Advanced Pain Management in Mesa, AZ
At the Pain Management Center at Mountain Vista Medical Center, we know pain. A multi-disciplinary team of pain management specialists and other health care professionals work together to diagnose and treat a wide array of painful syndromes, diseases, and unrecognized symptoms.
If you are one of the 50 million Americans suffering from chronic pain, isn’t it time you got help? Call 1-877-924-WELL for more information about your pain treatment options right here in Mesa, AZ. Wondering if your symptoms can be defined as “chronic pain?” Take our two-minute self-assessment quiz to find out.
Pain Treatments at Mountain Vista
The following treatment options may be available to you through the Pain Management Center at Mountain Vista Medical Center. Click on a treatment option to learn more.
Epidural Steroid Injection
Also known as ESI, epidural steroid injection is one of the most common therapies for joint pain – especially pain in the lower back. Epidural steroid injections have been used for treating lower back pain since 1952. Since then, the administration – and thus effectiveness – of these drugs has improved. Today, pain management specialists may use fluoroscopy or x-ray guidance to carefully place the ESI in the exact region of epidural space that requires treatment.
Epidural steroid injections may be used to manage pain caused by herniated discs, pinched or inflamed nerves, spinal stenosis, and other causes. Injections take just a few minutes to administer, and may provide pain relief for several months.
Opioids – or ‘opiates’ – are a class of drugs frequently used for pain management. If you’ve ever had surgery, then you probably received some type of opiate for post-op pain. Common opioids include hydrocodone (Vicodin), oxycodone (Percocet and Oxycontin), and codeine. Opioids work by suppressing your body’s ability to perceive pain. By limiting the pain signals traveling along your nerves, opioids can allow you to live your life with fewer interruptions from chronic pain.
Opioids are only prescribed after the patient has been thoroughly evaluated and all other conservative treatment alternatives have been considered. Your primary care provider may refer you to a pain management specialist in order to create an opioid-based pain management plan that fits your symptoms, medical/drug-use history, and lifestyle.
Vertebroplasty / Kyphoplasty
Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat degenerative disc disease, spinal stenosis, and spinal compression fractures. They share a similar goal and somewhat similar methodology. Both procedures restore volume to compressed vertebrae in the spine by injecting bone cement through a needle.
In a vertebroplasty procedure, the physician injects bone cement into the compressed vertebral space. The cement hardens, stabilizing the vertebra and restoring lost height. In a kyphoplasty procedure, bone cement is injected – just like it is in the vertebroplasty procedure. The main difference between kyphoplasty and vertebroplasty is that when performing kyphoplasty, the physician inflates a small balloon in the vertebral space immediately prior to injecting the bone cement.
Success rates for both of these procedures are high. Many patients with vertebral fractures are able to significantly reduce their pain and enjoy improved mobility within a couple days of the procedure.
Medial Branch Block
The medial branches are nerve endings near the facet joints (in the spine) that transmit sensation back to the brain. Medial branches may be damaged in the back or neck during an automobile accident or some other form of trauma. When this occurs, your pain management specialist may recommend a medial branch block to diagnose the facet joint pain.
By blocking different medial branches at different times and noting any changes in symptoms, your physician can determine which facet joints are causing you pain. This diagnostic procedure can be very helpful in locating the source of your pain and providing a basis for treatment. Joint injections or radiofrequency neurotomy/ablation may be used in the affected facet joints.
Facet Joint Injection
A facet joint injection is a common treatment method for back pain, especially pain caused by osteoarthritis and other types of degeneration. While facet joint injections do not treat or restore degenerated facet joints, they can be very effective for providing pain relief.
These injections can be used for diagnostic or pain management purposes. Diagnostic facet joint injections typically contain a fast-acting anesthetic. This allows the pain management specialist to inject the patient with medication at different areas in the spine. If symptoms lessen, then it could be that the physician has injected the painful facet joints. Once the degenerated/painful facet joint has been detected, it may be injected with a time-released corticosteroid for long-term pain relief.
Because degenerated joints often irritate nerves around the spine, pain may radiate out into the neck, arms, buttocks, hips, legs, and elsewhere (depending on the location of the degenerated facet joint). As such, effective facet joint injections may treat pain throughout the body by lessening nerve irritation.
Radiofrequency neurotomy, also referred to as “radiofrequency ablation” (RFA), is an interventional treatment method for controlling pain in the neck or back caused by injury, osteoarthritis, facet joint syndrome, occipital neuralgia, and other degenerative conditions of the spine.
Typically, patients undergoing radiofrequency ablation will have already had a medial branch block (neck) or lateral branch block (lower back) in order to locate the presumed source of the pain. Once the site has been located, the physician uses advanced imaging technology to guide the placement of the RFA needle. The device then emits heat, disrupting the problematic nerves, and preventing them from transmitting pain signals to the brain.
Sympathetic Nerve Block
A sympathetic nerve block – also known as a stellate ganglion block – is a diagnostic procedure done to locate the source of pain in the sympathetic nervous system, which runs the length of the spine from the chest to the lower back. A sympathetic nerve block can also be used to provide short-term pain relief when a steroid is added into the injection mixture.
Sympathetic nerve blocks may be used in diagnosing and treating pain associated with Complex Regional Pain Syndrome, Reflex Sympathetic Dystrophy, shingles, and more.
Peripheral Nerve Block
A peripheral nerve block is a therapeutic nerve block used for treating nerve disease/dysfunction in the arms or legs. When used as a regular treatment option for chronic pain, this therapy may be called Continuous Peripheral Nerve Block (CPNB). Peripheral nerve blocks may be used to provide pain relief from carpal tunnel syndrome, sciatica, or leg/knee pain.
SI Joint Injections
The sacroiliac (SI) joints connect the spine to the pelvis. When these joints become inflamed or otherwise dysfunctional, pain may develop in the lower back and upper buttock, radiating along the upper thigh.
At Mountain Vista Medical Center, your pain management specialist may use an SI joint injection to treat sacroiliac joint pain. The injection is a mixture of local anesthetic and steroid medications, which provides immediate pain relief (the local anesthetic), followed by some soreness for 24-48 hours, and then pain relief for several months (the steroid), assuming the joint was properly targeted. In order to maximize the effectiveness of the injection, your physician may use some kind of imaging technology, such as ultrasound or x-ray, for guidance in placing the needle.
A discogram (you may also hear the word ‘discography’) is a diagnostic test used to determine which disc(s) is the source of your back pain. During this outpatient procedure, your pain management specialist will have you lie facedown on a table. Using fluoroscopic guidance, your physician will place needles into the discs of your back. If needle placement and probing causes you to experience a pain that’s similar to the symptoms of your chronic pain, then your physician may stop the testing, having found the problematic area.
Because of its invasive nature, discography is not a first-line diagnostic tool for back pain. Discography candidates are usually patients who are experiencing chronic back pain despite physical therapy, medication, and other conservative treatments. A discogram may also be used for perioperative purposes to help your surgeon prepare for your spinal fusion procedure.
Spinal Cord Stimulator Implant
A spinal cord stimulator implant is a small, implantable device that stimulates the nerves, preventing the brain from receiving constant pain signals from the spinal cord. These devices may be used to help manage pain caused by failed back surgery (post-laminectomy syndrome), diabetic neuropathy, and complex regional pain syndrome (CRPS).
Because these implants are semi-permanent devices, they are not used as first-line pain management options. If your pain management specialist has told you that a spinal cord stimulator implant may be right for you, here’s what you can expect from the procedure:
First, patients undergo a five to seven day trial period, during which they wear a portable generator with wires attached to the nerves. This stimulator will emit different electrical currents to see which ones the patient’s symptoms respond to. If a current is found to be successful, then a permanent generator with lead wires is placed just beneath the skin, and the device is programmed to emit the pain-regulating current.
RACZ Caudal Neurolysis
RACZ caudal neurolysis is an injection procedure used to treat scar tissue from a past surgery that is irritating the nerves. Post-laminectomy syndrome (failed back surgery syndrome) is one of the most common health problems for which a pain management specialist may recommend this procedure.
RACZ caudal neurolysis is an outpatient procedure that takes just an hour or less. During the procedure, the patient lies face down on a procedural table, and the physician injects the sacral hiatus (between the base of the spine and the tailbone) with local anesthesia. Next, using fluoroscopic guidance, the physician inserts a thin, flexible catheter through a needle into the scar tissue. A mixture of anesthetics and steroids is administered through this catheter; the mixture painlessly dissolves the scar tissue, providing relief from pain in the leg and back.
Trigger Point Injections
Trigger points are knots that develop in overworked or injured muscles. These knots can be especially painful and tender. They may appear almost anywhere in the body, but tend to show up with the highest frequency in muscle groups in the arms, legs, neck, and lower back.
Trigger point injection is a relatively painless procedure used to relieve pain in trigger points. Patients with myofascial pain syndrome, fibromyalgia, and tension headaches may benefit from injections. The injection may contain a mixture of anesthetics and steroids or nothing at all (a technique known as dry needling).
Take Control of Your Pain
Specialists are waiting to help you at the Pain Management Center at Mountain Vista Medical Center. Call 1-877-924-WELL for more information. Not sure if your pain is “chronic pain?” Take our two-minute self-assessment. Pain management is possible; but it’s up to you to make the call.