Interventional Pain Management

Epidural Steroid Injections

Inflammation is the body's natural response to the presence of bacteria. If the body remains in a state of extended inflammation, it will begin releasing pain signals. The body responds with naturally produced cortisone hormones to relieve the pain.

An epidural steroid injection (ESI) is a concentrated injection of steroids to treat pain and inflammation. Commonly used to treat back and leg pain, it is a nonsurgical treatment method that can reduce inflammation and improve mobility. Using a local anesthetic, also known as a numbing agent, and steroid medication, a doctor will give the patient an injection in the spine's epidural space.

When pain is caused by inflamed spinal nerves, delivering the ESI directly to the epidural space surrounding the spinal cord and the nerve roots can reduce pain and inflammation. The majority of patients find relief from this type of injection therapy. However, each patient may experience different lengths of relief. Some might have a few months of relief, while others may have a few years. It is common to get a series of these injections to provide long-term relief. 

Nerve/Root Blocks

Nerve and root blocks can be administered to patients via injections with medications that have an anesthetic effect. This numbing effect can create a loss of feeling in the nerve bundles that cause pain. The numbed nerves stop sending pain impulses to the central nervous system, helping the patient control and prevent painful symptoms.

Medial Branch Blocks / Radiofrequency Ablation

A medial branch block (MBB) is a primarily diagnostic nerve block directed at the medial nerves. These nerves are branched through the facet joints in the spine. An interventional pain physician will use guided fluoroscopy, which is a live x-ray, to administer the injection outside the joint and near the medial nerves. MBBs allow the interventional pain physician to determine if the source of pain is from the facet joints or a separate issue.

If a patient has an appropriate level of relief for a duration of time, their pain specialists may recommend that they move on to receiving a radiofrequency ablation (RFA). As the name implies, the injection uses radio frequency to prevent pain signals from traveling through the body. RFAs target specific nerves with a controlled, mild electric current that "burns" the nerves. A lesion is created over these nerves that prevents the nerves from sending pain signals to the brain.

Trigger Point Injections

Trigger points can be found throughout the body, with hyper-irritable spots in the taut skeletal muscle band. When compressed, they can cause pain and produce referred or radiating pain. Pain that feels like it is spreading or radiating is a symptom of trigger point pain.

When the muscle cannot relax, creating "knots" and other pain symptoms that you can feel. Trigger point injections (TPI) directly treat this type of pain. TPIs can soothe throbbing muscles and provide the patient with relief. An interventional pain physician may administer a TPI to several injection sites associated with the trigger point pain. 

Facet Joint Injections

Facet joints are the spinal joints that connect the spine and provide stability. Injury or degenerative diseases can strain these spine areas, causing severe pain. Facet joint injections (FJI) are a nonsurgical treatment option for many patients.

The interventional pain specialist uses fluoroscopy to determine the specific location of the facet joint injection. The injection penetrates the facet joint, delivering anesthetic and anti-inflammatory medication to the patient. 

Many patients find sufficient relief from injection therapy that lasts months or years. However, other patients may require more invasive measures to appropriately and safely treat their pain. An interventional pain specialist can determine if some patients would benefit more from surgical interventions.

Lysis of Adhesions

Lysis of adhesions is a minimally invasive interventional pain management treatment that focuses on breaking down scar tissue that has formed around nerves, causing chronic pain. This procedure is particularly beneficial for patients experiencing ongoing pain after surgery or injury. During the treatment, a catheter is guided to the affected area, and medications are administered to dissolve the scar tissue. By eliminating the source of pressure on the nerves, lysis of adhesions offers patients significant pain relief and improved function.

Stellate Ganglion Block

The stellate ganglion block is an injection therapy designed to alleviate pain in the upper extremities, head, and face by targeting the sympathetic nerves in the neck. This treatment involves injecting local anesthetics and steroids into the region, which reduces inflammation and provides immediate pain relief. Additionally, the stellate ganglion block can help diagnose the root cause of the pain, guiding further treatment options.

Sacroiliac Joint Injections

Another interventional spine and pain management technique are sacroiliac joint injections. Sacroiliac joint injections are a targeted approach to treating lower back and buttock pain caused by dysfunction or inflammation in the sacroiliac joints. This procedure involves injecting anti-inflammatory medications directly into the affected joint, providing focused pain relief and assisting in the diagnosis of the underlying issue. Sacroiliac joint injections can offer significant relief for patients suffering from conditions like sacroiliitis and other joint-related problems.

Lumbar Sympathetic Block

A lumbar sympathetic block is an injection-based treatment that targets the lumbar sympathetic nerves located in the lower back. This procedure is particularly effective in alleviating pain in the lower extremities, especially for patients with conditions such as complex regional pain syndrome and peripheral vascular disease. The treatment involves injecting anesthetics and steroids into the affected area, reducing inflammation and providing immediate pain relief.

Spinal Cord Stimulator

The spinal cord stimulator (SCS) is a small device surgically placed in a patient's lower back. Before a patient undergoes the final placement surgery, they can have a trial experience. The trial is used to determine if a patient will experience a sufficient amount of relief before undergoing invasive surgery.

The trial is performed by an interventional pain specialist in the office. The trial lasts between three to five days, and if the patient experiences more than 50% relief, they are a good candidate to move on to the full procedure. The patient will then go to a skilled surgeon to place the SCS for them. 

The spinal cord stimulator has small threads, known as leads, that are surgically placed in specific areas of the spine. Attached to the nerves to directly treat pain, the SCS provides relief by sending small electrical impulses. These mild impulses mask the pain signals before they can reach the brain. Instead of pain radiating throughout your body, the sensation changes to something manageable.

The pain-relieving stimulation can be flexibly programmed for the therapy to provide a gentle tingling sensation, if the patient even feels anything. A mild tingle wins over a pain that radiates. The spinal cord stimulator is clinically proven to provide superior relief compared to conventional pain treatments. The SCS treats chronic pain that can be found throughout the body, such as intense neck pain or shoulders.

The SCS has become an ideal solution to incorporate into a chronic pain patient's journey to relief. With a spinal cord stimulator, patients are able to manage their pain with fewer oral opioid medications or none at all. Having a spinal cord stimulator can prevent a cycle of pain, suffering, disability, and pain again in patients.

Intrathecal Pump

A small medical device, an intrathecal pump, is surgically placed within the body to deliver pain medication directly to the spinal cord. Similar to a spinal cord stimulator, an initial trial is done for the patient to determine if sufficient relief is provided. If the patient's pain decreases by at least 50%, the patient is a good candidate for the intrathecal pump. 

An interventional pain specialist will refer the patient to the appropriate pain surgeon to place the device inside the patient's body. A surgically placed catheter will deliver pain medication directly to the spinal cord, providing immediate relief from chronic pain. An intrathecal pump offers a targeted approach to treating pain safely.

When your pain is severe enough to interfere with your daily activities and becomes debilitative to your life, it is essential to find an interventional pain specialist who can determine the best treatment course. A skilled pain management professional can assist chronic pain patients in returning to living full and functional lives.

Peripheral Nerve Stimulation

Peripheral nerve stimulation is a minimally invasive procedure designed to treat various chronic pain conditions, including neuropathy and post-surgical pain. During this treatment, small electrodes are implanted near the affected nerves, delivering electrical impulses that disrupt pain signals and provide relief. Peripheral nerve stimulation can offer a life-changing solution for patients suffering from ongoing pain.

The Minuteman Procedure

The Minuteman procedure is an advanced spinal fusion technique that stabilizes the spine and alleviates pain resulting from spinal instability or degenerative disc disease. This minimally invasive approach uses a small implant to fuse the vertebrae together, providing lasting pain relief and improved spinal function. The Minuteman procedure offers a quicker recovery time and reduced postoperative pain compared to traditional open surgery.

Minimally Invasive Lumbar Decompression (MILD)

Minimally invasive lumbar decompression (MILD) is a cutting-edge procedure designed to treat lumbar spinal stenosis by removing excess ligament tissue causing nerve compression. This minimally invasive technique results in a faster recovery and reduced postoperative pain compared to traditional open surgery. MILD can offer significant relief for patients suffering from pain and limited mobility due to spinal stenosis.

Aurora ZIP Lumbar Fusion

Aurora ZIP lumbar fusion is an innovative spinal fusion technique that uses a unique, minimally invasive approach to stabilize the spine and alleviate pain caused by degenerative disc disease or spinal instability. This procedure reduces muscle damage and promotes a faster recovery time, allowing patients to return to their daily activities sooner. Aurora ZIP lumbar fusion has the potential to transform the lives of those suffering from chronic back pain.

Vertiflex 

Vertiflex is a groundbreaking, minimally invasive procedure that involves the insertion of an interspinous spacer to relieve pain caused by lumbar spinal stenosis. By placing the spacer between the vertebrae, the narrowed spinal canal is opened, relieving pressure on nerves and providing immediate pain relief. Vertiflex offers patients an alternative to invasive surgery, with a shorter recovery time and reduced risk of complications.

Sacroiliac Joint Fusion

Sacroiliac joint fusion is a minimally invasive treatment that aims to stabilize the sacroiliac joints, reducing pain in the lower back and buttocks. By fusing the joints together using specialized implants, this procedure eliminates excessive motion and provides lasting relief for patients suffering from sacroiliac joint dysfunction. Sacroiliac joint fusion can significantly improve the quality of life for those experiencing chronic pain in the lower back and buttocks.

The Intracept Procedure 

The Intracept Procedure is a revolutionary, minimally invasive treatment for chronic low back pain caused by vertebral endplate nerves. Using radiofrequency energy, the procedure targets and ablates these nerves, offering significant pain relief and improved function without the need for major surgery. The Intracept Procedure has the potential to provide life-changing results for patients suffering from chronic low back pain and increasing their overall function.