Author: Palm Beach Pain Institute

Do I Need Surgery To Relieve My Chronic Shoulder Pain?

How often have you had a twinge in your shoulder and taken over-the-counter pain medication? Probably too many to count. Then two days later that pain is a bit worse. How many times do you reach for a pain reliever before you decide to take action? Maybe you procrastinate because you fear surgery is the only treatment that will help. Let’s dive into when surgery may be needed to relieve chronic shoulder pain.

What Is Chronic Pain?

Shoulder pain or any pain is considered chronic if you have been in discomfort for longer than three months. You don’t necessarily need to have it every single day, but a consistent pain that keeps coming back for more than three months.

woman holding her shoulder in pain

The shoulder is a major joint that allows for so much motion. You can move your shoulder about 360 degrees. It doesn’t take much to strain a tendon, ligament, muscles, or other tissues. It is fairly easy to sustain a rotator cuff injury, develop shoulder arthritis, a fracture, frozen shoulder, bursitis, instability, or nerve issues to name a few. You don’t need to be an athlete to hurt your shoulder.

Making an appointment with our board-certified pain specialist, Dr. Merson, at our clinic in Delray Beach, FL will give you the information you need and begin a series of treatments without surgery. Schedule an appointment online today by filling out our secure form.

Conservative, Non-Surgical Shoulder Treatments

After a thorough examination and tests, most specialists will begin with conservative treatments for chronic shoulder pain, and they may be all you need. This will depend on the cause and severity of the pain.

Physical Therapy

This is a common treatment to relieve chronic shoulder pain.. You will focus on strengthening your shoulder muscles, restoring normal movement, and reducing pain. You will also learn how to prevent re-injury.


These can include over-the-counter plus prescribed pain relievers like anti-inflammatory medications and non-narcotic pain relievers.


A steroid injection may be recommended in concert with other treatments to reduce inflammation. These will reduce pain while you strengthen your shoulder.

PRP Injections

Platelet rich plasma, or PRP, injections are another treatment to restore normal movement and flexibility. This is an injection of your own blood to help heal and regenerate damaged tissue.

Dr. Merson may have additional conservative care recommendations and activity modifications to keep you active and comfortable during the healing process.

Only a very severe shoulder injury or condition would necessitate surgery. Surgery can hopefully be avoided since there are a number of conservative options that can alleviate your shoulder pain.

Contact board-certified pain specialist, Dr.Merson, at (561) 499-7020 for the correct diagnosis and effective treatment options to relieve chronic shoulder pain. Fill out our online secure form to schedule an appointment at our pain management clinic in Delray Beach, FL.

How to Find Sacroiliac (SI) Joint Pain Relief

How to Find Sacroiliac (SI) Joint Pain Relief

Oh my aching back! How many times have you said this out loud or thought about it? It might have been pain from your sacroiliac joint in your lower back. If so, keep reading to discover how to find sacroiliac (SI) joint pain relief.

What Commonly Causes Sacroiliac (SI) Joint Pain?

We have one sacroiliac joint on each side of our body, and it’s where your ilium and sacrum bones join together. The sacrum is the wide flat bone between your tailbone and lumbar spine, and the ilium is often called the hip bone. This joint rarely moves.

A sudden injury or repetitive stress can cause the SI joint to become inflamed and painful.

Sacroiliac joint


It can develop from:

  • Pregnancy
  • An infection
  • Arthritis
  • Sitting for extended periods

Conservative Treatments for SI Joint Pain

Once pain management specialist Marcie Merson, MD has made a diagnosis, the treatments are usually very conservative at first and then, if needed, gradually increase one at a time or tried concurrently.


At the first sign of SI pain, try not to twist your body. After resting for several days, the pain should subside, just be careful not to overdo the rest time or the joint may become stiff. Try walking.


Over-the-counter nonsteroidal anti-inflammatory medications can help right after an acute injury. They can be combined with ice to reduce pain.

Dr. Merson may prescribe muscle relaxers if needed.

Ice and Heat

Both help to reduce inflammation and pain. Use ice for several days right after the pain begins, but don’t begin using heat until later.

Physical Therapy

Ask Dr. Merson to refer you for some physical therapy. This can begin as early as a couple of days after the pain begins. PT will help you strengthen weak muscles putting stress on the SI joint. It will also help you treat any underlying issues that cause the injury.

A physical therapist may also perform manipulations to relieve tight muscles in the lower back and make your joint more mobile.

Minimally Invasive Treatments

Most patients are pain free after the above treatments, but for those who find no relief, injections may be the next course of action. The injections will contain a mixture of corticosteroids with anesthesia to both reduce inflammation and pain. You can only be injected a few times a year. This treatment has a 90% success rate.

When None of the Above Works

Most patients are relieved of pain when these treatments are applied.

For the few who do not find relief, there are two other options:

  1. Radiofrequency ablation which uses radio waves to destroy the pain signals from the joint to the brain.
  2. Spine fusion surgery is the last resort.
    There is no single way to manage SI joint pain that will work for everyone. A combination of non-surgical treatments is usually necessary for effective pain relief.

Contact Palm Beach Pain Institute at (561) 499-7020 if you are having lower back pain in the Delray Beach area to schedule a consultation with pain management specialist Marcie Merson, MD. You can also request an appointment through our secure online form. Dr. Merson has extensive experience diagnosing and treating sacroiliac joint pain, and she may be able to help you, too.

Osteopathic Manipulation Treatment: What You Should Know

Is back or neck pain affecting your quality of life? If you have tried other sources of pain relief like over-the-counter medications, prescription meds, acupuncture, or chiropractic treatments, osteopathic manipulation may finally provide some relief. Keep reading to find out more.

Osteopathic Manipulation Treatment (OMT)

Osteopathy is a science that incorporates an in-depth understanding of applied anatomy and physiology – structure and function of the human body and uses techniques to achieve health in the functioning of the tissues and organ systems. Osteopathic treatment addresses the whole person in the individualized approach that Dr. Merson develops for each patient.  Dr. Merson attended the University of Miami School of Medicine, an allopathic (M.D.) school, and developed an interest in and trained in Osteopathic Medicine early in her career. She uses Osteopathic principles in her diagnosis and treatment of patients.

Osteopathic manipulative therapy is a type of treatment performed by a physician. It works for acute and chronic pain, and can treat many conditions. Dr. Merson at Palm Beach Pain Institute uses effective hands-on techniques to help a patient’s pain.  Osteopathic techniques do much more than simply manipulating a patient’s muscles and joints.

man receiving arm treatment


The techniques help many of the body’s tissue layers, including the fascia, ligamentous structures and fluids including the vasculature (veins and arteries) to function as well as possible.  Dr. Merson evaluates each patient from a medical and an Osteopathic perspective and develops a comprehensive, individualized treatment plan.

Traditional Osteopathic Manipulative Medicine treats conditions including neck and low back pain with comprehensive solutions for issues that affect up to approximately 80% of people at some point during their lifetime.

Dr. Merson is specially trained in healing the musculoskeletal system and its disorders, and treats the structural imbalances in your body to improve the circulation, connective tissues including the ligaments, bones and fascia to relieve pain. Dr. Merson at Palm Beach Pain Institute uses a variety of Traditional Osteopathic techniques.  During treatment Dr. Merson gently moves, stretches, and manipulates a patient’s body and may perform techniques that move the muscles and joints, sometimes stretching the limbs into different positions helping to align joints.

Some of the movements can be slow utilizing pressure, or they can be quick sudden movements.

None of these manipulations should be painful, but you may feel some mild changes in your body and possibly some soreness  for a day or so after treatment.

What Can OMT Treat?

Besides back pain, there are many other conditions and disorders that OMT can relieve.

They include the following:

  • Asthma and sinus infections
  • Bowel issues like irritable bowel syndrome (IBS) and constipation
  • Sports injuries and repetitive stress injuries
  • Chronic pain like migraines, fibromyalgia, and arthritis
  • Musculoskeletal problems like carpal tunnel syndrome, back and neck pain, and joint pain
  • Problems during pregnancy like insomnia, edema, and sciatica
  • COPD along with conventional medications

Goals of Osteopathic Manipulation

The key goals of osteopathic manipulation are to reduce pain, improve range of movement, and encourage blood flow.

Contact board-certified physician Dr. Merson at (561) 499-7020 if you have been having chronic pain and want an evaluation for an osteopathic manipulation treatment in Delray Beach, FL.

How to Start a Conversation About Managing Your Chronic Pain

Describing your pain can be like trying to explain what the color purple looks like. Only describing pain is harder since you don’t have anything you can visualize for someone else. Whether your pain just happened due to an injury or it comes and goes almost every day, being able to clearly define it for your doctor is important for healing. We will give you some guidelines for how to start a conversation about managing your chronic pain.

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Understanding Pain Management Injections

Living with chronic pain is a daily adventure. One day it’s your knee, and the next day it could be your lower back that is bothering you. Roll the dice. When pain becomes a major part of your life, you need some relief. Understanding pain management injections could help improve your quality of life and get you back to doing what you love.

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The Relationship Between Chronic Pain And Fatigue

Are you feeling tired because you’re in constant pain? Are you in pain because you don’t have the energy to move around like you used to? Is your pain wearing you down? Answering yes to these questions puts you in a unique group of people who suffer from chronic pain. It could be from arthritis or pain in your lower back, your hips, legs, or shoulder. The relationship between chronic pain and fatigue is real and debilitating.

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6 Ways To Avoid Holiday Back Pain

“It’s the most wonderful time of the year”… sang Andy Williams decades ago, but it still plays on those radiostations that start holiday music at Halloween. Maybe they do it just to give you a head start on stress. You know, the shopping, decorating, wrapping gifts, assembling toys, planning holiday dinners, and you can fill in the rest-stress. Somebody somewhere might be happy, but it’s certainly not you, especially if you have back issues. Keep reading for 6 ways to avoid holiday back pain.

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The Relationship Between Nutrition And Migraines

Does diet play a role in getting a migraine? Are there certain triggers which bring one on? Is it the food or a chemical within the food? The relationship between nutrition and migraines is mostly anecdotal, but more clinical studies are being done right now. Let’s review the facts we do know.

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