Treat your pain and live a better life…

best-pain-doctor-nycWelcome to my blog about pain. Unfortunately, many people suffer from chronic pain. As a board certified physician in physical medicine and rehabilitation, my specialty is treating these people with both acute and chronic pain.

A majority of my practice is working with patients that are experiencing back and neck pain.

My goal with this blog is to help patients who are experiencing any type of back or neck pain to understand what is causing their pain and discuss options that are available to end their pain. I hope to be able to provide readers with a portal that they can can use to educate themselves and facilitate treatment.

My specialty is my Interventional Spine Skills including cervical and lumbar epidural steroid injections, facet injections, medial branch blocks, Radiofrequency ablation, sympathetic ganglion blocks, spinal cord stimulator trials, sacroiliac joint injection, piriformis muscle block and musculoskeletal joint injection. I also perform many other procedures to alleviate acute and chronic pain.

I hope you enjoy reading my blog as much as I enjoy writing it and observing people from all over the world reading it.

– Matthew Grimm, M.D.

Category Archives: Chronic Pain

What Are Nerve Blocks?

What Are Nerve Blocks?If you suffer from pain, you may be looking for any type of pain solution. You cannot think about anything you are doing because the pain is intense. Nothing you take seems to help. The pain continues and puts you at a constant level of discomfort. This is when you may need more advanced treatment options for your pain. Nerve blocks may be something your pain doctor in New York City offers to you. What is it? How can it work to reduce the amount of pain you feel even if there are other treatment options that have not worked for you?

Understanding Nerves

The nerves in the body are a complex network that links every component, organ, and area of your body to the brain. They send messages from that area to the brain to tell it when something is not right. These nerves are what tell your brain there’s pain  and to do something to resolve it. However, sometimes these nerves become damaged. They may over communicate with the brain. And, in some cases, there just is no treatment for the pain. When this happens, your doctor may encourage you to use a nerve block, which, in essence, helps stop the communication between the brain and the nerves.

What Are Nerve Blocks?How Can They Help You?

Nerve blocks can help to turn off the pain signals that are causing you the discomfort your feel. There are various types of nerve blocks available and each works in its own way. Some of the ways that nerve blocks can work include the following:

    • They can treat painful conditions using a local anesthetic. This is a therapeutic function.
    • Diagnostic nerve blocks can help doctors to determine what the underlying cause of the pain is.
    • Doctors can also use nerve blocks called prognostic nerve blocks to produce the outcome of a specific type of treatment they are using or considering, such as whether or not surgery would help.
    • Preemptive nerve blocks work as they seem, to prevent pain from occurring as it relates to a procedure that is approaching.
    • They can also be used as a treatment. This may help a patient to avoid the use of surgery for care.

What Are Nerve Blocks?Nerve blocks are one source of pain management available to doctors. It is important to consider that this is not always the best solution for each person. When you meet with your NYC pain doctor, you’ll learn more about your options.

Contact our New York pain doctor today at 646-862-5555 to discuss your needs and to find out what treatment options may be exactly what you need.

What Is Cognitive-Behavior Therapy for Pain Management?

cbt_partsCognitive behavior therapy is one of the options your doctor may recommend for the treatment of pain. Pain management is the goal of finding a way to reduce the amount of pain felt by a person. What we know about pain is that it occurs for many reasons and for some people, it is more severe than for others. In some situations, there is an emotional or mental connection to pain. In some of these situations, the use of cognitive behavior therapy can be helpful in overcoming those intense, painful moments.

What Is Cognitive Behavior Therapy?

Cognitive behavioral therapy is a type of psychotherapy. It is a type of therapy in which the thoughts and behaviors of an individual are believed to be contributing to the negative way a person feels. The negative feelings experienced in these individuals leads to more sensitivity to pain. That is not to say he pain isn’t real. In this type of treatment, the goal is to reduce pain by reducing negative feelings.

There are many strategies that can be utilized as a part of cognitive behavioral therapy in the treatment of pain. Generally, it takes time for doctors to determine the best possible treatment option for the patient, since some methods may not work as well. The goal of this therapy is to:

  • man-gestures-as-he-speaks-to-therapistImprove coping skills of the individual in dealing with pain
  • Increase the individual’s level of confidence
  • Improve self efficiency in the management of pain
  • Aid in changing how you behave and respond when pain occurs

Is this type of treatment right for everyone? Most people can benefit from a pain management program that does address some level of cognitive therapy. However, the type and amount of help it offers will differ from one person to the next. Keep in mind that this should be just one-step in your treatment, not the only step.

To find out if cognitive behavior therapy for pain management is right for you, come in to our offices to discuss your condition. When your doctor talks to you, you’ll learn more about how this and other pain management methods can help to improve the way you go through your life and aid in reducing the amount of pain that you feel. For many people, it is quite life changing. Let us help you. Call our New York offices today to learn more.

What Medications Are Being Used to Improve Chronic Pain?

chronic painChronic pain can be one of the most difficult of all types of disease and illness to live with. If you are struggling with pain, you don’t have to. More advanced treatment options are becoming available, including the use of a new type of medication.

Take a closer look at some of the medications being used to improve chronic pain in many people today.

Nonsteroidal Anti-inflammatory Drugs

One of the most common medications used as a first line of treatment for chronic pain is NSAIDs. These are over-the-counter medications, prescription strength products are also available. Generally, this type of medication is ideal for acute types of muscle and bone pain. However, taking them chronically can lead to negative effects o the kidneys, the body’s ability to clot blood, and other concerns.

Antidepressants

One of the latest types of medications used to treat chronic pain is a line of antidepressants. Older antidepressants are often very helpful in controlling pain. They are beneficial because patients can often get pain relief at lower doses with the use of tricyclic antidepressants. They are often taken on an as-needed basis. They treat most types of pain, depending on the severity of the condition.

Anticonvulsants

Anticonvulsants, also known as anti-seizure medications, can work for some types of pain, specifically nerve pain such as shooting pain or a burning feeling. These products can help with minimal side effects in many people, though some can develop weight gain and glaucoma if they are overused. There is the need to carefully monitor liver and kidney health when taking these medications.

Muscle Relaxants

In some situations, the use of muscle relaxants can be beneficial, especially in those who have the same type of pain but not consistently. These products can make people drowsy, but most are safe to use on an as-needed basis.

Which Type of Medication Is Right for You?

Those experiencing chronic pain and discomfort want a solution. That solution may come from one of these types of medications. In some situations, over-the-counter products are effective. In other cases, doctors need to increase the amount and type of medication being taken to improve your day to day pain level.

chronic painEvery situation is very different. For pain medication and treatment, come in to see the best pain doctor in New York. Schedule an appointment with our team today to discuss your needs.

Call us at 646-862-5555 to schedule a consultation.

How Do Anti-Seizure Medications Treat Pain?

treat painThe use of anti-seizure medications as a treatment option for pain is not a new concept. In fact, it is one of the oldest methods used to treat chronic pain conditions especially in those that have experienced long-term pain or are unable to see relief from other types of pain medications.

The first medications of this type were designed to provide relief from epilepsy. They work to calm the nerves and aid in reducing the symptoms of burning and tingling common with pain. Often times, pain that feels as though it is shooting through the arm, leg, back or other area is also due to nerve damage.

How Does Anti-Seizure Drug Treatment Work?

The use of anti-seizure medications are highly effective in treating pain. However, doctors do not understand fully why this is. The exact mechanism of why this type of medication works is not fully understood, but what it seems to do is to turn off some of the transmissions of pain signals to the brain. When a person experiences pain, such as a burn on the fingertip, nerves transfer this pain signal through the nerve system to the brain. This type of medication tends to calm those sensations, therefore limiting the number, frequency, or intensity of these types of signals moving to the brain.

For some people who have chronic pain, these signals fire too often and sometimes without the need to do so. Overactive transmission of pain signals like this sometimes happen because nerves are damaged. This can happen in many situations including from chemotherapy treatment, herniated disks, fibromyalgia, and shingles.

How Medications Work

treat painAnti-seizure medication works to calm these signals. It works particularly well for some types of conditions including for trigeminal neuralgia, a type of condition that causes painful, searing facial discomfort that feels much like an electric shock.

The treatment with carbamazepine, a type of anti-seizure medication, is highly effective in this type of situation.

What we don’t know is when anti-seizure medication is going to be effective. If you have chronic pain, and have yet to try anti-seizure medications, it may be a helpful treatment to you depending on the cause of your pain and the current condition you are in. There are risks to taking these medications, which is why it is important to work with a trusted pain medication doctor in New York when seeking treatment. Call us to schedule an appointment at 646-862-5555.

Recognizing Chronic Pain’s Mental Impact

chronic painChronic pain is debilitating. It limits your ability to move. You may find that every step hurts. In other cases, you may find it difficult to move your fingers, sit for a long time, or accomplish other types of daily tasks. It is debilitating because you cannot achieve the simple things you used to be able to do.

For many people, chronic pain is not about an injury or disease, but rather a damaged nerve or neuropathy that is otherwise unexplained. In all cases, the physical damage is only one element of the problem.

You Are Suffering Mentally, Too

In every situation, no matter if you have mild to severe chronic pain, one thing becomes clear. Your pain takes a mental toll on you as well. How limiting chronic pain can be to your mental health depends on a number of different factors.

  • Sleepiness and exhaustion: Many people begin to feel the mental limitations when they become severely fatigued. While this can be brought on by physical ailments, it can also be caused by the mental wear and tear. When you are tired, you are less capable of responding in a healthy manner.
  • Anxiety: The development of anxiety in some people is also debilitating. Anxiety occurs when a person knows an outcome is unlikely but is apprehensive and worried about it occurring at an uncontrollable level. Over time, this can limit the individual’s ability to do things he or she once enjoyed and even stops the individual from focusing.
  • Depression: Mental health can also worsen into depression especially for those who are genetically predisposed for it. Depression is life threatening and it can lead to a low quality of life.

chronic painIf you are feeling any of these mental concerns the first step is to seek out treatment from a doctor for your pain. Getting your pain under control through specialized methods can help in most cases.

 

However, most people also need mental health treatment. Mental health care aids in improving the thought patterns and emotions you are feeling by bringing you back to a more logical level. For some, medications are necessary while others benefit from cognitive or talk therapy.

 

Finding a solution for the way you feel is not something you should put off. Turn to a pain specialist like our doctor in New York, to get the answers and treatments you need to finally start feeling better.

Call us at 646.862.5555 to schedule a consultation.

Can Visual Imagery Be Effective for Pain Management?

Many people struggle with pain for reasons simply not easy to control. Often times, pain doesn’t work the way it should. Pain is supposed to be a warning moving from the nerves to the brain signaling a problem for the brain to handle. Sometimes, nerves become damaged and pain signals trigger at the wrong time, when there is no real physical risk, or continuously by not shutting off. In all cases, finding a treatment for this troubled nerve signals isn’t always easy. Pain medications and therapy can help, but for some, imagery can be even more powerful.

What Is Imagery as a Treatment?

Imagery is just what it sounds like. It is a type of pain management technique in which an individual uses sound, visual stimulation, or other pictures that help them to move away from the pain and to focus on something else. The goal is to create a visual “thought” in the mind that is relaxing and pleasant to the individual.

pain managementBy focusing on this good thought, it may be possible to move the brain’s focus away from the pain they are feeling and instead allows them to focus on something else, something good and positive. Imagery is often an effective tool for those suffering from chronic pain that is untreated or does not minimize enough even with medication or other pain management techniques. Does it work for you?

Can It Help You?

Visual imagery can help many people, but it does not always work for all patients. It is a good idea to first focus on getting into a relaxing state. Then, focus on an image as clearly as possible in your mind’s eye that is positive and happy. The longer you focus on it, the more your brain moves away from the pain. The longer you do this, the longer the pain may subside. Whether or not it works depends on the individual’s ability to maintain that positive presence as well as how intense the pain is.

pain managementIn many situations, it is possible to see significant improvement by using visual imagery. This treatment option does not require the use of a doctor, however, it can be taught by a specialist to create a more significant improvement. And, it compliments other pain management techniques that may also help you. If you suffer from chronic pain, call our New York doctor for help at 646-862-5555 .

Doctor for Chronic Pain Management

What Is Chronic Pain?

Chronic pain is pain that continues past a month beyond the usual recovery period for an injury or illness. It can also include pain that goes on for months (or years) chronicdue to a chronic condition. The pain is not always constant but can interfere with the quality of life for an individual.

 

Chronic pain can affect every part of a person’s daily life. Individuals complaining from chronic pain may have health issues such as neck pain, lower and upper back pain, headache and sciatica. Other serious conditions that are associated with chronic pain also include osteoarthritis, fibromyalgia and cancer.

Early intervention of chronic pain also lets patients become more active. It also helps avoid worsening health and the emotional complications of ongoing pain.

Chronic Pain Management Goals

The first goal of chronic pain management is to help bring pain under control and manage the side effects of treatment. The second goal is to improve quality of life. Managing chronic pain is essential to work and being able to perform daily tasks. Chronic pain management helps increase physical function, decreased reliance on medication and a faster return to work and daily activities.

Doctors for chronic pain have techniques to reduce painful symptoms while avoiding surgery whenever possible. When surgery is the best option, chronic pain doctors try to use minimally invasive techniques that are very safe and effective.

Better Methods for Chronic Pain Management

chronicIt’s estimated that almost one in four people in the United States suffer some form of joint pain regularly, but only half of them have visited pain doctors for chronic pain relief. Some of the reasons are that people get accustomed to the pain or feel it’s part of getting older. But with a consultation with a chronic pain doctor, patients get a better understanding of what pain management is and how it works.

Chronic pain doctors use a combination of method that includes physical therapy, exercise, acupuncture and counseling. Many doctors opt to include other forms of treatment to eliminate or minimize the use of narcotics. This approach helps avoid some side effects from addictive drugs or chemicals that make it difficult for each patient to enjoy a normal life.

Palliative Medicine

Palliative medicine is the ongoing, total care of individuals with incurable illness. It involves compassionate therapies with the main goal to maximize comfort for patients.

Active programs include the treatment of pain, related to fatigue cancer pain, anorexia syndrome and cancer treatment. Some community-based hospice programs have already been implemented as has a home visit program.

With all the treatment options available for various forms of chronic pain, there is no need to suffer needlessly. Contact us today at 646-862-5555  to schedule an appointment with the best chronic pain doctor in NYC.

Dr. Grimm answers the question: What is an EMG test?

What Is an EMG?

Best-EMG-Testing-Doctor-NYC-1Electromyography or EMG is a study of the electrical activity of muscles. If you have numbness or weakness your doctor may request an EMG to determine the cause. In cases of neck or low back pain associated with numbness or weakness of an arm or leg, an EMG can help to identify which nerve root is compressed or irritated. This can help guide treatment decisions.

An EMG test is routinely accompanied by a nerve conduction study in order to definitively identify the level of nerve involvement. In other words, your doctor wants to make sure that your leg numbness or weakness is not caused by a problem of your peripheral nerves.

Procedure: How is an EMG done?

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Under sterile conditions, a very fine electrode is inserted into select muscle groups to measure their electrical activity at rest and during contraction. The electrical activity is visualized on a computer monitor and analyzed by the performing physician.

During the nerve conduction portion of the exam, select peripheral nerves are stimulated electrically and responses of the appropriate muscle groups are recorded. This test determines the integrity and function of your peripheral nerves.

Indications for an EMG

Best-EMG-Testing-Doctor-NYC-3An EMG and nerve conduction study is frequently performed in cases of neck or low back pain specifically for the purpose of identifying cervical or lumbar nerve root irritation. Assuming that nerve root irritation has been present for at least three weeks, the test can aid in localizing the level and severity of nerve root involvement. An EMG is a valuable adjunctive test in the evaluation of neck or low back pain when nerve root irritation is suspected.

If you suffer from neck or back pain, contact the best pain doctor in NYC, Dr. Matthew Grimm to schedule an examination.

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Trigger Point Injections

 

Best Pain Management Doctor NYC3Trigger point injections are used to treat chronic pain in discrete, focal muscle groups in the neck, arms, legs, and lower back. These multiple muscle groups have trigger points, which are hyperirritable knots of muscle that are taut and which fail to relax. These cause local pain, which may also radiate or spread to other parts of the body. Although trigger points may be treated using nonsteroidal anti-inflammatory drugs, antidepressants, physical therapy and acupuncture, their effects are often short lasting compared to trigger point injections.

Trigger point injections may also be used to treat a variety of conditions, including fibromyalgia, tension headaches, temporomandibular joint pain, and myofascial pain syndrome.

How Trigger Point Injections WorkBest Pain Management Doctor NYC2

Trigger-point injection is a minimally invasive, safe, and effective way to inactivate trigger points and provide prompt, symptomatic pain relief. The procedure involves inserting a small needle into the patient’s trigger points, which are located in muscle groups in the neck, arms, legs and lower back. The injection contains a local anesthetic and may include a corticosteroid to reduce inflammation. Usually, a brief course of treatment that is given in a doctor’s office will result in sustained relief. Since the treatment uses locally administered medications, it does not have a widespread effect on the body; rather, only painful areas are targeted, and no systemic side effects are expected.

Patients benefit from this procedure because after the injection, trigger points are inactivated and inflammation and pain are reduced for several months, allowing the patient to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.

Best Pain Management Doctor NYC4General Procedure

A trigger point injection is an outpatient procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. The patient is initially briefed about the procedure and prepared beforehand so that he is relaxed.

The patient is placed in a comfortable recumbent position (either prone or supine) to allow muscle relaxation. Trigger points are located by palpating the muscles and finding knots under the skin. Once a trigger point is located the overlying skin is cleansed. The doctor isolates the point with a pinch between the thumb and index finger to stabilize it and inserts a needle directed to the point. The doctor warns the patient of the possibility of a sharp pain, muscle twitching, or unpleasant sensation when the needle touches the tight muscular band.

A small amount of local anesthetic is injected into the trigger point. The doctor then withdraws the needle a little and redirects it in different directions under the skin, injecting small amounts of anesthetic in each direction. This is done until the local twitch response is no longer elicited or muscle tautness is no longer felt. Pressure is applied on the skin after the needle is completely withdrawn to stop any bleeding. A simple bandage is applied to cover the area.

Post-injection soreness may be experienced, but this is expected to resolve in a few days. Patients are encouraged to remain active, using a full range of motion in the muscles, but are advised to avoid strenuous activity a few days after injection.

Contact Us

Trigger Point Injection is a minimally invasive, safe, and effective means of treating muscle pain that is unresponsive to other forms of treatment. If you want more information about treating painful trigger points, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your pain.  Make an appointment with the NYC’s top board-certified interventional pain management physician to know if trigger point injections are a treatment option for you.

Best Pain Management Doctor NYC5

Treatment of Acute and Chronic Pain

Treatment of acute and chronic pain p02Pain is an unpleasant symptom that sends a signal that something may be wrong or that damaging stimuli may be present in the body. This uncomfortable feeling may range from mild to severe, and may last for a short moment, come and go, or persist for a long time.

A variety of conditions can cause pain, including injury, degenerative processes, and disease. Its treatment depends on many factors, and while some types of pain respond to single treatments, others may need a combination of treatment modalities.

Treatment of Acute Pain

Treatment of acute and chronic pain p01Acute pain often occurs suddenly and is usually localized and sharp in quality. It warns an individual of a disease or a threat to the body, or it may be caused by injury, surgery, or natural processes like childbirth. Acute pain may be mild and short lasting, or it may be severe and long lasting. In most cases, however, it disappears when the underlying cause has resolved. If unrelieved, acute pain may lead to chronic pain.

Treatment of acute and chronic pain p03The treatment of acute pain often involves identifying an underlying cause and treating it. Options for symptomatic treatment of pain may include the use of:

· Hot compress

· Ice packs

· Oral medications like Acetaminophen (ex. Tylenol®)

· Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen

· Local anesthetic injection (ex. lidocaine)

· Nerve blocks (epidural anesthesia)

· Physical therapy, including massage and exercise

· Surgery

Depending on the type and cause of acute pain, symptoms may be managed by general practitioner, an internist, a surgeon, or a pain management specialist.

Treatment of Chronic Pain

Pain that persists despite healing of an injury or disease may be considered as chronic pain because pain signals in the nervous system remain active for several weeks, months, or even years. The pain may lead to other symptoms like muscle tension, limited mobility, depression, lack of energy, anxiety, sleep disturbances, and changes in appetite. These symptoms may also affect an individual’s daily activities and relationship with others. Common complaints include low back pain, chronic headaches, arthritis, cancer pain, neurogenic pain, and psychogenic pain.

Although chronic pain may originate from an injury or disease process, some people suffer from long lasting pain in the absence of physical injury or damage. The cause of chronic pain may be unknown or undiagnosed; however, treatments may be given to relieve the individual’s symptoms and to improve the quality of their life. Usually, a combination of treatments is needed, and these are often given to suit individual needs. These may include:

· Oral pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs), although its use may be limited because of potential side effects from chronic use

· Narcotics (such as morphine or codeine), although its use is limited by its potential for abuse and side effects

· Other medications, such as anticonvulsants, antidepressants, and anxiolytic drugs

· Localized anesthetic injections, like trigger point injections and hip joint injections

· Nerve blocks, like stellate ganglion block and epidural block

· Electrical stimulation, like spinal cord stimulation

· Radiofrequency ablation

· Physical therapy

· Psychotherapy

· Relaxation techniques such as deep breathing

· Biofeedback

· Behavior modification

Because of the complexity of the character of chronic pain, its treatment has evolved into a specialty. The management of chronic pain in most cases involves a multidisciplinary approach. This means that a team of specialists may be needed to evaluate, diagnose, and treat one’s condition, including internists, surgeons, anesthesiologists, psychiatrists, and physical therapists. Most patients who suffer from persistent pain that does not respond to conventional treatments are referred to a Chronic Pain Clinic, which is managed by a Chronic Pain Specialist, a highly trained physician to diagnose and treat difficult cases of pain syndromes.Tallahassee pain doctor

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If you need more information about pain and its associated symptoms, make an appointment with NYC’s top Pain Management Specialist who will help improve your symptoms, increase your mobility, and take control of your life.