Chronic Pain Treatments

Chronic Pain Treatments - Epidural Steroid Injection (ESI) - Ketamine Treatments - Pain Blocks

Epidural Steroid Injection (ESI)

Epidural steroid injection (ESI) may bring relief to those who suffer from low back pain or sciatica. It may be used to treat neck pain and mid-back pain as well. ESI on the neck and cervical spine may be complicated and risky, and Dr. Grubbs is one of the few physicians in the Sarasota-Bradenton area who performs this procedure.

ESI is an outpatient procedure that takes about 20 to 30 minutes. Before the procedure, the patient is brought into the CT suite and lies flat on the stomach. Using a local anesthetic, one of SIR’s board-certified anesthesiologists numbs the patient’s lower back. Then utilizing state-of-the-art CT imaging, Dr. Grubbs safely guides the needle into the epidural space. He first injects contrast to make sure the needle is accurately placed within the epidural space, and he then injects the steroid. The patient may feel pressure as the steroid is injected, but this should not be painful. After the procedure, the patient spends about 30 minutes to an hour in the post-op recovery area and then may go home with a driver.

Ketamine IV Treatments

Ketamine is an infusion therapy that treats a variety of pain conditions:

  • Neuropathic pain
  • Centralized or intense widespread pain
  • Complex regional pain syndrome, or CRPS—chronic or excessive pain that most frequently affects one of the limbs (arms, legs, hands, or feet) and usually occurs after an injury or trauma to that limb)
  • Hypersensitivity or hyperalgesia—an extreme reaction to a stimulus that is normally only slightly painful, such as a pinch
  • Allodynia—pain from a stimulus that normally does not cause pain, such as touch or temperature

IV Ketamine may reverse the symptoms for these conditions by blocking the specific pain receptors. It may be a viable option for pain management if conventional approaches, such as medications, physical therapy, and standard clinical interventions, are not successful in alleviating the pain.

IV Ketamine therapy is also used to treat depression and is especially effective in treating posttraumatic stress disorder (PTSD), resulting in often significant and rapid reduction in the severity of PTSD symptoms severity. Find more information on Ketamine in the next section.

Celiac Plexus Block

The celiac plexus is a bundle of nerves that surrounds the aorta, the main artery in the abdomen. While these nerves control basic nerve functions, they can carry pain information from the abdomen back to the spinal cord and brain. A Celiac Plexus Block is an injection of medication that helps relieve this abdominal pain, often caused by cancer or chronic pancreatitis.

Facet Block

The facet joints are small stabilizing joints located between and behind adjacent vertebrae. They are can become painful due to arthritis, injury, or stress from being in almost constant motion. Facet joint disorders are among the most common of recurring low back and neck problems. The cervical, thoracic, and lumbar facet joints can be injected with a small amount of local anesthetic and/or steroid to anesthetize them and block the pain. The injection helps diagnose the cause and location of pain and provides longer term pain relief by reducing inflammation.

Selective Nerve Root Block

The nervous system controls everything we do and feel so when a nerve is damaged, it will signal the body to feel pain. If severe leg or arm pain is impacting your quality of life, a Nerve Root Block may be beneficial. This procedure is similar to other injections used to treat pain. Like an Epidural Steroid Injection, the patient is asked to lie flat on the stomach. The skin is numbed with a local anesthetic by one of SIR’s board-certified anesthesiologists. Dr. Grubbs will then use advanced CT imaging to guide the needle to the nerve root. After he injects contrast to confirm the needle’s location within the nerve root, he injects a compound of medicine that includes a local anesthetic and a steroid.

The procedure takes about 20 to 30 minutes, followed by about 30 minutes in post-op recovery. Immediate pain relief should occur in the days following the procedure, but the Nerve Root Block may need to be repeated in a few months.

Stellate Ganglion Block

A Stellate Ganglion Block is an injection of local anesthetic into the sympathetic nerve tissue of the neck, located on both sides of the voice box in the neck. This injection is performed to diagnose and manage pain in the face, head, arms, and chest caused by nerve injuries, shingles, or persistent angina. It also improves mobility and reduces swelling, color, and sweating changes in the upper extremity. The Stellate Ganglion Block can be for diagnostic or therapeutic purposes, or both.

Trigger Point Injection

A trigger point is an area of spasm and inflammation in skeletal muscle. Common sites of trigger points include the upper and lower back, shoulder areas and, less commonly, in the extremities. A palpable nodule may be present in the muscle where the trigger point is located. There is much tenderness in the area of the trigger point, and pain may radiate from the trigger point to an area around it. An injection is administered directly into the trigger point and may or may not include an anesthetic, corticosteroid, or mixture. The injection makes invalidates the trigger point and relieves the pain.

Arthrogram

An arthrogram is a series of images performed to evaluate the condition of a joint after a contrast agent is injected to the joint. At SIR, arthrograms frequently use a special type of x-ray called fluoroscopy to guide needle placement into the joint, inject the appropriate amount of contrast, and take pictures of the joint. Arthrograms show the surfaces of soft tissues lining the joint as well as the joint bones, whereas a regular x-ray shows only the joint bones. Arthrograms are often used to study shoulders (for rotator cuff tears) but have diagnostic and therapeutic uses for other areas, such as hips, knees, ankles, wrist, elbow, and jaw.

Discogram

A discogram is a diagnostic test used to determine if the source of back pain may be an intervertebral disc, a disc that acts as a cushion between the vertebrae and allows motion of the vertebrae. During a discogram, dye is injected into the soft center of the disk, sometimes reproducing the patient’s back pain. It may be necessary to inject several intervertebral discs to pinpoint the cause of the back pain.

Ketamine IV Therapy – Chronic Pain – Depression - Manatee And Sarasota Therapy – Chronic Pain – Depression - Manatee And Sarasota

Ketamine, discovered in the early 1960s, is an anesthetic drug that has been used since about 1970 in both human and veterinary clinical applications. For a number of reasons, including the emergence of newer drugs for anesthesia, the use of ketamine as an anesthetic declined. However, due to its unique properties and newly discovered clinical uses, ketamine IV Therapy is increasingly being used for treatment of chronic pain and depression. Sarasota Interventional Radiology is currently the only multi physician office in Manatee or Sarasota Counties to use Ketamine infusion therapy.

Molecular Structure Of Ketamine

Ketamine is leading edge medicine for the management of chronic pain. It functions as a strong NMDA receptor antagonist that eliminates pain hypersensitivity in patients with neuropathic pain and several other types of chronic pain.

Ketamine works by blocking the nerve channels that cause intense pain while allowing the nerves themselves to function normally. It has proven effective in relieving both neuropathic pain as well as other types of chronic pain.

Neuropathic pain is pain that results from damaged nerve fibers and presents as shooting and burning pain, tingling and numbness.

In recent years, clinics have opened up across the country for the sole function of distributing ketamine for pain relief, and it is becoming a lucrative business. Sarasota Interventional Radiology, headed by Gerald E. Grubbs, MD, board-certified and fellowship-trained pain management specialist, is not one of those clinics but rather is a professionally owned and operated medical facility. SIR uses advanced technology for unparalleled diagnosis and treatment of many diseases and offers the latest in minimally invasive procedures that meet the highest standards for exceptional clinical quality, cost efficiency, and patient satisfaction. Sarasota Interventional Radiology may offer other pain-relieving treatment options in the event that ketamine is not appropriate therapy for a particular patient.

Ketamine Therapy for Depression

Standard therapies to treat depression include prescribed antidepressants and/or psychotherapy. These are important and viable therapies that can improve even the most severe cases of depression, especially when treated early. In some cases of clinically diagnosed cases, ketamine is an additional therapy that may result in significant improvement.

Ketamine has been shown to be effective in patients who suffer from depressive conditions:

  • Anxiety
  • Bipolar Depression
  • OCD (Obsessive Compulsive Disorders)
  • PTSD (Posttraumatic Stress Disorder)
  • Postpartum Depression
  • Severe or Unipolar Depression

Ketamine as treatment for depression and mood disorders has been on the rise, particularly at so called Ketamine Clinics that are only prescribing ketamine in their pop-up clinics. At Sarasota Interventional Radiology has the experience and has many treatment options and may prescribe a different treatment option to meet your unique needs. SIR was established over 15 years ago.

Laser Therapy – Arthritis – Carpal Tunnel Syndrome – Fibromyalgia - Migraines

The most technologically advanced and powerful Class IV Cold Laser Therapy available today as a safe and effective option to treat pain and inflammation.

Class IV Cold Laser Therapy uses a laser beam to activate certain areas of the body to generate very specific types of response. The type of response that can be obtained depends on the strength of the laser beam. Approved by the FDA in 2006, the Class IV Cold Laser stimulates cellular activity, expediting the healing processes to reduce inflammation and repair damaged tissue.

Class IV Cold Laser Therapy is a deep-tissue penetration that significantly increases the body’s cellular production of adenosine-triphosphate (ATP) to reduce inflammation and heal the affected area. This powerful deep-tissue penetration safely and effectively treats more conditions than traditional low-level laser therapy.

Advantages of Class IV Cold Laser Therapy include:

  • Provides healing and immediate pain relief with no side effects, drug interaction effects, or invasive surgery
  • Treats acute and chronic conditions as well as post-surgical pain
  • Takes only about ten minutes

Numerous studies have shown that Class IV Cold Laser Therapy can help with a variety of conditions. The following list represents some common uses of this therapy but is not all-inclusive of the conditions that can be helped:

  • Arthritis
  • Back pain
  • Bursitis
  • Carpal tunnel syndrome
  • Diabetic complications, e.g., neuropathy and foot ulcers
  • Fibromyalgia
  • Heel spurs
  • Knee pain
  • Migraines
  • Neck pain/whiplash
  • Nerve root pain
  • Plantar fasciitis
  • Postoperative pain
  • Repetitive stress injuries
  • Shingles
  • Shoulder pain
  • Strains and sprains
  • Tendonitis
  • Tennis elbow
  • TMJ

Other conditions that may be helped by Class IV Cold Laser Therapy include:

  • Wounds that are slow to heal and have been resistant to treatment, including slow healing fractures
  • Multiple trigger points (sore spots in the muscles) that do not go away, including areas associated with fibromyalgia
  • Soft tissue injuries
  • Ulcers

At Sarasota Interventional Radiology, we use laser technology to provide our patients with drug-free, surgery-free laser therapy to relieve pain.

RF Nerve Destruction Treats – Nerve Pain – Plantar Fasciitis – Shoulder Pain – Tendonitis – Tennis Elbow - TMJ

RF Nerve Destruction is a nonsurgical technique used to manage chronic pain. With this technique, heat energy is created and delivered via an RF needle to targeted nerves that carry pain impulses. The resulting nerve lesion, or area of tissue destruction, often provides long-term relief and is appropriate for patients who have already undergone injection techniques for pain. RF Nerve Destruction can reduce or eliminate pain for a few months or up to as long as a year.

Numerous studies have shown that Class IV Cold Laser Therapy can help with a variety of conditions. The following list represents some common uses of this therapy but is not all-inclusive of the conditions that can be helped:

  • Arthritis
  • Nerve pain
  • Plantar fasciitis
  • Postoperative pain
  • Repetitive stress injuries
  • Shingles
  • Shoulder pain
  • Strains and sprains
  • Tendonitis
  • Tennis elbow
  • TMJ
  • Back pain
  • Bursitis
  • Carpal tunnel syndrome
  • Diabetic complications, e.g., neuropathy and foot ulcers
  • Fibromyalgia
  • Heel spurs
  • Knee pain
  • Migraines
  • Neck pain/whiplash

IMPORTANT! All information presented in this website is intended for informational purposes only and not for the purpose of rendering medical advice. Statements made on this website have not been evaluated by the Food and Drug Administration. The information contained herein is not intended to diagnose, treat, cure or prevent any disease. View SIR's Notice of Privacy Practice