Prolotherapy, also known as proliferative therapy, is an orthopedic procedure by which an irritant solution is injected into joints, tendons or ligaments experiencing pain. The injection triggers the body’s natural response to strengthen these areas and is used as part of a pain management program for conditions including arthritis, degenerative discs and chronic lower back pain.

RFA treatment uses the application of electrical current to nerve tissue in order to disrupt pain signals emanating from a specific area. It is a non-surgical procedure currently being used for cancer patients in the removal of small tumors and for chronic pain relief. RFA is used most commonly to treat lower back pain, neck pain and arthritic join pain. 

For PRP Injections, blood from the patient is drawn and processed to extract platelet rich plasma which is then reintroduced to the patient in the area that they are experiencing pain. Platelets contain reservoirs of several enzymes, growth factors and other bioactive compounds that assist with tissue repair and wound healing. By extracting, isolating and then reintroducing this autologous plasma to a weakened or distressed area PRP therapy aids in soft tissue repair and regeneration. PRP injections are a growing tool for pain specialists to treat soft tissue and musculoskeletal conditions.  

An epidural steroid injection is a non-surgical procedure used to treat lower back pain and neck pain. These injections target the “epidural space” within the spine directly to allow for the steroid to effect the nerve roots. There are three different manners in which an ESI is conducted (Caudal Block, Translumbar and Transforaminal) and imaging is required to determine which is the most appropriate way to perform the procedure for you if you are a candidate.

TPIs are implicated most commonly for the treatment of myofascial pain that does not respond to standard pharmacological (NSAIDs, analgesics, muscle relaxants) and non-pharmacological treatments (physical therapy, heat, massage). The injections are performed at the trigger point (knot of hyperirritable muscle) to relieve and alleviate pain.  

Botox® injections are providing pain specialists with a new modality for treatment of chronic pain associated with headaches, neck and shoulder pain. The injections work by triggering chemical denervation at nerve endings and thereby blocking nerve pain for chronic pain sufferers that have not responded to other treatment modalities. Pain relief often lasts for 3-4 months and the onset of relief typically begins one week following treatment. Botox® injections are typically implicated for treatment of muscle pain arising from chronic muscle spasm, headaches, neck pain and myofascial pain.

Nerve blocks are injections of pain relieving or anti-inflammatory medications used to block pain from a specific set of nerves. The injections are guided at our clinic by ultrasound or fluoroscopy to ensure precision and accuracy. There are three-types of nonsurgical nerve blocks (Epidural Analgesia or Anesthesia, Spinal Analgesia or Anesthesia and Peripheral Nerve Blockades) and our pain specialist will determine the appropriate type for you. Nerve blocks offer immediate and possibly long-term relief of arthritic pain, lower back pain, headaches and migraines as well as Chronic Regional Pain Syndrome.

TransCranial Direct Current Stimulation is the application of very low-level current to targeted areas through electrodes. This nonsurgical and non-invasive treatment modality is a form of neurostimulation that has an analgesic (pain-relieving) effect on target areas with repeated use. The treatment modality is used to treat neuropathic pain, fibromyalgia, spinal injury pain, migraines as well chronic pain of various origins. 

Phonophoresis is a nonsurgical and non-invasive treatment modality that employs the use of ultrasound technology to apply analgesics and anti-inflammatory agents in an effort to increase absorption of the agents. Ultrasound therapy has been used to treat a variety of musculoskeletal disorders and phonophoresis combines this therapeutic potential with the transcutaneous administration of pain relieving medication so that a higher concentration of medication can be delivered. This modality is implicated for the treatment of conditions such as osteoarthritis, neuropathic pain, soft tissue injuries and bursitis.

Iontophoresis is another treatment modality that is nonsurgical, non-invasive and ideal for patients unable to receive injections. Iontophoresis applies a very low level electrical current to pain affected areas in order to deliver analgesic and anti-inflammatory medications through the skin. This type of transdermal drug delivery is used to treat conditions such as bursitis, arthritis, tendinitis and plantar fascititis. 

Medical Cannabis therapy is an additional treatment modality for pain specialists and involves the use of cannabis to treat chronic and non-chronic pain conditions. At Toronto Pain Clinic, medical cannabis therapy is one tool in our pain specialists’ toolbox to alleviate pain that has been non-responsive to other pharmacological approaches.

At Toronto Pain Clinic, we understand that pain relief is at the forefront of patients’ minds as they come through our doors. We work with our multidisciplinary team to determine what treatment modalities are appropriate for your specific needs and craft a pain management program to suit your lifestyle. The list of services above is a list of the tools in our toolbox that can be used in different formulations to design the appropriate plan in consultation with you. Please note that not all treatments listed above will be suitable for all patients and it is important to develop an individualized pain management program for each patient.