Pain Management

/Pain Management
Pain Management 2018-06-19T15:30:49+00:00

Meet Our Team

Charles Daknis, MD

Keiron Greaves, MD

Adam Meyers, DO

Neck and back pain can greatly limit what you are able to do. It can affect your work, your level of activity, and even your ability to complete everyday tasks.

There are several conditions that can cause neck and back pain, including:

  • Failed back surgery syndrome
  • Herniated or bulging discs
  • Complex Regional Pain Syndrome (RSD)
  • Cervical/lumbar radiculopathy (numbness, tingling, and/or weakness)
  • Facet syndrome
  • Spinal stenosis

Whenever possible, we offer our patients at Seaview nonsurgical and minimally invasive treatment options for back and neck pain to help relieve your symptoms. Our pain management specialists, Dr. Charles Daknis, Dr. Keiron Greaves, and Dr. Adam Meyers, are fellowship trained in pain management and will help you solutions to manage your pain.

If you would like to learn more about pain management options at Seaview, or would like to schedule an appointment with one of our specialists, please call our office at (732) 660-6200 or use our online appointment booking service.

Pain Management Injections Offered At Seaview Orthopaedics

Injections can be used to both diagnose the source of pain and help alleviate the pain caused by spinal conditions. Our experienced pain management specialists offer several different types of injections to help you manage your back and neck pain. After your diagnosis, our specialists will work with you to develop a treatment plan that helps manage your pain and helps delay or even avoid the need for spine surgery.

Our doctors typically administer spinal injections using x-ray guidance to allow for accurate needle placement. Injections typically consist of a numbing medication like lidocaine, a corticosteroid, or a mixture of the two. The numbing medication provides more instant pain relief, while anti-inflammatories like corticosteroids, provide more long-lasting pain relief.

Below are some of the spinal injections our pain management specialists offer.

Epidural Steroid Injections

Epidural steroid injections are a common way to manage back pain. Epidural steroid injections are administered in the dura, the sac that surrounds the nerve roots and contains cerebrospinal fluid. Injecting steroids into this area can reduce inflammation, which may be helpful for patients with spinal stenosis, herniated discs, or degenerative disc disease.





Selective Nerve Root Block

Selective nerve root blocks can be used to both diagnose the source of nerve root pain and treat pain caused by the inflamed nerve root. This injection consists of both lidocaine and steroids, and is given between the vertebrae at the nerve root. Because lidocaine provides instant pain relief, we are able to tell whether the nerve root is the cause of the patient’s back pain. The steroid then provides longer lasting pain relief by reducing inflammation around the nerve root.

Stellate Ganglion Block

The stellate ganglion are a collection of nerves located in the neck and are part of the sympathetic nervous system. These nerves supply the face and arms, and though they are not involved with feeling or movement, trauma, infection, or other conditions can sensitize the nerve, causing pain. An injection given near the stellate ganglion, called a stellate ganglion block may be used to treat these symptoms, or to diagnose the source of pain. Patients are typically sedated when this injection is given. Most patients need a series of injections to have longer-lasting pain relief.



Sacroiliac Joint Injection

The sacroiliac joints are located on both sides of the sacrum, connecting it to the hip. Inflammation in these joints can be painful. Sacroiliac joint injections can be used to diagnose and confirm the source of pain, and also treat the pain. For diagnostic purposes, a numbing medication will be injected. If the injection is given for pain relief, anti-inflammatory medication is also included in the injection to provide longer-lasting pain relief.



Facet Block

Facet joints, tiny joints that are present at every segment of the spine, help to stabilize the spine and guide motion. Facet joints can become arthritic, or may become painful with an injury or stress on the back. A facet block injection can help relieve this pain. This injection contains a mixture of numbing medication and an anti-inflammatory to provide both immediate and long-lasting pain relief.



Lumbar Sympathetic Block

A lumbar sympathetic block, consisting of an anti-inflammatory medication, is administered around the sympathetic nerves that are located on both sides of the spine in the lower back. These injections can be used to help with lower back pain, sciatica (leg pain), reflex sympathetic dystrophy, complex regional pain syndrome, and peripheral neuropathy. Patients are typically sedated before the injection is given. Some patients need multiple injections to experience continued pain relief.



Piriformis Block

The piriformis is a muscle located in the bottock region. Spasms in this muscle can irritate the sciatic nerve, causing pain, numbness, and tingling along the back of the leg down to the foot. A piriformis block, consisting of local anesthetic and a corticosteroid, may be injected directly into the piriformis muscle to provide relief from the pain and spasm. This can assist with physical therapy, which is also typically part of the treatment plan.

Trigger Point Injections

A trigger point is a “knot” or area of the muscle or connective tissue that becomes sensitive and painful when compressed. Trigger points can cause pain in other parts of the body (referred pain), or can cause radiating pain throughout the muscle. Trigger point injections, during which anesthetic and steroids are injected into the trigger point, can help to alleviate the pain.

Discography

A discography is a type of injection used in the diagnostic process to determine why a patient has not responded to nonsurgical treatment methods. First, your doctor will inject an anesthetic to numb the area. Then, using x-ray guidance, a guide needle is inserted so that it just touches the outer surface of the disc. A smaller needle is then passed through the guide needle and advanced toward the center of the disc. If multiple discs are being examined, this process is repeated. When all of the needles are placed, the discs are pressurized by injecting a small amount of contrast dye into each disc. Your doctor will note where pain, if any, is felt. The needles are then removed, and CT images may be taken to show the insides of the disc.



Minimally Invasive Pain Management Solutions Offered At Seaview Orthopaedics

In addition to spinal injections, our pain management experts also offer minimally invasive solutions to help patients with neck and back pain.

Spinal Cord Stimulator Implant

Spinal cord stimulators are implanted near the the spine. These stimulators generate mild electrical pulses to disrupt pain signals from reaching the brain. To implant spinal cord stimulators, your doctor will use x-ray guidance to insert a hollow needle into the epidural space. Thin, insulated wires called leads are passed through the needle. The leads have electrical contacts attached to them to conduct the electrical currents. You will then be awakened to provide feedback on electrode placement to ensure that they cover all areas needing pain relief.

Once lead placement has been verified, you are sedated once again, and your doctor will implant the generator through a small incision. The generator will be placed either in the abdomen, upper buttocks, or upper chest, depending on the patient’s preference and with comfort considered. Wires are connected to the leads, then tunneled under the skin and connected to the generator. An external controller is used by the patient to control the electrical pulses.