Information on chronic pain and addicton

Christopher Frandrup, M.D., DABPM, FIPP

Category: Treatment (Page 1 of 3)

Ketamine Therapy

Ketamine infusions may be effective for various pain conditions such as neuropathic pain, complex regional pain syndrome (CRPS), migraines, fibromyalgia, post-herpetic neuralgia and spinal cord injury. Ketamine was first used in 1966 as an anesthetic and recently interest in its properties has been growing.  Ketamine is what is known as an N-methyl-D-aspartic acid (NMDA) receptor antagonist.  The activity of this receptor can be altered in various conditions such as chronic pain, depression and PTSD. 

Ketamine is a potent anesthetic, but the anesthetic effects are short-lived. In low doses it is tremendously effective in reducing pain.  In high doses, ketamine can cause euphoria and hallucinations which has popularized its recreational use. The long-term benefits from ketamine derive from the way it changes activity in the spinal cord and brain to reduce nerve activity activated by disease states.  Chronic pain and depression are often interlinked.  Individuals suffering from chronic pain often become depressed.  On the other hand, we know if you suffer from depression, you are more prone to chronic pain as well.  It is estimated that between 50-75% of chronic pain patients have depression.  Ketamine is one of a few treatments targeting both aspects of this problem.  When used for depression, it is recommend the diagnosis of depression be confirmed by a physician.  In addition, you should first try antidepressant medication before resorting to ketamine infusions.  Antidepressants generally take weeks to work for depression.  What is remarkable about ketamine is the immediacy of the antidepressant effects.  When it works, it takes only hours instead of weeks!  Ketamine works differently than traditional antidepressants and can therefore be especially beneficial to those who have not responded to antidepressants. 

Ketamine is widely used to treat acute pain, especially following surgery.  In low doses, ketamine can reduce post operative pain and reduce the need for strong narcotics by 40% with very little side effects.  We now know uncontrolled acute pain can lead to chronic pain.    If you have had a major operation recently, you may have been given ketamine as part of your anesthetic.   The successful use of ketamine in the operating room has lead to surge in use for chronic pain as well. 

Ketamine can be administered through many different routes. Most commonly, ketamine is delivered through an intravenous (IV) pump. Sometimes, patients will ingest ketamine orally as a pill. Ketamine can also be applied directly to the skin as a topical gel or cream, inhaled through the nose, or injected into a muscle or bone.

Patients with chronic pain have been successfully treated with intravenous or intranasal ketamine.   Those responding to treatment have seen the following results:

▪ reduced pain

▪ improved depression

▪ more hopeful

▪ improved interpersonal relationships

▪ more relaxed

At Allpria Healthcare, we use ketamine a possible treatment option to treat various chronic pain disorders and depression.  Therapy is individually tailored to your needs and our professional office staff provides a safe and comfortable experience for the infusion.  The success rates for ketamine therapy vary based on the condition, but more that 70% of patients has a beneficial response.   At low dose the side effects are minimal but may include dizziness, abnormal muscle movements, changes in blood pressure or heart rate, increased salivation, disorientation, nausea, redness or swelling at the IV site, and allergic reactions. These side effects will subside once the infusion stops. Schedule an appointment to discuss if this treatment is right for you.

What Herniated Disc Treatment Works?

What Herniated Disc Treatment Works? |

What Herniated Disc Treatment Works?

Herniated disc is one of the most painful, debilitating lower back pain conditions that a person can experience. The pain caused by herniated disc is different for each person who experiences it and can even change as the condition progresses. Because this condition can be unpredictable, a herniated disc treatment that works can also vary from person to person.

Herniated disc treatment – What is herniated disc?

The spine consists of 33 individual vertebrae, each stacked upon a fluid-filled sac that keeps the bones cushioned from rubbing against each other. This fluid-filled sac is called an intervertebral disc. It is made up of a jelly-like interior (the nucleus pulposus) and the outer layer that contains the nucleus pulposus (the annulus fibrosis). When an intervertebral disc herniation occurs, the outer layer becomes weakened, allowing the nucleus pulposus to leak out. The cushion between the bones is gone, and the result can be very painful.

A herniated disc can be caused by a number of different factors:

  • Time: The continued action and pressure of gravity as people age can begin to wear down the annulus fibrosis.
  • Injury: If the spine is injured (i.e., as a result of a car accident or other trauma to the back), the intervertebral disc may be weakened and begin to leak.
  • Improper use: A sudden, awkward movement such as lifting a heavy object improperly can cause a herniated disc.

Symptoms of a herniated disc are as varied as the condition itself.

  • Pain: Pain location varies depending on which disc is herniated. A herniated disc in the lower back can produce pain in the buttocks, thigh, and calf (and possibly the foot). If the disc is herniated in the neck, pain may be shooting in the arm and shoulder area.
  • Tingling or numbness
  • Weakness

Over time and left untreated, disc herniation can cause permanent nerve damage.

Herniated disc treatment – Risk factors to watch out for

There are several risk factors that increase the likelihood that a person will experience a herniated disc.

  • Age: Because herniated discs can be caused by bone deterioration, older adults have a higher incidence.
  • Genetics: There is a potential hereditary connection to disc herniation.
  • Weight: Being overweight or underweight increases an individual’s risk for developing herniated disc.
  • Lifestyle: Smoking contributes to bone density loss and can increase the spine’s vulnerability to fracture, either from injury or wear-and-tear. Excess consumption of alcohol and prolonged use of steroids can also contribute.
  • Occupation: Occupations that feature repetitive motion and twisting or bending increase a person’s risk of a herniated disc.

Herniated disc treatment – What works?

What herniated disc treatment works varies widely depending on many different factors. These include:

  • Location of the herniation
  • Activity levels
  • Other health conditions
  • Severity of the herniation

For some patients, a course of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) combined with targeted exercise and strengthening may be all that is necessary. Most treatment plans are guided by the following steps.

Step 1: Anti-inflammatory medications

Whether over-the-counter or prescribed, a herniated disc treatment generally begins with a period of anti-inflammatory drugs used to control pain and inflammation. For some patients, this is enough to allow them to begin exercise or other activities to heal the herniated disc.

Step 2: Injections

Epidural steroid injections or nerve blocks may be recommended for those patients who find no relief with NSAIDs. These injections target the affected nerves directly. Steroid injections are anti-inflammatory and offer pain relief but have only been proven effective for approximately 50% of patients. Nerve blocks numb the nerve so that other treatments can begin.

Step 3: Physical therapy or chiropractic care

Because a herniated disc can be the result of decreased space between the vertebrae, doctors may recommend chiropractic care to help lengthen the spine and physical therapy to strengthen the supporting muscles. Physical therapists may design an exercise plan, offer manual therapy, apply hot and cold treatments, or administer electrical stimulation.

Step 4: Surgical options

Surgery is an option that is exercised only after all other options have been tried. If pain and numbness persists, the pain management specialist may recommend a surgical procedure called a discectomy. This procedure removes the herniated material that is pressing on the nerve and causing pain.

For more serious and unresponsive pain due to a herniated disc, the entire disc may need to be removed. This is a rare procedure that also includes inserting metal hardware to connect the remaining vertebrae for stability.

If a patient experiences sudden loss of bowel or bladder control, this is considered a medical emergency that is often addressed with surgery. This condition can become very serious very quickly, and patients should go to the emergency room if this arises.

Prevention before treatment for a herniated disc

As with many lower back pain conditions, the best way to treat a herniated disc is to take steps to prevent it from occurring in the first place. There are ways to keep your lower back safe and healthy.


Regular exercise that focuses on strengthening the abdomen and lower back is the best way to prevent a herniated disc. Rather than spending hours doing crunches, exercises that focus on the whole body are just as valuable. Swimming, standing poses in yoga (including planks), and targeted exercises for the back are excellent ways to help strengthen the muscles that support the spine.

Eat well

A well-balanced diet that includes plenty of calcium and vitamin D-rich foods helps maintain strong muscles to support the spine. A healthy diet also helps maintain an appropriate weight for your frame.

Stop smoking

Among other things, smoking contributes to a loss of bone density that can contribute to spinal fractures and herniated discs. Quitting smoking is one of the best things you can do for your health, with benefits that start just 20 minutes after your last cigarette. It may be difficult, but there are many resources out there to help.

Herniated disc treatment can be as varied as the herniated disc itself. Have you ever experienced herniated disc? What treatments worked for you?

Cortisone Shot In The Knee – What To Expect

Cortisone Shot In The Knee - What To Expect |

Cortisone Shot In The Knee – What To Expect

With any type of machine, the longer you use it, the more stress and strain is placed on its moving parts. This holds true with our bodies as we age. A common feature of aging is osteoarthritis. Osteoarthritis affects our joints and is seen as a “wear and tear” condition that is simply a function of our joints being used repetitively for a long period of time. We feel osteoarthritis most keenly in our weight-bearing joints. Knees in particular can be very painful. There are many different types of treatments for knee pain related to osteoarthritis or other conditions. A common procedure after rest, ice, and non-steroidal anti-inflammatory drugs (NSAIDs) is to get a cortisone shot in the knee. If you are considering a knee joint injection, here’s what to expect.

What is a cortisone shot in the knee?

A cortisone shot in the knee is a minimally-invasive procedure that involves injecting a corticosteroid into the knee. Corticosteroids help to suppress the immune response that is triggering inflammation. This inflammation is caused by the rubbing of bone on bone in the knee joint. Rubbing occurs in the joints as cartilage naturally wears thin over time.

A cortisone shot is just one type of knee joint injection. Others may include hyaluronic acid (HA) or platelet rich plasma (PRP). HA injections are generally aimed at restoring lubrication in the knee joint. PRP works to use the patient’s own red blood cells to repair damage. A cortisone shot in the knee focuses on relieving pain and inflammation specifically.

Conditions treated with a cortisone shot in the knee

Osteoarthritis is the most common source of knee pain, but there are other conditions that can affect this complex joint. Four bones make up the structure of the knee: the patella, fibula, tibia, and femur. Cartilage and ligaments connect all of these bones and keep them stable.

The posterior and anterior cruciate ligaments (the PCL and ACL) connect at the center of the knee joint and help stabilize the knee through rotation. The lateral and medial ligaments also help stabilize and support the joint, while the medical meniscus cartilage provides cushioning.

Damage, injury, or deterioration in any part of this joint can cause knee pain. In addition to pain caused by osteoarthritis, some of the most common pain conditions treated with a cortisone shot in the knee include:

  • Cartilage tear
  • Tendinitis
  • Bursitis
  • Gout

Each of these conditions causes inflammation, pain, and limited mobility.

The procedure

Before any treatments occur, a pain management specialist will take a complete medical history. A thorough physical examination that includes range-of-motion tests will be conducted.

In some cases, the doctor may request imaging such as X-ray or MRI to confirm a diagnosis. A cortisone shot in the knee may not be the first treatment offered if the pain is mild and can be managed in other ways.

If a cortisone shot in the knee is recommended, the knee will be thoroughly cleaned and sterilized. A local anesthetic is used most often, but patients may request mild sedation if that is more comfortable.

The pain management specialist uses fluoroscopy (live X-ray) to guide a very thin needle into the joint space of the knee. Proper placement of the injection is important for both patient safety and pain relief. Once located, a corticosteroid is injected into this space.

The entire procedure takes between 15 and 30 minutes. In many cases, pain relief is dramatic and occurs within 24 to 48 hours. Patients need only take minimal time off (usually just the day of the procedure).

Effects from knee cortisone shots

A cortisone shot in the knee is most effective for the first shot, with its pain-relieving effects diminishing slightly with each shot after. The effects of a shot can last from four to six weeks. Results can be improved if other lifestyle and supportive changes are made to manage knee pain.

Cortisone shots will not be injected directly into a tendon. If the pain management specialist believes that an inflamed tendon is the cause of pain, they may choose to place the injection near the tendon instead.

Potential side effects

Although a cortisone shot in the knee is minimally-invasive and non-surgical, there is a slight risk of side effects. Side effects are rare and generally mild. Short-term, less serious side effects can include:

  • Bleeding
  • Swelling, pain, or bruising at the site of the injection
  • Allergic reaction
  • Face flushing
  • Synovium inflammation
  • Insomnia
  • Temporary increase in blood sugar

Over time and with more injections, side effects can become more prevalent and serious. Tendons and cartilage may become weaker. Other long-term side effects of cortisone shots in the knee are:

  • Easy weight gain and puffiness
  • Easy bruising
  • Acne
  • Thinning skin
  • High blood pressure
  • Increased risk of osteoporosis
  • Cataracts
  • Bone damage (avascular necrosis or osteonecrosis)

Is a cortisone shot in the knee effective?

A meta-analysis of high-quality studies in the UK found that a cortisone shot in the knee was effective for relieving inflammation and pain in both the short and long term. The analysis also found that although there is concern for cartilage damage due to the corticosteroids, most cases of damage were due to the underlying disease, not the cortisone shot in the knee.

Another study compared the results of knee injections versus placebo groups and found clinical and statistical evidence that cortisone shots in the knee offered more pain relief at one week than placebo.

Finally, a meta-analysis in 2015 looked at all types of treatments for knee pain and found that a cortisone shot in the knee was the most effective. This meta-analysis included 137 studies with over 33,000 study participants total. The focus was on short-term pain relief, with the reviewers noting that long-term data is not robust enough to include.

In all of the research above, researchers are careful to note that a cortisone shot in the knee may address the symptoms of pain and inflammation in the short-term but underlying causes must be addressed for proper treatment. A knee joint injection may allow pain patients to begin other treatments, such as physical therapy, so that a holistic pain management plan can be implemented.

As with all potential treatments, talking to your doctor is the first step. Have you ever had a cortisone shot in the knee? Was it effective for your knee pain?

What is a drug addiction?

Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services
Drug Facts: Understanding Drug Abuse and Addiction
Many people do not understand why or how other people become addicted to drugs. It is often mistakenly assumed that drug abusers lack moral principles or willpower and that they could stop using drugs simply by choosing to change their behavior. In reality, drug addiction is a complex disease, and quitting takes more than good intentions or a strong will. In fact, because drugs change the brain in ways that foster compulsive drug abuse, quitting is difficult, even for those who are ready to do so. Through scientific advances, we know more about how drugs work in the brain than ever, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and lead productive lives.Drug abuse and addiction have negative consequences for individuals and for society. Estimates of the total overall costs of substance abuse in the United States, including productivity and health- and crime-related costs, exceed $600 billion annually. This includes approximately $193 billion for illicit drugs,1$193 billion for tobacco,2 and $235 billion for alcohol.3 As staggering as these numbers are, they do not fully describe the breadth of destructive public health and safety implications of drug abuse and addiction, such as family disintegration, loss of employment, failure in school, domestic violence, and child abuse.

What Is Drug Addiction?

Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self-control and hamper his or her ability to resist intense impulses to take drugs.Fortunately, treatments are available to help people counter addiction’s powerful disruptive effects. Research shows that combining addiction treatment medications with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse.Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.

What Happens to Your Brain When You Take Drugs?

Drugs contain chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs cause this disruption: (1) by imitating the brain’s natural chemical messengers and (2) by overstimulating the “reward circuit” of the brain.Some drugs (e.g., marijuana and heroin) have a similar structure to chemical messengers called neurotransmitters, which are naturally produced by the brain. This similarity allows the drugs to “fool” the brain’s receptors and activate nerve cells to send abnormal messages.Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters (mainly dopamine) or to prevent the normal recycling of these brain chemicals, which is needed to shut off the signaling between neurons. The result is a brain awash in dopamine, a neurotransmitter present in brain regions that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this reward system, which normally responds to natural behaviors linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to psychoactive drugs. This reaction sets in motion a reinforcing pattern that “teaches” people to repeat the rewarding behavior of abusing drugs.As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. The result is a lessening of dopamine’s impact on the reward circuit, which reduces the abuser’s ability to enjoy not only the drugs but also other events in life that previously brought pleasure. This decrease compels the addicted person to keep abusing drugs in an attempt to bring the dopamine function back to normal, but now larger amounts of the drug are required to achieve the same dopamine high—an effect known as tolerance.Long-term abuse causes changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively despite adverse, even devastating consequences—that is the nature of addiction.

Why Do Some People Become Addicted While Others Do Not?

No single factor can predict whether a person will become addicted to drugs. Risk for addiction is influenced by a combination of factors that include individual biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:

  • Biology. The genes that people are born with—in combination with environmental influences—account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction.
  • Environment. A person’s environment includes many different influences, from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and quality of parenting can greatly influence the occurrence of drug abuse and the escalation to addiction in a person’s life.
  • Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to more serious abuse, which poses a special challenge to adolescents. Because areas in their brains that govern decision making, judgment, and self-control are still developing, adolescents may be especially prone to risk-taking behaviors, including trying drugs of abuse.

Prevention Is the Key

Drug addiction is a preventable disease. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective in reducing drug abuse. Although many events and cultural factors affect drug abuse trends, when youths perceive drug abuse as harmful, they reduce their drug taking. Thus, education and outreach are key in helping youth and the general public understand the risks of drug abuse. Teachers, parents, and medical and public health professionals must keep sending the message that drug addiction can be prevented if one never abuses drugs.


  1. National Drug Intelligence Center (2011). The Economic Impact of Illicit Drug Use on American Society.Washington D.C.: United States Department of Justice. Available at:, 2.4MB)
  2. Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report. Available at: (PDF 1.4MB).
  3. Rehm, J., Mathers, C., Popova, S., Thavorncharoensap, M., Teerawattananon Y., Patra, J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet, 373(9682):2223–2233, 2009.

Radio Frequency Lesioning

What Is Radiofrequency Lesioning?

Millions of adults in the United States suffer from various types of chronic pain conditions. The pain associated with these conditions can be severe and can have a detrimental impact to an individual’s personal and professional lives. Additionally, chronic pain has a significant impact on the U.S. economy, resulting in increased healthcare utilization, including rehabilitation and decreased worker productivity.Pain-Doctor-Epidural-Steroid-Injection-Procedure-5Patients suffering with chronic pain are often treated with a combination of medication, physical therapy, as well as epidural steroid injections and other conservative treatment options. However, not all patients experience pain relief from these treatment methods. Radiofrequency lesioning is a minimally invasive procedure that may be used to treat chronic pain that has been unresponsive to conservative measures. Radiofrequency lesioning uses heat to effectively destroy the sensory nerve endings that are believed to be the source of pain. By destroying the nerve endings, pain and other related symptoms are reduced following treatment.Before recommending radiofrequency ablation, diagnostic local anesthetic nerve blocks need to be performed to ensure that the patient is an ideal candidate. A diagnostic nerve block involves injecting a local anesthetic into the area of the nerve that is believed to be causing the patient’s pain. The local anesthetic essentially temporarily numbs the area and should result in reduced pain symptoms. The effectiveness of radiofrequency lesioning can be predicted from a patient’s response to the temporary nerve block procedure.

How Is Radiofrequency Lesioning Performed?

Cervical-Radiofrequency-Ablation-Procedure-6A radiofrequency lesioning procedure is performed in an outpatient setting. Generally, radiofrequency lesioning procedures take approximately 30 to 60 minutes to complete.The nerve supply to the painful structure is targeted during a radiofrequency lesioning procedure. A small needle or radiofrequency cannula is positioned next to the targeted nerves using fluoroscopic guidance. Once the needle is in place, small currents are applied to ensure proper needle placement. Once the proper placement of the needle or cannula is confirmed, a local anesthetic is injected to numb the area. The radiofrequency generator is then utilized which delivers an electrical current that produces radiowaves. These radiowaves heat the targeted nerve ending for up to 90 seconds, which results in destruction of the targeted nerve. The needle is then removed and the procedure is complete.

Pain-Doctor-Radiofrequency-Ablation-Procedure-8After the procedure, patients may experience discomfort around the needle placement site, which usually subsides within a few days. Occasionally, patients may experience temporary burning or numbness, which usually subsides within a few weeks.The risks associated with radiofrequency lesioning include: bleeding, infection, or allergic reaction to the local anesthetic used during the procedure. Rare side effects include: nerve damage, which may lead to permanent altered sensations including numbness, burning, tingling, and possibly extremity weakness.

Radiofrequency lesioning procedures generally provide long-term pain relief; however, the pain pathways may regenerate over time. Therefore, it is possible that the procedure may need to be repeated.

Conditions Related To Radiofrequency Lesioning

There are various conditions that may be successfully treated with radiofrequency lesioning, including:

  • Facet joint pain
  • Discogenic pain
  • Coccydodynia
  • Sympathetically mediated pain

facet joint syndromeFacet joint pain is one of the most common causes of chronic spinal pain.  Radiofrequency lesioning of the medial branch of the posterior primary ramus can denervate the facet joint and effectively provide long-term pain relief for some patients. Successful radiofrequency lesioning for patients suffering with facet joint pain typically lasts for more than a year.Spinal pain that is arising from the intervertebral discs of the spine is another common source of pain, commonly referred to as discogenic pain. Once the painful disc is identified radiofrequency lesioning can be used to partially denervate the intervertebral disc, by either lesioning the rami communicans, or by using intradiscal denervation techniques. The use of radiofrequency lesioning is contraindicated if there is a disc herniation that is causing nerve impingement, if there is disc disease at multiple spinal levels, or if there is advanced degenerative disc disease.

Coccydodynia (tailbone pain) that is the result of organic causes can be treated by radiofrequency lesioning of the coccygeal nerve or the ganglion impar. Prior to using radiofrequency lesioning, a minimum of two blocks are performed to confirm that the pain is organic in nature.

Pain that is transmitted by the sympathetic nerves may be treated using radiofrequency lesioning by lesioning the sympathetic chain at the spinal level or at the stellate ganglion. This results in an interruption of nerve signal transmission.

Additional radiofrequency lesioning can be used to treat trigeminal neuralgia by thermocoagulation of the Gasserian ganglion. It can also be used to treat nociceptive radicular pain by partial rhizotomy of the dorsal root ganglion. Furthermore, it can be utilized to treat cancer pain by lesioning the sphenopalatine ganglion and stereotactic cordotomy.


Cervical-Radiofrequency-Ablation-Procedure-3Millions of adults suffer from chronic pain conditions in the United States. Patients suffering from these conditions not only experience physical symptoms, they often also suffer emotionally and physically if their pain cannot be effectively managed. Radiofrequency lesioning is a minimally invasive method that can be used to effectively treat pain that has been unresponsive to conservative treatment options.The nerves that are believed to be responsible for causing pain are targeted during a radiofrequency lesioning procedure.

The targeted nerves are destroyed by the application of heat. Radiofrequency lesioning can be used to treat a variety of conditions including facet joint pain, discogenic pain, tailbone pain, and sympathetically mediated pain.

Radiofrequency lesioning is generally safe; however, as with any surgical procedure, there are minimal risks involved including mild injection site soreness, bleeding, infection, and temporary altered sensation in the extremities.

Serious side effects are very rare. Patients suffering from unresponsive spinal pain should discuss the possibly of radiofrequency lesioning with their physician, as it may provide effective, long-term relief of their symptoms.


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  3. Kawaguchi M, Hashizume K, Iwata T, Furuya H. Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of hip joint pain. Regional Anesthesia & Pain Medicine. 2001;26(6):576-581.
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  5. Nagda JV, Davis CW, Bajawa ZH, Simopoulos TT. Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain.Pain Physician. 2001;14(4):371-376.
  6. Oh WS, Shim JC. A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain. Clinical Journal of Pain. 2004;20(1):55-60.
  7. org. American Academy of Pain Medicine – Get The Facts on Pain. 2015.

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