ACUTE pain management is provided to patients undergoing surgical procedures associated with significant postoperative pain. Typical procedures might include open chest surgery (thoracotomy), intraabdominal surgery (laparotomy) and orthopedic surgery. "Epidural" pain relief or analgesia is the most frequent technique employed and entails placing an epidural catheter in the epidural space of the spinal canal, either prior to or after the surgical procedure. Narcotic pain killers, often combined in dilute local anesthetic mixtures, are infused to provide profound pain relief with minimal side effects. Side effects can include respiratory depression, itching, nausea, headache and difficulty urinating. An ASANR physician evaluates each patient daily and makes appropriate changes where indicated. An ASANR physician is "on call" 24 hours a day to respond to any issues relating to postoperative pain and/or side effects. Your anesthesiologist will discuss with you appropriate pain management options prior to surgery.
CHRONIC pain management is provided to patients referred by their primary treating physicians who have debilitating and/or intractable pain that persists beyond the interval for normal tissue healing. Patients undergo a medical evaluation by an ASANR physician and a treatment plan is formulated. The treatment plan may recommend diagnostic and/or therapeutic nerve injections as well as referral for physical therapy, chiropractic manipulation, acupuncture, pyschobehavioral therapy, or surgery.
- Back and neck pain
- Failed back surgery syndrome
- Spinal stenosis
- "Shingles" (acute and chronic postherpetic neuralgia)
- Cancer pain
- Peripheral neuropathies
- Myofascial pain syndrome
- Phantom limb pain
- Complex regional pain syndrome - Type I (formerly called "reflex sympathetic dystrophy")
- Complex regional pain syndrome - Type II (formerly called "causalgia")
- Facial pain
- Spasticity associated with neuromuscular or spinal cord disease/injury
- Post thoracotomy pain
- Rib fractures
- Limb pain from inoperable vascular insufficiency
- Occipital neuralgia
- Discography
- Epidural steroid injections
- Selective nerve root injections (for diagnostic and therapeutic indications)
- Spinal endoscopy
- Intradiscal electrothermal therapy
- Spinal facet joint injections
- Sacroiliac joint injections
- Sympathetic nerve injections (cervical, thoracic and lumbar)
- Celiac/splanchnic plexus injections
- Therapeutic peripheral nerve injections
- Neuroaugmentation (spinal cord stimulation)
- Neurodestructive (cryneurolysis/radiofrequency ablation/chemical neurolysis)
- Spinal catheters for intraspinal infusion therapies
- Implantable pumps to deliver intraspinal medications
- Trigger point injection
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InterStim Home Page: Web site about the use of InterStim Continence Control Therapy in the treatment of urinary urge incontinence.
