An Individualized Method For Interventional Pain Management

Conditions like herniated discs and spinal stenosis can compress nerves, leading to inflammation and pain. This pain may radiate to other areas, such as the arms or legs. Epidural injections are outpatient treatments designed to relieve pain in the arms, shoulders, and neck (for cervical epidurals) or in the legs, hips, and lower back (for lumbar epidurals). By injecting steroid medication, these injections help reduce nerve swelling and inflammation, which can alleviate pain. Epidural steroid injections can be administered in the cervical, thoracic, or lumbar regions of the spine.

An intra-articular injection is designed primarily to relieve pain in the knees, shoulders, ankles, and hips. These injections come in various forms, including hyaluronic acid, local anesthetics, platelet-rich plasma (PRP), and corticosteroids. Each type serves a specific purpose in alleviating pain and addressing inflammation issues.

A medial branch block is a diagnostic procedure used to identify a painful facet joint. The facet joints are located between the vertebrae in the spine and allow the spine to bend, flex, and twist. In addition to providing temporary pain relief, medial branch blocks help with diagnosis. The nerves responsible for transmitting pain signals from the facet joints to the brain are called medial branch nerves. When a branch block is administered and the pain diminishes, it helps pinpoint and confirm the source of the pain. If successful, you may be a candidate for radiofrequency ablation.

A sacroiliac (“SI”) joint injection, like most of our other injections, is designed to identify the cause of low back pain and reduce discomfort. The procedure involves numbing the joint with an SI joint injection and using contrast for precision. If you experience noticeable pain relief, it’s likely that the sacroiliac joint is the source of the pain, and anti-inflammatory medication may be recommended. When combined with physical therapy and rehabilitation, these injections can help alleviate chronic pain.

If diagnostic medial branch blocks successfully relieve facet joint pain for a short period, you may be a candidate for radiofrequency ablation. In this minimally invasive procedure, the physician uses heat from radio waves to treat the painful facet joints, a process also known as radiofrequency rhizotomy. This treatment can address pain that hasn’t responded to medications or physical therapy. Radiofrequency ablation can provide relief from facet joint pain for anywhere from six months to two years.

A sympathetic nerve block can be used to diagnose or treat pain related to the sympathetic nervous system—a network of nerves that extends from your spine and controls various involuntary body functions like blood flow, digestion, and sweating. The location of your pain generally dictates where the nerve block will be administered. This procedure is primarily used to treat complex regional pain syndrome. Additionally, a stellate ganglion block, which is a type of sympathetic block in the cervical spine, may help alleviate symptoms of long COVID (such as loss of smell), post-traumatic stress disorder, and other conditions.

Spinal cord stimulation (SCS) uses electrical impulses to relieve chronic pain in the back, arms, and legs. It is thought that these electrical pulses prevent pain signals from reaching the brain. SCS is also an option for people with neuropathic pain. However, conservative treatments like medication, physical therapy, chiropractic care, and home exercises should be tried first before considering SCS. Patients typically undergo a trial period to assess whether the implant will be effective for them before a permanent SCS implantation is performed.

Kyphoplasty is a minimally invasive procedure used to treat compression fractures. During the procedure, bone cement is injected into the fractured vertebrae to fill the damaged areas and help stabilize and strengthen the spine. One or more vertebrae may need to be treated.