CONDITIONS

Dr. Kaplan’s Board Certification as a pain management specialist gives him the ability to treat multiple painful conditions. From acute to chronic pain states, below is a list of common pain states that Dr. Kaplan specializes in care. If you have a painful condition that is not listed, please contact the office for an appointment.

Abdominal Pain

Cause

Most causes of abdominal pain are not serious and can be readily diagnosed and treated. However, abdominal pain can also be the sign of a serious illness, and it is important that you learn to recognize which symptoms are severe and when to call a doctor.

Symptoms

Abdominal pain is felt in the part of the trunk below the ribs and above the pelvis. It usually comes from organs within the abdomen or organs adjacent to the abdomen, and may be caused by inflammation, distention of an organ, or by loss of the blood supply to an organ. Symptoms may include bloating, gas, indigestion, constipation, GERD, heartburn, and/or chest pain.

Cervical Facet Arthropathy (Arthritis in the Neck)

Cause

Facet joints are susceptible to wear and tear, degeneration, inflammation and arthritic changes. Inflammation and degenerative changes to the facet joints may result in pain, loss of motion, and if severe encroachment or pinching of the nerve exiting the spinal column. Causes of facet joint arthropathy include: degeneration or general wear and tear of the joint, sudden fall or trauma like a motor vehicle accident can result in a facet joint irritation, genetic factors, muscle weakness and poor posture, joint stiffness, and sedentary lifestyle.

Symptoms

Symptoms can vary from mild to severe and may mimic the symptoms of a disc problem. Other common symptoms include: pain in the neck, shoulder blade or radicular to the shoulder into the arm; pain and tenderness localized at the level of the involved facet joint; muscle spasm and changes in posture in response to the injury; loss of motion of the neck including an inability to turn the head, look up or bend backward, or move sideways to the affected side; and sitting for extended periods of time or performing activities overhead will be difficult.

Facial Pain/TMJ Syndrome

Cause

The temporomandibular joint (TMJ) acts like a sliding hinge, connecting your jawbone to your skull. TMJ disorders can cause pain in your jaw joint and in the muscles that control jaw movement. The exact cause of a person’s TMJ disorder is often difficult to determine. Your pain may be due to a combination of problems, such as arthritis or jaw injury. Painful TMJ disorders can occur if the disk erodes or moves out of its proper alignment, the joint’s cartilage is damaged by arthritis, or many cases, the cause can be unclear.

Symptoms

Signs and symptoms of TMJ disorders may include: pain or tenderness of your jaw, aching pain in and around your ear, difficulty chewing or discomfort while chewing, aching facial pain, locking of the joint, making it difficult to open or close your mouth. TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there’s no pain or limitation of movement associated with your jaw clicking, you probably don’t need treatment for a TMJ disorder.

Failed Back Surgery Syndrome (Persistent Pain After a Spine Surgery)

Cause

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a misnomer, as it is not actually a syndrome – it is a very generalized term that is often used to describe the condition of patients who have not had a successful result with back surgery or spine surgery and have experienced continued pain after surgery. There is no equivalent term for failed back surgery syndrome in any other type of surgery (e.g. there is no failed cardiac surgery syndrome, failed knee surgery syndrome, etc.). There are many reasons that a back surgery may or may not work, and even with the best surgeon and for the best indications, spine surgery is no more than 95% predictive of a successful result.

Symptoms

Common symptoms associated with failed back surgery syndrome include diffuse, dull and aching pain involving the back and/or legs (or the neck and/or arms). Patients may also complain of sharp, pricking, burning or stabbing pain in the extremities.

Headache: Migraine

Cause

Although much about the cause of migraines isn’t understood, genetics and environmental factors appear to play a role.

Symptoms

When untreated, a migraine usually lasts from 4 to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less often. During a migraine, you may experience the following symptoms: pain on one side or both sides of your head; pain that has a pulsating, throbbing quality; sensitivity to light; sounds and sometimes smells; nausea and vomiting; blurred vision, and lightheadedness; and sometimes followed by fainting.

Headache: Chronic

Cause

The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause. Conditions that may cause non-primary chronic daily headaches include: inflammation or other problems with the blood vessels in and around the brain, including stroke; infections (such as meningitis); intracranial pressure that’s either too high or too low; brain tumor; or traumatic brain injury.

Symptoms

By definition, chronic daily headaches occur 15 days or more a month, for at least three months. True (primary) chronic daily headaches aren’t caused by another condition. There are short-lasting and long-lasting chronic daily headaches. Long-lasting last more than four hours. They include: chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua.

Joint Pain (Arthritis or Injury)

Cause

Joint pain can be caused by injury affecting any of the ligaments, bursae, or tendons surrounding the joint. Injury can also affect the ligaments, cartilage, and bones within the joint. Pain is also a feature of joint inflammation (arthritis, such as rheumatoid arthritis and osteoarthritis) and infection. In extremely rare cases, it can be a cause of cancer of the joint. Pain within the joint is a common cause of shoulder pain, ankle pain, and knee pain.

Symptoms

Symptoms and signs associated with joint pain can include: joint redness, joint swelling, joint tenderness, joint warmth, limping, locking of the joint, loss of range of motion of the joint, stiffness, and weakness.

Low Back Pain (Herniated Disc)

Cause

As a disc degenerates and breaks down, the inner core can leak out through the outer portion of the disc, and this condition is known as a disc herniation or a herniated disc. The weak spot in the outer core of the intervertebral disc is directly under the spinal nerve root, so a herniation in this area puts direct pressure on the nerve.The nerve runs through the leg, and any type of pinched nerve in the lower spine can cause pain to radiate along the path of the nerve through the buttock and down the leg. This type of pain is also called sciatica or a radiculopathy.

Symptoms

General symptoms typically include one or a combination of the following: leg pain (sciatica), which may occur with or without lower back pain; numbness, weakness and/or tingling in the leg; lower back pain and/or pain in the buttock; loss of bladder or bowel control (rare), which may be an indication of a serious medical condition called cauda equina syndrome.

Lumbar Radiculopathy (Pain from Herniated Disc)

Cause

Discs are soft, rubbery pads located between the bony vertebrae that make up the spinal column. Composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus), discs allow the back to bend and also act as shock absorbers. The spinal column surrounds and protects the spinal cord and nerves. When the cartilage develops a defect or tear, the nucleus can break through. Much like toothpaste, the nucleus bulges out or herniates, putting pressure on the nerves. Even slight amounts of pressure can cause pain, numbness, or weakness.

A herniated disc in the lower spine can put pressure on the sciatic nerve (sciatica). When pinched, sciatic pain may be experienced anywhere along these branches, radiating from the buttocks down the back of the leg and sometimes through the shin and foot. Often, leg pain occurs without any back pain.

Symptoms

Pain may vary from mild to severe. Symptoms may be experienced suddenly or gradually and may also include: pain in both legs; burning, tingling (a “pins–and–needles” sensation), or numbness in the buttock leg, or foot; pain with specific movements, usually bending forward or twisting; intensified pain with prolonged sitting, bending, sneezing, or coughing; weakness in one or both legs; and loss of bladder or bowel control (this is rare).

Neck Pain (Strain/Sprain)

Cause

Triggers for the onset of neck muscle strain can be traced to several common activities that strain the neck anatomy, such as too much time in an awkward position hunched over a steering wheel while driving, hunched forward to view a computer monitor, or cradling a phone in the crook of the neck; sleeping in a position that strains the neck, such as with a pillow that is too high or too firm; any form of trauma that impacts the neck, such as from whiplash in a car accident; or from a fall in which one lands on the top of the head.

Symptoms

Most episodes of neck muscle strain (or other soft tissue strain or sprain, such as ligaments or tendons) result in a stiff neck and/or pain in a shoulder muscle. Symptoms typically include difficulty and pain when moving or rotating the head or neck.

Pelvic/Testicular Pain

Cause

Several types of diseases and conditions can cause pelvic pain. Often chronic pelvic pain results from more than one condition. Pelvic pain may arise from your digestive, reproductive or urinary system. Recently, doctors have recognized that some pelvic pain, particularly chronic pelvic pain, may also arise from muscles and connective tissue (ligaments) in the structures of the pelvic floor. Occasionally, pelvic pain may be caused by irritation of nerves in the pelvis.

Symptoms

Depending on its source, pelvic pain may be dull or sharp; it may be constant or off and on (intermittent); and it may be mild, moderate or severe. Pelvic pain can sometimes radiate to your lower back, buttocks or thighs. Pelvic pain can occur suddenly, sharply and briefly (acute) or over the long term (chronic). Chronic pelvic pain refers to any constant or intermittent pelvic pain that has been present for more than a few months. Sometimes, you may notice pelvic pain only at certain times, such as when you urinate or during sexual activity.

Cervical Radiculopathy (Pain from Herniated Disc)

Cause

A cervical herniated disc is diagnosed when the inner core of a disc in the neck herniates, or leaks out of the disc, and presses on an adjacent nerve root. It usually develops in the 30-to-50-year-old age group. While a cervical herniated disc may originate from some sort of trauma or neck injury, the symptoms commonly start spontaneously.

Symptoms

A herniated disc in the neck can cause a variety of symptoms in the neck, arm, hand, and fingers, as well as parts of the shoulder. The pain patterns and neurological deficits are largely determined by the location of the herniated disc. These are typical pain patterns associated with a cervical disc herniation, but they are not absolute. Some people are simply wired up differently than others, and therefore their arm pain and other symptoms will be different.

Complex Regional Pain Syndrome (CRPS)

Cause

Many cases of complex regional pain syndrome occur after a forceful trauma to an arm or a leg, such as a crush injury, fracture or amputation. Other major and minor traumas — such as surgery, heart attacks, infections and even sprained ankles — also can lead to complex regional pain syndrome. Emotional stress may be a precipitating factor, as well.

Symptoms

Signs and symptoms of complex regional pain syndrome include: continuous burning or throbbing pain, usually in your arm, leg, hand or foot; sensitivity to touch or cold; swelling of the painful area; changes in skin temperature; changes in skin color; changes in skin texture; changes in hair and nail growth; joint stiffness, swelling and damage; muscle spasms, weakness and loss (atrophy); or decreased ability to move the affected body part. Symptoms may change over time and vary from person to person. Most commonly, pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch) occur first.

Fibromyalgia

Cause

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Doctors don’t know what causes fibromyalgia, but it most likely involves a variety of factors working together. These factors may include: genetics, infections, or physical or emotional trauma.

Symptoms

Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event. Symptoms of fibromyalgia include: widespread pain, fatigue, sleep disorders, cognitive difficulties, depression, headaches, and pain or cramping in the lower abdomen.

Failed Cervical Surgery (Persistent Pain After Neck Surgery)

Cause

This is pain that starts or persists after a neck procedure. The cause of continued pain after neck surgery will vary depending on the patient, and the surgery that was performed. Other issues that may may include the existence of multiple pain sources, misdiagnosis before the surgery, or complications during the surgery or the rehabilitation process.

Symptoms

Symptoms of failed neck surgery syndrome vary depending on the cause, location, and severity of the condition. The most common symptoms of both syndromes is pain. The pain usually starts after a surgical procedure, but it may also persist despite the surgical procedure.

Headache: Occipital Neuralgia

Cause

Occipital Neuralgia is a distinct type of headache caused by irritation or injury to the nerves, which can be the result of trauma to the back of the head. This occurs when there is pinching of the nerves by overly tight neck muscles, or compression of the nerves. Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), and frequent lengthy periods of keeping the head in a downward and forward position are also associated with occipital neuralgia.

Symptoms

Symptoms include: shooting or stabbing pain in the neck – radiating over the head, constant headaches, pain behind the eyes, dizziness, and nausea.

Intercostal Neuralgia

Cause

The cause of intercostal neuralgia is related to irritation to the intercostal nerves. This can be related to compression of the nerves, muscles and ligaments via trauma or scar tissue, or a direct injury to the area from surgery. Other causes include inflammation of the intercostal nerves associated with an outbreak of shingles, tumor, or radiation for the treatment of some cancers.

Symptoms

Intercostal neuralgia is described as pain that wraps around your chest, sometimes described as a band radiating from the back of the body to the front chest or upper abdomen. The pain may be described as burning, spasm-like, aching, gnawing and stabbing. The pain may worsen with sudden movements of the chest such as laughing, coughing or taking deep breaths with exertion.

Low Back Pain (Strain/Sprain)

Cause

Twisting or pulling a muscle or tendon can result in a strain. It can also be caused by a single instance of improper lifting or by overstressing the back muscles. A chronic strain usually results from overuse involving prolonged, repetitive movement of the muscles and tendons. A sprain often results from a fall or sudden twist, or a blow to the body that forces a joint out of its normal position.

Symptoms

Symptoms of a strain or sprain include: pain that worsens with movement, muscle cramping or spasms (sudden uncontrollable muscle contractions), decreased function and/or range of motion of the joint (difficulty walking, bending forward or sideways, or standing straight), and in some cases, the person may feel a pop or tear at the time of the injury.

Lumbar Facet Arthropathy (Arthritis in the Joint of the Spine)

Cause

Facet joints can also become arthritic due to a back injury earlier in life. Fractures, torn ligaments, and disc problems can all cause abnormal movement and alignment, putting extra stress on the surfaces of the facet joints. The body responds to this extra pressure by developing bone spurs. As the spurs form around the edges of the facet joints, the joints become enlarged. This is called hypertrophy. Eventually, the joint surfaces become arthritic. When the articular cartilage degenerates, or wears away, the bone underneath is uncovered and rubs against bone. The joint becomes inflamed, swollen, and painful.

Symptoms

Pain from facet joint arthritis is usually worse after resting or sleeping. Also, bending the trunk sideways or backward usually produces pain on the same side as the arthritic facet joint. Pain may be felt in the center of the low back and can spread into one or both buttocks. Sometimes the pain spreads into the thighs, but it rarely goes below the knee.

Muscle Pain

Cause

The most common causes of muscle pain are tension, stress, overuse and minor injuries. This type of pain is usually localized, affecting just one or more muscles or parts of your body. Systemic muscle pain, which you feel throughout your body, is different. It’s more often the result of an infection, an illness or a side effect of a medication.

Symptoms

Almost everyone has sore, aching muscles now and then. Muscle pain (myalgia) can range from mild to excruciating. Though it often goes away in a few days, sometimes muscle pain can linger for months. Muscle pain can develop almost anywhere in your body, including your neck, back, legs and even your hands.

Neck Pain (Herniated Disc)

Cause

Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As you age, your spinal disks lose some of their water content. That makes them less flexible and more prone to tearing or rupturing with even a minor strain or twist.

Symptoms

If your herniated disk is in your neck, the pain will typically be most intense in the shoulder and arm. This pain may shoot into your arm or leg when you cough, sneeze or move your spine into certain positions. People who have a herniated disk often experience numbness or tingling in the body part served by the affected nerves. Muscles served by the affected nerves also tend to weaken. This may cause you to stumble, or impair your ability to lift or hold items.

Vertebral Compression Fractures

Cause

A vertebral compression fracture occurs when the block-like part of an individual bone of the spine (vertebra) become compressed due to trauma. Usually the trauma necessary to break the bones of the spine is quite substantial. In certain circumstances, such as in elderly people and in people with cancer, these same bones can be fragile and can break with little or no force. The vertebrae most commonly broken are those in the lower back, but they may break in any portion of the spine.

Symptoms

Pain tends to be in the lower back but may occur in the middle or upper back or neck. Some people may also have hip, abdominal, or thigh pain. Such symptoms such as numbness, tingling, and weakness could mean compression of the nerves at the fracture site. Symptoms also may include losing control of urine or stool or inability to urinate. If these symptoms are present, the fracture may be pushing on the spinal cord.

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