Helping to alleviate #chronic #pain in people involves more than just prescribing pills for them to pop or giving them a shot. Pain management, or algiatry, is the medical specialty of preventing, evaluating, treating, and rehabilitating persons in pain.Chronic pain may have originated with an injury or infection or there may be an ongoing cause of pain. Some people suffer chronic pain in the absence of any past injury or evidence of body damage.Whatever the cause of the pain, its management and relief should take a multidisciplinary and #holistic approach. It’s also important to note that there is not just one approach to pain management; what works for one person may not work for another person who has the same disease and is the same gender or age.

Often, medications alone aren’t enough to treat chronic pain. Other treatments may be more effective and medication may be more effective when combined with other treatments. Other available treatments may include:

• Nerve blocks. If a group of nerves, called a ganglion or plexus, causes pain to a specific organ or body region, injections with local anesthetics may be useful for blocking the pain in that area.

• Electrical stimulation. The most common form of electrical stimulation is transcutaneous electrical nerve stimulation (TENS), a technique that uses a small, battery-operated device to stimulate nerve fibers through the skin.

• Injections. Local anesthetics, sometimes combined with a corticosteroid, may be injected around nerve roots or into muscles and joints to relieve irritation, swelling, and muscle spasms.

• Surgery. Although sometimes surgery is clearly necessary to relieve a problem that is causing pain, it is often a treatment of last resort. If pain has not responded to any other treatment, surgery on certain nerves may offer relief and allow you to resume normal activities.

• Massage therapy: Used for a variety of health-related purposes, including pain relief, rehabilitation of sports injuries, stress reduction, increased relaxation, addressing anxiety and depression and general wellness.

• Meditation: Sometimes used to increase calmness and physical relaxation, improve physiological balance, cope with an illness, or enhance overall well-being.

• Tai chi: Tai chi practitioners move their bodies slowly, gently and with awareness, while breathing deeply. Among other benefits, it can be practiced to ease pain and stiffness.

• Yoga: Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation.

• Acupuncture: The most used and studied acupuncture technique involves penetrating the skin with thin, solid, metallic needles that are manipulated by hand or electrical stimulation.

A multidisciplinary approach is designed to help people become part of the treatment team and take an active role in regaining control of their life. The focus of multidisciplinary pain management is to help restore their function in spite of the pain.

Paul Coelho, M.D., is a physical medicine and rehabilitation physician in the pain management department at The Corvallis Clinic. He can be reached at 541-754-1266.

Curated from A holistic approach to pain management | Columnists | democratherald.com

Nerve Testing

EMG Testing- What you need to know

by David Brooks

July 2, 2020

Here at the Neurological and Pain Institute, we’ve performed hundreds of successful EMG procedures. The following article below from the Hospital for Special Surgery outlines the basics of the procedure. If you still any lingering questions, feel free to give us a call. Your comfort and safety are our top priority. … Joseph H. Feinberg, MD Physiatrist-in-Chief, Hospital for Special Surgery Medical Director, Center for Brachial Plexus and Traumatic Nerve Injury Associate Professor of Rehabilitation Medicine, Weill Cornell Medical College

What is an EMG test?

Electromyography (EMG) is a form of electrodiagnostic testing that is used to study nerve and muscle function. Commonly performed by a physiatrist or neurologist trained in this procedure, EMG testing can provide your doctor with specific information about the extent of nerve and/or muscle injury and can also determine the exact location of injury and give some indication whether the damage is reversible.

What should you expect from EMG testing?

There are two parts to EMG testing: a nerve conduction study and a needle exam for muscle testing. Both may result in some discomfort, but are usually well tolerated without the need for medication beforehand. The nerve conduction study entails stimulating the nerves at different points with small electric shocks, artificially activating them so their function can be measured. The needle exam involves inserting very fine needles into several muscles. The needle has a microscopic electrode that picks up both the normal and abnormal electrical signals given off by a muscle. Routinely, your doctor will perform both parts of the procedure, but there are situations where only the nerve conduction or muscle testing is performed.EMG testing usually takes anywhere from 30 to 90 minutes, depending on the condition being tested and findings of the study. A report that includes the results and an interpretation will be sent to your doctor.

What you should know before an EMG test?

An EMG test is extremely safe. EMG needles are used for only one patient, are not recycled, and are immediately disposed of following use. Side effects may include some muscle soreness, which rarely lasts more than an hour or two after the exam. Patients on anticoagulation or blood thinners and those with pacemakers or implanted defibrillators should notify the physician performing the test, but generally this is not a contraindication. Patients with joint replacements or other artificial components in their body do not need to take antibiotics specifically for the EMG. Patients on medication should take their usual medication on the day of the test. No special preparation is necessary.

Why has an EMG test been ordered?

If you have numbness, decreased sensation, tingling, radiating pain, or burning, your doctor may refer you for an EMG. Symptoms such as muscle spasms, weakness, and difficulty buttoning clothes, handling objects, or walking may also indicate the need for an EMG. Conditions that EMG testing helps diagnose include carpal tunnel syndrome, a pinched nerve, radiculopathy, sciatica, neuropathies, muscle diseases, muscular dystrophy, Lou Gehrig’s disease, and myasthenia gravis.

Curated from EMG Testing: A Patient’s Guide – HSS

Auto Accident

The Importance of Seeing A Neurologist After A Car Accident

by David Brooks

July 2, 2020

Car accidents can be terrifying, especially if head injuries are involved. It is absolutely imperative to see a neurologist following an accident. This can not only document the injury and severity for protective purposes, but also bring about the fastest healing possible. For further reasons seeing a neurologist is so necessary following a car accident, check out the list below from The Coastal Pain and Neurology Center. …

Three Reasons You Should See a Neurologist After Your Car Accident

Treat InjuriesIf you do happen to injure your head during a car accident, a neurologist will know just how to treat it. Because they specialize in head trauma, they have dealt with many car accident victims. Your neurologist will likely use an imaging test to see inside your brain and diagnose any issues there may be.
Prevent Conditions From Getting WorseNeglecting to see a neurologist after obtaining an injury can allow it to get worse and cause more problems down the road. However, a neurologist will know exactly what to do to heal it and prevent it from developing any further.
Relieve SymptomsNeurological disorders often come with a variety of symptoms such as blurred vision, loss of hearing or severe headaches. A neurologist will help relieve these symptoms as much as possible while treating the injury.

If you’ve gotten into a car accident recently, visit a neurologist to make sure that you have not obtained an injury. Even if they don’t find anything wrong, at least you have the peace of mind that you are healthy.

Curated from Three Reasons You Should See a Neurologist After Your Car Accident | Coastal Neurology, Inc.

Neuromuscular Disorder

Our Approach to Neuromuscular Disorder Treatments

by David Brooks

July 2, 2020

We treat neuromuscular disorders in our clinic. These are disorders that can negatively impact muscle control, making it hard to control how someone moves parts of the body like their legs. In some patients it impacts only part of the body, while others experience problems overall.

These disorders can make it difficult to enjoy full mobility or to live life without discomfort. Some people find that they are unable to work, care for their children or do any of their favorite things. Treatment can help. This makes it important to visit our clinic for help as quickly as possible.

Types of neuromuscular disorders

Neuromuscular disorders can involve the spinal cord, muscle cells, nerve cells and even the metabolism.

Common symptoms

Since there are several types of disorders, the symptoms a patient will experience can be highly varied. They will differ based on the area of the body that is impacted and how severe the condition is. In general, symptoms may include:

Numbness and tingling
Spasms
Loss of muscle control
Week or painful muscles
Cramping and stiffness
Ongoing pain
Joints freezing

Treatment solutions

Some of the treatment options include:

Surgery. In some situations, surgery will be necessary in order to restore function or mobility.
Medications. Some drugs have proven effective to manage the symptoms associated with neuromuscular disorders and to reduce any discomfort caused by them.
Therapy. Physical therapy, speech therapy, and other forms of alternative medicine can be useful when done in conjunction with taking medication.

A comprehensive approach

We understand that each patient is different and because of that, a treatment that works for one patient may not work for the next. We take a comprehensive approach to ensure that whatever is necessary, our patients have access to it. This may involve doing things like taking medication but also benefiting from physical therapy. Ultimately, our goal is to help our patients live as full of a life as possible so we will continue to make recommendations and adjustments to the treatment if we feel it can be improved over time. We become our patients partner in health, looking at treatments as something that needs to work right away but also needs to be managed long-term.

For patients who have struggled with a disorder for years, it is important to remember that things do change. New treatments and medications may become available that are more effective than ones currently being taken or tried before. There needs to be an openness to try new things to see if they can produce better results. We have an open mind in our office and regularly recommend that our patients try new treatment solutions that have been found to help. Our focus is on results so we adjust based on the goal of helping our patients to live their best life.

Schedule consultation

Learn more about the various treatment solutions that we can implement and our approach to health care by scheduling a consultation today. We look forward to being of further assistance to you.

Neuropathy

Diabetic Neuropathy: Types, Symptoms and Treatments

by David Brooks

July 2, 2020

Diabetics often suffer from a variety of health problems as a result of their condition, diabetic neuropathy being one of them. This refers to nerve damage that can be the result of having high blood sugar. Since these heightened amounts of glucose can cause injuries to the nerve fibers running through the body, it is possible to experience nerve damage in the feet and legs.

There are several types of neuropathy

Since this refers to nerve damage, there are several types of neuropathy and where it occurs will directly influence the symptoms that are associated with it. For example, autonomic neuropathy is going to cause problems with the stomach, heart, bladder, sex organs, intestines and even the eyes. By comparison peripheral neuropathy impacts the feet and legs, along with arms and hands. Then, radiculoplexus neuropathy can impact the hips, thighs and buttocks. There is even a mononeuropathy which can cause damage to a single nerve instead of causing problems with an entire area. In other words, diabetic neuropathy can impact the entire body.

Symptoms

Anyone who is concerned that they may have this condition should schedule an examination with our office. It is important to treated right away so we do not recommend self diagnosing the problem but instead, visiting us for a professional evaluation. In the meantime, some of the symptoms associated with the condition are:

Tingling and burning sensations in the feet and legs
Bladder problems
Pain in the chest or abdomen
Dropping things
Difficulty swallowing
Sexual problems with men and women
Irregular body temperature
Fast heart rate when resting
Irregular pain
A lack of coordination
Obvious foot problems that can include deformities, ulcers and joint pain
Sensitivity to touch
Weak muscles

Treating neuropathy

The most important thing is to regulate blood sugar levels by following the doctor’s orders in regards to medication, diet and exercise. Also, stop smoking and try to avoid drinking alcohol.

Some patients may need to take prescription medications in order to find relief from pain. Several have been found to be effective such as anti-seizure medications and antidepressants. Even though these were not originally intended to treat neuropathy, they have been effective. Other medications may be prescribed that are specific towards treating a particular problem. For example if neuropathy is causing sexual dysfunction, medication for ED may be prescribed. If it is leading to digestive problems, medication may be taken for that, etc.

It is possible to feel better

Many of these symptoms can seriously impact a persons’ quality of life. For example, if neuropathy impacts the ability to walk, pick up things, or perform sexually, it could cause daily interference with a persons’ normal routine. This makes it important to seek help right away.

Schedule an examination

Because neuropathy is so incredibly diverse, the only way to make a recommendation for treatment is to conduct a thorough examination, review all of the symptoms associated with it and then create a thorough treatment plan. We encourage you to schedule an appointment with our office so that we can do so.

Neurological Disorders

What are Neurological Disorders?

by David Brooks

July 2, 2020

We treat neurological disorders in our office and frequently receive questions about these conditions, including what would constitute a neurological disorder. If you are unsure if you have one or if you should visit our office, here is what you should know.

What are neurological disorders?

These are a group of diseases affecting the nervous system. They affect the brain, spinal cord, nerves, nerve roots, muscles and neuromuscular junction. For a non-doctor, this essentially means that it can impact almost all areas of the body. Since everything in the body is influenced by the brain and the nerves from the brain, someone with one of these disorders could have issues from everything having to do with their mental clarity to their physical bodily functions.

These neurological conditions include:

Epilepsy
Alzheimer’s
Meningitis
HIV
Zika virus
Malaria
Stroke
Migraines
Dementia
Parkinson’s disease
Brain disorders
Multiple sclerosis

These are just a few of the conditions that are neurological.

What causes neurological disorders?

Given that there are so many types of disorders, what causes them is going to be incredibly varied. However, these conditions can be caused by a bacterial infection, such as with meningitis. Others can because of viral infection, like HIV or Zika. Still, others are caused by a neurological disorder that is not bacterial or viral, such as epilepsy. Our goal is to determine the cause of the issue as best as possible so that we can treat it.

Treatment options

Living with a neurological disorder can be incredibly difficult and it requires ongoing medical care. Our goal is to provide our patients with Comprehensive Care and support so that they can live as good of a life as possible. Is possible, for example, to live a full and healthy life with epilepsy as long as it is controlled with medication. The key is to visit our office and see a doctor on a regular basis so that the treatments can be customized to be as effective as possible.

We also work with other physicians to ensure that any treatment can be a comprehensive one and make it most likely that our patients will be able to manage their symptoms and feel better.

Even young people can suffer from these disorders

There’s a common misconception that only elderly people suffer from neurological problems. This is not the case. While something like Alzheimer’s certainly affects the elderly primarily, other conditions like Zika or epilepsy can impact someone of any age. Because of that, we treat both children and adults in our office and recommend scheduling an appointment right away so that we can provide assistance. If a child visits our office, we may involve a pediatric specialist as well, but that can be determined during the consultation.

Visit our office today

It is critical that patients seek help for a neurological disorder as quickly as possible. To do so, call our office and schedule an appointment. We can conduct an examination and necessary tests. We can also discuss symptoms and treatment options at that time. We will also answer questions in detail.

Neuropathy

Risk Factors for Neuropathy

by David Brooks

July 2, 2020

Neuropathy is incredibly common. In fact, it impacts more than 3 million Americans every year. This is a condition that is caused by nerve damage and can impact multiple areas of the body. We treat this condition in our office and recommend visiting us for help. Anyone who is unsure if they are suffering from neuropathy needs to have a physician officially diagnose them and make treatment recommendations. This is not something that can be self-diagnosed or treated at home. As such, the first step should always be calling a physician.

Factors leading to damage

Since neuropathy refers to all types of nerve damage, there are many factors that can cause it, based on where in the body the damage occurs. Knowing that, some factors that can contribute to damage include, but are not limited to, the following:

Diabetes. It is incredibly common for diabetics to suffer from nerve damage and even to require the amputation of feet because of it.
Exposure to toxins. If someone is exposed to toxins at home or in the workplace, it can lead to nerve damage.
Infections. Some infections can also lead to long-term nerve damage, it is important to visit the doctor and have problems treated as they arise.
Working at a computer all day. Carpal tunnel is a form of nerve damage that many office workers suffer from by typing on a computer or working at a desk all day, every day.
B12 deficiency. Dietary factors can also lead to nerve damage, such as a lack of B12.
Back injury. If a back injury leads to a pinched nerve, it can cause issues like sciatica pain.
Thyroid problems. Hypothyroidism has been linked to neuropathy as well.

Symptoms of neuropathy

It is important to visit a physician immediately if these symptoms begin to present themselves. This increases the likelihood of treatment being effective. Some symptoms include:

Tingling sensations
Numbness
Weakness
The feeling of being pricked with pins and needles
Lack of sensation
Limbs constantly falling asleep
Extreme skin sensitivity

These are just a few of the symptoms that indicate the need to visit a physician. However, we believe that patients can often tell that something is wrong, even if they cannot identify exactly what it is. Anyone that feels they have nerve damage after being in an accident, suffering from an infection or living with a disease like diabetes, it is important to visit our office for an examination.

Treatment options

In many cases, neuropathy is not reversible but it is treatable. We can treat the condition with things like oral medications, topical creams, and alternative therapies. What we recommend will be based on where the nerve damage has occurred and what has caused it. It will be important to address any underlying health concern that has led to the condition as well. For example, diabetics will need to do what is necessary to get their blood sugar levels under control so that the problem does not become worse while it is being treated.

Schedule an appointment

To learn more about this condition or to find out if you are suffering from neuropathy, call our office and schedule an appointment.

Neuropathy Treatment

Neurogenx as a Neuropathy Treatment

by David Brooks

July 2, 2020

Our neuropathy treatment is highly effective for helping patients to improve their quality-of-life by reducing pain and increasing mobility. One of our treatments is Neurogenx. This is a highly effective treatment that uses high-frequency electronic waves to gently reach deep down through the muscle and tissue to relieve neuropathy symptoms and severe neuromuscular pain. The treatment is FDA cleared and it has been proven to be effective when treating nerve pain in the arms, hands, legs, and feet.

Neurogenx is minimally invasive

This is a non-surgical treatment. Patients often visit us because they know they need a real solution for their pain but are worried about anything that would be invasive or surgical in nature. Fortunately, we are able to provide patients with an incredible amount of relief without surgery thanks to this cutting-edge technique.

Neurogenx helps people suffering from the following symptoms:

Burning sensations in the legs and feet
Pins and needles
Cold hands and feet
Difficulty sleeping due to painful feet or tingling sensations
Numbness
Difficulty standing or walking due to balance issues or pain
Stabbing pain
Falling down regularly
Being unable to feel things when walking, such as the texture of flooring or even the gas pedal beneath feet

These are just a few of the symptoms that can be either solved or at least lessened through a Neurogenx treatment.

How it works

The Neurogenx neuropathy treatment is an electromedical treatment. It uses high-frequency electronic waves to penetrate through the skin and reach deep down into the muscles and tissue. Since it uses electronic waves, there is no cutting, no heat and no pain caused by the treatment itself. Once these electro waves have reached the cellular level, changes are made there that result in a reduction of swelling and removal of excess fluids and waste products. Also, the pH levels are altered and the cellular metabolism is increased. Combined, these cellular changes promote healing within the body and work to relieve pain.

By changing the body at the cellular level, this neuropathy treatment helps to prevent long-term symptoms whereas most neuropathy treatments are only temporary. Eventually, they typically require patients to return for treatment after treatment. With this particular treatment, patients can experience long-term relief and require fewer visits to reach that point.

It works with other treatment solutions as well

Some patients are also looking for immediate pain relief and may benefit from something like nerve block injections. Neurogenx can work with this treatment as well.

Learn more about Neurogenx today

Find out if this neuropathy treatment can work for you by scheduling a consultation. We can conduct an examination, run tests and determine if this is the right way to treat your neuropathy symptoms. If so, we can schedule an appointment for this treatment and get you started right away so that you can begin experiencing life free from neuropathy pain and other symptoms.

Pain Management

A Low Back Pain Treatment That Works!

by David Brooks

July 2, 2020

We provide a comprehensive lower back pain treatment in our office and recommend that anyone who is suffering from occasional or chronic pain visit us for help immediately. We use noninvasive methods to help our patients regain their mobility and feel better.

Treating office workers with back pain

Recently, we have been treating more and more office workers for low back pain. If you sit at a desk all day and have recently noticed that it is painful to remain in the chair, it may be time to schedule a treatment. Many people do not realize that there are two types of workplace injuries. The first is one that happens in a traumatic event such as the back being pulled out of alignment due to lifting a heavy object. The other is an injury that occurs over time due to repetitive motion. If an office worker is sitting in a chair that is not ergonomically correct and does not support the back, it is possible to begin suffering from low, mid and upper back pain as a result.

This could potentially be classified as a workplace injury so it may be possible to have worker’s compensation benefits pay for treatment. Most large corporations are happy to do so because treating back pain and providing workers with a more supportive workstation can prevent more drastic problems later on.

Our treatment is fast

For anyone who is busy at work, the idea of leaving to go to the doctor can be stressful. There are calls to make, appointments to keep and work to get done. We understand that and work diligently to ensure that our patients can get in and out of our office as quickly as possible. Our low back pain treatment can be completed in under an hour so it is possible to visit on your lunch break and still get back to the office in time for the next meeting.

Our treatment is noninvasive

Another benefit of our treatment is that it is noninvasive. There is no surgery, no cutting, and no injections. This is important for two reasons. First, there is no additional trauma placed on the body. For example, if someone were to have back surgery, the body would then have to deal with the trauma of recovering from that event in addition to the pain that it has already been suffering.

This is not the case with our treatment. Second, since it is a noninvasive treatment, there is no recovery time at all. Patients can visit our office for relief, leave and go about their day without any complications. Other types of back pain treatment may involve the need to recover for weeks or even months at home. This is certainly not conducive to maintaining a busy work schedule. Because of this, most busy professionals prefer our treatment option.

Our treatment is affordable

For anyone that is paying for the treatment, instead of receiving treatment through worker’s compensation insurance, our treatment is still affordable. We do accept insurance and can also discuss cash payment options when someone calls our office.

Our treatment produces real results

Even though our treatment is convenient, noninvasive and affordable, it is still highly effective and produces the desired results – a reduction in back pain. Patients that visit for treatment generally find that they begin experiencing relief immediately; and with continued treatments, their back pain either goes away entirely or is so minimal that it does not influence their day any longer.

Schedule an appointment

We encourage you to call our office and schedule a low back pain treatment today so that we can begin to help you feel better.

Personal Injury

Vertigo, Nausea, Confusion and Other Signs of Head Injury

by David Brooks

July 2, 2020

If you are in an accident that affects your head and need treatment for vertigo, concussion, headache, vomiting, confusion or blurry vision, we can help. There are many types of head injuries that come with differing symptoms. Any injury that affects the head requires immediate medical attention to determine the extent of the damage and what treatment will be most effective. Head injuries can affect your entire well-being.

Types of head injury

Laceration

A laceration is a deep cut. It can occur on the head or brain. If the brain has a laceration, it is typically a result of a perforating head injury or skull fracture. If only the skin of the head is lacerated, it may bleed profusely due to the presence of superficial blood vessels, but it usually does not cause any longterm damage.

Symptoms of a brain laceration are a sudden and severe headache, nausea and vomiting, lethargy or fatigue, seizures, or weakness in areas of the body. Loss of consciousness is also possible.

Hematoma

A hematoma involves bleeding outside of the blood vessels. This build-up of blood could be a surface injury (resembling a bruise) or it could occur in the brain, causing loss of consciousness or even brain damage. Symptoms of a hematoma include a headache, confusion, slurred speech or dizziness.

Hemorrhage

Hemorrhaging is bleeding that is profuse or out of control. Hemorrhaging can occur within the brain tissues or in the space around the brain after an injury. Any type of hemorrhaging has the potential to be detrimental. Symptoms of a brain hemorrhage are numbness, weakness in part of the face, confusion, headache, difficulty speaking, difficulty walking and possibly vomiting.

Edema

Edema is another word for swelling or fluid retention. Swelling of the brain tissues leads to pressure against the skull and potential injury.

Concussion

A concussion is a typically mild brain injury caused by impact. Concussions occur when something hits the head or body hard enough to cause a violent shake of the head and brain. Most concussions resolve fairly quickly, but in some cases, they may lead to serious medical problems.

Common concussion symptoms include a headache, confusion, irritability, unequal pupil size, loss of memory, lack of coordination, vomiting, vertigo, ringing in the ears, slow reaction speed, sensitivity to light and sound, lethargy and fatigue.

Fracture

A skull fracture is a crack in the cranial bone. While the fracture itself may not be visible, there are other symptoms associated with a skull fracture. Swelling, bruising and tenderness in the area of impact and bleeding or drainage from the nose or ears are common symptoms.

Contusion

A contusion is bruising of the brain tissues. Bleeding and swelling of the brain near the sight of impact are symptoms of a contusion. Skull fractures and hematomas also symptoms that people need to watch for.

Visit our office for help

If you or a loved one have been in an accident that has injured your head and you are experiencing vertigo, nausea, headache or confusion among other symptoms, seek medical help immediately to determine the extent of damage and receive treatment.

David Brooks

What is an EMG test?

What should you expect from EMG testing?

What you should know before an EMG test?

Why has an EMG test been ordered?

Three Reasons You Should See a Neurologist After Your Car Accident

Types of neuromuscular disorders

Common symptoms

Treatment solutions

A comprehensive approach

Schedule consultation

There are several types of neuropathy

Symptoms

Treating neuropathy

It is possible to feel better

Schedule an examination

What are neurological disorders?

What causes neurological disorders?

Treatment options

Even young people can suffer from these disorders

Visit our office today

Factors leading to damage

Symptoms of neuropathy

Treatment options

Schedule an appointment

Neurogenx is minimally invasive

How it works

It works with other treatment solutions as well

Learn more about Neurogenx today

Treating office workers with back pain

Our treatment is fast

Our treatment is noninvasive

Our treatment is affordable

Our treatment produces real results

Schedule an appointment

Types of head injury

Laceration

Hematoma

Hemorrhage

Edema

Concussion

Fracture

Contusion

Visit our office for help

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