Premier Pain Talk


The Premier Pain Talk podcast is focused on helping those living with chronic pain. Host, Dr. Michael Danko, will share cutting-edge treatments that are improving the lives of those living with pain and chronic medical conditions. If you have lost hope of getting relief from your suffering or have been searching for ways to regain lost function, tune in to hear options that might be right for you. Pain management does not always involve opioid medications and when a team of professionals work together to address your unique medical conditions, you can be assured to receive the best possible outcome.

Radio Ablation For Chronic Pain - EP 8
Radio Ablation For Chronic Pain Today on Premier Pain Talk , Dr. Danko is talking about a very common procedure in interventional pain management called radio frequency ablation. There are many conditions that can be effectively treated with it including arthritic joints and nerve pain from various sources. Tune in to hear how it works and the purpose it serves for many!   Episode Highlights: Radiofrequency ablation in layman’s terms is sometimes referred to as ‘burning the nerves’; other terms it goes by are rhizotomy and radiofrequency neurotomy. Dr. Danko explains how a radiofrequency ablation uses the word radio in it because it uses radio waves to create a current that heats a small area of nerve tissue.There are a wide range of conditions that can be treated with radiofrequency ablation and is a pretty common procedure; It can be used outside of interventional pain management in oncology, vascular treatments, and others.In terms of pain management, the spine is the most common area treated but it can also be used for joints or other nerves that are causing pain. Arthritic facet joints at the base of the back and facet joints in the neck and thoracic spine are common ailment points in need of treatment. Dr. Danko explains what symptoms may occur. Sacroiliac joints have high innervation, meaning there is a high supply of nerve to them   and pain may be experienced trying to get in or out of a car or chair, laying on the affected side.What about arthritic joints? When may you need radiofrequency treatment?There are other conditions that cause nerve pain that can be treated with radiofrequency treatments. Not all conditions qualify but it is important to talk with you pain physician to decide whether it could be effective for your situation.How do you determine if you are an appropriate candidate for radiofrequency treatment?What are the precursors to radiofrequency treatments?For those who don’t respond to these treatments there are other treatment options that can be considered based on further evaluation.This is a safe procedure to do in an outpatient facility and often without any sedation or light sedation.The procedure from start to finish is around 30 minutes give or take depending on the area with the ablation itself only taking 90 seconds or two 90 second intervals.The Premier Pain Institute has offices in Mt. Orb, Ohio, Loveland, Ohio, and Hillsboro, Ohio. You can find more information on this procedure at https://premierpaintreatment.com/ 3 Key Points: Radiofrequency ablation or RFA is a common procedure in interventional pain management that uses radio waves to create a current that heats a small area of nerve tissue.If you’re trying to delay a total joint replacement, radiofrequency treatments may be a viable option; It is not commonly known that if you continue to have pain after a joint replacement, this can be effective as well.How do you know if you are a good candidate for radiofrequency treatments for your pain? Dr. Danko explains the conditions and indicating factors. Resources Mentioned: https://premierpaintreatment.com/https://www.facebook.com/PremierPainTreatment/Premier Pain Institute Phone #: 513-454-7246
4d ago
12 mins
Aurora Zip And Silo Minimally Invasive Spinal Fusion Treatments - EP 7
Aurora Zip And Silo Minimally Invasive Spinal Fusion Treatments This week's episode is brought to you by a webinar that Dr. Michael Danko hosted with his practice, Premier Pain Institute. Two treatments are discussed are the zip procedure, also called posterior spine fusion and  Silo, a sacroiliac joint fusion. Dr. Danko explains how both of the treatments are used in his practice and have great outcomes. Tune in for all of the details.  Episode Highlights: Dr. Danko discusses the minimally invasive spine technology from Aurora Spine and Pain, specifically the zip and silo products. Dr. Danko and Dr. Feldheim are with Premier Pain Institute located in Cincinnati, Ohio. They have offices in Loveland, Ohio, Mt. Orb, Ohio and Hillsboro, Ohio.When are you a candidate for posterior spine fusion?Spinal stenosis is a reduced space around the nerves in the spinal canal; With this condition, patients typically have difficulty with standing and walking that amplifies their back and leg pain. Patients may also experience weakness and numbness.Degenerative disc disease is the condition where the discs in the vertebrae start to lose their cushioning over time and those discs can become painful. During the process of degenerative disc disease, a condition called spondylolisthesis can occur where the bony structure starts to slip and is not aligned properly.Nearly all humans will experience degenerative discs at some point in their lives; 90% of people are affected by age 50. Dr. Danko reviews the symptoms you may experience with it.What is the treatment for degenerative disc disease? The first step is usually physical therapy and the modalities they have to offer. Dr. Danko explains the indication to progress to imaging, injections, and beyond.What is the zip procedure? It is the alternative to the pedicle screw fixation procedure. Dr. Danko explains the implant and how it works.What is the recovery process for the zip procedure?What is Silo? When do patients need it?Fusion sounds like a scary procedure but Dr. Danko explains how it is a safe, straightforward, outpatient procedure.If you believe that you are a candidate for any of these procedures, your first step is to discuss your situation with a provider at the office.  3 Key Points: Many patients that have ongoing back pain are sent for imaging to help detect what exactly is the problem. At Premier Pain they are often having  imaging performed to detect conditions like spinal stenosis, disc herniation, degeneration of the disc or vertebrae, and spondylolisthesis. The doctors use the images to piece together along with the patient symptoms to know where the target of exactly what they need to treat.Dr. Danko explains the process of outpatient zip procedure and how it works as well as what the recovery process looks like.The sacroiliac joint fusion performed with SILO is a safe and effective treatment. Dr. Danko explains how patients may end up being in need for the procedure. There is a progression in the conservative treatment plan including external supportive devices, anti-inflammatory medications, and injections before moving on to more durable solutions or permanent fixes. Resources Mentioned: https://premierpaintreatment.com/https://www.facebook.com/PremierPainTreatment/Premier Pain Institute Phone #: 513-454-7246
May 10 2022
17 mins
Premier Pain Talk- How Physical Therapy Can Help With Chronic Pain, With Dr. Drew Burchett? - EP 6
How Physical Therapy Can Help With Chronic Pain, With Dr. Drew Burchett? On this episode of Premier Pain Talk, Dr. Danko is talking to a friend, physical therapist, Dr. Drew Burchett. Dr. Burchett is the Director of Physical Therapy at The Therapy & Balance Centers in Delhi, Ohio. They will be discussing the importance of physical therapy for chronic pain. Tune in now. Episode Highlights: Dr. Burchett introduces himself  and talks about his approach to treating chronic pain and how it differs from brand new or acute injury.Patients with chronic pain who have been in physical therapy before have a story and they may be concerned that they already tried it  and it made their pain worse or it didn’t work. Dr. Danko and Dr. Burchett discuss the challenges and reasons why the patient should come back to try again.How often does the issue with chronic pain for a patient actually stem from a deconditioning or weakness that they may have? How much is it about establishing good habits and targeting those points?Dr. Burchett explains the progression from making a positive difference in pain to strengthening and posture and gait issues.80% of people will have low back pain at some point in their life. It is really important to have options for patients. Dr. Danko asks Dr. Burchett to share specific interventions regarding low back pain.Trigger point dry needling is extremely effective at relaxing specific muscles in the lumbar spine. Dr. Burchett explains what it is and what the patient experience is like.What about aquatic therapy? When is a patient best suited for it? There has to be a continuation of therapy beyond the formal physical therapy sessions. Physical therapists often talk about core stabilization and the importance of tailoring continuing home exercise programs specific to the patient.Dr. Burchett is not only an expert physical therapist, he is also a certified IronMan U Coach. He has a strong athletic background. He shares about that journey and what kind of athletes he coaches.Dr. Danko asks how Dr. Burchett decides if someone will be a good fit for their type of coaching or if a general coaching model would be better for that individual.Good quality nutrients are of high value in all aspects of life whether it is training for athletic events, managing chronic pain, or just staying healthy.They discuss different metrics to monitor change and progress along the way.What is heart rate variability? The trends of shifts and movements are key to watch for.Dr. Danko asks Dr. Burchett to explain how heart rate variability fluctuates and why.Dr. Burchett shares a story about a high level runner who had recurring anterior shin pain. He explains how people like her often are doing micro traumas to their bones and the importance of changing running form.As we age, we slow down and that is the fact of life but there are ways to improve quality of life through physical therapy interventions and other practices like these discussed today.     3 Key Points: Acute injuries differ from chronic pain issues. Physical therapy interventions are used to treat both with different approaches. Dr. Burchett explains how they focus away from a pain number and more on the progress of feeling better.There are physical therapists for a wide variety of injuries and conditions. Oftentimes when patients with chronic pain have already been in physical therapy and felt like it didn’t work they are reluctant to return or just do so out of obligations by insurance. Dr. Burchett shares about providing a new perspective for those types of patients.Dr. Burchett saw the need for medical knowledge in triathlon coaching which was the start of the inspiration for starting the business, Performance and Science with a friend of his. They take a different approach by looking at the athlete as a whole person and using scientific data to guide their plans. Tweetable Quotes: “Most of the patients that have chronic pain have been dealing with it for a long time and they may have done physical therapy early on when the issue was new or acute but then often for one reason or another they may get sent back to physical therapy for an ongoing condition that is considered more of a chronic condition.” -Dr. Michael Danko“When it is an acute injury patient, we really try to get them out of pain as quickly as possible and that is typically successful with physical therapy interventions.” - Dr. Drew Burchett“When you have a patient with chronic pain a lot of times since they have done therapy before, they have a story, and they may have a concern that they have already tried it and it made their pain worse or it didn’t work.” - Dr. Micheal Danko “Tell me what you have done before and tell me what was not successful, because if I know what was not successful then I am going to do a completely different route and try different interventions, techniques, and treatments so that we can find something that will work.” -Dr. Burchett“My main focus in the first couple of sessions is to try to make a positive difference in your pain.” -Dr. Burchett“We do nutritional logs, we monitor heart rate variability to make sure that they aren’t overtrained and they aren’t sick. We can see sickness coming from a mile away..there is a lot of data that we comb through everyday to make sure that we can make that person successful.” -Dr. Burchett Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/ Dr. Burchett: https://www.facebook.com/PremierPainTreatment/https://www.fyzical.com/delhi-oh/About/Staff
May 3 2022
39 mins
What Is The Difference Between Peripheral Nerve Stimulation And Spinal Stimulation, With Dr. Matt Wiederholz?- Ep 5
On today’s episode, Dr. Danko talks with Dr. Matthias Wiederholz; He is the founder and visionary behind Performance Pain & Sports Medicine, also known as Performance. Performance is a boutique medical practice with a focus on the treatment of acute and chronic pain. Dr. Danko and Dr. Wiederholz have worked together on targeted drug delivery and today they are going to discuss a new therapy called peripheral nerve stimulation of which Dr. Wiederholz is one of the leading experts in the country. Episode Highlights: Dr. Wiederholz shares how he started medical school in New Jersey and then did his residency training in physical medicine rehabilitation in Houston, TX where he met his wife.What is peripheral nerve stimulation?This podcast raises awareness about therapy so that patients can understand the options and not lump them all together. Dr. Danko explains how he doesn’t want a patient to disregard a peripheral nerve stimulator because they think it is a spinal cord stimulator or stay stuck with opinions that they may have acquired due to a relatives experience years ago because much has changed.Dr. Wiederholz explains peripheral nerve stimulation, the core principles, and how it differs from spinal cord stimulation.There is a lot of emphasis on targeting nerves but it is also a therapy that can be used not just for neuropathic but also mechanical pain with joints and other varieties.Dr. Danko asks Dr. Wiederholz to share some of the most common sources of pain that he treats with peripheral nerve stimulation.What about comorbidities or delaying joint replacement?Dr. Wiederholz shares a story about a patient of his and how the gel injections and steroid injections were not lasting; They targeted the nerves around her knee and had great success.Where does peripheral nerve stimulation fit in the progression of therapy?What about the trial phase for trying it out first?Can it help arthritis?What will patients feel and not feel when their nerves are being stimulated?If someone does some online searching of peripheral nerve stimulation they may see reference to it being a wearable technology. Dr. Danko asks Dr. Wiederholz to talk about it and what it looks like for the daily life of a patient. What is it like to have practices in two different states? For Dr. Wiederholz, he is in Houston, TX and Lawrenceville, NJ.  Dr. Wiederholz shares some personal life details about living in two different states and how he balances it.   3 Key Points: When you think of the nervous system there are two main parts: 1) The Central Nervous System which is your brain and spinal cord and then 2) The Peripheral Nervous System which is all the other nerves in your body. There are a huge number of targets for peripheral nerve stimulation.Peripheral nerve stimulation uses electrical impulses to stimulate nerves and block pain signals. The technology does have similarity to spinal cord stimulation however, there are important differences and with peripheral nerve stimulation it is a very targeted approach.Peripheral nerve stimulation has a wide variety of applications for patients not just neuropathic but also including mechanical pain in the joints.   Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/ https://www.performancepain.com/provider/matthias-wiederholz-md
Apr 26 2022
35 mins
How Peripheral Nerve Stimulation Controls Chronic Pain, With Dr Tim Feldheim- Ep 4
How Peripheral Nerve Stimulation Controls Chronic Pain, With Dr Tim Feldheim On today’s episode, Dr. Danko and Dr. Feldheim discuss the rapidly growing and emerging therapy in chronic pain, peripheral nerve stimulation. Dr. Felheim completed his training at The University of Florida and a fellowship at Case Western University. At The Premier Pain Institute they have had positive experiences with peripheral nerve stimulation that they are sharing with the listeners. Tune in for the details!   Episode Highlights: Dr. Feldheim explains who peripheral nerve stimulation is good for. They most commonly see peripheral neuropathy characterized by inflammation of the nerves in the lower extremities but can affect the upper; it is usually accompanied by intense burning, numbness, tingling like feeling.What is Reflex Sympathetic Dystrophy (RSD)?Lumbar radiculitis is an extremely common cause of a diseased nerve pain state, a lot of people know this as sciatica.Dr. Feldheim reviews the list of other conditions that cause peripheral nerve pain and damage.Neuropathic pain can be caused by crushing of nerves, lacerations due to trauma or injury, surgical insults, stress injury, small fiber neuropathy and phantom limb pain post  amputation.What are the current treatments for peripheral nerve stimulation? Dr. Feldheim reviews the medications that are commonly prescribed as well as topical treatments and therapeutic modalities that may help.What is peripheral nerve stimulation? It does not include FieldSTEM.At PPT, one of their most common is the shoulder, they target the suprascapular nerve. Peripheral nerve stimulation is a very safe and effective option. If you are very active,  need routine MRI, or for those who have not had success with spinal cord stimulation, this can have great benefits.Dr. Danko explains how there is a trial with peripheral nerve stimulation and why that is both exciting and important.Multiple imaging modalities can be used to target the nerves.Dr. Danko explains the setup of the devices and how they work. A team of specialists work with the STIMwave technologies on insurance and things of that nature.Dr. Danko asks Dr. Feldheim to share other conditions that he has seen in regards to peripheral nerve stimulation.Are these procedures done in the office or the operating room?How long does the trial last? Dr. Feldheim explains which patients would be best served with spinal cord stimulation and peripheral nerve stimulation.What about knee replacement issues? Needing a battery versus not needing a battery: what are the pros and cons? Dr. Danko explains.How does stimulation compare to the TENS unit? How long does the procedure take and what is the recovery period?   3 Key Points: There are many conditions that can cause issues in peripheral nerves. Dr. Danko and Dr. Feldheim are explaining the common causes and current treatments for this type of pain.The wearable device used for peripheral nerve stimulation is very durable and effective offering freedom to do daily activities and have better quality of life.What is the difference between spinal cord stimulation and peripheral nerve stimulation and what are indicators for one treatment over the other?   Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/ 513-454-7246
Apr 19 2022
37 mins
How Can Spinal Cord Stimulation Relieve Your Pain? With Dr. Michael Fishman- EP 3
On this episode of Premier Pain Talk, host Dr. Michael Danko talks with Dr. Michael Fishman. He is a fantastic pain physician of the Greater Philadelphia area. They are discussing spinal cord stimulation and some of the new horizons coming with it as well as digital health and data capturing and potentially new options for pain therapy down the road.   Episode Highlights: Dr. Fishman went to medical school at Jefferson Medical College, and he developed an interest in anesthesia, ENT, and neck surgery. And at the end of the day, he ended up as a surgery resident at a program outside of Philadelphia.During his time working with the anesthesiologist at the hospital, Dr. Fishman ultimately found that perhaps there is a better use of his interests to look after patients after surgery and around their surgeries. Dr. Fishman’s clinic is like a lab where we get the opportunity to think of new ways to help people and ways to get patients the right treatment at the right time.One of the therapies that gets Dr. Danko super excited and makes it not feel like work sometimes, is something called a spinal cord stimulator. It is an implantable device and has been around for many years.Spinal stimulation in Dr. Danko’s mind has gone through now maybe even more advancements than cell phone technology or other technology of any type.What is ‘The Gate Control Theory On Chronic Pain’?Tonic stimulation is something that people should be familiar with, and it's a buzzing electrical sensation or maybe tapping and pulsing. They talk about how it had previously been practiced.Over the last few years, there has been a  fine tuning of  the electrical signals that are being passed in the spinal cord. If you talk to a bunch of different pain doctors or different people from industry, you are going to get a bunch of different answers for advancements with changes in the way the electricity is being delivered through devices.There is a psychological and social component that is also important to understand when you think about why pain doctors do what they are doing; That is why when they do apply therapies like simulation, it's important to understand biologically why also.For humans, isolation, depression, anxiety, status, etc all go in the same path with pain; But we can change the pain experience for the better or for the worse.    3 Key Points: One thing about Yale Haven hospital that everybody should know is it is smack dab in the middle at the junction of I-95 I-91, which means that it is a super busy hospital and gets most of the trauma in the state.DTM therapy is fantastic and the science behind how to fine-tune that therapy is very durable. Getting patients the right treatment is the job of a pain doctor, but it’s also about the right timing being understood and the circumstances/ context for each person to make the best version of themselves that they can be, says Fishman.    Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/ https://www.christianhospital.org/painfree https://celerihealth.com/
Apr 12 2022
45 mins
The Benefits Of Pain Pump Implant Therapy For Chronic Pain, With Dr. Chris Beuer- Ep 2
The Benefits Of Pain Pump Implant Therapy For Chronic Pain, With Dr. Chris Beuer On this episode, Dr. Danko introduces his friend Dr. Chris Beuer from St. Louis, Missouri. He feels fortunate to have found the feel of pain management and have the ability to actually make a difference in people’s lives. They discuss Pain Pump Therapy, what it is, and why it is used. These two doctors are passionate about improving quality of life for their patients. Tune in now. Episode Highlights: Dr. Beuer introduces himself, shares about his practice in St. Louis, and what brought him to his current job position. What is pain pump therapy and why is it used?Pain pumps have a reputation of being hard to manage but a lot has changed over the years. Dr. Beuer explains.Dr. Danko has found that the earlier you can offer the Pain Pump Implant Therapy, the better in the chronic pain world. It doesn’t mean it is the first thing you jump to but it is also not something you need to wait to use as a ‘salvage therapy’.What conditions are best for the pump? What are the steps to determine if it's right for the situation? Dr. Danko asks Dr. Beuer to talk about when it is indicated for patients.There is an ability to test the pain pump as well to see if it is worth it to the patient to try.How do pain pumps help people come off other pain medications?There is concern that a pump is limiting. Life using it is very simple. The medicine is refilled about every three months or so which takes a couple minutes to do. It is also important to note that it is on very low doses because it is very effective whenDr. Danko brings up that they both have been involved in a lot of Clinical Research and there is also a lot of great data already out on pump therapy.What about cancer pain? What are typical situations that are seen in pain management practice?Pain pumps can also be used for spasticity issues. Cerebral palsy, spinal cord injuries, or strokes are common scenarios with these spasticity issues. Dr. Beuer shares how he got into triathlons and Iron Man competitions. Originally people told him there was no way he could do it in six months and he took it as a challenge. He has completed 16 Iron Mans and shares experience about brutal weather.Patient education on the body’s ability to adapt is important too for understanding a plan of building strength. Dr. Danko asks Dr. Beuer to share about his experience being involved with Team USA in triathlons. 3 Key Points: Premier Pain Talk is shedding light on the misconceptions about pain management. The field is not correctly portrayed in the media. It is not just about handing out pills. There are many interventional procedures, including pain pumps.How do pain pumps help people who have been on long term pain medications to no success?The body has an incredible ability to adapt. Patient education around the topic is so important in showing them that they can overcome limitations, too.  Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/ https://www.christianhospital.org/painfree
Apr 5 2022
33 mins
Premier Pain Talk with Dr. Michael Danko- Ep 1
Premier Pain Talk, Answers Your Questions About Chronic Pain Relief! This a new podcast about pain management, healthcare, and what the journey is like for many. Dr. Michael Danko and Kyle Ingebritson introduce themselves and discuss their goal and mission of the podcast. They desire to shed light on the knowledge gap of what pain management is, dispel misconceptions, and have fun while educating listeners.    Episode Highlights: Dr. Michael Danko and Kyle Ingebritson introduce themselves and the mission of the podcast. There is a knowledge gap of what pain management is and many patients are scared away. Dr. Danko talks about how patients and providers alike have misconceptions about the field of care.How does the field of pain management gain understanding for new interventions?How many years does it take to function as an independent pain management doctor?Pain management had potentially been forgotten about and it is back now. Kyle asks Dr. Danko to share his viewpoint on how therapies are related and where it fits.Dr. Danko shares his journey in life and career formation to where he is now. What is chronic pain management? Premier Pain Treatment Institute was opened by Dr. Danko in 2016. They now have 3 locations and 8 providers. It started as a sub lease and a rental in another office. A staff of 40 people with different personalities and different needs as well as changes in the business overtime takes intentionality to be a good manager of people and lead everyone well.Kyle asks Dr. Danko to share about his life and hobbies.  3 Key Points: There are many misconceptions around pain management and what it actually is; Patients and providers alike have all sorts of formulated thoughts from culture and media. Connecting how therapies are related is important in considering where pain management overlaps. It is helpful to create an understanding and benefit of care.Premier Pain Treatment Institute is a leading provider of Pain Management Services in Greater Cincinnati and Northern Kentucky.  Resources Mentioned: https://premierpaintreatment.com/ https://www.facebook.com/PremierPainTreatment/
Mar 29 2022
15 mins