"I am progressing as Dr. Hough Indicated. I like the technology that his office used to track treatment." November 2018
The first step is a consultation with one of our doctors. In addition to taking a thorough history and performing a detailed physical examination, we review relevant laboratory results, imaging studies and notes from other doctors. Then we help you to understand the diagnosis (or diagnostic possibilities) and we develop with you a comprehensive plan for further evaluation and pain care. Finally, we send a report back to your doctor. Our aim is to inform and reassure you while engaging you as a member of the care team.
Epidural steroid injections are the most commonly performed procedures in our medical practice. They are administered to relieve pain from conditions such as slipped discs, spinal stenosis, sciatica and radiculopathy.
Pain Management Specialists performs these procedures with xray guidance and local anesthesia. It takes just a few minutes to complete amd relief usually lasts a few weeks to a few months.
Facet Joint Denervation
Radiofrequency facet joint denervation is performed to alleviate pain caused by inflammation or arthritis of the knuckle-sized facet joints of the cervical, lumbar or thoracic spine. In a two-step process, up to several affected joints are first anesthetized and later the nerve supply to the joints is interrupted using a heatable needle. Much like pruning a bush, the nerve is not killed and will later grow back. Relief typically lasts for 6-12 months.
Spinal Cord Stimulation
Spinal cord stimulation uses a pacemaker-like device to apply mild electrical stimulation to suppress pain signals as they travel to the brain. It is most commonly used to care for patients with chronic back and leg pain after spinal surgery, but can be used for a variety of other conditions as well.
Recently, high frequency spinal cord stimulation was introduced to the US by Nevro. This technology has dramatically enhanced success rates compared to existing technologies. Now, over 70% of patients with chronic back and leg pain can experience meaningful, sustained pain relief with spinal cord stimulation. Pain Management Specialists’ doctors pioneered the use of the Nevro Senza HF10 device in the Baltimore-Washington area.
Dorsal Root Ganglion Stimulation
Dorsal root ganglion stimulation is a new type of spinal cord stimulation that uses mild electrical signals to suppress abnormal pain and sensitivity after nerve injury. Introduced to the US by St. Jude Medical (now Abbott) in 2016, Pain Management Specialists was first in Maryland to employ this advanced technology. Suitable patients include those with chronic regional pain syndrome and those who have sustained a nerve injury from trauma or surgery.
For many people with acute and chronic pain, medication is an important part of a comprehensive care plan. Unfortunately, the use of the morphine-like pain medications known as opioids has become a sort of one-size-fits-all treatment for pain of all types, often replacing rather than supplementing more effective and less toxic therapies.
Pain Management Specialists follow the Centers for Disease Control guidelines for the use of opioids. This approach emphasizes comprehensive treatment with minimal to no opioids and close monitoring of the small minority of patients being treated with opioids.
While Pain Management Specialists does not offer physical rehabilitation in-house, we work closely with a number of physical and occupational therapists and selected chiropractors who employ exercise-based approaches to pain relief and restoration of physical function.
We believe that active, rather than passive forms of physical therapy, supplemented by regular fitness exercise is essential to achieving the best results.
Top Conditions Treated
Back and neck pain is among the most common and costly medical conditions and the leading cause of occupational disability world-wide. It shouldn’t be that way.
Pain Management Specialists strives to reduce the burden of spinal pain through cost-effective diagnosis and comprehensive, yet efficient care that empowers you to heal. Yet when that doesn’t work, we provide a customized care plan consisting of low-risk medications and interventions to alleviate pain and restore optimal function.
Pain from nerve injury or damage can be caused by a medical condition like diabetes or multiple sclerosis, by nerve entrapment, injury or surgery. This type of pain is often accompanied by numbness, sensitivity to touch and muscle weakness or spasm. It is often more difficult to control with typical pain relieving medications.
Pain Management Specialists’ doctors utilize non-opioid medications, injections and sometimes electrical stimulation to care for those with neuropathic pain with a high degree of success.
Pain After Spine Surgery
Persistent pain following spinal surgery is all too common. In a recently published study of 1842 back surgery patients, over 20% were somewhat or very dissatisfied with their results. Unfortunately, more surgery is often not a solution.
Pain Management Specialists takes the same deliberate approach to pain after spine surgery as they do to other pain conditions. We make the right diagnosis and emphasize tailored, low-risk pain care to get you back on your feet quickly. For those with refractory back and leg pain, we offer the latest procedures and neuromodulation to manage pain without drugs.
Chronic Regional Pain Syndrome
(CRPS) has gone by many names. You might have heard it called reflex sympathetic dystrophy or causalgia. It is an uncommon condition that starts after a minor injury like a sprain, or following a fracture or surgery, especially when a nerve is injured. It causes pain and sensory changes and some combination of muscle spasm, joint contracture, temperature and color changes, thinning of the skin and bones, and abnormal hair and nail growth.
CRPS is best addressed with a combination of physical therapy, sympathetic nerve blocks and non-opioid medications. Unfortunately, many cases of CRPS do not respond well to first-line therapies and require a type of treatment known as neuromodulation. Neuromodulation involves inserting a pacemaker-like device into the spine to calm the affected nerve pathways.
Pain From Cancer
According to the US National Cancer Institute, moderate to severe pain affects 80% of people with advanced cancer. It may be caused by inflammation, nerve compression or tissue destruction by the tumor itself, or by treatment of the cancer with drugs, radiation or surgery. Care can be challenging because pain fluctuates and is often accompanied by other symptoms like nausea and fatigue. Sometimes the best solution is to more aggressively treat the cancer, but other times the best approach is to focus on the symptoms.
Pain Management Specialists has decades of experience in treating cancer pain in hospital and office settings. The mainstay of pain care is the use of medications, but sometimes they are not effective or well tolerated. We also offer injection therapies and implanted spinal medication pumps to optimize pain control in suitable patients.
*Prescription Refill Notice: We do not do refills without appointments and we try to prescribe what patients will need until their next appointment. When our patients are out of their medicine, that typically means that they need to be seen. We do not prescribe narcotics without appointments