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

Franklin Pain and Wellness Center

RSSGrab Franklin Pain and Wellness Clinic's RSS Feed

Tips for Managing Back Pain at the Office

Darren Kincaid - Friday, February 09, 2018
Comprehensive Pain Management - Franklin, MA

Over time, poor posture may be caused by habits from everyday activities such as sitting in office chairs, staring at the computer, cradling a cell phone, carrying a purse over same shoulder, driving, prolonged standing, caring for small children, or even sleeping.

Poor posture can easily become second nature, causing and aggravating episodes of back and neck pain and damaging spinal structures. Fortunately, the main factors affecting posture and ergonomics are completely within one's ability to control and are not difficult to change.

The following guidelines suggest several ways to improve posture and ergonomics, especially for people who work sitting in an office chair for most of the day.

  1. Identify the warning signs of back pain caused by poor ergonomics and posture

    Back pain may be the result of poor ergonomics and posture if the back pain is worse at certain times of day or week (such as after a long day of sitting in an office chair in front of a computer, but not during the weekends); pain that starts in the neck and moves downwards into the upper back, lower back, and extremities; pain that goes away after switching positions; sudden back pain that is experienced with a new job, a new office chair, or a new car; and/or back pain that comes and goes for months.

  2. Keep the body in alignment while sitting in an office chair and while standing

    When standing, distribute body weight evenly to the front, back, and sides of the feet. While sitting in an office chair, take advantage of the chair's features. Sit up straight and align the ears, shoulders, and hips in one vertical line. Any prolonged sitting position, even a good one, can be tiring. Shifting forward to the edge of the seat with a straight back can alternate with sitting back against the support of the office chair to ease the work of back muscles.

    Some people benefit from a naturally balanced posture that is achieved by sitting on a balance ball; in this posture the pelvis is rocked gently forward increasing the lumbar curve which naturally shifts the shoulders back (similar to sitting on the edge of a chair seat).

    Also be aware of and avoid unbalanced postures such as crossing legs unevenly while sitting, leaning to one side, hunching the shoulders forward, or tilting the head.

  3. Get up and move

    As muscles tire, slouching, slumping, and other poor postures become more likely; this in turn puts extra pressure on the neck and back. In order to maintain a relaxed yet supported posture, change positions frequently. One way is to take a break from sitting in an office chair every half hour for two minutes in order to stretch, stand, or walk.

  4. Use posture-friendly props and ergonomic office chairs when sitting

    Supportive ergonomic "props" can help to take the strain and load off of the spine. Ergonomic office chairs or chairs with an adjustable back support can be used at work.

    Footrests, portable lumbar back supports, or even a towel or small pillow can be used while sitting in an office chair, on soft furniture and while driving.

    Using purses, bags, and backpacks that are designed to minimize back strain can also influence good posture.

    Proper corrective eyewear, positioning computer screens to your natural, resting eye position can also help to avoid leaning or straining the neck with the head tilted forward.

  5. Increase awareness of posture and ergonomics in everyday settings

    Becoming aware of posture and ergonomics at work, at home, and at play is a vital step towards instilling good posture and ergonomic techniques. This includes making conscious connections between episodes of back pain and specific situations where poor posture or ergonomics may be the root cause of the pain.

  6. Use exercise to help prevent injury and promote good posture

    Regular exercise such as walking, swimming, or bicycling will help the body stay aerobically conditioned, while specific strengthening exercises will help the muscles surrounding the back to stay strong. These benefits of exercise promote good posture, which will, in turn, further help to condition muscles and prevent injury.

    There are also specific exercises that will help maintain good posture. In particular, a balance of core muscle and back muscle strength is essential to help support the upper body and maintain good posture.

  7. Wear supportive footwear when standing

    Avoid regularly wearing high-heeled shoes, which can affect the body’s center of gravity and induce compensatory alignment of the entire body, thus negatively affecting back support and posture.

    When standing for long periods of time, propping a leg up on a foot rest, wearing supportive shoe orthotics, or placing a rubber mat on the floor can improve comfort.

  8. Remember good posture and ergonomics when in motion

    Simply walking, lifting heavy materials, holding a telephone, and typing are all moving activities that require attention to ergonomics and posture. It is important to maintain good posture even while moving to avoid injury, walking tall with shoulders back for example.

    Back injuries are especially common while twisting and/or lifting and often occur because of awkward movement and control of the upper body weight alone.

  9. Create ergonomic physical environments and workspaces, such as sitting in an office chair at a computer

    It does require a small investment of time to personalize the workspace, home, and car, but the payoff will be well worth it. Undue strain will be placed on the structures of the spine unless the office chair, desk, keyboard, and computer screen, etc. are correctly positioned.

    It's much easier and less time consuming to correct everyday ergonomics and minimize back or neck pain than to add doctor visits and corrective therapies for debilitating pain conditions.

  10. Avoid overprotecting posture

    Remember that it is important to maintain an overall relaxed posture. Avoid restricting movements by clenching muscles or adopting an unnatural, stiff posture. For individuals who already have some back or neck pain, it's a natural tendency to limit movements to avoid provoking increased pain.

    However, unless there is a fracture or other serious problem, the structures in the spine are designed for movement and any limitation in motion over a long period of time creates more pain and a downward cycle of less motion and more pain.

The above changes are relatively easy to make and will pay off in terms of a healthier spine and less pain and stiffness over time.

For more information on managing back pain, contact Comprehensive Pain Management in Franklin, MA.

Source: spine-health.com

Understand Your Pain Treatment Options

Joseph Coupal - Thursday, February 01, 2018
Comprehensive Pain Management - Franklin, MA

Pain can be a debilitating condition, but there are ways to keep it under control. Learn about different pain management options.

Whether your pain is from arthritis, cancer treatments, fibromyalgia, or an old injury, you need to find a way to get your pain under control. What's the best approach to do that?

The first step in pain management is scheduling an appointment to determine the cause of your pain and learn which pain management approach is often the most effective for it. There are many different pain management options available: You can find the right treatment combination to get the relief you need.

Before you try to treat your pain, it's important to understand how pain is defined.

The International Association for the Study of Pain came up with a consensus statement. "Pain is an unpleasant sensory and emotional experience. That's extraordinarily important. When we focus only on the sensory aspect, we fail to appreciate the suffering component of the pain, which is important to recognize because pain is not what occurs at the periphery.

Why Do People Experience Pain Differently?

Pain is real and it's physical — there's no mistaking that. But pain is measured and specific to one person based on that person's perception of the pain, and that's why everyone's pain is different.

What the brain perceives is indisputably modifiable by emotions. That means that people who are fearful of pain, depressed, or anxious may experience pain differently and perhaps more severely, than someone who has pain but isn't experiencing those other emotions.

Pain Management: Treating Mind and Body

It is important to approach pain both physically and emotionally and address people as entire human beings. So while chronic pain medication can be effective and important for pain management for many people, it isn't the only tool available when it comes to pain treatment and it shouldn't be the only tool that's used.

Medications. There are a lot of medications that are prescribed for pain, although opioids (narcotics) and benzodiazepines may not be the best options. Those treatments have their own problems, and there are no good studies on using opioids for long periods of time for the treatment of chronic pain.

Types of chronic pain medication used include:

  1. NSAIDs (non-steroidal anti-inflammatory drugs), including ibuprofen, naproxen, and aspirin
  2. Acetaminophen (Tylenol)
  3. Antidepressants, which can improve sleep and alleviate pain
  4. Anti-seizure medications, which can be effective in treating pain related to nerve damage or injury
  5. Steroids, like dexamethasone and prednisone, to alleviate inflammation and pain

Therapy. Therapy can be aimed at both the mind and the body. It is important to look at any of these therapies as not being purely physical or purely psychological but a mixture of both of those things.

  1. Physical therapy is a very important part of any pain management program. Pain can be worsened by exercise that isn't done correctly (or interpreted incorrectly as pain rather than overuse), and a physical therapist can tailor the right exercise regimen for you. Proper exercise slowly builds your tolerance and reduces your pain — you won’t end up overdoing it and giving up because it hurts.
  2. Cognitive-behavioral therapy allows people to learn and have a better understanding of what the pain is from, and what they can do about it. This therapy is really about understanding the role of pain in your life and what it actually means for you.

Other pain management options. A variety of approaches and modalities can help you deal with both the physical and emotional parts of pain:

  1. TENS (transcutaneous electrical nerve stimulation) therapy
  2. Meditation
  3. Relaxation techniques
  4. Visual imagery, as simple as picturing a peaceful scene, for example
  5. Biofeedback, which teaches control over muscle tension, temperature, heart rate and more
  6. Heat and cold therapy
  7. Manipulation and massage

The bottom line: Seek help for your pain as soon as it becomes a problem in your life. We aren't guaranteed lives without pain. But when chronic pain starts to destroy your ability to function in the world, then it's a problem that needs to be addressed.

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

Source: everydayhealth.com

Spinal Cord Stimulation for Chronic Pain in the Back and Neck

Joseph Coupal - Thursday, January 11, 2018
Comprehensive Pain Management - Spinal Cord Stimulation in Franklin, MA

People whose back or neck pain has not been relieved by back surgery or other treatments may have another option to consider: spinal cord stimulation.

Around the world, some 14,000 patients undergo spinal cord stimulator implants each year. Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column, modifying or blocking nerve activity in a non-medicinal way to minimize the sensation of pain reaching the brain.

Spinal cord stimulation was first used to treat pain in 1967. Spinal cord stimulation was approved by the Food and Drug Administration (FDA) in 1989 to relieve pain from nerve damage in the trunk, arms, or legs, and now accounts for about 90 percent of all neuromodulation treatments. That number is expected to grow to manage chronic disease states as the population ages and as spinal cord stimulation is expanded to treat other diseases.

Spinal cord stimulation, also called neurostimulation, directs mild electrical pulses to interfere with pain messages reaching the brain. A small device implanted near the spine generates these pulses. The implanted generator used in spinal cord stimulation has similarities to a cardiac pacemaker, leading some to call the device a pacemaker for pain.

Growing Interest in Spinal Cord Stimulation

Spinal cord stimulation has been used for decades, and is being recommended for an increasing number of conditions. Failed back surgery syndrome, cervical and lumbar radiculitis, neuropathy, and complex regional pain syndrome are some conditions that may be helped by the therapy.

Smaller devices have made implantation less invasive, and innovations—such as devices that are compatible with magnetic resonance imaging (MRI)—have expanded the number of people likely to consider the therapy.

In addition, nationwide efforts to reduce reliance on opioid pain medications are bringing renewed interest to a range of pain-relief treatments that do not involve medications—including spinal cord stimulation.

Finding a doctor with experience is important in the case of spinal cord stimulation, as more experience generally leads to greater expertise. Also, spinal cord stimulation is a rapidly changing field of medicine, with new devices arriving frequently on the market. A specialist with experience in the procedure is likely to be more adept and up-to-date on the latest techniques and devices.

For more information on spinal cord stimulation contact Comprehensive Pain Management in Franklin, MA.

Source: spine-health.com

Happy New Year from Comprehensive Pain Management

Joseph Coupal - Wednesday, December 27, 2017
Happy New Year from Comprehensive Pain Management

Happy New Year from Comprehensive Pain Management. We would like to thank our patients, friends, family, and our community for allowing our business to be part of your lives in 2017. We wish all of you a wonderful and prosperous 2018!

If we have had the pleasure of being your choice for pain management this year, we hope that we provided the highest level of customer service, patient care, and met all of your needs. If you find yourself in need of the services we offer, we hope you come see us again in 2018.

It is our sincere wish that in the New Year you are surrounded by warmth, family, and friendship and that 2018 brings you good health and prosperity. From all of us here at Comprehensive Pain Management we hope you have a safe and exciting New Year surrounded by friends and family.

“We all come home, or ought to come home, for a short holiday – the longer, the better…” ~ Charles Dickens

CPM Annual Christmas Party

Joseph Coupal - Friday, December 22, 2017
Comprehensive Pain Management - Christmas Party 2017

 

Give A Free Holiday Gift in 30-Seconds or Less

Joseph Coupal - Wednesday, December 20, 2017
Comprehensive Pain Management - Give A Free Holiday Gift in 30-Seconds or Less

If a friend, relative, or valued service provider has a website, give them the gift of a business Facebook “like” this Holiday season. This act is free and will literally take you 30 seconds or less. By doing so, you help your friend or relative further establish business credibility and trust from an online standpoint.

Why do this? The reason is simple. Facebook “likes” is something that business owners can refer to promote their business popularity and interaction with their clients. It is also a widely accepted conclusion that Facebook “likes” play some role in how a website converts visitors into customers.

So if you know anyone with a website and wish them well in business, take 30-seconds and “like” their business Facebook page. Look for the Facebook logo usually located at the top or bottom of the website’s home page. Then shoot them a quick note saying, “Happy Holidays. I recently “liked” your business Facebook page and wish you continued business success in 2018 and beyond”. It would be a kind gesture and one that cost you nothing other than 30 seconds of your time.

To all our regular readers of this blog, we wish you all Happy Holidays and only the best for 2018 and beyond.

Back pain: What you can expect from steroid injections

Joseph Coupal - Wednesday, December 13, 2017

Comprehensive Pain Management in Franklin, MATry conservative measures first to control pain, and know the limits and risks of this therapy if you choose to try it.

Most people who suffer from back pain already know the drill: time heals this wound. Over weeks to months, the pain will calm down, and you will slowly return to your normal life. In the meantime, try to stay as active as possible and rely as much as possible on over-the-counter pain relievers.

But for some people, these conservative measures may not relieve the agony soon enough—especially if the problem is back pain caused by irritated spinal nerves. After a few weeks, just getting to the bathroom can be a challenge. At that point, you may be offered an injection of a steroid medication to calm the war zone in your lower back.

Even for nerve-related back pain, guidelines discourage hasty intervention with steroids. You would do less invasive, less aggressive things first.

However, if you choose this therapy, know its limits. The shots are almost always a temporary measure. In general, it's for symptom control, and not a definitive treatment.

Injection targets

Used appropriately, steroid injections can calm inflamed joints and tissues but do not speed healing or prevent future problems. Here are some of the most common targets for steroid injection therapy:

Epidural space. Epidural injections target the area around the spinal cord where nerve "roots" exit and extend to other parts of the body. The area near the nerve roots may be the source of low back pain, such as sciatica.

Tendons and bursae. Steroids are used for tendinitis—inflammation of a tendon, the tough, fibrous cord of tissue that connects muscle to bone. Steroids may also be used to calm down an inflamed bursa (bursitis). Bursae are cushioning pads of tissue that reduce friction between muscles and tendons as they move across bones and other joint structures.

Joints. Steroids are sometimes injected into a joint to calm inflammation related to arthritis. Common targets are the knee and the facet joints in the spine.

How long should you wait before considering injection therapy? It depends on the intensity of the pain and how long you can bear it before it starts to ease on its own. Most people experience substantial improvement in six to eight weeks.

How steroid shots work

Steroid injections contain various formulations of medications. A common combination is the numbing drug procaine hydrochloride—known to millions of dental patients as Novocain—mixed with the anti-inflammatory drug cortisone.

Once the injection finds its target, the numbing effect will start to wear off within hours. As the Novocain wears off, the pain may temporarily come back. Then 24 to 48 hours after the injection, you can begin to expect whatever benefit you're going to get.

What to expect

If the injection works, you'll certainly be grateful for the relief, but success is not guaranteed. In studies of large groups of back pain sufferers, the benefit is small to none on average. It's hard to predict what you, individually, will experience.

Steroid injections do not change the course of a chronic back pain condition. Months down the road, you will generally end up in the same condition as if you never got the shot. In the meantime, the shot could ease your discomfort.

For more information on epidural injections for back pain, contact Comprehensive Pain Management in Franklin, MA.

Source: Harvard Health

Kyphoplasty for Vertebral Fractures Reduces Pain and Opioid Use

Joseph Coupal - Thursday, November 30, 2017

Comprehensive Pain Management in Franklin, MABalloon kyphoplasty shows safety and efficacy in improving quality of life, pain, and functional outcomes, while reducing opioid use, among patients treated for vertebral compression fractures (VCFs).

It was found that all primary endpoints demonstrated statistical improvement and these were maintained or improved throughout a 12-month follow-up.

Secondary endpoints, including opioid usage, activity, angulation correction, and height restoration, also showed statistical improvement.

In balloon kyphoplasty, a minimally invasive treatment for VCFs caused by bones weakened from osteoporosis or cancer, the compressed bone is gently raised to its normal position and the cavity created is filled with orthopedic cement to stabilize the fracture.

The procedure differs from vertebroplasty only in the use of the balloon approach.

This, the largest prospective outcomes trial for kyphoplasty to date, involved 350 patients with painful, acute, or subacute VCF who were enrolled at 24 sites and underwent kyphoplasty.

The patients had a mean age of 78 years; 77% were female. All had one to three acute or subacute fractures less than 4 months old. Approximately half (54.9%) had bilateral kyphoplasty.

Most patients had VCF due to osteoporosis (343 of 350), and the remaining cases were due to cancer.

The patients' average pain scores were greater than 7 on a scale of 1 to 10, and disability on the Oswestry Disability Index (ODI) was greater than 30 on a scale of 0 to 100.

Follow-up data collected at 1-, 3-, 6-, and 12-month time points showed significant improvements in various measures.

In terms of the primary endpoints, patients showed significant improvements in the numeric rating scale for back pain, from an average of 8.7 at baseline (on a scale of 0 to 10) to 3.3 at 1 month, 2.7 at 3 months, 2.5 at 6 months, and 2.4 at 12 months.

Disability measures on the ODI showed improvement from 63.4 (on a 0-to-100 scale) to 32.9, 28.1, 27.1, and 27.2 at these time points, respectively.

Measures of quality of life improved to 34.9, 36.6, 36.6, 37.6, and 38 at the same time points.

Average score on the EuroQol-5-domain, which also assesses quality of life, improved from 0.383 points (scale of 0 to 1) at baseline to 0.693, 0.731, 0.739, and 0.741, respectively.

All improvements were statistically significant.

Importantly, the percentage of patients taking opioids dropped from 71.5% at baseline to 55.3% at 12 months.

The mean number of days with limited activity per month declined significantly from about 11 days to approximately 2 over the 12-month follow-up (P < .001 for all time points). The mean number of bed-rest days also dropped sharply from six per month to less than one (P < .001 for all time points).

In terms of measures of kyphotic angulation and vertebral height improvement, index fracture midline height improvements were observed at postoperative and 3-month time points, as well as at the 12-month time point.

In terms of adverse events, there were five device- or procedure-related events (1.46%), all of which resolved with appropriate treatment.

The current findings are notable in light of previous research questioning the benefits of vertebroplasty, including a study in the New England Journal of Medicine showing no improvement from the procedure over a sham treatment at all time points up to 6 months.

With as many as 40% of people over the age of 80 having had developed VCFs during their lifetime, and about 1.5 million people developing VCFs annually, the development of kyphoplasty is a very positive.

The findings build on previous evidence of potential benefits of kyphoplasty.

This study adds further evidence that kyphoplasty can be effective in treating painful osteoporotic compression fractures.

Previous randomized comparative studies have also shown benefit of balloon kyphoplasty vs medical treatment.

For more information on Kyphoplasty, contact Comprehensive Pain Management in our various loactions.

Source: medscape.com

Chronic Pain Management

Joseph Coupal - Thursday, October 26, 2017
Comprehensive Pain Management - Franklin, MA

A pain management specialist has 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.

The field of medicine understands that pain is complex. It is 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, prescribing of medications, 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. 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.

The most important consideration in looking for a pain management specialist is to find someone who has the training and experience to help you with your particular pain problem. You also need to feel comfortable with them. Many types of chronic pain may require a complex treatment plan as well as specialized interventional techniques.

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

Source: ASRA

Injections for Treating Pain

Darren Kincaid - Friday, October 13, 2017

Comprehensive Pain Management in Franklin, MA Injections of pain-relieving medication are common for the treatment of back pain. But, many more painful sites throughout the body can benefit from an injection such as arthritis in the knee, neck pain or hip pain; a joint injection may be just the thing you need.

How Injections Work

Injections can be used on various sites throughout the body to relieve pain and reduce inflammation. While inflammation is a natural part of the body’s immune response – and can therefore help us heal – the prolonged inflammation that occurs as part of many chronic conditions result in long-term pain and sensitivity.

Injections for knee, neck or hip pain may contain various medications; a physician will determine which ones are appropriate based on your particular condition. Typically, a combination of a local anesthetic and steroid medication will be utilized. While the anesthetic works to reduce pain in the short-term, the steroid will work to reduce pain and inflammation in the longer-term, usually up to several months.

A patient may still experience pain after the anesthetic wears off but before the steroid medication takes effect. This is normal and pain relief should occur soon. For some patients, one injection may be enough to provide adequate long-term relief; however, others may require several injections to experience the full benefits.

The Procedure

Injections are a simple, quick and precise way to treat pain at the source. In preparation for an injection, your physician will clean the area to be treated and then inject a numbing medication. To ensure that the medication is injected at the precise area it’s needed, the physician utilizes an X-ray device called a fluoroscope and a test injection of dye.

When the needle’s proper placement is ensured, a syringe filled with medication is attached and the medication is injected. After the needle is removed, the site may be covered with a small bandage.

More than Just Pain Relief

Injections help to both relieve pain and restore function. In doing so, they can also help an individual get more from physical therapy. And therapy, in turn, can actually help prolong and increase the pain-reliving effects gained from injections, in addition to preventing pain recurrence and re-injury.

In addition, the pain relief gained from the combination of injections and therapy can oftentimes help pain sufferers decrease their reliance on opioids. And a lower dose of opioids means a lower chance of dangerous opioid-related side effects.

Injections are a safe, low-risk way to treat pain at the source and get you moving again.

For information on injections for treating pain, contact Comprehensive Pain Management in Franklin, MA.

Source: apmhealth.com


Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Get e-mail notifications of new blog posts! Enter email address below.

Enter your email address:

Recent Posts


Archive