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Services - Pain Management

Pain Management

 

Whether you’ve just had surgery or are dealing with a chronic medical condition or if you have acute pain, SHA helps you to manage these and helps you by not letting it be a daily struggle. We manage common back pain to pain related to cancer or other diseases and also acute pain following surgery. Specialists at SHA offer a compassionate environment and provide treatment plan based on the individual case that is best suited to the patient.

 

The effectiveness of pain treatments depends greatly on the strength of the Doctor-patient relationship. Pain treatment is never about the doctor’s intervention alone, but about collaboration between the doctor, the patient, and the family.

 

It involves treating all types of pain, including musculoskeletal, spinal and neuropathic pain disorders. With an accurate diagnosis and early intervention, we hope to help patients avoid spiralling into a state of chronic pain, or at least reduce the severity of pain, and improve patients’ quality of life. Minimally invasive procedures and proper use of medications are implemented to achieve those goals. This unique and focused combination of skills permits our experts to treat you, through a comprehensive non-surgical treatment plan that reduces or helps manage your pain and improves your quality of life.

 

  1. Acute pain. Following surgery or other procedures, many people need short-term pain management. Injuries not requiring surgery may also cause significant pain that needs to be controlled. Treatments for acute pain may be as simple as a local anaesthetic or as complex as specialized procedures to minimize stress on the heart and blood pressure. Our anaesthesiologists work with you to decide the plan best suited for your individual needs so you can rest and begin healing.
  2. Chronic pain. A growing number of people are coming forward for help with pain that affects them over long periods of time. Our anaesthesiologists work using a multidisciplinary, comprehensive approach to care for people with significant chronic pain. Our pain management anaesthesiologists are skilled in reducing pain while preserving spine and nerve function. We use a variety of techniques for managing pain, including:

Treatment

  1. Basic Pain Treatment:
    • Rest and diet changes
    • Exercise and physical therapy
    • Anti-inflammatory drugs (ex: ibuprofen)
    • Cognitive and behavioral modification
  2. Mid-Level Pain Treatment:
    • Injections. Local anesthetics injected in or near nerves may reduce pain and inflammation in particular parts of the body.
    • Nerve blocks. We inject special medicines into large nerve clusters to reduce or eliminate pain in particular parts of the body.
      • > Celiac Plexus Block- Local anesthetic is injected to cervical plexus near a group of nerves that stimulate the abdominal organs. 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- Small amount of steroid medication is injected near nerves in your lower back. The medication is injected into the epidural space, an area surrounding the spinal cord and nerves.  This helps to relieve pain in your neck, arms, legs, chest or lower back. An ESI also may be performed to relieve pain caused by shingles. This type of block helps to increase mobility by reducing inflammation and decreasing pain.
      • > Facet Joint Block- Anesthetic is injected to 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.
      • > Hypogastric Plexus Block- 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- Local anesthetic is injected in the area between two ribs. It is used 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- Local anesthetic is injected around a group of nerves in your lower back (lumbar area). It is 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. It is very effective and has a long lasting pain relief.
      • > Spine CATH IDET Therapy- It is a minimally invasive treatment in which a physician applies controlled levels of heat to a broad section of the affected disc wall. The heat contracts and thickens the collagen of the disc wall and raises the temperature of the nerve endings. The therapy may result in contraction or closure of the disc wall fissures and a reduction in the bulge of the inner disc material and a desensitization of the pain sensors within the disc.
      • > Stellate Ganglion Block- Local anesthetic is injected around stellate ganglion 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. 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- Small amounts of local anesthetic and steroids are injected 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.
      • > Vertebroplasty- Percutaneous vertebroplasty is a procedure for the treatment and stabilization of vertebral compression fractures. A compression fracture of the vertebrae means the bone has collapsed or is crushed. Compression fractures are the result of bone that has been weakened, most commonly by osteoporosis and in rare cases, by cancers, benign tumors or trauma.
    • Opioid medicines- These pills may reduce pain to manageable levels when taken as directed.
    • Electrical stimulation- We use a small, handheld device to stimulate nerves through the skin to reduce pain.
  3. Advanced Pain Treatment-
    • Spinal Cord Stimulation – This technique uses electrical signals to mask the perception of pain traveling from the painful area to the brain. In place of pain, patients feel a mild tingling sensation called “paresthesia.” It may provide long-lasting pain relief and can be used with other therapies.
    • Surgery- Surgical treatments may range from minor outpatient procedures to brain and spinal procedures. Surgery may be needed when structural problems occur within the spinal column often caused by injury or disease.
    • Implantable drug pumps- Pumps deliver pain medication directly to the space surrounding the spinal cord. Direct application reduces the amount of opioids needed to relieve painful symptoms.
    • Neuroablation- Often used as a last resort when other therapies fail, Neuroablation is a surgical technique that destroys nerves and tissue, permanently blocking nerve signals to the brain.

 

Side effects

After have general anaesthesia you may have side effects like pneumonia, heart problems, and vomiting.

With high doses of local anaesthetic, the effect might spread to the rest of the body affecting heart and the brain.

With spinal anaesthesia some people suffer with headaches.

The risk factor depends on your age, type of anaesthesia, your general health, and how you respond to the medicines used. If you have a pre-existing heart or lung disorder, your chances of problems from anaesthesia may be higher.