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Tratamiento del dolor
En Sacramento

¿Es usted uno de los millones de personas que sufren dolor crónico?

According to the Centers for Disease Control and Prevention (CDC) over 50 million adults in the United States suffer from chronic pain, with 20 million having pain that is considered “high-impact” meaning the pain interferes with their lives every day.

We understand the complexity of chronic pain, and we have dedicated ourselves to empowering lives with advanced pain management and pain treatment in Sacramento. With a patient-centric approach, our team offers multi-specialty care that is individually tailored depending on the cause of the pain, and how the pain affects the patient. From medications to surgical and non-surgical treatment of pain, trust us to guide you toward a pain-free tomorrow.

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How Do We Treat Pain?

Pain management doctors are highly-trained specialists  who can evaluate, diagnose, and treat different kinds of pain (acute, chronic, high-impact chronic, etc.). From headaches to chronic low back pain to neuropathy, pain management specialists are are highly trained physicians and midlevel providers who are experts in the treatment of a wide range of pain conditions. With a patient-centric approach, our pain management team offers diverse pain treatments beyond medications.

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To treat pain well, we need to classify the type of pain and its cause.  There are different categories of pain, depending on the severity, location, cause, and duration. To assist in accurate diagnosis and treatment, they can be classified as:

  • Acute pain — sudden onset pain which may last for a short duration and often resolves without intervention by a pain specialist. Could be caused by trauma, or an overuse injury.

  • Chronic pain — will often begin as acute pain but persists. This could be due to disc degeneration of the spine, arthritis, back pain, neck pain, fibromyalgia, previous surgery, diabetes, or many other factors.

  • Nerve pain —  is caused by nerve inflammation, nerve compression, or nerve damage.   Classic example is Sciatica when a spinal nerve root is irritated in or near the spine. Nerve pain can be caused by a multitude of factors: herniated discs, CRPS, injury to the brain, injury to the spinal cord,  diabetes, among others. Nerve pain treatment targets these underlying causes, offering relief through specialized procedures, medications, and physical rehabilitative strategies.

  • Phantom pain — refers to painful sensation perceived in a body part that is no longer present subsequent to surgical or traumatic removal.   Can be treated with specialized injection therapies, medications, spinal cord stimulation.

  • Musculoskeletal pain — is a result of damage to ligaments, tendons, and muscles in conditions such as rotator cuff injury, fibromyalgia, bursitis, etc.

  • Referred pain — the source of the pain is not actually where the pain is felt. For example, during a heart attack, pain can be experienced in the back, neck, left shoulders, and arms.

Distinguishing between the types of pain helps in an accurate diagnosis, which in turn determines the right treatment by a pain management specialist.

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Different Types of Pain Require Different Types of Treatment

In the past, the first line of treatment for chronic pain was the prescription of powerful pain medications. In 2016, after years of recorded painkiller addiction and overdose deaths with a national crisis in opioid abuse, the CDC amended its guidelines for the treatment and management of pain.

A multi-modal, patient centered approach has now replaced the previous treatment of over-reliance on opioid medications. A multi-modal approach includes combing the use of medications, non-surgical interventions, physical therapy, and sometimes minimally invasive surgical procedures to reduce pain and improve function.

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The multi-modal patient centered approach to pain management employed by Dr. Linn and his team may include one or more of the following:

Medications or Pharmacological Interventions:

Medications are often at the foundation of pain treatment. Chosen depending on the type of pain, intensity of the pain and the severity of the symptoms, pain medications can be categorized as:

Prescription drugs

  1. NSAIDs can be prescribed usually after surgery or to treat cancer pain.

  2. Opioid analgesics are sometimes prescribed for short-term pain, such as post-surgery pain.

  3. Adjuvant medications are prescription drugs made for other conditions but are also effective in treating chronic pain.

    1. Select antidepressants are often used to treat chronic pain.

    2. Membrane-stabilizing medications or anti-seizure drugs such as gabapentin or pregabalin are also prescribed to help control pain.

  4. Topical pain relievers such as lidocaine patches, lidocaine creams, and NSAID topical gels are prescription strength medications often used for acute and chronic pain.

  5. A short course of muscle relaxants can be beneficial for musculoskeletal pain.

Non-prescription pain relievers or analgesics

  1. Over-the-counter non-prescription strength analgesics such as aspirin or acetaminophen can relieve pain and stiffness.

  2. OTC Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen also reduce pain.

  3. OTC topical pain relievers such as creams, lotions, and gels can be applied to the skin to relieve pain.

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Non-Surgical Interventions

At times, pharmacological interventions with medicines may not be desired, or may not provide an adequate level of pain relief.  Dr. Linn may recommend different types of injection therapies to help reduce and manage chronic pain. They could include

Injections

  1. Trigger point injections — Trigger point injections or TPIs are given directly into painful muscles. The injection may comprise local anesthetic or corticosteroids in varying combinations. The effects of trigger point injections can last weeks to months, depending on the severity of the condition.

  2. Viscosupplementation — Viscosupplementation is when a lubricating fluid is injected into the joints, typically the knees. This is used to relieve arthritis pain. This treatment may be done along with a prescribed course of pain medications.

  3. Epidural steroid injections — Epidural steroid injections are a mix of anesthetics and steroids, used for sciatica pain, back pain, and neck pain treatment. The medication is injected into the epidural space around the spinal cord to numb the pain signals and reduce the inflammation.

  4. Nerve block injections — Nerve block injections deliver an anesthetic near the specific nerves before they transmit the pain signals from reaching the brain. These injections treat nerve inflammation and can also be used to locate the actual source of the pain.

  5. Radiofrequency ablation — Radiofrequency ablation or RFA is a minimally invasive treatment used to treat multiple types of pain.  It is widely used for, and can provide long-term relief from, low back pain and neck pain that is caused by arthritis.  It can also help with knee, hip, and shoulder pain by inactivating nerve endings that go into those joints.

  6. Spinal cord stimulator — Implanted devices such as a spinal cord stimulator are used to relieve the pain signals communicated through the spinal cord. In this procedure, a spinal cord stimulator is surgically implanted under the skin. This helps to modify or block the pain signals from reaching the brain. The patient remains in control of the device and can turn it on or off without removing the implant.

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Depending on the severity and cause of the pain, Dr Linn generally approach the treatment as follows:

  1. Acute pain — Usually treated mainly with OTC or prescription pain medication, non-opioids, physical therapy, heat therapy

  2. Chronic pain — Often treated with select pain medication, physical therapy,  procedures such as viscosupplementation, nerve injections, TENS, radiofrequency ablation, as well as implantation of spinal stimulators.

  3. Breakthrough pain — Usually treated with strong, fast-acting prescription pain medication, as well as holistic treatment options are used.

  4. Nerve pain — Mild to moderate pain can usually be treated with nerve blockers, sometimes spinal cord stimulation.

  5. Phantom pain — Usually treated with prescription medications or alternative therapies. In some cases, a spinal cord stimulator may be indicated.

  6. Muscle pain — Usually treated with OTC pain relievers and physical therapy, sometimes trigger point injections.

Referred pain — Apart from OTC pain relievers to relieve the immediate pain sensations, injection therapies may be beneficial.

Preguntas frecuentes

What are the benefits of interventional pain management over medication?

   - Unlike medication which may only provide temporary relief and come with potential side effects, interventional pain management targets the source of pain more directly, often providing longer-lasting relief with fewer systemic effects.

 

Are interventional pain management procedures safe?

   - Yes, interventional pain management procedures are generally considered safe when performed by trained and experienced medical professionals. As with any medical procedure, there are risks involved, but these are typically minimal and outweighed by the potential benefits.

 

How long do the effects of interventional pain management procedures last?

   - The duration of pain relief varies depending on the individual, the specific procedure performed, and the underlying condition being treated. Some patients experience relief for weeks to months, while others may find relief to be more long-term.

 

Will I need multiple treatments?

   - The number of treatments needed varies depending on the severity of your condition and how well you respond to the initial treatment. Some patients may require only one procedure, while others may benefit from a series of treatments to achieve optimal relief.

 

Is there downtime after interventional pain management procedures?

   - Most interventional pain management procedures are minimally invasive and require little to no downtime. You may experience some soreness or mild discomfort at the injection site, but you should be able to resume normal activities shortly after the procedure.

 

Will my insurance cover interventional pain management procedures?

   - Coverage for interventional pain management procedures varies depending on your insurance provider and policy. It's important to check with your insurance company beforehand to understand what is covered and what out-of-pocket expenses you may incur.

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How long does it take to see results from pain management treatments?   

   - The timeframe for experiencing relief from pain management treatments varies depending on the individual and the specific treatment being used. Some patients may experience immediate relief, while others may require multiple sessions or weeks to notice significant improvement. Our team will work closely with you to monitor your progress and adjust your treatment plan as needed to achieve the best possible outcome.

 

Are your pain management treatments covered by insurance?

   - Most of our pain management treatments are covered by insurance plans, but coverage can vary depending on your specific plan and the treatments recommended by your physician. Our knowledgeable staff will work with you to verify your insurance coverage and provide assistance with any questions or concerns you may have about billing and payment options.

 

What are the potential risks and side effects of pain management treatments?   

   - Like any medical intervention, pain management treatments carry some risks and potential side effects. These can vary depending on the type of treatment being used and your individual health status. Before undergoing any treatment, our team will thoroughly discuss the potential risks and benefits with you and address any questions or concerns you may have.
 

What should I bring to my appointment at the pain management clinic?    

   - To ensure a smooth and efficient visit, please bring the following items to your appointment: your photo ID, insurance card(s), a list of current medications (including dosages), any relevant medical records or imaging studies, and a completed patient registration form if you received one in advance. This information will help us better understand your medical history and develop an appropriate treatment plan.

 

How often will I need to come in for appointments?    

   - The frequency of follow-up appointments will depend on your individual treatment plan and response to therapy. Some patients may require regular visits for medication management or other ongoing treatments, while others may need less frequent monitoring once their symptoms are under control. Our team will work with you to determine the appropriate schedule for follow-up care based on your needs and goals.

 

Can I request a specific pain management treatment?

   - We welcome your input and encourage open communication about your treatment preferences and goals. While we consider patient preferences when developing treatment plans, the selection of specific pain management treatments will ultimately be based on your individual needs, medical history, and clinical evaluation. Our team will work collaboratively with you to develop a personalized treatment plan that addresses your unique situation.

 

Are there any lifestyle changes I can make to help manage my pain?

       - Yes, adopting certain lifestyle changes can complement your pain management treatment and improve your overall well-being. This may include maintaining a healthy diet, engaging in regular exercise or physical activity, practicing stress-reduction techniques such as mindfulness or relaxation exercises, getting adequate sleep, and avoiding activities or habits that exacerbate your pain. 

 

What can I do to prepare for interventional pain procedures?

   - Prior to undergoing interventional pain procedures, our team will provide you with specific instructions to help you prepare. This may include temporarily discontinuing certain medications or supplements, arranging for transportation to and from the clinic, and wearing comfortable clothing. We will also discuss any potential risks or side effects associated with the procedure and address any questions or concerns you may have.

 

How long does it take to recover from interventional pain procedures?

   - The recovery time following interventional pain procedures can vary depending on the type of procedure performed and your individual response to treatment. In many cases, patients can resume their normal activities shortly after the procedure, although some may experience mild discomfort or temporary restrictions on certain activities. Our team will provide you with personalized post-procedure instructions and follow-up care to ensure a smooth recovery process.

 

What should I do if I experience worsening pain or new symptoms after treatment?

   - If you experience worsening pain or new symptoms after treatment, it's essential to contact our office promptly for further evaluation and guidance. While some degree of discomfort or transient side effects may be expected after certain treatments, significant or persistent symptoms should be reported to your pain management specialist for assessment and possible.
 

What are the most common interventional pain management procedures?

    - Common procedures include epidural steroid injections, facet joint injections, nerve blocks, radiofrequency ablation, spinal cord stimulation, and intrathecal pump implantation, among others. The choice of procedure depends on the nature and location of your pain.

 

Is interventional pain management suitable for all types of pain?

    - While interventional pain management can effectively treat many types of pain, it may not be appropriate for every individual or condition. Consulting with a pain management specialist can help determine if you are a suitable candidate for these procedures.

 

What are the risks associated with interventional pain management procedures?

    - Although rare, risks associated with interventional pain management procedures may include infection, bleeding, nerve damage, allergic reactions to medications, and temporary increase in pain. Your physician will discuss these risks with you before the procedure.

 

What should I expect during an interventional pain management procedure?

    - Procedures are typically performed on an outpatient basis and may involve imaging guidance such as fluoroscopy or ultrasound to ensure accuracy. Local anesthesia or sedation may be used for comfort, and the entire process usually takes less than an hour.  We have developed individual webpages for many of the procedures we perform, please check the menu above for details.

 

Is interventional pain management suitable for pregnant women?

    - While some interventional pain management procedures may be safe during pregnancy, others are not recommended due to potential risks to the mother and fetus. It's important to discuss any concerns with your obstetrician and pain management specialist.

 

Can interventional pain management help with cancer-related pain?

    - Yes, interventional pain management techniques can be beneficial in managing cancer-related pain, helping to improve quality of life for patients undergoing cancer treatment. These procedures can target specific areas of pain caused by tumors or cancer treatments.

 

What are the success rates of interventional pain management procedures?

    - Success rates vary depending on the procedure performed, the underlying condition being treated, and individual factors such as overall health and response to treatment. Your healthcare provider can discuss expected outcomes based on your specific situation.

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