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Archive for November 2019

Adding Aqua Therapy Can Help Improve Your Pain.

Here at Cahaba Pain, we try several types of interventions to help our patient that are experiencing pain. We use these methods in addition to medications, if applicable. One option that has shown benefit is hydrotherapy.


What is hydrotherapy?

Excellent question. Many people might know this better as aqua therapy. Basically, this is physical therapy but, in a heated pool and under the instruction of a physical therapist. Studies have shown an improvement in quality of life and decreasing pain in patients that have tried hydrotherapy for low back pain, knee pain, etc. (Yücesoy et al, 2019). The water helps lighten the strain on the joints and the back allowing the patient relief while exercising. Aqua therapy has also been shown to help patients lose weight, as well.

Making exercise a part of your everyday life improves your overall health.

Staying active in the setting of chronic pain is a challenge, to say the least. However, it is important to physical and mental health to exercise. It seems to be a cycle. Patients will hurt after activity, so they will not move to avoid this pain. A lifestyle of little to no movement or physical activity can lead to a life of more pain and depression. Aqua therapy can help with this struggle and break the cycle. Ask your provider about aqua therapy.

Emily Walker, CRNP

Yücesoy, H., Geçmen, I, Adigüzel, T, Karagülle, M, & Karagülle, K. M. (2019). International Journal of Biometeorology. Efficacy of balneological outpatient treatment (hydrotherapy and peloidotherapy) for the management of chronic low back pain: a retrospective study. Advanced online publication. doi: 10.1007/s00484-018-01668-9

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How smoking affects more than just your lungs.

There are some lifestyle choices that can increase pain in patients. Smoking, for instance, can intensify pain. Smokers tend to report higher pain scores and more impairments to daily functions than nonsmokers.
Smoking can also delay healing, worsen bone health, and weaken discs in the back. https://www.ncbi.nlm.nih.gov/pubmed/30192304 Along with these reasons, we also know that smoking causes significant harm to the lungs and increases the risk of various cancers.

How can I quit?

We all know smoking is bad for your body and those around you. How can I quit? We can work with you in this journey. The quitting process truly is a journey. It is a marathon and not a sprint. There are several tools to help. Medication, like nicotine patches and Chantix, are very helpful. Also, there are free apps available for download on your phone. We recommend counseling along with medication therapy. An accountability partner for encouragement, is always helpful.

Have you made the decision to quit?

Stopping smoking is a hard decision to make, but a step in the right direction for health and decreasing pain. If you are ready to quit smoking, please let us support you in taking that first step in this marathon.

Emily Walker, CRNP

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Treat Your Osteoarthritis Knee Pain.

Osteoarthritis in the knees can cause a significant amount of pain that can affect a person’s ability to perform normal activities of daily living. As the amount of joint fluid decreases, there is less cushion from the cartilage to protect the joint. This damage in the knee can cause a great deal of pain that slowly progresses with walking, bending, and sitting or lying for long period. Staying active with regular physical activity is vital for the muscle strength in protecting the joints. Maintaining a healthy weight is important to reduce the stress placed in the joints. Continued range-of-motion exercises improve the stiffness to keep the proper movement and flexibility.

What to do when conservative measures don’t help the pain?

When the conservative measures discussed above do not keep the pain under control and the mobility continues to worsen, another option to look at is having a steroid injected into to the joint. This can decrease the inflammation enabling the joint to move with less pain. The down falls to these steroid injections are that they do not provide long lasting relief and steroids themselves have side effects with long term use. Many people can also have contraindications with steroid use for other medical problems.


Hyalgan is an FDA approved treatment of pain for osteoarthritis.

When more conservative measures have failed to provide adequate pain relief and function hylagan is a great treatment. The fluid (or protection) that is in the joint decreases with worsening arthritis. Essentially, Hyalgan is used as a replacement fluid for this loss as it adds back in the “cushion”, thereby reducing the pain. The Hyalgan can be a three-week injection series or a one-time full dose. While this is not a permanent treatment or cure, it should provide at least six months or more of moderate to significant pain relief. If the series provides six months or more of pain relief, it can be repeated. This injection series should not interact with oral medications and should not have a systemic affect. Hyalgan is a safe choice for osteoarthritis pain. Watch our video on how these injections are done and talk to your doctor today if you feel that is could be right for you. https://cahabapain.com/procedure-simulations/#vm_A_c2aaee2b

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CBD oil – Too good to be true?

You may notice that everywhere you look you see cannabidiol (CBD) marketed in a variety of products including drugs, food, dietary supplements, cosmetics, pet food, and other animal health products. This oil is a derivative of the marijuana plant and promises to cure a whole host of ailments. Some of these include: Chronic pain, anxiety, depression, joint pain, fibromyalgia and the list goes on.


Lets look at the facts.

According to the CDC (Centers for Disease Control), CBD oil is currently not a regulated product. This means that manufacturers could add substances to the oil. The additives could make the product cheaper or even dangerous if used without physician supervision. There are many locations to obtain CBD oil including private entrepreneurs which have been known to provide the product, as well.


As of July 2019, the FDA (Food and Drug Administration) has only approved one type of CBD oil.

Epidiolex, for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome. Otherwise, the FDA warns consumers that CBD oil products are not approved for the prevention, treatment, or cure of any disease.

In the setting of chronic pain, more scientific research is needed to study the risks and benefits of CBD oil. Please speak with your physician prior to using any CBD products.

Emily Walker, CRNP

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