Be Free From Back And Neck Pain

( - New York, NY – Acute and chronic unrelenting back and neck pain can wear a person down, causing them to assume the most drastic measure will be the most effective. This mindset drives many patients to seek surgical procedures that often lead to months of painful recovery and mediocre results without considering the alternatives. Recent research in The Journal of the American Medical Association has suggested that patients who opt for nonsurgical treatments can achieve the same benefits from pain reduction and improved function in the long run, as those who select surgery.

For acute and chronic, persistent and intense pain, the specialty of Interventional Pain Management has recently come to the forefront as the treatment of choice for patients looking for non-surgical alternatives. According to Interventional Pain Management Specialist Dr. Reza Ghorbani, “Many people don’t realize that surgery is not the only option. As doctors, it is our duty to not only help relieve our patients’ pain but to give them as much objective information as possible to make better decisions for their health.”

Dr. Ghorbani notes that up to two-thirds of Americans experience back pain at some point in their lives. “At The Advanced Pain Medicine Institute, we provide comprehensive management of our patients’ pain condition using the latest advanced and cutting edge interventional procedures, in return reducing persistent pain and improving the quality of our patients’ lives.”

What Makes Interventional Pain Management Different?

Separating itself from other specialties such as Chiropractics, Orthopedics and Neurosurgery, Interventional Pain Management seeks to relieve pain without the use of invasive procedures, providing minimal downtime for patients, making it an ideal procedure for those seeking pain relief without long periods of recuperation.

According to The American Chronic Pain Association, over 86 million Americans suffer from chronic pain and can be frustrated with previous surgical treatments that did not provide permanent relief. The specialty of Pain Management focuses on the prevention, evaluation, diagnosis, treatment and rehabilitation of painful disorders. On top of its healing benefits, Interventional Pain Management can also play a role in identifying the root cause of the pain, which if left untreated may affect many areas of life. Specialists realize that emotional problems, family relationships, financial anxiety and job-related distress and can all add to the cycle of pain.

When Should Someone Seek Treatment?

According to Dr. Ghorbani, “for most people, pain tends to dissipate with the usage of over the counter pain medications within a few weeks. However, the sooner the pain can be treated, the less likely it will get worse or cause other health issues.” Effort and cooperation from patients is crucial in gaining maximum benefit from Interventional Pain Management.

Dr. Ghorbani adds “there are three factors that determine whether a patient can have the optimal outcome: the right diagnosis, the right treatment and the right timing. Without these three factors, properly timed, patients often suffer longer than necessary.” Dr. Ghorbani notes he employs a three-tier system to guide his patients through the proper protocol for pain management.

· Tier I: Over-The-Counter Pain Management

o Many patients cope with pain for weeks or months with the aid of over the counter drugs such as Motrin, Advil, Tylenol, and traditional physical therapy programs. Dr. Ghorbani is introducing a new OTC pain reliever – Noxicare – to aid in pain relief:

§ Launching in mid-February 2010, Noxicare, a topical cream, is a breakthrough natural, patent-pending pain relief formula that is a proprietary combination of 7 of the world’s most potent natural pain relievers including tumeric, willow bark, ginger, holy basil, rosemary extracts, alpha lipoic acids and boswellia extract, that quickly and effectively alleviate inflammation, muscle aches and nerve pain—without side effects and without a prescription.

§ While some other products might reduce inflammation, decrease muscle aches or increase blood flow to ease painful nerve endings, Noxicare cream treats all three types of pain—not by numbing the pain point—but by targeting the source of the pain with a natural formulation that deeply penetrates layers of skin to help promote the body’s own healing process. Noxicare relaxes the muscle and reduces inflammation to alleviate pain, while working to increase blood flow to calm painful nerve endings. Noxicare will soon be available in tablets for all-over pain. Developed by Dr. Ghorbani, Noxicare has proven to be a valuable pain management tool, especially helpful for those suffering from athletic injuries, arthritis, fibromyalgia, neuropathy associated with diabetes, side effects of chemotherapy, musculoskeletal disorders and tension headaches.

· Tier II: Traditional Narcotics & Injections

o According to Dr. Ghorbani, after a patient spends three to four weeks in the first tier with no relief or results, they should be moved to the second tier, which consists of prescription-strength pain killers and pain management injections such as epidural steroid injections.

· Tier III: Minimally Invasive Procedures

o The third tier is meant to be a bridge between the second tier and the traditional next step of invasive spine surgery. Dr. Ghorbani believes in exhausting every non-surgical option available before spine surgery is required. In the third tier, a patient undergoes minimally- invasive procedures such as disc surgery with needles, lumbar decompression using fine instuments with no incision involved or a spinal cord implant using fluroscopy with local anesthesia and IV sedation. All of the above procedures are done as an outpatient with no hospital stay and fast recovery.

Conditions Treated by Dr. Ghorbani

Herniated/Bulging Disc, causes a type of pain also known as Sciatica, in which a bulging or herniated disc in the spinal cord causes pain to radiate from the lower back to as far as the toes. According to Dr. Ghorbani, treatment of sciatica is focused on the relief of pain, by reducing inflammation in the area of injury, therefore maximizing function and mobility.
Treatment: Epidural Steroid Injection
A widely accepted form of treatment for acute or chronic spine related pain, epidural steroid injections can provide pain relief and promote natural healing. The procedure is done using X-Ray guidance for precision and safety. This procedure is safe, takes only a few minutes and is done under local anesthesia and IV sedation as an outpatient procedure with no hospital stay. They can often stave off the need for more invasive procedures. Typical injections contain two parts – a steroid or cortisone to act as an anti-inflammatory agent, and a fast-acting local anesthetic to provide instant pain relief.

Treatment: Percutaneous Disc Decompression
A simple, innovative solution for treatment of Disc Herniations following failed conservative care. Dr. Ghorbani removes the herniated or bulging Disc under fluoroscopic guidance. This procedure uses a very small probe with no need for making an incision. This procedure, which only takes 5 minutes, can alleviate pressure on adjacent nerve roots. It is shown to be safe and effective in clinical studies and proven to considerably reduce pain intensity and improve functional status. An outpatient procedure using local anesthesia and IV sedation, it is correlated with low complication rates and faster recovery.

· Spinal Stenosis is a narrowing of one or more areas in the spine causing pressure on the spinal cord or nerves in the compressed areas. Spinal Stenosis can cause cramping, pain or numbness in the legs, back, neck, arms or shoulders; a loss of feeling in the extremities; and sometimes problems with bladder or bowel function.

Treatment: Minimally Invasive Lumbar Decompression (mild)
For patients who have not gained relief with other conservative treatments, mild is performed to relieve pressure on the spinal cord or nerves, minimally invasive lumbar decompression uses small needles and fine probes to remove a small portion of the bone to reduce pressure. The procedure takes about 45 minutes and is done with the use of local anesthetic and IV sedation as an outpatient procedure with no hospital stay. Patients are able to recover in a relatively short period of time with minimal discomfort.

Facet Joint Disease (Arthritis/Degeneration) is one of the most common causes of low back pain. The facet joint is like any other joint in your body - it has cartilage that lines the joint, (this allows the bone to glide smoothly over one another) and a capsule surrounding the joint. The function of the facet joint is to provide support, stability, and mobility to the vertebrae (spine). There are two facet joints between each vertebra. They are located on each side of the vertebrae. Facet disease can occur at any level of the spine, but are most common in the lumbar region. The Facet Joints naturally degenerate over time, at times causing pain due to an inflamed joint. These symptoms can cause spasms in the lower back, as an attempt to stabilize the lower back.
Treatment: Facet Joint Thermal Ablation (Rhizotomy/Neurotomy)
During Facet Joint Thermal Ablation, the Doctor uses radio waves similar to Microwave to deaden the nerve that innervates the joint and causes painful symptoms. By eliminating the nerve supply of the joint, Dr. Ghorbani can reduce pain associated with that joint. This procedure is safe, takes less than 10 minutes and is done under local anesthesia and IV sedation as an outpatient procedure with no Hospital stay.

Failed Back Syndrome is a collection of conditions that surface after any number of spine surgeries. Problems can include dull and achy pain, pain that radiates into the hips, buttocks, and thighs, or sharp stabs of pain in the back and legs. This corrective surgery is less invasive and provides great outcomes with pain relief to those who have previously received other treatments and surgeries.
Treatment: Spinal Cord Stimulator Implant

Also called SCS, this procedure uses electrical impulses to relieve chronic pain of the back, arms and legs. These electrical pulses prevent pain signals from being received by the brain and replace the feeling of pain with a tingling or massaging sensation, thus reducing or eliminating pain entirely. Candidates for this procedure include those who suffer from neuropathic pain secondary to Failed Back Syndrome or other spinal conditions for which conservative treatments have been unsuccessful. SCS Implant is safe, takes about 60 minutes and is done under local anesthesia with IV Sedation as an outpatient procedure with no hospital stay. Custom programs set up with the physician allow patients to control the level of stimulation.

About Interventional Pain Management Specialist Dr. Reza Ghorbani, MD
Dr. Reza Ghorbani, MD, ABIPP, FIPP, is a Harvard-trained, board certified Interventional Pain Management Specialist. He is the President and Medical Director for the Advanced Pain Medicine Institute in the Greater Washington, DC area. Dr. Ghorbani graduated with honors from Tufts University, followed by Tufts University School of Medicine. After his Surgical Internship at St. Elizabeth's Medical Center, he completed his residency in Anesthesiology at Harvard University's Brigham and Women's Hospital. Dr. Ghorbani went on to complete his Fellowship in Pain Management, also at Harvard University's Brigham and Women's Hospital.

Dr. Ghorbani is an active practitioner with offices at several Washington, DC area locations. He is a staff member at Suburban Hospital in Bethesda, Maryland, an affiliate of Johns Hopkins University School of Medicine, as well as a practicing surgeon at other respected hospitals and medical centers in the greater Washington, DC area. Prior to his move to Washington, DC in 2007, Dr. Ghorbani was in private practice, providing pain management services in Boston for 10 years


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