The Pain Management Center at BOSH offers a comprehensive range of services for patients with acute or chronic pain. Through the combined expertise of pain specialists, we offer the most advanced treatment options available, in a supportive and compassionate environment. Acute pain that is inadequately managed may result in chronic pain, impeding the patient's return to normal function and daily activities. Depression and increasing age affect the likelihood of patients experiencing chronic pain. Our aim is to reduce your suffering and help you lead a comfortable life.
Pain Management overview: If your pain persists after the healing process, you might have what is called chronic pain. If the current treatment you are receiving stops working, or if your pain begins to get worse over time, your doctor may suggest that you see a pain medicine doctor. Cancer pain is another condition that can be managed by a pain medicine doctor while the patient continues to receive treatment for various types of cancer. The pain can be due to cancer surgery or treatment procedures.
Treatment: Pain medicine doctors are experts at diagnosing why you are having pain as well as treating the pain itself. They also manage acute pain caused by surgery, a debilitating illness, or a serious injury. You may be treated in the hospital or in an outpatient clinic.
The pain you may experience after surgery is the result of a stimulus to thousands of nerve cells that rest beneath your skin and sense heat, cold, touch, light, pressure and pain. When there is an injury to your body, such as surgery, these tiny cells send messages along nerves into your spinal cord and then up to your brain. Medications given for pain relief can block these messages. There are generally two types of pain acute pain and chronic pain.
Types of Treatment
Pharmacotherapy: Over-the-counter medications and topical agents such as lotions and creams can be used as a milder treatment approach. If these medications do not work, a physician can prescribe stronger medications such as muscle relaxants or a number of pain killers.
Interventional Approaches: Interventional approaches are used to manage chronic pain such as diagnostic and therapeutic blocks. As well as implanted nerve stimulators, pumps and catheters can be used. Steroid injection techniques, where a needle injects a local anesthetic mixed with a steroid into the area where the pain is originating, are often used to lessen pain. The implantable devices are surgically placed just under the skin and can deliver medicine directly to the spinal cord or stimulate the nerves to alleviate pain.
Rehabilitation Approaches: Some examples of rehabilitation approaches include physical therapy and transcutaneous electrical nerve stimulation (TENS) Unit therapy. Physical Therapy and Occupational Therapy can help by improving and strengthening mobility and function. TENS Unit therapy uses electrical stimulation through electrodes near the area of pain to offer relief.
Medications for Managing Pain: Due to rapid advances in medicine, a wide variety of medications and treatments are available for acute, chronic, and cancer pain. Patients are often prescribed medications before receiving other forms of therapy.In addition, your pain medicine doctor may conclude that a combination of medication and treatments may be right for you. Your therapy plan will be tailored to specific needs and circumstances.
Celiac Plexus Block: The celiac plexus is an injection of a local anesthetic near a group of nerves that stimulate the abdominal organs. "Celiac" refers to the network of nerves. "Block" refers to the use of a local anesthetic to prevent sensory nerve impulses from reaching the brain.This type of block is used most commonly to treat upper abdominal pain, which may be due to cancer or chronic pancreatitis. The procedure can lessen or eliminate your abdominal pain. It can also help your physician find the cause of your pain. This is known as a diagnostic nerve block.
Epidural Steroid Injection: An epidural steroid injection (ESI) places a small amount of steroid medication near nerves in your lower back. The medication is injected into the epidural space, an area surrounding the spinal cord and nerves. An ESI may be performed to relieve pain in your neck, arms, lets, chest or lower back. An ESI also may be performed to relieve pain caused by shingles. By reducing inflammation and decreasing pain, an ESI allows patients to increase their mobility.
Facet Joint Block: A facet joint block is an injection of a small amount of local anesthetic near the facet joint. Facet joints are located on the side of your spine, away from the spinal cord. A facet joint block relieves pain known to be related to the facet joints and is performed if your doctor suspects that your neck or lower back pain may be caused in part by the small facet joints of the spine. This procedure can help your doctor better determine the cause of your pain (diagnostic nerve block).
Hypogastric Plexus Block: The hypogastric plexus is a collection of nerves that is located near the lower part of your abdomen in the upper front of your pelvis. A hypogastric plexus block involves placing an anesthetic near the region of the plexus and usually involves a series of injections repeated at weekly intervals. This treatment has brought relief for many patients who suffer from pelvic pain including pain of the bladder and lower intestines. It also treats pain of the uterus, ovaries, and vagina in women, and pain of the prostate and testicles in men.
Intercostal Nerve Block: An intercostal nerve block is an injection of a local anesthetic in the area between two ribs. "Intercostal" means between the ribs and "nerve block" refers to the use of local anesthetic to prevent painful impulses from reaching the brain. An intercostal nerve block is used to treat pain due to shingles, which is an acute viral infection that causes inflammation of the nerves that spread outward from the spine. It may also be performed to treat pain caused by surgical incisions in the chest area or to help determine the cause of your pain.
Lumbar Sympathetic Block: A lumbar sympathetic block is an injection of local anesthetic around a group of nerves in your lower back (lumbar area). A lumbar sympathetic block may be performed if you have reflex sympathetic dystrophy (RSD), a disease involving a disturbance of circulation to the skin that often leads to neuropathic pain (pain caused by a disorder of the nervous system).
Radiofrequency Ablation: Radiofrequency ablation uses an electrical current produced by a radiowave to heat up a small area of nerve tissue, thereby decreasing pain signals from that tissue. Clinical data shows that radiofrequency ablation can provide effective, lasting pain relief.
Stellate Ganglion Block: The stellate is a group of nerves in the neck area. A stellate ganglion block is an injection of a local anesthetic around this group of nerves to relieve pain. The pain relief will affect one side of the head and neck, the upper arm and upper part of the chest on the same side of the body. A stellate ganglion block can decrease pain and increase the circulation and blood supply to the affected arm. The procedure may be performed on people who have circulation problems or the following nerve injuries reflex sympathetic dystrophy, excessive sweating in the palms or arm pits, causalgia, herpes zoster, or phantom limb pain.
Trigger Point Injections: Trigger point injections (TPIs) place small amounts of local anesthetic and steroids in the area of the muscle where you have pain or tenderness. These areas are called trigger points because they produce pain when they are stimulated. TPIs are performed to relieve myofascial pain, which is pain in the specific muscle or muscle group.
Tunneled Epidural Catheter: A tunneled epidural catheter is a small catheter that is placed in the epidural space and tunneled under the skin. It provides a small dose of pain-killing medication and stays in place during a patient's rehabilitation. This arrangement provides excellent pain relief with only a small dose of medication.