Tag Archives: Dr Nomen Azeem

Driving … A Pain In The Neck? AND IN MY BACK!

driving neck pain

We’ve heard many times about how important it is to maintain good posture at our workplace desks to protect our neck and spine, however most of us don’t give it a second thought when driving. Unlike sitting in a chair, the spine experiences variations of force when in a car. Vibrations from car movement may push on the discs, our internal “shock absorbers”, acting as cushions.

Proper driving posture and seat positioning may avoid a myriad of chronic problems. Here are some helpful tips to avoid discomfort:

Position your car seat to the proper height and distance across from the wheel so that your hands can comfortably reach the recommended “10 and 2” or “9 and 3″ location.

  • Your thighs should rest as much as possible on the seat in order to align your knees on the same level plane as your hips.
  • Elbows should be slightly bent.
  • Consider using a neck support, one similar to that used on a plane. This keeps your neck straight. Even a 20 degree downward curve in the neck will cause stress over time.
  • If you have lumbar support in your car, use it. If not, use a portable back support or a rolled up sweater to place at the small of your back.
  • A seat cushion used for extra padding will help protect your spine from a bumpy ride.
  • For long rides, take regular breaks; get out and s-t-r-e-t-c-h.
  • If you have cruise control, use it to give your back a rest. Place both feet firmly on the car floor. Bend your ankles a few times to stimulate blood flow.

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Whatever the cause of your neck or back pain, don’t delay having it checked. Chronic pain needs assessment, particularly if it’s worse at night and wakes you up from your sleep.

The physicians at Sarasota Orthopedic Associates are experts in diagnosing, evaluating, and treating neck and back pain. Call us at 941-951-2663 for an appointment at one of our four locations in Sarasota, Lakewood Ranch, Venice, or Bradenton. For more information about us, visit our Facebook page at www.facebook.com/srqsoa or our web page at www.SOA.md

GETTING TO KNOW YOU – Nomen Azeem, MD

Azeem lab coat half

Over the past couple weeks we’ve met the more personal sides of Dr Michael Gordon and Dr Paul Lento.  Next to answer our questions is Nomen Azeem, MD, an Interventional Pain Management physician here at SOA.

What inspired you to become a physician?

I have always felt that providing care to improve a person’s health or to save a person’s life is not just a noble occupation but also carries a great responsibility to provide comfort and assurance to people in many times their most vulnerable moments.

Why Interventional Pain Management?

The debilitating effects of chronic pain physically, mentally, and psychosocially are many times overlooked or discounted. I believe that Interventional Pain Medicine is one of the most rewarding fields in medicine because in addition to providing treatment for chronic pain patients, you provide hope that can really impact their lives.

What do you love most about your job?

I love the candid moments of elation that I witness in patients that have received significant pain relief following an Interventional Pain Procedure.

What is your biggest challenge?

Convincing some patients that there are options to treat pain that are safer and more effective than opioid pain medications.

If I weren’t an orthopedic physician I’d be a __________________.

I’d be an entrepreneur.

Your proudest moment?

It’s a tie between, my wedding day, the birth of my first child, and the birth of my second child.

Where is the most interesting place you’ve travelled?  Why?

My wife and I traveled to Istanbul, Turkey for our first international trip after being married and it was amazing! The mesh of cultures from Europe, Asia, and the Middle East was astounding. I would highly recommend Istanbul as a top travel destination.

Any hobbies?  Activities?

I love to spend time with my family. Beyond that, anything athletic or working out helps to pass the time.

What’s your next adventure?

An international trip with the kids.

Your guilty pleasure food?

Anything with a staple ingredient being coconut.

Dr Nomen Azeem is Fellowship Trained and Double Board Certified in Physical Medicine & Rehabilitation (PM&R) and Pain Management”. You may read his medical biography by visiting our website here. To make an appointment with Dr Azeem, call 941-951-2663. Sarasota Orthopedic Associates has 13 physicians across 4 locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and we offer same day appointments when needed. Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

CERVICOGENIC HEADACHES

Headache1      cervicogenic headache

Cervicogenic headaches are characterized as head and neck pain originating from the cervical region, a type of secondary headache. This classification is due to the source of the headache being in the neck.  Cervicogenic headaches may be from muscle pain and spasms of the neck muscles, cervical facet joints, or the occipital nerve, located at the base of the skull.  Multiple studies have indicated that cervicogenic headaches may be under-diagnosed, with estimates of prevalence ranging from 2% up to 22%.

Any injury to the neck or cervical region of the spine can lead to cervicogenic headaches. This injury may be an acute, sudden injury resulting from an automobile accident, a sports-related injury, or a fall, or it may be the result of a long-term sustained injury caused by bad posture or degenerative changes with age.

Cervicogenic headaches rarely present auras or nausea that are commonly associated migraine headaches and the pain is not responsive to traditional migraine medications.  However, cervicogenic headaches have been known to precipitate migraine headaches. Appropriate diagnosis of cervicogenic headaches is done by a thorough history and physical exam. Another way in which cervicogenic headaches can be readily diagnosed is if treatment of the neck is able to provide rapid relief from the headache.

PT myofascial release

The specific treatment for cervicogenic headaches varies by patient and by what is found to be the cause of the headaches. If the problem found in the neck is a result of musculature, then muscle-specific treatment options may provide relief. Such treatments include muscle relaxants, physical therapy including myofascial release, and/or trigger point injections into the muscle. For patients whose cervicogenic headaches are a result of damage to the cervical facet joints, there is often underlying inflammation contributing to pain generation. In this case, an interventional procedure known as a radiofrequency ablation (RFA) can block the pain signal being generated from the joints. To directly address the nerve triggering the cervicogenic headache, the occipital nerve, nerve blocks can be administered to inhibit the problematic signaling.

According to Dr. Nomen Azeem, Interventional Pain/Sports Medicine Physician at SOA, “The first step to treating cervicogenic headaches is correctly identifying the source. Unfortunately, in the more difficult cases there may be overlapping sources, in such cases we take a step-wise approach to obtain maximal pain relief.” Dr Azeem sees patients in all three of our offices: Sarasota, Lakewood Ranch, and Venice.  Appointments are made by calling 941.951.BONE (2663). Visit our website by clicking  here for more information about Sarasota Orthopedic Associates.

 

 

 

CUTTING EDGE TREATMENT FOR VERTEBRAL COMPRESSION FRACTURES

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Vertebral compression fractures affect approximately 25 percent of all postmenopausal women in the United States and are recognized as the hallmark of osteoporosis.  The prevalence of this condition steadily increases with advancing age, reaching 40 percent in women 80 years of age. Although less common in older men, compression fractures also are a major health concern in this group. Acute and chronic pain in the elderly is commonly attributed to severe pain from vertebral compression  and often leads to further disability. In addition to physical limitations, vertebral compression fractures may produce a psychosocial and emotional burden on the aging person who already faces losses of independent function. This may cause the person to worry about what the future may bring. These worries are not unfounded, because there is a substantial risk of subsequent fractures of all types and further morbidity in persons who have had a vertebral compression fracture.

About one third of vertebral fractures are actually diagnosed, because many patients and families regard back pain symptoms as “arthritis” or a normal part of aging.  Dr. Nomen Azeem, Interventional Pain/Sports Medicine Physician at Sarasota Orthopedic Associates states, “It is vital to conduct a thorough physical examination as close to the onset of pain symptoms as possible. This is combined with imaging such as X-ray and/or MRI of the spine to confirm the diagnosis.  When it comes to vertebral compression fractures, the sooner you can treat the patient, the better!”

Percutaneous-vertebroplasty(800x550)

Conservative treatment includes analgesic, muscle relaxers, a back brace and physical therapy. Patients who do not respond to conservative treatment or who continue to have severe pain may be candidates for percutaneous kyphoplasty. Percutaneous kyphoplasty involves using a high-pressure balloon which is placed into the center of the collapsed vertebral bone to restore the shape and height meanwhile creating a cavity.  After the cavity is created, acrylic cement is injected into the collapsed vertebra to stabilize and strengthen the fracture and vertebral body.   According to Dr. Azeem, “Kyphoplasty is a great option in the appropriately selected patient. It is amazing the magnitude of pain relief that is reported by the patient immediately following the procedure.”

The physicians at Sarasota Orthopedic Associates are committed to getting our patients back on their feet, back to work, back in the game, and back to life. Same day appointments are available in our three offices located in Sarasota, Lakewood Ranch, and Venice. You may call 941-951-BONE (2663) for an appointment.

 

CHRONIC PAIN: A new innovative, minimally invasive treatment

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Chronic pain is a largely under-treated and misunderstood disease that affects more than 1.5 billion people worldwide according to the American Academy of Pain Medicine. Sarasota Orthopedic Associates offer an alternative solution that has proven to be quite successful for many of its patients:  spinal cord stimulation (SCS) which was approved by the FDA in 1998. In a 2009 study published in the Journal of Clinical Monitoring and Computing, researchers noted that SCS is “effective in reducing intensity, duration and frequency of pain experienced by the patient.”

SCS is for those who have endured chronic pain in the neck, back, arms or legs, neuropathic pain (burning, tingling or numbing sensations), or inadequate surgeries.  Think of it as analgesia “on demand,” though the patient must go through a broad prescreen before the trial can be done.

HOW IT WORKS

The SCS system consists of a pulse generator with remote controls, implanted to stimulate electrodes and conducting wires, known as “leads”, connecting the electrodes to the generator, similar to a pacemaker. To qualify for permanent implantation, a patient must undergo a trial period of about a week. During this time, a temporary stimulator device is implanted by the physician after a local anesthetic or sedative is administered. The physician places the leads under the skin, guided by an X-Ray machine and a radiology technician. The leads are then attached to a small, hand-held generator that the patient controls. The generator sends electrical pulses to the spinal cord, thus interfering with the nerve impulses that cause the pain sensation.

scs - Azeem

The system replaces pain with a feeling of massaging – or merely just the absence of pain. It may allow for reduced pain medication and help the patient improve mobility. Often times patients experience relief immediately, though the leads may occasionally need to be adjusted for optimum performance.

The spinal cord stimulation devices at Sarasota Orthopedic Associates are supplied by St. Jude Medical, whose motto is “Power over pain.” The company has a longstanding relationship with physicians and are able to directly answer patients’ questions or help them out with maintenance of the device. Says Dave Moss of St. Jude Medical, “We provide the stimulation device and become the first line when dealing with it. We have an excellent relationship with Sarasota Orthopedic Associates and Dr. Nomen Azeem and, we are very ingrained in the practice while working efficiently with their staff.”

“As an interventional pain physician, I witness the debilitating effects of chronic pain physically, mentally, and psycho-socially which impact individuals’ quality of life” said Dr Nomen Azeem. “All pain physicians worry of the long term systemic effects of pain medications. Fortunately, the technological advances being made in the field of neuro-modulation are astounding and have revolutionized how we think about treating neuropathic pain.” Dr. Azeem, Interventional Pain and Sports Medicine Specialist at Sarasota Orthopedic Associates, has seen a vast increase in quality of life for many of his patients, without having to resort to invasive surgery or increased medication.

Dr. Azeem is double board-certified  in Interventional Pain Management and Physical Medicine and Rehabilitation, and an expert in minimally invasive procedures for treating chronic back pain (with or without leg pain), chronic neck pain (with or without arm pain), pain that persists after back or neck surgery, peripheral neuropathy, Reflex Sympathetic Dystrophy (RSD), Occipital Neuralgia, and Post-Herpetic Neuralgia.  Click HERE to learn more about Dr Azeem or HERE to learn more about Sarasota Orthopedic Associates.

 

PRP – What is it and how can it help me?

prp

Platelet rich Plasma (PRP), a minimally invasive treatment for Tendinitis and Arthritis, is an enriched blood product composed primarily of platelets — a type of cell found in the blood. PRP is an emerging clinical tool for use in a wide variety of medical applications. With PRP, a blood sample is collected and then blood plasma is concentrated with higher than normal amounts of platelets, which most famously play a role in blood clotting, but have also been discovered to release a multitude of protein growth factors involved in many other biological responses involved in healing and tissue repair. The theory behind PRP is that by introducing platelets in large quantities to an injury site, the excess of growth factors might stimulate inflammation and heal long-term injuries contributing to chronic pain. PRP was first utilized during an open heart procedure in 1987, and has since found application in a wide variety of medical specialties. The growing medical application of PRP is a direct result of an increased understanding of platelets and their physiological role in healing processes.

PRP-Feat

Musculoskeletal injuries are one of the most common causes of chronic pain and disability in the world, and PRP has been shown to be particularly suited their treatment. Tendons in particular are vulnerable to injury as they anchor muscle to bone and are responsible for handling large amounts of force. They also heal very slowly, as the fibrous tissue contains very little vascular supply with which to receive blood and healing mediators such as platelets.  PRP has more recently been reported to be helpful in the treatment of chronic pain due to osteoarthritis, bursitis, and plantar fasciitis. Clinical studies continue to accumulate data on the potential benefits of PRP therapy. Some of the best documented musculoskeletal conditions that have been effectively treated with PRP therapy include:

  • Epicondylitis (Tennis Elbow/Golfer Elbow)
  • Tendinopathy/tendonitis (Achilles/Patellar/Rotator Cuff)
  • Osteoarthritis

Dr. Nomen Azeem, Interventional Pain and Sports Medicine Physician at Sarasota Orthopedic Associates, has done extensive research in the use of PRP for painful musculoskeletal conditions and has had numerous patients benefit from this progressive treatment.  He reports, “Many patients become frustrated having tried anti-inflammatories, physical therapy, and even steroid injections without long lasting relief of their pain. I am excited to be able to offer a minimally invasive treatment option for such patients, allowing them to experience long term pain relief.” For more details, please visit our website HERE.

 

A NEW TREATMENT FOR CHRONIC KNEE PAIN

knee pain

Chronic knee pain is a very common complaint in the United States. The typical conservative treatments for knee pain are physical therapy and over-the-counter pain medicines. The next step in treatment may call for injections, with steroids or visco-supplementation such as Synvisc/Euflexa treatment, along with prescription pain medications. Beyond that, knee replacement surgery has been a common solution to chronic knee pain due to osteoarthritis.

Dr. Nomen Azeem, an Interventional Pain and Sports Medicine Physician at Sarasota Orthopedic Associates, offers a new solution called knee radiofrequency ablation (Knee RFA) for his patients who suffer from chronic knee pain. This procedure can help patients delay or even avoid surgery, and may also provide pain relief to patients who have already had knee replacement surgery.

Knee RFA is an outpatient procedure carried out in two steps. In the first procedure, which is diagnostic, a medication is injected into the nerves around the knee, called the genicular nerves. This medication serves to temporarily block the pain signals.

If a patient gets pain relief from the diagnostic procedure, the doctor will move forward with the second step, which is the actual knee radiofrequency ablation. In this procedure, a specialized needle is used to apply heat directly to the genicular nerves of the knee. After a genicular nerve is heated in this way, it is unable to continue sending pain signals to the brain. The pain relief from this procedure may last six months or more. While this is a new type of procedure, radiofrequency energy has been used in medical procedures for over 75 years and is very safe.

Dr. Nomen Azeem, of Sarasota Orthopedic Associates, is excited to offer this treatment and says, “The genicular nerve block and radiofrequency ablation of the knee has been a great option for several of our patients who suffer from chronic knee pain.”

A recent patient who is happy with the results achieved just one week after his procedure said, “I’ve had pain since my knee replacement. Nothing provided me with any pain relief, aside from drugs. This procedure has provided 95 percent pain relief so far. It has definitely helped my quality of life.”

For more information on Dr Nomen Azeem, please click HERE. To explore the full web site please click HERE.

 

 

Treating Arthritic Back Pain: A SOLUTION

backpain

Arthritis or Osteoarthritis that causes back pain can be a debilitating condition for the people who suffer from it, and a challenging condition for physicians to treat. Arthritis of the back affects the facet joints in the spine and although these joints can be injected, studies have shown that this may only provide temporary pain relief.  With the recent technological advances in the field of interventional pain medicine, physicians now have the ability to block the pain from these joints for a much longer period of time.

Radiofrequency ablation is an outpatient procedure in which a specialized needle is used to apply heat directly to the nerves causing pain. After the nerves are heated, they are unable to continue sending pain signals. In addition to back pain, radiofrequency ablation is often used to treat buttock pain, posterior thigh pain, neck pain, shoulder pain, and headaches. Studies have shown that radiofrequency ablation can reduce pain severity and frequency in the majority of patients with facet arthritis for up to one to two years.

Radiofrequency ablation is carried out in two steps. In the first procedure, which is diagnostic, a medication is injected into the back over the sensory nerves of the facet joints, also known as the medial branch nerves. This medication serves to temporarily block the pain signals.

If a patient gets pain relief from the diagnostic procedure, the doctor will move forward with the second step, which is the actual radiofrequency ablation.

Nomen Azeem, MD has seen a vast increase in quality of life for hundreds of his patients, without having to resort to invasive surgery or increased medication. He is a double board-certified Interventional Pain Management and Physical Medicine and Rehabilitation, and an expert in minimally invasive procedures for treating arthritic back pain, including spondylosis, degenerative changes, and osteoarthritis. Click HERE for more information about Dr Azeem.