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Pain Medicine Treatments

Pain management physicians at the University of Chicago Medicine use a multimodal, multidisciplinary and comprehensive approach to treatment. Whether a patient is suffering from a common pain condition or is experiencing severe or complex pain, our experts work together collaboratively to find the best solution for each patient. This includes investigating uncommon treatment options for patients with extreme conditions whose pain was not relieved with traditional methods. We are committed to creating the appropriate treatment strategy to match our patients' individual condition.

Common Treatment Options

Botox injections
Celiac plexus block
Discography
Epidural scar tissue lysis
Epidural steroid injections
Facet joint injections
Intravenous infusions
Joint injections
Kyphoplasty
Minimally invasive lumbar decompressions (MILD)
Peripheral nerve blocks
Radiofrequency treatments
Selective nerve root blocks
Spinal cord stimulation
Spinal medication infusions
Sympathetic nerve blocks
Trigger point injections

Botox injections

Known for its ability to smooth wrinkles, injections of Botox® (a brand name drug that contains botulinum toxin) may also reduce muscle pain. The medication works by blocking nerve impulses to the muscles in the injected area. As a result, the muscles relax and spasms decrease, reducing pain and increasing range of motion. In addition, botox has been proven more effective in treating refractory migraines than conventional treatments.

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Celiac plexus block

Medication is injected to relieve abdominal pain originating from the upper abdominal organs (pancreas, stomach and liver) by blocking pain signals from the celiac plexus nerves. This typically reduces pain associated with abdominal cancer or chronic pancreatitis.

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Discography

Spinal discography is performed to diagnose conditions of the spinal discs. During the procedure, the physician injects contrast dye into healthy and diseased discs to pinpoint pain and determine if any discs have tears or other disruptions. Spinal discography can aid physicians in diagnosing herniated, bulging or torn discs, and degenerative disc disease as well as determine an appropriate course of treatment.

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Epidural scar tissue lysis

When scar tissue restricts the normal movement of nerves, an individual can experience persistent pain. Epidural scar tissue lysis is a procedure designed to remove excess scar tissue in the epidural space (the area between the inside of the spine and the protective layer around the spinal cord). Using a fluoroscope to visualize the affected area, the physician injects a medication that disperses the scar tissue and applies steroids to decrease inflammation and boost pain relief.

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Epidural steroid injections

An epidural steroid injection (ESI) may be performed to relieve neck, back, arm and leg pain caused by spinal stenosis (a narrowing of the spinal column), spondylolysis (stress fractures), disc herniation or other conditions. During this minimally invasive procedure, medication is injected into the spinal nerve through the epidural space (the area between the protective covering of the spinal cord and vertebrae). While the effects of an epidural steroid injection are temporary -- lasting anywhere from several days to several years -- the goal is to help patients resume their daily routine and begin a physical therapy program, if recommended.

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Facet joint injections

Facet joints are small joints, located at each segment of the spine, that provide stability and enable the vertebrae to bend and twist. Degeneration of these lubricated connections can occur from everyday wear and tear, arthritis of the spine, a back injury or other stress to the back, and can cause pain in the spinal cord. Injection of a steroid medication into the cervical (neck), thoracic (upper back) or lumbar (lower back) region anesthetizes the facet joints and blocks the pain. Pain relief from this procedure is intended to help a patient better tolerate physical therapy during rehabilitation for a back condition or injury.

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Intravenous infusions

During an infusion, anesthetic medication is delivered intravenously through the arm or hand via a needle or catheter and will be infused for up to several hours. There are a variety of medications that can be used for infusions, and physicians might use several in combination to achieve the best result. Infusion offers an alternative treatment option to oral medication and is often used for patients with chronic pain, including neuropathic pain, cancer pain, arthritis, gastrointestinal disorders and more.

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Joint injections

During a joint injection, the physician injects a steroid medication into the affected area to reduce swelling and inflammation of joint tissues. The goal is to reduce irritation and alleviate joint pain. Our physicians use ultrasound or x-ray to perform the injections for maximal benefit of our patients.

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Kyphoplasty

When patients suffer from vertebra compression factures or compress of the vertebra, physicians can perform kyphoplasty. During this procedure our physicians insert a needle into the vertebra and places an inflatable balloon-like device. As the balloon inflates, it creates space in the vertebra that can then be filled with bone cement. This releases compression and stabilizes vertebra. The pain relief after this procedure is very effective. Our physicians perform this procedure for osteoporosis and cancer related vertebral (spine) fractures

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Minimally invasive lumbar decompression (MILD)

Minimally Invasive Lumbar Decompression (MILD) is performed to treat lumbar spinal stenosis (LSS). LSS is a condition in which the spinal canal narrows and compresses the spinal cord nerves in the lower back. This narrowing may be caused by thickened ligament tissue, formation of excess bone or bulging of the discs. Symptoms can include pain or numbness in the buttocks, leg and lower back. During the MILD procedure, the small pieces of bone and excess tissue that cause the narrowing of the spinal cord are removed. The procedure is done in an outpatient ambulatory setting using minimal sedation.

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Peripheral nerve block

A peripheral nerve block is used for the diagnosis and treatment of nerve pain, which is sometimes the result of nerve damage. The procedure involves injecting a local anesthetic and sometimes an anti-inflammatory steroid, targeted around a specific nerve. Disrupting painful nerve impulses can result in various degrees of symptom relief. If a patient attains limited relief after the first block, the physician may recommend a series of blocks, which may result in sustained relief.

Radiofrequency treatments

During a radiofrequency neurotomy, radio waves are sent to interrupt pain signals between the brain and the affected nerve. A physician delivers heat-generated waves, using image-guided technology to directly target and block the nerve. More than 75 percent of patients with facet or joint pain (such as knee, shoulder or hip pain) experience relief, lasting between 3 and 18 months, after the treatment.

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Selective nerve root blocks

If a nerve root becomes compressed, it may cause inflammation and pain. When an imaging study does not clearly show which nerve is responsible for the pain, the selective nerve root block (SNRB) procedure may be used to identify the source. In addition to this diagnostic function, a selective nerve root block can provide therapeutic relief of low back pain and/or leg pain, and also can treat far lateral disc herniation (a disc that ruptures outside the spinal canal).

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Spinal cord simulations

If a patient has chronic leg or arm pain, and has not found relief through conventional therapies, then spinal cord stimulation may be an option. The procedure involves sending low voltage electrical signals from an implanted battery-powered generator to nerves in the spinal cord in order to interrupt pain signals. After spinal cord stimulation, patients usually experience a comfortable, tingling sensation instead of pain.

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Spinal medication infusion

The spinal infusion pump (also known as a morphine pump or an intrathecal infusion pump), delivers concentrated amounts of medication into the spinal fluid space via a small catheter. The purpose of this procedure is to continuously saturate pain receptors with medication, thus adequately alleviating the patient’s pain.

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Sympathetic nerve block

The sympathetic nerve block procedure is used to establish if there is damage to the sympathetic nerve chain, a set of nerves that extends the length of the spinal cord. Using image guidance, the physician inserts a needle into the lumbar (lower) or thoracic (upper) area of the back and injects an anesthetic medication into the targeted area. While it is primarily done for diagnostic purposes, the procedure may bring long-term pain relief to the damaged area.

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Trigger point injections

Trigger points -- also known as muscle knots -- are distinct spots located in a taut bundle of fibers within the skeletal muscles. These points can cause localized pain and often are associated with musculoskeletal conditions. A trigger point injection (TPI) aims to alleviate pain through a shot of a corticosteroid that inactivates the trigger point. The physician may inject multiple sites in one office visit. One treatment session usually brings sustained relief.

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