House Calls

WIN 2018

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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h o u s e c a l l s { winter 2018 } 33 PROBLEM SOLVED: Gary received two corticosteroid injections over two months, then underwent eight months of physical therapy. Today, he is pain-free and back on the golf course. To locate the root of the pain, pain management doctors can use nerve blocks—a procedure in which they inject an anesthetic around a nerve; if pain is relieved after the injection, it can be gathered that the pain originated from that site. Once the source has been identified and discomfort reduced by the anesthetic, corticosteroids can be injected into the same area to reduce inflammation and decrease the pain. It's important that the two be used in conjunction—the anesthetics block the pain and give the body and brain a chance to reset and start over with decreased pain, while the steroids reduce swelling and inflammation. For example, when injected into a muscle spasm (called a "trigger point injection") the treatment quickly relaxes the muscle so that it can heal. Similar but unique strategies are used for other sources of pain, from blocking facial nerves for a severe case of shingles to relaxing muscles in the upper arm for chronic shoulder pain. Names of injection treatments vary (see sidebar), as do protocols. "Depending on a patient's response, we may do one block and never see them again, or we may schedule recurring blocks every few months for years," Dr. Wooten explains. "Injections are giving chronic pain patients a long-term option other than surgery." In some cases, pain is reduced to a level that the patient can handle from day to day. In most, it can be remedied altogether. Dr. Wooten recalls one patient who underwent nine operations for recurring hernias before having a simple nerve block injection. "He called to say it was the best he'd felt in 10 years." Dr. Wooten himself knows how an effective pain management strategy can be life changing. While reaching over his head to paint crown molding in 2005, he felt a sharp pain in his neck that worsened over time. "Like many patients, I would return to activity only to have the pain come back," says Dr. Wooten. Over the course of three months, he had four blocks injected into his neck to ease the pain. Today, Dr. Wooten is "absolutely pain free," as long as he avoids strenuous work with his arms overhead. "I'm a living example of how seeking pain management can improve your life," he says. TOOLS OF THE TRADE In recent years, pain management options have become safer and more sophisticated than ever thanks in large part to advancements in anesthetic and corticosteroid injections. Here, take a peek at some of the treatments in Roper St. Francis pain management doctors' toolbox: CERVICAL, LUMBAR, AND TRANSFORAMINAL EPIDURAL BLOCK: given for pain in the back and leg or the neck and arm/hand TRIGGER POINT STEROID INJECTION: used for treating painful areas of muscle that contain a trigger point (or knot) STELLATE GANGLION BLOCK: an injection for regional pain in the arm or hand PERIPHERAL NERVE BLOCKS: used to treat or diagnose pain FACET JOINT INJECTIONS: provide relief for neck and back pain HIP, KNEE, SHOULDER INJECTIONS: treatments targeting those specific areas LUMBAR SYMPATHETIC BLOCKS: given for pain in the leg "It's time to get help if you've been feeling pain for more than two weeks or if it's affecting your ability to sleep or do regular daily activities." —DR. THOMAS WOOTEN Although prescription pain relievers may still be issued after a procedure, they are no longer considered long-term solutions for pain management. (Turn to page eight to learn why.) ROAD TO RECOVERY

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