absenteeism and amounts to as much as 57.5 days lost per employee each year.

For more information on combatting the effects of chronic pain in the workplace, contact Comprehensive Pain Management in Franklin, MA.

Source: Risk Managment Magazine

How Spinal Cord Stimulation Works to Treat Chronic Back Pain

Joseph Coupal - Friday, May 04, 2018
Spinal Cord Stimulation Works - Franklin, MA

Spinal Cord Stimulator (SCS) systems work by interrupting pain impulses before they reach the brain to help you manage your pain and lead a fuller life.

The Science of Pain

Your nerves and brain are constantly communicating with each other. And when you feel pain, it's because the nerves are sending a pain signal to your brain. The pain can be acute, which occurs immediately after an injury and goes away within two months when treated properly. Or the pain can be chronic, which includes any type of pain that lasts six months or longer.

How Do Spinal Cord Stimulator Systems Work?

SCS systems have a small implanted pulse generator (IPG) and thin wires called ‘leads” that are placed into your body. To manage your pain, the leads deliver tiny pulses to specific nerves on the spinal cord that mask pain signals traveling to the brain. Some people say SCS feels like a gentle tingling or fluttering sensation that replaces the pain. The medical term for this is "paresthesia." The feeling is different for everyone and the amount of pain relief you receive from SCS therapy will vary.

Spinal Cord Stimulation, or SCS, may offer hope for many of the estimated 100 million people who suffer from chronic pain. For more information on spinal cord stimulation for treating back pain, contact Comprehensive Pain Management in Warwick, RI.

Employers Target Back Pain Through Wellness Plans

Joseph Coupal - Friday, April 27, 2018
Comprehensive Pain Management - Franklin, MA

Employee Benefit News (EBN) reports that back pain relief is gaining popularity as a wellness plan offering. Nearly half of Americans suffer from musculoskeletal disorders such as back pain and the annual cost of treatment and absenteeism to employers is around $213 billion annually. Back pain accounts for 10% of healthcare costs and is a major cause of lost productivity.

Employers spend three times as much on musculoskeletal disorders as cardiovascular disease. This adds up to about $1,200 per employee a year.

Poor posture often causes back problems, and one employer shared how it teamed up with UpRight, a wearables technology vendor, to help employees improve their posture. They created a device that can detect slouching and reminds employees to correct their posture.

Employee wellness programs have expanded beyond physical fitness, healthy eating and weight control. After employers learned more about what was distracting employees, wellness programs expanded to include financial and emotional well-being.

Helping employees manage back pain — a major and costly health concern — through wellness programs is a similar response to a critical need among employees.

A poll shows that 51% of remote workers suffer from back pain and other musculoskeletal disorders because they often develop poor working habits by not having an ergonomic setup at home. Offering back-pain management through wellness programs not only helps maintain a healthier workforce, it's also a way to engage off-site employees, who sometimes feel isolated from the workplace.​

For more information on back pain prevention at work, contact Comprehensive Pain Management in Franklin, MA.


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