Meridian Vein and Pain

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Meridian Vein and Pain

Minimally invasive venous disease and chronic pain treatment. Faster recovery and reduced discomfort. Welcome to Meridian Vein and Pain.

Led by Dr. Amit Lakkaraju, with 10+ years of experience, our team specializes in treating venous diseases and chronic pain using minimally invasive, image-guided procedures. Explore a healthier, pain-free life with Meridian Vein and Pain’s vain care and pain management treatments.

13/09/2024

Pakington Street!
Our new home 🏠

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01/09/2024

Consent ✅

I’d like to present a case of a 44y old female who has had thyroid carcinoma about 5yr ago. She went on to have a total thyroidectomy and radiotherapy to her neck. She presented with hypersensitivity of the neck skin and dilated capillaries. The appearances were consistent with a condition called radiation fibrosis. Digging deeper into her case though, she was unable to swallow without forward flexing her neck and could not yawn. She had some anxiety and features of PTSD. She also had neck pain and jaw symptoms. She had hypersensitive anterior neck skin and was unable to wear scarves or high necked collars.

We performed 12 sessions of MLS laser and 4 sessions of 5% dextrose prolotherapy. During these prolotherapy sessions we hydrodissected the vagus nerves bilaterally and performed bilateral dextrose stellate ganglion blocks. We released the neck fascia and paraoesophageal soft tissues. I also performed bilateral c3/4 to c6/7 facet joint prolotherapy.

She is now 6 months post treatment and is able to swallow in all positions including whilst lying down and yawn in all positions. Her mood has lifted and her neck pain has resolved. She says her neck feels fuller. Her hypersensitivity has resolved and so she is able to wear make up and a scarf over the area.

The points I want to convey are:
1. Radiation fibrosis in her case effected a number of layers of the neck. By performing prolotherapy we not onl released those scarred tissues, we were able to perform neuroprolotherapy to the vagus nerve and stellate ganglion. The fascial improved her neck mobility and swallowing.

2. Vagus neuroprolotherapy helped with not only the swallowing but produced vagal nerve stimulation. I think it helped with the parasympathetic issues that she had.

3. Her anxiety, PTSD and mood were improved with the stellate ganglion blocks.

4. The gaunt look and general neck mobility were improved by the process of hudrodissection

5. The MLS laser has helped with not only reducing peripheral sensitisation but also the general skin health. I feel it may have helped in the general improvement of the skin texture also.

01/09/2024

We can attest to this, having done high dose PRP to a number of patients with good out comes at 6-12 months.

29/08/2024

Platelet Rich Plasma is a non-surgical, non-cortisone therapy that can be beneficial in improving patients joint or tendon pain. Not all PRP is the same. Talk to us at Meridian to see what options there are to manage yourself hip and knee pain.

28/08/2024

🚧👷🏽‍♂️Renovations underway👷🏽‍♂️🚧
Can't wait to show off our new location

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23/08/2024

Soon to be opening.

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22/08/2024

Thought I would post a very insightful set of suggestions from Dr Dos Santos, an interventional pain physician and someone I follow:

💊 If you’re an otherwise healthy active adult suffering from discogenic low back pain (pain due to degenerative disc disease - loss of height of the lumbar intervertebral discs), here are 5 actions medical science has proven you should take to decrease pain and improve overall spine health:

⚠️ Avoid Alcohol and To***co: Level I clinical research data indicates that alcohol and to***co use can accelerate disc degeneration. Smoking reduces blood flow to the discs, depriving them of essential nutrients, while alcohol can lead to dehydration and poor disc health. Although some authors (Zhang et al., 2008) have theorized that moderate alcohol consumption (up to 2 drinks per day) may protect against degenerative disc disease, this hypothesis has never been proven in clinical studies. Reducing or eliminating these substances can slow the progression of degenerative disc disease and improve overall spinal health (Rajesh et al., 2022; Lv et al., 2022).

🏋🏻‍♂️ Core Strengthening Exercises: Strengthening the muscles that support your lumbar spine can reduce the load on your intervertebral discs. Focus on exercises such as planks, bird-dogs, and pelvic tilts. These exercises engage the core muscles, providing stability and reducing stress on the lumbar region. Recent clinical research studies have shown that a routine focusing on core strengthening exercises can reduce pain, improve the clinical condition and daily living activities of people with discogenic low back pain (Kuligowski et al., 2021).

🍔 Weight Management: Maintaining a healthy weight (Body Mass Index

21/08/2024

Treat unwanted spider veins with our Sclerotherapy treatment… walk in, walk out procedure 💃

18/08/2024

Let’s talk low back pain and sciatica.

About 16% of the Australian population suffers from low back pain issues of which 10-15% have sciatica.

Acute or chronic back pain can be disabling and draining.

Beyond 3 months, back pain technically is called chronic. Multiple bouts of back pain is called recurrent.

So what causes it?

Traditionally we have thought about back pain in terms of structures becoming diseased. CT and MRI scans of the lumbar spine often show discs bulging or protruding, arthritic joints or pinched nerves.

We now know that there is more to the issue. The modern theory of chronic pain has shown the following:
1. There is a genetic and familial predisposition

2. Mental health and stress plays a big factor in pain experiences.

3. Social (family or partners) and environmental factors ( weather or work conditions) can affect it too.

4. Background health issues can also contribute to it ( low vitamin D, thyroid problems, autoimmune conditions or chronic diseases and viral infections such as Ross River fever or Ebstein Barr virus)

Therefore how can we deal with all these factors?

1. Movement is medicine: exercise plays a transformative role in improving pain therefore exercising can be helpful. The issue comes when pain prevents movement let alone exercise.

2. Medication: there are various medications that act on different pain pathways. These can manage pain effectively although side effects can be a major issue. We know that in the setting of non-cancer pain, the higher the dose of opioids, the more likely pain is going to get worse (opioids not only are addictive but exacerbate pain)

3. Psychotherapy: this can help with managing the psychological component of pain.

4. Image guided pain interventions: these can turn off the peripheral triggers of pain and therefore help in managing pain.

We at Meridian have a multimodality non-pharmacological approach to managing pain:. We use noninvasive and invasive methods, energy based treatments, chemicals and heat. These include:
- Non-invasive pain laser also known as MLS laser
- Nerve treatments such as radiofrequency neurotomy and Botox
- PRP and other regenerative therapies.

We have found that a single type of treatment is not enough.

We make an individualised treatment plan combining multiple modalities over an 8 week period. We aim to improve pain and function by 60-80%.

Finally, we track your pain levels and function over 12 months using a phone app.

If you would like to discuss your issues please contact us at
https://meridianveinandpain.com.au

16/08/2024

Does Varicose Veins treatment need to be performed in theatre?

This is an commonly asked question I get:
Short answer is no 👎🏾 modern varicose vein treatments do not need you to go to hospital and have this performed under a general anaesthetic.

In fact, varicose vein treatments are done in clinic under local anaesthetic. At Meridian Veins we have ticked over 700 patients in the last year all done under a local anaesthetic without any need for sedation. These were all walk in walk out procedures with minimal post operative issues.

In fact a lot of vascular specialists were aware of this fact for over a decade. Here is a paper from 2009 looking at its feasibility.

1. Hamel-Desnos C, Gérard JL, Desnos P. Endovenous laser procedure in a clinic room: feasibility and side effects study of 1,700 cases. Phlebology. 2009 Jun;24(3):125-30. doi: 10.1258/phleb.2008.008040. Erratum in: Phlebology. 2009 Aug;24(4):190. PMID: 19470864.

09/08/2024

Let’s talk varicose veins.

Varicose veins in the legs are caused by a degenerative process effecting the vein wall and vein valves. This process appears to have a genetic/familial pattern of inheritance. About 1 in 3 to 1 in 5 Australians have varicose veins. They can present in patients as young as 15 but are more commonly seen during and after pregnancy as well as in people who stand for prolonged periods of time.

Veins in the legs bring blood from the foot to the heart. There are 3 levels of veins:
- skin veins also known as spider veins
- superficial veins which lie in the subcutaneous fat between the skin and the muscles… these are the veins that become varicose.
- deep veins which lie in the muscles. Deep veins are the most efficient way blood returns to the heart. Blood in the deep veins is pumped back by the surrounding muscles.

Superficial veins have one way valves that prevent back flow.

When the vein valves become degenerate, they fail to close properly and so back flow of blood into the legs occurs. This results in increased pressure within the veins, leading to vein dilation and enlargement of the vein branches. These dilated branch veins are what we see as varicose veins.

Apart from cosmetic issues, is there any other problems with varicose veins???

- varicose veins can cause pain, aching, nerve pain or itching.

- varicose veins tend to have sluggish blood flow. This can in certain circumstances lead to superficial or deep vein thrombosis (clots in the legs).

- varicose veins usually are thin walled veins. They are more likely to seep fluid into surrounding tissues and less likely to clear fluid from the ankles. Therefore, a very common complaint is swelling around the ankles. This swelling becomes more likely when you are unable to mobilise say after an operation or because of flat feet or arthritis in the knee or feet.

- varicose veins often have associated lymphatic issues that can contribute to swelling around the ankles.

- varicose veins cause poor skin health around the ankles and shin bones. Patients with varicose veins often have dry, scaly skin around the ankles. They are more prone to eczema. Skin can become hyper-pigmented, dark and mottled. In extreme cases this can lead to ulcers.

- varicose veins can get inflamed, a condition called “phlebitis” (pronounced flebitis). This can give rise to clots, a condition known as “thrombophlebitis”.

- finally, varicose veins can bleed when knocked or sometimes spontaneously. When these varicose veins bleed internally they can give rise to bruising or haematomas ( accumulation of blood in the soft tissues). When they bleed externally, it can be very difficult to control without medical help.

So, varicose veins are not innocent. Vein health directly impacts leg health.

In the following posts I will talk about management techniques and what we at Meridian can do to manage varicose veins.

Please contact us either by direct messaging us or visiting our website:

https://meridianveinandpain.com.au

Address

Suite 10, Specialist Consulting Suites, Torquay Health Hub, 1-3 Cylinders Road

3228

Opening Hours

Tuesday	09:00 - 05:00
Thursday	09:00 - 17:00
Friday	09:00 - 17:00

Telephone

+61352648388

Website

https://meridianveinandpain.com.au/

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