Pain Management
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.
What is Interventional Pain Management?
Interventional Pain Management is a specialized branch of medicine focused on identifying, reducing, and controlling pain using minimally invasive techniques. Unlike general pain relief approaches that may rely solely on medication, interventional methods target the source of pain directly to improve function and quality of life.
These treatments can:
- Reduce inflammation and nerve irritation
- Improve mobility and physical performance
- Delay or prevent the need for surgery
- Support recovery when used alongside physical therapy and rehabilitation
Our goal is to address your pain at its root cause, not just mask the symptoms. Talk to a pain management specialist and get a treatment plan just for you.
Common Conditions & Procedures
- Back and neck pain from herniated or degenerative discs
- Sciatica and nerve compression
- Spinal stenosis
- Facet joint arthritis
- Sacroiliac (SI) joint pain
- Complex Regional Pain Syndrome (CRPS)
- Chronic joint pain (shoulder, hip, knee)
- Pain from osteoarthritis
- Post-surgical pain syndromes
- Pain related to sports injuries or trauma
- 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)
- Interlaminar
- Transforaminal
- Caudal
- Joint Injections
- Shoulder
- Knee
- Hip
- Sacroiliac
- 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
- Genicular
- Si Joint
- Sympathetic Blocks
- Stellate Ganglion
- Lumbar
- 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
- Kyphoplasties
How We Treat Pain
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.
With most types of surgery there is an inherent amount of pain and soreness that may occur afterward. For surgery we aim to use a multimodal approach to managing pain. We start pain management both preoperatively and intra-operatively with our anesthesia team.
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, non steroidal anti inflammatory medications, neuropathic medications, and opioids. 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.
Pain Management FAQs
In many cases, you do not need a referral to see our Pain Management specialists. However, some insurance plans may require one. We recommend checking with your insurance provider or calling our office at (407) 254-2500 to confirm your specific requirements.
A pain management specialist has advanced training in diagnosing and treating complex pain conditions, often using targeted, minimally invasive procedures. While your primary care doctor can help manage general health and prescribe medications, a pain specialist focuses specifically on identifying the root cause of your pain and developing a comprehensive treatment plan, often in coordination with your other healthcare providers.
We offer a range of interventional and non-interventional treatments, including non-opioid methods first and transition to opioids as a last resort. Your treatment plan may include spinal injections, nerve blocks, radiofrequency ablation, massage therapy, acupuncture, regenerative medicine techniques, and coordinated physical therapy programs. Your treatment plan will be customized to your specific condition and goals, and you’ll work with your specialist to ensure that these methods are working to keep your pain at bay.
Pain is particular to each patient and condition. Your doctor will give you a timeline for recovery. Results vary depending on the treatment and the underlying cause of your pain. Some patients experience immediate relief, while others notice gradual improvement over days or weeks. Your specialist will discuss realistic expectations based on your individual care plan.
In many cases, pain management can mitigate the need for surgery. By targeting the source of pain with minimally invasive procedures and comprehensive rehabilitation, pain management can often delay or eliminate the need for surgery. However, if surgery becomes necessary, your pain management team will coordinate closely with your orthopaedic surgeon for a smooth transition.
