Overview
Fairview Hospital Pain Management Center provides outpatient and inpatient diagnosis, education and treatment services for patients with chronic pain, cancer pain and acute pain. A multidisciplinary team of professionals work with the center in the following specialties:
- Anesthesia.
- Nursing.
- Physical therapy.
- Psychology.
- Pharmacology.
The center is open Monday - Friday, 8 a.m. - 4:30 p.m. and Saturday, 8:30 a.m. - noon for outpatients.
For more information or to make an appointment, call 216.476.7331.
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Pain Management Doctors
What type of training does a pain management doctor have?
Like other physicians, anesthesiologists earned a college degree and completed four years of medical school. They spent four more years learning the medical specialty of anesthesiology and pain medicine during residency training. Many anesthesiologists who specialize in pain medicine receive an additional year of fellowship training to become a “sub-specialist,” or an expert in treating pain. Some also have done research, and many have special certification in pain medicine through the American Board of Anesthesiology (ABA). The ABA is the only organization recognized by the American Board of Medical Specialties to offer special credentials in pain medicine.
When do I need to see a pain medicine doctor?
If your pain persists after the healing process should be over, you might have what is called chronic pain. If the current treatment you are receiving stops working, or if your pain begins to get worse over time, your primary care doctor may suggest that you see a pain medicine doctor.
Cancer pain is another condition that can be managed by a pain medicine doctor while the patient continues to receive treatment for various types of cancer. The pain can be due to cancer surgery or treatment procedures, including radiation therapy and chemotherapy, or the tumor itself.
What does a pain medicine doctor do?
Pain medicine doctors are experts at diagnosing why you are having pain as well as treating the pain itself.
They also manage acute pain caused by surgery, a debilitating illness, or a serious injury. You may be treated in the hospital or in an outpatient clinic.
- The pain medicine doctor will work closely with your primary care doctor.
- Pain medicine doctors will review your medical records as needed.
- They will ask you to describe your pain in detail.
- They may ask you to fill out a detailed questionnaire which helps to assess the impact your pain is having on your life and daily activities.
- They will perform a complete physical examination.
- They may need to order other tests and review their findings to determine what is causing your pain and how the problem can be corrected.
Our Staff
Relieving Post-Surgical Pain
The pain you may experience after surgery is the result of a stimulus to thousands of nerve cells that rest beneath your skin and sense heat, cold, touch, light, pressure and pain. When there is an injury to your body, such as surgery, these tiny cells send messages along nerves into your spinal cord and then up to your brain. Medications given for pain relief can block these messages.
Medical science has produced significant advances for the treatment of post-surgical pain, including some that do not require the use of narcotics.
There are two major ways that pain is relieved after surgery:
- Narcotics, such as morphine, can cause unpleasant side effects such as nausea, drowsiness, constipation and difficult breathing.
- Peripheral Nerve Block is a way of relieving pain that can cut down or even stop the need for narcotics.
Types of Treatment
There are generally two types of pain – acute pain and chronic pain.
- Acute pain is temporary. It may last from a few seconds to several months. This pain usually goes away as normal healing occurs. Pain due to an injury or pain due to childbirth is examples of acute pain.
- Chronic pain lasts far beyond the time of normal healing. It may be the result of an injury that did not heal properly or may be due to other reasons such as nerve damage, cancer or arthritis. Neck pain, lower back pain and migraine headaches are examples of chronic pain.
There are generally two types of pain – acute pain and chronic pain.
- Acute pain is temporary. It may last from a few seconds to several months. This pain usually goes away as normal healing occurs. Pain due to an injury or pain due to childbirth is examples of acute pain.
- Chronic pain lasts far beyond the time of normal healing. It may be the result of an injury that did not heal properly or may be due to other reasons such as nerve damage, cancer or arthritis. Neck pain, lower back pain and migraine headaches are examples of chronic pain.
Pharmacotherapy
Over-the-counter medications and topical agents such as lotions and creams can be used as a milder treatment approach. If these medications do not work, a physician can prescribe stronger medications such as muscle relaxants or a number of pain killers.
Interventional approaches
Interventional approaches to manage chronic pain such as diagnostic and therapeutic blocks can be used as well as implanted nerve stimulators, pumps and catheters. Steroid injection techniques, where a needle injects a local anesthetic mixed with a steroid into the area where the pain is originating, are often used to lessen pain. The implantable devices are surgically placed just under the skin and can deliver medicine directly to the spinal cord or stimulate the nerves to alleviate pain.
Rehabilitation approaches
Some examples of rehabilitation approaches include physical therapy and transcutaneous electrical nerve stimulation (TENS) Unit therapy. Physical Therapy and Occupational Therapy can help by improving and strengthening mobility and function. TENS Unit therapy uses electrical stimulation through electrodes near the area of pain to offer relief.
Medications for managing pain
Due to rapid advances in medicine, a wide variety of medications and treatments are available for acute, chronic, and cancer pain. Patients are often prescribed medications before receiving other forms of therapy.
In addition, your pain medicine doctor may conclude that a combination of medication and treatments may be right for you. Your therapy plan will be tailored to specific needs and circumstances.
- Common pain relievers – Non-aspirin pain relievers such as acetaminophen can relieve headaches and minor pain but do not reduce swelling.
- Anti-inflammatory drugs – Used to relieve pain, inflammation and fever.
- Opioid pain medications – Morphine-like drugs prescribed to treat acute pain or cancer pain.
- Anti-depressants – Studies now show anti-depressants can relieve certain pain in addition to treating depression.
- Anti-seizure medicines – Used to relieve what some patients describe as “shooting” pain by decreasing abnormal painful sensations caused by damaged nerves.
Celiac plexus block
The celiac plexus is an injection of a local anesthetic near a group of nerves that stimulate the abdominal organs. "Celiac" refers to the network of nerves. "Block" refers to the use of a local anesthetic to prevent sensory nerve impulses from reaching the brain.
This type of block is used most commonly to treat upper abdominal pain, which may be due to cancer or chronic pancreatitis. The procedure can lessen or eliminate your abdominal pain. It can also help your physician find the cause of your pain. This is known as a diagnostic nerve block.
Epidural steroid injection
An epidural steroid injection (ESI) places a small amount of steroid medication near nerves in your lower back. The medication is injected into the epidural space, an area surrounding the spinal cord and nerves.
An ESI may be performed to relieve pain in your neck, arms, lets, chest or lower back. An ESI also may be performed to relieve pain caused by shingles. By reducing inflammation and decreasing pain, an ESI allows patients to increase their mobility.
Facet joint block
A facet joint block is an injection of a small amount of local anesthetic near the facet joint. Facet joints are located on the side of your spine, away from the spinal cord. A facet joint block relieves pain known to be related to the facet joints and is performed if your doctor suspects that your neck or lower back pain may be caused in part by the small facet joints of the spine.
This procedure can help your doctor better determine the cause of your pain (diagnostic nerve block).
Hypogastric plexus block
The hypogastric plexus is a collection of nerves that is located near the lower part of your abdomen in the upper front of your pelvis. A hypogastric plexus block involves placing an anesthetic near the region of the plexus and usually involves a series of injections repeated at weekly intervals.
This treatment has brought relief for many patients who suffer from pelvic pain including pain of the bladder and lower intestines. It also treats pain of the uterus, ovaries, and vagina in women, and pain of the prostate and testicles in men.
Intercostal nerve block
An intercostal nerve block is an injection of a local anesthetic in the area between two ribs. "Intercostal" means between the ribs and "nerve block" refers to the use of local anesthetic to prevent painful impulses from reaching the brain.
An intercostal nerve block is used to treat pain due to shingles, which is an acute viral infection that causes inflammation of the nerves that spread outward from the spine. It may also be performed to treat pain caused by surgical incisions in the chest area or to help determine the cause of your pain.
Lumbar sympathetic block
A lumbar sympathetic block is an injection of local anesthetic around a group of nerves in your lower back (lumbar area). A lumbar sympathetic block may be performed if you have reflex sympathetic dystrophy (RSD), a disease involving a disturbance of circulation to the skin that often leads to neuropathic pain (pain caused by a disorder of the nervous system).
Radiofrequency ablation
Radiofrequency ablation uses an electrical current produced by a radiowave to heat up a small area of nerve tissue, thereby decreasing pain signals from that tissue. Clinical data shows that radiofrequency ablation can provide effective, lasting pain relief.
Spine CATH IDET therapy
Due to age or injury, cracks or fissures may develop in the wall of an intervertebral disc. These fissures are filled with small nerve endings and blood vessels and can be a chronic source of pain. Also, the inner disc tissue frequently bulges (herniation) into these fissures in the outer region of the disc.
Spine CATH IDET therapy is a minimally invasive treatment in which a physician applies controlled levels of heat to a broad section of the affected disc wall. The heat contracts and thickens the collagen of the disc wall and raises the temperature of the nerve endings.
The therapy may result in contraction or closure of the disc wall fissures and a reduction in the bulge of the inner disc material and a desensitization of the pain sensors within the disc.
Stellate ganglion block
The stellate is a group of nerves in the neck area. A stellate ganglion block is an injection of a local anesthetic around this group of nerves to relieve pain. The pain relief will affect one side of the head and neck, the upper arm and upper part of the chest on the same side of the body.
A stellate ganglion block can decrease pain and increase the circulation and blood supply to the affected arm. The procedure may be performed on people who have circulation problems or the following nerve injuries – reflex sympathetic dystrophy, excessive sweating in the palms or arm pits, causalgia, herpes zoster, or phantom limb pain.
Trigger point injections
Trigger point injections (TPIs) place small amounts of local anesthetic and steroids in the area of the muscle where you have pain or tenderness. These areas are called trigger points because they produce pain when they are stimulated. TPIs are performed to relieve myofascial pain, which is pain in the specific muscle or muscle group.
Tunneled epidural catheter
A tunneled epidural catheter is a small catheter that is placed in the epidural space and tunneled under the skin. It provides a small dose of pain-killing medication and stays in place during a patient's rehabilitation. This arrangement provides excellent pain relief with only a small dose of medication.
Vertebroplasty
Percutaneous vertebroplasty is a procedure for the treatment and stabilization of vertebral compression fractures. Vertebrae are the bones that join together and make up the spinal column. A compression fracture of the vertebrae means the bone has collapsed or is crushed. Compression fractures are the result of bone that has been weakened, most commonly by osteoporosis and in rare cases, by cancers, benign tumors or trauma.
In some cases, the bone does not stabilize and continues to move, causing persistent pain. For many patients, this pain severely limits their activities and reduces the quality of their lives. Vertebroplasty is a minimally invasive outpatient procedure performed using x-ray guidance. Most people go home the same day as treatment and experience pain relief within 48 hours.
