Dr Oz: The Revolutionary Cure for Pain in Pottsville

September 12, 2012 by

Schuylkill County: For those of you in pain it just doesn’t have to be that way anymore.  The Dr. Oz show titled The Revolutionary Cure for Pain was about this new treatment, what he termed the “Pain Eraser”.  Our office has the “Pain Eraser” since February 2012 and I can say the results I have seen are truly amazing.

chiropractor pottsville Dr Oz: The Revolutionary Cure for Pain in Pottsville

We have had incredible responses with patients that have rheumatoid arthritis. The reduction of pain has been astonishing, especially in their hands and feet.

Patients with chronic arthritis have also responded well.  Remo Piccioni of Pottsville could only walk one block because of his arthritic knees.  He was told his knees were so bad that they were bone on bone. He is now walking one half mile without pain.  Another patient could hardly walk without arthritic pain in both knees. She just returned from a cruise to Alaska and reported that she did well; she was able to move about the ship without pain and had no flare-ups.

We have had remarkable success with neuropathy with a number of patients.  Some responses have been very quick and others were slower but all responded.

chiropractor pottsville Dr Oz: The Revolutionary Cure for Pain in Pottsville

Remo Piccioni receiving the “Pain Eraser” treatment

Some other conditions that we have treated with great success are carpal tunnel and all types of shoulder pain.  We also have treated dozens of Schuylkill County residents with foot and ankle pains with extraordinary results.

Some of the most astonishing pain patients have been chronic back pain sufferers. We have a few patients that have “tried everything” and ended up at our office as their last resort.  The back pain specialists at Jefferson Hospital in Philadelphia saw one patient. He had a complete work-up for this back pain.  Nevertheless, he was told there was nothing they could do. Just come back when the pain gets worse.  With one treatment, he was moving his back and legs unbelievably better.  Another patient had back surgery and was not doing well.  He was “all over” looking for help.  He even had a series of ozone shots in his back muscles that helped temporarily. But one treatment and the “Pain Eraser” he walked out of the office pain free.

If you have pain, and are tired of “living with it”, you owe it to yourself to try the “Pain Eraser”.

Click on the link below to watch the Dr. Oz show on the “Pain Eraser”.

Dr. Oz: The Revolutionary Cure for Pain

 

Filed Under: Arthritis, Back Pain, Car Accidents, Carpal Tunnel Syndrome, Chiropractic, Foot Pains, Neck Pain, Sciatica, Shoulder Pain, Work Injury Tagged With: , , , , , , , , , , ,

It’s almost Christmas Eve! Santa’s Treatment Update

December 23, 2010 by Leave a Comment

Ho! Ho! Ho! 

Christmas is almost here!  Can you feel the excitment?  We can here at Doctors’ Choice because Santa’s been here getting ready for his big night!  He’s exercising and Doc Novatnak has been treating Santa with his extra special care, making sure Santa’a able to carry all those goodies to the children of Pottsville and all of Schuylkill County. 

Santa’s a great patient.  He has made all of his appointments and cheerfully exercises and follows his treatment plan.  Good thing too, his back was a complete mess when he started treatment here at Doctors’ Choice a few weeks ago.  Dr. Novatnak is confident that Santa will make his rounds, and not have any problems with low back pain on Christmas Eve. 

Everyone at Doctors’ Choice has enjoyed having Santa here preparing for the holiday season. 

Merry Christmas to all of our wonderful patients!  Have a safe and happy holiday season!

Filed Under: Back Pain, Chiropractic, Chiropractic News, Health Tips, Local News, Uncategorized Tagged With: , , , ,

Health Tips For Low Back Pain During Pregnancy in Pottsville, Schuylkill County

February 28, 2010 by Leave a Comment

Pottsville, Schuylkill County: We have treated many patients that have suffered from pregnancy low backache. About 66% of pregnat women suffer from it. One of the first questions asked is…

What’s causing my back pain?

Most likely blame your growing uterus and hormonal changes for your aching back. Your expanding uterus shifts your center of gravity and stretches out and weakens your abdominal muscles, changing your posture and putting a strain on your back.

The extra weight you’re carrying means more work for your muscles and increased stress on your joints, which is why your back may feel worse at the end of the day. Your growing uterus may also cause back and leg pain if it’s pressing on a nerve.

Hormonal changes during pregnancy loosen your joints and the ligaments that attach your spine to your pelvis.  This can make you feel less stable.  Because of this you may develop pain when you walk, stand, sit for long peroids, roll over in bed, get out of a low chair or tub, bend, or lift things.

What does pregnancy low back pain feel like?

Typically, there are two common patterns of low back pain in pregnancy:

  • Lower back pain
  • Buttock pain that may travel down your leg.

Some women have symptoms of both types of low back pain.

The low back pain may be similar to the back pain you may have experienced before you were pregnant. You feel it over and around your spine approximately at the level of, or a little above, your waist.  You might also have pain that radiates to your legs. Sitting or standing for long periods of time and lifting usually make it worse, and it tends to be more intense at the end of the day.

Buttock pain is even more common.  You may fell it deep inside your buttocks, on one or both sides, and sometimes down the back of your thighs.

Positions in which your hips are bent — such as sitting in a chair and leaning forward while working at a desk — may make the pain worse. Women with buttock pain are also more likely to have pain in the front of their pelvis over their pubic bone.

Could it be sciatica?

When low back pain radiates into the buttocks and thighs, it’s often confused with sciatica — a condition that’s actually relatively uncommon. True sciatica, caused by a herniated or bulging disk in the lower part of the spine, affects only about 1 percent of pregnant women.

If you have sciatica, your leg pain will usually be more severe than your back pain.  You are also more likely to feel the pain below your knee.  It may also travel to your toes.  Sciatica may also cause feelings of tingling or pins and needles in your legs, sometimes numbness.

Who is most likely develop low back pain during pregnancy?

Not surprisingly, you’re most likely to have low back pain if you’ve had this kind of pain before, either before you got pregnant or during a previous pregnancy. You’re also at higher risk of back pain if you have poor flexibility and weak back and abdominal muscles.

What can I do to get pain relief?

Pregnant women suffering from low back pain should:

  • Take it easy. Don’t let yourself get too fatigued. (But don’t take to your bed for long periods, either, since bed rest is generally not helpful in the long run for low back pain and may even make you feel worse.) Avoid activities like vacuuming and mopping that require you to bend and twist at the same time. If there’s no one else to do these chores, move your whole body rather than twisting or reaching to get to out-of-the-way spots.
  • Wear comfortable shoes and avoid high heels. As your belly grows and your balance shifts, high heels will throw your posture even more out of whack and increase your chances of stumbling and falling.
  • It’s equally important to avoid standing for too long. If you need to stand all day, try to take a midday break and rest lying on your side while supporting your upper leg and abdomen with pillows.
  • To get a good night’s rest, try sleeping on your side with one or both knees bent and a pillow between your legs. As your pregnancy advances, use another pillow or wedge to support your abdomen.
  • Listen to your body. If you find that a particular activity makes your back hurt, then avoid doing it!
  • Learn relaxation techniques. They may help you cope with the discomfort and may be especially useful at bedtime if your back pain is just one more thing that makes it hard to get to sleep.

When should I tell my doctor or midwife about my back pain?

You should always let your caregiver know that you have back pain. Studies show that although women complain about back pain, they infrequently tell their caregiver.

Although not required for treatment, we have received patient referrals from doctors and physician assistants for treatment of pregnancy backache.

Studies have shown that the type of hands on treatment we provide is safe and effective pregnancy backache.

If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our services.

Want To Know More?

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA

This information is solely advisory, and should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your medical history.

Filed Under: Health Tips, Pregnancy Back Pain Tagged With: , , , , , , , , , ,

Schuylkill County: What You Need to Know About Steroid Shots in the Spine (Epidurals)

November 4, 2009 by Leave a Comment

Pottsville PA: Over the last few years, I have observed more and more of our patients coming into our office after they were to the “pain clinic” and had shots in their spine (Epidural is the medical term).  Not long ago this treatment was unheard of.  Now we have three “pain clinics” in Pottsville alone.  There are lot more doctors giving these shots.
Before you subject yourself to this treatment for back or neck pain there are a few things you should know.

Acute Back and Leg Pain
In 1994, the Agency for Health Care Policy and Research of the U.S Department of Health and Human Services published a guideline titled Acute Low Back Problems in Adults: Assessment and Treatment.  They defined acute to mean low back and leg pain from day 1 to less than 90 days duration.
In this study, they reviewed all the current literature and only took into consideration the most valid studies.  There were 26 studies for epidural injections.  What they published and recommend concerning epidurals may astonish you.
An epidural shot was not a recommended treatment!
The report suggested an option of an epidural shot for sciatica (nerve pain down the leg) only to avoid surgery!  (At least one adequate study.)
The report recommended against an epidural shot just for back pain without sciatica!
Their recommendations concerning epidural shots have not changed in 15 years.

Chronic Back and Leg Pain
Chronic back pain is typically defined as pain more than 90 days duration.
In 2007, Web MD published an article titled; Steroid Shots for Back Pain Don’t Work.  The American Academy of Neurology’s Therapeutics and Technology Assessment Subcommittee reviewed four studies on epidural shots for back pain with sciatica.  What they found was epidural shots did not:
•    relieve back pain more than a placebo 24 hours, 3 months, or 6 months after injection,
•    appear to improve the patients’ average back function, and
•    help the patients avoid surgery.
There was a slight drop in pain 2 to 6 weeks after the injection compared with patients who got placebo injections, but it was not “clinically meaningful”.
In short, the Subcommittee advised against epidural shots for chronic back pain.

Our Experience and Recommendation
All interventions have risk; epidural shots are no exception.  One risk is spinal infection.  Unfortunately, one of our patients experienced this risk.  He was in Gesinger for an extended stay and was cut neck to his buttock.  Eventually the infection was stopped but he had scarring all along the spinal cord.  He was told he would never walk again.  When he came to our office, he was walking with a walker.  He was not expected to improve.

In light of the above, I have seen a few patients that have had their pain reduced by steroids, some for a few weeks, and some for a few months.  We have even recommended epidural injections when we thought it might be helpful as the patient was going through rehab for their back problem.
Now that your armed, if your doctor recommends an epidural shot for your back or neck pain talk to him or her about this information…. And Think Again.
I will talk about treatment recommendations in the future blogs.

You may want to read the WebMD artile linked below title, “Steroid Shots for Back Pain Don’t Work”

The most current thinking is that the epidural shots should be combined with conservative therapy, like we do at our office.

Looking for more information on the treatment of chronic low back pain in Pottsville PA?  Check out the “Back Pain”  tab on our blog page.

http://www.chiropractorpottsville.com

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA

Sources
You can find the clinicians U.S Department of Health and Human Services guideline at: http://www.chirobase.org/07Strategy/AHCPR/ahcprclinician.html
The Web MD article can be found at:

http://www.webmd.com/back-pain/news/20070305/steroid-shots-for-back-pain-dont-work

Filed Under: Back Pain Tagged With: , , , , , , ,

Schuylkill County: Whiplash—An Extraordinary Strain and Sprain Neck Injury

October 30, 2009 by Leave a Comment

Pottsville PA Whiplash Sufferers

Whiplash; What Is It? 

Whiplash is a rapid far-reaching strain to the muscles and sprain to the ligaments to the neck.  It usually also affects small ligaments around the small joints and discs between the vertebra.  It may cause “pinching” or irritation of the neck spinal nerves that can cause pain, numbness, and tingling down the arm into the fingers.

How does it happen? 

A rear-end car crash is the most common cause.  The sudden jolt to the neck from the crash happens so fast that you cannot brace yourself.  It a rear-end crash your head accelerates first back and then forward beyond the limits of the muscles and ligaments that hold our bones firmly together (often referred to as a “strain/sprain”). 

Your neck is very defenseless to this type of injury because your head, which weighs about 12 to 15 lbs, is attached at the top to a flexible neck.  This imbalance causes your neck to behave like a slingshot.  Whiplash injuries more commonly worse in women because women longer and weaker necks.  Older people may experience more extensive injuries because of preexisting conditions, like arthritis.

What are the symptoms? 

The primary symptom is neck or upper back pain.  Sometimes the pain develops immediately.  Most times the pain is delayed for hours or days.  Sometimes the onset of symptoms is delayed days, weeks, or months.  We have often seen patients with neck pain that they say happen for no reason or they just woke up with the pain.  The cause of this may be years earlier from a car cash.  We see evidence of the whiplash on x-rays.

Even if you do not feel pain after a car crash, a doctor that can recognize a whiplash injury should always examine you.

Each person’s symptoms may be different because of their own preexisting condition and their position at the time of the crash.  A partial list of possible symptoms includes: 

  • muscles spasms,
  • loss of movement,
  • headache,
  • dizziness,
  • concentration &/or memory loss,
  • difficulty swallowing, chewing &/or hoarseness,
  • burning or tingling,
  • shoulder/arm/hand radiating pain, and more.     

How is whiplash diagnosed? 

Usually by a doctor trained in the diagnosis and treatment of whiplash.  Even when symptoms are not present or seem insignificant, a doctor can take a careful history and perform a neurological and orthopedic exam.  The doctor may order special bending x-rays of your neck.  X-rays may show a change in the curvature or contour of your neck.  A MRI or CT scan to better assess the discs and nerve roots may be indicated when pain radiates down an arm.  When persistent concentration/memory loss is present, a consult by a neuropsychologist is helpful.

How is it treated? 

In most cases, non-surgical methods are usually appropriate.  If you go to a family medical doctor, typical approaches include a wait & watch approach.  This may be appropriate if you do not have symptoms.  If you do have symptoms he or she may order medications such as anti-inflammatory drugs, painkillers, &/or muscle relaxants.  Although helpful for pain, medications do nothing to help the physical mechanical problems of whiplash.

Some MD’s may refer you to a doctor of chiropractic or order physical therapy.  These types of therapy help the mechanical injuries.  Sometimes the muscle injuries may be so severe that a referral to a physiatrist or a doctor that performs trigger point injections is necessary.  If conservative treatment fails, surgery may be indicated.  Surgery may include repair for persistent disc herniation or spinal fusion.

Chiropractic care and physical therapy treatment may include:

  • modality use (electrical stimulation, traction/decompression, ultrasound),
  • spinal manipulation,
  • mobilization,
  • massage and other soft tissue release techniques,
  • exercise training,
  • activity modification training.

The goal is restore normal pain free neck function.  Care may also include a mix of provider approaches, when appropriate.

How can it be prevented? 

The degree of severity of whiplash can be decreased or maybe avoided completely by:

  • the use of seatbelts (especially in high speed collisions),
  • placing the headrest close to the head (less than1 inch),
  • placing the headrest high enough to avoid “ramping” over it. (slightly above the half way point)

I know from personal experience that this strategy has helped me.  I demolished my car a few years ago and the only injury I had was a half way torn fingernail.  I also have to credit the airbag.

My passenger had a preexisting herniated disc and he did not even get a sore neck!

It is also makes sense to avoid distractive activities while driving – cell phone use, adjusting the radio, taking your eyes off the road (eye contact during conversation), dosing off, reading a book (this is more common than you think!). 

Important to know! 

If you would like us to look at your driving position in your car, just give us a call and ask us.  We would be happy to do so at no charge.

Doctors of Chiropractic have a unique advantage over other health care providers.  Studies show that spinal manipulation and other manual therapies have the highest levels of patient satisfaction and faster recovery rates compared to other forms of health care. 

If you, a loved one, or a friend is struggling with whiplash from a motor vehicle collision, you can depend on receiving a great examination from an experienced doctor trained in whiplash.  The therapeutic approach at this office will encompass all different doctor specialties that may be necessary to resolve your injury.

Want to know more?

We have a 12-page booklet I authored that explains whiplash, diagnostic tests, and treatment in much greater detail.  If you woujld like a copy, we can send it to you by e-mail.  Just go to “Contact Us” in the black bar above and request the “Whiplash” booklet in the “Message” box.

http://www.chiropractorpottsville.com 

 

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA

Filed Under: Car Accidents, Whiplash Tagged With: , , , , , , , , , , , , , , , ,

Schuylkill County: Whiplash…Why Do I Hurt So Much?

October 28, 2009 by 2 Comments

 There are many reasons why whiplash from a car accident can cause long-term pain.

There are ligaments in the neck that can give rise to pain.  The most intense pain comes from ligaments with the largest amount of pain nerve fibers.  Such as ligaments around the joints and the spinal ligaments that hold the neck bones together.  In a whiplash type injury, these ligaments are over-stretched. 

A “whiplash” injury in a rear-end accident is unique.  Upon impact, your car rapidly accelerates forward while your head remains in its original position.  This action results in an initial straightening of your neck followed by an extreme backward movement of your head.  The ligaments and muscles in the front of the neck become over stretched and tear.  Next your head is propelled forward into extreme flexion, which can then tear the ligaments and muscles in the back of your neck.  All this occurs in slightly more than one-half a second!  It is so fact that you cannot even remember that your head went backwards.  It is faster than your brain can record this trauma!

Damage to the ligaments and muscles is difficult to “prove” by x-ray.  Bending views or, flexion/extension x-ray methods help show the damage to the joints.  On the bending x-ray, we will see an abnormal forward and/or backward shifting of the vertebra.  The more abnormal shifting the worse the whiplash.  Sometimes there is permanent damage.  The abnormal shifting of the vertebra on bending x-rays may be present for years or a lifetime.  That is why whiplash pain may be so chronic. 

Recent technology advances can now record the trauma and long-term damage to muscles.  At our office, we use “dynamic surface EMG” to measure how the neck muscles are working compared to normal.  We can measure muscle spasm and abnormal muscle movements.  This can be a great aid in helping to treat your injury and help your attorney to “prove” your “whiplash” or soft tissue injuries. 

Not all car accidents occur from behind.  In fact, only about 1/3 occur from this direction.

One study that investigated which direction of impact created the greater degrees of injury found that 57% of the chronic pain patient group were in a rear-end collision.

They also found that women had more ligament injury compared to men.  They surmised it was because women generally have longer and weaker necks.  Frontal and rear end collisions result in significantly higher levels of ligament injury compared to side impacts.

Another well-published reason why neck pain can “hurt so much” after a car crash is that the pain message from the “pain nerves” becomes “memorized” by the brain and nervous system.  It also takes less stimulation of the “pain nerves” (something as simple as turning your neck) to trigger the pain.

This is similar to the “phantom limb” phenomenon that often occurs after leg amputation.  Some patients can still “fell” the leg pain after the limb has been removed. 

Other symptoms beside neck pain often occur with “whiplash” injuries.  They may consist of: 

  • headache,
  • TMJ / jaw pain,
  • dizziness,
  • coordination loss,
  • memory loss,
  • difficulty in formulating thought,
  • poor communication,
  • losing your place during conversation, and more.

At Doctors’ Choice Physical Medicine and Rehabilitation, we have a unique advantage over other health care providers in the treatment of whiplash. We have a Doctor of Chiropractic, a licensed physical therapist, and licensed massage therapist to perform manual therapies, including spinal manipulation. These types of therapies yield higher levels of satisfaction and faster recovery rates compared to other forms of health care. 

 Patients with whiplash injuries need a thorough history and physical examination.  We understand and can perform the special diagnostic tests that are necessary to demonstrate or “prove” whiplash.  We have prepared the necessary reports for many attorneys for successful settlements.

If you, a loved one, or a friend is struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving high quality evidence-based therapeutic approach at this office.  

Want To Know More?

http://www.chiropractorpottsville.com

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA

 

Filed Under: Car Accidents, Whiplash Tagged With: , , , , , , , , ,

Schuylkill County: What You Need to Know About Steroid Injection in the Spine (Epidurals)

October 27, 2009 by Leave a Comment

Pottsville PA: Over the last few years, I have observed more and more of our patients coming into our office after they were to the “pain clinic” and had injections in their spine (Epidural is the medical term for this procedure). Not long ago in the Pottsville/Schuylkill county area, this treatment was almost unheard of for neck and back pain. Now it seems to be the recommendation of choice, even before more conservative treatment.

Before you subject yourself to epidural injection treatment for back or neck pain there are a few things you should know about it.

Acute Back and Leg Pain

In 1994, the Agency for Health Care Policy and Research of the U.S Department of Health and Human Services published a guideline titled Acute Low Back Problems in Adults: Assessment and Treatment. They defined acute to mean low back and leg pain from day 1 to less than 90 days duration.

In this study, they reviewed all the current literature and only took into consideration the most valid studies. There were 26 studies for epidural injections. What they published and recommend concerning epidurals may astonish you.

An epidural steroid injection was not a recommended treatment!

The report suggested an epidural injection for sciatica (nerve pain down the leg) as an option only to avoid surgery! (There was at least one adequate study.)

The report recommended against an epidural injection just for back pain without sciatica!

Their recommendations concerning epidural injections have not changed in 15 years.

Chronic Back and Leg Pain

Chronic back pain is typically defined as pain more than 90 days duration.

In 2007, WebMD published an article titled; Steroid Shots for Back Pain Don’t Work. The American Academy of Neurology’s Therapeutics and Technology Assessment Subcommittee reviewed four studies on epidural injections for back pain with sciatica. What they found was epidural injections:

  • did not relieve back pain more than a placebo 24 hours, 3 months, or 6 months after injection, 
  • did not appear to improve the patients’ average back function, and
  • did not help the patients avoid surgery.

There was a slight drop in pain 2 to 6 weeks after the injection compared with patients who got placebo injections, bit it was not “clinically meaningful”.

In short, the Subcommittee advised against epidural injections for chronic back pain.

Our Experience and Recommendation

All interventions have risk; epidural injections are no exception. Although small, one risk is spinal infection. Unfortunately, one of our patients experienced this adverse reaction. He was in Gesinger for an extended stay and was cut neck to his buttock. Eventually the infection was stopped but he had scarring all along the spinal cord. He was told he would never walk again. When he came to our office, he was walking with a walker. He told me he was considered lucky. He was not expected to improve.

In light of the above, I have seen a few patients that have had their pain reduced by epidural steroid injection, some for a few weeks, and some for a few months. We have even recommended epidural injections when we thought it might be helpful as the patient was going through rehab for their back pain and sciatica problem.

Now that you are armed, if your doctor recommends an epidural injection for your back or neck pain talk to him or her about this information…. And Think Again.

Our recommendations are:

  • If you have not failed conservative treatment for back and leg pain, such as anti-inflammatory medication with manipulation and physical therapy, do not do it. Do the conservative treatment before considering and epidural injection.
  • If you just have neck or back pain there is not any evidence in the peer reviewed literature that suggest an epidural would be helpful, do not do it.
  • If you have back and leg pain, failed at least 6 weeks of conservative treatment (no improvement in pain levels or function) and were told you need surgery, then there is some evidence that and epidural may provide some relief. The most recent consensus is that the epidural injection should be performed if you are also going through a exercise rehab program at the same time

I will talk about treatment recommendations in future blogs.

Want To Know More?

http://www.chiropractorpottsville.com

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA

 Sources

You can find the clinicians U.S Department of Health and Human Services guideline at: http://www.chirobase.org/07Strategy/AHCPR/ahcprclinician.html

The WebMD article can be found at:

http://www.webmd.com/back-pain/news/20070305/steroid-shots-for-back-pain-dont-work

Filed Under: Back Pain, Neck Pain Tagged With: , , , , , , , , , , , ,