The First Step
During the initial visit, the patient is evaluated to determine the source of pain. To begin, our trained medical team will listen to the patient’s history and perform a physical exam. Imaging such as x-rays, CT scans and MRI’s may need to be provided to assist in identifying the pain source.
Interventional pain management allows Dr. Parr to deliver medication directly to the site where the pain originates. This is accomplished through injection therapy. Patients are mildly sedated during the injection to avoid trauma and stress. The injection blocks or intervenes between the pain site and the brain and can significantly reduce or eliminate the sensation of pain for the patient.
The use of medications can also help to decrease pain. We use many types that relieve pain such as anti-depressants, anti-seizure, anti-psychotic and non-steroidal medications. However, the use of opiate analgesics or narcotics is not the answer to the treatment of chronic pain. They can be addicting and can decrease the patient’s ability to cope with pain. One of the best ways to treat chronic pain can be to decrease the need for narcotic pain medication.
For patients who are considered to be appropriate candidates, these highly technical interventional treatments are also available at the Northshore Interventional Pain Management Center:
Greater Occipital Nerve Block
1. Where is the occipital nerve?
The occipital nerve is located at the base of the skull and extends up the back of the head.
2. How are occipital nerve blocks performed?
You will be asked to pull your chair forward so the physician can stand behind you. The physician will mark the area to be injected and clean the area with an antibacterial solution. The physician will pass the needle through the skin and deeper tissues and inject the medication into the area around the occipital nerve.
3. How soon will the treatment help?
The onset of pain relief may be as soon as 15-20 minutes. This is due to the effect of the local anesthetic. Your pain may return in 6-8 hours as the local anesthetic wears off. The effect of the steroid will be felt in 48-72 hours. The steroid should provide longer relief because of its anti-inflammatory effects.
4. Can the occipital nerve blocks be repeated?
If you have relief from of your pain, the injection may be repeated as soon as one week.
5. What are the risks and hazards of this procedure?
As with any procedure, there is the potential for problems. The risks are minimal. Problems that could occur are: Slight bleeding and risk for Infection.
6. How should I care for myself after the injection?
Bedrest is not required. You may resume your normal activities the day of the injection. You may continue your normal diet and medications after the procedure. To relieve any soreness at the injection site, you may apply ice to the site 20 minutes on/ 20 minutes off on the day of the injection. At subsequent times, you may choose to apply ice or heat. Please do not apply either for more than 20 minutes at a time.
Sphenopalatine Ganglion Block
1.What is a Sphenopalatine Ganglion Block?
This procedure is an injection of a numbing agent through the nostrils (one or both) with a simple applicator. The numbing agent works on the ganglion area to provide pain relief for multiple head and facial pain conditions and is performed as an outpatient procedure.The procedure entails low risks and is exceptionally well tolerated by patients.
2.What exactly is the sphenopalatine ganglion?
The definition of a ganglion is a “mass of nerves” and in the case of the sphenopalatine ganglion, represents a nerve bundle that reaches out to the lacrimal gland, paranasal sinuses, palate, and throughout the upper pharynx and nasal cavity. The location of the ganglion is in a bony cavity called the pterygopalatine fossa, which is deep in the midface and behind the nasal cavity.
Because of such a broad reach that the nerves from the SPG expand to, the ganglion plays a role in causing pain associated with acute and cluster headaches, trigeminal neuralgia, TMJ, RSD, and facial pain.
3.What are the risks of an SPG block?
The risks of sphenopalatine ganglion nerve blocks are very low. With the topical procedure, patients may sustain a bitter taste in the mouth from dripping of the numbing agent down the oropharynx.
Injections maintain a slight risk of infection, along with a slight risk of a nose bleed or temporary lightheadedness.
4. Patient discharge Instructions:
After the 8 minute absorption duration, The patient was discharged with instructions to:
Scheduled a patient follow up appointment in 6 weeks, unless headache or facial pain symptoms return prior to that time frame.