Patients with chronic pain often benefit from radiofrequency ablation (RFA). This procedure gently “heats” a small area of nerve tissue, thereby curbing the pain signals that would otherwise be transmitted by those nerve fibers. Patients that may benefit from RFA include those suffering from low back and neck pain, as caused by facet joint disease and spondylosis (degenerative arthritis). Many individuals that suffer with chronic pain experience relief after treatment, and this relief can last for six months to one year or even longer. Some patients report mild discomfort at the treatment site, but this discomfort generally subsides after a day or two. Due to the general safety of the procedure and the extended period of relief afforded by RFA, the treatment has become a great option for a wide range of patients.
Prior to performing RFA, a patient meets with their physician for an evaluation. The physician describes the procedure in detail, covering all aspects of the RFA. If the patient desires to pursue the treatment, he or she generally receives a mild sedative and local anesthetic, which minimizes any discomfort felt during the procedure. The physician then inserts small needle(s) near the area of pain, and guides the instrument to the target area with the help of x-ray technology (flouroscopy). A microelectrode inserted through the needle stimulates the intended nerve tissue with radiofrequency current. The physician may ask the patient several questions during this process to optimize the overall treatment. Following the procedure, the patient is typically observed in the recovery area while the sedation wears off, and then the patient is discharged home. Patients should carefully follow their physician’s recommendations to ensure proper healing.
About the Author
Dr. Daniel Batlan is the Medical Direoctor of Specialized Pain Management, which has six locations in Southern Nevada (www.treatpainlv.com). A graduate of the University of Pennsylvania, he subsequently earned his Doctor of Medicine degree from The Loyola University of Chicago School of Medicine. Next he completed his Anesthesiology Residency and Pain Management Fellowship at the Johns Hopkins Hospital and the Cleveland Clinic Foundation, respectively. One of Nevada’s leading pain management specialists, Dr. Daniel Batlan consistently employs the most cutting-edge treatments to provide an optimal level of care.
Used by medical practitioners for more than 2,500 years to treat a range of medical conditions, acupuncture pulls from the theory of qi, which maps the flow of energy through the body. Good health depends on proper energy flow, which sometimes becomes impeded or otherwise thrown off balance. Acupuncture, the application of needles at certain points on the body, helps to correct energy flow and achieve or maintain total health. Many patients have found acupuncture a vital part of their individual pain management plans. While those suffering with chronic pain should not necessarily rely on acupuncture as a primary part of their care, the practice offers a great supplement to other pain relief methods. Acupuncture has proven helpful in the management of several different types of chronic pain, including back and neck discomfort. The process of applying needles to the skin stimulates the central nervous system, altering the ways in which the body interprets pain.
Last year, the journal Anesthesia & Analgesia actually featured a study conducted by the University of Munich that examined the potential therapeutic benefits of acupuncture. The study found that the practice likely affects the “A delta” and “C” pain fibers to produce analgesic benefits for patients. In the study, 24 volunteers received various types of acupuncture, including the regular needle process, high frequency electrical stimulation, or a combination of both. After receiving the therapy, the study showed that pain thresholds increased by up to 50 percent in the patients, as demonstrated by thermal and mechanical testing administered before and after acupuncture treatment. Although subjects received acupuncture in only one leg, the pain threshold for both legs increased.
Scientists still have not uncovered the exact mechanism by which acupuncture benefits the patients. At present, many believe that the process releases opioid peptides in the brain, a naturally occurring pain reliever. Acupuncture may also alter the release of neurotransmitters involved in pain sensation. The team plans to conduct further studies that look more directly into the mechanisms involved.
About the Author
Dr. Daniel Batlan serves as the Medical Director of Specialized Pain Management (SPM), an practice located in Las Vegas, Nevada, that specializes in the relief of chronic and acute pain. After graduating from The Loyola University of Chicago School of Medicine, he completed a residency in Anesthesiology at The Johns Hopkins Hospital, followed by a fellowship in Pain Management at The Cleveland Clinic Foundation. Dr. Daniel Batlan employs cutting edge technologies to manage pain, complementing traditional “western” medical treatments [e.g., Epidurals, Trigger Point Injections, Discography, Spinal Column Stimulation, Physical Therapy] with alternative approaches, such as acupuncture. You can learn more about Dr. Batlan & Specialized Pain Management at their website: http://www.treatpainlv.com
Dr. Daniel Batlan, MD, MBA is the Medical Director of Specialized Pain Management (SPM), a medical practice that is dedicated to excellence in the treatment of individuals that suffer from chronic and acute pain disorders. Based in Las Vegas, Nevada, his practice offers an extensive range of treatment options for virtually all painful conditions.
Dr. Batlan is among the most well trained specialists in America. He earned his medical degree from The Loyola University of Chicago School of Medicine in 1985. Next, he completed an Anesthesiology Residency at the prestigious John Hopkins Hospital. Following completion of his studies at Johns Hopkins, Dr. Batlan decided to specialize in pain management. He received intensive training during his Pain Management Fellowship at The Cleveland Clinic Foundation, which was distinguished as the largest pain management training program in North America at the time of Dr. Batlan’s education. Dr. Batlan also completed management training at The New York University – Leonard Stern Graduale School of Business, earning an MBA. Dr. Batlan is grateful to have trained at these internationally recognized graduate programs.
According to Dr. Batlan, pain management was still an emerging field when he completed his training. The quality of The Cleveland Clinic’s programs attracted physicians from around the world to pursue studies in the field of pain medicine. Moreover, The Cleveland Clinic also attracted an international clientele of patients suffering from pain. The clinic’s services were in such high demand that an average of 50 patients received treatment every day for an array of common and rare pain disorders. This volume of patient care provided Dr. Batlan with two elements essential to working effectively as a pain management specialist: experience and confidence.
During the program, Dr. Batlan learned the important values he continues to utilize in his practice to this day. These attributes include an emphasis on communication, as well as the importance of obtaining a detailed history and conducting a comprehensive examination in order to achieve accurate diagnosis. Additionally, Dr. Batlan learned many of the modalities he uses for pain management, including epidurals and advanced nerve blocks, trigger point injections, joint blocks, discography and implantation of pain pumps and spinal column stimulators.
By the time he completed The Cleveland Clinic’s Pain Management Program, Dr. Batlan had participated in the treatment of hundreds of patients. He was ready to build a practice in the relatively new and highly gratifying field of medicine.
To learn more about Dr. Batlan, please visit his website at www.treatpainlv.com.
In the first part of this two-piece article, we explored some of the pain management services offered by Dr. Daniel Batlan at his Specialized Pain Management clinic. Clients are either referred to Dr. Daniel Batlan through a physician, or seek treatment themselves to receive one of the center’s innovative treatments. This article will briefly cover some of Dr. Daniel Batlan’s treatments and their uses.
1. TENS. Dr. Daniel Batlan offers transcutaneous electrical nerve stimulation (TENS) units, which can be worn on a belt and attached to different sections of the body by gel pads. The TENS unit is a battery-operated device that gives a soft, electronic massage. It can be used for many hours each day, and is perfect for those with musculoskeletal issues.
2. Epidurals. This service, which is one of the most common treatment options given by pain management specialists, involves an injection into the spine that treats different conditions like osteoarthritis, sciatica, “pinched nerves”, and herniated or slipped vertebral discs.
3. Physical Therapy. Dr. Daniel Batlan offers and / or can make referrals to physical, occupational, and swimming therapy services that help individuals affected by chronic pain reach their full potential for physical capacity.
4. Sacroiliac Injections. This procedure treats the sacroiliac joint, which is located at the back of the pelvis. Patients who experience pain in their upper buttocks because of an inflammation of the joints or a degenerative condition can receive a sacroiliac injection right in the doctor’s office.
5. Trigger Point Injections. One of the most common pain-block services, trigger point injections are recommended for patients with muscle spasm issues or fibromyalgia.
As a pain management physician, Dr. Daniel Batlan works with his patients to relieve, reduce, or manage pain. Among the most highly advanced pain control modalities is spinal column stimulation (SCS), a method that interrupts pain transmission, thus reducing or eliminating the perception of pain.
Question: Please explain the basics of spinal column stimulation.
Dr. Daniel Batlan: A spinal column stimulator is a small implantable device with a transmitter placed under the skin of the abdomen or buttocks, with leads that connect to the spinal column. After the device is implanted, the transmitter or stimulator sends electrical pulses along the leads to the spinal column, effectively interrupting pain signals.
Question: What can a patient expect when you implant one of these devices?
Dr. Daniel Batlan: The implantation is a two-part process. First, I want to be certain the device will effectively manage the patient’s pain, so I insert two small wires into his or her epidural space and attach an external unit. Then I have the patient use the device for several days to see how well the treatment works for them. If it is successful at reducing pain after several days, he or she can have the permanent stimulator inserted. The permanent device is implanted entirely underneath the skin, allowing the patient to resume virtually all of their normal activities.
Question: Who can benefit from this type of device?
Dr. Daniel Batlan: The device often works well for patients that have undergone previous spinal surgery and experienced no relief of pain relief. It also may be effective for patients who have tried a variety of management techniques and nothing works for them. Patients who are not surgical candidates or who do not wish to undergo surgery may also do well with these devices. Finally, spinal stimulation is also effective for selected patients with neuropathic pain, such as Reflex Sympathetic Dystrophy [RSD] and other causes of neuropathy.
Question: What is the efficacy of the treatment?
Dr. Daniel Batlan: I have had patients tell me it is life altering. In my experience, it provides relief to a large number of patients, eliminating 50 percent or more of their pain.
A graduate of the Leonard N. Stern Graduate School of Business at New York University where he earned his MBA, Dr. Daniel Batlan is a veteran medical professional who serves as medical director at Specialized Pain Management in Las Vegas, Nevada. Further, Dr. Daniel Batlan is certified by the National Board of Medical Examiners (NBME), the American Academy of Pain Management (AAPM), and the American Board of Anesthesiology (ABA).
In 2016, the ABA was recognized for the quality of its branding work with a gold MarCom Award from the Association of Marketing and Communication Professionals (AMCP). The award, which is given as part of a national competition that has about 6,000 entries each year, commended the ABA’s work in launching a new website, logo, and overall brand identity.
Entrants to the competition range from individual entities to Fortune 500 companies, with approximately 20 percent eventually walking away with a gold prize. When speaking about the award Deborah J. Culley, MD, the ABA’s secretary, was quick to note the work of the ABA team in making the brand synonymous with the quality of its educational and certification programs.