Radiofrequency ablation (RFA) is one of the newer treatment options for pain coming from the facet joints which can contribute to chronic pain in the neck or lower back, or from the sacroiliac joints which can cause chronic low back pain. RFA is a minimally invasive, non surgical procedure which uses heat to reduce or stop the transmission of pain. Performed in the PCA physician’s offices, the RFA waves ablate, or “burn” the nerve that is causing the pain, which then stops the pain signals from traveling to the brain. People experiencing stomach pain or pelvic pain from pancreatic or ovarian cancer may also be candidates for RFA.
Peripheral Nerve Stimulation
Pain is most often treated with injections, oral medications or nerve blocks as non-surgical options based on the reason for the pain. However, if these treatments fail and the pain becomes chronic, peripheral nerve stimulation (PNS) may be considered in consultation with your PCA physician. PNS is a minimally invasive, surgical procedure which implants electrodes directly on the nerves or under the skin where the pain is occurring. PNS could be a treatment option if you are living with pain from cluster headaches or migraines, complex regional pain syndrome, post amputation or phantom limb pain among other conditions.
Spinal Cord Stimulator
Spinal Cord Stimulator (SCS) is a therapy which masks pain signals before they reach the brain. It involves a small device, much like a pacemaker, that sends electrical pulses to the spinal cord in order to modify the pain signals. After the device is implanted, these pain signals are no longer perceived or they are replaced by a faint tingling feeling. SCS does not eliminate the source of pain as it simply changes the way the brain perceives the pain. SCS is used most commonly to treat neuropathic back and leg pain which may have resulted after back surgery and it can also be used to avoid back surgery in the first place. Other conditions considered for SCS treatment include complex regional pain syndrome and peripheral neuropathic pain.
Back or leg pain can come from several different conditions, so accurately diagnosing the reason for the pain is critical for a proper treatment plan. A discogram is a diagnostic procedure which helps to determine if your back or leg pain is related to a degenerative vertebral disc. By injecting dye into each of the vertebral discs to recreate the pain, the discogram allows the physician to view your disc and locate the pain source. If you feel pain when the dye is injected, it is likely that the disc is the source of your pain. If you don’t feel the same kind of pain, your physician will explore other possible causes of your pain in order to diagnose and develop an appropriate treatment plan accurately.
Genicular Nerve Radiofrequency Ablation
Genicular nerve radiofrequency ablation (GNRFA) is an outpatient procedure which provides a non surgical approach to treat chronic knee pain if other treatment options have not been successful. Radiofrequency ablation of the genicular nerves (the branch of nerves surrounding the knee) might be a successful alternative to surgery. With GNRFA there are no incisions and no need for steroid or cortisone injections. This procedure stuns the painful nerves to prevent the pain signals from reaching the brain, which allows for quality of life to improve and function to return.
Medications are often part of a treatment plan for people living with pain in order to improve quality of life by reducing or removing pain. Because each patient is different with a unique medical history and medication plan, management of the various medications is critical for overall safety. Medication management by PCA is an outpatient service which reviews and evaluates the effectiveness, or efficacy, of the prescriptions and notes any side effects you might be experiencing and how the medications are working together.