23 Dec Intercostal Nerve Block
There may be some instances in which standard pain interventions such as steroid injections or surgery are not effective enough for the given issue. In this type of situation, the nerves that send pain signals to the brain can be blocked, decreasing pain in the affected area. Common areas for this are neck and middle to the lower back, knee and other large joints.
Typically pain physicians rely on a steroid injection to decrease inflammation, offering several months of relief. However, inflammation in these joints can increase over time, overcoming the effects of the steroids. The doctor could then perform a rhizotomy or neurotomy. A rhizotomy uses electricity to cauterize or heat the nerve to block pain signals. Prior to doing the rhizotomy, a nerve block, also known as a “medical branch block” when used in the neck, back, or thorax, is performed. If the patient confirms this block is effective, the doctor will determine that a rhizotomy can be performed. While a rhizotomy can be done with sensory and/or motor testing, Dr. Neleson prefers to do both to increase the effectiveness and safety of the procedure. This method can result in 6 to 18 months of relief. Downtime for a rhizotomy typically is one day.
Rhizotomies can also be done in other parts of the body, including the shoulder, hip, and knee. If being done on a knee, this procedure can be performed either before or after a knee or joint replacement. However, there have been several incidents in which total knee replacements were done without benefits despite having replaced the joint. Although knee replacements are a practical option, they are not perfect for everyone. Patients may be too young or medically unstable, cannot afford a total knee replacement, or do not have the time to make a full recovery. These are instances in which a knee or geniculate rhizotomy may be a more viable option. Typical time of relief for a geniculate or knee rhizotomy is 3 months
For more information or to see if you would be a good candidate for a rhizotomy procedure, schedule a consultation with Dr. Neleson at one of his two pain management clinics in Sherman or Frisco.