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Juan Firnhaber, M.D. (Curriculum Vitae)
Assistant Professor, Center of Pain Medicine
Team Members
Leta Peterson, RN
Cheryl Schilb, RN
Mary Lamb, Office Coordinator
Shanna Cranford, Clinical Technician
Contact Information
501-686-8818
Faculty and Staff can access the Pain Services SharePoint site by clicking here.
The following is a list of procedures performed by the Pain Medicine team:
Occipital Nerve Block
- Occipital neuralgia
- Post-herpetic neuralgia
Cervical Facet Block
- Arthropathy/arthritis
- Headaches from cervical region.
Cervical Epidural Steroid Injection
- Cervical radiculitis/radiculopathy
- Post herpetic neuralgia
- +/- cervical disc annular tear
Cervical Selective Nerve Root Block-Transforaminal Epidural
- Cervical radiculitis/radiculopathy
- Post-herpetic neuralgia
- Diagnostic
Cervical Medical Branch Block and/or Radiofrequency Ablation
- Diagnostic/therapeutic for cervical facet arthropathy.
Thoracic Epidural Steroid Injection
- Radiculitis/radiculopathy
- Post-herpetic neuralgia
- Herpes zoster (+/-)
Intercostal Nerve Block
- Anesthesia of chest wall
- Post - herpetic neuralgia
- Neuritis
Lumbar Facet Block
- Lower back pain felt to arise from lumbar facets
- Facet arthropathy demonstrated on radiological studies that corresponds to level of pain (Facet pain is a diagnosis of exclusion and facet block is diagnostic and sometimes therapeutic)
Lumbar Epidural Steroid Injection
- Radiculopathy/Radiculitis, spinal stenosis, possible benefit in discogenic pain
Lumbar Transforaminal Epidural Steroid Injection
- Radiculopathy/Radiculitis
- Spinal stenosis
- Possible indication in discogenic pain
- Post-surgical back where anatomical considerations make translaminar approach unfeasible
- Procedure preference
Lumbar Selective Nerve Root Block
- Diagnostic/therapeutic for radiculopathy/radiculitis
- Symptomatic foraminal stenosis
Lumbar Medial Branch Block and/or Radiofrequency Ablation
- Pain associated with lumbar facets.
Sacroiliac Injection
- Lumbar back pain off neuraxis often with radiation into groin
- Sacroiliac arthropathy
Piriformis Injection
- Chronic strain of muscle
- Piriformis stretch maneuver
S1 Transforaminal Injection
- Sacral radiculitis/radiculopathy
- Lumbosacral discogenic pain
Caudal
- Lower lumbar or sacral radiculitis/radiculopathy
- Previous lumbar laminectomy with potential extensive scarring
Trigger Point Injections
- Painful muscular contractions with definable trigger points?
Ilioinguinal, Genitofemoral, Iliohypogastric Block
- Pain in groin
- Base of penis
- Mons pubis
- Scrotal sac
- Labia majora
Lateral Femoral Cutaneous Nerve Block
- Meralgia paresthetica-sensory changes in antero-lateral thigh and hip with pain and/or numbness
Stellate Ganglion Block
- Diagnosis and treatment of complex regional pain syndrome (CRPS) of the upper extremity
- Perfusion abnormalities of the upper extremity.
Celiac Plexus, Lumbar Sympathetic, Superior Hypogastric
- Celiac: acute and chronic pancreatitis, pancreatic carcinoma, upper abdominal malignancies
- Lumbar Sympathetic: Complex regional pain syndromes of the lower extremity, vascular insufficiency
- Superior hypogastric: Mid-gut and colon malignancies, sometimes rectal and pelvic malignancies
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