Back Pain

Back Pain

Back pain is one of the most common medical problems in the United States. It is the #1 reason for a doctor to write a prescription for narcotics. Back pain can range from a dull, constant ache to sudden, sharp pain. Sometimes it can come on suddenly – from an accident, a fall, or lifting something heavy, or it can develop slowly because of age-related degenerative changes to the spine. In some cases, inflammatory disorders or other medical conditions cause back pain.

Treatment varies depending on the cause and symptoms; however, there are steps you can take to improve your health and lower your chance of developing chronic long-lasting back pain. If you are already experiencing chronic back pain, there are still things you can do to help alleviate the pain and reduce your need of drugs and back surgery.

Understanding the Anatomy of the Back

There are many different structures in the anatomy of the back that work together to support your body. Problems with any one of these structures can cause back pain.
There are four regions of the spine:

  • Cervical spine (neck)
  • Thoracic spine (mid back)
  • Lumbar spine (low back)
  • Sacrum and coccyx (tailbone)

Parts of the spine and back include:

Vertebrae – small bones stacked on top of one another, which protect the spinal cord.
Spinal cord – a long bundle of nerves that run down the back through a canal in the vertebrae.
Intervertebral discs – cushion-like pads between the vertebrae that act like shock absorbers and spacers for the spine.
Ligaments – short bands of tough, flexible tissue that hold the vertebrae in place.
Tendons – cord of tissue that connects muscle to bone.
Muscles – a bundle of dynamic fibers that support your spine and upper body and help you move.

Who Gets Back Pain?

Anyone can experience back pain; however, there are several factors that increase your risk. Risk factors include;
Fitness level: People’s fitness level plays a big role for those experiencing back pain. Back pain is more common among those who are not physically fit. For example, weak muscles can increase a person’s chance of having back pain. Back pain is also more likely if you exercise too strenuously after being inactive for a while.
Weight gain: A diet high in calories, carbohydrates, and sugar, combined with an inactive lifestyle, can lead to obesity. This can put stress on the back
Job-related risk factors: Jobs that require heavy lifting, pushing, pulling, or twisting can injure the back. A desk job may also play a role, especially if you have poor posture or sit all day in an uncomfortable chair.
Age: Back pain becomes more common with age, particularly after the age of 45. This is commonly due to spinal degeneration, arthritis and degenerative disc disease. However, even young people can have back pain.
Heredity: Genetics can play a role in some disorders and disease procesess that cause back pain.

Types of Back Pain

Doctors and researchers describe the types of back pain in the following ways:
Acute back pain happens suddenly and usually lasts a few days to a few weeks.
Subacute back pain can come on suddenly or over time and lasts 4 to 12 weeks.
Chronic back pain may come on quickly or slowly and lasts longer than 12 weeks.

Symptoms of Back Pain
Back pain can range from local pain in a specific spot to generalized pain spreading all over the back. Sometimes the pain radiates down towards your buttocks, legs, or abdomen. The intensity of back pain varies for each person. People can experience back pain from many different situations, these include;

  • Increasing pain with lifting and bending.
  • Worsening pain when resting, sitting, or standing.
  • Back pain that comes and goes.
  • Stiffness in the morning when awakening and lessened back pain with activity.
  • Pain while sleeping
  • Pain during different activities such as, running, skiing, golfing, -liftweights etc.
  • Pain that radiates away from the back into the buttocks, leg, or hip.
  • Extreme pain that could nearly imobilize you for a period of time

You should seek a consultation with a medical provider if your pain does not improve after a few weeks or if any of the following symptoms happen with your back pain:

  • Numbness and tingling
  • Severe back pain that does not improve with medication
  • Back pain after a fall or injury
  • Back pain along with:
    • Trouble urinating
    • Weakness, pain, or numbness in your legs
    • Fever
    • Weight loss that you did not intend

Causes of Back Pain
Back pain can be caused by many different things, including mechanical or structural problems with the spine, inflammatory conditions, and other medical conditions.

Mechanical/Structural Problems

Back pain can happen when mechanical or structural problems develop in the spine, discs, muscles, ligaments, or tendons in the back.
Sprain: an injury to the ligaments that support the spine, often occurring from twisting or lifting improperly.
Strain: an injury to a muscle or tendon in the back or neck.
Degenerative disc disease: wear and tear causes the discs between the vertebrae of the spine to break down.
Herniated or ruptured discs: the discs compress and irritate nearby nerves. This often occurs at the lumbar and cervical level.
Spondylolisthesis: a vertebra in the spine slips out of place.
Spinal stenosis: a narrowing of the spinal column that puts pressure on the spinal cord and nerves.

Fractured vertebrae.
Scoliosis or other congenital changes to the spine.

Inflammatory Conditions
Ankylosing spondylitis a specific type of arthritis of the spine.
Other types of inflammatory arthritis of the spine.

Other Medical Conditions
Osteoporosis, which can lead to painful fractures of the vertebrae.
Fibromyalgia, a condition of widespread muscle pain and fatigue.
Kidney stones or infections.
Endometriosis, which is the buildup of uterine tissue in places outside the uterus.
Infections that involve the bones of the spine or the discs between these bones, which can cause pain.
Tumors, in rare cases, that develop on the spine or other areas of the back.

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Joint Pain

Joint Pain

What is the cause of joint pain?
Acute joint pain is typically the result of an injury or direct trauma while chronic joint pain can be caused by rheumatoid arthritis or osteoarthritis. Chronic joint pain can also develop as a result of an underlying medical condition such as dislocation, infection, osteoporosis, cancer, or fibromyalgia.

When should I seek medical care?
Joint pain can occur in any joint of the body, but most patients who experience joint pain do so in the knees, hips, shoulders, or spine. Persistent and severe pain that prohibits your ability to complete everyday tasks should be evaluated by a doctor as soon as possible. If you notice redness, joint deformity, swelling, or reduced range of motion, please contact our office to schedule an appointment.

What treatments are recommended for joint pain?
If over-the-counter medications prove unable to relieve your pain, we may then proceed with other treatments such as prescription medications, epidural steroid injections, or nerve blocks.

Strengthening the muscles surrounding the joint is important to healing and preventing future flare ups, so we may recommend at-home exercises or physical therapy as well.

There are many causes of joint pain. The different causes result in differing features, treatments and outcomes.

Joint pain is discomfort that arises from any joint. The medical word for joint pain is arthralgia. This is different than the word arthritis, which means inflammation of the joint, which causes pain and sometimes warmth, redness and/or swelling of the joint. A joint can be painful without being inflamed, or it can be both painful and inflamed. Joint pain may affect just one joint or it may affect many different joints. The pattern of the joint pain in terms of how many and which joints are affected will depend on the underlying cause.

What are the causes of joint pain?
There are many causes of joint pain. The cause of joint pain may be obvious, such as following a sports injury. Joint pain may also be caused by different structures in or around the joint. The underlying cause may therefore be a problem with:

  • The bones of the joint or near the joint.
  • The tendons, ligaments or muscles around the joint.
  • The lining of the joint

Joint pain may also be caused by dysfunction in another part of the body. This is called ‘referred pain’. For example, a problem in your hip may cause you to also feel pain in your knee. Nerve pain also occurs when a herniated disc in your back causes pain in your leg (called sciatica after the sciatic nerve which is often the one being squashed by the out-of-place disc).

Causes of joint Pain

Joint, bone or soft tissue injuries: injury to the joint for example sprains and strains, fractures, and dislocations.

Osteoarthritis (OA): the most common form of arthritis. Osteoarthritis can also develop from previous damage to the joint such as a fracture or previous injury or by chronic ‘wear and tear’ of the joint. It may be most noticeable at first in just one joint, such as the knee or hip, but as time goes on usually affects several joints. As well as the knee, hip, and hands, areas in the spine are often affected as well. OA mainly involve damage to the cartilage that covers the ends of the bones. The main job of the smooth, slippery cartilage is to help the joints glide and move smoothly. This type of arthritis causes the cartilage to become thinner, rougher, and sometimes even torn or frayed. To compensate for the loss of cartilage and changes in joint function, the body begins to change the shape of the bone to restore stability in the joint. This can cause undesirable bony growths to develop, called osteophytes or bone spurs.

Inflammatory Arthritis: causes inflammation, pain, and swelling of joints. Examples are rheumatoid arthritis and psoriatic arthritis.

Fibromyalgia: causes pains and tenderness in many areas of the body, as well as tiredness and other symptoms.

Ankylosing spondylitis: this is a form of arthritis. It mainly affects the lower back but other joints and other parts of the body are sometimes affected

Auto immune diseases – for example, ankylosing spondylitis, systemic lupus erythematosus and scleroderma: connective tissue diseases affect tissues throughout the body, including tendons, ligaments, skin, eyes, cartilage, bone and blood vessels.

What can I do about my joint pain?

At Reno Regenerative Medicine our mission is to help people heal naturally without unnecessary drugs and surgery. When patients come to us with joint pain, we do a comprehensive exam including imaging. We then determine if the person is a good candidate for care in our office. If the person is a good candidate, we recommend a care plan that may include:

  • Joint injections
  • Therapeutic exercise
  • Chiropractic care
  • Bracing
  • Physiotherapy

In our experience when patients use a combination of these therapies it can have a profound impact on their health that reduces pain and increases function. Our approach is much different than the standard of care. We are trying to help your body heal to solve the problem. Not just treating the symptoms of joint pain.

Typically, with joint pain, the first thing a person will do is try something at home. They might do stretches or exercises, maybe take some ani-inflammatories to deal with the pain. If that doesn’t work they might try chiropractic or physical therapy. If that doesn’t work, they got to the doctor. At the doctor they most likely get a cortisone injection. The relief from cortisone is usually temporary and you can only get so many cortisone injections in a joint without side effects. After injections the next stop is surgery, and after that more surgery.

It is very difficult to get the results you want by the current standard of care. Our goal is to help people get back to the lifestyle that they want. To get back to the activities they like to do and share these experiences with their loved ones. We have helped thousands of patients with joint pain over the years. The first step to see if we can help you is to schedule a consultation here

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request an appointment

Knee Pain

Knee Pain

Knee pain is increasingly becoming a more common problem in society. It is a complaint we see frequently. The most common complaint associated with knee pain is considered the normal “wear and tear.” Another ailment that affects the knee is osteoarthritis. The symptoms and progression of osteoarthritis and knee pain can be reduced through our individualized approach to chiropractic care.

Knee pain is increasingly becoming a more common problem in society. It is a complaint we see frequently. The most common complaint associated with knee pain is considered the normal “wear and tear.” The truth is there is no such thing as normal wear and tear. Osteoarthritis is one of the most common conditions that affect peoples knees. This is a degenerative process that starts when there is dysfunction in the knee. This can be caused be previous injuries or chronic dysfunction.

The knee joint is the largest joint in the body. It is responsible for much of the lower body’s movement, and is comprised of mucles,cartilage, ligaments, and tendons. The knee is weight bearing and is highly susceptible to many injuries from trauma and from repetitive stress. In addition, multiple muscles are connected to our knees, and can cause pain to radiate from different areas.

Some people are more likely to develop knee problems than others. Many jobs, sports, and recreational activities can increase your chances of having problems with your knees. Your risk is also greater as you get older.

A few common knee injuries include:

  • Knee Osteoarthritis
  • Patellar Tendonitis (Jumper’s knee)
  • Knee Bursitis (inflammation of fluid filled sacs near your knee joint)
  • Knee Sprains or strains
  • Ligament tears, sprains, or strains
  • Osgood-Schlatter Disease
  • IT (Iliotibial) Band Syndrome


Many knee pain causes are the result of a traumatic injury. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee.

Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the knee. Activities such as stair climbing, running, or jumping stress joints and other tissues can lead to irritation and inflammation.

Knee pain can often happen because of tightness in another part of the body such as in the adductor muscles, hip flexors, quadriceps, and hamstrings. Tight muscles and joints can change how the knee responds to impact from walking or running.

Other common causes of knee pain include a Baker Cyst (a buildup of synovial fluid, or joint fluid that helps with lubrication, behind the knee), rheumatoid arthritis, knee dislocation, a torn meniscus (a rupture in one or more of the cartilages in the knee), or a torn ligament.

WHAT are common symptoms of knee pain?

Although the causes may be different, most often they share the same symptoms, including:

  • Pain, swelling, or bruising may be can be mild to severe and develop quickly or gradually
  • The severity of the pain can vary, from a minor ache to a severe disabling pain.
  • Knee pain can be localized, such as in the front of your knee, or diffuse throughout the knee, depending on which structure is involved.
  • You may experience trouble walking, limping due to discomfort, or locking of the knee joint.
  • The pain can vary depending on what bones of the knee are involved, such as the knee joint (femur, tibia, fibula), the kneecap (patella), or the ligaments and cartilage (meniscus) of the knee.
  • Other problems can develop due to overcompensating for knee pain and favoring one leg over the other.


At Reno Regenerative Medicine our mission is to help people heal naturally without unnecessary drugs and surgery. When patients come to us with knee pain, we do a comprehensive exam including imaging. We then determine if the person is a good candidate for care in our office. If the person is a good candidate, we recommend a care plan that may include:

  • Joint injections
  • Therapeutic exercise
  • Chiropractic care
  • Bracing
  • Physiotherapy

In our experience when patients use a combination of these therapies it can have a profound impact on their health that reduces pain and increases function in their knee. Our approach is much different than the standard of care. We are trying to help your body heal to solve the problem. Not just treating the symptoms of joint pain.

Typically, with knee pain, the first thing a person will do is try something at home like heat or ice. They might do stretches or exercises, maybe take some ani-inflammatories to deal with the pain. If that doesn’t work they might try chiropractic or physical therapy. If that doesn’t work, they got to the doctor. At the doctor they most likely get a cortisone injection. The relief from cortisone is usually temporary and you can only get so many cortisone injections in a joint without side effects. After injections the next stop is surgery, and after that more surgery.

It is very difficult to get the results you want by the current standard of care. Our goal is to help people get back to the lifestyle that they want. To get back to the activities they like to do and share these experiences with their loved ones. We have helped thousands of patients with joint pain over the years. The first step to see if we can help you is to schedule a consultation.

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request an appointment

neck pain

Neck Pain

The neck, also called the cervical spine, begins at the base of the skull and contains seven small vertebrae. The cervical spine supports the full weight of your head which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury.

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shoulder pain

Shoulder Pain

Shoulder pain is a very common condition and affects almost half of the U.S. Most patients feel some sort of pain, limited range of motion, an inability to engage in activities of daily living (ADL) or something more serious as a permanent disability.

The shoulder works with surrounding muscles and tendons to allow for a broad range of motion in the arm. Because of the shoulder’s design, our arms can rotate, push, pull, and lift objects overhead with relative ease. Because we rely on the shoulder for daily movements, wear and tear in the shoulder can often lead to painful shoulder injuries.  The most common problems that people are concerned about are tears in the rotator cuff and arthritis.

The shoulder is a complicated joint. Because it has a wide range of motion it is also less stable then other joints in the body. This can lead to shoulder problems

Typical causes of shoulder pain are overuse and trauma. These occur frequently during activities like weightlifting, football, or gymnastics. Common conditions include bursitis, rotator cuff tendonitis/tears, and shoulder impingement.

Most causes of shoulder pain fall into these two categories:


  • Joint Dislocation
  • Fracture
  • Ligament or muscle tear


  • Inflammation (shoulder tendonitis/tendinitis, shoulder bursitis)
  • Arthritis
  • Ligament or muscle tears


Symptoms vary depending on the type of shoulder injury. Shoulder injuries will cause pain with movement and may cause weakness in the joint when attempting activities of daily living or sports. Typically, an injury to the shoulder will be painful and easily aggravated by movement.

Depending on your condition, you may experience any of the following symptoms:

  • Dull, aching pain that worsens with activity
  • Stiffness or reduced mobility
  • Joint swelling or edema
  • A clicking sound from the shoulder
  • Pain or difficulty raising your arms
  • Tenderness to the touch
  • Radiating pain into your arm or neck
  • Difficulty sleeping

Common Shoulder Problems

Rotator Cuff Tears

The rotator cuff is part of your shoulder made up of muscles, tendons, and ligaments.  Rotator cuff tears can occur when these structures are damaged. This can happen in a sudden injury or slowly over time due to arthritis or impingement. At reno regenerative medicine we have several options to help people with rotator cuff issues.

Arthritis in the shoulder

There are a few joints in the shoulder that are all susceptible to arthritis. The glenhumeral joint is the biggest joint in the shoulder and is typically what people think of as their shoulder joint.There is also the AC joint that can develop arthritis that is part of the shoulder as well. Shoulder arthritis develops when there is damage to the joint or laxity in the joint from torn tendons and ligaments , like a rotator cuff tear.

Bursitis in the shoulder

We have many areas in our bodies that have bursas, these fluid filled sacs help cushion tendons when they insert onto bones. Sometimes these sacs can become irritated and inflamed. When this happens the bursa can become painful. Bursitis is very common in the shoulder in a condition called subacromial bursitis.

Frozen shoulder

Frozen shoulder, also called adhesive capsulitis, involves stiffness and pain in the shoulder joint along with the loss of range of motion. Signs and symptoms typically begin slowly, then get worse over time. The leading theory of how frozen shoulder occurs is that the ligaments around the shoulder thicken and get tighter. This is painful and causes the range of motion of the shoulder to be limited. Having to keep a shoulder still for a long period increases the risk of developing a frozen shoulder. This might happen after having surgery or breaking an arm.

What can I do about my shoulder pain?

At Reno Regenerative Medicine our mission is to help people heal naturally without unnecessary drugs and surgery. When patients come to us with joint pain, we do a comprehensive exam including imaging. We then determine if the person is a good candidate for care in our office. If the person is a good candidate, we recommend a care plan that may include:

  • Joint injections
  • Therapeutic exercise
  • Chiropractic care
  • Bracing
  • Physiotherapy

In our experience when patients use a combination of these therapies it can have a profound impact on their health that reduces pain and increases function. Our approach is much different than the standard of care. We are trying to help your body heal to solve the problem. Not just treating the symptoms of joint pain.

Typically, with joint pain, the first thing a person will do is try something at home like heat or ice. They might do stretches or exercises, maybe take some ani-inflammatories to deal with the pain. If that doesn’t work they might try chiropractic or physical therapy. If that doesn’t work, they got to the doctor. At the doctor they most likely get a cortisone injection. The relief from cortisone is usually temporary and you can only get so many cortisone injections in a joint without side effects. After injections the next stop is surgery, and after that more surgery.

It is very difficult to get the results you want by the current standard of care. Our goal is to help people get back to the lifestyle that they want. To get back to the activities they like to do and share these experiences with their loved ones. We have helped thousands of patients with joint pain over the years. The first step to see if we can help you is to schedule a consultation here

read more

request an appointment



According to the American Chiropractic Association, one of the most common causes of neck pain is whiplash resulting from a car accident. A sudden forced movement of the head or neck in any direction and the resulting “rebound” in the opposite direction is known as whiplash. The sudden “whipping” motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots.

Whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip.

Whiplash is commonly caused by rear-end car accidents. But whiplash can also result from sports accidents, physical abuse and other types of traumas, such as a fall. Whiplash may be called a neck sprain or strain, but these terms also include other types of neck injuries.

Most people with whiplash get better within a few weeks by following a treatment plan that includes pain medication and exercise. However, some people have chronic neck pain and other long-lasting complications.

Signs and symptoms of whiplash usually develop within days of the injury, and may include:

  • Neck pain and stiffness
  • Worsening of pain with neck movement
  • Loss of range of motion in the neck
  • Headaches, most often starting at the base of the skull
  • Tenderness or pain in the shoulder, upper back or arms
  • Tingling or numbness in the arms
  • Fatigue
  • Dizziness

Some people also have:

  • Blurred vision
  • Ringing in the ears (tinnitus)
  • Sleep disturbances
  • Irritability
  • Difficulty concentrating
  • Memory problems
  • Depression


Whiplash typically occurs when your head is forcefully and quickly thrown backward and then forward. This motion can injure bones in the spine, disks between the bones, ligaments, muscles, nerves and other tissues of the neck.

A whiplash injury may result from:

  • Auto accidents. Rear-end collisions are a major cause of whiplash.
  • Physical abuse or assault. Whiplash can occur if you are punched or shaken. It’s one of the injuries seen in shaken baby syndrome.
  • Contact sports. Football tackles and other sports-related collisions can sometimes cause whiplash.

How is a whiplash treated?

Your healthcare provider will determine specific treatment for whiplash, based on:

  • Your age, overall health, and medical history
  • The extent of your injury
  • Your tolerance for specific medicines, procedures, or therapies
  • Expectations for the course of your injury
  • Your opinion or preference

Treatment may include:

  • Ice applications for the first 24 hours
  • Cervical (neck) collar
  • Gentle, active movement after 24 hours
  • Anti-pain ,anti-inflammation medication Serapin
  • Trigger point injections
  • Therapeutic Excercise
  • Chiropractic manipulation
  • Spinal Decompression
  • Cold laser therapy
  • Pulsewave therapy


Most people who have whiplash feel better within a few weeks and don’t seem to have any lasting effects from the injury. However, some people continue to have pain for several months or years after the injury occurred. This is precisely why everyone who is suspected of having whiplash should reach out to a medical provider to access the situation

It is difficult to predict how each person with whiplash may recover. In general, you may be more likely to have chronic pain if your first symptoms were intense, started rapidly and included:

  • Severe neck pain
  • More-limited range of motion
  • Pain that spread to the arms

The following risk factors have been linked to a worse outcome:

  • Having had whiplash before
  • Older age
  • Existing low back or neck pain
  • A high-speed injury
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Pain relief

Pain relief is one of the top reasons that people seek medical attention. Chronic pain is defined as pain lasting longer than 12 weeks and though conventional treatment options such as medication and surgery can treat pain, they may come with unwanted side effects and lengthy recovery periods. Fortunately, both chronic and acute pain can be effectively treated with naturopathic medicine.

At Reno Regenerative Medicine, we believe in treating pain by identifying and effectively treating your underlying condition, not simply suppressing the symptoms. Our treatment focuses not only on addressing your physical pain, but your total health including your physical, psychological, and emotional wellbeing.

Naturopathic treatments have been used for centuries in pain management and have proven effective in restoring balance to your central nervous system and reducing inflammation throughout the body. Common naturopathic treatments include acupuncture, hydrotherapy, massage therapy, meditation training, lifestyle counseling, and chiropractic care.

We will work with you to create a customized treatment plan that takes into account your individual needs. Our care is comprehensive and patient-centered. We are always happy to work alongside your other healthcare team professionals to ensure you are receiving the best treatment possible.

For more information on pain management and our services or to schedule a consultation, contact our office today at (775) 683-9026.

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Neuropathy is a medical condition caused by damaged nerve cells and often associated with autoimmune diseases, infections, diabetes, tumors, or hereditary conditions. Peripheral neuropathy currently affects over 20 million people in the United States with symptoms ranging from tingling or burning pain and nausea to muscle spasms, difficulty moving your arms or legs, or atrophy.

What is peripheral neuropathy?

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system. Our
bodies have millions of nerves that send signals between the central nervous system (the brain and spinal cord) and all other parts of the body. Peripheral nerves send many types of sensory information to the central nervous system (CNS), such as a message that the feet are cold. They also carry signals from the CNS to the rest of the body. Best known are the signals to the muscles that tell them to contract, which is how we move, but there are different types of signals that help control everything from our heart and blood vessels, digestion, urination, sexual function, to our bones and immune system. The peripheral nerves are like the cables that connect the different parts of a computer or connect the Internet. When they malfunction, complex functions can grind to a halt.

More than 20 million people in the United States have been estimated to have some form of peripheral neuropathy, but this figure may be significantly higher—not all people with symptoms of neuropathy are tested for the disease and tests currently don’t look for all forms of neuropathy. Neuropathy is often misdiagnosed due to its complex array of symptoms.

What are the symptoms of peripheral nerve damage?

Symptoms are related to the type of nerves affected.

Motor nerve damage is most commonly associated with muscle weakness. Other symptoms include painful cramps, fasciculations (uncontrolled muscle twitching visible under the skin) and muscle shrinking.

Sensory nerve damage causes various symptoms because sensory nerves have a broad range of functions.

Damage to large sensory fibers harms the ability to feel vibrations and touch, especially in the hands and feet. You may feel as if you are wearing gloves and stockings even when you are not. This damage may contribute to the loss of reflexes (as can motor nerve damage). Loss of position sense often makes people unable to coordinate complex movements like walking or fastening buttons or maintaining their balance when their eyes are shut.
The “small fibers” without myelin sheaths (protective coating, like insulation that normally surrounds a wire) include fiber extensions called axons that transmit pain and temperature sensations. Small-fiber neuropathy can interfere with the ability to feel pain or changes in temperature. It is often difficult for medical caregivers to control, which can seriously affect a patient’s emotional well-being and overall quality of life. Neuropathic pain is sometimes worse at night, disrupting sleep. It can be caused by pain receptors firing spontaneously without any known trigger, or by difficulties with signal processing in the spinal cord that may cause you to feel severe pain (allodynia) from a light touch that is normally painless. For example, you might experience pain from the touch of your bedsheets, even when draped lightly over the body.
Autonomic nerve damage affects the axons in small-fiber neuropathies. Common symptoms include excess sweating, heat intolerance, inability to expand and contract the small blood vessels that regulate blood pressure, and gastrointestinal symptoms. Although rare, some people develop problems eating or swallowing if the nerves that control the esophagus are affected.

There are several types of peripheral neuropathies, the most common of which is linked to diabetes. Another serious polyneuropathy is Guillain-Barre syndrome, which occurs when the body’s immune system mistakenly attacks the nerves in the body. Common types of focal (located to just one part of the body) mononeuropathy include carpal tunnel syndrome, which affects the hand and the wrist, and neuralgia paresthetica, which causes numbness and tingling on one thigh. Complex regional pain syndrome is a class of lingering neuropathies where small-fibers are mostly damaged.

What are the causes of peripheral neuropathy?
Most instances of neuropathy are either acquired, meaning the neuropathy or the inevitability of getting it isn’t present from the beginning of life, or genetic. Acquired neuropathies are either symptomatic (the result of another disorder or condition; see below) or idiopathic (meaning it has no known cause).

Causes neuropathy include:

Physical injury (trauma) is the most common cause of acquired single-nerve injury. Injury from automobile accidents, falls, sports, and medical procedures can stretch, crush, or compress nerves, or detach them from the spinal cord. Less severe traumas also can cause serious nerve damage. Broken or dislocated bones can exert damaging pressure on neighboring nerves and slipped disks between vertebrae can compress nerve fibers where they emerge from the spinal cord. Arthritis, prolonged pressure on a nerve (such as by a cast) or repetitive, forceful activities can cause ligaments or tendons to swell, which narrows slender nerve pathways. Ulnar neuropathy and carpal tunnel syndrome are common types of neuropathy from trapped or compressed nerves at the elbow or wrist. In some cases, there are underlying medical causes (such as diabetes) that prevent the nerves from tolerating the stresses of everyday living.
Diabetes is the leading cause of polyneuropathy in the United States. About 60 – 70 percent of people with diabetes have mild to severe forms of damage to sensory, motor, and autonomic nerves that cause such symptoms as numb, tingling, or burning feet, one-sided bands or pain, and numbness and weakness on the trunk or pelvis.

Vascular and blood problems that decrease oxygen supply to the peripheral nerves can lead to nerve tissue damage. Diabetes, smoking, and narrowing of the arteries from high blood pressure or atherosclerosis (fatty deposits on the inside of blood vessel walls) can lead to neuropathy. Blood vessel wall thickening and scarring from vasculitis can impede blood flow and cause patchy nerve damage in which isolated nerves in different areas are damaged—called mononeuropathy multiplex or multifocal mononeuropathy.

Systemic (body-wide) autoimmune diseases, in which the immune system mistakenly attacks a number of the body’s own tissues, can directly target nerves or cause problems when surrounding tissues compress or entrap nerves. Sjögren’s syndrome, lupus, and rheumatoid arthritis are some systemic autoimmune diseases that cause neuropathic pain.
Autoimmune diseases that attack nerves only are often triggered by recent infections. They can develop quickly or slowly, while others become chronic and fluctuate in severity. Damage to the motor fibers that go to the muscle includes visible weakness and muscle shrinking seen in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. Multifocal motor neuropathy is a form of inflammatory neuropathy that affects motor nerves exclusively. In other autoimmune neuropathies the small fibers are attacked, leaving people with unexplained chronic pain and autonomic symptoms.

Hormonal imbalances can disturb normal metabolic processes, leading to swollen tissues that can press on peripheral nerves.
Kidney and liver disorders can lead to abnormally high amounts of toxic substances in the blood that can damage nerve tissue. Most individuals on dialysis because of kidney failure develop varying levels of polyneuropathy.

Nutritional or vitamin imbalances, alcoholism, and exposure to toxins can damage nerves and cause neuropathy. Vitamin B12 deficiency and excess vitamin B6 are the best known vitamin-related causes. Several medications have been shown to occasionally cause neuropathy.

Certain cancers and benign tumors cause neuropathy in various ways. Tumors sometimes infiltrate or press on nerve fibers. Paraneoplastic syndromes, a group of rare degenerative disorders that are triggered by a person’s immune system response to a cancer, can indirectly cause widespread nerve damage.

Chemotherapy drugs used to treat cancer cause polyneuropathy in an estimated 30 to 40 percent of users. Only certain chemotherapy drugs cause neuropathy and not all people get it.

Chemotherapy-induced peripheral neuropathy may continue long after stopping chemotherapy. Radiation therapy also can cause nerve damage, sometimes starting months or years later.

Infections can attack nerve tissues and cause neuropathy. Viruses such as varicella-zoster virus (which causes chicken pox and shingles), West Nile virus, cytomegalovirus, and herpes simplex target sensory fibers, causing attacks of sharp, lightning-like pain. Lyme disease, carried by ticks, can cause a range of neuropathic symptoms, often within a few weeks of being infected. The human immunodeficiency virus (HIV), which causes AIDS, can extensively damage the central and peripheral nervous systems. An estimated 30 percent of people who are HIV-positive develop peripheral neuropathy; 20 percent develop distal (away from the center of the body) neuropathic pain.

Genetically-caused polyneuropathies are rare. Genetic mutations can either be inherited or arise de novo, meaning they are completely new mutations to an individual and are not present in either parent. Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood. Charcot-Marie-Tooth disease, also known as hereditary motor and sensory neuropathy, is one of the most common inherited neurological disorders. The small-fiber neuropathies that present with pain, itch, and autonomic symptoms also can be genetic. As our understanding of genetic disorders increases, many new genes are being associated with peripheral neuropathy.

How is peripheral neuropathy diagnosed?
The bewildering array and variability of symptoms that neuropathies can cause often makes diagnosis difficult. A diagnosis of neuropathy typically includes:

Medical history. A doctor will ask questions about symptoms and any triggers or relieving factors throughout the day, work environment, social habits, exposure to toxins, alcohol use, risk of infectious diseases, and family history of neurological diseases.

Physical and neurological exams. A doctor will look for any evidence of body-wide diseases that can cause nerve damage, such as diabetes. A neurological exam includes tests that may identify the cause of the neuropathic disorder as well as the extent and type of nerve damage.

Body fluid tests. Various blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, infections and signs of abnormal immune system activity. Less often other body fluids are tested for abnormal proteins or the abnormal presence of immune cells or proteins associated with some immune-mediated neuropathies.
Genetic tests. Gene tests are available for some inherited neuropathies.

Additional tests may be ordered to help determine the nature and extent of the neuropathy.

Physiologic tests of nerve function

Nerve conduction velocity (NCV) tests measure signal strength and speed along specific large motor and sensory nerves. They can reveal nerves and nerve types affected and whether symptoms are caused by degeneration of the myelin sheath or the axon. During this test, a probe electrically stimulates a nerve fiber, which responds by generating its own electrical impulse. An electrode placed further along the nerve’s pathway measures the speed of signal transmission along the axon. Slow transmission rates tend to indicate damage to the myelin sheath, while a reduction in the strength of impulses at normal speeds is a sign of axonal degeneration. Inability to elicit signals can indicate severe problems with either.

Electromyography (EMG) involves inserting very fine needles into specific muscles to record their electrical activity at rest and during contraction. EMG tests irritability and responsiveness, detects abnormal muscular electrical activity in motor neuropathy, and can help differentiate between muscle and nerve disorders.

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Hormonal Imbalance

What Causes Hormonal Imbalance?
When there is too much or too little of a particular hormone in our bloodstream, we can suffer from a hormone imbalance. For women hormonal imbalances are more common during puberty, pregnancy, and menstruation. Even if the imbalances are small, they can cause side effects in your body.

Hormones regulate most major body functions and processes. They regulate our metabolism and appetite, our heart rate, sleep cycle, growth and development, mood and stress level, body temperature, plus reproductive cycles and sexual functions.

While some hormones fluctuate throughout your lifetime and may just be due to aging, your signs of hormonal imbalance will depend on what hormones or glands aren’t working properly.

Typical Signs of Hormonal Imbalance In Women

Symptoms associated with the most common causes of hormonal imbalance include the following;

  • Unexplained weight gain or loss
  • Problems sleeping
  • Excessive sweating
  • Very dry skin and rashes
  • Irritability and anxiety
  • Long term fatigue
  • Increased thirst
  • Changes in blood pressure, heart rate, and blood sugar
  • Decreased sex drive
  • Infertility

Women suffering with hormonal imbalance have many of the above symptoms, but they also have some additional signs like heavy, irregular, or painful periods, hot flashes, breast tenderness, acne before and during menstruation, hair growth on the face, neck, back, or chest, skin tags, deepening voice, clitoral enlargement, and darkening of the skin along neck creases, in the groin area, and under breasts.

Treatments For Hormonal Imbalance

Hormone replacement therapy (HRT) is used commonly to balance hormones in women after menopause. It is used for a certain period of time before being discontinued.

Bioidentical hormones are another way to balance out hormones. They are man-made hormones similar to those in our bodies like estrogen, progesterone, and testosterone. They are advertised as being safer and more natural than conventional HRT.

At this time, medical societies and researchers state that the risks and benefits of conventional and bioidentical hormones should be considered equal. Talk with Reno Regenerative Medicine about their use if you are having symptoms.

Men tend to accept changes in their bodies as just part of the aging process. However, most symptoms of “aging” are actually caused by a hormone imbalance, which affects not only testosterone, but also cortisol and thyroid levels. It is true that as men age, they are more likely to experience male hormone imbalance, but there are other contributing factors as well. Here is what you should know about this common but underreported condition.

The Importance of Hormones

Hormones regulate the various systems in the human body, including digestion, growth, metabolism, mood, movement, reproduction, respiration, stress, and tissue function, among others. When your hormones are unbalanced, it can affect virtually all aspects of your overall health and functioning.

Contributing Factors to Male Hormone Imbalance

Aging definitely plays a role in male hormone imbalance. Male growth hormones tend to steadily decrease after the age of 20. By age 40, most men retain only half of their original growth hormones, and by age 80 they typically retain only 5%. Still, this can be affected by other factors, including:

  • Activity level
  • Dietary choices
  • Genetics
  • Injuries
  • Medications
  • Stress

Symptoms of Male Hormone Imbalance

It is easy to chalk up the symptoms of a hormone imbalance to other factors, such as tiredness and overwork, especially in the beginning. Over time, though, these symptoms tend to worsen until they start changing your way of life. Here are just a few of the most common symptoms:

  • Cognitive decline
  • Depression
  • Erectile dysfunction
  • Fatigue
  • Hair loss
  • Loss of muscle mass
  • Low sex drive
  • Memory loss
  • Weight gain

Types of Male Hormone Imbalance

Most male hormone imbalances fall into one of four types:

Andropause: Also known as male menopause, this is the most common type of male hormonal imbalance.

Hypothyroidism: This condition occurs when the thyroid gland becomes underactive.

Hyperthyroidism: This condition occurs when the thyroid gland becomes overactive

Treating Male Hormone Imbalance

Fortunately, male hormone imbalance can be successfully treated. The treatment of choice is typically Bio-Identical Hormone Replacement Therapy (BHRT). This natural solution uses biologically identical replacement hormones, available in pill, cream, gel, and skin patch forms, to gently rebalance your hormone levels.

The hormones are derived from natural sources and have virtually no side effects when properly used. We will prescribe and adjust them based on your unique needs. We may also recommend changes in diet, exercise, and overall lifestyle to support your hormone replacement therapy and maximize the benefits.

What does treatment for hormone imbalance look like at Reno Regenerative Medicine?

The first step in doing hormone optimization is a thorough exam and bloodwork to see what hormones you may or may not need. When we have the results we start you on a hormone plan. After thirty days we will check you blood again looking for changes in hormone levels. Your provider may adjust your plan at this time so that your hormones are optimized. We will continue to monitor your hormone levels every few months to ensure the best results.

Benefits of Hormone optimization may include

  • Increased muscle strength and mass
  • Increased sexual potency and frequency
  • Lower cholesterol levels
  • Increased energy, stamina and endurance
  • Improved mental functioning and ability
  • Improves mood and feeling of well-being
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Sexual Dysfunction

Sexual dysfunction is a common problem among both men and women. It can be caused by physical problems and medical conditions, such as heart disease and hormone imbalances, or by psychological problems, like anxiety, depression and the effects of past trauma.

What is sexual dysfunction in males?

Sexual dysfunction is any physical or psychological problem that prevents you or your partner from getting sexual satisfaction. Male sexual dysfunction is a common health problem affecting men of all ages, but is more common with increasing age. Treatment can often help men suffering from sexual dysfunction.

The main types of male sexual dysfunction are:

  • Erectile dysfunction (difficulty getting/keeping an erection).
  • Premature ejaculation (reaching orgasm too quickly).
  • Delayed or inhibited ejaculation (reaching orgasm too slowly or not at all).
  • Low libido (reduced interest in sex).


What causes sexual dysfunction in males?

Physical causes of overall sexual dysfunction may be:

  • Low testosterone levels.
  • Prescription drugs (antidepressants, high blood pressure medicine).
  • Blood vessel disorders such as atherosclerosis (hardening of the arteries) and high blood pressure.
  • Stroke or nerve damage from diabetes or surgery.
  • Smoking.
  • Alcoholism and drug abuse.

Psychological causes might include:

  • Concerns about sexual performance.
  • Marital or relationship problems.
  • Depression
  • Effects of past sexual trauma.
  • Work-related stress and anxiety.

Premature Ejaculation

Studies suggest that the breakdown of serotonin (a natural chemical that affects mood) may play a role in PE. Certain drugs, including some antidepressants, may affect ejaculation, as can nerve damage to the back or spinal cord.

Physical causes for inhibited or delayed ejaculation may include chronic (long-term) health problems, medication side effects, alcohol abuse, or surgeries. The problem can also be caused by psychological factors such as depression, anxiety, stress or relationship problems.

Erectile dysfunction (ED)

Erectile dysfunction (ED) is the inability to get and keep an erection for sexual intercourse. ED is quite common, with studies showing that about one-half of American men over age 40 are affected. Causes of ED include:

  • Diseases affecting blood flow such as hardening of the arteries.
  • Nerve disorders.
  • Stress, relationship conflicts, depression and performance anxiety.
  • Injury to the penis.
  • Chronic illness such as diabetes and high blood pressure.
  • Unhealthy habits like smoking, drinking too much alcohol, overeating and lack of exercise.

Low libido (reduced sexual desire)

Low libido means your desire or interest in sex has decreased. The condition is often linked with low levels of the male hormone testosterone. Testosterone maintains sex drive, sperm production, muscle, hair and bone. Low testosterone can affect your body and mood.

Reduced sexual desire may also be caused by depression, anxiety or relationship difficulties. Diabetes, high blood pressure, and certain medications like antidepressants may also contribute to a low libido.


How is male sexual dysfunction diagnosed?

Your doctor may begin the diagnosis process with a physical exam. Physical tests may include:

  • Blood tests to check your testosterone levels, blood sugar (for diabetes) and cholesterol.
  • Blood pressure check.
  • Rectal exam to check your prostate.
  • Examination of your penis and testicles.


How is male sexual dysfunction treated?

Many cases of sexual dysfunction can be corrected by treating the mental or physical problems that cause it. Treatments include:

  • Medications: Drugs that help improve sexual function by increasing blood flow to the penis. Sildenafil (Viagra®), vardenafil (Levitra®), and tadalafil (Cialis®) are safe and effective for most men.
  • Hormone therapy: Low levels of testosterone raised by hormone replacement therapies that include injections, patches or gels.
  • Psychological therapy: A psychological counselor to help you address feelings of anxiety, depression, fear or guilt that may affect sexual function.
  • Mechanical aids: Vacuum devices and penile implants that can help some men with erectile dysfunction.
  • Gainswave Therapy
  • PShot


Can male sexual dysfunction be prevented?

While male sexual dysfunction cannot be prevented, dealing with the causes of the dysfunction can help you better understand and cope with the problem when it happens. To help maintain good sexual function you should follow the same program that is recommended to maintain cardiovascular health.

  • Follow your doctor’s treatment plan for any of your medical/health conditions.
  • Limit your alcohol intake.
  • Quit smoking.
  • Eat a heart healthy diet (the Mediterranean diet is often recommended).
  • Get regular aerobic and weight training exercise.
  • Get treatment if needed for any emotional or psychological problems such as stress, depression and anxiety.
  • Communicate better and more often with your partner.


Female Sexual Dysfunction


Persistent, recurrent problems with sexual response, desire, orgasm or pain — that distress you or strain your relationship with your partner — are known medically as sexual dysfunction.

Many women experience problems with sexual function at some point, and some have difficulties throughout their lives. Female sexual dysfunction can occur at any stage of life. It can occur only in certain sexual situations or in all sexual situations.

Sexual response involves a complex interplay of physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any component can affect sexual desire, arousal or satisfaction, and treatment often involves more than one approach.


Symptoms vary depending on what type of sexual dysfunction you’re experiencing:

  • Low sexual desire. This most common of female sexual dysfunctions involves a lack of sexual interest and willingness to be sexual.
  • Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty with arousal or are unable to become aroused or maintain arousal during sexual activity.
  • Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
  • Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.


Sexual problems often develop when your hormones are in flux, such as after having a baby or during menopause. Major illness, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease, can also contribute to sexual dysfunction.

Factors — often interrelated — that contribute to sexual dissatisfaction or dysfunction include:

  • Any number of medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease and bladder problems, can lead to sexual dysfunction. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sexual desire and your body’s ability to experience orgasm.
  • Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm.
    The vaginal lining also becomes thinner and less elastic, particularly if you’re not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire also decreases when hormonal levels decrease.
    Your body’s hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.
  • Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and demands of being a new mother may have similar effects.
    Long-standing conflicts with your partner — about sex or other aspects of your relationship — can diminish your sexual responsiveness as well. Cultural and religious issues and problems with body image also can contribute.

Risk factors

Some factors may increase your risk of sexual dysfunction:

  • Depression or anxiety
  • Heart and blood vessel disease
  • Neurological conditions, such as spinal cord injury or multiple sclerosis
  • Gynecological conditions, such as vulvovaginal atrophy, infections or lichen sclerosus
  • Certain medications, such as antidepressants or high blood pressure medications
  • Emotional or psychological stress, especially with regard to your relationship with your partner
  • A history of sexual abuse
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