If your pain does not respond to conservative approaches, a second line of therapy may be needed. The therapies offered in the second level can be used in conjunction with level 1 treatment.
Opioids
Opioids are prescription painkillers that block the ability of receptors in the brain to interpret pain signals. Physicians typically prescribe opioids for severe pain conditions that do not respond well to Level 1 treatment. Opioids can be very effective in relieving pain, but they can carry significant side effects, including drowsiness, constipation, dizziness and even potential addiction.
Nerve Blocks
A nerve block is performed by injecting a combination of local anesthetic, steroid, and/or anti-inflammatory agents into the affected area of pain. It is used to lessen the painful signals transmitted by nerves with relief ranging anywhere from a few hours to several months. Nerve blocks may need to be repeated for sustained relief, and may also be needed to give patients enough relief to successfully complete physical or rehabilitation therapy.
Thermal Procedures
Signals traveling along nerves from painful areas to the brain can be disrupted using heat treatments of the nerve delivered through needles. Radiofrequency ablation uses high-frequency energy to heat or cauterize specific nerves. The nerve treatment can last months or even more than a year. The procedure will sometimes need to be repeated when the nerves grow back and start transmitting pain signals again.
