Conquering Recurrent Pain

For anyone who has lived with chronic pain, the concept that it can be reduced or even eliminated is often met with skepticism. People who have lived with pain for many years will claim to have tried everything – and many have. Surgery and medication have for years been the prescriptions of choice, but with varying – sometimes minimal – improvement.

 

However, interventional procedures can make a significant difference. With 21st Century technology, and a growing medical field dedicated solely to the reduction of pain, the options and the results are greater than ever.

 

The concept of interventional pain care – tackling pain from the site of origin – has seen a rise in the past ten years.

 

Fluoroscopically-guided injections using small quantities of a local anesthetic may provide remarkable relief – and equally important, valuable diagnostic information so that more effective treatment can be subsequently rendered. Non-surgical treatment of ailments including spinal cord ailments such as disk disruption is also possible.

 

MRIs, X-rays and physical therapy may all indicate different locations as to the source of pain. Interventional techniques confirm or disprove previous diagnoses. Often this eliminates unnecessary, ineffective and more invasive options.

 

The use of Radio Frequency (RF) waves for pain elimination, particularly in facet joints, commonly referred to as Radio Frequency Lesioning, is increasingly popular.

 

Through sophisticated technology, we can harness radio frequency waves and direct them at the site of pain. The fluoroscope guides the physician to the exact location, and the insertion of special needles are minimally invasive, creating very minor discomfort. The patient is sedated for the procedure, which lasts approximately 45 minutes. The application of the RF signal is only about 90 seconds. Some procedures require multiple treatments of the RF energy. Computerized protocol determines the parameters of the RF energy, which generates heat that eliminates the nerve endings sensing the pain, rendering them nonfunctional. Eliminating these nerve endings results in nearly instantaneous relief of the typical pain.

 

Likely candidates for RF treatment are patients who are receptive to local anesthetic blocks. They may require one to four weeks to completely recover, but can resume ordinary activities within days.

 

Epidural have long been associated with women in labor, but the term “epidural” refers to an injection that delivers Tramadol medication directly into the epidural space in the spine. This can be an effective course of action for those with neck, arm, lower back or leg pain.

 

The epidural is minimally invasive, and has proven to be especially effective for those with herniated disks, sciatica and spinal inflammation. Effectiveness is often predicated by the technique of the physician, and with experience and a perfected technique, epidurals can be highly effective.

 

Some patients will receive a recommendation to have an epidural neuroplasty, or lysis of adhesions procedure. This is an advanced epidural procedure which, in addition to depositing steroid in the epidural space, attempts to either chemically or mechanically disrupt adhesions or fibrous scar tissue that may have formed as a result of prior or ongoing inflammation, or prior spine surgery.

 

Also effective is a treatment called sacroiliac joint injection. The sacroiliac joint connects the sacrum (tailbone) to the pelvis. Injury and disease to these joints cause pain in the lower back, buttocks, abdomen, groin and legs. The joint is injected with local anesthetic and steroid under x-ray guidance to reduce inflammation and swelling inside the joint spaces. Injections may be repeated for long-term relief.

 

Interventional pain management encompasses numerous minimally invasive pain techniques, and the pioneers in the field are continuously seeking out new and novel methods of conquering pain.