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Instructions for Acute Neck Pain

Posted on December 1, 2014 at 7:35 PM

Instructions for Acute Neck Pain

 

1. What positions are best for me?

A. Whatever provides you with relief from pain.

B. For sleeping, sleep on a soft pillow that molds to the neck and is comfortable. Positions that provide comfort may change as your condition corrects.

C. Have someone drive you to the office for treatment so you will not have to make any strenuous or sudden moves.

D. Wear your cervical collar (if one was prescribed). You can sleep with the collar on, if you take it off for sleep, follow line B. If it becomes uncomfortable during waking hours, try loosening it, or you may remove it for 10-15 minutes.

E. Do not sleep on you stomach, unless absolutely necessary for pain relief.

 

2. What should I do to relieve the pain and inflammation?

A. Apply ice in a plastic bag or refreshable ice pack over the painful area for ten minutes on, one hour off. Do this continuously, while awake, until the doctor tells you otherwise.

B. Initially when ice sis applied to skin there will be a burning sensation, this should change to a deeper feeling of cold and or numbness after about 2-3 minutes. If you have sensitive skin or if the skin has a burning sensation after 3-5 minutes when ice is applied directly; wrap with a thin cloth, the thickness of a pillowcase or a thin t-shirt, this will allow the cold to penetrate without irritation.

C. If you have to take medication let the Dr. know. Please follow the instructions carefully and make sure you understand the side effects, especially whether or not you should drive. Keep in mind that all drugs are toxic and do not correct anything. It's not a lack of medication that caused you problem and makes you hurt.

 

3. What would be the wrong thing for me to do?

A. Do not apply heat. it will increase the swelling.

B. Do not hold you head in extreme positions, such as looking down, for extended periods.

C. Do not attempt an y exercises, unless prescribed by your doctor.

D. Do not test you neck by moving it around, twisting, bending, etc. (after an adjustment or at any other time) this only aggravates you injury.

E. Do not do any strenuous activities such as reaching, pulling, lifting, bending, etc.

F. Do not give up hope. Healing takes time. Remember, we are here to help. If you have any questions, please ask us. We'll listen. We care. 24 hours a day.

 

Cervical Curve Restoration - Isometric Home Therapy

Posted on December 1, 2014 at 7:35 PM

Cervical Curve Restoration - Isometric Home Therapy

 

Many patients who suffer from headaches, neck aches, shoulder or arm related problems demonstrate a "loss" of the normal 35 to 45 degree uniform forward curve that must be present for maximum cervical function. This loss can be caused by a variety of situation ranging from a "whiplash type" injury to bad sleeping habits. The result is a biomechanical imbalance, predisposing a person to unseen weight bearing to discs and posterior joints, alteration of the intervertebral foramina with undue stress and pressure on the nerves and blood vessels is an open invitation to early hard and soft tissue degeneration.

 

Many times weakened posterior cervical muscles are a major part of these problem and isometric strengthening techniques assist in regaining a normal to near normal posture. These exercises are for those who still have some curve in their neck. Those who have the straight or "military" neck or reversed cureve need to be using head weights first, then proceed to do the cervical isometric exercises.

 

• have patient sit with assistant standing behind them.

• place an open hand on the upper chest to stabilize them.

• the other hand should be cupped with the wrist held 90 degrees back.

• the cupped hand should support the occiput of the patient.

• The patient should slowly but forcefully extend their head and neck to the maximum position as the assistant resists this action with the cupped hand but not enough to stop the exercise.

• this should be repeated 5 or 6 times and be preformed twice a day until desired results are accomplished.

• immediate "change" of posture should be felt by the patient after the exercise.

• caution should be taken to not over stress the tissues but enough isometric tension should be used to accomplish the desired results.

 

Electrical Muscle Stimulation

Posted on December 1, 2014 at 7:35 PM

Electrical Muscle Stimulation

 

Electrical Muscle Stimulation is a procedure used to passively exercise muscular soft tissue up to the tolerance of healthy tissue, but not past the point of pain where tissue destruction could take place. The electrical current stimulates the nerves as they enter the muscle and gently contracts the muscle in a rhythmic pattern to accomplish a variety of therapeutic benefits.

 

For fast healing without undue stress of active exercise, muscle stimulation can passively (by involuntary response) run the effected soft tissue through a variety of contractions conducted by computerized messages specially programmed at various impulses per second. This organized bombardment of electrical commands builds muscle strength and stability while the muscle is at physiological rest. Normal reflex patterns are then re-established in the motorized receptors of the muscle, thereby restoring the proper tension and flexibility of the soft tissue with voluntary control.

 

At the time of injury, muscles, ligaments, and parravertevral soft tissue (known as mesenchymal connective tissue) are flooded with lactic acid and toxic materials. These toxic materials must be cleansed by the lymphatic system. Unlike the "blood" system which has a heart to pump it, the lymphatic system relies upon the movement of the surrounding tissues to push it through. While this natural movement can be severely painful. Stimulation, which contracts the muscles in rhythmic patterns, aids greatly in assisting the body in this cleansing process.

 

Because inactivity allows a muscle to heal in a weakened state, muscle stimulation is an excellent procedure because it promotes healing, strengthening, and stabilizing factors in the recuperating muscle.

 

Therapeutic Ultrasound

Posted on December 1, 2014 at 7:30 PM

Ultrasound

 

Ultrasound is high frequency sound waves. It is a therapeutic device that is widely used by all health fields: hospitals, medical doctors, dentists, osteopaths, podiatrists, chiropractors, and physical therapists. Ultrasound waves penetrate the tissue and causes a vibration from the sound in the tissue - "micro massage".

 

Microscopic massage - the vibration of each individual cell - causes the cell to greatly increase its metabolic rate or throw off its waste products. This is very helpful because injured or malfunctioning tissue can not metabolize or throw off its waste products due to congestion, which can cause a weakened state, malfunction, scar tissue, or calcification.

 

Clinic effects of the ultrasound waves

 

• 1. Mechanical vibration of the cells is accomplished because of the high frequency of the ultrasound waves causing the molecules and the tissue cells to "rub" against each other.

 

• 2. The friction of movement of cells creates heat in the tissues which in turn increases the circulation in the immediate area.

 

• 3. The increased circulation means that nutrition is being brought in to the area for healing and waste matter and debris are being removed.

 

• 4. An analgesic effect (pain relief) is generally produced when the nerve root (neurotrophic) treatment is used because of the effect on the sensory nerves of the involved tissue.

 

General Conditions Treated by ultrasound

• Sprains

• Strains

• Arthritis

• Edema

• "Wry" neck

• Tenosynovitis

• Pulled muscles

• Pulled tendons

• Arthritis

• Bursitis

• Coccygodynia

• Myalgia

• Myelitis

• Myositis

• Neuralgia

• Osteitis

• Radiculitis

• Rheumatitis

• Sciatica

• Sinusitis

• Synovitis

• Trauma

• Lumbago

 

Your Spine & Nervous System

Posted on December 1, 2014 at 7:30 PM

Your spine & nervous system are an engineering miracle which plays a major role in your health and well being. The cervical spine of your neck consists of seven interlocking bones. The brain stem becomes the spinal cord which is the “information superhighway” of your nervous system. It keeps your brain in control of the workings of every organ, tissue and cell of your body. The forward curve of the neck is known as normal lordosis. This curve permits proper range of motion so you can look over your shoulder or gaze upward.

 

Trauma, such as whiplash injuries, can compromise spinal curves. This can cause some spinal joints to become fixated and not move enough. Other joints become hypermobile, moving too much. These changes can affect the nervous system.

 

Pairs of nerve roots branch off the spinal cord from between each spinal bone through openings called the intervertebral foramina. When spinal bones lose their proper motion or position, they change the shape of these openings. The result? Nerves can become irritated, chafed, or pinched. Theses “subluxations” alter the way your nervous system sends and receives nerve impulses. This can interfere with your brain’s ability to accurately monitor and control your body. Ill health can result.

 

In the middle of the back, the 12 moving bones of the thoracic spine should have a backward curve. These vertebrae have a slightly different shape to accept the curved bones that form the rib cage. Like other spinal bones, each has a protrusion on the back side called a spinous process. These make the little bumps that you can feel up and down your spine.

 

Transverse processes project from both sides of each vertebral body to which powerful muscles attach. They also help form the interlocking “fingers” which connect with the vertebra directly above. Many of the pain-sensing nerves of the spine are located in these facet joints. A special kind of tissue called disc is located between each vertebral body. These spinal “shock absorbers” connect and help provide proper bone spacing so nerve roots can exit the spinal cord. Healthy discs have a jelly-like material known as the nucleus pulposus contained within a fibrous ring called the annulus. While a disc can’t “slip”, injury can cause a disc to bulge, herniated, or rupture. This can put pressure on nearby nerves, changing the way they convey impulses to and from your brain.

 

The lumbar spine consists of five vertebrae in the lower back. Like the neck, it should have a natural forward curve. Problems can produce compensation reactions in the upper areas of the spine.

 

Like tributaries of a river, nerves exiting the spine in this area form the sciatic nerves which run down the back of each leg.

 

Neglecting structural of functional problems can cause spinal decay. Poor biomechanics and the effects of gravity can cause bone spurs. This compromises the shape, function and identity of affected joints.

 

The 24 moving bones of the spinal column rest on the sacrum, a triangular bone between both hips. Originally five bones at birth, they fuse together and connect to both hips at the sacroiliac joints.

 

Spondylolisthesis results when a lumbar vertebra slips forward over the sacrum.

 

Four rudimentary vertebrae, which have fused together, form the coccyx or tailbone. The coccyx usually moves in unison with the sacrum above.

 

A healthy spine allows you to be and do your best by protecting the vital nervous system link between your brain and your body. Find out how chiropractic care can help you get well and stay well.

 

 

Why is it that my adjustments don't hold?

Posted on December 1, 2014 at 7:30 PM

Why is it that my adjustments don’t hold?

 

Since the primary function of the nerve cell is that of making/synthesizing and transport of proteins, the overall health of your nerve cells is what is going to have a direct effect on how long your adjustments are going to hold. Since proteins do most of the work in the nerve cell (regulate the sodium/potassium pump, enzymes, neurotransmitters, cell membrane strength/function, and organelle function) protein replacement is for cellular protein repair, thus the nerve cell is under constant repair. Typically protein has three ½ lives times (the half-life is the amount of time it takes for half of the atoms in a sample to decay), which are dependent on the overall health of the nerve cells. The ½ life of protein expression are: 4 – 6 hours, 1 – 4 days, and 30- 40 days. These are the times which, as a patient, you are requested to return after your treatment. As you get healthier, the less frequent you will have to come in for your adjustments (every 30 – 40 days).

 

Also note that physiologically, after an injury, your body does not begin to heal for 90 days. However, the treatments you get prior to that 90 day period are important so as to improve the overall health of the cells, so when the healing does “kick in”, you will heal in the proper position, with less scar tissue.

 

What is chiropractic?

Posted on December 1, 2014 at 7:25 PM

What is chiropractic?

 

Chiropractic champions a natural method of healing, advocating a non-surgical, non-invasive, and drugless approach to the treatment of patients. Grounded n a view of the individual as an integrated being, the Doctor of Chiropractic focuses on spinal health and wellness as the keys to overall health and well being.

 

Because of the interrelatedness of the body’s various systems, chiropractic theory holds that spinal mechanics – including the vertebrae, corresponding nerves and soft tissues – play a primary role in the health of the whole body. Structural or mechanical abnormalities in the spine, which cause pain, dysfunction, and loss of mobility to thousands of people a year, can successfully be treated.

 

What does a Doctor of Chiropractic do?

Posted on December 1, 2014 at 7:25 PM

What does a Doctor of Chiropractic do?

 

The primary treatment for spinal dysfunction (spinal misalignment or subluxations) is a procedure known as vertebral adjustment, or more generally, spinal manipulation. An adjustment is a technique in which the chiropractor skillfully applies pressure to an area of the spine (or other joint) that is not functioning properly or is out of alignment. The procedure is often, but not always, applied manually and sometimes, but not always, a “popping” sound can be heard. The “popping” sound is a release of nitrogen gas within the synovial fluid of the joint capsule when pressure is released from the joint – like popping a cork from a champagne bottle. The result is reduced pain and inflammation, and restored function to the injured/affected area(s).

 

In addition to adjustment or manipulation, patients may also receive a treatment plan which uses physiological procedures, such as ultrasound, electrical muscle stimulation, controlled exercises and stretching, nutritional counseling, and other professional advice that may improve overall health.

 

Patient progress under chiropractic care will be carefully monitored. Subjective improvements and objective clinical findings will be noted and treatment will be modified to meet the patient’s changing condition. Should it be found that another type of health care would benefit healing, a referral to the appropriate provider will be made.

 

Juicing For Your Health

Posted on December 1, 2014 at 6:35 PM

Juicing For Your Health

 

For what is going on with you, and this is basic without me finding out the full on history and getting you on specific neurotransmitters (the building blocks of every single function of your body). The best and easiest way is to buy a juicer and do 2 fresh juices per day for 2 to 3 weeks then you can go down to one, but eat veggies and fruit more so with your meals. Continue to eat fish/sushi (tuna, halibut, mackerel, sea bass, trout, catfish, some salmon) and chicken (although I don't recommend chicken because of the hormones they have, but a free range chick will be ok). Every 2 weeks have a steak - cooked medium rare is the best (you can do one every week if you are craving it). Red meat is important, don't pay attention to the "hype" about it being bad for you - it's just that hyped up bull shit!

 

The juicers can be expensive (up to $450), but you can find a great one for about $90 - Juiceman II or Juiceman Jr., but the $70 one at Target is still great. The best bang for the buck is the Breville Juicer for $99.

 

Juicing the following will help you:

 

carrots - 4 to 6

 

kale - 1 cup raw

 

swiss chard - 1 cup raw

 

collard greens - 1 cup raw

 

red cabbage - 1 cup raw

 

nappa cabbage - 1 cup raw

 

spinach - 1 cup raw

 

parsley - 1/4 cup raw

 

1/2 red bell pepper

 

beet stalks & leaves - from 1 beet

 

1/4 to 1/2 beet (you can put a whole beet in if you like)

 

1/2 white potato

 

1 apple or 1 pear (pears will roto-rooter your colon, so do only if you know you can be by a bathroom for a couple of hours the first time, then your system will stabilize and you can do any time)

 

The juices should be consumed within 2 hours of preparation, but the sooner the better.

 

The taste may feel gritty, because of the potato & beet, but it should be tasty. If it is not, add an extra apple or pear or do one of both.

 

You will notice you will begin to feel much better overall, many of your cravings for things begins to diminish, your hair and skin will improve, your liver will definitely begin to work better at filtering toxins and your immune system will be awesome. You will be retraining your entire system and hitting the basics for the neurological function to begin to alter and improve everything - whatever the "lab levels" are only a surface finding (tip of the iceberg) to more extensive problems which have not presented themselves, yet.


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I hope you all are staying safe and healthy! Get ready, this is a long one, and I ask that you read the entire document - I will need for you to print it out, sign the bottom and bring it to your appointment.

On July 1, 2020, the New Mexico Governor Lujan-Grisham extended the executive order 2020-004 order until August 30, 2020.


What does that mean for my upcoming appointment?


The restrictions set forth by the Public Health Order issued March 27, 2020 which affect the health care services and procedures I am able to provide have been reinstated.


What restrictions are those?


Health care facilities, ambulatory surgical facilities, dental, orthodontic and endodontic offices in the State of New Mexico are prohibited from providing nonessential health care services, procedures, and surgeries.

Non-essential health care services, procedures, and surgeries include those which can be delayed for three (3) months without undue risk to the patient's health. Examples of criteria to consider in distinguishing between essential and nonessential actions include:


a. Threat to a patient's life

b. Threat of permanent dysfunction of an extremity, including teeth, jaws, and eyes

c. Risk of metastasis or progression of staging

d. Prenatal and postnatal care

e. Any other factors that will conserve medical resources without creating an undue risk of permanent harm to patients.


This Order's prohibition on non-essential health care services, procedures, and surgeries is not meant to apply to:


1. The provision of emergency medical care or any actions necessary to provide treatment to patients with emergency or urgent medical needs


2. Any surgery or treatment that if not performed would result in a serious condition of a patient worsening


What does that mean for me?


You warrant care in my facility and need to keep your scheduled appointment, if you meet any of the following criteria:


• Pain Level is 6 or more on the 0-10 pain scale - see The PAIN Scale in the blog post below.


• You perform Fukada's Test (the MONSTER MARCH) for 60 seconds and you: move forward more than 1 foot, and/or step to either side more than 6 inches, and/or turn either direction more than 10 degrees, and/or you move backwards more than 6 inches.


• You are having or have had seizures since your last visit.


• You are having or have had facial or extremity twitching or paralysis since your last visit.


• You are having or have had a decline in your cognitive functioning since your last visit.


• You are having or have had debilitating migraines since your last visit.


• You are having or have had any of your joints slip out/dislocate, and/or lock up/freeze since your last visit.


• You are having or have had any extremity burning, numbness, tingling or altered sensation since your last visit.


• You are having or have had any extremity weakness since your last visit.


• You are having or have had any uncontrollable tremors or shaking of your head and/or extremities since your last visit.


• You are having difficulty performing your regular activities of daily living.


If you do not meet any of the above stated criteria, then I need to reschedule your appointment for after August 30, 2020.


I take the health of each of my patients VERY SERIOUSLY and want to protect each of you the best that I can. It is my hopes you will be respectful and help protect the health of other patients, as well as my health, so I may continue to protect yours. During the COVID-19 crisis, there will be some changes to your office visit experience. In order to be open and remain open, while following the New Mexico Department of Health guidelines and restrictions, I must implement the following which are NON-NEGOTIABLE. If you feel you cannot abide by the following guidelines, I respectfully ask that you do not come in to the office at this time.


1. Only one patient will be allowed in the office at any given time.

a. If families or spouses come with the person being treated, they must remain in the vehicle during the treatment session.

b. If multiple family members are being treated on the same day, the persons not being treated must remain in the vehicle until they are given the clear to come in for their treatment session OR sit in the office with a face mask/covering on the entire time they are waiting their turn.


2. Please look at the door prior to coming in for your treatment.

a. If there is a RED Do Not Enter sign, please do not come in the office - either there is already a patient in the office being treated or the office is being decontaminated from the previous patient.

b. If there is a GREEN Safe to Enter sign, the office has been vacated by the previous patient and the office has been decontaminated.


3. When you come for your appointment, please leave any bags, purses or personal items which you will not need for your appointment in your vehicle.


4. Please have a face mask/covering on BEFORE you come into the office.

a. Face mask/covering must be worn at all times.

b. Face mask/covering must cover your nose AND mouth at all times.

c. Halloween and/or tribal masks/coverings are not considered appropriate at this time.


5. Upon entering the office:

a. Please stand by the door until I am able to take your temperature. If your temperature is at or above 99.5° F, you will be asked to leave the office immediately and call the New Mexico Department of Health for follow up for COVID-19 testing.

b. If your temperature is below 99.5° F, you are to remove your shoes – if you do not have socks on, please inform me and I will provide you with a pair.

* It is preferable you wear your own socks to your appointments.

* It is preferable that you not wear shorts or short skirts to your appointments.


6. Once in the office, go to the Restroom and place your keys, cell phone, and wallet on the designated black counter top by the sink.


7. Remove your shirt.


8. Wash your hands, forearms and elbows with the red foam cleanser on the sink and dry the areas with the provided towels. IT DOES NOT MATTER THAT YOU JUST TOOK A SHOWER, THE RED FOAM CLEANSER IS AN ANTIMICROBIAL AND YOU OR SOMEONE AROUND YOU MAY HAVE PUT RESPIRATORY DROPLETS ON THESE AREAS VIA COUGHING OR SIMPLY SPEAKING ANY TIME BEFORE YOUR APPOINTMENT. I WILL BE TOUCHING THESE AREAS WITH MY BARE HANDS.


9. Put on the long sleeved T-shirt provided.


10. Put your face mask/covering back on if you removed it while in the bathroom.


11. When treatment is completed, remove the provided long sleeved T-shirt and socks, along with any towels you may have used, and place them in the laundry bin.


12. If you use the toilet at any time during your time in the office – WASH YOUR HANDS WITH SOAP AND WATER AFTERWARDS.


Please wash your hands PRIOR TO helping yourself to cookies, coffee or tea, AND use the disinfecting wipes to wipe down any containers, knobs, tea machine, and/or refrigerator door surface you may have touched.


SCREENING PROTOCOL:


I respectfully request that you delay making or reschedule your appointment if you or anyone you have come in close contact with currently meets or within the past 14 day has met any of the following:


• Has common cold or flu-like symptoms OF ANY TYPE - runny or stuffy nose, loss of smell, sneezing, chest congestion, sore throat, loss of taste, cough, fever, shaking chills, nausea, vomiting, or diarrhea. DO NOT MISTAKE THESE SYMPTOMS FOR ALLERGIES, IF YOU HAVE TAKEN AN ALLERGY MEDICATION AND STILL HAVE THE SYMPTOMS IT IS CONSIDERED A COLD OR FLU.


• Has been in person-to-person contact with someone with common cold or flu-like symptoms OF ANY TYPE


• Has been in person-to-person contact with someone who works around someone with common cold or flu-like symptoms OF ANY TYPE


• Has been diagnosed with Covid-19


• Has been in person-to-person contact with someone diagnosed with Covid-19


• Has been in person-to-person contact with someone who works around someone diagnosed with Covid-19


• Has travelled to high risk areas of COVID-19 (any area – village, town, city, county, state, country – with more than 5 confirmed cases), and/or they did not wear protective face mask/covering while in public, and/or did not practice appropriate social distancing while in public, and/or did not self-quarantine for 14 days after any of the aforementioned


• Has been in person-to-person contact with someone who has travelled to high risk areas of COVID-19 (any area – village, town, city, county, state, country – with 5 or more confirmed cases), and/or they did not wear protective face mask/covering while in public, and/or did not practice appropriate social distancing while in public, and/or did not self-quarantine for 14 days after any of the aforementioned


• Has been, yourself, or in person-to-person contact with someone who has been to a dine in or patio seating restaurant or bar. It does not matter if you or they did or did not wear a protective face mask/covering, as the protective facemask/covering had to be removed in order to consume food/drink, you/they have been in enclosed, poorly ventilated areas, or in an air draft outside with multiple people who were close enough to be exposed to a Covid-19 carrier.


• Has been, yourself, or in person-to-person contact with someone who has been to an on site/campus school (they have physically been going to a school or campus in any capacity) or has taken a school bus. It does not matter if they did or did not wear a protective face mask/covering, as the protective face/mask covering had to be removed in order to consume food/drink, you/they have been in enclosed, poorly ventilated areas, or in an air draft outside with multiple people who were close enough to be exposed to a Covid-19 carrier.


* IF YOU WORE A MASK WHILE IN CONTACT WITH THE AFOREMENTIONED, YOU MAY COME IN – EXCEPT THOSE GOING TO RESTAURANTS, BARS OR SCHOOLS


* IF YOU DID NOT WEAR A MASK WHILE IN CONTACT WITH THE AFOREMENTIONED, PLEASE REFRAIN FROM COMING IN AT THIS TIME.


NOTE: Santa Fe and the surrounding counties are all high risk areas at this time.


For your safety:


• I will be wearing a face mask and scrub cap while you are in the office;


• I will wear protective glasses while you are face up on the treatment tables;


• I will be changing all linens after each patient;


• I will spray down and wipe all surfaces with a combination of ODO-BAN disinfectant (EPA-registered) and hydrogen peroxide, and 95% isopropyl alcohol – using a fresh cloth each time and on each different surface;


• I will be using UVC and Ozone Lights in each room after each treatment;


• I will be changing my scrubs, scrub hat, protective glasses, and face mask after each decontamination procedure from the previous patient;


• As always, I will be continuously cleaning my hands and arms with disinfecting wipes and isopropyl alcohol during treatment and using chlorhexidine gluconate solution when I wash up between patients and decontamination procedures.


• The office now has a state-of-the-art air purifier in each room which filters and cleans the air of ultrafine particulate matter down to the size of .03 microns. (The average size of the corona virus particle is 0.120 microns).


Thank you for taking the time to read through this entire message. It is my hopes you will be honest and respectful of the new office guidelines - I do not enjoy having to call the New Mexico Department of Health to report people who have put me at risk, nor do I enjoy having to be constantly tested for COVID-19 and having to shut down for 14 days after someone violates the guidelines and lied about it in order to come in.


Please let me know if you have any questions or concerns. I look forward to continuing to assisting you with your healthcare needs.


Yours for better health,


Dr. P. Nadine Gonzales – Dr.G


PS - Some may have lost their jobs and/or their health insurance because of the COVID-19 crisis. Please call Medicaid at 855-637-6574 to see if you qualify for coverage. If you do not qualify for Medicaid, you can apply for discounted premium health insurance at BeWellNM.com or call 833-862-3935. Note that I am treating established cash patients and established patients who now qualify for Medicaid PRO BONO until July 31, 2020.


___________________________________________________

PATIENT SIGNATURE

 ___________________________

 DATE



THE PAIN SCALE


0 – Pain free.


Mild Pain - Nagging, annoying, but doesn’t really interfere with daily living activities. (1-3 Pain Level)

1 – Pain is very mild, barely noticeable. Most of the time you don’t think about it.

2 – Minor pain. Annoying and may have occasional stronger twinges.

3 – Pain is noticeable and distracting, however, you can get used to it and adapt.


Moderate Pain - Interferes significantly with daily living activities. (4-6 Pain Level)

4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.

5 – Moderately strong pain. It can’t be ignored for more than a few minutes, but with effort you still can manage to work or participate in some social activities.

6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.


Severe Pain - Disabling; unable to perform daily living activities. (7-10 Pain Level)

7 – Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.

8 – Intense pain. Physical activity is severely limited. Conversing requires great effort.

9 – Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.

10 – Unspeakable pain. Bedridden and possibly delirious. Very few people will ever experience this level of pain.


When rating their pain, the most common mistake people make is overstating their pain level. That generally happens one of two ways:

Saying your pain is any number greater than 10 on a scale of 0 to 10.


While you may simply be trying to convey the severity of your pain, what your doctor hears is that you are given to exaggeration and he will not take you seriously.


Smiling and conversing with your doctor, then saying that your pain level is a 10.


If you are able to carry on a normal conversation, your pain is not a 10 - nor is it even a 9.


Consider the fact that natural childbirth (no epidural or medication) is generally thought to be an 8 on the pain scale. Just as with the first example, your doctor will think you are exaggerating your pain and it is probably not nearly as bad as you say.