All posts in Pain management Procedures

Cervical radiculopathy

Cervical radiculopathy

Pain is often misleading. It can radiate and travel throughout the body leaving a patient unsure of the actual source of pain or injury this is the case with cervical radiculopathy.

Symptoms

Impingement of a nerve in the cervical spine (neck) can often cause cervical radiculopathy or cervical radiculitis.

This type of pain is particularly deceiving as it may present as shooting pain, tingling, numbness and muscle weakness  and may be felt in the neck, upper back, shoulders, arms, hands and/or fingers.

Causes

Cervical radiculitis usually occurs as a result of some underlying condition affecting the cervical discs or vertebrae. Such conditions may be; herniated disc in the neck, spondylolisthesis, or a buldging disc for example. In some cases the cause of these conditions is due to an injury or trauma of some kind, however, very often cervical pain is due to degeneration in the spine. Age, poor body mechanics, smoking, and genetics are all factors that contribute to neck pain.

Treatment of cervical radiculopathy

Radiating pain can mask the underlying cause or source of pain which could lead to an  inaccurate diagnosis and mistreatment of the pain.

Therefore it is imperative that patients  seek the medical attention of a qualified pain specialist who can perform appropriate diagnostic tests and order MRIs or XRAYs to pinpoint the true source of their pain.

The conservative, non-surgical and minimally invasive treatments offered by interventional pain specialists often solve the pain associated with cervical radiculitis at the source of the problem.

Interventional pain management offers advanced injection based procedures that reduce the need for medications, provide longer term pain relief and reduce the likelihood of expensive surgeries with long recovery times.

Procedures designed specifically for the cervical spine include:

 



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Response to the Surgeon General’s Letter

Response to the Surgeon General’s Letter

The Surgeon General, Vivek H. Murthy, M.D., M.B.A. recently sent out a letter to all American physicians urging us to do everything in our power to address the opioid epidemic.

The opioid epidemic is a very real and serious situation, so too is the need to treat pain responsibly.

Newbridge Spine & Pain Center is one of the Greater Washington area’s premier interventional pain management facilities dedicated to treating pain. Our physicians are Anesthesiologists with sub-specialty training in pain management.

There are many misconceptions about the ‘pain management’ specialty resulting from the mismanagement and over-prescribing of addictive painkillers. However, our specialization, interventional pain management, addresses both the rising opioid epidemic and the need to treat pain.

Treating pain in a conservative, responsible manner is our daily commitment.

We do this by:

  • Utilizing non-surgical, interventional pain procedures to quickly and effectively reduce pain levels.
  • In cases where medication management is unavoidable, we aim to reduce reliance on pharmacologic substances, opioids & narcotics by maintaining low doses and outlining treatment plans that take a multidisciplinary approach to include; weight-loss, physical therapy and/or counseling for example.

The Newbridge team spends a significant amount of energy encouraging our fellow healthcare providers to refer to interventional pain management before prescribing or laying out a treatment plan. This is because our therapeutic procedures work at the onset of pain as well as for chronic pain conditions.

Dr. Jay GonchigarWe firmly believe that the sooner a patient can be treated by a pain specialist using interventional methods the less likely that patient is to be prescribed a long-term medication schedule.

Most pain complaints relate to pain originating throughout the spine, however, an interventional pain doctor can treat acute and chronic pain all throughout the body to include the limbs and joints in the peripheral body.

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Osteoarthritis and Knee Pain

Osteoarthritis and Knee Pain

As pain providers we see a significant number of patients experiencing knee pain. One of the most common causes of persistent knee pain is osteoarthritis.

Osteoarthritis is a form of arthritis that affects the joints and the cartilage of the joints, it impacts flexibility and can result in painful bone spurs.

The general symptoms of this type of arthritis are stiffness, pain and swelling of the affected joints is also common.

X-rays and MRI scans can confirm a diagnosis. Sometimes called degenerative joint disease, osteoarthritis cannot be cured, however, pain can often be relieved without the need for invasive surgery.

Pain caused by osteoarthritis in the knee can be alleviated a variety of ways. Newbridge physicians offer injections of corticosteriods which have proven to help inflammation of swollen joints, however, additional options are also available and are commonly used to relieve knee pain.

Supartz injections are specifically designed to help osteoarthritis of the knee joint. Supartz is a solution made of purified sodium hyaluronate. Hyaluronan is a chemical naturally found in the joint tissues and the fluid that fills your joints.

treating knee pain due to osteoarthritisGenicular nerve blocks and radio-frequency. The genicular nerve block procedure is performed to both diagnose the source of pain ascertain effectiveness of an RFA treatment. A successful nerve block procedure generally qualifies a patient for radio-frequency ablation (RFA) of the same nerve this treatment has proven to be an extremely popular and effective long term pain solution.

 

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Pudendal Nerve Block

Pudendal Nerve Block

The pudendal nerve is the primary nerve of the perineum. It carries sensation between the genitals as well as motor supply to various pelvic muscles. Neuropathic pain in the perineum, genital and ano-rectal areas may come as a result of entrapment.

Pudendal nerve entrapment syndrome is a fairly uncommon condition resulting from prolonged compression of the pudendal nerve. The most common causes for pudendal nerve entrapment include:

  • Repeated mechanical injury (e.g. sitting on bicycle seats for prolonged periods over many years or months)
  • Trauma to the pelvic area e.g. during childbirth
  • Damage to the nerve during surgical procedures in the pelvic or perineal regions
  • Compression from lesions or tumours arising in the pelvis
  • Any cause for the development of peripheral neuropathy (e.g. diabetes or vasculitis).

[Source: dermnetnz.org]

At Newbridge we perform local anesthetic and corticosteroid nerve block procedures to reduce swelling and inflammation for patients presenting with pudendal nerve pain.

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What is the cause of my neck pain?

What is the cause of my neck pain?

Neck pain is the second most common complaint among our patients second only to lower back pain of course.

There are myriad reasons that pain in the neck can occur. Sometimes the cause is obvious, a patient has had an accident or injury resulting a physical trauma that causes pain in the neck or cervical region. However, other times you may not be able to pin point a specific incident or don’t understand what happened to actually cause the pain you are experiencing. In medical terms this is called idiopathic pain which can be more difficult to treat.

Your neck is made up of ligaments muscles and bones. The cervical spine (the upper vertebrae of the spine) goes from the skull to the torso between each vertebrae are discs that act as shock absorbers between the bones.

Injury, inflammation and a range of abnormalities to any of the above can cause neck pain and stiffness.



Types of neck pain and possible causes

Pain going down your neck through your shoulders or arms is called radiating neck pain or cervical radiculopathy. If you experience this you may be suffering from either a cervical herniated disc  spinal spinal stenosis or degenerative disc disease.

Cervical radiculopathy is commonly associated with an injury near the nerve root and is often called a “pinched nerve”. Radiating pain may be accompanied by numbness or tingling down the arm.

Spinal stenosis is the narrowing of the spinal canal. As the spinal canal narrows it puts pressure on the nerves which in turn may cause pain. Foraminal stenosis is the narrowing the cervical disc space due to the enlargement of a joint in the spinal canal. In some cases this condition may require surgery.

Degeneration of the disc, where the space between the individual vertebrae becomes smaller and the disc becomes less spongy and therefore less capable of absorbing shock, is also a very common cause for neck pain.

In some case muscle stiffness may be the cause of neck pain. In these cases trigger point injections can help by encouraging blood flow to the region by igniting the body’s inclination to self heal.

If you are experiencing neck pain that persists your pain management specialist can order Xrays and MRIs to discover the root cause of this pain and develop a multi-modal treatment plan to combat pain and help you regain your quality of life.

 

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Trigeminal Neuralgia

Trigeminal Neuralgia

Trigeminal Neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve in the face.

The Trigeminal nerve carries sensation from the face to the brain. It is a progressive pain condition meaning it can start out as random mild attacks and develop into bouts of extreme pain. For patients experiencing trigeminal neuralgia putting on make up brushing teeth or washing your face can become extremely painful. Studies have found that this condition is more common in women and people over 50 years of age.




The disruption of nerve functioning, also known by the name tic douloureux, is often caused by contact between the nerve and a vein or artery; however, multiple sclerosis and tumors have also been known to cause this type of pain.

How is it treated?

It is always best to come prepared when visiting your pain specialist. Make note of what triggers your pain and where on your face the pain occurs. You may be referred to pain management following a visit with a neurologist.

Our interventional pain management specialists have successfully performed trigeminal nerve ganglion blocks to reduce TN pain. Call your nearest pain clinic to learn more.

In severe cases your pain specialist may refer you to a neurosurgeon for further treatment, such treatments may include:

  • Stereotactic radiosurgery (includes Cyberknife)
  • Microvascular decompression
  • Neurectomy

 

 

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Interventional Pain Management. What is it?

Interventional Pain Management. What is it?

What is interventional pain management?

Interventional pain management or interventional pain medicine is a sub-specialty of pain management. Interventional pain specialists are devoted to the use of minimally-invasive techniques such as facet joint injections, nerve blocks, radiofrequency ablation, vertebral augmentation, and neuromodulation (implantable drug delivery) therapies.

Finding long lasting relief can be difficult for many suffering from chronic pain. Interventional pain procedures offer new hope for patients presenting with any variety of persistent and severe pain conditions. In addition these procedures can help prevent patients from being tied to a long-term medication schedule.

Interventional pain specialists are highly trained in a myriad of pain procedures that treat the underlying source of pain, these procedures play a pivotal part of a multi-disciplinary approach to relieving pain.

These treatments offer pain relief for a wide range of conditions from headaches, pain in the neck, back or spine, to stomach, shoulder, pelvic, hip, knee or foot pain.

Patients often comment that seeking interventional pain management at the early stages of their diagnosis and treatment speeds up their recovery time and ability to pursue daily activities.interventional pain specialist

Is interventional pain management right for me?

These techniques, performed by qualified anesthesiologists, provide relief and improve the quality of life of many patients. To determine if a particular procedure or combination of procedures is right for you talk to your doctor, or make a new patient appointment. Our anesthesiologists will review your MRIs, Xrays, medical history and any records from your referring physician to determine a) the root cause of your pain and b) if you are a candidate for a procedure and c) what procedure you may benefit most from.

Interventional procedures are out-patient procedures performed in our office or ASC (ambulatory surgical centers) most of these procedures take less than 45 minutes from the time you enter the procedure room and require minimal recovery time. For patients who are anxious or in severe pain our office is equipped to offer monitored anesthesia care (sedation) to help you relax during your procedure.

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Genicular Nerve Block for the Knee

Genicular Nerve Block for the Knee

Genicular Nerve Block & RF Ablation

The genicular nerve block and RFA are a proven and popular procedure to combat knee pain. The specialist interventional pain management physicians at Newbridge Spine & Pain Center perform this innovative new procedure for treating patients with knee pain without surgery. Genicular Nerve Block or Genicular Radiofrequency Nerve Ablation can be done before if the hopes of preventing surgery or after knee surgery to offer pain relief.

This state-of-the-art procedure relieves pain in patients experiencing knee pain due to any of the  following conditions:

  • Chronic Knee Pain
  • Degenerative Joint Disease (of the knee)
  • Osteoarthritis (OA) of the knee
  • Prior to or following a total knee replacement
  • Prior to or following a partial knee replacement
  • Patients unfit for knee replacement
  • Patients who wish to avoid a knee replacement

The procedure is performed in 2 stages:

  1. Diagnostic Genicular Nerve Block – this procedure consists of placing a small amount of a local anesthetic, on the genicular nerves. This tests the patient’s response and determines if there is sufficient pain relief in the knee to justify performing a therapeutic neurotomy
  2. Genicular Nerve Ablation – during this therapeutic portion of treatment, your pain management physician will perform a radiofrequency ablation (RFA) of the genicular nerves, restoring function of the knee and alleviating pain.



If you or someone you know is experiencing knee pain or suffers from any of the above conditions give us a call at any one of our four convenient locations in Maryland and Virigina to discuss what our interventional pain management procedures can do to relieve your pain.treating knee pain

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Pain due to Scoliosis

Pain due to Scoliosis

We’ve been getting a number of questions regarding pain treatment for scoliosis lately. We thought we’d elaborate a little on what scoliosis is and what we can do to help manage pain associated with this condition.

What is Scoliosis?

Scoliosis is an abnormal (usually sideways) curving of the spine. The spine might look like the letter “C” or “S.” An inward curving of the spine is called lordosis.

What causes pain in Scoliosis patients?

As the spine twists it effects the supporting musculature and can affect heart and lung function if severe enough. The imbalance of the spine causes trouble with posture and puts stress on joints that wouldn’t otherwise see so much weight.

How can a pain management specialist help scoliosis patients?

In the setting of scoliosis our pain specialists would make sure the scoliosis is not severe enough to require surgery. If the scoliosis is not severe we can deal with the stress of the curved spine on the joints of the spine and the pain due to pinch nerves where the spine bends and puts strain on the supporting muscles on each side.

Treatment includes facet blocks, epidurals, trigger points for myofascial pain, muscle relaxants, nerve pain medications, gait supporting accents such as canes and foot insoles.

In cases where surgery is required our pain management physicians will refer the patient to an Orthopedic spine surgeon. Following surgery and orthopedic treatment a pain specialist can continue to help manage pain associated with scoliosis and would do so in coordination with a patient’s Orthopedic specialist.

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Treating Pelvic Pain

Treating Pelvic Pain

Pelvic Pain

The causes for pelvic pain vary greatly and differ between men and women. Pelvic pain may come from the male and female reproductive systems, the colon, bladder or lower intestines.

Conditions that commonly cause pelvic pain in both males and females include:

  • Irritable bowel syndrome
  • Urinary tract infections
  • Cancer in the pelvis
  • Appendicitis
  • Crohn’s Disease
  • Hernia
  • Kidney Pain

relieve pelvic painFor females pelvic pain can be brought on by ‘cluster’ conditions affecting the reproductive system such as endometriosis. It should come as no surprise that treatments for pelvic pain vary depending on the cause a severity of the pain.

In cases where pelvic pain becomes chronic and does not respond to medication you may be referred to a pain management specialist by your urologist, OBGYN, Oncologist or Internist.

Chronic pelvic pain may be treated with medication or an appropriate minimally invasive and non-surgical procedure. For example a pain management physician may perform a hypo-gastric plexus block. 

The hypo-gastric plexus is a group of nerves near the end of the spinal cord by blocking these nerves a pain specialist can prevent patients from experiencing pain sensations. This type of non-surgical procedure is an injection of anesthesia medication plus a steroid and usually takes about 30 minutes.

Pelvic pain can be debilitating and indicate a serious condition. If you are experiencing pain in your pelvis or abdomen seek medical attention urgently. If the pain becomes chronic you should request a referral to a specialist pain management provider. Specialists in pain management are uniquely trained and equipped to handle pain and understand that medication is not the only option.

 

 

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