Physician Huntsville: Trigger Point Injections for Pain Management


Physician Huntsville: Trigger point injections are used to relieve extremely painful areas of muscle. Trigger points are very tight bands or small areas of a muscle that are very sensitive to touch and pressure. The trigger point can irritate surrounding nerves and cause referred pain. Referred pain is a type of pain that radiates to nearby areas. Traumatic injury, overexertion, muscle tension, muscle spasms, pinched spinal nerves, and hormonal deficiencies are common causes of trigger points. Trigger point injections are used to treat involved muscles in many areas of the body. The neck, back and shoulders are particularly common areas injected.

Treatment with Trigger Point Injections

Physician Huntsville: Your doctor can administer trigger point injections in his or her office. Treatments take several minutes. Repeated treatments are sometimes necessary. You may receive a nerve block or simple local anesthetic prior to the procedure to prevent pain.

Your doctor will insert a small needle into your trigger point and inject a local anesthetic. The anesthetic medication provides pain relief and relaxes intense muscle spasms. A steroid medication is sometimes included in the injection. Your doctor will provide you with instructions to reduce initial pain and swelling caused by the procedure. Trigger point injections are usually followed by physical therapy treatments aimed at pain relief and muscle stretching.

Medical Doctor Huntsville: Knee Cap Pain

Knee Cap Pain

Medical Doctor Huntsville: Aching or sometimes burning pain over the kneecap. Prolonged sitting (AKA moviegoer’s knee) often brings on pain. Other activities such as squatting, crouching, stair climbing and running can also bring it on. Your kneecap may make funny noises such as grinding or popping.

The Causes for Knee Cap Pain

Knee pain over the anterior or kneecap area of the knee is extremely common in the aging weekend warrior. Possible causes are an increase in weight (ouch!), weak quadriceps (thigh muscles), arthritis under the kneecap and malalignment of the leg (mostly in women).

The Basic Stretch

Hamstrings- The basic towel stretch. Lie on your back. Holding the two ends of a bath towel loop the towel over the bottom of your foot. Keeping your knee straight pull back . Your leg should be at approximately 90 degrees with your body and in line with your body. If you are doing this right you should have a good pull on your hamstrings. Quads- Kneel with your feet underneath you and your buttocks resting on your heels so that you are sitting like Ken Watanabe in the “Last Samurai” at a Buddhist shrine. . Lean back keeping your knees and feet on the floor until your thighs get tight and stretch.

The Basic Strengthening exercise- TV quad sets. When you are sitting watching TV, straighten your knee until it locks. Hold it like this until you get a good burn in your quads. Relax. Repeat 2-3 times a day. You can do a similar exercise in the gym. Set the leg extension machine from full extension (knee locked straight out) to about thirty degrees of flexion (or knee slightly bent). Put on enough weight to get 10-12 repetitions. Do this two to three times a day, three time a week.

Bracing /Splints

Medical Doctor Huntsville: The basic treatment for these type of problem is stretching and strengthening. However, you might consider some support in the form of a brace or splint to facilitate your recovery. You may also need these braces to help you participate in certain activities. If you want minimal bracing and maximal benefit then I would recommend the classic Cho-Pat strap. This will allow you to pursue most of your activities without weighting you down. For those needing more secure stabilization of the kneecap with activities then the Corflex-J brace would be my recommendation.
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When to worry about knee pain

With any knee pain, catching or locking especially with squatting activities is a serious concern. If this happens, get thee to a doctor. Your symptoms should start to improve with your program in three to four weeks. If things are not improving or getting worse by four weeks this also should prompt you to find a friendly doctor’s office. If at any time you develop sharp shooting pains, numbness, tingling, swelling or discoloration of the limb please call your doctor for an appointment. My mantra for medical problems is “When in doubt, check it out”. If things don’t feel or look right talk to someone who knows.

Other things

If your running shoes are over six months old, change them out.

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Medical Doctor Huntsville: Carpal Tunnel Syndrome

Carpal Tunnel Treatment in AlabamaTreating carpal tunnel in the elderly: early electrodiagnostic testing is key. Early diagnosis crucial.

Approximately 90% of mild-to-moderate cases of carpal tunnel syndrome respond to conservative management.

However, given that the condition is progressive, the earlier it is diagnosed the more likely it is to respond to conservative intervention.

Conservative management, of course, typically includes nighttime wrist splinting, use of nonsteroidal antiinflammatory drugs (with or without diuretics), oral or injectable steroids and physical or occupational therapy.

Naturally, though, before commencing conservative management of carpal tunnel syndrome, the patient’s complaint must be diagnosed as such. The “gold standard” of testing for carpal tunnel syndrome is an electrodiagnostic study performed by or under the direct supervision of a board-certified specialist adhering to testing standards and guidelines developed by the American Board of Electrodiagnostic Medicine.

The most relevant electrodiagnostic tests for diagnosing carpal tunnel syndrome are electromyography (EMG) and nerve conduction studies (NCS). In addition to identifying abnormalities associated with specific symptoms and signs of carpal tunnel syndrome, these two tests are capable of excluding other neurologic diagnoses.

Further, these tests can yield data of the sort necessary for accurately assessing the severity of nerve damage. Typically, testing that demonstrates nothing but sensory abnormalities will be found to have mild carpal tunnel syndrome, while sensory abnormalities accompanied by motor dysfunction are usually taken as evidence of moderate severity. The condition is considered truly severe when testing reveals decreased or absent sensory or motor responses distal to the carpal tunnel or neuropathic abnormalities.

These tests can be repeated at future dates to gauge the effectiveness of therapy and other interventions.


Carpal tunnel syndrome is a serious problem for the elderly.

It is treatable, but treatment is most effective when started while the condition is in an early stage. Carpal tunnel syndrome should be suspected when patients – old or young – present with symptoms even loosely characteristic of the condition. These patients should promptly undergo electrodiagnostic testing to establish or rule out carpal tunnel syndrome as the diagnosis.

However, a problem with electrodiagnostic testing is that often the interpretation of the raw data is reported in ambiguous terms. Worse, delivery of the unhelpfully vague report takes many long weeks, during which time the specialist who performs the interpretation is uncommunicative.

At the medical offices of Eric R. Beck, MD, PhD, FAAPMR, none of these shortcomings exists. We are very clear as to whether a study comes back normal or abnormal; if the latter, we then spell out the degree of severity so that you can confidently proceed with treatment planning. Further, we offer extremely rapid turnaround on our reports of findings:

Typically, we put a summary report in your hands within 24 hours and a full report a short time later.

We also see your patients quickly, usually seven days after we are contacted with a request to schedule an appointment.

Once your patient arrives here, he or she is treated with utmost courtesy. Moreover, we strive to make the examination as painless and stress-free as possible by offering ethyl chloride numbing of the skin prior to needle testing.

We welcome your referrals of patients suspected of carpal tunnel syndrome and other musculoskeletal-neurologic problems. We can perform comprehensive evaluations of your patients and, if you desire, initiate treatment and perform follow-up, keeping you apprised every step of the way. But no matter the way you choose to utilize us, know that your patients will be satisfied by the high-quality services and interactions delivered at each encounter and will return to you as willing as ever to continue entrusting you with their ongoing care.

For more information about carpal tunnel syndrome diagnosis and treatment, please call Valley Center for Nerve Studies in Huntsville, Fort Payne and Birmingham, Alabama at (256) 382-1603.

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