Please click the listed treatments for more information and educational videos.

Intercostal Nerve Blocks

An intercostal nerve block is an injection of medication that helps relieve pain in the chest area caused by a herpes zoster infection (or “shingles”) or a surgical incision. Intercostal nerves are located under each rib. When one of these nerves or the tissue around it gets irritated or inflamed, it can cause pain. A steroid medication and local anesthetic injected under the rib can help reduce the inflammation and alleviate the pain. Intercostal nerve blocks also can be used to help diagnose the source of pain.

Splanchnic Nerve Block

A splanchnic nerve block is an injection of medication that helps relieve upper abdominal pain, commonly due to cancer or chronic pancreatitis. The splanchnic nerves are located on both sides of your spine. They carry pain information to your brain from organs in your abdomen. Blocking these nerves can help you stop feeling abdominal pain.

Botox Injections

BOTOX® (onabotulinumtoxinA) is a prescription medicine that is injected into muscles and indicated to prevent chronic headaches. Botox® has been approved for treating headaches that are present more than 15 days per month. It is used to prevent headaches in adults with chronic migraine, who have 15 or more days each month with headache lasting 4 or more hours each day, in people 18 or older.

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Trigger Point Injections

Trigger point injection (TPI) is used to treat extremely painful areas of muscle. Normal muscle contracts and relaxes when it is active.

 

A trigger point is a knot or tight, ropy band of muscle that forms when muscle fails to relax.

 

The knot often can be felt under the skin and may twitch involuntarily when touched (called a jump sign).

Kyphoplasty

Kyphoplasty is a minimally invasive surgery used to treat a spinal compression fracture. Spinal compression fractures occur primarily in spinal vertebrae that have been weakened by osteoporosis.

 

Compression fractures typically occur in the thoracic region of the spine, which includes the T1 through T12 vertebrae, but may also occur in the lumbar spine, or L1 through L5.

 

The goals of Kyphoplasty are to reduce pain from the fracture, stabilize the vertebra, and restore the vertebra back to its normal height.

Stellate Ganglion Block

A stellate ganglion block is an injection of local anesthetic in the sympathetic nerve tissue of the neck. These nerves are a part of the sympathetic nervous system.

 

The nerves are located on either side of the voice box, in the neck. A stellate ganglion block blocks the sympathetic nerves that go to the arms, and, to some degree, the sympathetic nerves that go to the face. This may in turn reduce pain, swelling, color and sweating changes in the upper extremity and may improve mobility.

 

It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome and Herpes Zoster (shingles) involving an arm or the head and face.

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Lumbar Sympathetic Nerve Block

A lumbar sympathetic block is an injection of local anesthetic into or around the sympathetic nerves. These sympathetic nerves are a part of the sympathetic nervous system. The nerves are located on the either side of spine, in the lower back. Normally these nerves control basic functions like regulating blood flow. In certain conditions, these sympathetic nerves can carry pain information from the peripheral tissues back to the spinal cord.

Occipital Nerve Block

An occipital nerve block is an injection of a steroid or other medication around the greater and lesser occipital nerves that are located on the back of the head just above the neck area.

Intrathecal Pump Implantation and Management

An intrathecal pain pump implantation, or targeted drug delivery, is used to relieve chronic pain. The intrathecal pain pump implantation delivers small amounts of medication directly to the intrathecal space (area surrounding the spinal cord) to prevent pain signals from being perceived by the brain. Because the medication is delivered directly to where pain signals travel, intrathecal drug delivery offers many people dramatic pain management, with a dose smaller than would be required with oral medication. This results in fewer side effects associated with oral medication, such as sleepiness, upset stomach, vomiting and constipation. A trial will be done first to determine if intrathecal pump implantation would work for your pain management. If you achieve a good level of pain relief (50 percent or greater) you may be a candidate for a permanent pump.

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Spinal Cord Stimulation

A spinal cord stimulator (SCS), also known as a dorsal column stimulator, is a device surgically placed under your skin to send a mild electric current to your spinal cord (Fig. 1). A small wire carries the current from a pulse generator to the nerve fibers of the spinal cord.

 

When turned on, the stimulation feels like a mild tingling in the area where pain is felt. Your pain is reduced because the electrical current interrupts the pain signal from reaching your brain.

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Platelet Rich Plasmapheresis (PRP)

Plasma Rich Plasmapheresis is a Regenerative Injection Therapy utilizes your body’s own bioactive proteins, also know as growth factors, to replace, repair and regenerate tissue. Platelet Rich Plasma is used to deliver the growth factors directly to the pain-initiating site. This is accomplished at the Pain & Healing Institute by taking a small volume of the patient’s own blood which is then concentrated by proprietary methods to collect a smaller sample that caries all the regenerative factors and platelets. Platelets are some of the first cells to typically go to an area that is damaged in the body to help with regeneration and clotting. These cells are rich in the nutrients and growth factors your body uses to heal it self. By injecting this in tissues that need powerful healing, we can dramatically enhance the body’s natural healing process. PRP has been used for over 20 years in numerous surgical fields to enhance bone grafting, accelerate wound healing and reduce the risk of infection after surgery. In recent years physicians have begun injecting PRP to treat chronic pain. Tennis elbow, plantar fasciitis, Achilles tendonitis, rotator cuff tears, meniscal tears, osteoarthritis and chronic low back and neck pain are all being treated with the injection of PRP with the goal of regenerating degenerated connective tissue.

Shoulder Joint Injections

Shoulder injections are used for diagnostic, as well as therapeutic purposes. The common substances injected include corticosteroids. Corticosteroids are strong anti-inflammatory medications reducing swelling and inflammation. These are often used in conjunction with physiotherapy rehabilitation and other medications for a more lasting cure of many conditions, such as subacromial impingement syndrome, AC joint pathology and inflammatory arthritides.

Lumbar Facet Rhizotomy (Neurotomy)

Lumbar radiofrequency neurotomy (facet rhizotomy) is used to treat nerve pain that originates in the spine joints of the lower back.  Lumbar radiofrequency neurotomy is useful for people that experienced relief following nerve blocks to the area.  The procedure “turns off” the specific nerve that carries information about pain.  The treatment provides pain relief for about a year, but can last much longer for some people.

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