Chronic pain is one of the most common reasons that patients seek medical care. Chronic pain prohibits patients from doing the things they enjoy. It affects all their decision-making as well as their mood while also disrupting sleep and eating patterns. Pain can also cause physiological symptoms such as an increase in blood pressure and heart rate. The management of pain is important to improving the quality of life. However, the debilitating medical condition is one of the most complex to manage.
Until recently, opioid-based medications have been used in the treatment of chronic pain. These medications have become an emergency, with a recent study revealing that deaths from opioids soared 30 percent in 2020. More than 2 million Americans are addicted to opioid drugs even though evidence shows that the long-term use of these drugs only reduces pain, on average, by approximately 30 percent. Therefore, physicians and pain specialists look beyond opioids for effective treatment of chronic pain.
The standard protocol of traditional pain management is comprised of medications such as NSAIDs. Using new multidisciplinary approaches, addressing the root cause of the pain can actually block the pain from transmitting through the body. These pain management alternatives make use of minimally invasive methodologies directly at the source of the pain. One such effective therapy is injections.
Cortisone is a type of corticosteroid that is used to treat painful joint inflammation. Corticosteroids are fast-acting synthetically produced hormones normally produced by the adrenal glands. There are two kinds: glucocorticoids and mineralocorticoids. By reducing inflammation, a Cortisone injection can alleviate pain and swelling.
The Cortisone injection is not a cure in that it does not treat the underlying condition however, it offers long term relief to specific areas of the body. By decreasing pain, patients can resume their rehabilitation or daily activities more effectively. Though Cortisone shots are most effective in treating inflammatory arthritis, they can also treat patients suffering from radicular pain as a result of a nerve root that has been irritated or compressed. Conditions include:
Spinal Disc Herniation
The injection takes less than 5 minutes and is performed in-office. Patients receive a local anesthetic and imaging is used to precisely target the site prior to the injection to avoid injury to discs or nerve roots and also make sure the targeted joint is properly injected. The medication is injected directly into the joint capsule or close to the joint capsule, depending on the condition being treated. Though there may be some residual pain at the injection site over the next 48 hours, patients are able to resume normal activities the next day.
A Cortisone injection typically relieves inflammation and pain between 6 weeks and 6 months. Due to side effects from corticosteroids, the number of shots a patient may receive within the course of a year is limited.
In Osteoarthritis, the cartilage around the knee joint wears down so much that it can no longer protect the bones that make up the joint. Synovial fluid is a naturally occurring substance within the joints. This fluid serves as a lubricant – a shock absorber – that also enables bones to move smoothly over one another. It’s the loss of synovial fluid that contributes to chronic pain of the joints.
Viscosupplementation – or “gel shots” – are most commonly used for knee pain that has not responded to physical therapy and/or medication. These shots involve the injection of a gel-like fluid called hyaluronic acid (HA) into the joint to act as synovial fluid. By injecting HA into the damaged, arthritic joint, the additional fluid can help facilitate movement and reduce pain.
Depending on the product used, a patient may receive one to five shots over an extended period of time.
Nerve blocks are another common pain management injection. These shots deliver an anesthetic close to the affected nerves in order to interrupt nerve “pain” signals before they travel to the brain. These injections treat pain caused by inflamed nerves but may also be used to help identify the source of the pain.
Facet joint injections target the small joints at each portion of the spine. These joints give the spine stability but can also become painful due to arthritis, stress, or pressure on the spine.
Facet injections help to relieve pain by injecting a numbing agent or a steroid drug into the facet joint. The shots are able to decrease swelling or even diagnose if the facet joint is the cause of pain.
Celiac plexus blocks are injections of pain medication that help relieve abdominal pain, commonly due to cancer or chronic pancreatitis. An injection of local anesthetic is used to block the celiac plexus nerves that transmit pain signals from the abdomen to the brain.
The Fascia Iliaca Block is used to help decrease pain in the leg, hip, or knee. This minimally invasive injection procedure is utilized to block pain signals originating at the femoral nerve before they reach the brain. Once the needle has passed through the layer of fascia, a mixture of anesthetic and corticosteroid is carefully injected, bathing the femoral nerve and other structures in medication to decrease swelling, decrease irritation, and alleviate pain.
A soft tissue injection is used for those who suffer from shoulder pain due to bursitis or inflammation of the bursa. A bursa is a small, fluid-filled sac that reduces friction between bone and muscles or tendons. The soft tissue injection for the shoulder helps to provide patients with pain relief from shoulder bursitis.
Pain is the body’s protective mechanism that communicates to the brain that patients should react. However, chronic pain causes frustration and a diminished quality of life. South Florida’s Best Spine Doctors at Spine and Wellness Centers of America, proudly offer a number of pain relief injections to combat chronic pain.
These minimally invasive procedures reduce pain and immediately improve the daily lives of patients who are able to return to normal activities.With their state-of-the-art equipment, such as the C-arm, the doctors at SWCA are able to provide image guidance for pinpoint accuracy while delivering injections.