Services we offer
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Epidural InjectionsThe membrane covering the spinal cord and nerve roots is called the dura. A narrow space surrounding the dura is called the epidural space. Nerves leave the spine through the epidural space and travel to the rest of the body. If these nerve roots become irritated and inflamed from a damaged disc or severe arthritis of the spine, pain may occur in areas the nerves travel to. We use fluoroscopy (X-ray) to carefully and accurately place steroid added to injection into the epidural space to decrease nerve root inflammation, accelerate healing and give pain relief. Indications: Disc herniation (sciatica), Radicular Pain, Spinal Stenosis, Cancer Pain
Facet InjectionsWhen low back pain, thoracic pain, or neck pain originates from facet joints (located at the back of each vertebra on each side), facet joint injections that include local anesthetic and a steroid may reduce inflammation and provide pain relief. Zen Pain and Wellness doctors use fluoroscopy (X-ray) to accurately place the injection. Alternatively, the nerve to the facet joint may be blocked using a local anesthetic. If adequate pain relief is observed, radiofrequency lesioning may be used on the nerve branches to help provide long-term pain relief. Indications: Back pain, Neck pain Whiplash, Painful facet arthritis, Cervicogenic headaches
Medial Branch BlocksMedial branch blocks (MBBs) are a minimally-invasive, non-surgical treatment that are used for arthritis-related neck and back pain. This pain management technique works by reducing the inflammation and irritation in the facet joints of the spine that is causing your pain. An exciting aspect of this pain relief modality is that, if it successful, a more long-term treatment option called radiofrequency ablation of the medial branch can be employed.
Spinal Cord StimulationThis relatively new treatment consists of a highly sophisticated, small computer that's implanted under the skin. It delivers a low-voltage signal through fine wires to the spinal cord, or selected nerves and masks the pain sensation with a pleasant tingling or massaging sensation. Indications: Intractable nerve injury pain, failed back syndrome, complex regional pain syndrome (formerly known as Reflex Sympathetic, some headaches).
Medication ManagementWhen chronic pain doesn't respond to interventional or conservative therapies, medications may be beneficial. Many associate pain medicines with narcotics. But every pain is different, so not all pain is treated the same. We use many different kinds of medicines to help manage chronic pain. For example, pain that is caused by nerve damage is best treated with certain anti-seizure or anti-depressant medications and sometimes narcotic medications. The pain caused by fibromyalgia is commonly treated with anti-seizure and/or anti-depressants. Other types of chronic pain respond best to narcotic medications and other types of medicines.Interventional Spine Medicine providers take prescribing narcotics very seriously. They work with patients closely to develop a treatment plan that helps them manage their pain safely as they are carefully monitored for potentially serious side effects.Patients receiving these medications sign a narcotic agreement that describes the side effects of chronic narcotic use, the risks involved and ISM policies regarding the misuse of narcotics. We have a very strong policy that includes no tolerance to misuse or abuse of any kind.
Peripheral nerve blocksPeripheral Nerve Blocks employ injection of a local anesthetic such as lidocaine to numb the nerves believed to be triggering pain. To help locate the triggering nerves causing the pain, we use ultrasound or electrical stimulation. Indications: Painful nerve conditions (Occipital Neuralgia, Ilioinguinal Neuralgia, Meralgia Paresthetica)
Trigger Point InjectionsTrigger point injections are used where bundles of muscle fibers become tight, knotted and unable to relax. They can occur as a result of injury, spinal or skeletal abnormality or poor biomechanics. Treatment to relieve trigger points include targeted trigger point injections of local anesthetic with or without steroids, chiropractic care, massage, stretching and physical therapy. In intractable cases, botulinum toxin injections often provide substantial and lasting relief. Indications: Myofascial pain, neck pain, shoulder pain, back pain
Quantitative Sensory TestingIdentifies early nerve damage (neuropathy) and helps determine treatment progress. More sensitive than an electromyelogram (EMG), it can detect abnormal function in small sensory nerves in patients with numbness or tingling, especially in the extremities, even when an EMG is normal.Indications: Diabetic pain and Neuropathy, Radiculopathy, Neuropathy
Ultrasound guided injectionsUltrasound guided injections are emerging as a new alternative to low dose x-ray guidance (fluoroscopy) for the delivery of therapeutic medications for some procedures. It allows the physician to see inside the patient and image not only bony structures, but also soft tissues to include nerves, muscles, joints, bursa, and blood vessels. It can be used to guide a needle into specific areas and identify nerves while avoiding vessels - thereby increasing accuracy in addition to safety.
Kyphoplasty/VertebroplastyVertebropasty and kyphoplasty are two innovative, minimally-invasive, non-surgical procedures that have proven to strengthen the vertebrae of your spine and significantly improve pain caused by vertebral body compression fractures. Fractures are often secondary to osteoporosis, cancer metastasis, or trauma. Arizona Pain Specialists is happy to provide these treatments to the Phoenix area. These exciting new therapies have helped people even when conservative therapies have not provided adequate relief
Sympathetic Nerve BlockSympathetic nerve block is the injection of a local anesthetic into a sympathetic ganglion to diagnose or treat pain disorders that involve the sympathetic nervous system.
The sympathetic nervous system is a linkage of nerves throughout the entire body. The nerves originate in the spinal cord and branch out to influence many bodily functions, such as blood pressure, urination, defecation, and sexual arousal.
A ganglion is a bundle of nerves that come together. The stellate ganglion (upper body) as well as the sympathetic chain (lower body) supply the entire body’s sympathetic nervous system. When these nerves are irritated or injured, the blood supply to your hands, feet, or other areas may be affected and can produce pain or sensory changes. Headaches, neck pain, and facial pain can also be seen in patients who have sympathetic nerve dysfunction.