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Dr. Stuart Krost | Leads pack in Pain Management Care St. Lucie County/Port Saint Lucie Florida Number 1 Rated 25 years Experience

(1888 PressRelease) Dr. Krost runs his own practice and is a dedicated Medical Doctor. He is board certified by the American Board of Physical Medicine and Rehabilitation. Patients visit him for a variety of reasons including, spondylolysis, spinal muscular atrophy (SMA), spasticity, fibromyalgia, and chronic pain.

(1888 PressRelease) Dr. Krost runs his own practice and is a dedicated Medical Doctor. He is board certified by the American Board of Physical Medicine and Rehabilitation. Patients visit him for a variety of reasons including, spondylolysis, spinal muscular atrophy (SMA), spasticity, fibromyalgia, and chronic pain.

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<strong>Dr</strong>. <strong><strong>St</strong>uart</strong> <strong>Krost</strong> | <strong>Leads</strong> <strong>pack</strong> <strong>in</strong> Pa<strong>in</strong> <strong>Management</strong> <strong>Care</strong> <strong>St</strong>. <strong>Lucie</strong> <strong>County</strong>/<strong>Port</strong> Sa<strong>in</strong>t <strong>Lucie</strong><br />

<strong>Florida</strong> <strong>Number</strong> 1 <strong>Rated</strong> <strong>25</strong> <strong>years</strong> <strong>Experience</strong><br />

1888 PressRelease ­ <strong>Dr</strong>. <strong>Krost</strong> runs his own practice and is a dedicated Medical Doctor. He is board certified by the<br />

American Board of Physical Medic<strong>in</strong>e and Rehabilitation. Patients visit him for a variety of reasons <strong>in</strong>clud<strong>in</strong>g,<br />

spondylolysis, sp<strong>in</strong>al muscular atrophy (SMA), spasticity, fibromyalgia, and chronic pa<strong>in</strong>.<br />

<strong>Port</strong> <strong>St</strong>. <strong>Lucie</strong>­Fort Pierce, FL ­ <strong>Dr</strong>. <strong><strong>St</strong>uart</strong> B <strong>Krost</strong> is Board Certified <strong>in</strong> the follow<strong>in</strong>g:<br />

Physical Medic<strong>in</strong>e and Rehabilitation<br />

Acute & chronic pa<strong>in</strong> management<br />

Sports medic<strong>in</strong>e<br />

<strong>St</strong>ate­of­the­art physical therapy<br />

Headaches<br />

Neck & back pa<strong>in</strong><br />

Carpal Tunnel Syndrome<br />

Myofascial pa<strong>in</strong> and fibromyalgia<br />

Work and auto­related <strong>in</strong>juries<br />

Disability assessment<br />

TRIGGER POINT INJECTIONS<br />

Trigger po<strong>in</strong>t <strong>in</strong>jections are <strong>in</strong>jections to the muscle belly. Injections are aimed at taut bands or areas of spasm<br />

with<strong>in</strong> the muscle belly. Taut bands can be pa<strong>in</strong>ful and the underly<strong>in</strong>g cause of pa<strong>in</strong> generation. Trigger po<strong>in</strong>t<br />

<strong>in</strong>jections are diagnostic and therapeutic. If there is significant relief after trigger po<strong>in</strong>t <strong>in</strong>jections, certa<strong>in</strong>ly one<br />

can consider that the muscle spasm is a pa<strong>in</strong> generator. The <strong>in</strong>jection consists of anesthetic as well as<br />

anti<strong>in</strong>flammatory medication.<br />

EPIDURAL STEROID INJECTION<br />

Epidural steroid <strong>in</strong>jections are a procedure to place medication both anti<strong>in</strong>flammatory as well as anesthetic <strong>in</strong><br />

the epidural space. The epidural space is located with<strong>in</strong> the sp<strong>in</strong>e around the sp<strong>in</strong>al cord and nerve roots. The<br />

goal of epidural <strong>in</strong>jections is diagnostic and therapeutic. Epidural <strong>in</strong>jections can relieve pa<strong>in</strong> that is generat<strong>in</strong>g<br />

from disc herniations as well as irritated or p<strong>in</strong>ched nerve roots. These procedures are performed under<br />

fluoroscopic guidance.<br />

FACET BLOCK<br />

Facet blocks are performed under fluoroscopic guidance and can be diagnostic and therapeutic. Injections are<br />

performed at the facet jo<strong>in</strong>t or the medial branch nerve. Improvement after this type of <strong>in</strong>jection would be<br />

diagnostic for facet jo<strong>in</strong>t related pa<strong>in</strong>.<br />

FACET RHIZOTOMY


Facet rhizotomy is a long act<strong>in</strong>g facet block either done chemically or with thermal heat. This procedure is<br />

<strong>in</strong>dicated if the patient does receive benefits from the facet block, however does not offer prolonged relief.<br />

STELLATE BLOCK<br />

This procedure is done <strong>in</strong> the neck, anesthetic blockade is performed at the stellate ganglion. The goal of this<br />

procedure is for blockade of the sympathetic cha<strong>in</strong>. This is diagnostic and therapeutic for evaluation and<br />

treatment of RSD.<br />

LUMBAR SYMPATHETIC BLOCK<br />

Lumbar sympathetic block is performed about the lumbar area. The goal of this procedure is for blockade of the<br />

sympathetic cha<strong>in</strong>. This would be diagnostic and therapeutic for evaluation and treatment of RSD.<br />

DISCOGRAM<br />

A discogram was performed for diagnostic purposes to identify pa<strong>in</strong> if a pathologic disc is act<strong>in</strong>g as a pa<strong>in</strong><br />

generator.<br />

IDET PROCEDURE<br />

An IDET procedure is a procedure done for a pathologic disc usually with annular tear that has been identified<br />

as a pa<strong>in</strong> generator. The goal of procedure is to destroy sensory nerve end<strong>in</strong>gs that are transmitt<strong>in</strong>g pa<strong>in</strong>ful<br />

signal. The ultimate goal is to relieve pa<strong>in</strong> from discogenic pathology.<br />

PERCUTANEOUS DISCECTOMY<br />

This is a m<strong>in</strong>imally <strong>in</strong>vasive procedure for treatment of a herniated disc. This is a procedure that could be done<br />

<strong>in</strong> an outpatient sett<strong>in</strong>g under fluoroscopic guidance to remove herniated disc material. The ultimate goal is to<br />

relieve pressure on the exit<strong>in</strong>g nerve root as well as relieve pa<strong>in</strong>.<br />

BOTOX INJECTIONS<br />

Botox is a long act<strong>in</strong>g treatment for muscular pa<strong>in</strong>. Botox acts locally at the <strong>in</strong>jection site to relieve muscle<br />

spasm and to relieve pa<strong>in</strong>. Benefits of this can last up to three to six months. This is also used for <strong>in</strong>tractable<br />

headaches that do not respond to more conservative measures.<br />

OCCIPITAL NERVE BLOCK<br />

Occipital nerve is located <strong>in</strong> the back of the neck at the junction of the head. Occipital entrapments can occur<br />

with underly<strong>in</strong>g spasm commonly caus<strong>in</strong>g occipital headaches. This can subsequently produce symptoms<br />

radiat<strong>in</strong>g to the top of the head as well as <strong>in</strong> back of the eyes. Occipital blocks can be diagnostic and therapeutic<br />

for occipital neuralgia/occipital headaches.<br />

ELECTRODIAGNOSTIC TESTING<br />

Electrodiagnostic studies are a diagnostic procedure to assess underly<strong>in</strong>g neuropathic problems. EMG/NCS can<br />

be diagnostic for cervical or lumbar radiculopathy/p<strong>in</strong>ched nerve, neuropathy or distal nerve entrapment such as<br />

carpal tunnel syndrome. EMG/NCS can be helpful <strong>in</strong> determ<strong>in</strong><strong>in</strong>g acute versus chronic conditions and identify<br />

neuropathic recovery. EMG/NCS are commonly used <strong>in</strong> conjunction with MRIs to correlate anatomical f<strong>in</strong>d<strong>in</strong>gs


and neuropathic function.<br />

PHYSICAL THERAPY<br />

Physical therapy comb<strong>in</strong>es passive and active treatment. Passive treatments <strong>in</strong>clude moist head pad, ice <strong>pack</strong>s for<br />

analgesia; Ultrasound treatment for production of heat at the muscle bone <strong>in</strong>terphase and stimulate blood flow;<br />

Electrostimulation to improve blood flow as well as muscle relaxation and analgesia; Massage treatment for<br />

muscle relaxation as well as analgesia to <strong>in</strong>crease extensibility of soft tissue. Active treatments <strong>in</strong>clude exercis<strong>in</strong>g<br />

and stretch<strong>in</strong>g as well as cardiovascular treatment to improve strength, range of motion as well as endurance.<br />

Physical therapy is a treatment as well as an education and experience to learn how to do th<strong>in</strong>gs on your own<br />

and eventually be progressed to a home exercise program<br />

LIFE CARE PLANNING<br />

Future care needs and life care plann<strong>in</strong>g are based on physical impairments as well as functional disabilities.<br />

This plan can outl<strong>in</strong>e what a patient will need <strong>in</strong> the future <strong>in</strong> terms of active and passive treatments, durable<br />

medical equipments, medical care medication as well as <strong>in</strong>terventional <strong>in</strong>jections and surgery. Costs can be<br />

<strong>in</strong>cluded <strong>in</strong> a life care plan.<br />

DISABILITY EVALUATION<br />

A physiatrist/physical medic<strong>in</strong>e rehabilitation specialist is a specialty of identify<strong>in</strong>g physical impairments and<br />

how those physical impairments result <strong>in</strong> physical disabilities and subsequent handicap. A physical medic<strong>in</strong>e<br />

rehabilitation specialist specializes <strong>in</strong> the neuromuscular and skeletal system to identify physical impairments<br />

and functional disabilities. A disability evaluation may lead to conclusions of physical restrictions as well as<br />

compensatory strategies to maximize functional <strong>in</strong>dependence.<br />

SPHENOPALATINE GANGLION BLOCK<br />

A sphenopalat<strong>in</strong>e ganglion block (SPG) is performed with a cotton tip probe with saturation of anesthetic at the<br />

SPG ganglion, which is located <strong>in</strong> the posterior aspect of the nose. This procedure is commonly used <strong>in</strong> reliev<strong>in</strong>g<br />

headaches as well as an adjuvant for pa<strong>in</strong> management.<br />

FUNCTIONAL CAPACITY EVALUATION<br />

Functional capacity evaluation is an assessment of physical function to identify physical capacity with<strong>in</strong> safe<br />

parameters to prevent <strong>in</strong>jury.<br />

EPIDURAL LYSIS OF ADHESIONS<br />

Epidural lysis of adhesions <strong>in</strong>dicated typically <strong>in</strong> a postoperative patient who has epidural scarr<strong>in</strong>g formation.<br />

Epidural scarr<strong>in</strong>g can cause irritation, <strong>in</strong>flammation and swell<strong>in</strong>g around the nerve roots. Epidural lysis of<br />

adhesions are performed to breakup scar tissue and relieve irritative focus of nerve<br />

When manag<strong>in</strong>g the patient with opioids, it is important to establish the differences among physical<br />

dependence, tolerance and addiction.<br />

The American Society of Addiction Medic<strong>in</strong>e as well as the American Pa<strong>in</strong> Society and American Academy of


Pa<strong>in</strong> <strong>Management</strong> def<strong>in</strong>e physical dependence as a state of adaption that is manifested by a drug class for which<br />

specific withdrawal syndrome can be produced by abrupt cessation, rapid dose reduction, decreas<strong>in</strong>g blood<br />

levels of the drug, and/or adm<strong>in</strong>istration of an antagonist. Tolerance, however, refers to a state of adaption <strong>in</strong><br />

which exposure to a drug <strong>in</strong>duces changes that result <strong>in</strong> dim<strong>in</strong>ution of one or more of the drug effects over time.<br />

Neither dependence or tolerance <strong>in</strong> and of itself is <strong>in</strong>dicative of addiction. Addiction is def<strong>in</strong>ed by the American<br />

Academy of Pa<strong>in</strong> <strong>Management</strong> and American Pa<strong>in</strong> Society as well as the American Society of Addiction Medic<strong>in</strong>e<br />

as a primary chronic, neurobiological disease, with genetic, psychosocial, and environmental factors <strong>in</strong>fluenc<strong>in</strong>g<br />

its development and manifestations. It is characterized by behaviors that <strong>in</strong>clude one or more of the follow<strong>in</strong>g:<br />

Impaired control over drug use, compulsive use, cont<strong>in</strong>ued use despite harm, and crav<strong>in</strong>gs. Abuse, however, is<br />

generally characterized by conscious, often psychosocial motivated use of illicit substances and medication<br />

outside the scope of usual medical practices, but the patient has the ability to stop the drug when harmed.<br />

Addicts, however, cannot stop use despite harm. The majority of legitimate pa<strong>in</strong> patients do not develop an<br />

addiction to their analgesic medication. There is a biological normal phenomenon to develop issues related to<br />

tolerance and dependence. It is the physician’s responsibility to address issues related to tolerance and<br />

dependence by monitor<strong>in</strong>g patients carefully on a regular basis and adjust medication accord<strong>in</strong>gly to avoid<br />

sequelae of tolerance as well as dependence. Dictated but not proof read.<br />

http://wetreatpa<strong>in</strong>.com/<br />

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