October 2022 – Northwest Suburban Pain Center

Auto Accidents and Pain

It is an unfortunate scenario to be involved in a car accident in the first place. The trauma of it all is in itself a turning point for most people. To add to this, physical trauma in the form of whiplash injuries as well as impact to the other body parts during the accident, culminating in a series of increased visits to the pain management physician’s office. The most common areas of pain we see secondary to a motor vehicle accident are the neck, lower back and shoulders. Most people are familiar with the term “whiplash injury”, but most incorrectly generalize this term with the entire body. This in fact is a physical re-demonstration of the cracking of a whip, especially in the cervical spine due to accidental impact. This causes progressive as well as chronic neck pain issues, which further radiates down the upper extremities in order to involve the nerve supply down the arm and into the fingers. Lower back and lower extremity pain issues are also a major area of either a new pathology that is generated as a result of that accident or aggravation in a pre-existing condition such as age-related degeneration or a slipped disc that was already affecting the patient, but now gets even worse in terms of pain presentation and neurological deficit. It is important that in the event of a motor vehicle accident, to seek immediate medical care depending on your situation. Regular follow-up with your primary doctor, and the need to see a specialist should be a priority. Most of these incidents end up in legal cases, to which the physician also has to be informed promptly. Interventional pain management techniques in addition to medication management are part of the treatment plan that is laid out for patients suffering from injuries they received during an MVA impact.

Imaging of the body part involved can include x-rays, MRIs or CT scans that show the amount of injury caused to it and the best pain management technique to be used. In most cases, if there was a pre-existing condition for which the patient was previously treated, and after the accident there was aggravation in pain or weakness, it is important to get a comparison of the imaging from before the accident in order to see progression or change in pathology of the affected body part. The physician’s office diligently documents every detail that the patient presents with, and answers he/she provides during the intake of history. This in combination with physical examination findings, physician recommendation and observation are the deciding factors for the length of care the patient will require, how much conservative management including physical therapy, dose and duration of medications that will be needed in parallel to interventions. Some patients even end up in surgery upon failing interventions. At Northwest Suburban Pain Center, we accept auto cases with open arms and guide the patients through their journey of pain caused as a result of these accidents in a stepwise manner as well as working alongside attorneys. If you think your pain started or has gotten worse as a result of a motor vehicle accident you were recently a part of, it is time you called us to take care of you !

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Low Back Pain and The Shopping Cart

Who says that only the current ongoing inflation is costing us the trip to the grocery store? The most common symptom of narrowing in the lumbar spine is when patients relate to us that when they go grocery shopping, the pain sets in and the cart comes to the rescue as they lean on it for some time until they are able to walk more. This is seen more and more commonly with central canal as well as foraminal stenosis in the lumbar spine. Dr. Bukhalo offers his insight into this by stating that in fact, his patients find themselves leaning towards the cart unconsciously as the pain flares up. Some of our non-shoppers describe this positioning as having to bend down while taking their evening walk and after a certain distance due to low back pain, while some who sing in the choir are not able to stand for very long and bend towards any support they can avail at the time.

When you think of how low back pain can affect such routines of our lives, it is important to think of how to manage this in the long term. The above body positioning examples are a way of relieving the pressure off the nerve root being compressed due to the narrowing in the spine. Similar is the action of steroids injected in the epidural space, where using their pharmacological qualities, they help reduce the pressure on the nerves overall. I like to put it as allowing the nerves to breathe a little. Always remember an irritated nerve is a nerve causing pain.

Such is the use of steroid-based epidural injections, or any other interventional procedure performed to ease the cause around the affected nerve. While we perform these on a daily basis, we adhere strictly to ensuring optimal placement of the needle using fluoroscopy, the comfort of our patient, sterilization, and most importantly establishing medical necessity. We see a lot of our patients wanting to “stay away from injections”, but if you are able to establish a direct correlation between your pain symptoms and the way it consciously and unconsciously affects your activities of daily living, you may want to reconsider if you want to live with constant pain, or make use of interventional state-of-the-art techniques to get better pain control. As Dr. Ahsan likes to explain to his patients, “medications throughout the day are just a band-aid” to your pain. I cannot emphasize enough how much this rings true to all our journeys with patients in pain.

If you think it is about time to address that nagging pain and dump the shopping cart, call us today!

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Regenerative Medicine: Treatment By Our Very Own

Regenerative medicine is a state-of-the-art technique involving one’s own stem cells and growth factors. Stem cells are the body’s own materials—cells from which all other cells with specialized functions are generated. There are 3 main types of stem cells: pluripotent stem cells, adult stem cells, and perinatal stem cells. Pluripotent stem cells divide into more stem cells or become any type of cell in the body. Adult stem cells are found in small numbers in most adult tissues such as bone marrow or fat, and they have a limited ability to give rise to various cells of the body. Perinatal stem cells are found in amniotic fluid and umbilical cord blood, and they have the ability to change into specialized cells.

One form of regenerative medicine is PRP or Platelet-Rich-Plasma. PRP uses a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles, and joints. One advantage of PRP is that they reduce the need for anti-inflammatories or opioids. The injections are created from your own blood, so the body will not react negatively to them. During the treatment, a small sample of blood is drawn and placed into a centrifuge that spins the blood at high speeds to separate the platelets from other components. The PRP is then injected into and around the point of injury, which will significantly strengthen the body’s natural healing of the tissue damage. A local anesthetic is used in the area of pain, and then the PRP is injected under ultrasound or fluoroscopic guidance to stimulate and enhance healing.

When PRP is injected into the area of pain, growth factors can initiate the body’s natural healing response to repair damaged tissue and restore normal function. The growth factors that play a role in tissue repair mechanisms are platelet-derived growth factor, transforming growth factor, insulin-like growth factor, and epidermal growth factor.

PRP therapy does not immediately remove the pain. However, the results are long term and often permanently heal the patient. Research studies and clinical studies have shown that PRP is very effective at relieving pain and allowing patients to return back to their normal lives. The need for surgery can be greatly reduced by treating injured tissues with PRP.

For now, regenerative medicine is an area which is not covered by insurance plans, however the price is very affordable and patients can get some competitive pricing from most providers. Northwest Suburban Pain Center offers services covering the full scope of regenerative medicine for pain conditions and we have had excellent clinical response as well as feedback from our patients.

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Healthcare Workers Go The Extra Mile

Just a week and a half ago, we bid farewell to a colleague who is moving to Texas. It was years of working together for a majority of the staff members, and the void is now a point of reflection for most of us who continue caring for our patients at NSPC. Work ethics, composure, and compassion are among the many required qualities of a healthcare worker. Due to recent COVID afflicted times, healthcare workers have been portrayed everywhere as heroes. It is really necessary to identify with this role at any level of the hierarchy. Dealing with the challenges when working in healthcare is always a shifting dynamic. Even in an outpatient setting, it is crucial for workers to meet the balance between the expectations of patients and the best possible treatment they can provide while staying realistic. Every patient brings to us a different story and every patient leaves us with a different experience to apply towards more to come. No matter what we are dealing with on a personal level when with the patient, that smile is always there so he or she feels better. When we lose good workers, we realize how much they contributed to the running of a healthcare setting. The open secret to patient care is a compassionate word and a patient ear that will listen. Moreover, some providers and their teams go the extra mile to invest in their patients’ care. Dr. Mohammad Ahsan is one such example; he prepares for his patients the night before so the care is well aligned to produce optimal results. This effort is recognized and applauded by the staff around him as well as it being apparent to the patient that their care is of utmost importance. When we see patients in pain, we offer a patient ear to their concerns, and narrations of how the pain has gotten worse, how they suffered a fall, or how the medication does not seem to work as well as expected. For this role, the gatekeepers are front desk staff as well as the clinical triage line, working tirelessly to provide the best possible response for patients. Dr. Yuriy Bukhalo and his team are very compassionate in offering immediate appointments depending on the patient’s pain level, listening to their concerns, and offering a personable foundation to the relationship. All our providers work diligently with referral coordinators to do their best in providing same-day interventions. Clinical offices, and especially specialist offices, are well known for a wait time before seeing the providers. We are no exception, and due to the fact that our providers spend an appreciable amount of time with patients individually, there tends to be a slight backup. A lot of our patients actually understand that since they in turn receive the appropriate time with their doctor. Dr. Meghan Bhave is well loved by her patients and is very concerned and compassionate towards her patients, their needs, and expectations. She and her team will not hesitate to go the extra mile so the patient feels comfortable. From a healthcare worker’s point of view, when we start our day, our focus is fully on our patients, and this is true for all levels of the hierarchy in the healthcare system, including non-clinical administration support staff. Patient care is the reason any issue that needs fixing is expedited at all levels of any healthcare organization. We care, is all we want to convey.

Business Insights Presented by Shooa Mohammadi, MPH for Northwest Suburban Pain Center Northwest Suburban Pain Associates

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Pain and Quality of Life

On an everyday basis, we witness patients in pain. Most come in later in their timeline of pain onset and one of the aspects that drives them to seek care is the impact of their pain on their quality of life. That one activity they absolutely love to do and pain comes in the way. Most of our patients play golf, some play tennis and some love to bake. When they have to think about the when and how of timing the activities they love to indulge in, because of the pain that sets in upon performing them, it is not invalidating to say, “Why!?” At the Northwest Suburban Pain Center, our providers are all board certified and fellowship trained to meet the expectations of their patients in the most profound manner. The goal is to ensure a better quality of life for our patients. What most patients are not aware of until they come to see a pain doctor is the fact that before contemplating surgery, there are interventional techniques to manage pain in one’s original anatomy. It can be your knee, hip, shoulder, spine, or muscle bodies. There is one more area that isagrowing part of pain management and that is regenerative medicine interventions which include platelet-rich plasma (PRP), amniotic fluid, bone marrow concentrate, adipose tissue, and much more by the day. While these procedures are not covered by health insurance, it is prudent to state that out-ofpocket pricing is very competitive today. If you want to find out if you are a candidate, please call us today for a consultation! We have seen success stories in our patients’ timelines with the clinic. In a moment of truth, pain management techniques do not cure you of the underlying condition. They only provide relief for a sustained period of time, until your body tells you it is in pain again. This is expected of the conditions that patients present with since a majority of pain conditions are irreversible except perhaps with surgery. However, the job of a pain physician is to make sure their patients can live with as little pain as possible before seriously considering surgery.

The term quality of life is inherent to our lives overall; it is how you wake up in the morning, how you are able to sleep at night, how you can twist to get that shot on the golf course, how you can bend down on your knees to help your child. It is all the aspects of your 24-hour day. It is how you would describe to someone when asked, “How’s life treating you?”. It is the goal to achieve improvement in leading a productive life, day to day, as well as in the long run.

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Treating Pain: Behind the Scenes With The Doctor

When patients walk in the door, most are literally bent in pain. There are so many conditions to treat and so many ways to help our patients, that it is relieving to know that pain management is one of the most growing fields of medicine, challenged by the variety of pain generators a single patient can present with. For instance, there can be one patient with multiple conditions for just the presenting lower back pain. It is due to stenosis in his/her spine, arthritis of the bony structures in the spine, irritation of the nerve at one spot or multiple levels in the spine, and each level supplies a different section of the limb or body part (also known as a dermatome). When pain physicians study your MRI or CT scan, they intricately study the various levels, pathology, and the best possible option to access the causative factor. It is fascinating to interact with patients to learn that the pain in and around their knees was actually coming from the spine!

Then follows an in-depth evaluation of imaging studies reinforced with physical examination findings and careful extraction of the most suitable treatment plan. Now, at times this treatment is not at all straightforward. As mentioned above, since there are multiple pain sources in just one individual, the physician’s job is to ensure maximum symptom resolution with the initial treatment. That is why multi-faceted treatments are offered one step at a time in a well-structured pain clinic. The common goal is to ensure patients in pain are offered all conservative and minimally invasive options, before contemplating surgery. All the physicians at Northwest Suburban Pain Associates come from diverse backgrounds and are extremely talented with regards to how pain is treated. They are trained in the most advanced techniques to date. All are fellowship trained, and board-certified and most carry the experience of over 20 years. While treatments initiate with epidural steroid injections to set a baseline assessment of how patient will respond, the physicians then go on to treat residual pain. All interventions are image-guided for optimal placement of medication; fluoroscopy and ultrasound, a combination of both at times.

Patients are gauged then to be candidates for more intricate, yet minimally invasive procedures. These include, and the list is not restricted to MILD (minimally invasive lumbar decompression), sacroiliac fusion (for patients not responding to steroid injections and radiofrequency ablation in this area), SCS (spinal cord stimulator)/DRG (dorsal root ganglion) trial for patients with peripheral neuropathy and post-operative pain, Intracept, Spinal Simplicity/ Minuteman that helps patients with spinal stenosis.

If you are in pain, call us today for immediate consultation!

Auto Accidents and Pain

Low Back Pain and The Shopping Cart

Regenerative Medicine: Treatment By Our Very Own

Healthcare Workers Go The Extra Mile

Pain and Quality of Life

Treating Pain: Behind the Scenes With The Doctor

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