Lumbar and Cervical Epidural Steroid Injections
An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing or managing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.
Lumbar and Cervical Facet Blocks
Facet joints are small joints that attach the vertebral bodies together and allow motion such as flexion, extension and turning in the spinal column. Similar to other joints, facet joints can also develop arthritis type conditions and be a source of back pain. Facet joint pain can be diagnosed by physical exam, x ray and diagnostic injections called facet blocks.
This procedure relieves pain by desensitizing the nerve that sends pain signals to the brain.
Selective Nerve Root Blocks
Selective Nerve Root Blocks is performed with the aid of fluoroscopic x-ray imaging in injecting a small amount of local anesthetic and steroid in close proximity to the spinal nerve root where the pain is being generated. This method of pain management is more effective as the medicine is placed closer to the pain generating site.
Discography is a diagnostic test by which the integrity of an intervertebral disc is tested through injection of contrast material in the disc. Normal discs can withstand certain amount of pressure without pain. Abnormal discs such as those with tears or degeneration will be painful with pressurization. A discogram is typically followed by a CT scan to evaluate the spread of contrast within the disc.
Stellate Ganglion Block
A block that is performed under fluoroscopy to determine if there is damage to the sympathetic nerve chain and if it is the source of the patient’s arm pain. This is primarily a diagnostic block but it may provide pain relief in excess of the duration of the anesthetic.
Lumbar Sympathetic Block
A Lumbar Sympathetic nerve Block involves injecting medicine around the sympathetic nerves in a lumbar or cervical area. By doing this, the system is temporarily blocked in hopes of reducing or eliminating pain. If the initial block is successful, then additional blocks are generally repeated in 7-10 days and repeated again until the pain diminishes.
Celiac Plexus Block
By blocking the Celiac Plexus, pain in the abdomen from tumors such as pancreatic tumors can be effectively treated. This procedure is usually reserved to patients with severe abdominal pain due to cancer.
Spinal Cord Stimulator Trials
In the wide world of pain-relief treatment options, one that has been successful for many chronic back pain sufferers is spinal cord stimulation. In this therapy, electrical impulses are used to block pain from being perceived in the brain. Instead of pain, the patient feels a mild tingling sensation.
Sacroiliac Joint Injections
The sacroiliac facet joints are a small joint in the region of the low back and buttocks where the pelvis actually joins with the spine. If the joints become painful they may cause pain in the low back, buttocks, abdomen, groin or legs.
A sacroiliac joint injection serves several purposes in pain management. First, by placing numbing medicine into the joint, the amount of immediate pain relief experienced will help confirm or deny the joint as a source of pain. Additionally, the temporary relief of the numbing medicine may better allow a chiropractor or physical therapist to treat that joint. Also, time release cortisone (steroid) will help to reduce any inflammation that may exist within the joint(s).
Trigger Point Injections
Specific areas in muscles and tendon/ligaments that are tender to touch are called Trigger Points. These can be injected by local anesthetic and steroid (cortisone) combination to relax the affected muscle and/or reduce inflammation in the area.
Knee, Shoulder and Elbow Injections
Any joint that is inflamed due to arthritis or injury can be injected by local anesthetic and steroids (cortisone) to reduce the inflammation and pain.