Dr. Kenneth Candido, MD

Thank you for requesting information on a possible hernia. The small raised central straight line up from your umbilicus towards your chest seems to me to be the "linea alba" (white line) that separates the right and left sides of your abdominal muscles. The tiny "bump" looks not like a hernia, but perhaps a defect or tear in the rectus abdominis muscle on that side, which is similar to a hernia. It seems more likely that the situation is one of either a torn muscle, or muscles, or a severely strained one. You should rest your abdominal muscles (no snowboarding; no abdominal exercises like crunches or sit-ups); seek medical attention where an ultrasound can be done of your abdominal wall; and wear an abdominal binder until the situation is resolved. An abdominal binder is a velcro like "girdle" that you can buy at any pharmacy without a prescription; I recommend that merely to maintain the integrity of your abdominal muscles until someone can actually make the correct diagnosis. Good luck! Kenneth D. Candido, M.D. Professor of Clinical Anesthesiology-UIC Pain Fellowship Director & Pain Clinic Medical Director Department of Anesthesiology and Pain Management ASIPP Board of Directors CEO & President of Chicago Anesthesia Associates CEO & President of Chicago Anesthesia Pain Specialists Advocate Illinois Masonic Medical Center 3000 N. Halsted St. Suite 823 Chicago, IL 60657 Phone: (773) 296-7937 Fax: (773) 296-3995 kdcandido1@gmail.com *kdcandido@yahoo.com <kdcandido@yahoo.com>*

Hello. A sharp pain over the temple requires immediate evaluation. While your young age (22) speaks against Temporal Arteritis, nevertheless, there is a large artery at the temple area that may become enlarged or inflamed. This cannot be treated unless an ultrasound examination is performed at the area of pain. With or without insurance, you should be seen and evaluated in the closest emergency department and have the examination performed. I would not recommend using any pain medications further until the evaluation has been completed. Hopefully it is a small and local area of inflammation, but nobody can tell without the examination. Good luck!

Back pain is not a true diagnosis really, because there are so many disparate things that can cause it, that it demands a thorough hands-on assessment by someone with experience dealing with the spine and muscles and ligaments of the back. I respectfully suggest that you seek out the services of someone experienced in diagnosing and treating the various causes of back pain, including ordering any indicated tests like X-Rays or perhaps MRIs. Without a comprehensive examination of the back and extremities, there is no way to comment upon the condition of back pain,
and it is foolish for me to attempt to guide you beyond seeking a face-to-face assessment. Good luck!!


Kenneth D. Candido, M.D.
Professor of Clinical Anesthesiology-UIC
Pain Fellowship Director & Pain Clinic Medical Director
Department of Anesthesiology and Pain Management
ASIPP Board of Directors
CEO & President of Chicago Anesthesia Associates
CEO & President of Chicago Anesthesia Pain Specialists
Advocate Illinois Masonic Medical Center
3000 N. Halsted St. Suite 823
Chicago, IL 60657
Phone: (773) 296-7937
Fax: (773) 296-3995
kdcandido1@gmail.com
*kdcandido@yahoo.com <kdcandido@yahoo.com>*

This is concerning, and requires an urgent visit to your nearest emergency department to assess possible disc herniation in your neck; versus a stroke; versus sudden onset of multiple sclerosis. There are many other possibilities of course, none of which can be evaluated without a face-to-face exam. Please do not wait but go get evaluated at once! Thank you and good luck!

Ankle pain has many causes, including arthritic ones, ligament strains or sprains, diabetes, fractures, and nerve tumors, among many others. Is the pain worse with standing? Walking? Sports? Is it affected by different weather conditions? Does it improve with rest and elevation and application of ice? Have you had any X-Rays or diagnostic assessments? All these questions have to be addressed by a competent foot and ankle specialist. This could include either a podiatrist (foot doctor) or an orthopedic foot and ankle specialist. Once you have undertaken the appropriate evaluation, only then can reliable treatment be safely and carefully applied. Good luck!

There are more questions than answers here. "Chronic pain" where? What part of the body? What is the diagnosis? Any prior studies of the spine? Have any prior surgeries? History of opioid use? History of disability claims made? There is so much to know besides the fact that your primary care doctor does not wish to use opioids. Nobody in this day and age is keen on using opioids for a pain issue now 25 years old, by the way. My recommendation? Do a Google search for reputable pain doctors within a 5-mile radius of your home, and start the investigation process of interviewing potential people who may be able to help you. Good luck!!!

Pain following a prostate biopsy can be considered to be inflammatory. My recommendation would be to use a nonsteroidal anti-inflammatory drug such as ibuprofen (assuming you don't have any significant risks for heart attack or stroke or have uncontrolled high blood pressure). Might need to use it for about three days and things should improve rather quickly. Good luck!

There are numerous reasons for arm pain, some innocent (muscular sprain or strain) and some more sinister (herniated disc in the neck with nerve root compression). The causes are so varied and so disparate, that no generalizations can be made. There needs to be an evaluation conducted by a competent musculoskeletal and neurological expert if pain persists beyond two weeks. That person can determine whether or not imaging studies or diagnostic laboratory assessments need to be undertaken. There is no mechanism available to make any definitive determination based on the limited information which you have provided. Good luck!


Kenneth D. Candido, M.D.
Professor of Clinical Anesthesiology-UIC
Pain Fellowship Director & Pain Clinic Medical Director
Department of Anesthesiology and Pain Management
ASIPP Board of Directors
CEO & President of Chicago Anesthesia Associates
CEO & President of Chicago Anesthesia Pain Specialists
Advocate Illinois Masonic Medical Center
3000 N. Halsted St. Suite 823
Chicago, IL 60657
Phone: (773) 296-7937
Fax: (773) 296-3995
kdcandido1@gmail.com
*kdcandido@yahoo.com <kdcandido@yahoo.com>*

Kidney stones cause an intense inflammatory response in the body, which leads to pain but also to muscle spasms. The ideal treatment medically includes the use of a nonsteroidal antiinflammatory type drug in conjunction with a muscle relaxer. One such combination could be the use of Ibuprofen 800 mg three times a day (if there is no risk or history of bleeding, obstruction, or perforation to the stomach and GI tract, and no history of stroke, heart attack, or blood clot), with Cyclobenzaprine (Flexeril) 10 mg twice a day. If the alkalinization of the urine using cranberry juice (or equivalent) fails to relieve the pain within 3 days, however, and help "pass" the stone in the urine, then it is imperative to seek appropriate medical care and treatment with a certified urologist. Good luck!

Severe muscle soreness from an intramuscular injection is never "normal". If the pain does not respond to ICE (not HEAT!) and mild anti-inflammatory type drugs (Ibuprofen 800 mg, or equivalent), you need to seek urgent medical care. Was the injection into the shoulder? Or buttocks? I suspect from what you said, it was the shoulder. The axillary nerve that controls shoulder deltoid movement is right on top of that area where some inject. It may have been bruised. If not better in 48 hours, go to the nearest emergency department. Good luck!


Kenneth D. Candido, M.D.
Professor of Clinical Anesthesiology-UIC
Pain Fellowship Director & Pain Clinic Medical Director
Department of Anesthesiology and Pain Management
ASIPP Board of Directors
CEO & President of Chicago Anesthesia Associates
CEO & President of Chicago Anesthesia Pain Specialists
Advocate Illinois Masonic Medical Center
3000 N. Halsted St. Suite 823
Chicago, IL 60657
Phone: (773) 296-7937
Fax: (773) 296-3995
kdcandido1@gmail.com
*kdcandido@yahoo.com <kdcandido@yahoo.com>*

This is an interesting question. Acupuncture has many proponents, particularly among Eastern Medicine experts. However, there is no scientific evidence that is clear and unequivocal which is in favor of the use of acupuncture as a definitive treatment for low back pain. I suggest that you seek out the services of a back specialist (interventional pain doctor; neurologist; neurosurgeon; physiatrist) if your back pain has been persistent for more than three months or if there are "red flag" signs. These include persistent numbness or weakness in the legs; pain with activity; nighttime pain; bladder or bowel changes in habits; or loss of reflexes. Good luck!

Pain after cataract surgery is rare, but not unheard of. If there is redness or swelling, you need to consult your ophthalmologist. If it is pain exclusively, you might try to apply some ice over the operated eye for 10-minute intervals, and if there are no reasons to avoid the use of anti-inflammatory type drugs, then use some Advil or Motrin or similar agent should be effective in the short term (3-4 days only). The best bet is to circle back with your surgeon and seek guidance, as that person is in the best place to recall if there was anything peculiar or atypical about your surgery. In most cases, the expectation is a few days of mild to moderate discomfort which can be successfully addressed using what I suggested above. Good luck!

KDC

Kenneth D. Candido, M.D.
Professor of Clinical Anesthesiology-UIC
Pain Fellowship Director & Pain Clinic Medical Director
Department of Anesthesiology and Pain Management
ASIPP Board of Directors
CEO & President of Chicago Anesthesia Associates
CEO & President of Chicago Anesthesia Pain Specialists
Advocate Illinois Masonic Medical Center
3000 N. Halsted St. Suite 823
Chicago, IL 60657
Phone: (773) 296-7937
Fax: (773) 296-3995
kdcandido1@gmail.com
*kdcandido@yahoo.com <kdcandido@yahoo.com>*

Good Morning. Several antidepressants have shown benefits for chronic pain management. One of the oldest and with a good track record of relative safety is Amitriptyline (Elavil). Typically taken once a night at bedtime, in small doses like 10 mg, it can be effective and safe for many. Consult your primary care doctor to be certain that you have no risks in using it. Others may work as well, but Amitriptyline has been around for a long time and seems to help many people, especially with nerve-related (neuropathic type) pain. Good luck!

Stomach pain in children can be related to benign conditions (most commonly in school-age kids is school avoidance if you can believe that!), but can also be related to serious illness, including appendicitis and other conditions. My recommendation is to have your child evaluated at an urgent care ("doc-in-the box") facility, but avoid an Emergency Room if possible, because the waiting time may be extensive. If the local urgent care facility deems the issue to be benign, then perhaps you have saved yourself an ER visit. If the urgent care facility deems it to be more serious, requiring extensive testing like a CT scan, then you may end up in the ER anyway. Good luck but don't wait too long. A child's health should be considered a priority!

There is no doubt that toothache can disrupt sleep. The bottom line is, why would you rely upon any "remedy" to address the sleep problem, when in medicine it is often stated that you must address the underlying cause to successfully cure the problem at hand. This means, please seek dental assistance to determine the source of that tooth issue. Resolve it. Most
likely there is some rather simple solution. Get it done and your sleep will revert back to its baseline. I don't make any recommendations on attempting to "override" the problem by masking it using sleep aids. Get the basic problem solved and the rest of your life (eating, talking, sleep) will by definition improve.
Good luck!

Kenneth D. Candido, M.D.

Hello,

That may be a serious neurological condition, and cannot be ignored. You likely will require an MRI of the cervical spine and an EMG (electromyography, nerve conduction velocity) study. Best bet is to get evaluated by a neurologist at the earliest convenience.
Good luck!

Kenneth D. Candido, M.D.

This is normal-for a period of time-but should be discussed with your obstetrician to see if it’s due to the normal events after delivery or possibly due to some pathology. Good luck!!

Hello,

Was the bladder removed at age 9 for a cancer? Have there been surveillance studies conducted to assure no recurrence, if that was the case? As far as addressing the symptoms, it would be prudent to seek an MRI of the thoracic ("middle") area of the spine, to assess the vertebrae (bones of the spine) and intervertebral discs (spacers between vertebrae). The type of pain you are describing can be the result of muscle strains or sprains; ligament stretching; nerve entrapment ('pinched nerve'); bony pathology (facet joint disruption); disc problems (herniated or bulging discs); or possibly some type of occult (hidden) malignancy. I strongly recommend an evaluation by a spine specialist and the obtaining of the MRI at the very least. Hopefully, it will be some type of muscle problem which can be addressed using topical (on the skin) analgesics or muscle relaxants taken by mouth.
Good luck!

Kenneth D. Candido, M.D.

This depends on many factors. First, was the spinal placed easily? Or were there multiple attempts? The longer it took to complete,
the longer the procedure pain will last. Secondly, is your back very muscular? In general, the greater the density of back muscles, the longer it will take for them to heal from the needle puncture. Finally, what was your body’s position in after placement of the spinal? Were you lying on your back and if so, for how long? Generally, the longer you lay on your back, the longer the healing process will be. The pain in any case should not last longer than 2 weeks; if it does, please seek immediate medical attention. Good luck! Meanwhile, ice and stretching exercises and over the counter acetaminophen or ibuprofen may be useful.

The most effective treatment is use of over-the-counter acetaminophen and/or non-steroidal anti-inflammatory type drugs like Ibuprofen. Ibuprofen and similar drugs work by reducing inflammation, and inflammation is the source of most cases of dental type pain. Acetaminophen is a reasonable analgesic for these types of moderate-level pain (4-7/10).
Good luck!

Kenneth D. Candido, M.D.