Dedicated to the Diagnosis and Treatment of Your Chronic Pain

Many patients find significant pain relief from a combination of acetaminophen (Tylenol) and NSAIDs (Diclofenac, naproxen, ibuprofen). When taken together, these medications work very effectively to reduce pain and inflammation. Our experts will advise you how much and how often to take these medications to address your pain.

Opioid medications are rarely recommended as they block the body’s natural ability to manage pain and can lead to dependency – more and more of the drug is required over time to achieve the same effect. For patients struggling with opioid tolerance or dependency, outpatient addiction services that can help.

Physical and occupational therapy is an integral part of our program to keep our patients active and involved and is commonly prescribed as part of our comprehensive program. Specific exercises and movements are personalized for each patient and designed to strengthen the affected body part(s), restore function and minimize pain.

Learn more about the full range of physical and occupational therapy services offered at University Hospitals.

To complement our whole-person approach to pain management, our experts may recommend one or more holistic approaches to treatment, offered through University Hospitals Connor Whole Health. Services include:

• Integrative medicine consults provide a personalized evaluation of each patient to determine which therapeutic and lifestyle approaches offer the best opportunity to achieve optimal health and relieve chronic pain. Learn more.
• Chiropractic care can help restore proper balance and function to the body’s structural, spinal and neurological systems. Evidence supports this drug-free approach for a variety of conditions, including back pain, neck pain, headaches, sciatica and pain in the muscles and joints of arms and legs. Learn more.
• Acupuncture is an ancient and effective technique to treat both acute and chronic pain, including lower back pain, neck pain, joint pain, and headaches and migraines. Learn more.
• Massage therapy is a way to help patients achieve mental and physical well-being. Massage has been used for thousands of years to relieve pain and tension caused by a variety of conditions and factors. Learn more.
• Meditation and guided meditation techniques that can promote relaxation and reduce the anxiety, stress and pain associated with various illnesses and conditions. Learn more.

Patients coping with chronic pain may also struggle with depression, anxiety or other mental health issues. The behavioral health specialists at University Hospitals are dedicated to helping patients with a variety of behavioral and coping strategies. Learn more.

For this outpatient procedure, our experts use X-ray guidance to position a needle or catheter in the area of the back or neck to be treated. Once the delivery device is in place, a small amount of local anesthetic and steroid medicine is injected into the epidural space that surrounds the spinal cord. The medicine calms inflammation and can help reduce the pain associated with herniated or protruding discs, disc degeneration, osteoarthritis of the spine and spinal stenosis.

When the pain being experienced is located in an injured or arthritic joint, the injection of local anesthetic and steroid medicine can reduce inflammation and calm the pain associated with joint movement. Our experts offer injections to treat the following joints:

• Knee
• Shoulder
• Sacroiliac (the joints that connect the pelvis and lower spine)
• Facet (small joints between the vertebrae in the spine)

Also known as rhizotomy, this nonsurgical, minimally invasive procedure delivers thermal energy (heat) through a catheter to destroy or remove a portion of nerve tissue. Once the nerve has been treated, pain signals are interrupted and pain is reduced. RFA is most frequently used to treat pain in the facet (spine) and sacroiliac (pelvis and lower spine) joints.

Using image guidance, a nerve block procedure delivers medication through a needle or catheter to a nerve or a group of nerves. The medication reduces inflammation and temporarily blocks pain signals from the nerve(s). Relief is usually immediate and can be temporary or long-term.

Some of the most common types of nerve blocks offered by our experts include:

• Sciatic. The sciatic nerve is the largest nerve in the human body. It originates in the lower back, travels through the buttocks and down each leg into the feet. If a herniated disk or an overgrowth of bone puts pressure on part of the nerve, it can cause inflammation, pain and numbness. A sciatic nerve block may provide relief from these symptoms.
• Genicular. The nerve branches that surround the knee joint are known as genicular nerves. A genicular nerve block may provide relief for people with chronic knee pain caused by injury or osteoarthritis that hasn’t been helped by medications and physical therapy.
• Occipital. The occipital nerves are a group of nerves in the back of your head. An occipital nerve block delivers anesthetic and/or steroid medications to these nerves to reduce inflammation and provide temporary pain relief from headaches, including migraine and cluster headaches that haven’t responded to other treatment methods.

This procedure involves the injection of steroid medications into the space around an irritated or compressed nerve root. It is most often performed when certain spinal conditions such as herniated discs in the neck or lower back are causing pain, numbness and weakness in the arms or legs (radicular pain).

This minimally invasive procedure delivers extreme cold through a catheter to destroy or remove a portion of nerve tissue. Once the nerve has been treated, pain signals are interrupted and pain is reduced.

A trigger point is a painful “knot” in a muscle that may form after injury, trauma or repetitive use. Instead of relaxing when not in use, the muscle fibers remain stuck in a contracted state, which can cause sensitivity to touch and pain with movement.

Trigger point injections deliver medicine directly to the affected muscle to relax the fibers and relieve pain. Medicines may include a local anesthetic with or without steroid medication or botulinum toxin (Botox). Trigger point injections can treat any muscle in the body, but are most commonly used for muscle pain in the neck, shoulders, arms, legs and lower back.

This surgical procedure involves the implantation of a small generator device under the skin in the lower back or buttock. The device is attached to a very thin wire that is placed just outside of the spinal cord in the epidural space. These devices deliver gentle electrical impulses to the spinal nerves, interrupting pain signals to the brain.

Another type of neuromodulation is the implantation of an intrathecal pump – a device that delivers a prescribed dose of medication directly into the spinal fluid. Because the medicine goes directly where it is needed, smaller doses can be used which can lead to fewer side effects and improved patient comfort.

A surgical procedure that uses thermal energy (heat) to treat the nerves inside the disc/bone endplates of the vertebra to interrupt pain signals. The Intracept procedure (basivertebral nerve ablation) is consistently effective in treating pain that is caused by damage to the endplates of your vertebra (vertebrogenic pain).

Compression of the nerves in the spinal cord is a common cause of chronic back pain. Although it can be the result of injury or trauma, it most often occurs as a result of aging and degeneration of the spongy discs that separate the vertebrae in the backbone. When these discs become worn down or protrude, the vertebral bones lose their protective cushioning and may put pressure on the spinal cord nerves, causing pain, weakness and numbness. In severe cases, loss of bowel and/or bladder control can occur.

Our experts offer the most advanced minimally invasive surgical techniques for spinal cord decompression, including the Vertiflex procedure. For this procedure, a small implant is placed inside the spine to keep the vertebrae separated and prevent compression when standing or walking. Maintaining the space between the vertebrae reduces pressure on the spinal cord nerves and relieves the associated symptoms.