Introduction to Pain Clinic Surgery

a. Drug therapy
Depending on the symptoms, non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, adjuvant analgesics, etc. are used alone or in combination. Oral medicines work differently depending on the person, and because side effects are less likely to occur, starting with small doses may not be effective for the first 1-2 weeks.

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b. Nerve block
At the pain clinic, we use an ultrasound device (echo) to safely and reliably perform nerve blocks.
By using echo, it is possible to visualize the spread of nerves, blocking needles to be punctured and the local anesthetic used.
"The location to block changes depending on the location of the pain." Brachial plexus block if your neck, shoulders, or hands hurt.

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c. Trigger point block (myofascial release, fascia release, hydro release)
Trigger point blocks are effective for stiff shoulders, lower back pain, and clumsiness in the neck caused by myofascial pain syndrome.
As with nerve blocks, trigger point blocks are performed safely and reliably using an ultrasound device (echo).

First, we use palpation and echo to find the trigger points that cause pain. The fascia near the trigger point is often adhesion (sticking), and it often appears bright (white) on echo. Once you find the trigger point, block it while watching the echo, and peel off the adhesion of the fascia. At the time of peeling, it may be accompanied by strong pain, so please do not hesitate to tell us in that case.
"Depending on the symptoms, it may be necessary to block several places."
 

d. epidural block
An epidural block is an injection performed from the back, in which a local anesthetic is injected into the epidural space, which is located in the spine (backbone), near the spinal cord, to reduce pain.
There is a single epidural block performed on an outpatient basis and a continuous epidural block performed on an inpatient basis.
It is used for herpes zoster-related pain, neck pain, and lower back and leg pain.
A single epidural block can be performed on an outpatient basis, but it will require about an hour of rest.
 

e. Nerve root block
A nerve root block is a block performed at the base of the spinal nerve that exits the spinal canal through the intervertebral foramina.
It is used for neck pain and lower back and leg pain.
We perform cervical nerve root block under ultrasound guidance and lumbar nerve root block under fluoroscopy. Ultrasound and fluoroscopy may be combined if necessary.
 

f. Spinal cord stimulation (SCS)
This is a method of alleviating intractable pain by sending a weak electric current to the spinal cord.
Effective against neuropathic pain and ischemic pain. Spinal cord stimulation therapy is intended to relieve pain and is not a fundamental treatment to remove the cause of pain.
The spinal cord is electrically stimulated by inserting a metal lead (stimulation electrode) into the epidural space near the spinal cord in the spine (backbone). A lead is inserted according to the painful area and electrical stimulation is performed.

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