Before ultrasound became a revolutionizing staple in the field of pain medicine, some brilliant, forward-thinking doctors used X-Ray (fluoroscopy) to add vision to their pain injections. But with these tools came drawbacks. Firstly, while fluoroscopy is excellent for viewing bones and spread of contrast, they do not let us see the intricate detail of muscles, tendons and ligaments. Secondly, they emit radiation, which means that they should only be used on an ‘as necessary’ basis. In our effort to provided safe, accurate and effective injections, about 10-15 years ago our field began using ultrasound to make major improvements. Not only is it 100% safe, ultrasound immediately transformed pain medicine patient outcomes.
Way before I became I pain physician I was acutely aware of a particular maxim: an ounce of prevention is worth a pound of cure. Despite its triteness, in this expression I found unbounded wisdom: wearing knee pads while rollerblading averted nasty knee cuts and ripped jeans, while a napkin in my lap discouraged tomato sauce stains. Back in my own days as an athlete – a batting helmet defended my skull from menacing fastballs. These days, this aphorism’s weighs heavily on my shoulders when I am confronted by yet another patient who is an athlete with an injury resulting from poor to complete reckless abandonment of sports nutrition. Many such patients have suffered muscle injuries and/or severe cramping that has resulted from dehydration, electrolyte abnormalities and/or potassium and magnesium deficiencies. This is not just frustrating because these kinds of injuries are extremely avoidable through a proper sports nutrition-inspired diet, but also failure to acquire the full range of protein, carbohydrates, micronutrients and vitamins an athlete requires will severely limit the ability to reach maximum performance. To put it in laypersons terms, without sports nutrition athletes will increase the likelihood of debilitating injury and will also be actively hampering their ability to perform to their full potential.
If you are considering back surgery because of a pain issue, it might not even be the most expedient treatment for you as it will not always alleviate or mitigate pain. Unless your back issue is neurological or an instance of instability of the spine, surgery simply is not your best course of treatment. If you suffer from muscular or myofascial pain, lumbar facet arthropathy or lumbar disc herniation, amongst other back pain issues, your best bet is to treat your back pain without surgery. Read my blog for the full details of the non-surgical treatments I recommend.
Musculoskeletal Ultrasounds (MSUs) are my go-to when attempting to pin down an issue that we don’t believe to be bone related. That means they are perfect for diagnosing muscle, tendon, and ligament injury – as this dynamic investigative and explorable procedure tells us in seconds the make-up of your musculoskeletal system. We have found that MSU has been pivotal in helping diagnose sports injuries and others who find they are in pain when they move a joint. Traditional analysis like x-rays and MRIs take static images where MSUs create dynamic images in motion. Let’s explore that some more.
