A complete medical history, physical exam, and diagnostic tests will be used to determine the exact source of your pain and appropriate therapy. Listed are some of our most common pain management therapies.
BI-LATERAL SACROILIAC INJECTIONS
Improper body mechanics may cause pain in one or both sides of the lower back. Often, the pain occurs in the sacroiliac joint that lies next to the spine, and connects the sacrum (bone at the bottom of the spine) with the pelvis.
One treatment approach is a sacroiliac joint block. The physician uses a fluoroscope to guide and insert the medication by needle directly into the joint. This treatment can be repeated up to three times in one year, and is usually coupled with physical therapy for mobility and maximum range-of-motion.
CERVICAL EPIDURAL INJECTIONS
Cervical vertebrae are bones that support your neck and head, and form the top part of your spine. The tunnel made by these vertebrae is the spinal canal. The spinal cord runs through the spinal canal, inside a sac called the "dura." Nerves branch off the spinal cord and exit through the vertebrae.
When one of these nerves is under pressure, it may become inflamed and swollen. Head and neck pain can often be felt in the head and arms. To relieve certain types of neck pain, medication is injected into the epidural space. Medication may also be injected near a specific nerve root leaving the spinal canal.
A cortisone injection can relieve pain of inflammation or sprains resulting from sports injuries to arthritis. Cortisone injections directly target the inflamed area. Often, one or more injections can bring lasting relief, and prevent surgery. Injectable cortisone is a type of steroid designed for pain relief.
FACET JOINT INJECTIONS
Each vertebra in your spine has facets (flat surfaces) that touch where the vertebrae fit together. These form a "facet joint" on each side of the vertebrae. Pain occurs when facet joints in your back or neck become inflamed. A facet joint injection into the inflamed joints can relieve pain and reduce inflammation.
LUMBAR EPIDURAL INJECTION
This procedure is designed to reduce and interrupt the pain cycle for low back and leg pain. The goal is to provide relief so you can continue daily activities. For pain relief, the injection will be in the epidural space. Medication may also be injected directly into the nerve root. The Pain Management Center can help you learn good body mechanics. They can provide back strengthening exercises, and you will be encouraged to walk on a regular basis.
INSTRASPINAL DRUG INFUSION SYSTEM
This procedure is designed especially for cancer patients. The instraspinal drug infusion system includes a pump that stores and releases prescribed amounts of morphine into the spinal canal. The pump is refilled by inserting a needle through the patient’s skin, and filling the pump’s port. The catheter is a flexible tube that delivers the morphine from the pump to the spinal cord.
The pump is surgically placed just underneath the skin, usually in the lower abdominal area. One end of the spinal catheter is inserted through a needle into the spinal canal. The other end is placed under the skin and connected to the pump. Adjustments in dose, rate and timing of medications are made using an external programmer. This allows flexibility to match medication dosage with patient pain relief needs.
SPINAL CORD STIMULATION
Perhaps you’ve been dealing with chronic pain in your back, neck, or spine for some time. You may already have tried medications, nerve blocks, physical therapy or surgery. Spinal Cord Stimulation is one treatment for chronic pain. A power source is used to send signals to your spinal cord to block the pain. The power source may be worn outside the body or implanted under the skin on your abdomen or buttocks. The implantable power source is small and will not show under clothing. You may be asked to keep a pain log to ensure relief from this pain control strategy.
REFLEX SYMPATHETIC DYSTROPHY (RSD)
Reflex Sympathetic Dystrophy results from injury to a nerve, often in the hand or foot. Untreated, RSD can cause pain and weakness and limit use of the injured area. Sprains, cuts or fractures can cause RSD.
Early-stage RSD symptoms include:
- Severe, burning pain
- Area is swollen and red
- Stiffening of the muscle, affected function and
- Warm and sweaty sensations
Medical treatments may include:
- Oral medications to relieve pain
- Nerve blocks to stop pain signals
- Spinal cord stimulators that send electrical signals to
- Sympathectomy to destroy a nerve that causes immobilizing pain
Therapeutic Interventions may include:
- Physical, occupational or hand therapy to improve
movement, build strength and reduce pain.
- Desensitization – different textures rubbed on painful
- Ice or heat to reduce inflammation and swelling.
TRIGGER POINT INJECTIONS
One or more tense or inflamed trigger points may cause muscle pain or spasms. Trigger points form when muscles are strained. A trigger point injection can relax the affected muscle and relieve pain. Any muscle in the body can have one or more trigger points. Depending on the number of trigger points, injections may be given over a period of one to two weeks. After the injection, rest and application of ice or heat (as directed by your physician) should bring additional relief.