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:
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).
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.
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.
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.
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.