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1st UA w/ PMP, what to expect?
Hello everyone, I am new here & first & foremost would like to say what a blessing this forum is for CP suffers & thank you all so very much for all of your empathy towards others who struggle with this. Your selflessness & endless support are surely a Godsend for many people who are at the end of their rope & simply in need of sympathetic 'shoulder' (or 'eye' ; ) I should say) to lean on; someone to listen.
I'll try my best to make this as short as possible as I know there are many that need time/space here as much if not more than I do right now.
I have been struggling with chronic hip (sacroiliac) & lower back pain for several years now. I have seen many different doctors over the years & had many tests performed to try & diagnose the problem to no avail until recently. Approximately a year ago not long after I had my first child (in which my pain escalated significantly during that pregnancy) my pain level had just reached a point where I wasn't getting any sleep at all, wasn't able to function during the day without help & was just having terrible trouble overall managing my home/daily life & taking care of my son. At this time I had already been told by many doctors that it was just strain, treated w/ several rounds of physical therapy & basically written off.
I finally ended up going to an urgent care clinic & basically demanded that they do anything & everything to find out the cause of my pain & fix it. That doctor examined me & did xrays & I was told that he thought I may be experiencing the early symptoms of RA & that he thought he may have spotted signs of it on my xray. He ordered an MRI & referred me to a pain specialist/spine doctor. At my initial visit a year ago I was told that my MRI showed my back was normal & that there was nerve damage in my rt hip, most likely caused by an early trauma or injury which after informing my doc of a serious injury I sustained in a car accident was considered to be the likely cause. I told them that the prior doc thought I should be tested for RA but the pain doc said I was too young & that was probably not the problem. RA is genetic & it is on both my mother's side as well as my father's. Why wouldn't they check me for that does anyone know?
I was put on a treatment plan consisting of quarterly (as needed) pain injections, neurontin, norco & valium.
I have been on this same treatment plan (with positive results) for about 11 months now & have had no problems until recently. I felt I had a very good relationship with my doctor & felt very comfortable being honest with him about many things going on in my life.
A couple of appointments back when I came in the nurse took my blood pressure/pulse. Apparently they were both very high as when my doc came in he asked me if there was something wrong & why was I so nervous about coming in to see him today?!? I said that I wasn't really quite sure why my pressure/pulse were up but that the most likely reason was the severe stress I am under. That day I basically vented on him & let everything out. I am a stay at home mom of a child in the midst of their terrible two's, and when I say terrible I mean absolutely nearly INTOLERABLE. All my life I've struggled with depression/anxiety & panic attacks yet I've always managed to be a very independent person.
Up until I became a mother (by far the most hardest yet rewarding job there is on this earth) I had a career & pretty much had my entire identity, self esteem, confidence, everything wrapped up in my work. I suddenly went from bringing home a paycheck (right before the economy took a nosedive unfortunately), getting promotions, to being at home all day with a screaming toddler, STRESS!
Anyhow I let loose on my doctor & I've come to think that I shouldn't have. I've heard that pain clinic doc's tend to treat patients like druggies & like they're just trying to get medicine. I never felt that way at all about my doc. Up until recently I truly felt like he believed me & really did understand the amount of pain I was in & the toll it had taken on my life. After I told him about the stress in my life he suggested a few different things for me todo. next time I called in for my meds he did call them in like normal but didn't give me my normal 2 extra fills. I thought this a little weird but didn't think about it much more at the time. At my next appt he seemed different to me, a bit standoffish & asking me a lot of weird questions about my meds (more than is normal for my appt) like was I ending up with a lot of leftover valium (those I only take when I have bad flareups, on an 'as needed' basis) and how often was I taking 2 tabs of my pain meds (I take those 1 - 2 tabs per dose 4 times daily) & just a bunch of stuff that seemed out of the ordinary to me. I still didn't think anything of it, I guess I'm kind of naive about all that stuff.
So my last appointment I had to call & reschedule (this was the first time I'd done this because they don't like for you to reschedule appts) because my husband wasn't able to take that day off from work to watch our son as well as I wouldn't have the money for my co pay until our payday. I called a week in advance & rescheduled it for 3 days later. When I went in for that appointment the nurse was asking me TONS of questions & I couldn't remember the exact day that I had last taken my valium. She got kind of short with me & said that I had to give her an EXACT DATE. So I just guessed. I should have known; sure enough they asked me to do a urinalysis.So I peed & the nurse said she'd get it to him & he'd be in to see me in a little bit. When he came in he said that they had to do random screening on everyone, that the DEA requires them to do that.
Here's the problem though, not only was I not able to pay my co pay earlier that week but I was supposed to pick up my meds 3 days before my appt & couldn't afford to do that either. I had some old Tylenol 3 that I took the 1st day I was out & a friend of mine gave me a few percocet she had left from a dental procedure to hold me over until I could pick up my norco when my husband got his paycheck. I have no idea how all that stuff works but she said that the oxycodone was pretty much the same thing as my norco so it wouldn't be any different than me taking my regular medicine. That's all fine I guess unless your doctor tests you. I don't really know. I honestly don't even know if he did the test there in the office or not, he acted like everything was fine. Does anyone know if they do the testing in the office or do you have to be called later with the results? I'm just really upset about this whole situation. Things are already tough enough as it is with my husband & I trying to hold everything together financially & I just can't believe I was so stupid not to know about this. I feel like my doctor thinks I'm a total nutcase, he made me feel like an unbalanced, out of control Mother & it just really hurts more than anything that the relationship I thought I had with him wasn't really that at all. I don't know what I'll do if I lose my doctor, I can't deal with this pain by myself, I want to be able to do the job I'm supposed to do at home, to be able to pick up my son & go & do things ithhim. Does anyone have any kind words of advice for me? This is just so crazy to me, I truly truly didn't mean to do anything wrong but I think I may have just messed up pretty bad. Does anyone know how those meds will come out in my urine test?
Thank you all so much for listening, everyone here is truly such a blessing.
I'll try my best to make this as short as possible as I know there are many that need time/space here as much if not more than I do right now.
I have been struggling with chronic hip (sacroiliac) & lower back pain for several years now. I have seen many different doctors over the years & had many tests performed to try & diagnose the problem to no avail until recently. Approximately a year ago not long after I had my first child (in which my pain escalated significantly during that pregnancy) my pain level had just reached a point where I wasn't getting any sleep at all, wasn't able to function during the day without help & was just having terrible trouble overall managing my home/daily life & taking care of my son. At this time I had already been told by many doctors that it was just strain, treated w/ several rounds of physical therapy & basically written off.
I finally ended up going to an urgent care clinic & basically demanded that they do anything & everything to find out the cause of my pain & fix it. That doctor examined me & did xrays & I was told that he thought I may be experiencing the early symptoms of RA & that he thought he may have spotted signs of it on my xray. He ordered an MRI & referred me to a pain specialist/spine doctor. At my initial visit a year ago I was told that my MRI showed my back was normal & that there was nerve damage in my rt hip, most likely caused by an early trauma or injury which after informing my doc of a serious injury I sustained in a car accident was considered to be the likely cause. I told them that the prior doc thought I should be tested for RA but the pain doc said I was too young & that was probably not the problem. RA is genetic & it is on both my mother's side as well as my father's. Why wouldn't they check me for that does anyone know?
I was put on a treatment plan consisting of quarterly (as needed) pain injections, neurontin, norco & valium.
I have been on this same treatment plan (with positive results) for about 11 months now & have had no problems until recently. I felt I had a very good relationship with my doctor & felt very comfortable being honest with him about many things going on in my life.
A couple of appointments back when I came in the nurse took my blood pressure/pulse. Apparently they were both very high as when my doc came in he asked me if there was something wrong & why was I so nervous about coming in to see him today?!? I said that I wasn't really quite sure why my pressure/pulse were up but that the most likely reason was the severe stress I am under. That day I basically vented on him & let everything out. I am a stay at home mom of a child in the midst of their terrible two's, and when I say terrible I mean absolutely nearly INTOLERABLE. All my life I've struggled with depression/anxiety & panic attacks yet I've always managed to be a very independent person.
Up until I became a mother (by far the most hardest yet rewarding job there is on this earth) I had a career & pretty much had my entire identity, self esteem, confidence, everything wrapped up in my work. I suddenly went from bringing home a paycheck (right before the economy took a nosedive unfortunately), getting promotions, to being at home all day with a screaming toddler, STRESS!
Anyhow I let loose on my doctor & I've come to think that I shouldn't have. I've heard that pain clinic doc's tend to treat patients like druggies & like they're just trying to get medicine. I never felt that way at all about my doc. Up until recently I truly felt like he believed me & really did understand the amount of pain I was in & the toll it had taken on my life. After I told him about the stress in my life he suggested a few different things for me todo. next time I called in for my meds he did call them in like normal but didn't give me my normal 2 extra fills. I thought this a little weird but didn't think about it much more at the time. At my next appt he seemed different to me, a bit standoffish & asking me a lot of weird questions about my meds (more than is normal for my appt) like was I ending up with a lot of leftover valium (those I only take when I have bad flareups, on an 'as needed' basis) and how often was I taking 2 tabs of my pain meds (I take those 1 - 2 tabs per dose 4 times daily) & just a bunch of stuff that seemed out of the ordinary to me. I still didn't think anything of it, I guess I'm kind of naive about all that stuff.
So my last appointment I had to call & reschedule (this was the first time I'd done this because they don't like for you to reschedule appts) because my husband wasn't able to take that day off from work to watch our son as well as I wouldn't have the money for my co pay until our payday. I called a week in advance & rescheduled it for 3 days later. When I went in for that appointment the nurse was asking me TONS of questions & I couldn't remember the exact day that I had last taken my valium. She got kind of short with me & said that I had to give her an EXACT DATE. So I just guessed. I should have known; sure enough they asked me to do a urinalysis.So I peed & the nurse said she'd get it to him & he'd be in to see me in a little bit. When he came in he said that they had to do random screening on everyone, that the DEA requires them to do that.
Here's the problem though, not only was I not able to pay my co pay earlier that week but I was supposed to pick up my meds 3 days before my appt & couldn't afford to do that either. I had some old Tylenol 3 that I took the 1st day I was out & a friend of mine gave me a few percocet she had left from a dental procedure to hold me over until I could pick up my norco when my husband got his paycheck. I have no idea how all that stuff works but she said that the oxycodone was pretty much the same thing as my norco so it wouldn't be any different than me taking my regular medicine. That's all fine I guess unless your doctor tests you. I don't really know. I honestly don't even know if he did the test there in the office or not, he acted like everything was fine. Does anyone know if they do the testing in the office or do you have to be called later with the results? I'm just really upset about this whole situation. Things are already tough enough as it is with my husband & I trying to hold everything together financially & I just can't believe I was so stupid not to know about this. I feel like my doctor thinks I'm a total nutcase, he made me feel like an unbalanced, out of control Mother & it just really hurts more than anything that the relationship I thought I had with him wasn't really that at all. I don't know what I'll do if I lose my doctor, I can't deal with this pain by myself, I want to be able to do the job I'm supposed to do at home, to be able to pick up my son & go & do things ithhim. Does anyone have any kind words of advice for me? This is just so crazy to me, I truly truly didn't mean to do anything wrong but I think I may have just messed up pretty bad. Does anyone know how those meds will come out in my urine test?
Thank you all so much for listening, everyone here is truly such a blessing.
With your financial difficulties, have you filed for SS disability? Anyone who had a job who is unable to work should file. You've paid into the system and, like most of us, don't want to have to take back but sometimes that is the hand you are dealt. If you have not, you should. If you have, and were denied, you should contact Allsup for help instead of hiring a lawyer. They got me approved within months. Their fee maxs out at $6,000 and they only take a percentage (I don't remember what) of what is owed in arrears. No one should be in a position where they can't afford the medications that they need to live....it makes us take desparate actions that end up hurting us more than helping.
I think things may have changed since I was offered a nerve ablation. What it meant at the time was that they would kill a major nerve or two that would not come back. I would be left with basically a "dead leg." I said definitely no. I won't go into those lengthy reason here but I am glad I made that decision. It was before I had a diagnosis and the large well known PM Clinic could not come up with one.
I kept my pain and was not sorry for It, as was the key to my final and correct diagnosis. My pain is in my buttocks, groin, lower back and hip and of course produces severe sciatica. A dead leg may have stopped the sciatica. I am not sure of that but it would not stopped the rest of the pain. Almost 12 years later It took a DO to diagnosis me who soon sent me to a different PM Clinic that I had not been to. They performed a test that confirmed her diagnosis. The diagnosis that no one else thought of and I had never heard of, nor did I know anyone who ever had it.
I don't know if you have SIJ Dysfunction but it certainly bares consideration. I even had a neurologist tell me after the diagnosis that I couldn't possibly have it. That's the reason we had the test done, to confirm her diagnosis, even though we both knew she was right. The rest of the medical community had to have "proof."
So I wish you the very best. It was a long search for me and I gave up in frustration and anger. Had I not seen this DO for a different reason and she discovered it I am not sure I would be here today. So keep searching. Never give up.
I kept my pain and was not sorry for It, as was the key to my final and correct diagnosis. My pain is in my buttocks, groin, lower back and hip and of course produces severe sciatica. A dead leg may have stopped the sciatica. I am not sure of that but it would not stopped the rest of the pain. Almost 12 years later It took a DO to diagnosis me who soon sent me to a different PM Clinic that I had not been to. They performed a test that confirmed her diagnosis. The diagnosis that no one else thought of and I had never heard of, nor did I know anyone who ever had it.
I don't know if you have SIJ Dysfunction but it certainly bares consideration. I even had a neurologist tell me after the diagnosis that I couldn't possibly have it. That's the reason we had the test done, to confirm her diagnosis, even though we both knew she was right. The rest of the medical community had to have "proof."
So I wish you the very best. It was a long search for me and I gave up in frustration and anger. Had I not seen this DO for a different reason and she discovered it I am not sure I would be here today. So keep searching. Never give up.
Tuck,
I will most certainly do that. I really do think you got me on to something here.It's been a very long road trying to figure out what is wrong with me & now I finally feel like I may be getting somewhere. I have told my PMP many times that I just would like him to figure out what's wrong & fix it so I don't have to be on any medication at all & just be pain free. He had mentioned doing nerve ablation on me but I'm not quite sure about that as I've read that the recovery time is longer than with the injections & I just don't have the option of being out of commission completely for too long a period of time. My husband works full time & I have to be able to function well enough to take care of our son. As it is right now I have to schedule my injections on Friday afternoons so I'm able to have his help for a couple of days afterwards since I'm usually in a lot more pain for 2 to 3 days after I have them. It would be great to find a treatment plan that works that I don't have to 'recover' from at all. I'm in Idaho so I'll have to check into it & see about finding a doctor that is covered under my insurance but I'm sure I can do that.
Thanks so much for all your help! Hope all is well with you!
I will most certainly do that. I really do think you got me on to something here.It's been a very long road trying to figure out what is wrong with me & now I finally feel like I may be getting somewhere. I have told my PMP many times that I just would like him to figure out what's wrong & fix it so I don't have to be on any medication at all & just be pain free. He had mentioned doing nerve ablation on me but I'm not quite sure about that as I've read that the recovery time is longer than with the injections & I just don't have the option of being out of commission completely for too long a period of time. My husband works full time & I have to be able to function well enough to take care of our son. As it is right now I have to schedule my injections on Friday afternoons so I'm able to have his help for a couple of days afterwards since I'm usually in a lot more pain for 2 to 3 days after I have them. It would be great to find a treatment plan that works that I don't have to 'recover' from at all. I'm in Idaho so I'll have to check into it & see about finding a doctor that is covered under my insurance but I'm sure I can do that.
Thanks so much for all your help! Hope all is well with you!
A D.O. can be found in many clinics across the US. They are very similar to MDs. There can go into any speciality, in fact you may have even seen a DO and not even have realized it.
Most every clinic in my area of Wisconsin has a DO on staff. However not all of them continue to practice OMT. If you goggle Doctor of Osteopathy you will learn about their focus and practices. You can even go to their site and locate one in your area.
I am glad that I could offer you some information. I just hope that it helps.
Best of Luck to You,
~Tuck
Most every clinic in my area of Wisconsin has a DO on staff. However not all of them continue to practice OMT. If you goggle Doctor of Osteopathy you will learn about their focus and practices. You can even go to their site and locate one in your area.
I am glad that I could offer you some information. I just hope that it helps.
Best of Luck to You,
~Tuck
Sandee,
I also wanted to thank you as well for such a quick response to my post. I really appreciate you all taking your own time out to help others with issues such as these. It can be very trying & confusing dealing with this & having to worry/wait to know what your fate may be. It definitely makes me feel somewhat better to know that although I may have made a mistake with this doc I still have options I can look into. Do you all know if my doc would maybe consider keeping me on as a patient just to do my quarterly pain injections? I understand that he most likely won't want to manage my meds anymore but I was just wondering if he would be open to continuing with my procedures. These help a lot & I don't know how many doctors do it here in my area, I had a hard time finding one initially that would & also took the insurance I have. They're very expensive. Once again thank you so much for your response!
I also wanted to thank you as well for such a quick response to my post. I really appreciate you all taking your own time out to help others with issues such as these. It can be very trying & confusing dealing with this & having to worry/wait to know what your fate may be. It definitely makes me feel somewhat better to know that although I may have made a mistake with this doc I still have options I can look into. Do you all know if my doc would maybe consider keeping me on as a patient just to do my quarterly pain injections? I understand that he most likely won't want to manage my meds anymore but I was just wondering if he would be open to continuing with my procedures. These help a lot & I don't know how many doctors do it here in my area, I had a hard time finding one initially that would & also took the insurance I have. They're very expensive. Once again thank you so much for your response!
Tuck,
I cannot even begin to tell you how very much I appreciate your help & advice! What you mention sounds very much like my problem. I have told the docs over & over in the best way I know how that my hip pain a lot of times feels as if it is 'not in there right' or almost like it is out of joint or something. They've never really done anything about it or said anything. I will most definitely mention this & look into finding an osteo specialist as you suggest.
Thank you SOOOO much for taking the time to help me. It means so much! I will keep y'all updated on what happens. Thanks again!
I cannot even begin to tell you how very much I appreciate your help & advice! What you mention sounds very much like my problem. I have told the docs over & over in the best way I know how that my hip pain a lot of times feels as if it is 'not in there right' or almost like it is out of joint or something. They've never really done anything about it or said anything. I will most definitely mention this & look into finding an osteo specialist as you suggest.
Thank you SOOOO much for taking the time to help me. It means so much! I will keep y'all updated on what happens. Thanks again!
Hello Kmart,
I am so glad that you found on MedHelp and took the time to post the detailed events. First, be calm, easy for me to say I know! I never realized the extent stress can play in chronic pain (CP) until I wasn't under stress for several days.
The UA will most likely reveal any opiates that you took in the last 48 hours. And yes they are usually sent out but not always. It depends on the lab capabilities of your clinic. Never take anything that is not prescribed for you. Hydrocodone and oxycodone (percocet) though similar are different. And Tylenol #3 contains codeine, which is different from both the preciously mentioned narcotics. I assume you signed a contract. You must follow that to the letter, or risk being discharged without notice from the OM practice. So be cautious and follow your contract for your own sake.
I am sorry that you now feel uncomfortable with your PMP. If he does not dismiss you for a abnormal Urine Drug Screen you may want to consider finding a new PMP. As you know it is so important that we are comfortable with our PMP. I have a great patient/doctor relationship, which is imperative, especially when we suffer with CP and the daily disruptions it beings to our lives. Is it possible that you are just being overly sensitive now that you have told him you inter feelings? He may just be looking for ways to better treat you given all the facts. I guess only time will provide you with those answers.
By the description of your chronic pain it sounds like you have SIJ (sacroiliac joint) Dysfunction. So do I. It is an extremely painful condition with little effective treatments available. I know the horrific pain it can bring. It took years for me to find a diagnosis. SIJ Dysfunction is under-diagnosed and often missed or dismissed as a pain causation.
Have you seen a D.O. (Doctor of Osteopathy)? Not all D.O.'s are equal or perform OMT (Osteopathic manipulation therapy). Mine PCP is an Internal Medicine Physician (D.O.) that does OMT. She attempts to keep the joint in alignment, when "out" I can barely ambulate or function. Because I live in Wisconsin it is our PCP that treat and prescribe to their CP patients. If it were not for my DO I would not be able to live with this pain. I encourage you to consult a DO that practices OMT. Her treatments have proven to be the only treatment that helps my SIJ pain.
I wish you the very best and am so glad that you have joined our community. MedHelp has been a God-sent to me. The wonderful support, information and understanding that our members extend to one another is like no other site. I hope you will become active in our community. Please let us know how you are doing and how the results of your next PM appointment goes. I will look forward to hearing from you again soon
Take Care,
~Tuck
I am so glad that you found on MedHelp and took the time to post the detailed events. First, be calm, easy for me to say I know! I never realized the extent stress can play in chronic pain (CP) until I wasn't under stress for several days.
The UA will most likely reveal any opiates that you took in the last 48 hours. And yes they are usually sent out but not always. It depends on the lab capabilities of your clinic. Never take anything that is not prescribed for you. Hydrocodone and oxycodone (percocet) though similar are different. And Tylenol #3 contains codeine, which is different from both the preciously mentioned narcotics. I assume you signed a contract. You must follow that to the letter, or risk being discharged without notice from the OM practice. So be cautious and follow your contract for your own sake.
I am sorry that you now feel uncomfortable with your PMP. If he does not dismiss you for a abnormal Urine Drug Screen you may want to consider finding a new PMP. As you know it is so important that we are comfortable with our PMP. I have a great patient/doctor relationship, which is imperative, especially when we suffer with CP and the daily disruptions it beings to our lives. Is it possible that you are just being overly sensitive now that you have told him you inter feelings? He may just be looking for ways to better treat you given all the facts. I guess only time will provide you with those answers.
By the description of your chronic pain it sounds like you have SIJ (sacroiliac joint) Dysfunction. So do I. It is an extremely painful condition with little effective treatments available. I know the horrific pain it can bring. It took years for me to find a diagnosis. SIJ Dysfunction is under-diagnosed and often missed or dismissed as a pain causation.
Have you seen a D.O. (Doctor of Osteopathy)? Not all D.O.'s are equal or perform OMT (Osteopathic manipulation therapy). Mine PCP is an Internal Medicine Physician (D.O.) that does OMT. She attempts to keep the joint in alignment, when "out" I can barely ambulate or function. Because I live in Wisconsin it is our PCP that treat and prescribe to their CP patients. If it were not for my DO I would not be able to live with this pain. I encourage you to consult a DO that practices OMT. Her treatments have proven to be the only treatment that helps my SIJ pain.
I wish you the very best and am so glad that you have joined our community. MedHelp has been a God-sent to me. The wonderful support, information and understanding that our members extend to one another is like no other site. I hope you will become active in our community. Please let us know how you are doing and how the results of your next PM appointment goes. I will look forward to hearing from you again soon
Take Care,
~Tuck
Hi,
I know you are going through alot. Unfortunately the medications you took that were not prescibed will show up in the urine test. These test are normally sent out as the ones that give immediate results are limited at best. So most doctors send them out. My last doctor had test that showed Oxycontin as well as illegal drugs. The cup cost 75.00 each time and he tested every month before you got your presciptions.
You should have explained that you had financial problems and was out so you took some other pain medicines to get you through. He may have understood and given you another chance. As it stands now I am so sorry to say he will most likley dismiss you from his practice. If they results back you could still go in and explain and maybe still have a chance.
I am sorry this has happened to you. Everyone is being effected by the recession were in. Even though Obama says were not in recession we are!
Many people are feeling it.
Other's will post heir advice also.
I would call and see if you can get into see your c\doctor in the morning and if you can't maybe write a letter explaining what happened and fax it in to the office. This letter will become part of your file.
We are here for you and hope things work out well:)
I know you are going through alot. Unfortunately the medications you took that were not prescibed will show up in the urine test. These test are normally sent out as the ones that give immediate results are limited at best. So most doctors send them out. My last doctor had test that showed Oxycontin as well as illegal drugs. The cup cost 75.00 each time and he tested every month before you got your presciptions.
You should have explained that you had financial problems and was out so you took some other pain medicines to get you through. He may have understood and given you another chance. As it stands now I am so sorry to say he will most likley dismiss you from his practice. If they results back you could still go in and explain and maybe still have a chance.
I am sorry this has happened to you. Everyone is being effected by the recession were in. Even though Obama says were not in recession we are!
Many people are feeling it.
Other's will post heir advice also.
I would call and see if you can get into see your c\doctor in the morning and if you can't maybe write a letter explaining what happened and fax it in to the office. This letter will become part of your file.
We are here for you and hope things work out well:)
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