At Wake Forest Baptist Health, we understand the effect that pain can have on a person. Acute pain—like the type following surgery, pinched spinal nerve pain—can hinder the healing process and even lead to other health problems. Chronic pain can impact your day-to-day activities, work and outlook.
That’s why our pain and spine specialists are dedicated to providing effective and safe pain treatment services on both an outpatient and inpatient basis. We serve as a partner for our patients, working closely with you to identify the best pain care techniques for your individual needs.
Pain and Spine Management Services
Our pain and spine specialists provide a variety of advanced interventional, medical and psychological pain and spine specialty services for outpatients.
Our outpatient pain and spine specialists provide advanced interventional and medical pain services for patients with acute, sub-acute and chronic (persistent) pain of spine, musculoskeletal, cancerous, neuropathic and arthritic origin.
Outpatient Pain and Spine Management
For patients with acute, sub-acute or chronic (persistent) pain, Wake Forest Baptist offers effective and rapid outpatient pain and spine specialty services. Our goal is to ensure your safety while helping you live a full life that are not dictated by pain.
What Should I Expect?
During your first appointment, which usually lasts around 30 minutes, your pain and spine specialist physician will work with you to fully understand your pain condition. We will work to diagnosis (find) the problem leading to your pain which can be coming from your muscles, nerves and/or spine.
Please note that no pain medications are initiated at the first consultation visit.
Your initial appointment will include a physical examination. Your doctor may request diagnostic tests, such as X-rays, magnetic resonance imaging (MRI) or computerized tomography (CT) scan, to better understand your condition. If such tests are required, your doctor may provide specific instructions on how to prepare for your appointment.
Next, your physician will work with you to develop a personalized pain and spine management plan. This may include medication, physical or occupational therapy, interventions (procedures) or a combination of approaches. There are circumstances that we may refer you to a spine surgeon for an evaluation for surgery, if needed. We will work with your primary care provider to facilitate your pain and spine management.
Following your initial appointment, follow-up appointments last up to 15 minutes. During these visits, you and our experienced nurse practitioner and/or physician assistant will discuss your pain level and formulate further plans. Our nurse practitioners/physician assistants have >30 years of cumulative pain experience. To further facilitate your needs at the follow-up appointments, be sure to review any changes in your pain level or any concerns with medications.
- Physical Therapy
- Medication Management
- Pain Psychology
- Interventional (Procedural) Treatments
- Epidural procedures (e.g. cervical, thoracic, lumbar, sacral interlaminar and transforaminal epidural steroid injections)
- Radiofrequency nerve destruction (e.g. radiofrequency ablation of medical branch nerves, genicular nerve ablation)
- Radiofrequency bone tumor ablation
- Neuromodulation trial procedures (e.g. spinal cord stimulators)
- Neuromodulation permanent implantation (e.g. peripheral nerve stimulators, spinal cord stimulator, IPG exchange)
- Vertebral augmentation procedures (kyphoplasty, sacroplasty etc)
- Peripheral Joint procedures (e.g. shoulder, hip, knee injection and denervation)
- Spinal Stenosis decompression (e.g. interspinous spacer implantation)
- Intrathecal procedures (e.g tunneled intrathecal catheter placement)
- Intrathecal permanent procedures (e.g. intrathecal pump implantation)
- Intradiscal procedures (e.g. discograms. biaculoplasty)
- Sympathetic nerve/plexus procedures (e.g. stellate ganglion block, celiac plexus)
- Peripheral nerve procedures (e.g. ilioinguinal, lateral femoral cutaneous nerve block)
- Orofacial procedures (e.g. trigeminal nerve block)
Inpatient Surgical Pain Management
For patients who undergo surgery at Wake Forest Baptist, pain management is an important part of the healing process. Our pain team includes physicians, advanced practice providers (nurse practitioners), and nurses who help ensure you are as comfortable as possible with minimal pain.
For post-surgical pain we focus on identifying patients prior to surgery that may have pain that is difficult to manage postoperatively. This may include acute postoperative pain, acute pain related to trauma, acute chronic pain, or chronic pain patients that are admitted to the hospital for conditions not related to their pain diagnosis.
Effective pain management has been shown to help patients heal more quickly and comfortably following a surgery. With less pain, you are more likely to be able to get out of bed, move with ease and do recommended breathing exercises. These simple steps can speed recovery, prevent lung problems, decrease the chance of a blood clot and shorten the overall length of time with pain.
The Post-Anesthesia Care Unit (PACU) serves inpatients following surgery to help manage their pain and encourage healing. The inpatient pain service also serves as a liaison to transition patients from the inpatient setting to the outpatient pain locations.
What Types of Pain Services are Available?
On the day of surgery and during recovery, pain management may involve one of the following methods:
- Continuous epidural analgesia, which are numbing and pain medicines given continuously through a small tube, usually in the middle of the back
- Continuous peripheral nerve block, which are numbing medications administered continuously through a small tube using a portable pump
- IV pain medicines, which are fast-acting medications administered through an intravenous drip. These can act as an effective backup for breakthrough pain
- Pain pills, which are usually stronger and longer-lasting than IV pain medicines
- PCA pump, which is a device that allows a patient to self-administer IV pain medication by pushing a button. This approach is typically used for patients who did not receive general anesthesia
- Peripheral nerve block, which are numbing medications given before surgery that last for many hours after surgery
The pain team works with each patient and surgeon to determine which pain management technique will work best. If you experience any side effects, such as nausea or itching, it’s important to tell the inpatient pain service physicians, advanced practice providers, or nurse, so they can decide if a different technique may be more effective.
Learn more about what to expect before, during and after surgery.