Pain Management

Arthritis isn’t a single disease; it’s a constellation of more than 100 types of related conditions and ultimately refers to joint pain or joint disease. Arthritis affects people of all ages, races, and sexes, and it is the leading cause of disability in the United States. While some types of arthritis occur more frequently in the elderly than younger people, it is not particularly an aging problem.

Some common symptoms of arthritis include pain, swelling, immobility, and diminished range of movement in joints. Symptoms can range from mild to intense and wax and wane over time. Some people may have a stable form of the disease for years, while others can advance and worsen. Chronic arthritis may result in acute pain and problems performing routine activities, making walking and climbing stairs painful and grueling.

Arthritis can also cause permanent changes to your joints. The changes may be evidently visible, like bumpy finger joints; however, the damage can often be seen only on X-rays. Some types of arthritis can even affect your organs, including the heart, eyes, lungs, kidneys, and skin.

As the name implies, inflammatory arthritis is where the immune system becomes overactive, destroying healthy joint tissue and other organs in the body (i.e., eyes, heart, and skin, to name a few).

Rheumatoid arthritis (RA), Psoriatic arthritis (PsA), gout, and juvenile arthritis are all types of autoimmune inflammatory arthritis. For these types of arthritis, early diagnosis and treatment are crucial, as slowing disease activity can help reduce permanent joint damage and improve functionality. We at Hoag Pain Management can assist in the diagnosis of inflammatory arthropathies and work with your rheumatologist to develop an effective treatment plan to manage your pain and keep you active.

Pain is one of the most common symptoms in cancer patients. Pain can be caused by cancer, cancer treatment, or a combination of factors. Tumors, surgery, chemotherapy, radiation therapy, and diagnostic procedures may cause cancer patients pain. Younger patients are likely to have cancer pain and pain flares than older patients. Patients with advanced cancers tend to have more severe pain. And many cancer survivors have pain that continues even after cancer treatment. Cancer pain can also have a profound effect on your quality of life, both physically and psychologically.

At Hoag Pain Management, we treat cancer pain by addressing the whole person. Pain management isn’t always about medication, although pain medication does play a role in controlling some cancer pain. We understand that easing your pain is an important part of your treatment and recovery and offer several natural therapies that can help improve your quality of life including:

• Acupuncture
• Massage Therapy
• Physical Therapy
• Behavioral Health Counseling
• Nutritional Counseling

When you are living with cancer, pain control is essential. The specialists at Hoag Pain Management will develop a tailored approach to managing pain caused by cancer to help you live more comfortably and improve your quality of life.

Carpal Tunnel Syndrome is a condition that is triggered when the median nerve in your hand gets compressed or pressurized. It is caused by the pressure put on the median nerve when it runs through a narrow passageway called the carpal tunnel, which is surrounded by ligaments and bones on the palm side of your hand. This pressure can lead to numbness, weakness, and tingling in your arms and hands.

Factors such as the anatomy of your wrist, arthritis, wrist fracture, and repetitive hand movements can all contribute to carpal tunnel syndrome. Treating it properly usually relieves the numbness and tingling and restores the strength and functioning of your wrist and hand.

Symptoms of Carpal Tunnel Syndrome

The condition starts gradually and can cause symptoms including:

• Pain in the wrist and hand
• Numbness and tingling
• Weakness in your hand and wrist

As we age, it’s not uncommon to experience some wear and tear in our neck. Cervical arthritis or cervical spondylosis is a condition that is caused by the natural degeneration of the joints in the neck and can lead to symptoms such as pain and stiffness. In fact, it’s a pretty common issue, with more than 85% of people over 60 experiencing it in some form.

Symptoms of Cervical Arthritis

Cervical Arthritis can cause stiffness and pain in the neck, which can be mild or severe. This pain can worsen when you’re looking up or down for long periods of time, or even when you’re doing activities that keep your neck in one position for a while like reading or driving. Other symptoms include:

• Numbness and tingling in your arms, legs, hands, and feet
• A popping or grinding sensation when you move your neck
• Difficulty walking or loss of balance
• Headaches
• Muscle spasms in your shoulders and neck
• Loss of bowel or bladder control in severe cases

Over time, cervical arthritis can lead to changes in the structure of the neck, such as herniated disks, bone spurs, and stiff ligaments. The condition may be a natural part of the aging process but it is important to keep an eye on any symptoms that may develop.

Cervical disc disease describes the degenerative process discs of the cervical spine undergo as individuals age. This disease is generally caused by the degeneration of the disc material of the spine, which causes loss of vertebral body height and places excessive pressure on the already weakened disc. This stress eventually causes the disc to bulge out into the spinal canal. In severe cases, the disc material can rupture the outermost layer of the disc into the spinal canal.

After the age of 40, most individuals face disc degeneration in one form or another. Pain in the spinal discs is usually due to the discs drying out or minor tears or cracks due to injuries or overuse. Any type of disc pain should be addressed by a qualified pain management specialist like the professionals at Hoag Pain Management.

Symptoms of Cervical Disc Disease

Cervical disc disease that has progressed and becomes symptomatic often results in:

• Neck and back pain that either suddenly appears or develops gradually over time
• Numbness and/or weakness that may radiate from the neck to the arm and hand
• Nerve issues and neurological symptoms in the upper ligaments

Cervical radiculopathy, popularly known as a pinched nerve, is the damage or alteration in how a nerve operates due to the compression of one of the nerve roots near your cervical vertebrae. There are seven small vertebrae that form your neck or cervical spine and start at the base of the skull. This is the area where the condition called cervical radiculopathy occurs.

The cervical spine houses nerves that transmit messages back and forth between the brain and your body. The roots of these nerves further branch out through various openings of vertebrae known as the foramen. Any kind of damage to these nerve roots can cause loss of sensation and pain in the entire nerve pathway, including the arm and hand, depending on the location of the damaged roots.

Symptoms of Cervical Radiculopathy

The key symptom of cervical radiculopathy is pain that radiates into your neck, arm, chest, shoulders, and upper back. Usually, this condition affects only one side of the body.

In most cases, cervical radiculopathy results from the various degenerative alterations that occur in the spine with age or due to an injury that causes a bulging, herniated intervertebral disc. As you age, the discs lose their height and start bulging out. Simultaneously, the core of these discs starts losing moisture, becoming brittle and stiffer. This condition causes collapse and settling of the disc space and loss of disc height.

As the term says, chronic pain is pain experienced in the body which is high in intensity and severity. The condition can last months and even years. In some people, chronic pain conditions are experienced in the whole body.

Chronic pain conditions or syndrome can lead to depression and anxiety if left untreated for a long time. It hinders your daily activities and can lead to stress. We all have known body aches and pains that were temporary and that went away in a few days. However, for some people, body pains can continue for a long time. It is called chronic pain if your body aches for 3-6 months. Experiencing continuous pain in your body that hampers your daily tasks can affect your emotional and physical health. Around 25% of people suffering from chronic pain will experience chronic pain syndrome (CPS) if the condition is left untreated. CPS may also be accompanied by depression and anxiety. And although CPS can be hard to cure, with the proper measures and treatments, the symptoms can be relieved.

Symptoms of Chronic Pain Conditions/Syndrome

CPS affects your physical health, social life, and emotions. Chronic pain can also lead to other symptoms such as:

• Anxiety
• Poor sleep
• Irritability
• Guilt
• Depression
• Feeling extremely tired and wiped out
• Drug or alcohol abuse
• Loss of interest in sexual activity
• Job loss
• Marriage and family problems
• Suicidal thoughts

Causes of Chronic Pain Syndrome

Numerous factors can lead to the development of Chronic Pain Syndrome. The condition usually starts with a painful condition or an injury like:

• Back Pain
• Arthritis and other joint problems
• Muscle strains and sprains
• Fibromyalgia
• Lyme disease
• Nerve damage
• Headaches
• Repetitive stress injuries
• Cancer
• Broken bones
• Inflammatory bowel disease
• Endometriosis
• Surgery
• Acid reflux or ulcers
• Irritable bowel syndrome

Overall, the root cause of CPS is a combination of both physical and emotional factors. Experts believe that people who develop CPS have alterations in their nervous and endocrine systems that predispose them to experience pain differently than others.

Others claim that CPS is a learned response. When the patient feels pain, they start to repeat specific behaviors even after the pain has subsided. CPS can affect people of all ages and genders; however, it is most common in women. Additionally, people who are also suffering from depression and anxiety are more likely to develop CPS.

Complex regional pain syndrome is a sub-type of chronic pain that affects an arm or a leg. CRPS usually develops after an injury, stroke, heart attack, or surgery. The pain depends on the severity of the initial injury.

Complex regional pain syndrome is uncommon and its causes are not clearly understood. Treatment of the condition is most effective when it is started early. In this case, the improvement of the condition is possible.

Signs & Symptoms of CRPS

Complex Regional Pain Syndrome (CRPS) can be caused due to an injury or a difference in the peripheral and central nervous systems. A trauma or an injury, particularly in the arm or leg, most likely triggers the condition which is often characterized by a variety of symptoms, including:

• Sensitivity to touch or cold
• Muscle spasms
• Weakness and/or swelling in the affected area
• Joint stiffness
• Continuous burning pain

Symptoms can change over time, and if left untreated, the condition can become irreversible. Early detection and treatment are crucial for managing CRPS, so it’s important to pay attention to symptoms and seek medical attention.

There are two types of CRPS:

• Complex Regional Pain Syndrome Type 1 occurs after an injury that does not directly damage the nerves of the affected limb. This is the most common type of CRPS.
• Complex Regional Pain Syndrome Type 2 has symptoms that are similar to CRPS Type 1 but this type of CRPS occurs after a nerve injury.

A compression fracture is a small break in the vertebrae, which is more common in women over 50. As women age, their bones weaken, and with osteoporosis, they’re more likely to fracture or break. Osteoporosis causes brittle bones and is a leading cause of compression fractures, in addition to trauma or injuries, and even cancerous tumors of the spine.

Signs & Symptoms of Compression Fractures

Compression fractures can be confirmed with an X-ray. Some people might not feel any pain, while others might feel pain while sitting or standing. Some of the common symptoms include:

• Sudden back pain that lasts longer than usual, usually between the lower back and shoulders. The pain gets better when you lie down and worse when you stand or walk
• Limited mobility and flexibility in the spine make it hard to twist or bend over
• A hunched-over appearance due to the compression of the vertebrae and curving of the back
• Loss of height
• Pinched nerves and nerve damage, causing tingling and numbness in the back area and difficulty walking
• Difficulty controlling the bladder and bowel

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Current evidence demonstrates that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.

Symptoms often begin after an event, such as physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.

Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

Symptoms of Fibromyalgia

Patients suffering from fibromyalgia may experience symptoms including:

• Widespread pain described as a constant dull ache
• Chronic fatigue where patients awake tired even after a full nights rest
• Difficulty with maintaining focus, paying attention, and concentrating on tasks. This is commonly referred to as “Fibro Fog”

It is common for people with fibromyalgia to experience fluctuations in their symptoms throughout the day, with some people reporting that their symptoms are worse in the morning, late afternoon, or evening. The pain experts at Hoag Pain Management are focused on helping you manage your symptoms to restore your quality of life.

Pain and discomfort in the hip can be caused by a variety of issues and can interfere with your quality of life and activities of daily living. Even walking can prove painful.

Hip pain caused by issues with the hip joint can be felt in your groin or the inside of your hip. Pain experienced on the outside of the hip, the outer buttock, or thigh is typically caused by problems with the muscles, ligaments, soft tissues, or tendons surrounding the joint. Pain may also be caused by problems in other parts of your body such as the lower back. This pain is called referred pain.

At Hoag Pain Management, we understand the importance of prompt and accurate diagnosis and treatment of hip pain. Our team of experienced professionals is dedicated to providing the highest level of care and utilizing the latest techniques and technologies to alleviate your pain and prevent long-term complications.

Signs & Symptoms of Hip Pain

Hip pain can be caused by multiple factors such as a minor dislocation, inflamed tendons, arthritis, trochanteric bursitis, and hip fractures. Symptoms that warrant attention by a pain management specialist may include:

• Swelling, tenderness, warmth, and soreness of the hip
• Pain in the hip joint that makes walking or simple movements difficult
• Loss of mobility and range of motion

Inflammatory bowel disease, or IBD, is a group of disorders that can cause chronic inflammation, which includes pain and swelling in the intestines. IBD involves Crohn’s disease and ulcerative colitis, which impact the digestive system. Effective treatments can help manage the symptoms of the condition. The condition can be lifelong, which makes expert consultation important.

Inflammatory bowel disease is an umbrella term that involves prolonged or chronic inflammation of the tissues in your digestive tract. The condition can be explained into two major types.

• Ulcerative colitis: This type of IBD condition involves the creation of inflammation and sores or ulcers along the lining of your large intestine and rectum.
• Crohn’s disease: Another type of IBD condition is distinguished by inflammation created on the lining of your digestive tract, which usually involves the deeper coating layers of the digestive tract. Crohn’s disease most likely impacts your small intestine. But it can simultaneously affect your large intestine and upper gastrointestinal tract.

Symptoms of IBD

• Abdominal pain
• Diarrhea or an urgent need to poop
• Loss of appetite or unexplained weight loss
• Gas and bloating
• Mucus or blood in stool
• Upset stomach

Knee pain is a common complaint for several reasons. Knee pain can be the result of an injury such as torn cartilage, ACL or meniscus tear, patellar dislocation, or tendonitis. Medical conditions like osteoarthritis, infections, and gout may also be causes of knee pain. The condition can affect people of all age groups.

Some minor types of knee pain can be well-treated by taking self-care measures. Such pain in the knee can also be treated with physical therapy and knee braces. In worst-case scenarios, your knee might require surgical repairs.

Symptoms of Knee Pain

The location and the seriousness of the knee pain can vary based on the cause of the problem. Signs and symptoms of the condition that accompany the knee pain include:

• Redness and warmth to the touch
• Swelling and stiffness in the knee
• Popping or crunching noises in the knee
• Weakness or instability in the knee area
• Inability to fully straighten the knee
• Difficult bearing weight on the knee

Although the symptoms of knee pain can be self-medicated and relieved within a few days, however, there are some symptoms that need medical attention.

• If you have marked knee swelling
• If you are unable to extend or flex your knee fully
• Have a fever followed by redness, swelling, and pain in your knees
• Have shooting knee pain associated with an injury
• Find it hard to bear weight on your knee
• Notice a deformity in your knee or leg

Seek professional help if any of these conditions arise.

Lumbar arthritis is when the joints in the lower back become inflamed, causing pain and stiffness. It’s usually caused by wear and tear on the joints over time but can also be brought on by injury or certain medical conditions. Treatments vary depending on the seriousness of arthritis and the level of pain and loss of mobility.

At Hoag Pain Management, we work with patients to assess their pain and create a personalized treatment plan to help restore their quality of life.

Symptoms of Lumbar Arthritis

Lumbar arthritis can be caused by a variety of factors including wear and tear of the cartilage in the joints over time, injury to the lower back, other forms of arthritis, and obesity which puts added strain on the joints of the lower back. Symptoms may include:

• Chronic lower back pain
• Stiffness in the lower back
• Limited mobility in the lower back
• Difficulty with daily activities such as standing up straight, bending over, or lifting objects
• Tenderness or swelling in the lower back joints

Symptoms may vary depending on the severity of your arthritis. Some patients may experience only mild discomfort. In contrast, others may have more severe pain and limited mobility. If you’re experiencing symptoms, Hoag Pain Management will deliver an accurate diagnosis and individualized treatment plan.

Lumbar disc disease, or herniated disc, is a condition that can be an acute or chronic process resulting in lower back pain. Depending on the location of the herniated disc, it can also lead to weakness, numbness, and pain in your legs

Chronic lumbar disc disease is mainly caused by a change in the structure of the spinal disc. Chronic disc disease occurs due to degeneration as you age. However, any severe injury can cause a herniated disc in the lumbar area. The characteristic symptom of lumbar disc disease include lower back pain and possibly leg pain and weakness which arise from inflammation and nerve compression

Lumbar disc disease is mainly caused by a change in the structure of the spinal disc. Usually, any disc disease occurs due to the normal breakdown as you age. However, any severe injury can cause herniated discs in the lumbar area. The characteristic symptom of lumbar disc disease, lower back pain, usually occurs from inflammation and abnormal instability.

Symptoms of Lumbar Disc Disease

Symptoms of lumbar disc disease vary, but the most common signs include…

• Lower back pain: Pain in the lumbar spine is the most common symptom of lumbar disc disease. This pain may spread to other parts of the body including the groin, buttocks, and upper thighs.
• Occasional pain spikes: Lumbar disc pain may get intense for days or weeks and then become mild again. These occasional pain spikes can be sudden and severe, leading to reduced mobility.
• Tenderness: The lower back may become tender and sensitive to touch. The tenderness is due to muscle tension and inflammation surrounding the diseased disc.
• Leg pain: Symptoms including numbness, weakness, and pain may occur in the buttock, hips, and legs if the nerve roots are being compressed.
• Feeling of giving out: Leg weakness: A sudden feeling of instability or weakness can create the sensation that your legs may give out.

Lupus is an autoimmune disease, which is triggered when your immune system attacks its own tissues and organs. Lupus is triggered by inflammation in any part of the body and can cause organ-specific complications affecting the kidneys, blood cells, brain, heart, lungs, and joints.

Lupus is an elusive disease with no definitive causes known. People with inherited predispositions to Lupus usually develop the disease when exposed to an environmental trigger. While there is no cure for lupus, the specialists at Hoag Pain Management take a holistic approach to manage the pain associated with this inflammatory disease.

Symptoms of Lupus

Lupus can be difficult to diagnose in its early stages because its signs and symptoms are the same as other ailments. Every patient presents differently with this disease, and symptoms can vary for each individual diagnosed with the condition. The symptoms of Lupus typically develop slowly and become more severe over time. Like with other autoimmune diseases, some people can experience periods of being symptom-free and then experience flare-ups where inflammation and pain worsen.

Some of the signs to look for with Lupus include:

• A butterfly-shaped rash on the face, mainly across the cheeks. While not every person will develop this distinct rash, it is one of the initial telltale signs of the disease. Rashes on other parts of the body may also affect some people.
• Fever
• Fatigue
• Joint pain, swelling, and stiffness
• Skin lesions that worsen with sun exposure
• Fingers and toes turn white or blue if exposed to cold or when experiencing a stressful situation
• Chest pain
• Headaches, memory loss, and confusion
• Dry eyes

Headaches are a common ailment that many individuals experience regularly. However, migraines are a distinct type of headache characterized by a recurrent, throbbing pain that typically affects one side of the head and may also cause nausea and disturbances in vision. According to the Migraine Research Foundation, migraines are the third most prevalent illness globally.

Migraines can be debilitating for those who suffer from them. Certain things can trigger a migraine attack such as hormonal changes in women, certain drinks, stress, and changes in sleep patterns. At Hoag Pain Management, our goal is to find the treatment that works for you to help provide you with more pain-free days and an improved quality of life.

Symptoms of Migraine Headaches

In addition to debilitating pain, migraines can lead to a host of symptoms such as:

• Visual disturbances
• Sensitivity to various stimuli such as light and sound
• Nausea
• Numbness in the face

These symptoms can be particularly debilitating for those who experience migraines regularly, often disrupting daily activities and even nighttime rest. Some individuals may even experience migraines for prolonged periods, lasting for weeks at a time. Other common signs of migraines include:

• Prodrome: Some people may experience symptoms a day or two before migraines, known as a “prodrome.” This can include things like constipation, food cravings, increased urination, frequent yawning, fluid retention, neck stiffness, and mood changes.
• Aura: Some people may also experience “aura” symptoms before or during migraines. These are reversible symptoms of the nervous system and can include things like vision loss, weakness on one side of the body, visual phenomena like seeing shapes or flashes of light, pins and needles sensations in the limbs, and difficulty speaking. Auras usually last up to 60 minutes.
• Attack: A migraine attack can last anywhere from 4-72 hours if not treated. This can vary from person to person. During an attack, you may experience symptoms like a throbbing or pulsing headache, nausea and vomiting, sensitivity to sound, light, smell, and touch, and ache on one side of the head (or sometimes on both sides).
• Post-drome: Once a migraine attack is over, you may feel drained, washed out, and confused. Some people may also feel elated. This is known as the “post-drome” stage.

Multiple sclerosis, or MS, is the most common chronic neurological disorder that affects young adults between the ages of 20-40. This condition is more common in women than in men, has no clear cause, and unfortunately has no proven cure. Although there is no particular cause of MS, genetic and environmental factors can play a role in its development. These factors cause the immune system of the body to mistakenly attack and destroy the fatty material called myelin around the nerves. Myelin is vital for protecting and insulating the nerves to efficiently and quickly transfer nerve impulses from the brain to the rest of the body.

As soon as myelin breaks down, a process called demyelination occurs resulting in patches of nerves that are scarred. This “scar tissue” can break down the communication network of the nerves. Simply put, the brain cannot talk to the other parts of the body resulting in sensory and motor dysfunction.

At Hoag Pain Management, we understand the complexities and challenges that come with living with MS. Our team of expert physicians and healthcare professionals is focused on providing the highest level of care and support to our patients living with MS. We offer a range of treatment options and therapies, tailored to individual needs, to help manage symptoms and improve quality of life.

Symptoms of Multiple Sclerosis

MS causes symptoms that are variable and unpredictable and can be experienced in different parts of the body. The most common symptoms of MS are:

• Weakness and numbness in the limbs
• Tremor, unsteady gait, or lack of coordination
• Partial or complete loss of sight
• Double vision or blurry vision
• Slurred speech
• Fatigue
• Dizziness

Neuropathy is a disease or dysfunction of one or more peripheral nerves. Also called peripheral neuropathy, this condition is a result of damage to the nerves located outside of the brain and spinal cord and often affects the feet and hands causing pain, numbness and/or weakness. Neuropathy is often caused by a medical condition like diabetes where uncontrolled blood sugar damages nerves over time. Other causes of neuropathy can include nerve injury and trauma, infections, and even certain medical treatments such as chemotherapy.

Symptoms of Neuropathy

Neuropathy symptoms can differ depending on the underlying cause. The symptoms that are commonly experienced include :

• Increased sensitivity to touch
• Pain
• Dysfunction in organs and glands
• Tingling, burning, or prickling sensation
• Permanent or temporary numbness
• Muscle weakness or wasting
• Impairment to urination and sexual function

Osteoarthritis is one of the most common types of arthritis that can damage any joint in the body, but it mainly occurs in the hands, hips, knees, and spine. It is an inflammatory disease of the whole joint resulting in degenerative damage to cartilage, bone, and the surrounding connective tissue. Osteoarthritis can result from post-traumatic injuries such as a torn ACL or fracture, damage from physically demanding manual labor, and lifestyle factors, including obesity which puts severe stress on joints.

Some symptoms of osteoarthritis include joint pain and stiffness. The prevalence of osteoarthritis tends to increase as we age. Maintaining a healthy lifestyle, including staying physically active, maintaining a healthy weight, and eating an anti-inflammatory diet, can help with symptom management and prevent disease progression.

Physical therapy, OTC non-steroidal anti-inflammatories, and assistive devices may help with symptom management for those with mild to moderate joint pain and stiffness. For those with severe symptoms, we offer procedures at Hoag Pain Management such as joint injections, nerve blocks and ablations, peripheral nerve stimulators, and regenerative medicine techniques such as Platelet Rich Plasma (PRP) injections that may help manage your symptoms.

Pelvic pain can affect both men and women, but it is more common in women. It is caused by issues in the pelvic region, including the reproductive organs, pelvic bone, and non-reproductive organs. It can be a symptom of an infection or a muscle strain in the area. It is vital to seek medical attention from a primary care provider if experiencing pelvic pain.

At Hoag Pain Management, we help patients who experience muscle and connective tissue irritation and nerve irritation in the pelvic region, developing a personalized approach to managing your pain and addressing its root cause.

Symptoms and Signs of Abdominal or Pelvic Pain

Pelvic pain can be a symptom of other body issues and can also be accompanied by other symptoms as well. However, it can be a warning sign that requires proper consideration. Some of the most common pelvic pain symptoms involve-

• Vaginal bleeding, spotting, or discharge
• Menstrual pain
• Dysuria (painful urination)
• Constipation or diarrhea
• Bloating or gas
• Pain during sex
• Fever and chills
• Rectal bleeding
• Hip pain
• Pain in the groin area

It’s important to have pelvic pain addressed by a primary care provider to rule out any serious medical conditions. Pain that is caused by a strain of the muscles and connective tissues (ligaments) in the structures of the pelvic floor can be treated by the specialists at Hoag Pain Management.

A pinched nerve is a condition where a nerve gets squeezed by surrounding tissues like muscles, bones, tendons, and cartilage. This can cause numbness, weakness, pain, and tingling. It can happen in different parts of the body, like a herniated disc that presses on a nerve root and causes pain down the leg. A pinched nerve in the wrist can lead to numbness and pain in the fingers, which is called carpal tunnel syndrome. It’s usually treatable with conservative methods, but if left untreated, it may require surgery.

Some common causes of pinched nerves include rheumatoid or osteoarthritis , repetitive stress on the affected area, obesity, injury, or repetitive sports movements.

Symptoms of a Pinched Nerve

Signs and symptoms of a pinched nerve can be easy to detect because of the distinct pain it carries.

• Sharp, burning, and aching pain that feels like radiating outward
• Decreased sensation or numbness in the area that is supplied by the nerve
• Muscle weakness in the area that feels affected
• Feeling that your hand or foot has fallen asleep quite frequently
• Sensations of needles, pins, and tingling in the affected area. It is also known as paresthesia.

Psoriatic arthritis is a type of autoimmune inflammatory arthritis that affects individuals with psoriasis, an autoimmune disease that causes red, scaly patches on the skin. With inflammatory arthritis, the immune system becomes overactive resulting in the destruction of healthy joint tissue as well as other organs and tissues in the body. The inflammation not only causes skin discomfort but also pain and swelling in the joints. Individuals with psoriasis are at higher risk of developing psoriatic arthritis as are people with a known family history of the condition.

Symptoms of Psoriatic Arthritis

Like other types of autoimmune inflammatory arthritis such as rheumatoid arthritis , symptoms can worsen over time with periods of remission (decreased inflammation of the skin and joints), and periods of symptom flare-ups. Symptoms include:

• Scaly, red patches particularly on the skin of the elbows, knees, and back
• Joint pain, tenderness, stiffness
• Swelling especially in the fingers, toes, and lower back
• Nail changes
• Eye pain and redness

Rheumatoid Arthritis (RA) is a type of autoimmune inflammatory arthritis. Inflammatory arthritis is where the immune system becomes overactive resulting in the destruction of healthy joint tissue as well as other organs in the body (e.g. eyes, heart, and skin to name a few). This inflammation affects the lining of your joints, causing pain and swelling that leads to deformity of the joints over time.

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis symptoms may come and go. You may experience what we call “flare-ups” where pain and inflammation interfere with daily living, as well as periods of remission where decreased inflammation results in less pain. The most common symptoms of RA include:

• Swelling and tenderness of the joints, usually starting in the fingers and toes
• Stiffness of the joints
• Fatigue and fever, usually experienced during a flare-up

Symptoms of rheumatoid arthritis can vary in severity and longevity from person to person which is why we focus on you as an individual and tailor treatments to your level of pain and progression of the condition.

A rotator cuff is a collection of tendons and muscles that keep the upper arm bone in the shoulder socket and allow smooth movement. Pain in the rotator cuff is usually caused by inflammation of the tendons and bursa (the sac where tendons glide across bones), called tendinitis, or a tear in the tendons called a rotator cuff tear. These injuries are common, especially as we age, and may occur in younger people who have jobs that involve frequent overhead arm motions, such as carpenters or painters.

Signs & Symptoms of Rotator Cuff Problems

A sudden accident or trauma can cause a rotator cuff tear, which results in severe shoulder and arm pain. But, sometimes, the tear is due to aging, and the pain starts off mild and can be treated with over-the-counter medications. But, as time goes by, the pain can get worse, and regular pain relievers stop working. Other signs of rotator cuff problems include:

• Pain and trouble lifting the arm
• A clicking or popping sensation when moving the arm
• Severe arm pain at night
• Weakness in the shoulder and arm
• Difficulty lifting heavy objects

If you experience these symptoms, Hoag Pain Management can accurately diagnose and treat rotator cuff problems with a personalized pain management program tailored to your needs.

Sacroiliac Joint Dysfunction is a condition affecting the joints located between the sacrum and the hip bones. This joint plays a crucial role in weight-bearing and movement, and any dysfunction can result in lower back and hip pain. This condition affects the joint between the sacrum and the ilium bones of the pelvis and can cause a range of symptoms that can make daily life difficult.

The sacroiliac joint is a critical area in your body that connects your spine to your pelvis. When this joint becomes dysfunctional, it can cause a variety of symptoms, including low back pain, stiffness, and limited mobility. Many people with sacroiliac joint dysfunction also experience pain in the buttock area that can spread down the back of the leg.

Symptoms of Sacroiliac Joint Dysfunction

Symptoms may include:

• Discomfort or pain in the lower back and hips that can be dull or sharp and range from mild to severe
• Pain in the buttock area that can spread down the back of the leg
• Difficulty standing or walking for long periods
• Stiffness or instability in the lower back especially after sitting or standing for long periods of time. This discomfort can limit your mobility, making it difficult to bend, twist, or perform other movements that require movement in the lower back.

If you’re experiencing these symptoms, it’s important to seek medical attention from the pain specialists at Hoag Pain Management, as early intervention can greatly improve outcomes. With proper care, including physical therapy and targeted exercises, Sacroiliac Joint Dysfunction can be managed and treated effectively.

Sciatica refers to pain that travels along the path of the sciatic nerve. The sciatic nerve travels from the lower back through the hips and buttocks and down each leg. Sciatica most often occurs when a herniated disk or an overgrowth of bone puts pressure on part of the nerve. This pressure eventually causes inflammation, pain, and numbness in the affected area. The pain associated with sciatica can be sharp and severe.

However, many cases of sciatica are relieved in a few weeks with proper pain treatment and oversight.

Symptoms of Sciatica

Sciatica usually occurs when the sciatic nerve is pinched. Some people with diabetes also develop sciatica as the disease damages nerves. Sciatica pain can be anywhere in the area of the sciatic nerve. Usually, the pain follows a path starting from the lower back to the buttocks and the backside of the thighs and calf.

The intensity of the pain can vary from mild pain to shooting and burning pain. Sometimes the pain can also feel like an electric shock or a jolt in the affected area. While pain is present as a result of this condition, coughing, sitting, or sneezing can cause more pain. Sciatica is usually experienced on one side of the body. Some people also feel numbness, muscle weakness, or tingling in the foot or leg.

Shingles are a type of viral infection that results in a painful rash. Shingles is the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. The exact cause of shingles is not known. However, it is believed to be triggered by a weakened immune system, stress, and certain medical conditions such as cancer and HIV. People with weak immune systems are at a higher risk of developing shingles.

It is estimated that 1 in 3 people will develop shingles in their lifetime. The impact of shingles increases with age, with the highest rates occurring in people over 60. The rash and associated symptoms can cause pain and extreme discomfort. The specialists at Hoag Pain Management have the tools needed to help relieve pain due to shingles.

Symptoms of Shingles

For people who have had the varicella-zoster virus (chickenpox), the virus lies dormant in the nerve cells near the spinal cord and brain. Shingles is the reactivation of the virus which manifests in a painful rash. While shingles is not contagious, individuals who have never had chickenpox are at risk of getting shingles if they come into direct contact with the fluid from the chickenpox blisters.

Common symptoms include:

• Severe pain, itching, or tingling in a specific area on one side of the body, followed by a rash that develops into fluid-filled blisters. Pain can be debilitating and may persist even after the rash clears up.
• Fever
• Headache
• Fatigue

Shoulder pain is the discomfort or pain around or in the shoulder joint. Unlike other joints, the shoulder joint is the most movable joint of your body. There are a group of four different muscles and associated tendons, collectively known as the rotator cuff, which provides your shoulder with a wide range of mobility.

Damage due to trauma, inflammation, or changes in the bone structure around your rotator cuff can cause shoulder pain. You might experience this pain while lifting the arm above your head or moving your arm in forward and back motion.

Signs & Symptoms of Shoulder Pain

There are several causes of pain or discomfort in the shoulder area. Some of the most common symptoms include:

• Pain in the back and the front side of the shoulder, in the shoulder joint, and upper areas of the arm. Sometimes, this pain is more of a catching pain. The kind of pain and location depends on the structure which is causing it.
• Limited movement of the shoulder
• Dislocation of the shoulder or the sensation of the shoulder joint slipping out and back into the socket joint (depending on the condition)
• Weakness in the upper arm and shoulder
• Redness and warmth in the affected area
• Pins and needles sensation and sharp, burning pain
• A grinding, popping or clicking sensation during arm movement.

Symptoms may be due to more complicated, long-term conditions such as rheumatoid arthritis or osteoarthritis. If you have rheumatoid arthritis, swelling and pain in the shoulders are common occurrences.

Sometimes, shoulder pain is attributed to overuse of muscles or injury. Minor shoulder pain can develop into chronic pain if symptoms are left untreated for extended periods. The pain can increase in intensity, restricting regular shoulder movements.

Temporomandibular Joint Disorder (TMD) is a common condition that affects the temporomandibular joint (TMJ), which is the joint that connects the jawbone to the skull. This condition can cause a wide range of symptoms, including pain, stiffness, popping and clicking of the jaw, headaches, and even difficulty with opening and closing the mouth.

Causes and Symptoms of TMD

The exact cause of TMD is not well understood, however, it is known to be caused by a combination of factors including trauma to the jaw, stress, and certain medical conditions such as arthritis. Some of the most commonly cited causes include:

• Trauma: Trauma to the jaw, such as from a blow or injury, can cause damage to the temporomandibular joint and lead to TMD.
• Stress: Stress can cause the muscles around the jaw to tense up and lead to pain and discomfort.
• Arthritis: Osteoarthritis, rheumatoid arthritis, or other types of arthritis can affect the temporomandibular joint and lead to TMD.
• Bruxism: Bruxism is a condition in which a person grinds or clenches their teeth, which can put strain on the temporomandibular joint and lead to TMD.
• Malocclusion: Malocclusion is a condition in which the lower and upper teeth do not meet correctly when the jaw is closed, which can put extra stress on the temporomandibular joint and lead to TMD.
• Jaw joint hypermobility and dislocations: Hypermobility or dislocation of the jaw joint can cause pain and discomfort.

It’s important to note that TMD can have multiple causes, and it’s likely that a combination of factors contributes to the development of this condition.

Tennis and golf elbow, also known as epicondylitis, are two conditions that happens when the tendons in your elbow get overworked or overloaded by repetitive motions of your wrist and arm. The pain is usually felt where the forearm’s tendons attach to the bony bump on either side of the elbow, but it can also spread down the forearm and into wrist. This injury doesn’t just affect tennis players and golfers, however. The condition is caused by the repeated contraction of the forearm muscles used to straighten or raise your wrist and hand. Anyone who makes repetitive motions of the elbow and uses their wrists or clenches their fingers tightly can experience this pain.

Symptoms of Tennis and Golf Elbow

The pain and weakness associated with the conditions of tennis and golf elbow flow from either side of the elbow to the forearm and wrist. You don’t have to be an athlete to experience the pain of tennis and golf elbow.

Trigeminal Neuralgia is a condition that causes intense, electric shock-like sensations on one side of the face. It is caused by inflammation of the trigeminal nerve, which is a nerve that carries sensation from your face to the brain. During the initial stage of the condition, individuals usually experience mild and short attacks. However, trigeminal neuralgia can escalate and lead to more frequent and more prolonged bouts of acute pain. The condition typically affects women more than men and older adults more than younger individuals.

At Hoag Pain Management, our goal is to develop the most effective and personalized pain management plan to alleviate the symptoms associated with this condition.

Symptoms of Trigeminal Neuralgia

• Sudden, intense pain on one side of the face that feels like an electric shock
• Pain triggered by touching the face, speaking, brushing teeth, or chewing.
• Facial spasms
• Pain in the teeth, jaw, cheek, lips, gums, and sometimes eye and forehead.
• Attacks that may come and go for weeks, days, months, or even longer
• Pain attacks that hit only one side of the face that become frequent and more intense over time

Many of these symptoms can be indicative of other conditions so it is always best to consult a medical professional if you suspect you have Trigeminal Neuralgia.

Acupuncture and massage therapy are valuable, non-invasive options that can complement traditional pain management treatments. Acupuncture involves the precise placement of thin needles at specific points on the body to stimulate natural healing responses, improve circulation, and reduce inflammation—helping to alleviate chronic pain and muscle tension. Massage therapy works by relaxing tight muscles, improving blood flow, and promoting overall relaxation, which can reduce pain intensity and enhance mobility. Both therapies may also help decrease stress and improve sleep quality, which play essential roles in pain perception and recovery. At Hoag, these evidence-informed therapies are integrated into personalized care plans to support each patient’s path toward lasting relief and improved function.

Physical therapy forms the foundation of many pain management plans. Our skilled therapists use targeted exercises, stretching techniques, and movement education to help reduce pain, improve function, and prevent future injuries. Treatment may include:

• Therapeutic exercise programs
• Manual therapy techniques
• Heat and cold therapy
• Electrical stimulation
• Patient education on proper body mechanics

Our pain specialists carefully evaluate your condition to prescribe the most effective medications while minimizing side effects. We focus on evidence-based approaches that may include:

• Anti-inflammatory medications
• Muscle relaxants
• Neuropathic pain medications
• Topical pain relievers
• Carefully monitored prescription pain medications when appropriate

We believe in treating the whole person, not just the pain. Our comprehensive approach includes:

• Stress management techniques
• Sleep hygiene education
• Nutritional counseling
• Mind-body therapies
• Activity modification strategies