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Florida Health Community, Inc.

FHC

About the Small Pain Fiber Nerve Conduction Study (SPF-NCS) device Using the SPF-NCS, our new pain diagnostic device, we can quickly, easily and accurately identify the source of a person's pain with a statistical sensitivity approaching 100%. Diagnosing pain is often both difficult and inaccurate. No longer! The portable SPF-NCS offered by FHC, is non-invasive, painless, easy to use and provides reliable and accurate results within just 15 minutes. Using our device, you to get an accurate understanding of your patient's root cause of pain which will lead to a more cost-effective, time-efficient and accurate treatment for your patients. Our trained and certified technician will locate the source of pain in patients with many types of chronic pain, including: Neck and back Pain Fibromyalgia Pain Carpal Tunnel syndrome Cubital Tunnel Entrapments Guyons Canal Entrapments CRPS / RSD Piriformis Syndrome Polyneuropathy Lower Extremity Entrapments And more... Our Services FHC provides a mobile service that brings the SPF-NCS directly to your office for immediate testing. We supply everything that is needed to perform the test. We will have a results report with a complete analysis sent to your office within 24 hrs. We can submit the medical billing for the test. Our billing specialist has 30 years experience.

How It Works The patented SPF-NCS sends an electrical signal at specific points that isolate specific A-delta sensory "pain" fibers. By detecting active or down-regulated A-delta function, SPF-NCS is able locate the injured nerve(s) with statistical sensitivity approaching 100%. The highest amplitude causing an action potential indicates pathology. A potentiometer verifies firing by detecting the action potential. Since the patient is his own control, independent of age or gender and population variables, the sensitivity is as high as is possible. High potentiometer amplitudes have been reported to have a close correlation with high VAS ratings. The device can also test C and A-beta fibers, which is useful when RSD or sympathetically mediated pain syndrome is suspected. SPF-NCS Physiology Conventional EMG (electrical muscle graph) cannot test the nerves causing pain, which is the reason why 40% of patients seek medical help. Only 2% of pain patients have motor nerve symptoms for which EMG is effective. Massachusetts General Hospital Handbook of Pain Management 2005 "EMG/NCV cannot test small pain fibers." "In MOST cases (over 50%) of neck and back pain the anatomic and physiologic diagnosis remains unclear." Neurological Text by Weiner & Goetz Lippinott 2005 states "EMG/NCV in the absence of motor symptoms, such as muscle weakness, is costly, time consuming and seldom benefits the patient.

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Florida Health Community, Inc.

FHC

This is the reason 43% of pain patients become chronic and 50% to 80% of back surgeries end in failures. The medical literature does not support that symptoms, physical exams, EMG/NCV or MRI can detect which nerve is causing pain. Only the SPF-NCS tests pain fibers! Guyton & Hall Explain How Pain is Referred At least 50% of patients misdirect doctors away from the source of pain due to referred symptoms. Over 90% of A-delta fibers reach the sensory cortex so they should allow the patient to exactly localization of the source of pain, but injury causes A-delta fibers to become numb. However, the poor localizing C-Type fibers keep functioning and can even up-regulate. The result is that 50% of patients are so confused they may even localize pain as coming from the opposite side. Guyton states: "It explains why patients often have serious difficulty in localizing the source of some types of chronic pain." Sensitivity and Specificity in Detecting Pre-DRG Pathology Evidence Based Medicine The SPF-NCS signal is designed to isolate specific types of sensory fibers. This is especially valuable in helping detect dysfunction in the A-delta fibers for evaluation of possible pre-DRG pathway pathology. Verification of firing is supported by the well documented fact that A-delta fibers are literally "hardwired" to the ventral motor pathway, so when they fire they not only produce a detectable action potential but additonally cause a subthreshold potential in the associated ventral motor pathway. SPF-NCS alone, or in conjunction with the potentiometer, can in a few minutes assess all the major nerves in a region to help detect the one or two requiring the highest voltage amplitude to initiate firing. Most important, the patient is his own control independent of age, gender or population data. As documented in medical text, conventional EMG/NCV cannot access the pain generating fibers of the pre-DRG in the absence of gross motor deficit, which is fairly rare, since most neck and back pain patient do not complain of, or demonstrate, weakness. Fibromyalgia The SPF-NCS has been shown to detect pre-DRG pathology in most of these patients leading to successful treatment in many cases. In one study the SPF-NCS not only revealed pre-DRG pathology in many of these patients but of the ten that were available for one-year follow-up all ten were free of all fibromyalgia symptoms. Double Objective Proof Preliminary findings support that pre-DRG pathology may have a close correlation with abnormal vertebral motion as viewed on A-P lateral bending x-ray. It is suspected that diminished proprioceptive sensory input can affect spinal motor function, which is well documented in Guyton & Hall, and other medical physiology textbooks, that the small intrinsic muscles of the spine are under major control on a level by level basis in the spinal cord. See Guyton & Hall 9th Edition Page 705 Studies and Organizational Support Over 400 published studies support the basic science behind small pain fiber nerve conduction studies. Presently studies are underway at the University of California at Davis and Irvine (UCD and UCI) and the VA in Long Island and many others. Studies already conducted clearly show this technology is the Gold Standard in detecting pain fiber pathology. The American Association of Sensory Electrodiagnostic Medicine (AASEM) holds annual conferences reviewing such studies and technology and more info can be found at www.sensorymedicine.org.