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Chronic Pain is pain that persists beyond the time of normal healing. It may occur without an initiating event or injury. It may become a disease itself, if left untreated.

Pain can affect a person physically, psychologically, and emotionally. It can lead to isolation and even disability. Success in dealing with chronic pain does not always involve completely eliminating it. Our goal is to eliminate pain or to reduce pain and disability to manageable levels. We provide a variety of treatment modalities and education to manage any remaining pain.

Treatments Offered
We offer a progressive program specifically designed to alleviate pain. We strive for maximum results with minimum treatment time. To do this, we explore a spectrum of treatment options — conservative medical therapies to the most advanced interventional techniques.

Your treatment plan will be personalized according to your diagnosis and health needs.

We work closely with your physician and your health care professionals.

Understanding Anatomy
Learn more about your back anatomy. That way, you can understand how an injection can help relieve or locate your pain.
      

Vertebrae
Vertebrae are the bones that stack up to form the spine.
Disks
Disks are "cushions" that provide padding between the vertebrae. A damaged disk can lead to inflammation and pain.

Nerve Root
A nerve root is the part of a nerve that leaves the spinal canal. Inflamed nerve roots can lead to back pain.
Sciatic Nerve
The sciatic nerve is a nerve that extends down to the leg. When its nerve roots are inflamed, buttock and leg pain often result.

  


 

PROCEDURES (most common)
Trigger point injections - A trigger point is a tight, painful "knot" of muscle fiber. It can form where a muscle is strained or injured. A trigger point is very tender to the touch. Any muscle in the body can have one or more trigger points. Several injections may be needed in each trigger point to best relieve pain. Injecting a trigger point can help relax the affected muscle and relieve the pain. These injections may be given in sessions 1 to 2 weeks apart. In some cases, you may not feel much change in your symptoms until after the third injection. Stretching exercises or physical therapy or chiropractic care will be recommended as part of the treatment plan.

Epidural steroid injections - An epidural steroid injection is a conservative treatment for spinal disease. A potent, anti-inflammatory medication is deposited into the epidural space in your back or neck around inflamed nerves. Usually a series of 3 injections is most effective and they will be scheduled about a week apart. This procedure can help relieve back or neck pain by reducing inflammation. An injection also can help your doctor diagnose the source of your pain. An epidural injection won't stop all the pain but it can reduce pain and break the pain cycle.

Spinal Cord stimulation - Neurostimulation uses a system, like a pacemaker, that is surgically placed under the skin. It sends mild electrical impulses to the epidural space near the spinal cord. The electrical impulses are delivered through a lead (a medical wire) that is also surgically placed. These tiny electrical impulses block the pain signal from reaching the brain. Testimonials

Because neurostimulation works in the area where the pain signals travel, mild electrical impulses (which are felt as tingling) can be directed to specific sites where you are feeling pain. Neurostimulation may give effective pain relief and may decrease the need for medications.

This therapy does not work by causing permanent changes to the spine or nerves. The surgery to place the implant is reversible and minimally invasive. Typically patients who have success with neurostimulation experience a 50 percent or greater reduction in their pain and improved ability to perform daily activities.

Radiofrequency ablation - This is a non-surgical, outpatient treatment to help alleviate pain and improve quality of life. A diagnostic injection will be done prior to the ablation to target the source of pain. Radiofrequency energy is used to heat up targeted nerve tissue and interrupt pain signals. A needle is placed through the skin and guided into place using x-ray. An electrode is inserted into the needle to deliver the radiofrequency energy to the area that is causing pain. Radio waves produce an electrical current that heats the small area of nerve tissue around the tip of the needle which in turn interrupts pain signals.

Vertebroplasty - The leading cause of vertebral body fractures is osteoporosis. Osteoporosis is a condition where the bone becomes thin and weak. Osteoporosis accounts for 700,000 vertebral fractures each year. The loss of bone and minerals causes the bone to become weak and sometimes a simple cough, sneeze, or sudden movement can cause a vertebral fracture. Vertebroplasty is a minimally invasive procedure and has been proven to reduce the chronic pain associated with a fracture. During the procedure a needle is inserted through the skin into the painful vertebral body. Bone cement is then injected into the vertebral body to stabilize the fracture. This procedure is done under x-ray. This procedure usually takes less than an hour and may go home shortly after it is completed. Mild sedation is used along with a local anesthetic at the site of the fracture. Most patients experience immediate pain relief within minutes to hours.

PROCEDURES (other)
Facet joint injections (Selective somatic nerve blocks)
Intrathecal drug delivery
Lumbar sympathetic blocks
Stellate ganglion blocks
Sympathetic nerve blocks

 
A - Cervical vertebrae are the seven bones of the upper spine.

B - Disks are cushions between the vertebrae. They Absorb the shock of movement.

C - Facets are the joints between the vertebrae.

D - Ligaments connect the vertebrae.

E - Muscles support the spine and move the head.

F - Foramina are openings between the vertebrae where nerves exit the spine.

G - Nerves branch from the spinal cord to the arms.

In addition, Dr. Smith continues to expand his knowledge and expertise with promising new procedures and drug therapies for pain management.

 
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