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Chronic Pain

Will My Migraines Get Better Over Time?

If you’re one of the millions of Americans suffering migraines, the term “debilitating” is rather an understatement. The disabling headache, along with the slew of distressing symptoms, can leave you to wonder when there’s going to be any reprieve and if it will ever get better over time.

The good news is that, while there’s no step-by-step plan to make migraine attacks stop, the condition can go into either a partial or full remission: partial means you have fewer than 15 days of migraine headaches, while full remission means you go an entire year without experiencing the symptoms.

Read on to learn about what can cause to migraines to worsen as well as the things you can do to avoid attacks and achieve remission.

Why Would Migraines Worsen Over Time?

One way a migraine can get worse is when it becomes chronic. This equates to having bouts of headache 15 or more days every month and of the other migraine symptoms on at least 8 days for more than 3 months.

This can be ascribed to the absence of a proper migraine treatment plan: how you treat your symptoms can have an impact on the frequency and severity of your symptoms.

Migraine headaches that persist and worsen need further medical evaluation, especially if you only started experiencing them after the age of 50, if they have occurred due to a head injury or a side effect of disease treatment, or if they are resistant to medication and lifestyle changes.

Heading Off Migraine Attacks

A commonsense strategy to stave off migraine attacks is to identify and avoid the very things that trigger them. Migraine headaches can be precipitated by smoking, alcohol, lack of sleep, caffeine, changes in schedule, hunger, strong fragrances, stress, and menstruation. Lifestyle changes, such as establishing a regular sleep and eating schedule, smoking cessation, reducing intake of alcohol and caffeine, using unscented products, and managing stress help head off attacks.

For women who have menstrual migraines, one way the attacks can be prevented is by taking medications before menstruation begins up until a few days after the period has ended. Medications used to treat migraines include triptans, gepants, and ditans, which belong to a class of drugs whose mechanism of action is to quiet down overactive pain nerves.

Doctors may also prescribe antidepressants, antiseizures, or beta blockers, to treat episodic migraines. Nonsteroidal anti-inflammatory drugs (NSAIDs), when taken at the onset of a migraine attack, can also help with managing the symptoms. The earlier you take your medication/s, the better they work.

Migraine Treatment in Wellington, FL

Here at Advanced Medical Clinic, board-certified internal medicine physician Dr. Ishan Gunawardene, along with the rest of our team, is dedicated to bringing one goal to fruition: keeping our patients healthy. Dr. Gunawardene can work closely with your neurologist or any other specialist contributing to your care to help you take full control of your migraine, so you can enjoy your life again.

Book your visit with Dr. Gunawardene today. Contact our staff at (561) 434-1935, or use our convenient online request form.

Why You Should See a Family Medicine Doctor for Your Chronic Pain

The Centers for Disease Control and Prevention (CDC) reports that chronic pain afflicts roughly 50 million adults in the United States. If you’re a statistic, one of your best bets to keep chronic pain from wreaking havoc on your mental health and interfering with your overall quality of life is to work with your family medicine doctor.

Read on to learn about the specific measures your family medicine doctor can employ to help you tackle your chronic pain.

Devising a Care Plan for Your Chronic Pain

Chronic pain has various potential causes. It could be caused by arthritis, fibromyalgia (a condition that causes widespread body pain), an untreated musculoskeletal injury, multiple sclerosis, or any other health problem.

Your family doctor can get to the bottom of your chronic pain by reviewing your symptoms, medical history, and current health status as well as ordering the necessary tests (e.g., blood work, diagnostic imaging, etc.).

If your family doctor deems that you need advanced treatment, they will coordinate your care with a specialist, such as a neurologist, pain management specialist, or orthopedic doctor, to determine the most effective intervention for your problem. Depending on the underlying cause, your care team may recommend surgery or ongoing treatment.

Recommending Additional Strategies for Chronic Pain

Your family medicine doctor may recommend any or some of the following strategies to enhance the efficacy of your care plan:

  • Exercise program – Exercise can have a positive impact on both your mood and pain threshold. It is also especially beneficial if your chronic pain is caused by arthritis, as it helps increase your mobility by reducing joint inflammation and stiffness.
  • Relaxation techniques (e.g., breathing exercises, mindfulness meditation, etc.) – These have been shown to help with chronic pain by stimulating the production of the body’s natural painkillers (endorphins).
  • Joining support groups – This equips you with emotional support as well as useful information about your specific condition.
  • Smoking cessation program (supervised by your doctor or another healthcare provider) – Studies show that smoking is linked to many health problems that cause chronic pain.
  • Behavior therapy/ professional talk therapy – Your family medicine doctor may recommend either or both of these modalities to help improve your coping strategies.
  • Nutritional recommendations – Your doctor may recommend a diet plan that includes anti-inflammatory foods, which can help with chronic pain.

Treatment for Chronic Pain in Wellington and Royal Palm Beach, FL

At Advanced Medical Clinic, our board-certified internist Dr. Ishan Gunawardene and our board-certified family nurse practitioner Shariffa Gunawardene are best known for their commitment to delivering the best possible treatment outcomes for the gamut of conditions—including those that cause chronic pain—affecting people of all ages. We will gladly collaborate with the right specialist to help you live well with or even conquer your pain.

To arrange a consultation with one of our providers, contact us at (561) 434-1935 or request an appointment by filling out this secure form.

Common Chronic Pain Conditions

Bodily pain that interferes with your ability to perform tasks, keeps you up at night, and saps you of energy is considered chronic pain. This condition plagues more than 50 million Americans – one in five adults – and it has many different reasons why it can occur.

If you have chronic pain, it is in your best interest to have an evaluation by a skilled physician who can diagnose the underlying cause. The doctor will then work with you to determine appropriate measures of treatment.

Let’s talk about some of the most common reasons behind chronic pain, and where you can go in Wellington for a thorough medical evaluation and treatment that works to reduce or eliminate your pain once and for all.

What Is Chronic Pain?

Chronic pain is constant or intermittent physical discomfort which lasts longer than three months without improvement. Chronic pain is a frequent cause of missed workdays, lost wages, and lost productivity.

It differs in severity and character from person to person, and it can even change on a daily basis. Patients often describe their pain as shooting, stabbing, burning, or throbbing.

Chronic pain conditions include the following:

●      Fibromyalgia

●      Migraine headaches

●      Arthritis

●      Cancer pain (from the disease itself or from its treatment)

●      Back pain

●      Neuropathy

●      Pain due to kidney disease

●      Postoperative pain that continues unabated

Along with the pain itself, you may experience comorbidities (simultaneous health problems) such as:

●      Insomnia

●      Fatigue

●      Unexplained weight loss

●      Poor appetite

●      Depression and anxiety

How Can My Family Doctor Help?

In order to determine what is causing your chronic pain, your doctor will first ask you to describe your pain. Give as much detail as you can regarding its severity, timing (how often it occurs), location(s) on your body, and what, if anything, helps to mitigate it.

The doctor will then perform a complete physical examination, order bloodwork and other lab tests as needed, and possibly do X-rays and other kinds of imaging scans. With a proper diagnosis, your physician can create a care plan to help keep your chronic pain under control.

Your treatment plan may include:

●      Over-the-counter or prescription pain reliever

●      Antidepressant medication

●      Cortisone shots (in-office injection therapy)

●      Physical therapy

●      Heat and cold therapy

●      Chiropractic care (spinal adjustments)

●      Stress management

●      Relaxation techniques

●      Biofeedback

●      Acupuncture 

Trusted Doctor in Royal Palm Beach and Wellington

Here at Advanced Medical Clinic, we will work diligently with you to get you the pain relief you deserve. You may have to try several things before finding a solution that works to quell your chronic pain, but we will indeed find something that works for you. There are many effective treatments out there today.

If you have any questions or would like to schedule an appointment, contact our friendly staff today by calling us at (561) 434-1935 or by filling out our easy-to-use online request form now. We look forward to helping you enjoy life without pain!

 

Acute Pain vs. Chronic Pain

Pain is a universally understood symptom of a health problem. Whether it’s due to an injury, a disease, or something else, pain is a way of alerting you that something is amiss in your body.

Determining when to see a doctor for pain symptoms can be a little confusing. For instance, a minor ankle sprain, a bruise, and a migraine all cause temporary pain. So, do they garner a doctor visit? Not necessarily. The trick to knowing when to see a doctor is understanding if your pain is acute or chronic.

In many cases, acute pain can be treated at home. However, chronic pain is a clear sign that your body has an underlying issue that is going unaddressed.

Let’s take a closer look at what it means for pain to be acute or chronic.

Acute Pain

More common that chronic pain, acute pain is usually preceded by an incident. Practically every person on the planet has experienced acute pain at some point or another. Acute pain can come after stubbing your toe, an exercise injury, wearing ill-fitting shoes all evening, a stress-induced headache, or throwing out your back when picking up a heavy object. Acute pain refers to pain that is temporary. This means, the underlying cause of the pain can be addressed quickly, at which time the associated pain symptoms dissipate. Most of the time, acute pain can be treated at home or through a quick visit to a primary care physician.

Chronic Pain

Chronic pain refers to pain symptoms that are felt for longer than a few weeks. If you throw out your back while picking up a heavy object, your pain symptoms should go away within a few days. If this isn’t the case, your pain could be chronic. Another sign of chronic pain is if your pain symptoms return intermittently for more than a few weeks. An example of this is migraine headaches. A migraine headache once in a while is considered acute pain. However, if you experience migraines on a regular basis, such as several times a month, it is considered chronic pain. Another example is foot pain that develops whenever you stand or walk for long periods of time.

Chronic pain is a definite sign that you need treatment. An underlying injury or condition is causing the pain symptoms, and because the cause is going unaddressed, the pain symptoms are returning repeatedly. Monitor how you feel, and seek medical attention if you are feeling unwell for quite some time. In many cases, chronic pain tends to get worse if left untreated. As such, your pain symptoms could increase in severity and frequency if you don’t seek medical care.

Chronic Pain Treatment in Wellington and Royal Palm Beach, Florida

Whether you have acute or chronic pain, seeking the advice of a medical doctor is always beneficial in reducing your symptoms. At Advanced Medical, we can help you manage your pain symptoms and treat the underlying cause.

To schedule an appointment, call (561) 434-1935 or submit an appointment request.

Types of Chronic Pain

Chronic pain is a common ailment that millions of people suffer from every day. Chronic pain refers to pain symptoms that last longer than a few weeks or pain that comes and goes repeatedly.

There are many causes of chronic, including a variety of health conditions, diseases, and injuries that leave permanent damage to the body. Before you get the right treatment, it’s important to determine the type or root cause of your chronic pain.

The most common types chronic pain are:

Fibromyalgia

Fibromyalgia is characterized by widespread pain linked to the musculoskeletal system. The chronic pain associated with fibromyalgia is caused by repeated nerve stimulation to the brain, which increase specific chemicals that signal pain. These neurotransmitters cause the brain’s receptors to build a type of pain-sensitivity that creates a memory of the pain to which the brain overresponds.

In addition to diffused pain, people affected by the condition may experience mood swings and fatigue that is exacerbated by difficulty with sleep. Memory may also be affected as cognitive issues can cloud thinking and the ability to focus.

Women develop fibromyalgia more often than men. There is no cure for the condition, and it can often cause tension headaches, irritable bowel syndrome, and problems with the temporomandibular joint. Since fibromyalgia has no cure, doctors aim to help patients manage the condition’s symptoms, so there is minimal effect on quality of life.

Nerve Damage

Nerve damage is another common cause of chronic pain, and peripheral neuropathy is one of the most common types.  A network of nerves connects the brain and spinal cord to the rest of the body. When peripheral nerves are affected by injury or disease, peripheral neuropathy can develop. The condition impairs muscle movement and causes pain and numbness in the limbs. Treatment focuses on managing symptoms.

Endometriosis

A common cause of chronic pain in the abdomen is endometriosis, a painful condition that causes excessive bleeding and cramps during a woman’s menstrual period. Endometriosis can also cause discomfort with urination and bowel movements. It is often managed with medications to control symptoms.

Osteoarthritis

Osteoarthritis is a degenerative disease that refers to joint cartilage that has been deteriorated, damaged, or torn beyond repair. The cartilage can degenerate due to wear and tear, overuse, or an injury. Stiffness and chronic pain are common symptoms of this condition.  Osteoarthritis is a progressive condition, which means symptoms tend to get worse with time. Osteoarthritis is often managed with pain medication, physical therapy, regenerative medicine techniques, and more. If these techniques do not help with pain symptoms, you may need joint surgery for long-term relief.

Back Pain

Back pain stemming from spinal stenosis, bulging discs, fractures, or compression of nerves in the spine can all be chronic in nature. Other conditions that are considered structural deformities, such as scoliosis, may also cause chronic pain. Back pain is often treated with physical therapy, medications to control symptoms, and in some cases, surgery.

Chronic Pain Treatment in Florida

If you are experiencing chronic pain, you don’t have to cope with it alone. Contact the experts at Advanced Medical Clinic today to get a diagnosis and treatment plan in place. To make an appointment, call (561) 434-1935. You can also request an appointment online.

How to Manage Your Chronic Pain

Chronic pain can affect your quality of life and impact your ability to enjoy everyday activities. It can even damage your self-esteem because you never feel like your best self anymore.

With chronic pain, it can have an isolating effect because the symptoms are not seen by others. However, pain sufferers want a solution – and the good news is that there are ways to effectively manage your chronic pain.

Let’s talk about some of the ways in which chronic pain can be stifled:

Medication

Pain medication includes those you can purchase over the counter (off the shelf) and those prescribed by doctors. Examples of over-the-counter pain relievers are acetaminophen, ibuprofen, and naproxen. These medications are effective at relieving mild to moderate pain on a short-term basis.

For severe chronic pain, doctors may prescribe pain medication that can only be obtained with a prescription. However, long-term use of these medicines can lead to unwanted side effects, and there is a potential of becoming addicted to prescription pain medications.

Implanted Pain Pumps

Chronic pain that does not respond well to conservative medication may respond to surgical implantation of a pain-relief pump. A pain pump is implanted underneath the skin, where it delivers a controlled dose of pain medication.

With this method, the pain medication is slowly released into the body on a continuous basis. This has been reported to provide immense relief in many chronic pain sufferers.

Spinal Cord Stimulation

A spinal cord stimulator is a device that is implanted underneath your skin in the middle of your back. It alters and interrupts pain signals before they have a chance to reach your brain. The device is the size of a pacemaker, and it delivers electrical pulses to the spinal cord.

Trigger-Point Injections

A local anesthetic is injected into pain trigger points, which are usually within a muscle. Depending on what the doctor decides, the anesthetic may be combined with a steroid.

Not all chronic pain sufferers have trigger points. However, those with fibromyalgia and myofascial pain syndrome, for example, usually do have trigger points – so this treatment can be very effective for those whose chronic pain is caused by those conditions.

Acupuncture

Taken from traditional Chinese methods of medical treatment, acupuncture involves the manipulation of different points of the body. Thin needles are used to prompt the body to release endorphins, which can block the pain signals traveling to the brain.

Alternative Therapies

There are also other therapies that can help to reduce your dependence on pain medicine, such as yoga, meditation, and physical therapy.

Pain Treatment in Palm Beach County

While there are many methods for managing your chronic pain, a trusted family doctor or nurse practitioner can provide you with the quality care that you need. Our health professionals can administer a combination of treatment methods if necessary to effectively relieve your pain symptoms.

Dr. Ishan Gunawardene of the Advanced Medical Clinic is a board-certified internist offering advanced and highly individualized treatment methods for chronic pain. His offices are conveniently located in Wellington and Royal Palm Beach.

If you have any questions about Dr. Gunawardene’s internal medicine services, please call our friendly team at (561) 434-1935, fill out our easy-to-use appointment request form online, or simply walk into our clinic to receive immediate medical attention. We look forward to seeing you here.

Treating COPD

Chronic obstructive pulmonary disease (COPD) is an incurable but treatable condition that affects over 16 million Americans who have been diagnosed with the disease. Many others suffer from it unknowingly.

The acronym COPD is an umbrella term that covers any disease affecting airway obstructions, especially emphysema and chronic bronchitis. Let’s take a look at the causes, symptoms, and ultimate treatments of the various disorders included in COPD.

Causes and Symptoms of COPD

The primary cause for COPD in developed nations like the United States is cigarette smoking. In underdeveloped nations, it tends to occur when people are overexposed to burning fuel for cooking or to heating elements in poorly ventilated homes and buildings.

The main types of COPD in the U.S. are chronic bronchitis and emphysema:

Chronic Bronchitis

This condition occurs when there is inflammation of the bronchial tubes, causing the bronchial tubes to narrow and produce excessive mucus. The narrowing and extra mucus together block airflow to and from the lungs, and sufferers develop a chronic cough while trying to breathe.

Emphysema

This is a condition whereby the smallest air passageways in the lungs are destroyed, causing shortness of breath. Emphysema is a result of exposure to damaging substances from smoking, irritating gases, or other particulate matter that gets trapped in the lungs and causes damage. Smaller airways can collapse when exhaling, further impairing breathing.

Treatment for COPD

Any of the COPD health conditions are manageable. They do require certain changes in lifestyle. The best way to manage your COPD symptoms is to stop smoking and to avoid secondhand smoke whenever possible.

Medical treatments for COPD include a bronchodilator, which comes in an inhaler. This medication can help relax the muscles of the airway, relieving coughing and making it easier to breathe.

Inhalant forms of steroids can also help with the symptoms of COPD, although they do have certain unpleasant side effects. You and your doctor can discuss whether the benefits outweigh the effects of COPD.

Oxygen therapy can also help considerably. There are modern ways of carrying around a portable oxygen tank that make it less obvious than before. Portable oxygen has indeed proven to extend the lifespan and improve the quality of life of a person with COPD.

Diagnosis of COPD

To get a diagnosis, your doctor will first review your family history. Up to 30% of people with COPD were never smokers, so the physician will be checking for a genetic predisposition to lung issues. The doctor will also discuss any potential exposure to lung irritants like cigarettes, or exposure to harmful fumes in the workplace.

They will also perform a series of diagnostic tests, such as the following:

  • Spirometry is a machine with a tube that measures how much air you can inhale and how quickly (and how much) air you can exhale.
  • A chest X-ray can show the presence of emphysema and rule out other potential problems.
  • A CT scan can detect emphysema and determine whether surgery could be beneficial, while it also screens for lung cancer.
  • An arterial-blood gas analysis will test how well the lungs bring oxygen to the blood and filter out carbon dioxide.

Family Doctors in Palm Beach County

COPD is a serious illness that requires management and medical supervision in order to continue enjoying life. If you are in the Wellington or Royal Palm Beach area, contact our team to schedule an appointment at Advanced Medical Clinic.

 

Call us today at (561) 434-1935 or request an appointment online now, and let us help you get back to better breathing!

How Your Doctor Can Help You Manage Your Pain

Chronic pain can wear you down and further degrade your physical and mental health. Your doctor can work with you to reduce your pain and improve your ability to carry on with your everyday activities.

Approaches to pain management have evolved over the last decade. Medical professionals increasingly put you at the center of all aspects of pain management, and that is a good thing. A common misconception is that pain medications such as opioids are the go to for pain management, but this couldn’t be further from the truth. There are many ways your doctor can help you manage your pain.

Encourage Communication

Your doctor can help you best by getting you actively involved in your treatment. By communicating openly with you, your doctor will involve you with decision-making and problem solving. Living better with chronic pain is the goal (after all attempts to correct the painful condition, of course), and this requires excellent communication between you and your physician, and your medical team. Communicative and caring physicians can empower you as a person, not just as a patient.

Listen and explain

Your doctor will ask you about how you experience your pain, and specifically, to describe your pain in everyday language. Because there are no specialized tests to assess where and how you feel pain, you are the primary source of information. Don’t hold back. You are your best advocate. Everybody has a different pain threshold, so it’s important to get a unique understanding of each patient.

In turn, your doctor can help you understand that even if your chronic pain has no specific cure, there are ways to manage it. Your doctor can provide you with resources such as easy to read information, referrals for physical therapists, and other therapeutic experts.

Provide options

You doctor will talk with you about these and other options for your pain management plan:

·      Medications including analgesics such as acetaminophen and non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen can be of help with mild to moderate pain.

Stronger pain medications, including opioids, provide important relief for patients who have strong or severe pain. You doctor will work with you to ensure that you receive the appropriate and safe type of medication.

·      Pain management procedures such as electrical stimulation, acupuncture, nerve blocks, or surgery may be appropriate if pain is not controlled by medications.

·      Non-invasive treatments such as biofeedback, behavior modification, and psychotherapy are all important tools.

·      Alternative or complementary medicine (CAM) include treatments such as acupuncture, massage, Tai Chi, mindful meditation, and relaxation techniques, all of which have been shown to be helpful.

Advise and support

Your doctor can suggest healthy lifestyle changes that will help you better manage your pain and improve your quality of life. Some suggestions your doctor may make include:

Exercise: Chronic pain caused by certain conditions such as arthritis shouldn’t stop you from engaging in physical activity. Natural painkillers or endorphins released by your body after exercise help reduce perception of pain, and exercise has been shown to boost mood. Of course, first discuss any exercise plans with your doctor to make sure they are safe and appropriate for you.

Diet: Eating regular meals rich in antioxidants and nutrients will help your body best deal with pain and stress. Eating fresh vegetables, fruits, and lean protein ensures you have the best fuel to repair and restore your health.

Reach out to us with any questions you have about how to manage your pain. call Advanced Medical in Wellington and Royal Palm Beach, Florida at (561) 434-1935 to request an appointment, or you can request an appointment online.

Chronic vs. Acute Pain

Pain, from the perspective of the medical professional, is often divided into two main categories: acute pain, and chronic pain. Acute pain is the type of pain that we feel as the immediate result of an injury (for example, your finger hurts after getting hit by a hammer when you are trying to drive a nail). Chronic pain is a pain that is more lasting or frequent in nature. Chronic pain, for example, might be more along the lines of having a back or joint pain that is either constant or comes and goes on a fairly regular basis. There are many different conditions linked to chronic and acute pain. These include autoimmune disorders, spine and nerve damage, neurological conditions like migraines, broken bones, nerve damage, burns, blunt trauma and lacerations, and much more.

The fact is that even minor pain caused by stubbing a toe, is seldom pleasant. Nor is it meant to be – pain is, after all, your body’s way of signaling you that something is wrong. Nature has hard wired us to feel pain when our body is injured or compromised in some way. The problem is though, that much like an alarm system that keeps blaring and refuses to shut off, your body can continue to send signals when you already know the issue exists. Acute pain is most often treated by treating the underlying cause of the pain. A broken arm for instance, normally begins to decrease in pain after the bone is set and the healing process has begun.

Chronic pain is often difficult to manage, becoming a quality of life issue. The degree of pain may vary from mild to debilitating, and in many cases, it is accompanied by other symptoms such as ongoing fatigue, depression or anxiety, irritability and an inability to concentrate. This is completely understandable. Some recent studies have also shown that chronic pain may actually alter brain chemistry, especially in the area of the brain that controls how emotions are processed.

Chronic pain conditions include:

·       Arthritis

·       Fibromyalgia

·       Cancer

·       Back or spine injuries

·       Neuropathy or other nerve damage

·       Multiple sclerosis

·       AIDS or HIV

·       Osteoarthritis

·       Migraines

When treating chronic pain, doctors may employ a variety of treatments ranging from targeted injections to surgery, physical or occupational therapy, prescription medications, bracing, and other pain management treatments.

At Advanced Medical Clinic, we understand pain. We treat people from all walks of life, and we know how to deal with both acute and chronic pain. If you are concerned about how chronic pain is affecting your quality of life, Dr. Ishan Gunawardene of Advanced Medical Clinic can answer all your questions. To make an appointment with us in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.