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Effective control of acute and chronic pain is an essential task for CCSI's medical team. Severe, un-controlled pain can obviously destroy a patient's quality of life, and thus CCSI makes pain management a very high priority. One type of treatment that we offer is interventional pain management. Under the expert direction of our physicians this type of treatment has brought relief from pain to numerous CCSI patients. The following article provides an overview of interventional pain management techniques.
Nerve blocks, epidural steroid injections and radiofrequency nerve ablation are non-operative forms of pain management. Therapeutic injections may be considered an adjunct to medication and physical therapy. Injection therapy may help control pain from degenerative disc disease, injury, osteoarthritis and other disorders of the spine. Pain management strives to relieve and control acute and chronic pain.
Table 1: Types of Pain
|Type of Pain||Symptom Description|
|Acute Pain||Severe, short-term pain, self-limiting|
|Chronic Pain||Consistent, not self-limiting|
|Neuropathic Pain||Burning, electric, shooting, tingling|
|Nociceptive Pain||Sharp, aching, throbbing, localized|
The following is a brief overview of different types of nerve blocks and epidural injections used to treat pain and discomfort caused by spinal disorders.
A nerve block is an injection of medication onto or near nerves. The injected medication may include a local anesthetic, steroid and narcotic.
Epidural Steroid Injections
The epidural space is the space surrounding the membrane that covers the spinal cord and nerve roots. Disorders such as spinal stenosis and herniated disc can cause nerve irritation, inflammation and pain. An epidural injection places anti-inflammatory medication (eg steroids) into the epidural space. Epidural injections are performed in the cervical, thoracic and lumbar spine.
Sacroiliac Joint Injection
The sacroiliac joint is the largest joint. It is located in the lower spine above the tailbone. Inflammation of the sacroiliac joint can cause low back and buttock pain. An injection of an anesthetic and steroid may help relieve joint pain.
Radiofrequency Nerve Ablation
Facet joints are one source of back pain. Radiofrequency nerve ablation uses radio waves to produce heat directed at a specific facet joint nerve. The heat destroys the nerve and relieves pain.
The ablation procedure is similar to a nerve block or spinal joint injection except two needles are inserted; each facet joint has two nerves. Fluoroscopic guidance is used to correctly position each needle. Then radiofrequency "radio waves" are directed through each needle. The ablation process takes about two minutes. The entire procedure takes about 2 hours.
For safety, some patients are not allowed to undergo a spinal injection for the following reasons:
Patient Preparation: At Home
It is important to follow all pre-test instructions. These instructions generally include:
What to Expect During the Procedure
After the Procedure
Spinal injections, like other medical procedures, have risks. Complications include risk of infection, low blood pressure, headache, and injury to nerve tissue.
At CCSI we perform the full -range of therapies outlined above. Our medical team will carefully discuss the options with you, and give you detailed instructions for before and after the procedure.