Hayes Pain Management Center
The Solution to Chronic Pain
610-633-6814
Treatments
One of the main reasons that available treatments for chronic pain do not work is that medical schools and training programs for graduate physicians educate physicians to focus on acute pain ( acute pain is a reflex that often tells our body to remove itself from a dangerous situation). For example, if your hand touches a hot stove, reflexively your brain advises you to take your hand out of the fire to prevent a third degree burn. Acute pain is often associated with acute back strains or sprains and usually lasts less than three months.
Chronic pain is classified as pain that lasts for more than three months, and many times, this can be pain that lasts for years. It is very complex and involves a much more complicated series of nerves and neuromodulators than acute pain does. Consequently, therapies need to be focused on dealing with chronic pain pathways.
The Hayes Pain Management Center focuses on treatments that will work for chronic pain to improve a patient's quality of life and to bring a patient back to an acceptable lifestyle.
Select one of our treatment options below for more information.
PENS Treatment
Dr. Hayes is specially trained, qualified, and licensed to perform a special type of physical medicine treatment for chronic pain syndromes. It is called Craig PENS Treatment, and it is very effective for treating chronic pain especially of the cervical spine and low back. It is also very useful for treating pain of the sciatica, migraine headaches, arthritis, complex regional pain syndrome, and RSD. This technique uses very fine, sterilized acupuncture needles which are essentially painless with no bleeding or risk of infection (as opposed to traditional hypodermic needles which cause more pain and bleeding). The needles are placed based upon the location of nerves involved in the patient's pain syndrome as opposed to traditional acupuncture where the needles are placed in meridians or energy channels often far from the site of pain. Utilizing this technique, Dr. Hayes has an 80 to 85 percent positive response rate in improving sciatica and low back pain. There is virtually no risk or side effects to this treatment.
With PENS Treatment, the needles are stimulated with battery operated stimulators at very specific frequencies. Treatments last anywhere from 20 to 30 minutes; some patients respond positively between six and ten treatments.
Dr. Hayes is one of the few doctors in Pennsylvania who uses this technique. This particular treatment must be performed by a health care provider who is licensed as both a licensed physician and as an acupuncturist. If you have any further questions regarding Craig PENS, you can log on to www.craigpens.com or speak to Dr. Hayes personally.
TRIGGER POINT THERAPY
TRIGGER POINT THERAPY is very often used along with the Craig PENS Treatment. Chronic myofascial spasm can be treated effectively by the release of tender nodules within tight muscle groups. These are where nerves innervate the muscles. Traditional trigger point therapy uses hypodermic needles where medications such as steroids or local nerve blockers are inserted to deactivate the nerve and release the muscle. However, a much safer method is used at HPMC. Dr. Hayes uses very thin acupuncture needles which can be painlessly inserted into the trigger point. With gentle and painless manipulation, the same effect can be achieved. The advantages are that there are no side effects, and there is less incidence of bleeding and infection. Furthermore, the treatments can be performed indefinitely and much more frequently until the problem is resolved. Manual therapy is very often more effective after dry trigger point therapy.
MANUAL MANIPULATIVE THERAPY
Manual Manipulative Therapy is not only effective as a stand-alone, therapeutic modality but enhances the effect of Craig PENS Treatment and/or dry trigger point therapy. This is not a massage but a very sophisticated method of applying hands on force to the human body by a qualified physician. With this therapy, the physician gives therapeutic application of manually guided forces to improve physiological functions, decrease pain, and improve homeostasis (restore the body to normal). Most frequently, the qualified trained physician addresses somatic dysfunction which means impaired or abnormally altered functions of the musculoskeletal system, joints, connective tissues, and even vascular, lymphatic, and neuroelements. In qualified hands, the positive outcomes are extraordinary and have minimal if non-existent risks or adverse effects.
Acupuncture
Acupuncture is a method of encouraging the body to promote natural healing and to improve functioning. This is done by inserting sterile disposable needles and applying heat or very mild electostimulation at very precise acupuncture points.
How Acupuncture Works
The classical Chinese explanation is that the channels of energy "QI" (pronounced "chee" ) run in regular patterns throughout the body and over its surface. These patterns called meridians are like rivers flowing through the body to irrigate and nourish the tissues. An obstruction in the movement of these energy rivers is like a dam that backs up a flow in one part of the body and restricts it in others.
The meridians can be influenced by needling the acupuncture points. The acupuncture needles unblock the obstruction at the dam and re-establish the regular flow through the meridians. Acupuncture treatments can help the body's internal organs to correct imbalances in their digestion, absorption, energy production, activities, and circulation of energy throughout the meridians.
Medications
There are many medications available to treat chronic pain including non-steroidal anti-inflammatories (referred to as NSAIDS such as Aleve and Ibuprofen), aspirin, Tylenol, analgesics including opiates and non-opiates, antidepressants, and a special class of drugs referred to as neuroleptics such as Neurontin, Topamax, and Lyrica. In some cases, pharmaceutical management is appropriate in managing chronic pain. Most medications come with short-term and or long-term side effects which is the reason why Dr. Hayes prefers to use PENS treatment and/or acupuncture which is virtually risk free.
However, in those cases where it is appropriate to use pharmaceutical management, Dr. Hayes may include that in the patient's treatment plan. He will work in concert with your personal physician. This will be discussed in detail at the conclusion of the initial intake session.
Addiction Medicine
There are patients who have been on opioids or opiates such as Vicodin, Loricet, Percocet, OxyIR, Oxycontin, Kadian, Avinza, and Fentanyl patches and have developed a dependence on these medications and wish to be tapered down. Dr. Hayes, in concert with their personal physician, can manage the pain of these patients with PENS and/or acupuncture while tapering their dose. Dr. Hayes has a waiver from the DEA (Drug Enforcement Agency) to use Suboxone to aid people in reducing the withdrawal symptoms from opiates.
This is an intensive program and follows strict federal and state laws and regulations. For further information on Suboxone, please visit www.samsha.org.
Ultrasound guided injection techniques which include:
Epidural injections
Facet joint injections
Nerve blocks
Intercostal blocks
Stellate ganglion blocks
Brachial plexus blocks
Sciatic injections
Piriformis blocks
All injection procedures use ultrasound guidance. Ultrasound guidance use has many advantages because it is a very sophisticated imaging device that accurately puts medication where it needs to be. This makes the injection much more effective reducing adverse effects. Unlike fluoroscopy, there is absolutely no exposure to radiation nor is anesthesia needed. It is a very accurate procedure, visualizing delicate structures which are avoided using this procedure. After a particular area is identified, an injection of either a local anesthetic along with a short acting and medium acting anti-inflammatory medication is usually used and is quite effective. The pain is generally minimal with very little or no bleeding.
The injections are done in the office under sterile conditions usually taking no more than 15-20 minutes. Ultrasound uses very safe sound waves so it can be used even in pregnant woman.
CERVICAL FACET BLOCKS
Cervical facet blocks are useful in the diagnosis and painful conditions involving trauma, arthritis, or any inflammation in the neck. Pathology or trauma of the neck can present as decreased range of motion, pain, spasm and palpable tenderness. Neck pain can be referred to the shoulder, scapula, upper arm, and even precipitate migraine headaches.
STELLATE GANGLION BLOCKS
Stellate ganglion blocks are useful in the treatment of many disorders involving the upper body or upper extremity and head. They may be useful in the treatments of such diseases as acute herpes zoster or shingles and trigeminal neuralgia. They may also be helpful in reducing the symptoms associated with reflex sympathetic dystrophy (RSD) or complex regional pain syndrome (CRPS) of the face, neck, upper extremity, or upper thorax. They are also useful in Reynaud’s Syndrome of the upper extremity and some atypical vascular headaches.
BRACHIAL PLEXIUS BLOCKS
Brachial plexus blocks are useful with pain emergencies associated with acute herpes zoster, brachial plexus neuritis, and shoulder and upper extremity trauma. They may also be used for reflex sympathetic dystrophy and/or complex regional pain syndrome of the shoulder and upper extremity.
MUSCULOSKELETAL BLOCKS
Musculoskeletal blocks of the upper extremity are useful for certain types of nerve entrapment syndromes or inflammation of tendons in the shoulder, elbow, wrist, and fingers.
INTERCOSTAL NERVE BLOCKS
Intercostal nerve blocks are used near the rib cage primarily for the treatment of shingles. As many as 50% of patients who experience the shingles rash will develop a very painful condition called post herpetic neuralgia which is sharp, lancing, burning pain radiating around the rib cage. This technique can be very useful in reducing pain.
CAUDAL EPIDURAL AND LUMBAR FACET JOINT BLOCKS
Caudal epidural and lumbar facet joint blocks are useful in the treatment of chronic low back pain either associated with arthritis, degenerative disc disease, and inflammation of the surfaces of the articulating joints of the vertebral spine.
SI JOINT AND PIRIFORMIS SYNDROME INJECTIONS
Very often, low back pain may be associated with inflammation of the sacroiliac joint which is the joint between the sacrum (bottom part of the spine) and the pelvic bone. There is a left and right joint. This pain can be due to trauma or arthritis of the back. Very often, individuals with other pain conditions of the low back will have imbalances of the musculoskeletal system which will put an unnecessary stress on the SI joint.
PIRIFORMIS SYDROME
The piriformis muscle is a deep muscle under the buttocks which moves the hip joint. What makes the triangular shaped muscle so important is that the sciatic nerve usually passes underneath it and in some individuals, part of it or all of it actually passes through it. When a sciatic nerve is inflamed, it can also cause a severe spasm of the piriformis muscle, and the piriformis muscle when in spasm can affect the sciatic nerve, setting up a self perpetuating pain process. Therefore, injection techniques to this muscle can be very helpful.
