Transforaminal Epidural Injections

About

A transforaminal epidural injection is given to patients with leg and/or back pain to relieve pain without invasive surgery. These injections allow the body time to heal in an effort to avoid more invasive surgeries.

How It Helps

A transforaminal epidural injection can help treat large disc herniation, foraminal stenosis, and lateral disc herniations.

Interlaminar Epidural Steroid Injections

About

An epidural injection helps deliver steroids into the epidural space around spinal nerve roots to relieve pain - back pain, leg pain, or other pain - caused by irritated spinal nerves. The epidural steroid injection reduces the inflammation of those nerves, which is often the source of the pain.

How It Helps

An interlaminar epidural steroid injection can help provide relief for nerve irritation along the spine.

Caudal Epidural Steroid Injections

About

The covering over the nerve roots in the spine is called the dura. The sleeve-like space surrounding the dura is called the epidural space. Nerves travel through the epidural space before they travel into your legs. The nerves leave the spine from small nerve holes. These nerves may become inflamed due to irritation from a damaged disc or from contact with a bone spur. Inflammation of these nerves may cause pain in your low back, hip, buttock, and legs. An epidural injection places anti-inflammatory medicine (cortisone) into the epidural space to reduce nerve inflammation and hopefully reduce your symptoms. By stopping or limiting nerve inflammation we may promote healing, and speed up mother nature, thereby reducing your pain.

How It Helps

A caudal epidural steroid injection can help reduce back and joint inflammation.

Epidural Lysis of Adhesions

About

Also known as the “Racz Procedure, this procedure’s name comes from “adhesion” meaning scar tissue and “lysis” meaning to dissolve or destroy. The procedure has proven effective treating chronic back and neck pain due to scar tissue formation. Scar tissue can form around nerve roots causing constant unrelenting pain. Adhesions are typically formed due to inflammation and irritation in the epidural space.

How It Helps

The procedure has proven effective treating chronic back and neck pain due to scar tissue formation.

Facet Joint Injections

About

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back. A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anesthetic (numbing agent) and/or steroid medication, which can anesthetize the facet joints and block the pain. The pain relief from a facet joint injection is intended to help a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition.

How It Helps

Facet joint injections can help treat arthritis or provide other types of pain relief.

Radiofrequency Ablation

About

Radiofrequency ablation (RFA or rhizotomy) is a procedure used to reduce pain. An electrical current is produced by a radio wave and used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area. Relief varies, depending on the causes and the location of the pain. It is possible that pain relief from RFA can last from six and up to twelve months. Some patients experience relief for years. Over 70% of patients who have RFA experience some kind of pain relief.

How It Helps

RFA can be used to help patients with chronic lower-back and neck pain, and pain related to the degeneration of joints from arthritis. The radio frequency waves are often directed at the nerves to the facet joints of the spine. These joints are located on either side of the vertebra. In order to identify the nerves that are to be treated, a local anesthetic, such as lidocaine, may be injected to see what nerve is producing the pain signals. If the anesthetic produces temporary relief, that nerve may benefit from RFA. Patients who have had temporary relief after epidural and facet joint injections may experience longer lasting relief with RFA.

Medial Branch Blocks

About

Medial branch nerves are small nerves that feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain. The medial branch block is often used as part of a 2-step diagnostic and treatment approach.

How It Helps

A medial branch block is simply diagnostic. After the test, a physician will determine what additional treatments you may need.

Types of Medial Branch Blocks

  • Cervical Medial Branch Nerve Blocks
  • Lumbar Medial Branch Nerve Blocks

Discography

About

A discogram, or discography, is an interventional diagnostic imaging test that helps determine whether a specific intervertebral disc may be the source of back pain. Intervertebral discs are sponge-like cushions between the vertebrae, or bones, of the spine. Discs act as a sort of shock absorber for the spine and help provide flexibility. Each disc has a strong outer layer called an annulus and a center part, called a nucleus, made of a soft, rubber-like material. When discs bulge or rupture, they may press on the nerves of the spinal column and cause pain or weakness. In a discogram, a contrast liquid is injected into the center of one or more spinal discs using x-ray guidance. This injection may temporarily reproduce the patient's back pain symptoms. As part of the procedure, an x-ray or CT scan also may be performed to obtain pictures of the injected disc.

How It Helps

A discogram is typically performed to help diagnose the cause of back pain and to guide the treatment of abnormal discs. The procedure also may be performed prior to surgery to help identify discs that need to be treated or removed.

Sacroiliac Joint Injections

About

The purpose of a sacroiliac joint injection is two-fold: to diagnose the source of a patient's pain, and to provide therapeutic pain relief. At times, these are separated and a patient will undergo a purely diagnostic or therapeutic injection, although often the two are combined into one injection.

How It Helps

A sacroiliac (SI) joint injection—also called a sacroiliac joint block—is primarily used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction.

Sympathetic Blocks

About

A sympathetic nerve block involves injecting numbing medicine around the sympathetic nerves in the low back or neck. By doing this, the sympathetic nervous system in that area is temporarily 'switched' off in hopes of reducing or eliminating pain. If the pain is substantially improved after the block, then a diagnosis of sympathetically mediated pain is established. The therapeutic effects of the anesthetic can occur, at times, longer than would be normally expected. The goal is to reset the sympathetic tone to a normal state of regulation. If the initial block is successful, then additional blocks may be repeated if the pain continues to sequentially diminish.

How It Helps

Sympathetic blocks temporarily “numb” the pain in the sympathetic nervous system.

Intercostal Nerve Blocks

About
An intercostal nerve block is an injection of medication that helps relieve pain in the chest area caused by a herpes zoster infection (or “shingles”) or a surgical incision. Intercostal nerves are located under each rib. When one of these nerves or the tissue around it gets irritated or inflamed, it can cause pain. A steroid medication and local anesthetic injected under the rib can help reduce the inflammation and alleviate the pain. Intercostal nerve blocks also can be used to help diagnose the source of pain.

How It Helps

An intercostal nerve block helps relieve pain in the chest area

Stellate Ganglion Blocks

About

The stellate ganglion is part of the sympathetic nervous system that is located in your neck, on either side of your voice box. A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

How It Helps

A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

Facet Joint Thermal Ablation

About
Facet thermal ablation is a minimally invasive surgical procedure is used to treat arthritic, injured or degenerative facet joints. The facet joints link the vertebrae together and enable forward movement, backward motion and twisting of the spine. Over time, as cartilage and connective tissues in the facet joints lose elasticity and begin to wear away, the bony parts of the joint can rub together, causing limited mobility and a number of painful symptoms. Often, in an attempt to repair and protect themselves, facet joints develop growths called bone spurs that can press against spinal nerves and cause painful symptoms.

How It Helps

The aim of a facet thermal ablation is to deaden the affected local nerve and clean off the joint with a laser.

Spinal Cord Stimulator

About

Spinal cord stimulation, also called neurostimulation, directs mild electrical pulses to interfere with pain messages reaching the brain. A small device implanted near the spine generates these pulses. The implanted generator used in spinal cord stimulation has similarities to a cardiac pacemaker, leading some to call the device a pacemaker for pain.

How It Helps

Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column, modifying or blocking nerve activity in a non-medicinal way to minimize the sensation of pain reaching the brain.