Pain Care Services

SERVICES WE OFFER

We specialize in determining those root causes to create a customized treatment plan for your specific needs, leading the way in comprehensive, invasive, and non invasive spine, and more.

The Pain Center of Illinois is here to help!

INJECTIONS

Atlanto-occipital and Atlanto-axial Joint Injection

The atlanto-axial joint is formed by the two highest neck vertebrae and it is a common cause of neck pain. The pain typically starts at the base of the scalp and can radiate to behind the eye. The atlanto-occipital joint is the joint between the skull and the highest neck vertebrae. It is a less common cause of upper neck pain and headache associated with rotation of the head.

X-ray is used to help guide a needle to the joint space.

Patients who have pain secondary to the joint involvement described above are good candidates for this injection.

3-5 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

Botox Injection for Spasticity

Botox is a neurotoxin produced by bacteria. It is used for a variety of cosmetic and medical procedures. When injected into muscle, it can be used to control severe muscle spasm.

The botox is prepared by mixing it and injected into the muscle in very small amounts. The location of the injection depends on which muscles are experiencing spasm.

Patients with severe muscle spasms such as facial spasms, focal dystonia, and torticollis may receive botox.

10-20 minutes

After the procedure, the patient is observed for 15-20 minutes for adverse side effects. They may then be discharged home.

Caudal Adhesionolysis of Scar Tissue

This is a type of epidural injection that is used to break up scar tissue that may be trapping nerves and causing pain.

The epidural space (a place close to but outside of the spinal cord) is entered through the sacral hiatus (near the tail bone). X-ray is used to guide the needle to the right spot. A catheter then may be inserted through the needle. Dye is injected and pictures are taken to look for areas of scar tissue. Once the scar tissue areas are determined, medications such as hypertonic saline or local anesthetic and steroid may be injected to break up scar tissue and alleviate pain.

Patients with a history of back surgery may be candidates.

20-30 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

Epidural Steroid Injections

This is a procedure that is commonly used to help relieve neck and lower back pain, and less commonly, abdominal, pelvic, groin, perineal and rectal pain.

X-ray is used to help guide a needle precisely into the epidural space near where nerves may be impinged causing pain. Steroid medication is then injected along these nerves to decrease inflammation and irritation of the nerves. Sedation can be given for our patient’s comfort.

Patients with neck and/or lower back pain from nerve impingement from disc herniation, sciatica, and nerve root compression may be candidates for the injection.

15-20 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

Facet Joint Injections

This procedure is performed to target the small joints in the spine that are prone to developing arthritis.

X-ray is used to help guide a needle to the area of the facet joint. Once the needle is in the right place, an appropriate amount of anesthetic and steroid is injected into the joint. Sedation can be given for our patient’s comfort.

Patients who have neck or lower back pain from arthritis of these small joints may benefit from this procedure.

15-20 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to continue their normal activities on the day of injection to see if their pain is better after injection, and are asked to keep a pain log. This will help to determine if the facet joints, are, in fact, a source of their spine pain.

Hip, Knee, and Shoulder Joint Injections

These are injections into various joints throughout the body to make a diagnosis of the source of the pain as well as to treat the pain coming from that joint.

X-ray or Ultrasound technology is used to help guide a needle into the correct part of the joint. A combination of local anesthetic for pain relief and steroid for anti-inflammatory effect is injected. Sedation can be given for our patient’s comfort.

Patients with painful joints are candidates. The cause of the pain (i.e., arthritis, injury, strain) must be determined. Infection must be ruled out before performing such a procedure.

10-20 minutes

Patients are monitored for side effects and then can be discharged home. Patients are usually asked to rest on the day of the injection and can return to their normal activities by the next day.

Sacroiliac Joint Injections

The sacoiliiac joint is a weight-bearing joint between the pelvic bone and the tail bone (coccyx). It can be responsible for as much as 30% of all patients who experience back pain.

X-ray is used to help guide a needle into the joint. Once inside the joint a small amount of contrast dye is injected to make sure it was properly paced and inside the joint.

Patients whose lower back pain is worsened with movement such as prolonged sitting, standing or transitioning from a sitting to a standing position.

10-15 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

Trigger Point Injections

Trigger points are sources of pain due to tender or inflamed muscles, tendons, or ligaments.

Local anesthetics such as lidocaine are injected in these painful areas to give relief.

Patients with myofascial or muscular pain are candidates for this therapy.

3-5 minutes

Following the injection, the patient is monitored for 10 minutes before being allowed to go home. Patients can return to their normal activities immediately. Most patients will start to feel improvement within 48 hours.

NERVE BLOCKS

Celiac Plexus Block

The celiac plexus is a network of interconnecting fibers behind the stomach. It can be a source of chronic abdominal pain. It gives rise to a number of smaller nerve bundles, including for the liver, spleen, stomach, pancreatic, and near the kidney.

X-ray is used to help guide a needle through the lower back to the celiac plexus. Sedation can be given for our patient’s comfort.

Patients with chronic abdominal pain from pancreatitis or pancreatic cancer are a few of the candidates.

45-60 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

Intercostal Nerve Blocks

This procedure is performed to target inflamed nerve roots that may be causing pain.

X-ray guidance is used to help place a needle near the intercostal nerve(s). Then a combination of local anesthetic and anti-inflammatory medication is injected.

Patients with painful areas of the chest or rib cage area after surgery in this area or after a shingles episode may benefit from this procedure.

15-20 minutes

Most patients will start to feel relief on the same day of the injection and will continue to have improvement in their pain.

Median Branch Nerve Blocks

This procedure is performed to target the nerves that provide sensation for the small joints in the spine. These joints are prone to developing arthritis with advancing age or after injury.

X-ray is used to help guide a needle to the area near the facet joint. Once the needle is in the right place, an appropriate amount of anesthetic and steroid is injected into the joint. Sedation can be given for our patient’s comfort.

Patients who have neck or lower back pain from arthritis of the facet joints may benefit from this procedure.

15-20 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to continue their normal activities on the day of injection to see if their pain is better after injection, and are asked to keep a pain log. This will help to determine if the facet joint, is, in fact, a source of their spine pain.

Occipital Nerve Blocks

This procedure is performed to target inflamed nerve roots that may be causing pain.

A needle near the occipital nerve at the base of the scalp is identified. Then a combination of local anesthetic and anti-inflammatory medication is injected.

Patients with painful areas of the base of the scalp or upper neck may be candidates.

15-20 minutes

Most patients will start to feel some relief on the same day of the injection and will continue to have improvement in their pain.

Peripheral Nerve Blocks

Certain chronic pain conditions are due to abnormal firing of nerves outside the brain and spinal cord. These nerves can be targeted for injection to help relieve pain and restore function.

Using X-ray or Ultrasound technology, a needle is placed directly next to the nerve to be blocked. This allows pain medication to be placed right on the nerve, maximizing pain relief.

Patients with painful peripheral neuropathies.

15-20 minutes

Most patients can resume their normal daily activities almost immediately.

Selective Nerve Blocks

Selective nerve blocks are performed to determine if a specific spinal nerve root is causing pain. This procedure can reduce inflammation around the nerve root and decrease pain.

X-ray is used to help guide a needle close to the spinal nerve root. Once there, a small amount of contrast is used to outline the nerve root. Local anesthetic is then used to block the nerve root and provide temporary pain relief.

Patients with inflamed nerve roots that may be causing them chronic pain are candidates for this procedure.

20-30 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

Sympathetic Nerve Blocks

This is a nerve block performed to determine if the source of pain is from sympathetic nerve fibers. These fibers are part of our nervous system and control basic functions of our body but they can also transmit painful impulses.

X-ray is used to help guide a needle into different nerve bundles. These may include the stellate ganglion, celiac plexus, hypogastric plexus, ganglion of impar and lumbar sympathetic chain. Sedation can be given for our patient’s comfort.

Patients with nerve pain such as those with CRPS (Complex Regional Pain syndrome) in the arm or leg. Also patients with facial pain, abdominal pain, pelvic area pain, as well as coccydynia (tail bone) pain.

20-30 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

DISC-RELATED TREATMENTS

Discogram

This procedure is used to identify which, if any, intervertebral discs in the neck or back are pain generators for a patient.

X-ray is used to help guide a needle into the intervertebral discs at the levels being studied. A pressure gauge is used to take readings. Dye is also injected and pictures taken to evaluate the shape of the disc. Sedation can be given for our patient’s comfort.

Patients with neck or back pain who have not responded to conservative therapies and for which the discs may be the source of pain for the patient.

45-60 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged. The patient may then be asked to obtain a CT scan of the area of interest. This will help to better evaluate the discs that are being studied. Patients are usually asked to rest on the day of the injection and can return to their normal activities by the next day.

IDET (Intradiscal Electrothermal Annuloplasty)

This is a procedure that is used to treat intervertebral discs that may be causing pain.

X-ray is used to help guide a needle and thermo-coupled electrode into the painful disc. Once proper placement is confirmed, the electrode is heated destroying painful fibers in the disc. Sedation can be given for our patient’s comfort.

Patients who have had painful intervertebral discs identified by discography are candidates for this procedure.

45-60 minutes

Patients often see improvement in their pain about 4-6 weeks after the procedure. Oftentimes physical therapy is also done after this timeframe to help facilitate healing and improve pain relief.

Nucleoplasty Percutaneous Disc Decompression

This procedure is performed to remove disc material from the spine in the hopes of the decompressing the intervertebral discs. Discs that are compressed may be bulging out and pressing on nerves, irritating them.

X-ray is used to help guide a needle into the intervertebral disc. Once the needle is in the right place, a special device is used to remove the disc material. Sedation can be given for our patient’s comfort.

Patients who have back pain from protruding or herniated discs may benefit from this procedure.

15-20 minutes

Following the injection, the patient may be monitored for 20-30 min before being discharged to go home. Patients are usually asked to rest on the day of the injection.

MORE SERVICES

Implantable Baclofen Pumps

This procedure is performed to implant a drug delivery device for patients who have chronic pain or spasticity.

X-ray guidance is used and sedation is given during this procedure. A catheter is placed in the back and a reservoir is implanted in the fatty tissue of the belly. The reservoir can then be refilled easily and medication can be delivered directly to where it is needed.

Patients with pain or spasticity are candidates.

45-60 minutes

Following the procedure most patients are monitored closely to make sure they are healing well. Oftentimes there is a significant improvement in their pain and/or spasticity.

Pain Medication Management

Certain chronic pain conditions may not be amenable to injection therapy and may require medication management.

A balanced multi-modal approach to chronic pain medication is used. This involves finding the right type of medication to treat your specific type of pain. This may or may not include opiate therapy.

Patients who are prescribed chronic pain medication are asked to sign a narcotic agreement, agree to mandatory random drug screens, and are expected to take the medication as prescribed. It is important that only one physician prescribe the patient medications and only one pharmacy fill their physician’s orders.

Radiofrequency Ablation

A pain management technique involving pulsed or thermal enegery that changes nerves so that they don’t transmit painful impulses.

The painful nerves are isolated and heated up so that painful impulses are hid.

Patients with small joint arthritis of the neck or lower back may benefit from this procedure.

30-45 minutes

Patients are encouraged to resume their normal activities after the injection. The amount and duration of pain relief will vary from individual to individual.

Spinal Cord Stimulators

This is a technique that is used for patients with chronic pain, specifically nerve pain. Oftentimes, this pain has not responded to other more conservative treatments.

Using X-ray guidance, a lead is implanted in the epidural space, a space close to but outside of the spinal cord. The lead stimulates sensory fibers that override the painful signals that are coming in from the affected part, resulting in less perception of the pain.

Candidates who have chronic pain after back surgery, or from CRPS, diabetic neuropathy, arachnoiditis, or post-herpetic neuralgia.

Two to three hours

Patients are asked to rest on the day of the procedure and resume activities as tolerated. Oftentimes patients notice a significant reduction in their pain.

Vertebroplasty

This is a procedure that is used to address painful vertebral body compression fractures. It involves injection of medical grade cement into the vertebral body under careful conditions.

Using X-ray guidance, a small needle is inserted through the back into the vertebral body. Bone cement is then injected into the vertebral body and allowed to harden. The needle is removed. The procedure is performed under sedation for our patient’s comfort.

Patients who experience back pain from compression fractures of the vertebral body are candidates for the procedure.

45-60 minutes

Following the injection, the patient may be monitored for 20-30 min. Patients are usually asked to rest on the day of the injection and may be given a back brace.

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