Peripheral neuropathy is a burning or aching pain due to nerve diseases. The pain can either be constant or intermittent and most often occurs in the arms or legs; however, it has been known to occur in the trunk, abdomen, head and neck. The pain can occur from irritation of one nerve or from several nerves. Generally, peripheral neuropathies are a consequence of diabetes, alcoholism or other neurological diseases.
Diagnosis
Doctors will use a physical examination to confirm the area involved. Neurological examinations can sometimes reveal loss of sensation to pinprick or to hot and cold temperatures. Weakness is sometimes noted in the affected extremity. Reflexes may be affected and there may be changes in the skin over the region. Evaluations of peripheral neuropathies usually involve tests appropriate for the primary disease, which doctors suspect is causing the problem such as diabetes. Evidence of nerve damage can sometimes be demonstrated with electrical nerve testing. Doctors who treat the pain as peripheral neuropathy will often use a nerve block procedure to help diagnose the problem.
Treatment
For some patients with peripheral neuropathy, the use of oral non-steroidal anti- inflammatory medications along with traditional pain medications can be helpful. For others, special medications help directly with nerve pain. These medications are often started at low doses and gradually increased until the desired affects are reached. Long-term relief can often be obtained with the use of therapeutic nerve blocks. These include injections of anesthetic medications along with anti-inflammatory medication around the painful nerves. The injections are usually performed in a short series over several weeks until symptoms subside or a plateau is reached in the treatment. If helpful, these injections can be repeated at appropriate intervals.
Nerve stimulation techniques can be helpful in certain types of peripheral neuropathy. Stimulation can either occur on the skin over the affected region, or in some cases, with stimulator electrodes placed surgically around the nerves or in the spine at the origin of the affected nerves. Although physical therapy is not usually helpful in relieving the pain from peripheral neuropathy, therapeutic exercises can help restore loss of function and allow patients to lead more active lives. In addition, behavioral modification techniques or biofeedback training with muscle relaxation exercises can help patients be less sensitive to the irritation from the affected nerves.
The Priority Health Spine Centers of Excellence program was created to ensure that all patients with persistent neck pain, back pain or other spine-related problems receive a comprehensive, non-surgical medical evaluation for their condition. For patients whose condition does not require urgent or emergent surgical intervention, an evaluation by a certified Priority Health Spine Center of Excellence is required prior to any referral to an orthopedic or neurosurgeon for back or neck care.
Tri-County Pain Consultants, PC is honored to be recognized by Priority Health as a Spine Center of Excellence for West Michigan. Our team of pain management specialists have a proven track record providing high quality medical care that meets and exceeds the strict criteria required by Priority Health for a Spine Center of Excellence designation.
Acupuncture
Acupuncture is the practice of using small needles inserted at very precise points on the body to promote natural healing and improve functioning. Acupuncture stimulates nerves, muscles and connective tissues, prompting increased blood flow to injured areas of the body, boosting the body’s natural healing process. Acupuncture provides a low risk treatment option that can be beneficial for pain syndromes due to an injury or associated with chronic degenerative diseases.
Cryoablation
Cryoablation is a procedure done in office that utilizes a specially equipped needle guided under fluoroscopy to freeze the area surrounding a nerve that is causing pain or discomfort. The goal of cryoablation is to interrupt the nerve’s ability to send pain signals to the brain and provide pain relief.
Discography
A discography is a diagnostic tool your pain management specialist may use to help determine the disc or discs that are the source of your pain. For this procedure, a contrast dye is injected into the gel like center of the suspected disc or discs, allowing your pain physician to see cracks or leaks in the disc membrane. Typically a patient receiving a discography will be given a local anesthetic or numbing agent. All discographies are performed by a certified pain management specialists under fluoroscopy.
IDET
IDET, or Intradiscal Electrothermal Therapy, is a procedure used to treat discogenic back pain. IDET involves the use a heated probe inserted into the gel like disc which heats up the inside of the affected disc. Heating the inside of the disc can destroy pain causing nerve fibers and seals any cracks or holes in the disc.
Intrathecal Pump Therapy
An intrathecal pump is an implanted medical device that delivers pain medication directly to the intrathecal space surrounding the spinal cord. An intrathecal pump is indicated in cases where patients have difficulty with oral medications or where previous pain interventions have been ineffective.
Kyphoplasty
Kyphoplasty is a procedure designed to help relieve pain caused by compression fractures of the spine. During a kyphoplasty procedure, a small tube is inserted into the fractured area. Once the tube is in place, the physician inflates a small balloon within the fractured area to raise the area, returning the broken pieces to a more normal position. The balloon is then deflated and the space is filled with a bone cement, effectively stabilizing the fractured area.
Manual Therapy
Manual therapy, or manipulative therapy, is a direct contact physical treatment used primarily to treat musculoskeletal pain and disability, intended to restore joint or soft tissue mobility. Treatment may include joint mobilization and manipulation, muscle stretching, and resistance therapy to advance muscle timing and activation.
Medication Management
Mecication Management is medical care provided by your pain management physician to optimize the use of prescribed medication to improve therapeutic outcomes for patients.
Nerve Block Technique
A procedure in which an anesthetic agent is injected directly near a nerve to block pain. A nerve block is a form of regional anesthesia.
Occupational Therapy
Occupational therapy is a task orientated treatment program designed to help patients regain their ability to perform daily living and work activities after serious illness injury or disability. Therapy focuses on the facilitation of daily tasks of self-care, work, and play/leisure activities, to help patients regain the ability to perform daily living and work activities.
Radiofrequency Lesioning
Radiofrequency lesioning is an advanced procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for 6–9 months. The procedure is typically most effective in treating joint pain in the spine.
Spinal Cord Stimulation
A spinal cord stimulator is a small electrical device implanted just under the skin in the lower back that delivers low level electrical signals to tiny electrodes implanted in the epidural space of your spine. These electrical pulses interrupt the pain signal from reaching your brain, replacing them with a mild tingling in the area where pain is felt. The device is controlled through a magnetic remote control, which allows patients the ability to turn the device on or off, and adjust the intensity as needed.
Stress Management
Stress management is clinical therapy designed to help individuals cope with or lessen the physical and emotional effects of strain and anxiety. Stress-management may include relaxation techniques, time-management skills, counseling or group therapy, exercise, and maintaining an overall healthy lifestyle.
