PATIENT EDUCATION

De Lucia Advance Practice LLC would like to be your partner in health care. Feel free to ask your questions and share your concerns with us. We will work with you to develop a wellness program for the care and treatment you need.

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De Lucia Advance Practice LLC provides a full range of medical services including the following.....

Arthritis is a condition that causes pain, stiffness and swelling in the joints. There are many different forms of arthritis, such as Osteoarthritis, Rheumatoid arthritis, Gout, and Psoriatic arthritis. Most forms of arthritis, cause pain, tenderness, and swelling, and may result in loss of movement in the affected joints. Over time, joints affected by arthritis may become severely damaged. Arthritis occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of a joint or after an injury. It can however, affect people of any age, including children.

Bursitis is the painful inflammation of a bursa, a sac between tissues that is filled with lubricating fluid. Bursae are located in many joints throughout the body. They act as cushions between bones, muscles, tendons and skin. Bursitis most often develops in the knee, shoulder, elbow, hip or Achilles tendon, but may occur in almost any joint. It typically occurs because of repetitive stress or traumatic injury, but may also be the result of a disease process. Bursitis is more common as individuals age.

The pain brought on by cancer is often a chronic state that persists for many months or years. The management of cancer pain typically involves numerous approaches designed to help cancer patients maximize their independence and capability. Our doctors are well trained in the diagnosis and treatment of chronic muscle and nerve pain problems caused by cancer and will work with each patient on a one-to-one basis to determine the best treatment plan for their individual pain.

The carpal tunnel is a narrow, fibrous passage in the wrist that protects the median nerve, which runs down the length of arm and through the wrist into the hand. The median nerve controls some hand movement, and sensation in the thumb, index and middle fingers, and half of the ring finger. Irritation or compression of the median nerve within the carpal tunnel can cause tingling and numbness in the fingers, a condition known as carpal tunnel syndrome (CTS).

Corticosteroid injections have been used for decades to temporarily relieve pain and inflammation in joints and soft tissues, and to relieve systemic inflammatory reactions. The advantage to injecting corticosteroid medication rather than taking it orally is that it is delivered more quickly to the affected area and often has more effective results. Corticosteroid injections are routinely used to reduce the pain and swelling of bursitis, tendonitis and arthritis. In addition, they are helpful in treating lupus, scleroderma and severe allergic reactions.

Fibromyalgia is a chronic condition that causes fatigue and widespread pain and tenderness in the muscles, ligaments and tendons. Individuals who suffer from fibromyalgia may have specific tender points on their body where they are particularly sensitive when pressure is applied. Fibromyalgia may also be associated with sleep problems, headaches and trouble concentrating. Women are more likely than men to develop fibromyalgia and it commonly occurs between the ages of 40 and 60.

Arthritis of the hand develops as the cartilage protecting the bones of the finger joints wears down over time. Over the years, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. Arthritis of the hand may cause the joints to lose their normal shape and limits the motion of the joints within the hand. It occurs more frequently in older individuals, as a result of normal wear and tear over time, that causes cartilage to wear away.

Neuropathic pain is a chronic condition caused by damage within the nerve fibers, resulting in the delivery of incorrect signals to the brain. Neuropathic pain, a response to injury to the central nervous or peripheral nervous system, usually causes tissue damage.In addition to stabbing, shocking or shooting (not aching) pain, patients may also experience numbness, tingling and weakness in the affected region of the body. They may also, because of exquisite nerve sensitivity, experience allodynia (pain provoked by gentle stimulus) or hyperalgesia (excessive pain provoked by a slight pain stimulus). A further addition to patient misery with neuropathic pain can be the insomnia suffered because of unremitting pain.

Osteoarthritis is the most common form of arthritis. It develops as the cartilage protecting the bones of a joint wears down over time. Over the years, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. It occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of a joint or after an injury. It commonly affects the fingers, knees, lower back and hips.

When osteoarthritis develops in the ankle joint, stiffness and pain can result, and balance and walking may be compromised. As people age, they are more likely to develop osteoarthritis, not only because of cartilage wear and tear, but because cartilage loses its ability to self-heal.

Pain management specialists are medical professionals well-trained in the diagnosis and treatment of acute, sub-acute and chronic muscle and nerve pain. Board-certified in this specialty and utilizing the most advanced treatment techniques, pain management physicians work one-on-one with patients who suffer from chronic pain to determine the best treatment plan to relieve symptoms and allow resumption and enjoyment of everyday activities.

A number of different types of medications may be used to reduce pain in various parts of the body. A number of medications may be helpful in relieving pain, depending on the medical condition of the patient and the severity of the pain being experienced.

Over-the-counter medications are frequently helpful in relieving symptomatic pain that is mild to moderate. Such medications may include analgesics such as acetaminophen and non-steroidal anti-inflammatory drugs, or NSAIDS, such as ibuprofen and naproxen.

Phantom limb pain is the feeling of pain or other sensations in a limb that has been amputated. The precise reason this occurs remains unknown, but apparently the brain of the amputee is continuing to receive messages from nerves associated with the amputated limb. Typically, there is the strong sensation that the amputated limb is still attached, and functioning as it was prior to the amputation.

Post-laminectomy syndrome is a condition in which a patient continues to experience pain and disability after a laminectomy, a type of spinal surgery. The development of post-laminectomy syndrome is a complication of the procedure. Post-laminectomy syndrome is a type of failed back surgery, a broader category which includes chronic pain following any spinal surgery, including spinal fusion.

Gout is a form of arthritis that causes painful, swollen, red and inflamed joints. Gout is caused by a buildup of uric acid that forms crystals in the joints and surrounding tissue. Patients with gout have an abnormal metabolism that reduces the effectiveness of the kidneys, causing uric acid to accumulate in the blood.

Elbow arthritis occurs when the cartilage of the elbow joint becomes worn or damaged. This cartilage normally acts as a cushion between the bone and the joint, and when it is worn away, the direct contact and friction between the bones causes pain, swelling, decreased strength and range of motion.

Ankylosing spondylitis is a form of chronic inflammatory arthritis that significantly affects the joints of the spine. This autoimmune condition causes swelling between the vertebrae, and often affects one or both sacroiliac joints, the joints that attach the spine to the pelvis. Pain, swelling, and stiffness in the lower back are the typical symptoms of ankylosing spondylitis, but inflammation may occur in other parts of the body, including the eyes.

Shoulder osteoarthritis, also known as degenerative bone disease and commonly called arthritis, is a disorder in which cartilage, which acts as a protective cover for the bones, degenerates. Without cartilage to act as a buffer, the affected bones rub together and wear each other down, resulting in pain and swelling.

Sjogren's syndrome is an autoimmune disorder that has two common identifying symptoms: dry mouth and dry eyes, but it may progress to affect joints, skin and vital organs. The cause of Sjogren's syndrome is unknown, although genetic components seem to put some individuals at greater risk for developing the disease. There is some evidence that Sjogren's syndrome may be triggered by a viral or bacterial infection. Often the syndrome occurs in patients who have another immune disorder, like rheumatoid arthritis or lupus.

Steroid injections are an advanced treatment option for patients with arthritis and other sources of joint pain, that have not responded well to other treatments such as exercise and oral medications. These injections deliver relief directly to the source of the pain and are considered safe for nearly all patients.

Toradol, also known as Ketorolac, is a medication used to relieve acute short-term pain. It is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce swelling in order to promote healing. A Toradol injection, administered either intravenously or intramuscularly, is usually given to provide pain relief after a surgical procedure, followed by up to 5 days of oral administration. Although a helpful medication for short-term pain relief, Toradol has a great many contraindications and potentially dangerous side effects.

Trigger point injections are a treatment option for pain in areas that contain trigger points, or knots of muscle that form when muscles contract and will not relax. Trigger points may develop after injury or overuse of the affected muscle. They may also be caused by stress and anxiety. These trigger points may also irritate the nerves around them and therefore cause pain in other areas of the body.

A ganglion cyst is a fluid-filled sac that usually forms on top of a tendon or the covering of a joint in the wrist or hand. It is the most common type of soft-tissue growth in the wrist or hand, and can develop suddenly or over time. Although usually benign and harmless, it can put pressure on nearby nerves, potentially causing pain, weakness or numbness.

A herniated disc, also known are a ruptured or slipped disc, is a damaged spinal cushion between two bones in the spine (vertebrae). . When a disc protrudes beyond its normal parameters and its tough outer layer of cartilage cracks, the disc is considered to be herniated. The inner material of the disc bulges through the torn cartilage, sometimes pressing on a nerve in the spinal canal. This results in back pain, often sciatic pain that extends into the buttocks and travels down the affected leg.

The tibial plateau is the top surface of the tibia, or shin bone, made of cancellous, or cartilage-like bone. A tibial plateau fracture is often the result of a fall, or a sports-related or a traumatic injury. An injury to the tibial plateau is especially distressing on the body, as the majority of standing body weight rests on this bone.

The collateral ligaments are located on the sides of the knees. The lateral collateral ligament (LCL) is located within the knee joint, connecting the outer side of the thigh bone (femur) to the fibula, the smaller bone in the lower leg. The LCL provides strength and stability to the joint and helps the knee to resist force and stay stable during unusual movement. An injury may cause the LCL to loosen, stretch, and possibly tear, resulting in pain and inflammation on the outer part of the knee. An LCL sprain commonly occurs in athletes who participate in collision sports such as rugby and football.

The meniscus is a C-shaped piece of tough cartilage located in the knee, that acts as a shock absorber between the shinbone and the thigh bone. A meniscus tear may be the result of an activity that forcefully twists or rotates the knee. A torn meniscus is a common knee injury that may be caused by playing sports, or a traumatic injury, and most frequently occurs when the knee joint is bent and the knee is then twisted. Torn menisci are common in athletes, but in some cases this condition may occur in older adults whose cartilage has worn away, as a result of many years of wear and tear of the joint.

The posterior cruciate ligament (PCL) is one of four ligaments that helps support the knee and protects the shin bone (tibia) from sliding too far backwards. Injury to the PCL most commonly occurs when the knee is bent and an object strikes the shin, pushing it backwards. This is commonly referred to as a "dashboard injury" because it often happens during a car accident when the shin is forcefully pushed into the dashboard. A PCL tear may also be caused by a sports injury or a fall. In many cases, a posterior cruciate ligament tear occurs along with injuries to other parts of the knee, including other ligaments, cartilage and and bone.

Patellofemoral syndrome, also known as chondromalacia patella, is a painful knee condition caused by a degeneration of the cartilage in the kneecap, which may be caused by overuse, injury, obesity or malalignment of the kneecap. While this condition can affect anyone, it is most common in athletes and people who put heavy stress on their knees.

The collateral ligaments are located on the sides of the knees. The medial collateral ligament (MCL) is located in the knee, connecting the inner side of the thigh bone to the shin (tibia) bone. The MCL helps the knee to resist force and keeps it stable against unusual movement. An injury may cause the MCL to loosen, stretch and possibly tear, resulting in pain and inflammation.

The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments in the knee. ACL injuries occur most commonly in athletes as a result of direct contact or an awkward fall. ACL reconstruction is usually not performed until several weeks after the injury, when swelling and inflammation have been reduced. In most cases, an ACL repair is necessary because there has been an avulsion of the ligament, which means that not only the ligament, but a piece of bone, has been fractured.

Muscles cramps, colloquially known as a charley horse, are a common, painful ailment. While not usually considered serious, the sudden contraction of the muscle, or spasm, can cause serious discomfort and temporarily interfere with function. In some cases, muscle cramps may be a sign of a medical issue that needs to be addressed. Muscle cramps can occur anywhere in the body, but most frequently occur in the legs, affecting the calf, hamstring or quadriceps muscles.

Myopathy, also known as disease of the muscle, occurs when the muscles of the body are attacked by the body's immune system. This attack damages the fibers of the muscles in the body leaving the body's muscles in a weakened condition. Myopathy can cause problems with muscle tone and voluntary muscle movement. Myopathy can be either genetic or acquired, and may be present at birth or develop later in life.

Osteomalacia, commonly referred to as rickets, is a softening of the bones that may occur as a result of a vitamin D deficiency. Bones affected by osteomalacia lack the proper amount of calcium, resulting in bones that are soft and more likely to fracture. This condition often leads to a dull aching pain in the bones, especially in the hips and lower back, and decreased muscle tone and strength. The main cause of osteomalacia is a vitamin D deficiency which may be the result of limited exposure to sunlight, a limited diet, stomach surgery, or certain anti-seizure medications.

Kyphosis is an exaggerated rounding of the upper back, sometimes called a hunchback. Most often found in postmenopausal women, when it is referred to as a "dowager's hump," it is also fairly common in adolescent girls. Although patients with kyphosis may suffer back pain, stiffness or fatigue, most people with mild cases have no discernible symptoms.

Osteoporosis is a condition that causes the bones to become weak and brittle and at a high risk for fracture. In all individuals, bone breaks down over time, but is replaced with new bone tissue. As people age, bone loss occurs at a faster rate than new bone mass is created, resulting in osteoporosis.

Plantar fasciitis is an inflammation of the plantar fascia, a ligament that runs along the bottom of the foot from the heel to the base of the toes. This ligament normally supports the arch of the foot, functioning as a shock absorber, but if, after repeated stretching, it tears, inflammation and severe heel pain result.

A heel spur is an outgrowth of bone, known as a bone spur or osteophyte, on the heel of the foot. Bone spurs form as the body attempts to repair damage caused by constant physical irritation, pressure or stress, and may form in various regions of the body. They develop in the heel for a variety of reasons.

Rheumatoid arthritis is an autoimmune disorder that causes symptoms of arthritis. Rheumatoid arthritis affects the lining of the joints, causing pain, stiffness, and swelling. It may also affect other organs of the body including the heart, lungs and blood vessels. Treatment focuses on controlling symptoms and preventing joint damage, and commonly includes medication to suppress the immune system and reduce pain and inflammation.

A laminectomy is a surgical procedure to relieve the spinal nerve compression that results from spinal stenosis or a herniated disc. Both spinal stenosis and disc herniation result in excessive pressure on adjacent spinal nerves, causing pain, cramping, numbness, tingling or weakness in the neck, shoulders, arms, lower back or legs, depending on where on the spine the problem occurs. Both conditions may result from aging, injury, or arthritic deterioration.

Chiari malformation (CM) is a structural abnormality in the brain in which the cerebellum is located in a lower position than usual. This happens when the skull is abnormally small or misshapen. When Chiari malformation occurs, the cerebellum is located below the foramen magnum. In this location, more pressure is exerted on the cerebellum and medulla (brain stem), and the functions they control, including balance and motor control, may be adversely affected. This condition may be congenital or develop as the patient grows and it may or may not result in symptoms.

Scoliosis is an abnormal curving of the spine. While all spines have a natural curve, patients with scoliosis have excessive spinal curving. Both girls and boys can develop scoliosis, but cases in females are more likely to require treatment.

Cauda equina ("horse's tail") syndrome, also known as CES, is a rare neurological disorder affecting the group of nerve roots at the bottom of the spinal cord. These nerve roots are responsible for the neurological functioning of the legs, feet, bladder, bowels and pelvic organs. Left untreated, cauda equina syndrome can result in permanent urinary or fecal incontinence, sexual dysfunction or paralysis.

Sciatica is an inflammation of the sciatic nerve, the longest nerve in the body. The sciatic nerve stretches from the spinal cord to the end of each leg and may become inflamed for a number of reasons, including age-related changes in the spine, obesity, or a sedentary lifestyle. Sciatica usually develops gradually as the nerve is compressed over time. This results in pain along the nerve pathway, as well as numbness, tingling and muscle weakness in the affected area.

Lateral lumbar interbody fusion (LLIF) is a spinal fusion technique performed from the side of the body rather than from the back or through the abdomen. Spinal fusion procedures are performed for the relief of persistent pain in the lower back, the lumbar region of the spine. LLIF can be used to treat nerve compression, disc degeneration, spondylothesis and other painful lower back conditions.

A brachial plexus injury affects the nerves responsible for communication between the spine and the arms, shoulders, and hand. Such an injury occurs when the nerves in this location are stretched or torn. This usually results when the shoulder is forced down and the neck stretches up as may happen when the arm is forced above the head. Depending on the severity of the brachial plexus injury, the symptoms may vary a great deal in intensity and duration.

Cervical fusion is a surgical procedure performed to join at least two of the vertebrae of the neck. This surgery is performed to alleviate pain in patients with disorders of the cervical spine, such as stenosis and degenerative disc disease. While there are several nonsurgical methods available to treat these conditions, some patients may benefit from cervical fusion to avoid future complications and achieve long-term relief.

Whiplash is a common neck condition that occurs as a result of a sudden backwards-forwards motion of the head, often associated with car accidents. This type of injury can stretch the muscles and ligaments as the neck moves out of its normal range of motion.

Degenerated discs are a common back problem. The spinal discs, soft, gelatinous cushions that separate the vertebrae, normally wear down during the aging process. Because the discs typically function as shock absorbers between the bones, allowing the spine to bend and twist, this deterioration, when extreme, can result in serious back pain.

Vitamin D is an important nutrient that aids in overall health by keeping bones strong and healthy. The body requires vitamin D to absorb calcium and phosphorous, which are crucial in building and maintaining strong bones and teeth. Although some studies seem to indicate that adequate levels of vitamin D can strengthen the immune system and protect against various health conditions, including diabetes, kidney disease, heart disease and high blood pressure, there is no definitive data to support that conclusion.