By Alexander Germanis
For as many years as mankind has been climbing mountains and exploring frozen wastes, it has developed ways to probe ahead in order to avoid thin ice and crevasses hidden beneath blankets of snow. Using the proper tools, like a walking stick or ice axe, has proven to be far more effective and safer than walking blindly ahead.
Using the proper tools to probe forward is done frequently for medical purposes as well. When a patient is experiencing pain of which they are unsure of the cause, finding that source of pain quickly and correctly means less suffering than if a doctor takes “shots in the dark,” so to speak.
Founder of Millennium Pain Center in Bloomington, Dr. Ramsin Benyamin has explained, in earlier parts of this series, the best things a doctor can do in order to diagnose a patient. Although listening to a patient and being thoroughly familiar with the patient’s history — medical and otherwise — is the first step toward making a proper diagnosis, Dr. Benyamin also feels many physicians tend to underutilize their own expertise in making diagnoses due to the convenience of modern medical scanning technology.
These tools, like magnetic resonance imaging (MRI), computerized tomography (CT), ultrasound, and fluoroscopy (live X-ray) should be used, not as a crutch for the doctor, but as instruments of confirmation and further investigation into the sources of a patient’s pain.
In Dr. Benyamin’s work, the use of the aforementioned imaging equipment does serve a purpose. “We are able to look at the smallest structures in the spine,” he explains, “and we are able to perform diagnostic procedures on each structure. That’s how we can help find the main source of the pain or ailment.”
Diagnostic work is common when doctors need to confirm their diagnoses. “If you have chest pains,” Dr. Benyamin continues, “the first thing they need to figure out is if it’s from your heart or your gastro-intestinal system; they do all sorts of diagnostic work. They’re making sure the more serious thing is not the problem.”
For this diagnostic work, a stress test is usually the preferred methodology. “A stress test is meant to stress your heart by increasing the heart rate,” the doctor elucidates, “by either running on a treadmill or injecting [dobutamine or adenosine] to increase your heart rate. They then observe you to see whether the chest pain reappears or not.”
Doctors like those at Millennium Pain Center put that same concept into practice for conditions like back pain. “We have a procedure called provocation discography,” Dr. Benyamin says. “We do it to confirm whether a disc is the source of pain or not. This is based on the same concept used in a cardiology stress test. We do a stress test on the disc by increasing the pressure in it.”
Pressure is increased by injecting a dye and then monitored with a manometer. “If the patient experiences back pain, we then do a CAT scan to see where the crack in the disc is. That’s just one example of how we confirm a diagnosis.”
New technology is not only utilized by the physician during the diagnosis and subsequent check-ups, but it can be employed by the patient while at the doctor’s office as well. While reviewing any pictures taken by CT or the MRI, Dr. Benyamin suggests the technology a patient brings in with them can be equally helpful. “When we review those pictures, I tell the patient to take a picture of [the scans] with their smartphone, so they have it for themselves.” Not only does this simple action give the patient an opportunity to look over the results later on, it goes a long way in aiding patients in understanding their condition better. “It’s a very good, powerful approach,” he adds.
“The most important thing,” Dr. Benyamin concludes, “is to first find the source of the pain and then pursue treatment. It’s as true with back pain as it is with chest pains or even headaches.”
Dr. Benyamin explains how the simple steps of diagnoses can be used to discover the real causes of migraine headaches in next month’s Healthy Cells Magazine.
If you missed the previous articles on proper diagnoses, you may read them online at www.HealthyCellsBN.com, or contact Cheryl at 309-664-2524.
For more information or to schedule an appointment, visit “Millennium Pain Center online at www.millenniumpaincenter.com, or call 309-662-4321. The office is located at 1015 S. Mercer Ave. in Bloomington. The practice provides the most advanced and comprehensive pain management for a wide variety of conditions, including a new treatment for knee osteoarthritis. Drs. Benyamin and Vallejo have been selected among 70 of the Best Pain Physicians in America.
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