Interventional Pain Treatment

Interventional Pain Management Specialists may put together a regimen of medication and steroid injections to relieve pain. Medication therapy can range from short-term anti-inflammatories to narcotic medication. If you're prescribed narcotic medication as treatment for chronic back pain, you may have to curtail activities such as driving.

The use of interventional pain management may be an option discussed during your appointment. A variety of pain treatment procedures are available at our Northside Hospital Spine Center locations.

Northside Hospital Spine and Pain Treatment Centers are pleased to anounce a new treatment option,MILD, (Minimally Invasive Lumbar Decompression), for patients who suffer pain due to Lumbar Spinal Stenosis (LSS).

Lumbar Spinal Stenosis

Narrowing of the spinal canal which compresses the spinal cord nerves, resulting in pain, stiffness, cramping or heaviness in the legs, buttocks, or lower back, when walking or standing for long periods of time. Pain due to LSS may be relieved when sitting, leaning forward or lying down.

The new MILD procedure is performed under local anesthesia with light sedation. The approach is through a tiny incision, (about the size of a baby aspirin), and does not require stitches – just a bandaid. It removes small amounts of excess tissue thereby reducing the pressure on the spinal cord nerves. The procedure itself usually takes about one hour and most patients go home the same day.

Advantages to MILD:

  • Outpatient procedure, performed in approximately one hour
  • Patient is able to resume light activities within just a few days
  • Requires no general anesthesia, implants, or stitches
  • Low complication risk
  • Study data show that 79% of patients experience significant reduction in pain and significan increase in mobility
  • The technique provides an attractive early option for treatment of LSS pain, but does not limit subsequent invasive procedures if needed

Epidural Steroid Injections

You may need steroid injections in the affected area to reduce inflammation around the disks, nerves and tissues inside the spine to treat pain. Epidural anesthesia involves the insertion of a hollow needle and a small, flexible catheter into the space between the spinal column and outer membrane of the spinal cord (epidural space) in the middle or lower back. The area where the needle will be inserted is numbed with a local anesthetic. Then the needle is inserted and removed after the catheter has passed through it and remains in place. The anesthetic medicine is injected into the catheter to numb the body above and below the point of injection as needed. The catheter is secured on the back so it can be used again if more medicine is needed.

  • How effective is an epidural?
    For many patients, there is immediate relief.
  • How long does the relief last?
    Length of relief varies. Some people get long-term relief from one injection. Other patients require 2 or 3 injections to get significant relief.
  • Is this considered a cure for back pain or sciatica?
    Sometimes epidural steroids interrupt the pain cycle and provide long-term relief. The epidural injection reduces inflammation of the nerves and tissues and allows the nerves to “accommodate” for pressure.

Nerve Block

Spinal anesthesia does not use a catheter but instead the anesthetic medicine is injected using a much smaller needle, directly into the cerebrospinal fluid that surrounds the spinal cord.  Spinal anesthesia numbs the body below the site of the injection or above it also. This depends on the anesthetic dose and the technique used to give it. A spinal catheter may be inserted and left in place for continuous spinal anesthesia. Technically, Selective Nerve Root Block (SNRB) injections are more difficult to perform than epidural steroid injections and should be performed by experienced physicians.

  • When should I expect relief?
    Your pain may be improved immediately after a nerve root block injection. The steroid used in nerve block injections, however, usually takes two or three days to start to have an effect in most people, peaking in about two weeks.
  • How long does the relief last?
    Success rates vary depending on the primary diagnosis and whether or not the injections are being used primarily for diagnosis. While there is no definitive research to dictate the frequency but it is generally considered reasonable to limit SNRB’s to three times per year.

Epidural and spinal anesthesia are usually combined with other medicines that make you relaxed or sleepy (sedatives) or relieve pain (analgesics). These other medicines are often given through a vein (intravenously, IV) or may be injected into the epidural space along with the local anesthetic.

You are monitored carefully when receiving epidural or spinal anesthesia because the anesthetics can affect the central nervous system, cardiovascular system, and respiratory system. Both spinal and epidural anesthesia may significantly affect breathing, heartbeat, and other vital functions.

Radiofrequency Ablation

Cool Radiofrequency ablation is a type of injection procedure in which a heat lesion is created on certain nerves with the goal of interrupting the pain signals to the brain, thus eliminating the facet or sacroiliac joint pain.  An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.    

  • How effective is an Radiofrequency?
    Success rates vary, but typically about 30% to 50% of patients undergoing this procedure will experience significant facet or sacroiliac joint pain relief for as much as two years. Of the remaining patients, about 50% will get some pain relief for a shorter period. Some patients do not experience any relief from facet or sacroiliac joint pain as a result of this procedure.
  • How long does the relief last?
    The degree of pain relief varies, depending on the cause and location of the pain. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years. More than 70% of patients treated with RFA experience pain relief.

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Appointments: (404) 459-1809
Patients will be seen in 24-48 hours whenever possible 


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5670 Peachtree-Dunwoody Rd.
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Atlanta, GA 30342


Northside Hospital - Forsyth
Medical Office Building
1100 Northside-Forsyth Dr.
Suite 400
Cumming, GA 30041
Phone: (770) 844-3200



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