Recent News and Health Tips

Why Should I Exercise?


Exercise can be difficult if you suffer from chronic pain, but it is one of the most highly recommended forms of conservative treatment. For those with diabetic neuropathy, the benefits of exercise can also help you manage your diabetes symptoms, which will in turn improve your neuropathy symptoms.

Diabetic neuropathy is a chronic condition involving damage to nerves from high blood sugar levels caused by diabetes. If you suffer from this debilitating condition, don’t give up! There are plenty of treatments and tips you can use to help relieve pain- including exercise! Talk to a Precision Pain Care staff member before introducing new exercises into your daily routine. Patients with diabetic neuropathy can find relief through treatment in a number of different ways:


  • Reduce your need of insulin
  • Control weight and take excess pressure off of your feet
  • Build strong muscles and bones
  • Give you motivation
  • Manage your blood sugar better, reducing your risk of nerve damage
  • Correct posture and gait complications


Two Causes of Back Pain

While Precision Pain Care treats a variety of injuries and conditions, some common sources of unfortunate back pain include compression fractures and spinal stenosis.


Spinal compression fractures are cracks or decaying of the vertebrae. Fractures can be caused by a sudden event, over time, or by a condition called osteoporosis. Osteoporosis is a disease that causes your bones to thin, thus making them more fragile. With frail bones, anything from a missed step, to an improper lifting of an object can result in a possible fracture. It is a common misconception that with age comes back pain. If you are over the age of 60 and have back pain, the odds that you have a spinal compression fracture are likely.

Fractures of the spine have the tendency to vary on the pain spectrum. Resulting pain may gradually worsen, stay consistent, improve, or in some cases not be felt at all. Some physical symptoms that might be an outcome resulting from compression fractures include loss of height, a curved back (kyphosis), stomach issues, hip pain, or trouble breathing. These symptoms tend to vary for each individual but typically one or more of these symptoms can be an indication of spinal compression fractures.

Vertebroplasty and Kyphoplasty for Treating Compression Fractures

At Precision Pain Care, we use a conservative approach to pain care and prefer to choose interventional or minimally invasive treatments if necessary. Vertebroplasty is one solution that is a minimally invasive treatment used to improve spinal compression fractures. High severity of pain, a relatively recent fracture, or failure of other conservative treatments are certain circumstances in which Precision Pain Care might suggest Vertebroplasty.

This type of procedure involves a small incision, followed by X-Ray guided injection of bone cement into the fractured vertebra. The patient is required to lie face down for the duration of the procedure and usually is awake but sedated. This method is an outpatient procedure and most people are allowed to return home the same day. Vertebroplasty allows the patient to eventually continue taking part in normal activities, diminishes pain requiring less medication needed, and avoids future spinal fractures.

Kyphoplasty is another common minimally invasive alternative to compression fractures. Similar to vertebroplasty, kyphoplasty involves the same incision and procedure. However, instead of bone cement infused directly in the vertebra, balloons are inserted through the needle and into the bone. After the balloon is in place, it is then inflated and filled with cement. The healing process most likely involves a day of bed rest, avoidance of lifting too much for the next six weeks, and also prevents future fractures, relieves pain, and allows you to get back to your normal life.

A physician with board certification and thorough training in the field of pain medicine can be difficult to find. Dr. Graf Hilgenhurst and our team of professionals here at Precision Pain Care specialize in the diagnosis of the source of your pain as well as the treatment and follow up care. Dr. Hilgenhurst has years of pain management experience, both as an anesthesiologist and an interventional pain physician. All of our spinal procedures utilize fluoroscopic technology in order to guarantee accurate placement of injections. For more information on vertebroplasty, kyphoplasty, or alternative procedures, contact a Precision Pain Care specialist today.


Spinal stenosis is a condition in which the spinal column shrinks which eventually compresses the spinal cord or nerves running through the spinal column. This condition can be inherited or gradually acquired. If it is inherited, the person may have been born with a narrower spinal canal. Scoliosis, an irregular curve of the spine, can also be a potential inheritance of spinal stenosis.

Pressure on the spine can too result from the degeneration of your back. With age, joints and bones can become larger and force into areas that they were not originally. Bone spurs can be a protrusion that perhaps grows closer into your spinal canal. Calcification of the ligaments of your spine could develop and begin to take up more space. Intervertebral disks lie in between your vertebrae and are the shock absorbers of your back. These disks can have a tendency to slip out of place and become herniated and potentially press against the spinal cord.

Symptoms of spinal stenosis may include cramping, numbness, weakness, or pain in the arms and legs. The Precision Pain Care team would recommend effective interventional solutions like flexing the lower back, as it has been known to help with the sometimes-painful symptoms. We would also most likely suggest a series of specific stretches and exercises that might help ease your pain. These treatments relieve symptoms by opening the spinal column and creating more space for the spinal cord and nerves.

In more severe cases, epidural steroid injections may be necessary as a temporary relief from symptoms of spinal stenosis. Although not a permanent remedy of the condition, epidural injections can be an effective way of pain reduction during the process of weighing potential future solutions. Unfortunately, spinal stenosis cannot be fixed permanently without surgery and the procedure to remove pressure from the spinal cord has its risks. However, depending on the helpfulness of nonsurgical treatments and levels of pain, conditions vary and surgery may not always be necessary.

Spine & Pain Physicians Surgery Center: Providing the Techniques Necessary for Pain Relief

Confronting the pain epidemic head on to address increasing reports of Americans suffering with back pain, Dr. Graf Hilgenhurst is proud to announce the opening of Spine & Pain Physicians Surgery Center. Staffed with highly qualified spine and pain relief experts, Spine & Pain Physicians Surgery Center will offer therapeutic procedures that provide solutions with minimally invasive therapies.

Dr. Hilgenhurst continues to offer his expertise and quality care to patients at Precision Pain Care, and will now be expanding his services at the new surgery center. Patients will receive better access to improved care for acute and chronic pain conditions. The Spine & Pain Physicians Surgery Center was established in Smyrna , Tennessee and is Rutherford County’s first surgery center solely dedicated to spine and pain treatment.

We offer a number of effective and reliable treatments, and hope Spine & Pain Physicians Surgery Center is right for you. Treatments are offered for conditions such as:

  • Disc Herniations
  • Spinal Stenosis
  • Radiating extremity pain
  • Tingling, numbness in the back, neck or limbs
  • Neuropathy
  • Complex Regional Pain Syndrome
  • Neck and back pain
  • Chronic and acute spine & pain conditions

Our team believes it is a patient’s right to get treatment, and we respect these rights. Every patient has the right to courtesy, respect, dignity, privacy, responsiveness, and timely attention. The team at Spine & Pain Physicians Surgery Center holds high standards to the quality of care we give to each patient. Patients can expect integrity and endless commitment through every phase of treatment.

The goal of the surgical center is to provide patients access to minimally invasive spine and pain treatments. Our team understands the uniqueness of each patient and is able to accurately diagnose and design treatment plans that are specific to their pain. Dr. Hilgenhurst and the Spine & Pain Physicians Surgery Center team provides patients with a safe and highly regulated environment where patients feel confident and hopeful for quality results.

Don’t let chronic pain take over your life. Early treatment is vital for spine pain management. If you or someone you love is living with debilitating pain, choose Spine & Pain Physicians Surgery Center for relief. Please call us at (615) 459-3881 for scheduling and directions.

Chicken-Apple Sausage

It’s so hard to decline that juicy sausage that so greatly compliments your eggs in the morning. Now, you can enjoy this breakfast meat without compromising your diet! Check out this recipe for chicken-apple sausage:

Serving size: 8 patties

2 tsp canola oil
1 small onion, diced
1 med sweet apple (Gala or Honeycrisp), peeled and diced
1 lb ground chicken
1 tbs finely chopped sage
1 tbs light brown sugar
1/2 tsp fennel seed, chopped
3/4 tsp salt
1/4 tsp ground pepper


  1. Heat oil in large non-stick skillet. Add onion and cook 2 minutes until softened. Add apples and cook for 2 more minutes. Transfer onion and apple to a large bowl and cool for 5 minutes.
  2. Add chicken, sage, sugar, fennel, salt, and pepper to the bowl with the apple and onion; mix
  3. Clean out the pan and coat with cooking spray. Over medium heat, scoop 4 portions (1/3 cup each) of the sausage mixture into the pain; flatten each into a 3-inch patty. Cook until browned (3 minutes each side).
  4. Coat pain and repeat with remaining sausage mixture

Women in Pain

Pain is often a regular, unwelcoming, reality for many women, let alone any human being. The most common causes of pain in women range from menstrual and childbirth pain, to headache and autoimmune pain. Wherever the pain stems from, there is always one commonality: it’s painful.

At Precision Pain Care, we understand that men and women read and feel pain differently. Studies show that men are less likely to report pain to their doctors than women, however, that doesn’t mean any pain is less real. The specialists at Precision Pain Care consider all options for treatment after ensuring a precise and real diagnosis is reached.

According to The Clinical Journal of Pain, about 40 percent of American women suffer with spinal issues. Muscle or ligament strain is one of the most common causes for back pain in women, triggered by strenuous lifting. Mothers often hold the task of constantly picking up and putting down their young children. Physical therapy, rest, and proper lifting techniques should be applied to avoid damaging the muscles or ligaments in the back. When lifting, be sure to use your leg muscles, as to not put excessive strain on the spine.

Other common causes of back pain that many women face is arthritis and osteoporosis. Women over 50 are especially vulnerable to this injury, as the joints and bones in the spine weaken and lose density as we age. Aqua therapy is one of the best ways to work out stiff joints and promote bone health. Talk to your doctor about lifestyle and diet changes that can be implemented into your treatment plan that can help support the health of your spine. Spinal injections may also be effective in reducing back pain.

Historically, women tend to be more sensitive to experimental pain stimuli than men. Having lower pain thresholds and lower pain tolerances, women are often inclined to get treatment immediately. The team at Precision Pain Care considers gender differences to ensure a unique, effective, and appropriate treatment strategy for each individual patient.

Research tells us that women are more likely to encounter pain conditions within their lifetime. Chronic migraines affect two percent of the population, most often affecting women. This debilitating problem, commonly referred to as a transformative migraine, can strike a person 15 or more times a day each month. Women are three times more likely to experience these aching migraine attacks.

Another infamous pain condition many women face is fibromyalgia. Fibromyalgia will likely affect various areas of your body and life. At Precision Pain Care, we take a “whole-patient” approach to treatment that encompasses body, mind, and environmental considerations. We stress the importance of patient education, not only for fibromyalgia, but all pain conditions. Patients may benefit from medication therapy, visualization and relaxation techniques, maintaining a healthy diet, and therapies such as physical therapy and massage. A collaboration of treatments can reduce pain while simultaneously improve mobility.

At Precision Pain Care, we provide tools for patients to manage their pain without surgical intervention. According to the Institute of Medicine, there are 100 million Americans in pain, the majority of whom are women. If you are a part of the pain population, let Precision Pain Care help. Contact one of our specialists today to start your journey to a pain free life.

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