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Embedded Files
Meditation Flute (Healing) Handpan
VIDEOS - MORE COMING SOON!
HEADACHES
TMS FOR MIGRAINE | DEPRESSION (5m)
NECK PAIN
CERVICAL COLLAR | NECK - CHIN TUCK
BACK PAIN
PATIENT - LUMBAR BRACE
FOR DOCTORS - LUMBAR SPINE LINE | KNEE BRACE | ROM HINGED BRACE | WRIST BRACE | TLSO | PEAK SCOLIOSIS BRACE |
NEUROPATHY | FOOT PAIN
PATIENT VIDEOS:
PROVIDER VIDEOS
ANKLE BLOCKS - ANATOMY (2m) | BLOCK(8 m) |
ASRA - USE ICE & 30Gs (Replace 25Gs for comfort)
+/- water soluble steroid + 5 ml (Instead of 15 ml, for surgeries)
If PLANTAR FASCIITIS add surgical prep x2, ice, 30g, 2-3 ml
SHOULDER PAIN
SHOULDER PAIN - EXERCISES FOR Shoulder: #1 Mayo | #2 Pendulum
SHOULDER PAIN - SLEEP POSITION #1 #2 #3 #4 (exercises)
PROVIDER VIDEOS
EXAM - SHOULDER ROM UE VIDEO
KNEE PAIN
VIRTURAL REALITY
EXERCISES
FOOT | PLANTAR FACIITIS - EXERCISES #1
======
HEADACHE
Brudzinski's Sign = Neck flexion causes hip/knee flexion; indicates meningeal irritation.
Suboccipital Tenderness = Pain upon pressure below skull base; tension or cervicogenic headache.
CERVICAL
Soto-Hall Test = Neck flexion supine; detects cervical injury or irritation.
Spurling’s Test = Extend, rotate, compress head; nerve root compression.
Lhermitte’s Sign = Flex neck causes shock sensation; spinal cord issue.
Bakody’s Sign = Arm overhead relieves pain; cervical radiculopathy.
THORACIC
Adam’s Forward Bend = Forward bending reveals rib hump; indicates scoliosis.
Thoracic Flexion Test = Forward bend, thoracic pain indicates facet or muscular issue.
LUMBAR
Straight Leg Raise (SLR) = Elevating leg causes sciatic pain; lumbar radiculopathy.
Bragard’s Test = SLR plus foot dorsiflexion increases pain; nerve root irritation.
Slump Test = Seated spinal flexion causes sciatic pain; neural tension.
Kemp’s Test = Extend, rotate, compress lumbar spine; facet joint irritation.
SI JOINT
Gaenslen’s Test = Leg drop off table stresses SI joint; identifies SI dysfunction.
FABER (Patrick’s) Test = Hip flexion/abduction/external rotation; pain suggests SI pathology.
SHOULDER
Neer’s Test = Passive forward flexion of shoulder; identifies impingement.
Hawkins-Kennedy Test = Shoulder internal rotation at 90° flexion; impingement syndrome.
ELBOW
Cozen’s Test = Resist wrist extension; lateral epicondylitis ("tennis elbow").
Golfer’s Elbow Test = Resist wrist flexion; medial epicondylitis ("golfer’s elbow").
Lateral Epicondyle Tenderness = Pain at outer elbow; lateral epicondylitis confirmed.
Medial Epicondyle Tenderness = Pain at inner elbow; medial epicondylitis confirmed.
WRIST
Phalen’s Test = Wrists flexed, backs together; tingling indicates carpal tunnel.
Tinel’s Sign (Wrist) = Tap median nerve; tingling suggests carpal tunnel syndrome.
HIP
Trendelenburg Test = Single-leg stand; pelvis drops indicating weak abductors.
Thomas Test = Supine knee flexion; lifted thigh reveals hip flexor tightness.
Piriformis Sign = Hip rotation with flexed knee causes pain; piriformis syndrome.
Trochanteric Bursa Pressure = Painful pressure over trochanter; bursitis confirmed.
KNEE
McMurray’s Test = Rotate knee flexed; clicking indicates meniscal tear.
Anterior Drawer Test = Tibia moves forward; ACL injury suspected.
ANKLE
Anterior Drawer (Ankle) = Forward foot displacement; tests anterior talofibular ligament integrity.
Thompson Test = Squeeze calf, no plantarflexion; Achilles tendon rupture.
ASA PHYSICAL STATUS I-VI [ASA READ] NITROX PLUS
https://pubmed.ncbi.nlm.nih.gov/
Anxiolysis|Sedation|Anesthesia Overview - go to conscious sedation(New!)
SPINE:
CERVICAL- FACET MBB RFA | ESI (CESI w/o ctr) |ONB | TPI |TH-ESI
LUMBAR - FACET MBB RFA | ESI (LESI w/o ctr) |TFESI |SACROILIAC JOINT|CAUDAL
NEVRO - Nevro channel SCS TRIAL [ download print 4 pages] - Detailed/40min
NERVE BLOCKS | TRIGGER POINT:
MIGRAINE NERVE BLOCKS: ONB |SPG block | Botox
UE NERVE BLOCKS | JOINT INJECTIONS
| SHOULDER | ELBOW | WRIST
LE NERVE BLOCKS | INJECTIONS
LATERAL FEMORAL CUT. NERVE
https://thepainsource.com/procedure-lateral-femoral-cutaneous-nerve-block/
KNEE PAIN:
Surgeries - Mobi-c Minimally Invasive TLIF TLIF
Sample info on Artificial Discs
MORE ON NITRONOX ...
AVOID IN 1ST AND 2ND TRIMESTER, OFTEN GIVEN FOR LABOR PAIN.
KETO SHOPPING LIST AND MENU (5 INGREDIENTS OR LESS PER ITEM)
ANTI-INFLAMMATORY DIET (video) DIABETES EDU( CLICK HERE FOR RESOURCES II - ANTI-AGING | ANTI-CANCER | ET AL )
NEW! - Antioxidant Smoothie Ingredients: 1/2 cup blueberries (fresh), 1/2 cup pomegranate seeds (or juice) 🍷, 1/2 cup kale leaves 🥬, 1/4 cup broccoli sprouts (or sub with 1 tsp broccoli sprout powder) 🥦, 1/2 tsp turmeric powder (with a pinch of black pepper for absorption) 🌿, 1/2 tsp Ceylon cinnamon 🌰, 1/2 inch fresh ginger (ginger paste) , 1 cup brewed and cooled green tea or matcha powder (matcha preferred) 🍵, 1/2 banana (optional, for natural sweetness) 🍌, 1/2 cup ice 🧊.
Prostate-Protective Power Smoothie - Blueberries (1/2 cup), pomegranate juice or seeds (1/2 cup), kale leaves (1/2 cup), broccoli sprouts or sprout powder (1/4 cup or 1 tsp), lycopene supplement (10–15 mg, opened or taken before smoothie), turmeric powder (1/2 tsp), black pepper (pinch), Ceylon cinnamon (1/2 tsp), fresh ginger (1/2 inch or 1 tsp paste), brewed and cooled green tea or matcha powder (1 cup or 1/2 tsp), banana (1/2, optional), ice (1/2 cup).
DOWNLOADS
HIGH BLOOD PRESSURE:
DIABETES EDUCATION
- Avocado Egg Salad: Eggs, avocado, lemon, salt, black pepper
- Garlic Butter Shrimp: Shrimp, garlic, butter, lemon juice, parsley
- Caprese Chicken: Chicken breast, mozzarella, tomato, basil, olive oil
- Zucchini Alfredo: Zucchini, heavy cream, parmesan cheese, garlic, butter
- Stuffed Bell Peppers: Bell peppers, ground beef, cheese, onion, taco seasoning
- Baked Salmon: Salmon, olive oil, dill, lemon, garlic powder |
- Cauliflower Mash: Cauliflower, butter, cream cheese, garlic, salt
- Spinach Omelette: Eggs, spinach, cheddar cheese, salt, black pepper
- Greek or Non-dairy Yogurt Bowl: yogurt, blueberries, almonds, chia seeds, cinnamon
- Steak and Asparagus: Steak, asparagus, butter, garlic, salt
ADDITIONAL SALMON (or sub Chicken or other lean meat) RECIPES
Lemon Garlic Chicken/Salmon: add lemon slices, garlic, olive oil, parsley
Parmesan Crusted: add parmesan cheese, almond flour, butter, garlic powder
Salmon Lettuce Wraps: add lettuce, avocado, lime juice, cilantro
Salmon with Pesto: add basil pesto, cherry tomatoes, olive oil, salt
Cajun Salmon: add Cajun seasoning, olive oil, garlic, lemon
Coconut Curry Chicken/Salmon: add coconut milk, curry powder, garlic, spinach
- BENEFITS OF THE KETO DIET
- Supports rapid weight loss by promoting fat burning.
- May improve mental clarity and focus.
- Helps stabilize blood sugar levels and manage diabetes.
- Reduces appetite and cravings due to high-fat, satiating meals.
- Can enhance energy levels and physical endurance.
ANTI-INFLAMMATORY DIET (video) DIABETES EDU( CLICK HERE FOR RESOURCES II - ANTI-AGING | ANTI-CANCER | ET AL )
NEW! - Antioxidant Smoothie Ingredients: 1/2 cup blueberries (fresh), 1/2 cup pomegranate seeds (or juice) 🍷, 1/2 cup kale leaves 🥬, 1/4 cup broccoli sprouts (or sub with 1 tsp broccoli sprout powder) 🥦, 1/2 tsp turmeric powder (with a pinch of black pepper for absorption) 🌿, 1/2 tsp Ceylon cinnamon 🌰, 1/2 inch fresh ginger (ginger paste) , 1 cup brewed and cooled green tea or matcha powder (matcha preferred) 🍵, 1/2 banana (optional, for natural sweetness) 🍌, 1/2 cup ice 🧊.
Prostate-Protective Power Smoothie - Blueberries (1/2 cup), pomegranate juice or seeds (1/2 cup), kale leaves (1/2 cup), broccoli sprouts or sprout powder (1/4 cup or 1 tsp), lycopene supplement (10–15 mg, opened or taken before smoothie), turmeric powder (1/2 tsp), black pepper (pinch), Ceylon cinnamon (1/2 tsp), fresh ginger (1/2 inch or 1 tsp paste), brewed and cooled green tea or matcha powder (1 cup or 1/2 tsp), banana (1/2, optional), ice (1/2 cup).
DOWNLOADS
HIGH BLOOD PRESSURE:
- VIDEO ON HTN | STRESS and HTN
- MANAGING HTN |EAT LESS SODIUM |
- Limit high blood pressure (HTN) with daily hibiscus tea (2-3 cups), about 250ml of beet juice, and by following the DASH diet rich in fruits, vegetables, and low sodium.
- Dietary Approaches to Stop Hypertension (DASH)
- FOR HYPERTENSION - Hibiscus Tea, Beets, Garlic
DIABETES EDUCATION
- PRE-DIABETES --> Prediabetes: Strategies for a Healthy Life
- PRE-DIABETES ACTION PLAN
- Managing Type 2 Diabetes
- Are You at Risk for Type 2 Diabetes? Why You Should Avoid Junk Food
- Diabetes and Choosing the Right Foods Diabetes and Exercise
- Diabetes Screening A1c TEST MONITORING GLUCOSE
- DIABETES FACTS
- After Your Diabetes Diagnosis
- TYPE 2 DIABETES
- INSULIN MED
- Diabetes and Foot Care
- Diabetes Eye Exam
- DIABETES IN KIDS Diabetes (Type 1)
- Managing Type 1 Diabetes in Children and Teens
MEDICATIONS (Rx)
Top 10 Pain Medication Classes: Concise Summary
1. NSAIDs
Dose: Ibuprofen 200-800mg q6-8h
Mech: COX inhibition, ↓prostaglandins
Ex: Ibuprofen, Naproxen, Diclofenac, Celecoxib, Meloxicam
SE: GI bleed, ulcers, renal injury
Warn: CV risks, High Blood Pressure, Kidney avoid long-term use
NSAIDs ↓ renal blood flow via COX inhibition, causing kidney injury. Avoid if renal impairment. Monitor BUN/Creatinine closely.
2. Acetaminophen
Dose: 325-1000mg q4-6h, max 4g/day
Mech: Central COX inhibition, ↑pain threshold
Ex: Tylenol, Panadol, Paracetamol, Feverall, Ofirmev
SE: Hepatotoxicity, rash, nausea
Warn: Liver damage risk at high doses
3. Opioids
Dose: Oxycodone IR 5-10mg q4-6h
Mech: Mu receptor agonist, ↓pain signaling
Ex: Morphine, Hydrocodone, Oxycodone, Fentanyl, Tramadol
SE: Constipation, sedation, respiratory depression
Warn: Addiction, overdose, tolerance risk
4. Anticonvulsants
Dose: Gabapentin 300-600mg TID
Mech: Ca²⁺ channel block, ↓neuropathic signaling
Ex: Gabapentin, Pregabalin, Carbamazepine, Topiramate, Lamotrigine
SE: Dizziness, sedation, weight gain
Warn: Withdrawal seizures, renal dose adjust
5. Antidepressants (TCAs, SNRIs)
Dose: Amitriptyline 25-75mg nightly
Mech: ↑Serotonin/norepinephrine, modulate pain pathway
Ex: Amitriptyline, Duloxetine, Nortriptyline, Venlafaxine, Milnacipran
SE: Sedation, dry mouth, weight gain
Warn: Cardiac toxicity, suicidal ideation risk
6. Muscle Relaxants
Dose: Cyclobenzaprine 5-10mg TID prn
Mech: CNS depressant, ↓muscle spasm
Ex: Cyclobenzaprine, Methocarbamol, Baclofen, Tizanidine, Carisoprodol
SE: Drowsiness, dizziness, fatigue
Warn: Dependence, avoid with CNS depressants
7. Topical Analgesics
Dose: Lidocaine patch 1-3 patches/day
Mech: Local nerve block, ↓pain signals
Ex: Lidocaine, Capsaicin, Diclofenac gel, Menthol, Methyl salicylate
SE: Skin irritation, burning, rash
Warn: Avoid damaged skin, systemic absorption risk
8. Corticosteroids
Dose: Prednisone 5-60mg daily tapered
Mech: Anti-inflammatory, ↓immune response
Ex: Prednisone, Dexamethasone, Methylprednisolone, Hydrocortisone, Triamcinolone
SE: Hyperglycemia, osteoporosis, insomnia
Warn: Immunosuppression, adrenal suppression with chronic use
9. NMDA Antagonists
Dose: Ketamine IV 0.1-0.3 mg/kg/hr
Mech: NMDA receptor block, ↓central sensitization
Ex: Ketamine, Dextromethorphan, Memantine, Amantadine, Methadone
SE: Hallucinations, hypertension, sedation
Warn: Abuse potential, psychosis risk
10. Cannabinoids
Dose: CBD 5-20mg BID
Mech: CB receptor modulator, ↓pain/inflammation
Ex: CBD oil, THC, Dronabinol, Nabilone, Nabiximols
SE: Dizziness, sedation, dry mouth
Warn: Psychoactive effects, impaired cognition, drug interactions
CERVICAL FACET PATTERNS
CERVICAL FACET PATTERNS
CERVICAL FACET PATTERNS
CERVICAL FACET PATTERNS
DISC BULGE VS HERNATION
Disc Bulge (DB) – Mild <3 mm, Moderate 3-5 mm, Severe >5 mm | ICD-10: M51.26 (L), M50.30 (C), M51.24 (T)
Disc Herniation (DH) – Protrusion 2-6 mm, Extrusion >6 mm | ICD-10: M51.26 (L), M50.20 (C), M51.24 (T)
Central Canal Stenosis (CCS) –
C-spine <10 mm (severe), 10-13 mm (moderate);
L-spine <12 mm (severe), 12-15 mm (moderate) | ICD-10: M48.02 (C), M48.04 (T), M48.06 (L)
Foraminal Stenosis (FS) – Significant narrowing <3 mm | ICD-10: M99.33 (C), M99.34 (T), M99.35 (L)
Facet Hypertrophy (FH) – Thickening >3 mm | ICD-10: M47.812 (C), M47.814 (T), M47.816 (L)
Ligamentum Flavum Hypertrophy (LFH) – Thickening >2-4 mm | ICD-10: M47.12 (C), M47.14 (T), M47.16 (L)
Spondylolisthesis (SPL) – Grade I: 0-25%, Grade II: 26-50%, Grade III-IV: >50% | ICD-10: M43.12 (C), M43.14 (T), M43.16 (L)
Spondylosis (SP) – Degenerative disc changes with osteophytes (1-3 mm) | ICD-10: M47.812 (C), M47.814 (T), M47.816 (L)
Osteophyte Complex (OC) – Bone spurs contributing to narrowing | ICD-10: M25.78 (C/T/L)
Thoracic Kyphosis (TK) – Hyperkyphosis >40-45° curvature | ICD-10: M40.09
Lumbar Lordosis Abnormality (LLA) – Loss of normal curvature | ICD-10: M40.56
Thoracic/Lumbar Radiculopathy (TR/LR) – Nerve root compression | ICD-10: M54.16 (L), M54.14 (T), M54.12 (C)
Cervical Myelopathy (CM) – Spinal cord compression | ICD-10: M47.12
SURGERIES ( Coming soon)
COMING SOON ...
MENTAL WELLNESS | MEDITATION | PSYCHOLOGY RESOURCES | HOTLINE
Mental Health Test - https://mhanational.org/
Suicide Hotline - https://988lifeline.org/
988 Suicide and Crisis Lifeline
988 Suicide and Crisis Lifeline
MEDITATION VIDEOS
MORE ADVANCED | 2 HR VIDEO
Natural Anxiety Options
CBD (25–100 mg/day) – Available in drops/tinctures; helps calm the brain and reduce anxiety.
L-Theanine (200–400 mg/day) – From green tea; promotes calm focus without making you drowsy.
Magnesium (200–400 mg/day) – A calming mineral that helps your body and brain relax.
Ashwagandha (300–600 mg/day) – A natural root that lowers stress hormones like cortisol.
Rhodiola (200–400 mg/day) – Helps your body stay strong under stress and boosts mental energy.
Lemon Balm (300–600 mg/day) – A gentle herb that soothes anxiety and helps with sleep.
STATISTICS ON MENTAL HEALTH
Anxiety Disorders: Approximately 19.1% of U.S. adults experience anxiety disorders annually.
Specific Phobias: Affect about 9.1% of U.S. adults annually.
Major Depressive Disorder: About 8.3% of U.S. adults have had at least one major depressive episode in the past year.
Social Anxiety Disorder: Approximately 7.1% of U.S. adults experience social anxiety disorder each year.
Attention-Deficit/Hyperactivity Disorder (ADHD): While often associated with children, ADHD affects about 4.4% of U.S. adults.
Post-Traumatic Stress Disorder (PTSD): Experienced by about 3.6% of U.S. adults annually.
Bipolar Disorder: Affects approximately 2.8% of U.S. adults each year.
Generalized Anxiety Disorder (GAD): Affects about 2.7% of U.S. adults annually.
Panic Disorder: Approximately 2-3% of U.S. adults experience panic disorder in a given year.
Obsessive-Compulsive Disorder (OCD): Approximately 1.2% of U.S. adults are affected each year.
EDUCATIONAL VIDEOS
Generalized Anxiety Disorder (GAD) Living With Social Anxiety Disorder Anxiety in Children
Phobia (Specific) Social Anxiety Disorder (Social Phobia)
Depression Living With Depression Depression in Children Psychotherapy (Talk Therapy)
Cognitive Behavioral Therapy (CBT)
Attention Deficit Hyperactivity Disorder (ADHD) in Adults (ADHD in Children)
Post Traumatic Stress Disorder (PTSD)
Bipolar Disorder (Overview) Living With Bipolar Disorder Panic Disorder
Panic Attack | Obsessive-Compulsive Disorder (OCD)
Clinical Trials for Mental Health Research Traumatic Events and Mental Health
Substance Use Disorders and Mental Health Taking Care of Your Mental Health in College
Mental Illness Mental Illness Warning Signs Cognitive Behavioral Therapy (CBT)
Getting the Most From Talk Therapy | Medical Marijuana (Medical Cannabis)
AWARENESS MONTHS
January
Mental Wellness Month: Recognized by organizations such as Mental Health America (MHA) and the National Alliance on Mental Illness (NAMI).
February
National Eating Disorders Awareness Week: Promoted by the National Eating Disorders Association (NEDA).
Rheumatoid Arthritis Awareness Day (February 2): Recognized by the Rheumatoid Patient Foundation.
March
Self-Harm Awareness Month: Supported by various mental health organizations to raise awareness about self-injury.
Dissociative Identity Disorder Awareness Day (March 5): Acknowledged by mental health advocacy groups.
Brain Injury Awareness Month: Led by the Brain Injury Association of America (BIAA).
April
Stress Awareness Month: Recognized by health organizations to highlight the impact of stress.
World Semicolon Day (April 16): Supported by mental health advocates to symbolize hope and love for those struggling with mental health issues.
May
Mental Health Awareness Month: Initiated by Mental Health America (MHA) in 1949.
National Anxiety Month: Recognized by organizations focusing on anxiety disorders.
Children’s Mental Health Awareness Week: Promoted by the National Federation of Families for Children’s Mental Health.
Arthritis Awareness Month: Led by the Arthritis Foundation.
International Fibromyalgia Awareness Day (May 12): Supported by the National Fibromyalgia Association.
International May 12th Awareness Day: Recognized by organizations focusing on ME/CFS and related conditions.
June
National Migraine and Headache Awareness Month: Promoted by the National Headache Foundation.
Pride Month: Celebrated by LGBTQ+ organizations and allies.
National PTSD Awareness Month: Recognized by the U.S. Department of Veterans Affairs.
July
Bebe Moore Campbell National Minority Mental Health Awareness Month: Established by NAMI to highlight mental health disparities.
International Self-Care Day (July 24): Promoted by the International Self-Care Foundation.
September
Suicide Prevention Awareness Month: Recognized by organizations like the American Foundation for Suicide Prevention (AFSP).
Pain Awareness Month: Led by the American Chronic Pain Association.
Rheumatic Disease Awareness Month: Promoted by the American College of Rheumatology.
National Spinal Cord Injury Awareness Month: Recognized by the United Spinal Association.
October
Mental Illness Awareness Week (First full week of October): Established by NAMI.
World Mental Health Day (October 10): Observed by the World Health Organization (WHO).
National Depression Screening Day: Promoted by Screening for Mental Health, Inc.
November
National Family Caregivers Month: Recognized by the Caregiver Action Network.
Transgender Awareness Week (November 13–19): Supported by GLAAD and other LGBTQ+ organizations.
International Survivors of Suicide Loss Day: Organized by the American Foundation for Suicide Prevention (AFSP).
Note: World Semicolon Day is observed annually on April 16 to raise awareness about mental health, suicide prevention, and self-injury. It also recognizes people who have survived suicide and those who are struggling with mental illness.
What is the significance of the semicolon?
The semicolon represents a choice to continue living, rather than ending one's life.
The semicolon separates two clauses, rather than ending one, which symbolizes hope and perseverance.
RESOURCES
Self-Help Groups
Self-Help Groups
Additional Resources
Additional Resources
Treatment Quitline: (800) 227-2345
Center for Substance Abuse Prevention (CSAP)
Center for Substance Abuse Treatment (CSAT)
Controlled Substance Schedule
Johnson Intervention Support
National Association of Alcoholism and Drug Abuse Counselors
NIDA Notes Newsletter
Principles of Drug Addiction Treatment: A Research Guide
Safe and Drug-Free Schools Program
Drug Abuse Warning Network
Smoking, Vaping, and Tobacco-Related Resources
Smoking, Vaping, and Tobacco-Related Resources
Toll-Free Quitlines:
Florida Department of Health: 1-877-U-CAN-NOW (1-877-822-6669)
The American Cancer Society: 1-800-227-2345
Local and state quitlines: 1-800-QUIT-NOW
Web Resources:
Smokefree.gov – Step-by-step quit smoking guides, SmokefreeTXT mobile service
BLOOD THINNERS & PROCEDURES (Hold)
**** Important Reminder ****
**** Important Reminder ****
***For Spine AND HIP INJECTIONS - here are instructions to stop bloodthinners.
For SI joint injections - no need to stop your blood thinner.
Do not stop taking your anticoagulant until you have been cleared to do so by the medical provider prescribing that medication.
Anticoagulants
Anticoagulants
Coumadin (warfarin): Stop 5 days before procedure; INR must be obtained on the day of the procedure.
Pradaxa (dabigatran): Stop 4 days before procedure.
Eliquis (apixaban): Stop 3 days before procedure.
Xarelto (rivaroxaban): Stop 3 days before procedure.
Bevyxxa (betrixaban): Stop 6 days before procedure.
Antiplatelets / Platelet Inhibitors
Antiplatelets / Platelet Inhibitors
Aspirin / Excedrin (any dose “baby” or otherwise): Stop 7 days before procedure.
Plavix (clopidogrel): Stop 7 days before procedure.
Effient (prasugrel): Stop 10 days before procedure.
Ticlid (ticlopidine): Stop 5 days before procedure.
Pletal (cilostazol): Stop 2 days before procedure.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Advil (ibuprofen): Stop 1 day before procedure.
Arthrotec (diclofenac): Stop 1 day before procedure.
Indomethacin: Stop 2 days before procedure.
Lodine (etodolac): Stop 2 days before procedure.
Mobic (meloxicam): Stop 4 days before procedure.
Aleve (naproxen): Stop 4 days before procedure.
Relafen (nabumetone): Stop 6 days before procedure.
Feldene (piroxicam): Stop 10 days before procedure.
Supplements
Supplements
Fish oil: Stop 6 days before procedure.
Garlic: Stop 7 days before procedure.
Vitamin E: Stop 7 days before procedure.
Turmeric: Stop 7 days before procedure.
Again, confirm these timelines with the provider who prescribed your medication.
ANTICOAGULANTES y PROCEDIMIENTOS
**** Recordatorio Importante ****
Para inyecciones en la columna vertebral Y la cadera – aquí están las instrucciones para suspender anticoagulantes.
Para inyecciones en la articulación sacroilíaca (SI) – no es necesario suspender su anticoagulante.
No deje de tomar su anticoagulante hasta que haya sido autorizado por el proveedor médico que le recetó ese medicamento.
Anticoagulantes
Anticoagulantes
Coumadin (warfarina): Suspenda 5 días antes del procedimiento; el INR debe obtenerse el día del procedimiento.
Pradaxa (dabigatrán): Suspenda 4 días antes del procedimiento.
Eliquis (apixabán): Suspenda 3 días antes del procedimiento.
Xarelto (rivaroxabán): Suspenda 3 días antes del procedimiento.
Bevyxxa (betrixabán): Suspenda 6 días antes del procedimiento.
Antiplaquetarios / Inhibidores de Plaquetas
Antiplaquetarios / Inhibidores de Plaquetas
Aspirina / Excedrin (cualquier dosis “baja” o normal): Suspenda 7 días antes del procedimiento.
Plavix (clopidogrel): Suspenda 7 días antes del procedimiento.
Effient (prasugrel): Suspenda 10 días antes del procedimiento.
Ticlid (ticlopidina): Suspenda 5 días antes del procedimiento.
Pletal (cilostazol): Suspenda 2 días antes del procedimiento.
AINEs (Antiinflamatorios No Esteroides)
AINEs (Antiinflamatorios No Esteroides)
Advil (ibuprofeno): Suspenda 1 día antes del procedimiento.
Arthrotec (diclofenaco): Suspenda 1 día antes del procedimiento.
Indometacina: Suspenda 2 días antes del procedimiento.
Lodine (etodolaco): Suspenda 2 días antes del procedimiento.
Mobic (meloxicam): Suspenda 4 días antes del procedimiento.
Aleve (naproxeno): Suspenda 4 días antes del procedimiento.
Relafen (nabumetona): Suspenda 6 días antes del procedimiento.
Feldene (piroxicam): Suspenda 10 días antes del procedimiento.
Suplementos
Suplementos
Aceite de pescado: Suspenda 6 días antes del procedimiento.
Ajo: Suspenda 7 días antes del procedimiento.
Vitamina E: Suspenda 7 días antes del procedimiento.
Cúrcuma: Suspenda 7 días antes del procedimiento.
TOP 10 MEDICAL DISEASES IN ADULTS
1. 🩸 Hypertension = High BP | 🛑 Salt, 🏃♂️ exercise | 💊 Meds, 🥗 DASH diet
2. 🧈 High Cholesterol = LDL ↑ heart risk | 🥦 Fiber, 🍤 diet | 💊 Statins, 🏋️♀️ fitness
3. ⚖️ Obesity = BMI ≥30 | 🥗 Whole foods, 🚶♂️ activity | 💊 Meds, 🏥 surgery
4. 🍬 Type 2 Diabetes / Pre Diabetes = Insulin resistance | 🥕 Low sugar | 💊 Metformin, 🏃♂️ wt loss
5. 🦴 Arthritis = Joint pain | 🛡 Avoid injury, ⚖️ weight control | 💊 NSAIDs, 🧘 PT
6. 😔 Depression = Mood ↓ 2+ weeks | 🤝 Social support | 💬 Therapy, 💊 SSRIs
7. 😰 Anxiety = Excess worry | 🧘♀️ Manage stress | 💊 Meds, 🧠 CBT
8. 🌬 Asthma/COPD = Airway issues | 🚭 No smoking | 💨 Inhalers, 💊 steroids
9. ❤️ Heart Disease = Clogged arteries | 🚭 Quit, 🚴♀️ move | 💊 Statins, 🥗 diet, 🏥 stents
10. 🧪 Chronic Kidney Dz = Kidney function ↓ | 🩺 BP, sugar control | 💊 ACEi, 🥬 diet, 🩻 dialysis
OBESITY | WEIGHT LOSS
Foods known to "starve" fat cells by reducing insulin spikes, inflammation, or promoting lipolysis include:
Green tea (EGCG boosts metabolism) w/ STEVIA INSTEAD OF SUGAR
Avocado (healthy fats decrease inflammation)
Cinnamon (improves insulin sensitivity)
Turmeric (curcumin reduces fat inflammation)
Blueberries (anthocyanins limit fat storage)
Fatty fish (omega-3 reduces adipocyte inflammation)
Chili peppers (capsaicin increases metabolism)
Broccoli (fiber and sulforaphane fight fat storage)
Apple cider vinegar (reduces insulin spikes)
Leafy greens (low-calorie, high nutrient density)
PRE-DIABETES | DIABETES - SEE YOUR DOCTOR AND DISCUSS YOUR TREATMENT OPTIONS
🩸 BLOOD SUGAR CATEGORY = A1C (%) and/or FASTING BLOOD GLUCOSE (mg/dL)
🩸 BLOOD SUGAR CATEGORY = A1C (%) and/or FASTING BLOOD GLUCOSE (mg/dL)
NORMAL = A1C less than 5.7% and = Fasting glucose less than 100 mg/dL
PREDIABETES = A1C 5.7% – 6.4% or = Fasting glucose 100 – 125 mg/dL
TYPE 2 DIABETES = A1C 6.5% or higher or = Fasting glucose 126 mg/dL or higher (on 2+ tests)
SEVERE OR UNCONTROLLED DIABETES = A1C over 9.0% and/or = Fasting glucose above 180–200 mg/dL (often with symptoms)
📚 Source: CDC Prediabetes and Diabetes Info
📚 Additional: ADA Diagnosis Criteria
HYPERTENSION - SEE YOUR DOCTOR AND DISCUSS YOUR TREATMENT OPTIONS
BLOOD PRESSURE CATEGORY = SYSTOLIC mm Hg (upper #) and/or DIASTOLIC mm Hg (lower #)
NORMAL LESS THAN 120 and LESS THAN 80
ELEVATED 120 – 129 and LESS THAN 80
HIGH BLOOD PRESSURE (HYPERTENSION) STAGE 1 130 – 139 or 80 – 89
HIGH BLOOD PRESSURE (HYPERTENSION) STAGE 2 140 OR HIGHER or 90 OR HIGHER
HYPERTENSIVE CRISIS (consult your doctor immediately) HIGHER THAN 180 and/or HIGHER THAN 120
FROM: https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure
Natural Supplements
1. 🌺 Hibiscus Tea (Hibiscus sabdariffa) Effect = Lowers systolic and diastolic BP Mechanism = Natural ACE inhibitor, diuretic, antioxidant
Study: McKay et al. (2009) found that drinking 3 cups/day reduced SBP by ~7 mmHg in prehypertensive adults. PMID: 19923373
1. 🌺 Hibiscus Tea (Hibiscus sabdariffa) Effect = Lowers systolic and diastolic BP Mechanism = Natural ACE inhibitor, diuretic, antioxidant
Study: McKay et al. (2009) found that drinking 3 cups/day reduced SBP by ~7 mmHg in prehypertensive adults. PMID: 19923373
2. ❤️ Beetroot Juice Effect = Rapid reduction in BP, especially systolic Mechanism = High in dietary nitrates → nitric oxide → vasodilation
Study: Kapil et al. (2015) showed 250 mL/day led to a ~7.7/2.4 mmHg drop in BP.
2. ❤️ Beetroot Juice Effect = Rapid reduction in BP, especially systolic Mechanism = High in dietary nitrates → nitric oxide → vasodilation
Study: Kapil et al. (2015) showed 250 mL/day led to a ~7.7/2.4 mmHg drop in BP.
3. 🧘🏽 Mindfulness Meditation / Breathing Effect = Reduces stress-driven BP spikes Mechanism = Lowers cortisol, activates parasympathetic response
Study: Park & Han (2017) demonstrated a significant BP drop in adults practicing mindful breathing 20 mins/day.
3. 🧘🏽 Mindfulness Meditation / Breathing Effect = Reduces stress-driven BP spikes Mechanism = Lowers cortisol, activates parasympathetic response
Study: Park & Han (2017) demonstrated a significant BP drop in adults practicing mindful breathing 20 mins/day.
4. 🧄 Garlic Supplements (Aged Extract) Effect = Lowers BP in hypertensive patients Mechanism = Enhances nitric oxide, mildly inhibits ACE
Study: Ried et al. (2013) found ~8.6 mmHg reduction in SBP with aged garlic extract
4. 🧄 Garlic Supplements (Aged Extract) Effect = Lowers BP in hypertensive patients Mechanism = Enhances nitric oxide, mildly inhibits ACE
Study: Ried et al. (2013) found ~8.6 mmHg reduction in SBP with aged garlic extract
5. 🥦 DASH Diet + Magnesium-Rich Veggies Effect = Clinically proven to lower BP Mechanism = Potassium, magnesium, fiber, low sodium
Study: DASH-Sodium trial: Reduced SBP by up to 11.5 mmHg in hypertensive adults
5. 🥦 DASH Diet + Magnesium-Rich Veggies Effect = Clinically proven to lower BP Mechanism = Potassium, magnesium, fiber, low sodium
Study: DASH-Sodium trial: Reduced SBP by up to 11.5 mmHg in hypertensive adults
Types of Pain
TYPES OF PAIN -> TESTS -> TREATMENTS
Most Common Types of Pain =
LBP - HAs - Joint - Neuropathic - FBM - Whiplash (acute)
Neck - Abd/Pelvic - Post-Op - CA - Dental/Face | PAIN RESEARCH
XRAY MRI EMG NCV | Cracking Joints | Sciatic N. |
1️⃣ Lower Back Pain (Most Common) | ~30-40% of adults at some point in life | Leading cause of disability worldwide | Causes: Muscle strain, herniated discs, arthritis (Spine | Knee), spinal stenosis.
DX: Spinal Stensosis - Cervical Lumbar
LUMBAR - FACET MBB RFA | ESI (LESI w/o ctr) |TFESI |SACROILIAC JOINT|CAUDAL
CERVICAL- FACET MBB RFA | ESI (CESI w/o ctr) |ONB | TPI |TH-ESI
2️⃣ Headaches & Migraines | ~15-20% of the population regularly [Tension 40% / Migraine 10% ] | Includes tension headaches, migraines, cluster headaches | Causes: Stress, dehydration, neurological disorders, hormonal changes. WHIPLASH (HEADACHE) |
3️⃣ Joint Pain (Arthritis & Osteoarthritis) | ~25% of adults | Common in knees, hips, hands, shoulders | Causes: Aging, wear-and-tear, autoimmune conditions (rheumatoid arthritis).
NON-STEROID TREATMENTS
Topical Treatments
CBD/THC Topicals – Apply 2–3 times daily as needed (20–30 mg per dose).
Diclofenac Gel (Voltaren 1%) – Apply 2–4 g up to four times daily.
Capsaicin Cream (0.025–0.1%) – Apply 3–4 times daily (initial burning sensation expected).
Therapies & Physical Treatments
Acupuncture – 1–2 sessions per week (based on response).
TENS Therapy – Use 15–30 min per session, up to 2–3 times daily.
Paraffin Wax Therapy – Heat wax to 125–130°F, dip hands 5–10 times, wrap, and leave for 15–20 min, repeat daily or as needed.
Hand Exercises – 5–10 min, twice daily (stretching, grip strength, and mobility drills).
Supplements & Natural Remedies
CBD - OTC is supplement - buy only at a reviewed, reputable company - usually 25-50 mg per dose 2-3x per day
Omega-3 (Fish Oil, EPA/DHA) – 1,000–3,000 mg daily.
Curcumin (Turmeric w/ Black Pepper Extract) – 500–1,500 mg daily, divided into 2–3 doses.
Collagen Peptides – 5–10 g daily (powder or capsules).
Magnesium Lotion (or Oral Supplement) – Apply 1–2 times daily OR take 200–400 mg magnesium glycinate orally.
LUPUS | LIVING WITH LUPUS | ANTI-INFLAMMATORY DIET | RESEARCH = CANNABIS AND AUTOIMMUNE DZ CANNABIS AND LUPUS
LUPUS AND DIET | LUPUS + NUTRITION |
4️⃣ Neuropathic Pain (Nerve Pain, Sciatica, Neuropathy) | ~10-15% of the population | Includes sciatica, diabetic neuropathy, post-herpetic neuralgia, carpal tunnel syndrome | Causes: Diabetes, nerve compression, injury, chemotherapy.
5️⃣ Musculoskeletal Pain (Fibromyalgia, Myofascial Pain, Chronic Pain Syndrome) | ~10-12% of adults | Widespread pain, often linked to stress or nervous system dysfunction | Causes: Muscle overuse, central nervous system disorders, psychological stress.
6️⃣ Neck Pain | ~10-12% of adults | Often work-related or posture-related | Causes: Poor posture, whiplash, arthritis, disc herniation.
7️⃣ Abdominal & Pelvic Pain (IBS, Endometriosis, Menstrual Pain) | ~10-15% of the population | Common in women and people with digestive disorders | Causes: Inflammatory conditions, hormonal imbalances, digestive disorders.
8️⃣ Post-Surgical & Post-Traumatic Pain | ~10-15% of surgery patients | Can develop into chronic pain | Causes: Nerve damage, scar tissue formation, inflammation.
9️⃣ Cancer Pain | ~30-50% of cancer patients (70-90% in late-stage cases) | Often severe and persistent | Causes: Tumor growth, nerve compression, chemotherapy side effects.
🔟 Facial & Dental Pain (TMJ, Toothache, Trigeminal Neuralgia) | ~5-10% of the population | Often related to nerve disorders or jaw misalignment | Causes: Tooth decay, jaw misalignment, nerve dysfunction (trigeminal neuralgia).
TOPICALS FOR RELIEF | KNEE PAIN | NEUROPATHY
OTC TOPICALS (CHECK WITH YOUR PRIMARY CARE DOCTOR PRIOR TO STARTING)
Menthol: Apply thin layer, 3–4x/day
Methyl Salicylate: No heat pads, 3x/day,
Lidocaine Patch: 12 hrs on, 12 hrs off,
Lidocaine Cream: Thin layer, max 4x/day
Diclofenac Upper: 2g, 4x/day, max 8g, Diclofenac Lower: 4g, 4x/day, max 16g, Diclofenac: Use card, not with NSAIDs
Capsaicin: Use 3–4x/day, not eyes, Capsaicin: Burning normal, consistent use needed
Camphor: Avoid broken skin, apply 3x/day
KNEE PAIN:
Diclofenac (Topical or Oral)
Diclofenac is a potent NSAID, inhibiting COX-1 and COX-2 enzymes, reducing prostaglandin synthesis, and alleviating pain and inflammation in knee structures.
Ice (Cryotherapy)
Cryotherapy reduces cellular metabolism, vasoconstricts blood vessels, and decreases inflammatory mediator release, effectively reducing acute swelling, pain, and tissue damage post-injury.
Compression (Knee Sleeves or Wraps)
Compression supports joint stability, minimizes swelling through fluid restriction, improves proprioception, and enhances venous return, promoting quicker recovery post-injury.
Elevation
Elevation enhances lymphatic drainage and venous return by leveraging gravity, reducing extravascular fluid accumulation, and mitigating localized inflammation and edema in the knee.
Platelet-Rich Plasma (PRP) Injections
PRP utilizes autologous concentrated platelets to release growth factors like PDGF and TGF-β, accelerating tissue regeneration, reducing inflammation, and promoting cellular repair in knee injuries.
Corticosteroid Injections
Corticosteroids inhibit pro-inflammatory cytokines, reducing synovial inflammation, suppressing immune response, and providing analgesic effects, particularly for acute inflammatory flare-ups in knee injuries.
TERPENES
✅ Top Medical Cannabis Terpenes (Nature = Effects | <15 words)
Myrcene = Mangoes, hops = Sedative, anti-inflammatory, enhances cannabinoid blood-brain absorption.
Limonene = Citrus peels = Mood-elevating, antidepressant, modulates serotonin/dopamine.
Linalool = Lavender = Calming, anti-anxiety, interacts with GABA/serotonin systems.
Pinene = Pine, rosemary = Bronchodilator, memory enhancer, inhibits acetylcholinesterase.
Beta-Caryophyllene = Black pepper, cloves = Analgesic, anti-inflammatory, activates CB2 receptors.
Terpinolene = Tea tree, apples = Sedative, antioxidant, modulates CNS activity.
Humulene = Hops, basil = Anti-inflammatory, reduces appetite, blocks prostaglandin pathways.
Ocimene = Mint, parsley = Antiviral, decongestant, boosts immune response via inflammation reduction.
1. Keep Warm
= Stay indoors in cold weather
= Wear layers: hat, scarf, gloves, warm socks
= Use thermal underwear for insulation
= Preheat car before driving
= Use gloves or hand warmers
= Take warm showers or baths
2. Manage Triggers
= Practice stress-reduction like meditation
= Reduce or eliminate caffeine
= Stop smoking to improve circulation
= Review medications with your doctor
3. Other Strategies
= Exercise regularly to boost circulation
= Eat a balanced, anti-inflammatory diet
= Try omega-3 or circulation-boosting supplements
= Use biofeedback to regulate temperature
4. Seek Medical Advice
= Schedule regular doctor visits
= Ask about prescription treatment options
= Discuss alternative therapies like acupuncture
1. Reduce Wrist Strain
= Keep wrists straight during typing
= Use ergonomic keyboards and mousepads
= Avoid prolonged repetitive hand movements
= Take frequent breaks to stretch hands
2. Support & Comfort
= Wear wrist splints, especially at night
= Apply cold packs to reduce swelling
= Elevate hands to reduce pressure
3. Improve Hand Health
= Stretch fingers and wrists daily
= Perform hand-strengthening exercises carefully
= Avoid gripping tools too tightly
4. Lifestyle Modifications
= Maintain healthy weight to reduce pressure
= Treat underlying conditions like diabetes or arthritis
= Reduce inflammation with anti-inflammatory foods or medications
5. Medical Options
= Get a nerve conduction test if needed
= Consider corticosteroid injections for severe pain
= Explore surgery if conservative treatments fail
Disclaimer: Information provided is for reference only and does not imply affiliation or endorsement with the mentioned individuals, companies, products, services, treatments, and websites. For informational purposes only - contact your medical provider for health and medical advice. Content accuracy, completeness, and timeliness are not guaranteed. Inclusion of information and websites does not constitute endorsement. Users should exercise caution when accessing external content. See your medical, legal, finance, tax, spiritual and other professionals for discussion, guidance, planning, recommendations and greater understanding of the risks, benefits, options and ability to apply any information to your situation.
AAPC | ICD-10 | CPT
AAPC | ICD-10 | CPT
https://thepainsource.com/icd-10-codes-for-physical-medicine-and-pain-management/
https://thepainsource.com/homepage/cpt-codes-pmr-pain-management-billing-and-coding/
SI JOINT INJECTION = 27096 + 77002 [ see aapc above, medicare , pain source ]
BILLING | CODING - VISITS v 0506
PAIN CPT CODES - PAIN SOURCE
American Academy of Professional Coders = AAPC | icd-10 / cpt codes / modifier 51 v 59
New Patient Visits [ 15 MIN ]
99201: Total time = 0 -14 minutes ✅ 99202: Total time = 15-29 minutes ✅
99203: Total time = 30-44 minutes ✅ 99204: Total time = 45-59 minutes ✅
99205: Total time = 60-74 minutes (must meet or exceed)
(Note: For 99205, additional time beyond 74 minutes can use prolonged service codes like 99417.)
Established Patient Visits: [10 MIN ]
99211: Total time = 0 - 9 minutes ✅ 99212: Total time = 10-19 minutes ✅
99213: Total time = 20-29 minutes ✅ 99214: Total time = 30-39 minutes ✅
99215: Total time = 40-54 minutes (must meet or exceed)
(Note: For 99215, if the time exceeds 54 minutes, prolonged service codes like 99417 may apply.)
Important Notes:
2021 E/M Coding Rules: Time includes both face-to-face and non-face-to-face activities on the day of the encounter (e.g., charting, reviewing records, communicating with the patient).
Prolonged Service Codes: For time exceeding these limits, CPT codes like 99417 or HCPCS code G2212 (Medicare-specific) should be added to account for prolonged services.
MORE RESOURCES - USE QR CODES OVER PRINTING
INJECTION VIDEOS - spine-health , view medica
MEDICAL/NUTRITIONAL
ANTI-AGING / ANTI-INFLAMMATORY
DASH AI FOODS AI FOODS (SEE PG 2) VIT C FOR SKIN / BOOST COLLAGEN
SCIENTIFIC INFO: 3100 AIs ANTI-AGING FACT vs FICTION
PSYCHOLOGICAL FLEXIBILITY
SURGERY / OTHER
SAFETY DATA SHEETS | HIPPA | BIOHAZARD / SHARPS | OSHA | CLINIC & CANNABIS STATUTES | BILLING/CODING/DOCUMENTATION & MEDICAL NECESSITY
https://chemicalsafety.com/sds-search/
HIPPA
Blood Thinners | ASRA, ET AL - PTS ON ANTI-PLATELET/ANTICOAGULANTS | IARS/AVOID HEMATOMA
BILLING | CODING - INJECTIONS V04.23.2025
S --> Dx CODES
Lumbar pain - M54.50 (Primary)
Other specified dorsopathies, lumbar region - M53.86
Displacement of intervertebral disc of lumbosacral region - M51.27
Disc displacement, lumbar - M51.26
MVA Date of Accident: 01/05/2022
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