Interventional Pain Management: A discipline of medicine devoted to the diagnosis and treatment of pain disorders.
Interventional Pain Management can be an excellent alternative for patients who have not found relief from other treatment methods. These procedures may be the solution for patients suffering from post-traumatic pain. Dr. Fernandez offers a wide array of treatments as part of a multimodal care plan in our state of the art facility:
What is Interventional Pain Management?
The phrase, “Interventional pain management includes the diagnosis and treatment of pain and related disorders by applying techniques that directly interact with the structures mediating the pain.
Interventional pain management is different from regular pain management in that it incorporates “combination therapy”. This means that each patient will be treated according to their condition and situation and will not just be treated with a prescription. Interventions are used to attack the pain at the site and really figure out what is causing the pain. An intervention may be anything from therapy, to injections, to surgery.
What is an epidural?
Used to treat lower back pain, an epidural is an injection of steroids and an anesthetic that is inserted into the epidural space. (omit of the spine) Given by an anesthesiologist or by a trained interventional spine care physician, epidurals can be administered in the office, surgery center or a hospital setting.
To place an epidural, your neck or back will be numbed with medication and a separate probe will be placed deeper into the spine to reach a specific targeted location where the medication can reach the nerves. Once in position, a syringe will be attached and medication will be administered into the space to help control pain. The probe is then removed, and you should be able to return home soon afterward.
Your doctor may do more than one epidural over the course of time using different doses of medication until she finds one that relieves your symptoms most effectively. This treatment can help control pain and potentially avoid the need for surgical intervention.
What are trigger point injections?
Trigger point injections are injections to the muscle belly. Injections are aimed at taut bands or areas of spasm within the muscle belly. Taut bands can be painful and may be the underlying cause of pain generation or the body’s protective mechanism when there is an injury deep to the muscle. Trigger point injections are diagnostic and therapeutic. If there is significant relief after trigger point injections, certainly one can consider that the muscle spasm is the pain generator. The injection consists of anesthetic as well as anti-inflammatory medication. If the relief does not last than an underlying pain generator must be identified.
What are facet injections?
A facet injection is a minimally invasive procedure used to temporarily relieve neck or back pain triggered by injury and inflammation of the facet joints. Facet joint pain causes include injury due to high impact. Used as a diagnostic tool to see if the pain is coming from your facet joints, facet injections can also be used as a treatment to relieve inflammation and pain caused by various spine conditions. If the effects of facet injections turn out to be only temporary for you, your doctor may recommend a more permanent solution with radiofrequency ablation.
What is a facet rhizotomy or radiofrequency ablation?
Facet Rhizotomy or Ablation is a long acting facet block done with radiofrequency waves to inactivate a painful nerve. This procedure is indicated for patient’s with more severe injuries, that have initial relief from a facet block, but not prolonged relief.
What is an occipital nerve block?
The occipital nerve is located in the back of the neck at the junction of the head. Impact to the back of the head such as happens during an accident when the head hits the headrest, can cause occipital headaches. This can subsequently produce symptoms radiating to the top of the head as well as in back of the eyes. Occipital blocks are a type of peripheral nerve block that can be diagnostic and therapeutic for occipital neuralgia/occipital headaches.
What is a cement fixation of the vertebrae?
Kyphoplasty/Vertebroplasty is a minimally invasive technique that relieves back pain caused by traumatic vertebral fractures. Causes include trauma such as a fall or motor vehicle accident. Osteoporosis makes it more likely that an impact will cause a vertebral compression fracture. The aim of cement fixation is to relieve pain, stabilize the fracture and prevent worsening of the condition.
Dr. Fernandez recommends cement fixation for severe pain and deformity that is not relieved by initial non-surgical treatment modes including rest, pain medications, and braces in order to decrease pain and improve function.
What are spinal cord stimulator implants?
Epidural stimulation allows the body to use its natural nerve pathways to control pain. It is believed that by sending an electrical impulse to the nerves, the impulse will block the brain’s ability to process pain. Working a bit like a distraction technique, the body focuses on the impulses sent out by the unit instead of the pain.
This procedure can be very beneficial if you have had a previous back surgery with no relief if you’ve had long- term pain that doesn’t have a specific diagnosis. Similar pain control measures have been used in the past by placing electrodes on the outside of the body (known as a TENS unit) onto the skin and sending impulses through the muscle. The stimulator is first placed externally as a trial in the office under local anesthesia. If the patient finds it to be helpful, then it is permanently placed.
Epidural stimulators are placed internally through a probe in the back in a fashion similar to the administration of an epidural. The stimulator is passed down the tube of the epidural into the spine under intravenous sedation and the device’s generator is deposited under the skin.
I’ve been to pain management before, it didn’t help. How is Dr. Vania E. Fernandez different?
Dr. Fernandez is a Medical Doctor who is Double Board Certified in both Anesthesiology and Pain Management from the American Board of Anesthesiology. She also has additional Fellowship training in Interventional Pain Management. This means she has extensive training dealing with the nerves, discs, and joints in the neck and back as well as throughout the entire body. Her entire career has been focused on the cause and treatment of pain. She and her staff take special care to treat patients with compassion on an individual basis with a multimodal approach catered to their specific condition.