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All posts by Jo Cartwright

Chronic pain can cause winter blues and depression

Chronic Pain, Winter Blues, and Ways to Overcome Both

Chronic Pain, Winter Blues, and Ways to Overcome Both

Living with chronic pain can elevate feelings of depression. Similarly, people who live with depression also experience chronic pain. The winter season often results in an increase in depression, typically knowns as seasonal affective disorder, and those living with pain often experience increased winter blues. Consequently, the link between pain and depression is strong.

How does chronic pain impact your mood?

Chronic pain from an injury or a medical condition can have several different effects on the body ranging from increased levels of cortisol, the stress hormone, to lack of energy, a decrease in physical activity, and mood disorders. Chronic pain can also disrupt sleep, causing chronic and constant fatigue. Eventually, persistent pain and fatigue can cause irritation as well as feelings of being overwhelmed, anxious and depressed. The link between pain and depression is complex yet strong and many individuals who live with chronic pain find the pain-depression cycle difficult to break.

How to Break the Pain-Depression Cycle

Chronic pain and depression often go hand-in-hand, so it makes sense that the two are also effectively treated together. The key is to report feelings of depression to a medical doctor so that the condition is not overshadowed by pain. In fact, about 50 percent of chronic pain patients suffer from depression due to chronic pain and find relief from treatment that focuses on relieving both conditions.

Following are important steps to follow when chronic pain is leading to depression:

  • Seek out an experienced pain specialist. The team at Integrated Pain Associates works with patients to identify the cause of chronic pain and target underlying medical conditions. Developing a comprehensive pain management plan is important to restoring a person’s quality of life, which is diminished after months or even years of living with pain.
  • Talk to a doctor about depression. Whether it’s the seasonal blues or long-term feelings of depression caused by chronic pain, IPA, we take a whole-person approach to care so that we’re treating the root cause and not just masking symptoms.
  • Exercise. People in pain often do not want to move let alone exercise or go to the gym. However, a sedentary lifestyle can intensify chronic pain, causing the body to become stiff and achy from lack of movement. Discuss with your pain specialist about easing into physical activity such as walking or swimming. Studies have shown that physical exercise helps the body heal as well as releases hormones and brain chemicals that have similar mood enhancing effects to antidepressants.
  • Eat healthy. Depression is more common in the winter months. With less sunlight and outdoor time, the body’s natural levels of vitamin D decrease, causing fatigue, lack of energy and overall malaise. Incorporate supplements and foods that are high in vitamin D such as fatty fish, fortified dairy products, and certain nuts into your daily diet.
  • Take in some sun. The winter months are darker and therefore, more depressing for many people. Couple this with chronic pain and mood is bound to falter. Make sure to get outside during the daylight hours to provide the brain with natural sunlight, which also provides our bodies with natural vitamin D. An added benefit: getting outdoors, even in the cold, is also a good way to add movement to your daily routine.

What to do about chronic pain?

When chronic pain leads to feelings of depression, the pain specialists at Integrated Pain Associates work to develop a pain management and treatment plan that is individualized and focused on restoring function and quality of life. Taking control of your pain will have long lasting mind-body effects.

Call us at 254-245-9175 to make an appointment or use the form on our site to send us a message.

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Chronic Back Pain can be treated with vertiflex


Back pain keeps you from the things you love

With an increasing number of patients being diagnosed with chronic pain across the country, we at Integrated Pain Associates strive to be on the leading edge of treatment options offered to our patients. It is likely that either you or somebody you know is suffering with chronic lower back and leg pain, which you may have been told is due to spinal stenosis. If this is the case, you are likely wondering what treatment options are available and are hesitant to pursue corrective surgery. One exciting option has become available which can fill the gap between conservative care and invasive surgery: Vertiflex.

Vertiflex is beneficial

To better understand how beneficial Vertiflex can be, it is best to first understand what lumbar spinal stenosis is. The lumbar spine (lower back) consists of five vertebrae which are located between the bottom of the ribs and the upper pelvis. Lumbar stenosis describes a condition when the spinal canal of

these vertebrae becomes narrowed, compressing the nerves that pass through this area as they travel into the legs. This stenosis may result in pain, numbness, cramping, or stiffness in the leg, buttock, or groin. These symptoms can make walking or standing quite difficult, but patients often reports relief when seated or bending forward.

How were symptoms treated before Vertiflex

Before Vertiflex, these symptoms were typically treated by either conservative treatment options including physical therapy and epidural injections, or by invasive surgical correction. Historically, surgical correction has been the only definitive option to increase the space around the nerves. This involves permanently and irreversibly altering the natural anatomy of the spine though the removal of bone and other surrounding tissue. We can now achieve similar pain relief by using Vertiflex, a small titanium spacer to indirectly decompress the posterior spine. The spacer is inserted into the posterior spinal column through a small tube about the size of a dime, which reduces tissue damage and blood loss. This can be performed in an outpatient surgical center, and is followed by rapid recovery time. Patients no longer have to worry about destabilization of the spine, as the natural anatomy is maintained, making this treatment completely reversible if the spacer ever needs to be removed in the future.

Integrated Pain Associates can help

At Integrated Pain Associates, we are proud to offer Vertiflex to our patients, utilizing some of the best technology on the market. If you are suffering with chronic back and leg pain caused by spinal stenosis, come in to Integrated Pain Associates where we’ll be happy to discuss whether Vertiflex is the right choice for you.

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National Blood Donors Month

It’s National Blood Donors Month

Since 1970, January has been designated as National Blood Donors Month in the United States. It’s a time to increase awareness of the need for blood donations in every community in the country. It’s also a time to encourage new donors to make their first donation.

Why should you donate blood this winter?

Blood Donations Decrease During the Winter Months

For many hospitals and donation centers, blood donations slow during the colder months.

Many regular donors are traveling for the holidays; others are suffering from colds or the flu, which prohibits donation. Additionally, donors face dangerous weather conditions that prevent them from giving.

Many donation centers also rely on students for a large portion of their blood donations throughout the year. The donation numbers dip significantly when schools are out of session during December and January.

Blood Donation Helps Multitudes of People

Did you know that donating blood also has benefits for the donor?

In addition to helping save lives, each blood donation comes with a mini check-up. The nurse at your blood donation center will check your blood pressure, hemoglobin, pulse and body temperature. After you donate, your blood will be sent to a lab where it is tested for a number of diseases, including HIV and infectious viruses. If anything returns a positive result, you’ll be notified immediately.

Another benefit of donating blood? A feeling of accomplishment and happiness. After all, you helped save lives!

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Abilene man became local hero when retrieving two boys from ‘very, very, very cold’ spillway

An Abilene man became a local hero this past Saturday when he retrieved two boys from a very cold sillway.  Vince Viola went fishing Saturday with his daughter.  What he caught, instead of fish, were two boys who had fallen in the water.  Viola is being called a hero after jumping into a spillway in the Fairway Oaks area to pull out a boy he believed to be 11-12 years old and another about 5 who twice went under the water that he estimated to be 12 feet deep.  With the help of his daughter and a girl he believes to be the sister of the youngest boy, plus golfers who came to help, the boys were rescued and Viola himself, exhausted from his effort in cold water, pulled to safety.

Viola, a physician assistant for 28 years and currently with Integrated Pain Associates, credited his cold-water training years ago as in the Army Reserve in Washington state. His only thought as he sprinted to help the boys after hearing the girl with them scream for help was to prepare himself for the shock of the water.

“And don’t panic,” he said.

Relating his story Sunday to the Reporter-News, Viola knows only that the boys were safe after their ordeal. He believes they live in the area, and went home. He was unable to follow them because he was recovering from being in the water and then being pulled from the concrete spillway by the golfers, who used golf ball retrievers to get him out.

“It took me 30 to 40 minutes to warm up,” Viola said.


Here’s what happened

Viola and his 13-year-old daughter, Kaitlyn, had gone to what Google maps calls a reservoir at Fairway Oaks, in southwest Abilene. There is a spillway near Woodlake Drive, Viola said.

They were “testing” new fishing gear, a Christmas present for her, about 2 p.m.

Viola is not sure what the three youngsters were doing near the spillway, where there is a chain-link fence serving as a safety barrier.

The Violas vaguely were aware of the youngsters’ presence.

He said the youngest apparently had fallen from the edge, and the older boy went in after him.

The Violas were alerted to trouble by the girl.

“I hear the the little boy’s sister screaming ‘He’s drowning,'” Viola later recounted to his friend, Dr. Dan Munton relayed to the Reporter-News. Viola estimated he and his daughter were about a quarter-mile away.

“I took off running,” Vince Viola said. He knew he had to go in to help, so he shed his heavy sweatshirt.

“The water was very, very, very cold,” he said. He said he had been to the same spot about 7 a.m. after getting coffee. There had been ice.

The low temperature Saturday in Abilene was 28 degrees.

Later, his daughter told him she heard her father “gasp” when he hit the water.

“I just knew this … I was going in and those kids were coming out,” he said.

Youngest boy went under

He got to the older boy, who “grabbed me by the neck,” Viola said.

He could not see the younger boy at the surface.

“I had nothing to hold onto,” he said.

He treaded water, reaching with one hand to find the younger boy.

He estimated the boy had been the water at least 2-3 minutes, and knew enough medically that he had to hurry.

“It’s real tough being in the water that long,” he said.

Finally, he located the boy and “I pulled him up by his hair,” he said.

But how to get them out of the spillway? Viola estimated the incline at 45-50 degrees.

The two girls, he said, formed a human chain. The younger boy was pulled first to safety, then the older boy.

“By that point, I’d been in the water 3-4 minutes. My hands and arms were frozen,” said Viola, who knew he had to have help getting to safety.

He was able to find something to stand on with one foot, but he’d slip trying to do more on the algae-covered landing, he said.

Then came more help, summoned by his daughter. Golfers on the nearby No. 17 hole motored in carts to the site and pulled the right club from the bag.

“It took two ball fetchers and four guys to get me out. They had to pull hard. I wouldn’t have had a chance.”

He rid himself of wet clothes and advised the older boy to do the same, then get home to warmth.


Cold-water training kicked in

In retrospect, the training he had decades ago kicked into gear. He had combat medic training in the late 1980s, then river cold water training.

He remembered asking those with him during the training if they ever had been in cold water. He had, falling through the ice playing hockey while growing up in northwestern Pennsylvania.

“It’s a miserable experience,” he remembered telling them. “It will take your breath away.”

You cannot panic, he told them. And himself Saturday.

“You absolutely cannot panic,” he said. “Thank God I didn’t.”

He doesn’t know the whereabouts of the boys but was going to check Sunday.

He only remembers telling the older boy to shed his wet clothes, socks and shoes. The air temperature was 50 or so degrees at mid-afternoon, he estimated.

“I couldn’t do anything else,” he said. “I was red as a lobster. One of the golfers gave me a towel.”

Viola was quick to credit all those who helped — the older boy who went in after the young boy, the two girls who helped get them to safety and the golfers who did the same for him.

Greg Jaklewicz is editor of the Abilene Reporter-News.   

View full story >  

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Holiday Hours

IPA Holiday Closures

Monday, December 23rd                    Christmas

Tuesday, December 24th                     Christmas

Wednesday, December 25th              Christmas

Tuesday, December 31st                     New Years Eve

(half day – 8am-12pm)

Wednesday, January 1st                     New Years Day


Extended Fridays

Due to the holiday closures, IPA will be offering extended Friday hours to ensure that we can accommodate all of our patients’ appointments.  Our extended Friday hours are:

Friday, December 6th                           8am-5pm

Friday, December 13th                        8am-2pm

Friday, December 27th                        8am-5pm

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DECEMBER 1-7 is National Handwashing Awareness Week

Washing your hands is one of the best ways to protect you and those around you from getting sick. Clean hands reduce the spread of germs and other bacteria easily found in public spaces like classrooms and libraries. Did you know the CDC has guidelines for washing your hands during this cold & flu season?

When to wash your hands

The CDC recommends everyone wash their hands before engaging in the following activities:

· Before, during, and after preparing food

· Before eating food

· Before and after caring for someone who is sick

· Before and after treating a cut or wound

· After using the toilet

· After changing diapers or cleaning up a child who has used the toilet

· After blowing your nose, coughing, or sneezing

· After touching an animal, animal feed, or animal waste

· After handling pet food or pet treats

· After touching garbage

How to wash your hands

Handwashing can be broken up into 5 easy steps:

· Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

· Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.

· Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.

· Rinse your hands well under clean, running water.

· Dry your hands using a clean towel or air dry them.

Washing hands with soap and water is the best method of eliminating germs, however these conditions aren’t always available. If you don’t have access to soap and water, try using an alcohol-based hand sanitizer that contains at least 60% alcohol. While these sanitizers can quickly reduce the amount of germs on your hands, they do not remove all types of germs and might not remove harsh chemicals.

For more information on effective hand washing methods and benefits, visit cdc.gov/handwashing

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Lower Back and Leg Pain Resulting from Irritated or Injured SI Joints

One of the most common causes of low back and pelvic pain occurs with injuries to the sacroiliac (SI) joint and ligaments.

SI Joint Dysfunction Facts & Information

If you are experiencing the seemingly unbearable symptoms of SI joint dysfunction, it’s important to have an accurate diagnosis with thorough tests and evaluations. Often times, sacroiliac (SI) joint dysfunction is difficult to diagnose because the pain patterns are frequently mistaken for nerve irritation in the lower back, muscles sprains, or hip bursitis.

How & Why Does SI Joint Dysfunction Develop?

First, it’s key to understand that the SI joint connects the pelvic bone (ileum) to the lowest part of the spine (sacrum). There are two SI joints. Each is located on either side of the sacrum. SI joints are small and very strong, providing structural support and stability. They function as shock absorbers for the pelvis and the low back, dispersing the forces of the upper body. Whenever an SI joint is irritated or injured, the resultant joint dysfunction may cause pain in the lower back and legs.

SI joints become painful because of alterations in the normal motion of the joints. Consider the following:

Two types of changes from normal motion can cause problems

Those changes are either too much movement (hyper-mobility) or too little movement (hypo-mobility)

Abnormal motion from work/sports can directly injure the joints via stretching/straining the primary SI ligaments

►   Any of these changes in joint mobility may lead to pain, as well as spasm in the supporting back and pelvic muscles

SI joint dysfunction may also result from direct trauma, such as injuries associated with a motor vehicle accident

► Or an injury from something as simple as a fall on the buttocks or a missed step when descending stairs


► Pain in the lower back
►  Generally aggravated by sitting, standing, or bending at the waist
►  When severe, there will be pain in the hip, groin, and legs


Proper diagnosis starts with an experienced pain management doctor. The type of pain that you may have with SI joint dysfunction can be similar to the symptoms of several types of disorders. Accurately determining the correct source of your pain is critical to successful treatment.
► Begins with a thorough clinical evaluation
► Including a complete medical history, analysis of your symptoms, and physical examination
► Testing may include x-rays, MRI and/or CT scans, electro-diagnosis (EMG)
These advanced diagnostic techniques definitively pinpoint the source of pain

Possible Treatments:

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IPA Building New Ambulatory Surgery Center on Ridgemont Drive

A group of physicians specializing in pain management is renovating part of a building on Ridgemont Drive to open a 7,400-square-foot ambulatory surgery center.

Integrated Pain Associates’ outpatient facility at 4351 Ridgemont Drive will have 10 pre-op bays, three surgery rooms and 10 post-op bays. The facility previously was home to Dr. Dan Munton’s Texas Sport and Spine, which IPA bought effective July 1 after Dr. Munton retired.

The Forge Training Facility continues to operate at the north side of the building that originally was home to Circuit City. D1 Sports previously was located in the building.

The surgery center cost is $3 million and is expected to open in July, IPA marketing representative Lydia Bailey said.

Central Texas roots

Dr. Scott Irvine started IPA in Killeen in 2007 with his wife. Since then, the group has grown to nine board-certified pain anesthesiologists serving more than 38,000 patients with practices also in Temple and Waco.

“We do all the most contemporary procedures,” Irvine said. “So, when they come, it’s not just one thing, or one dimensional. It’s multiple dimensions, and I think that is what’s been most exciting for these folks.”

IPA expanded into Abilene in September 2018 with the acquisition of Abilene Spine and Joint operated by Drs. Edward Brandecker and Roberta Kalafut at 1888 Antilley Road.

IPA is moving the Antilley Road surgery center to the new center on Ridgemont Drive, Irvine said.

“In the context of contemporary medicine and meeting all the new criteria associated with surgery centers, it does not pass. It passes now, because it’s grandfathered it, just like so many older things are, but that’s why we’re moving it,” Irvine said.

The new surgery center will be brighter, roomier and more streamlined for the benefit of patients and staff, he said.

Welcomed move

The expansion into Abilene has been positive, Irvine said.

“What we’ve found is the people are just spectacular. The people are just wonderful,” Irvine said about the doctors’ expansion into Abilene.

Two IPA physicians are based in Abilene: Dr. Scott Campbell and Dr. Jerry Tarver.

“One of our requirements on these sorts of things is we don’t want to be viewed as sort of sharks coming to town,” Irvine said. “We hire people and put them in your town. They live there. We have two physicians who actually live and go to church in town. They’re part of the city.”

Irvine and other IPA physicians at Central Texas locations rotate through the practice to assist, Irvine said.

“You have to kind of think about it in terms of you would sort of think about a franchise,” Irvine said. “We’re taking a successful patient management model, we keep everybody educated and contemporary and then we say, ‘OK, let’s open this up and you guys can run this as your place.’ And, that’s what’s happening,” Irvine said.

Interventional procedures are used to address pain at the nerves instead of solely using narcotics, including opioid medications. Such minimally invasive procedures as a dorsal collar stimulator or implanted decompression spinal devices can reduce pain by 50 to 70 percent, Irvine said.

“We can then reduce your narcotic dosing by that amount and then reduce the exposure to the risks associated with opioids,” he said.

What else is in the works (or not yet) for Abilene

Following are updates on other commercial projects in the city, based on city permitting information:

► 3550-3558 S. Clack St. – A site plan for a new retail shell for multiple tenants has been submitted to the city for review, said Tim Littlejohn, building official with the city of Abilene. The lot is just north of Cheddar’s.

► 3650 S. Clack St. – The lot where a Burger King recently was razed after sustaining major storm damage has been cleared. Plans have been filed for a new Burger King building.

► Inca Trio Fire Services  – A new company building is being built at 1009 Martin St.

► ALDI’s – No word from the company on a timeline for plans announced late last year to locate a store next to Kohl’s. The city also does not have permitting applications on file for the company, Littlejohn said.

► Torchy’s Tacos – The Austin-based regional restaurant and bar has listed on its website three job postings for an Abilene location: assistant manager, kitchen manager and managing partner. The company has not submitted permitting requests with the city, Littlejohn said.

► Panera Bread – Although long-rumored that the restaurant is coming to Abilene, no plans are on file with the city for the business, Littlejohn said.

► Tea2Go is opening a second location at 1152 E.N. 10th St. on Oct. 5. 

By , Abilene Reporter-News

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Join us this Pain Awareness Month

Integrated Pain Associates joins the global health care community in recognizing September as Pain Awareness Month.  This international campaign was first established in 2001 to create greater understanding that pain is a serious public health issue. Pain Awareness Month is dedicated to helping people with chronic, acute and cancer pain lead better lives. The movement is supported by health care providers and facilities, research universities and foundations, pharmacists, community and advocacy groups, government agencies, legislators, and the media.

September is Pain Awareness Month

Integrated Pain Associates supports Pain Awareness Month at each of its Texas pain care centers in Killeen, Waco, Temple and Abilene. Some of the goals of this worldwide public awareness campaign include:

·         – Promote awareness of pain as a serious and complex public health issue

·         – Increase awareness of the different types of pain conditions & disorders

·         – Educate patients about available pain treatment & management resources

·         – Provide informational toolkits to nurses and pharmacists

·         – Work with lawmakers to shape responsible pain treatment policies

Learn more about Pain Awareness Month:  https://uspainawarenessmonth.com/

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Texas Sport & Spine Acquired by Integrated Pain Associates

Abilene, Texas – Texas Sport & Spine has been acquired by Integrated Pain Associates, a Central Texas based Interventional Pain Management practice that originally opened in Abilene in September 2018.

Dr. Dan Munton, owner of Texas Sport & Spine, announced on Tuesday, June 4th his desire to shift the focus of his practice and has trusted Integrated Pain Associates to assume care for his patients at Texas Sport & Spine starting July 8, 2019. IPA will continue to provide the exceptional pain care that patients have come to expect and will offer a broad range of treatment options, injections and interventional procedures.

Integrated Pain Associates is dedicated to improving its patient’s quality of life by treating the root cause of chronic pain and reestablishing function. IPA has clinics in Killeen, Waco, Temple and Abilene and has cared for Central Texas for over a decade. Since opening in Abilene they have treated nearly 2500 patients and are honored to be serving the Abilene community.

Integrated Pain Associates will be relocating their clinic to the current Texas Sport & Spine location in early July. The new address will be:

Integrated Pain Associates
4351 Ridgemont Dr.
Abilene, TX 79606

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