801-4NO-PAIN

Treatments

Here at the UPRI we focus on helping patients reclaim their lives from pain. We have something that no one else can offer. Most who are suffering from pain are required to see many different doctors, in many different clinics and/or locations, for their pain. Here at UPRI, we have pain specialists under one roof to benefit YOU: Medical doctors who specialize in pain management, Health Quest Chiropractic, and the Trauma Awareness Treatment Center. Our skilled and friendly staff are focused on what your needs are and how we can best serve those needs.


Chiropractic Care

For Acute and Chronic Pain

Chiropractic is the third largest area of medicine that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuro-musculo-skeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

What is a Chiropractor?

A Doctor of Chiropractic (DC) often referred to as chiropractors or chiropractic physicians is a medical professional who is trained to diagnose and treat disorders of the spine, muscles, and nervous system. Doctors of Chiropractic use a hands-on approach to health care and treat patients of all ages — infants, children, and adults

What do Chiropractors do?

Chiropractors use traditional diagnostic testing methods (such as x-rays, MRI, and lab work) along with spinal and orthopedic examination to find dysfunction within the spine and joints. Chiropractors treat these dysfunctions by a combination of techniques including applied pressure, muscle work, and manual manipulation of the vertebrae and joints (called adjustments). Using these techniques, chiropractors are often able to relieve pressure and irritation on the nerves and restore joint mobility.

Will chiropractic care help?

The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.” The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. Adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, and allowing tissues to heal.

What to expect?

The Chiropractor will have you lie down on a chiropractic table and perform the adjustments by using a quick, shallow thrust into the dysfunctional joint. Sometimes a “pop” is heard. Most patients report a feeling of relief and improved ability to move their body. Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours. Ice is typically more helpful than heat during the first 2-3 days after an initial treatment.

A Comprehensive approach.

In many cases, such as lower back pain or headaches, chiropractic care may be the primary method of treatment. When the condition warrants co-management in conjunction with other members of the health care team (physical therapist, massage therapist, etc..), chiropractic care will complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition. By starting chiropractic care immediately in your treatment you can reduce the amount of scar tissue formed, improve healing and treat the cause of your pain not just the symptoms of pain.

Why does chiropractic require multiple visits?

In acute conditions, an injured body is constantly tightening joints and muscles and guarding against potential future injury. Proper motion of joints and soft tissue is required for proper healing. Repeated treatments prevent tightness,
restrictions and improper healing. In chronic condition we have to retrain muscles, ligaments and soft tissue to behave in proper function instead of the habits of dysfunction that have developed. Much like putting braces on teeth, time and repetition is required to have a lasting effect. The goals of a patient’s treatment plan is to restore joint function and joint mobility, increase muscle strength, decrease pain and inflammation, improve flexibility, resume normal daily and recreation activities, and return to work as tolerated.

Cervical Facet Injection

For Neck Pain and Headaches

A cervical facet joint injection is an outpatient procedure for diagnosing and treating neck, shoulder, upper back pain, and headache pain.

What are cervical facet joints?

Cervical facet joints are small joints located in pairs on the back/side of your neck. These joints provide stability and guide motion in your spine.

What is cervical facet joint pain?

You may feel pain if a cervical facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected. Cervical facet pain can occur in an area from your head down to your lower shoulder blade. (See diagram on the left) Why are facet joint injections helpful?

Why are facet joint injections helpful?

A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many  occasions, provide long-term pain relief.

What will happen to me during the procedure?

An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an x-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, the physician numbs a small area of skin with numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use x-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected

What should I do after the procedure?

20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

How will I feel after the procedure?

On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone  becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

When can I resume activity?

On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

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Cervical Interlaminar Epidural Injection

For Neck, Shoulder, Upper Back and Arm pain

A interlaminar epidural injection is an outpatient procedure for diagnosing and treating neck, shoulder, upper back, and arm pain.

What is the epidural space?

The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the back and into the arms and legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc, injured soft tissue or from contact in some way with the bony structure of the spine.

What is an epidural and why is it helpful?

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots and other soft tissue, hopefully reducing the pain in the back or arms. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

What happens during the procedure?

An IV is started so that relaxation medication can be given. The patient is placed lying on their side on the x-ray table and positioned in such a way that the physician can best visualize the spine using x-ray guidance. The skin on the lower neck or back is scrubbed using 2 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a small needle, using x-ray guidance into the epidural space. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. A mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected.

What happens after the procedure?

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet (“pain diary”). This will be available online.

How will I feel after the procedure?

A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. The neck, upper back or arms may feel weak or numb for a few hours. This is to be expected, however it does not always happen. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, another treatment may be indicated. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working. Patients are generally asked to be at the appropriate facility one hour prior to the procedure and can expect to be at that facility approximately 2-3 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work.

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Trigger Point Injections

For Neck, Shoulder, Upper Back and Headache pain

A trigger point injection is an outpatient procedure for diagnosing and treating head, neck, shoulder, upper back, and arm pain

What is a trigger point?

Myofascial trigger points are felt to be hyperirritable foci in muscles and fascia associated with taut muscle bands. Trigger points are diagnosed by palpation and produce a local twitch response and a referred pain pattern distal to the site of muscle irritability. Trigger points cannot be properly diagnosed in the acute stages of neck or back pain when muscle spasm and inflammation are present. Initially, trigger points generally respond to a program of stretching and correction of poor postural mechanics with or without other modalities, such as superficial heat or cold. Trigger point injections should be reserved for patients who have not responded in the first four to six weeks to a properly directed rehabilitation program and appropriate pharmacologic intervention.

What is a trigger point injection and why is it helpful?

The trigger point injection into the trigger point of the injured muscle. This allows for relaxation of the muscle and improved healing. These injections are an adjunct treatment, which facilitates participation in an active exercise program and may assist in avoiding the need for surgical intervention.

What happens during the procedure?

A small needle is inserted into the trigger point and a local anesthetic (e.g., lidocaine, procaine) with or without a corticosteroid is injected. Saline solution can also be injected. Injection of medication inactivates the trigger point and thus alleviates pain. Sustained relief usually is achieved with a brief course of treatment. The injection may cause a twitch or pain that lasts a few seconds to a few minutes.

What happens after the procedure?

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet. Numbness from the anesthetic may last about an hour and a bruise may form at the injection site. Pain can be relieved by alternately applying moist heat followed by ice for a day or two. In most cases, stretching exercises and physical therapy are performed following TPI. A follow-up appointment will be made for a repeat block if indicated.

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Lumbar Transforaminal Epidural Injection

For Low Back and Leg Pain

A lumbar transforaminal epidural injection is an outpatient procedure for diagnosing and treating low back and leg pain.

What is the epidural space?

The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the back and into the legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or from contract in some way with the bony structure of the spine.

What is an epidural and why is it helpful?

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

What happens during the procedure?

An IV is started so that relaxation medication can be given. The patient is placed lying on their side on the x-ray table and positioned in such a way that the physician can best visualize the low back using x-ray guidance. The skin on the back is scrubbed using 2 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician
directs a small needle, using x-ray guidance into the epidural space through the bony opening of the exiting nerve root. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. A mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected

What happens after the procedure?

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet (“pain diary”). This will be
available online.

How will I feel after the procedure?

A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. The back or legs may feel weak or numb for a few hours. This is to be expected, however it does not always happen. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10  days after the injection, another treatment may be indicated. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working. Patients are generally asked to be at the appropriate facility one hour prior to the procedure and can expect to be at that facility approximately 2-3 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work.

Download PDF

Lumbar Interlaminar Epidural Injection

For Low Back and Leg Pain

A lumbar interlaminar epidural injection is an outpatient procedure for diagnosing and treating low back and leg pain

What is the epidural space?

The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the back and into the legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or from contract in some way with the bony structure of the spine.

What is an epidural and why is it helpful?

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

What happens during the procedure?

An IV is started so that relaxation medication can be given. The patient is placed lying on their side on the x-ray table and positioned in such a way that the physician can best visualize the low back using x-ray guidance. The skin on the back is scrubbed using 2 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a small needle, using x-ray guidance into the epidural space. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. A mixture of numbing medicine (anesthetic) and anti- inflammatory (cortisone/steroid) is injected.

What happens after the procedure?

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet (“pain diary”). This will be available online.

How will I feel after the procedure?

A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. The back or legs may feel weak or numb for a few hours. This is to be expected, however it does not always happen. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, another treatment may be indicated. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working. Patients are generally asked to be at the appropriate facility one hour prior to the procedure and can expect to be at that facility approximately 2-3 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work.

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Thoracic Transforaminal Injection

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Thoracic Facet Injection

For Back Pain

A thoracic facet joint injection is an outpatient procedure for
diagnosing and treating back pain.

What are thoracic facet joints?

Thoracic facet joints are small joints located in pairs along the spine in your back. These joints provide stability and guide motion in your spine.

What is thoracic facet joint pain?

You may feel pain if a thoracic facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are  injured. Facet pain also depends on which facet joint is affected. Facet joint pain can refer to other areas of the body.

Why are facet joint injections helpful?

The thoracic facet joints can cause pain in your back and other areas. A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of Immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

What will happen to me during the procedure?

An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an x-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, the physician numbs a small area of skin with  numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use x-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected.

What should I do after the procedure?

20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned. How will I feel after the procedure? On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical, chiropractic treatment, or massage therapy after the  injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

When can I resume activity?

On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

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Sacroiliac Joint Injection

For Low Back and Buttocks Pan

A sacroiliac joint injection is an outpatient procedure diagnosing and treating low back and buttocks pain.

What is the sacroiliac joint and why is a sacroiliac joint injection helpful?

The sacroiliac joint is a large joint in your lower back and buttocks region. When the joint becomes painful, it can cause pain in its immediate region or it can refer pain into your groin, abdomen, hip, buttock or leg. (see image at left.) A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the joint is numb it means this joint is more likely than not your pain source. Furthermore, time-release cortisone will be injected into the joint to reduce any presumed inflammation, which on many occasions can provide long-term pain relief.

What will happen to me during the procedure?

If needed, an IV will be started so that adequate relaxation medication can be given. After lying on an x-ray table, the skin over your lower back/buttock will be well cleansed. Next, the physician will numb a small area of skin with medicine (anesthetic) which stings for a few seconds. The physician then will use x-ray guidance to direct a very small needle into the joint. He will then inject several drops of contrast dye to confirm that the medication only goes into the joint. A small mixture of numbing medication (anesthetic) and anti-inflammatory cortisone will then be slowly injected.

What should I do and expect after the procedure?

20-30 minutes after the procedure, you will move your back to try to provoke your usual pain. You will report your remaining pain, (if any) and also record the relief you experience during the next week, on a “pain diary” we will provide. You may or may not obtain improvement in the first few hours after the injection, depending on if the sacroiliac joint is your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

How will I feel after the procedure?

On occasion, the part of your treated spine may feel slightly weak or have an odd feeling in your leg for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical, chiropractic treatment, or massage therapy after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

When can I resume activity?

On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

Download PDF

Lumbar Facet Injection

For Low Back Pain

A lumbar facet joint injection is an outpatient procedure for diagnosing and treating low back pain, buttock, hip or groin pain.

What are lumbar facet joints?

Lumbar facet joints are small joints located in pairs in your lower back. These joints provide stability and guide motion in your spine.

What is lumbar facet joint pain?

You may feel pain if a lumbar facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected. Facet joint pain can refer to other areas of the lower body.

Why are facet joint injections helpful?

The lumbar facet joints can cause pain in your lower back, hip, buttock, or leg. A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

What will happen to me during the procedure?

An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an x-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, he physician numbs a small area of skin with numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use x-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected.

What should I do after the procedure?

20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

How will I feel after the procedure?

On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical, chiropractic treatment, or massage therapy after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

When can I resume activity?

When can I resume activity? On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

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Medication Management

At the Utah Pain Relief Institute we assist patients by managing their medication regiments for chronic pain symptoms. In today’s medical industry there are many new guidelines and regulations coming down for pain issues from different regulatory agencies that are causing providers to manage patient care differently and prescribe medications differently. This is quite a process, and the Utah Pain Relief Institute is one of the leading clinics in the nation for complying with these new guidelines and regulations and assisting other clinics to do the same. Many of the new guidelines and regulations that have been put in place do not allow a family or primary care doctor to prescribe medications to patients when they have been a patient for more than two months. Once a patient has been injured, or is in pain for more than two months and no relief has been found, their condition moves from being classified as “Acute” to “Chronic.” Once a patient is no longer in the “Acute” stage of their pain and it has progressed to “Chronic” the patient will need to be seen by a Pain Specialist Provider and should not be seen by their family physician or primary care provider.

This is where we come in to the picture. When you are seen by one of our providers you will be evaluated with regards to your pain symptoms. This could include the need for some imaging like an MRI, CT scans, or x-ray imaging to help the providers to further understand the extent of the injury and the potential cause of the continuing pain. Some of these procedures may have already been done by past providers and we will be able to use that imaging as long as it is recent and no new injuries have occurred since the imaging was done. Once we have this imaging, we can determine the extent of the injury and make a treatment plan to assist the patient to achieve more functionality with less pain.

Chronic pain management clinics will not be able to eliminate all of your pain, but our goal is to lessen it enough so that you will receive the best results and achieve greater physical functionality. We do this by prescribing appropriate medications that will assist in cancelling the pain signal so that you will not feel the pain. We also perform numerous therapeutic injections that will also lessen the pain you are feeling. When the pain levels are decreased, it assists the patient and gives you the ability to do physical therapy and/or Chiropractic care for physical rehabilitation to help correct the issue that is causing the pain symptoms. The ultimate goal of pain medication management is to lower the pain level enough to help the patient do proper physical rehab that will help correct the issue and then the patient can be taken off of the medication that they have been prescribed for the pain allowing them to function well enough during their day to day activities without having to take the pain medications.

Pain medications are broken down into two parts:

  1. One is a type of medication that acts quickly and does not last very long. This medication is what is known as an instant release/immediate release medication.
  2. The other type is a medication that acts slowly and lasts longer in the patient. This medication is what is known as a long acting/extended release medication.

Some providers will only use the first type of medication and some will use a combination of both types of medication. This will depend on what the provider feels will provide the best pain relief for the patient and create the best functionality while not harming the patient.

Opioid medication for pain management can be dangerous if it is not done carefully and overseen by a specialist that has been practicing prescribing these medications for a good duration of time. Many providers do not manage these medications well and many patients have suffered because of it. We are a medical team trained in the practice of prescribing Opioid medications for the pain management of our chronic pain patients. We are the specialists. Come let us help you achieve your best functionality because of our many years of experience helping other patients achieve theirs.

Platelet Rich Plasma Therapy – PRP

Accelerated Natural Healing for tendon and ligament injuries You hear a pop and feel the pain. You just injured an important part of your body, before you can say; “Ice pack please,” your body has already dispatched its own emergency response expert – blood – to the site of the injury. Inside our blood are platelets. These sticky, colorless components allow surface injuries, such as a paper cut, to clot. Contained in platelets are growth factors. It is these growth factors that stimulate cell production and allow many types of injuries – including tears in deep, soft tissues – to heal. This system, though highly effective for most injuries, leaves certain tissues at a biological disadvantage. Because tendons, ligaments and some other parts of your musculoskeletal system have a limited blood supply, growth factors may not reach the injury site in sufficient quantities to promote rapid or complete cell repair. The result can be a longer or inadequate recovery, which may ultimately result in a need for surgical intervention. Platelet-rich plasma (PRP) is a concentration of a patient’s own platelets and growth factors used to improve the healing environment for certain tendon, ligament and other orthopedic conditions. This concentrate is also referred to as “autologous conditioned plasma (ACP).” Professional and amateur athletes value PRP therapy for its ability to help accelerate recovery from certain injuries, reduce the need for surgery and allow a quicker return to sport. However, anyone with a tendon or ligament injury may be considered and candidate for PRP therapy.

Improving the healing environment with PRP therapy

For more than 20 years, concentrated platelets have been used to help accelerate recovery following injury or surgery. Heart surgeons first used this treatment to promote wound healing and minimize blood loss. Specialists in many other disciplines, including orthopedics, followed. Currently, some joint surgeons use concentrated platelets in patients to decrease bleeding at the surgical site, reduce the need for narcotic therapy after surgery, and improve range of motion. In sports medicine, PRP therapy has been recommended as an alternative to surgery in patients with chronic elbow tendonitis, a category of injuries that includes tennis elbow. For other tendon and ligament injuries, there are examples of PRP therapy accelerating injury recovery in athletes and allowing a faster return to sport.

Who should consider PRP therapy?

You may want to consider PRP therapy if you have been diagnosed with and injury to a tendon (attaches muscle to bone) or to a ligament (connects bone to bone). The injury can be either recent or chronic.

Some common diagnoses include:

  • Tennis elbow, also called lateral elbow epicondylitits
  • Golfer’s elbow, also called medial elbow epicondylitis
  • Bursitis or impingement of the shoulder
  • Jumper’s knee, also called patella tendonitis
  • Achilles’ tendonitis, located in the ankle
  • Plantar fasciitis, a common problem in the foot
  • Any ligament strain or sprain

Early Data suggests that concentrated platelets also may be beneficial in the treatment of arthritis in any joint.

How is the procedure performed?

If you believe you may be a candidate for PRP therapy, your problem will first be evaluated by your Utah Pain Relief Institute, who will discuss the benefits and risks of treatment with you. You will then be scheduled for a return appointment, at which time the procedure will be performed. Prior to treatment, you will be advised to discontinue the use of anti-inflammatory medications, such as ibuprofen, one week prior to your injection.

Please notify your physician if you have an allergy to Lidocaine (xylocaine) or bupivacaine (marcaine).

Similar to a blood test, the procedure can be performed in the Utah Pain Relief Institute in about 30 minutes. A small amount of blood is removed from your arm and specially prepared to separate the platelets from other components. The concentrated platelets are injected into the injured area, where they work by releasing growth factors to improve healing.

What happens after treatment?

Many patients return to work the same day. You will be advised to decrease activities for a day or so and  discontinue the use of anti-inflammatory medications for six weeks. One week following treatment, patients usually begin a rehabilitation program to further promote healing. A return to full activity will depend on your condition. PRP therapy can accelerate healing of acute injuries, but chronic problems may still require a longer recovery period. Your Utah Pain Relief Institute physician will provide guidance on how quickly you can safely resume your activities. In general, patients can expect to see significant improvement in symptoms and dramatic return of function. Traditional treatments such as medications, cortisone injections or surgery may no longer be needed.

Are there risks associated with PRP therapy?

Though uncommon, the risks of PRP therapy are similar to that of any injection. They include pain, infection, persistence or worsening of symptoms, blood clot, nerve injury, skin discoloration, calcification, and scarring. If you experience these or other side effects, please contact your Utah Pain Relief Institute physician at 801-466-7246.

Is this treatment covered by insurance?

Like other newer procedures, most insurance companies do not cover PRP therapy.  patients who choose to undergo PRP therapy must pay for the treatment out of pocket. For our patients’ convenience, the Utah Pain Relief Institute accepts cash, personal checks, CareCredit®, Discover Card®, Master Card®, Visa®, and American Express®.

Accelerated Healing the Natural Way Gary Child, D.O., at the Utah Pain Relief Institute is one of the only physicians in the state of Utah offering PRP therapy as a treatment option for ligament, tendon and other  orthopedic injuries. Dr. Child’s goal is to foster healing through minimally invasive techniques in an anatomic or natural manner. PRP therapy is certainly consistent with his philosophy and practice. Learn more To learn whether PRP therapy is appropriate for you, please contact the Utah Pain Relief Institute at 801-466-7246. Our phone receptionist will be happy to schedule a consultation appointment for you with our physicians.

Massage Therapy

For Acute and Chronic Pain

Massage is a popular therapy used to relieve muscle tension, spasms, inflammation, fluid retention, aches, stiffness, and pain. Other benefits include improved circulation (blood and lymph), general flexibility, range of motion, and increased tissue elasticity (e.g. scar tissue). During treatment, the massage therapist will include localized massage (e.g. low back or neck) as a prelude to exercise. Massage increases circulation and warms muscles and other soft tissues (e.g. tendons, ligaments).

How does massage work to relax muscles?

As the therapist uses their hands or specialized tools to rhythmically knead, rub, and stroke (effluerage) muscles, circulation is stimulated. Blood flow delivers oxygen and nutrients, and is key to helping muscles eliminate waste products, such as lactic acid, that may collect in muscles from spasms causing pain. Following trauma, muscles may act as mini-splints to protect and limit motion, similar to a cast on a broken arm. A typical example is a person who uses a computer for a prolonged time period without taking a break to stretch the neck. The result: stiff neck, aching, even pain.

What is Neuromuscular Therapy?

This technique is a very specialized form of manual therapy. A therapist trained in NMT is educated in the physiology of the nervous system and its effect on the muscular and skeletal systems. Neuromuscular Therapy is the utilization of static pressure on specific myofascial points to relieve pain. This technique manipulates the soft tissue of the body (muscles, tendons and connective tissue) to balance the central nervous system. In a healthy individual, nerves transmit impulses (which are responsible for every movement, function and thought) to the body very slowly. Injury, trauma, postural distortion or stress cause nerves to speed up their transmission, inhibiting equilibrium and making the body vulnerable to pain and dysfunction. It is therefore necessary to stabilize low levels of neurological activity to maintain normal function and overall health.

What is deep tissue massage?

This technique targets chronic muscle tension. The therapist’s strokes are slower, using more direct pressure and friction. Depending on the texture of the deeper layers of muscle and tissue felt, the therapist periodically adjusts their hand positions, strokes, and intensity to work the tissues to release tension.

What is myofascial release?

Myofascial release, or soft tissue mobilization, is a therapy used to release tension stored in the fascia. Fascia are sheets of fibrous tissue that encase and support muscles, separating them into groups and layers. Following trauma, the fascia and muscles may shorten restricting blood flow. The techniques used in myofascial release relax muscle tension and break up fascial adhesions.

What is trigger point and myotherapy?

Trigger points are tiny, tight nodules that form in muscles causing referred pain. Sometimes myofascial pain can be linked to one or more trigger points. The treatment goals include alleviating muscle spasms, improving circulation, and releasing trigger points. The therapist applies direct momentary pressure to a trigger point to cause its release. During the massage, the therapist may return several times to a stubborn trigger point to elicit its release. As trigger points are released, the therapist stretches the muscle using a technique called Spray and Stretch. This technique incorporates a superficial cooling agent such as Fluori-Methane, a local anesthetic that depresses nerve response. The anesthetic is sprayed over muscles as they are gently stretched, soothing tight muscles.

What to expect.

During your massage it is important to communicate with the therapist whether the pressure is too light or too gentle. After your massage make sure that you drink plenty of water to help your body flush out any waste products that were in the muscles that have now been released.

Psychiatric Counseling

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