Pinpoint Pain Relief: Injections for Acute and Chronic Pain

Minimally invasive procedures including injection therapies are a safe and effective alternative to surgery and medication. Learn more about these treatments for common spine, nerve and joint conditions.

The U.S. Centers for Disease Control (CDC) reports pain is the leading reason Americans access the health care system. With more than 50 million Americans living with acute and chronic pain, it’s important to explore treatment options available including minimally-invasive injection therapy.

Many people suffering with common spine, nerve or joint conditions are often seeking alternatives to surgery or medication. The double board-certified specialists at Tennessee Valley Pain Consultants utilize minimally invasive techniques and injection therapies to target specific pain conditions – helping people avoid surgery and medications. Injection therapies range from diagnostic to therapeutic and are performed under x-ray guidance – with little to no recovery time.

“If a procedure is successful, we can pinpoint and treat the pain—the hope is to get months of pain relief from these procedures which are performed in an outpatient setting,” says Dr. Clayton Newell, anesthesiology and pain management physician with Tennessee Valley Pain Consultants. “Patients typically return home within a few hours.”

It’s important for patients to educate themselves on options available for their conditions. Below is a breakdown of the most common injection therapies offered for spine, nerve and joint conditions and how they can alleviate pain without surgical intervention.

Epidural Steroid Injections (ESIs), Medial Branch Blocks, and Facet Injections:

Back pain is the most commonly cited pain in adults and can result from injury or the degenerative spine process of aging. A slipped vertebrae or herniated (bulging) disc in the spine can create pressure on nerves causing numbness and tingling down the legs or arms. This type of burning pain can also be a result of neuropathic pain (including diabetic neuropathy), scar tissue from surgery, or arthritis. “Most spinal conditions can be treated non-surgically,” adds Dr. Newell.  Epidural Steroid Injections can alleviate this particular pain. During the procedure, a physician inserts steroid into the specific dermatome causing the pain. Medial branch blocks are a similar option but target the pain-generating nerve at a different angle. Facet blocks are performed where two vertebrae connect together to abate burning pain.

Selective and Sympathetic Blocks, Celiac Plexus Blocks, and Stellate Ganglion Blocks

Other injections also offer pain relief by targeting different pathways in your body. A selective block is a way to specifically pinpoint the nerve root causing your pain – down to the side of one specific vertebrae. Sympathetic blocks are able to treat a larger area than selective blocks and are often helpful for patients with lumbar neuropathy or pain in a particular region. Specifically, a celiac plexus block is a type of sympathetic block for pain in the upper abdominals or pancreas, whereas a stellate ganglion block treats pain from the neck or shoulder down the arm.

Sacroiliac Joint Injections

The sacroiliac (SI) joint is where the pelvis meets the tailbone. Typically, a steroid is injected into the area to provide a window of pain relief. A diagnostic SI joint injection can also be performed to lead to ablation for longer-term pain relief, especially if a patient has another condition where receiving steroids could be harmful, such as diabetes.

Radiofrequency Ablation and Spinal Cord Stimulation

Radiofrequency ablation and spinal cord stimulation offer more long-term relief and is a steroid-free solution for chronic pain management. Radiofrequency ablation often begins with a diagnostic medial branch block to find the affected nerve in the spine. If the medial branch block is effective, radiofrequency ablation is performed. Ablation is performed with a specific type of needle attached to a probe to ablate or “burn” the painful nerve. This stops the problematic nerve from transmitting pain signals to the brain. According to Dr. Newell, “If the patient gets short-term relief (above 80%) from a medial branch block, a radiofrequency ablation may be performed for an average of 6-12 months’ worth of relief, depending on how fast the nerve regenerates.”

Spinal cord stimulation (SCS) is another option for longer term relief. With SCS, patients receive a 7-day trial prior to permanently placing the device. If a patient experiences adequate pain relief, a permanent device will be implanted. This stimulator sends electrical pulses to stop pain transmission from the spine to the brain – much like a cardiac pacemaker but for the spine to stop pain at its source. Spinal cord stimulation is an option that can be utilized to control many different types of chronic pain, and is often used for neuropathic pain, post-surgical pain, and arachnoiditis.

“The great thing about spinal cord stimulation is it’s one of the few things we have that you can try before you buy…it can change certain patients’ lives,” states Dr. Newell.

One or a combination of injections may be recommended as a long-term treatment plan to adequately control pain. While Tennessee Valley Pain Consultants are able to prescribe medications, pain can often times be controlled with the proper rotation of injections. Since not all pain is a like, it is important to find a provider who will create a custom treatment plan for each patient.

“Pain is often hard to quantify, but we do our best to tailor our treatments to the patient providing the most benefit in the long run,” says Dr. Newell. At your first appointment with Tennessee Valley Pain Consultants, your skilled physician will partner with you to help create a multimodal approach to your specific pain that aligns with your goals to enhance your quality of life.

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This post was written by Tennessee Valley Pain Consultants