Chronic pain can oftentimes get in the way of doing the things you love to do. You may benefit from a multi-disciplinary approach to managing your pain including the possible use of physical therapy, therapeutic modalities, prescription medication and/or interventional pain management consisting of steroid injections.
All of these options are available at Orlando Orthopaedic Center and all of our Pain Management physicians are Board Certified with a subspecialty in Pain Management.
Common Conditions & Procedures
- History of the painful condition
- Physical examination review
- Review of any notes, X-rays, MRIs, laboratory studies and other information
Following your initial evaluation, a treatment regimen will be recommended and is individualized for each patient and varies depending on the nature of the condition.
The multi-disciplinary approach is utilized to manage complex and difficult pain conditions. The Pain Management physician performs pain-relieving procedures and serves as a consultant to other physicians. This involves counseling patients and families, prescribing and supervising rehabilitative and behavioral health services, as well as recommending and prescribing medications useful in the treatment of chronic pain.
- EMG & NCV Studies
- Epidural Steroid Injections
- Facet Joint Injection
- Stimulator Implants
- Trigger Point Injections
- Epidural Injections (Cervical, Thoracic, Lumbar)
- Joint Injections
- Trigger Point Injections
- Facet Injections And Medial Branch Blocks (Cervical, Thoracic, Lumbar)
- Nerve/Muscle/Plane Blocks
- Head – Occipital, Trigeminal, Sphenopalatine Ganglion
- Neck – Scalenes
- Extremities – Brachial Plexus, Sciatic, Posterior Tibial, Iliohypogastric, Genitofemoral, Piriformis
- Knee – Genicular
- Thorax – Intercostal
- Abdominal – Transversus Abdominal
- Radiofrequency Ablations
- Medial Branches
- Si Joint
- Sympathetic Blocks
- Stellate Ganglion
- Celiac Plexus
- Inferior Hypogastric Plexus
- Ganglion Of Impar
- Spinal Cord Stimulator Trials And Implants
- Dorsal Root Ganglion Stimulator Trials And Implants
- Peripheral Nerve Stimulator Trials And Implants
- Shoulder – Suprascapular
- Knee – Infrapetallar Saphenous
- Back – Superior Cluneal
- SI Joint – Medial Cluneal
- Foot/Ankle – Tibial
- Intrathecal Trials And Pump Trials And Implants
Pain Management FAQs
We begin your treatment with conservative therapies including physical therapy, chiropractic care, massage therapy, pain counseling, cognitive behavior therapy, acupuncture, and other alternative methods. Conservative care also includes medications. We start with non-opioid medications first and then use opioids as a last resort.
Non-opioids medications include, NSAIDs, acetaminophen, muscle relaxants, topical medications, and neuropathic medications. Typically these are not controlled substances. Opioids are typically controlled substances.
After conservative care, we may offer minimally invasive procedures such as steroid injections, ablations, and nerve stimulators.
There are many different types of corticosteroids. When you come into our office for a cortisone shot, we choose which type based on many factors including your type of pain and location of your injection.
We also take into account your safety profile, keeping in mind any of your medical concerns and comorbidities.
Typically steroid injections take effect within 3 to 10 days. Some patients feel relief before this, and for others it could take even longer.
On average steroid injections last 3 to 6 months. However, this number can vary and depends on how well you respond to the steroid.
A nerve block typically refers to when we use numbing medication to temporarily relieve pain from a particular nerve. This can be done almost anywhere in the body.
The numbing agents we use for a nerve block last from several hours to up to a day depending on the local anesthetic. We typically inject the medication surrounding or near the nerve using imaging guidance such as an X-ray or ultrasound.
A nerve block that uses a numbing agent is often considered a diagnostic procedure rather than a therapeutic treatment for nerve pain. A diagnostic nerve block typically only lasts up to a day and helps us diagnose where your pain is coming from.
We can also use steroids in a similar fashion to provide more long-lasting relief from the pain. If a steroid is used, you can get therapeutic relief for several months, but it can vary depending on the cause of your pain.
Many of our surgeries involve regional anesthesia techniques such as spinal blocks and peripheral nerve blocks under ultrasound guidance which help to numb the surgical area. As surgeons we also do a local injection with different medications to dull the pain as well. Our peripheral nerve blocks for joint surgery typically wear off within a day or so.
Swelling and inflammation then tends to set in about 1-2 days after the surgery. We typically aim to treat postop pain with a host of different medications that work via different mechanisms and on different pain receptors in your body.
These medications include acetaminophen (also known as tylenol), non steroidal anti inflammatory medications (such as ibuprofen, meloxicam, diclofenac, or celecoxib), neuropathic medications (such as neurontin or pregabalin), and opioids (such as tramadol or hydrocodone). Steroids and muscle relaxants can also play a role on occasion.
By targeting several different pain pathways we can effectively treat pain and help make our patients as comfortable as possible for their recovery period. If a patient is experiencing pain several weeks to months after surgery they may be referred for a chronic pain management consultation with our anesthesia-trained pain physician team.
Patients may also be referred to our pain management physicians before surgery to see if they would be candidates for minimally invasive treatments other than surgery.