Pain Management Treatment

Our comprehensive and state-of-the-art interventional pain management techniques help treat painful symptoms and help you regain your normal life. The treatment techniques are catered to individual patients' needs. At Chronic Pain Institute we specialize in creating treatment plans that help you regain your normal lifestyle free of pain. We invite you to learn more about some of the conditions and treatments at Chronic Pain Institute on this page.

Epidural Steroid Injections

An epidural steroid injection is an injection of local anesthetic and steroid deposited into the epidural space. The epidural space is a space located in the spine just outside of the sac containing spinal fluid. The goal of an epidural steroid injection is to provide pain relief by reducing the inflammation (swelling) of the nerve roots as they exit the spine. An epidural steroid injection will not correct the preexisting medical problem but may improve the level of pain. It is not unusual for someone to need more than one injection to get long term benefit. The injections are done routinely in a series of three injections about 2 weeks apart if needed. If the pain is improved significantly no further injection is needed.

Selective Nerve Root Blocks

A selective nerve root block is an injection of local anesthetic and steroid into the area where the nerve root exits the spinal column. A nerve root block usually is performed for pain in the arm or leg that follows the path of a single nerve (i.e. sciatica). A selective nerve root block may be diagnostic and/or therapeutic. Therapeutic injections are intended to provide long-term pain relief. Most patients require more than one injection.  If you receive sufficient relief from the injection, the nerve root block can be repeated if your pain returns.

Caudal Epidural Steroid Injection

Steroid injections into the sacral epidural space through an opening at the base of the spine, just above the tailbone or coccyx are useful in patients with certain types of low back and leg pain. This technique is particularly useful in patients who have had previous back surgery. Medications injected through the caudal approach distribute through the epidural space and bathe the inflamed nerve structures in a mixture of local anesthetic, anti-inflammatory medication, and steroid solution to attempt to decrease inflammation and pain.

Occipital nerve injections

Injury and compression of the occipital nerve within the muscles of the neck can cause headache and neck pain (occipital neuralgia). Occipital nerve injections can be used treat neck pain and headache.

Trigeminal nerve block

The trigeminal nerve and its branches supply the face. Blocking these nerves can be used to treat facial pain and headache.

Stellate Ganglion Block

The stellate ganglion is a nerve complex in the neck that controls autonomic function in parts of the face and arms. These autonomic functions include whether the skin is warm or cool to the touch, as well as responses like sweating and goose bumps. In certain conditions, the nerves from the stellate ganglion as well as some nearby nerves can become involved in the transmission of pain signals from the face and arms to the brain. Blocking these nerve signals can produce dramatic and sometimes long-term relief of pain. This block is usually performed under X-ray guidance to minimize the risks to the patient. After receiving this block, the patients will often notice several common side effects. These include an enlarged pupil and drooping eyelid on the side that was blocked, a hoarse voice, and the sensation of having a lump in the throat. These are normal responses to stellate ganglion block and will resolve in 8-12 hours. Patients usually return to work the day after this procedure.

Intrathecal Pump Implant

This Devise is typically used in patients with cancer or patients with severe spasticity symptoms. Implantable drug delivery systems are surgically implanted beneath the skin of the abdomen or buttocks and a catheter is implanted into the cerebrospinal fluid next to the spinal cord. The implanted drug delivery pump continuously infuses medication next to the spinal cord to control undesirable symptoms. These procedures are typically performed in a hospital or surgery center operating room with an anesthesiologist caring for the patient during the procedure. Usually the patient will be able to go home after the procedure.

Discography

Discography or discogram, is a diagnostic procedure used to determine if back pain is caused by one or more discs and to help surgeon plan the correct back surgery. The procedure involves pressurizing discs with an injection of sterile liquid to induce pain in the affected discs.

Radiofrequency Therapy

Radiofrequency current is used to heat up a small volume of nerve tissue, thereby interrupting pain signals from that specific area. Radiofrequency techniques can be used to help manage: chronic neck pain, chronic facial pain, chronic mechanical low back pain, chronic headaches, and chronic malignant pain involving the nervous system.

Vertebroplasty

Vertebroplasty is a nonsurgical therapy used to strengthen a broken vertebra (spinal bone) that has been weakened by osteoporosis or, less commonly, cancer. Vertebroplasty can increase functional abilities, allow a return to the previous level of activity, and prevent further vertebral collapse. It is usually successful at alleviating the pain caused by a compression fracture. Often performed on an outpatient basis, vertebroplasty is accomplished by injecting an orthopedic cement mixture through a needle into the fractured bone.

Medial Branch Block

Each vertebra in the spine is connected by two facet joints- one on each side of the spine. For back or neck pain believed to originate in these joints, a facet joint block can be both diagnostic and therapeutic. This injection can confirm whether the facet joints are indeed the source of pain and can help relieve the pain and inflammation.

Intradiscal Electrothermal Annuloplasty (IDET)

This procedure is used to treat pain as a result of damaged discs. This procedure involves the insertion of a needle into the affected disc with the guidance of an X-ray machine. A wire is then threaded down through the needle and into the disc. The wire is then heated, resulting is destruction of small nerve fibers that have grown into and invaded the degenerating disc. The heat also triggers the body to generate new reinforcing proteins in the fibers of the disc.

Spinal Cord Stimulation

Spinal cord stimulation is a very effective therapy for controlling pain related to nerve damage. Stimulating electrodes are placed next to the spinal cord and are attached to a pacemaker like device which can be implanted under the skin. The spinal cord is then stimulated with small electrical impulses which substitute a pleasant sensation for the pain the patient usually experiences. Spinal cord stimulation can be effective for failed low back syndrome, complex regional pain syndromes, peripheral neuropathy, and a variety of other pain states related to nerve damage. Trials of spinal cord stimulation can be done in the office.

Trigger Point Injections

Trigger point injections are done primarily to treat pain related to muscle spasm. Local anesthetic and in some cases cortisone is injected into the painful muscle to relax it. These injections can provide long lasting pain relief in many types of myofascial pain.