Fellowship Trained & Board Certified in Pain Medicine

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All Posts in Category: Tips

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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NSAID use in Chronic Pain Management

Non-steroidal anti-inflammatory drugs (NSAIDS) are a common class of medications used to treat pain and fever. The most widely prescribed and over the counter formulations are Ibuprofen, Naproxen, Mobic, Diclofenac and Celebrex. These have been utilized for pain control for many years. Their role in decreasing inflammation has been proven to be beneficial in the management of acute pain, but also intermittently with chronic pain.

Risks of taking NSAIDs

     Although these medications serve as good alternative to opioid medications, they do pose a risk to your overall health. In 2005, the Food and Drug Administration released a black box warning on the risk of experiencing a stroke or heart attack with NSAID use. In 2015, they strengthened their stance on this risk due to evidence revealing a stronger correlation between the two. In addition, NSAIDs have also been known to increase an individual’s risk of bleeding.

Talk with your provider before starting a new medication

    Before starting you on an NSAID your provider will likely inquire about your previous medical history. Any individual with a history of a bleeding disorder, GI ulcer, previous heart attack/heart problems, or previous stroke will likely need to refrain from using these medications. If you are currently taking an NSAID and you answered yes to any of the above medications, it is important you discuss this with your provider.

Are NSAIDS the appropriate medication to help treat your pain?

     In summary, while NSAIDS are very useful for pain control they are not always appropriate for every patient. They are preferably utilized short term for acute pain flares and discontinued after this time. However, they are always outlier situations in which they may be used for a longer periods of time. If you are concerned about your current NSAID use and how you can decrease your risk of side effects talk with your provider today.

Natalie Chism, CRNP

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Interpreting online reviews of pain management practices

While online reviews of  service industries are helpful, they should be read with some skepticism, especially when it comes to pain management practices.  Some reviews are fraudulent, created by people who have never been to the practice or perhaps created by a computer program.  Legitimate, enthusiastic positive reviews may have more to do with likability of the physician rather than his or her care, and negative reviews are no different.

Frequently, a pain management practice will see a new patient and recommend weaning the patient off controlled pain medications such as opiates or avoiding them altogether.  This often results in tremendous dissatisfaction for some patients, and many of these patients will go online immediately to post a negative review.  Often these reviews go on to criticize other aspects of the practice or simply misrepresent the truth.  Please consider this hypothetical example.  A patient is seen at initial evaluation and the pain physician tells him that his MRI and physical exam do not show or suggest a problem that is severe enough to put the patient on an opiate such as hydrocodone.  The patient then leaves the clinic angry and posts an online review stating that the physician treated him “like an addict.”  This is false and misleading.  Of course, the clinic cannot respond because doing so risks betraying the patient’s privacy as it relates to his health.

It makes sense that if opiates have been over-prescribed in recent years, pain management clinics will see new patients that they believe should not be on opiates.  This news, even when delivered compassionately in a manner that focuses on the diagnosis and the risk of the medication, is often not well-received.  Conversely, while most physicians strive for excellence, a 5-star review may not always be accurate.  Therefore, one should consider pain management reviews carefully.

Other data that might be helpful to consider when choosing a physician include board certification, fellowship training, the reputation of the physician among other health professionals in the community, and the experiences of people you know and trust.


As always, the mission of our practice is to provide excellent, compassionate care, and we thank you for being willing to share feedback to help us grow!

You can click the link below to submit a review. Don’t feel obligated to include your full name, as these reviews are public. Your feedback is valued!

If your experience has not been to our high standard, please feel free to call us and ask for our practice manager, Lynne Marston.

Thank you for your continued support and feedback!

T. Wade Martin, M.D.
R. Brian Thoma, M.D.


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