What are pain management procedures?
When you’re in pain, it’s tough to think about anything else. MacNeal Hospital’s multidisciplinary team of specialists can help you reclaim your life, with a comprehensive pain management treatment plan designed to reduce discomfort and improve and restore function. We treat arthritis, back pain, headaches, joint pain and more. Learn more about some of the treatments and procedures offered at MacNeal.
Epidural steroid injections
An epidural steroid injection is a very effective, low risk, minimally invasive treatment used to treat chronic pain in the neck, arms, back and legs. Epidural steroid injections have been a mainstay of pain management for over 60 years because they work well; several types are available depending on the patient’s condition.
Kyphoplasty is often discussed along with vertebroplasty, another procedure. These are used to treat fractures in the bones of the spine, the vertebrae. During a vertebroplasty, the doctor injects a cement-like material into the bone to make it more stable. During a kyphoplasty, the doctor first inflates a balloon-like device in the bone to make space. The space is then filled with cement.
Nerve blocks, or neural blockades, are procedures that can help prevent or manage many different types of intractable pain. They’re often injections of medicines that block pain from specific nerves. They’re meant to bring pain relief rather than total loss of feeling.
Radiofrequency ablation (rfa)
Used to treat chronic pain caused by spinal injury or deterioration due to conditions relating to vertebrae and intervertebral discs which may in turn affect the nerves in the area. The most common condition treated is degenerative arthritis of the facet joints in the neck or back. RFA uses thermal energy to deaden tiny nerve endings.
Spinal cord stimulators
Spinal cord stimulation is one treatment for chronic pain. A small medical device sends signals to your spinal cord. These signals keep the chronic pain messages from being sent to your brain. Instead, you may feel tingling from the electrical signals.
The sympathetic nervous system is controlled by nerves called ganglions. One large ganglion, called the stellate ganglion, helps control nerves in the upper body. In the lower body, nerves are controlled by several ganglions that make up the sympathetic chain.
Trigger point injections
The cause of your muscle pain or spasms may be one or more trigger points. Your healthcare provider may decide to inject the painful spots to relax the muscle. This can help relieve your pain. Relaxing the muscle can also make movement easier. You may then be able to exercise to strengthen the muscle and help it heal.
Vertebroplasty is a procedure in which a special medical-grade cement mixture is injected into a fractured vertebra. The vertebrae are the small bones that make up the spine. When they become fractured, you’ll often experience pain and a loss of mobility.
How should I prepare for my exam?
- If you have an active infection and are taking antibiotics, the medication course must be complete prior to the procedure.
- Inform us if you are or may be pregnant, or have allergies to medications or x-ray dye (contrast).
- Arrive 15 minutes early to complete registration.
- Bring your insurance card and a valid photo ID.
Depending on the injection procedure you are having, the following preps may also apply:
- Do not eat solid food 2 hours prior to the appointment.
- You may need someone to drive you home.
- If you are taking blood thinners (Coumadin, Plavix or Ticlid), you will have to stop the medication prior to the procedure. Contact your healthcare provider before stopping any medication to determine if it is safe for you.
What happens during my procedure?
Depending on the area to be injected, you will be positioned on an x-ray table on your stomach or back. The area will be cleansed with an antiseptic solution and a local anesthetic will be applied to numb the area where the needle will be inserted.
Fluoroscopy (a type of low-dose x-ray) is used to clearly view the area in real time, on a video monitor. This ensures exact placement of the needle during the procedure. After the needle is placed, contrast material is injected to confirm that the needle is in the correct location. Some patients feel a slight pressure sensation or discomfort as the contrast is injected. This is temporary and will gradually dissipate within a short time after the procedure.
Depending on the type of procedure you’re having, the injection may contain one or both of the following:
- Anesthetic, which helps give immediate pain relief.
- Steroid preparation, which may provide longer relief of your symptoms.
After the procedure, you will be observed for a short time.
What happens after my procedure?
A summary of the procedure and findings will be sent to your healthcare provider.
Refrain from driving, rigorous activity and alcohol consumption for the remainder of the day. You can resume normal activity the next day. You may feel soreness at the needle insertion site for two to three days; you can use an ice pack to relieve any discomfort, up to 15 minutes per hour.
As with any procedure involving a needle, there is a small chance of infection or bleeding. Rarely there could be neural injury, headache, temporary numbness, weakness or facial flushing.