inpatient AND Outpatient chronic pain service

The field of Pain Medicine specializes in the treatment of pain and it’s sequelae. The Pain Management Center at Columbia University consists of a group of professionals dedicated to alleviating pain and helping patients’ live active and rewarding lives.

We accomplish this through state-of-the-art clinical expertise spanning medical, behavioral, and surgical disciplines. We treat the whole person and emphasize both - restoring the patient to optimal functioning as well as reducing their pain and distress.

The Pain Management Center is comprised of several physicians, a nurse practitioner, a clinical psychologist, support staff, and numerous affiliated specialists, all of whom are well trained and experienced with pain management.

Recognizing that pain affects people in many different ways, we attempt to approach their treatment from a biospsychosocial model. We recognize that pain not only causes physical discomfort, but it also interferes with a person’s ability to carry out normal activities, such as employment, housework, and recreation. Pain interferes with sleep, appetite and activity level and also affects emotional well being. It is quite common for people in pain to experience increased feelings of depression, anxiety, anger, helplessness or hopelessness. These effects of pain can interact with each other and aggravate an already difficult situation by increasing the pain or distress or both. Our Center uses a comprehensive medical and behavioral approach to understand and treat pain.

Evaluation in Pain Management

When you first become a patient with the Pain Management Center a thorough assessment takes place. The intake procedure will include a review of previous medical records, an intake questionnaire, and an initial visit. You may be seen only by the pain physician or by a team comprised of one or more physicians and a clinical psychologist. After reviewing your medical records and your responses to the intake questionnaire, the team will spend time interviewing you and a physician will conduct a physical examination. Recommendations for treatment will be made and necessary prescriptions written. You will also be given an appointment to return for a medical follow-up visit in 2-4 weeks. If psychological intervention is recommended, then you will be asked to return for follow-up with the psychologist as needed.

Conditions Treated at the Center:

  • Arthritis pain
  • Cancer pain
  • Neuropathic pain
  • Headaches
  • Myofascial pain syndrome
  • Chronic pancreatic pain
  • Post-herpetic neuralgia
  • Phantom limb pain
  • Pelvic pain
  • Low back pain
  • Sympathetically maintained pain

Treatment in Pain Management

Our treatment approach is interdisciplinary and is likely to include more than one of the following modalities.

Medical Management

  • Opioids
  • Antidepressants
  • Anticonvulsants
  • Antiarrythmics
  • Topical medications

Acupuncture

  • Approaches
  • Classical Chinese
  • French energetics
  • Electroacupuncture
  • Auricular
  • Musculoskeletal Treatments
  • Surface Energetics
  • Trigger point deactivationTendinomuscular treatment
  • Percutaneous electrical nerve stimulation
  • Osteopuncture
  • Gua Sha

Radiographically Guided (x-ray and CT scan) Spinal Injections

  • Epidural block
    • Translaminar (conventional)
    • Transforaminal
  • Selective nerve root block
  • Facet block
    • Intra-articular
    • Medial branch
  • Sacroiliac joint block
Other radiographically (x-ray and CT scan) guided injections
  • Celiac plexus block
  • Stellate ganglion block
  • Lumbar sympathetic block
  • Ganglion of impar block
  • Peripheral nerve blocks
  • Neuraxial blocks (including neurolysis)

Other injections

  • Trigger point injection
  • Subcutaneous infiltration

Intravenous infusions

  • Lidocaine
  • Phentolamine
  • Intravenous regional sympathetic block

Neuromodulation

  • Spinal cord stimulation
  • Transcutaneous electrical nerve stimulation

Implantable technologies
(in cooperation with specialized neurosurgical team)

  • Spinal cord stimulation
  • Intrathecal drug delivery system

Behavioral/Psychological Techniques:

  • Cognitive Behavioral therapy
  • Stress management techniques
  • Biofeedback
  • Group therapy
  • Family counseling related to pain and chronic illness
  • Management of mood disorders related to pain and chronic illness

Adult Outpatient Pain Center Clinical Staff:
David Bandola, MD
Anis Dizdarevic, MD
Nomita Sonty, Ph.D.
Leena Mathew, MD
Michael L. Weinberger, MD

 

 

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Columbia University Medical Center Department of Anesthesiology