WHAT IS PAIN MANAGEMENT?
Pain
management is an American Board of Medical Specialties recognized field
that focuses on treating chronic and, in some cases, acute pain.
Rapid
growth in the specialty in both clinical and research areas has made a
vast number of treatment options available, ranging from oral
medications to interventions including injections into joints, nerve
blocks, both temporary and permanent, and surgery, including spinal
endoscopy, minimally invasive disc removal in the spine, radio-frequency
ablation of injured nerves, and implantation of spinal pumps and spinal
cord stimulators.
New modalities of treatment are being introduced regularly to help patients lead more active, full lives.
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Please
use this website to familiarize yourself with some of the many services
offered at our office to improve the quality of your life if you, or
someone you love, suffer from chronic pain. |
The
following are simplified descriptions, and only serve as
introductions. Your physician will discuss recommended interventions in
more detail. |
(click images for larger view)
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Minimally-Invasive Discectomy |
Minimally Invasive Discectomy is a less-invasive alternative to open spine surgery, and this outpatient procedure used when a bulging disc is thought to be the cause of chronic pain, after non-surgical pain treatment is unsuccessful.
With x-ray guidance, local anesthetic is injected, a ½-inch incision made, and a needle-like device is guided in to remove some of the disc fluid, which allows the disc to return to its normal position. The patient is sent home, the dressing removed the next day, and is ready to return to normal work, within 2 weeks. |
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Trigger Point Injections |
Trigger Point injections are indicated in the treatment of myofascial pain. They may on occasion be used in attempts to treat fibromyalgia pain. The treatment involves the injection of a local anesthetic into the painful sites which should start helping the local and radiating pain, but may have to be repeated. In general, we do not inject steroid into trigger points because of the risk of muscle damage with repeated injections, and other side effects. |
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Sacroiliac Joint Injections |
One of the leading causes of chronic low back pain, that may or may not include radiating pain into the hip, groin, or thighs, sacroiliac joint dysfunction can be effectively treated with a combination of simple stretching, appropriate heat application, and joint injection. Injection is done with fluoroscopic (x-ray) guidance, and may need to be repeated. More invasive treatment options are available if this fails to provide long term relief. Core strengthening exercises can help prevent recurrence of this pain cause |
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Epidural Steroid Injections |
Epidural Steroid Injections are usually offered in a series of up to three, these injections are usually indicated for treatment of radiating low back pain associated with disc bulges or ruptures. They may also be used for pain that is limited to the back, or pain remaining after back surgery. Fluoroscopic guidance may or may not be used to facilitate the injection, as there is not strong scientific evidence that it reduces complications. After sterile skin preparation, local anesthetic is injected into the skin so that a needle may be advanced comfortably into the bony spinal canal after which steroid and a rinse of saline is injected and the needle removed. |
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Headaches |
Headache diagnosis and treatment has become much more sophisticated over the past several years, progressing from ‘take an aspirin” to advanced imaging, physical examination, medical, and interventional management. Headaches that were incapacitating and unmanageable five years ago, are now easily and successfully addressed. We at Advanced Pain Specialists have a special interest in headache diagnosis and treatment. |
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Low Back Pain |
Low back pain that is acute (less than 2-3 months) is most often due to muscle spasm or injury, but should be evaluated by your pain management physician. Other common causes, that may become chronic, include disc degeneration, sacroiliac joint, and facet joint dysfunction or inflammation. Treatment may include injection (Epidural steroid injection, or sacroiliac joint injection), physical therapy, and medical management. In some cases, minimally invasive surgery (minimally invasive discectomy, spinal endoscopy, or even fusion), or even extensive surgery by a spine surgeon, may be required. |
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Spinal Endoscopy |
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