Pain Management Techniques Bring Relief

Minimal, interventional treatments restore function, mobility.

Created with pieces torn from magazines, the collage of Audrey Hepburn that Gina Rooney fashioned in her spare time last year was recently purchased by a private buyer. For other potential buyers, there’s more where that came from.

“I’ve created several collages,” Gina explains. “I’ve done a couple of Audrey Hepburn and I also did one of Jackie Kennedy and one of Marilyn Monroe. They’re all in my home art studio, but one day I hope to show them as part of a collection. That’s my dream.”

It’s not her only dream. For a decade, Gina, 49, has dreamed of a life void of the crippling pain she’s had to deal with since a surgical procedure aimed at repairing a bothersome neck issue went horribly wrong.

“I go in and say, Make me feel better, and Dr. Khalaf does that.” - Gina

“I go in and say, Make me feel better, and Dr. Khalaf does that.” – Gina

 

The surgery was a discectomy and fusion of two herniated cervical discs. During the procedure, the discs were replaced with cadaver bones and a plate. The problem is that the hardware has been pressing on Gina’s spinal cord. As a result, her spinal cord atrophied. 

The damage cannot be corrected, and because Gina has yet to find a surgeon who will take on the challenge of replacing the hardware, she has been forced to live with the excruciating consequences.

“It’s mostly neuropathy that I’m dealing with, and I feel it in all my limbs – numbness, tingling, pain, the whole nine yards,” Gina laments. “It was so bad a few years ago that I had to give up my job because of it.

“I was a hairdresser, and I couldn’t stand all day because I felt that pain and tingling in my legs and feet so much. Even something like blow-drying someone’s hair, there’s a lot of repetitive motion in that, and that was just agonizing.

“I’d be in tears after doing something like that, but the odd thing is, the more active I am, the less pain I have because I’m not focused on it. That’s why I do my artwork. It’s part of my mental therapy.”

Gina’s pain was so great that prior to becoming a hairdresser, she was forced to leave a job as a veterinary assistant. She now works as the manager of a retail store. Were it not for Majid R. Khalaf, MD, she probably wouldn’t be able to do that either.

Block and Tackle 

Dr. Khalaf is an interventional pain management specialist and founder of Spine & Joint Treatment Center, where he specializes in minimal and interventional treatments and procedures for pain.

Gina went to see Dr. Khalaf about four years ago on the recommendation of a friend.

“When Gina first came to me, she was in a great deal of discomfort,” Dr. Khalaf remembers. “She said to me, If you can decrease my pain just a little bit, enough so that I can keep working and be able to survive, I’ll be OK with that.

“So, I adopted her as a patient, and I was very frank with her. I said, I’ll do everything I can to help you, but I can’t promise anything because I can’t reverse the damage to your spinal cord. But I can help you with some of your pain so let’s do that, and she agreed.”

After a thorough examination and review of Gina’s MRI, Dr. Khalaf determined that by using a variety of treatments he could alleviate a great deal of the pain Gina was experiencing in her neck, lower back, legs and feet.

Dr. Khalaf began with a series of cervical nerve blocks, which are the injections of an anesthetic into a nerve. If the procedure relieves the pain, the doctor knows that nerve is the source and a target for a longer-lasting treatment, such as radiofrequency ablation.

The nerve blocks on Gina worked, so Dr. Khalaf performed an ablation. Delivered through a probe to targeted nerves, these treatments use radio waves to produce heat that creates a spot on the nerve that impedes the transmission of pain signals to the brain. 

“The heat creates something like a disruption on the highway that the pain travels along,” Dr. Khalaf explains. “The disruption keeps the pain from running from one end of the highway to the other and provides pain relief for a period of time.”

The period of pain disruption lasts for anywhere from six months to a year, but the procedure can be repeated, so Dr. Khalaf treats Gina’s cervical nerve pain as needed, about once every six or nine months. Her care doesn’t end there, though.

In addition to treating her cervical neck pain, Dr. Khalaf treats pain in Gina’s back. He does this with transforaminal epidural injections, which are designed to alleviate pain by treating the roots of irritated nerves in the spine.

During this procedure, the epidural space is accessed from the side of the body rather than the back. This allows the physician to target particular nerve roots with a medicinal cocktail that leads to better, lasting results.

A Deeper Dive 

According to studies, the long-term success rate with transforaminal epidural injections runs between 71 and 84 percent. Dr. Khalaf achieved those rates in treating Gina, who also receives radio-frequency ablation treatments on her back.

“Gina visits us on an as-needed basis, and one of the problems she has is that she struggles to hold her neck up because of the damage to her spinal cord,” Dr. Khalaf notes. “For that we sometimes do a deeper procedure called a trigger point injection.”

Also known as a TPI, a trigger point injection is used to treat fibromyalgia and painful knots of muscle in the arms, legs, lower back and neck. By injecting a small amount of anesthetic and steroid into areas called trigger points, the pain is relieved.

With Gina, Dr. Khalaf discovered that trigger point injections delivered to both sides of her neck alleviate spasms and tension in the trapezius muscles, which run from the neck to the upper back and are used to move the head and shoulder blades.

“All the treatments we’ve provided have given her a lot of relief,” Dr. Khalaf says. “I think the best way to put it is that we’ve got her functioning normally again. We’ve been able to put a smile on her face and improve her life a little bit.”

Gina says Dr. Khalaf and his treatments have improved her life immensely.

“Everybody deals with pain of some sort,” Gina reasons. “And I know that I am always going to have pain. But what Dr. Khalaf has done for me is allow me to function and give me back my mobility. That’s why I never miss an appointment with him.

“I go in and say, Make me feel better, and Dr. Khalaf does that for me. The treatments work, and I know that if I didn’t go to see him, I would be paying for it, so I can’t tell you how much I appreciate what he does for me.

“Not only does Dr. Khalaf make me feel better and help me with my pain, but he’s such a nice person. Between him and his office staff, you couldn’t ask for anyone better. They treat you like a person, not like a number or an insurance claim.”

© FHCN article by Roy Cummings. Photo courtesy of Gina Rooney. mkb
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