Procedures And Intervention Specialist

What is pain management?

Pain management specialists have advanced training in diagnosing, preventing, and treating painful medical conditions. After identifying the cause of your pain, Dr. Chan and Dr. Shwartzman offer innovative treatments to provide long-term pain relief for even the most stubborn pain that doesn’t respond to traditional therapies.

Common minimally invasive pain management techniques offered at Comprehensive Pain Management include:

• Epidural injections
• mild® procedure
• Spinal cord stimulation
• Kyphoplasty
• Radiofrequency ablation
• Lumbar microendoscopic discectomy
• Intracept 

Dr. Chan and Dr. Shwartzman perform these quick and relatively painless techniques with local anesthesia, though they also offer intravenous sedation for men and women who may be anxious or have mild discomfort.

In addition to these minimally invasive procedures, Dr. Chan and Dr. Shwartzman also offer pain intervention techniques, like trigger point injections, facet joint injections, and medial branch blocks.

What are trigger point injections?

A trigger point injection is an interventional pain management treatment where Dr. Chan or Dr. Shwartzman delivers pain-relieving medication directly into the muscle causing your pain. These medications often include a mixture of pain relievers as well as anti-inflammatories.

Trigger point injections can provide relief for a variety of painful conditions, including fibromyalgia, neuropathy, and neck or low back pain.

What are facet joint injections?

During this treatment, Dr. Chan and Dr. Shwartzman use X-ray guidance to locate the small joints between your vertebrae, known as facet joints, causing your pain. Once identified, they inject medication combining pain relievers and anti-inflammatory medications directly to your joint.

Dr. Chan and Dr. Shwartzman might recommend a facet joint injection to treat chronic spinal pain caused by facet syndrome or spinal arthritis.

What is a medial branch block?

Medial branch blocks are powerful pain interventions that enable Dr. Chan and Dr. Shwartzman to deliver a local anesthetic to the medial branch nerves supplying your facet joints.

Your facet joints can grow inflamed for a variety of reasons. When this occurs, it’s common to experience radiating pain and achiness in different areas of your spine that can worsen with movement.

What is an epidural injection?

There are three different types of epidural injections:

Interlaminar epidural injection

The lamina is a type of bone on the back of the spine. Interlamina means “between the two lamina.” The needle is injected into the epidural space, which introduces steroid medication and numbing. For over 60 years, epidural injections have been done in the interlaminar variety and are the most long-lasting procedure variety.

Transforaminal epidural injection

This epidural injection is closer to the problem area. The foramen is where the nerve roots come out of the spinal canal. The steroid injection goes in the area outside the foramen which is in the transforaminal area and usually where the nerve root is getting pinched.

Caudal epidural injection

This is when the needle goes into the bottom of the sacrum area. Numbing and steroid medicines are injected, and go into the lumbar area via gravity, thus, reaching multiple areas to provide pain relief. The caudal epidural injection is optimal for spinal stenosis where multiple nerve roots may be getting pinched. 

The following are indications for epidural injections:

• Herniated disc with radiculopathy or sciatica
• Spinal stenosis
• Inflamed nerve roots due to degenerative disc disease
• Tear in the outer part of the disc, “annular tear”

For more information on procedures and intervention techniques used in pain management, call Comprehensive Pain Management today.