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: Acute Pain

Why Do People Experience Pain Differently?

pain doctorIt’s frustrating to be told your pain isn’t that bad. What may actually be occurring is that you may be feeling pain differently from others around you. Sometimes, people are simply more sensitive to pain than others are. While you may be labeled a wimp, in truth, your ability to withstand pain stems from the structure of the brain, something you cannot control at all. Everyone experiences pain differently and once you understand why this is, you may feel better about reaching out for medical help through such situations.

What Determines Pain Sensitivity?

Studies have been conducted to try and pinpoint what causes pain and worsens it in humans. One study found that changes in the sensitivity to pain stem from differences in the amount of grey matter in your brain. Grey matter is a large part of the central nervous system. It is where most your brain’s neuronal cell bodies are located, which is how your brain communicates in regards to what hurts, where it hurts, and why it hurts.

The study found that those people who have less grey matter in their brain had a higher pain intensity rating and therefore were more prone to higher sensitivity than those who had more brain matter. More specifically, those with a larger amount of grey matter in the areas of the brain that control attention and internal thoughts are believed to be a trigger for higher pain levels.

Other studies tell us that people who report higher levels of pain are those that have more brain activity in the areas that control pain. This includes the primary somatosensory cortex, which is where pain sensations are transferred from the body. Additionally, cognitive factors also play a role. For example, those who have past experiences with pain, and different experiences of pain, are likely to have different pain tolerance levels than those that do not.

What Does It Mean to You?

pain doctorIf you feel pain, it means you need help. The amount of pain you feel may be very different from what other people feel. More so, you should not judge your pain sensitivity against another person’s when it comes to getting help. Rather, focus on finding the right type of pain management solution for your unique needs. Every situation is very different.

When it comes to finding a solution, call the best pain doctor in New York at 646-862-5555.

Epidural Steroid Injection for Neck pain

An Epidural Steroid Injection (ESI) is a simple, safe and effective non-surgical treatment that involves the injection of a steroid medication into the Epidural Space of the spine, the portion of the spine with the irritated nerves. The procedure is intended to reduce inflammation and eliminate pain in the Epidural Space. ESI has been used for over 40 years to effectively treat chronic neck pain as well as a variety of other problems along the spine.

How is the Epidural Steroid Injection (ESI) Done?

The most common technique used for Epidural Steroid Injection technique is with X-Ray guidance (fluoroscopy). The injection is performed under local anesthesia. Some patients prefer intravenous sedation. The procedure usually takes about 5-10 minutes. Recovery is a 15-20 minutes before being discharged.

Does the Epidural Steroid Injection (ESI) Hurt?neck pain

A local anesthetic that is injected at the beginning of the procedure may sting, but ESI is a routine procedure that is tolerated extremely well by a wide age range, from teenagers to senior citizens.

How Should I Prepare For An Epidural Steroid Injection?

You should not have anything to eat or drink for at least 8 hours before your scheduled procedure. If you are scheduled to receive sedation during the surgery, someone will need to drive you home.

Please discuss the medications you are taking with your doctor before the procedure. This is particularly important if you are taking medication for high blood pressure, a heart condition or medication that can thin the blood and cause excessive bleeding.

What Should I Expect After The Epidural Steroid Injection (ESI)?

Some patients notice reduction in your pain for the first 1-2 hours after the injection. This is due to local anesthetic injected with the steroid. When it wears off, your pain will return similar to what it was before the procedure. Pain relief with ESI generally happens in 3-5 days, but some patients experience pain relief before then. Diabetic patients need to pay careful attention for a rise in blood sugar during the first few days after an epidural steroid injection.

Following discharge home, you should get rest and relaxation. If you have minor pain at the injection site, apply an ice pack to reduce swelling and discomfort.

Neck-pain-Olympic-Hot-Tub-CompanyHow Many Epidural Steroid Injections (ESIs) Will I Need?

The number of injections needed depend on your response to each individual injection. If you have no pain following one injection, you will probably not need additional injections. If you don’t experience pain relief after two injections, an alternative treatment may be recommended for your neck pain.

Side Effects or Complications of Epidural Steroid Injection (ESI)

Some patients notice a mild increase or worsening of their pain. This is usually temporary and disappears for after a day or two. Most patients experience positive results, but some can have minor side effects:

Nausea

Bleeding

Infection

Itching

Rash

Spinal headache

Flushing and sweating

If you have questions about any of your symptoms, contact your doctor or seek medical attention as soon as possible.

Can Epidural Steroid Injections (ESIs) Be Repeated If My Pain Returns?

Epidural Steroid Injections (ESIs) help relieve pain for approximately half of the patients treated. This ESI can definitely be repeated if it was helpful for your pain in the past, with a usual wait for at least 4-6 months after your last injection.

Contact us today at 646-862-5555 to schedule an appointment with the best neck Pain doctor in NYC for Epidural Steroid Injections to treat your neck pain.

 

Stomach Pain Doctor

Stomach Pain Doctor

Almost everyone has experienced stomach pain or abdominal pain. While it may be very uncomfortable or slightly painful, most causes of stomach pain are not serious and can be easily treated with over the counter medications. It is important, though, to recognize that some forms of stomach pain can also be the sign of a serious illness. Because of this reason, it is important that you learn to recognize which symptoms are serious and when to see a doctor for stomach pain.

Common Causes of Stomach Pain

Most mild stomach aches or cramps are due to indigestion, constipation, stomach flu, menstrual cramps, food poisoning or allergies and lactose intolerance. More serious causes of stomach ache can include ulcers, gallstones, hernia, kidney stones, urinary tract infections and endometriosis.stomach pain

Symptoms of Stomach Pain That Are Cause for Concern

Stomach pain that is severe or accompanied by any of the following symptoms requires prompt medical attention:

  • Nausea or fever

  • Inability to keep food down for several days

  • Blood in bowel movements

  • Breathing problems

  • Blood in vomit

  • Pain during pregnancy

  • The abdomen is tender to the touch

  • The pain started after an injury to the abdomen

  • The pain does not go away for several days

These symptoms should not be ignored as they may signal internal inflammation or infection that requires medical attention as soon as possible. For some people, some of these symptoms may be caused by colorectal, ovarian or abdominal cancer.

stomach painDetermining the Cause of Stomach Pain

There are so many potential causes of stomach pain so your doctor will perform a complete physical examination to narrow down what is causing the stomach ache. You will also be asked several related questions about the pain you are feeling. Typically your doctor will ask you:

  • The type of pain are you experiencing: Is the pain stabbing and severe or is it a dull ache?

  • Whether the pain is throughout your abdomen or on one spot or side.

  • When the pain occurs. Does it happen more often in the morning or at night? Is the pain constant? Does it start after eating certain types of foods or after drinking alcohol?

  • Do you get the pain during menstruation?

  • How long have you had the pain.

  • Does the pain also radiate to other parts of your body?

  • Are you currently taking any medications or herbal supplements?

  • Any medical condition or pregnancy.

  • Does eating or lying on one side relieve or aggravate the pain?

  • Any recent injuries?

After a quick, initial evaluation, your doctor may have you take some tests to help make the diagnosis. Depending on your stomach pain symptoms, these tests may include blood or urine tests, or enemas, barium swallows, x-ray, an endoscopy or ultrasound.

Treatment for Serious Stomach Ache

Treating abdominal pain is dependent on diagnosing the cause based on the symptoms:

  • Medications for inflammation, gastroesophageal reflux disease or ulcers.

  • Antibiotics for infections.

  • Dietary changes abdominal pain caused by certain foods or beverages.

  • Local or spinal injections of numbing agents or corticosteroids. 

  • In severe cases such as appendicitis and hernia, surgery is needed.

If you are experiencing painful, acute (sudden) stomach pain, please visit your nearest emergency room. If your stomach pain has been chronic (ongoing) and painful, contact us today to schedule an appointment with the best Pain doctor in NYC.

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

Contact Us

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.

Best Pain Doctor NYC

 

Welcome to our new blog!

We will be writing informative posts on the many chronically painful conditions that we treat and the ways that we treat chronic pain with many different interventions and modalities.

Here is a list of some of the many painful conditions that we treat:

  • Back Pain
  • Sciatica
  • Herniated Discs
  • Annular Tears
  • Spinal Stenosis
  • Facet Arthropathy
  • Sacroiliac Joint Pain
  • Failed Back Surgery Syndrome
  • Whiplash Injuries
  • Compression Fractures
  • Cancer Pain
  • Herpes Zoster Pain
  • Complex Regional Pain Syndrome
  • Headaches & Migraines
  • General Joint Pain

Here is a list of some of the interventions and modalities we use in order to relieve chronic pain:

  • Epidural Steroid Injections
  • Selective Nerve Root Injections
  • Lumbar Facet Injections
  • Cervical Facet Injections
  • Sacroiliac Joint Injections
  • Radiofrequency Ablation
  • Intercostal Nerve Blocks
  • Trigger Point Injections
  • Botox Injections
  • Discography
  • I.D.E.T.
  • Percutaneous Disc – Decompression
  • Sympathetic Blocks
  • Vertebroplasty
  • Intrathecal Infusion Pumps
  • Spinal Cord Stimulation

In addition to this site, Dr. Grimm maintains another informative web page. Please  =Click Here=  for more information.

© Copyright 2012
Best Doctor NYC
bestpaindoctornyc@gmail.com

Welcome to my Pain Doctor Blog

Welcome to my Blog about pain. My name is Dr. Matthew Grimm.

My goal with this blog is to help patients who are experiencing back or neck pain to understand what is causing their pain and discuss options for treatment. I hope to be able to provide readers with a portal where they can use my blog to facilitate treatment options or just become more educated.

About me:

I received my Medical Degree at Jefferson Medical College in Philadelphia, Pennsylvania. I did my residency training in Physical Medicine and Rehabilitation at University of California Irvine and at William Beaumont Hospital in Detroit Michigan. I served as the Chief Resident in Physical Medicine and Rehabilitation department during my fourth year. I also became board certified and passed the specialty boards in the top of my field. I went on to pursue specialized training in Interventional Spine and Pain Management at the Georgia Institute for Clinical Research, where I was able to perfect my technique in Interventional Spine Skills including cervical and lumbar epidural steroid injections, facet injections, and medial branch blocks. Radiofrequency ablation, sympathetic ganglion blocks, spinal cord stimulator trials, sacroiliac joint injection, piriformis muscle block and musculoskeletal joint injection. I am an expert on both acute and chronic pain management.

Thanks for visiting my blog. I hope you find it educational, enlightening and entertaining. Please feel free to add comments and questions to my blog posts.

Dr. Matthew Grim