If you are experiencing pain in one of your shoulders, you may qualify for our research study involving the investigational use of an approved pain patch for shoulder impingement syndrome. Once enrolled, you will receive all study related care and medical supervision associated with the treatment at no cost.

Impingement syndrome can occur when structures in the shoulder get pinched between the shoulder blade and the end of the collar bone. Parts of the shoulder that can be involved include the tendons of the rotator cuff muscles.  You may have heard of people complaining of having problems with their rotator cuff. That is what this is. Other involved tissues include biceps tendons or bursa sacks.

Once these structures start to get irritated and swollen, symptoms can get worse.   Patients will get a deep achy pain in the shoulder that is worse with reaching back, reaching out or up (like answering a question!). Even rolling over in bed and laying on it can cause more pain.

Current research does not clearly show that any one treatment is better than another. Because of this, there are no specific rules for treating impingement syndrome. Treatment can include medications, physical therapy, and injections. In some cases surgery has to be performed to create more space for the tendons, or if the tendons get damaged. Impingement syndrome can be very stubborn and can take months to get better.

If you are above the age of 18 and have are experiencing shoulder pain (and think you may have impingement syndrome) please call 208-939-2100 ext.# 4 to get more information, and to see if you qualify.

These are drugs that are safe and effective when used appropriately, but deadly in the wrong hands.

How can you prevent a tragic poisoning? The most important thing is to remove unused medications from your house, and to secure medications that you are currently using.

Many local jurisdictions have ways of disposing unwanted pills. For example, in southwest Idaho, local police and sheriffs have a drop box to get safely get rid of old medications. Check with your local authorities about disposing of unwanted medications.

What else can you do?

Always keep medications out of sight, and out of reach! Put them away when you are done with them. And don’t forget to put the caps back on. Those ‘child proof’ caps really do work.

Visit Poison Prevention.org (http://www.poisonprevention.org/index.htm ) for more information. Remember, securing your pills can prevent a fatal overdose.

The problem is that these articles are written by authors who seem to forget their audience: out of shape people.

Generally, the exercises are challenging and fun, but frequently feature a mixture of motions (like combining regions – exercising both the lower and upper body; or combining actions – walking while lifting something) and are probably not appropriate for many readers. If you are not already in decent shape it is unlikely that you can safely or correctly perform these activities.

The problem is that with combinations of motions, you need to focus on too many things simultaneously to do them all correctly, particularly if you are a bit out of shape. For me, the classic example is the ‘walking lunge’. This happens all the time, people trying to do a lunge while walking – and doing neither well: they are off balance, lunges bent forward or to the side, knees wobbly, shoulders tight.

So what should you do if you are returning to the gym and trying to get back into shape? Although perhaps not as fun or trendy, the good old strength training machines at your local gym  are an ideal starting point. These machines are designed reduce the number of things you have to do at any one time (generally to work 1 joint and group of muscles). That makes them easier and safer. When you use all the machines, you ideally get a full body workout. If you do the circuit without long breaks between machines, you keep your heart rate consistently elevated for a decent cardio workout. All of this while minimizing your chance of injury.

So skip the ‘walking lunge’. Forget the the ‘squatting arm pulls”. Keep your New Year’s resolution by hitting the machines at your local gym.

The FDA slapped a manufacturer of more than 400 dietary supplements with in injunction permanently halting production of its entire product line.  This severe penalty was levied for having ingredients in its products that were not on the label, and for failure to report serious adverse events associated with certain products.

These products were manufactured by ATF Fitness Products Inc. (ATF), Manufacturing ATF Dedicated Excellence, Inc. (MADE) and sold under the brand names “Sci-Fit,” “Nature’s Science” and “For Store Only ” or “FSO”.

The web sites for these products state that every ingredient is “meticulously thought out” and that their products are “guaranteed for quality”.

My patients have heard me say this many times: supplement manufacturers are not held to the same standard of manufacturing as pharmaceuticals. Just because a label says a product is “pure” or “natural” or “highest quality”, does not make it safe.  When buying dietary supplements, as this case demonstrates, you cannot believe what is on the label.

Read more about it here: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm281017.htm

Have you seen all the ads lately from healthcare providers? There are chiropractors advertising treatment for diabetes, autoimmune and thyroid disorders. There are ads for laser treatments for low back pain (FDA Cleared!). There are ads for osteoarthritis featuring “the latest non-surgical treatments”. Some come with “free consultations”; others offer “free gourmet meals”.

>One of my biggest frustrations as a physician is that when patients are hurting — from arthritis or from playing a sport or auto accident or from a work injury – they are susceptible to these kinds of sales pitches. As a result, patients can sometimes get unhelpful, inefficient, overpriced or just plain wrong treatment.

>While the newspapers and the internet can be great sources of information, it can be difficult for a layperson to sort out good information from bogus sales pitches. It is unlikely that you will get unbiased factual information at a free dinner. And frequently ads with the catchiest slogans or the sites with the best looking pages (or those that turn up on top of searches) are not best places to find the facts.

I have been trying to get information to my patients about what is appropriate treatment and what is not. And my web developer (webgoddess.net) and my search engine optimization consultant (www.seodonetherightway.com) have done a great job at increasing my internet visibility and traffic. Look for more articles here about treatment of pain and musculoskeletal problems.

But where else can patients go to get unbiased medical information?

Here are a few suggestions.

Health.NIH.gov is the National Institutes for Health web page designed for patients. It has an alphabetical disease index – from Addison’s disease to Wegener’s granulomatosus. While not quite A to Z , it is a comprehensive source of reliable information on diseases and treatments.

NLM.GOV is the web site for the National Library of Medicine that is known for Medline. It is a wonderful resource for scientific information. You can find summaries of journal articles on individual studies. In many cases the full article is available. The information can be very technical and search terms are not always intuitive, but with a little practice (and using the tutorials) you can be researching and answering your own questions about diseases.

Cochrane.org is a website from an organization, the Cochrane Collaboration, which reviews and summarizes medical information using the best data available. Go to the clinical reviews section. This site lists the reviews by diagnoses, so getting the summary you need is very easy. The information in the summary though may seem a bit technical, as the reviews are not written for lay people. But don’t let that discourage you; it is worth struggling through some of the jargon to get at the answers you want.

Webmd.com is a site that is full of ads and content that is sponsored by drug companies. But is also full of good, basic information about disease states and is written for the general public. It also has handy tools like a pill identifier, doctor finder and symptom checker.

Whatever information you find, you should never base treatment decisions solely on the web-based information. Take what you learn back to your doctor and see if together you can develop a plan that is based on sound science and fits your personal preferences. It could be that a free gourmet meal and “the latest non-surgical treatment” for arthritis or “lasers for back pain” are not what you need.

Injury Care Medical and Ladd Family Pharmacy are again partnering with the Idaho Food Bank for the Great Turkey Drive on Thursday, November 3, 2011. Donate a frozen turkey or make a cash donation toward the purchase of a turkey between 7 AM to 7 PM to help us meet out goal of 500 turkeys and/or $5,000 for those in need this holiday season.

TWO Donation Locations: Bring your turkey or $ equivalent to Ladd Family Pharmacy at 1109 S. Broadway in Boise OR Injury Care Medical Center in Meridian on the corner of Eagle and McMillan (4850 N Rosepoint Way # 100) OR donate online by clicking the button below.

Door Prizes and FREE Flu Shots are offered (Ladd Family Pharmacy only) along with gift card giveaways, special in-store discount coupons, and more. Anyone donating is eligible.

Special thanks goes to 94.9 The River, 107.1 KHITS, Variety Rock 105.1 and 100.3 the X  as well as KIVI and Fox 9 who is helping raise awareness for the event.

During the holiday season, the Idaho Food Bank distributes over 1.5 million pounds of food to their partner agencies.

Idaho Hunger Facts

• Approximately 17,300 different people in Idaho receive emergency food assistance in any given week.
• 32% of the members of households in Idaho are children under 18 years old
• 10% of the members of households are children under the age of 6
• 4% of the members of households are elderly
• 44% of the members households include at least one employed adult
• 26% are homeless
• Among all client households served by emergency food programs in Idaho, 85% are food insecure (in a state of being unable to provide food for oneself or family)
• 42% of the clients are experiencing hunger
• Among households with children, 85% are food insecure and 35% are experiencing hunger
• 55% of clients in Idaho report having to choose between paying for food and paying for utilities
• 34% had to choose between paying for food and paying their rent or mortgage
• 36% had to choose between paying for food and paying for medicine or medical care

Our goal is to help those in need in the communities where we live and work. That is why the Annual Food Drive is so important and why it needs all of us participating to be successful.

Thank you for your support.

RIP-OFF: You have to report your injury within 24 hours or you lose your rights to file a claim.
FACT: You have 60 days from the time of the injury (or from the time you realize you are hurt).

RIP-OFF: My employer is not required to have coverage.
FACT: All Idaho employers are required to have coverage. Call the Idaho Industrial Commission to find out if your employer is exempt.

RIP-OFF: The insurance company must approve of all medical treatment.
FACT: Idaho law specifically states that all reasonable and necessary care will be paid for by the employer and that prior authorization is not required (IDAPA 72-432).

RIP-OFF: Case managers have to be in the exam room with me and my doctor.
FACT: You can ask a case manager to leave; they have no right to be there.

RIP-OFF: My employer threatened to fire me if I file a claim.
FACT: Call the industrial commission! It is illegal to fire an employee for filing a claim.

RIP-OFF: I think my case manager is telling my doctor that I am not really hurt.
FACT: Tell the doctor that you are his patient and that you want to get better.

RIP-OFF: I was told that my injury was due to preexisting problems and I am not covered.
FACT: There is no exclusion for preexisting conditions in the workman’s comp system.

RIP-OFF: My doctor released me back to work without restrictions, but I can’t do the work.
FACT: Get another medical opinion, ask to be referred to another doctor and call the Industrial Commission. You may need to consult an attorney.

RIP-OFF: My doctor told me there was nothing more he could do for me.
FACT: Get another medical opinion; ask to be referred to another doctor.

RIP-OFF: I am being put through a „work hardening‟ program.
FACT: Many of these programs are designed to close out your claim. If you can‟t do the work, get another medical opinion, ask to be referred to another doctor and call the Industrial Commission. You may need to consult an attorney.

MYTH: The workers compensation system is full of fraud and waste.
FACT: Studies show that only 1 to 2 percent of workers’ compensation claims are fraudulent.

MYTH: People who file injury claims don‟t want to work and take advantage of the system.
FACT: Good people get hurt and deserve good medical care.

MYTH: If I hurt my spine I need to get a MRI immediately to see if I have a disc herniation.
FACT: Getting diagnostic tests like MRIs too soon can lead to unnecessary treatment. Studies show that most back or neck problems, including herniations, will get better in time.

MYTH: Doctors document all the injuries and symptoms that I have been telling them about.
FACT: Doctors cannot always write everything down. Review the chart notes to be sure.

MYTH: Medications only mask the problem, do not help me heal and may make things worse.
FACT: Medications can help heal some of the causes of pain and disability. They can be an important part of healing.

MYTH: All treatment providers are more or less the same.
FACT: The kind of provider you see will have an impact on your recovery.

Important Phone Numbers

• Idaho Department of Insurance: 800-721-3272
• Idaho Industrial Commission: 334-6000, 800-950-2110
• Idaho Industrial Commission, Rehabilitation Division: 334-6000, 800-950-2110
• Idaho Bar Association (Idaho State Bar): 334-4500
• Injury Care Medical Center: 939-2100

This report is provided as a public, educational service by Injury Care Medical Centers. While every attempt is made to ensure that the information it contains is accurate and up to date, we cannot be responsible for consequences of incorrect information.

• Got Shoulder Pain?
• Where to Find Good Medical Information on the Web
• New Year, New Exercises?
• Back Pain – Do You Need Surgery?

If you are suffering from back pain or a back injury, you probably are confused about the variety of treatment options: injections, medications, physical therapy, chiropractic, lasers, surgery, traction and acupuncture, to name a few.

Which is best for you?

At Injury Care Medical Center, we have experience with all these and more. We will listen to you, answer your questions, address your concerns and create a treatment plan that is best for you.

Shocking Back Pain Fact.

If you live in southwest Idaho, you need to be aware of this shocking fact: Idaho spine surgeons perform back surgeries at a rate of about 18 surgeries per 1,000 enrolled lives.* That might not seem like a lot, but it is a lot more than almost anywhere else in the nation.  For example, the average national rate of spine surgeries for Medicare enrolees is less than 4 for every 1,000!** If you or a loved one have been told that you need back surgery, you owe it to yourself to get another, non-surgical opinion.

This is especially important because the success rate for spinal surgery for back pain overall is only about 50%.***

In fact, despite what the ads say, the success rate for most treatments for back pain is not much better.² No one treatment is universally effective.

At Injury Care Medical Center, we have helped dozens of patients avoid surgery, and dozens more get back to living normal, active, pain-free lives. Contact us today for more information or to arrange an appointment to see how we can help you.

* Blue Cross Idaho Data
** http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913862/
*** http://www2.cochrane.org

50 years ago, before clot-busting drugs, before angiograms and catheters, before we even knew to give an aspirin for a heart attack, there was not a lot physicians could do to treat acute cardiovascular events, like strokes or heart attacks. In fact, an old medical saying when treating a stroke was “don’t just do something, stand there”.

So there were some people, 50 years ago, that when having a stroke or a heart attack, chose to stay at home and hope for the best. Even though stroke and heart attack treatments were not very effective, no medical professional at the time would have advised a patient to stay at home.

That was why I was surprised recently when I read an article from the New York Times News Service.