Interventional Pain Management
Many musculoskeletal pain conditions, including back, neck, and joint problems, may be managed over time through conservative treatment using a variety of specialized modalities to enhance mobility and avoid surgery, or to optimize your function before or after surgery. This type of pain management is called Interventional Pain Management.
Physiatrists at the Spaulding Rehabilitation Network specialize in the diagnosis and treatment of diseases and conditions that affect your ability to function in a normal capacity. With a unique blend of extensive training that includes a strong emphasis in neurology, musculoskeletal and sports medicine, rheumatology, and pain management, physiatrists often specialize in Interventional Physiatry, also known as Interventional Pain Management.
Our Physical Medicine and Rehabilitation physicians treat pain using precisely placed anti-inflammatory injections into the spine and pelvis, often guided by fluoroscopy, a specially equipped x-ray. Therapeutic injections may be considered an adjunct to medication, physical, or occupational therapy, and lifestyle modifications.
Approach to Care
Pain impacts all aspects of a person’s life, which is why we use which is why we use a holistic approach to care. Our physiatrists provide treatment that involves the whole person, addressing the physical, mental, emotional, vocational and social needs of the patient to maximize his or her quality of life. Following a comprehensive evaluation, our physicians will work with you to develop an individualized, interdisciplinary treatment plan that may include medical management, psychological support, physical, occupational or speech therapy and many other rehabilitation techniques. Our clinical team will also work with you on prescribing therapeutic exercise and utilizing minimally invasive procedures to help reduce your pain. Your treatment will also focuses on improving sleep, mood, cognitive functioning, restoring roles and relationships. We collaborate closely with physical therapists and the entire clinical team to improve patient pain and function and get you back to living life. Our goal is to help restore function after illness, injury or surgery, as well as teach patients how to prevent future injuries.
Expertise
Our extensive interdisciplinary team includes physiatrists, physical and occupational therapists, psychologists, massage therapists, nutritionists, psychiatrists and acupuncturists specializing in the management of pain.
We have more than 25 years experience treating a wide variety of pain conditions, including sports injuries, back pain, head and neck pain, fibromyalgia, arthritis, complex regional pain syndrome and reflex sympathetic dystrophy. Our psychiatrists and psychologists specialize in cognitive behavioral therapy and mind-body approaches to managing pain.
Program Director(s)
Each Spaulding Rehabilitation Network facility has on-site physiatrists who are experts in pain rehabilitation and who direct the Interventional Pain Management programs.
Research & Innovation
The Spaulding Rehabilitation Network is dedicated to researching new treatments in the field of Interventional Pain Management. Our researchers, including physicians and other clinicians, use several cutting-edge treatments to help relieve pain.
Treatment
Sacroiliac Joint Injection
Description
Inflammation in the largest joint, located in the lower spine above the tailbone, can cause back and leg pain. An injection of an anesthetic and steroid may help relieve pain from this joint.
Treatment
Platelet Rich Plasma (PRP)
Description
This is an emerging treatment in which your own growth factors are injected into painful ligaments and tendons weakened by injury. Blood is drawn from you and processed to produce the platelet-rich fraction, which is then injected into your affected ligaments, tendons, and joints.
Treatment
Acupuncture
Description
This is a complementary approach to treating musculoskeletal pain. Needles applied to specific acupuncture points stimulate your central nervous system, thereby altering your perception of pain. Acupuncture can help relax muscles, reduce inflammation, and increase blood flow to injured areas.
Treatment
Radiofrequency Nerve Ablation
Description
Also known as Facet Joint Radiofrequency, this procedure is designed to interrupt pain signals coming from the spinal joints. The technique uses radio waves to produce heat directed at a specific facet joint nerve. The heat destroys the nerve and relieves pain.
Treatment
Botulinum Toxin Injections
Description
Botulinum toxin is a substance that interrupts the messaging between nerves and muscles. When injected, Botulinum toxin can reduce pain and muscle hyperactivity, such as spasticity associated with cerebral palsy, spinal cord injury, multiple sclerosis, brain injury, and stroke. It is also used to treat movement disorders known as dystonias.
Treatment
Viscosupplementation
Description
As cartilage in the joints breaks down due to osteoarthritis, injections of viscosupplementation gel can help lubricate the joint, reduce pain, and improve function. One to three injections may provide several months of relief. This is currently FDA approved for the knee only.
Treatment
Prolotherapy
Description
Also known as Proliferation Injection Therapy or regenerative therapy, this approach involves injecting a specialized solution into the body, in the region of tendons or ligaments, for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain.
Treatment
Trigger Point Injections (TPI)
Description
This technique is used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. A small needle containing a local anesthetic is inserted into your trigger point, making it inactive and alleviating pain. TPI is often used to treat fibromyalgia, tension headaches, and cervicogenic headache, and muscle pain syndromes.
Treatment
Epidural Steroid Injections
Description
The epidural space is the space surrounding the membrane that coves the spinal cord and nerve roots. Epidural injections place anti-inflammatory medication (steroids) into the epidural space or around the spinal nerves. The injections are given in the lumbar spine.
Treatment
Nerve Blocks
Description
This is an injection of medication onto or near nerves. Most injections are performed under fluoroscopic guidance for precise targeting and optimal safety. They include:
- Peripheral Nerve Block – Designed to treat painful conditions involving peripheral nerves, such as carpal tunnel syndrome and other types of neuralgias, these blocks can alleviate pain caused by inflammation and scarring of the nerve.
- Selective Nerve Root Block – Also known as Transforaminal Epidural, these nerve blocks may alleviate pain and discomfort from irritation and inflammation of a nerve root in the lumbar spine, as with sciatica.
- Sympathetic Nerve Block – These may help alleviate chronic pain symptoms caused by irritation or overactivity of the sympathetic nervous system.
- Facet Joint Block and Medial Branch Blocks – Joint inflammation and degeneration in the spinal joints can cause back and neck pain. A facet joint block is an injection of local anesthetic and steroid medication into the joint. A medial branch block is a diagnostic procedure in which the nerves to these joints are anesthetized temporarily in order to determine the origin of the pain.
Locations
Interventional Pain Management is offered at these Spaulding Rehabilitation Network locations:
Inpatient
Spaulding Rehabilitation Hospital Boston
Spaulding Rehabilitation Hospital Cape Cod
Outpatient
Spaulding Outpatient Center Braintree
Spaulding Outpatient Center Medford
Spaulding Outpatient Center Orleans
Spaulding Outpatient Center Plymouth
Spaulding Outpatient Center Yarmouth
Spaulding Outpatient Center Framingham
Spaulding Outpatient Center Sandwich
Related Services
The following services are related to the Interventional Pain Management at the Spaulding Rehabilitation Network:
Electrodiagnostic Evaluations/EMGs
Nerve Conduction Studies
Ultrasound-Guided Injections
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The quarterly publication of Spaulding Rehabilitation Network and the Harvard School of Physical & Rehabilitation Medicine.
