 Procedural and Surgical Services
MHNI has developed a special general pain team to focus on pain illnesses beyond headache. Most of these special services are provided on the campus of Chelsea Community
Hospital (CCH) in Chelsea, Michigan. Certain noninvasive services are provided at
MHNI.
Various interventional pain techniques are utilized, including but not limited
to:
Click On a Procedure For a Definition Below
Such interventions are provided only after conservative therapies have proven ineffective
in decreasing or eliminating an individual's pain. The general pain team focuses
on the most effective and innovative techniques available.
Trigger Point
Injection- A trigger point injection is used to treat painful and tender
areas of the muscle. A trigger point is a tight band of muscle, or knot, that occurs
when the muscle fails to relax. The trigger point can irritate surrounding nerves
and cause pain in other parts of the body. The injection is made in the area where
the trigger point has formed and returns the muscle to its relaxed state, relieving
the pain.
Occipital Nerve
Block- The occipital nerves that are located at the back of the head can
refer pain forward causing head pain. An occipital nerve block can provide pain
relief. The blocks are typically given in a series of three.
Cervical, Thoracic,
Lumbar Epidural-Epidural injections either in the neck, mid-back
or low back region can provide an anti-inflamatory effect thereby reducing pain.
The injections are typically given in a series of three over time.
Facet Block-
A Facet Block is an injection of local anesthetic into a painful joint in the cervical
or lumbar spine. The injection reduces the inflammation in the painful joint or
joints and decreases the pain.
Epidurogram-
An epidurogram is a method of directly visualizing and treating the inside of the
spinal column using direct vision. A small flexible fiberoptic catheter is inserted
through a tiny incision and the areas of concern can be seen on a video monitor.
Adhesions, or scar tissue, that may be irritating specific nerves can often be effectively
treated using this device.
Cryoneurolysis-
Cryoneurolysis is a procedure that involves "freezing" damaged nerves to relieve
pain. A special probe is carefully guided to the specific nerves that are causing
the pain and discomfort. Once the placement of the probe is correct the tip of the
probe is cooled to temperatures between -50 C and -70 C. The freezing temperature
of the probe causes the surrounding tissue to absorb heat, which breaks up the outer
core of the nerve while the wall of the nerve remains intact. This reduces or eliminates
the pain and allows damaged nerves to grow as healthy nerves.
Radiofrequency
Nerve Ablation- Radiofrequency Nerve Ablation is a technique that has been
found to be beneficial for treating chronic pain that is triggered by certain nerves.
The technique involves the use of specialized needles to direct microwave energy
to "heat up" and inactivate painful nerves. In addition, radiofrequency is effective
in treating pain that may stem from diseased joints in the neck.
Neurostimulation Therapy
· Peripheral Nerve Stimulation - Many patients who suffer from intractable
headaches that have not responded to medical therapy, have a significant occipital
nerve component which contributes to their pain. Peripheral nerve stimulation to
the occipital nerve utilizes a small lead(s) that is placed just beneath the skin
to stimulate the occipital nerve and replace the pain with a "tingling" feeling.
The device is completely implanted under the skin and the patient has control with
a remote device. This procedure is performed on an outpatient basis and usually
does not require hospitalization.
Neurostimulation Therapy
· Spinal Cord Stimulation - Spinal cord stimulation involves implanting small
electrical leads across the area of the spinal cord to deliver low voltage electrical
stimulation that block pain signals from being perceived by the patient. Pain-stopping
nerve fibers are activated by the stimulation and replace the pain in the area with
a pleasant tingling sensation.
IntraDiscal ElectroThermal
Therapy (IDET)- IDET is a recent technology that is gaining widespread
acceptance for treating low back pain that is disc related. With the help of x-ray,
a small thermal catheter is carefully guided to the disc that is producing the pain.
Once it is properly positioned, the catheter is heated, raising the temperature
inside the disc. The heat from the catheter contracts and thickens the protein of
the disc wall and deactivates many of the nerve endings that are responsible for
causing the pain.
Intrathecal Drug
Delivery- Intrathecal drug delivery involves using a small pump that is
surgically placed under the skin to deliver medication directly into the space where
fluid flows around the spinal cord. The medication flows through a catheter that
is also surgically placed. The medication goes directly to the area in the spinal
cord where the pain signals are being produced. Because Intrathecal drug delivery
goes directly to the area causing the pain, it offers significant pain relief with
much lower doses of medication than would be required by taking pills.
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