Cross+Talk – Attorney Daniel Kim Talks About Pain Management with Dr. Chang from Restore Orthopedics

If you are injured in a car, motorcycle, or truck accident, it is important to be evaluated by a qualified medical professional. Not all symptoms appear immediately, and some can worsen over time. Neck and back pain are among the most common symptoms after an accident. Failing to get proper pain management after a car accident can lead to long-term issues. In the video above, Car Accident Lawyer Daniel Kim discusses how to treat ongoing pain and nerve damage following an accident.

Here is the transcript of the conversation between Attorney Daniel Kim & Dr. Chang from Restore Orthopedics and Spine Center:

Daniel: We’re here today with Dr. Chang from Restore Orthopedics. Dr. Eric Chang and I have worked together for years. I’ve worked with many pain management physicians in Los Angeles and Orange County. Dr. Chang is one of the better ones out there. Today we are going to talk about car accidents and pain management. People ask me about… One of the most common types of treatment that clients have is epidural steroid injections along with other injection types such as facet block injections and others.

Daniel: What is an epidural steroid injection?

Dr. Chang: The main purpose of an epidural is to help with nerve pain. If you have back pain going down your legs caused by sciatica it’s usually an irritation caused by the body and there are irritating substances that get on your nerve. One of the main purposes is to clean up those substances, so we can inject volume and fluid to clean up the nerve. The second is an anti-inflammatory to keep the swelling down.

Another way to look at it is, if you’re in pain, you can either make the house bigger or reduce the people living in the house, and if the nerve is swollen, one way to reduce the size and inflammation is an epidural.

Daniel: So what exactly is being inserted into the body?

Dr. Chang: We do use a needle the tip is the size of a ballpoint pen. However, before we do anything we make sure the patient is comfortable. There are two types of anesthesia we use, local anesthesia to numb the skin, and through IV (intravenous), we make the patient comfortable. Some patients choose to be completely asleep comfortably. We monitor the vitals to make sure everything is fine. As long as the patient is breathing and doing well it’s a safe procedure.

Daniel: When you have the concept of going under and being awake during the procedure can you explain what exactly happens?

Dr. Chang: It depends on the goal of the patients. Sometimes the patients want to be awake. So we allow them to choose. We never choose for them. But if they’re concerned due to the fear of the procedure, I generally suggest anesthesia.

Daniel: Let’s discuss the benefits of steroid injections. When somebody gets an injection, what is a typical result they can expect?

Dr. Chang: They may feel diminished pain due to the washing effect where the irritating substances are washed off. They continue to see improvement. The steroid takes about 5 to 7 days to decrease the inflammation and the size of the nerve.

Daniel: People fear the unknown. They fear what they don’t know. For my clients and people in general when they hear the word epidural, they think of pregnancy. People think they don’t need an epidural, but that’s not the case.

Dr. Chang: Epidural in that term is just describing the space we go into. For an epidural during pregnancy, it’s an entirely different procedure. It’s apples to oranges.

Daniel: What are the side effects?

Dr. Chang: If you’re allergic to any materials in epidural we catch that beforehand. It’s very rare that people are allergic to lidocaine or bupivacaine. Your doctor would have told you that in advance. So it’s entirely safe even before the procedure.

Daniel: Lots of times when patients have pain it’s either epidurals or the facet. Can you tell us about facet injections?

Dr. Chang: We’ll make the correct diagnosis then we’ll make the decision whether you’ll need an epidural or a facet block. For an epidural, generally, it’s nerve pain. For facet blocks, it’s generally whiplash or bony arthritis type of pain.

Daniel: When patients go see a pain management physician they will sometimes recommend RFA (Radio Frequency Ablation)?

Dr. Chang: It’s using energy to remove pain fibers. When acute pain becomes chronic, it’s because pain fibers grow into the bones of the patients who suffered whiplash in a car accident. Most people will get better in 3 months. That would be considered acute pain. But if the pain lingers, it would be chronic pain. The underlying reason is that pain fibers grow into the joints and a non-surgical safe way is to use high energy and put the high energy over the bones. It takes about 90 seconds for the procedure and is a very safe way to treat these kinds of pain.

Daniel: Rhizotomy. What is Rhizotomy?

Dr. Chang: Rhizotomy is done after a facet injection and the result is good with appropriate levels. We’ll use Rhizotomy, which is high energy, and place that energy at the level of the bones and sort of yank the weeds out of the grass and make sure your anatomy stays perfect and only the pain fibers go away.

Daniel: For many of my clients and others there are many myths regarding pain management… What are some of the myths you can debunk so that people can understand pain management is safe?

Dr. Chang: The good news is that it’s very difficult to paralyze someone because the spinal cord ends much higher than where we put the injection. There is zero percent chance to paralyze someone.

Daniel: OK, Thank you for your time today.

If you have any additional questions about pain management after a car accident, contact us for a free consultation.