Advanced pain therapies have helped thousands of people return to their normal activities. Sierra Surgery Hospital has state-of-the-art services available to help patients and their physicians treat pain.
Diagnostic Injections
After an X-ray or CT scan, your doctor may prescribe a diagnostic injection -- also referred to as a block -- to further diagnose the source of your pain. This procedure basically anesthetizes a particular area blocking pain. If you receive temporary pain relief after this procedure, then your doctor will have a better idea about the source of your pain and can develop a treatment program.
Stellate Ganglion Nerve Block
The stellate ganglion is a grouping of nerves in the neck area that is often associated with arm pain through the sympathetic nerve chain. The stellate ganglion nerve block procedure involves an injection of an anesthetic to the area -- usually at the sixth or seventh cervical vertebra. After the procedure, you will be asked to assess your pain level once again to determine if the procedure was successful.
Lumbar Sympathetic Block
The lumbar sympathetic block procedure involves an injection of anesthetic into the lower back or lumbar area. By providing an anesthetic block to the sympathetic nerve group, this diagnostic procedure can determine if damage to these nerves is the source of pain. This block is often utilized for patients with RSD (reflex sympathetic dystrophy), which is either general or local pain caused by a nervous system disorder.
Selective nerve root block
Selective nerve root block involves injecting an anesthetic and steroid directly to the area surrounding a specific nerve root in the spine. This block can play an important role in determining if a particular nerve root is the source of pain.
Celiac Plexus Block
The celiac plexus, also referred to as the solar plexus, is a grouping of nerves in the abdomen. A celiac plexus block is used to anesthetize the nerve grouping to provide relief from abdominal pain most often associated with cancer or chronic pancreatitis. This procedure is performed using a fluoroscope to guide the injection into the abdomen.
Discography
Discography is a diagnostic procedure in which small amounts of contrast dye is injected into one or more spinal discs to further diagnose back pain. A special X-ray called a discogram is used to assess any damage to the disc, which may also be viewed on a flouroscope. A CT scan may also be used to obtain a thorough image of the spinal discs and any damage that has occurred.
IV Regional Anesthetics
Used to block pain sensations from larger parts of the body, IV regional anesthetics can play an important role in pain management or surgery. This type of procedure involves anesthesia being injected near a bundle of nerves that then block sensation for a portion of the body, such as the abdomen, arms, or legs. Examples of regional anesthetics are peripheral nerve blocks and epidural blocks.
Facet Joint Injection
Facet joints are located on the spine where vertebrae slightly overlap each other. These joints restrict movement of the spine and can be the cause of significant pain. A facet joint injection or block requires the injection of anesthetic directly into the joint using a fluoroscope to guide needle placement. This procedure can help determine if a particular facet joint is the cause of pain.
Cervical Thoracic Epidural Steroid Injection
The cervical thoracic epidural steroid injection procedure delivers a steroid medication to the area around the spine. Instead of an anesthetic block to diagnose pain or provide short-term relief, the epidural steroid injection can provide relief for weeks and even up to a year. Cervical thoracic steroid injections are used to treat pain in the neck, shoulder, arms, upper back, along the rib cage, and in the abdomen.
Radiofrequency Nerve Ablation
The radiofrequency nerve ablation procedure involves placing a microelectrode near a nerve or nerve bundle and then using radiofrequency to heat the surrounding tissue and nerves. This takes the nerves’ ability to produce pain away. Ablation procedures can result in months or even years of significantly reduced pain for many patients.
Intrathecal Drug Therapy
The spinal cord is surrounded by a small space called the intrathecal or subarachnoid space. Spinal fluid, which protects the spine and brain, flows through this area. Intrathecal drug therapy involves the direct injection of pain medication into this area of the spine. This treatment may involve a needle guided by a fluoroscope or if continuous pain therapy is needed, a pump that delivers a steady stream of pain medication in the intrathecal space through a catheter can be surgically implanted. This form of therapy is traditionally offered after several other treatment modalities are attempted without success.
Implantable Therapies
For patients who have not seen the desired results from other therapies, implantable devices may offer a pain management solution. Implantable therapies involve two main types – pain pumps and spinal cord stimulation. Each of these treatment options are explored only after other therapies, such as oral medication, physical therapy, nerve blocks, and others have been administered without success. Intrathecal pain therapy involves the surgical implantation of a small pump into the abdomen to administer a steady stream of pain medication directly into the spinal cord. Spinal cord stimulation can involve either an implanted device or an external power source that administers low levels of electric current into the spinal cord. Each of these implantable therapies is designed to control pain for an extended period.
Caudal Adhesionolysis
The caudal adhesionolysis procedure involves inserting a needle or multiple needles into the spinal canal to inject medication, saline, or anesthetic. This process essentially breaks up scar tissue that then frees nerves that have been trapped in the scar tissue to relieve the pain.
Intraspinal Drug Therapy
Intraspinal drug therapy administers pain medication directly into the spinal cord. This treatment utilizes a small pump implanted into the abdomen. The pump delivers pain medication into the spine through a small catheter. Because the medication is administered directly, it requires less medication and may also reduce the side affects experienced in taking oral medication.
Nucleoplasty
Nucleoplasty is a fairly new procedure used to treat herniated spinal discs that are placing pressure on surrounding nerves. This procedure involves using radiofrequency energy to essentially remove material from the spinal disc. Special instruments are used to heat the tissue which then shrinks and alleviates pressure and reduces pain.
Atlanto-Axial/Atlanto-Occipital Joint Injections
The atlanto-axial joint (the articulation between the atlas with the axis) and the atlanto-occipital joint (the articulation between the atlas and the occipital bone) are complex structures located in the area where the vertebra meets the skull. These joints can be the source of significant pain, which is often manifested in headaches and upper neck pain. This treatment involves the injection of pain medication or anesthetic directly into the joint to create a block that relieves pain.
Spinal Cord Stimulation
During spinal cord stimulation electrical current is administered directly into the spine to block pain sensation. Spinal cord stimulation can involve either an implanted device or an external power source which administers low levels of electric current into the spinal cord through a catheter with an electrode or lead at the end.
