The sensation of pain unfortunately plays a prominent role in many of our lives. While the sensation of pain is a form of communication between our mind and body, it regrettably cannot always be controlled without intervention. At the Chicago Pain and Wellness Institute S.C., we can help to alleviate your pain and also help to improve your quality of life. There are several options for targeted pain relief that we offer including:
- Epidural Steroid Injections for Back Pain
- Celiac Plexus Blocks for Abdominal Pain
- Facet Injections for Aching Low Back Pain
- Stellate Ganglion Block for Upper Extremity Nerve Pain
- Bursa Injection for Bursitis
- Sacroiliac Joint Injection for Tailbone Pain
- Lumbar Sympathetic Blockade for Nerve Pain of the Lower Extremity
- Superior Hypogastric Plexus Block for Pelvic Pain
- Intercostal Nerve Block for Rib and Chest Wall Pain
- Occipital Nerve Block for Headache
- Supraorbital Nerve Block for Headache
- Spinal Cord Stimulation for Chronic Low Back and Radicular Pain
- Kyphoplasty for Vertebral Compression Fractures
- Radiofrequency Ablation to Destroy Pain Transmitting Nerves
- IV Sedation by an Anesthesiologist
- Botox for Chronic Migraine
Epidural Steroid Injections
Epidural steroid injections are advocated for spinal degenerative disorders with radiculopathy, spinal stenosis, discogenic pain or spondylosis, failed surgery disorders, refractory cervicogenic headaches and spinal fractures. The most common indication for epidural injections is to place corticosteroid adjacent to an inflamed nerve root that is causing radicular symptoms. Nerve root inflammation may stem from an acutely herniated intervertebral disc causing nerve root irritation or other causes of nerve root impingement such as isolated foraminal stenosis. An epidural steroid injection includes both a long-lasting corticosteroid (e.g., triamcinolone, betamethasone) and an anesthetic numbing agent (e.g., lidocaine, bupivacaine). The drugs are delivered into the epidural space of the spine, which is the area between the protective covering (dura) of the spinal cord and the bony vertebrae.
Celiac Plexus Blocks
Celiac plexus blocks are used to control pain arising from intra-abdominal structures. These structures include the pancreas, liver, gall bladder and abdomen. The most common application of the block is to treat pain associated with intra-abdominal malignancy, particularly pain associated with pancreatic cancer. Local anesthetic under xray guidance is injected at the celiac plexus, a diffuse network of nerve fibers that lie over the surface of the aorta at the T12/L1 verterbral level.
The pain caused by facet arthropathy is most pronounced over the axis of the spine and is exacerbated by movement, particularly extension of the spine, which forces the inflamed articular surfaces of the facet joints together. Axial spinal pain at rest or worsening with forward flexion or rotation of the spine is also a common feature. A facet injection includes both a long-lasting corticosteroid (e.g., triamcinolone or methylprednisolone) and an anesthetic numbing agent (e.g., lidocaine or bupivacaine). The drugs are delivered to the painful facet joint, either inside the joint capsule or in the tissue surrounding the joint capsule using xray guidance. Each vertebra has four facet joints, one pair that connects to the vertebra above (superior facets) and one pair that connects to the vertebra below (inferior facets)
Stellate Ganglion Block
A stellate ganglion block (sympathetic block) is an injection of local anesthetic into the front of the neck for pain located in the head, neck, chest or arm caused by sympathetically maintained pain (reflex sympathetic dystrophy), causalgia (nerve injury), herpes zoster (shingles), or intractable angina. Stellate ganglion blocks are also used to see if blood flow can be improved in circulation problems typically from Raynaud’s or CREST.A stellate ganglion block is an injection of local anesthetic (bupivicaine) around the stellate group of nerves in the neck under ultrasound guidance. The pain relief will affect one side of the head and neck, the upper arm and the upper part of the chest on the same side of the body. A stellate ganglion block may be performed to decrease pain and increase the circulation and blood supply to the affected arm.
A bursa injection is carried out by delivering local anesthetic and steroid medications into specific synovial fluid filled fibrous sacs which are adjacent to joints in the body often under ultrasound guidance.
Sacroiliac Joint Injection
The Sacroiliac joints are paired structures formed by the sacrum medially and the ilium of the pelvis laterally. The sacroiliac joints are the principal load-bearing structures that connect the vertebral elements of the spine with the pelvis and lower extremities. Once the sacroiliac joints become painful, they may cause pain in the low back, buttocks, groin or legs. The local anesthetic and steroid is injected under xray guidance into the sacroiliac joint. The procedure may be both therapeutic and diagnostic and may be followed with radiofrequency of the sacroiliac joint for longer lasting relief.
Lumbar Sympathetic Block
The lumbar sympathetic blockade has been used extensively to the treatment of sympathetically maintained pain syndromes involving the lower extremities including complex regional pain syndrome and peripheral vascular insufficiency due to small vessel occlusion. A local anesthetic is injected under xray guidance over the lumbar sympathetic chain which consists of four to five paired ganglia that lie over the anterolateral region of the spinal cord from T11 to L2.
Superior Hypogastric Plexus Block
The Superior hypogastric plexus block is used in the treatment of pain arising from the pelvic viscera. Patients suffering from endometriosis or locally invasive cancer involving the vagina, uterus, ovaries, prostate and rectum often gain significant pain relief. A local anesthetic under xray guidance is injected at the superior hypogastric plexus which is located over the anterior surface of the fourth and fifth lumbar vertebrae and first sacral vertebrae.
Intercostal Nerve Block
An intercostal nerve block reduces the inflammation of tissues by injecting local anesthetic around the intercostal nerves that are located under each rib. This is most useful
Occipital Nerve Block
An occipital nerve block is an injection of a steroid and local anesthetic around the greater and lesser occipital nerves that are located on the back of the head just above the neck. The block is usually done under ultrasound guidance and reduces the swelling of tissue around occipital nerves to treat migraine headaches.
Supraorbital Nerve Block
The supraorbital nerve is a small nerve that provides sensation to the scalp, forehead, and upper eyelid. When these nerves are irritated the patient may experience muscle spasms and frontal headaches. Injection with local anesthetic and steroid may offer relief from these headaches.
Spinal Cord Stimulation
Spinal cord stimulation (SCS) is a procedure that uses an electrical current to treat chronic pain. Spinal cord stimulation is most often used for patients with chronic and severe neuropathic pain, who have not responded to conservative treatments. Patients with the following conditions may benefit from SCS: post-laminectomy pain syndrome, radiculopathy, diabetic neuropathy and complex regional pain syndrome. Implanting the stimulator is typically done using a local anesthetic and a sedative. We will first insert a trial stimulator through the skin (percutaneously) to give the treatment a trial run. If the trial is successful, a more permanent stimulator may be implanted.
Patients with vertebral compression fractures (VCFs) who do not respond to conservative treatment or whose pain is unbearable may be helped by vertebral augmentation. This minimally invasive procedure uses a balloon catheter to create a void in the fractured vertebra, which is then filled with acrylic bone cement. Most experts believe that pain relief is achieved through mechanical support and stability provided by the bone cement. Vertebral augmentation is a well-established treatment for patients suffering from painful VCFs caused by osteoporosis, metastatic spinal tumors, and multiple myeloma. Benefits include measurable pain relief, increased range of motion, return to previous levels of activity, improved quality of life, and low complication rate. The overall success rate for vertebral augmentation in treating osteoporotic fractures is approximately 85% to 90%. Patients experience a dramatic reduction in pain, increased mobility, and improved overall quality of life.
One in six Americans suffers from back pain every day. Facet joints are a well-recognized source of pain in patients with persistent back pain. There are options for relieving facet joint pain. Radiofrequency ablation (also called radiofrequency neurotomy or lesioning) is a minimally invasive procedure that can provide lasting relief to those suffering from facet joint pain. In fact, multiple clinical studies show that radiofrequency neurotomy significantly reduces pain severity and frequency for one to two years in the majority of patients.
IV Sedation by an Anesthesiologist
Patients will receive Versed or Propofol during their procedure while being monitored the whole duration by a board certified anesthesiologist
Botox for Chronic Migraine
To Be Added