Gramercy Pain Management & Rehabilitation 2015

Learn more about Gramercy Pain Management & Rehabilitation

 

New Location for Gramercy Pain Management

Gramercy Pain Management is pleased to announce our new location and enhanced services. On 11/1/14 we will be at 67 South Main Street Pearl River, NY 10965

Dr. Scott Gottlieb

Learn more about Dr. Gottlieb and how he can assist you to live a pain free life.

 

Dr. Steve Show

Dr. Steve Show

Dr. Gottlieb Makes an appearance on the Dr. Steve Show.

 

Complex Regional Pain Syndrome

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Difficult-to-Diagnose Pain Condition Needs Early Intervention

Posted by Scott Gottlieb
 
Paula Abdul has been open about the difficult-to-diagnose pain syndrome she has been battling for 25 years. The former “American Idol” judge announced in 2005 that she has Complex Regional Pain Syndrome, in the hopes of bringing awareness to the obscure, often misunderstood, condition. According to a USA Today article published, she said after the announcement her occasionally hyper-animated behavior on the show was caused by her joy at finally being pain-free; she had found the right medication. CRPS is chronic pain that usually results from trauma to a nerve after an injury: falls, strains, sprains, burns or even bruises. Someone who has undergone surgery or had a stroke is also at risk. Fortunately, it is not very common; in my practice, only 8 percent of our patients have CRPS. While the condition can afflict anyone, including children and teens, it generally affects women in their 40s. There is no known cause of CRPS and it has gone by many names over the past 150 years. The USA Today article said it was first described by a doctor treating soldiers with cannonball injuries in the Civil War: Causalgia. It has had several other names since then, including algodystrophy, Sudeck’s Atrophy, variable pain syndrome, shoulder-hand syndrome and more recently and perhaps the most common: reflex sympathetic dystrophy. There are two kinds of CRPS: Type 1 and Type 2. The leg, arm hand or foot are the most affected body parts. For example, if someone hurts his toe, the pain can radiate through the entire foot and leg even after the toe is healed. For some reason, the sympathetic nervous system gets the wrong signal and supports the painful response to the injury. Unfortunately, there is no single test for CRPS. The diagnosis is based primarily on physical exam findings. The pain is often described as a sharp stabbing pain, electrical current or tingling sensation. Light touch or movement can be very painful for someone with CRPS. Also there are often changes around the affected area, such as a change in skin color, temperature, and excessive swelling and sweating. In some cases, it can attack the bone and muscle. The prognosis is different for each patient. Some get relief if it is treated very early. (Treatments range from anesthesia injections to electrical stimulators implanted in the spine). If the diagnosis is delayed, the disorder is harder to treat and the condition may become irreversible. About Dr. Scott Gottlieb: Dr. Scott Gottlieb is a pain management expert and the founder of Gramercy Pain Management. He is the director of Pain Management at New York Eye and Ear Infirmary (NYEE) and has treated over 3,000 patients. Dr. Gottlieb is board certified in both pain management and anesthesiology. He has offices in both Manhattan and Montebello, N.Y. in Rockland County.

Phantom Limb Pain: Phenomenon or Reality?

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Phantom Limb Pain (PLP) was once believed to be a psychological problem, but is now considered a very real issue for those who suffer from this affliction.

PLP is a mild to severe pain felt at the area of amputation. Experts say the sensations experienced derive from the brain and spinal cord. A person with PLP may be subjected to these symptoms because pain receptors transmit signals to the brain where it can be modified to either enhance or inhibit the sensation levels. This burden can most often occur when a leg or an arm has been surgically removed. It can also occur when a tongue, breast, or eye is lost.

Some symptoms that a PLP sufferer may feel post-amputation include:

  • Tingling
  • Cramping
  • Feelings of hot and cold
  • Itchiness, throbbing, shooting and burning pains

Not everyone who loses a limb suffers from PLP. It is still unknown why some experience these symptoms and others do not.

Treatment is available for someone who is being affected by this hardship, they include:

  • Medications – pain-relievers, antidepressants, beta-blockers
  • Heat application
  • Relaxation techniques
  • Massage of the amputated area
  • Surgery to remove scar tissue trapping a nerve
  • Physical therapy
  • Neurostimulation – spinal cord or deep brain stimulation

For some, the pain disappears over time.

Another option for a person with PLP is to receive a spinal cord stimulator; tiny electrodes inserted along the spinal cord. A small electrical current delivered to the spinal cord can sometimes relieve pain.

Accepting to live with the loss of a body part can be difficult. Staying active and finding distractions is known to help sufferers cope with PLP.

Radiofrequency Ablation: Say Goodbye to Chronic Pain

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Chronic pain is not an easy issue to live with. With today’s advanced technology, Radiofrequency Ablation (RFA) has made it possible to eliminate this debilitating ailment.

RFA is a procedure used to reduce pain by utilizing electrical currents produced by radio waves that heat up a small area of nerve tissue and decrease pain signals from the pungent area.

More than 70 percent of patients treated with RFA experience relief. The alleviation can last six to 12 months, sometimes even years.

People who are treated using RFA are often long-time chronic low-back and neck pain sufferers due to the deterioration of joints from arthritis.

During the RFA procedure, an IV is placed into a sufferer’s arm vein along with anesthesia, to ease discomfort. The person will be awake while the doctor inserts a small needle into the chronic area. The doctor then uses an X-ray machine to guide the needle in to the specific region.

A microelectrode (a small electrode with a tip that can be inserted into the wall of a single cell) is then inserted through the needle to begin the stimulation process. A small radiofrequency current is then sent through the electrode into the nearby tissue, heating it.

The side effects of RFA may include:

  • Leg numbness: This may occur because of the anesthesia given during the procedure and should only last a few hours.
  • Mild back discomfort: Patient can develop this when the anesthesia wears off and usually lasts two or three days. Applying ice to the area the day of the procedure and moist heat the day after can help decrease the ache.
  • Discomfort: This can include swelling and bruising at the site of treatment

This procedure has been proven to be a safe and successful way to treat some forms of pain. RFA is not recommended for people who have active infections or the ability to form blood clots.

 

About Dr. Scott Gottlieb:

Dr. Scott Gottlieb is a pain management expert and the founder of Gramercy Pain Management.  He is the director of Pain Management at New York Eye and Ear Infirmary (NYEE) and has treated over 3,000 patients. Dr. Gottlieb is board certified in both pain management and anesthesiology. He has offices in both Manhattan and Montebello, N.Y. in Rockland County.

Homework, Sports, and Back Pain? What Parents Need to Know

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It’s officially back to school and you know what that means – homework, sports… and back pain?  The new school year brings a whole new slew of problems facing students.  Before you just jump to the medicine cabinet, it is important to understand the possible different sources of pain and what they might mean.

Backpacks:

Heavy backpacks on young, growing bodies can cause poor posture, muscle spasms, as well as shoulder, neck, and back pain.  Besides buying backpacks that are properly sized and feature padded shoulder straps, it is important to make sure children carry no more then three normal sized books in their backpacks.  If your child is still feeling pain after reducing the strain on their bodies, you should seek medical attention.

Sports:

Regardless of whether it’s a high impact or low impact sport, all athletes are still subject to pain and injuries.  While athletes may take precautions warming up, stretching, and staying hydrated, problems may still be inevitable.  Different pains can arise throughout the body causing discomfort but it is important to know what kinds of pains will work themselves out and what signal medical help.

Usually, pains in the back, shoulders, and knees and cramps in the muscles will ease or be gone within a day and leave little to worry about.  What can be a cause for concern are pains that don’t diminish and start to inhibit normal daily routines or worsen with training.  This lingering pain can’t be cured with over the counter pain relievers and can signal more serious problems.  It is important not to ignore these signs and to have them assessed by a medical professional who can help formulate the best form of treatment to get you back in the game in no time.

 

About Dr. Scott Gottlieb:

Dr. Scott Gottlieb is a pain management expert and the founder of Gramercy Pain Management.  He is the director of Pain Management at New York Eye and Ear Infirmary (NYEE) and has treated over 3,000 patients. Dr. Gottlieb is board certified in both pain management and anesthesiology. He has offices in both Manhattan and Montebello, N.Y. in Rockland County.

Fibromyalgia 101:

Fibromyalgia 101: Listen to an interview with Dr. Gottlieb (starts at minute 51) at Blog Talk Radio

Debunking Myths About Epidural Injections

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Although the term “epidural” is commonly associated with an injection given to women during labor, an ESI (epidural steroid injection) can be used as a relief for many different circumstances of pain in both men and women. An epidural injection is a procedure that is typically used to help alleviate neck and back pain (in addition to arm and leg pain) caused by inflamed nerves.

How it works:

An epidural steroid injection essentially involves bathing an inflamed nerve root in order to decrease the irritation of the nerve root that is causing pain. Despite the simplicity of this common practice, there are many myths and concerns associated with the beneficial procedure.

During the steroid injection, a needle (the size of a thick strand of hair) and syringe are used to enter the epidural space and deposit small amounts of long-lasting steroids around the inflamed spinal nerve. The simple method is performed through fluoroscopic guidance; the viewing instrument is used to visualize the local anatomy during the injection. Afterward, the needle is placed into the epidural space, targeting the inflamed area with a maximal amount of steroids, thereby minimizing exposure of the rest of the body to the steroids.

What to expect:

Although many myths have projected the idea that ESIs are an instant cure for pain, the injections are not an overnight fix to the enduring discomfort of a patient. The epidural, however, generally helps the patient resume his or her normal activities by alleviating the pain so that the patient can proceed to seek physical therapy to slowly strengthen and heal the area that has caused them discomfort.

The effects of ESIs are different with every patient as some injections provide long-term relief of up to a year and others experience short-term relief consisting of a few weeks to a small number of months. It is usually suggested that no more than three ESIs are administered within a 6 month time frame.

Those receiving an ESI for back and nerve pain will have their vital signs examined and pain relief will be assessed frequently throughout the procedure. If there are any possible side effects from the medicine, the anesthesiologist on duty will be involved. Similarly to the symptoms experienced by women during an epidural for labor pain, some possible side effects include drops in blood pressure, itching, and nausea/vomiting depending on the amount of dosage received by the patient.

Keep in mind:

While ESIs are a useful non-surgical treatment for many patients, they are not right for everyone. Those suffering from infection, bleeding problems, or spinal tumors are not recommended candidates. It’s important to note that as with any type of injection, there are some risks associated with ESIs.  Some major risks include bowel and bladder incontinence, infections, headaches caused by epidural punctures, nerve damage, and bleeding.

An anesthesiologist will be involved in the management of this procedure to ensure the best possible outcome in providing pain relief, minimizing side effects, and ensuring your overall safety. However, it is important to assess the risks and benefits of an epidural steroid injection with your doctor to help determine if this treatment plan will be right for you. This form of pain management may also not work for everyone. If the injection does not provide relief, a new treatment may be better suited for you.

 

About Dr. Scott Gottlieb:

Dr. Scott Gottlieb is a pain management expert and the founder of Gramercy Pain Management.  He is the director of Pain Management at New York Eye and Ear Infirmary (NYEE) and has treated over 3,000 patients. Dr. Gottlieb is board certified in both pain management and anesthesiology. He has offices in both Manhattan and Montebello, N.Y. in Rockland County.