Research is showing that pain is more complex than physicians once thought. Psychology, sociology, genetics and many other factors play an important role in how pain is perceived and experienced. This has lead to significant advances in the field of Interventional Pain Management.

In regards to chronic neck and back conditions, Pain Management is used in three common scenarios:

1. The underlying cause of pain is not immediately obvious.

2. Rest, activity modification or medications have not helped alleviate pain caused by an accident, injury or spinal condition.

Once a patient chooses their Pain Management specialist, a series of steps will help find and then eliminate pain.

Step 1: Obtaining A Detailed Medical History

A detailed medical history helps the physician get to know and understand the patient. Some of the things he or she will look for are:

• Accident and/or injury details
• Prior neck and/or back pain
• Pre-existing conditions
• Social factors (i.e. occupation, smoking, diet)
• Family history

Once a history is taken, a physical exam is performed.

Step 2: Performing a Physical Exam

A physical exam helps the pain management physician diagnose the condition (separately from the referring physician). In some cases, the diagnosis is the same. In others, it may not be. Regardless, both diagnoses will be taken into account when creating a treatment plan.

Step 3: Confirming the Diagnosis Using Imaging Studies 

In many cases, X-rays or MRI’s can help determine the underlying cause of pain by showing damage to cartilage, tissue or joints.  In the case of the spine, pain in the extremities is actually caused by a spinal condition and an MRI can help determine if this is what is causing pain.

Step 4: Creating a Treatment Plan

The physician decides what treatment options will alleviate pain without side-effects. Many options are available:

1. Medication Management. Pain, anti-inflammatory and muscle relaxing medications are used to decrease pain so that the ligaments, muscles, and bones can heal properly. In many cases, this is combined with Physical Therapy to maximize pain relief.
2. Nerve Blocks. This needle-based procedure is used as both a pain relieving treatment and as a diagnostic indication of the source of pain. During this procedure, an anesthetic is administered near the small nerves connected to the facet joints, known as median nerves.  In most instances, multiple levels of the spine will be treated simultaneously.
3. Epidural or Steroid Injections. These injections use a steroid combined with saline to deliver medication directly into the epidural space. The steroid will help reduce the inflammation that is causing the localized or radiating pain.  The needle is guided using a real time X-Ray, known as a fluoroscope, to ensure proper identification of the epidural space as well as proper placement of the needle.

Step 5: Living a Pain-Free Life

At Total Orthopedics and Sports Medicine, our Pain Management Team utilizes a multidisciplinary approach to treat back and neck pain and uses the most advanced treatment modalities on Long Island.   This team works hand in hand with our team of Orthopedic and Sports Medicine specialists as well as Physical Therapists to develop unique treatment plans based on the lifestyles, habits and goals of each of our patients.  We have locations across Long Island and Manhattan, so if if you, or someone you love is dealing with chronic pain, contact us today!