Pain Management

Pain Treatments

Sometimes a combination of treatments is the most effective way to treat pain. NMMC offers several treatments that may be used together to most effectively treat your pain:

Medication Management

Although opiate pain medications have numerous side effects, our providers understand there is an important role for the use of opiates to manage pain. We do not believe that opiates should be the primary or sole treatment for any pain condition. Rather, they should be used in the smallest doses necessary in addition to other non-opiate medications, procedures, therapy, surgery and counseling.

We do not prescribe these medications casually and we do not prescribe these to every patient we see. Some patients may have medical or social histories that may put them at a higher risk for addiction and abuse with narcotics.

As part of a comprehensive pain management program, medications can be used to help reduce pain. 
Some of these medications include:

• Opioids
• NSAIDs (nonsteroidal anti-inflammatories)
• Muscle relaxants
• Acetaminophen
• Neuropathic medications such as Lyrica or Neurontin

We work closely with patients to monitor compliance with medications utilizing narcotic agreements, pill counts and urine drug screens. We accept patients by physician referral and self-referral for medication management services.

Pain Management Procedures

We utilize the guidelines provided by the American Society of Interventional Pain Physicians, The American Board of Pain Medicine, and the Spine Intervention Society.

Our pain management doctors are trained and proficient in the most effective methods of pain management. With board certifications and decades of experience with pain management techniques, our physicians offer a variety of interventional pain procedures including the latest therapies and technologies.

Nerve blocks. When pain is localized to a particular area of the body, a nerve block may be useful. A nerve block is an injection of nerve-numbing substance that blocks the nerve transmission of pain before it can reach the brain. These can be used for pain in the face, neck, chest, abdomen, spine, pelvis, arms and legs.

Trigger point injections. Trigger point injections are used to treat painful areas of muscle that have knots of muscle that do not relax. A small needle is inserted into the trigger point with a local anesthetic or saline and may contain a corticosteroid.

Epidural steroid injections. If you have intense pain in your legs or arms from inflamed spinal nerves, an epidural steroid injection might offer relief. Often, nerve passages from the spine to your arms or legs become narrowed, causing this pain. Injected steroids reduce inflammation and open up these passages to provide pain relief.

Surgery

Surgical intervention for chronic pain should be used after other, non-surgical approaches have been attempted. When other efforts are ineffective, NMMC neurosurgeons offer minimally invasive brain and spine procedures.

Our board-certified neurosurgeons work closely with the other pain management disciplines, including rehabilitation, medication management and physical medicine, to help reduce your pain.

Outpatient Rehabilitation Services

• Aquatic therapy is ideal for patients with arthritis, chronic pain, fibromyalgia or sports injuries. By eliminating the effects of gravity on the body, the stress on muscles and joints is greatly reduced.
• Dry needling is used to treat dysfunctions in soft tissue to diminish persistent pain.
• Occupational therapists can help chronic pain patients by evaluating the pain’s impact on a patient’s desired activities and quality of life and equip him or her with the skills and strategies to manage the pain.
• Physical therapists play an important role in managing chronic pain by administering treatments that include strengthening and flexibility exercises, manual therapy, posture awareness and body mechanics instruction. Physical therapists can also help you understand the underlying cause of their pain.

Other Services

To help you manage your pain, we also make referrals to other providers when appropriate, including:

• Addiction Services
• Physical therapy
• Occupational therapy
• Aquatic therapy
• Neurosurgery
• Neurology
• Behavioral Health/Counseling
• Orthopedics
•  Wellness Centers through the Bridge to Wellness program.
• Durable medical equipment (such as support braces)
• Clinic social worker to provide extra support as needed