Subacute and Chronic Pain Management

We offer a multidisciplinary approach to treat the whole patient in order to most effectively manage ongoing musculoskeletal pain.  Our toolbox is loaded with non-surgical interventional pain procedures, medication management, pain psychology, massage therapy, K-Laser therapy and outside resources which include physical therapy, acupuncture and chiropractic treatment.

EMG / NCS

An EMG, or an electromyogram, measures electrical activity of muscles both at rest and in contraction. A nerve conduction study, or NCS, measures how well nerves are able to send electrical signals. Both tests can be done to learn what is causing nerve and muscle issues or pain. An EMG can be done to locate the source of muscle weakness, paralysis, or twitching, which could be inside a muscle, in the nerves supplying a muscle, in the spinal cord, or inside an area of the brain. It tests for things like herniated discs or amyotrophic lateral sclerosis. An NCS is performed in order to locate damage to the peripheral nervous system. This test can discover nerve damage such as carpal tunnel syndrome or Guillain-Barré syndrome.

Epidural Steroid Injections

 

Medial Branch Block of the Facet Joint

At each segment of the spine are small joints called facet joints. They provide support and assist in motion. Due to injury of the back, mechanical stress to the back, or arthritis of the spine, pain can be experienced at the facet joint. A medial branch block involves injection of a local anesthetic medication into the small medial nerves connected to a facet joint. The anesthesia numbs the joint or blocks the pain. The pain relief is usually temporary and, depending on the medication, can last for several weeks or months. The pain relief can help a person have more tolerance in performing a physical therapy session designed to improve the back condition or injury. There are usually two objectives for using facet blocks. The first is to assist in diagnosing the location and cause of pain and the second is to give pain relief.

Sacroiliac Joint Injections

Radiofrequency Ablation

Minimally invasive Radio Frequency Ablation can be used to treat chronic pain in the facet joints. Facet joint pain is often associated with previous surgeries, auto accidents, and pain resulting from degenerative diseases such as spinal arthritis. Patients typically tolerate RFA treatment well and the majority experience pain relief. During this outpatient procedure, a local anesthetic and a mild sedative is administered to the patient. Dr. Lewis uses fluoroscopy to guide a small needle which is positioned over the nerve associated with the patient’s pain. A microelectrode is then placed through the needle and an electrical current heats up surrounding nerve tissue creating a lesion, which interrupts pain signals stemming from the area. The procedure usually lasts between 30 and 90 minutes and can help alleviate pain for 6 to 24 months.

Peripheral Nerve Blocks

Spinal Cord Stimulation

A type of electrical stimulation for chronic pain, spinal cord stimulation is an innovative technology that is frequently used to alleviate chronic neuropathic pain. The technique involves placing soft, thin wires near the spinal column. These wires connect to a programmable generator in the abdomen or upper buttocks area and administer electrical currents to the spinal column. Only low-voltage stimulation is used in spinal cord stimulation treatment. The electrical charges allow the body to better manage pain by interfering with the pain signal as it travels to the brain. Although the pain is not entirely removed, most patients see between a 50 and 70 percent reduction in pain, and many find themselves able to perform daily activities with greater ease or take less pain medication. Due to the simplicity of spinal cord stimulation, it makes it easy for doctors to test patients ahead of time for any negative reactions. It also allows for a quick procedure. Spinal cord stimulation is associated with very few side effects and is easily removed if it does not work. The procedure is also minimally invasive and does not limit patients in terms of recreational activity.

Medication Management

Certified Suboxone Prescriber

Psychological Evaluation and Treatment

Physical Therapy

Cold Laser Treatment

Cold Laser is an FDA cleared non invasive treatment which promotes healing in sub acute and chronic pain areas. During treatment the area of pain is targeted with specific wavelengths of light, which have been identified to interact with surrounding cells and enhance the body’s natural regenerative functions. Many patients report positive results in as little as one treatment. Some of the conditions that typically respond well to K-Laser include: Arthritis Pain, Degenerative Discs/Joints, Sciatic Pain, Back and Neck Pain, Carpal Tunnel Syndrome, Sprains, Fibromyalgia, Athletic Injuries, Work Related and Auto Injuries. Please call our office to find out more about treatment options.

Trigger Point Injections