Monthly Archives: December 2012

What to Expect With an Epidural Steroid Injection

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When an individual is suffering from sciatica due to a pinched nerve, the pain may be excruciating. It may prevent a person from being able to work, play with their kids, concentrate or enjoy life for weeks to months.Sciatica treatment

Of the various treatments that can help reduce the pain of sciatica, epidural steroid injections at a Las Vegas pain management clinic are one of the best ways of making life much more tolerable for individuals.

When an epidural steroid injection is recommended by a Las Vegas Pain Management Doctor, it is performed as an outpatient with the person being able to go home the same day. The procedure itself does not require either oral or IV sedation, however, some patients are used to that or have significant anxiety and want to have sedation. Often times, the procedure is performed simply with numbing medicine around the skin and through the soft tissues down to the bone overlying the spine.

Modern Las Vegas Pain Doctors use either ultrasound guidance or fluoroscopy, which is a real-time form of x-ray. This allows for the highest level of accuracy available, as previous studies have shown without image guidance the miss rate for epidural injections is as high as 40%.

Las Vegas pain managementPatients are usually placed on their belly on a well padded table that allows x-rays to go right through. The procedure itself takes approximately 10 to 30 minutes depending on the difficulty encountered with needle placement.

Once the needle is satisfactorily placed, the pain doctor will place contrast in the area to make sure it is successful. At that point numbing medicine along with steroid medication is injected to relieve the sciatica pain.

The patient is then taken to the recovery area and watched for approximately 30 to 60 minutes to make sure no allergic reaction occurs and the vital signs remain stable.

Pain relief may be immediate with an epidural steroid injection. Also it may be immediate and then wear off after a day once the numbing medicine wears off. When that occurs, steroid medication will often “kick in” after three days or so and may last for weeks to months.

Many studies have looked at the effectiveness of epidural steroid injections for sciatica. Overall, the good to excellent results occur in 75 to 90 individuals. The duration of pain relief is typically six weeks to upwards of 2 to 3 months. At that point, the injections may be repeated. Typically an individual will receive a series of three injections 1 to 2 weeks apart.

The risks of epidural steroid injections are small but real. There is a risk of infection, bleeding, nerve injury which is usually transient, and allergic reaction. A person may also have some transient reaction to the cortisone used, which may include a temporary blood sugar increase or slight weight gain or water retention.Pain Clinic Las Vegas

Overall, epidural steroid injections are some of the most beneficial procedures in pain management today. If you are experiencing significant sciatica pain or what you think may be due to a pinched nerve, seek treatment with Pain Management Las Vegas trusts today.

Treatment may include epidural injections and also possibly pain medication, Las Vegas Chiropractor treatment, physical therapy, acupuncture or spinal decompression therapy.

What to Expect With a Radiofrequency Ablation

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For chronic neck or back pain, radiofrequency ablation has been one of the best technological advancements in pain management in the 21st-century. It is just not every Radiofrequency Ablationday when a Las Vegas Pain Management procedure comes along that can provide 6 to 18 months of consistent pain relief.

Along with offering pain relief for chronic neck and back pain, radiofrequency ablation has also shown benefit for headaches, sacroiliac joint pain and more. What should patients expect from a radiofrequency ablation (RFA) procedure?

First of all, radiofrequency procedures are performed as an outpatient either in a Las Vegas pain clinic procedure center or at a separate surgery center. Some patients opt for either intravenous oral oral sedation, which may include the patient taking a Valium 30 minutes prior to the procedure. Other patients require no anesthesia at all other than having the skin numbed up and the soft tissues numbed down to the area of where the procedure is radiofrequency neurotomygoing to be performed.

Almost all Las Vegas pain doctors utilize image guidance for the procedure, which usually includes fluoroscopy, which is a real-time form of x-ray.

The Pain Management Las Vegas doctor places the radiofrequency needles into the area around the joints being treated. Once they are in place, the needles are stimulated to make sure they are not close to an actual nerve root.

If an arm or a leg jumps as a result of the stimulation, the doctor will reposition the needle until that does not occur. The nerves being treated are not nerve roots, rather they are tiny little nerve endings that only provide sensation.

Radiofrequency Neurotomy

Radiofrequency neurotomy procedures work well for facet joint arthritis.

Once accurate placement is achieved, the needles are heated up to approximately 80°C for 60 to 90 seconds. This will heat up and deaden the tiny nerve endings around the painful joints.

Once this is completed, patients are taken to the recovery room and monitored for 30 to 60 minutes to make sure that no allergic reaction occurs and vital signs remained stable. Patients are then allowed to go home.

The effectiveness of radiofrequency ablation procedures is extremely good to excellent. Over 75% of patients achieve more than 50% pain relief for over six months. The procedure may not work right away, and there may be some muscle spasms and it may take one to two weeks for pain relief begins to work.

If the procedure works well and then wears off after 6 to 18 months, a repeat radiofrequency ablation procedure has been shown to work just as well as the initial one.

Pain Management Education Is Deficient in American Medical Schools

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A new study out of the Journal of Pain shows that pain management education in American medical schools is limited and fragmentary. Chronic pain affects over one third of United States adults, and the treatment of pain often is in adequate. Along with that, we now know that pain education for the future doctors of America is inadequate as well.

This is surprising considering the depth of the problem in the American population. The researchers looked at US medical schools to see what kind of pain management education was being offered and how many medical schools provided that type of education.

Less than 4% of US medical schools taught a required pain course. 16% of the schools offered an elective in pain management education.

Most US medical schools do not teach any courses on pain management, in addition another large number of schools have fewer than five hours of pain education in a four-year period. The researchers use the term fragmentary in regards to pain management being taught in the context of a more general course which is not really focused on pain much at all.

Pain is one of the most common reasons people in America go to see a doctor or to an emergency room. Typically about an hour is spent in medical school on opioid pharmacology and not much else. The researchers noted that some of the areas that are under educated include cancer pain, pediatric pain, and legal issues pertaining to narcotic medications.

With such a considerable amount of regulatory effort being spent on going after doctors prescribing pain medication, it would seem prudent for education to be offered rather than simply punishment.

One of the recommendations that came out of the study was to increase the number of required pain focused courses that are offered in medical schools and to place pain management into a more organized in formal delivery system. The researchers noted that both emotional and intellectual skills are important when it comes to providing compassionate and educated pain management for patients.

When seeking pain management doctors in Las Vegas and Henderson areas, make sure the ones under consideration for you have either finished fellowship training specifically in pain management or are Board Certified. A fellowship entails a complete year in learning the ins and outs of interventional procedures along with medication management for Pain Relief treatment.

Along with simply increasing the knowledge base for effectively treating their patients, they have also learned the emotional aspects of dealing with Pain Management as well.

If you or a loved one is suffering from acute or chronic pain, seek the best pain management doctors and chiropractors in Las Vegas and Henderson today. 

New Research Shows Radiofrequency Ablation Works Well for Whiplash

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Whiplash is a problem that results mostly from car accidents. Approximately 3,000,000 people annually sustain whiplash injuries in the US, which leads to damage of the Whiplash painligaments and joints in the neck. The surrounding muscles can also experience damage and spasms as well.

15% of those who sustain whiplash end up with chronic neck pain that lasts for years. Since chronic neck pain often responds well to radiofrequency ablation, a recent study looked at RF procedures for those who had chronic pain from whiplash.

In the study, approximately 60 participants were evaluated and the results were presented at the World Congress of Pain meeting.

The participants had gone through at least six months of conservative treatment which may have consisted of physical therapy, medications, chiropractic treatment and those sorts of therapies.

Radiofrequency ablation worked exceptionally well in over 65% of the study group.

The patients typically experienced pain relief for over six months on average. Along with seeing significant pain reduction, patients experienced functional improvements and there was a significant return to work percentage.

Las Vegas pain clinic

Radiofrequency Ablation

It is no secret that cervical radiofrequency ablation works well for chronic neck pain due to arthritis of the cervical facet joints. Now we have evidence showing those who end up with chronic pain after a whiplash injury can also see excellent results with radiofrequency ablation.

Along with RFA for neck pain due to whiplash, additional treatments that may help include physical therapy Las Vegas, chiropractic manipulations, TENS units, trigger point injections, facet blocks and spinal decompression therapy.

Call a Las Vegas Chiropractor, pain doctor, or PT clinic to get started on your neck pain treatment today!