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Treatment Options for Chronic Pain


By Amy Kennard

If you suffer from chronic pain, you know how much it affects your day-to-day life, restricting certain activities or making them virtually impossible. It can also affect your mental health when you can no longer do the things you enjoy.

According to the Centers for Disease Control and Prevention (CDC), one in five Americans, or about 50 million people, suffers from chronic pain. Of those, about 19.6 million say the pain interferes with their daily lives.

But there is hope. A growing medical specialty called interventional pain management medicine utilizes a variety of therapies and treatments to help relieve or reduce chronic pain.

Touched by Chronic Pain
Dr. Paul Naour and Dr. Jason Michaels are interventional pain management specialists at McLean County Orthopedics (MCO). Like many others in this field, they began their careers as anesthesiologists. But Dr. Naour’s interest in chronic pain started much earlier. “I had a personal experience with a debilitating athletic injury in high school. It wasn’t until I received an epidural steroid injection and started physical therapy that I was able to get some relief. I even wrote a high school term paper titled ‘The Enigma of Chronic Pain.’”

Epidural steroid injections are the most common procedures performed by the pain medicine specialists at MCO. Typically performed in the clinic using X-ray guidance, the physician will inject steroid medication around an inflamed nerve. These injections are most commonly delivered to the low and mid back or neck, and help with pain related to sciatica, herniated discs, slipped vertebrae, joint cysts, and more. “The procedure is performed with sedation or local anesthesia right in our office and takes only minutes,” Dr. Naour explained.

Other treatments for chronic pain include:

Radiofrequency Nerve Ablation
Radiofrequency nerve ablation, also known as RFA, is a technique that uses needles to apply heat around small sensory nerves in order to prevent the ongoing transmission of that pain signal. This procedure is commonly used for arthritic pain involving the neck, low back, or knees. “RFA can provide pain relief for six to 18 months until the sensory nerve slowly grows back,” said Dr. Naour, “then the procedure can be repeated as needed.”

Ultrasound-Guided Procedures
Ultrasound-guided procedures are regularly performed at MCO for pain involving joints, bursa, muscles, and peripheral nerves. “The major advantage of using ultrasound-guidance is that it allows extremely specific placement of medication around the painful source, while avoiding other structures that may be in close proximity to the affected area, such as blood vessels,” explained Dr. Naour.

Spinal Cord Stimulation
Spinal cord stimulation is helpful for patients who have not experienced significant improvement with back surgery or are no longer experiencing lasting benefit from injections. It involves placing a small device within the epidural space that provides electrical pulses to the spinal cord, masking pain signals.

A compression fracture is essentially a collapse of a bony segment in the spine, which can cause severe pain and sometimes lead to a hunched over posture. In a procedure called kyphoplasty, a special cement is placed in the vertebrae to stabilize the bone, restore vertebrae height, and hopefully significantly reduce pain.

For patients with chronic migraines, BOTOX® injections can provide some relief. The physician injects a tiny needle around the head and neck, where chronic migraines normally occur, to prevent them before they start. The procedure takes about 15 minutes and are usually repeated every 12 weeks or so.

Helping People Stay More Active, Longer
The success of interventional pain management doesn’t lie solely with the treatments like the ones mentioned above. “By involving physicians, physical therapy, and even pain psychology, we provide a multi-disciplinary approach to patient care in the most efficient way possible—all right here on site,” explained Naour. “I really believe we have the best musculoskeletal care in the area because we have such a wide range of specialists. We meet with each other on an ongoing basis to collaborate on cases in order to provide the patients the comprehensive care they need to manage pain.”

Dr. Naour foresees the field of interventional pain management growing in the years to come. “Sixty is now the new 30,” he explained. “People want to live better and be more functional longer. For instance, the trajectory for knee replacements in the next 20 years is skyrocketing. People need to take responsibility for their own healthy lifestyles, and there is a lot on the horizon as we continue to develop new and better methods to manage pain and help keep people active.”

McClean County Orthopedics (MCO) is a multi-physician specialty practice located in Bloomington, Illinois. Dr. Jason Michaels and Dr. Paul Naour are both interventional pain management specialists and anesthesiologists who work with other MCO physicians, therapists, and staff to provide patients with comprehensive treatment options for their chronic pain. They are located at 1111 Trinity Lane, Suite 111, Bloomington, IL. Learn more by visiting their website at or by calling (309) 663-6461.