Procedures
Ankle Injections
Ankle pain is common after trauma with fractures or sprains, causing difficulty with activities that consist of standing and walking. The ankle can be injected with pain medication and steroid to reduce pain inflammation.
Epidural Injections
Spinal pain is often caused by irritated or damaged nerves from the neck or back. These nerves travel into the arms or legs and can cause pain, burning, tingling or even weakness and muscle loss. The pain specialist physician uses a specialized x-ray machine to guide the needle to the area causing the symptoms and instill this region with pain medications and steroids which help reduce swelling and heal the nerves. The epidural injection takes 5-10 minutes depending on how many nerves are involved. It is a safe and very effective procedure for Pain Management.
Facet Injections
Facets are located on the spine, these are joints or knots you see when looking at your back. They can become inflamed, just as any other joint in the human body by excessive use. By using a steroid facet injection, you can reduce this inflammation and pain. They can be performed in the cervical, thoracic or lumbar spine
Hip Bursa Injections
The hip may be painful from an inflamed bursa, which can affect walking and even sleeping. Pain medicine and steroids are injected into the inflamed region which is found shallow to and overlying the hip joint.
Hip/Trochanteric bursa
Development of hip arthritis is a common cause of pain and makes it difficult to walk. The pain specialist will guide a needle into this joint using a specialized x-ray where either steroids or a unique lubricant “made from rooster comb” will be injected.
Knee Injections
Knees are often painful because of injury from trauma, torn ligaments or from development of arthritis with age or repetition trauma. The pain physician locates the joint and will inject pain medicine or steroids to help reduce inflammation and pain. Sometimes a specialized lubricant made from “rooster comb” may be used to give pain relief that potentially lasts 6-10 months.
Medial Branch (Nerve) Blocks
Facet joints are often the cause of spinal pain. These are small joints in the back of the spinal bones and overlap each other like shingles on a roof. These joints can become arthritic and develop pain with movement. The pain physician uses a specialized x-ray to locate small nerves which give feeling to these joints and inject pain medicine and steroids to block the pain and determine which joints are causing the symptoms.
Radio frequency Nerve Ablation or RFA
After the pain physician has determined which spinal joints are responsible for causing pain (by the median branch block) he will use a specialized needle to permanently block the pain signals. This needle is placed alongside the nerves which give feeling to the involved facet joint. The needle tip is heated to 80 degrees for 2 minutes which then activates 3 nerves. The patient feels only a vague warm sensation in their back but often obtains pain relief for 6-10 months (until the nerves grow back).
Sacroiliac joint injection
The Sacroiliac or SI joint injections are a cause of low back pain and pelvic pain. Involvement may be due to pelvic trauma with strain of the supporting ligaments or arthritis of the joint. Since this is a curved joint, the pain physician uses a specialized x-ray to find this joint and then injects pain medication and a steroid to reduce pain and inflammation.
Shoulder Injections
The shoulder joint is complex and made up of four separate main joints as well as several tendons and bursa. The pain physician will determine exactly where the shoulder pain is coming from. Injections can be performed into the targeted region using pain medicine and steroid to reduce pain and inflammation. In some cases a specialized lubricant made from “rooster comb” may be used to give pain relief that potentially lasts 6-10 months.
Sympathetic Nerve Blocks
It is common to develop significant pain on an arm or leg after trauma or surgery of a joint. The nerves into these limbs become very inflamed causing burning, tingling with a cold sensation, stiffness and weakness. The pain physician can place pain medication and steroids along these nerves (in the neck or back) to reduce pain and swelling. Oftentimes there is immediate return of warmth and movement to those involved limbs.
Trigger Point Injections
Muscle spasms is often responsible for pain and patients may have a long term connection from sports injuries, abnormal positions, postures at work activities or related to diseases like fibromyalgia. The involved muscles often feel hard, tight, and knotty—usually having a decreased motion. The pain physician will inject the tender areas with pain medication (and possibly steroids) to reduce spasms, help relax the muscles and decrease pain.