OSF St. Mary Medical Center
The Pain Clinic at OSF St. Mary Medical Center offers non-narcotic treatment of chronic pain by Dr. Afram. He is a pain specialist, trained in the field of anesthesiology that focuses on the diagnosis and management of chronic pain. Dr. Afram performs procedures using steroids injections, nerve blocks, or spinal cord stimulators to decrease pain related to specific regions of the body.
The epidural steroid injection (ESI) is a minimally invasive procedure used to help relieve neck, arm, back and leg pain due to inflamed spinal nerves. X-ray (fluoroscopy) is used to assist in guiding the needle to the location needing treatment, by injection a steroid close to the inflamed area the medicine can help to lower inflammation and thereby reduce pain. The effect of an ESI give temporary relief that can last for days, weeks, or months. The goal in performing an ESI is to decrease pain in order for the patient to resume normal activities.
The facet joints are located on either side of each vertebra “back bone” of the spine. These joint allow the spine to bend and twist. As people age these joint can become arthritic and inflamed causing pain to the neck that radiates into the shoulder or low back pain radiating into the buttocks and upper thighs. Usually this pain is located on one side and involves more than one level. Using x-ray (fluoroscopy) steroids and a small amount of local can be injected directly into the joint or more often the small medial branch nerves that are connected to a specific facet joint. This is a diagnostic test and the injection can last a few hours to few days, at the most. This is normal. This injection is performed as an indicator of success before radiofrequency lesioning of these nerves is considered.
Radiofrequency lesioning is a procedure in which the nerve or nerves identified as transmitting a pain signal to the brain are interrupted to relieve pain. This is a minimally invasive procedure and is performed using a probe that helps identify the nerve location and then is heated to interrupt the pain signal. Before consideration for this procedure the patient must first have a successful block using local anesthetic and steroid of the identified nerve or nerves. Recovery time is short and patients can return to work within 24 -40 hours.
Sacroiliac (SI) Joint Injection
The sacroiliac (SI) joint is located in the pelvis, linking the iliac bone (pelvis) to the sacrum (lowest part of the spine above the tailbone). This joint transfers weight between your upper body and legs and is essential during walking. Dysfunction in the sacroiliac joint presents as low back and/or leg pain. The leg pain can be particularly difficult, and may feel similar to sciatica or pain caused by a lumbar disc herniation. X-ray (fluoroscopy) is used to guide the needle into the joint at which time local anesthetic and a steroid are injected.
Trigger Point Injections
A trigger point is a “knot” that is formed when bands of muscle become tight. This condition causes intense discomfort and can restrict movement. Trigger points most commonly develop in the neck, lower back, arms, and legs. Immediate relief of pain can be done by injecting the trigger point using local anesthetic and a steroid.
A bursa is a fluid-filled sac that the body uses to countering friction at a joint. When the
bursa becomes inflamed it is known as a condition called bursitis which can make movement of the joint painful. The most commonly effected joints are the hip and shoulder. If this inflammation does not respond to conservative treatment as steroid can be injection to reduce the inflammation quickly.
This type of injection is used to target problems with the sympathetic nerves that spread out from the spine to different parts of your body. These nerves control involuntary bodily functions including blood flow, digestion, and sweating. The location of your pain determines location of the injection and which nerves will be blocked. Many times this injection is used for a condition known as complex Regional Pain Syndrome also called Reflex Sympathetic Dystrophy.
To make an appointment with the pain clinic please have your physician contact us and send any medical record discussing your pain status, list of medications, any diagnostic imaging (x-ray, MRI or CT), and EMG.