March Arizona Pain Monthly

Arizona Pain Monthly | March 2011Page 2 Smile!

Page 3Arizona Pain Monthly | March 2011 Smile!


Welcome to Arizona Pain Monthly Magazine

Welcome to the March issue of Arizona Pain Monthly! We hope you are able to get outside and enjoy the beautiful weather before we’re upon another summer in Arizona!

While we may all understand and appreciate that the brain controls our every function both voluntary and involuntary, we may often take for granted the fact that the brain is also our emotional epicenter – and because of that, will have a great impact on how we perceive things. According to an article in USA Today, a positive outlook can do great things for your overall well-‐being. The late Christopher Reeve is an excellent example of how a positive outlook can impact your health. While his cheerful attitude did not cure him, many believe that it was in fact this at-‐titude that allowed him to live as long as he did after his devastating accident. Those with a bright outlook are often healthier than those with a negative perspective – research has shown that being positive can improve cardiac health

improve painful conditions. At Arizona Pain Specialists, we have seen the effects of a good at-‐

a happy outlook on life improve at a faster rate than those who focus on the negative aspects. Whether it is their families, a hobby, or a passion for helping others, a focus on something besides pain will help immensely. By being positive and focusing past your pain, you can see that life is worth living and that there are many aspects to

be enjoyed and to be thankful for!

Our theme this month revolves around understanding how the brain and emotions play a major role in your pain management, and the focus word is SMILE. The simple act of a smile is good for your health – it causes the body to produce endorphins, which are known as the body’s natural painkillers. These endorphins work further to improve the body’s overall sense of well-‐being and

relaxation, which can be

those suffering from chronic pain conditions. We encour-‐

SMILE, whether it is a hug from a loved one or friend, an activity that you enjoy, or just because you’re happy to be alive. A SMILE can go a long way!

We hope that this issue is educational and informative. We thank you for your continued loyalty if you are a long-‐standing patient, and we welcome you to the Arizona Pain Specialists family if you are a new patient.

Until next time, remember at Arizona Pain Specialists, we believe you can be pain free.

Blessings to you and your family,

Dr. Tory McJunkin & Dr. Paul Lynch

Please contact us at [email protected] if you have questions or comments.


Smile


With Dr. Paul Lynch: I have heard quite a bit about opioid

medications in the news lately. Can you advise on whether these are safe medications?

Absolutely! You are correct, opioid medications have been a hot topic in the recent headlines. Just a few short weeks ago, USA Today came out with an article regarding a 3 star general admitting to a depen-‐dence on prescription pain medica-‐

prescription pain medication abuse among NFL players.

Prescription pain medications can be taken safely if the patient is aware of their potency, side effects, and risks of dependence – and if their physician is dedicated to solving the underlying problem. At Arizona Pain Specialists, for exam-‐

source of our patients’ pain, rather than masking the problem with medications.

There are some things to take into consideration while taking a prescription pain medication. We recommend that you create a list of questions to ask your health care provider regarding opioids. Some

questions to ask include: will I build a tolerance to this medica-‐tion? What are the early signs of addiction? How long will I need to take this medication? What will be the side effects?

It is important to tell your doctor of every medication, vitamin, and herbal supplement you are cur-‐rently taking, and to inform them when you begin taking any new medications. Ask your treating physician about possible interac-‐tions with basic things including your daily cup of coffee or a glass of wine with dinner.

It is also important to ask your physician all of the particulars of how to take your medication. Some questions you may want to ask include: what time of day and how many times a day should I take my medication? Is it best to take the medication on an empty stomach? Are there any activities I should avoid while taking my medication?

How and where you store your medications is also extremely important. Your physician should explain that you should keep your medications in a safe location where they are not accessible to others.

It is important to never take extra doses of your medication even if the pain gets worse and you feel as though the medication is not help-‐ing. If this is the case, you should al-‐ways speak to your physician about what the next step should be.

At Arizona Pain Specialists, we do have patients who take prescription pain medications, but we work very

the source of their pain, rather than just masking it with large doses of powerful pain medications. With our comprehensive model, we also make sure that if a patient is taking prescription pain medications, we are still working toward alleviating their pain with the goal to get them off consistent use of opioid medica-‐tions.


Grilled Citrus Tuna

tuna steaks Whisk all ingredients except tuna in a small dish. Place tuna steaks in a large zip-‐top plastic bag. Pour marinade over the top of the steaks, seal the bag, and place the bag into the refrigerator. Marinate

occasionally.

Grill tuna over medium-‐high heat

once. Be sure to remove the tuna from the grill before the outside begins to form a crust.

Pineapple Smoothie

best to brew this from loose leaves)

chopped

Blend all ingredients in a blender until the smoothie is at the desired consistency.

Pineapples, ginger, and green tea

foods!

Walnut Pesto

cheese

chopped

Simmer vegetable stock and garlic -‐

utes, let cool for a few minutes.

Add basil to a food processor or

chopped. Remove garlic cloves from broth, add to basil. Add Parmesan cheese and walnuts and

adding broth in small amounts at a time and process until the pesto is at the desired consistency.

Pesto can be used on top of pasta, in chicken dishes, as a tomato replacement for bruschetta, or as a spread on sandwiches.

Walnuts are a great addition to


According to a national survey, more than one-‐quarter of U.S. adults have recently expe-‐rienced pain that has lasted over a day. The sensation of pain is generated by the nervous system. Pain can come in many different forms, from dull to sharp and temporary to chronic. Many people are turning to acupuncture, one of the oldest healing practices in the world, to rid their body of the pain.

In Chinese medicine it is believed that the -‐-‐

ponents are not in balance, the vital energy -‐

balance is believed to be the common cause of diseases. Through stimulation of a tiny needle,

to restoration of health and balance within the body.

Acupuncture is growing increasingly popu-‐

Americans have used acupuncture in the

reasons for being treated by acupuncture

complaints. Through studies, including patient feedback surveys, acupuncture has proven to help a wide range of pain condi-‐tions.

Although acupuncture has existed for hundreds of years, the science behind it is still being actively studied in order to bet-‐ter understand why it works. Interestingly, a new technology called “functional MRI” is being used to study this ancient healing art. By utilizing functional magnetic resonance

pictures of the brain while patients are ex-‐periencing pain to determine acupuncture’s effect on the signals the brain uses to transmit pain. The fMRI technology is able to measure metabolic changes in the brain while the pa-‐tient is exposed to certain stimuli.

“Until now, the role of acupuncture in the perception and processing of pain has been controversial,” said lead researcher Nina Theysohn, M.D., from the Depart-‐ment of Diagnostic and Interventional Radiology and Neuroradiology at Univer-‐

-‐

evidence that acupuncture decreases pain as well as other ailments of the body. The studies demonstrate that the areas of the brain involved in pain perception had less metabolic activity when treated with acupuncture. The exciting results of these studies are ground breaking news.

The World Health Organization, the National Institutes of Health, and clinical experience now show that acupuncture is useful in treating chronic and acute pain, including carpal tunnel syndrome,

and back pain, sciatica, and tendonitis. Also, it has been known to help addictions, anxiety, depression, digestive disorders, ear and eye disorders, immune function, insomnia, neurological disorders, re-‐productive disorders, upper respiratory disorders, and urinary disorders.

In addition to being an effective healing art, acupuncture is very safe with side ef-‐fects and complications occurring rarely. Many health insurance plans are also be-‐ginning to consider acupuncture as a cov-‐

information about acupuncture please ask your health care provider.

At Arizona Pain Specialists, we provide acupuncture at all three locations, provid-‐ed by licensed and experienced acupunc-‐turists. If you have any questions or would like to see how acupuncture can help you,

today.

-‐Tiffany Moat, D.C.

Chiro Corner:


Acupuncture

for Pain Relief


What Would You Do If You Were Pain Free? Jeff Is Still Running!

Runner Jeff Grabosky is still running across the United States – at print time, he had made it halfway across New Mexico.

His blog details his harrow-‐ing journey including mountain lions, extreme elevation changes and temperatures below freez-‐

his journey and no matter what he faces each day, his blog posts are positive and detailing the scenery he has seen.

“I am not sure if the truck driv-‐ers are all talking to each other or what but I must have had

at me today after only a couple the entire previous month,” Grabosky posts on his blog on

th. “I’ll take all the encouragement I can get so I was happy with the support.”

Grabosky has run through elevations between sea level and

details the weather and men-‐tioned a morning temperature of

running for the day.

Grabosky is running to pray for others and bring awareness to the power that prayer can have on someone’s life. A practicing Catholic, Grabosky said before departure that the most impor-‐tant item he would be bringing on his journey would be his rosary. Grabosky requests that people continue to send him

prayer requests and let him help shoulder their burden, at least for a little while.

Arizona Pain Specialists has been proud to partner with and support Grabosky in this amazing accomplishment. To see Grabosky’s daily progress live, visit www.ArizonaPain.com and click on the “Jeff Runs America” graphic on the home page. Grabosky is providing Arizona Pain Specialists with “vlogs” or small video logs of his journey, which can also be found on the website. To further sup-‐port Grabosky, “Where’s Jeff?” teeshirts are available for sale in all three locations.

The star

indicates Jeff ’s

progress at the

time of print.

Great job, Jeff!



Plantar Fasciitis: A Common Foot Ailment Expert Guest Dr. Michael Esber

Pain on the bottom of the heel, also known as plantar fasciitis or heel pain syndrome, is the most prevalent complaint presenting to foot and ankle specialists and may

of all adults.

Anatomy:

On the bottom of the foot, there is a ligament-‐like soft tissue band, called the plantar fascia that runs from the ball of the foot to the heel.

-‐brous, this band of tissue does not stretch. Whether the cause is foot biomechanics, work habits, sud-‐den increase in activity, or obesity, mechanical overload on the plan-‐tar fascia may contribute to the development of plantar fasciitis,

and micro tearing of the plantar fascia along its course. Pain due to plantar fasciitis generally presents in the heel region at the attach-‐ment of the fascia to the plantar

would be a winter visitor who has not golfed for few months then

days a week. Another example is a warehouse employee who works

-‐though the overwhelming cause is mechanical in origin causing plan-‐tar fasciitis, pain in the heel may be the result of arthritic, neurological, traumatic, cystic or other systemic conditions. A short list of these etiologies includes:

-‐-‐Plantar fascia tear -‐

lent to carpal tunnel syndrome in the hand) -‐-‐Stress fracture of the heel bone -‐-‐A cyst in the heel bone -‐-‐Gout

-‐-‐Arthritis such as rheumatoid arthritis or psoriasis -‐-‐Tight Achilles tendon -‐-‐Soft tissue mass in the heel area. -‐-‐Decrease in heel fat pad

Symptoms:

Symptoms of plantar fasciitis are very classic. Patients will often complain of pain in the heel or arch area with the

the morn-‐ing or upon standing after sitting for a period of time. After a period of walking, the Achilles tendon, which is attached to the plantar fascia around the back of the heel, will stretch out and the pain will generally disappear. Patients describe

stabbing pain with a needle or a nail in the center of the heel. It can affect both limbs, but in general, patients complain of pain in one heel at the time. The problem can have a rapid onset and be very painful in a short period of time. However, in the majority of cases, plantar fasciitis is slow to progress and

can gradually increase in sever-‐ity. If plantar fasciitis symptoms do not resolve with time and are left untreated, the pain can be very severe or even disabling. I can re-‐call one patient in particular in the

calls. After I rang the door bell it took the patient awhile to open

opened the door, she was on her knees crying and in agony. She was diagnosed with plantar fasciitis of both heels.


Diagnosis:

The treating physician should obtain a comprehensive patient his-‐tory to determine the most accurate diagnosis. Plantar fasciitis in its early stages is generally indicated by an improvement in pain after walking for a short period. In more severe or chronic cases, the pain may not be improved by walking or increased activity.

There are physical examinations that should be performed to evalu-‐ate plantar fasciitis. I usually cup the patient’s heel in the palm of my hand and squeeze gently on the sides of the heel. If the patient has true plantar fasciitis, this test will produce a severe pain.

Once a tentative diagnosis has been made, I will usually obtain standard

limb. If the patient does not improve as expected, additional diagnostics may need to be performed, includ-‐ing:

-‐-‐Magnetic resonance imaging

stress fractures)

to measure the thickness of the fascia and guide my cortisone injec-‐tions) -‐-‐Nerve conduction velocity testing

-‐ment.

-‐-‐Neurosensory testing

Treatment:

Treatment for plantar fasciitis generally begins conservatively and may include padding and strapping of the foot, therapeutic generic foot inserts, prescription

-‐tions, herbal oral and topical anti-‐

B complex vitamins, and a cortico-‐steroid injection localized to the area of maximum pain. I also direct my patients in basic exercises and stretches they can perform that will improve their condition and

-‐portive shoes and avoid walking barefooted in addition to recom-‐mending over-‐the-‐counter arch supports and well-‐constructed shoes with thick soles and pro-‐nounced arches for the best sup-‐port.

In most cases of plantar fasciitis, conservative treatments will al-‐leviate most pain and patients will begin to show improvement within just a few weeks. If improvement is noted, I advise the patient to main-‐tain the initial course of treatment.

custom orthotics to help control the way the foot functions and hopefully prevent the recurrence of the fasciitis.

If the patient is still suffering from recurring pain after the initiation of conservative treatments, I will add different treatments to their plan: repeat corticosteroid injec-‐tions, physical therapy, medica-‐tions targeting nerve involvement,

and a short leg walking boot to immobilize and support the foot

-‐

months.

Before determining that surgical intervention is the next step, I will usually refer the patient to consult with a pain management physician, internal medicine specialist, or other appropriate physician to rule out other causes and to further the courses of treatment.

If surgery is indicated, I may recommend a plantar fasciotomy, which involves clipping of the plan-‐tar fascia near the heel to resolve the pain. Radiofrequency coblation, which will stimulate the fascia to heal itself may also be recom-‐mended, and is less invasive than surgery.

Plantar fasciitis could be classi-‐

majority of cases and is a common

regular basis. Plantar fasciitis will respond to conservative treatment

take a few months before complete pain alleviation is experienced.

Dr. Esber practices podiatry at

Arizona Foot Health Center. The

Valley in Sun City West. Dr. Esber

Glendale.

To make an appointment with Dr.

Esber, call 623-‐546-‐4930



to helping her patients become pain free, and is overwhelmingly a patient favorite!

See what you have in common with Laurie! Favorite activities: Cooking, traveling, wine tasting.Favorite TV shows: Favorite sports team: Indianapolis Colts, Purdue Boilermakers and Notre Dame Fighting Irish.Favorite food: Mexican cuisine. Favorite movie: Heathers. Favorite location in the world: Cozumel, Mexico. Favorite location in Arizona: Sedona. Favorite thing about Arizona: The warm weather and sunshine. Favorite bands: Depeche Mode and Sarah McLachlan. Favorite book: I’m not embarrassed to admit I’m a Twi-‐hard fan! Famous person you would like to meet, dead or alive, and why? Princess Diana, because she was extremely humble and altruistic. Unknown fact about you: Unknown talent: I compose silly songs. What celebrity do people say you look like: I’m one of a kind! As a child, what did you want to be when you grew up? A singer or actress. Where are you from originally: South Bend, Indiana.

Kent does a variety of jobs at Arizona Pain Specialists, but each job supports the day-‐to-‐day operations of all three clincs. He is responsible for an array of administrative tasks that keep every-‐thing running smoothly.

Kent has been with Arizona Pain Specialistsand says his favorite part of his job is that he gets to go to the dif-‐ferent clinics and meet and interact with nearly everyone in the company. He appreciates the variety his positions offers, and likes the fun and challenges that come with each of his tasks.

After living in Southern California for many years, Kent says it is a great pleasure living in Arizona with the great climate and plenty of places to visit. He enjoys bicycling, hiking, tennis, swim-‐ming and traveling.

Kent mentions that he enjoys seeing the joy on the patients’ faces at the different clinics after being treated and pain free at last!

Meet Laurie S., Nurse Practitioner

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