Pain Treatments Offered:

  1. Medical Therapy
  2. Epidural Injections and Selective Nerve Root Blocks
  3. Sacro-Iliac Joint (SI Joint) Injections
  4. Facet Joint Injections and Medial Branch Blocks
  5. Radiofrequency Therapy
  6. Spinal Cord Stimulation
  7. Intrathecal Pump Placement
  8. Occipital Nerve Stimulation
  9. Coeliac Plexus Block
  10. Lumbar Sympathetic and Stellate Ganglion Injections
  11. Other Available Treatments


Medical Therapy

At the pain clinic, your therapy plan will be tailored to your specific needs, circumstances, and preferences. Depending on the cause of your pain, treatments may include one or more of the following:

Medical therapy in the form of tablets. These tablets for pain may include:

  • Non-aspirin pain relievers such as paracetamol relieve minor pain and are sometimes combined with other drugs to provide greater pain relief.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs and Coxibs) are used to treat prevent pain caused by inflammation.
  • Corticosteroids are used for more severe inflammatory conditions.
  • Opioid pain medications are morphine-like drugs and  are  prescribed short term for acute pain, for for cancer pain and for some chronic non-cancer pain.
  • Antidepressants can be useful for relieving certain types of pain and may also promote sleep, which can be difficult when you are in pain.
  • Gabapentinoids are very helpful when treating pain that results from disease or injury to nerves

Often medications, by themselves, aren't enough to treat chronic pain. Other treatments may be more effective than medications, and medication may be more effective when combined with other treatments.

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Epidural Injections and Selective Nerve Root Blocks
 

Epidural Injections

The benefits of the epidural steroid injections include a reduction in pain of the spinal origin, primarily in leg or arm pain. While the effects of an epidural injection tend to be temporary providing relief from pain for one week up to one year, an epidural can be very beneficial for patients during an episode of severe back or neck pain. Importantly, it can provide sufficient pain relief to allow the patient to progress with their rehabilitation program. 


Sacro-Iliac Joint (SI Joint) Injections
 

Sacro-Iliac Joint Injections

The Sacro-Iliac Joint injection is an injection of medications into the SI Joint where the pelvic bone meets the tailbone. The benefits of the SI Joint Injection include a reduction in pain and increase in mobility. While this injection is also temporary for one week for up to a year, it is also highly beneficial during periods of severe pain and can provide sufficient relief to allow patients to progress with their rehabilitation program. 

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Facet Joint Injections and Medial Branch Blocks
 

Facet Joint InjectionsThe spinal facet joints support the spinal column. Stresses on the joints can be caused by sudden or repeated lifting motions of the lower back leading to facet irritation or injury. In the older population and with abnormal postures, arthritic changes may play a role in the development of the facet syndrome.

A Facet Injection is an injection of medications into the actual facet joints in the spine. It usually includes an anaesthetic and a steroid. Medial Branch Blocks are similar to the Facet Injections, except instead of targeting the arthritic joints, the nerve that leads to the joint is injected, usually with only anaesthetic. 


Radiofrequency Therapy
 

Radiofrequency TherapyRF lesioning is a safe, proven means of interrupting pain signals. Radiofrequency current is used to heat up a small volume of nerve tissue, thereby interrupting pain signals from that specific area.

Radiofrequency techniques can be used to help manage: chronic neck pain, chronic facial pain, chronic mechanical low back pain, chronic headaches, and chronic malignant pain involving the nervous system. 

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Spinal Cord Stimulation
 

Spinal Cord Treatments Spinal cord stimulation and peripheral nerve stimulation use an implanted device, a spinal cord stimulato, to deliver low levels of electrical energy directly to nerve fibers.

This direct approach to treating pain at its source can be very effective. This is very useful for failed back surgery, CRPS Type 1 and 2, and for peripheral neuropathies

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Intrathecal Pump Placement
 

Intrathecal Pump Treatments Intrathecal pumps deliver medication directly into the cerebrospinal fluid surrounding the spinal cord. They are connected to fine tubes placed into the fluid. This form of neuromodulation allows for delivery of opioids in chronic pain conditions including cancer pain as well as for anti-spasticity agents such as baclofen  for Multiple Sclerosis.

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Occipital Nerve Stimulation

This is a procedure for specific types of migraine sufferers. Two electrods are implanted at the back of the head and are connected to an implanted nerve stimulator. The electrical stimulation overrides the pain impulse of the migraine preventing the typical headaches.  


Coeliac Plexus
 Block

Coeliac Plexus Block

This structure is a collection of nerves in the upper abdomen that transmits many of the pain signals from the organs of the abdomen to the brain. The plexus can be temporarily blocked using local anaesthetics or permanently ablated using phenol or alcohol solutions. The block is particularly effective for  pancreatic pain and other pains of the upper abdomen.


Lumbar Sympathetic and Stellate Ganglion Injections
 

Lumbar Sympathetic Treatments

Lumbar Sympathetic Blocks (for the lower extremities) and Stellate Ganglion Injection (for the upper extremities) is an injection that delivers anaesthetic directly into the sympathetic nerves (located to the sides of the spine) or the stellate ganglion. This relieves the  pain of CRPS, reduces swelling and increases circulation for one week up to a year. 

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Other Available Treatments
  • Injections. Local anaesthetics, sometimes combined with a corticosteroid, may be injected around nerve roots or into muscles and joints to relieve irritation, swelling, and muscle spasms.
  • Nerve blocks. If a group of nerves  causes pain to a specific organ or body region, injections with local anaesthetics may be useful for blocking the pain in that area.
  • Physiotherapists may prescribe a specially tailored exercise program to increase function and decrease pain. Other physical therapy option may include whirlpool therapy, ultrasound, and deep-muscle massage.
  • Neuromodulation. The function of the nervous system can be altered by neuromodulation. This may involve electrical modulation by dorsal column stimulators or injecting drugs directly into the fluid surrounding the spinal cord by a pump.
  • Other electrical stimulation. The most common form of electrical stimulation used in pain management is transcutaneous electrical nerve stimulation (TENS), a technique that uses a small, battery-operated device to stimulate nerve fibers through the skin.
  • Psychological support and counseling. Although pain is a physical sensation, many people in pain suffer emotionally with feelings of anger, sadness, and hopelessness. Dealing with unrelenting pain can affect your ability to hold a job, maintain a home, meet family obligations, and relate to friends and family members. Psychological support, along with medical treatment, can help  manage a condition.

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