Top10MD Blog


 10 months ago    Leave a comments (0)

Osteoarthritis, one of the most common adult joint diseases, is one of the leading causes of chronic pain and disability in the world. In fact, approximately 50 million Americans have joint arthritis.

Current treatments that we have available to treat joint arthritis include:

  • Anti-Inflammatories & Narcotics
  • Steroid Injections
  • Joint Replacement

Why Traditional Doesn’t Always Work

These therapies have had some levels of success in masking joint pain, but NONE of them have the ability to reverse and heal degenerated joints. Sadly, medications can only mask your pain symptoms temporarily with the risk of dangerous side effects such as stomach ulcers from NSAIDs and addiction from prescribed narcotics.

Steroid injections may also help decrease pain for a period, but multiple doses of steroids over time may actually accelerate the joint damage. Scary…right? Joint Replacement surgery is often used and has come a long way, but remember, there is always risk to surgery – risks such as infection, anesthesia, disability and chronic pain. It also burns the bridge of allowing you to preserve your natural joint.

Other Options

A few recommended approaches that help to reverse arthritic joint pain include:

  • The Texas Cell Institute Anti-Inflammatory Nutrition & Lifestyle Program
  • Natural Herbal Supplements
  • Hyaluronic Acid
  • Platelet Rich Plasma
  • Stem Cells

Platelet Rich Plasma (PRP) has recently become an option for patients with osteoarthritis. An article released by the Journal of American Sports Medicine stated that PRP is “safe and provides quantifiable benefits for pain relief and functional improvement in patients with knee Osteoarthritis.” They also had scientific evidence to back this.

In addition to cell-based therapies, patients also experience an individualized Anti- Inflammatory Joint Program, which includes intervention with hydration, proper nutrition, blood analysis, exercise, rehabilitation, stress management, smoking cessation and sleep quality.

Healing your arthritic joint is a process, and there are steps you can take without having to take long-term medication or go through invasive surgery. Patients will enjoy being able to get back to the life they want to live again, play with their children and grandchildren and eliminate having to take pills to manage joint pain.

Dr. Amit Mirchandani joined Metropolitan Anesthesia Consultants in 2011 and specializes in Orthopedic based Anesthesia as well as Regenerative Medicine, i.e. Stem Cell Replacement Therapy. Dr. Mirchandani has been named 2016 Top10MD an honor only 1-in- 3 doctors in the United States succeed with this recognition. To schedule your appointment contact Dr. Mirchandani at 972-668- 9612.


 10 months ago    Leave a comments (0)

Does an 85-year-old female need the same dosage & quantity of opiates as a 35-year-old male? Does a ligament sprain require the same as a broken hip? Do any other factors play a role such as stress, smoking, or sleep? Does time of day matter in regards to a patient’s pain level?

America makes up about 5% of the world’s population but consumes over 95% of the world’s hydrocodone. This “investment” in opiates has not translated into better pain control, increased functionality and decreased disability either. In fact, we have observed quite the contrary.

What Must Prescribing Change?

We must demolish the way opiates are prescribed. The imprecision in the way opiates are currently prescribed has had fatal consequences, both to our patients as well as to our health care system.

In fact, the Center for Disease Control and Prevention have declared overdoses from opioid painkillers to be a public health epidemic.

Opiates are a class of drugs that include both illicit (heroin) and licit prescription pain relievers such as hydrocodone, oxycodone, fentanyl, morphine and others. Although Opiates are dangerous and their prescription must be individualized for specific patient needs.

Substance abuse, addiction, street sales and overdose death are being facilitated by the imprecise, over-prescription of opioids and this issue is not simply just “the doctor’s fault.” It is much more complex than that.

The Pain Process

Physicians have a very challenging time prescribing opioids. Pain is now considered the “fifth vital sign.” While the other four measures are objective (heart rate, blood pressure, oxygen saturation and respiratory rate), pain is currently not.

Pain is a subjective measure that has now been placed into an objective category. This is extremely dangerous.

In addition, hospitals and physicians are beginning to have their reimbursements tied to patient satisfaction with their pain, or lack there of. This relationship has not only led to over-prescription of opiates, but also the dangerous leverage for patients to demand more opiates.

To make matters worse, the current prescription of opiates are schedule 2, which requires physicians to regularly prescribe a larger quantity of narcotics than necessary to patients to prevent patients from potentially running out of pain medicine before their next follow-up visit.

What Is To Be Done?

As a medical consultant to VEEP Works technology, we are collaborating on creating the intelligence and real-time technology to empower physicians with extremely valuable data evaluating a patient’s subjective, objective, and biochemical markers to individualize a patient’s need for opiates. With this information, only the exact quantity of pills at the exact dosage will need to be prescribed, leaving less pills in the bottle to become addicted to, sell on the street, or accidentally overdose on.

This will make this world more intelligent, precise, and safe for our patients.

Dr. Amit Mirchandani is a Texas Pain Management Specialist and double Board Certified by the American Board of Anesthesiology and the American Board of Anesthesiology – Pain Management. Dr. Mirchandani joined Metropolitan Anesthesia Consultants in 2011 and specializes in Orthopedic based Anesthesia as well as Regenerative Medicine, i.e. Stem Cell Replacement Therapy. Dr. Mirchandani has been named 2016, 2017 Top10MD an honor only 1-in- 3 doctor’s in the United States succeed with this recognition. To schedule your appointment contact Dr. Mirchandani at 972-668- 9612.


 1 year ago    Leave a comments (0)

Often patients are merely treated for pain, rather than going to the source of the injury to fully heal it. For instance, if you go to your health care provider for knee pain, which is common amongst patients, the physician may suggest strong medications, steroid injections, and/or possible surgery.

Medications can open the floodgates to possible long-term side effects, such as narcotic addiction.  Steroids can actually accelerate cartilage damage in your joints, potentially increasing your chance of needing surgery.  Surgery can have significant medical risks, and the decision to have surgery should be weighed carefully and after all conservative options have been tried.

Just witness how professional athletes have approached joint pain. Professional athletes such as Tiger Woods, Kobe Bryant, Hines Ward, Stephen Curry and others have taken a different approach when it comes to their injuries due to the long-term effects.

Traditional processes of treatment have been considered the “gold-standard.” But, for Regenerative Medicine patients, it is not golden enough.

When addressing patient pain, it is important to understand the injury and define the cause of the pain. Educating the patient on how to improve their health at the cellular level is crucial as Regenerative medicine pain-management-regenerative-medicine-athlete-sports-top10mduses the body’s growth factors and powerful cells to heal injury and torn and damaged tissue.

Regenerative Medicine is not simply a magic injection, however. It is part of a larger process that includes simple tasks such as a better diet, more exercise, keeping hydrated, and managing stress – all of which can help create the proper environment for your body’s regenerative cells to be effective. Regenerative Medicine focuses on strengthening and rehabilitation programs as well. This allows for further strengthening of the structures around the joint and to help put your body’s symmetry back together in a healthier, more functional manner.

Regenerative Medicine is important for you to consider because it

  • Helps you avoid long-term medications and their terrible side effects.
  • Helps you to avoid invasive surgery and heal chronic pain.
  • Allows you to preserve your body’s natural anatomy and symmetry for long-term health and function.

At Texas Cell Institute, we have treated professional athletes to help them avoid prescription narcotics, which may cause side effects, like sedation, that would have prevented the athlete from competing at the highest level.

It is hard avoiding getting injured. As an athletic community, we want to stay active and physical. It is how you treat your injury afterwards, however, that makes all the difference.

Dr. Amit Mirchandani is a Texas Pain Management Specialist and double Board Certified by the American Board of Anesthesiology and the American Board of Anesthesiology – Pain Management. Dr. Mirchandani joined Metropolitan Anesthesia Consultants in 2011 and specializes in Orthopedic based Anesthesia as well as Regenerative Medicine, i.e. Stem Cell Replacement Therapy. Dr. Mirchandani has been named 2016 Top10MD an honor only 1-in- 3 doctor’s in the United States succeed with this recognition. To schedule your appointment contact Dr. Mirchandani at 972-668- 9612.


 1 year ago    Leave a comments (0)

Osteoarthritis can make performing ordinary and everyday tasks at work or home much more challenging. Opening your bottle of vitamins in the morning, trying to grasp and maneuver your computer mouse, or grasping your steering wheel can become nearly impossible. Climbing one flight of stairs, standing up and sitting down on a chair, can be tough. Pain Management Specialist Dr. Mark LeDoux warns that many people believe the effects of osteoarthritis are inevitable, so they don’t do anything to manage it. “Steps can be taken to prevent further joint damage, control your pain, and prevent your work and family life from being affected by the condition,” he advises.

Osteoarthritis, also known as degenerative joint disease, is the most common type of arthritis. Osteoarthritis is linked to the breakdown of a joint’s cartilage. It can cause the cartilage in a joint to become stiff and lose elasticity, making it more susceptible to injury. As the movement continues and the cartilage diminishes, ligaments and tendons stretch causing pain. In some cases, the bones start to rub against each other causing intense pain.

What Are the Symptoms of Osteoarthritis?

Osteoarthritis is most common in people middle-aged and older, and more commonly affects women than men. The symptoms can range from mild to extremely severe. Most feel symptoms in their hands, hips, knees, feet and the back.

Symptoms of Osteoarthritis

  • Soreness and stiffness in the joints
  • Cracking sound when joint bends
  • Swelling around a joint
  • Pain worse after activity or at the end of the day
  • Stiffness that goes away after movement
  • Pain after either overuse or long periods of inactivity
  • Bony enlargements in the middle and end joints of fingers

Dr. Mark LeDoux is an Interventional Pain Management Specialist dual certified by both the American Board of Pain Management and the American Board of Anesthesia respectively with a Fellowship in Interventional Pain Management. Dr. LeDoux is co-director of Interventional Spine & Pain with offices in Dallas and Addison Texas. To schedule, a consultation with Dr. LeDoux click on his profile or call his office at 214-888- 3900.


 1 year ago    Leave a comments (0)

If you have been watching the Olympics, I am pretty sure you might be wondering what are those dark red spots on the Olympians shoulders and back. Some say it is hickeys, while others like to refer to them as huge cigarette burns. Fortunately, that is not the case. These spots are due to a cool technique called cupping.

What is cupping and how does it work?

Cupping is a technique that is mostly used in Asia and Middle Eastern countries, but most commonly in China. Cupping is a form of therapy that is done with a round-glass suction cup. Others might use bamboo or earthenware depending on preference. A flammable substance such as paper, herbs or even alcohol is placed in the cup and then set on fire. The cup is then warmed and placed on the sore parts of the body. This creates a partial vacuum that is said to help with blood flow and stimulating muscles. This helps to relieve pain due to soreness.

What else is it used for?

Previous studies have shown that cupping has been used for treating cancer pain and lower back pain. In both of the studies, it was reported that cupping did, indeed, help to relief pain. A 2012 study published by the journal PLoS ONE suggests that cupping therapy might be the new placebo effect. They concluded that cupping therapy could be effective with other treatments such as acupuncture or even medications in treating diseases and conditions.

Cupping is also used to treat:

  • Anemia
  • Hemophilia
  • Arthritis
  • Fibromyalgia
  • Fertility
  • Gynecological Disorders
  • Eczema
  • Acne
  • High Blood Pressure
  • Migraine
  • Anxiety
  • Depression
  • Allergies
  • Asthma

Olympians such as Michael Phelps, Alex Naddour, and Pavel Sankovich have all posted pictures of cupping effects and seem to be happy with the results. Pavel Sankovich even went as far as posting on his Instagram account about the technique stating, “Cupping is a great recovery tool.” Michael Phelps also showed snippets of his cupping therapy on his Instagram.

It’s not the first time cupping has made the rounds in history. It has been around for a while and has been used worldwide. If a massage just doesn’t do it for your body anymore, cupping might be the technique to give a shot.


 1 year ago    Leave a comments (0)

Surgeries that some consider routine can still sometimes cause serious complications. No matter how straightforward you think your surgery might be, you still want to be in the absolute best surgical hands.

Today, your surgeon and hospital are especially important for procedures that are new or complex or even routine. You should be concerned and research but your surgeon and the hospital for that matter as most errors happen in a hospital setting according to John Hopkins report in May noting the third leading cause of death is medical errors. In your search for the best surgeon one indicator is how often your surgeon performs the procedure you’re seeking. For example, a study by researchers at New Hampshire’s Dartmouth-Hitchcock Medical Center of people undergoing surgery for pancreatic cancer found that annual death rates were nearly four times higher for those treated by surgeons who performed the fewest operations.

With that being said, how should you choose a surgeon, someone with whom you’ll be sharing some of your most personal information and entrusting with life-and-death decisions? Communication with your surgeon is essential.

Ask your prospective surgeon these questions before going under…

Are you board certified, and is your certification current?

  • Look for a surgeon who has the necessary board certification(s), necessary training, and has maintained their certification(s) in the specialty they are practicing.

Is this surgery necessary?

  • Avoiding surgery entirely is the only sure way to avoid a surgical complication; understanding the effectiveness of the surgery and having exhausted alternatives you then need to compare the results of your alternatives with the possible risks of the surgery. 

What are your success, failure, and complication rates?

  • Not all surgeons are willing to be upfront with this information, but a good surgeon will.

What is your experience with this surgery?

  • Ask your surgeon how many of these procedures he or she has performed and compare that number with other surgeons performing the same procedure. The best surgeon is not necessarily the busiest surgeon; it’s about avoiding the surgeon who has not performed the procedure as much or as often or as well.

What’s the hospital’s infection rate?

  • Seventeen states now make that information public, and many hospitals report their rates voluntarily. Kudos to them! After asking these questions and others relating to your needs, likes, and dislikes, do your homework and make your choice. Your final decision could be one of the most important you’ll make for you and your family.

To locate a Top10MD Surgeon you can trust visit and schedule your appointment today.


 1 year ago    Leave a comments (0)

A back injury can get you down and have you unable to move. Whenever you are suffering from an injury, whether in the thorax, lumbar, or cervical region of the back, facet joint injections may be the best method for treating your pain. The injection is a numbing agent that helps relieve pain in the back region during physical therapy. Physical therapy is not easy. Sometimes the way the therapist manipulates the back and exercises it can have you in great pain. These injections are good for helping you get through these tough sessions.

Facet joint injections are named based on the type of joints they are injected into. The spine is full of facet joints. Each joint is separated by cartilage which makes the movement of the joints in the spine smooth. These joints are very flexible and give you a wide range of motion. Any injury to these joints may limit your mobility making bending and twisting tough to do. The facet joint injection contains anesthesia which is used to numb the pain. It may seem like the only purpose of the injection is to get rid of the pain, but it has another important purpose as well.

When you are experiencing pain, it could be a joint, muscle, ligament, or tendon causing the problem. Facet joint injections are good for ruling out potential issues. When an injection is inserted into the joint, you may feel all your pain go away instantly, or you may continue to have pain and discomfort. If your pain goes away completely, your problem is the joint. If the pain does not go away at all or takes quite a bit of time to subside, the source of your problem is probably not a joint but something else. The other good thing about this injection is that it is accompanied by a steroid shot that makes the pain reliever last longer.

The procedure for facet joint injections is a bit more detailed than your normal flu shot. The doctor will numb the area first and uses an X-ray to guide them into the right spot. For a facet joint injection to work, you have to place it into the joint. The only way to see the joint is through the X-ray. Once the needle is inserted, contrast dye is used to make sure it is in the right place. Once that is verified, the medication is injected into the joint. The procedure is relatively quick, and once it’s over, your pain should be diminished.

Facet joint injections are great, especially if you are dealing with pain that prevents you from getting the therapy you need. To truly heal from a back injury involving your spine, it is important for you to go through physical therapy. If therapy cannot be done, you will not heal as quickly.  If you are suffering from facet joint pain, speak with your physician about this injection. It may help you gain your strength back.
Dr. Mark LeDoux is a dual Board Certified Interventional Pain Management Specialist and Anesthesiologist by the American Board of Anesthesiology with a Fellowship in Interventional Pain Management. Dr. LeDoux is co-director of Interventional Spine & Pain with offices in Dallas and Addison Texas. Dr. LeDoux has been named 2015-2016 Top10MD an honor only 1-in-3 doctors succeeds within the United States. To schedule a consultation with Dr. LeDoux, click on his profile or call his office at 214-888-3900.


 1 year ago    Leave a comments (0)

When you hear the word Botox, you usually think about the cosmetic uses. Botox does help you look younger by reducing crow’s feet and getting rid of frown lines, but now Botox has become a successful treatment for a lot of other disorders. Can you imagine going into the doctor’s office for a headache, getting a Botox injection, and a few days later having no pain at all? Well, it is possible, and it is happening daily. Botox is no longer just a cosmetic drug. It has highly successful results for all kinds of problems.

Botox or botulinum toxin is a drug that people previously only used for cosmetic. The word toxin may scare people, but it is not harmful to the body when used in this manner. Don’t get me wrong; it can be harmful if you have too much in the body or if it is contaminated. The doctor gives Botox in controlled and specific amounts. Botox is a neuromuscular blocker that affects the nervous tissue helping to relax the nerves.  As a result, it then treats a lot of muscle disorders.

There are those who deal with muscle spasms, stiffness, and rigidity. Botox works great for muscle issues because it essentially paralyzes the specific muscle. When the muscle is paralyzed, it will relax, and the stiffness will cease for the duration of the Botox which is typically 3-6 months. Spasms in the muscle can be extremely disabling, but a Botox injection may relax the spasm. Dystonia is a major muscle disorder treated by Botox. Dystonia is the involuntary contraction of the muscles that lead to abnormal movements or spasms. Just one injection of Botox in the muscle can stop these severe muscle spasms. Parkinson’s is a neurological disorder that cannot be treated with Botox, but it may help with some muscle spasms in the beginning stages.

Botox has also been seen to help with migraines, excessive sweating, and bladder control. Migraines are another disorder that can also be debilitating. It may be caused by certain foods, light, or noise, but biologically it the pain is transmitted nerves. If that specific nerve is paralyzed, you will not be able to feel that intense pain in the brain known as a migraine. This process is caused chemo-denervation which Botox is known for.  You may not think sweating is controlled by nerves, but it is. For this reason, you do not sweat all the time. When you start getting hot, the body responds by sweating. When your sweating is excessive, the nerves contributed to the sweating may need to be controlled. Overactive bladder and lack of bladder control are both urinary problems treated with Botox.

You probably never thought Botox could fix so many things. Botox is a highly effective treatment for diseases stemming from the nerves or muscles listed above. When you go into the office, they set up the shots and inject them into the area that is giving you trouble. The injection site may be slightly sore, but afterward, you should feel relief.  The bad part about Botox is that it is not a one-time cure. It is a treatment that you must go back for once it wears off. If you are dealing with any of these health problems, you should talk to your doctor about Botox. It could be the quick fix you have been looking for.

Dallas Interventional Pain Management Specialist Dr. Mark LeDoux is Board Certified by the American Board of Osteopathic Medicine and the American Board of Anesthesia respectively with a Fellowship in Interventional Pain Management. Dr. LeDoux is the co-director of Interventional Spine & Pain with offices in Dallas and Addison Texas. To schedule a consultation with Dr. LeDoux click on his profile or call his office at 214-888- 3900.


 1 year ago    Leave a comments (0)

First, there was carpal tunnel syndrome, now “text neck” is the new tech-induced body condition. Text Neck Syndrome occurs when we are stuck in an unnatural posture of looking down for periods of time. This position leads to soreness in the neck and shoulders, tightness across the shoulders, and even chronic headaches. “The injuries from Text Neck Syndrome results from repetitive stress, “says Dallas Fort Worth Spine Surgeon Dr. Mark Valente- “having your head hung forward and looking down at your device for extended periods of time is not healthy.”

The more you flex your neck, the more weight it has to carry. For every inch forward your head hangs from correct posture- ears above shoulders- the weight of your head increases 100%. If you can remember from Jerry Maguire, we all learned the human head weighs 10 pounds, so imagine how much it begins to weigh as you lean your head forward to select that perfect emoji.

Once upon a time, kids’ heads would be hung to read books, textbooks, study, and take tests. But in the good old days, it would even out when we would then go outside and exercise. We would be balanced and wouldn’t spend the greatest amount time in a poor posture position while texting or using a mobile device.

The most common symptoms associated with Text Neck Syndrome are headaches and neck and shoulder pain. In younger adolescents, Text Neck can increase the curvature of the spine. Research has suggested this syndrome could lead to early onset arthritis or a decrease in lung capacity.

Symptoms of Text Neck Syndrome

  • Neck pain and tightening
  • Shoulder pain and tightening
  • Chronic headaches

The Solution

As with many health problems, if you do nothing, you will get worse. So, it’s important to implement steps to improve your posture, strengthen your neck, and create better habits.

  • Take frequent breaks, look up and stretch your neck every 15 minutes
  • Hold your device up near eye level
  • Do posture strengthening exercises

Patients should seek medical attention if the above measures do not relieve the pain.

Dallas Fort Worth Dr. Mark Valente is a fellowship-trained Minimally Invasive Spine Surgeon Board Certified by the American Osteopathic Board of Orthopedic Surgery. Dr. Valente routinely performs all aspects of spinal surgery – cervical, thoracic and lumbar, including minimally invasive procedures. If you’re experiencing neck or back pain schedule your initial consultation today with Dr. Mark Valente to begin your path to a pain-free life at 972-707-0005.


 1 year ago    Leave a comments (0)



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