Alleviate Your Pain

Ninety million Americans suffer from pain that can affect sleep, mood, and countless other things that many of us take for granted. A study from the Mayo Clinic found that as many as 20 percent of those suffering don't seek treatment. Part of the problem is doctors who can misdiagnose pain.

Many major medical centers have pain centers that use a combination of therapies to help people with chronic pain. After we spoke about pain on “FOX & Friends" earlier in the week, I got a lot of e-mail from people in pain who had questions. There is no need to suffer!

I went to an expert, Dr. Jose Contreras, division director of Pain and Palliative Care at Hackensack University Medical Center, and asked him some basics of pain management.

Dr. Manny: What is a pain center and how can a patient find one?

Dr. Jose Contreras: A pain center is a medical facility which is designed to specifically focus on the treatment of various chronic pain syndromes. Often, the treatment of chronic pain involves a multimodal approach including, but not limited to, pain medications, physical therapy, occupational therapy, psychiatry and complimentary alternative medicine. Thus, the term "pain center." These can include lower-back pain, cancer pain, shingles pain and painful conditions due to chronic disease such as diabetes and multiple sclerosis.

Dr. Manny: Back pain is very debilitating for many Americans. What are some of the latest treatments?

Dr. Jose Contreras: To determine the treatment of back pain, one must find the cause or diagnosis. These can include pain due to tumor, infection or injury, to name a few. The latest treatments are likely interventional (i.e. surgical) and driven by advances in medical technology. These include such procedures as kyphoplasty, multiple disk replacement surgeries and spinal cord stimulation (which involves the insertion of electrodes that stimulate the nerves having a pain-relieving effect).

Dr. Manny: What is the best treatment for carpal tunnel syndrome (CTS) pain?

Dr. Jose Contreras: The best treatment is the one that works. CTS is due to entrapment of the median nerve as it passes into the hand. Depending on the severity of the condition there are multiple approaches. These include conservative medical management, anti-inflammatories, steroid injections and nighttime splints. If this treatment fails and muscle weakness occurs or progresses, surgical decompression of the nerve can be beneficial and may be required.

Dr. Manny: What are some of the available treatments for arthritis sufferers, other than cortisone injections?

Dr. Jose Contreras: Again, it depends. There are varying degrees of severity of the condition, and treatment is dictated by the severity. Conservative medical management includes anti-inflammatories (Ibuprofen and Ibuprofen like drugs), acetaminophen (Tylenol), topical local anesthetics (recent evidence for their benefit), steroids and, lastly, in severe cases, immunosuppressive agents. Assistive devices such as splints, canes and walkers can help. Measures such as heat/ice and physical therapy, and in extreme cases, surgical measures such as joint replacement (hip and knee) may help.

Dr. Manny: Foot pain is a very common problem, specficially heel spurs. What do you recommend for that pain?

Dr. Jose Contreras: Again, depending on the severity, everything from conservative medical management to surgery.
• Reduce inflammation: Anti-inflammatories and physical measures such as various forms of ice therapy

• Stretching and strengthening: various exercises to improve muscle strength and resting night splints help keep ankle flexed

• Reducing impact: custom molded orthotics such as metatarsal bars on the bottom of shoes to reduce the impact of walking

• Extra-depth, extra-width shoes and molded shoes can accommodate pain

• Low impact exercising such as swimming

In severe conditions casting the foot and/or extracorporeal shockwave therapy (recently FDA approved — it is believed EST can help stimulate bone and tissue growth).

P.S. Don't forget to watch FOX News Channel. And please feel free to write to me at DRMANNY@FOXNEWS.COM and tell me what you think. Ask a question, share a thought, share a remedy — We'll try to answer all of your mail online or on the air.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit