Our board-certified anesthesiologists are all fellowship trained in Interventional Pain Medicine.
The Anesthesiology Pain Medicine practice offers a number of medical and interventional treatments that can help most patients manage their pain successfully.
They offer exceptional, innovative pain management care, including the most advanced minimally invasive procedures for reducing or eliminating pain and restoring physical function.
Anesthesia for Pain Management
The goal of interventional procedures is to provide pain management services for people who suffer from acute and chronic pain issues. We work to identify the site of pain, decrease inflammation and provide relief to help you improve your quality of life.
Pain that comes from injured or inflamed nerves can often be improved by injecting certain medications to the area of injury. These treatments also allow you to work effectively with physical therapists and start personal exercise programs to regain strength and function with less pain.
What Makes Us Different?
- All of the physicians in this practice are board-certified anesthesiologists fellowship-trained in Interventional Pain Medicine and are national leaders in safe, effective, and innovative pain management. They deliver comprehensive care including consultation, diagnostic and therapeutic procedures, including spinal cord and peripheral nerve stimulation and other modulation techniques.
- Our patients are treated by the same physicians throughout course of care
- Consultation and treatment offered in the same visit
- The Anesthesiology Pain Medicine practice utilizes research protocols to guide in patient care
- Extremely one of the highest rates of patient satisfaction in the U.S.
- Immediate add on appointments for referring physicians patients
Types of Pain
The sacroiliac joint is implicated in 18-30 percent of cases of chronic low back pain. Pain is typically located in the middle upper buttock region below your beltline but can radiate to the hip, groin or back of the thigh. Because it resembles many other causes of back pain, it is often overlooked as a primary cause of pain.
For most patients, sacroiliac pain is constant, dull, deep and aching. It can occur after deceleration injuries and falls. Scoliosis patients and those with chronic hip rotation, hip joint degeneration, or leg length discrepancy often suffer from some element of sacroiliac pain. Nearly 30 percent of patients experience sacroiliac pain after lumbar fusion surgery.
Pain medications and rehabilitation are essential starting points after a correct diagnosis. Image guided sacroiliac joint injections and nerve ablation procedures can also improve chronic pain and improve function and quality of life for a longer term. Several well designed studies have proven that nerve ablation procedures of the sacroiliac joint are not only safe, but beneficial to patients in the long-term.
Want to know more? Cusi, Br J Sports Med. 2013 Jul;47
Chronic neck pain is often caused by cervical facet joints
Cervical facet pain is present in up to 50 percent of patients with chronic neck pain problems or headache. Pain is usually distributed in the neck and may refer or radiate upwards to the occipital and frontal regions of the head, as well as down to the shoulder and around the shoulder blade. It is usually worse with range of motion of neck, like turning the head to look behind you. It is commonly seen in patients with an occupational history of overhead work and in those with history of a whiplash-type injury.
Analgesics and physical therapy are useful treatments for cervical facet pain. For those with symptoms that won’t go away with simple measures like these, image-guided injections (medial branch blocks) are useful to confirm diagnosis. Denervation of the cervical facet joints with radiofrequency ablation is a safe and effective procedure that can result in pain relief for up to a year.
Want to know more? Lord SM, Barnsley L, Wallis BJ, McDonald GJ, Bogduk N. Percutaneous radio-frequency neurotomy for chronic cervical zygapophyseal-joint pain. N Engl J Med. 1996 Dec 5;335(23):1721-6.
What is Degenerative Disc Disease, really?
Degenerative Disc Disease (DDD) is the likely nexus of multiple painful spinal conditions including spinal stenosis, disc herniation, facet arthritis and spinal ligament thickening. Disc pain can originate from disruption of the annulus fibrosis, or outer portion of the spinal discs. With time and chronic inflammation, there is an in-growth of granulation (scar) tissue and nociceptors (new nerve endings) in to the disc, essentially up-regulating pain transmission from the "sick" disc. The delicate balance of the spinal disc tissue health can be disrupted by tobacco use, repetitive trauma and genetic factors. The pain caused by DDD is typically in the low back and may radiate in a non-dermatomal, non-myotomal pattern into the buttocks, hips, and thighs. Pain is classically worsened by prolonged sitting, driving or riding, and by spinal range of motion maneuvers. The remainder of findings is usually non-specific. Most patients respond to activity modification, postural retraining, physical therapy and anti-inflammatories. Epidural steroid injections may be indicated when these conservative modalities fail. There are some new emerging regenerative treatments for DDD including platelet rich plasma (PRP) and stem cell injections.
Information on less common types of pain
Upper Back and Thoracic Pain
Although upper back pain and thoracic pain are not very common spinal disorders, they can result in significant discomfort and pain. Thoracic pain may be caused by internal organ pathology (lung cancer, esophageal disorders, heart disorders), referred pain(cardiac angina, cholecystitis), muscular irritation (myofascial pain), joint dysfunction of thoracic cage and upper back, pain from herniated or degenerated disk, nerve pain (intercostal neuralgia, herpes zoster), or pain from osteoporotic vertebral body collapse.
Abdominal pain is usually caused by disease of internal organs of the abdominal cavity and is often treated by gastroenterologist or surgeon. Interventional pain management can be offered to patients who suffer from advanced cancer of internal organs (especially pancreatic cancer) or other chronic conditions (chronic pancreatitis, abdominal angina).
Chronic Pelvic Pain
Chronic pelvic pain may occur in the presence of known or suspected organ pathology, or without any evidence of any underlying physical cause. Pelvic pain is more common in women, with most common causes being endometriosis, pelvic inflammatory disease, pelvic adhesions, neoplasm, and myofascial pain of the pelvic floor muscles. Specific exercises can alleviate symptoms in many women. Often times an interventional pain procedure can be performed with good improvement in patient’s pain.
Central Pain Syndromes
Central pain is produced by lesions of the central nervous system: spinal cord, brain and brainstem. Examples of central pain are: multiple sclerosis, neoplasm, stroke.
Peripheral Nervous System Pain AKA peripheral neuropathy results from peripheral nerve lesions. This peripheral nerve lesions may be caused by Herpes Zoster (postherpetic neuropathy), diabetes (diabetic neuropathy), entrapment neuropathy (pain after inguinal hernia repair), and chronic alcoholism (alcoholic neuropathy). There are specific pain medications prescribed by a pain specialist which can substantially improve pain in these patients.
Complex Regional Pain Syndrome
CRPS applies to a variety of seemingly unrelated disorders having similar clinical features and manifesting the same fundamental disturbed physiology that occurs when nerves are injured, even in a minor way. Sometimes sprains, strains, fractures and crush injuries result in CRPS symptoms.
Pain is characterized by constant, spontaneous, severe burning pain and hypersensitivity to light touch. If persistent, it results in changes to the skin, hair, and bone.
Our physicians provide care for many medical conditions, including (but not limited to) the following:
- Atypical Facial Pain
- Cancer Related Pain
- Cervicogenic Headache
- Chronic Knee Hip And Shoulder Pain From Osteoarthritis
- Chronic Knee Pain After Joint Replacement
- Complete Regional Pain Syndrome (CRPS/RSD)
- Degenerative Disc Disease
- Facet Syndrome
- Herniated Discs
- Low Back Pain
- Neck Pain
- Neuropathic Pain
- Occipital Neuralgia
- Trigeminal Nerve Pain
- Vertebral Compression Fractures
Our physicians offer a comprehensive array of diagnostic and therapeutic procedures and consultation, including:
- Celiac Plexus Blocks and Neurolytic Procedures
- Diagnostic Sacroiliac Nerve Blocks
- Epidural Steroid Injections
- Facet Joint Injections
- Facet Nerve Injection
- High Frequency Stimulation
- Hip Shoulder Knee Joint Injections
- Intradiscal PRP and Stem Cell Injections
- Intrathecal Pump Trials and Implantation
- Lumbar Sympathetic Ganglion Injections
- Nerve Ablations for Chronic Knee and Hip Pain
- Occipital Nerve Blocks
- Percutaneous Disk Decompression
- Peripheral Nerve Stimulation
- Provocation Discography
- Radiofrequency (RF) Ablation Procedures
- Regenerative Therapies Including Stem Cells and PRP
- Sacroiliac Joint Injections
- Sacroiliac Nerve Ablation
- Selective Spinal Nerve Injections
- Sphenopalatine Nerve Blocks
- Spinal Cord Stimulation
- Spinal Cord Stimulation Trials and Implants
- Stellate Ganglion Injections for Hot Flashes
- Stellate Ganglion Injections for Pain
- Transforaminal Epidural Steroid Injection or Selective Spinal Nerve Injection
- Trigeminal Nerve Block
- Trigger Point Injections