Arthritis is one of the leading causes of joint pain that affects more than 53 million American adults. To understand your arthritis symptoms and get relief from chronic pain and discomfort, visit Southern Pain Specialists in Birmingham, Alabama. Led by pain management specialist Kenneth Varley, MD, the team provides conservative and interventional pain management solutions for mild to severe arthritis.
What is arthritis?
Arthritis is a chronic condition that causes joint pain, swelling, and stiffness. The types of arthritis are divided into categories based on the general causes of each condition. Categories of arthritis include:
Degenerative arthritisDegenerative arthritis — also called osteoarthritis — is the most common type of arthritis that results from trauma, overuse, and wear and tear on your joints. It shows up mostly in the knee, shoulders, hips, and wrists.
Inflammatory arthritisInflammatory arthritis is caused by inflammation that attacks and damages your joints. It typically appears in multiple joints at once and may have flare-ups. Common types are rheumatoid and psoriatic arthritis.
Infectious arthritisInfectious arthritis occurs when an infection — possibly from a cut in your skin or surgery — attacks your joint. This is an emergency situation because the infection can cause serious damage to your joints in a short period of time.
Metabolic arthritisMetabolic arthritis is the result of metabolic end products from your digestive system getting deposited into your joints. The most common type is gout, which shows up most often in the big toe as redness, swelling, and pain.
How is arthritis diagnosed?
Arthritis is diagnosed through consultation, physical exam, imaging — most often X-rays — and possibly blood testing. Dr. Varley always completes thorough exams to identify the cause of your arthritis symptoms and provides treatment as quickly as possible so you can get relief from your joint pain and discomfort right away.
How is arthritis treated?
Treatment for arthritis depends on your diagnosis and the severity of your symptoms. Conservative management of arthritis symptoms includes:
- Nonsteroidal anti-inflammatory medications.- Over-the-counter pain medications.- Physical therapy.- Changes to your diet, in cases of metabolic arthritis- Weight loss, if appropriate.
For more complicated arthritis cases, Dr. Varley also provides advanced forms of therapy, including:
- Nerve blocks.- Radiofrequency ablation (RFA).- Facet injections.- Viscosupplementation for chronic knee pain.- Sacroiliac joint injections.- Epidural steroid injections.
Back pain affects about 80% of adults in America at some point in their lives. If you’re struggling with back pain and need expert advice, see pain management specialist Kenneth Varley, MD, in Birmingham, Alabama. As the founder of Southern Pain Specialists, Dr. Varley offers extensive testing and treatment options to determine the exact cause of your back pain.
Why does my back hurt?
Pain can occur in any of the anatomical structures in your back, although the two main causes are often mechanical and radicular pain. Mechanical pain comes from dysfunctional joints, meaning they don’t move properly or are deformed due to arthritic changes. Radicular pain is the result of nerve irritation or compression.
Common causes of back pain include:
- Facet joint dysfunction.- Sacroiliac joint dysfunction.- Arthritis.- Sciatica.-Radiculopathy.- Spinal stenosis.- Herniated discs.
Compression fractures in the spine may also be sources of pain for those with osteoporosis or a history of spinal trauma. If any of these conditions are left untreated, they may become progressive and cause permanent damage to your nerves or joints.
Back pain is a symptom, so how is the cause diagnosed?
In addition to a comprehensive consultation and physical exam, Dr. Varley also provides advanced diagnostic procedures, such as:
- Discography.- Facet joint diagnostic injections.- Sacroiliac joint diagnostic injections.- Diagnostic selective nerve root blocks.- Diagnostic sympathetic nerve blocks.
How is back pain treated?
Dr. Varley recommends different treatment options for back pain depending on your diagnosis and the severity of your symptoms. Conservative treatments for back pain include:
- Nonsteroidal anti-inflammatory medications.- Over-the-counter and prescription pain medications.- Physical therapy.- Bracing.
Dr. Varley may recommend an interventional pain management procedure if conservative therapies aren’t enough. Potential recommendations may include:
- Epidural steroid injections.- Facet injections.- Intradiscal electrothermal therapy (IDET).- Radiofrequency ablation (RFA).- Sacroiliac joint injections.- Vertebral augmentation (kyphoplasty)Spinal cord or nerve root electrical stimulation (SCS).
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What is radiofrequency ablation?
Radiofrequency ablation (RFA) is a medical procedure that uses an electric current to carefully heat a small segment of your nerve tissue to prevent it from sending pain signals. This can provide a long-lasting solution to nerve pain associated with chronic sacroiliac joint pain and arthritic pain in your spine. In many cases, pain relief lasts 6-12 months, although some people can experience pain relief for years after an RFA treatment.
How does radiofrequency ablation work?
During the RFA procedure, Dr. Kenneth Varley inserts a thin, sterile needle into the affected area. He uses an X-ray to guide the needle to the precise location of your pain for exact, specific treatment. Dr. Varley then inserts a microelectrode through the needle, which may cause a tingling sensation in the area where you’ve been experiencing pain.
Dr. Varley then sends a small electric current through the microelectrode to heat the nerve in the treatment area. As nerve tissue is heated, the heat alters it slightly so it can’t send pain signals to your brain. The procedure is only performed on the affected nerve, so other nerves and tissues in the area remain unaffected. The procedure is considered low risk and has few side effects, such as mild soreness or discomfort at the site for 1-2 days afterward.
Am I a candidate for radiofrequency ablation?
To determine if RFA is the right treatment for your nerve or joint pain, Dr. Varley first examines the injured area and performs a series of tests, such as X-rays, nerve studies, or diagnostic injections called nerve blocks, to determine which nerve is sending pain signals. In some cases, nerve blocks — injectable medication used to block pain signals — are enough to effectively relieve patient pain.
If Dr. Varley determines that a particular nerve is the source of your pain and other treatments, including nerve blocks, have been unsuccessful, he may recommend RFA or another procedure, depending on the severity of your pain and overall health.
What should I expect when getting radiofrequency ablation?
Before getting RFA, Dr. Varley administers an anesthetic solution to the area via an injection, so the only discomfort you may feel is mild tingling during the procedure. Afterward, you can typically go home on the same day to recuperate. Dr. Varley follows up with you shortly after your visit to determine how effective the procedure was and if additional care is warranted.
Sciatica can cause sharp and shooting pain, numbness, and tingling from your buttock to your foot. For effective relief from discomfort caused by sciatica, visit Southern Pain Specialists in Birmingham, Alabama.
What is sciatica?
Sciatica is a symptom resulting from inflammation or irritation of the spinal nerve roots in your lower back which forms the sciatic nerve. Direct irritation of the sciatic nerve after it leaves the spine can also occur. The sciatic nerve travels from the lower part of your spine through your buttocks to the back of your thighs and calves before ending at your feet. It’s located on both sides of your body, though symptoms are typically only felt on one side.
What are the symptoms of sciatica?
Sciatica symptoms may vary depending on the cause of nerve irritation or compression, as well as your daily activities. Possible symptoms of sciatica include:
- Sharp, shooting pain down the back of your leg.- Numbness and tingling in the back of your leg or foot.- Buttock pain.- Weakness in the muscles of your legs and feet.- Pain that’s worse while coughing, sneezing, or having a bowel movement.- Pain that’s worse when you bend forward or stretch your hamstrings.- Movements that put tension on your sciatic nerve, such as bending forward to tie your shoes, can cause an increase in symptoms. Symptoms may resolve with rest or certain positions, such as lying flat on your back.
What causes sciatica?
There are a number of factors that must be ruled out before diagnosing your condition. Common causes of back and leg pain which may cause or mimic sciatica include:
- Piriformis syndrome.- Sacroiliac joint dysfunction.- Lumbar radiculopathy.- Spinal stenosis.- Facet joint dysfunction.- Arthritis.
How is sciatica diagnosed?
To diagnose sciatica, Dr. Varley begins with a physical exam and diagnostic testing. He may recommend imaging, such as X-rays, magnetic resonance imaging (MRI), or a CAT scan. Advanced diagnostic testing like diagnostic nerve blocks or joint injections may help confirm the diagnosis. These tests help Dr. Varley determine where your nerve pain is coming from and what conditions or anatomical structures are compressing or irritating your sciatic nerve.
How is sciatica treated?
Based on your diagnosis and the severity of your condition, Dr. Varley discusses which treatment options are best for you. He may recommend one or more of the following options, depending on your specific case:
- Nonsteroidal anti-inflammatory medications.- Over-the-counter or prescription pain medications.- Physical therapy.- Epidural steroid injections.- Intradiscal electrothermal therapy (IDET).- Radiofrequency ablation (RFA).- Spinal cord or nerve root electrical stimulation (SCS).
Vertebral compression fractures are a common complication of osteoporosis, affecting about 750,000 people every year. To get relief from the severe pain and complications associated with vertebral compression fractures, visit Kenneth Varley, MD, at Southern Pain Specialists.
What is a vertebral compression fracture?
A vertebral compression fracture is a type of fracture that occurs when the inner layers of a bone in your spine break down and collapse. This results in the loss of height in the vertebrae and may also compress nerves or soft tissues in the surrounding area. Compression fractures require treatment to prevent further damage to the bone and soft tissues in the area.
What are the signs of a vertebral compression fracture?
Vertebral compression fractures typically cause severe back pain when they occur. Other symptoms include:
- Sudden onset of back pain.- Increased pain when standing or walking.- Decreased pain while lying flat on your back.- Decreased spinal mobility.- Eventual loss of height.- Eventual deformity and disability.
It’s possible to have more than one compression fracture at a time, especially in cases of trauma or severe osteoporosis. Not all compression fractures are painful, and other conditions can mimic fracture pain. Dr. Varley rules out other causes of back pain and confirms that the vertebra should be treated with diagnostic nerve blocks before proceeding with kyphoplasty. Multiple compression fractures can cause an obvious change to your posture called kyphosis, in addition to other symptoms.
What causes vertebral compression fractures?
The most common cause of vertebral compression fractures is osteoporosis. Compression fractures are most likely to occur in the thoracic spine — or middle back — especially the lower half of the thoracic spine where your rib cage ends, although they can occur anywhere in your spine.
Other potential causes are trauma or metastatic cancer. Types of trauma that can cause compression fractures are car accidents, sports injuries, and falls. If you’ve experienced any trauma and have back pain, it’s best to be evaluated by Dr. Kenneth Varley to determine if you have a vertebral compression fracture.
How are vertebral compression fractures treated?
Dr. Varley performs a procedure called kyphoplasty to repair vertebral compression fractures. During this procedure, he makes two small incisions in your skin and uses a drill to make space on the sides of the vertebrae to insert two deflated surgical balloons. The balloons are filled with a contrast medium until they expand to the desired size, which restores height to the vertebrae. Dr. Varley then injects surgical cement into the vertebrae to fill the space that has been compressed. The cement dries and restores strength and height to your spine and protects the nerves and soft tissues in the area from further damage.
Nerve blocks are used to diagnose and treat pain from nerves and joints associated with your lower back and neck. To learn about the benefits of nerve blocks and determine if the procedure is right for you, visit Kenneth Varley, MD, at Southern Pain Specialists.
What is a nerve block?
A nerve block is a type of injection that uses an anesthetic solution to numb the nerves that are causing your pain. Dr. Kenneth Varley performs nerve blocks using fluoroscopy or ultrasound to guide the needle to the exact location of your pain for the most precise treatment possible. Light electrical impulses may also be administered to your nerves during the procedure in order to locate the exact nerve that is causing your pain.
How do nerve blocks work?
As soon as the nerve block is injected into the epidural space — the fluid-filled space around your spinal cord — the anesthetic medication takes effect. It is quickly absorbed by your nerves in the area to block pain signals that are sent from your nerves to your brain. Since nerve blocks are placed at the nerve roots where they attach to your spinal cord, you get relief from the root to the end of your nerves, which may continue all the way to your fingers or toes, depending on which nerves are being treated.
When is a nerve block recommended?
Dr. Varley recommends nerve blocks for patients suffering from chronic joint or nerve pain that hasn’t responded to other conservative treatments, like anti-inflammatory medications or physical therapy. Conditions that can benefit from nerve blocks include:
- Low back pain.- Sciatica.- Neck pain.- Arthritic pain in the spine.- Sacroiliac joint pain.- Facet joint pain.
To determine if a nerve block is right for you, Dr. Varley discusses your symptoms and previous treatments you’ve tried before performing a physical exam and ordering additional tests, like X-rays or a CT scan.
What can I expect when getting a nerve block?
When you arrive for your nerve block procedure, Dr. Varley first cleans your skin and injects a numbing solution to minimize discomfort.
Mild sedation is administered before Dr. Varley inserts the needle for the nerve block using the appropriate imaging technology. He injects the nerve block solution and then removes the needle. This occurs in about 5-10 minutes. Nerve blocks typically take 15-20 minutes to work.
After your procedure is complete, Dr. Varley cleans your skin and applies a bandage. He provides after-care instructions and follows up within a few days to determine how you’re doing.
Osteoporosis is a common condition that affects about 54 million American men and women. Since it can lead to serious fractures such as vertebral compression fractures and hip fractures, prevention and early diagnosis and treatment from Southern Pain Specialists can help reduce your risk of broken bones and other complications.
What is osteoporosis?
Osteoporosis is a condition resulting from the loss of bone calcium, which decreases bone density and strength. Bone loss occurs gradually over many years and often has no symptoms. You may first find out you have osteoporosis after experiencing a fracture. It’s best to be screened for osteoporosis if you are a woman over the age of 50, a man over 70, or have family members with osteoporosis.
What causes osteoporosis?
Bone is constantly being broken down and rebuilt as a normal part of aging. When bone is broken down — called resorption — bone cells dissolve and are replaced by new, healthy ones in a process called formation. Osteoporosis occurs when the amount of bone being broken down outpaces the formation of new bone.
This leads to the development of microscopic holes in your bones that make it weaker. This can happen in any bone in your body, so if left untreated, osteoporosis can cause fractures in your spine and limbs.
Am I at risk of developing osteoporosis?
Since bone changes are a normal part of the aging process, being over the age of 50 increases your risk of developing osteoporosis, which increases even more as you get older. Other risk factors for developing osteoporosis include:
- Being female.- Family history of osteoporosis.- Previous fracture.- Menopause or having a hysterectomy.- Long-term glucocorticoid therapy.- Rheumatoid arthritis.- Primary or secondary hypogonadism in men.
Certain medications, including those used for breast cancer treatment, may also cause an increase in bone loss.
How is osteoporosis diagnosed?
Dr. Kenneth Varley performs bone densitometry scans in the office to determine the amount of bone loss in your body. This is a simple and painless type of X-ray that detects osteoporosis and osteopenia. Once the test is complete — which takes 5-10 minutes — Dr. Varley analyzes the data collected from the test to determine the density of your bones.
How is osteoporosis treated?
There are many ways to manage osteoporosis and reduce your risk of developing osteoporosis-related fractures, including vertebral compression fractures. Most treatments involve medications that help build more bone. Other treatments include hormone replacement therapy and lifestyle recommendations, like increasing your daily activity level, which may help strengthen your bones.
Numbness, tingling, and weakness in your arms, hands, legs, or feet may result from peripheral neuropathy. To find the cause of your peripheral neuropathy and get effective treatment, visit pain management specialist Kenneth Varley, MD, in Birmingham, Alabama.
What is peripheral neuropathy?
Peripheral neuropathy is a condition that affects the peripheral nerves located in your arms, hands, legs, and feet. When these nerves are irritated or compressed, they produce specific symptoms that can become uncomfortable or make simple tasks, like typing, opening a jar, or walking, difficult.
What are the signs of peripheral neuropathy?
Common signs of peripheral neuropathy include:
- Numbness or tingling in your arms, hands, legs, or feet.- Weakness in your limbs.- Difficulty gripping objects.- Poor coordination.- Difficulty walking.- Loss of sensation in your hands or feet.
Peripheral neuropathy can become dangerous if it prevents you from feeling sensations in your hands and feet that may lead to burns, trips, or falls. Peripheral neuropathy is also a progressive condition that can get worse over time and cause permanent damage to your nerves.
What causes peripheral neuropathy?
The leading cause of peripheral neuropathy in your legs and feet is diabetes, while the leading cause in your hands is carpal tunnel syndrome. With diabetes, high blood sugar irritates nerves throughout your body — although the symptoms are most notable in the legs and feet.
With carpal tunnel syndrome, the median nerve in the inner part of your wrist that controls sensation and movement in your hand becomes compressed. The median nerve can be compressed by muscles in your forearm or wrist or the tendons in your carpal tunnel if they swell due to overuse. If left untreated, carpal tunnel syndrome can become chronic and permanently damage your nerves.
How is peripheral neuropathy diagnosed?
Different tests are available to examine your nerves and isolate the cause of your symptoms. Nerve-specific tests include nerve conduction velocity (NCV) and electromyogram (EMG) tests, which check how quickly your nerves can send impulses to and from your brain and the muscles in your hand and wrist.
Dr. Kenneth Varley may also recommend an X-ray or diagnostic ultrasound to rule out other potential causes of your symptoms, like bony abnormalities or muscle tears.
How is peripheral neuropathy treated?
Treatment for peripheral neuropathy depends on your diagnosis and the location and severity of your symptoms. Possible treatments include:
- Dietary supplements, including magnesium and B vitamins..- Nonsteroidal anti-inflammatory medications.- Activity changes.- Nerve gliding exercises.- Spinal cord or nerve root electrical stimulation.- For peripheral neuropathy caused by diabetes, Dr. Varley works with your primary care provider or internal medicine specialist to manage your diabetes and control your blood sugar.
DEXA Scan lets fitness enthusiasts, athletes, and dieters measure body composition. See exactly how much body fat and muscle you have and where. Track your progress as you work through a new program. Results show you:
- Overall body fat, lean tissue (muscle), bone weight, and percentages- Breakdowns for both legs, arms, and your torso-Visceral fat (the dangerous fat around organs) and muscle are distributedVisceral fat (the dangerous fat around organs)- The primary advantage of DEXA Scan over other devices is that the DEXA Scan measures your actual body fat and gives you precise measurements.
How a DEXA Body Composition Scan Works
The total scan takes about 7 minutes, where you’ll be lying flat on the scanning bed. The DEXA is the ‘gold standard’ body composition testing. It has the greatest precision and shorter scan times.
DEXA Scan helps identify patients at high risk of osteoporosis and bone fractures. By monitoring bone density, physicians and patients can assess risk and proactively treat the problem.
Bone density peaks at age 30 and then decreases over time. That is why it’s important to do strength training, weight-bearing exercise, and to include enough calcium and vitamin D in your diet.
Women are 4 times more likely to develop osteoporosis due to their lighter, thinner bones and longer life spans. Statistically, being Asian or Caucasian also puts you at higher risk. Or if you have a narrow build.
How a DEXA Bone Density Scan Works
A Bone Densitometry test is used to measure how strong your bones are. It is commonly used to identify osteoporosis, a condition that causes a decrease in the density of bones resulting in fragility, and to determine a person’s risk for developing fractures. The risk for developing a fracture is determined by age, weight, and family/personal history.
DEXA is today’s established standard for measuring bone mineral density (BMD) and is most often performed on the spine, hips, or forearm.
Osteoporosis risk factors:
- Are female and older than 65.
If you are female, menopausal, or post-menopausal and:- Under the age of 45.- Under 65 with other risk factors.- Not taking estrogen.- Over 5 feet 7 inches tall.- Weigh less than 125 pounds.- Are male and older than 70.- Are male and have clinical conditions associated with bone loss.- Have broken a bone over the age of 50.- Have lost more than an inch of height.- Have unexplained back pain.- Have personal or family history of fractures, smoking, or osteoporosis.- Use medications that are known to cause bone loss (including corticosteroids, anti-seizure medications, and certain barbiturates or high-dose thyroid replacement drugs).- Have Type I Diabetes, Liver Disease, or kidney disease.- X-ray evidence of vertebral fracture or other signs of osteoporosis.- Have Thyroid conditions, such as Hyperthyroidism.- Parathyroid condition, such as Hyperparathyroidism.- High bone turnover (shows up in the form of excessive collagen in urine samples).- Experienced a fracture after only mild trauma.