Interventional Pain Management
Is joint or spine pain limiting your lifestyle? If you’re looking to find effective pain relief and improve your quality of life, turn to the pain management specialists at New Hampshire Orthopaedic Center (NHOC). Our experts specialize in treating arthritis pain, sciatica, herniated discs, spinal stenosis and all other types of neck and back pain.
Pain Management Excellence in New Hampshire
Interventional pain management techniques can help you find relief from pain caused by arthritic joints and compressed spinal nerves. If nonsurgical treatments like oral pain medication are no longer effective and physical therapy is too painful, you may benefit from minimally invasive procedures. NHOC offers:
- Skilled physicians: All our pain management doctors are board certified in anesthesiology with additional certification in pain management. We perform hundreds of interventional treatments and minimally invasive procedures each year, so you can trust our experience.
- Customized care plans: Our pain management experts are dedicated to understanding what causes your pain and how it affects your life. We learn about your lifestyle and recovery goals so we can tailor a care plan that’s best for you.
- Improved quality of life: We aim to get you moving again, free of pain and limitations. The treatments we offer can help you participate in physical therapy, go about your daily activities and enjoy time with loved ones.
- Minimally invasive procedures: Joint injections, nerve blocks and nerve ablation are nonsurgical, office-based procedures. There’s no anesthesia involved, and you go home the same day.
Diagnosing Neck and Back Pain
Diagnosing spine pain can be difficult. It can affect many areas of your body, including your neck, shoulders, arms, hands, abdomen, hips, legs and feet.
Our pain management specialists begin by asking questions about your lifestyle, activity level, when the pain started, where you feel it and what activities make it worse. During a physical exam, they check to see if you’re able to sit, stand, walk and lift your arms and legs.
To help locate where the pain is coming from, our doctors may order one or more tests, including:
- Spine X-ray: These images show your vertebrae (spinal bones). We use them to check for or rule out arthritis or broken bones.
- CT scans or MRI: These scans create detailed images of all the bones, muscles, tendons, ligaments, nerves and blood vessels in and around the spine.
- Electromyography (EMG): This test stimulates nerves and measures how your muscles respond to the electrical impulses produced by those nerves. EMG can confirm nerve compression caused by conditions such as herniated discs or spinal canal narrowing (spinal stenosis).
Interventional Pain Management Procedures We Offer
At New Hampshire Orthopaedic Center, we offer numerous minimally invasive procedures. Some, like injections and nerve ablation, are nonsurgical, and we do them in our office. The most common office-based procedures we perform include:
Transforaminal epidural steroid injection
An epidural steroid injection (ESI) helps relieve pain, numbness and tingling from inflamed spinal nerves. The injection contains a corticosteroid (anti-inflammatory) medication and numbing solution. It’s injected into the area of the spine where the nerve is compressed:
- Cervical spine (neck): We may recommend a cervical ESI for pain in the neck, shoulders, arms or hands.
- Thoracic spine (upper- to mid-back): We may perform a thoracic ESI for pain in the upper back, ribs or abdomen.
- Lumbar spine (low back): You may have a lumbar ESI for low back or leg pain.
“Transforaminal” refers to the injection approach we use. For a transforaminal ESI, our doctors place the needle through the side of the spine into the foramina, the openings where nerve roots exit your spine.
Many conditions can compress nerves, causing inflammation and pain. An epidural steroid injection might be right for you if you have a herniated disc, degenerative disc disease, spinal stenosis, spondylosis (spinal osteoarthritis) or sciatica.
The medication typically takes a few days to begin working. Epidural steroid injections provide temporary pain relief, enabling you to participate in physical therapy and other daily activities. Many people experience pain relief and improved function for several weeks or months.
Intra-articular steroid injection
Corticosteroid (cortisone) shots can help relieve osteoarthritis pain and inflammation in any joint – knee, hip, shoulder, elbow, wrist, ankle and even toe and finger joints. They are injected directly into the affected joint. Corticosteroids may provide arthritis pain relief for several months.
Medial branch block injection
A medial branch block injection provides temporary pain relief from facet joint pain. A pair of facet joints are located between each bone in your spine (vertebrae). They connect the vertebrae and allow the spine to bend and twist.
Medial nerves run through the facet joints. Over time, the medial nerves can become pinched and inflamed from spinal osteoarthritis, degenerative disc disease and joint strain.
A medial branch block works by temporarily blocking pain signals sent from the medial nerves to the brain. The injection is primarily diagnostic, though. If we suspect your pain is coming from the facet joints, we do a medial branch block to confirm this and pinpoint the exact location of your pain. Once we verify the facet joints are the problem, we may recommend radiofrequency ablation for longer-term pain relief.
Radiofrequency ablation interrupts pain signals sent from the affected spinal nerve to the brain. Our experts insert a hollow needle into the painful joint. An electrode at the needle tip sends a gentle electrical current to the targeted nerve. This creates a heat lesion on the nerve, preventing the pain signal from traveling to the brain.
We typically recommend radiofrequency ablation for facet joint pain and sacroiliac joint pain. You may experience pain relief for six months to two years.
Sacroiliac joint injection
The sacroiliac (SI) joints are located at the end of your spine. They connect the large, triangular bone (sacrum) to the hip (pelvic) bones. The hip is a large, weight-bearing joint, and the SI joints act as shock absorbers. They can cause pain in the low back, buttocks or hip.
If we suspect your pain is coming from one of your sacroiliac joints, we might recommend an SI joint injection to diagnose and treat low back pain, pelvic pain or sciatica. The injection contains corticosteroid medication to decrease inflammation and relieve pain.
Contact Us About Pain Management
For questions about our interventional pain management services, or to make an appointment with one of our pain specialists, call or text 603.883.0091.