Managing Your Pain for a Better Life

At some point, everyone experiences pain. Often indicating that something is wrong, the way in which pain is experienced can range from mild and infrequent to severe and constant. This long-term discomfort is commonly known as chronic pain... and pain management is the practice of controlling it.


Pain left untreated can interfere with the healing process by affecting the immune system while draining you both physically and mentally. More than any other type, back pain is one of the most common problems for people, especially in the lower back. The muscles located in the lower back support the spine and are in constant use (even while sitting). In addition, your spine is continually bending, twisting and straightening, all of which results in a steady level of stress on your back – stress that can easily result in strain. And since the lower back supports most of your body weight, that’s usually where most common injuries occur.

While the injury can be temporary and sometimes heal on its own, it’s often more severe, even permanent. If it persists for three months or longer, it’s considered chronic pain. The discomfort of back pain can impede rehabilitation by interfering with exercise and increase the risk of psychological problems, including depression, anxiety and a host of other secondary ailments – all with chronic pain at their root.

Recently however, researchers have discovered a great deal about the physiological and psychological impacts of pain, leading to a wide array treatments that can provide partial or even complete pain relief. The practice of pain management draws upon a variety of scientific disciplines that enable its practitioners to systematically study pain, diagnosing its cause and prescribing treatment and prevention.

You don’t have to live with pain.

At Longview Radiologists, we realize how closely feeling good relates to your quality of life. That’s why we provide a number of options when it comes to the management and treatment of chronic pain – proud to be the only out-patient facility in the area to offer the following life-enhancing treatments: At Longview Radiologists, we realize how closely feeling good relates to your quality of life. That's why we provide a number of options when it comes to the management and treatment of chronic pain – proud to be the only out-patient facility in the area to offer the following life-enhancing treatments:



Epidural Steroid Injection

An epidural steroid injection (ESI) is a minimally-invasive procedure that can help relieve the pain caused by inflamed spinal nerves, often resulting from spinal stenosis, spondylolysis, a herniated disc, a degenerative disc, or sciatica. The effects of ESI injections may result in temporary pain relief for several days, months or years. The goal is to reduce pain to allow you to resume normal activities and a physical therapy program.

During this procedure, a radiologist will inject cortisone into the epidural space between the protective covering of the spinal cord and vertebrae. After being monitored for a short time, you can leave the office. But you must have someone with you to drive you home.

Most patients can walk around immediately after the procedure and resume full activity the next day. Soreness around the injection site may be relieved by using ice and taking a mild analgesic such as Tylenol.

ESI procedures should NOT be performed on people who have an infection, are pregnant, or have bleeding problems. If you are on blood thinners, such as Coumadin, you must consult with your physician and stop taking it four days prior to the procedure.



Facet Injection

A facet injection is a minimally-invasive procedure that can temporarily relieve neck or back pain caused by inflamed facet joints due to arthritis, injury or degeneration. The effects of facet injections tend to be temporary, providing relief for several days, but can sometimes last for years.

During a facet injection, the patient is awake throughout the entire process. Lying face-down on a table, you'll receive a local anesthetic, which will numb the skin before the injection is given. With the aid of a fluoroscope (a real-time x-ray), the radiologist directs a hollow needle through the skin and muscles of your back to the sensory nerves located in the facet joints. Fluoroscopy allows the doctor to watch the needle on the monitor in real time to make sure it goes to the specific facet joint. Some discomfort occurs but patients typically feel more pressure than pain. When the needle is in the correct position, the radiologist injects the anesthetic and corticosteroid medication into your facet joint capsule. One or several joints may be injected depending on the location of the pain. The needle is then removed.

Most patients can walk around immediately after the procedure. After being monitored for a short time, you can leave the office. But you must have someone with you to drive you home.

Facet injections should NOT be performed on people who have an infection, are pregnant, or have bleeding problems. If you are on blood thinners, such as Coumadin, you must consult with your physician and stop taking it four days prior to the procedure.



Sacroiliac Joint Injection

The sacroiliac joint is a large joint in your lower back and buttocks region. When the joint becomes irritated, it can cause pain in the immediate region or radiate into your groin, abdomen, hip, buttock or leg.

Sacroiliac joint injections are primarily used for diagnostic purposes, helping your doctor determine the cause of your back pain, and may not provide you with any long-term relief from the pain. The injections eliminate pain temporarily by filling the sacroiliac joint with an anesthetic medication that numbs the joint, ligaments and joint capsule around the sacroiliac joint.

During a sacroiliac joint injection the patient is awake for the entire process. Lying face down on the table, the patient receives a local anesthetic, which will numb the skin before the injection is given. With the aid of a fluoroscope (a real-time x-ray), the radiologist directs a needle into the joint. A small mixture of numbing anesthetic and anti-inflammatory cortisone is then slowly injected. Some discomfort occurs but patients typically feel more pressure than pain.

If the pain goes away for several hours, it is highly likely that this particular joint is the source of your pain. And once you and your doctor know which structure is causing pain, you can explore more permanent or long-term treatment options.