Interventional Pain Management

Epidural Steroid Injections – Cervical and Lumbar

An epidural steroid injection (ESI) combines anesthesia pain relief medicine with corticosteroids, which are used to reduce inflammation and allow the body to begin the healing process. Cervical inflammation typically causes pain in the neck, shoulders or arms, and lumbar inflammation causes pain in the lower back, hip and legs.

Biacuplasty

Biacuplasty is a minimally invasive procedure that’s used to help relieve chronic discogenic (disc related) pain. The treatment uses a unique and innovative cooling system, known as water-cooled radiofrequency (RF) ablation, to treat damaged intervertebral discs. Biacuplasty delivers bipolar RF energy using tiny probes inserted within two needles that are placed bilaterally in the targeted disc. The treatment helps significantly reduce disogenic pain without having to go through a major surgery.

Botox Injections

Botox is a highly purified protein that is injected into muscles to eliminate muscle contractions. Botox injections are also used to treat chronic migraines.

Peripheral Nerve Blocks

A peripheral nerve block involves an injection that temporarily numbs a specific area. The injection stops pain signals from going to the brain, providing temporary pain relief that can have long-lasting effects.

Trigger Point Injections

Trigger points are focal areas of spasm and inflammation in skeletal muscle. The corrective procedure involves the injection of medication directly into the trigger point. Trigger point injections can be used to treat a number of conditions, including but not limited to, fibromyalgia, tension headache and neck/back pain.

Sciatic Nerve Blocks

The sciatic nerve is the largest and longest spinal nerve in the body and transmits sensory information from the legs to the spinal cord. The injection, which is a mix of a local anesthetic and a steroid, temporarily blocks the pain signal being sent to the brain by a compressed sciatic nerve. Depending on a patient’s condition and preferences, the doctor may take one of three approaches. These approaches include the anterior approach, the transgluteal approach or the subgluteal approach.

Spinal Cord Stimulator

A spinal cord stimulator is a small pulse generator that is implanted into the body. It sends mild electrical pulses to the spinal cord, which causes an interruption in the pain signal from reaching the brain. The device helps to control chronic pain and has been used for more than 30 years.

Stimwave

Stimwave’s newest FDA-cleared Freedom SCS System™ utilizes the world’s smallest, wireless, injectable neurostimulator and leverages patented advancements in nanotechnology. With this tiny injectable microchip device, the main unit transmits instructions wirelessly and can be worn on a belt or ball cap. It’s the first wireless, microtechnology neuromodulation device for relief of chronic back and leg pain. Small pulses of energy are delivered to electrodes near surrounding nerves, triggering a reaction that enables the brain to remap specific pain signals, thus providing pain relief.

Video: http://stimwave.com/

Intrathecal Pumps

An intrathecal pump delivers medication directly to intrathecal space, which surrounds the spinal cord. The pump can be programmed to release different amounts of medicine, depending on the prescription. Intrathecal pumps can help relieve chronic pain and lessen spasticity.

Video: Pain Pump Testimony

Piriformis Injections

A piriformis injection is used to treat piriformis syndrome, a common cause of buttock and leg pain. The injection goes into the buttock muscle and releases anesthetic and cortisone medication. The injection can help determine the cause of pain and temporarily eliminate pain and/or discomfort. The effects can also be long lasting.

Medial Branch Nerve Blocks

There are several types of medial nerves, all of which are located in different segments of the spine. A medial branch nerve block temporarily interrupts the pain signal that is being carried from a spinal joint. It quickly relieves pain and allows patients to go about their daily lives without having to take medications or undergo physical therapy treatment.

Radiofrequency Sympathectomy

Sympathectomy destroys nerves in the sympathetic nervous system. It is performed under anesthesia by using radiofrequency. Sympathectomy helps to increase blood flow and decrease pain from diseases involving narrowed blood vessels and complex regional pain syndrome.

Caudal Steroid Injection

The caudal steroid injection involves sending local anesthetic and steroid medication to the lower back around the irritated nerves. Caudal steroid injection is a type of epidural injection that is often used to relieve back and leg pain.

Adhesiolysis

Adhesiolysis, also known as Epidural Lysis of Adhesions or the Racz Procedure, is a minimally invasive procedure designed to eliminate scar tissue that’s causing chronic spine and extremity pain. Scar tissue is an expected result from trauma to the body, previous injury or inflammation. Adhesiolysis is performed under X-ray guidance that provides visualization of the spine. A patient is injected with a dye, which highlights the area affected by scar tissue buildup. A special Racz Catheter is then inserted to administer a mixture of medications used to break up scar tissue and decrease inflammation and pain.

Cervical Epidural Steroid Injection

A cervical steroid injection delivers steroids into the epidural space surrounding spinal nerve roots to help relieve pain in the upper spine/neck, and upper extremities often caused by irritated nerves.

Percutaneous Disectomy/Nucleoplasty

Percutaneous discectomy/nucleoplasty is a minimally invasive treatment for chronic low back pain that results from remove certain types of painful degenerative disc disease or contained disc herniation. IDET treatment may allow patients to experience significant pain relief without having to undergo major spinal surgery for disc removal, spinal fusion or disc replacement.

Suprascapular Nerve Blocks

The suprascapular nerve provides the major sensory supply to the shoulder joint. Individuals with arthritis or bursitis of the shoulder joint may experience severe pain and discomfort in the shoulder region. A surprascapular nerve block injection is used to relieve the pain resulting from these conditions. This procedure is performed for diagnostic as well as therapeutic purposes in conjunction with physical therapy.

Intercostal Nerve Blocks

Intercostal nerves are located under each rib. When one of these nerves (or the surrounding tissue) gets irritated or inflamed, it can cause pain. Two common reasons for irritated intercostal nerves are a herpes zoster infection and a surgical incision or rib fracture. An intercostal nerve block is an injection of medication that helps alleviate pain in the chest area due to these conditions.

Stellate Ganglion Blocks

During this procedure, medicine is injected into the front of the neck, on either side of the voice box. Stellate ganglion blocks usually help relieve pain in the head, neck, chest or arm, and can help identify sources of pain. Stellate ganglion blocks can also help to reduce swelling, color and sweating in the treatment of complex regional pain syndrome.

Sympathetic Blocks

The procedure involves injecting an anesthesia and a corticosteroid to the area of the sympathetic nerve ganglion. It is a minimally invasive treatment and can be very helpful in reducing chronic pain.

Facet Joint Injections

Facet joint injections are used to deliver a medication which blocks pain by anesthetizing spinal joints. They are used to determine the cause of pain in the body and to provide pain relief. Facet joint injections are also able to immediately identify sources of pain. Patients are asked to keep a pain journal for several days after this procedure. The journal is reviewed with your physician upon your next office visit.

Radiofrequency Lesioning

Radiofrequency lesioning is a procedure in which needles are used to purposefully form lesions along selected nerves. After the needles heat the nerve for about one to two minutes, the nerve ceases to carry pain signals. As the body tends to try to re-grow nerves that are blocked in this manner, surgical benefits may last anywhere from six to nine months and even permanently in some cases.

Sacroiliac Joint Injections

The sacroiliac joints, located on either side of the spine, connect the sacrum with the hip. Joint inflammation and/or dysfunction in this area can cause severe and chronic pain. When these symptoms persist, a doctor may recommend a sacroiliac joint injection. A needle containing pain-relieving medication is injected directly into the joint. This procedure is performed for diagnostic, as well as therapeutic purposes.

Discograms

This procedure uses X-ray images to examine intervertebral discs in the spine. The X-rays are used to determine sources of back pain and identify a painful or degenerative disc.

Platelet-Rich Plasma Injections

Platelet-Rich Plasma (PRP) is a patient’s own concentrated platelets. PRP injections are used to heal wounds and soft tissue. The process begins with a patient having blood samples drawn, which are placed in a centrifuge that spins the blood and separates the platelets from other components, and then the PRP is injected into the injured target area. This is a natural healing process that can effectively treat tendon, muscle, and ligament injuries that aren’t complete tears. It can be used to help with arthritis as well. PRP injections relieve pain and help strengthen and speed up the patient’s healing process as a regenerative therapy.

Stem Cell Therapy

For patients suffering from chronic joint and disc pain, stem cell therapy provides an excellent alternative as a non-invasive treatment. Regenerative therapy has also been effective in treating lung dysfunction and systemic diseases. Stem cells are taken from the patient’s fat tissue and delivered through injections to help repair damaged or degenerated tissue. The process is relatively simple and done on an outpatient basis, utilizing a mini liposuction procedure with the patient under local anesthesia. Stem cells repress inflammation, thus resulting in decreased pain and long-lasting relief. The treatments help improve function and mobility for patients.