Treatments

View All Advanced Treatments View All Common Treatments Or use the quick links below How To Become A Patient Patients wishing to be treated must be referred to the Doctors Pain Clinic by their physician. An initial consultation will determine if a patient is accepted for treatment. Doctors Pain Clinic will communicate the treatments and progress to the referring physician as needed.

• Nerve Blocks
• Injections
• Radiofrequency Blocks
• LASE (Laser Assisted Spinal Endoscopy)
• Nucleoplasty
• Provocative Discogram
• Neurostimulation
• Implanted Medicine Pumps
• Diagnostic Tests

Advanced Treatments

Radiofrequency Block: An outpatient procedure in which a radiofrequency current is used to heat a small volume of nerve tissue interrupting pain signals from that specific area. [ back to top ]

Laser Assisted Spinal Endoscopy (LASE): This minimally invasive outpatient procedure uses a miniature endoscope with a laser fiber enabling the physician to view the nucleus (center) of the disc and to remove a portion of it thus reducing or eliminating the pressure on the nerve root along with the pain. This procedure is performed primarily on patients whose pain radiates down into one or both legs.  Visit www.clarus-medical.com for detailed information.

Click here to read and view video about two local patients who have undergone successful LASE procedures.

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Percutaneous Discectomy
STRYKER® Disc Decompression: This option is for patients suffering from low back and leg (radicular) pain due to contained disc herniations. This option is also performed on those who have failed in their conservative treatments and are interested in trying minimally invasive options before considering traditional back surgery.
Percutaneous Discectomy is performed in surgery using local anesthetic or conscious sedation to allow patient monitoring in order to pinpoint the pain source. With the help of fluoroscopic guidance (live video X-Ray), the DEKOMPRESSOR ® discectomy probe removes disc tissue via a tiny puncture in the skin similar to a simple injection. Removal of disc tissue may relieve painful pressure on the surrounding nerves. The total procedure takes 30-60 minutes. Visit: www.dekompressor.com

Nucleoplasty: A minimally invasive outpatient procedure in which a transmitter catheter is inserted into the nucleus of the disc and uses radio waves to dissolve tissue volume. This reduces or eliminates the pressure on the nerve root along with the pain. Visit www.nucleoplasty.com for more information. [ back to top ]

Provocative Discogram: An outpatient diagnostic X-ray test that attempts to replicate the patient’s pain symptoms in order to pinpoint the pain source in the discs. Dye and an antibiotic mixture is injected into the disc enabling the physician to determine whether the disc is painful when the pressure is increased in the disc or whether the pain is typical of the patient’s pain pattern. [ back to top ]

Neurostimulation: An outpatient procedure where a neurostimulation system is surgically placed under the skin to send mild electrical impulses to the spinal cord or to a peripheral nerve. These electrical impulses are    delivered through a lead (a special medical wire) that is also surgically implanted to specifically cover the area where pain is felt. For more info visit www.medtronic.com. [ back to top ]

Intrathecal Drug Delivery System: Outpatient/inpatient surgical treatment. A catheter (thin flexible tube) is implanted in the intrathecal space and is connected to a pump releasing medicine at a set rate. With delivery of medicine to receptors in the spinal cord, smaller amounts of medicine are needed to obtain relief from pain and a reduction in side effects. Antispasmodics such as Baclofen, and pain medicines such as Dilaudid and morphine sulfate are delivered by the pump.

Common Treatments

Epidural Injection - An outpatient/office procedure which involves placement of anti-inflammatory agents into the epidural space to reduce disc and nerve inflammation, producing relief. [ back to top ]

Transforaminal Epidural Injection: A Transforaminal Epidural Injection is performed to relieve low back and radiating leg pain. The transforaminal approach is a very selective injection around a specific nerve root. The foraminae are small openings between your vertebrae through which the nerve roots exit the spinal canal and enter the body. By injecting medication around a specific nerve root, the doctor can determine if this nerve root is causing the problem. This type of epidural injection is used most often for diagnostic purposes, and it is commonly used in the neck. The medication injected can help reduce swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica and herniated discs. However, many patients get significant relief from only one or two injections. In some cases, it may be necessary to repeat the procedure.

Therapeutic nerve blocks are outpatient/office procedures where local anesthetic and anti-inflammatory medication injections are given near a specific nerve or group of nerves to relieve pain:

Intercostal nerve block - An injection of a local anesthetic and anti-inflammatory medication in the area between two ribs. An intercostal nerve block is performed for pain due to herpes zoster (commonly known as shingles), an acute viral infection that causes inflammation of the nerves that spread outward from the spine. It may also be performed for pain caused from a surgical incision in the chest area or to help determine the cause of your pain. (Diagnostic nerve block)

Lumbar Sympathetic Block - An injection of local anesthetic around a group of nerves in your lower back. It may be done if you have complex regional pain syndrome (CRPS), a disease involving a disturbance of circulation to the skin or neuropathic pain (pain caused by a disorder of the nervous system).

Facet Nerve Block - An injection of anti-inflammatory and anesthetic medication in and around the facet joint area to reduce the swelling around the nerve. This is performed if your doctor suspects that your neck or lower back pain may be caused in part by the small facet joints of the spine (Facet joints are located on the side of your spine, away from the spinal cord.).

Celiac Plexus Block - An injection of anesthetic and anti-inflammatory medication around the group of nerves (celiac plexus) that affect the abdominal region. This is performed most commonly for the treatment of upper abdominal pain which can be due to cancer or chronic pancreatitis.

Stellate Ganglion Block - An injection of anesthetic medication around the collection of nerves that affect the upper limb. This may be performed to decrease pain and increase the circulation and blood supply to the affected limb. A stellate ganglion may be performed for people who have circulation problems or the following nerve injuries: Complex Regional Pain Syndrome (CRPS), Causalgia, Herpes Zoster and Phantom Limb Pain.

Sacroiliac Joint Injection - The sacroiliac facet joints are a small joint in the area of the low back and buttocks where the pelvis joins with the spine. If the joints become painful they may cause pain in the low back, buttocks, abdomen, groin or legs. A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief experienced will help confirm whether or not the joint is the source of pain. Also, the temporary relief of the numbing medicine may better allow the physician to treat that joint. Also, time release cortisone (steroid) will help to reduce any inflammation that may exist within the joint(s).
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Trigger point injections - An outpatient/office procedure where small amounts of local anesthetics and anti-inflammatory medications are injected in the area of the muscle where you have pain or tenderness. These areas are called trigger points because they produce pain when stimulated. Trigger Point Injections are performed if you have myofascial pain which is pain in a specific muscle or muscle group. [ back to top ]

TENS (transcutaneous electrical nerve stimulation) - An outpatient/office procedure where a small extractable device delivers electric impulses to nerve endings to stop pain. [ back to top ]

Acupuncture - An office procedure which involves inserting fine needles into the skin at specific points on the body to relieve chronic pain. [ back to top ]

EMG - A nerve test to determine if you have neurological problem. [ back to top ]

MRI - A state-of-the-art X-ray procedure to help determine where your pain is coming from.

Medications: may be prescribed that can be helpful for specific pain problems.

Physical Therapy: the evaluation and treatment of physical disabilities designed to improve physical strength, range of motion and ability. Physical therapy is used in conjunction and to complement and enhance the pain management treatment plan.