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Injections for Pain

istock 508301579 1 Dr. Trujillo utilizes different methods to help his patients get past their chronic pain. From pain pumps to radiofrequency ablation to surgery, he has various tools at his disposal. But in some cases, the best option turns out to be injections of corticosteroids. These work to decrease the nerve inflammation that is behind the pain. These aren’t usually viewed as long-term or permanent solutions, but these injections can calm issues such as tendinitis to the degree that the condition resolves. In other cases, they are a good bridge to reduce the pain and inflammation while the patient uses exercise or physical therapy to build strength in the muscles surrounding the painful joints. In April’s two blogs, let’s get into the injection therapies we use at Summit Healthcare Pain Clinic.

Why injections?

Obviously, no one wants to deal with chronic pain. It begins to impact the patient’s quality of life. But at the same time, most patients hope to avoid surgery, such as joint replacement, or at least to delay the need. Corticosteroid injections can provide an effective treatment to help patients manage their pain without surgery. It can also be a good alternative to long-term oral medication use. These injections can enable patients to perform the exercises and build the strength needed to help decrease the causes of their pain moving forward.

Corticosteroid injections

Although all of these injections involve some amount of corticosteroid, they can also be the main ingredient. That’s the case when Dr. Trujillo uses these injections for arthritis pain. Because arthritis is, by definition, inflammation of the joint, the direct injection of steroid into the joint can make inroads against the inflammation. For these injections, Dr. Trujillo often uses x-ray guidance to ensure the proper placement of the injection. Because arthritis isn’t a condition that will reverse itself, the use of steroid injections is helpful to allow the patient to employ other means to try and protect their joints. Corticosteroid injections can be repeated, but they need to be spaced out at least 4-6 weeks. Patients cannot receive more than four injections within a year, as more frequency can lead to cartilage damage in the joint. In April’s second blog, we’ll get into two other injection options we use at Summit Healthcare Pain Clinic. Until then, if you’re dealing with chronic pain, please call Dr. Trujillo at (855) 768-4968 to schedule a consultation.

Repetitive Strain Injuries

adobestock 331416842 1 As its name implies, a repetitive strain injury is a result of prolonged, repetitive, and forceful movement. Such movements tend to be seemingly harmless at first — typing on a keyboard, hitting a tennis ball, hand movements by assembly line workers — but become increasingly harmful as the same movements are repeated over and over, day after day.

These repeated movements cause damage (also known as micro tears) to the muscles, tendons, and nerves of the body part involved. The most commonly affected parts include the fingers, wrists, forearms, and elbows. Repetitive strain injuries are not a specific medical disorder but rather a collective term of conditions such as carpal tunnel syndrome, bursitis, and tendonitis. Most of us will suffer the pain from one of these at some point in their life.

At Summit Healthcare Pain Clinic, Dr. Trujillo treats the pain from many issues caused by repetitive stress.

Common signs and symptoms of repetitive strain injuries

  • Numbness and tingling sensations
  • Weakness
  • Loss of grip strength
  • Sharp pain
  • Restricted mobility in the affected joints, tendons, and muscles

Are you at risk?

There are three basic components that increase your risk for repetitive strain injury: poor posture, poor technique, and overuse. The following factors can further put you at risk for these injuries:

  • Your job requires heavy computer use all day
  • Infrequent breaks
  • Lack of exercise
  • A stressful work environment
  • Long fingernails (These put the fingers in an unnatural position, consequently putting stress on your fingers.)
  • Chronic lack of sleep
  • Overweight or obese
  • Poor ergonomics
  • Existing health conditions such as diabetes, arthritis, thyroid disorders, or any condition that involves swelling

At Summit Healthcare Pain Clinic, we help you understand what movements or stresses are behind your tendinitis or other sources of pain. From there, we’ll work with you to correct the movements, if possible, and to help you deal with the pain in the meantime. Call us at (855) 768-4968 to schedule an appointment with Dr. Trujillo.

Problems with Your Hips

adobestock 236181436 1 Because the hips feature large bones, many people don’t think of them when it comes to chronic pain. The knees, shoulders, and even the ankles can seem more destined for overuse and damage.

Ah, but your hips will let you know when they’re not happy. At Summit Healthcare Pain Clinic, Dr. Trujillo helps patients get past their chronic hip pain so they can get back to doing the things they love.

What makes up the hips?

The hip is a ball-and-socket joint that joins the ball of the thigh bone (femur) to the socket of your pelvis. Inside the hip joint is a cartilage lining that cushions impacts between the femur and the hip socket. But those impacts can be pretty intense in the hips, and they can be very repetitive. That’s why dancers, gymnasts, and other athletes that participate in sports with impact often have damage to their hip cartilage, not to mention strains, bursitis, and the effects of osteoarthritis.

Common hip conditions

These are some common hip problems that lead to chronic hip pain:

  • Bursitis of the hip — Bursitis is the painful swelling of the bursae, the fluid-filled sacs that cushion areas where tendons and muscles slide across bone. When a patient has hip bursitis, the bursa at the top of the femur is affected. Because it is involved in so many movements, when this bursa is inflamed it can be very painful.
  • Arthritis in the hip — Osteoarthritis in the hip is gradual loss of cartilage due to daily wear and tear. As the cartilage wears down, or tears, it leads to chronic inflammation that can make it difficult to sleep, let alone perform certain normal activities. Usually, arthritis in the hip is in the form of osteoarthritis, but it can also develop after a traumatic injury.
  • Osteoporosis in the hip — When a person develops osteoporosis, their bone density drops. This leads to the bones weakening and breaking much more easily than is normal. A precursor of osteoporosis is known as osteopenia.
  • Avascular necrosis of the hip — If you’re old enough to know about Bo Jackson (if not, watch the ESPN 30-for-30 show or check out highlights on YouTube), this is the injury that sent him into retirement. A seemingly simple tackle led to dislocation of his hip. This led to avascular necrosis, where the bone tissue begins to die because it isn’t receiving enough blood. This eventually led Mr. Jackson to full hip replacement.

Having pain in your hips? Let’s see how we can help at Summit Healthcare Pain Clinic. Call us at (855) 768-4968 to schedule an appointment with Dr. Trujillo.

Degenerative Disc Disease

istock 865888454 Degenerative disc disease is one of the most common causes of low back and neck pain, but it’s not really a “disease.” As with spondylosis that we discussed in this month’s first blog, degenerative disc disease is misunderstood, except for the universal pain that it can cause.

Although called a disease, degenerative disc disease refers to symptoms of back or neck pain caused by wear-and-tear on a spinal disc or discs. In some cases, degenerative disc disease also causes weakness, numbness, and hot, shooting pains in the arms or legs. This is radicular pain. In most patients we see at Summit Healthcare Pain Clinic, their degenerative disc disease is causing low-level chronic pain with intermittent episodes of more severe pain.

Fortunately, Dr. Trujillo can manage the majority of cases of degenerative disc disease pain through non-surgical methods.

What causes the pain?

A degenerating spinal disc doesn’t always have a direct link to pain or other issues. The discs themselves don’t have nerves in them; the nerves are adjacent to the discs in the spinal cord and in the nerve roots exiting the spinal cord. The pain usually occurs when the degenerating disc affects other structures in the spine, such as the muscles, joint, or nerve roots.

This pain usually comes from two main factors:

  • Inflammation — Inflammatory proteins from the disc space interior can leak out as the disc degenerates, causing swelling in the surrounding spinal structures. This inflammation can produce muscle tension, muscle spasms, and local tenderness in the back or neck. If a nerve root exiting the spinal cord becomes inflamed, pain and numbness may radiate into the arms and shoulders in the cervical spine, or into the hips or legs in the lumbar spine.
  • Abnormal instability — As the outer layer of the spinal discs degrades, this can lead to small, unnatural motions between vertebrae. That’s because the normal outer layer is responsible for cushioning and support between the vertebrae. When these motions occur, this can cause tension and irritation in the surrounding muscles, joints, and/or nerve roots as the spinal segment becomes progressively more unstable. This can lead to intermittent episodes of intense pain.

Often both inflammation and instability can lead to muscle spasms. These can be quite painful. A muscle spasm is the body’s attempt to stabilize the spine.

If you’re suffering from any of the pain discussed above, it could be due to a degenerating disc. This merits a call to Summit Healthcare Pain Clinic Associates. Dr. Trujillo can help you with the chronic pain. Call us at (855) 768-4968 to schedule an appointment.

Spondylosis Equals Osteoarthritis

istock 860132590 1 Sometimes health care terms are as complex as the condition, or at least it can seem that way. Take the term “spondylosis.” That sounds like something intense, especially since hardly anyone has ever heard of the term.

In reality, spondylosis is not really a condition, but a term for degeneration of the spine usually due to osteoarthritis. It’s not a clinical diagnosis. Spondylosis is anything but rare. Just about everyone has some degree of spinal degradation over time. It’s simply the wear and tear from daily living.

Dr. Trujillo deals with the pain caused by this degradation in our spine, the degradation of spondylosis.

How is spondylosis diagnosed?

Since spondylosis isn’t a specific condition, Dr. Trujillo looks to find the specific source of your pain. This starts with a physical exam and taking a detailed history of the symptoms you’ve been having. He’ll check your range of motion when bending forward, backward, and side-to-side. He’ll look for an abnormal curvature in your spine. He’ll feel your spine for any tender spots, muscle tightness, spasms, bumps, or areas of inflammation.

He’ll most likely use magnetic resonance imaging (MRI) or computer tomography (CT) scans to help pinpoint the areas where the pain is originating. These imaging technologies allow him to see the soft tissues, such as the discs and the nerve roots. We also use x-rays to gauge the degeneration of your vertebrae.

Can spondylosis be prevented?

Our patients from around the Show Low area ask us what they can do to prevent this deterioration of their spine. Spondylosis is spinal osteoarthritis, and osteoarthritis is the most common type of arthritis. That’s because it is “wear and tear” arthritis caused by, well, simply living. Over 80 percent of people over the age of 40 will show evidence of spondylosis on x-rays. According to the Arthritis Foundation, spinal arthritis may affect as many as three quarters of people over the age of 60.

But that doesn’t mean you can’t do anything about it. These are some things you can do to help ward off the effects of spondylosis:

  • Stay active — It doesn’t have to be some killer workout regimen, just walking, moving, doing yard work, riding a bike, anything but sitting around all day.
  • Eat better — More fruits and vegetables. Less fat. Less red meat. More fish. You do need protein, so everything in moderation.
  • Hit your ideal weight — It’s hard when our metabolism slows to a snail’s crawl as we get older, but losing weight is simply a numbers game: burn more calories than you take in. Obesity is a good way to ruin your later years in life.
  • Reduce stress — Stress is tied to spondylosis. Try and mitigate it as much as possible.
  • Stop smoking — If you do, it’s time to stop. Smoking cigarettes is directly linked to osteoarthritis, as it impedes blood flow, which helps keep our joints healthy.

If you have chronic pain due to spondylosis, there’s no reason to simply live with it. Call Dr. Trujillo at Summit Healthcare Pain Clinic Associates, (855) 768-4968, and let’s see how we can help.

Botox Is More than a Wrinkle Relaxer

istock 1134005495 1 When people hear the brand name Botox, they assume it’s the wrinkle erasing phenomenon. But there’s much more to Botox than wrinkles. Beyond cosmetic use, the FDA has approved Botox for an ever-increasing variety of uses, everything from treating involuntary eyelid spasms to stopping excessive sweating to urinary incontinence.

Botox has even been approved for the treatment of chronic migraine headaches, and that’s where Dr. Trujillo puts it to use for our patients from Show Lo and the surrounding areas.

What causes migraines?

The causes of migraines are not fully understood. It is thought there are genetic and environmental factors involved. Changes in the way the brainstem interacts with the trigeminal nerve are thought to be involved. So are imbalances in brain chemicals.

What is chronic migraine? How are they different than other migraines?

The frequency is key. Chronic migraine is defined as having 15 or more headache days each month, with migraines occurring on at least 8 of those days, with headaches lasting 4 hours or longer. Chronic migraine is a distinct condition from other types of migraine headaches, like episodic migraine. Chronic migraines occur more frequently, and the pain is more severe.

What is Botox?

Botox is made of the botulinum toxin, a neurotoxin produced by the bacteria that cause botulism. In the 50s it was discovered that when this neurotoxin is injected into a muscle in a very tiny amount, it temporarily paralyzes the muscle. Botox is well known for its cosmetic treatment of wrinkles. When erasing wrinkles, the injected Botox stops muscles that form wrinkles on the upper third of the face from contracting. Botox blocks the nerve message from getting to the brain, so the muscle is not ordered to contract. Without the contraction, the wrinkle above the muscle doesn’t form.

How does Botox work on chronic migraines?

In 2010, the FDA approved the use of Botox for treatment of chronic migraines. Botox appears to work better in cases of more frequent migraines. The FDA did not approve Botox for use on non-chronic migraines. This is probably because Botox prevents migraines but doesn’t have an effect once an unexpected migraine happens.

For migraines, Dr. Trujillo injects Botox around the pain fibers involved in headaches. The Botox enters the nerve endings in the injection area and blocks the release of chemicals involved in pain transmission. Without these chemicals, pain networks in the brain are not activated.

Botox prevents migraines; it doesn’t address them once they start. It takes time to work. Usually, the second or third treatment session shows the maximum effect. One treatment session lasts from 10-12 weeks.

Do you suffer from chronic migraines? Call Dr. Trujillo at Summit Healthcare Pain Clinic, (855) 768-4968. Botox could be just the thing for you.

These Misconceptions Could be Hurting Your Back

copy of istock 898357594 If there is one thing about humans that is almost universal, it would be back pain. Studies have shown that sooner or later over 80 percent of us will have some degree of back pain. While it may have seemed like a good idea at the time, maybe getting up off our hands and arms and rising onto just two feet wasn’t such a great idea after all.

At Summit Healthcare Pain Clinic Associates, we see all sorts of back pain due to all sorts of causes. Most cases resolve through the use of conservative treatments and patience. Some are serious enough to merit surgery. But there are misconceptions out there that could be leading to your pain, so let’s cover a few of them in this second blog of 2021.

  • 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 actually 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 Mad Men 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, one of our first methods of conservative treatment are 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, the lower five vertebrae and discs heading into your pelvis. 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.

Don’t Get on the Bad Side of Your Tendons

istock 1157911166 At Summit Healthcare Pain Clinic, we see lots of patients with tendinitis. Basically, the term simply means the inflammation or irritation of a tendon. Our tendons are the thick fibrous cords that attach our muscles to our bones.

Let’s get into what causes so much pain with tendinitis, along with what Dr. Trujillo and our staff does to help our patients get past the pain.

What is tendinitis?

Inflammation or irritation. That could apply to many things in life, such as an overbearing boss. But when it applies to your tendons, the clinical term is tendinitis. Tendinitis will show itself with pain and tenderness just outside a joint. Technically, you can get tendinitis in any tendon, but it’s most common around the shoulders, elbows, wrists, knees, and heels.

What are some common conditions that are tendinitis?

You may know some common cases of tendinitis by their more common monikers:

  • Tennis elbow
  • Golfer’s elbow
  • Pitcher’s shoulder
  • Swimmer’s shoulder
  • Jumper’s knee

What are the symptoms of tendinitis?

If you’ve used your tendon to the point of inflammation, you’ll be able to feels in at the point where the tendon attaches to the bone. You’ll likely have:

  • Pain often as a dull ache, especially when moving the affected limb or joint
  • Tenderness at the location
  • Mild swelling

What causes tendinitis?

Tendinitis is most often caused by repetitive, minor impact on the affected area. If you keep performing the same movement over and over, as for work or a particular sport, the tendon involved becomes overworked and inflammation follows.

Tendinitis often results from a person using improper technique. This is especially true with repetitive sports, such as tennis, where the arm is placed in the same position over and over when contacting the ball. In this case, improper technique can create more vibration between the ball, racquet, and the arm, leading to more stress on the tendon and resulting tendinitis.

In December’s second blog, we’ll delve more into tendinitis, including how Dr. Trujillo helps patients get past the pain.

In the meantime, if you’re dealing with chronic pain, please call us at (855) 768-4968 to schedule an appointment.

More About Fibromyalgia

Fibromyalgia is a painful condition that affects the bones and muscles, creating widespread pain. Unfortunately, there is no cure. The key is to helping the patient manage the condition and handle the pain.

As a pain specialist, Dr. Trujillo and Summit Healthcare Pain Clinic are uniquely prepared and experienced both diagnosing fibromyalgia and then helping the patient handle his or her condition.

In this second November blog, let’s get into more about fibromyalgia.

How is fibromyalgia diagnosed?

The first threshold for diagnosis is that the patient has had widespread pain throughout the body for at least three months. In the past, doctors were to check 18 specific points on the patient’s body to see how many of them were painful when pressed firmly. That is no longer required.

Today, Dr. Trujillo looks for pain that occurs in four out of five areas. This has been the new standard since 2016, replacing the trigger points. These are the five areas:

  • Left upper region, including shoulder, arm, or jaw
  • Right upper region, including shoulder, arm, or jaw
  • Left lower region, including hip, buttock, or leg
  • Right lower region, including hip, buttock, or leg
  • Axial region, including the neck, back, chest, or abdomen

Treatments

Dr. Trujillo uses a combination of medications, treatments, and self-care strategies for his fibromyalgia patients. The goal is to minimize symptoms and improve the patient’s general health.

  • Medications — Over-the-counter pain relievers, antidepressants, and anti-seizure drugs are all used. Most not only reduce pain, but they can also improve the person’s sleep.

Therapies

  • Physical therapy — A physical therapist can teach you exercises that will improve strength, flexibility, and stamina. Water-based exercises are particularly helpful.
  • Occupational therapy — An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body.
  • Counseling — Talking with a counselor can help you build your confidence and reduce stress that is fueling your fibromyalgia.

Lifestyle changes

  • Stress management — It’s important to avoid or limit overexertion and emotional stress.
  • Sleep habits — Developing healthy sleep patterns and routines fights insomnia.
  • Regular exercise — At first exercise may be painful, but over time it will decrease symptoms.
  • Healthy lifestyle — Better diet, cutting out tobacco products, limiting caffeine, and seeking out things that you enjoy and fulfill you.

If you’re suffering from chronic widespread pain, you may have fibromyalgia. Please call Dr. Trujillo at (855) 768-4968. We can help.

The Amplified Pain of Fibromyalgia

Fibromyalgia is a condition that affects the bones and muscles. It is characterized by widespread muscle and joint pain and fatigue. Although not fully understood, researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.

As if that weren’t bad enough, fibromyalgia is often misdiagnosed by many providers, as its symptoms can mimic those of other conditions.

Dr. Trujillo has extensive experience with fibromyalgia and helps patients manage their condition. In November’s two blogs, let’s get into this painful, mysterious condition.

What is fibromyalgia?

Fibromyalgia is the second most common condition affecting your bones and muscles. Symptoms often begin after an event, such as physical trauma, surgery, infection, or significant psychological stress. But in others, the condition gradually builds without a triggering event. When a person has it, they have widespread musculoskeletal pain, accompanied by fatigue, sleep, memory, and mood issues.

What causes fibromyalgia?

Although the true causes of why a person develops this condition aren’t fully understood. It’s generally acknowledged that it’s a problem with how the brain and spinal cord process pain signals they receive from the nerves. It’s thought that repeated nerve stimulation causes the brain and spinal cord of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain. It also seems that the brain’s pain receptors develop a sort of memory of the pain and become sensitized, meaning they can overreact to painful and nonpainful signals.

Who is more at risk of developing fibromyalgia?

There are certain risk factors for this condition:

  • You’re a woman
  • You have another painful disease, such as arthritis, or an infection
  • You have a mood disorder, like anxiety or depression
  • You were physically or emotionally abused or have post-traumatic stress disorder
  • You are sedentary
  • Other family members have it

What are the symptoms of fibromyalgia?

The short description is that the person aches all over. These are common symptoms:

 

  • Muscle pain, burning, twitching, or tightness
  • Low pain threshold or tender points
  • Draining fatigue
  • Trouble concentrating and remembering
  • Insomnia
  • Feeling continually nervous, worried, or depressed

Doctors often misdiagnose fibromyalgia as osteoarthritis, bursitis, or tendinitis. The difference is that with fibromyalgia, the pain and stiffness isn’t localized but throughout the body.

In this month’s second blog, we’ll delve deeper into fibromyalgia.

If you’re suffering from chronic pain, please call us at Summit Healthcare Pain Clinic, (855) 768-4968.

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