Severe Headaches: Migraines and How to Treat Them


Migraines are severe headaches that affect over 30 million Americans per year. Marked by nausea, vomiting and sensitivity to light and sound, migraines are debilitating and disruptive, sometimes with little or no relief for days at a time. Understanding their progression, potential triggers and effective treatments can greatly help those suffering to combat migraines and regain control of their lives.

Characteristics of Migraines

As far as severe headaches go, migraines are in a category of their own. Generally manifesting in childhood, what starts as a localized headache in one area of the head turns into throbbing, pulsating pain that causes nausea, vomiting, sensitivity to light and sound, mood swings, fatigue and even sinus pain and congestion. They are exhausting and debilitating and, for many who suffer, can last anywhere from two to four days.

Migraines follow a four-stage pattern:

  1. The first stage is known as the prodromal stage, and it starts one to two days before the migraine comes on. The individual may notice being thirstier than usual, craving specific foods, yawning more often than usual and going to the bathroom more. He or she may also become irritable and tired.
  2. In the second stage, the aura stage, the visual disturbances that accompany migraines begin to pop up. The individual may experience flickering of lights, areas where he or she appears to lose vision, and has difficulty focusing. He or she may also notice difficulty concentrating or speaking and may feel some numbness or tingling throughout the body.
  3. The third stage, the actual attack, is when the headache begins. Usually starting above the eyes and moving to one side of the head (although sometimes it can cover the entire head), the headache becomes more intense, often throbbing and pulsating. During this stage, nausea, vomiting, lightheadedness and worsening of symptoms during physical activity may also occur.
  4. The last stage is the postdrome stage, the period after the headache when the individual is exhausted, fatigued, lacking in energy and sluggish.

Migraine Headache Relief

Being aware of migraine triggers may go a long way in helping patients prevent migraine attacks. Some common triggers for these severe headaches include:

  • Specific types of foods, especially those containing MSG, caffeine, nitrates or alcohol
  • Missing meals
  • Stress
  • Environmental factors
  • Lack of or too much sleep

Migraine headaches are treated in several ways, depending on history of migraines, severity of symptoms and efficacy of previous treatment. Medication is one of the go-to primary treatments for migraines –from over-the-counter migraine formulas of acetaminophen, aspirin and caffeine, to prescription medications that work to constrict blood vessels and block pain pathways in the brain. In some cases, anti-depressants, opioids and even beta blockers are used to treat migraine headaches. There are also alternative treatment therapies that have proven effective in easing migraine symptoms. These include acupuncture, massage therapy and biofeedback.

If you are suffering from migraines or persistent headaches, contact MISI today at 877-504-9759 to schedule a consultation with one of our migraine specialists.

Pain Relief Mysteries: Does Weather Really Affect Pain?


Can bad weather make pain relief impossible? You may have come across someone who declared his sinus headache or joint pain was an indicator bad weather was imminent. According to many doctors, when the weather takes a turn for the worse, or rain is on the horizon, patients are able to predict the changes with relative accuracy.

Theories about Weather

While research has been conducted, the current results are too mixed to definitively prove or disprove these claims.

One theory correlates barometric air pressure to chronic pain. Barometric air pressure is how “heavy” or “thick” the air feels. When the pressure is high, it presses against our bodies and prevents joints and tissue from expanding. When the pressure drops, which happens before a storm or wet weather conditions, the lack of pressure on our joints and tissues allows them to become inflamed more easily.

Another theory asserts that nerves become more sensitive due to injury, swelling, scarring or adhesions. As a result, it may appear that changes in weather, or cold weather have a negative effect on chronic pain.

The Truth about Chronic Pain

Whatever the real reasons, sometimes patients erroneously believe that moving to warmer climates may provide them with some chronic pain relief. While a warmer climate may be helpful, the root cause of their chronic pain won’t go away. It’s important for patients to learn how to manage their chronic pain effectively, regardless of weather.

Following a pain management plan that works for the patient is an important part of pain relief. Remaining active is another crucial piece of chronic pain relief. Being mindful of their emotional or mental state and tackling issues of depression or anxiety, in time can be extremely helpful in maintaining a good frame of mind so pain can be properly managed. These are just some of the many steps you can take for pain relief, regardless of the weather changes!

Chronic Pain Relief: The Psychological Effects of Pain


More than 100 million adults in the U.S. suffer from chronic pain. Chronic pain often not only affects the body but also the mind and emotions of a patient as well. These emotions have a big impact on how a patient finds chronic pain relief.

An individual who battles physical pain every day has many mental and emotional obstacles to overcome.  For instance, people who suffer from chronic pain are more likely to suffer from depression. The frustration, anger, hopelessness, anxiety and sadness that accompany chronic pain can be too much for someone to handle, leaving them drained of energy and feeling defeated. Long-term pain can put stress on the brain and cause cognitive issues such as low mood, exhaustion, and concentration and memory difficulties, no matter what the underlying pain condition is.

Chronic pain and its psychological effects have the ability to reduce a patient’s quality of life. In some cases, the psychological effects of pain can outlive the physical pain itself and become the major health disorder. For instance, under-managed chronic pain may lead to:

  • Increased stress
  • Depressed mood
  • Insomnia and exhaustion
  • Decreased memory and concentration

A chronic pain management program should contain aspects that encourage a sound mental and emotional wellness component. Over time, cognitive strategies and lifestyle changes can improve the psychological effects of chronic pain. There are no easy solutions, but here are some simple treatment options that can help provide pain relief:

  • Meditation and relaxation techniques can reduce muscle tension caused by pain.
  • Regular physical activity, including strengthening and flexibility exercises, can improve pain threshold.
  • Healthy eating can reduce painful symptoms such as inflammation. Research suggest that certain foods help reduce pain more than others.
  • Staying socially active and keeping positive people around you can improve mental stability and decrease likeliness of depression and low mood.

These activities can improve psychological health, reduce stress, improve sleep and increase confidence, happiness and self-esteem. Pain relief isn’t just about treating physical ailments. In order to truly understand and alleviate the burden of chronic pain, the mind needs to be treated as well.

Back Pain Relief: How Does Weight Affect Pain?


Studies have shown that over one-third of obese Americans suffer from musculoskeletal joint and back pain. While there are many possible reasons for this, experts agree that there is a direct correlation between excess weight and how a person is affected by pain. For many who carry extra weight, back pain relief may be more difficult to achieve.

Excess Weight and Pain Relief

There are many red flags connecting excess weight to issues with pain and pain management.

  • Excess weight, particularly in the midsection of the body, shifts a body’s center of gravity forward and leads to poor posture, creating strain on the back muscles.
  • Overweight patients are also at a greater risk of suffering from conditions such as sciatica, herniated discs and pinched nerves.
  • Damage to the spine, particularly to the discs and vertebrae, can result from carrying extra weight.
  • The strain on the joints from excess weight can lead to a greater risk of osteoarthritis.

Lack of exercise and a sedentary lifestyle leads to weight gain, which can make pre-existing pain much worse. Studies show that overweight individuals have a greater risk of complications from back surgery.

Weight Loss for Back Pain Relief

A healthy weight loss regimen is a good place to start when seeking upper or lower back pain relief in overweight individuals. A doctor-supervised weight loss program that includes a well-balanced diet is advisable for patients wanting to achieve weight loss. In overweight patients, losing 10% of their weight can make a difference in relieving pressure from the joints, spine and lower back.

Many people suffering from chronic back pain are under the impression they will be less likely to hurt their back if they limit the amount of activity or exercise they participate in. However, regular activity helps with lower and upper back pain relief as well as other types of chronic pain. Physical activity activates the exchange of nutrients between spinal discs, keeping the spine healthy.

Low-impact activities such as walking or water aerobics are highly effective ways to get started on an exercise regimen. They help to burn calories, aid in weight loss and remain gentle on the joints, spine and lower back. For more information about back pain relief treatment options, visit the Minimally Invasive Spine Relief website.

Do Hip and Leg Pain Increase With Age?


The process of aging brings about aches and pains people may not expect. Whether caused by wear and tear on the joints or conditions related to aging, hip and leg pain are common occurrences for those experiencing the pains of getting older.

Many factors increase the chances of leg and hip pain as a person gets older.

  • Joint and bone conditions. In addition to those who are overweight, the elderly are at a higher risk of developing debilitating conditions such as arthritis and osteoarthritis, which cause inflammation of the joints and weakening of tissue. Osteoarthritis is one of the main causes of a hip injury. Another common condition that emerges with age and causes intense pain in a number of areas including knees and hips, is bursitis. This condition is a direct result of the fluid sacs in the joints becoming inflamed.
  • Degeneration of tissue. With aging comes a decrease in joint cartilage, which can also result in leg and hip pain.
  • Decreased bone density. As men and women age, they tend to lose bone and muscle density due to hormonal changes of menopause or conditions such as osteoporosis. These changes in bone density can result in increased hip and leg pain, ultimately changing posture and causing other complications.
  • Spinal herniation. As aging occurs and spinal discs begin to degenerate, they can often herniate. This may cause pain in the lower back, but it may also affect the sciatic nerve, resulting in pain that radiates into the hip and leg area.
  • Injury from falls or accidents. Weakened bones and joints and changes in the spine can affect the way an older person walks or stands. Hip and leg injuries are not uncommon as a person ages, and those injuries can cause chronic pain.

Pain relief from leg and hip pain can be achieved with the right course of treatment. Following a comprehensive clinical assessment that includes imaging and a physical examination, a treatment plan can be determined according to type, severity and cause of the pain. In most cases, pain relief can be achieved with non-surgical treatment methods, including medication, physical therapy and rest.

As aging occurs, it is important to take a special interest in one’s spinal health. This means being mindful of lifting techniques and listening to the body when there is pain or discomfort. Try these leg and hip stretches at home to help alleviate back pain, and to learn more about pain conditions and treatments, visit the MISI pain relief website.

Can Acupuncture Offer Pain Relief?


Acupuncture has long been recognized as one of the mainstays of alternative medicine, offering patients pain relief through a more holistic method. A practice in traditional Chinese medicine, this technique is said to help balance the flow of energy in the body.

How does Acupuncture Work?

Acupuncture practitioners believe that a disruption to the flow of energy in the body can cause many ailments, including chronic pain. In order to cure these ailments, it is essential to balance the flow of energy. In acupuncture, very thin needles are placed strategically through the skin and into various “energy flow” points in the body, redirecting the flow of energy and re-balancing the body. Western practitioners believe that acupuncture triggers a boost in the body’s natural pain killers, increasing blood flow and stimulating pain relief.

How is Acupuncture Used for Chronic Pain Relief?

Studies show that primarily, acupuncture helps with post-operative and chemotherapy-related nausea and vomiting, as well as post-operative dental pain. However, used in conjunction with other treatments or as an alternative therapeutic treatment, acupuncture has shown promise in providing pain relief for many acute and chronic conditions. This includes conditions such as fibromyalgia, headaches, lower back pain, osteoarthritis, carpal tunnel syndrome, myofascial pain, tennis elbow, neck pain and even labor pain.

While studies are still in progress to determine the biological and physiological connections that make acupuncture a potential alternative method for chronic pain relief– there is no doubt that acupuncture can be an effective part of pain relief and management.

Acupuncture Side Effects

It’s important to note that side effects associated with acupuncture are generally due to poor acupuncturist training or poor hygiene. Minor risk associated with acupuncture can include soreness, light bleeding and bruising around the needle placement locations. However, more severe side effects can include organ injury, if the needles are inserted too deeply, or infections. That is why it’s vital to find your state’s certified training requirements and license regulations. While most states regulate acupuncture and require practitioners to undergo certified training to be licensed, some states do not have regulations in place.

Ice or Heat for Back Pain Relief ?


If you’re one of many back pain sufferers, you’re probably familiar with the use of ice or heat for back pain relief. Two very common non-pharmaceutical treatments, heat and ice therapies have their own benefits. It’s important to figure out which is the right form of therapy for your condition.

Ice: Shocking the Muscles into Relief

Ice therapy is a common and effective method for reducing swelling and inflammation caused by lower back injuries, muscle sprains and conditions such as arthritis.

How does cold therapy help? The shock of the cold applied to the injured area causes the veins to contract, giving the muscles room to flex and become less inflamed. Combining ice therapy with heat is a great way to help the area recover faster. Doctors generally recommend ice therapy in three 10-15 minute increments a day for the first few days following an injury.

Heat: Blood and Oxygen Flow

Heat therapy can be a more effective method of lower back pain relief for those suffering from chronic lower back pain and back injuries. When applied, heat relaxes the veins, which has several effects on the injured area:

  1. It improves blood flow so nutrients and oxygen, necessary for the healing of tissue, can get to the injured area faster.
  2. The heat relaxes and soothes the muscles, reducing pain.
  3. The increased flow of oxygen and blood helps the body to eliminate cellular waste so the injured area can heal faster.

Heat is often used in combination with ice therapy for injuries to the lower back. However, it’s also an effective solo treatment for chronic back pain. Moist heat — showers, baths or moist warm towels — often works best for back pain relief, but heating pads and all-day heat packs can help alleviate pain throughout the day. Typical treatment lasts 15-20 minutes.

Long-lasting Pain Relief

Heat and cold therapies can be great for relieving back pain for minor injuries, but if the pain persists, you may need a more effective way to get the upper or lower back pain relief you need. If you’re experiencing chronic pain from arthritis, a degenerative disc or another back condition, talk to your doctor to find the right pain management plan for you.

Minimally Invasive Spine Surgery | What Does ACGME Fellowship-Trained Mean?

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When severe pain and chronic back problems force you to seek spine surgery, it can be easy to overlook aspects of your surgeon’s training and experience for quick relief. While we know it can be tempting to find any doctor experienced in minimally invasive spine surgery to entrust your back problems to, the truth is something as serious as spine surgery requires someone with the training and expertise to treat those issues safely and effectively. An ACGME (Accreditation Council for Graduate Medical Education) fellowship-trained spine surgeon is the ideal professional to treat your symptoms.


Why does ACGME fellowship training matter?

Some doctors choose to pursue fellowship training past their residency in order to become more specialized in their area of choice. While it means an additional year of school, that year prepares dedicated surgeons for the challenges of performing potentially life-altering procedures.

As a patient, you may not know that, while any qualified doctor can attempt to treat back pain, a spine surgeon with ACGME fellowship training has the knowledge necessary to not only locate the source of pain, but to treat it with greater accuracy and effectiveness. In fact, once fellowship training is over, in order to ensure their expertise in their chosen specialty, additional board exams are required.

ACGME fellowship-trained doctors are more informed about the latest technology and treatment options for your specific needs. A general practitioner may be able to give you a treatment plan for your pain or injury, but may not know enough about the specific area to identify newer and more effective treatments to implement.


What should you look for in fellowship-trained back doctors?

  • Find a doctor who is board eligible or board certified with ACGME fellowship training in spine surgery.
  • Find a doctor you are comfortable with. It doesn’t matter how highly recommended they are, if you do not feel comfortable with a doctor, it will not work. Being uncomfortable may prevent you from asking important questions regarding your condition and treatment.
  • Find a specialist with access to the latest technology and treatments available for your condition. Whether you suffer from chronic back pain or herniated discs, it’s important to err on the side of caution and find someone with access to all of the best possible equipment, medication and surgical treatments in the industry. That will give you the greatest chance for a fast recovery.
  • Look for a doctor working in a specialty practice. Chances are, if your doctor is fellowship trained in the spinal column and working in a practice specializing in that area, they treat patients with spinal problems exclusively. This means they will have a greater understanding of specific problem areas that you may need help with.


MISI specialists: Your minimally invasive spine surgery awaits

Every spine surgeon at MISI is fellowship-trained with specialties in orthopedic and spine care. They have been handpicked by MISI’s director, whose priority is to give patients access to the most highly qualified, highly educated and highly experienced medical professionals in their field. When you go to MISI in search of an ACGME fellowship-trained spine surgeon, you can rest easy knowing that you will receive only the best and most experienced in minimally invasive spine surgery.

A surgeon with the right level of expertise should treat your debilitating pain. Call MISI today at (855) 339-4481 to set up your appointment with an ACGME fellowship-trained specialist and get yourself on the road to recovery.

Dr. Michael Rimlawi, Dr. Bryce Benbow and Dr. Mike Shah Give Thanks


From left to right: Dr. Bryce Benbow, Dr. Mike Shah and Dr. Michael Rimlawi

Throughout the year, the MISI physicians and staff, are hard at work ensuring their patients can spend their lives free from pain and discomfort.  This time of year, we’ve asked three of our physicians to reflect on what they’re most thankful for.

For Dr. Michael Rimlawi, his home and work families are at the top of the list. “I am lucky enough to have a loving family and an amazing staff,” says Dr. Rimlawi. “I am also grateful to hear from my patients after surgery that they are able to do things they thought they would never be able to do again, like pick up their children, go for a walk or return to playing golf without pain. It’s statements like this that make our efforts worthwhile.”

Dr. Bryce Benbow echoes Dr. Rimlawi’s sentiments when he thinks about what he is appreciative of. “I am thankful for my wonderful wife and children and the fortune of having a career that allows me to help others, while improving their quality of life.”

It is safe to say, at MISI, the holidays are all about family.  So when Dr. Mike Shah thinks of what he’s thankful for, his response should come as no surprise – “Family is so important this time of year, in particular. Without their support and the dedication of my staff, I wouldn’t be able to treat as many patients as I do each week.”

The opportunity to help patients find relief is something that makes Dr. Shah’s work meaningful. “The importance of treating patients with pain brings on true personal accomplishment, “ he continues,  “knowing that patients leave from our care feeling relief and ready and able to return to their lives.”

Looking back at 2014, we at MISI have a lot to be thankful for: all our wonderful doctors, our caring staff and most importantly our phenomenal patients.  We give many thanks for you and to you.

Minimally Invasive Spine Surgery and More | How MISI Treats Football Injuries

minimally-invasive-spine-surgeryDuring football season, you’ll often hear the same thing from your fantasy football-loving friends: “I can’t believe my player is injured!” As the season for this punishing sport rolls on, so does the potential for damage, at every level of play.  We often see patients with injuries similar to those that take your favorite quarterbacks and wide receivers out of the game, some of which we treat with innovative pain management procedures and if needed, minimally invasive spine surgeries, including:

  • Herniated Discs: You may remember Tony Romo suffering a herniated disc toward the end of the 2013 season. This type of injury can create serious pain and numbness in the lower back and legs. While the traditional surgical method requires stripping away back muscles and exposing the spine, we perform minimally invasive spine surgery, which is much less traumatic and avoids damaging muscles and surrounding tissues. Instead, the procedure often involves the use of real time X-rays and the insertion of a small tube system through a 3-7mm incision. Through minimally invasive spine surgery, patients can recover faster and get back to living.
  • Finger Fractures: Dez Bryant delayed treatment for his pinkie fracture for three games in the 2012-2013 season. Putting off finger fracture treatment is something you should never do. A fractured finger may seem like a small thing, but in reality it can be a complex injury. There are many bones in the hand that work together to perform specialized tasks, so an injury to one of them can cause the entire hand to be misaligned. Usually, fractured fingers can be repaired non-surgically using a splint, but in particularly bad cases surgery is required to promote and allow for proper healing.
  • Torn Meniscus: This is one of the most common sports injuries. When he landed awkwardly after a jump during this season opener, Jadeveon Clowney tore a meniscus, taking him out for four to six weeks. When one is torn, a person can experience pain, stiffness, swelling and the knee “giving way.” Similar to our minimally invasive spine surgery, we treat torn menisci using minimally invasive knee arthroscopy by inserting a tiny camera through a small incision to provide a clear view inside of the knee. Once inside, the surgeon repairs or trims the tears using state-of-the-art instruments and techniques.
  • Whiplash: This happens when an impact or blow causes the head to jerk forward or backward abruptly. Jay Cutler was forced to take some time out when he suffered this injury in 2012. A person suffering from whiplash has pain and stiffness in the neck and often in the muscles of the head, chest, shoulders and arms. For whiplash pain, we use real-time X-rays to map out pain trigger points, letting the doctors know exactly where to apply medicine.

Football players can benefit from minimally invasive surgery, but so can the rest of us! MISI is the most advanced option for treating spine, hand, foot and general pain. Call the Minimally Invasive Surgical Institute today at 855-466-6741 or visit our website to set up an appointment.