Pain Management Services
The pain team focuses on the most effective and innovative techniques available. The center provides individually tailored treatment programs that may involve a single treatment method or a combination of medications, injections, physical therapy, and other services or procedures. As with other persistent illnesses, pain disorders require ongoing re-evaluation and treatment modifications. Pain programs have shown that pain education, coupled with stress reduction and relaxation techniques, can help patients more effectively manage their pain, reduce doctor visits, and prevent relapses.
Your first visit at the Saint Alphonsus Comprehensive Pain and Spine clinic will include an overview of your pain and medical history, a medical records review, and an examination. Please bring a list of all your current medications and other medications that you have tried for this condition. This includes dosages and the prescribing physician’s name. You will also be asked to sign a medication treatment agreement.
Conditions Treated
- Neck and Back Pain (post-spine surgery, herniated/bulging/degenerated discs, spinal stenosis, radicular/sciatica, myofascial/muscular pain)
- Vertebral Compression Fractures
- Complex Regional Pain Syndrome (CRPS, Causalgia/RSD)
- Cancer Pain
- Headache (migraine, trigeminal autonomic cephalgias, cervicogenic)
- Abdominal & Pelvic Pain
- Joint Pain
- Nerve Pain (peripheral neuropathy, neuralgias, post-traumatic nerve injuries, etc.)
Pain Management Procedures
- Epidural steroid injections
- Nerve root injections
- Sacroiliac (SI) joint injections
- Radiofrequency ablation (RFA) (spine, SI and other joints)
- Minimally invasive lumbar decompression (mild procedure) for spinal stenosis
- Spinal cord stimulation (dorsal column and dorsal root ganglion)
- Vertebral augmentation (kyphoplasty, tumor ablation)
- Peripheral nerve injections and stimulation (occipital, ilioinguinal, genitofemoral, intercostal, lateral femoral cutaneous, pudendal etc.)
- Trigger point injections
- Sympathetic nerve blocks/neurolysis (celiac, lumbar sympathetic, superior hypogastric, ganglion impar)
We offer treatment that deals with the pain at the level of the affected nerves. The type of injection is determined after a thorough evaluation is completed.
A typical injection consists of a steroid to decrease inflammation and/or a local anesthetic to numb the area. Two common types of injections are trigger point injections and epidural steroid injections.
Trigger point injections are injections into the muscles, epidural steroid injections are injections into the epidural space and the area that surrounds the spinal canal. The medication bathes the nerve roots at several levels.
Epidural steroid therapy is helpful for sciatica, which is often low back and leg pain due to degenerative discs or spinal stenosis.
These may need x-ray guidance and may include injections into the facet joints, as well as specific single nerve root injections. Another common injection includes sympathetic blocks for reflex sympathetic dystrophy. In this case, a local anesthetic is used to interrupt the sympathetic nervous system. The goal is to reset a possibly malfunctioning sympathetic nervous system. When combined with other treatment modes, such as education and exercise, the above injections may be therapeutic, and may provide diagnostic information.
Neuromodulation techniques that involve stimulation of the nerves peripherally with TENS units, muscle stimulators, or acupuncture.
Some interventions are offered only after conservative therapies have proven ineffective in decreasing or eliminating pain. We may consider neurolytic procedures, which destroy the nerves by using radiofrequency (heat), cryo procedure (freezing), or chemicals (alcohol, phenol). Other times, implantable systems, such as spinal cord stimulators or intrathecal/ spinal infusion pumps for continuous infusion of medications in the spinal fluid, may provide relief of chronic refractory pain.
Further diagnostic work is sometimes required. This may include lab work, x-rays, MRI/CT scans, etc. Diagnostic manometric discograms are also performed at the pain center.