Comparing “board certification” to eggs

The topic of “Board Certification” in pain management can seem to be about as confusing as trying to understand the label on a carton of eggs.  Your local grocery store has them all:  cage free, free range, vegetarian fed, no hormones, antibiotic free, and organic.  There are certainly differences in price for these types of…

Can e-cigarettes help me quit smoking?

Some of the concerns about smoking include cancer, nicotine, tar and carbon monoxide.  I have had several patients recently ask me if e-cigarettes would help them quit smoking tobacco, so I started looking into the data (and there’s lots of it out there – both pro and con).  Obviously, this is a very complicated topic…

Office-based injections more affordable

It’s no secret that hospitals have been aggressively purchasing physician medical practices over the past 5 years.  One reason for this is that hospital administrators have found new sources of revenue to support their large overhead.  Much of this revenue is in the form of facility fees and subtle changes in the way services are…

Use of steroids in epidural injections

The use of steroids in epidural injections has been considered “off-label” for many years, but it shouldn’t detract from the fact that there have been several properly conducted randomized trials and systematic reviews (as well as guidelines), showing significant long-term effectiveness of using them. Hundreds of thousands of patients every year avoid potentially unnecessary spine…

Sciatica Pain and Weakness: Is Surgery The Answer?

When patients seek medical care for a painful disc herniation and a motor deficit (muscle weakness, limping, or a dropped foot), the motor deficit sometimes becomes an overriding concern, steering patients toward early surgery.  A recent Netherlands study has disputed that notion.  While the motor deficit did improve significantly faster with surgery, the long term…

Spinal injections relieve pain and return patients to daily activities

Spinal injections, or epidurals, for low back pain have been found to help relieve pain and aid patients in returning to performing daily activities according to the results of a recent study.  The study, conducted by the Accreditation Association for Ambulatory Health Care Institute for Quality Care, reported that more than 78% of patients receiving…