San Diego Pain Management Doctors - Perlman Clinic

Pain Management in San Diego

Interventional pain management is a sub-specialty of medicine that uses injections and minimally invasive techniques to diagnose and treat painful conditions. Not all pain is the same, which is why it is important to consult your primary care physician to identify the best pain management plan for you.

Pain is categorized as acute or chronic pain. Pain associated with broken bones, labor, a cut or surgery are examples of acute pain. Acute pain can be mild or last for several weeks or up to six months and typically resolves with proper treatment. If gone untreated, acute pain can develop into chronic pain. Chronic pain generally describes pain lasting longer than three months and possibly for years. Long-term cancer pain, lower back pain, headaches and arthritis pain are examples of chronic pain. Consequences of chronic pain include lethargy, muscle tightness, and emotional/mental health changes, such as depression or anxiety, and changes in your quality of life.

If acute pain or chronic pain is affecting your quality of life, consult your primary care provider. At Perlman Clinic your provider will address the source of your pain and, if necessary, refer you to our Interventional Pain Management team.

How does Perlman Clinic approach pain management?

Brandon Van Noord, M.D., a Board Certified Anesthesiologist specializing in Pain Management, heads our pain management team.

Our pain management team is able to treat both acute and chronic nociceptive pain (caused by something similar to a cut or broken bone) and neuropathic pain (pain caused by damage or disease that affects the nervous system). During your visit, we will conduct a full history and physical examination, where our providers will aim to determine what is causing your pain and develop a personalized treatment plan. We offer comprehensive pain management solutions for:

  • Radicular pain
  • Somatic pain
  • Pain due to sport or injury
  • Post-surgical pain
  • Secondary pan due to acute or chronic illness and treatment of illness
  • Complex regional pain syndrome
  • Sympathetically maintained pain
  • Fibromyalgia
  • Interstitial cystitis
  • Myofascial pain
  • Chronic, daily or reoccurring migraines
  • Peripheral nerve pain

Once diagnosed, our physicians offer a variety of treatment options:

  • Interventional procedures
  • Medication management
  • Physical therapy or chiropractic therapy
  • Psychological counseling and support
  • Acupuncture and other alternative therapies
  • Referral to other medical specialists

Finally, we are able perform a range of diagnostic and therapeutic injections in both out-patient and in-office settings, including:

  • Epidural steroid injections
  • Facet joint injections
  • Medial facet block
  • Spinal cord stimulation
  • Diagnostic nerve blocks
  • Platelet rich plasma therapy
  • Radiofrequency ablation
  • Rhizotomy
  • Trigger point injections
  • Sympathetic plexus blocks
  • Spinal cord stimulator trial / implantation
  • Intrathecal pump trial / implant / refill

Common Pain Management Treatment Options:

Transcutaneous Electrical Nerve Stimulation (TENS)

Transcutaneous electrical nerve stimulation is a medical therapy that uses low-voltage electrical currents for pain management and relief. The TENS device is a compact, batterypowered machine that connects two electrodes to the area of pain on your skin. The electrical currents stimulate nerve fibers and interfere with normal pain signals, alleviating pain. It is also believed that the electrical impulses induce the secretion of endorphins, which are the bodies natural painkillers. TENS is most commonly used for muscle, joint or bone pain associated with conditions such as fibromyalgia or osteoarthritis and for acute chronic pain management such as labor or cancer pain. TENS is a safe treatment and can be conducted in the privacy of your home. It is important to consult your physician to show you how to use the device before administering treatment yourself.

Nerve Blocks

Nerve blocks are another common pain management treatment. Pain is caused by a group of nerves called the ganglion or plexus, which cause localized pain to an organ or part of the body. Nerve blocks are a nerve-numbing medicine that blocks pain signals. Nerve blocks are injected into the region of the body experiencing pain. Nerve blocks can be used for a variety of medical reasons, including therapeutic treatment, diagnosis, prognostics and preemptive aims. Therapeutic nerve blocks can be administered for pain management, diagnostic nerve blocks can be used to identify causes of pain, prognostic nerve blocks can be used to determine optimal pain management treatment plans and preemptive nerve blocks are used to prevent pain associated with, for example, a medical procedure.

Opiate-derived medications

In some cases, synthetic opiate mediation is necessary for pain relieve and management. Opiates, for example morphine, codeine, heroin or opium, are highly addictive drugs and must be used and administered responsibly. Opiates are derived from opiate poppy seeds which contain pain relieving compounds called alkaloids. Medicinal opiates come in three varieties, natural, synthetic or semisynthetic opioid drugs. Natural opiates come directly from the reside of opium poppy. Synthetic and semisynthetic opiates, like hydrocodone and oxycodone, are synthesized in a laboratory and not found in nature. Synthetic opiates are stronger than natural opium.