Allevio is working hard on a pilot project for Canadian patients who are 55+ years of age, managing a pain condition, and who are going to be spending a portion of their winter in Florida this year.

Essentially, if you are going south this winter and choose to participate in the program, Allevio will work with you and an affiliated physician in Florida to help ensure you receive high-quality, continued and coordinated care.  We also want to make sure our patients aren’t taken advantage of and their Florida-based physicians are putting patient needs first.

If you are going south this season, please let us know: snowbirds (AT) or call us at extension 22 to let us know. If you want to learn more about the project or participate, we’d love to hear from you!


Stuck waiting on hold to speak with a member of our team for too long, or do you have a quick question you’d like answered without having to call or email?  Feel free to send us an instant message! The link is on the bottom of our webpage, and we are happy to help however we can.

Our IM application gives you instant access to our administrative team, where you can ask them a question, securely transfer documents, and even change appointments.

Best of all, the service is completely FREE to use for our patients and people looking for information about what we offer while we are ironing out the bugs… While we may charge for it in time, for now, please feel free to use it instead of picking up the phone.

We look forward to chatting with you!


There is a small percentage of patients who continue to have pain after having Total Knee Arthroplasty(TKA), i.e. a total knee replacement. While pre-operative screening is recommended to ensure the best outcomes for patients recovering from this procedure, between 8-23% will continue to have pain that lasts longer than the expected recovery period. This can be a result of chronic signaling or changes to the nerves which have been “rewired” to transmit pain messages more effectively. When this happens, the pain is considered chronic and requires that these messages be interrupted in order to provide patients with relief.

One option for Total Knee Pain is pulsed radiofrequency. How does PRF work? Electromagnetic waves are delivered to the nerve that change the pain signaling patterns to the brain (see this great video in a previous blog post about how neuropathic pain signals are transferred). Imagine it as a kind of reset button for the nerve that has been carrying too many pain messages. Once the targeted nerve has been stimulated with the electrode it is reconditioned to its pre-pain state. Because pulsed radiofrequency is applied in very short bursts, there is no long-term damage done to the nerve. The treatment takes minutes to perform and the patient is able to resume her normal activities in just a few hours.





The latest from the Apollo Blog outlines very interesting and encouraging interim research about chronic pain patients who are using opiates (pain killers) as their main way to manage their pain: a significant number of patients who are on addictive pain killers are reporting using less of those drugs while on the medical cannabis available through the Apollo program.

Also very interesting: a clinically significant number of their patients are offering lower numbers on pain scores, leading us to think that they are finding some relief for their pain when other types of treatments are failing.

According to a preliminary analysis of Apollo patient data, 27% lowered their use of opioid medications, which included Percocet, methadone and oxycodone. Across all patients, a significant average pain reduction score of 30% was reported.

Through the research, we are proud to present that 54% of patients showed a clinically significant reduction in pain score. Clinical significance is present when a pain score reduction of more than 30% is reached. Patients at or above this level saw an average reduction in pain score of 45%.

As a practice that is keen to see the world not just improve the way it manages pain, but better manage addictive medication, we see this as a major development for patients looking to manage pain without the challenges of high-dose narcotics.

Several Allevio physicians work closely with and are actively referring into the program.


Today we are happily sharing another whiteboard video by Dr. Mike Evans, Toronto based professor, doctor and health educator extraordinaire.

Dr. Evans outlines some very practical aspects of preparing for joint surgery which encourage the patient to be at the centre of the process. The key message: all of the surgeons, nurses and practitioners that participate in your care before and after your joint surgery will be doing everything they can to support you with their skill and expertise, but ultimately you will play the instrumental role in the healing and long term functionality of your new joint.

The video points out that, in Ontario, patients are generally in and out of hospital after 4 days… sometimes sooner. This gives us bit of perspective on this major procedure. The actual surgery is a the shortest event in the whole process. It is what you do before and after your time in the hospital that will influence your outcome dramatically.

Dr. Evans introduces the idea of the new normal: Your joint has been causing you pain and therefore limiting your activity. After surgery it might be difficult to imagine doing things you had avoided to prevent pain leading up to the replacement. However, it is important to develop the physical  and mental strength before  your procedure and keep up this momentum and attitude in the days and months after surgery. More specifically, simple tasks done in advance (organizing your home for your return and having a contact list of people to call on for help) can allow you to focus on your rehabilitation as soon as you leave the hospital.

We see a lot of people at Allevio who are considering joint replacement or are working with our specialists post-operatively.  We are in the process of developing a Total Knee Program and we currently offer several therapies that address pain following joint replacement surgery. If you are a patient considering or having a joint replacement, please take time to research the conditions and treatments below, or feel free to ask your clinical team about these options. It is always important to do homework and understand what treatments may be available, and what independent reserach has shown for any treatment you may consider.

Some potential treatments may include:

Pulse Radio Frequency

Platelet Rich Plasma (see previous post)

Osteopathy (see previous post)

Chiropractic strategies including various modalities

Custom designed support bracing and orthotics, available through certified and trained experts such as Chiropractors for bracing and Chiropractors or Chiropodists for orthotics.


In a recent article in  Chatelaine, an assistant editor tested out osteopathy for her joint pain. Like many first time patients of osteopaths (also known as DOs or Doctors of Osteopathic Medicine) she was surprised by just how much information could be determined by observation and touch alone. The final verdict: not only was the physician able to aleve some of her discomfort, but she was also able to tell her about her digestive and respiratory problems after one session of hands-on therapy.

So what is osteopathy exactly?

In short, an osteopath is trained to treat the whole person instead of the symptoms or disease. The intricacy of all of the body’s systems (musculoskeletal, respiratory, cardiovascular, digestive, reproductive, or nervous system) are considered when trying to determine the source of imbalance causing sickness or discomfort. The overall idea is to restore function so the body can find its way toward healing itself naturally.

What sets osteopaths apart is their holistic approach, the osteopathic medicine structure influences function, and osteopaths are trained to touch and observe the body to determine the state of tissues, muscles, fluids, and bones.

There have been several studies which demonstrate that osteopathy is particularly effective in treating chronic pain. The holistic approach of an osteopath takes into account the patient’s full life situation (for example; stress, mental health, living conditions) and uses a combination of treatments to restore balance and function to all systems. As pain is a complex experience, many patients benefit from the the comprehensive approach of osteopathic techniques.

While Allevio Pain Management offers Osteopathy services as part of its integrated care model, Allevio always suggests patients find a provider that they are comfortable with, who can communicate and collaborate with their existing team for care, and of course who is a member in good standing with their local college or governing body.


Pain travels along two pathways simultaneously. One pathway delivers information to the brain reporting a physical sensation while another sends signals to the amygdala and the anterior cingulate cortex, which are the areas of the brain that process emotion. This emotional component to pain is an expanding area of research in mind/body medicine. Researchers are trying to determine to what extent the mind can be used to affect chronic discomfort. At the forefront are studies on what is called mindfulness meditation, a practice that brings awareness to the body and alleviates painful sensations through relaxation, visualization, and breathing techniques. By bringing attention to the present state of the body mindfulness meditation is hypothesized to reduce the anticipation and negative appraisal of pain.

One of the central tools of mindfulness meditation is a “body scan”, basically a 20-40 minute guided visualization which draws focus to different areas of the body to better identify and thereby control the interpretation of pain signals (for an example, check out this  sound cloud link) . The idea here is to develop the body scan technique gradually until you are able do this effectively and on your own for a few minutes everyday.

But does it really work?

A comprehensive article in The Atlantic presents both anecdotal and scientific evidence on how the mind can affect sensory experience.

In this short report from the BBC, a journalist investigates the growing interest in mindfulness meditation and the science behind the practice. About 5 minutes into the report he visits a neuroscientist whose MRI imaging of the brain shows that pain messages were in fact  moderated or  “turned down” during mindfulness meditation.

The bottom line, something changes when we start to calm the mind and listen to our bodies signals.


London’s Dr. Patricia Morley-Forester will be speaking on local CBC radio stations across the country on Monday April 28th, with a focus on discussing chronic pain in Canada. Dr. Patricia Morley-Forster is a Professor of Anesthesiology at Schulich Medicine & Dentistry, University of Western Ontario and a thought and practice leader in the area of chronic pain. Tuning in will be worthwhile for patients, their caregivers, and physicians.

Here’s a list of the times that Dr. Pat Morley-Forester will be speaking on local CBC stations, please take a look and tune in!

6:50 Charlottetown – Island Morning
Matt Rainnie – Host
Twitter: @islandmorning

7:00 Sudbury – Morning North
Markus Schwabe – Host
Twitter (show): @MorningNorth
Twitter (host): @cbcmarkus

7:20 Cape Breton (Sydney) – Information Morning
Steve Sutherland – Host
Twitter: @InfoMorningCB

7:40 Winnipeg – Information Radio
Terry MacLeod/Marcy Markusa – Host
Twitter: @CBCInfoRad

7:50 Regina – The Morning Edition
Host: Sheila Coles
Twitter handle: @sheilacolescbc

8:10 Kelowna – Daybreak South
Chris Walker – Host
Twitter: @cbckelowna

8:20 Saskatoon — Saskatoon Morning
Leisha Grebinski – Host
Twitter: @cbcsaskatoon

8:40 Whitehorse – A New Day
Sandi Coleman – Host
Twitter (show): @cbcanewday

8:50 Vancouver –The Early Edition
Rick Cluff – Host
Twitter (show): @cbcearlyedition



Allevio Expert Opinions Ottawa decided to attend and be a sponsor of the CCLA conference at Mt. Tremblant – the focus is on continuing education of the legal community, and there are a lot of very forward thinking minds who are attending. The whole experience so far has been really impressive, not only is everyone very bright but they are also very friendly to new faces.

So far, we have met personal injury lawyers from firms like: Connolly Obagi, McNally Gervan,, Tierney Stauffer, Heenan Blaikie, and Quinn Thiele Mineault Grodzki. The conversations around Ottawa-Based Medical Legal Expert Opinions have been very interesting, and we are proud that Allevio Expert Opinion’s Ottawa work is being embraced by the local personal injury, tort litiation, and LTD (Long Term Disability) firms.


More than managing headaches and chronic pain, Allevio is here to help you get your life back. Our services are completely geared to offering you the best relief available.

Our Flagship Location

240 Duncan Mill Road Main Floor Suite 101 Toronto, Ontario M3B3S6

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