Treatments

Here’s the good news, there are many choices for the treatment of pain. It is possible to improve your quality of life through interdisciplinary pain management techniques and procedures. We encourage you to take an active role in your therapy and be a crucial part of the treatment team. It may seem daunting, but we provide the educational resources and emotional support to help you with your pain management journey.

conservative therapy

Conservative Therapy

The first option we like to consider is conservative options. Physical therapy, chiropractor, acupuncture, yoga, and pilates are all good options to try to help with pain without taking any medicines or interventions.  Frequently these modalities can help prolong benefit as well.  Any type of core strengthening is beneficial to help minimize the stress to the low back.  Frequently, many insurance plans will require people to try therapy before they approve other options such as medicines or interventions.   We are happy to consider a referral to a conservative option for you.

Medicines

The next option in treating pain is usually medicines.  There are millions of combinations of medicines available.  The main types of medicines include anti-inflammatories, muscle relaxants, nerve-calming medicines, and narcotics. Anti-inflammatory medicines include ibuprofen (Advil), naproxen (Aleve), and diclofenac (Voltaren).  Other types of anti-inflammatory medicines that are prescription strength include Celebrex and Mobic.  These medicines are usually used for arthritis type pains.

The next type of medicine is muscle relaxants.  Medicines such as Flexeril, Robaxin, Skelaxin, Zanaflex, and baclofen are used to help relax the tight or spastic muscle.  Frequently there are used in conjunction with other medicines. Nerve calming medicines are used to decrease irritation of nerves.  Neurontin (Gabapentin) and Lyrica (Pregabalin) are very common nerve-calming medicines.
Others include Elavil, Pamelor, Cymbalta, and Trileptal.

The final main class of medicines is narcotics.  These are medicines used to blunt pain but do not actually help improve the cause of any pain.  These medicines are highly regulated and restricted as they can be addictive and cause many side effects such as constipation, urinary retention, liver problems, shortness of breath, decreased mentation or dizziness, difficulty thinking, driving, or concentrating respiratory depression,  and even death.  If we agree narcotics are available for your treatment, you will have to sign a narcotic contract and follow its rules.

Interventions & Injections

There are MANY ways to do injections/interventions.  We only use the highest level of procedures and follow all national guidelines. Treatment options include:

Epidural Steroid Injections  (ESI) (neck, mid-back, and low back)

Facet Steroid Injections  (neck, mid-back, and low back)

Trigger Point Injections  (neck, mid-back, and low back)

SI Joint Steroid Injections

Shoulder Steroid Injections

Hip Joint Injections

Hip Joint Injections

Knee Joint Injections

Bursa Injections

Radio Frequency  (nerve burning) (neck, mid-back, low back, and SI joints)

Celiac Plexus Blocks

Stellate Ganglion Blocks

Dorsal Root Ganglion Stimulation

Sacrococcygeal Joint Steroid Injections

Spinal Cord Stimulation / Dorsal Column Stimulation  (neck and low back)

Discograms

Interventions

Lumbar Sympathetic Blocks

Most often, we find using some options from each category provides the maximum benefit. Every patients treatment plan is personalized at each visit.

Surgery

The fourth main treatment option for pain is surgery.  Many times insurance companies will want you to try to try other modalities including therapy, meds, and injection before they will approve the surgery.  Dr. Moran and his team only work with highly respected and trusted surgeons.  If you are not obtaining the benefit you want or need, a surgical consult will most likely happen.  The surgeon will then decide if you are a good candidate for surgery or not.
other pain management options

Other Options

Other options to consider include stem cell injections and/or ketamine infusions, CBD, botox, and viscosupplementation.  Although these modalities work well in the appropriate patients, they are not currently covered by insurance.

Learn How to Manage your Lower Back Pain

“Dr. Moran helped me so much when I first went to see him for neck pain. I’ve always felt like he’s willing to work with me to find the best way to alleviate my pain.”

-Carrie R.

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