Complete Medical Pain Management Consultation
A complete history of the medical problem, physical examination, and a variety of diagnostic services form the backbone of a Pain Management Consultation. Appropriate recommendations to the referring provider and the patient result in new directions and opportunities for management of complex pain problems. Narcotic prescribing and assumption of care is NOT a usual component of the initial Community Health & Rehabilitation, unless prior arrangements have been made.
Ongoing Medical Treatment and Pain Management
Although pain cure is desirable, pain management is an on-going process that maximizes function, improves comfort, and stabilizes medical care for the chronic pain sufferer. Regular office visits are necessary to provide continuity of care. Narcotic/opioid pain medication prescribing may or may not be part of the treatment plan. Special arrangements are made for those who need to take controlled substances in order to maximize function and manage their chronic pain.
Trigger Point Injection.
Trigger points are usually small areas of tightly knotted muscle and connective tissue that cause localized and referred pain. By injecting anesthetic medicine into these points the muscle can relax so one can gently stretch the tissues back to normal length, bringing lasting pain relief.
Community Health & Rehabilitation, offers lidocaine infusion for many types of neuropathic pain. Once one of our providers has approved the patient for this treatment, an appointment is made with one of our receptionists. At the time of the appointment, the patient checks in at the front desk and is directed to the Community Room in the lower level. The specialized room accommodates six patients for treatment, staggered every 15 minutes. The medical assistant checks the patient, the registered nurse administers the IV and a medical doctor concludes the visit. The entire appointment can take up to an hour. Please avoid scheduling other appointments so as not to feel rushed or anxious during this procedure. Intravenous administration of Lidocaine, an anesthetic medication used to reduce nerve pain, can improve some types of pain.Viital signs and cardiac rhythm are monitored as indicated throughout the treatment. Some conditions respond well to treatment and may have lasting results from several weeks to several months following treatment. IV lidocaine treatment is considered a success if more than 30% pain reduction occurs for 10 days or more. Reasons for considering treatment are varied:
- Pain flare-ups that are not responding to usual treatment modalities.
- A desire for a reduction in baseline pain in order to improve function.
- Temporary improvement needed for a defined period of time such as travel for an upcoming vacation.
- As part of the treatment plan to achieve the next level in exercise tolerance, physical conditioning, functional capacity, or treatment tolerance.
- As a part of pre- or post-operative care.
The term "arthritis" means joint inflammation. Inflammation can cause pain, swelling and stiffness. The two common types of arthritis are osteoarthritis (OA), the breakdown of joint cartilage, and rheumatoid arthritis (RA), the inflammation of the joint lining, called synovium. Joint injections are useful therapeutic techniques for arthritis, impingement syndromes and tendinopathies.
The bursa is what cushions the tendon and helps prevent friction between the tendon and the bone. A Bursa Injection can help determine the pain source and may provide long-term relief by reducing inflammation. A thin needle is inserted into the center of the bursa thought to be causing the pain and a combination of anti-inflammatory (steroid) and anesthetic (numbing) medication is then injected to decrease inflammation and relieve pain.
Plexus or ganglion is a group of nerves that can mediate pain from a specific organ or body region. An injection of medication into a specific area can block the pain. This nerve-numbing substance is called a nerve block. There are different nerve blocks for various areas of pain such as:
- Trigeminal nerve blocks (face).
- Ophthalmic nerve block (eyelids and scalp).
- Supraorbital nerve block (forehead).
- Maxillary nerve block (upper jaw).
- Sphenopalatine nerve block (nose and palate).
- Occipital nerve block (head and scalp).
- Peripheral nerve blocks, including shoulder, arm, leg, foot, hand, abdomen and back.The following blocks are performed by other providers in the community. We will refer you to the appropriate provider:
- Cervical epidural, thoracic epidural, and lumbar epidural block (neck and back)
- Cervical plexus block and cervical paravertebral block (shoulder and upper neck)
- Brachial plexus block, elbow block and wrist (shoulder/arm/hand, elbow and wrist)
- Subarachnoid block and celiac plexus block (abdomen and pelvis)