Friday, December 24, 2010

Why so I have Pain?

  • At some point in their lives, 80% of Americans will experience back pain.
  • You can injure your back by coughing or sneezing.
  • If you have a sprained or strained back—not a serious injury—use ice to help reduce swelling, muscle spasms, and pain for the first 24 to 48 hours after you injure your back.
  • If you have a sprained or strained back-not a serious injury-use ice first. After 48 hours, switch to heat to warm and relax sore tissues.
  • Good posture is one of the best ways to avoid straining your spine.
  • Exercising on a regular basis helps you maintain a healthy spine.
  • Each year, back pain costs Americans about $100 billion in medical bills, disability, and lost productivity.
For a better understanding of where your pain is coming from, come visit us and  allow us to help get you back to a pain free version of you.

Wednesday, December 22, 2010

Merry Christmas From Republic Spine and Pain

Wishing all our patients a Wonderful Christmas.
We Hope the New Year brings you all wellness, joy and enlightenment.

Happy Holidays!

Sunday, December 19, 2010

Tips to Prevent Back Pain

In previous blogs we have dicussed the correct and incorrect way to lift objects and exercises to strengthen back muscles. Here are some TOP TIPS of things to be mindful of...

  • Protecting Your Back in Bed
    You'd think it would be difficult to injure your back while sleeping. While unconscious your muscles are relaxed and you're not lifting or carrying anything. But the truth is, if you have a bed that does not offer your back enough support, it could be the reason why you wake up with back-stiffness.  Also, if you are in a position that is bad for your back and you stay in it for eight hours while you sleep, you could be damaging your back without knowing it.

  • Protecting Your Back in the Morning
    While you're getting ready in the morning to start your day there are a host of bad habits that could put stress on your back. For instance, when you stand at the sink, brushing your teeth, do you support your back?  There's nothing like starting out your day on the right foot.

  • Protecting Your Back in the Car
    Many of us spend a significant portion of our days in the car. Strangely, little though is given to how comfortable we are in our cars, or what damage our car seats could be doing to our backs.

  • Protecting Your Back at Work
    Your office is like your home-away-from-home. Yet, almost not consideration is given to how comfortable you are while sitting at your desk. The wrong type of chair, a keyboard or monitor that is positioned at the wrong angle, or just sitting in one position for too long can all add up to significant back problems.

  • Protecting Your Back While Exercising
    It's a vicious cycle. If your back hurts, you will probably stop exercising. But if you stop exercising, you are more likely to injure your back. Even if your back is bothering you, it is important to get at least a little exercise. Movement keeps the joints in your back lubricated and loose.

  • Stretches for Your Back
    Keeping your back flexible is a big part of keeping your back injury-free. When your back tightens up, you are more likely to pull or strain a muscle.

  • Exercises for Your Back
    Though we told you earlier how to exercise without injuring your back, what we did not do is show you exercises to specifically strengthen your back. The muscles in your back not only support the spine, but they hold up your entire upper-body. Your back muscles need both strength and conditioning to perform their functions properly.

  • Protecting Your Back While Lifting
    Most people who throw out their back do so by attempting to lift an object incorrectly. Lifting puts more stress on your back than any other activity -- with the possible exception of carrying.

  • Protecting Your Back When Moving Objects
    Transporting or carrying an object may not provide the immediate, traumatic stress that comes when trying to lift an object, but it can do just as much damage to your back. There are several techniques you can employ to help you move objects that won't result in a trip to the emergency room.

  • Diet and Back Pain
    Watching what you can eat can also help protect your back. Most obviously, if you do not carry a lot of weight on your front, it will take a lot of strain off of your back muscles. But in addition to the benefits of maintaining a healthy weight, the right foods can also prevent back injuries. If you are tired and fatigued from lack of nutrition, you are much more likely to pull a muscle or acquire another back injury.

  • Stress and Back Pain
    Stress and tight muscles go together hand-in-hand. If you are carrying a lot tension in your upper back and shoulders, you are ripe for a back injury.

Thursday, December 16, 2010

Smoking and Back Pain

Low back pain affects 80 percent of us at some point in our lives. As a result, researchers are working diligently to determine what factors contribute to this pain. Some of the factors that have been identified include an occupation requiring a heavy physical workload, low levels of leisure physical activity, high body mass index, living in a small community, having a low educational level and being a smoker. While some of these factors may seem like common sense, some may be more surprising to you. The primary goal of this article is to present some evidence as to the effects smoking has on back pain and some possible explanations as to why.

It would seem logical that the more demand an activity or load places on the spine, the more likely it is that the spine may become injured. If the spine is injured, pain is likely to result. This is the obvious explanation as to why high body mass index and heavy occupational workloads tend to be associated with low back pain. However, an important factor with chronic loading of any part of the body is how well the body can recover or heal from the small damage caused by the loading. Ideally, the body heals a little stronger than it started and is more resistant to that same load in the future. If the body is not able to heal sufficiently, further injury develops. The key to healing is providing sufficient time between when the demand is placed on the body and the area of the body having enough blood supply to provide healing. An example of the time factor is a blister on your foot. Given enough time the blister will heal and the foot will be ready for taking stress once again. If the stress that created the blister is small and time is given between when the stress is applied, a callous forms instead of a blister. The body adapts instead of being injured. In the case of blood supply, think of the inside of your lip. This area has a rich blood supply and if cut will heal quite fast. The spine is similar. If it has a good blood supply, it will adapt to the physical demands placed on it. If the demand is too great, damage will occur.

One of the chief effects of smoking on the spine is that smoking contributes to atherosclerosis. Atherosclerosis is when plaque or other material builds up on the inside of blood vessels, causing decreased blood supply especially to areas that are fed by very small vessels. The bones and discs of the spine are supplied by these small vessels and are affected by atherosclerosis which decreases the spine’s ability to heal itself. This eventually leads to degeneration of the spine and the onset of pain. In this way, smoking increases the risk of developing atherosclerosis related to back pain [Source: Kaupplia, Leino-Arjas].
Also related to the spine’s ability to heal is the role of a bone cell called an osteoblast, a specialized cell the builds bone tissue. Nicotine is a major chemical in smoking that contributes to its addictive properties. However, nicotine also inhibits the activity of osteoblasts [Source: Glowacki]. Decreased osteoblast activity from nicotine causes the bones of the spine to have a reduced ability to rebuild. Over time, the bone is used up faster than it can be rebuilt causing osteoporosis and other degenerative conditions causing pain.
Another connection that has been made between smoking and low back pain is the message of pain itself. Smokers have been found to have higher ratings of pain than nonsmokers [Source: Ackerman, Scott, Vogt]. While the exact reasons for this are not entirely clear, it appears to have some connection with chemical interference with the body’s natural hormonal activity for pain detection. Essentially, the hormones and chemicals that help the body deal with pain are inhibited by smoking.

Other questions about smoking include whether smoking has an effect on intervertebral discs or on neck pain. At this time there is no conclusive evidence of smoking causing either of these conditions [Source: Gore, Leboeuf-Yde]. We may find that there is a link with further research. However, even if it is found that smoking does not cause disc problems or neck pain, the fact remains that smokers will tend to have more feelings of pain if there is an injury caused by something else.

The body is a remarkably resilient system. It can adapt and heal. However, it is also susceptible to harmful influences. It is up to each of us to take care of our own bodies and limit those harmful things by the choices we make. Smoking cessation, exercise and an improved diet are all personal decisions and habits that can be improved. Your body will thank you.

  • Ackerman WE 3rd, Ahmad M. Effect of cigarette smoking on serum hydrocodone levels in chronic pain patients. J Ark Med Soc. 2007 Jul; 104(1): 19-21.
  • Bjorck-van Dijken C, Fjellman-Wiklund A, Hildingsson C. Low back pain, lifestyle factors and physical activity: a population based-study. J Rehabil Med. 2008 Nov; 40(10):864-9.
  • Freedman MK, Sauline MF, Overton EA, Holding MY, Kornbluth ID. Interventions in chronic pain management: approaches to medication and lifestyle in chronic pain syndromes. Arch Phys Med Rehabil. 2008 Mar; 89(3 Suppl 1):556-60.
  • Glowacki J, Schulten AJ, Perrott D, Kaban LB. Nicotine impairs distraction osteogenesis in the rat mandible. Int J Oral Maxillofac Surg. 2008 Feb; 37(2):156-61.
  • Gore DR, Carrera GF, Glaeser ST. Smoking and degenerative changes of the cervical spine: a roentgenographic study. Spine J. 2006 Sep-Oct; 6(5):557-60.
  • Kaupplia LI. Atherosclerosis and disc degeneration/low back pain - a systematic review. Eur J Vasc Endovasc Surg. 2009 Mar 25.
  • Leboeuf-Yde C, Kjaer P, Bendix T, Manniche C. Self-reported hard physical work combined with heavy smoking or overweight may result  in so-called modic changes. BMC Musculoskelet Disord. 2008 Jan 14; 9:5.
  • Leino-Arjas P, Solovieva S, Kirjonen J, Reunanen A, Riihimaki H. Cardiovascular risk factors and low-back pain in a long-term follow-up of industrial employees. Scand J Work Environ Health. 2006 Feb; 32(1): 12-19.
  • Mikkonen P, Leino-Arjas P, Remes J, Zitting P, Taimela S, Karppinen J. Is smoking a risk factor for low back pain in adolescents? A prospective cohort study. Spine. 2008, Mar 1;33(5): 527-32.
  • Scott SC, Goldberg MS, Mayo NE, Stock NE, Poltras B. The association between cigarette smoking and back pain in adults. Spine. 1999, Jun 1;24(11):1090-98.
  • Vogt MT, Hanscom B, Lauerman WC, Kang JD. Influence of smoking on the health status of spinal patients: the National Spine Network database. Spine. 2002 Feb 1;27(3): 313-19.

For support groups in Austin to help quit smoking, visit these websites :

Monday, December 13, 2010

Be a Fan of Austin's Republic Spine and Pain on Facebook!

Facebookers! We value your support !
Follow Us on Twitter & Fan us on Facebook

Our patients are online researchers and we have got to keep up with you!

Our Austin Pain Clinic is becoming so Tech Savvy!

Friday, December 10, 2010

Pain Management Austin -

We are very blessed to work for 2 of Austins Best Pain Management Physicians.
They are always educating staff and patients on what is available to help patients not suffer and provide options for patients to choose from.

Wanted to share our Pain physicians Bio's from our website.


Dr. Yeh and Dr. Ostadian met during their fellowship training in Dallas and realized they had a mutual vision for providing appropriate, compassionate and patient-centered care to those individuals suffering from chronic and acute pain. From there, they decided to create Republic Spine and Pain to treat those suffering from pain in the underserved areas of North Austin, Cedar Park, Round Rock and their surrounding communities.
Dr. Yeh and Dr. Ostadian believe in a multi-disciplinary approach to pain management. This belief forms the cornerstone philosophy of Republic Spine and Pain’s strive to work with patients and their families to develop personalized care plans that utilize interventional techniques, medications, physical therapy, and minor surgery when indicated, to relieve pain and restore functionality.

Dr. Clement Yeh, MD

Dr. Clement Yeh has had the blessing of being a lifelong Texas resident. He was born in Dallas, TX and attended Arlington Martin High School. He then attended Baylor University on a Presidential and Premedical scholarship where he obtained a degree in biology and a minor in chemistry. In addition to being a member of Sigma Alpha Epsilon fraternity, he was also a 4-year starter on the Baylor men's soccer team and named the team's most valuable player his senior year.

Dr. Yeh then later attended Texas Tech University School of Medicine for his medical education. During this time, he had the opportunity to complete his clinical clerkships in El Paso, TX where he had the immensely rewarding opportunity to mentor University of Texas at El Paso premedical students in guiding their career choices. This is also where his love of Mexican food was born.

Later, Dr. Yeh continued his medical education at Parkland Memorial Hospital and UT Southwestern Medical Center in Dallas, TX where he completed a residency in Anesthesiology. While a resident there, he published research in cardiovascular anesthesia as well as took the opportunity to present research posters at national anesthesiology meetings.

Although Dr. Yeh thoroughly enjoyed the fast-paced and intellectually stimulating environment that anesthesiology provided, his desire for a more traditional patient-physician relationship spurred him to pursue additional training in the field of pain medicine. He chose to remain at UT Southwestern Medical Center to complete his fellowship training in interventional pain management where he was trained in the latest interventional techniques and treatments for acute and chronic pain conditions and the importance of using a multidisciplinary-guided approach to treating pain. During this time, he was also able to present cutting edge research findings at national pain society meetings.Dr. Yeh is also a Board-Certified Anesthesiologist.

When not seeing patients in clinic or practicing anesthesiology part-time, Dr. Yeh can be found playing ultimate frisbee and soccer at Zilker park as well as wakeboarding and snowboarding when the seasons permit. Although he has spent the majority of his life in the Dallas area, he is now pleased to call our state’s wonderful capital home.


  • Travis County Medical Society
  • Texas Medical Association
  • Texas Pain Society

Dr. Mahan Ostadian, DO

Dr. Mahan Ostadian considers himself a Texas native since his early college years. He attended the University of Texas in Austin where he completed his premedical training and obtained a degree in biology. During this time, he remained active in the community while volunteering in the emergency room at Round Rock Community Hospital. He also continued his goal of becoming a physician by staying involved in Alpha Epsilon Delta pre-medical honor society at the university.

Dr. Ostadian left Austin to attend University of North Texas Health Sciences Center - Texas College of Osteopathic Medicine in Fort Worth to complete his medical degree. While obtaining a solid foundation in the basic sciences, he also learned the interrelationship of the body's nerves, muscles, bones, and organs as well as the importance of treating the whole person. He was selected to the Dean’s List for academic excellence during this time.

Next, Dr. Ostadian continued his medical training through completing a residency in Anesthesiology at Scott and White Memorial Hospital. He remained on staff as an Assistant Professor of Anesthesiology there after his residency and was heavily involved as part of the hospital’s pain management team in helping treat patients’ post-operative pain. Currently, he enjoys his continued involvement at Scott and White in resident education.

While working as faculty at Scott and White Memorial Hospital, Dr. Ostadian decided to pursue fellowship training in interventional pain management from the respected UT Southwestern School of Medicine and Parkland Memorial Hospital in Dallas. During his fellowship training, he was involved in several research projects and presented research posters at national pain management conferences. Dr. Ostadian is a Board-Certified Anesthesiologist with advanced training in the latest interventional techniques and treatments for acute and chronic pain conditions.

Dr. Ostadian was thrilled about returning to Austin with his wife Mona, and their daughter Alana, and hopes to make a difference in the community. Dr. Ostadian is a huge college football fan and hopes his daughter will someday have the same passion that he has for Longhorn football. He is also excited to join with Dr. Yeh who shares his goals of providing exceptional compassionate care to all of their patients.


  • American Society of Anesthesiologists
  • American Medical Association
  • Travis County Medical Society
  • American Society of Regional Anesthesia and Pain Management
  • Texas Medical Association

Tuesday, December 7, 2010

Austin Pain Clinic - What Makes Us Different?

We're devoted exclusively to Austin Pain Management Patients.

Republic Spine and Pain  is devoted exclusively to advanced interventional pain management.

Our physicians offer patients a variety of interventional procedure options in an effort to avoid or reduce medication needs.  Minimally invasive procedures are beneficial in two ways:  First, interventions can be helpful in precisely identifying the source of the pain. Second, interventions can frequently provide long-term pain relief without surgery.

We utilize advanced imaging technology to ensure that pain relief is delivered precisely where patients need it most. If through the diagnosis process we determine that a patient needs a different treatment, we have a vast referral network to other preeminent specialists in Cedar Park, Round Rock & Austin. Our doctors may also refer you to other, non-physician specialists for additional care, such as physical therapy, occupational therapy or home health care. We will share information frequently with each of the other member team, to ensure that are all working together to provide you with the best possible relief of your pain.

Our Pain Management physicians and staff have many years of experience in caring for people struggling with chronic pain.  If you haven’t found success in managing your chronic pain, please consider calling Republic Pain ( 512 219 8787 ).

Referrals to Pain Management  are not generally required for office visits unless specified by your insurance company.

You don’t want to live in pain, and you don’t have to.
Please call us today.

Sunday, December 5, 2010

Vertebroplasty Procedure Animation

Vertebroplasty is a procedure that offers relief to patients suffering prolonged and debilitating pain from compression fractures in the spinal vertebrae. It involves injecting bone cement into the vertebrae to stabilize fractures, and results in significant pain relief and restoration of mobility in many patients.
To learn more click on the video link or ask our physicians on your consultation appointment.

Friday, December 3, 2010

Pain Management Austin - Republic Spine & Pain

Naomi Judd Offers Support to Those Living With Chronic Pain

She is now a spokesperson for the national education program Partners Against Pain.

Sunday November 21st, 2010


(NewsUSA) - It may surprise you to learn that before she became a country music icon, Naomi Judd was a critical care nurse. Unlike facing a stadium full of adoring fans, as a nurse she witnessed the daily challenges faced by people with chronic pain and those who care for them.

More recently, Judd watched a dear friend suffer from excruciating pain during his battle with pancreatic cancer. Because he was an educated and empowered patient, he received excellent pain management and was able to live his remaining days to the fullest.

As a spokesperson for the national education program Partners Against Pain, Judd now has 50 million reasons to let others know that they don't need to suffer in silence. That's because the latest statistics show that more than 50 million Americans live with pain, making it one of the top reasons people seek medical care.

Judd is encouraging people with pain and their caregivers to learn as much as they can about proper pain management. "From day to day, pain can limit your ability to enjoy your work, your hobbies -- even rob you of the simple joys of hugging someone you love," says Judd.

Each person's pain is unique and different. In many cases, managing pain requires an integrative approach that combines prescription medicine with complementary techniques such as physical therapy, acupuncture and massage.

Judd wants people to know the journey to appropriate pain management can begin with a visit to the recently updated Partners Against Pain website ( The new, user-friendly layout features customized sections for patients, caregivers and healthcare professionals that make it easy find information about various painful conditions, including arthritis, cancer pain and low back pain. Special downloadable features -- such as a Patient Comfort Assessment Guide with a daily pain diary and pain management log -- are also available, along with links to other pain education and advocacy groups.

The website also contains valuable information and tools to help family caregivers meet the unique challenges of caring for loved ones coping with chronic pain.

Partners Against Pain is a national education program provided by Purdue Pharma