Pain Management
The pain management program at Fatima Hospital provides evaluation
and management for a wide variety of pain conditions and disorders.
Under the medical direction of Dr. Keith Perry, a board certified
anesthesiologist on staff with more than 10 years of pain
management experience, the program staff works with referring
physicians in diagnosis and treatment of chronic and acute
spine disorders, post-traumatic and post-surgical pain symptoms,
as well as regional pain syndromes, shoulder pain, and pain
associated with some forms of cancer.
Some of the procedures performed include, but are not limited
to, epidural steroid injections, facet joint and facet joint
nerve injections, hypogastric and celiac plexus injections,
joint injections, including sacroiliac joint, hip and knee
joints, and also trochanteric bursa injections, chostochondral
and intercostals blocks, as well as radiofrequency neurotomy.
Most injections are done under fluoroscopic imaging for safe
and accurate results.
More information on procedures performed:
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Epidural Steroid Injection
Epidural steroid injection is a non-surgical procedure
that treats pain and can serve as a diagnostic tool.
Conditions such as sciatica, herniated discs, and spinal
stenosis are usually treated with epidural nerve blocks.
Under fluoroscopic guidance, the physician injects
local anesthetic and the steroid either directly into
the collection of nerves in the back or into the joint
spaces of the spine. Injected steroids help reduce the
inflammation of the nerves and also serve as temporary
form of pain relief so the body can begin its natural
healing process.
These injections usually given in a series of three
for a cumulative effect. They can be given in a neck
(cervical spine), upper back (thoracic spine), lower
back ( lumbar spine), and from the level of the tailbone
(caudal approach).
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Sacroiliac Joint Injection
The Sacroiliac Joint is located next to the spine and
connects the sacrum with the pelvis. Sacroiliac Joint
injections are used for diagnosing and treating back
pain associated with Sacroiliac Joint dysfunction. With
this procedure, a physician, using fluoroscopic guidance,
inserts a needle into the sacroiliac joint and injects
lidocaine and a steroid. Lidocaine, which is a local
anesthetic, confirms the specific joint as a source
of the pain, while the steroid promotes pain relief.
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Facet Joint Injection
Facet joints are located on either side of the vertebrae
and give the spine its flexibility. When these joints
are irritated or inflamed, they can be a source of back
pain.
Facet joint injections are used for diagnostic and
therapeutic purposes. Under fluoroscopic guidance, a
physician places a needle in the center of the facet
joint or in the nerves leading up to it. First a local
anesthetic is injected though the needle. If the injection
is performed to treat the inflamed joint, then the doctor
will also inject a steroid following the local anesthetic.
In those cases when the injection is performed for diagnostic
purpose, then the local anesthetic is the only substance
injected. If the pain subsides, then the doctor knows
that the facet joint is the root of the problem.
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Radiofrequency Neurotomy
A radiofrequency neurotomy uses a low-level electrical
stimulation to locate the nerve source of the pain.
The tip of the probe is heated, using radiofrequency
energy to temporarily interrupt or destroy the nerves
that carry the pain signals. If the procedure is successful,
patient should expect some pain relief within 2-5 days.
It may take up to one month for the full benefit of
the procedure to occur. Pain relief often lasts 6 moths
to a year or longer and the procedure can be repeated
if needed.
A common nerve that is ablated by radiofrequency neurotomy
is the facet nerve. The facet joint nerve is one of
the causes of lower back pain. It is easily treated
by radiofrequency neurotomy and usually provides good
to excellent relief of lower back pain.
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Patient information
We do not require a referral, although it's helpful to have
MRI or X-ray reports along with the office notes from your
treating physician.
All patients come in for evaluation by Dr. Keith Perry first
and then they are scheduled for the injection.
On the day of the procedure, all patients are required to
have a ride home. Patients who are scheduled for the injection
with sedation are instructed to fast, starting the night before
the scheduled procedure.
If you would like to schedule a consultation
with Dr. Keith Perry,
please call 456-3157.
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