Interventional Pain Medicine

Our Pain Specialists treat a wide variety of pain-related conditions, helping those in our community to achieve an improved quality of life. The following are common services provided by our Doctors, based on the specific needs of our patients.


Nerve block injections can help with diagnosis as well as being an effective treatment for numerous musculoskeletal pain conditions. The interventional pain medicine experts at Pain Specialists of Oregon in Eugene, Oregon, use nerve blocks to diagnose and treat back, neck, and joint pain. Find out how you could benefit from their advanced approaches to pain management by calling Pain Specialists of Oregon today.

What is a nerve block?

Nerve blocks are injections of medication that stop your nerves from sending pain messages back to your brain. Nerve blocks use several medications, including local anesthetics. A local anesthetic, such as lidocaine, can completely numb the injection site for several hours.

Neurolytics, like alcohol or phenol, damage part of the nerve's pathway, stopping it from working.

Nerve blocks may contain steroids - powerful anti-inflammatory drugs.

Nerve blocks always contain a local anesthetic. Depending on why you're having a nerve block injection, yours might also contain a neurolytic or steroid.

Why might I need a nerve block?

Nerve blocks have two important uses:

1. Diagnostic. Your Pain Specialists of Oregon provider uses nerve blocks to help them diagnose your condition. By blocking the messages from specific nerves, they can locate the source of your pain. Your provider is likely to perform diagnostic nerve blocks in conjunction with nerve conduction velocity (NCV) and electromyogram (EMG) studies.

2. Therapeutic. A nerve block injection provides swift relief from pain. The local anesthetic blocks pain completely, but only for a short while. The other ingredient in your nerve block injection - the steroid or neurolytic - is longer-lasting but is less effective at masking all your pain.

In many cases, people who have a nerve block injection find that their pain doesn't come back as severely after the anesthetic wears off. That could be due to the act of interrupting the constancy of pain, known as breaking the cycle of pain.

What kind of nerve block might I need?

Pain Specialists of Oregon has nerve blocks to suit every need. Examples include stellate ganglion blocks for pain in the head, neck, arm, and chest and complex regional pain syndrome (CRPS), as well as:

  • Celiac plexus blocks for abdominal pain
  • Intercostal nerve blocks for chest wall pain
  • Hypogastric plexus blocks
  • Ganglion impar blocks
  • Splanchnic plexus blocks

These last three nerve block injections reduce pelvic pain.

What is a facet nerve block?

Facet nerve blocks are injections into the small facet joints in your spine. These joints give your spinal column stability and help your back to move smoothly. Like other joints, the facets have a layer of cartilage for protection, which can wear away over time.

That results in painful osteoarthritis in the facet joints. A facet nerve block can help identify the exact facet joints affected as well as offer relief from your pain.

The Pain Specialists of Oregon team administers your nerve block using fluoroscopy or ultrasound imaging. That ensures the perfect needle placement.

To find out if a nerve block could help you, call Pain Specialists of Oregon today.



What is an epidural injection?

An epidural injection is a shot of pain or inflammation-relieving medication into the epidural space of the spine. The epidural space is the fat-filled region surrounding and insulating the spinal cord. It serves the purpose of protecting the spinal cord and nearby nerves from damage.

When medication enters the epidural space during epidural injections, the pain relief can be either short- or long-term. Typically, epidural injections involve a corticosteroid, which reduces inflammation around the spinal cord, and possibly a local anesthetic like lidocaine for an immediate numbing effect.

You can get epidural injections wherever the pain originates along your spinal column. Most often, people experience pain originating in either the lumbar region (low back) or cervical region (neck) of the spine. To make sure the injection goes to the right place, Pain Specialists of Oregon uses fluoroscopy (X-ray) guidance.

Which type of epidural injection should I get?

The team at Pain Specialists of Oregon provides two types of epidural injections for all regions of the spine. After an in-depth examination with possible imaging tests to make or confirm a pain diagnosis, the team might recommend epidural injections with either of these approaches:

Interlaminar epidural injections

Interlaminar epidural injections enter the epidural space by way of an opening between two vertebrae in the back of the spine called the interlaminar window. That is the simplest way to access the epidural space with an injection and involves minimal discomfort because the needle lands far from the damaged nerve root.

Transforaminal epidural injections

Transforaminal epidural injections enter the epidural space through the bony opening directly corresponding to the irritated nerve root. These injections are more complex than interlaminar epidural injections but can be more effective in some cases. They require fluoroscopy guidance every time.

What do epidural injections treat?

Epidural injections can treat pain that originates in nerve roots exiting the spinal cord. Nerve roots branch out into the nerves that reach every corner of your body, so irritation at a nerve root can cause widespread or referred pain in regions other than the back or neck. Irritation of nerve roots often comes from tissue inflammation near the spine.

Pain Specialists of Oregon might include epidural injections in your treatment for:

  • Herniated disc
  • Degenerative disc disease
  • Spinal stenosis
  • Spinal arthritis
  • Bone spurs

It takes 1-3 days for the effects of the steroid in your epidural injections to take effect. If you experience positive results from your treatment, which can lend up to several months of relief, you can come back in for follow-up injections at Pain Specialists of Oregon.

To learn more about epidural injections and their benefits for pain conditions, call Pain Specialists of Oregon today.



What is radiofrequency ablation (RFA)?

Radiofrequency ablation is a minimally invasive pain management strategy that uses heat energy to block pain signals. The heat comes from radio waves delivered through a thin needle affixed with a microelectrode. The procedure is done in-office, and you go home the same day to recover.

The RFA energy blocks the signals from your nerves that would normally tell your brain you’re feeling pain. The procedure offers significant, long-lasting relief for 9-12 months.

Why should I consider radiofrequency ablation for pain management?

Radiofrequency ablation is minimally invasive and may help you avoid surgery. It also causes no scarring and has a low risk of complications. You recover quickly and need no general anesthesia to undergo RFA therapy.

Am I a candidate for radiofrequency ablation?

People with chronic back pain, joint pain, or neck pain are good candidates for RFA. Radiofrequency ablation is also effective for people with arthritis pain or peripheral nerve pain.

RFA isn’t usually used as a first-line pain relief strategy. When you come in for your visit, the team asks about the nature and severity of your pain and other forms of pain treatments you’ve used in the past.

What happens during radiofrequency ablation treatment?

Radiofrequency ablation is a relatively quick treatment, but plan to be at the office for several hours to allow for appointment preparation and proper aftercare.

Your provider numbs the area to receive treatment to ensure your comfort. You may also be given IV sedation to help you relax. They use a special device, called a fluoroscope, to take X-ray images to direct needle placement.

A thin, hollow needle is placed into the treatment area and guided by the fluoroscope images to find the correct treatment area. Your provider then passes a radiofrequency electrode through the needle to deliver RF energy and destroy the nerve or nerves causing pain.

If you’d like to explore how radiofrequency ablation can help you reduce pain and restore function, call Pain Specialists of Oregon to set up a consultation.





What is platelet-rich plasma (PRP)?

Platelet-rich plasma is a derivative of your own blood. To create the substance, a sample of your blood is spun down in a centrifuge to concentrate the platelet count. This sample is then combined with a small amount of your plasma (the liquid portion of your blood).

Platelets are a natural component of your blood that helps with clotting and wound healing. When concentrated in PRP, the platelets are able to send healing cytokines to the treated area to spur the development of new tissue and reduce inflammation.

How does PRP improve healing?

Your platelets are rich in growth factors, which have an intense healing effect. When injected into damaged or injured joints or connective tissue, they can:

  • Reduce inflammation
  • Accelerate healing
  • Recruit stem cells to the damaged area
  • Trigger the production of blood vessels
  • Stimulate and support tissue regeneration
  • Increase stem cell effectiveness

PRP injections offer healing that delays or eliminates your need for surgery in places like your hip or knee. PRP has healing effects that help stimulate the regeneration of cells that can build muscle, ligaments, cartilage, bone, and skin.

How are PRP injections used for pain relief?

Your doctor at Pain Specialists of Oregon precisely targets damaged tissues with PRP injections. PRP is used to treat joint and connective tissue conditions like:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Knee pain and injury
  • Tendonitis and bursitis
  • Shoulder and elbow joint pain
  • Herniated discs

PRP injections may even be used in conjunction with surgery to speed healing and enhance your recovery.

What is it like to get platelet-rich plasma treatments?

PRP treatment is a simple, in-office procedure. You provide a sample of blood in a traditional blood draw — usually through your arm. Once your blood is prepared as PRP, your provider numbs the treatment area and uses real-time ultrasound imaging to find the exact point for the injections.

Once the PRP is injected, you’re welcome to head home. You may have some discomfort at the injection site for a few days. Your provider may recommend you avoid strenuous activities for a few days or weeks so the PRP can start working without extra stress.

To learn more about how platelet-rich plasma can help heal your joint pain, call Pain Specialists of Oregon, or use the online tool to request your appointment.



What is a spinal cord stimulator?

A spinal cord stimulator is an implanted device that delivers electrical impulses directly to your spinal cord. The impulses interfere with pain signals sent by nerves in your spinal cord, bringing relief to your back, neck, arms, or legs.

Your provider at Pain Specialists of Oregon may recommend a spinal cord stimulator if other nonsurgical solutions to reduce your pain have failed.

During implantation of the spinal stimulator, your provider places the device underneath your skin and carefully slides the electrodes into the epidural space of your spine. You control the electrical impulses that block pain with a handheld device.

How does spinal cord stimulation work?

There are many manufacturers of spinal cord stimulators, including Boston Scientific, Nevro, Medtronic, and Nalu.

The team at Pain Specialists of Oregon works with these manufacturers to find the device that offers the best treatment for you. The physicians have expertise in spinal cord stimulation and can compare features of different models to recommend the best device suited for your specific needs.

Spinal cord stimulators come in a variety of models, including:

Conventional

Conventional spinal stimulators are low maintenance but require minor surgery to replenish the power source.

Radiofrequency

Radiofrequency spinal stimulators can help people with extreme pain in several areas of their bodies. This model requires an external attachment to manage the device but delivers the highest electrical impulses for pain reduction.

Rechargeable

This spinal stimulator features a rechargeable battery. The rechargeable system lasts longer than the conventional device. However, you will still need minor surgery if the power source ever stops holding a charge.

Am I a candidate for a spinal cord stimulator?

Candidates for spinal stimulators may have any of the following conditions:

  • Chronic back pain
  • Chronic neck pain
  • Lumbar radiculitis
  • Cervical radiculitis
  • Inflammation of your spinal nerves
  • Peripheral neuropathy
  • Complex regional pain syndrome

If you’ve exhausted other treatment options and still suffer pain that interferes with daily life, contact Pain Specialists of Oregon today.









Why does cancer cause pain?

Pain-related to cancer may occur when the tumor enlarges and presses against nearby nerves, organs, or other tissues. Notably, some types of cancerous tumors release chemicals that cause inflammation and pain.

Cancer surgery, chemotherapy, and other treatments can also cause pain as a side effect. Certain hormonal therapies prescribed for breast cancer, for instance, may lead to significant joint and muscle pain.

Pain-related to arthritis and other noncancerous conditions may also worsen during your cancer treatment. That may be due to decreasing pain tolerance and the effects of the therapy on your overall physical health. 

Will pain interfere with my cancer recovery?

Poorly treated pain can have a significant impact on your physical health and your emotional well-being, both of which are vitally important to overcoming the effects of cancer.

Complications related to chronic pain include:

  • Fatigue
  • Difficulty concentrating
  • Poor sleep
  • Depressed mood
  • Decreased mobility   
  • Loss of appetite
  • Increased stress and anxiety

All these factors can interfere with your response to cancer treatments. They may result in a general sense of malaise that prevents you from participating in exercise programs, enjoyable hobbies, or other activities beneficial to your health. 

What treatments help relieve cancer pain?

Most cancer pain is controllable with treatment, and the goal is to alleviate the discomfort and stop future pain before it starts.

Your Pain Specialists of Oregon provider may recommend a combination of therapies to successfully manage your pain, which may include:

Nerve blocks

During this in-office injection procedure, your specialist delivers an anesthetic that may be combined with a corticosteroid into the targeted nerve area. The anesthetic plus the steroid numbs the area and decreases inflammation that’s irritating the nerve.

Radiofrequency ablation

Radiofrequency ablation (RA) is performed in the office under X-ray guidance (fluoroscopy). During the procedure, your provider uses a specialized needle to deliver radiofrequency current into the targeted nerve. 

That heats the nerve tissue and causes targeted damage to interfere with its ability to send pain messages to your brain. While the targeted nerves eventually regrow, the pain relief can last for many months. RA may also be repeated as necessary.

Other treatments your specialist may recommend for cancer pain include:

  • Epidural catheter placement, which delivers anesthetic directly to nerves in your spine
  • Transcutaneous electric nerve stimulation (TENS) 
  • Physical therapy
  • Massage and other integrative therapies such as yoga 

For effective relief from cancer pain, call the Pain Specialists of Oregon office to schedule an appointment or use the online scheduling tool to request a visit.