VARIOUS PAIN TREATMENTS

Trigger Point Injections - A trigger point injection is used to treat painful and tender areas of the muscle. A trigger point is a tight band of muscle, or knot, that occurs when the muscle fails to relax. The trigger point can irritate surrounding nerves and cause pain in other parts of the body. The injection is made in the area where the trigger point has formed and returns the muscle to its relaxed state, relieving the pain.

Epidurogram - An epidurogram is a method of directly visualizing and treating the inside of the spinal column using direct vision. A small flexible fiberoptic catheter is inserted through a tiny incision and the areas of concern can be seen on a video monitor. Adhesions, or scar tissue, that may be irritating specific nerves can often be effectively treated using this device.

Radiofrequency Nerve Ablation - Radiofrequency Nerve Ablation is a technique that has been found to be beneficial for treating chronic pain that is triggered by certain nerves. The technique involves the use of specialized needles to direct microwave energy to "heat up" and inactivate painful nerves. In addition, radiofrequency is effective in treating pain that may stem from diseased joints in the neck.

Facet Block - A Facet Block is an injection of local anesthetic into a painful joint in the cervical or lumbar spine. The injection reduces the inflammation in the painful joint or joints and decreases the pain.

Cryoneurolysis - Cryoneurolysis is a procedure that involves "freezing" damaged nerves to relieve pain. A special probe is carefully guided to the specific nerves that are causing the pain and discomfort. Once the placement of the probe is correct the tip of the probe is cooled to temperatures between -50 C and -70 C. The freezing temperature of the probe causes the surrounding tissue to absorb heat, which breaks up the outer core of the nerve while the wall of the nerve remains intact. This reduces or eliminates the pain and allows damaged nerves to grow as healthy nerves.

Cervical, Thoracic, Lumbar Epidural - Epidural injections either in the neck, mid-back or low back region can provide an anti-inflamatory effect thereby reducing pain. The injections are typically given in a series of three over time.

Occipital Nerve Block - The occipital nerves that are located at the back of the head can refer pain forward causing head pain. An occipital nerve block can provide pain relief. The blocks are typically given in a series of three.

Neurostimulation Therapy -

· Peripheral Nerve Stimulation - Many patients who suffer from intractable headaches that have not responded to medical therapy, have a significant occipital nerve component which contributes to their pain. Peripheral nerve stimulation to the occipital nerve utilizes a small lead(s) that is placed just beneath the skin to stimulate the occipital nerve and replace the pain with a "tingling" feeling. The device is completely implanted under the skin and the patient has control with a remote device. This procedure is performed on an outpatient basis, under local anesthesia, and does not require hospitalization.

Spinal Cord Stimulation - Spinal cord stimulation involves implanting small electrical leads across the area of the spinal cord to deliver low voltage electrical stimulation that block pain signals from being perceived by the patient. Pain-stopping nerve fibers are activated by the stimulation and replace the pain in the area with a pleasant tingling sensation.

IntraDiscal ElectroThermal Therapy (IDET) - IDET is a recent technology that is gaining widespread acceptance for treating low back pain that is disc related. With the help of x-ray, a small thermal catheter is carefully guided to the disc that is producing the pain. Once it is properly positioned, the catheter is heated, raising the temperature inside the disc. The heat from the catheter contracts and thickens the protein of the disc wall and deactivates many of the nerve endings that are responsible for causing the pain.

Intrathecal Drug Delivery - Intrathecal drug delivery involves using a small pump that is surgically placed under the skin to deliver medication directly into the space where fluid flows around the spinal cord. The medication flows through a catheter that is also surgically placed. The medication goes directly to the area in the spinal cord where the pain signals are being produced. Because Intrathecal drug delivery goes directly to the area causing the pain, it offers significant pain relief with much lower doses of medication than would be required by taking pills.