Treatments

How we can help alleviate your pain

At Maryland Pain Centers, we take your treatment very seriously.  Different pain conditions call for different modes of treatment and depending on your age and life circumstances one will likely be better than another.

We pride ourselves on the fact that we put our patients first. We will create an individualized treatment plan best suited to your unique needs and never use a one-size-fits-all approach.

To help you better understand the available treatments we implement, we compiled an easy-to-digest explanation of the most common ones we use and included some helpful information describing each one.

Some of Our Most Common Treatments

This is an outpatient treatment involving an injection of a steroid-anesthetic medication. It can reduce swelling and inflammation of irritated spinal nerves. The injection takes only a few minutes to complete.

In preparation for the procedure, you’ll be asked to lie face down and a cushion will be placed under your abdomen. One of our physicians will administer a local anesthetic to numb the skin and tissue.

After the area is numb, our physician will carefully guide a needle to where the irritated nerve roots are and inject contrast solution through the needle. Our physician uses a fluoroscope (a type of x-ray device) to confirm that the tip of the needle is positioned correctly within the epidural space.

After the needle’s position has been confirmed, our physician will inject a steroid-anesthetic medication. This medication bathes the irritated nerve roots and helps alleviate your pain.

Afterward, you may feel significant relief even after one injection. However, some patients may need multiple injections before they feel the full benefit of the medication.

This diagnostic procedure is performed to identify a painful facet joint. The facet joints are the joints between the vertebrae in the spine. They allow the spine to bend, flex, and twist.

In preparation for the procedure, you’ll be asked to lie on your stomach. One of our physicians will administer a local anesthetic to numb the skin and tissue.

Once the tissue is numb, our physician inserts a needle into the skin. The needle is carefully guided down to the facet joint. A contrast solution is injected through this needle. This contrast solution helps our physicians see the area on a camera called a fluoroscope and confirm the location of the needle’s tip.

Once there is confirmation that the needle is positioned correctly, our physician attaches a syringe containing an anesthetic medication. This medication is injected around small nerves called the medial branch nerves. These carry signals to and from your facet joints. The anesthetic will temporarily block sensation in these nerves.

If the temporary injection relieves your pain, our physician may inject a more long-lasting anesthetic. However, if the temporary injection does not relieve the pain, our physician may test nearby facet joints to identify the correct one.

Radiofrequency ablation is a minimally invasive procedure that is usually performed with local anesthesia and mild sedation.

As with many spinal injections, radiofrequency neurotomy is best performed under fluoroscopy (live x-ray) for guidance in properly targeting and placing the needle (and for avoiding nerve or other injury).

An intravenous line is often started so that relaxation medicine (sedation) can be administered. You’ll be asked to lie on a procedure table and the skin over your neck, mid-back, or lower back will be well cleaned. Then, our physician will numb a small area of skin with an anesthetic.

Our physician will use fluoroscopy to direct a special (radiofrequency) needle alongside the medial or lateral branch nerves. A small amount of electrical current is often carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves.

This current should briefly recreate the usual pain and cause a muscle twitch in the neck or back. The targeted nerves will then be numbed to minimize pain while the lesion is being created. The radiofrequency waves are introduced to heat the tip of the needle and a heat lesion is created on the nerve to disrupt the nerve’s ability to send pain signals. This process will be repeated for additional nerves.

The entire radiofrequency ablation procedure usually takes 30-90 minutes, and you’ll return home the same day.

This injection procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce swelling and inflammation in the joint.

You’ll be asked to lie face down and a cushion will be placed under your stomach for comfort and to arch the back. One of our physicians will use touch and a fluoroscope to find your sacroiliac joint. A local anesthetic will be administered to numb the skin and all the tissue down to the surface of your sacroiliac joint.

Then, our physician will  guide a needle through the anesthetized track and into your sacroiliac joint. A steroid-anesthetics mix is injected into the sacroiliac joint, bathing the painful area in medication. The needle is removed, and a small bandage is used to cover the tiny surface wound.

This is outpatient procedure designed to reduce or relieve the pain of trigger points. These small, tender knots can form in muscles or in the soft, stretchy connective tissue that surrounds muscles and organs. The trigger point injection treatment takes only a few minutes to complete.

In preparation for the procedure, you will be positioned comfortably and one of our physicians will press and pinch the skin to locate the trigger point. Once it has been identified, our physician will cleanse the overlying skin. A topical anesthetic may be used to temporarily numb the skin.

Our physician carefully inserts a needle through the skin and into the trigger point and injects an anesthetic mixture into the trigger point. This causes the trigger point to relax. If the trigger point does not relax completely after the first injection, our physician may adjust the needle’s position and give additional injections.

When the injection is complete, our physician removes the needle and a small bandage may be placed over the injection site. You may be encouraged to stretch and move the muscle after the injection.

Dry needling is a technique our physicians use to treat myofascial pain. The technique uses a “dry” needle, one without medication or injection, that is inserted through the skin into your trigger points.

Dry needling is typically done in order to release or inactivate your trigger points in order to relieve pain or improve range of motion.

Dry needling involves a thin filiform needle that penetrates the skin and stimulates underlying myofascial trigger points and muscular and connective tissues. The needle allows our physician to target tissues that are not manually palpable and treat your pain.

Adjuvant pain medications are medications that are not typically used for pain, but may prove helpful for its management. Usually, they are used to enhance the pain relief provided by commonly used pain medicines. However, they may also be prescribed on their own without other pain relievers. Adjuvant medications are most often used for neuropathic and other chronic pain problems. There are several different types of adjuvant drugs including antidepressants, anti-seizure medications, muscle relaxants, sedatives or anti-anxiety medications, and botulinum toxin.

Spinal cord stimulation (SCS) uses electrical impulses to relieve chronic pain of the back, arms, and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

In preparation, the injection site is anesthetized. One or more insulated wire leads are inserted through an epidural needle or through a small incision into the space surrounding the spinal cord, called the epidural space.

Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals. You’ll provide feedback to help our physician determine where to place the stimulators to best block your pain.

The leads are connected to an external trial stimulator, which will be used for approximately one week to determine if SCS will help the patient. If you and our physician determine that the amount of pain relief is acceptable, the system may be permanently implanted. At the end of the trial implantation, the leads are removed.

A permanent implantation may be performed while you are under sedation or under general anesthesia.

Botox is a purified form of botulinum toxin type A that has long been used to relax muscles and treat uncontrolled muscle contractions caused by a number of medical conditions.

Our physicians usually utilize this treatment method to help you significantly reduce chronic neck pain.

What Sets Us Apart

We also accept same day consultations

We use a patient-centered approach that always puts your needs first

We participate with most commercial health insurance plans

Caring and friendly staff ready to help you

Want to schedule an appointment?

Call us today at (301) 774-1622 or book online right now.