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Complex Regional Pain Syndrome

Regional pain syndrome is essentially a malfunction of the nervous system. It can either occur after a crush injury or prolonged immobilization from an extremity injury or from a nerve injury itself.

The symptoms can be very debilitating and misdiagnosed by other physicians since the nervous system controls every aspect of your peripheral function. Symptoms can include random swelling of joints, sweating, coldness or warmness of an extremity or color changes, all occurring at random intervals not associated with any specific events.




Treatments

  • Intrathecal Pump
    An intrathecal pump is a method of inserting medication directly into the subarachnoid or intrathecal space of a patient’s spinal cord, where the cerebrospinal fluid is stored, to quickly and effectively treat chronic pain resulting from conditions including failed back surgery syndrome, cancer pain and chronic pancreatitis. The pump can also alleviate muscle rigidity and spasms arising from Cerebral palsy, multiple sclerosis, stroke, or damage to the brain and neck. In this procedure, a small pump is surgically placed under the skin of a patient’s abdomen, delivering a pain relieving drug solution through a catheter to the targeted area in the spinal cord. The implantation of an intrathecal pump comprises three stages. The first is a psychological evaluation, which is required by the insurance provider to resolve any psychological contraindications to the procedure beforehand. The second stage is a trial phase where the medication that will be transmitted via the intrathecal pump is injected directly into the patient’s spine. The patient is then admitted to the hospital for a 24 hour observation to monitor any reduced pain or negative side effects. If the trial is successful, a surgical procedure is scheduled to have the intrathecal pump installed, which is the third phase. For more information visit http://www.medtronic.com/patients/chronic-pain/living-with/index.htm
  • Spinal Cord Stimulator
    Spinal cord stimulation is a form of electrical neurostimulation designed to reduce chronic pain felt by patients in their back and limbs as a result of various conditions including failed back surgery syndrome, reflex sympathetic dystrophy, and peripheral neuropathy. Rather than directly targeting the source of chronic pain, SCS interferes with the transmission of pain signals from certain nerves, preventing the brain from fully recognizing sensations of pain. The implantation of a spinal cord stimulator comprises three stages. The first is a psychological evaluation, which is required by insurance. The purpose is to resolve any psychological contraindications to the procedure beforehand. The second stage is a trial phase lasting typically between five and seven days. In this phase, electrodes are implanted in the epidural space using a technique very similar to a standard epidural injection. The electrodes are then activated to determine whether the stimulation is effectively relieving the pain. If the trial stage is successful, the patient returns to have the electrodes removed. A permanent device is then implanted through a simple outpatient surgical procedure. The strength of electrical stimulation can be changed by the attending physician or patient to adjust to shifting pain levels, providing adaptive, optimal pain relief in the process. For more information visit http://www.medtronic.com/patients/chronic-pain/living-with/index.htm
  • Stellate Ganglion Block
    A stellate ganglion block is the injection of local anesthetic and steroids into and around a patient’s sympathetic nerves in the neck region. In this procedure, a needle is guided to the stellate ganglion, a cluster of sympathetic nerve cell bodies at the front of the patient’s cervical spine, where the sympathetic nerves reside, using fluoroscopic imaging for guidance and monitoring the patient with an EKG, blood pressure cuff and oxygen monitor. Local anesthetic and steroids are administered to block pain sensations and decrease inflammation in the affected area, allowing the nerves to reset and providing relief for an extended period of time. Stellate ganglion blocks help treat several conditions including Reflex Sympathetic Dystrophy, Sympathetic Maintained Pain, Complex Regional Pain Syndrome and Herpes Zoster (shingles) of the upper body extremities. The local anesthetic administered during the procedure usually wears off after several hours with the nerve block lasting a few hours longer. Response to the treatment varies on a case-by-case basis, with some patients requiring repeat injections to treat their condition.
  • Lumbar Sympathetic Block
    A lumbar sympathetic block is the injection of local anesthetic and steroids into and around a patient’s sympathetic nerves located in the lower back.  The sympathetic nervous system helps to control the body’s internal organs. In this procedure, a needle is guided to the front part of the spine, where the sympathetic nerves reside, using fluoroscopic imaging for guidance and monitoring the patient with an EKG, blood pressure cuff and oxygen monitor. Local anesthetic and steroids are administered to block pain sensations and decrease inflammation in the affected area, allow the nerves to reset and providing relief for an extended period of time. Lumbar sympathetic blocks help treat several conditions including neuropathy, vascular disease, Complex Regional Pain Syndrome and Herpes Zoster (shingles) in the lower body. The local anesthetic administered during the procedure usually wears off after several hours with the nerve block lasting a few hours longer. Response to the treatment varies on a case-by-case basis, with some patients requiring repeat injections to treat their condition.
  • Infusion Therapy
    Infusion therapy entails administering pain medication through a needle or catheter, typically using an intravenous (IV) drip. Infusion therapy may also be used through other means including intramuscular injections and epidural routes. This method of treatment helps to counter the severity of patient conditions by reaching the bloodstream faster than oral medication. Many conditions are also unresponsive to these oral alternatives. Infusion therapy is a flexible treatment that can be applied to a host of pain conditions including arthritis, cancer, and immunologic and complex regional pain syndromes. Infusion therapy is tailored to your condition and is often repeated on a scheduled basis.
  • Chronic Pain Management
    Chronic pain refers to any pain lasting in excess of six months. There is no clear cause, as the term applies to any long-term discomfort arising from an initial injury. Chronic pain can occur in virtually any part of the human body and often contributes to other residual health problems including fatigue, decreased appetite, mood swings, and a lack of mobility. These difficulties negatively affect a person’s ability to lead a comfortable lifestyle. Many advances in modern medicine are helping people to manage their chronic pain more effectively to reduce suffering and enhance a patient’s quality of life and functionality. We will fully evaluate your condition and design a holistic, individually tailored plan to help you return to your life.
  • Image-guided Nerve Blocks and Injection Therapies
    Image-guided nerve blocks and injection therapies allow specialists to treat pain in a specific part of the body, such as an organ or a limb. Targeting an isolated group of nerves that carry the pain sensation from the affected area, a needle is inserted in the spine and guided to the area where the nerve or nerve cluster is irritated. Using the imaging technique of fluoroscopy to track the needle’s movement, local anesthetic is then administered to numb acute pain. Steroids can also be used to control nerve inflammation. Nerve blocks can be used for different reasons associated with chronic pain. While therapeutic nerve blocks control pain associated with various conditions, Diagnostic and Prognostic nerve blocks help to determine the source of a pain and predict the outcome of certain treatment respectively. Preemptive nerve blocs are also used before certain procedures to prevent ensuing discomfort.
  • Dorsal Root Ganglion Stimulation

    The physicians at Blue Ridge Pain Management are the only physicians in Southwest Virginia who are certified to use dorsal root ganglion stimulation. This cutting edge technology provides a giant leap forward. Spinal cord stimulators are implanted devices that utilize low-intensity electrical pulses to trigger selective nerve fibers to diminish pain from the source.

    To find out more about dorsal root ganglion stimulation, download our fact sheet.




Providers

Anthony L. Dragovich, M.D.

Dr. Anthony Dragovich is a board certified anesthesiologist and pain medicine physician with expert proficiency in the placement of implantable devices and ultrasound guided procedures. Dr. Dragovich performed his anesthesiology residency at Walter Reed Army Medical Center … Read More

George Montgomery Baylor, M.D.

Dr. George Montgomery “Monty” Baylor is a board certified anesthesiologist and pain management physician with a wealth of experience with advanced interventional therapies. Dr. Baylor completed his medical school training at Marshall University School of Medicine.  … Read More

Marc A. Swanson, M.D.

Dr. Marc Swanson has been a pillar of the Roanoke Valley for the past 23 years.  He is board certified in both Anesthesiology and Pain Management.  He practices holistic pain medicine with a focus on … Read More

Laura Davis, PA-C

Mrs. Laura Davis is a caring, compassionate Physician Assistant who has practiced pain medicine for the past six years. She was born in Ohio and completed her undergraduate work at Wright State University.  Her acceptance to … Read More

Dana Hurt, PA-C

Ms. Dana Hurt is an area native who feels fortunate to be able to give back to her beloved community. She was born in Bedford and has completed her education in the local region.  She attended … Read More