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Cigarette smoking and it’s detrimental effects to a person’s health has been widely publicized and how it is linked to different types of cancer, cardiovascular and respiratory diseases, but it also is linked to back pain. The Centers for Disease Control and Prevention estimate that 42.1 million Americans smoke cigarettes and many of them suffer from a health condition related to this habit. Smokers are more prone to back pain and back pain is one of the leading causes of disability and is the most common reason for people missing work.

Smoking cigarettes and the chemicals found in them can affect back pain in a few different ways. The nicotine in cigarettes causes disc degeneration when the blood flow to the discs between the vertebrae is restricted, and it is a common form of back pain. The chemicals in cigarettes reduce calcium absorption which prevents bone growth, and can lead to osteoporotic fractures due to low bone mass. Smoking cigarettes affects these body functions but it also affects the brain.

Researchers have found that smoking interferes with the brain’s circuit for pain, and leading to smokers being prone to back pain. Two regions of the brain, the medial prefrontal cortex and the nucleus accumbens play a large role in chronic pain development. Smokers have been found to have a stronger connection between these two regions of the brain and are less resilient to pain.

The link between cigarettes and health conditions including chronic back pain has been researched by many and found that cessation of smoking could help improve health conditions. When a patient is suffering from back pain and going to have surgery many physicians recommend to stop smoking due to its adverse effects on health and recovery. The habit of smoking plays a role in chronic back pain and could be worsening ones condition.

Whiteman, Honor. (2014) Smoking linked to increased chronic back pain. http://www.medicalnewstoday.com/articles/284869.php

Knowyourback.org (2015) Retrieved from http://www.knowyourback.org/Pages/SpineInTheNews/FeatureArticles/BackHurtPutDownthatButt.aspx

Cdc.gov (2015) Smoking statistics. Retrieved from http://www.cdc.gov/tobacco/data_statistics/index.htm

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We are very thankful to the California Legislative Assembly and Assembly Woman Melissa Melendez for recognizing our medical practice.

We always strive to provide the best care possible and recognition from our peers is always welcome and keeps us motivated to fulfill our mission.

I would like to thank our Patients for their support and our Staff for there diligence and hard work that made this possible.

Lets keep doing what we do. High five

Helen came to us with several years of neck pain attributed to arthritis in her cervical spine. The pain was severe, caused her headaches and affected her sleep. She had pain in her neck when she turned her head and had difficulty looking around when she was driving. Pain was constant. We evaluated her at Pacific Pain Pain Care, got MRI’s of her cervical spine and diagnosed her with cervical facet arthritis.

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The facet joints are small joints in the cervical spine that allow for extension and rotation of the cervical spine. When these get arthritic you get pain in the neck and shoulder blades often with associated headaches when you turn or twist your neck.

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In the first instance we treated her with medications and Physical therapy. When this did not relieve her symptoms we performed diagnostic medial branch nerve block in the cervical spine with local anesthetic only. When we were sure she had excellent relief from the diagnostic locks we went on to perform radio frequency ablation/rhizotomy (burning) of these same nerves for long term pain relief. Procedure was done in our office, no sedation was used. She is here 6 weeks post procedure follow up and doing well with less pain and more range of motion of her neck. Able to drive and check her blind spot too..

To discuss your options call 855 854 PAIN (7246). Office locations- Wildomar CA, Corona CA.

ecently Miguel has been seen in our clinic for sciatic pain from his low back down his leg. The pain was described as sharp, shooting constant pain down the back and side of his leg to his foot. The pain was disabling him and affecting his work and life style. After we examined him we ordered an MRI of his Lumbar spine which showed a L5/S1 disc bulge pressing on his left L5 and left S1 nerve. We performed a type of epidural called a trans- foraminal epidural where we inject steroid around the nerve root of the L5 and S1 nerve. This reduces the inflammation and the pressure on the nerve. This resulted in pain relief for Miguel. He was able to resume his normal activities with less pain.

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This type of injection is very specific to a nerve that has been identified as causing the pain, the nerve is identified by patient history, site of pain complaints and also MRI of his spine totfesi determine what disc is pressing on what nerve. This type of procedure allows us to deposit high concentrations of steroid at a particular site without having all the side effects of taking oral steroids like a Medrol dose pack or having an epidural that is not proximate to the site/cause of pain. The procedure is done with live x-ray (fluoroscopy) guidance and contrast material is used to ensure that the nerve in question is identified and no medicine is injected into blood vessels or into the spinal fluid. Once absolute confirmation of needle location is established, the steroid medicine is injected. Our results have been promising for this type of injection. If you suffer from similar complaints then this procedure might be beneficial to you. Each procedure has its own unique sets of risks and benefits that your physician will discuss with you.

People often ask us what it is that we do. Patients who are referred to us often don’t know why they were sent to us. This blog is to explain what we do, why you need to see us and how to find a reputable pain management doctor.

People often develop pain in there life that lasts beyond 4-6 weeks. This is called Chronic Pain. Some causes of chronic pain are arthritis, spinal stenosis, sciatica, bulging discs, post surgical pain, diabetic neuropathy, chronic headaches etc.. etc.. Typically these conditions are treated by Internal medicine and family physicians with medications. If the pain is not being controlled you may need to see a pain management specialist.

Many times these conditions are not amenable or curable by surgery. But,...

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We would like to thank our patients for there support and well wishes over the last year and are very honored to receive gifts and cards from them. Below I have posted copies of some of the cards we got. The encouragement helps us to stay focused on our mission.

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John has been a patient of ours for several months. He was referred by his Neurologist for the treatment of post stroke pain. Initially he had pain in his right arm, right lower back and right leg after a left hemisphere stroke 3 years ago. He had been suffering for several years with this pain and reduced function of his right arm. His physicians prior had been treating him for chronic post stroke pain with medications.

When he started seeing us we tried a variety of medications including opioids, anti-neuropathics, anti spasmodics and NMDA antagonists with minimal relief and cognitive side effects. We obtained an MRI of his Cervical spine to see if his right arm pain was coming from discs in his neck pressing on the nerves of his right arm, He did have some disc bulges with nerve root compression and underwent cervical epidural steroid injections with some relief. His right low back pain was found to be arthritis of the right lower lumbar facet joints from physical examination and MRI of his lumbar spine. We performed radiofrequency ablation of the nerves supplying the right lower lumbar facets with excellent relief of his low back pain and also his right leg pain which was from the facet joints also. His low back pain was resolved.

The right arm was still bothering him, the cervical epidural did not give him the long term relief we expected. We then changed our focus to his right shoulder as a possible pain generator. We obtained an MRI of his right shoulder which showed an old rotator cuff tear- the ends were too far apart to approximate and was not amenable to surgery as he was at high risk for frozen shoulder. Per his orthopedic surgeons (2 opinions) he would need physical therapy and cortisone shots in his right shoulder. He got these, but they were not helpful.

We started him on a course of proliferative therapy (prolotherapy) injections in his shoulder, capsule and bursa’s with ultrasound guidance. This helped with his pain by causing inflammation and proliferation of fibrous tissues to strengthen his shoulder capsule. As a result he has less pain and uses less pain medication. Also as seen on the video his right arm function is returning the loss of which was attributed to his stroke but turned out to be originating from his shoulder.

To discuss your options please call us on 855 854 PAIN to schedule an appointment in one of our offices in Corona, Wildomar or Costa Mesa serving surrounding cities of Newport Beach, Irvine, Anaheim, Santa Ana, Garden Grove, Huntington Beach, Orange County, Murrieta, Temecula, Canyon Lake, Riverside County and north San Diego County

In our pain clinics in Corona, Wildomar and Costa Mesa we have had good success with the medication Lyrica (Pregabalin) for our patients with chronic neuropathic conditions like diabetic neuropathy, small fiber neuropathy, Failed Back Surgery Syndrome and Fibromyalga. Lyrica seems to be tolerated better than other anti neuropathic medications that we try. I found good information for patients about this medication at the NIH (national Institute of Health) website, the link is - http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000327/.

Pacific Pain Care

36243 Inland Valley Drive #10,

Wildomar, CA 92595

Phone. 855-854-7246

Fax. 951-268-9516

Email. schedule@pacificpaincare.com

Pacific Pain Care

2097 Compton Avenue #102,

Corona, CA 92881

Phone. 855-854-7246

Fax. 951-268-9516

Email. schedule@pacificpaincare.com