The goal at Integrity Pain Consultants is to target the causes of chronic pain and not just mask the symptoms. We believe we can help you return to a more active fulfilling lifestyle.
- We may recommend that you undergo a minimally invasive, non-surgical procedure.
- Our treatments are on the leading-edge of pain management and have been proven successful in treating pain.
- All procedures are out-patient procedures; you will be able to go home the same day.
- Many of the treatments we perform have been shown to help our patients reclaim their active lives!
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This procedure involves injecting a medication into the epidural space, where irritated nerve roots are located. This injection includes both a long-lasting steroid and a local anesthetic (lidocaine, bupivacaine). The steroid reduces the inflammation and irritation, and the anesthetic works to interrupt the pain-spasm cycle and nociceptor (pain signal) transmission. The combination medicine then spreads to other levels and portions of the spine, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes.The most important and greatest success achieved with the use of epidural steroid injections (ESI) is the rapid relief of symptoms that allows patients to experience enough relief to become active again. With this help, patients regain the ability to resume their normal daily activities.
There are several types of epidural steroid injections, and the specific type you receive depends on the cause of your pain syndrome. Dr. Homolya will decide which procedure is more beneficial to you after reviewing your history, performing a physical exam, and determining the cause of your pain. The main difference in the types of ESIs is the position where the needle is inserted as well as the amount of nerve roots treated.
Facet injections are a minimally-invasive non-surgical treatment that is used as treatment for many different causes of neck and back pain. It works by reducing the inflammation and irritation in the facet joints of the spine that is causing you pain.
The syndromes most commonly requiring facet joint pain treatment include: Spinal Stenosis, Herniated Disc, Sciatica and Spondylolysis.
The facet joint of the spine is a moveable connection that connects one vertebra (bone of the spine) to another. This injection includes both a long-lasting steroid and an anesthetic (lidocaine, bupivacaine). The steroid reduces the inflammation and irritation, and the anesthetic works to numb the pain. The combination medicine then spreads to other levels and portions of the spine, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes
The facet injections and the epidural steroid injections (ESI) are very similar but differ in the location that they inject the medicine. In an ESI, the medication is injected into the epidural space, whereas in the facet injection, it is injected directly into the joint.
Medial branch blocks 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.
The facet is a joint that connects one vertebra (bone of the spine) to another. The needle is placed over the nerve that provides sensation to the facet joint. This nerve is the medial branch. The injection includes both a long-lasting steroid and a local anesthetic like lidocaine. The steroid reduces inflammation and irritation, and the anesthetic works to numb the pain. The entire procedure usually takes less than 15 minutes.
RFA has been used for many years, and the technique continues to improve with better efficacy and fewer risks. Patients can experience significant pain relief with a minimally invasive procedure that does not require a long hospital stay.
Radiofrequency Ablation is a procedure which creates a nerve lesion produced by localized heat. When the lesion is placed over a painful nerve, pain signals are interrupted and pain perception by the brain is decreased.
The procedure is performed in an outpatient setting. The treatment is done with local anesthesia along with IV sedation when needed. Before the procedure begins your physician starts by cleaning the skin over the injection site and injecting a local anesthetic to numb your skin.
Another needle is placed through the numb tissue and the entire procedure is performed using fluoroscopic (X-ray) guidance. When the needle is in the correct location, an electrode is introduced into the center of the needle. Stimulation is initiated first with sensory stimulation and then with motor stimulation. When the correct needle position is verified, local anesthetic and sometimes a steroid medication are injected.The electrode is heated to 50-80°C and kept at that temperature for several minutes. Electro-thermal heat is generated, which allows for destruction of surrounding pain fibers, thereby decreasing your pain.
A nerve root block is an injection of local anesthetic (numbing medicine) and steroid injected under X-ray guidance into the area where the nerve exits the spinal column. A nerve root block is usually ordered by your doctor for pain in the arm or leg that follows the path of a single nerve. A nerve root block may be diagnostic (a test to determine the source of your pain) and/or therapeutic (to relieve your pain). If you get a period of sustained pain relief from the injection, the block may be repeated. Sometimes the block is done to help identify whether or not surgery might be helpful and at what level such surgery might be most helpful.
The Transforaminal Steroid Injection is used mainly for diagnostic purposes. Nerve roots exit the spinal canal and enter the body through small openings between the vertebrae called the foraminae. Doctors inject a mix of steroids in the area around a selected nerve root between the foraminae to determine if that nerve is, in fact, the cause of the pain. This type of injection is most commonly used in the cervical spine region.
The Lipogems procedure processes your own body’s fat tissue in order to cushion and support areas of injury or damage as your own body heals itself. Lipogems is injected precisely into areas in the body in order to help establish an environment conductive to tissue healing and repair. Click Here To View the Lipogems Video
Discography is a diagnostic tool used to determine whether certain discs of the spine are the source of a patient’s neck or back pain. Low back pain affects approximately 80% of the general population at least sometime during their lifetime. It is also the fifth leading cause of physician visits, as well as the leading cause of work-related disability.
Discography has been used to diagnose the cause of low back and neck pain, especially when non-invasive imaging, such as magnetic resonance imaging (MRI), does not reveal abnormalities consistent with the pain symptoms. Discography is considered for patients who have disabling low back pain, neck pain, and arm or leg radiation pain when other conservative diagnostic methods and treatments have failed.
A lumbar sympathetic block is an injection of local anesthetic into the back using X-ray guidance. With this procedure, we are blocking the sympathetic nerves to your leg. These nerves typically are not responsible for sensation, but they can be “turned on” in certain pain syndromes. This procedure is typically ordered by your doctor for pain located in the buttocks and/or legs that is caused by sympathetically maintained pain, or complex regional pain syndrome. Lumbar sympathetic blocks are also used with circulation problems (e.g., vascular insufficiency) to see if blood flow can be improved. Lumbar sympathetic blocks may have therapeutic or diagnostic value.
The use of platelet rich plasma (PRP), a portion of the patient’s own blood having a platelet concentration above baseline, to promote healing of injured tendons, ligaments, muscles, and joints, can be applied to various musculoskeletal problems. Click Here To View The PRP Video.
A sacroiliac joint injection is designed to diagnose and treat pain and inflammation from sacroiliac joint dysfunction. Either too much or too little movement in one of the sacroiliac joints, which are located at the bottom of the spine on each side of the sacrum, can cause lower back pain and/or leg pain. An injection in the sacroiliac joint usually has two goals: to confirm the sacroiliac joint as the source of the pain, and to alleviate that pain.
Spinal Cord Stimulator therapy is an exciting procedure that is becoming increasingly popular for the treatment of many causes of chronic back pain. This revolutionary treatment works by blocking pain perception from traveling up through the spinal cord to the brain. It involves a small device that is placed near the spinal cord in the epidural space. The spinal stimulator device delivers low-level electrical impulses that interfere with the perception of pain, especially chronic nerve pain.
A stellate ganglion block has both diagnostic and therapeutic value. It has a wide array of therapeutic indications including: Sympathetically-maintained pain syndromes
Complex Regional Pain Syndromes Type 1 and 2,
Reflex sympathetic dystrophy,
Causalgia (nerve injury),
Phantom limb pain,
and Herpetic neuralgia from herpes zoster (shingles).
A trigger point injection is the administration of certain drugs directly into areas within muscles or fascia (the protective material surrounding many muscles of the body, which is composed of a material similar to connective tissue) that are sources of pain. This type of muscular pain may be a symptom of a variety of conditions. The affected areas are also known as trigger points, as they are “points” of tightness, tenderness, or discomfort in a specific muscle that may affect movement, normal function, or the quality of life of people affected by them.The drugs included in trigger point injections may be local anesthetics such as lidocaine or procaine.
The injection is part of an overall comprehensive treatment plan.
The theory behind the use of steroids is based on their anti-inflammatory effects to limit pain, to allow earlier motion, and to allow quicker healing.
Trochanteric bursitis is a common problem that causes pain in the area of the hip over the bump that forms the greater trochanter. Eventually the pain may radiate down the outside of the thigh. When the bursa sac becomes inflamed, pain results each time the tendon has to move over the bone. The pain may eventually be present at rest and may even cause a problem sleeping. Injection of a small dose of corticosteroid and local anaesthetic into the bursa might relieve these symptoms by reducing inflammation in or around the bursa.
The type of injection given depends upon the nature of the injury, and may be used to treat inflammation, inhibit the transmission of pain messages, promote healing, or to lubricate the joint.