TMC's Integrative Pain Center is here to develop treatment plans tailored to meet each patient's unique needs and preferences. Our goal is provide safe and effective care that manages pain and helps patients live happier and healthier lives.
The TMC Integrative Pain Center provides advanced pain treatment and management in a hospital-based setting that is held to the highest safety standards.Chronic pain can have a major impact on every part of your life. Daily activities can seem impossible and things that you once enjoyed unreachable. We work with you and your primary care doctor to design a treatment plan tailored to meet your unique needs and preferences. To best meet the needs of each patient, we offer a wide range of pain therapies.All interventional procedures are performed by physicians who are board-certified in anesthesiology and pain management. The center’s stringent safety guidelines and highly-trained staff have earned the respected Joint Commission accreditation.To further enhance care quality and safety, the support staff features registered nurses who are specially trained in pain modalities, including sedation and recovery. Radiology technologists, patient care technicians and medical assistants are also part of the expansive care team.
Procedures and services offered
Celiac plexus block
Facet joint intervention
Interlaminar and caudal epidural
IV sedation
Joint injection
Lumbar sympathetic block
Medication management
Physical therapy guidance
Spinal approaches
Stellate ganglion block
TFESI
Trigger-point injection
Ultrasound-guided injections
Conditions and symptoms we treat
The TMC Integrative Pain Center provides treatment for a wide-range of injuries, illness and conditions that cause chronic or acute pain, including:
Arthritis of spine
Chronic pain
Degenerative disc disease
Failed back surgery
Fibromyalgia
Herniated discs
Low-back pain
Neuropathy
Occipital neuralgia
Radicular pain
Scoliosis
Spinal stenosis
If you do not see a condition you are experiencing, please contact our office at (520) 324-2080 for more information.
Patient resources
For first time patients, we ask you do the following to help with your first visit:1. Call our office to receive the new-patient forms and bring them with you to your first appointment.
You can also fax the completed forms to: (520) 299-8202
2. Please arrive 30 minutes early to your first appointment and wear loose and comfortable clothing.3. Please bring these items with you to every visit:
ID card
Insurance card
Any imaging (X-ray, CT scan, MRI) you have
Current list of medications
Please review the following guidelines to help us ensure you and all patients have a positive experience at every visit.
Please arrive 15 minutes early to every appointment.
Please provide our office with 24-hour notice to cancel an appointment.*
Please allow 3 business days for all medication refill requests.
For patient safety, we conduct random drug screenings and pill counts.
As a respected best practice, each pain medication prescription is filled for 30 days.
*An appointment absence without prior notification can result in dismissal from the clinic.
Prior to the procedure, when scheduling the appointment, discuss with the staff: what medications you are taking. It may affect your procedure, especially blood thinners, antibiotics and steroids.
We encourage every patient to have a friend or family member accompany them to the procedure and to provide transportation.
Please wear comfortable and loose-fitting clothing.
If you have any questions about your procedure, please call our office at (520) 324-2080
An epidural steroid injection is a minimally-invasive procedure that delivers steroid medication through a needle into the epidural space. The epidural space is the area outside of the sac of fluid around your spinal cord. The steroid decreases swelling and pressure on the nerves around your spine, which will help relieve pain.
Steroids are a strong anti-inflammatory medication. When the steroid is placed specifically into a joint, spine or muscle, it reduces the area's inflammation and irritation. Irritation causes your back, leg, joint, or muscle pain and discomfort.
Steroids can be injected into muscles and joints to reduce pain caused by inflammation. Inflammatory chemicals are usually produced by the body in response to injury of the tissue leading to redness, heat, swelling and pain. Steroids can reduce those chemicals and your body’s immune response to the inflammation. These are the most common steroid medications used at TMC Integrative Pain Center:
BETAMETHASONE
DEXAMETHASONE
The exact medication used during your procedure will also be listed on your discharge/home care instructions.
Common side effects include mild injection-site pain, temporary worsening of usual pain, flushing, insomnia or increased blood sugar. These side effects are usually temporary and resolve within one to three days.
The steroid usually takes effect between one and 14 days after the procedure. Some patients require a second injection after 14 days.
Most of the time, the injection is not painful. You may feel some pressure during the injection. Before the steroid injection, the site is injected with numbing medicine.
Several types of medication can be used to provide pain relief during the injection. The drug used during your procedure will be listed on your discharge/home care instructions. TMC Integrative Pain Center uses the following medication:
Bupivacaine: Bupivacaine is a numbing medication. Bupivacaine blocks the nerve impulses that send pain signals to your brain. The actions of bupivacaine act longer than a similar numbing medicine, lidocaine.
Lidocaine: Lidocaine is a numbing medication, also known as a local anesthetic. Lidocaine is sometimes mixed with a small amount of epinephrine to decrease bleeding at the injection site and make the numbing effects last longer.
The provider uses fluoroscopy or ultrasound to guide the needle placement. Spine and major-joint injections are assisted with fluoroscopy, a specialized X-ray machine that allows the provider to visualize the needle placement in real-time with immediate images. Ultrasound is typically used for muscle injection. This is sometimes called a trigger-point injection (TPI). Like fluoroscopy, ultrasound helps guide the provider with the needle placement.
A medial branch block (MBB) is an outpatient procedure for diagnosing and treating pain. The injected numbing medicine blocks or "turns off" specific nerves in the spine. Medial branch nerves carry pain signals from the facet joints to the brain.
Medial branch blocks are performed to determine whether joints in the spine are the source of back or neck pain. Like the medial branch block, the genicular nerve block has the same purpose, but the pain source is in your knee. During the genicular nerve block the provider injects the area of concern to determine if further treatment will be beneficial in blocking pain.
Pain relief from a medial branch block or genicular nerve block typically lasts from 2 to 4 hours. Some patients report shorter or longer duration of pain relief.
For some procedures, you may need to stop blood thinners. This will be discussed with your provider at the time of your appointment. Before stopping any medications, it is important to speak with the doctor who prescribes your blood thinner.
If you are receiving sedation, you cannot eat eight hours prior to your appointment. You can have clear liquids within those eight hours, but two hours before the appointment, you cannot drink anything. We ask that you not eat or drink for two hours prior to your appointment for any procedure without sedation.
A clear liquid is anything you can see through, such as apple juice, water and even gelatin. Coffee is considered a clear liquid as long as it does not have anything added to it, like cream and sugar.
We recommend you bring a driver to your procedure appointment. It is REQUIRED that you have a driver if you receive sedation or have injections in your neck (cervical) area.
There can be extensive paperwork to fill out before your appointment. We use this information to plan your care.
Regular appointments: Arrive 15 minutes prior to appointment
Patients receiving sedation: Arrive 30 minutes prior to appointment
New patients: Arrive 60 minutes prior to appointment; unless you completed your new patient paperwork at home
If you are unsure of your arrival time, please contact the front desk, (520) 324-2080, option 3
The TMC Integrative Pain Center uses a variety of medications during procedures to help you become more comfortable. Please let us know if you have any questions about this information. The most common medications used are:Local anesthetics: These are “numbing” medications similar to the ones dentists and oral surgeons use in the mouth with the last part of the name being “CAINE”. These block nerves that send information/messages to the brain (including pain, temperature, touch, pressure). They are different in how long the effects will last. Sometimes they are mixed with other medicines to make them work better (epinephrine and sodium bicarbonate). See information below.
Bupivacaine: this takes longer to start working but will last longer than lidocaine (up to 8 hours).
Lidocaine: this starts working quickly but does not last as long (up to 2 hours).
Epinephrine: also known as adrenaline. This causes blood vessels to narrow (get smaller), which decreases bleeding at the site of the injection and can also make the numbing medication last longer.
Sodium bicarbonate: also known as baking soda. This sterilized medication can reduce the burning of numbing medication (neutralizes the acid) and may help it work quicker so you feel the effects sooner.
IV dyes or contrast agents: These allow the provider to visualize the precise needle location during the procedure to make sure it is in the correct place. These procedures are done with the fluoroscopy machine. Ultrasound injections do not use these.
