Pain Intervention                         Pain Management The Surgery Center For Pain Intervention is conveniently located right here in our office.       We provide comprehensive chronic pain management care.



SERVICES





ACUTE MIGRAINE MANAGEMENT

Acute migraine management is to provide an intermediate treatment for those that have not responded to their regular migraine regimen at home. This treatment will hopefully help to avoid an ER visit. We offer combination of triptan injection, non-steroid anti-inflammatory injection and nerve block with local anesthetics. There is no narcotic injection such as Dilaudid, Demerol or morphine shots. Expect your stay in the office between 30 to 60 minutes. Then you can choose to go to Urgent care or ER if your relief is not enough. The success in breaking migraine cycle is roughly 50%. You should be able to drive yourself home after these treatments.

PRP (PLASMA RICH PLATELET) INJECTION

PRP is obtained by drawing your own blood and spinning it down to isolate the components of platelets, then injects it back into the area of pain. Platelets contain many different growth factors that can stimulate the growth of your connective tissue or joints such as tendon, muscle, ligament, bursa, knee joint. PRP injection is to promote your own body to heal by itself. This kind of treatment is not FDA approved and is therefore considered investigational.

INTERVENTIONAL PROCEDURES

Interventional procedures are performed in the office or Outpatient Surgery Center to reduce both acute or chronic pain. Sedation can be provided for your comfort and fear. Dr. Chen's staff will discuss the option of sedation with you and address the preparation requirement for the procedures.

TRANSLAMINAR EPIDURAL INJECTIONS

Translaminar Epidural Injections are usually done to reduce inflammation from nerve pain such as sciatica by using cortisone. We provide these injections under fluoroscopy guidance at the outpatient surgery center conveniently located adjacent or close to our office. Dr. Chen has personally done more than 10,000 of these injections over the back and neck. There has been not a single case of nerve or spinal cord damage.

TRANSFORAMINAL EPIDURAL INJECTION

Transforaminal Epidural Injection: This injection is done specifically to identify and/or treat the nerve that is causing pain by using novocaine or cortisone. It is done under fluoroscopy's guidance at the outpatient surgery center conveniently located adjacent or close to our office. More than 10,000 of these have been done by Dr. Chen. There has been not a single case of nerve or spinal cord damage.

FACET JOINT INJECTION

Facet Joint Injection: Facet Joints are located in the spine from the neck down to the lower back. Facet injection with novocaine and/or cortisone is performed under fluoroscopy guidance to reduce arthritis pain of neck and back at outpatient surgery center conveniently located adjacent or close to our office. These injections carry minimal risk of nerve damage.

RADIOFREQUENCY THERMOCOAGULATION (RFTC)

RFTC: RFTC is to use heat (RF) either to quiet the nerve senses or to train the nerve to behave properly. Nerve does grow back or regenerate in 3-6 months. RFTC will need to be repeated if pain returns with regeneration of the nerve. This procedure is done under fluoroscopy guidance at outpatient surgery center conveniently located adjacent or close to our office.

SACROILIAC JOINT INJECTION

Sacroiliac Joint Injection: SI Joint is the joint that connect the sacrum to the pelvic. Sprain and strain can happen to this joint with limited amount of trauma or injury. SI joint injection with Novocain and/or cortisone is performed under fluoroscopy guidance to reduce inflammation of joint and the supporting tissue around the joint. It is done at outpatient surgery center conveniently located adjacent or close to our office or it can be performed in the office setting. These injections carry minimal risk of nerve damage.

SPINAL ENDOSCOPY

Spinal Endoscopy: Spinal endoscopy is to place a small fiberoptic scope through the tailbone up into the lower lumbar area. The inflammation or the scarring is cleaned up under direct vision. This procedure is done under fluoroscopy guidance at outpatient surgery center conveniently located adjacent or close to our office.

SYMPATHETIC BLOCKS

Sympathetic Blocks: Sympathetic blocks are done to improve circulation and to reduce nerve pain from nerve irritation. This procedure is done under fluoroscopy guidance at outpatient surgery center conveniently located adjacent or close to our office.

STELLATE GANGLION BLOCK

Stellate Ganglion Block: This injection is done for pain in the head, neck and shoulder and it is performed under fluoroscopy guidance at outpatient surgery center conveniently located adjacent or close to our office.

CELIAC PLEXUS BLOCK

Celiac Plexus Block: This injection is done for abdominal pain at outpatient surgery center conveniently located adjacent or close to our office.

LUMBAR SYMPATHETIC BLOCK

Lumbar Sympathetic Block: This injection is done for leg pain at outpatient surgery center conveniently located adjacent or close to our office.

HYPOGASTRIC PLEXUS BLOCK

Hypogastric Plexus Block: This injection is done for pelvic pain at outpatient surgery center conveniently located adjacent or close to our office.

TRIGGER POINT INJECTION

Trigger Point Injection: TPI is the injection to the soft tissue such as muscle, tendon or ligament to reduce inflammation by using Novocain with or without cortisone. This injection is commonly done in the office.

OCCIPITAL NERVE BLOCK

Occipital Nerve Block: Occipital Nerve Block is for the treatment of headache by using novocaine or cortisone or neurochemical. RFTC or cryneurolysis is also an option to reduce occipital nerve pain. This nerve block is done either at office setting or at outpatient surgery center conveniently located adjacent or close to our office depending on your insurance coverage.

INTERCOSTAL NERVE BLOCK

Intercostal Nerve Block: This procedure is done for chest wall pain such as infection from Shingles. This nerve can be killed by using neurochemical or RFTC. This nerve block is done either at office setting or at outpatient surgery center conveniently located adjacent or close to our office depending on your insurance coverage.

CARPAL TUNNEL INJECTION

Carpal Tunnel Injection: Carpal tunnel injection is done in the office to reduce the inflammation in the Carpal Tunnel at your wrist by using cortisone. This injection is usually tried before surgery.

BOTULINUM TOXIN INJECTION

Botulinum Toxin Injection: Botox injection is utilized for muscle spasm and headache. The injection usually needs to be repeated due to regeneration of the nerve.

NEUROLYTIC BLOCK

Neurolytic Block: When the cause of pain is from localized nerve irritability, using chemical to destroy the nerve may be an option. This nerve block is done either at office setting or at outpatient surgery center or in the hospital conveniently located adjacent or close to our office depending on safety of the procedure.

CRYONEUROLYSIS

Cryoneurolysis: Cryoneurolysis is another way to freeze or destroy the localized irritated nerve. Unlike neurolytic block, it does not cause any soft tissue irritation from chemicals. The pain however could return if nerve grows back within 3-6 month. Cryoneurolysis is done at outpatient surgery center conveniently located adjacent or close to our office.

SPINAL CORD STIMULATOR TRIAL AND IMPLANT (DCS)

Spinal Cord Stimulator Trial or Implant (DCS): DCS is one of the most advanced pain technology. Temporary electrodes are placed into the epidural space for 5-7 days at outpatient surgery center for a trial period. It is designed to divert or block the pain sensation at the level of spinal cord. Permanent system including electrodes and rechargeable battery generator can be implanted if trial provides significant or more than 50% pain relief.

SPINAL PUMP IMPLANTATION

Spinal Pump Implantation: Spinal Pump is commonly called morphine pump. It is one of the most advanced pain technology. It is an one hour surgery to implant a catheter which is connected to a pump to infuse medication into spinal space. It takes much less medication to cover the pain than taking by oral method. Many medications such as morphine, baclofen and other similar medicine can be infused safely to provide relief.

DISCOGRAM

Discogram: Discogram is a diagnostic procedure to further examine the condition of the disc. This procedure is usually done prior to surgery to identify the pathology and to help determine the kind of surgery.

MEDIAL BRANCH BLOCK

Medial Branch Block: MBB is commonly performed as a test to see if your pain comes from joints over your spine. It is commonly performed for diagnostic purpose. Sometimes it can have therapeutic effect. Your response to the MBB will help your physician decide if you may benefit from Radiofrequency Thermocoagulation.

PAIN MANAGEMENT CONSULTATION

Pain Management Consultation: Consultation is to provide overall assessment and to offer treatment direction. Interventional procedures can be recommended to reduce the total amount of pain. Medications can be prescribed to reduce pain. In addition, we will do off-site referral if pain psychology or pain physical therapy is needed.