Conditions Treated
Conditions Treated
Dr. Provenzano and the staff at the Institute for Pain Diagnostics and Care treat patients who have a wide variety of pain-related conditions. These conditions can include neck- and back-related pain – such as degenerative disc disease, herniated discs, lumbar radiculopathy, post-laminectomy pain syndrome and spinal stenosis – as well as nerve and limb pain, that may include diabetic peripheral neuropathy, peripheral nerve pain, phantom limb pain, postherpetic neuralgia, trigeminal neuralgia and facial pain. Dr. Provenzano and the IPDC staff also specialize in the treatment of cancer pain.
Treatment Methods
Dr. Provenzano and the IPDC staff develop a multidisciplinary treatment plan for each patient that may include physical therapy, medication management, cognitive behavioral therapy and minimally invasive procedures that are designed to ease the patient’s pain, improve quality of life and restore function. From x-ray guided joint injections to nerve blocks, to implantable devices, Dr. Provenzano’s pain treatment procedures are customized to the patient’s needs. In certain cases, advanced procedures may be beneficial. Advanced procedures include:
Epidural Steroid Injection
Epidural steroid injections can help patients who suffer from neck, arm, back, and leg pain caused by inflamed spinal nerves. Epidural steroid injections may be performed to relieve pain caused by spinal stenosis, or a disc herniation. Targeted with visual guidance at a specific level based on MRI and physical examination findings, Dr. Provenzano injects pain medication into the patient’s epidural space to reduce inflammation in and surrounding the spinal nerve roots and adjacent tissues. The goal is to reduce inflammation to accelerate the recovery process.
Radiofrequency (Rhizotomy)
Radiofrequency lesioning is a safe, proven means to interrupt the nerve supply to the facet joint and thus the pain signal. Under x-ray guidance, Dr. Provenzano can interrupt the patient’s pain signal and reduce pain in individuals who suffer from facet joint related neck and low back pain..
Spinal Cord Stimulation
Spinal cord stimulation (SCS) involves the delivery of pulsed electric signals near the spinal cord to reduce and control pain for certain medical conditions. Spinal cord stimulation may be considered when medical management, surgical intervention, and physical therapy have not been effective in relieving pain. SCS may also be beneficial in treating inoperable peripheral vascular disease. Using this method of pain management, Dr. Provenzano can provide effective pain relief for many pain related conditions including:
- Post-laminectomy pain syndrome (persistent pain after neck and back surgery)
- Complex regional pain syndrome (previously known as RSD and causalgia)
- Peripheral neuropathic pain
- Pain from inoperable peripheral vascular disease
- Pain from inoperable ischemic heart disease
Spinal cord stimulation has been proven to be effective for many of these conditions with lasting results in terms of pain relief, pain medication reduction, and improvement in quality-of-life indices and satisfaction scores.
Vertebroplasty
Under x-ray guidance, Dr. Provenzano injects bone cement into a fractured vertebra in order to stabilize it. Patients usually see significant pain relief typically within 48 Hours but results are often immediate. Patients have also reported an increased range of motion and can usually return to previous levels of activity. Back to top
Intrathecal pump treatment
Patients with cancer who have not found adequate relief through conservative pain therapies may benefit from intrathecal drug delivery, or a “pain pump.” Intrathecal drug delivery is a method of giving medication directly to the spinal cord. Dr. Provenzano surgically implants the pump, placed under the skin of the abdomen, that delivers pain medication through a catheter to the area around the spinal cord.
Recent evidence also suggests that a pain pump may be a treatment option if other traditional methods have failed to relieve pain symptoms. Because the medication is delivered directly to the spinal cord, symptoms can be controlled with a much smaller dose than is needed with oral medications. The goal of a drug pump is to better control pain symptoms and to reduce oral medications; thus reducing their associated side effects. Individuals suffering from cancer pain who undergo the treatment may experience a reduction in pain, an increased survival rate, as well as overall improvement in activities of daily living.
All advanced procedures are performed with visual assistance through ultrasound or fluoroscopy. Back to top