Frequently Asked Questions

What can patients expect from Union Anesthesia Associates and Raritan Anesthesia Associates?
Why is it beneficial that all of our physicians are Board Certified Anesthesiologists?
What can I do to protect my back when I lift heavy objects? What is proper lifting technique?
What is Acute Pain?
What is Chronic Pain?
What is Neuropathic pain?
What is Nociceptive Pain?
What is Endoscopic Laser Spine Surgery?
What are the advantages of Endoscopic Laser Spine Procedure?
What is Herniated Disc and what are the causes of Herniated Disc?
What are the symptoms of Herniated Disc?
What are the treatment methods for Herniated Disc?
What are Epidural Steroid Injections?
What if steroidal Injection did not work for me?
What is Selective Nerve Root Block?
What is a Discogram?
What is Spinal Cord Stimulation?
What is an Intrathecal Pump?
What is Percutaneous Discectomy/Nucleoplasty?

What can patients expect from Union Anesthesia Associates and Raritan Anesthesia Associates?
Union Anesthesia Associates and Raritan Anesthesia Associates has been providing advanced care for over 30 years for a range of illnesses and injuries that affect the spine and nervous system. Our five physicians all are board certified in not only pain management, but in anesthesiology as well. Our practice consistently provides quality information about pain and pain relief measures to our patients, while using the most advanced groundbreaking surgical procedures for the spine. Our compassionate staff are dedicated health care providers committed to providing an effective pain management program for each patient by responding quickly to their needs and reports of pain.

Why is it beneficial that all of our physicians are Board Certified Anesthesiologists?

Anesthesiologists ensure that patients are safe, pain-free and comfortable during and following surgery.
Their research has led to the development of newer, more effective treatments for patients who have pain unrelated to surgery.
Anesthesiologists spend four additional years learning the medical specialty of anesthesiology and pain medicine during residency training.

What can I do to protect my back when I lift heavy objects? What is proper lifting technique?
To prevent low back pain when you lift heavy objects, let your lower body do most of the work. Squat down in front of the object while keeping your back straight. (This position protects your back, but it can be hard on your knees.) Tighten your abdominal muscles as you unbend your knees to lift straight up. Keep the object as close to your chest as possible and do not twist at the waist; your shoulders and hips should always be aimed in the same direction when you lift or carry heavy objects. Never pull a heavy object when you can push it instead. For shifting very heavy objects, get help. Use pushcarts, wheelbarrows and forklifts when they are available.

What is Acute Pain?
Acute pain results from disease, inflammation or injury to tissues. This type of pain generally comes on suddenly—for example, after trauma or surgery—and may be accompanied by anxiety or emotional distress.

What is Chronic Pain?
Chronic pain is usually defined as pain that persists greater than 3 to 6 months or pain that persists after healing has occurred. Pain Management is integral to treating chronic pain.

What is Neuropathic pain?
Neuropathic pain is caused by damage to nerve tissue. It is often described as a burning or stabbing pain. These damaged nerve fibers send incorrect signals to other pain centers. The impact of nerve fiber injury includes a change in nerve function, both at the site of injury and areas around the injury.

What is Nociceptive Pain?
Nociceptive pain is caused by an injury or disease outside the nervous system. This type of pain is sensed by special receptors that transmit the pain impulse through the nervous system to the brain.

What is Endoscopic Laser Spine Surgery?
Endoscopic laser spine surgery is a minimally invasive method of performing spinal surgery. During traditional spinal surgery, the surgeon must cut muscles, but in endoscopic surgery, the surgeon need only separate the muscles to reach the affected area. This procedure minimizes injury to surrounding tissues, which means you experience less pain and scarring after surgery. Endoscopic surgery also requires less anesthesia, reducing the risks of anesthesia-related side effects.

What are the advantages of Endoscopic Laser Spine Procedure?

Minimally invasive surgery which requires a very small incision, resulting in minimal bleeding
No general anesthesia used (which could be high risk in some patients)
Post operative infection at the incision site rarely occurs
Recovery period is usually very quick

What is Herniated Disc and what are the causes of Herniated Disc?
Each disc of the spine is designed much like a jelly donut. As the disc degenerates from age or injury, the softer central portion can rupture (herniate) through the surrounding outer ring. This abnormal rupture of the central portion of the disc is referred to as a disc herniation.

The most common location for a herniated disc to occur is in the disc at the level between the fourth and fifth lumber vertebrae in the low back. This area is constantly absorbing the impact of bearing the weight of the upper body. This is especially important when we are standing or sitting. The lower back is also critically involved in our body's movements throughout the day, as we twist the torso in rotating side to side and as we hinge the back in flexion and extension while bending or lifting.

Herniated Discs cause pain in the spine and/or down one or both arms or legs. Pain may or may not be present. Sometimes the symptoms of a herniated disc are numbness, tingling, electrical currents, shocks or the sensation that water or bugs are running over the skin. Weakness may also be a symptom. Herniated Discs cause physical irritation and/or chemical irritation of the spinal nerves that are in close proximity to the herniation, which results in the above symptoms.

What are the symptoms of Herniated Disc?

Radiculitis (sciatica)
Individuals suffering from radiculitis report pain that radiates along a nerve path because of pressure or inflammation of the nerve root where it connects to the spine. The location and type of pain depends on the area of the spine where the compression occurs. For instance, radiculitis in the cervical spine may cause pain in the neck or down the arm. If located in the thoracic spine, radiculitis may cause pain in the chest area. The most common complaint, however, is in the lower or lumbar area, with pain in the hips, legs and feet. This type of pain is often called sciatica, since it most usually originates from the lumbar region, where the nerves that make up the sciatic nerve enter the spinal canal. Sciatica is a common problem for those suffering from disc deterioration or injury involving the lower back.
Radiculapathy
Radiculopathy is a condition due to a compressed nerve in the spine that can cause pain, numbness, tingling or weakness along the course of the nerve. Radiculopathy can occur in any part of the spine, but it is most common in the lower back (lumbar radiculopathy) and in the neck (cervical radiculopathy). It is less commonly found in the middle portion of the spine (thoracic radiculopathy).

What are the treatment methods for Herniated Disc?
As with all injuries, treatment should begin with conservative measures. These include reducing activity without complete bed rest and using appropriate pain and anti-inflammatory medications. Usually pain will resolve within a few days to weeks. If pain continues, other forms of treatment such as chiropractic and physical therapy may be indicated. For persistent symptoms, interventional pain management therapy may be necessary. This treatment may include an injection of cortisone (steroid), which is a strong anti-inflammatory placed into the affected nerve. This medicine is injected into the epidural space of the spine (see "Epidural Steroid Injections" below). The treatment is very effective in most cases. The injection may need to be repeated if only partial relief is obtained. The procedure takes just a few minutes and is performed on an outpatient basis. Although this treatment poses low risk for complications, such as headache, in very rare cases they can occur.

What are Epidural Steroid Injections?
Epidural Steroid Injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. ESIs have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.

What if steroidal Injection did not work for me?
Patients need to realize that each patient is different and treatment options depend upon the severity of symptoms and neurologic function. Any signs of progressive deterioration of function, including sudden weakness or loss of bowel or bladder control, may indicate an emergency situation and need to be evaluated immediately. For patients who do not respond to the above, surgical options may be necessary. These options include percutaneous disc surgery, endoscopic/laser spine surgery, minimally invasive disc procedures or, in rare cases, more extensive spine surgery

Selective Nerve Root Block
What is Selective Nerve Root Block?
Nerve blocks are used for pain treatment and management. Often a group of nerves, called a plexus or ganglion, which causes pain to a specific organ or body region can be blocked with the injection of medication into a specific area of the body. The injection of this nerve-numbing substance is called a nerve block.
What should I expect after the nerve block procedure?
Nerve Root Block would alleviate the pain from back and legs.
How is it done?
The patient is given a local anesthetic. The physician then locates, under fluoroscopy, a specific spinal nerve root. A needle is introduced through the skin into the area adjacent to the nerve root. Medication is then injected into the area, bathing the nerve root.
How long does the Nerve Root Block procedure take?
The time varies depending upon how many nerves are evaluated. Usually thirty minutes or less.

Discogram
What is a Discogram?
A discogram is a diagnostic test performed to view and assess the internal structure of a disc and to determine if it is a source of pain.
How is Discogram performed?
The patient is given intravenous medication as a relaxant and a local anesthetic is injected into the patient's skin in the area that is being examined. A needle is inserted through a previously placed needle in the skin and into the disc under fIouroscopy. A radiopaque dye is injected into the disc, or discs if more than one disc is being examined. A CT scan is usually performed on the painful disc after the dye is injected to obtain images of the dye distribution. This will demonstrate annular tears, scarring, disc bulges and changes in the nucleus of the disc.
How long does it take to do a Discogram?
Thirty minutes, plus an additional thirty minutes if a CT is indicated, plus recovery time of several hours.

What is Spinal Cord Stimulation?
Spinal Cord Stimulation is the use of electrical impulses that are used to block pain from being perceived in the brain.

What is an Intrathecal Pump?
An Intrathecal Pump is a surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located.

What is Percutaneous Discectomy/Nucleoplasty?
Percutaneous Discectomy is a procedure in which tissue is removed from the disc in order to decompress and relieve pressure.