Treatments for Pain

A Continuum of Treatment Options

CPC specializes in the treatment of spine disorders such as degenerative disc disease, small disc herniations, neck and back pain, post-surgical pain, cancer pain, reflex sympathetic dystrophy, post-herpetic neuralgia, as well as other painful conditions.  Once a diagnosis is established, therapies can be offered, including fluoroscopically guided spinal injections, sympathetic blocks, trigger point injections, and other procedures.  These are performed in combination with ongoing physical therapy, and non-narcotic medications.  The physicians at CPC are experts in the placement of medications at specific locations of the spine, joints, peripheral nerves, and soft tissues.  This is done to treat pain syndromes, or to diagnose the problem that might be causing pain.  Many of the procedures are performed with fluoroscopy, a type of x-ray, so that the needle can be directed specifically to the site in question.  The patient should expect a discussion of the purpose, risks, side effects, complications, and desired results of the injection procedure.  When indicated, the following procedures are expertly performed by the physicians:

Epidural Steriod Injections – cervical, thoracic and lumbar spine
Sympathetic Ganglion Blocks – stellate and lumbar
Sympathetic Plexus Blocks – celiac and hypogastric
Facet Joint Injections
Selective Nerve Root Blocks – cervical, thoracic and lumbar spine
Peripheral Nerve Blocks
Sacro-Iliac Joint Blocks
Trigger Point Injections
Radiofrequency Neurolysis
Diagnostic Discography
Occipital Nerve Blocks
Placement of Spinal or Epidural Catheters
Implantation of Spinal Cord Stimulator
Implantation of Intrathecal Catheters and Infusion Pumps
IDET
Cryoablation

State-of-the-Art Therapies With Proven Success

CPC prides itself on how it stays abreast of cutting edge technologies.  One such example is the work that Dr. Keith Kittelberger has conducted using implantable neurostimulation devices and intrathecal pumps.In controlled studies, neurostimulation has been found to be more effective than repeat spine surgery in appropriately selected patients.  Neurostimulation uses a small system that is surgically placed under the skin to send mild electrical impulses to the spinal cord or to a peripheral nerve.  The electrical impulses are delivered through a lead (a special medical wire) that is also surgically placed.  These electrical impulses block the pain signal from reaching the brain. Another implantable device option involves a small pump that is surgically placed under the skin of the abdomen to deliver medication directly into the intrathecal space and spinal fluid.     This therapy delivers medications directly to the pain receptor sites, through a catheter, using only a fraction of the dose that would be required with oral or IV medication.    “The care of the patient with one of these devices requires the coordinated effort of the entire pain clinic.  The staff have gone to special courses to familiarize themselves with the implants and are involved in the refills and analysis of pumps as well as some neurostimulation reprogramming”, states Dr. Kittelberger.  A mental health provider is also heavily involved in the pre-operative selection of appropriate candidates for implantation.