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Santosh Singh Bhadoriya
Dr. Santosh Singh Bhadoriya
 
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Interventional Pain Management

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Effective control of acute and chronic pain is an essential task for Spine Cool medical team. Severe, un-controlled pain can obviously destroy a patient's quality of life, and thus Spine Cool makes pain management a very high priority. One type of treatment that we offer is interventional pain management. Under the expert direction of Kevin Schmidt, M.D., MBA this type of treatment has brought relief from pain to numerous Spine Cool patients. The following article provides an overview of interventional pain management techniques.

Table 1: Types of Pain

Types of PainSymptom 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

Nerve Blocks

  • Peripheral Nerve Block
    Paresthesias are sensations described as numbness, tingling, or a ’pins and needles’ feeling. These sensations may be caused by a disturbance in the peripheral nervous system. The nerves outside of the brain and spinal cord are the peripheral nerves. Sensory peripheral nerves transmit information to the central nervous system. Motor peripheral nerves transmit information from the brain.

  • Selective Nerve Root Block (SNRB)
    Pain and discomfort from cervical or lumbar radiculopathy may be relieved by a SNRB. A radiculopathy is irritation and inflammation of a nerve root that serves a particular body part (eg arm, leg).

  • Sympathetic Nerve Block
    Sympathetic nerves regulate part of the autonomic (involuntary) nervous system. This includes such bodily functions as sweating and blood flow. Conditions causing chronic pain often involve the sympathetic nerves.

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.

Patient Restrictions

  • Anemia
  • Asthma
  • Bleeding problems
  • Infection
  • Kidney disease
  • Pregnancy/breast-feeding
  • Severe spinal abnormality

Patient Preparation: At Home

It is important to follow all pre-test instructions. These instructions generally include:

  • Stop blood thinning medication 2 days prior to the test
  • Do not take any aspirin product 5 days prior to the test
  • Stop anti-inflammatory medication 5 days prior to the test (Vioxxâ„¢ or Celebrexâ„¢ is an exception)
  • Stop pain medication 8 hours prior to the test
  • Do not eat or drink 6 hours prior to the test
  • Arrange for someone to provide transportation home

Patient Preparation: At the Medical Facility

  • The medical staff will review the patient’s history, condition, medications taken on a daily basis, food and/or drug allergies, and other information.

  • The patient changes into a gown and lies down in a hospital bed. The facility provides a secure place for the patient’s personal items.

  • An EKG monitor (heart function), automatic blood pressure cuff (blood pressure), and oximeter (measures blood-oxygen levels) are attached to the patient. This equipment enables the medical staff to consistently monitor the patient’s vital signs before, during and after the procedure.

What to Expect During the Procedure

  • The procedure is performed in a sterile setting similar to an operating room.

  • Before proceeding, the fluoroscopy C-arm is positioned over the patient. Fluoroscopic guidance is used during the procedure to guide the needle into the proper position.

After the Procedure

  • The patient is wheeled to the recovery area where the medical staff continues to monitor vital signs.

  • Patients are usually discharged home when stable with written instructions.

  • Steroids may cause side effects that include blurred vision, frequent urination, increased thirst and change in blood sugar levels. If these side effects become bothersome or worsen, seek medical attention.

  • If fever, chills, increased pain, weakness or loss of bowel/bladder function occurs, seek immediate medical attention. " Follow-up with the treating physician.

Possible Complications

Conclusion

At Spine Cool 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.