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Pain Medicine

If you suffer from chronic pain, you know how much it drains your energy, undermines your confidence, and robs you of participating fully in your life. Mountain Medical Injury and Pain Professionals (MMI) specializes in pain medicine as well as managing and reducing chronic pain safely and effectively with the most advanced treatment options. We care about your overall well-being and take a multidisciplinary approach to restoring your quality of life.

We will help you choose the specialists and treatments that you believe in to manage your pain effectively. We will work with you to formulate your ideal pain management plan. Together with your physician, you will choose from traditional treatments like medication and surgery as well as alternative treatments like biofeedback, acupuncture, or medical marijuana.

Some of the Services Provided:

Medications

MMI can provide you with non-surgical options to help relieve pain. MMI Providers stay up to date on the latest medications to help you decrease your pain without sacrificing your function. MMI will help you safely use medication to manage your chronic or acute pain.

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Physical Therapy

At Mountain Medical Injury and Pain Professionals physicians empower patients to reach their best physical condition. The foundation of pain management depends on stabilizing the muscles, bones, and connective tissue in healthy anatomic position and then maximizing muscle tone to decompress joints, nerves, vessels and organs.

Each MMI facility has an excellent Physical Therapy staff in the clinic or nearby to address physical therapy issues. Physical Therapists can help you recuperate from injury or surgery or help you to maximize your well being through physical fitness. Your provider may suggest physical therapy or personal training.

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Psychotherapy

Mental health is an important component of physical well-being. MMI will help you explore psychotherapeutic options and choose the appropriate therapist and type of treatment.   At MMI, we work with some of Colorado’s best therapists who specialize in many areas including neuropsychology, cognitive behavioral therapy, EMDR, and biofeedback.

Visit the website of Mountain Medical Care for more information

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Bursa Injections

Bursa injections help relieve pain associated with inflammation in the bursa. The bursa is a fluid filled sac that functions as a gliding surface to reduce friction between bones, tendons, or muscles around a joint. Bursae are filled with synovial fluid and are located in the major joints of the body.

Bursitis is inflammation in one or more bursae.   When a bursa is inflamed it no longer facilitates smooth and frictionless functional gliding between body tissues and normal movement becomes painful.   Bursitis occurs often in the shoulders, elbows, hips and knees due to overuse or traumatic injury.

A bursa injection is a direct way to decrease pain associated with bursitis. During a bursa injection your provider will administer local anesthetic and anti inflammatory medications into the bursa. The bursa injection can provide immediate relief from pain associated with bursitis.

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Joint Injections

Joint injections can relieve pain from acute injury or chronic overuse.   Normally the joint is first aspirated to determine if fluid in the joint is due only to inflammation or also to infection. If no infection is found, anesthetic and corticosteroids can be injected to stop pain and inflammation. Joint Injections allow muscle spasms to relax and swelling to subside so that the joint can return to normal anatomic position where healing can occur most quickly. Physical therapy can help to stabilize the joint for long term benefits. When pain is reduced or eliminated through the use of these injections, your doctor at MMI confirms the source of your pain and can better target your treatment.

You may receive one of the following joint injections as an out-patient procedure:

Shoulder Joint Injections: glenohumeral, subacromial, RA, or AC joints

Knee Injections: with anesthetic and corticosteroid or hyaluronic acid

Joints of Hands and Wrists: Carpometacarpal Joint Injections

Joints of Feet and Ankles: Tarsalmetatarsal Joint Injections

Sacroiliac Joint Injections

Facet Injections: the joints on either side of each vertebra in your cervical, thoracic, and lumbar spine.

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Nerve Blocks

Sometimes due to traumatic injury or repetitive activities, a group of nerves, called a plexus or ganglion, can become irritated and cause pain in a specific area of the body. Nerve blocks can be used to stop nerve pain or to diagnose the source of pain. A nerve block is any planned disruption of the signals traveling along a nerve. Nerve blocks can be therapeutic or diagnostic. A nerve block is an anesthetic and/or anti-inflammatory injection in a certain nerve or group of nerves to treat pain. Guidance from ultra sound or fluoroscopy may be used to place the needle in exactly the right location.

Therapeutic nerve blocks can control acute or chronic pain. These blocks can be single treatments, multiple injections or continuous infusions to stop pain for a short time during a surgery or for a longer period to allow other treatments like physical therapy to help the injury heal. Diagnostic nerve blocks define the cause of pain and predict the outcome of surgical procedures.

Your doctor at Mountain Medical Injury may suggest a nerve block. Some of the most common nerve blocks include:

Occipital Nerve Blocks to alleviate migraine, cluster headaches, and headache pain at back of the head.

Peripheral Nerve Blocks can stop pain in any nerve distribution.

Selective Nerve Root Blocks (SNRB) focus on a specific nerve root. Nerve roots are attached to the spinal cord. When one of the lumbar nerve roots becomes compressed and irritated, it can produce back pain and/or numbness, tingling and sometimes weakness down a leg.

Medial Branch Blocks are another block used to isolate the source of back pain. The medial branch is a nerve that carries pain signals from the facet joint in the spine to the spinal cord.

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Trigger Point Injections

Trigger points are intense areas of muscle spasm that cause referred pain, radiation of pain into another area of the body. Back and shoulder pain, neck pain and headaches, fibromyalgia pain, and myofascial pain syndrome all can benefit from trigger point injections. A needle carefully inserted into a trigger point can release the spasms and stop the pain. Medications including anesthetics and corticosteroids can be injected into the trigger point to anesthetize the area, stop the nerve pain, and allow nerve response to stop signaling pain. Trigger point injections can provide pain relief and promote healing.

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Carpal Tunnel Injections

The median nerve is confined in the carpal tunnel which is a narrow corridor of ligament and bones at the base of the hand. Tendons in the carpal tunnel can swell and pinch the median nerve causing inflammation with pain and tingling in the hand and wrist and sometimes shooting pain up the arm. Carpal Tunnel Injections can relieve swelling and reduce pressure on the nerve. In mild cases carpal tunnel injections combined with cock up splints and physical therapy can manage carpal tunnel pain. Severe carpal tunnel compression may lead to surgery.

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Occipital Nerve Blocks

Swelling or inflammation near the occipital nerves in the back of the head and in the neck can cause pain and discomfort. Occipital Nerve Blocks are steroid injections into that nerve and help relieve pain and inflammation.

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Osteopathic Manipulations

Osteopathic manipulation treatment (OMT) helps relieve back pain and other musculoskeletal disorders. At MMI your physician may move your muscles and joints using techniques including stretching, gentle pressure and resistance. This hands-on approach is used to both diagnose and treat medical conditions.

Osteopathic manipulation has been shown to speed healing after surgery, and often replaces the need for surgery altogether while reducing the need for drug therapies. OMT decreases spasms, improves blood flow and allows optimum alignment for best healing. A study in the New England Journal of Medicine showed that there was a statistically significant difference in the recovery rates of patients with low back pain who had undergone osteopathic manipulation treatment compared with those who had received “standard medical care.” Most importantly, the patients treated with osteopathic manipulation required dramatically less medication like pain killers, anti-inflammatories, and muscle relaxants.

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Epidural Steroid Injections

Epidural Steroid Injections (ESI) can help relieve pain from herniated discs, disc degenerations, or spinal stenosis. An ESI can relieve the debilitating pain from traumatic injuries or progressive degeneration in your back with radiation of pain or numbness into your lower extremities. ESI are performed under fluoroscopic guidance and are an effective treatment for lower back or leg pain.

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Facet Injections

Facets are tiny joints on either side of each vertebra in your cervical, thoracic, and lumbar spine. Facet injections are used both to diagnose the root cause of back pain and to provide pain relief. These injections deliver anesthetic medications that block pain and corticosteroids that reduce inflammation. When pain is reduced or eliminated through the use of these injections, your doctor at MMIPP confirms the source of your pain and can better target your treatment. These injections can also help you to better tolerate a physical therapy routine to promote overall healing.

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Nutritional and Lifestyle Counseling

Mountain Medical Injury implements clinically recognized nutritional programs to help patients heal and stay well long term. Combining nutritional and lifestyle counseling (coaching) we speed rehabilitation and improve patients’ lives in many ways.

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MMJ

Even though recreational use of marijuana is now legal in Colorado, if you need marijuana for medical reasons, it is still important to obtain a “red card” and have your usage recorded by a physician. Used for appetite enhancement for cancer patients, pain relief, epileptic seizures, the treatment of post-traumatic stress disorder (PTSD), anxiety, and other recognized medical conditions, medical marijuana should be a part of your medical record. Not only can this protect you by documenting your tolerance if you are pulled over in a traffic stop, our doctors at MMI can counsel you on the best therapies for your condition. Additionally, patients using medical marijuana can possess up to two ounces at a time. Finally, medical marijuana costs significantly less for higher-quality product due to exemption from some taxes and adequate supply. At MMI, we recognize that marijuana is a legitimate drug used to treat legitimate medical ailments, and we treat you with the respect your condition affords you.

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Dry Needling

Dry needling is a useful component of injury and pain management that uses a thin needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. The technique is used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and to diminish persistent peripheral nociceptive input, and reduce or restore impairments in body structure and function, leading to improved activity and participation.

Dry needling is sometimes called intramuscular stimulation and is a method of manual therapy your doctor might choose to help you decrease spasms and pain and speed healing. It is a fusion of trigger point injections without medication and acupuncture techniques. If you choose to try dry needling, your provider will use needles to relax “Ah Shi” points, which correspond to muscle spasms associated with trigger points. Introducing a needle into an Ah Shi point resets the spasm response and allows the point to relax.

Dry Needling can also access traditional acupuncture channels. Dry needling is an excellent tool for decreasing pain and facilitating fast recuperation. Dry needling has been found to be as effective as injection of substances for relief of pain in muscles and connective tissue.

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Acupuncture

Acupuncture is an alternative form of medicine stemming from traditional Chinese medicine. In acupuncture, thin needles are inserted in acupuncture points. Heat, pressure and laser light can be also be utilized in acupuncture. Acupuncture is used to treat numerous medical conditions including chronic pain.

Acupuncture is a component of the health care system of China that can be traced back at least 2,500 years. The general theory of acupuncture is based on the premise that there are patterns of energy flow (Qi) through the body that are essential for health. Disruptions of this flow are believed to be responsible for disease. Acupuncture may, it has been theorized, correct imbalances of flow at specific points close to the skin.

The conclusions of many trials and systematic reviews of acupuncture agree that acupuncture is a valid tool for medical treatment and that acupuncture is effective for a wide range of conditions.

Mountain Medical Providers also at times use electroacupuncture where an electrical current is passed through the acupuncture needles. This technique has been shown to be another effective treatment for the relief of pain.

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