Interventional Pain Management

Interventional Pain Management

Soda is a Four Letter Word

By Matthias H. Wiederholz

America has an obesity problem.  And it seems the rest of the developed world is following suit.  A question that many people wonder is whether soda consumption increases the likelihood of weight gain. The short answer is YES.

Soft drink consumption has increased globally from 9.5 gallons per person per year in 1997 to 11.4 gallons per person per year in 2010.  Simply a 1% rise in simoft drink consumption contributes to an additional 4.8% overweight adults, 2.3% obese adults, and 0.3% adults with diabetes.1  If this trend of increased consumption of caloric beverages continues, it is clear that these rates will rise drastically.

There is an alarming statistic. Consumption of sugar sweetened beverages (SSB) in the United States is increasing.2,3  About half of mothers with children age 2 reported that their children drank SSB’s at least one day per week.  Moreover, there is a much higher likelihood that children who drink the highest amount of SSB come from low-income families.  These families are the same families that likely have limited access to quality healthcare.

So what does this mean for society in general?  Well, SSB consumption is increasing and the obesity epidemic is worsening.  Insulin resistance is becoming commonplace.  Based on the studies outlined above, we can conclude that soda consumption is certainly contributing to this problem.  In fact, as mentioned earlier, soda consumption predicts weight gain.

Therefore, if you don’t want to gain weight, don’t drink soda!

don’t drink soda


  1. Basu S, et al. Relationship of Soft Drink Consumption to Global Overweight, Obesity, and Diabetes: a Cross-National Analysis of 75 Countries. American Journal of Public Health. Nov 2013; Vol 103, No. 11: pp. 2071-2077.

Back to Health with Nutritional Wellness

By PPSM Staff

Back to Health

Are you struggling through your day with low energy?  Are you too stressed to make healthy balanced meals for you & your family?  Are you feeling frustrated you aren’t reaching your health & wellness goals?  Have diets failed you?

If you answered “Yes” to any of these questions, you need Nutritional Intervention!

Imagine feeling renewed & energized everyday! This is possible – PSSM can help!

Discover Nutritional Wellness with PSSM.

Performance Spine & Sports Medicine is a proud partner of Gold’s Gym “Extra, Extra” Wellness Series ~ designed just for you!

Join us for this FREE lecture:

THURSDAY    SEPTEMBER 26    6PM    Gold’s Gym Lawrenceville, Mind & Body Room

Learn ALL About Nutritional Wellness:

• Creating habits for long term weight loss
• Nutritional considerations for pain & inflammation
• How food sensitivities can hinder optimal health
• Decoding popular diets…. Calorie counting (when, why, how) & more!

Get expert advice from Chiropractic Physicians Susann Clothier, D.C. & Michael Dougherty.  Everyone can benefit from this important health topic.  Bring a friend!

Empower Your Mind  –&-  Get Back to Health.   ‘See you  Thursday!

PSSM Susann Clothier, D.C.PSSM-Michael-Dougherty,-D.C

Rotator Cuff Tendinopathy, By Mahmud Ibrahim MD

By PPSM Staff

Rotator Cuff TendinopathyThe shoulder is one of the most mobile joints in the body. The rotator cuff is a group of muscles that attaches to the shoulder joint via tendons. These tendons not only control the movements of the shoulder, but also help to stabilize the shoulder joint. Over time, patients can develop “wear and tear” of the rotator cuff, called tendinopathy. Tendinopathy can range from slight inflammation of the rotator cuff to a tear of the tendon. Rotator cuff tears are rarely seen in patients under the age of 40. Other risk factors for rotator cuff tendinopathy include repetitive overhead movements, weak shoulder muscles, forward posture of the shoulders, heavy lifting, and a direct blow to the shoulder. Diabetics are at increased risk for developing tendinopathy. Symptoms can include shoulder pain, especially with overhead activities or reaching behind, pain when lying on the affected shoulder, popping or clicking in the shoulder, and limited motion of the shoulder. Initially, symptoms may improve with rest; however, as the degeneration continues, the pain can become constant and occur even at rest. Eventually, the pain can interfere with daily activities. In addition to a physical exam, rotator cuff tendonapathy can be diagnosed with an MRI or ultrasound of the shoulder. Ultrasound is useful as it is (1)noninvasive, (2)can be performed in the office, (3)does not involve being placed in a small tube like structure, (4)and takes only about 5-10 minutes. Ultrasound has actually been found to be more sensitive than MRI in detecting rotator cuff problems. In addition, the physician can show the patient the affected areas in real time.



First line treatment for rotator cuff tendinopathy usually includes physical therapy to help strengthen the rotator cuff muscles, correct the poor posture, and teach proper form for lifting and overhead activities. Medications can include oral anti-inflammatories as well as other pain medications. Ice is also helpful to reduce inflammation. When oral anti-inflammatories are not enough, it may be necessary to perform a corticosteriod injection into the shoulder to help reduce the inflammation. Ultrasound can also be used when injecting the shoulder as it allows the physician to directly visualize the needle and ensure the medication is being injected directly into the affected area. Newer treatment options also include Platelet Rich Plasma, also known as PRP. This treatment involves taking the patient’s own blood, spinning it down, concentrating and extracting the growth factors in the blood, and injecting those growth factors directly into the affected area. This has been shown to actually promote the healing of degenerated tendons. There are also several surgical options available, but they are more invasive and are therefore rarely considered first line treatment options.

Shoulder pain is a common problem. With the proper treatment, the pain can be significantly reduced and improve a patient’s quality of life.  For more information or to schedule a consultation, please call our office in Lawrenceville, NJ at 609-588-8600.

Anxiety and depression, making your back pain more chronic and harder to treat By, Mike Dougherty, DC

By PPSM Staff

We’ll try to keep short and sweet about what we’re reading.  Here’s an old article that resonates pretty well:  “Improved outcome after lumbar microdiscetomy in patients shown their excised disc fragments:  A prospective, double blind, randomized, controlled trail.”

This was published in the journal of neurology, neurosurgery, and psychiatry in 2008.  In this study, patients who underwent lumbar microdiscectomy, a procedure where herniated disc material is cleaned up from the spinal canal reducing nerve pressure.   The patients were put into two categories.  There were those that were given the removed fragments from their surgery and those that weren’t.  Overall, both patients experienced relief but the patients that were given their disc fragments reported improvements in leg symptoms and back pain significantly more than the control group.  There were also improvements in associated leg weakness and paraesthsia.  This group also reported a reduced need to take pain medication sooner after the surgery. 

Anxiety and depressionThese are interesting findings that demonstrate how our mental state can affect our physical state.  Anxiety and depression are common among patients presenting for back surgery and influence the duration of low back pain and the development of a more chronic condition.  Preoperative anxiety or depression and passive pain coping strategies are well established negative prognostic indicators following lumbar microdiscectomy.  Prognostic indicators are factors that influence how quick or slow someone will recover from an injury.

Unfortunately, clinicians forget this and opt to diagnose solely based on findings on MRI or X-ray.  Poorly explained MRI or X-ray findings can lead patients to assume their condition has no hope of getting better.  Think about the diagnosis, “degenerative disc disease.”  The words alone are suggestive of a “disease” that can never improve.  This leads many to assume that they “have a bad back.”  This leads to some of the passive pain coping strategies that make back pain more chronic and harder to treat.

The most important factors are what we find during our clinical examination.  Imaging does play a crucial role in the diagnosis and management of certain conditions, however, should never be solely relied on until conservative measures have been exhausted.  If you need a second opinion regarding surgery, don’t hesitate to ask.

Neck & Shoulder Pain Relief with Non-Surgical Care

By PPSM Staff

Neck & Shoulder pain

“Oh, My Aching Neck!”

Do you suffer from Neck or Shoulder pain?  Look no further!  Your solution to the best non-surgical approach in diagnosis & management is here!

Empower Yourself. Eliminate Your Pain!

Learn about:

• Differentiating between Neck & Shoulder pain
• Diagnostic Imaging:  What test do/don’t I need
• Therapeutic Injections for the shoulder  / Therapeutic Exercise
• Nutritional Strategies for pain & inflammation


Learn more!  MARK YOUR CALENDAR!  Gold’s Gym of Lawrenceville, NJ, is proud to host some of Performance Spine & Sports Medicine’s healthcare seminars, designed for you! Make PSSM at Gold’s Gym your FREE access to expert advice. Dr. Michael Dougherty


Dr. Michael Dougherty, Chiropractic Physician at Performance Spine & Sports Medicine, will be presenting this informative seminar & is ready to answer your questions.  Save the date:

 DATE  >  THURSDAY, June 27
 TIME  >  6:00PM
 WHERE > GOLD’S GYM Lawrenceville

You deserve the best in health ~ ‘See you there!

Stress Incontinence

By PPSM Staff

Stress Incontinence

Does Your Pelvic Floor Fail You when you Laugh, Sneeze, Run or Jump?                                  You are not alone!

Many women ages 25 – 50 suffer from Stress Incontinence.  Stress Incontinence is caused by weakening of the muscles that keep urine stored in the bladder.  Stress Incontinence can be prevented & treated with CONSERVATIVE treatment.                 Physical Therapy can help!

The following are signs that your bladder is not functioning properly:

• You cannot sit through a movie without having to pee.
• You have to get up at night to pee.
• You have a strong urge to pee, but void less than a coffee cup worth.
• You have to strain or have pain with urination.

Dr. Aisling Linehan

Learn more!  MARK YOUR CALENDAR!  Gold’s Gym of Lawrenceville, NJ, is proud to host some of Performance Spine & Sports Medicine’s healthcare seminars, designed for you!  Make PSSM at Gold’s Gym your FREE access to expert advice.

Dr. Aisling Linehan, Physical Therapist at Performance Spine & Sports Medicine, will be presenting this informative seminar & is ready to answer your questions.  Save the date:

 TIME  >  6:00PM
 WHERE  >  GOLD’S GYM of Lawrenceville, Mind & Body Room
Knowledge really is power!                                                              

Orthopedic Doc in Newtown and Lawrenceville Discusses Surgery Prevention For Knee Arthritis (1 of 3)

By PPSM Staff

It is uncertain whether having surgery results in a better outcome than the more conservative option of physical therapy. The New England Journal of Medicine recently featured a study which involved 330 participants who were similar in age, gender, race or ethnic group and divided into two groups. Half of the participants had surgery followed by a course of physical therapy treatment and the other half had physical therapy treatment alone. The groups were mixed in with each other and followed the same physical therapy program. At the conclusion of the study, only 30% of participants who started with physical therapy had arthroscopic knee surgery after 6 months. The study states, “we did not find significant differences between the study groups in functional improvement 6 mos. after randomization; however 30% of patients who were assigned to physical therapy alone underwent surgery within 6 months.” According to this study 70% of patients who went the conservative route and chose NOT to have surgery as their first option saw improvement with physical therapy alone and NO SURGICAL INTERVENTION.

If you have a meniscal tear or osteoarthritis, don’t think surgery is your only option! Physical therapy can help you and I’m going to outline a beginner exercise program to help with knee pain.

Make sure to start your beginner routine with a nice hamstring stretch:

hamstring stretch

If you feel unsteady, you can use a chair or table for support.





After you stretch, begin with Fire Hydrants– Do 2 sets of 15.

Fire Hydrants




Make sure to rest for 30 seconds between reps and 1 minutes between sets!







Next, do 2 sets of Side Step Ups:


Side Step Ups



You can hold a light weight in each hand, I recommend 2-3lbs.  Make sure to rest 30 seconds between sets!









Then move on to Side Leg Lifts:

Side Leg Lifts




Lay on your side, slowly lift your leg up and hold, lower your leg.  Repeat 15 times each leg for 2 sets.




Lastly, Bridge to Squat:

Bridge to Squat


Using a ball for support, slowly lower yourself in the squat position.  Make sure to do 2 sets of 15!


Performance Spine & Sports Medicine supports “National Prescription Pain Medication Take-Back Day” at Mercer County

By PPSM Staff

Spine & Sports Medicine

Do you or your friends & relatives have a medicine cabinet full of old pain medications?

The Medical Doctors at PSSM ask that you collect any unwanted, unused or expired perscription pain medications.  Help Mercer County get rid of them safely!  Here’s how:

This Saturday, April 27th, is National Prescription Drug Take-Back Day.  

Several local Police Departments and law enforcement agencies will be participating in the U.S. Drug Enforcement Administration’s (DEA) initiative.  This nationwide drug take-back day brings attention to the issue of pharmaceutical controlled substance abuse.

The DEA website states “The National Prescription Drug Take-Back Day aims to provide a safe, convenient, and responsible means of disposal, while also educating the general public about the potential for abuse of these medications.”

From 10am to 2pm, our local heroes will be operating collections sites for safe disposal.

Local Drop-off Locations

  • Hamilton Police Department:  1270 Whitehorse Avenue, Hamilton
  • Princeton Police Department:  1 Valley Road, Princeton
  • Hopewell Branch of the Mercer Cty. Library:  245 Pennington Titusville Road, Pennington
  • Ewing Police Department:  2 Jake Garzio Drive, Ewing
  • County Administration Bldg:  640 South Broad Street, Trenton