Pain Management
More than 50 million Americans — approximately 21 percent of the population — live with chronic pain, according to the U.S. Pain Foundation. Chronic pain is a complex condition with multiple causes. It can affect all facets of life, including sleep, concentration, energy levels and the ability to work or do daily tasks. If you’re one of the many living with chronic pain, MultiCare pain specialists can help.
What we treat
Pain is a legitimate medical syndrome associated with an unpleasant sensation and the emotional response to that sensation. Pain can be caused by any number of events, such as an auto accident, work or sports injury, surgery or infection. Your response to a painful sensation is as individual as you are.
We treat chronic pain associated with various conditions and parts of the body:
- Back and neck pain
- Bone pain
- Epilepsy-related pain
- Fibromyalgia-related pain
- Headaches
- Muscle pain
- Nerve pain (neuropathy)
- Parkinson’s disease-related pain
How we help
There are a variety of different ways to treat chronic pain. At MultiCare, we offer medical pain management and interventional pain management. Both approaches can help improve your day-to-day functioning and quality of life, now and in the years to come.
Medical pain management
Medical pain management is a holistic approach that can help you understand why you’re experiencing pain and find ways to better manage it in the long term. Our medical pain management team incorporates treatments and techniques from a variety of specialties to create a tailored plan just for you. Medical pain management may include:
Medication management. Sometimes prescription medication can help treat pain. We specialize in safely managing medication for high-risk patients and those with complex conditions.
Botox treatment. Shorter-term treatments such as Botox injections can reduce pain in muscles and surrounding nerves, joints and other structures. This approach can be useful when the intensity of pain blocks your ability to participate in pain management education or therapy.
Bracing and other adaptive equipment. For some patients, adaptive equipment like splints, walking sticks or wheelchairs can ease pain and make it easier to participate in activities. Our pain management specialists can evaluate what adaptive equipment is right for you and prescribe devices that will help you achieve the best outcomes.
Multidisciplinary treatment. We help initiate and coordinate treatment with specialists such as psychologists, chiropractors, massage therapists, physical therapists and acupuncturists.
Interventional pain management
Interventional pain management is a specific kind of pain management treatment. Rather than relying on medications, lifestyle adjustments or multidisciplinary techniques to manage pain, interventional pain management uses procedures to block the source of your pain. These minimally invasive diagnostic and therapeutic procedures can decrease painful sensations, improve function and mobility, reduce inflammation and decrease reliance on pain medications.
Interventional pain management is commonly used to treat:
- Spine pain (low back pain or neck pain)
- Pain from damaged or pinched nerves (sciatica or radiculopathy)
Most interventional pain management procedures can be performed on an outpatient basis, and we provide sedation for your comfort. Explore the FAQ below to get answers to frequently asked questions about interventional pain management.
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Epidural steroid injections. Injections in the spine can help relieve pain caused by herniated discs, spinal stenosis or other conditions. These injections, which take just a few minutes to perform, can aid healing while making it possible to resume many normal activities. It is often necessary to perform an initial series of several epidural steroid injections separated by a few weeks.
Facet joint and medial branch nerve injections. Facet joints are sets of joints lining your spine, from the base of your neck to the low back. Whiplash injuries to the neck, arthritis and other issues can lead to pain in and around these joints. Each facet joint is connected to medial branch nerves. Injections of local anesthetic can block nerve signals, relieving the joint pain and allowing your doctor to pinpoint where the pain is coming from.
Radiofrequency neuroablation. This procedure is used to deactivate small nerves around the spine. For example, if facet joints are causing pain, the small nerves that serve the facet joints can be turned off with radiofrequency neuroablation. Relief may last for months to years.
Lumbar provocative discography. When pain in the low back does not respond to basic treatments, it may be necessary to investigate the intervertebral disks as the source of the pain. Disks that are bulging or have tears can be painful but may still look normal on traditional X-rays. Lumbar provocative discography is a procedure that can help identify these disks. During the procedure, which takes about 30 minutes, a small needle is guided into the center of the disks. We then inject dye while taking X-rays.
Spinal cord stimulation. Spinal cord stimulation is for patients with pain in the spine and limbs that has not responded to other treatments. The technique uses electrical stimulation to block pain signals. Small devices called leads are placed over the spinal cord where the pain signals are converging. Temporary leads are placed initially, and a permanent system can be implanted if the temporary leads result in significant relief over a three-to-five day trial period.
Transforaminal steroid delivery and selective nerve root blockade. During these procedures, we inject a combination of local anesthetic and steroids where a nerve exits the spinal column. The goal is to help reduce pain and inflammation in the spine or relieve pain that radiates from the spine to other areas of the body.
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In some cases you may be able to have a procedure on the same day as your evaluation. But it can take time to check with your insurance company and secure authorization before scheduling the procedure. Our staff works quickly and efficiently to support timely scheduling. You can help this process by ensuring that we have up-to-date information about your insurance.
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Anxiety and sedation can cause some people to be nauseous, so your stomach must be empty for the procedure. Please don’t eat for four hours before your appointment. However, you can take your usual medications with sips of water.
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Yes. It is important to tell your prescribing doctor or other health care provider that you are going to have a procedure. This provider will instruct you about when to stop taking the medication. Sometimes your blood will be checked on the day of the procedure to make sure it is safe to proceed.
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Most procedures take less than 10 minutes to perform. We ask that you arrive a little early for your appointment to fill out any necessary paperwork. After the procedure, you will stay in the recovery area of our facility for 20-30 minutes. Since you will receive sedation as part of your procedure, you will need a responsible adult to drive you home.
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The vast majority of procedure will take place under fluoroscopic guidance, which uses low-intensity X-rays to show the outlines of bone structures. Your doctor may also use a small amount of dye to confirm that medications are flowing precisely where they need to go to achieve a good result.
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Plan to relax for the rest of the day. If you receive a steroid injection, you may be uncomfortable until the medicine begins to take effect (one to two days). If your doctor uses local anesthetic to block nerves, such as facet joint nerves, the medicine will wear off in about four to six hours. Generally, it is safe to resume your normal activities the next day, including going to work.
Referral required
A referral is needed to schedule an appointment with a MultiCare pain management specialist. If you are experiencing chronic pain, contact your primary care physician to request a referral today.
