Improving Quality of Life with Fibromyalgia

People with fibromyalgia can improve how they feel. “This may seem out of reach when you’re feeling hopeless and depressed, but it’s true,” said Twin Cities Pain Clinic Nurse Practitioner and fibromyalgia specialist, Nancy Cleveland. “The first step is to rule out other more life-threatening diseases because the symptoms can be similar to so many other illnesses.” 

What is Fibromyalgia? Fibromyalgia (fi-bro-my-al-gee-uh) is a disorder that causes pain in your muscles, joints, ligaments and tendons. the pain is especially intense when pressure is applied to areas called “tender points.” Common tender points are the back of the head, the elbows, the shoulders, the knees, the hip joints, and around the neck.

Fibromyalgia affects around 3-6% of he population in the United States. This disorder might be hereditary, so you may have family members with similar symptoms. More women than men have fibromyalgia. 

What are the symptoms of fibromyalgia? Increased sensitivity to pain is the main symptom of fibromyalgia. Many other symptoms also occur in people with this disorder. Symptoms may come and go- here are a few of them:

You may have some degree of constant pain, but the pain may get worse in response to activity, stress, weather changes and other factors. You may have a deep ache or a burning pain. You may have muscle tightening or spasms. Many people have migratory pain (pain that moves around the body.)

Most people with fibryomyalgia feel tired or fatigued. This fatigue may be mild or very severe. You may also have trouble sleeping, which may add to the fatigue.

Depression or anxiety may also occur as a result of your constant pain and fatigue, or the frustrations you feel with the condition. “Depression is huge. No one can see your source of pain, but you know it’s real,” said Cleveland, who sees multiple patients a week with fibromyalgia. “Psychotherapy sessions can be a tremendous help. It’s an important step in getting over this huge hurdle and on your way to developing coping skills.”

The good news is that fibromyalgia does not cause any permanent damage to the muscles and organs. This is not a life-threatening disease, but it is chronic. Although there is no cure, there are many things you can do to feel better.

What can I do to relieve my symptoms? Find an exercise that gets all your body moving and do it consistently, according to Cleveland. Yoga classes, warm water therapy, swimming, and low-impact aerobic exercises are among the best things you can do. “The important lesson here is to not overdo it when you’re feeling good,” said Cleveland. “This can lead you to have several bad days. It is more important to find out how much you can exercise and remain consistent on good and bad days. You will want to strike a balance.” Many people find that a routine time to eat, sleep, and exercise helps to ease their symptoms.

You may need to begin at a very low level of exercise (5 minutes every day is helpful at first). Continue to increase the length and frequency of exercise until you are exercising for at least 30 to 60 minutes, 3 to 4 times a week. Once you reach this point you can consider switching to higher-impact exercise, like walking, jogging and tennis. A physical therapist experienced in treating fibromyalgia can help you develop an exercise regime to follow at home.

Because the symptoms of fibromyalgia are made worse by stress and poor sleep, it is important to cut stress out of your life whenever possible and to get as much sleep as you need. Since alcohol and caffeine can contribute to poor sleep, avoid these substances around bedtime. 

Is there any medicine I can take to help my symptoms? Several medicines can help reduce the symptoms of fibromyalgia. Many of these medicines are taken before bedtime and help reduce pain and improve sleep.

Your doctor may recommend treating your symptoms with acetaminophen (one brand: Tylenol) first. He or she may also prescribe another medicine for you to take, non-steroidal anti-inflammatory medicines are not usually effective in treating fibromyalgia when taken alone. 

“In addition to all these steps, you need to have the mental mindset to do the things that will help improve your pain symptoms,” said Cleveland. “That means choosing something even if you’re not feeling up to it and appreciating the good things, even if it’s just the weather. It goes a long way in improving your psyche.”

Employee Spotlight: Kirsten

Employee Spotlight: Kirsten

 Meet Kirsten, a Patient Service Representative at the Twin Cities Surgery Center. Kirsten was nominated for the Employee Spotlight for working hard every day to make sure that every patient is taken care of regardless of how many hoops she needs to jump through to get there. Kirsten’s attention to detail and reliable work ethic make her the perfect candidate for the Employee Spotlight this week!


What is your position?

I am part of the front desk admin team at the Twin Cities Surgery Center. I assist patients from the time they call o make their appointment to the time their chart gets scanned into their patient account and all the necessary points in between.

How long have you been with TCPC? 

I began working at TCSC on December 4th, 2017. I’ve been here for 3 months!

 What are some of your hobbies

I’ve been blessed with 2 adorable teenagers so any time I get to spend time with them fills my “hobby spot”! Beyond that I have several other hobbies, but my passion is cooking. I love to create recipes from scratch using ingredients, lots of spices and a variety of meats. As a mom, I wanted my kids to know that eating vegetables was not an option, so early on I developed the “eat your age” method where they had to eat as many vegetables for however old they were. While they were growing up it alleviated a lot of stress at the table & now they eat vegetables/salads with no issues. I have a Facebook page where I share the recipes I create & showcase on a few Twin Cities local TV stations so all of my fiends have an opportunity to try out my dishes & give me feedback. It really is one of the BEST passions/hobbies I could ever ask for because food is one of the biggest common denominators among every person on earth, food brings us all together & is essential for daily living. 

 What is your favorite thing about working at TCPC? 

I love the variety that my role at Twin Cities Surgery Center provides me each day. I love doing the “data entry” because it’s quiet & there is such a feeling of accomplishment in getting piles of papers off the counter & put into the shredder because it is now all on the computer. I also LOVE talking to people so helping out patients by scheduling them for their procedures & checking them in during the day gives me an outlet to chat with people. I had one couple that I really connected with because they needed help getting the husband scheduled. I looked at it as if it was my own grandparents, who have now all passed away. What if my family members needed help, I’d want someone else to help them just like I have the ability to help others here at TCSC. It took several days and several calls back and forth to schedule the husband & I was able to chat with this couple when they came for the procedure, it brought tears to my eyes because they were so very thankful for all of my help. You can’t always make everyone happy, but if you can make even one person happy, it’s worth every effort to do just that. 


Thank you for all of your hard work, Kirsten!

Depression and Chronic Pain

Unlearning Helplessness: Fighting Depression and Staying Optimistic When Dealing With Chronic Pain

In the medical and psychological communities, the idea that a sick person’s mental status and stress-coping mechanisms affect their body is hardly new. Years of studies have demonstrated the power of the mind in healing the body: keeping an optimistic attitude lessens chronic pain and speeds recovery. Some studies suggest that optimism boosts the immune system – preventing disease and helping the body recover from illness faster – and a recent Mayo Clinic study even shows that people with an optimistic outlook live 20 percent longer than those who see the glass half-empty.

For chronic pain patients, there are obvious health benefits to being optimistic – but is your personal attitude and outlook on life really something you can control? Can you actually turn years of pessimistic and depressed thoughts upside down during a time of such great challenges for your body and your mind? 


Many lifelong pessimists fall into a behavior pattern called learned helplessness – a sense of a complete lack of control over one’s life, or that one’s actions are futile and will have no effect on the outcome of a bad situation. In a way, the patient has “given up” on changing his or her situation. First theorized by psychologist Martin Seligman in the late 1960’s, learned helplessness is an all-encompassing life outlook that affects the way an individual copes with emotional as well as physical pain: uncontrollable bad events disrupt a person’s ability to adapt to stress, while controllable bad events can be changed or avoided (making them less stressful).

Chronic pain patients often fall into this pattern because they begin to see their pain as an uncontrollable event. Without the comfort or hope of relief, pain patients can easily fall into depression, reject the support of loved ones, or abandon their search for solutions. It’s important to stay positive by remembering that treatment centers – such as Twin Cities Pain Clinic – provide a wealth of innovative treatment options and programs for managing chronic pain. The “helpless” coping style is learned – and it’s possible to retrain your outlook by disputing your own views, building a support network, and actively looking for a solution to your problem.

Don’t let pain control your life – or define who you are.  

Eating Your Way to Reduced Pain

Food Tips for Chronic Pain Patients

With treatment from a pain specialist, physical therapy, and some other lifestyle alterations, chronic pain patients can help keep their pain under control. Research is showing that what we eat can also have an effect on the body’s pain levels – especially in fibromyalgia patients.

Many experts blame fibromyalgia pain on oversensitive nerve cells in the brain and spinal cord, and certain foods may stimulate the release of neurotransmitters that heighten this pain. While research in the area is young, specialists have compiled a list of healthy and helpful eating tips for patients with back pain, neck pain, fibromyalgia and other types of chronic pain. 

Eat more whole fruits and vegetables, legumes, and omega-3 fatty acids. Research shows that a diet high in fruits, vegetables, and omega-3’s increases inflammation in the body, increasing muscular and joint pain. A diet high in whole, fresh foods also helps control weight – and as overweight pain patients tend to report more severe pain, controlling weight can indirectly help control pain. 

Eat less refined, processed “junk food”. Heavily refined, sugary, and chemically processed foods are known to irritate muscles, disrupt sleep, and interfere with immune function – three things that can enhance chronic pain. Aspartame, a chemical sweetener used in diet soft drinks, has also been found to heighten pain sensitivity in some fibromyalgia patients.  

Avoid nightshade vegetables. While vegetables are a nutritious and important part of a pain patient’s diet, vegetables in the nightshade family – such as tomatoes, potatoes, and eggplants – can increase joint pain and arthritis symptoms in some individuals due to neurotoxins in the plants. While many will experience no difference, some sensitive patients will improve remarkably without nightshade vegetables.  

Preventing Knee Pain

Keeping your knees agile and pain-free!

Minnesotans are known for pushing themselves to the limit in order to make the most of our long summer days – golfing, tennis, water skiing, biking, and running can all take a toll on the knees, especially if you’re middle-aged. Almost one in three Americans older than age 45 report some type of knee pain, and it’s a common reason that people visit their doctors or the emergency room, according to the Mayo Foundation for Medical Education and Research.

Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Or, certain medical conditions, including arthritis, gout and infection, may be at the root of your knee pain. More serious injuries, such as a ruptured ligament or tendon, may require surgical repair. Many relatively minor instances of knee pain respond well to self-care measures.

Although every knee problem can’t be prevented – especially if you’re active – you can take certain steps to reduce the risk of injury or disease. Here’s how. 

Move More – “I know it sounds counter intuitive, especially if your knee is sore, but the most important thing for knee health is to be active,” says Leigh Callahan, Ph.D., an associate professor with the Thurston Arthritis Research Center at the University of North Carolina. “A knee that isn’t used stiffens; the muscles around it start to atrophy, and because these muscles would otherwise absorb some of the shock that moves up the leg with every step, a stiff knee has to take on more of the body’s weight than a supple one.”

Strengthen Your Thigh Muscles – In a recent study of 265 men and women with knee osteoarthritis, Mayo Clinic researchers found that those with the strongest quadriceps (thigh muscles) had less knee pain and better physical function than those with the weakest. But there’s a right way and a wrong way to build those muscles. If you’re an avid gym-goer, avoid the leg-extension machines, Kenny suggests. “They put far too much stress on the knee joint,” he says.

Stretch Regularly – Maintaining flexibility is important, especially in the muscles and tendons that connect directly to the knee, such as the hamstrings and the quadriceps. If these tissues become overly taut, they can pull the knee out of alignment. 

Lose The Weight –  Losing as little as 5 percent of your body weight can dramatically reduce your chances of developing knee arthritis, the most common cause of knee pain. 

If your doctor recommends surgery right away, seek a second opinion. Several major studying of arthroscopic surgery to remedy sore knees have found little or no benefit. Physical therapy, as well as anti-inflammatory medicines, can be just as effective – and less invasive.

Normally, the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Depending on your injury, training is likely to focus on the muscles in the back of your thigh (hamstrings), the muscles on the front of your thigh (quadriceps), and your calf, hip and ankle. You can do some exercises at home. Others require the use of weight machines, exercise bicycles or treadmills, which may mean visits to an athletic club, fitness center, or clinic. 


Employee Spotlight: Kaylee

Employee Spotlight: Kaylee

 Meet Kaylee, a triage nurse for Twin Cities Pain Clinic. Kaylee was nominated for the Employee Spotlight for always being willing to help staff and patients alike! Kaylee treats every patient with the respect and patience, and puts a tremendous amount of care into her work each day.  These qualities make her the perfect candidate for the Employee Spotlight. 



What is your position?

I am a triage nurse at TCPC. I am responsible for helping patients communicate with their provider outside of office visits. I also help with patients’ questions, like clarification on a treatment plan and medication questions. 

How long have you been with TCPC? 

1 1/2 years

 What are some of your hobbies

The most important thing in my life is my faith in Jesus! I enjoy spending time with friends and family and being outside as much as possible! I love cross country skiing, snowshoeing, biking, rollerblading, running and going for walks. I also love cooking and looking at flowers! 

 What is your favorite thing about working at TCPC? 

I love feeling like I am making a difference in patients’ lives! It is an exciting challenge to try to find ways to serve each patient’s needs, get to know them individually and show them how much we care. TCPC is well organized and has a mission I am proud to be a part of! My coworkers are amazing and we all make such a great team!


Thank you for all of your hard work, Kaylee!

Botox Injections for the Treatment of Migraine Headaches

We’ve all heard of Botox, responsible for generations of smooth foreheads in Hollywood. But Botox has also brought relief to many people who suffer from chronic medical conditions. In 2018 Botox was approved for use with chronic migraine, and many patients are reporting success. What do you need to know before considering it?

What type of Headache Responds Best to Botox?

Botox is only FDA-approved for chronic migraines, which means headache on 15 or more days a month. Botox is not recommended for patients who experience fewer than 15 headache days a month.

What is Botox? 

Botox is a form of botulinum toxin, a neurotoxin produced by the bacteria that causes botulism. When the Botox botulinum is purified and used in tiny doses in specific areas, it temporarily reduces muscle contractions for approximately 3 months.

How Does Botox Work?

Botox is injected around pain fibers that are involved in headaches. Botox enters the nerve endings around where it is injected and blocks the release of chemicals involved in pain transmission. This prevents activation of pain networks in the brain.

Botox prevents migraine headaches before they start, but takes time to work. One treatment lasts for 10-12 weeks, and patients reported that two Botox treatments reduced the number of headache days by approximately 50%.

What is Treatment Like?

When you receive your first Botox treatment, expect to be in the office for about a half hour. Your Certified Nurse Practitioner uses a very small needle that feels like a pinprick. He or she injects small amounts of Botox into shallow muscles in the skin. Each treatment typically involves multiple injections in seven key areas of the head and neck.

The most common side effect from the Botox shots is a sore neck, and we recommend using an ice pack to reduce the discomfort.

It can take up to six months to see the maximum benefit from Botox. In the meantime, you can continue your regular medications with no risk of a drug interaction.



Article from American Migraine Foundation


Measuring Your Pain: How Doctors Standardize the Subjective

Measuring Your Pain: How Doctors Standardize the Subjective

Pain is – in its nature – a personal experience. Though it has a definite physical cause, your pain is as subjective as your emotions and identifying its root cause can be difficult without a concrete method of defining it.

For your doctor, measuring a patient’s pain is as difficult as it is for the patient to describe it – and fortunately, there are a number of ways around it. By using predefined pain scales, physicians can acquire a more accurate picture of their patients’ pain levels, form a better diagnosis, and ensure they prescribe the right treatment.

Most chronic pain patients are familiar with the “0-10” pain scale. Patients are asked to rate their pain level on a scale of zero to ten, with zero representing “pain-free” and ten representing the highest level of pain imaginable; the test is simple, non-specific, and often the most effective and accessible way to reach a patient.

Often physicians will ask their chronic pain patients to record their pain levels daily or during certain tasks using a Visual Analog Pain Scale on a scale of zero to ten. Varying situations – such as an emergency room visit versus a monthly appointment with a pain specialist – require different methods of analysis, and having an effective method of measuring pain makes the diagnosis more accurate. For a chronic pain patient, being able to communicate pain levels in a medically standardized way opens a world of opportunities in pain management – and in life. 

Patient Satisfaction

Take a look at patient reviews of the doctors and staff at Twin Cities Pain Clinic. We welcome feedback about our team, pain care clinics & surgery center so we can continuously improve processes and the overall experience. 


Location: Woodbury Clinic 

“I am truly grateful for the high level of care and compassion (especially during these very difficult times specifically for chronic pain patients and their families). I will continue to recommend TCPC to family, friends and associates. The experienced doctors, medical technicians, and other very important staff members work diligently to ensure that my family and I receive the treatments, medications (and insurance approval necessary to receive them) to improve our quality of life and function. Convenient and flexible appointment scheduling and an outstanding team of professionals who show genuine compassion and a commitment to better the lives of their patients make Twin Cities Pain Clinic a place you will look forward to returning to and recommending to others!”


Location: Maple Grove Clinic

“Usually there is always something negative to say about a medical office. I can truly say that I have only positive things to say about this clinic and the staff! They work hard, they are always smiling and positive which really means a lot to people who constantly have pain issues. It’s easy to get sucked into a negative mood. But when i walk in and see smiles, it changes everything! Thank you!”



Location: Twin Cities Surgery Center 

“I have had many surgical procedures, so I have had a wide variety of surgical experiences. Twin Cities Surgery Center is one of my best experiences I have ever had. All of the staff from the receptionists to the nurses and then to the doctors are very professional and caring. I highly recommend this facility.”


Location: Edina Clinic  

“My first visit at TCPC was by far THE best experience I have ever had in regards to my chronic pain! I was early, which is the reason for the brief wait. Check-in was short and efficient. Due to arriving early, they did my blood work and urinalysis before I saw Karen, instead of after, which demonstrates that they’re mindful of time. Karen arrived within minutes of my finishing with the nurse and we started on time. Karen is absolutely AMAZING! She took time to ask me questions and answer mine. She actually listened to me and heard what I had to say. Most importantly, she treated me with dignity and respect! Everyone I encountered did so and this is something I have never experienced with medical professionals and my chronic pain. Staff are clearly knowledgeable and truly care. I start Physical Therapy next week and my MRI’s are being done today! I left feeling hopeful that my pain is going to be managed appropriately and that my quality of life just might improve! I highly recommend TCPC!”

Click here to complete the Patient Survey. 

Employee Spotlight: Sallie

Employee Spotlight: Sallie

 Meet Sallie, the Lead Patient Service Representative at Twin Cities Pain Clinic’s Woodbury location. Sallie was nominated for the Employee Spotlight for being a great leader in the Woodbury office. She is hard working, reliable, and very helpful! Sally greets everyone with kindness and a smile, which makes her the perfect candidate for the Employee Spotlight. 



What is your position?

I am the Lead Patient Service Representative in Woodbury. I manage all admin tasks for the Woodbury office including check-in/out, scheduling, sending cc’s for TCPC, answering phones, ordering supplies, managing communication between the other clinic locations with newsletters/email/etc, and lots of other miscellaneous day-to-day tasks!

How long have you been with TCPC? 

I started at TCPC in May of 2017. 

 What are some of your hobbies

I am a mom to 2 boys (6 months and 2.5 years) so my hobbies mainly revolve around spending time with my husband and kiddos. When I have time to myself I love reading, DIY home craft projects, going to see my horse (Stuart) and shopping!

 What is your favorite thing about working at TCPC? 

I love the positive atmosphere and everyone’s willingness to help each other out. I feel appreciated, valued and respected as both a person and an employee. I also like how we offer such a wide range of options for patients with pain- if one thing does not work we have a whole ‘tool box’ of ideas that we can try so that patients do not have to live in pain. 


Thank you for all of your hard work, Sallie!