Frequently Asked Questions

Advanced Pain Centers offers answers to many of your questions below:

What Causes low back pain?

If I undergo Spinal Decompression treatment, how long does it take to see results?

How long does it take to complete Spinal Decompression treatment?

Do I qualify for Spinal Decompression Treatment?

Are there any side effects to the treatment?

What types of pain does Advanced Pain Centers treat?

What types of treatment does Advanced Pain Centers provide?

How long will I have to wait for my initial evaluation?

What is the procedure for the initial evaluation?

What if I have questions about my treatment?

How many people are affected by chronic pain and how is quality of life affected by chronic pain?

What are the billing procedures and payment options for my treatment?

Will my health insurance pay for Pain Management?

If insurance is involved, what is my financial responsibility?

If I have no health insurance coverage, what is the cost of my treatment?

Do I have to get my insurance pre-authorization or do you do it?

If my insurance plan requires a pre-authorization, can I be seen or starttreatment without the authorization? Can I get a retroactive authorization?

What is the difference between a sprain and a strain?

What is sciatica?

What is spinal stenosis?

What is degenerative disk disease?

What is a torn rotator cuff?

What is frozen shoulder?

What is a dislocated shoulder?

What are shin splints?

What is a torn ACL? MCL?

What are muscle spasms?

What is a torn meniscus?

What is tendinitis?

What is bursitis?

What is arthritis?

What is carpal tunnel syndrome?

What is tennis elbow?

What is plantar fasciitis (heel spur)?

What is a ruptured Achilles tendon?

What is a bulging/ruptured/herniated disk?

What is radiculopathy/nerve impingement?

What causes low back pain?
Low back pain can be caused by a number of factors from injuries to the effects of aging.The spinal cord is protected by the vertebrae, which are made of bone. Between each vertebra are soft discs with a ligamentous outer layer. These discs function as shock absorbers to protect the vertebra and the spinal cord. Many of the problems that cause back pain are the result of herniation and degeneration of the intervertebral disc. Degeneration is a process where wear and tear causes deterioration of the disc. Herniations, or bulging of the disc are protrusions from the disc that press on surrounding nerves, causing pain or numbness.

If I undergo Spinal Decompression treatment, how long does it take to see results?
Most patients report a reduction in pain after the first few sessions. Typically, significant improvement is obtained by the second week of treatment.

How long does it take to complete Spinal Decompression treatment?
Sessions times are between 30-45 minutes, daily for the first 2 weeks and 3 times per week for the following 2 weeks. Though, the number of sessions may vary depending upon the severity of the condition.

Do I qualify for Spinal Decompression treament?
Since I began using Spinal Decompression spinal disc decompression unit, I’ve been inundated with questions from both doctors and patients as to which cases it will best help. Obviously proper patient selection is essential to favorable outcomes, so let me explain to you of the Inclusion and Exclusion criteria so you may make the right decision since not everyone qualifies for Spinal Decompression treatment.

Inclusion Criteria:

Pain due to herniated and bulging lumbar discs that is more than four weeks old

Recurrent pain from a failed back surgery that is more than six months old.

Persistent pain from degenerated disc not responding to four weeks of therapy.

Patients available for four weeks of treatment protocol.

Patient at least 18 years of age.

Exclusion Criteria:

Appliances such as pedicle screws and rods

Pregnancy

Prior lumbar fusion less than six months old

Metastatic cancer

Severe osteoporosis

Spondylolisthesis (unstable)

Compression fracture of lumbar spine below L-1 (recent).

Pars defect

Pathologic aortic aneurysm.

Pelvic or abdominal cancer

Disc space infections

Severe peripheral neuropathy

Hemiplegia, paraplegia, or cognitive dysfunction.

Are there any side effects to the treatment?
Most patients do not experience any side effects. Though, there have been some mild cases of muscle spasm for a short period of time.

The most obvious differences between Spinal Decompression and the VAX-D would be their success rate and the comfort levels while a patient is being treated. Below are some side by side comparisons.

Spinal Decompression

excellent Success Rate

Patient lays on back (supine)

Harnesses prevent any stress to the shoulders or arms.

The amount of decompression can be targeted to the specific disc level by varying the angle of traction.

VAX-D

72% Success Rate

Patient lies face down (prone) which can be very uncomfortable

Required patients had to hold on with their hands causing severe shoulder/arm problems

Nonspecific for disc levels with its straight-line traction

What types of pain does Advanced Pain Centers treat?
APC specializes in diagnosing (finding the precise cause of) and treating chronic pain. We also treat cancer pain and, sometimes, acute pain.

What types of treatment does Advanced Pain Centers provide?
Advanced Pain Centers are committed to providing the highest quality and caring in its service. We do this utilizing a wide array of modern tools: precision nerve injections, radiofrequency, IDET, spinal cord stimulation, implantable morphine pumps, physical therapy, medicines and psychological support. The clinic is state of the art and is operated by a highly trained, certified and compassionate staff.

How long will I have to wait for my initial evaluation?
Patients are generally scheduled within two weeks for a new evaluation.

What is the procedure for the initial evaluation?
Patients enjoy a relaxed, personalized experience in a beautiful, convenient location. Patients receive a welcome packet in the mail, prior to their visit, to fill in at their leisure, thereby reducing waiting time at the office.A member of the Advanced Pain Centers staff will perform your initial evaluation. Our staff includes nurses and a Board-certified pain management specialist. After your initial examination, your doctor will discuss with you the most effective program for your problem.Most patients are seen and treated on an outpatient basis, although under certain conditions, treatments may require hospitalization.We will keep your family doctor or referring physician informed of the nature of your treatment and of your progress.

What if I have questions about my treatment?
Advanced Pain Centers recognizes that medical procedures can at times be unsettling. Every effort is made to simply and completely answer all questions related to procedures. Advanced Pain Centers believes that patient education is paramount to the healing process. We offer informational brochures and booklets on the most common problems treated and procedures performed.

What are the billing procedures and payment options for my treatment?
Advanced Pain Centers participates with Medicare, Blue Cross Blue Sheild and all Health Care plans. We also accept all insurance plans as an out-of-network provider. Billing procedures are simplified by sending bills only after an insurance statement and payment are received. This ensures correct billing the first time. Our financial advisor is fully trained to answer any questions about your bills or to help with your questions about insurance forms. Our office accepts cash, personal checks as well as VISA, MasterCard, and Discover cards.

Will my health insurance pay for Pain Management?
Benefits vary per employer. Our staff will do a complete benefit check and review your benefits with you, if you wish. All your financial questions will be answered to the best of our ability with the information available.

If insurance is involved, what is my financial responsibility?
Patient responsibility depends on what benefits your employer purchased in your insurance plan. Each employer is different in what they choose to provide as covered benefits. We will verify your benefits before your appointment and we can help you understand your insurance coverage and your financial responsibility during your financial consultation.

If I have no health insurance coverage, what is the cost of my treatment?
The costs can vary depending on what type of treatment is needed by the patient. APC offers numerous cash global discount packages to choose from. We will be happy to arrange a conference with our insurance specialist to review the costs in detail with you.

Do I have to get my insurance pre-authorization or do you do it?
If your insurance requires a pre-authorization to see a specialist, then you must get a referral from a Primary Care Physician to see a pain specialist for an initial appointment. After the initial consultation, our office will obtain any future pre-authorizations, sometimes with the assistance of your referring doctor.

If my insurance plan requires a pre-authorization, can I be seen or start treatment without the authorization? Can I get a retroactive authorization?
Unfortunately, most plans that require an authorization will not issue authorization after treatment. Such authorizations usually apply only to emergency cases involving potential for loss of limb, eyesight, or life.

What is the difference between a sprain and a strain?
A strain occurs when a muscle is stretched or torn. A sprain occurs when a ligament is stretched or torn. Strains are often the result of overuse or improper use of a muscle, while sprains typically occur when a joint is subjected to excessive force or unnatural movements (e.g., sudden twists, turns, or stops). Sprains can be categorized by degree of severity:

A first-degree sprain stretches the ligament but does not tear it. Symptoms include mild pain with normal movement.
A second-degree sprain is characterized by a partially torn ligament, significant pain and swelling, restricted movement, and mild to moderate joint instability.
In a third-degree sprain, the ligament is completely torn with mild to severe pain, swelling, and significant joint instability.

What is sciatica?
In the low back, nerves join to form the sciatic nerve, which runs down into the leg and controls the leg muscles. Sciatica is a condition that may cause radiating pain, numbness, tingling, and/or muscle weakness in the leg but originates from nerve root impingement in the lower back. Nerve impingement is most often caused by a herniated disk or spinal stenosis.

What is spinal stenosis?
Stenosis refers to a narrowing of the spinal canal, usually in the lower back (lumbar) region. This narrowing is often a result of the normal degenerative aging process. It occurs as the disks of cartilage that separate the spine's vertebrae lose water and the space between the vertebrae become smaller, causing friction between the bones. The loss of water in the disks makes them less flexible and unable to act as shock absorbers in the spine. Daily wear and tear on the spine becomes more significant without these shock absorbers. As the disks degenerate, vertebrae may shift, causing the spinal canal to narrow. In some cases, the nerves that travel through the spinal column to the legs become squeezed. This can cause back and leg pain, and even leg weakness. Arthritis and falls also contribute to the narrowing of the spinal canal, compressing the nerves and nerve roots and causing pain and discomfort.

What is degenerative disk disease?
Degenerative disk disease is a general term applied to back pain that has lasted for more than three months. It is caused by degenerative changes in the intervertebral disks in the spine and can occur anywhere in the spine: low back (lumbar), mid-back (thoracic), or neck (cervical).Under the age of 30, these disks are normally soft, and they act as cushions for the vertebrae. With age, the material in these lumbar disks becomes less flexible and the disks begin to erode, losing some of their height. As their thickness decreases, their ability to act as a cushion lessens. The less dense cushion now alters the position of the vertebrae and the ligaments that connect them. In some cases, the loss of density can even cause the vertebra to shift their positions. As the vertebrae shift and affect the other bones, the nerves can get caught or pinched and muscle spasms can occur. Degenerative disk disease is primarily a result of the normal aging process, but it may also occur as a result of trauma, infection, or direct injury to the disk. Heredity and physical fitness may also play a part in the process.

What is a torn rotator cuff?
The rotator cuff is a group of tendons and their related muscles that help keep the shoulder and upper arm bone securely placed in to the socket of the shoulder blade. The rotator cuff stabilizes the shoulder joint and helps you to raise and rotate your arms. There are three stages of rotator cuff tears:
A stage 1 tear is a partial tear less than 1 cm in size. It is accompanied by some pain following overhead arm movements, but range of motion is not limited.
A stage 2 tear is a partial tear greater than 1 cm but less than 5 cm in length. Pain is common during and after overhead arm movements, as well as at night. It may be accompanied by a slight decrease in range of motion.
A stage 3 tear is a full tear greater than 5 cm in size. Stiffness, weakness, and pain occur during and after overhead arm movements and during sleep. There may be a slight to severe decrease in range of motion in the shoulder.

What is frozen shoulder?
Frozen shoulder (adhesive capsulitis) is a condition in which the tissues around the shoulder joint stiffen, scar tissue forms, and shoulder movements become difficult and painful. It can develop when you stop using the joint normally because of pain, other injury, or a chronic health condition, such as diabetes. Any shoulder problem can lead to frozen shoulder if you do not work to maintain its full range of motion.

What is a dislocated shoulder?
A shoulder dislocation (shoulder instability) occurs when the upper end of the arm bone pops out of the shoulder joint. This injury may be caused by a direct blow to the shoulder, a fall on an outstretched hand or arm, or an exaggerated overhead throwing motion.

What are shin splints?
Shin splints are an inflammation of the periosteum, a fibrous sheath that surrounds bone. In this case, the affected bone is the shin bone, or tibia. Shin splints are usually accompanied by pain and swelling in the front of the lower leg. Most frequent in runners, this overuse injury is caused by the repetitive stress of running on hard surfaces.

What is a torn ACL? MCL?
There are four ligaments in the knee: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). The ACL and PCL stabilize front-to-back knee movements, while the MCL and LCL stabilize side-to-side movements. The ACL can be sprained or torn if the knee is straightened beyond its normal limits (hyperextended), twisted, or bent side-to-side. A sprained or torn ACL is common in sports and usually results from a hard stop or aggressive twisting of the knee. The PCL is the least common ligament to be injured.The MCL is injured when a force is exerted on the outside of the knee, pushing it inward, while the LCL is injured by a force exerted on the inside of the knee that pushes it outward. This type of hit is frequent in contact sports like football or hockey. A torn knee ligament is usually accompanied by feeling or hearing a pop in the knee at the time of injury, severe pain and swelling, and joint instability.

What are muscle spasms?
When muscles become inflamed, they can also spasm, or contract tightly, as a response to injury. While they are the body's way of protecting itself from further injury, they often produce excruciating and often debilitating pain. Muscle spasms are common in the low back (lumbar) muscles.

What is a torn meniscus?
The medial and lateral menisci (plural of meniscus) of the knee are two crescent moon-shaped disks of tough tissue that lie between the ends of the upper leg bone and lower leg bone that form the knee joint. Meniscus tears commonly occur during sports when the knee is twisted while the foot is planted firmly on the ground. In people over the age of 40 whose menisci are worn down, a tar might occur with normal movement, minimal activity, or minor injury.

What is tendinitis?
Teninitis is inflammation of a tendon, a band of tissue that connects muscle to bone. It is most commonly the result of overuse during physical activities. Repetitive motions can stretch and irritate the tendon, causing pain and swelling. Tendinitis occurs around joints such as the elbow, shoulder, wrist, ankle, or knee.

What is bursitis?
Bursitis is inflammation of a bursa or bursae (more than one bursa), small fluid-filled sacs that cushion areas of friction around joints. Bursae contain synovial fluid that lubricates the joints. Bursitis typically occurs as a result of overuse during physical activities or infection of the synovial fluid. If a bursa becomes infected or irritated from repetitive stress, it will cause pain and limited movement. Bursitis is most common in the shoulder, knee, hip, elbow, or heel.

What is arthritis?
The most common form of arthritis, osteoarthritis, can affect any joint in the body, but most often afflicts the knees, hips, and fingers. Most people will develop osteoarthritis from the normal wear and tear on the joints through the years. Joints contain cartilage, a rubbery material that cushions the ends of bones and facilitates movement. Over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As bones rub together, bone spurs may form and the joint becomes stiff after long periods of activity or inactivity.

What is carpal tunnel syndrome?
Carpal tunnel syndrome is the term used to describe a specific group of symptoms (tingling, numbness, weakness, or pain) in the fingers or hand and occasionally in the lower arm and elbow. These symptoms occur when there is pressure on a nerve (median nerve) within the wrist (carpal tunnel). Carpal tunnel syndrome develops over time because of repetitive hand motions that damage muscle and bone in the wrist area.

What is tennis elbow?
Lateral epicondylitis, commonly known as tennis elbow, is inflammation of the tendon that connects the muscles of the forearm, wrist, and hand to the upper arm at the elbow. The tendon on the bony outside (lateral) part of the elbow (the epicondyle) is most often irritated by overuse during physical activity.

What is plantar fasciitis (heel spur)?
Plantar fasciitis is the most common cause of heel pain. It is commonly referred to as a heel spur, although a heel spur, or bony growth on the heel bone, develops as a result of plantar fasciitis. The condition occurs when the long, flat ligament on the bottom of the foot (plantar fascia) stretches irregularly and develops small tears that cause the ligament to become inflamed. This inflammation is most often caused by walking with an abnormal inward twisting of the foot, called pronation. Over time, this slightly abnormal step may increase tension on the plantar fascia and cause it to become inflamed.

What is a ruptured Achilles tendon?
The Achilles tendon is the largest tendon in the body. It connects the muscles in the lower leg (calf) to the heel bone. With every movement of the foot, the Achilles tendon stretches and tightens. Because it is under so much stress, it can partially or completely tear (rupture) from excess force or overuse. Ruptures usually occur about two inches above where the tendon attaches to the heel bone.An Achilles tendon rupture is most common in middle-aged "weekend warriors" who are not conditioned for athletics and who neglect to properly warm up and stretch prior to exercise. Ruptures frequently occur from sudden movements that stress the calf muscles, such as jumping or quick stops; from overstretching; from vigorous exercise after a long period of inactivity; or from untreated Achilles tendinitis/tendinosis (overuse).

What is a bulging/ruptured/herniated disk?
The spinal vertebrae are separated by flexible disks of shock absorbing cartilage. These disks are made of a supple outer layer with a soft jelly-like core (nucleus). If a disk is compressed, so that part of it intrudes into the spinal canal but the outer layer has not been ruptured, it may be referred to as a "bulging" disk. This condition may or may not be painful and is extremely common. Herniated disks are often referred to as "slipped" or "ruptured" disks. When a disk herniates, the tissue located in the center (nucleus) of the disk is forced outward. Although the disk does not actually "slip," strong pressure on the disk may force a fragment of the nucleus to rupture the outer layer of the disk. If the disk fragment does not interfere with the spinal nerves, the injury is usually not painful. If the disk fragment moves into the spinal canal and presses against one or more of the spinal nerves, it can cause nerve impingement and pain. If the injured disk is in the low back, it may produce pain, numbness, or weakness in the lower back, leg, or foot. If the injured disk is in the neck, it may produce pain, numbness, or weakness in the shoulder, arm, or hand.

What is radiculopathy/nerve impingement?
Radiculopathy refers to a condition in which the spinal nerve roots are irritated or compressed. Many people refer to it as having a "pinched nerve." Lumbar nerve impingement indicates that the nerve roots in the lower spine are involved, while cervical radiculopathy is associated with nerve roots in the neck. Nerve impingement is most often caused by a herniated disk or spinal stenosis.

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