Pain Conditions We Treat

Choose Specialty Pain Care with Anesis


Pain is traditionally thought of as a symptom of an underlying disease or injury. The preference is always to treat as best as possible any underlying problem that may be causing pain. Episodes of acute pain can often be effectively treated, but some pain can at times persist and become chronic. There are many diseases of the spine, joints, and other body systems that cannot be cured, and may lead to lasting changes in the nervous system. In these situations, many experts argue that chronic pain should be considered a disease in and of itself. Unlike acute pain, chronic pain usually does not subside, and may never be eliminated entirely. It often becomes a lifelong condition that must be carefully managed in order to minimize suffering and maximize physical functioning and quality of life.
Specialty pain care combines aspects of many medical and allied disciplines to address the long-term physical, emotional, and psychosocial aspects of chronic pain. Pain related-diagnoses often differ–but are complementary to–the disease states recognized and treated by other allied specialists, such as orthopedists, rheumatologists, neurologists, and surgeons. Our providers emphasize a multimodal approach to managing pain that includes physical therapy, home exercises, medications and supplements, interventional therapies, behavioral health counseling, nutritional counseling, and targeted referrals to other specialists and complementary/alternative medicine providers.
If you don’t find your condition addressed in these summaries, don’t hesitate to fill out the appointment form.


Arthritis and Joints



Painful joints can develop in one or multiple sites depending on the condition. The hip, knee and shoulder are large joints which are subject to degeneration or damage to soft tissues causing pain. As with most musculoskeletal conditions, treatment begins with physical therapy to correct mechanical conditions that predispose the joint(s) to ongoing damage. Anti-inflammatories and supplements such as glucosamine-chondroitin can be useful, as well as topical medications and bracing. Direct injection of a cortisone medication or a cartilage supplement into the joint can sometimes benefit the patient’s pain. Some forms of joint damage can benefit from orthopedic surgery. For knee pain associated with nerve damage to the knee, often after a replacement, numbing of three sensory nerves surrounding the knee using electrical energy generated at a needle tip can effectively provide long-term relief.

Some forms of widespread arthritis are the result of autoimmune disease and are best diagnosed and treated by a rheumatologist. Widespread joint pains can be the result of amplified processing of sensory information in the nervous system called central sensitization, which is thought to be associated with fibromyalgia.  This and its associated conditions are handled under a separate header.




The Spine

One of the most common chronic painful conditions that people suffer from is pain of the neck or back. Musculoskeletal pain of the neck can also cause referred pain to areas of the head or shoulder. Back pain frequently refers to the flank, buttock or thigh. If a nerve root is involved, the pain may radiate all the way to the hand or foot. Sometimes, low back pain may originate in the sacroiliac joint. This is a large joint between the tail bone (sacrum) and hip bone (ilium) bound by a very thick ligament that may become strained or inflamed. Sacroiliac injury can mimic sciatica in its radiation to the leg.

The treatment of musculoskeletal pain of the neck and back begins with physical therapy to correct the mechanical problems that initially caused the pain. This may be supplemented with anti-inflammatories, topical medications, chiropractic, massage, acupuncture and other alternative therapies. Some prescription medications in the class of antiepileptic or antidepressant drugs may be useful for nerve pain. Behavioral therapies may also be recommended for helping patients cope with the psychosocial burdens of chronic pain.

For persistent pain of the spine there are interventional therapies which may be useful. An epidural injection of steroid can calm an inflamed nerve root and accelerate healing of a compressed nerve. The sensory nerves of the spinal joints themselves can be numbed on a long-lasting basis using electrical energy, provided a patient obtains temporary relief from a local anesthetic on those nerves. There are some individuals with extensive disease or significant disc herniations who could require surgery. There are highly effective therapies for pain of the spine, with or without nerve root injury, that block pain signals from getting to the brain by creating an electrical field in the epidural space with an implanted electrode and battery system.



Spinal Cord Stimulation




The Nerves

Many types of injury to peripheral nerves or the central nervous system may result in chronic pain called neuropathic pain. Traumatic injuries, including surgery, or a case of shingles can cause neuropathic pain which begins suddenly and persists. Chronic diseases like diabetes can cause progressive neuropathic pain with a more insidious onset. Physical therapy may be appropriate for certain types of neuropathic pain, but typically anticonvulsants, certain types of antidepressants, and topical medications are used to control symptoms. Certain neuropathies may benefit from therapeutic nerve blocks or even implantable devices. In the case of neuropathy due to chronic disease, control of the underlying disease is crucial to help prevent worsening of symptoms.



Click on the options below to learn about the treatments we offer:

Lumbar Sympathetic Block

Stellate Ganglion Block

Dorsal Root Ganglion Stimulation

Peripheral Nerve Blocks

Intercostal Nerve Blocks

Tap Block (Transversus Abdominus Plane Block)






Fibromayalgia and Associated Conditions

Fibromyalgia is a disorder characterized by widespread pains and other associated symptoms of fatigue, headache, and disturbed sleep. The biological basis of the disorder is poorly understood; the immune system and nutritional factors may play a role, but the most recent evidence suggests that fibromyalgia is a dysfunction in the sensory and regulatory processes of the central nervous system (brain and spinal cord). Brain imaging studies suggest that people with fibromyalgia have amplification of background sensory information from the small nerve endings which exist throughout the body, including the musculoskeletal system. Most individuals are not aware of this surveillance activity of the nervous system, but if the signal is turned up, like white noise on a radio, it can be distracting and uncomfortable. Enhanced sensory input and disrupted regulation of other routine bodily functions having to do with sleep, digestion and urination can cause symptoms like insomnia, headache, irritable bowel symptoms and pelvic pain.

The term that has been coined for this set of conditions is “central sensitization syndromes”. We administer a questionnaire to all of our new patients to help detect these syndromes. If this survey along with other clinical information support this diagnosis, we have various strategies to offer help.









Various Treatments and Strategies


Headaches

Chronic headache is common disorder. Migraine and tension headaches are the most common types, but there are a host of diagnoses associated with headaches. Chronic opioids, benzodiazepines, and barbiturates such as Fioricet may transform occasional headaches into chronic daily headaches, and should be avoided. Headaches may also originate from the upper cervical spine. In these cases, physical therapy and/or interventional pain therapies are likely to benefit. Patients with chronic headaches who have not had prior consultation with a neurologist would benefit from their expertise.




Click on the options below to learn about the treatments we offer:
Sphenopalatine Ganglion Block
Occipital Nerve Block






Abdominal Pain

Abdominal pain has many potential causes, and should always be addressed by appropriate specialties such as gastroenterology, urology, and or gynecology prior to referral for pain management. Irritable bowel syndrome (IBS) is often a source of difficult to diagnose abdominal pain. In some cases, abdominal pain is a result of surgery and can be treated as neuropathic pain. Chronic inflammation of the pancreas, or difficult to treat cases of inflammatory bowel disease (IBD) such as Crohn’s or Ulcerative Colitis may also be a source of abdominal pain. Usually, pain from these diseases are more appropriately managed by a gastroenterologist, however there are some interventional therapies that may be appropriate.








Interventional Therapies (Vary)


Durable Medical Equipment

Durable medical equipment, or DME, is equipment and/or supplies ordered by healthcare providers for everyday or extended use to treat pain in the back, neck, wrist and knees.  A wide range of devices backed by industry-leading research and biomechanical analyses are available to treat a variety of ailments in those areas.  Restricting range of motion to promote faster healing, alleviating muscle fatigue through targeted compression and enhanced stability, and improving posture to promote natural anatomical alignment are among the many applications of durable medical equipment.  Advances in technology have provided many options for very specific conditions and can be fitted accordingly to each patient.  Ask your provider at Anesis if DME is a good option for you.






Anesis Spine & Pain Care

How We Help



What we do

WE CARE ABOUT YOU


Helping you, our patient is our main goal. We want to help maximize your physical functioning and quality of life.


We give you

EXPERT PHYSICIANS


Our physicians are experts in the pain & spine care field. They’re experienced with many years of helping solve pain problems, just like yours.


We offer

Quality Medical Advice


We take the time to answer your questions and give you the best course of action to take.

Anesis Spine & Pain Care

Providing multi-disciplinary care for those suffering from chronic pain.

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Tel: 206-538-6300

Fax: 206-538-6301

Email: [email protected]

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