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Call Us Today!
502-995-4004
Call Us Today!
502-995-4004

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What We Treat:


Our services include, but are not limited to, the treatment of
• Adult & Geriatic Pain
• Pediatric Pain
• Interstitial Cystitis/Pelvic Pain
• Reflex Sympathetic Dystrophy
• Sports Injuries
• Migraine Headaches, Whiplash
• Acute & Chronic Pain
• Low Back Pain
• Management of Cancer Pain

Services


We specialize in the following procedures:

Cervical Facet Joint Injection

Facet injections are injections of medications into the actual facet joints. Facet joints are located between each set of vertebrae in the spine from the neck to the tailbone. Facet joints allow each vertebra to move against the vertebra just above and just below it.

During this procedure, an anesthetic and a steroid are injected into one or more of the cervical facet joints. The injection can be used to diagnose and/or treat. If the injection temporarily lessens your pain and helps you move your neck better, then your doctor will know which facet joint is causing the pain.

Why are facet joint injections helpful?
If the joints become painful due to arthritis, injury, or mechanical stress, they can cause pain in various areas. The cervical facet joints can cause pain in your head, neck, shoulder or arm. A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

What will happen to me during the procedure?
An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an X-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, the physician numbs a small area of skin with numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use X-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected.

What should I do after the procedure?
20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source.

*The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

How will I feel after the procedure?
On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur.

Can I take my regular medications after the procedure?
You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate.

When can I resume activity?
On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

When your pain is improved, start your regular exercise in moderation. Even if you are significantly improved, gradually increase your activities over 1-2 weeks to avoid recurrence of your pain.

Diagnostic Facet Joint Blocks

minutes.

What is it?
A block that is performed to confirm that a facet join is the source of pain and the decrease pain and inflammation in a facet joint or joints.

How is it done?
The patient is given a local skin anesthetic – a needle is then inserted into the facet joint or facet capsule and an anesthetic and steroid are injected by the physician. This is done under fluoroscopy.

Expected Results
Decrease in or relief of back pain.

How long does it take?
Thirty minutes.


Blocks are done in conjunction with physical therapy.

Epidural Steroid Injection

What is an epidural?
An epidural is an injection of medicine into the epidural space (the space along your spine just outside the spinal fluid). Epidural Steroid Injections can be done anywhere along the spine where the epidurals are given:
    Cervical (neck)
    Thoracic (upper to mid back)
    Lumbar (lower back)
    Caudal (tailbone)
What does an epidural do?
An epidural steroid is used to reduce the amount  of inflammation on the nerve roots as they come off the spinal cord. Many conditions such as arthritis of the spine, bulging and/ or ruptured disks, spinal stenosis,  and post-herpetic neuralgia (continued pain after shingles) can cause nerve root irritation.
How is an epidural Administered?
After taking a thorough history and talking in detail to the doctor, you will be brought into a treatment room. You will be asked to sit on the side of a stretcher or lie on your stomach if you will be having a caudal epidural. After you have signed the consent form, the doctor will come in to begin the procedure which usually takes 15-20 minutes to complete. The doctor will first numb your skin then place a needle into the epidural space of your spine. Once in the epidural space, a mixture of local anesthetic and steroid will be injected. The needle is then removed and you will be asked to lie on the side that bothers you most. Your blood pressure, heart rate, and breathing will closely monitored over the next 15 minutes. After this initial recovery period, you will go into the recovery room for 30 minutes or until you can walk on your own.

Lumbar Facet Joint Injection

What are lumbar facet joints?
Lumbar facet joints are small joints located in pairs in your lower back. These joints provide stability and guide motion in your spine.

Why are facet joint injections helpful?
If the joints become painful due to arthritis, injury, or mechanical stress, they can cause pain in various areas. The lumbar facet joints can cause pain in your lower back, hip, buttock, or leg. A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

What will happen to me during the procedure?
An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an X-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, the physician numbs a small area of skin with numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use X-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected.

What should I do after the procedure?
20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

*
The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

How will I feel after the procedure?
On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur.

Can I take my regular medications after the procedure?
You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate.

When can I resume activity?
On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

When your pain is improved, start your regular exercise in moderation. Even if you are significantly improved, gradually increase your activities over 1-2 weeks to avoid recurrence of your pain.

Radiofrequency

A radiofrequency neurotomy is a type of injection procedure in which a heat lesion is created on certain nerves with the goal of interrupting the pain signals to the brain, thus eliminating the facet or sacroiliac joint pain.

A medial branch neurotomy affects the nerves carrying pain from the facet joints, and a lateral branch neurotomy affects nerves that carry pain from the sacroiliac joints.

These medial or lateral branch nerves do not control any muscles or sensation in the arms or legs so there is no danger of negatively affecting those areas. The medial branch nerves do control small muscles in the neck and mid or low back, but loss of these nerves has not proved harmful.

Before this procedure is undertaken, the joints and branch nerves will have already been proven to be painful by a diagnostic form of spinal injection, and will not have responded to other treatment methods. If effective, the neurotomy should provide facet or sacroiliac joint pain relief lasting at least nine to fourteen months, and sometimes much longer. After this period of time, however, the nerve will regenerate, and the facet or sacroiliac joint pain may return.

Success rates vary, but typically about 30% to 50% of patients undergoing this procedure will experience significant facet or sacroiliac joint pain relief for as much as two years. Of the remaining patients, about 50% will get some pain relief for a shorter period. Some patients do not experience any relief from facet or sacroiliac joint pain as a result of this procedure.

Sacroiliac Joint Injection

What is the sacroiliac joint and why is a sacroiliac joint injection helpful?

The sacroiliac joint is a large joint in your lower back and buttocks region. When the joint becomes painful, it can cause pain in its immediate region or it can refer pain into your groin, abdomen, hip, buttock or leg.

A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the joint is numb it means this joint is more likely than not your pain source. Furthermore, time-release cortisone will be injected into the joint to reduce any presumed inflammation, which on many occasions can provide long-term pain relief.

What will happen to me during the procedure?

If needed, an IV will be started so that adequate relaxation medication can be given. After lying on an X-ray table, the skin over your lower back/buttock will be well cleansed. Next, the physician will numb a small area of skin with numbing medicine (anesthetic) which stings for a few seconds. The physician then will use X-ray guidance to direct a very small needle into the joint. He will then inject several drops of contrast dye to confirm that the medication only goes into the joint. A small mixture of numbing medication (anesthetic) and anti-inflammatory cortisone will then be slowly injected.

What should I do and expect after the procedure?

20-30 minutes after the procedure, you will move your back to try to provoke your usual pain. You will report your remaining pain, (if any) and also record the relief you experience during the next week, on a €œpain diary€ we will provide*. You may or may not obtain improvement in the first few hours after the injection, depending on if the sacroiliac joint is your main pain source.

*The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

On occasion, you may feel numb, slightly weak or have an odd feeling in your leg for a few hours after the injection. You may notice a slight increase in your pain lasting for several days as the numbing medication wears off before the cortisone is effective. Ice will typically be more helpful than heat in the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur.

Can I take my regular medications after the procedure?

You may take your regular medications after the procedure, but try to limit them for the first 4-6 hours after the procedure, so that the diagnostic information obtained from the procedure is accurate. You may be referred for physical or manual therapy after the injection while the numbing medicine is effective and/or over the next several weeks while the cortisone is working.

On the day of the injection, you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities. When your pain is improved, start your regular exercise/activities in moderation. Even if you are significantly improved, gradually increase your activities over 1-2 weeks to avoid recurrence of your pain.

Sympathetic Nerve Block

What it is?
A sympathetic nerve block involves injecting numbing medicine around the sympathetic nerves in the low back or neck. By doing this, the sympathetic nervous system in that area is temporarily ‘switched’ off in hopes of reducing or eliminating pain. If pain is substantially improved after the block, then a diagnosis of sympathetically mediated pain is established. The therapeutic effects of the anesthetic can occur, at times, longer than would be normally expected. The goal is to reset the sympathetic tone to a normal state of regulation. If the initial block is successful, then additional blocks may be repeated if the pain continues to sequentially diminish.

How is it done?
A local anesthetic is given in the lumbar area of the back. A needle is then inserted into the back under the fluoroscopy next to the vertebral body. The block may be performed on both sides the spine. An anesthetic medication will be injected into the area.

Expected results
The patient may note redness of the lower extremity and a feeling of warmth.

How long does it take?
It takes 30 minutes for the procedure followed by a recovery period. 


Call Us Today At 502-995-4004

KENTUCKIANA PAIN SPECIALISTS

3710 Chamberlain Ln
LouisvilleKY 40220
Phone: 502-995-4004
Fax: 502-933-5559
Email:
 info@painstopshere.org

Hours

Mon - Fri: 09:00 - 16:30
Sat: Closed
Sun: Closed
Saturday By Appointment

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In Business Since 1992