Pain Management

Pain Management


Pain Management

Herniated disc

Pain Management

Spinal Stenosis

Pain Management


NoraCare offers Pain Management Treatments


Have you ever been diagnosed with “Sciatica”, “Herniated disc”, “Spinal Stenosis” or “Arthritis”?

Is your injury interfering with your ability to earn a living or is it holding you back from enjoying your favorite hobbies?

Does your sciatica limit quality time with family and friends?

Low back pain is the most common reason people visit a doctor, second only to the common cold. Most people will experience back pain sometime in their life. What’s worse is that people who get back pain once will most likely get back pain again!!

The problem is that there are many confusing messages out there about the best treatments for back pain. Patients find themselves going from doctor to doctor, one therapy program to another trying to find an answer with little to no results. Worse yet, there are some patients that opt for surgery with devastating results with even worse back pain than before!

So what is this revolutionary treatment? In order to understand it, let us first talk about how some back pain can be caused by the domino effect of a “HERNIATED DISC”!

First, a person can have a herniated disc in the spine because of bad posture or misalignment in the spine as well as weakened muscles that fail to support the spine.

Second, the herniated disc can get worse over time and start to press on or irritate nerves that come out of the spine. These are nerves that control the muscles in your arms and legs. An example of this is the sciatic nerve. The sciatic nerve is the longest nerve in the body, coming from the lower spine and going down into the leg and branches into the foot. If the herniated disc is in the low back and irritates the nerve, the result can be something called sciatica, pronounced SIA’DIKA. Not all leg pain is sciatica, but most all sciatica involves leg pain. The pain is described as a “toothache” like pain, sometimes sharp, stabbing or “electric shocks” going down the leg or foot. Sometimes the leg can have cramps or weird sensations of something crawling with “pins and needles” up and down the leg.

Next, as the herniated disc worsens over time, it becomes more and more inflamed and sends chemicals that irritate the nerve further with worsening muscle spasms in the back and leg.

Last but not least, if the pain is not treated aggressively and early enough, the body becomes even more sensitive to pain and your brain starts to focus and tune into pain even more over time. The pain becomes even harder to treat!! For many patients, the pain starts to interfere with work, daily life, and sometimes cause depression.

First: cutting-edge diagnostics. Electromyography also known as “EMG” is a nerve test that is used for specific patients and musculoskeletal ultrasound to evaluate for any joint pains that might also affect the patient.

Second: specialized medical care: Remember that medicine is highly specialized and you need more than a general doctor treating your pain. Evaluation and direction by specialized physicians that have mastery of ALL the NON-SURGICAL techniques against back pain is like having a team of generals coordinating your army of care and treatment. From spine injections such as EPIDURAL INJECTIONS, FACET INJECTIONS or NERVE BLOCKS, a specialized doctor, Noracare has the expertise to guide the patient toward the right path.

Third: chiropractic manipulation, traction and posture correction along with use of laser therapy, electrical stimulation and other modalities can provide comfort and help relieve pain immediately

Fourth: medical acupuncture can be an effective treatment and alternative to medications, procedures and surgery. Medical acupuncture is specifically covered for Medicare patients to treat chronic low back pain. But, acupuncture can help with all types of pain from headaches, joint pain and neck pain.

Pain Management, Pain Management


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    Universal Pain Assessment Tool

    This pain assessment tool is intended to help patient care providers assess pain according to individual patient needs. Explain and use 0-10 scale for patient self-assessment. Use the faces or behavioral observations to interpret expressed pain when patient cannot communicate his/her pain intensity.

    Many patients misunderstand the pain scale but as a guide for most patients, we explain to patients to imagine doing a favorite hobby or activity. Now if the patient can easily forget the pain when doing something enjoyable like watching a movie or listening to music, the pain level is at MOST 4/10 pain. The moment the pain is at a 5/10 pain, the pain is LESS forgettable but the patient can still function and complete an activity. When the pain is graded 6/10 OR MORE, the pain is severe enough that a patient CANNOT enjoy any activity nor forget about the pain no matter what the situation is. At NORACARE, 10/10 pain is the worst possible pain which means the pain is bad enough to not allow any meaningful functioning like walking or getting out of bed. When the pain is consistently disabling, a spine injection may be needed just to calm the symptoms of pain down from a “7-8/10 pain” to a manageable 2-4/10 pain.

    At NORACARE we use a “burning house” analogy: Back pain is like a burning house and an epidural injection is like a water hose that puts out the flames. But this is far from a cure. After the fire is put out, you still have a burnt house that needs rebuilding and needs protection from getting burned again!!! That is the role of the chiropractic treatments, therapeutic exercises and / or medical acupuncture. IN CERTAIN PATIENTS, the importance of a spine injection can be viewed like this: The longer a patient waits to have the injection; it is much more difficult to treat the back pain. It is like a burning house with flames that continues to grow and spread out of control 3,4,5.

    Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Spine. Jan 1 1995; 20(1): 11-19
    Pengel LH, Herbert RD, Maher CG, Refshaunge KM. Acute low back pain: systematic review of its prognosis. BMJ. 2003; 327-323
    Long, A, et al. Does it matter which exercise? A randomized controlled trial of exercise for low back pain, Spine 2004; 29: 2593-2602
    Nygaard OP et al, The inflammatory properties of contained and noncontained lumbar disc herniation. Spine 1997; 22: 2484-2488

    We are NORACARE

    For our patients, we strive to give them the very best path to Health, Unique Solutions for pain management, plan for optimal health, and injury prevention.

    We provide a truly empathic care.


    – Dr. Joseph Jimenez

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