About Your Pain Management Procedures

 

 
 

Lewis

Lewis OR

  Pain Management by Dr Jerry Lewis
 

For more than 20 years, Jerry Lewis, M.D. has helped thousands of patients restore their quality of life by reducing their chronic pain. As a pain management specialist, Dr. Lewis is dedicated to staying on top of technological advances and cutting-edge techniques that effectively diagnose and treat pain.

He offers each patient a customized treatment plan that may include pharmacological management, patient counseling, and/or minimally-invasive procedures, such as headache/migraine neurostimulation, spinal cord stimulation, vertebral body augmentation, discography, rhizotomies, nerve blocks, and steroid injections.

Dr. Lewis is board certified in anesthesiology by the American Board of Anesthesiology and a Diplomate of the American Board of Pain Medicine. He has been in private practice since 1993 and joined Pinnacle Pain Medicine in 2003.

Jerry W. Lewis, MD is board-certified in anesthesiology by the American Board of Anesthesiology and a diplomat of the American Board of Pain Medicine.

- Graduated from the University of Oklahoma Medical School

- Completed his residency in anesthesiology with additional training in pain

 

 
 

What to Expect for your Pain Management Procedure:

- We will call you the day before your procedure to give you instructions. Please make sure that Dr. Lewis' office or the referring physician has the correct contact information for you. If you are not available, we will leave you a detailed message.
- We ask that you arrive 45 minutes prior to your procedure time. If you are late you may have to be moved in the schedule or possibly changed to another day so please be on time.
- DO NOT EAT OR DRINK ANYTHING 8 HOURS PRIOR TO YOUR PROCEDURE TIME! This includes hard candy and gum. Failure to do this can result in your procedure being cancelled or rescheduled. The only exception to this is if you are taking medication for high blood pressure or for acid reflux. Please take these medications first thing in the morning with a sip of water. All other medications can be taken after you are finished with your procedure.
- For all of Dr. Lewis' procedures an IV will be started and a short acting general anesthesia will be given. You will only be asleep for the duration of the procedure (about 10 minutes) and patients usually awaken after about 5-10 minutes.
- Please remember to bring your drivers license (or photo ID), insurance cards, and a list of medications that you take on a regular basis along with the correct dosages.
- You will need to have a ride to take you home. You will be unable to drive or operate any heavy machinery until the day after your procedure. Your ride must be present at the time of discharge, no exceptions.
- Visitors will not be allowed back in the pre-op or recovery areas unless there is a legal reason for them to be there (i.e. patient is a minor or has a power of attorney). This is to protect the privacy and medical information of all patients as required by HIPPA.
- Most procedures will only take about 15 minutes to complete and recovery time is only about 10-15 minutes.  So you can plan on being at our facility for about 1.5 hours.
- Please make sure to drink plenty of fluids the day before your procedure. This makes starting your IV much easier.
- Please remember that Dr. Lewis will not write any prescriptions for pain medication on procedure days. If you need a refill you will have to contact the office and make an appointment.
 
 

Pain Management Procedures:

Cervical, Thoracic, and Lumbar Epidural Steroid Injections:
The purpose of these injections is to place a steroid (an anti-inflammatory) into the epidural space of your spine with the intended purpose of decreasing the pain that you are experiencing in that area. Dr. Lewis will use fluoroscopy (a motion picture Xray) to place the medicine in the correct areas. Dr. Lewis will also use a numbing medicine so you may experience numbness down an arm or leg but this will fade in a few hours. Also, typically people feel better upon awaking and throughout the first day. It is not unusual for some, if not all, of your pain to return after the first day. Steroids take 7-10 days to reach their peak effect, so please continue to use ice and prevent further irritation to those areas (i.e. working out, physical therapy). It may be necessary to have multiple injections to fully decrease the pain you are experiencing.
 
Discogram:
A discogram is a diagnostic procedure only. It helps to confirm or rule out the disc(s) as the source of your pain and to help your physician plan if and where surgery is needed. The procedure itself can be uncomfortable but pain medicine will be given to help alliveate you pain once the procedure is complete. You will be taken to the operating room and given sedation while Dr. Lewis places the needles in the discs associated with your pain. You will then be woken up and fluid will be injected into these discs and you will be asked to describe, if any, pain that you are experiencing. If you state that you are having pain in that area, IV dye will be injected into that area to highlight the disc. Once you are awake enough in recovery after the procedure you will be taken downstairs to complete a CT scan. The initial part of the discogram takes about 30 minutes and the CT only takes about 10 minutes after a recovery of about 15-20 minutes. After you have been discharged, we encourage you to go home, eat a light meal and try to rest. Typically the pressure you feel from the IV dye injected into your discs will dissipate after a few hours. As always, we recommend lots of ice to your injection sites and you can take any pain medication as prescribed.
 
Cervical and Lumbar Rhizotomy:
The purpose of a rhizotomy is to decrease and/or eliminate pain symptoms arising from degenerative facet joints within the spine. The procedure involves destroying the nerves that innervate the facet joints with highly localized heat generated with radiofrequency. By destroying these nerve fibers at the facet joints, the communication link that signals pain from the spine to the brain can be broken. The facet joints are the sliding joints allowing the vertebrae of the spine to slip over one another without losing contact. It is typically required to perform facet injections at the affected area prior to performing a rhizotomy to ensure its efficacy. You will be given an IV and anesthesia for this procedure, which usually lasts about 30 minutes. Please make sure to follow all pre-op instructions prior to your procedure. Most patients experience several months of pain relief, some even up to a year after a rhizotomy. The recovery period for a rhizotomy is usually 2-3 weeks while the nerves are dying. Patients typically have soreness, bruising, and occasionally itching at the injection sites. You will be given samples of a Lidoderm patch, a topical anesthetic, to use for the first few days after the procedure to help with this. We also encourage the use of ice and pain relievers to help relieve any discomfort.
 
Sacroiliac Injections:
The sacroiliac joint is the joint in the bony pelvis between the sacrum and the ilium of the pelvis. Inflammation or irritation of this joint can cause low back pain and referred pain into the buttock or back of the thigh. It can be on just one side or both joints can be inflamed. Dr. Lewis will inject a steroid and a numbing medication, using fluoroscopy, into the affected area to attempt to relieve pain and decrease the inflammation. It can occasionally happen that the injection itself can further irritate the joint and you may continue to have pain. We encourage using lots of ice and rest to help allievate this discomfort.
 
Transforaminal Injections:
Transforaminal injections are the injection of a long acting steroid into the opening at the side of the spine where a nerve root exists. This opening is known as a foramen. There is a small sleeve of the epidural space that extends out over the nerve root, and this is where the medication is placed. The injection of the steroid is used to reduce inflammation of this nerve root and hopefully reduce pain, tingling and numbness. This procedure is similar to epidural injections in that it only takes about 10 minutes to perform. An IV will be started and a general anesthetic administered. Recovery time is also about 10-15 minutes. Use of ice and pain relievers after discharge are again encouraged.
 
Download Dr Lewis' Post Op Instructions Here:
Post Op Instructions: Pain Post Op Instructions