In addition to minimally invasive surgery options, Miami Neurological Institute offers treatments that offer relief for chronic and acute pain. Common pain conditions include:

Pain Management Conditions

• Cancer Pain
• Carpal Tunnel Syndrome
• Cervical Post Laminectomy Syndrome
• Cervical Radiculopathy
• Chronic Pain Syndrome
• Degenerative Disc Disease
• Diabetic Neuropathy
• Facet Syndrome
• Fibromyalgia
• Lower Back Pain
• Lumbar Radiculopathy
• Lumbar Post Laminectomy Syndrome/Failed Back
• Meralgia Paresthetica
• Multiple Sclerosis
• Neck Pain
• Neuropathy
• Osteoarthritis
• Pinched Nerves
• Post-Thoracotomy Pain
• Reflex Symp. Dystrophy (CRPS I and II)
• Sacroiliac Joint Degeneration and Dysfunction II
• Sciatica
• Scoliosis
• Spasticity
• Spinal Cord Injury
• Spinal Stenosis
• Thoracic Radiculopathy
• Vascular Insufficiency
• Vertebral Body Fractures

Pain Management Treatments

Epidural Steroid Injections

An epidural steroid injection is a treatment option for sciatica and low - and mid-back, neck and leg pain. These painful conditions cause inflammation, which may in turn cause significant nerve root irritation and swelling. Steroids inhibit the inflammatory response and reduce pain.

An epidural steroid injection is often used on conjunction with a customized physical therapy program for longer-term relief. In fact, an injection may provide sufficient pain relief to allow a patient to progress with the stretching and exercise portions of the physical therapy program.

One injection may provide pain relief for one week up to one year, and patients may have up to three injections in a one-year period.

Intra-articular Injections

Osteoarthritis is a joint disease that occurs when there is a loss or damage to the cartilage that normally acts as a cushion between bones. This lack of cushion and inflammation cause pain. While osteoarthritis can affect any joint in the body, the most common affected areas are the knees, hands, hips, feet and spine.

While no cure exists, treatments are available to relieve pain, including intra-articular injections. This treatment involves the injection of a pain medication, such as cortisone, into a joint space to reduce the inflammation that is causing the pain.

Radiofrequency Ablation

Radiofrequency ablation (RFA) is a safe and effective non-surgical procedure that is used to reduce chronic low back and neck pain as well as joint pain from osteoarthritis. During and RFA procedure, an electrical current produced by a radio wave is used to heat up a small area of nerve tissue, which decreases pain signals from that specific area. Patients are awake during the procedure but may have an IV line placed and/or a local anesthetic and sedative. This reduces any discomfort during the procedure.

Depending on the cause and location of the pain, relief may last from six to 12 months.

Spinal Cord Stimulation

A spinal cord stimulator (SCS) is a safe and effective pain solution that has been in use for more than 30 years. The stimulator - which is implanted in the patient's lower back or buttocks - is small, light and more portable. Patients can control their pain via remote control and recharge the unit while on-the-go, and new technology has also made it easier for doctors to implant.

Pain is an electrical signal that travels along nerve fibers through the spinal cord to the brain. An SCS masks these pain signals by delivering doses of electricity to change the pain signal into something the brain interprets as a pleasant sensation called "paresthesia." People describe paresthesia as feeling like a gentle tingling or massage.

Patients use the implanted SCS 24 hours a day, seven days a week and recharge it remotely approximately every four days. The SCS comes with a remote control that allows a patient to regulate the power, depending on his or her current pain level. The procedure is reversible, which means that even though it is surgically implanted, the device can always be removed by a doctor.

Medial Branch Blocks

Medial branch nerves are small nerve branches that control sensation to the facet joint, which is part of the spine. A medial branch block is an injection of local anesthetic - with or without steroid - outside the joint space near the medial branch nerve. Depending on how many joints are involved, the procedure may require multiple injections.

The procedure is usually done in a procedure room with the patient lying on his or her stomach. An intravenous (IV) may be administered, and the skin is numbed with a local anesthetic. Using x-ray guidance, the doctor places needles in the joints or the medial branch. Once the needles are in the proper location, local anesthetic (with or without steroid) is injected through the needles, and the needles are removed.

Many patients benefit from lasting pain relief from these injections, and the block may be repeated as necessary.

Neurolysis

Neurolysis, which is also referred to as radiofrequency (RF) neuroloysis, uses heat to destroy selected nerve fibers. Basically, this prevents the neural transmission of pain from a specific nerve system; eliminates pain; and reduces the likelihood of recurrence. RF neurolosys is used when injections or blocks are no longer effective for pain relief for conditions such as neck and back pain caused by facet joint syndrome and brachial plexus injuries.

Sympathetic blocks

The sympathetic nervous system is a group of nerves called the sympathetic nerve tissue, which are located on both sides of the lower spine. These nerves can carry pain information from the peripheral tissues back to the spinal cord, resulting in discomfort and reduced mobility. A lumbar sympathetic block is an injection of local anesthetic, which may reduce lower back pain, swelling, improve mobility, and/or aid in pain relief associated with neuropathy and peripheral vascular disease.

Patients may be given a sedative intravenously but remain awake during the approximate 30-minute procedure. The skin and tissue are numbed with a local anesthetic before the physician inserts the anesthetic with a needle to the sympathetic nerves. Multiple injections may be recommended for optimum effectiveness, but response varies depending on the severity and stage of the condition causing the pain.

Medication Management

A patient who suffers from chronic or acute pain is not alone. Millions of Americans suffer from chronic pain, and fortunately, there are many options for controlling pain and helping people maintain quality of life.

There are many prescription, over-the-counter, and alternative medications to control both chronic and acute pain. It is important for a patient to consult with his or her physician to figure out which medications - alone or combined - are safe, have minimal side effects, and provide a livable level of pain relief.

Often, medication management combined with physical therapy and healthy lifestyle choices offers solid pain management for those whose pain has diminished quality of life.