Pain Guide and Services

Arm Pain

Back Pain

Leg Pain

Interventional Procedures

Epidurals

An epidural injection delivers steroids into the epidural space around spinal nerve roots to relieve pain – back pain, leg pain, or other pain – caused by irritated spinal nerves. The steroid used in the epidural steroid injection reduces the inflammation of those nerves, which is often the source of the pain.

Facet Injections

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back.

Medial Branch Nerve Block

Medial branch nerves are small nerves that feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain. A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure. If the patient experiences marked pain relief immediately after the injection, then the facet joint is determined to be the source of the patient’s pain.

The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then the patient may be a candidate for a subsequent procedure – called a medial branch radiofrequency ablation – for longer term pain relief.

Selective Nerve Root Block

A selective nerve root block (SNRB), is primarily used to diagnose the specific source of nerve root pain and, secondarily, for therapeutic relief of low back pain and/or leg pain

Sympathetic Block

A sympathetic block typically involves a series of injections to relieve leg pain (sciatica) caused by complex regional pain syndromes, usually after injury to a joint or limb.

Sacroiliac (SI) Joint Injection

Is primarily used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction.

Implantable Devices

When oral medications and/or nerve blocks do not sufficiently control the pain, advanced pain therapies or implantable systems may be effective for treating neuropathy. These systems are designed to interrupt transmission of pain signals from the spinal cord to the brain. If the pain signals do not reach the brain, then the patient does not actually feel the pain.

a) Dorsal Column Stimulator (DCS) or Spinal cord stimulation (SCS)for pain control introduces low levels of electrical current to the dorsal portion of the spinal cord to block the sensation of pain. The device is implanted during a surgical procedure, and may include a fully implanted system or a system with an external power source.

b) Intrathecal pumps (or pain pump) delivers pain medication (typically morphine) directly to the intrathecal space around the spinal cord via an implanted pump. The pump is implanted during a surgical procedure, and medication in the pump is added periodically (e.g. monthly) by injecting medication through the skin into the pump reservoir.

Other Interventional Procedures

Radiofrequency (Rhizotomy)

This injection procedure a needle with a probe is inserted just outside the joint. The probe is then heated with radio waves and applied to the sensory nerve to the joint in order to disable the nerve.

Intrathecal Implantable Trials and Pumps

(Or pain pump) – Delivers pain medication (typically morphine) directly to the intrathecal space around the spinal cord via an implanted pump. The pump is implanted during a surgical procedure, and medication in the pump is added periodically (e.g. monthly) by injecting medication through the skin into the pump reservoir.

Dorsal Column Stimulators

Or Spinal cord stimulation (SCS) for pain control introduces low levels of electrical current to the dorsal portion of the spinal cord to block the sensation of pain. The device is implanted during a surgical procedure, and may include a fully implanted system or a system with an external power source.

Discography (Discogram)

A discography (discogram) is a test to determine the anatomical source of lower back pain for the patient. This procedure is most frequently used to determine if degenerative disc disease is the cause of a patient’s pain (discogenic low back pain). Disco grams may also be performed to assist in preoperative planning for candidates for a lumbar spinal fusion.

Kyphoplasty and Vertebroplasty

The goals of a kyphoplasty surgical procedure are designed to stop the pain caused by a spinal compression fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture. Prior to injecting the cement-like material used to heal the fracture, a special balloon is inserted and gently inflated inside the fractured vertebrae. The goal of this step is to restore height to the bone thus reducing deformity of the spine. Most patients return to their normal daily activities after either procedure.

Peripheral Nerve Blocks

– Suprascapular
– Occipital
– Ilio-inguinal
– Intercoastal
– Supratrochlear
– Supraorbital and Infraorbital Neuralgia
– Mental
– Trigeminal
– Genitofemoral
– Ilioinguinal
– Abdominal and Pelvic Procedures
– Treatments for Cancer Pain
– Celiac Plexus Block/Splanchnic Block
– Celiac Plexus Neurolysis
– Ganglion Impar Block
– Hypogastric Plexus Block
– Pudendal Nerve Block

Pain Management

Pain management is designed to treat chronic pain and allow a person to live a full, enjoyable life. Pain management requires a person’s dedication, commitment, and knowledge in order to achieve the best results. It can be a great alternative to back pain surgery. It’s important to understand the differences between non-invasive non-drug pain management (e.g. exercise), pain management (e.g. pain medications and anti-depressants), and invasive pain management (e.g. injections).

Hand & Wrist Care

Wrist pain can be caused by disease or injury affecting any aspect of the wrist joint, including the bones, ligaments, and connective tissue surrounding the area. Joint pain is medically known as arthralgia.
Pain is a feature of joint inflammation (arthritis) that may occur in the wrist.
Repetitive motion injuries can cause pain in the wrist and hand. Tumors of the bones or other structures in the hand are a very rare cause of wrist pain.

Sports Medicine

Exercise is an important part of a healthy lifestyle, and sports are one approach many people choose to use to get their exercise.
– For people with back pain, sports can still be a viable option if they pay attention to their back.
– For others who participate in sports, knowing the type of strain various sports place on the back may help prevent a back injury.

Leg & Arm Pain

Many types of leg pain stem from lower back conditions like a herniated disc, spinal stenosis, or spondylolisthesis that irritate the nearby nerve root, with symptoms carried from the sciatic nerve down the back of the leg and even into the foot.
The term “sciatica” is used to describe symptoms of leg pain and possible numbness, tingling, and weakness that is referred from the lower back along the sciatic nerve. With sciatica, the patient may feel no back pain but have severe leg pain.

Spine Center

While neck pain (in the cervical spine) is less common than lower back pain (in the lumbar spine), millions of people experience neck pain and/or related arm pain at some point in their life.
The vast majority of episodes of neck pain will get better with time and can be addressed with non-surgical treatments. However, there are a few symptoms that are possible indications of a serious medical condition and patients with these symptoms should seek medical attention immediately.

Shoulder Care

The most common causes of upper back pain are muscular irritation (myofascial pain) and joint dysfunction. There can be an injury to a disc in the upper back (such as a thoracic herniated disc or degenerated disc) that causes upper back pain, but such injuries are very rare.
It is important to note that the thoracic spine (also called upper back, middle back, or mid-back) is very different in form and function than the cervical spine (neck) or the lumbar spine (lower back).

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