Pain Management in Houston, TX.

For pain, a large 2022 review found moderate-quality evidence that TENS reduces pain intensity compared with a placebo device. Guideline bodies have been more cautious because many older trials were small, so we use it as a low-risk add-on rather than a stand-alone cure.

That is Horner's syndrome, and it means the block reached the ganglion. Drooping eyelid, small pupil, and reduced facial sweating on the treated side are expected signs of success, not complications. They resolve within hours.

Sciatica and radiculopathy, arthritis and joint pain, chronic neck pain, migraines and occipital neuralgia, and post-surgical pain, among others — the nerve targeted depends on the source.

MRI shows disc structure but can't reliably tell which abnormal-looking disc is actually generating pain — many people without any back pain have abnormal-appearing discs. Discography adds a functional test by attempting to reproduce your familiar pain.

Most patients feel brief pressure or stinging as the local anesthetic is placed. The injection is generally well tolerated under fluoroscopic guidance, and sedation is available if needed.

RFA is offered only after diagnostic medial branch blocks confirm that the targeted joint is the pain source. Good relief from those blocks predicts a better response to ablation.

Most current systems are MRI-conditional, meaning MRI is permitted under specific conditions. Your device manufacturer and implanting physician will provide the exact parameters.

Many patients reduce or eliminate oral opioids. Some continue a smaller dose. The goal is to reduce total systemic exposure.

Primarily a diagnostic test. Its main purpose is to confirm whether your cervical facet joints are causing your neck pain and whether radiofrequency ablation is likely to help. Any pain relief from the block itself is usually short-lived.

TENS targets sensory nerves to reduce pain. EMS and NMES use a stronger current to make the muscle contract, which helps rebuild strength and re-educate muscle after injury or surgery.

Yes. Ultrasound or fluoroscopy is used to place the needle accurately near the nerve, which improves both safety and effectiveness.

Often, temporarily. The recurrent laryngeal nerve runs nearby and can be partially anesthetized. Do not eat or drink until you can swallow normally.

No — it's a minimally invasive, needle-based, same-day procedure done through the skin under X-ray guidance, with no incision.

Typically up to three in a six-month period, spaced two to three weeks apart, to limit cumulative steroid exposure. Some patients get enough relief after one or two and don't need the full series.

Reproduction of your concordant (familiar) pain when a disc is pressurized, ideally with a nearby painless control disc for comparison. Strict pressure and interpretation standards are used to keep the false-positive rate low.

Because outcomes depend on it. Untreated depression, active substance use, and unrealistic expectations reliably predict poor results. The evaluation is meant to help you, not to disqualify you.

The pump can run dry, which risks abrupt withdrawal. Refill appointments are not optional, and the ability to attend them reliably is part of candidacy.

A single block has a meaningful false-positive rate. Requiring two positive blocks on separate days improves the likelihood that a subsequent radiofrequency ablation will succeed.

Often, yes. For appropriate patients we can set up a home unit and teach safe pad placement and settings for ongoing self-management.

No. Bilateral stellate ganglion blocks on the same day are avoided because bilateral vocal cord or phrenic nerve involvement could compromise the airway or breathing.

Serious complications are rare. Temporary soreness, a small burn risk, transient numbness, and, uncommonly, incomplete relief can occur. Your physician reviews these beforehand.

Yes. Discography is debated because of concerns about false positives and evidence that disc puncture may accelerate degeneration over time. When performed to strict standards in carefully selected patients, its diagnostic specificity is high.

No — it reduces inflammation around the irritated nerve, relieving pain and creating a window to rehabilitate. Many cervical disc herniations improve over time.

Yes. Ziconotide is a non-opioid intrathecal agent, and bupivacaine is often combined with an opioid to allow lower doses of each.

No. The realistic goal is substantial pain reduction, less opioid use, and restored function. Anyone promising elimination of all pain is overselling the therapy.

Most protocols require substantial relief — commonly 50 to 80 percent — of your familiar pain while the anesthetic is active. Keeping a pain diary for several hours afterward is essential.

It is not used over a pacemaker or implanted defibrillator, the front of the neck, the head, or a pregnant uterus, and it is avoided over cancer, infection, clots, or numb areas. We screen for these first.

The hand warms measurably and, in sympathetically maintained pain, the pain drops substantially within minutes. Skin temperature is often recorded before and after.

Rare but serious complications include discitis (disc infection); more common are headache, temporary increased pain, numbness, or bleeding. Prophylactic antibiotics reduce infection risk.

Typically 5 to 7 years, at which point the battery expires and the pump is replaced in a straightforward outpatient procedure.

That's useful information: it means the cervical facet joints likely aren't the source, and your physician will investigate other causes such as a disc or nerve root.

Leads can migrate and devices can fail. Reprogramming solves many problems; revision surgery addresses the rest. Devices can also be removed.

A positive response is usually followed by a short series, timed so that physical therapy falls within the window of relief.

Yes. The system can be explanted if it is no longer needed or no longer working.

Heavy sedation is generally avoided because it can confound the diagnostic result.