Conditions We Treat | The Pain Center of Illinois

Work Related Injuries / Motor Vehicle Accidents

Common injuries include neck and back pain as well as shoulder, knee or other joint, soft tissue or nerve injuries. We use medications and interventional therapies where applicable to help relieve pain and facilitate restoration of function.

Low Back Pain

Low back pain is a major source of chronic pain. It is estimated that it will affect 80% of all people at some point in their lives. It is the most common cause of job-related disability. The most common causes of lower back pain are injury of overuse of muscles, ligaments, or joints, or pressure on nerve roots in the spinal canal. Nerve impingement can occur from herniated discs, spinal stenosis, spondylolisthesis (when there is a slippage in between vertebrae), compression fractures, or spinal deformities such as scoliosis. Finally, the discs themselves may be a source of pain.

Neck Pain

Neck pain is also a major source of pain. It may be due to inflammation and tenderness of muscles in and around the neck, arthritic degeneration, or disc herniation causing nerve impingement. Diagnostic injections help us to determine the source of the pain and effectively treat it.

Shoulder pain

The shoulder joint is a common source of pain. Common causes of shoulder pain include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, and rotator cuff arthropathy. Radiologic imaging can help to determine if any structural abnormalities are present and injection therapy can help to diagnose as well as treat the source of the problem. A multimodal approach is often used that involves medication to manage the pain and physical therapy to help restore function.

Spasticity

Spasticity is a disorder of muscle control. It is caused by abnormal signaling from the brain and spinal cord to the muscles. It is often found in patients with cerebral palsy, stroke, and traumatic brain injury. Patients often complain of pain, involuntary movements, contractures, and decreased functional ability. Medications can be used to help relax musculature and physical therapy is often utilized to help restore function. Finally, implantable treatment options are available to help with refractory spasticity.

Spinal Stenosis

This is a condition that leads to narrowing of the spinal canal. This narrowing may lead to pinching of the spinal cord and nerves. Patients often complain of lower back pain and leg pain and may experience numbness, tingling, and weakness. Injections can be done to help with this condition.

Whiplash

This is an injury caused by hyperextension and then flexion of the neck. This often happens in rear-end collisions, when one vehicle that is stationery is hit from behind by a fast-moving vehicle. The muscles, ligaments, and other soft tissue structures may experience damage during this type of injury. Oftentimes the patient does not experience significant pain until 24-48 hours later.

Chest Wall Pain

This type of pain originates from the structures of the chest wall, such as skin, ribs, and muscles. This pain is caused by injury, inflammation, or infection of these structures. An example of a condition that may cause chest wall pain is costochondritis.

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Neuralgia and Neuropathy / Diabetic

This type of pain comes from the nerves themselves. Whether they have been damaged from trauma or lack of adequate blood flow, these nerves start to fire abnormally leading to pain. When possible, diagnostic injections help us to determine the source of the pain. There are many effective medications that can be used to treat nerve pain.

Osteoporosis (Compression Fracture)

Compression fracture of vertebrae leads to loss of vertebral height. Trauma of the spine or weakening of bones in the spine leading to compression fractures is very common in the elderly. This may lead to the development of chronic pain and disability. Kyphoplasty or vertebroplasty are minimally invasive procedures designed to treat pain from compression fractures.

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Chronic Headache and Migraines

Chronic headache has many causes. A common type of headache that we treat is related to neck pathology, called cervicogenic headache. This type of headache is usually one-sided, tends to start in the neck region and radiates toward the eyes, temple, ear or forehead. It is often brought on by neck movement or local pressure over tender spots in the neck. When this type of headache is present, diagnostic injections such as cervical medial branch blocks can help to identify the source of pain. If the diagnosis is made, then the headache is treated with radiofrequency ablation of the cervical medial branches with an average of 6-12 months pain relief.

Another type of headache is called occipital headache. This headache is generally located in the base of the scalp and often characterized by sharp jabbing sensations around the greater or lesser occipital nerves. There is often associated numbness or tingling in the affected area. Diagnostic injections in this area also help to determine the source of the pain.

In summary, post-herpetic neuralgia is a disease that is very common and can be treated aggressively with medication management to reduce pain, long term suffering and disability.

Complex Regional Pain Syndrome (CRPS)

This pain disorder, formerly called Reflex Sympathetic Dystrophy (RSD) or Causalgia, is characterized by severe pain, swelling, and changes in the skin. It may occur in the area of injury or spread to another part of the body. It is related to dysfunction of the autonomic nervous system and can result in significant impairment in quality of life and function.

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Facial Pain / Trigeminal Neuralgia

Trigeminal Neuralgia is chronic pain condition that affects the area of the face supplied by the trigeminal nerve. It usually affects the middle or lower part of the face. The pain is usually on one side and is characterized by paroxysms of electric shock-like pain lasting from several seconds to two minutes. Patients with trigeminal neuralgia go to great lengths to avoid contact with trigger areas that may precipitate an attack.

Pancreatitis

Pancreatitis is inflammation of the pancreas and can lead to chronic abdominal pain. It occurs when enzymes in the pancreas start to digest the pancreas itself instead of food in the small intestine. It can be acute or chronic and has many causes. The two most common causes of pancreatitis are gallstone disease and alcoholism.

Pelvic and Abdominal Pain

Chronic pelvic or abdominal pain has many causes. Treatable causes must be addressed first with the help of the other specialists such as a primary care doctor, gynecologist, or urologist. Conditions that cause chronic pelvic and abdominal pain may be related to the abdominal wall itself. These include neuropathies related to the genitofemoral nerve, ilioinguinal nerve, iliohypogastric, and pudendal nerve. Injections can be done to help address this pain.

Post Stroke and Post Thoracotomy Pain Syndrome

After stroke patients can develop a neuropathic pain disorder that is of central origin. This pain disorder may be effectively treated with medications.

Post-thoracotomy pain syndrome is a common pain disorder that occurs after chest surgery. The source of this pain may be neuropathic or non-neuropathic in nature. Trauma to the intercostal nerve during surgery is the most likely cause. Patients often complain of sharp pain that may be burning in nature. Injections can be done to identify the source of the pain.

Shingles / Post Herpetic Neuralgia

This is a chronic pain syndrome brought about by reactivation of the varicella zoster virus (chicken pox). After primary infection it lies latent in nerve cell bodies, i.e.,, dorsal root ganglionDRG, cranial nerve, or autonomic ganglion of the host, normally contained by competent T-cell immunity. With aging, T-cell immune responsiveness to VZV declines. The virus replicates fully and spreads along neural tissue within a dermatome. Nearly all older adults are latently infected with VZV, with the lifetime incidence estimated to be 20-30% in general population and up to 50% of people living until the age of 85. Overall, it affects 1 million people per year in the US. It often affects the thoracic dermatomes (50-70%), but also cranial, cervical, lumbar (10-20%), and the sacral (2-8%) dermatomes.

Characteristic features of neuropathic pain in dermatomal areas, mainly sensory nervous system involvement, and absence of radiologic finding distinguish PHN from other pathologies. PHN should be considered in any patient who has a history of chicken pox illness and presents with severe pain. Risk factors for developing PHN include increasing age, greater severity of acute pain, greater severity of rash, and prodromal pain. The pain is often described as a burning, aching, throbbing pain. The patient may also have paroxysms of stabbing or shooting pain. While most PHN resolves within one year of the resolution of the rash, it can and often does last for years and cause substantial suffering and reduction in quality of life. The goal of treatment includes reduction of pain and associated symptoms including depression, insomnia, and functional impairment. Most commonly used therapies for treatment of PHN include tricyclic antidepressants and antiepileptics including gabapentin and pregablin, lidocaine patch, andas well as opioid analgesics. Treatment depends on patient comorbidities, patient preference, cost, and formulary restrictions.