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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.

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.

Herniated Disc Treatments

A herniated disc is one of the most, if not the most, common spine complaints in the United States today. Approximately 5.1% of men and 3.7% of women will have a herniated disc during their lifetime. A disc is a component of the spine that cushions the space between the bones. When there is a tear in the outer ring of the disc, a jelly-like material seeps out and a herniation occurs. As a result of this, intense pressure is pushed against nerves or the spinal cord. Pain is almost guaranteed at this point, while some patients endure neurological problems as well.

Precision Pain Care is dedicated to offering the most effective treatment plans to all of their patients. A herniated disc does not automatically mean surgery, but rather, more conservative pain management techniques are considered and applied first. Based on the physician’s recommendation, and the patient’s concerns, a plan is created.

After taking a history and getting a good physical exam, the next step is an accurate diagnosis. In most cases, a diagnosis is obtained by getting an MRI. Most people will get better with time, modification of activities, and over-the-counter anti-inflammatory pain medication. The pain from a herniated disc usually resolves without intervention.

When pain is severe, an epidural steroid injection (ESI) can work wonders at relieving pain from an inflamed nerve root. These procedures are performed at Precision Pain Care using state-of-the-art equipment, and are always done under X-ray guidance for greatest accuracy. By injecting only the inflamed nerve, patients have the best chance of getting their pain under control so that they can give their bodies time to heal. The majority of patients will not need surgery, if they can get their pain under control well enough and get back to their daily lives.

When conservative care is not providing results, however, surgery can remove the herniation. A micro-discectomy, or minimally invasive discectomy, is a common surgery that removes the herniated disc from the spine. The surgery is performed through a small incision. After the discectomy, the physician will recommend the patient take it easy for a couple of days and then at approximately six weeks, begin a physical therapy program. We work closely with several highly qualified Orthopedic Spine Surgeons and Neurosurgeons in Nashville, Smyrna, and Murfreesboro.

The treatment process for a herniated disc is really a quality of life decision. Precision Pain Care is a pain treatment center that caters to a range of patients’ needs. From conservative to surgical, these treatment options continue to serve every patient.

Pain Awareness Month

September is Pain Awareness Month. Nearly 100 million Americans suffer from chronic pain and go through what seems to be endless treatment courses.

Pain strikes in various ways, which makes it difficult to directly treat patients. What works for one person will not necessarily have the same effect on the next. Precision Pain Care recognizes every patient’s condition and treats him or her appropriately with the best and most effective options.

During the month of September, physicians, medical clinics, organizations, local businesses, patients, and families get together to raise public awareness of matters concerning pain and pain management. Even a small conversation with your friends and family gets the word out. Chronic pain is sometimes associated with negative thoughts and beliefs. Talk with your healthcare provider and follow these steps to make your journey easier.

  1. Take control: The course of pain is unpredictable. Patients may often feel discouraged after months or even years of failed treatments. Keep your head high and your feelings even higher. A good attitude makes a difference with pain levels.
  2. Have a good relationship with your doctor: Make sure you trust your doctor and that you feel comfortable talking with him/her about everything.
  3. Never ignore pain: People will continue to preach the belief that it is only pain and there is nothing physically wrong. Don’t let those people affect the way you treat your condition. Report every symptom or change to your doctor immediately.
  4. Sleep: Inadequate sleep can lead to fatigue, depression, and irritability. A restful, routine sleep pattern is essential to coping with chronic pain.
  5. Have a support team: Chronic pain can make you feel lonely and isolated. Surround yourself with friends and family who make you feel good and support your decisions.

Precision Pain Care believes in raising awareness about pain and pain management. The entire medical staff is committed to making the road to recovery a smooth one for all our patients.

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