Chronic Pain

MANAGING PAIN TO IMPROVE QUALITY OF LIFE

Pain can have a detrimental effect on all aspects of quality of life, including physical and emotional aspects. At Avella Injury and Pain Management, we will work closely with you to determine your goals and provide treatments with the aim of improving your quality of life.

WHAT IS CHRONIC PAIN?

Chronic pain is defined as pain that persists beyond the usual recovery period or in association with a chronic health condition, such as arthritis. Pain is a very personal experience that is influenced to varying degrees by biological, psychological and social factors. In some cases, this pain can go on for years, and can severely impact your life. We treat chronic pain related to the following:

HEAD

  • Migraine headaches
  • Tension-type headaches
  • Cluster headaches
    (trigemino-autonomic cephalgia)
  • Trigeminal neuralgia
  • Post-traumatic headaches
  • TMJ dysfunction
  • Cervicogenic headache

SPINE

  • Whiplash associated disorder
  • Cervical sprain/strain
  • Thoracic sprain/strain
  • Lumbar sprain/strain
  • Myofascial pain
  • Degenerative disc disease
  • Herniated discs
  • Cervical radiculopathy
  • Lumbar radiculopathy/sciatica
  • Spinal stenosis
  • Facet joint arthritis
  • Spinal arthritis
  • Osteoarthritis
  • Sacroiliac joint dysfunction

SHOULDER

ELBOW

  • Bursitis
  • Lateral/medial epicondylitis
  • Tennis elbow
  • Golfer’s elbow

HAND AND WRIST

  • Tendonitis
  • Arthritis
  • Post-fracture pain

HIPS

  • Bursitis
  • Arthritis
  • Sprains/strains

KNEE

  • Arthritis
  • ACL/PCL strain
  • MCL/LCL strain
  • Post-operative knee pain
  • Meniscal injury
  • Patellofemoral syndrome
  • Knee Osteoarthritis

FOOT AND ANKLE

  • Arthritis
  • Tendonitis
  • Post-fracture pain
  • Sprains/strains
  • Plantar fasciitis
  • Achilles tendonitis

OTHER

  • Fibromyalgia
  • Multiple sclerosis
  • Complex regional pain syndrome (CRPS)
  • Motor Vehicle Accident related injuries
  • Work related injuries
  • Sports Injuries

WHAT SERVICES ARE OFFERED FOR CHRONIC PAIN?

Chronic pain or injuries can be managed through pharmacotherapy (medications) or one of our pain relieving procedures. The professionals at Avella will recommend the best options for you.

PHARMACOTHERAPY (MEDICATIONS)

Treatment of pain often requires the use of one or a combination of medications with pain-relieving properties. Pharmacological options include a multitude of drug classes and are typically approached systematically, both with regards to type of medication used and the dose required. Combination therapy is usually more effective versus single therapy with the goal of addressing different aspects of the pain pathway while simultaneously minimizing adverse effects. Medications may include NSAIDS, opioids, antidepressants, antiepileptic drugs or muscle relaxants. Adjuvant medications, such as antispasmodics, cannabinoids or topical analgesic agents, may also be added for improved pain control.

Ask us about our Personalized Medicine. An emerging approach for disease treatment that uses each person’s unique genetic make-up to guide medication choices, instead of relying on the “trial and error” approach to medications management.

MEDICAL CANNABIS

Medical cannabis can often be an effective adjunct in the treatment of pain and associated insomnia. A dedicated cannabis consultation, medical document, treatment plan and education is provided to patients. Please see the medical cannabis page for more details.

Many of our treatment options are covered by OHIP and third-party insurance providers. Speak with your primary healthcare provider about getting a referral to Avella Injury and Pain Management today.

PROCEDURES

TRIGGER POINT INJECTIONS

Trigger point injections are given to isolated painful muscle areas. These injections can be used in many different muscle groups, such as shoulders, arms, low back and neck, depending upon where the trigger points exist. These can be both diagnostic and/or therapeutic.

JOINT, BURSA AND TENDON SHEATH INJECTIONS

Injections into the joints, bursae, tendon sheaths and soft tissues are given for both diagnostic and therapeutic purposes, and can be useful to manage pain, improve function and increase your quality of life.

SACROILIAC JOINT INJECTIONS

Injections in the low back region are given into the sacroiliac joint for both diagnostic and therapeutic purposes.

NERVE BLOCKS

Injections are given to block a single nerve or multiple nerves in an attempt to block nerve impulses. Doing so can be useful for diagnostics, or with managing pain.

CAUDAL EPIDURALS

A caudal epidural steroid injection is given in the lowest part of the epidural space in order to alleviate pain in the low back and leg caused by conditions such as sciatica, herniated discs and other back problems. The goal of this procedure is to diagnose and/or manage pain and improve function and quality of life.

BOTULINUM TOXIN INJECTIONS*

(ONABOTULINUMTOXIN A)Botulinum toxin products are injected into specific areas to block nerve transmission at the neuromuscular junction leading to relaxation/weakness of the corresponding muscle. It is used for specific therapeutic indications such as chronic migraine, cervical dystonia, adult focal spasticity, blepharospasm and severe axillary hyperhidrosis (excessive sweating). The goal of this procedure is to manage pain and improve function and quality of life.

Botulinum toxin can be used to manage pain and improve function.

ULTRASOUND GUIDED PROCEDURES

Ultrasound guided injections are considered a safe and effective method to treat painful musculoskeletal and joint symptoms. The use of ultrasound allows injection treatments to be delivered accurately into the exact location of injury or damage. The following is a list of procedures that utilize ultrasound technology to guide injections.

VISCOSUPPLEMENTATION*

Viscosupplementation is a procedure in which a gel-like fluid called hyaluronic acid is injected into an arthritic joint and acts as a lubricant. This image-guided procedure may reduce pain and swelling in an arthritic joint, leading to improved function and quality of life.

PRP TREATMENT*

An injection of platelet-rich plasma (PRP), also known as autologous conditioned plasma, is a form of regenerative medicine used for the treatment of various musculoskeletal injuries as well as for hair loss and cosmetic applications. Injections involve drawing a patient’s own blood, centrifuging (spinning) the blood to remove red blood cells, and injecting the platelet rich portion back into specific treatment areas. The platelet-rich plasma contains concentrated platelets as well as growth factors that may stimulate a healing response and enhance tissue regeneration and repair. This is an image-guided procedure.

FACET JOINT INJECTIONS

Injections are given into the low back region, specifically at the site of the lumbar facet joints. This is done in order to diagnose and/or treat pain being generated by arthritic facet joints. This is an image-guided procedure to diagnose and/or manage pain.

SACROILIAC JOINT INJECTIONS

Injections in the low back region are given into the sacroiliac joint for both diagnostic and therapeutic purposes to improve quality of life.

BARBOTAGE PROCEDURE

Calcium deposits within the tendons of the rotator cuff are a common cause of shoulder pain. The barbotage procedure is used for the treatment of calcific tendonitis. This technique involves ultrasound-guided injections into the shoulder joint in an attempt to break up calcium deposits, and, if possible, aspirate (remove) the calcium out of the joint. Doing so can help to manage pain, increase function and improve quality of life.

* Speciality services, let the professionals at Avella recommend the best options for you.

Phone: 905-315-7007
Fax: 289-714-2516

5045 Mainway Unit 118
Burlington, ON L7L 5Z1

Business Hours

Monday – Saturday
9:00 am to 5:00 pm

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