Monthly Archives: March 2014

FAQs on Radiofrequency Ablation from a Las Vegas pain center

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FAQ Radiofrequency Ablation

What is radiofrequency ablation?

Minimally invasive techniques such as laparoscopic surgery, shock wave lithotripsy, and radiofrequency ablation have allowed physicians to treat patients with minimal damage to Back pain doctor Las Vegastissues. These procedures are associated with better outcomes, faster recovery time, and improved patient satisfaction compared to traditional open-surgery techniques. Minimally invasive procedures are also preferred by hospitals and insurance corporations because of shorter in-patient stay.

Radiofrequency ablation (RFA) is a minimally invasive procedure that uses energy, rather than a scalpel, to destroy tissues, such as malignant tumors. Radiofrequency energy is used to heat up, and eventually ablate (destroy) the target areas of tissue. This procedure has been used with positive results in a wide variety of conditions.

How is radiofrequency ablation done?

RFA is an outpatient procedure usually done under local anesthesia. The patient may be given an oral or an intravenous sedative if further relaxation is needed. Similar to other surgical procedures, the sterile technique is observed for RFA. The needle injection site is scrubbed with an antiseptic solution such as povidone-iodine or chlorhexidine, and the surrounding area Radiofrequency ablation Las Vegasis draped with sterile linen.

The operation begins upon insertion of the needle-like probe through the skin. Insertion through the tissues is done under fluoroscopic (X-ray) guidance, although other imaging modalities such as computerized tomography (CT) scans and ultrasound scans have also been employed, with similar success rates.

The needle is guided until the target area is reached, and then the RFA probe is turned on. Initially, electric stimulation is done prior to the actual radiofrequency ablation. The electric sensation is described as a buzzing, tingling, or deep ache.

Once the Las Vegas Pain Management Doctor has determined that the probe is in the right place, a local anesthetic will be inserted. High-frequency electrical energy is then delivered through the RFA probe, heating up the surrounding tissue, causing damage and eventual cellular death.

The needle is then withdrawn, and the patient is kept under observation for approximately 20 minutes before being sent to the recovery room.

What conditions benefit from RFA?

RFA has found application in a wide range of conditions, particularly those that require precise removal of tissues with minimal damage to the surrounding areas. These include, but are not limited to, conditions such as:

  • Malignancies – the need for open surgery has been reduced with the introduction of Radiofrequency Ablation Las VegasRFA to destroy malignant tissue.
  • Varicose veins – RFA has been shown in some studies to be equally effective as the traditional open surgery techniques, with good outcomes.
  • Obstructive sleep apnea (OSA) – initial case studies have shown that RFA can be used in the treatment of OSA; however, further large scale studies are still needed to validate their effectiveness and safety.
  • Cardiac arrhythmias – dysfunctional firing of cardiac tissues can cause arrhythmias (irregularities in the heartbeat) such as atrial flutter, atrial fibrillation, supraventricular tachycardia, premature ventricular contraction, among others. RFA has been very successful as a technique to destroy dysfunctional cardiac tissue while sparing neighboring areas.
  • Pain management – RFA has also been used as a technique for surgical blocks. An initial diagnostic nerve block is done under local anesthesia before RFA is attempted. This procedure is indicated for patients who are suffering from back or neck pain due to arthritis in the facet joints of the spine. RFA is used to destroy neural tissue, disrupting the transmission of pain signals to the brain.

What are the risks of RFA?

RFA is a well-tolerated procedure that provides mostly excellent outcomes. The procedure has been established to be safe, having high success rates and low complication rates in populations like children and adolescents.Pain clinic Las Vegas

Success rates are varied, but for patients undergoing RFA for low back pain, around 60 to 80% would experience significant pain relief for as much as two years. Most would experience some form of pain alleviation, although for a shorter period. Some studies have shown that over 80% of patients undergoing RFA for cervical facet neurotomy can experience alleviation of pain after the procedure. Pain is usually relieved from nine to 14 months, or until the nerve regenerates.

However, similar to other surgical procedures, there are always risks present for the patient. These include the risk of infection at the surgical site, intraoperative damage to muscles, Pain center Las Vegasnerves and surrounding tissues, pain at the injection sites, bruising, bleeding, or hematoma formation. There is usually some swelling and bruising at the site of treatment, however this usually resolves after a few days.

The best pain center in Las Vegas is Nevada Pain. The center accepts over 50 insurances, achieving success rates over 95% with a combination of medical and interventional therapies.

Call (702) 323-0553 for more information and scheduling with the best neck and back pain treatment in Las Vegas!

5 Best Treatments for Trigeminal Neuralgia

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Trigeminal neuralgia, also known as Fothergill’s disease, is known for causing pain from the trigeminal nerve that runs through the face. It is considered one of the most painful disorders a person can contract and it is estimated that approximately 1 in 20,000 suffers from this condition. It can be difficult to estimate the true number of trigeminal neuralgia patients Trigeminal Neuralgiabecause this condition is frequently misdiagnosed.

Symptoms of Trigeminal Neuralgia

This condition causes intense pain in the face that may last anywhere from a few minutes to a few hours. Something as slight as an air current or light touch can be enough to trigger an episode. In some cases an episode occurs spontaneously with no trigger at all.

Attacks may affect one side of the face, but around 10 percent of patients experience symptoms across both sides. The pain is described as feeling like a crushing, burning, electric shock or shooting pain across the nerve branches in the face. This pain may spread across other divisions of the nerve over time.

Best Treatments for Trigeminal Neuralgia

There are five main treatment options that are considered the most effective for managing trigeminal neuralgia discomfort.Trigeminal Neuralgia Radiofrequency

  • Gallium maltolate ointments or creams have been found to be helpful in easing symptoms of refractory postherapetic trigeminal neuralgia symptoms.
  • Some patients have found success with using low doses of antidepressants including amitriptyline to manage their pain.
  • Anticonvulsant medications that contain carbamazepine are generally used to help minimize the effects of trigeminal neuralgia. The two most commonly prescribed medications include lidocaine and clonazepam.
  • In some cases duloxetine has been found to be very effective in minimizing symptoms of trigeminal neuralgia. This is particularly helpful if this condition appears to be causing depression in the patient as well.
  • Opiate-based medication combined with gabapentin can be very effective in easing the neurologic pain that is often associated with trigeminal neuralgia. Oxycodone and morphine are commonly prescribed, though patients that use these medications will need to be monitored carefully as these medications can be habit forming.

Some pain management doctors in Arizona recommend surgical therapy for trigeminal Best Las Vegas Pain Centerneuralgia symptoms if medical treatments have not been effective, though the success rates with surgical therapy are not magnificent. While performing surgery may ease the pain, it can cause widespread numbness throughout the facial area that is often considered awkward or limiting.

There are three general procedures which are used to address the symptoms of trigeminal neuralgia if all other treatment options have been exhausted. The nerve splits into three areas throughout the face, and doctors will frequently use a balloon compression to address the portion of this nerve that is causing symptoms.

This technique is more commonly used on elderly patients that developed trigeminal neuralgia along with another medical conditions. Microvascular decompression is more commonly used to address the needs of patients that are experiencing pain from the ophthalmic nerve. Glycerol injections can also be used to coat the nerve to eliminate erratic pain signals but it needs to be administered with a lot of skill.

Trigeminal neuralgia is a tricky condition and very complicated. The pain management doctors in Las Vegas with over 80 years of combined experience are at Nevada Pain. The Las Vegas pain clinics offer both medical and interventional treatments with success rates over 95%. Call (702) 323-0553 for more information and scheduling today!

What is Spinal Decompression Therapy?

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Spinal decompression therapy has been a revolutionary treatment offered by Las Vegas chiropractors. The treatment may help patients avoid surgery, achieve Pain Relief and get back to doing the things in life that have been put on hold.

Anatomy of spinal disc disease

Degenerative change in the discs of the spine is a normal consequence of aging. The discs become dehydrated which results in narrowing of the discs. The outer fibrocartilaginous ring of the disc (annulus fibrosus) may crack or rupture thus allowing the inner nuclear material to Spinal Decompression Therapy Las Vegasleak into the spinal canal (a condition known as a herniated or prolapsed disc).

The herniated disc may compress a spinal nerve causing a condition commonly known as sciatica (where pain from the lower back radiates down into the leg).

Treatment options

Conservative treatment of symptomatic disc disease consists of analgesic medication (nonsteroidal anti-inflammatory drugs and/or opioids), bed rest and physical therapy. The recovery period may be prolonged but eventually, the extruded disc material may be reabsorbed by the body. Epidural corticosteroid injections may be beneficial in alleviating pain by suppressing the inflammation around the irritated nerve root.

Spinal decompression therapy in Las Vegas may further aid in the conservative management of spinal disc disease. The goal of spinal decompression is to distract the vertebrae thereby creating a negative pressure within the disc.

Las Vegas chiropractorThis negative intradiscal pressure is reported to produce a suctioning or vacuum-like effect on the disc causing retraction of a bulging disc and/or a reduction in the size of a herniated disc. The herniated disc is thus pulled away from the irritated nerve root relieving the pain of sciatica.

Mechanical traction versus spinal decompression therapy

Traditional lumbar traction (which has been in use for decades) produces a constant, Chiropractor Las Vegascontinuous force on the pelvis in only one direction. According to proponents of spinal compression therapy, this continuous force is met with tightening and spasm of the paraspinal muscles which actually increases the intradiscal pressure.

Modern spinal decompression tables are equipped with a microchip-controlled computerized feedback system that senses the occurrence of back spasm or resistance to the applied decompressive force and decreases the force of distraction accordingly. Spinal decompression units can also adjust the angle at which the distraction forces are applied.

Other reported benefits of spinal decompression therapy

The negative pressure gradient created by spinal decompression therapy is also reported to improve the delivery of blood, oxygen and nutrients to the disc thus providing an optimal healing environment.

Spinal decompression treatment protocol

Spinal decompression works through a series of 15 one minute alternating decompression and relaxation cycles with a total treatment time of 30 minutes. For the low back, the patient lies  on his/her back or stomach on the decompression table, with a set of padded straps snug around the waist and another set around the lower chest.

For the neck, the patient lies on his/her back with a pair of soft rubber pads behind the neck. Spinal traction Las VegasThe treatment is quite comfortable and is generally, well-tolerated. A series of 16 to 20 sessions is usually the minimum number needed but treatment may last several months and require 30 or more sessions.

Spinal decompression therapy and the FDA

Spinal decompression therapy has received U.S. Food and Drug clearance. Spinal decompression devices have been cleared for traction (stretching) which may relieve back pain but scientific evidence specifically in regard to lowering intradiscal pressure is lacking.

The top Las Vegas chiropractors and pain management doctors are with Nevada Pain. These Award Winning pain doctors and chiropractors offer incredible success rates with a variety of alternative and traditional treatment options.

For the top pain management specialists in the Las Vegas and Henderson areas, call (702) 323-0553 today!

FAQs on Kyphoplasty and Vertebroplasty

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by Nevada Pain

What are kyphoplasty and vertebroplasty?

Kyphoplasty and vertebroplasty are procedures that have been developed to treat spinal compression fractures. Both of these procedures use bone cement, which is injected into the fracture site; this then hardens and stabilizes the broken vertebra. It also acts to prevent Kyphoplasty Las Vegasfurther injury or re-injury.

What is the difference between kyphoplasty and vertebroplasty?

Both vertebroplasty and kyphoplasty use medical-grade bone cement to repair fractured or compressed vertebrae. This is usually inserted under fluoroscopy (X-ray guidance) into the affected vertebra by Las Vegas pain management doctors.

When the bone cement hardens, it provides structural support and stabilization to the broken vertebra. This will then immediately fuse the fragments of the vertebra into a continuous piece, thus resolving the irritation and inflammation caused by the broken fragments rubbing against each other, and against nerves and other soft Vertebroplasty Las Vegastissues. The exothermic heat released by the polymerization process (hardening of the bone cement) can also be a factor that contributes to the alleviation of the pain symptoms.

Vertebroplasty is used in conditions that require stabilization of the spine. This procedure has also been shown to help prevent repeat fractures.

Kyphoplasty is similar to vertebroplasty in that both techniques use bone cement to stabilize patients. However, this involves the injection of a balloon tamp in the vertebral body first. This balloon is then inflated, increasing the height of the vertebra and increasing the available space for the bone cement. Bone cement is then injected into the target space after the balloons are deflated.

The benefits from the kyphoplasty procedure are similar to that of vertebroplasty. This procedure is either conducted under general anesthesia or IV sedation. It may also require admission to the hospital for one night, but not necessarily.

What conditions benefit from kyphoplasty and/or vertebroplasty?

Kyphoplasty and vertebroplasty are invasive procedures that should only be recommended if other conservative measures have already failed. Medication and physical therapy along with bracing should be first line treatments prior to the consideration of surgical interventions.

The two procedures can be used to treat fractures of the vertebral body, which can come from a wide range of conditions. Osteoporosis (weakening of the bone) is the most common reason for fractures. Other reasons that can contribute the vertebral fracture include, but are not limited to:

  • Growth from malignanciesLas Vegas pain clinics
  • Metastatic cancer
  • Vitamin D deficiency
  • Menopause
  • Chronic renal disease
  • Rheumatoid arthritis

Certain medications have also been identified to cause osteoporosis, and continued intake of the following can contribute to the weakening and fracture of the spine:

  • Steroidskyphoplasty4
  • Anticonvulsants
  • Heparin
  • Alcohol
  • Cytotoxic drugs
  • Thyroid replacement drugs

What are the clinical outcomes of kyphoplasty and vertebroplasty?

The procedures are well tolerated by most patients. However, these procedures are only recommended after the failure of more conservative options. It is recommended that in the absence of risk factors for failure of non-surgical management, an initial three-week trial of conservative treatment be considered.

Kyphoplasty2Some studies have shown that kyphoplasty can readily alleviate pain symptoms in over 80% of patients. Vertebroplasty has also been shown to be effective in alleviating pain from vertebral fractures. The procedures (vertebroplasty and kyphoplasty) have comparable outcomes. However, kyphoplasty has been shown to offer a higher degree of correction for spinal deformities. It has also been shown to result in less leakage of bone cement.

What are the risks of kyphoplasty or vertebroplasty?

Similar to any surgical operation, kyphoplasty and vertebroplasty both place the patient at risk for surgical infection (from a non-sterile environment). Other possible risks of the procedures Pain specialist Las Vegasinclude intra-operative damage to muscles, nerves and other soft tissues, or pain that persists beyond the disease’s window period.

There is also the risk of adverse effects from leakage or erroneous placement of the bone cement. However, these risks are all well below 1%.

The top Pain Management Doctors in Las Vegas and Henderson are at Nevada Pain. The Board Certfiied and Award Winning doctors provide kyphoplasty and vertebroplasty along with bracing and medication management for those with vertebral compression fractures.

Along with offering these minimally invasive procedures, the Las Vegas pain clinics treat all kinds of conditions of back and neck pain, sciatica, RSD, fibromyalgia, headaches, failed back surgery, neuropathy and more.

Over 50 insurances are accepted, call (702) 323-0553 for more information and scheduling today!

Epidural Injections Used for Chronic Back Pain

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by Nevada Pain

Chronic back pain can be difficult and makes it hard to enjoy a normal life, but there are treatment options available. One of these options is an epidural injection, which is inserted into the area aEpidural Injections Las Vegasround pinched nerves near your spine.

Your Las Vegas Pain Management Doctor may use these injections if the pain spreads down your body to your lower spine, hips, or legs. This type of chronic pain may be the result of a bulging disc putting pressure on a nerve near the spine.

The Epidural Injection Procedure

Before you receive epidural injections, your Pain Management Doctor in Las Vegas will have you undergo an MRI or CT scan to help identify the source of the pinched nerve(s). After your doctor determines that you would benefit from epidural injections, you will either have them performed in an office setting, or at an ambulatory surgery center.
Pain clinic Las Vegas
You will be asked to lie on your stomach in order to allow the LV pain doctor access to your spine. While sedation is not necessarily needed for this procedure, your doctor may opt to give you medication to help you relax.

If this is the case, you will need to have someone drive you home after the procedure, as these medications can impair your ability to operate a vehicle. The epidural affects your spine, which is the most important part of a body.

Before beginning the procedure, your skin will be numbed with an anesthetic. This helps to eliminate any pain you might feel during the epidural injections. Once your skin is numb, the injection process will begin, using the following steps:

  • A needle will be inserted toward the spine.Pain Management Las Vegas
  • Using a fluoroscopy, an x-ray video machine, provides a clear picture of your spinal region so your pain doctor can maneuver the needle into the correct area between the vertebrae.
  • Contrast dye will be injected to determine if the needle is in the right space between your spine and spinal cord.
  • Once the needle is in the correct position, a solution containing corticosteroid and anesthetic will be injected.

It is important to note that epidural injections are a short-term solution in order to treat the pain from pinched nerves in the back. Pain relief may last days to months, at which point the injections may be repeated. Patients may receive a series of injections each time – up to 3 over a period of 6-8 weeks. After this procedure, you should feel relief from your chronic back pain. This relief can last anywhere from weeks to months depending on the type of work you do.

After the Procedure

Once the epidural injections are complete, the doctor at the Las Vegas pain clinic may ask you to rest for the remainder of the day. There is a slight chance you may feel some pain or discomfort around the site of the injection. Typically this dissipates within a few hours.

The steroid used in the epidural injection may take several days to actually take effect, which is why your pain may become worse before it improves. If your pain does not subside after 2-3 days, you should consult your doctor immediately.

The Risks of Epidural Injection

Like any procedure, there are some kind of risks associated with the epidural injections. These are slight, less than 1%. These small risks include:

  • Bleeding – Which causes a hematoma around the spinal column.NV_PainSpeclst2
  • Allergic reaction – To any of the medications used during the procedure.
  • Damage to the nerve root – Which can increase pain in your legs.
  • An abscess or infection – Around your spine or spinal area.
  • Short-term dizziness, nausea or headache.
  • Short term blood sugar increase.

The top pain clinics in Las Vegas are Nevada Pain. Over 50 insurances are accepted, with the pain management doctors in Henderson and Las Vegas being Board Certified and Award Winning.

The doctors offer both medical and interventional Las Vegas pain management, with success rates exceeding 95%! Call (702) 323-0553 for more information and scheduling today!