- Pain management medication that includes various classes of medicine: non opioid (e.g., NSAIDs), opioids, and adjuvant analgesics.
- Pain Management Protocol
- Trigger Point Injection or Dry Needling for a case with muscle pain such as myofascial pain syndrome.
- Epidural Steroid Injection utilizing selective nerve root block and/or interlaminar techniques, allowing steroid to be injected into the area of back pain that also propagates along spinal nerves affected by the condition.
- Facet Joint Injection that introduces local anesthesia and/or steroid into a facet joint to treat pain that does not shoot down the legs.
- Radiofrequency Ablation (RFA) that converts radio frequency into heat around the tip of a needle at intervals, to help treat chronic pain – for example, when the patient responds well to facet joint injection and there is a need to extend the effect by another 6 – 12 months.
- Sympathetic Block which impedes sympathetic nervous system that affects arteries and causes sympathetically maintained pain of the limbs – for example, due to an accident.
- Neurolytic Celiac Plexus Block via an injection that eliminates autonomic nerves around celiac plexus, using neurolytic agent (e.g., 50 – 90% alcohol), for severe cases with cancer in the upper abdomen area such as pancreatic cancer.
- Intrathecal Drug Delivery Device Implantation that places a small device for delivering pain management drug directly to the spinal cord. The device is inserted under the abdominal skin and is suitable for patients who need such a high dosage of opioids medication that the drug’s side-effect may be undesirable. The device can be a fully implanted intrathecal pump or one with a reservoir that can be refilled periodically.
- Spinal Cord Stimulation through an implant of a small device that generates and directs a low current into the spinal cord, to help manage the patient’s pain. This is appropriate for cases with complex regional pain syndrome.