TREATMENTS

Our procedures are successful in rehabilitating patients suffering from pain. Patients often come to our office with very high levels of pain, feeling discouraged and even hopeless. After the initial evaluation and treatment, most patients leave with a refreshed sense of hope. The key to the success of Flint Hills Pain Management is the quality professionalism and almost immediate results produced by our pain treatment systems. We tailor our pain management techniques to each individual patient's needs by accurately diagnosing their condition. There is no one-size-fits-all treatment. We focus on recommending the exact type of professional pain treatment that will provide the most accurate pain relief.

At Flint Hills Pain Management, you receive the specialized care required for your recovery. That's what we're all about: results that give you back the quality of life you always enjoyed. We want to welcome you to a facility that has a caring group of providers and staff who truly understand your pain and are well equipped to bring you the level of care that you deserve.

For more information about Flint Hills Pain Management call (785) 320-7576

Interventional Pain Management: A Comprehensive Approach to Chronic Pain

For chronic pain sufferers, finding relief from their pain can be difficult and time-consuming. Often, patients are shuffled back and forth between primary care physicians, specialists, and therapists in search of a solution to their pain. Interventional Pain Management can be a useful alternative for patients who have exhausted other treatment methods without success. Read on to find out more about this emerging area of medicine.

What is Interventional Pain Management?
According to the American Society of Interventional Pain Physicians (ASIPP), interventional pain management is a, "discipline of medicine devoted to the diagnosis and treatment of pain related disorders." Interventional pain medicine utilizes a multidisciplinary approach, in which a team of health care professionals works together to provide a full range of treatments and services for patients suffering from chronic and/or acute pain.

The goals of interventional pain management are to relieve, reduce, or manage pain and improve a patient's overall quality of life through minimally invasive techniques specifically designed to diagnose and treat painful conditions. Interventional pain management also strives to help patients return to their everyday activities quickly and without heavy reliance on medications.

Medical Collaboration
Our office will work with your primary care physician (or another physician who may refer you to an interventional pain management provider).

Another important member of the team is you! In fact, interventional pain management emphasizes and relies on the full cooperation of patients throughout the treatment process for a successful outcome to be achieved.

Back Pain and Interventional Pain Management Treatments

For back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management providers have a wide array of treatments that can be used including the following:

Epidural injections (in all areas of the spine): the use of anesthetic and steroid medications injected into the epidural space to relieve pain or diagnose a specific condition.
 

Nerve, root, and medial branch blocks: injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.
 

Facet joint injections: an injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief.

Interventional pain management providers often encourage other treatments such as physical therapy, occupational therapy, and lifestyle modification (such as exercise, diet, and smoking cessation) to further enhance these procedures.

What Can You Expect?
At your first appointment with an Interventional Pain Management specialist, you will be given a thorough physical exam. The provider will also talk to you about your past medical history. Please bring with you any past MRIs, CTs, or x-rays related to your pain condition.

It is also important for you to inform the provider about other treatments you have tried, including medications that you are currently taking. Be sure to include alternative therapies you may have tried such as acupuncture, herbal remedies, chiropractic, or massage. Your present condition will be discussed, including where your pain is located, the severity, occurrence, and other symptoms related to your pain.

Before any treatments are started, your interventional pain management provider will review diagnostic tests to rule out other conditions that may present similar symptoms. These tests may include x-rays, CT scan, MRI, and possibly blood tests. Psychological evaluations may also be done at this time. The provider may recommend additional studies (no need to if the studies are current and appropriate) and review past studies.
The study of these tests enables your interventional pain management specialist to design a comprehensive pain program specifically for you.

Once the treatment plan has been determined, your interventional pain management provider will help you to coordinate the treatments you need. Be sure to follow your provider’s instructions carefully. Your full participation in your treatment is important for a successful outcome.

You Are Not Alone
If you are suffering from chronic pain and have not been able to find treatment that provides relief, consider seeing an Interventional Pain Management provider. The comprehensive approach, with you as an important team member, may well be the answer you are looking for.

Works Cited

Thomas, Santosh A., and Mary Claire Walsh. "Interventional Pain Management: A Comprehensive Approach to Chronic Pain." Back Pain, Neck Pain, Sciatica - Symptoms Exercises Treatments Causes. N.p., n.d.

Caudal Steroid Treatment

Patients suffering from sciatica, herniated or bulging discs, or spinal stenosis often find relief from steroid injections. In this procedure, both a steroid and a local anesthetic are injected into either the epidural space or the joint spaces in the spine. The precisely delivered medication reduces inflammation of the nerve roots and relieves pain, allowing the body to heal.

Procedure: During the procedure, you will be instructed to lay face-down on a procedure table. Your provider will numb your skin with a local anesthetic. Once your skin and the surrounding tissues are numb, the injection is performed. The needle guides a tiny catheter to the area which delivers the medication. After the needle and catheter are removed, you will need only a small bandage to protect the puncture wound as it heals. Most patients are able to go home immediately.

Providers perform epidural injections with the aid of x-ray fluoroscopy. The x-ray guides the provider in proper placement of the needle to ensure maximum safety and effectiveness. The procedure is performed on an outpatient basis and is considered a safer alternative to surgery and heavy medication. Patients report that this procedure is brief and relatively comfortable.

Benefits: The main benefit of this procedure is that most patients find that their pain is reduced immediately. In most cases, a series of injections will be performed over a period of time set by your provider. Doing multiple injections ensures that you receive maximum relief. Another benefit is the ability to avoid surgery and cut down or eliminate use of heavy medications. The procedure is especially effective for patients suffering from low back pain, leg pain, numbness, and/or tingling.

Celiac Plexus Block

The celiac plexus is a bundle of nerves in the abdomen that sends pain signals to your brain from a variety of abdominal organs. Blocking these nerves from sending pain signals may be an appropriate way to manage pain originating from many of these organs. This type of block is commonly used to treat pain caused by cancers of the abdomen, especially pancreatic cancer, as well as other abdominal disorders such as chronic pancreatitis.

Procedure: Although the celiac plexus is in your abdomen, which we think of as being in the front of the body, the best way to reach it for the purposes of the block is through the back. For the procedure, you will be asked to lie on your stomach on a procedure table. Once your skin and the surrounding tissues are numbed with a local anesthetic, the injection is performed. Your provider will insert a long, thin needle into the proper area. This part of the procedure may be uncomfortable.. After the needle is removed, you will need only a small bandage to protect the puncture wound as it heals. The entire procedure generally takes around thirty minutes, and most patients are able to go home immediately and return to their normal activities the next day.

Benefit: For most patients, relief from pain is immediate but may not be complete. It may take a series of several injections to obtain maximum relief. Patient response to the procedure varies a great deal, with some patients reporting extensive pain relief for a very long time, while others need numerous repeated injections to achieve relief. The main benefit is that most patients are able to cut down or eliminate use of heavy medications, increasing their quality of life as side-effects from pain medication are avoided.

Cervical Steroid Treatment

Patients suffering from neck-related pain conditions may find relief from cervical epidural steroid injections (CESIs). These injections are specifically designed to treat conditions caused by irritation of the spine and nerve roots located in the neck. These nerves can become irritated as the result of many spinal conditions, including spinal stenosis and bulging or herniated discs. Such conditions often result in radicular symptoms, meaning that painful or tingling sensations will shoot or radiate down one or both arms. These symptoms are referred to as cervical radiculopathy and can be highly uncomfortable to the point of becoming disruptive to daily activities. CESIs offer an alternative to surgery and heavy medication to help you feel better safely and quickly.

Procedure: During the procedure, you will be asked to lay face-down on a procedure table or sit in a chair in a position where the provider can easily view the area. Your provider will numb the area with a local anesthetic. Once the skin and surrounding tissues are numb, the provider then injects both steroids and additional anesthetic into the epidural space of the cervical spine. The precisely delivered medication reduces inflammation of the nerve roots and relieves pain, allowing the body to heal. Patients report that this procedure is brief and relatively comfortable. Most likely, your provider will provide intravenous sedation to help you relax throughout the procedure and tolerate any discomfort.

Providers perform the injection with the aid of x-ray fluoroscopy. The x-ray guides the provider in proper placement of the needle to ensure maximum safety and effectiveness. It is performed on an outpatient basis; most patients are able to go home immediately with only a small bandage over the area. Your provider will most likely ask you to rate your pain immediately after the procedure and continue to keep track of your level of pain once at home so you can determine how successful the injection was.

Benefits: The main benefit of CESIs is the immediate relief that most patients experience after just one injection. For some patients, multiple injections may be required to achieve optimal results. If partial relief is achieved, your provider may recommend repeating the injections to further decrease your pain.

Epidural Steroid Procedures

Many conditions caused by irritation of the spine and nerve roots can be successfully treated with epidural steroid injections, commonly referred to as ESIs. These nerves can become irritated as the result of many spinal conditions, including spinal stenosis, bulging or herniated discs, and sciatica. Such conditions often result in radicular symptoms, meaning painful or tingling sensations that shoot or radiate down one or both legs (as in lumbar radiculopathy) or one or both arms (as in cervical radiculopathy). There are several different types of ESIs with different names depending on the location and method involved. Your pain specialist will determine the type of ESI that is right for you depending on the nature and severity of your condition.

Procedure: During the procedure, you will be asked to lay face-down on a procedure table. Your provider will numb the injection site with a local anesthetic. Once the skin and surrounding tissues are numb, the provider will then inject both steroids and an additional anesthetic into the epidural space of the spine. The precisely delivered medication reduces inflammation of the nerve roots and relieves pain, allowing the body to heal. Patients report that this procedure is brief and relatively comfortable. Most likely, your provider will provide intravenous sedation to help you relax throughout the procedure and tolerate any discomfort.

Providers perform epidural injections with the aid of x-ray fluoroscopy. The x-ray guides the provider in proper placement of the needle to ensure maximum safety and effectiveness. It is performed on an outpatient basis; most patients are able to go home immediately with only a small bandage over the area. Your provider will most likely ask you to rate your pain immediately after the procedure and continue to keep track of your level of pain once at home so you can determine how successful the injection was.

Benefits: A major benefit of all ESIs is that most patients experience immediate relief. If partial relief is achieved, your provider may recommend repeating the injections to further decrease your pain.

Facet Blocks

Inflammation of the facet joints of the spine is the most common cause of lower back pain. Facet blocks determine which spinal facet joint is the source of pain. They also decrease or relieve pain by reducing inflammation around the spinal joint.

Facet Injections

Facet injections are another non-surgical option for patients suffering from neck and back pain. Similar to ESIs, facet injections reduce pain by alleviating inflammation and irritation within the facet joints of the spine. Herniated discs, spinal stenosis, and sciatica are all treatable with facet injections.

Procedure: During the procedure, you will be asked to lay face-down on a procedure table. Your provider will numb the injection site with a local anesthetic. Once the skin and surrounding tissues are numb, the provider will then inject both steroids and an additional anesthetic into the facet joint, which connects two vertebrae. The precisely delivered medication reduces inflammation and relieves pain, allowing the body to heal. Patients report that this procedure is brief and relatively comfortable.

Injections are performed on an outpatient basis; most patients are able to go home immediately with only a small bandage over the area. Your provider will most likely ask you to rate your pain immediately after the procedure and continue to keep track of your level of pain once at home so you can determine how successful the injection was.

Result and Benefits: The main benefit of facet injections is that most patients experience immediate relief. If only partial relief is achieved, your provider may recommend repeating the injections to further decrease your pain.

Fluoroscopy

Video Fluoroscopy: Using Breakthrough Technology with Pinpoint Accuracy
At Flint Hills Pain Management we take the accuracy of pain treatment very seriously. To make sure our treatments are done with the best science can offer, we use a Video Fluoroscope. This marvel of technology enables the provider to see the pain area in a 3-dimensional x-ray video format. Pain treatment is 70% more accurate by means of this equipment.

Years of experience allow the providers at Flint Hills Pain Management to achieve impressive results for patients suffering from pain. The procedures use small amounts of various medications directly applied to the source of the pain, which can significantly relieve acute and chronic pain conditions. Not only can we give fast relief for these painful conditions, but we can also help prevent flare-ups by rehabilitating the underlying weakness.

Services include:

Selective Nerve Root Blocks
Pain, usually caused by bulging/herniated discs and/or by arthritic impingement, is relieved or lessened by performing a selective nerve root block. Such a block helps determine whether a specific spinal nerve root is the source of pain and then helps to reduce inflammation around that nerve root.

Facet Blocks
Facet blocks help determine whether a specific spinal facet joint is the source of pain and then helps to reduce inflammation around that spinal joint. It decreases or relieves pain caused by facet inflammation, which is the most common cause of low back pain.

Peripheral Joint Blocks
Another common cause of low back pain is inflammation around the sacroiliac (SI) joint, which can be decreased or relieved by performing a peripheral joint block. Again, the block determines if the SI joint is the source of pain and reduces the inflammation around it.

Other peripheral joint blocks are used for treatment of areas away from the spine – shoulder, knee, elbow, wrist and other potential problem areas

Myofascial Trigger Point Treatment
This treatment is used to help areas of the muscle that have hypersensitive zones because of the accumulation of toxins and other by-products of injury.

Ganglion Impar Block

A Ganglion Impar Block is a minimally invasive procedure that can successfully treat pain originating in the perineal area, especially if your pain is due to certain types of cancer. This procedure can also successfully eliminate or reduce pain for some patients suffering from spinal cord malformations, some genital disorders, and failed back surgery syndrome. Duration of relief varies, generally ranging from a few weeks to a few years. The procedure can be repeated if the first attempt is successful.

Head and Neck Procedures

The neck is a complex system of joints, ligaments, and muscles, any number of which can become injured or deteriorate and cause you pain. Whether your neck pain was brought on by a traumatic injury or is the result of a chronic condition, our team of providers will give a professional diagnosis and prescribe a treatment system that can result in reducing or completely eliminating the pain.

Intradiscal Electro-thermal Therapy

Intradiscal Electrothermal Therapy is an outpatient surgical procedure that involves the insertion of a probe into the painful disc. The probe applies heat to the area in an attempt to destroy the nerves that are causing pain. Recovery is generally quick, and the procedure is highly successful in the long term. Recurrence of pain can be treated with a repeat procedure.

Joint Stiffness and Pain Relief

Inflammatory joint conditions (such as rheumatoid arthritis, psoriatic arthritis, gout, tendinitis, bursitis, and occasionally osteoarthritis) can be treated with joint injections (intra-articular injections). These injections are performed by inserting a needle into the affected joint to administer a dose of an anti-inflammatory agent (most commonly corticosteroids). This technique can also be used to remove excess fluid from the joint or to replace bursa fluids with another highly viscous fluid.

Mechanical Lumbar / Cervical Traction

Therapeutic traction refers to therapies that safely and gently stretch or mobilize the spine. Traction can be manual (such as by a chiropractor or therapist) or mechanical (in which the patient is positioned by an apparatus). The goal is to reduce the patient's pain and improve range of motion. Traction is generally an option for the treatment of all pain, except where the structural integrity of the spine is in question (e.g., osteoporosis).

Medial Branch Blocks

Patients suffering from arthritis in the neck and/or back may find relief from medial branch blocks. The medial branch nerves are responsible for relaying pain signals from the facet joints of the spine to the brain. Accordingly, blocking these nerves can relieve pain by preventing the pain signals from getting anywhere.

Procedure: For the procedure, you will be asked to lay face-down on a procedure table. Your provider will numb the injection site with a local anesthetic. Once the skin and surrounding tissues are numb, the provider will perform in the injection using x-ray fluoroscopy. The entire procedure is quick and relatively comfortable. Most patients are allowed to go home shortly after the procedure. Your provider will likely ask you to rate your pain shortly after the procedure and to continue to keep track of your pain after you go home to assess whether the injection was successful.

Benefits: Although the medial branch block provides immediate relief for most patients with facet joint-related pain, the relief does not last. However, it is an effective diagnostic tool in that relief from the block indicates that your pain is, in fact, originating from the facet joint. If that is the case, then a more long-term treatment such as radiofrequency ablation is likely to be beneficial.

Myofascial Trigger Point Treatment

Myofascial Trigger Point Treatment is used to help areas of the muscle that have hypersensitive zones because of the accumulation of toxins and other by-products of injury.

Occipital Nerve Block

Patients suffering from occipital neuralgia and headaches caused by neck problems may find relief with occipital nerve blocks. This procedure numbs the greater and lesser occipital nerves with an injection consisting of an anesthetic and a corticosteroid. These nerves lie just under the skin on the back of your head. Your provider may also suggest that a facet joint injection in your neck be performed to achieve total relief.

Procedure: As with other injection procedures, your provider will number the area with a local anesthetic prior to performing the block. Once the skin and surrounding tissues are number, the very thin needle will be inserted to deliver the medicine directly to the area surrounding the occipital nerves.

Result and Benefits: Patient response to the occipital nerve block varies widely. If the first injection achieves the desired result, then your provider will know that you are suffering from occipital neuralgia. In that case, it is recommended that the procedure is repeated, since a series of blocks usually satisfactorily treats the problem. You may also be a good candidate for occipital nerve stimulation.

Peripheral Joint Blocks

Peripheral joint blocks are used for treatment of areas away from the spine, such as the shoulder, knee, elbow, wrist, or hip. These injections are performed with the assistance of x-ray fluoroscopy to ensure accurate delivery of medication to the problem area.

Peripheral Nerve Stimulation

Peripheral nerve stimulation, or PNS, is used to control chronic pain by means of electrical situation to the nerves that are transmitting pain signals. The peripheral nerves are distinct from the nerves of the spine, and therefore are not treatable with the same techniques used on the spinal nerve roots.

To begin with, an electrical stimulation device will be installed on a trial basis. If you find that your pain is reduced sufficiently, then a permanent unit will be a good option. The permanent stimulator lies under the skin and inhibits the pain-causing nerves from transmitting their pain signals to the brain, making you more comfortable.

Sacroiliac Joint Treatment

Sacroiliac Joint Injections
Similar to epidural steroid injections, sacroiliac (SI) joint injections are the precise delivery of medication (specifically steroids and local anesthetic) to the nerve roots of the sacroiliac joint space. The SI joints connect the pelvis and spine; accordingly, any inflammation within the SI joints can lead to severe low back pain. The injection reduces inflammation and associated irritation of the nerve roots, relieving pain and allowing the body to heal.

Procedure: The procedure for an SI joint injection is similar to that of an ESI. During the procedure, you will be asked to lay face-down on a procedure table. Your provider will numb the area with a local anesthetic. Once the skin and surrounding tissues are numb, the provider then injects both steroids and additional anesthetic into the SI joint.

Providers perform the injection with the aid of x-ray fluoroscopy. The x-ray guides the provider in proper placement of the needle to ensure maximum safety and effectiveness. It is performed on an outpatient basis. Most patients are able to go home immediately with only a small bandage over the area. Your provider will most likely ask you to rate your pain immediately after the procedure and continue to keep track of your level of pain once at home so you can determine how successful the injection was.

Result and Benefits: SI joint injections are considered a highly effective treatment for SI joint disease. Patients report that this procedure is brief and relatively comfortable. Most patients report immediate relief to some degree, allowing them to reduce their use of pain medicine and increase their daily activity.

Selective Nerve Root Blocks

Selective nerve root blocks help determine whether a specific spinal nerve root is the source of pain and then help to reduce inflammation around that nerve root with an injection of medicine directly to the problem area.

Sphenopalatine Ganglion Block

A sphenopalatine ganglion block is a nonsurgical procedure designed to treat facial and head pain such as headaches and trigeminal neuralgia.

Stellate Ganglion Block

Stellate Ganglion Block is a minimally invasive procedure designed to relieve pain in patients suffering from many conditions, including complex regional pain syndrome, reflex sympathetic dystrophy, and phantom limb pain.

Superior Hypogastric Plexus Block

The Superior Hypogastric Plexus Block is a minimally invasive procedure that uses an injection to treat chronic pelvic pain. This block is especially effective against cancer-related pain, as well as pain originating from many organs of the abdominal and pelvic region.

Sympathetic Block

This procedure delivers a local anesthetic to a sympathetic ganglion, one of a number of nerve bundles in the body. If your pain condition originates from one of these bunches of nerves, then a sympathetic block may provide instant and complete relief of your pain.

Procedure: The block is performed by injecting a local anesthetic to numb the area first. Your provider may also administer a mild sedative to help you relax and tolerate any discomfort. Using x-ray guidance, the pain-relieving medication is then introduced to the sympathetic nerve ganglion by way of a very thin needle. Once the procedure is complete, you will be asked to rate your pain in order to determine whether the block was successful.

Result and Benefits: If the block is not successful, then your  provider will be able to rule out a potential diagnosis. If your pain is completely relieved after the procedure, however, then not only does your pain go away, but also your provider has confirmed that your pain did in fact originate from the sympathetic nervous system. Most patients in this situation find that they are able to reduce or completely eliminate use of heavy pain medication and return to their normal level of activity.

Therapeutic Injections

To replace heavy oral medication, therapeutic injections can deliver the necessary treatment directly to the affected area, offering instant relief. Usually after swallowing pain medication, one needs to wait until the ingredients "kick in", while therapeutic injection offers relief almost instantly. With traditional medication, the entire body absorbs the pain medicine, making patients drowsy, sleepy, or unable to sleep, disabling the patient from leading a normal life. Therapeutic injections offer a more reliable and accurate treatment with better results but fewer or no side effects.

Selective Nerve Root Blocks
Pain, usually caused by bulging/herniated discs and/or by arthritic impingement, is relieved or decreased by performing a selective nerve root block. Such a block helps to determine whether a specific spinal nerve root is the source of pain and then helps to reduce inflammation around the nerve root.

Facet Blocks
Facet blocks help to determine whether a specific spinal facet joint is the source of pain and also helps to reduce inflammation around the spinal joint. It decreases or relieves pain caused by facet inflammation, which is the most common cause of low back pain.

Peripheral Joint Blocks
Another common cause of low back pain is inflammation around the sacroiliac (SI) joint, which can be decreased or relieved by performing such a block. Again, the block determines if the SI joint is the source of pain and reduces the inflammation around it, offering instant pain relief and valuable diagnostic information. Such blocks are used for treatment of areas away from the spine – shoulder, knee, elbow, wrist, and other potential problem areas.

Myofascial Trigger Point Treatment
This treatment is used to help areas of the muscle that have hypersensitive zones because of the accumulation of toxins and other by-products of injury.

X- Ray Diagnoses

Although less detailed than an MRI or CT scan, x-rays are a quick, comfortable way for your provider to take pictures of the inside of your body. X-ray is an important primary diagnostic tool.