We offer a full compliment of interventional procedures designed to relieve pain. Most of our procedures are performed under X-ray guidance and I.V. sedation administered by highly experienced certified nurse anesthetists.
The procedures we perform include:
- Epidural Steroid Injections
- Selective Nerve Root Blocks
- Trigger Point Injections
- Peripheral Nerve Blocks
- Stellate Ganglion Blocks
- Lumbar Sympathetic Blocks
- Ultrasound Guided Procedures
- Genicular Nerve Blocks and Ablations
- Facet Injections and Medial Branch Blocks
- Radiofrequency Lesioning and Denervation
- Spinal Cord Stimulation
- Discography (Discogram)
Common Treatable Conditions
While our primary focus is interventional procedures aimed a relieving pain, we are also an excellent resource for directing patients to appropriate adjunctive therapy, such as physical therapy, occupational therapy, acupuncture, behavioral therapy and neurosurgery.
Conditions that we treat:
- Acute/Chronic Back pain
- Herniated Lumbar Disc/Sciatica pain
- Acute/Chronic Neck pain
- Post Laminectomy Syndrome (failed back surgery)
- Whiplash Injuries
- Herniated Cervical Disc
- Headache, Occipital & Cervicogenic
- Reflex Sympathetic Dystrophy (RSD) or called Complex Regional Pain Syndrome
- Post Herpetic Neuropathy (Shingles Pain)
- Diabetic Neuropathy
- Compression Fractures of the Spine
- Sacral Insufficiency Fractures
- Other Painful Conditions
Common Questions about our treatments:
What to expect after the procedure?
Some patients experience significant pain relief soon after the procedure. Some may experience some increase in the pain for few days. For some the relief may take up to 2 weeks.
What are the main side effects from steroids?
Steroids may result in a temporary increase in blood pressure and blood sugar. Some patients experience temporary weight gain. Patients who undergo repeated injection are at an increased risk for osteoporosis. For the first 2 weeks after the injection, patients are more at risk for opportunistic infection.
Other possible side effects from the procedure?
It may simply not help the pain. Any spine procedure carries a small risk of neurological injury. Injury to the spinal fluid sac can result in severe headache (Spinal headache) which may require additional procedures.
Selective Nerve Root Blocks (Transforaminal Epidural Injections)
This is a procedure in which a mixture of a steroid (cortisone) and a local anesthetic is injected in the vicinity of a nerve root. It is effective in reducing the inflammation in that particular nerve root.
This treatment is especially beneficial in patients who had undergone previous back surgery or patients with scoliosis. There are time when this procedure is also considered in patients who have not benefited from traditional epidural injections.
Side effects of steroids (please see Epidural Injections). Temporary increase in pain, because the injection is done in a relatively tight area. Spinal headache is rare after this kind of injection. Injuries to the nerve root, spinal cord or blood supply to major neurological structures (rare).
Medial Branch Block
Facet joints are an important part of the spine. They are essential for its stability. They also allow for side bending and twisting motion. Like other joints in the body, they are prone to injuries and degenerative changes which result in pain, tenderness and muscle spasms. Facet joints have a dedicated nerve supply called the medial branches. Each joint is supplied by 2 nerves. One nerve is located at the same level and a second nerve at the level just above. Medial branch blocks involve injecting a small amount of local anesthetic (novocaine) in the vicinity of each nerve.
What to expect after the procedure?
You will be asked to keep track of the pain level the first few hours. We recommend that you try the activities that would cause your pain such as walking up steps, vacuuming/sweeping the floor or mowing the lawn. When the effects of the local anesthetic wear off, the pain will return and because you have been more active it may be worse than normal. Overall this is a simple and very safe procedure. It is performed under fluoroscopic guidance and IV sedation.
The following business day, a member of our nursing staff will call you. You will be asked of the degree and duration of the pain relief. We consider 50% pain relief for several hours as a positive test. If you had a positive test, we recommend that you undergo the definitive treatment which is known as Radiofrequency Rhizotomy Procedure.
The procedure involves injecting local anesthetic near the spine. If the medicine reaches any of the major nerves; this may result in numbness and weakness in the area supplied by that nerve. This weakness will only last few hours. If this occurs to you, we recommend that you limit your activities to avoid accidents or falling down.
Any procedure may result in an allergic reaction to the medication. Other risks may be infection, injury or bleeding.
This is a procedure designed for treatment of compression fractures of the spine. One or two needles are placed into the compressed vertebral body. A balloon is then inserted through the each needle and inflated to regain the height of the vertebral body.The cavity created by the balloon is then filled with bone cement to stabilize the fracture and correct the deformity. Most patients enjoy instant relief of their back pain.