Chronic Pain Articles

Dermatomes Link to Pain

Uncategorized
What are Dermatomes? A dermatome is an area of skin in which sensory nerves derive from a single nerve root. The body is divided into specific regions called dermatomes. A dermatome refers to the part of the embryonic somite. The spinal cord is broken up into 31 dermatome segments. Each segment has a pair (left and right) of ventral (frontal) and dorsal (posterior) nerve roots; which relays motor and sensory nerve sensations, including pain.  Combined on each side the anterior and posterior nerve roots form the spinal nerves as they exit the vertebral canal through the neuroforamina. The segments are composed of eight cervical, twelve thoracic, five lumbar, five sacral, and one coccygeal. Dermatomes exist for each of the nerve roots. Each specific dermatome transmits sensory information via the sensory…
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The Physical Exam

Chronic Pain Conditions, Sunday Thoughts for Monday Morning, Therapies & Treatments
by: Dr. Michael A. Castillo I have a medical pet peeve lately, physicians relying on MRIs and EMG to make diagnoses, without performing a physical exam. Medicine is an honor to have a career in because you get to touch people physically and emotionally. It comes with a great deal of responsibility. I am getting more referrals where a patient hasn’t been physically examined. The patient tells me what is wrong in the history because the MRI says so. The proper order is History, Physical Examination, and then Tests (MRI, X-rays, Nerve Tests, et al) to create a diagnosis. A mentor once said, “Don’t order a test if it is not going to change what you are going to do, and know what you are going to do with the…
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Pain: Let’s Talk

Chronic Pain Conditions, Nerve Pain
by: Dr. Michael A. Castillo I was told September is “Pain Awareness Month.” Pain is strictly an individual concept. Medicine uses a blank line 10cm long, 0-10/10 scale, smiley faces to crying faces, and other methods. None are really appropriate for all patients, or have been shown to cross reference to another person’s pain. There is no consistent way to deal with an individual’s pain. Pain can break up a family or a family can endure. Friends can remain friends or can be completely lost. Successful lives can be completely lost or never started. Simple activities can become impossible to accomplish. People in pain can be thought to be lying to get out of life. Pain can lead to depression. At its worst pain can lead to a rapid dwindling…
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Knee Pain

Chronic Pain Conditions, Platelet Rich Plasma, Therapies & Treatments
by: Dr. Michael A. Castillo We use our legs every day and knee pain is common. The first thing we need to understand is what is wrong with the knee. There is need for a physical exam and an MRI. There can be injury to the internal knee and the external knee. There can be three approaches to the knee: internal injections with hyaluronic acid (roster comb), external injections with steroid or natural anti-inflammatory injections, regenerative medicine, and surgery (endoscopic and total knee arthroplasty). I do not suggest injection of steroid as we now know it increases degeneration of the joint. It may be used as a bridge to a total knee replacement. Knee pain from sports injury, or aging. There are many approaches to treating knee injuries. The internal…
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Caring, Quiet, and Hugs

Uncategorized
by: Dr. Michael A. Castillo I am in Albuquerque for the next week. I came to see my son, and my father. My Uncle Leo passed on Friday. My daughter, wife, and I were present. My daughter was holding his hand. She cared enough to sit with him the last few days of his life believing someone should be present. The same should happen during life. Please remember your family members today for they will one day not be with us on this earth but only in our hearts and memories. For people in pain or just needing rest, the best thing sometimes is just quiet. I think people should just sit quietly and give thanks for the good in their life even if it is barely a bit. Go…
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Back Pain After Spine Surgery

Therapies & Treatments
by: Dr. Michael A. Castillo Dr. Castillo's thoughts about intrathecal pain pump management for treating back pain after surgeries. Intrathecal pain pump management is a proven safe and effective therapy for managing chronic pain. I send a lot of patients for surgery (We are working to heal the spine with our regenerative medicine practice. That is a different topic for a different Sunday.) There are patients in danger of hurting a nerve in their spine which allows them to function. The purpose of surgery is to fix a problem with the spine and stabilize the spine. Some people have no back pain after surgery, and we don’t talk about these outcomes. A lot of people are not so lucky. I tell all my patients, “Surgery is to fix pathology. Surgery…
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PRP and Stem Cell Therapies are they effective?

Platelet Rich Plasma, Regenerative medicine, Therapies & Treatments
by: Dr. Michael A. Castillo It’s an age-old question in medicine, is this safe? Is it effective? With the rise of regenerative medicine or stem cell therapies, people wonder if therapies such as Platelet Rich Plasma and Stem Cells are safe and effective for conditions such as arthritis. Platelet Rich Plasma and Stem Cell therapies can be an effective treatment for arthritis and other conditions. Regenerative medicine is considered to be safe because most regenerative therapies use cells collected from the patient (platelet rich plasma, or stem cells from bone marrow or fat tissue), which minimizes adverse reactions. Some of the most common reactions following procedures are temporary pain and swelling. The effectiveness of regenerative medicine is debated; research into Platelet Rich Plasma and Stem Cell therapies is ongoing. Some…
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Neuropathy Awareness Week

Peripheral Neuropathy
May 5th thru the 12th is National Neuropathy Awareness Week. Neuropathy is a chronic condition that affects millions of people in America. While there is no cure for neuropathy, there are ways to manage the pain associated with it. Many groups including the Foundation for Peripheral Neuropathy and the American Health Council help patients dealing with pain find additional resources such as mental health guides for managing pain. As well as garnering support for research funding to learn more about peripheral neuropathy. So this Neuropathy Awareness week, take time to learn more about this condition and how it can affect the body. https://www.youtube.com/watch?v=EPD4ijRcrm8 Dr. Castillo discusses neuropathy, some of its causes and possible treatments. Neuropathy is a chronic condition. It’s estimated that 7-10% of people have neuropathic pain. In many…
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Pain: Acute vs. Chronic

Chronic Pain Conditions
Broken bones are an example of acute pain Acute and chronic pain have important differences that can give physicians important clues for diagnosing and treating pain. And the types of pain are different, in some cases acute pain can develop into chronic pain. Acute Pain By definition it is temporary, and it may occur suddenly usually associated with an injury or illness. Acute pain serves as the body’s alarm system to prevent further trauma. Like a strained muscle, resting the muscle prevents further injury, giving the muscle time to heal. Generally the source of pain is clear, and if the injury heals usually the pain ceases. Examples of acute pain: Car accidentBroken bonesBurnsFallsSurgerySports injuries Usually there is a pattern occurrence of injury or illness followed by a period of healing…
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Untraditional Approach to Sports Injuries

Platelet Rich Plasma, Regenerative medicine, Therapies & Treatments
If a sports injury does not respond to nonsurgical treatments Dr. Castillo may recommend regenerative medicine therapy Some sports injuries heal fairly quickly on their own with rest and mild activity; while others are like a torn ACL, are unlikely to heal with traditional treatments. Now regenerative medicine such as Platelet Rich Plasma (PRP) therapy, Stem Cell Therapy, and others may be able to help heal sports injuries and get players back on the field. What is Regenerative Medicine? Regenerative medicine is the process of using cells to create newly functional tissues or repair tissue damaged from aging, disease, or trauma. The goal of regenerative medicine is to repair damaged tissue that most likely would not properly heal on its own. There are different types of regenerative medicine: cellular, tissue…
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