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Pain Management

Compass Rehabilitation Center therapy team offers years of expertise and advanced training in neck and back pain rehabilitation. Our neck and back pain specialists work closely with Lansing Neurosurgery and on-site physical rehabilitation physicians to provide comprehensive, targeted care for all patients with spinal-related conditions, including:

  1. Low back or thoracic pain
  2. Neck pain and arm pain
  3. Bulging or herniated discs
  4. Spondylosis and spondylolithesis
  5. Disc degeneration
  6. Sciatica
  7. Radiculopathy, and leg pain
  8. Decreased range of motion
  9. Decreased strength and endurance
  10. Post-surgical rehabilitation
  11. Spinal cord injuries
  12. Spinal Stenosis

Pain Management Team

Discograms

A discogram is a diagnostic procedure used to determine if there is any structural damage to the vertebral discs, and whether this damage is causing the patient’s pain. A disruption of the disc’s integrity is often a common source of pain. This procedure is generally performed to determine the location of the problem and what type of operation might be needed in order to fix it.

Under x-ray guidance, local anesthetic is used to numb the area being tested. Contrast dye is then injected through a needle into the middle of the disc(s). If there is no damage to the disc, the patient should only feel minor discomfort. If there is damage noted, the patient might feel pressure, familiar pain, or unfamiliar pain. If the patient feels familiar pain, it is very likely that the disc is the source of the patient’s problem. Although x-rays will be taken during the procedure, it is also common to receive a follow-up CT scan in order to see multiple views of the disc.

In order to address any discomfort to the patient during the discogram, the patient may choose to receive mild sedation before the procedure begins, as well as IV pain medication following the procedure’s completion.

Injection Therapy

An epidural steroid injection is a possible treatment option for many forms of neck, back and leg pain.  A combination of local anesthetic, such as Lidocaine or Bupivacaine, and steroid is injected into the epidural space that is believed to be the source of your pain.  The steroid will help reduce any inflammation in this area and relief from this procedure can last anywhere from days to over a year depending on your condition.

This procedure is done using sterile technique and performed under live x-ray (fluoroscopy).  The patient can also choose to receive mild sedation, with the approval of their physician, in order to help ease the discomfort of the procedure.

Nerve Blocks

There are several types of nerve blocks that are used to treat and manage pain.

Therapeutic nerve blocks can be used to temporarily control pain. This is generally achieved by injecting a combination of local anesthetic, such as Lidocaine or Bupivacaine, and steroid onto or near the nerves that are believed to be causing your pain. The steroid will help reduce any inflammation in this area and relief from this procedure can last anywhere from days to over a year depending on your condition.

Nerve blocks can also be used for diagnostic purposes, such as determining if one would benefit from a facet rhizotomy (see below). By injecting a local anesthetic, like Lidocaine or Bupivacaine, the nerves that are believed to be causing pain are put “to sleep”. This injection acts in a similar way to the anesthetic that a dentist uses to numb your mouth prior to dental work. Although the relief is temporary, a series of successful nerve blocks provide a good indication that longer lasting relief from the rhizotomy will be successful.

Both diagnostic and therapeutic nerve blocks are provided using sterile technique and performed under live x-ray (fluoroscopy). The patient can also choose to receive mild sedation, with the approval of their physician, in order to help ease the discomfort and/or anxiety of the procedure.

Rhizotomy

The goal of a facet rhizotomy is to provide pain relief by destroying the nerves that carry pain signals to the brain. Generally, patients undergoing this procedure have had a series of successful diagnostic nerve blocks identifying the source of their pain. The rhizotomy is performed by using a radiofrequency probe, an ultra thin wire that is passed through a special needle. Using local anesthetic and x-ray guidance, the needles are placed into the space where the nerves are located. The probe provides heat to the location for ninety seconds, thereby destroying the nerves that are causing pain. The application of heat should not cause a burning sensation for the patient. In addition to mild sedation, the patient can also choose to receive IV pain medication, with the approval of their physician, in order to address any potential discomfort to the patient during this procedure. Unfortunately, the facet rhizotomy is not a permanent solution. The nerves will grow back over time and the procedure might need to be repeated in approximately six months to a year.

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