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Trochanteric Bursitis

Man with back pain holding aching part We have bursae strategically placed throughout our bodies. These sacs contain a small amount of fluid, and they act as cushions between our bones and soft tissues, helping to reduce friction. They are especially important in our joints, such as the shoulders, elbows, hips, and knees. When we overuse an area where there are bursae, they become inflamed. This is bursitis. In our hips we have two major bursae that are prone to inflammation. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis. Another bursa — the iliopsoas bursa — is located on the inside (the groin side) of the hip. Inflammation in this bursa is not as common as in the trochanter, and the pain occurs in the groin. Dr. Trujillo helps our patients calm the inflammation of trochanteric bursitis at our Show Low practice.

What are the symptoms of trochanteric bursitis?

The main symptom of trochanteric bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may transition into more of an ache, and it can spread to a larger area. Typically, the pain with trochanteric bursitis is worse at night when the person is lying on the affected hip. It also can be painful to get up out of a chair after sitting for a while. Trochanteric bursitis often worsens with prolonged walking, stair climbing, or squatting.

Who gets trochanteric bursitis?

Hip bursitis can affect anyone, but it is more common in women and middle-aged or elderly people. These are risk factors for developing this form of bursitis:
  • Repetitive stress injury — Running, climbing stairs, bicycling, or standing for long periods of time causes inflammation.
  • Hip injury — Injuries from falls or simply lying on that side of the body for too long can lead to inflammation.
  • Spine disease — Scoliosis, arthritis of the lumbar spine, and other spine problems cause inflammation.
  • Leg-length inequality — If one of your legs is significantly shorter than the other leg, this tilt affects the bursae when you walk.
  • Rheumatoid arthritis — This form of arthritis attacks the joints, including the bursae in them.
  • Previous surgery — If you’ve had surgery around the hip of have had prosthetic implants placed, this can irritate the bursa.
  • Bone spurs or calcium deposits — These can develop within the tendons that attach muscles to the trochanter, irritating the bursa.
If you have chronic hip pain, it may be trochanteric bursitis. In January’s second blog, we’ll get into treatments of this painful condition. Until then, if you’re having hip pain, give Dr. Trujillo a call at (855) 768-4968 to schedule an appointment at Summit Healthcare Pain Clinic Associates.

You May Be Able to Have mild Treatment for Your Lower Back Pain

Adult woman is holding her lower back, suffering from unbearable pain. In December’s first blog, we got into lumbar spinal stenosis, its causes, and how treatment usually progresses. Those treatments often involve surgery, either a laminectomy or spinal fusion, to address the nerve compression that is spinal stenosis.

But Dr. Trujillo and Summit Healthcare Pain Clinic may have a better option for you. It’s called mild® and we’ll detail how it works in this final blog of a forgettable COVID year.

Who is right for mild® treatment?

Not every patient with lumbar spinal stenosis can have mild® treatment. During your appointment to see if it can work for you, Dr. Trujillo will go through your medical history and various possible tests:

  • Check limitations in mobility, standing duration, walking distance ability
  • MRI, CTs scan, or X-rays — Imaging tests that show bone, ligament, and discs
  • Myelogram — Spinal canal x-ray

As with all pain treatments, he’ll begin with the most conservative options, such as physical therapy, medication, possible steroid injections, maybe spinal cord stimulation. If those don’t relieve your pain, and if you have a specific buildup of bone and ligament tissue that is causing your compression, mild® treatment could be the next step.

How is mild® done?

mild® is an FDA-cleared procedure that has been performed safely on thousands of patients. After applying local anesthesia, Dr. Trujillo makes a tiny incision, smaller than a child’s aspirin tablet. Fluoroscopy is then used to guide Dr. Trujillo to the precise site of the nerve compression. Through this incision he inserts specialized tools designed specifically for mild® procedures. These tools are then used to remove small pieces of bone spur and excess ligament that have created the narrowing in the spinal canal. This creates more space for the nerves in the canal. This decreases or eliminates the nerve compression, which reduces pain and restores mobility.

The procedure takes less than 1 hour. There isn’t use of general anesthesia. There are no implants or stitches. The small incision can usually be closed with only a Steri-strip.

Documented results

As mentioned above, mild® is an FDA-cleared treatment. Clinical studies used to gain FDA clearance have shown that it is a safe procedure that can help patients stand longer and walk farther, with very low risk. Studies have shown an increase is standing time from 8 to 56 minutes. Walking distance increases rise from 246 feet to 3,956 feet. Pain is reduced by 53 percent.

Interested in doing something about your lumbar spinal stenosis without resorting to open surgery and fusion? Call us at Summit Healthcare Pain Clinic, (855) 768-4968. We can help.

You May Be Able to Have mild Treatment for Your Lower Back Pain

In December’s first blog, we got into lumbar spinal stenosis, its causes, and how treatment usually progresses. Those treatments often involve surgery, either a laminectomy or spinal fusion, to address the nerve compression that is spinal stenosis.

But Dr. Trujillo and Summit Healthcare Pain Clinic may have a better option for you. It’s called mild® and we’ll detail how it works in this final blog of a forgettable COVID year.

Who is right for mild® treatment?

Not every patient with lumbar spinal stenosis can have mild® treatment. During your appointment to see if it can work for you, Dr. Trujillo will go through your medical history and various possible tests:

  • Check limitations in mobility, standing duration, walking distance ability
  • MRI, CTs scan, or X-rays — Imaging tests that show bone, ligament, and discs
  • Myelogram — Spinal canal x-ray

As with all pain treatments, he’ll begin with the most conservative options, such as physical therapy, medication, possible steroid injections, maybe spinal cord stimulation. If those don’t relieve your pain, and if you have a specific buildup of bone and ligament tissue that is causing your compression, mild® treatment could be the next step.

How is mild® done?

mild® is an FDA-cleared procedure that has been performed safely on thousands of patients. After applying local anesthesia, Dr. Trujillo makes a tiny incision, smaller than a child’s aspirin tablet. Fluoroscopy is then used to guide Dr. Trujillo to the precise site of the nerve compression. Through this incision he inserts specialized tools designed specifically for mild® procedures. These tools are then used to remove small pieces of bone spur and excess ligament that have created the narrowing in the spinal canal. This creates more space for the nerves in the canal. This decreases or eliminates the nerve compression, which reduces pain and restores mobility.

The procedure takes less than 1 hour. There isn’t use of general anesthesia. There are no implants or stitches. The small incision can usually be closed with only a Steri-strip.

Documented results

As mentioned above, mild® is an FDA-cleared treatment. Clinical studies used to gain FDA clearance have shown that it is a safe procedure that can help patients stand longer and walk farther, with very low risk. Studies have shown an increase is standing time from 8 to 56 minutes. Walking distance increases rise from 246 feet to 3,956 feet. Pain is reduced by 53 percent.

Interested in doing something about your lumbar spinal stenosis without resorting to open surgery and fusion? Call us at Summit Healthcare Pain Clinic, (855) 768-4968. We can help.

A Less Invasive Way to Deal with Lower Back Pain

back view of man sitting on bed and suffering from back pain Most of us will deal with lower back pain at some point in our lives. According to the CDC, one out of four U.S. adults report having lower back pain within the last three months. It is the most common pain reported.

Often that pain will be due to nerve compression from lumbar spinal stenosis.

To reduce pain and increase mobility for those patients, Dr. Trujillo can perform a minimally invasive procedure known as mild®. Let’s get into mild for this year’s final two blogs.

Lumbar spinal stenosis

Lumbar spinal stenosis (LSS) is a condition where the spinal canal narrows and compresses the spinal cord nerves in your lower back. This compression in the lumbar spine is common — over 2 million Americans are diagnosed with it every year.

As we age, the natural wear and tear from the loads placed on our spine can lead to a number of contributing factors that cause the narrowing of the spinal canal — thickening of ligament tissue, formation of bone spurs on the lamina at the back of the vertebrae, and bulging or herniating spinal discs. These all can shrink the space available in the spinal canal. This is lumbar spinal stenosis.

What are the symptoms of LSS?

The narrowing of the spinal canal can cause several symptoms such as pain, numbness, or a tingling sensation in your buttocks, legs, and lower back. It may also limit the amount of time/distance you are able to stand or walk. If your symptoms increase when you walk or stand, but you experience relief when you sit or bend forward, then you may have a certain type of LSS that can be treated by the removal of excess tissue that is causing the narrowing of the spinal canal.

How is LSS typically treated?

Options for treating lumbar spinal stenosis have ranged from conservative measures such as steroid injections or physical therapy up to open surgery with a laminectomy or spinal fusion.

Obviously, open spinal surgery for LSS is difficult. Patients will typically stay in the hospital for 3-5 days. General anesthesia is used, and the patient has an incision that may run from 3 to 5 inches.

Fusion is a difficult surgery and involves a very lengthy recovery period. Plus, it can limit some movement because two vertebrae are fused together into a single piece.

If you’re the right patient, Dr. Trujillo may have a better option, mild®. You have to have the right situation to be a candidate, but if so, this is an amazing alternative to open surgery.

In December’s second blog, we’ll get into the details of how mild® is done. Until then, if you have any sort of chronic pain in your back, there’s no reason to live with it. Call Dr. Trujillo at Summit Healthcare Pain Clinic Associates, (855) 768-4968, to schedule an appointment to see how we can help.

Truth or Fiction About Your Back Pain

iStock 1278837533 Back pain is about as universal a condition as us homo sapiens have. Sooner or later over 80 percent of us will have back pain. Who said getting up off our arms and onto two feet was a good idea? 

At Summit Healthcare Pain Clinic Associates, we see all sorts of back pain due to all sorts of causes. Some are serious enough to merit surgery. Others respond to our treatments such as radiofrequency ablation or spinal cord stimulation. Others simply need some home TLC. 

But there are misconceptions out there that could be leading to your pain, so let’s cover a few of them here. 

  •     Sit up straight — Sure your mom always told you to sit up straight. But your back doesn’t like it all the time. It’s better to take a few breaks and lean back in your chair and let your back curve for a bit. And try standing for part of the day, such as when you’re on the phone.
  •     No heavy lifting — This may be a personal mantra, but you can lift heavy stuff, as long as you do it the right way. Squat down close to it, with your back straight and head up. Stand, using your legs to push up the load and your arms to hold it close to your middle. No twisting or bending your body.
  •     Bed rest for bad pain — While watching all eight seasons of Breaking Bad in one bed session could seem like a nice treatment for your aching back, it can actually make it worse.
  •     Back pain comes from injury — You’re just as likely to have back pain due to disc degeneration and other conditions as from trauma.
  •     Exercise is bad for back pain — At Summit Healthcare Pain Clinic, one of Dr. Trujillo’s first methods of conservative treatment is to provide certain exercises when you have hurt your back. These will start with gentle movements and build in intensity. Beyond that, regular exercise is the best way to prevent back pain.
  •     Firm mattresses are better — Nope. Research has shown that people who sleep on medium-firm mattresses hurt less than those who sleep on firm mattresses. There are many more mattress options today than just a decade ago, and many will allow returns up to 100 days after trying them out. Your back will tell you which one it likes.
  •     Weight doesn’t affect your back — Being overweight is one of the prime factors for ongoing back pain. You’re simply adding load to your lumbar spine. Overweight people who do not exercise also commonly have back pain.

OK, we’ve cleared up a few misconceptions about why your back is aching. Now to do something about your pain, call us at Summit Healthcare Pain Clinic Associates, (855) 768-4968 to make an appointment.

How is Fibromyalgia Treated?

iStock 1167360886 1 In October’s first scary blog we discussed the chronic pain disorder of fibromyalgia. This is still a somewhat mysterious ailment that seems to amplify pain sensations in the patient. 

As a pain specialist, Dr. Trujillo has extensive experience of fibromyalgia. In October’s second blog, let’s get into some of the treatments he may use to help our patients deal with the pain. 

What are the current treatments for fibromyalgia? 

At Summit Healthcare Pain Clinic, our treatments for fibromyalgia include a mix of medication, therapy, and self-care. There is no cure for this condition, but the goal is to minimize the symptoms and improve the patient’s general health. Treatment success varies with different patients. 

Medications

Medications seek to reduce pain and improve the patient’s sleep. 

  •     Pain relievers — We usually start with over-the-counter options, such as acetaminophen, ibuprofen, or naproxen sodium.
  •     Antidepressants — Duloxetine (brand name Cymbalta) and milnacipran (Savella) have shown to help ease pain and fatigue in some patients. Muscle relaxants can help with sleep.
  •     Anti-seizure drugs — Certain medications originally intended to treat the seizures of epilepsy are often useful for reducing certain types of fibromyalgia pain. Pregabalin (Lyrica) was the first drug approved by the FDA to treat fibromyalgia.

Therapy

With therapy, the goal is to strengthen the body and work around some of the pain. 

  •     Physical therapy — Exercises are used to improve strength, flexibility, and stamina. Water-based therapy can be a good option here.
  •     Occupational therapy — Occupational therapists help fibromyalgia patients adjust their workspace and the way certain tasks are performed to reduce stress on the body. 
  •     Counseling — Counselors can help patients cope with the pain and stress of fibromyalgia.

Self-care

Lifestyle changes and self-care are critical components in the management of fibromyalgia. 

  •     Stress reduction — It’s important for patients with fibromyalgia to limit overexertion and emotional stress. It’s good to keep working, as remaining active is important. We’ll help you with stress management techniques such as deep-breathing exercises or meditation.
  •     Sleep — Fatigue is one of the main symptoms of fibromyalgia, so getting more sleep is important. We’ll help you with sleep strategies and habits that will improve the quality of your nights.
  •     Exercise — Although it may seem counterintuitive, exercise can decrease your pain. This may not be the case at first, but exercise such as walking, swimming, biking, and water aerobics can be very helpful.

Alternative medicine

With chronic pain conditions, alternative therapies can be effective. That’s why meditation, yoga, and acupuncture have been practiced for thousands of years. 

  •     Acupuncture — This Chinese medical system inserts fine needles through the skin to various depths. The needles cause changes in blood flow and levels of neurotransmitters in the brain and spinal cord.
  •     Massage therapy — Massage can reduce the patient’s heart rate, relax tight muscles to improve range of motion, and increase the body’s production of natural painkillers.
  •     Yoga and tai chi — The combination of meditation, slow movements, deep breathing, and relaxation can be very effective for relieving fibromyalgia symptoms.

If you’re dealing with chronic pain of any sort, we need to hear from you. Call us at (855) 768-4968.

The Mystery of Fibromyalgia

iStock 640218792 Fibromyalgia is a chronic disorder that causes pain in the muscles and bones, areas of tenderness, general fatigue, and sleep and cognitive problems. Fibromyalgia is not fully understood, but research shows that when a person has fibromyalgia their pain sensations become amplified. 

Many doctors don’t understand this chronic condition and they misdiagnose what’s going on, as symptoms of fibromyalgia can mimic those of other conditions. 

Dr. Trujillo has extensive experience with fibromyalgia and can help you manage the condition. 

What are the symptoms of fibromyalgia? 

Fibromyalgia causes what is now referred to as “regions of pain.” Some of these regions overlap with what was previously referred to as areas of tenderness called “trigger points” or “tender points.” 

The pain in these regions feels like a consistent dull ache. The agreed upon diagnosis of fibromyalgia is if you have pain in 4 out of 5 regions of pain. This 2016 revision of the diagnosis of fibromyalgia updated the former criteria laid out in 1990 of “chronic widespread pain.” 

Other symptoms of fibromyalgia include: 

  •     Fatigue
  •     Sleep difficulty
  •     Long periods of sleep without feeling rested
  •     Headaches
  •     Depression
  •     Anxiety
  •     Trouble focusing
  •     Pain or dull ache in the lower body
  •     Dry Eyes
  •     Bladder problems, like interstitial cystitis

How is fibromyalgia diagnosed? 

When diagnosing fibromyalgia, Dr. Trujillo looks for widespread pain that has plagued the patient for over three months. This pain should be occurring in 4 out of the 5 areas of pain that have been used since 2016 in lieu of the former evaluation of trigger points. 

There isn’t a lab test for fibromyalgia, but Dr. Trujillo may order certain tests so that he is able to rule out other conditions that can display similar symptoms. These will usually be any of the following blood tests: 

  •     Complete blood count
  •     Erythrocyte sedimentation rate
  •     Cyclic citrullinated peptide test
  •     Rheumatoid factor
  •     Thyroid function tests

Diagnosing fibromyalgia is easier for Dr. Trujillo, who is a pain specialist, compared to most typical physicians who have little experience with the condition. 

In October’s second blog, we’ll get into how Dr. Trujillo treats fibromyalgia at Summit Healthcare Pain Clinic Associates. Until then, if you’re dealing with chronic pain of any sort, we need to hear from you. Call us at (855) 768-4968.

Tell Those Muscles to Relax

shutterstock 566470942 Sometimes when we’re tense or when we overuse a muscle it can stay tight and is difficult to relax. A knot forms in the muscle that can be quite painful. These knots can actually be felt through the skin. These are trigger points. 

At Summit Healthcare Pain Clinic Associates, Dr. Trujillo uses trigger point injections for our patients from Show Low and the surrounding areas. Trigger point injections encourage knotted muscles to relax, eliminating the pain they were causing. 

What is a trigger point? 

A trigger point is a highly sensitive bundle of muscle fibers that have been tensed for such a period, whether due to overuse or enduring stress, that they cannot relax, and they turn into a small knot. Unlike an area of muscle tightness or fatigue that can be wide in scope, trigger points are very specific spots that can be quite painful to the touch. 

Are there other reasons for developing trigger points? 

The main reason you develop these muscle knots is from overuse or from continued clenching due to anxiety or stress. But other factors can also increase your odds of developing a trigger point: 

  •     Repetitive movements
  •     Hunched or slouching posture
  •     Joint problems, such as with arthritis

What are trigger point injections? 

At Summit Healthcare Pain Clinic Associates, we help our patients with this acute muscle pain with trigger point injections. Here’s how Dr. Trujillo delivers these. 

He first feels for the trigger point. He’ll ask for your feedback as he pushes on the area of your pain. When he locates the trigger point, we clean the surface skin. In most cases, we then apply a topical numbing cream. Once the skin is numb, Dr. Trujillo inserts a needle containing a mixture of Lidocaine (anesthetic) and a corticosteroid down into the knot of the muscle and dispense the mixture into the location. The Lidocaine instantly provides pain relief; the corticosteroid reduces inflammation, which causes the muscle to relax and release the trigger point. 

We find that trigger point injections, thanks to the longevity of corticosteroid effects, often fully relieve the patient’s pain for months or even permanently. We can target various trigger points in a single session, if needed. 

Do you have a knot in back or neck? Call us at Summit Healthcare Pain Clinic, (855) 768-4968, and let’s see if trigger point injections could help.

More About the Pain of Sciatica

iStock 1203043225 In this month’s first blog, we got into sciatica, the painful nerve condition that causes pain to radiate down into the hips, buttocks, and legs. Since sciatica is a common condition, let’s give you some more information about it in this blog to start the fall. 

If you’re suffering from sciatica, Dr. Trujillo has many options for helping you get past the pain. 

What should I avoid if I am suffering from sciatica? 

You could think that moving as little as possible would be the best thing for sciatica. Actually, exercise and movement are better for relieving sciatica than bed rest. Inactivity makes the pain worse in most cases. In general, you’ll need to feel your way through movements or activities that seem to exacerbate your pain. 

There are certain exercises you’ll need to avoid, however. 

  •     Bent-over row
  •     Leg lifts and leg circles
  •     Full-body squats
  •     Weightlifting
  •     Abdominal stretches
  •     Rotating stretches
  •     Touch the toes stretches
  •     Running

What Are the Exercises That Help Sciatica? 

Sciatica exercise involves three keys: strengthening, stretching, and aerobic conditioning. 

  •     Strengthening exercises focus on the spinal column and supporting muscles, ligaments, and tendons. Beyond the back, these exercises focus on the abdominal, gluteal, and hip muscles.
  •     Stretching is important for sciatica, especially the hamstrings. The target of these stretching exercises are the muscles that are causing pain due to being overly tight and inflexible.
  •     Low-impact aerobic exercise is a component of treatment; it encourages the exchange of fluids and nutrients. Plus, aerobic exercise releases endorphins, the body’s natural painkillers.

Here’s a link to a variety of exercises for sciatica.

How long can sciatica last? 

The duration of sciatica typically depends on the type and severity of the underlying problem. In most cases, sciatica usually resolves in 4-8 weeks. This would be acute sciatica. Chronic sciatica can last up to two years. 

If you have pain in your hips, buttocks, and leg, typically on one side, please call us at Summit Healthcare Pain Clinic. We can help reduce the nerve compression that is causing your sciatica. Call us at (855) 768-4968 to schedule a consultation with Dr. Trujillo.

Sciatica Is a Pain…In the Leg

Copy of Copy of Copy of iStock 1166298317 1 The pain caused by sciatica is a common reason patients come see Dr. Trujillo and our team at Summit Healthcare Pain Clinic Associates. Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. It’s rare for sciatica to affect both sides, as the part of the nerve affected by the compression is usually only on one side of the body. 

Sciatica can cause debilitating pain, but the good news is that for most people they get better within 6 to 12 weeks. 

Dr. Trujillo helps our patients overcome the pain of sciatica. 

What causes sciatica? 

Sciatica most commonly occurs when a herniated disc, bone spur on the spine, or narrowing of the spinal column (spinal stenosis) compresses part of the nerve. This results in inflammation, pain, tingling, and often numbness down the affected leg served by the nerve. The term sciatica comes from the nerve that is being pinched, the sciatic nerve. 

What are the risk factors for sciatica? 

These conditions make it more likely that you may develop sciatica: 

  •     Age — Age-related changes in the spine (issues such as herniated discs and bone spurs) are the most common causes of sciatica.
  •     Obesity — Excess weight places more stress on the spine.
  •     Occupation — There is some thinking that jobs that require you to twist your back, carry heavy loads, or drive a vehicle for long periods of time contribute to sciatica.
  •     Prolonged sitting — If you have a sedentary lifestyle or have to sit for prolonged periods of time, you’re more likely to develop sciatica.
  •     Diabetes — Because diabetes affects the way your body uses blood sugar, this increases your risk for nerve damage.

Will Sciatica Go Away on Its Own? 

Whether your sciatica will resolve on its own is dependent on how bad the disc herniation or spinal compression is. It also depends on lifestyle issues. For instance, if you have a job that involves a good deal of heavy lifting, or prolonged sitting without breaks, both of those activities can damage discs. 

The key is to not take it easy. Movement is important to start the healing, coupled with ice/heat and anti-inflammatory medications. If you start exercising, particularly stretching your hamstrings and strengthening your core, there’s a good chance your sciatica will get better in a few weeks. 

Do you have pain in your buttocks and down a leg? You may have the nerve compression of sciatica. Please give us a call at Summit Healthcare Pain Clinic Associates, (855) 768-4968, to schedule an appointment so we can help you get past the pain.

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