Monthly Archives: August 2013

FAQ’s on Facet Injections from a Las Vegas pain management clinic

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What Are Facet Injections?

Facet injections provide medication to the facet joints. Facet joints are situated in between the vertebrae starting from the neck all the way to the tailbone. These joints make it Las Vegas pain doctorpossible for the vertebra to move against each other.

The injections are non invasive and are not only used for treatment purposes but diagnostic as well. When it comes to diagnosis, facet injections can help to identify if pain is resulting from your facets at a certain level(s). With treatment, they can be used to relieve pain and inflammation that is caused by various spinal conditions.

How Long Does The Injection Take and What Is In It?

The injections with a Las Vegas Pain Management Doctor usually take less than half an hour and contain a mixture of steroids and local anesthesia.

Is The Injection Painful?

Yes, there is some minor pain involved as the needle is inserted through the skin to deeper tissues. However, this pain is numbed with anesthesia and the numbing medication is inserted using a thin  needle. Many patients ask for intravenous sedation as this makes the procedure more tolerable.

What Is The Procedure for Facet Injections?

Pain clinics Las VegasThere are different types of facet injections and though the process is pretty much the same, the lying position may differ. For most facet injections, you will be asked to lie on your stomach while if you are undergoing a cervical facet injection you will need to lie on your back.

Patients are monitored using a blood pressure cuff, blood oxygen monitoring device and an EKG. The injection area is cleaned with an antiseptic before the injection is carried out. A few injections can be administered in one visit, but these are usually not more than four. The injections are administered by Board Certified Pain Management Doctors in Las Vegas.

How Do I Prepare for Treatment?

If you are under medication such as blood thinning medication or anti-inflammatory drugs, your Las Vegas Pain Clinic will advise you stop taking the medication a few days before the procedure. This is an outpatient procedure and you need to organize for transportation from hospital since you may not be in a position to drive especially if you have been given a local anesthesia.

Are There Side Effects?

Yes there are several side effects that come with the medications and you will experience Pain Clinics in Las Vegassoreness on the injection site a day or two after the injection. Pain is also a common side effect and these side effects are temporary. There are other risks involved and these are bleeding, infection, spinal block and others. You need not worry much about the dire side effects as these are uncommon.

How Effective Are Facet Injections?

These injections tend to be more effective in conditions whose pain is related to inflammation or facet arthritis. Over 70% of all patients who are administered with facet Las Vegas pain management doctorsinjections enjoy some pain relief. The pain can subside for a couple of days or possibly a few months.

If the pain is relieved and eventually returns, a radiofrequency ablation may be indicated for longer term pain relief.

How Many Injections Do I Need?

You only need one injection for a facet joint. However, it may take several injections depending on the extent of your symptoms and the injections may be carried out in a group of joints. When it comes to multiple injections, usually three are administered with a maximum of four being conducted at the same time.

If the injections are effective, you can undergo this procedure for about three times a year. Las Vegas pain managementIf the injections have produced good results, you could be considered for facet rhizotomy which is a procedure that destroys the nerve fibers that are responsible for the pain.

The Nevada Pain Network connects those in pain with Pain Management Doctors Las Vegas and Henderson trust. These doctors are Board Certified and Award Winning, such as the  pain doctors at Innovative Pain Care Center. Most insurances are accepted, along with self pay.

If you or a loved one is suffering from chronic neck or back pain, call (702) 323-0553 today for more information and scheduling!

FAQ’s on Superior Hypogastric Plexus Block

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What is this Type of Block?

A superior hypogastric plexus block is a kind of injection used to manage pain from the region of the pelvic that is not being managed adequately by oral medications.  This type of block can also be indicated if the side effects for a pain relieving medication (excess nausea, constipation, Pelvic Pain Las Vegasand sedation) are not tolerable to the patient.

Since the “superior hypogastric plexus”  encloses efferent sympathetic fibers to and afferent pain fibers from the urethra, uterus, vagina, vulva, bladder, perineum, penis, prostate, rectum, testes and descending colon, this block can possibly get rid of pain that begins from the above named regions.  The most recent literature shows that the block has been effective in treating both malignancy-related anal-rectal pain and nonmalignant penile pain which further adds validation for the use of this block.

Used on pain beginning from the urethra; bladder; uterus; vulva; vagina; perineum; penis; prostate; testes; rectum; and descending colon or pain that is secondary to: endometriosis, metastasized cancer to the pelvis (cervical, testicular, prostate, testicular, colorectal etc.); and radiation injury.

What is the Anatomy of this Area?

Pelvic Pain Treatment Las VegasThe “superior hypogastric plexus” is a retroperitoneal configuration that lengthens bilaterally, just anterior to the vertebral column and between the lower third of L5 and upper third of S1 vertebral bodies.  It is formed by efferent sympathetic nerves and pelvis visceral afferents from branches of the aortic plexus and fibers from the splanchnic nerves.

Its location allows it to innervate the majority of pelvis viscera (including the urethra, vagina, bladder, perineum, prostate, vulva, penis, rectum, testes, and descending colon).

Description of this Block

This type of block is normally done with a posterior approach (through the back).  If you can lie down on your abdomen, face down without any large agony your Las Vegas Pain Doctor will most likely use this method.  If you are not able to lie down in this position, this position causes you too much pain, your LV pain doctor deems it to technically difficult based on your anatomy of your lower spine, he or she might choose the anterior method or the transdiscal method.

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Hypogastric Plexus Block

The anterior method might be done with fluoroscopy, computed tomography-guidance or guidance by ultrasound and it lets you lay down on your abdomen or your side.  Using this technique, your physician progresses the needle through the skin and muscle of your back and L5-S1 intervertebral disc to reach the “superior hypogastric plexus”. But, the posterior method remains one of the more common methods to performing this block and is also done under fluoroscopy or computed tomography-guidance.  Fluoroscopy tends to be the imaging technique favored since there is less radiation exposure to the patient.

You will be asked to lie down on your stomach with a pillow under the pelvis to help flatten out the natural curvature in the lower lumbar spines.  Your lower back will then be prepped and draped in a sterile manner prior to local anesthesia being administrated at the two points of entry of the needle into the skin.  When your skin is sufficiently anesthetized, 2 needles will be advanced under control of the fluoroscope until placement of the needle is correctly obtained.  Their correct placement will also be established by administration of contrast dye.  Once there is validation of the position either a diagnostic block or a therapeutic block will be done.

How to know if this Block is a Success

A successful block is marked by pain relief that is profound.  Local anesthetic usually directed for “superior hypogastric plexus” diagnostic block or for those patients with Pain Management Clinic Las Vegasnon-cancer related pain. For those with a known response to management of local anesthetic onto the “superior hypogastric plexus,” a therapeutic block is done with management of the neurolytic agent such as phenol.  Radiofrequency ablation of the “superior hypogastric plexus” is also another treatment modality for longer-lasting pain relief.

The procedure usually takes less than 15 minutes. Often your Vegas pain doctor will recommend intravenous sedation to make the procedure more comfortable. Your physician will monitor your pain and vital signs (pulse, blood pressure, temperature) after the procedure.

The Nevada Pain Network connects those having pelvic pain with pain management doctors Las Vegas trusts. The treatments may include pain medication management, or interventional procedures such as superior hypogastric plexus blocks. If you or a loved one is experiencing pelvic pain, let the Network help you with Board Certified, Award Winning pain clinics in Las Vegas such as Innovative Pain Care Center.

Call (702) 323-0553 for more information and scheduling.

FAQ’s on Kyphoplasty from a Las Vegas pain clinic

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Kyphoplasty is a Las Vegas Pain Management and spine corrective surgical procedure that is performed on patients who are suffering from spine fractures. The fractures that are treated using this procedure can either be the result of osteoporosis fracture, a primary Compression fracture Las Vegasbone tumor or metastatic cancer. The main goal of Kyphoplasty is to restore the height of the fractured vertebrae and decrease an individual’s pain (Resnick and Garfin, 2005).

                What are the major indicators for having a Kyphoplasty procedure in Las Vegas?

People who are suffering from debilitating pain in their spine due to a compression fracture are ideal candidates for having Kyphoplasty. Moreover, patients suffering from metastatic cancer that have developed compression fractures in their spines will also find this procedure massively helpful in correcting the shape of their spine and in reliving the pain that they are experiencing.

Anyone who has suffered an injury in an accident that has resulted in a compression Kyphoplasty Las Vegasfracture in his spine is also a prime candidate for undergoing Kyphoplasty for reversing the damage and restoring the shape of his spine.

Usually the initial treatment involves pain medication management and spinal bracing. If this fails,

                                          

What does a Kyphoplasty procedure entail?

Kyphoplasty is a surgical procedure that involves the use of bone cement which is injected into the spinal fracture to stabilize the damage sustained by the fractured vertebrae. Before the injection of the bone cement, the use of a balloon is made to open up the void in the Kyphoplasty Procedurespinal column for restoring the size of the vertebrae and also for ensuring that the bone cement can be injected easily.

The placement of the balloon is done using a needle that is inserted in the fractured vertebrae. The balloon is then inflated to create the gap in which the bone cement is to be inserted. Once the balloon has done its job, it is deflated and the bone cement is placed. Then the cement hardens within 20 minutes and pain relief is usually dramatic.

                      How does Kyphoplasty help the doctor provide treatment?

Kyphoplasty can help the Pain Management Doctors in Las Vegas providing treatment to the patient by limiting his pain and restoring some of the balance to his spine. In the case of patient suffering from metastatic cancer that have developed compression fractures in their spine, the use of this procedure is of massive help to the LV pain doctors as it provides them the chance to focus on treating the other symptoms of their disease while the pain caused by compression fracture is dealt with by Kyphoplasty.

                            What to expect during a Kyphoplasty procedure?

Before you undergo a Kyphoplasty procedure you are going to be asked to stop taking medication that is generally prescribed for thinning the blood like aspirin and warfarin. Your doctor might even ask you to stop taking other medications too if he sees fit. You must try to avoid smoking or drinking alcohol before the procedure as well.

The Kyphoplasty procedure begins with the sterilizing of the skin above the portion of the fractured vertebrae. You might be given a local or general anesthetic to make sure that you do not feel pain during the procedure. Spinal Fracture Treatment

After cleansing, the skin is then numbed after which the doctor inserts a needle into the fracture. Then a balloon is placed inside the fracture which is then inflated to widen the gap in the fractured vertebrae, restoring it to its original height. This gap is then going to be filled with bone cement using another needle. The procedure is going to be over in about an hour’s time.

                    What are the risks of having a Kyphoplasty procedure?

Usually Kyphoplasty is a safe procedure which does not have many risks. In some cases Pain Clinic Las Vegashowever the patient might develop an infection or allergy, internal bleeding might happen and sometimes leakage of the bone cement in the body can occur too. According to Ray (2008) pulmonary emboli of cement is also reported in some of the patients that undergo this procedure.

There is a low risk of the cement leaking where it’s not supposed to go. This may include into the spinal canal, where it can cause a neurologic issue.

                  What are the benefits of having a Kyphoplasty procedure?

The most significant benefit of having a Kyphoplasty procedure is relief from the pain caused by the compression fracture. Moreover, the quality of life of the patients undergoing this procedure improves considerably as well.

Pain relief in multiple studies has been shown to exceed 90%. Typically the relief is dramatic and immediate, and patients start to ambulate more and increase activities of Las Vegas pain clinicdaily living.

The best pain management clinics in Las Vegas are in the Nevada Pain Network. Innovative Pain Care Center, for instance, offers a Double Board Certified, Award  Winning pain doctor who offers an impressive amount of treatment options, including kyphoplasty.

Over 25 insurances are accepted, and there are 2 clinic locations. Call (702) 323-0553 for more information and scheduling today!

Adult Degenerative Scoliosis and Nonoperative Treatment

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Spinal deformity can be a very painful condition in the life of an adult. Nerve compression or the spine can both result in a great amount of pain due to Adult Scoliosis. With proper Pain management clinic Las Vegasnonoperative treatment by a Pain Management Doctor in Las Vegas, patients can achieve a very tolerable level of baseline pain, avoid surgery, and get back to performing desired activities.

What is Adult Scoliosis?

Adult Scoliosis is a deformity of the spine. It can be carried from childhood scoliosis or be the result of degenerative disc disease and arthritic degeneration of the spine that resulted in a permanent deformity. It can cause a range of problems in adulthood, and many of the symptoms can be painful in the back and legs. Adult Scoliosis can affect the overall quality of life of a patient. It can be disabling with associated pain in the back and lower legs ranging from mild to severe from nerve compression.

Diagnosis of Adult Scoliosis

A series of diagnostic tests will be used by your Las Vegas pain clinic doctor to determine if there is an imbalance or spinal deformity. Some can be very obvious and seen with the Scoliosis Treatment Las Vegasnaked eye, but others may rely on long views of the spine being positioned for the relationship of the pelvis, lower extremities, and spine to be investigated.

Adult Scoliosis is multi-factored. Many pre-operative tests may be performed to determine the nature of therapy or surgical intervention, such as a DEXA Scan, CT myelography (study of nerve positioning), or MRI. For example, if an individual has very poor bone quality on the DEXA Scan the spine may not be able to hold on to hardware so surgery would be a bad idea. The MRI can show if nerves are being pinched due to the arthritis, which is known as spinal stenosis.

X-rays are used to follow the progression of a spinal curve and as a follow-up after a surgical procedure. The X-ray is the most important diagnostic test for Adult Scoliosis, as it gives the most accurate information on subluxations (slips) and spinal rotation. Many patients do not have the crucial X-ray before surgery and this may warrant further revisional surgeries.

Treatment Options for Adult Scoliosis

Adult Scoliosis and its treatment can vary depending on a number of factors. On average, most cases of Adult Scoliosis will not need surgical intervention for the patient to lead a Best pain clinic Las Vegasproductive life.

  • Non-surgical treatment

Non-surgical treatment has a twofold goal of reducing symptoms of pain, and to increase the functional abilities of the patient with strengthening, improving flexibility, and a wider range of motion. These are factors that impact the spine through its support and flexibility, to help ward off the progression of this degenerative condition.

  • Medications

Deteriorating facet joints and increased, or sustained, inflammation of the spine can be very painful. Usually the first treatment sought is through NSAIDS and pain relievers that are effective on arthritis conditions and these conditions typically share many common symptoms with Adult Scoliosis.

For acute exacerbations of adult scoliois, short term narcotics may be very beneficial. Over the long term, the risks of narcotics start to outweigh the benefits. So this needs to be weighed and discussed with your pain doctor in Las Vegas. During the painful times, muscle relaxers may also be used.

For the leg pains due to spinal stenosis, neurogenic stabilizing medications such as Lyrica can be beneficial.

  • Injections

To decrease inflammation and relieve pain, your Nevada pain management doctor may recommend epidural or facet injections for treatment. Medication or a numbing agent is directly injected into the affected region of the spine.

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Radiofrequency Ablation

The epidural injections are the gold standard for spinal stenosis, and may provide relief for months at a time. A series of injections may be necessary, which can be repeated every few months.

Facet blocks may be helpful for the arthritis pain, or medial branch blocks to diagnose which joints are causing the most pain. In and of themselves, these injections can provide a few months of Pain Relief.

Once these injections  wear off, a radiofrequency ablation may provide 12 to 18 months of extended pain relief. The issue with adult scoliosis is that a lot of joints are typically affected, so the RFA may be necessary in quite a few joints. The good news is that RFA is such a revolutionary procedure, it can help patients avoid the need for surgery as operations for adult scoliosis have potential complications.

  • Surgery

Candidates for surgery are the patients who are experiencing limited range of motion when walking that may be accompanied by severe pain (lumbar stenosis and neurogenic claudication). Lumbar stenosis patients usually have spinal decompression surgery along with the extensive fusion. If a spinal curve is present which may cause further complications involving stability or acceleration in the progression of the curve, then a spinal fusion procedure will be considered.Pain Management Las Vegas NV

These procedures have significant complication risks and are used as a last resort, quality of life procedure.

Adult Scoliosis can cause considerable pain and limited function for patients. Thankfully, Pain Management Doctors in Henderson and Las Vegas have considerable nonoperative options that are well over 90% successful at helping patients avoid the need for surgery.

For the best pain management Las Vegas has to offer, call the Nevada Pain Network today at (702) 323-0553.

What to Expect with a Vertebroplasty Procedure?

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What is a Vertebroplasty?

The elderly population witnesses a great deal of vertebral compression fractures, which is a common pathology among this group. The consequences of this condition can be Las Vegas pain managementdevastating at times.

Vertebroplasty was initially used for treating cancer pain from vertebral fractures and is today being used for the treatment of osteoporotic vertebral compression fractures. The treatment is quick, outpatient and over 90% effective.

The Procedure

Before the procedure, the patient has to go through several non invasive diagnostic tests. These consist of x-rays and an MRI scan. After these tests, the exact position and severity of the fracture is reviewed. The MRI shows if the fracture is new and still trying to heal, or if it’s old and no longer active.

The procedure is an outpatient one and the patient is either conscious or put under. Numbing medicine is injected under the skin and through the soft tissues down to the area of the fracture. After locating the fracture on fluoroscopy (real time x-ray), a small needle will be placed for administering the local anesthetic.

It is a straight forward procedure, where a needle is inserted into the vertebral body that has been damaged and the vertebroplasty bone cement is injected into the vertebral body through the needle, under a local anesthetic. The cement hardens within ten minutes and Pain clinic in Las Vegasthe fracture becomes stabilized.

The effect is that further collapse of the vertebral body is prevented and it also removes the pain that results from the fracture. It has been seen to be a relatively safe and effective procedure for treating such fractures among the elderly population.

Providing Emotional and Physical Well Being

The patients’ pain from spinal fractures is considerably reduced following vertebroplasty at a Las Vegas Pain Clinic. This results in a reduction of use of narcotics for controlling pain. The major benefits that patients can expect from the treatment are a quick recovery; reduction in medications; increased mobility; and lowered complication risks.

Vertebroplasty Procedure

Vertebroplasty Procedure

Vertebroplasty also offers relief from pain and enables early mobilization to get the patient back up and walking. This helps avoid severe complications that can arise from chronic back pain or from a prolonged bed rest. The complication rate is also low, especially when it is performed by experienced pain management doctors in Las Vegas. There is a minimal rate of infection or neurologic complication.

It offers a safe procedure leading to satisfactory outcomes in case of vertebral compression fractures. Thus, it offers a quicker recovery of the patient, both physical and emotional.

Immediate Treatment

In order to get the best benefits from Vertebroplasty, it is suggested that the fracture Las Vegas pain clinicshould be treated as soon as possible, as older fractures can also respond to the treatment, but the pain relief might not be much in the latter case. Most insurance companies want the patient to have a trial of medication management along with spinal bracing initially.

If this fails, a vertebroplasty procedure may be an extremely effective outpatient procedure for patients with over a 90% good to excellent outcome.

If you or a loved one is experiencing significant mid back or low back pain from a suspected vertebral compression fracture, Las Vegas pain clinic doctors can help you. The Nevada Pain Network connects those in pain with pain management doctors in Las Vegas that are Board Certified and accept most insurance.

Call (702) 323-0553 for more information and scheduling today!