Introducing Dorota Zolotenko, RN. Our new Cosmetic Injector!
- At April 18, 2018
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Dorota is a Registered Nurse with an honours graduate degree from Centennial College. Since her graduation, she practiced 7 years in long term care and occupational health, but her passion in cosmetic nursing never ceased. In 2007, she finally began to pursue her dream and began training for Botox and filler injections. She successfully honed her skills in different clinical settings and is now excited to join our team here at Wilderman Medical Cosmetic Clinic! Her friendly and kind demeanor cannot be missed.
We look forward to our journey together Dorota!!
Cingal®
- At January 15, 2018
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What is Cingal®?
Cingal® is a new medication being introduced to the Wilderman Medical Clinic. It has been proven to provide short and long term relief of pain associated with osteoarthritis (OA).
Why is Cingal® so effective?
The medication has two parts: Hyaluronic acid (HA) and a fast acting steroid, triamcinolone hexacetonide. Hyaluronic acid provides long lasting pain relief, while the steroid gives fast and short-term relief of pain.
What is Hyaluronic Acid?
Hyaluronic Acid (HA) is an organic molecule that makes up a large portion of the synovial fluid. Synovial fluid acts as a lubricant between two joints, reducing the friction between articular cartilages. Thus, injection of HA can provide lubrication and mechanical support of joints by bulking up the synovial fluid.
Why choose Cingal®?
The medication was developed by Anika Therapeutics, a company that already has a strong line of products that treats pain associated with OA. The hyaluronic acid used is a cross-linked formulation, unique to Anika Therapeutics. It is even sold separately by the company and has been proven to provide relief from symptoms of OA for 6 months. It is a highly concentrated, non-animal based HA. Combined with an FDA-approved steroid for treating inflammation, the unique Cingal® formulation can provide rapid and long term pain relief.
The procedure is done in a single-injection. It has shown to be effective in initial injection and repeat injections. Therefore, if you have found other methods of treating OA pain ineffective or unsatisfactory, Cingal® can be a great option to add to become an effective part of your treatment plan.
Cognitive Behavioral Therapy (CBT) as a Potential Treatment for Managing Chronic Pain
- At December 11, 2017
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As the popularity of mindfulness practices increases among the general public, it is not unusual for scientists and health professionals to begin to consider the potential benefits of various psychotherapeutic approaches in managing health conditions. Some have put forward the idea that Cognitive Behavioral Therapy (CBT), one of the more popular psychotherapeutic approaches, can be used as a way to manage chronic pain.
At its most essential, CBT is a family of skills-based training exercises. It is largely founded on the premise that an individual, not their external conditions, create their own experiences. This understanding lends itself to the idea that pain is perceptual, rather than being a sensory phenomenon. As a perceptual phenomenon, pain takes into account the varied responses different individuals have to similar kinds of pain. As a sensory phenomenon, the pain would largely be described as a response to tissue damage. Under this perceptual phenomenon framework, additional factors such as cognitive, social and attentional are used to describe pain which then expands the pool of potential treatment options.
While CBT as a form of chronic pain management seems to provide some benefits, there is still much research to be done on measuring its efficacy. However, numerous studies, including a Cochrane review, have concluded that when compared with treatment-as-usual or wait-list control conditions, CBT had a statistically significant albeit small effect on pain and disability and it proved to be superior to other psychological treatments for chronic pain.
Future research should focus on what specific aspects of CBT work and for which kinds of patients the treatment works on.
Please visit cbt.drwilderman.com for more information.
Written by Eleanor Ndaiga
References:
Hofman S G et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses. Cognit Ther Res [Internet]. 2012 Oct [cited 2017 Nov 17]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/
Williams A C de C, Eccleston C, Morley S. Psychological Therapy for Adults with Longstanding Distressing Pain and Disability. Cochrane Database Syst Rev [Internet]. 2012 Nov [cited 2017 Nov 17]. Available from: http://www.cochrane.org/CD007407/SYMPT_psychological-therapy-adults-longstanding-distressing-pain-and-disability
Ehde D M, Dillworth T M, Turner J A. Cognitive-Behavioral Therapy for Individuals with Chronic Pain. Am Psychol [Internet]. 2014 Feb-Mar [cited 2017 Nov 23]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24547801
Songer D. Psychiatry [Internet]. 2005 May [cited Nov 24]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000182/
Managing Lower Back Pain: 3 Types of Pain Management
- At August 04, 2017
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Lower back pain is one of the most common symptoms that patients are diagnosed with. Over 80% of the population will experience lower back pain at least once in their lifetime. The most common culprits are: muscle strains, injuries, or overuse. Back pain could also be a symptom of more serious conditions such as a herniated disc, osteoarthritis, spinal stenosis, etc. Pain management is usually assigned to patients with chronic back pain, which is defined as a pain that lasts for over three months, and/or pain that is caused by tissue unable to be healed.
Back pain management could be a very effective alternative to surgery. But in order to reach full potential, it requires the patient to be determined, committed, as well as knowledgeable about their situation. There are three types of pain management that are used to treat lower back pain: non-invasive non-drug pain managements, non-invasive pharmacologic pain managements and invasive pain management.
Non-invasive non-drug pain management techniques include exercises, manual techniques, behavioural modification, superficial heating/cooling of skin, and electrotherapy.
- While exercises to treat back pain may seem counterintuitive, they are instead very beneficial. Although strenuous activity should cease as soon as a patient experiences back pain, this should only be a temporary action. Over time, resting after experiencing lower back pain can impede healing. Therefore, after a certain amount of time, active back exercises are essential for mending the spine and lower back region.
- Manual techniques such as manual physical therapy differ from conventional treatment methods due to the treatment’s use of hands as opposed to devices or machinery. In this specific therapy, practitioners use their hands to put pressure on muscle tissue and manipulate joints, in an attempt to decrease back pain caused by muscle spasm, muscle tension, and joint dysfunction (Robert Daul). More information on these techniques can be read in the article, “Pain Relief through Manual Physical Therapy and its Various Techniques”.
- Behavioural methods such as cognitive therapy aim to ease patients’ pain by relaxation techniques, coping techniques as well as many other methods. It involves learning to control muscle tension, blood pressure and heart rate for symptomatic improvement.
- Superficial heating/cooling of skin involve the use of cold packs, hot packs, ultrasound, and diathermy (the use of high-frequency electromagnetic currents to produce heat and apply it to affected lesions). This kind of therapy should be used along with exercises.
- The most widely used type of applied electrotherapy used is transcutaneous electrical nerve stimulation (TENS). TENS therapy reduces back pain by stimulating the sensory nervous system via electrodes with low voltage currents in the affected area. A patient can select the amount of frequency current, as well as several different stimulation patterns from a variety of options provided by a hand held controller. The effectiveness of this therapy is varied for each individual; to some, the results were beneficial and positive and to others, the results were neutral and provided no effect.
Non-invasive pharmacologic pain managements use pain relievers and other related drugs to alleviate chronic back pain. They may be used during any stage of back treatment, starting from initial diagnosis and continuing on during rehabilitation or in cases of a failed back surgery. These pain managements include a variety of common treatments such as:
- Analgesics, pain relieving medication, which can include acetaminophen.
- Nonsteroidal anti-inflammatory agents (NSAIDs) including aspirin, ibuprofen, naproxen, and COX-2 inhibitors.
- Muscle relaxants, which are used to treat muscle spasms as a result of back pain.
- Narcotic medications, which serve as an anaesthetic and are not used for chronic conditions but more so for acute or post-operative pain.
- Neuromodulating medications, which are used to treat neuropathic and muscular pain.
- Antidepressants and anticonvulsants, which are also applied to treat neuropathic pain.
Note: extended or long-term use of most medications mentioned above may increase health risks.
Invasive pain managements include injections and/or insertion of devices into the body. There are various different invasive therapies used to treat back pain, some of which are:
- Injections are often temporary pain relief methods resulting from a direct administration of steroids or anaesthetics into joints, ligaments, muscles or around nerves. This method’s results could also be used to identify or confirm a diagnosis of a suspected region of pain.
- Prolotherapy involves injecting an irritant solution in order to cause an inflammatory response. This event stimulates blood circulation and ligament restoration, thus encouraging natural healing to occur.
- Radiofrequency radio ablation essentially involves administering heat to specific nerves in attempt to disrupt pain signalling to the brain, therefore eliminating or greatly diminishing the pain.
- Surgically implanted electrotherapy devices include implantable spinal cord stimulators (SCS) and peripheral nerve stimulators. This method is generally used when a patient’s back pain was not relieved via These SCS implants send mild electrical currents along the spinal cord in order to disrupt signalling to the brain, thus minimizing the feeling of pain.
- Implantable opioid infusion pumps are responsible for transporting opioid substances (or narcotics) directly to the spinal cord and therefore relieving the pain.
Written By: Natalia Pan
References
Daul, R. (2006, January 13). Manual Physical Therapy for Pain Relief. Retrieved June 28, 2017, from https://www.spine-health.com/treatment/physical-therapy/manual-physical-therapy-pain-relief
Revord, J. P. (2012, October 12). Invasive Pain Management Techniques. Retrieved June 28, 2017, from https://www.spine-health.com/treatment/pain-management/invasive-pain-management-techniques
Revord, J. P. (2012, October 12). Noninvasive Pain Management Techniques. Retrieved June 28, 2017, from https://www.spine-health.com/treatment/pain-management/noninvasive-pain-management-techniques
Revord, J. P. (2017, April 21). Transcutaneous Electrical Nerve Stimulators (TENS). Retrieved June 28, 2017, from https://www.spine-health.com/treatment/pain-management/transcutaneous-electrical-nerve-stimulators-tens
Ullrich, P. F. (2009, June 15). Exercise and Back Pain. Retrieved June 28, 2017, from https://www.spine-health.com/wellness/exercise/exercise-and-back-pain
Introducing Synolis VA
- At July 28, 2017
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Introducing Synolis VA – a smart injectable hyaluronic acid gel that acts just like healthy joint fluid and is proven to provide significant pain relief in the first week of the treatment!
SYNOLIS VA ACTS LIKE HEALTHY JOINT FLUID
Osteoarthritis is caused by a breakdown of cartilage, a rubbery substance that covers the ends of each bone within a joint. This breakdown is due to the alteration of the synovial fluid that cannot perform its function: limitation of friction between the bones and shock absorption to protect the cartilage.
Synolis VA is a smart hyaluronic acid gel that is injected into the joint and acts like a healthy synovial fluid.
SYNOLIS VA PROVIDES FAST, INTENSE PAIN RELIEF SO YOU CAN FEEL BETTER
Sorbitol, a natural and powerful anti-oxidant maintains Synolis VA’s effects over time. The result? Not only 7 out of 10 patients reporting feeling a benefit as early as the first week of the treatment with Synolis VA, but pain relief is observed at least 6 months.
Treatment consists of a single session injection of Synolis VA into the joint affected by osteoarthritis.
BRING BACK YOUR MOBILITY
Improvement of the joint function and fast reduction of pain are crucial to restore your mobility.
With Synolis VA, these effects are perceived the days following the treatment.
ENJOYING YOUR LIFE AGAIN
After a treatment of Synolis VA, your quality of life is improved allowing you to focus on what really matters.