Treatments ~ Injections
Cervical Epidural Steroid Injection
The cervical vertebrae are essentially the neck vertebrae. When neck pain is present as a result of a pinched nerve or nerve irritation, often the best solution is a cervical epidural steroid injection. During the procedure, an anti-inflammatory steroid is injected directly into the epidural space, flooding the nerve with the powerful medication. The entire procedure is performed using fluoroscopy guidance, to ensure patient safety and surgical accuracy. You can think of fluoroscopy as a sort of real-time x-ray imaging.
Epidural Steroid Injection
Epidural steroid injections, or ESIs, are a minimally invasive treatment that has been used for decades to temporarily relieve low back and leg pain (sciatica). While they do not treat serious underlying spinal conditions, ESIs are often effective in relieving the chronic pain these conditions often cause. During the procedure, anti-inflammatory medication (steroids) are injected directly into the epidural space-the outermost space of the spine.
Facet Joint Injection
A facet injection is a minimally invasive treatment option for pain caused by inflamed facet joints. Facet joint pain is often related to spinal stenosis, sciatica or arthritis and is characterized by neck, arm, low back or leg pain. Each vertebra has four facet joints that connect it to the vertebra above and below. The injection may also be used as a diagnostic test to determine if facet joint inflammation is the source of a patient's pain.
A facet injection is a combination of a long-lasting steroid and a local anesthetic that are injected either into the joint capsule or its surrounding tissue. The steroid reduces inflammation and can relieve pain for a few days to a few years. This procedure can be repeated up to three times a year for those who experienced successful but short-term pain relief.
Joint injections can be a very effective method of obtaining relief from a variety of conditions and injuries affecting a joint. The medications administered during these injections only affect the targeted area and do not usually cause side effects. Joint injections are commonly used by doctors to treat conditions such as gout, tendinitis, bursitis, arthritis, rheumatoid arthritis and occasionally osteoarthritis. Joint injections can also be useful for diagnosing many conditions that impact joints by determining the cause of a patient's pain, stiffness, and limited range of motion. Joint injections may be administered to relieve pain in the shoulder, knee, ankle, elbow, wrist, thumb, and hip.
Joint injections are minimally invasive procedures that are typically performed under local anesthesia in either a doctor's office or a hospital. The procedure generally takes about 20 minutes to complete. After the surface of the skin is thoroughly cleaned, a needle attached to a syringe is inserted into the joint. Corticosteroid medications may be administered to reduce the inflammation in the joint. A numbing agent, such as lidocaine, may also be administered in order to relieve the pain in the affected joint. Not only will a joint injection alleviate painful symptoms, but the injection may also help the doctor determine the source of the joint pain.
The results of a joint injection are usually immediate, although only temporary. Pain relief and increased function in the joint may last for up to six months. In some cases, patients may not experience respite after the first injection. However, up to three injections can safely be performed within a six-month period, provided at least two to three weeks apart. Repeated injections may offer an extended reduction of symptoms.
Sacroiliac Joint Steroid Injection
Sacroiliac joint steroid injections help to diagnose and relieve lower-back pain caused by problems with one or both of the sacroiliac joints, which connect the spine's base (sacrum) to the pelvis's ilium bones. If one or both of the sacroiliac joints is inflamed (sacroiliac-joint dysfunction), a patient can experience pain in the buttocks and lower back that worsens when running or standing. Sacroiliac-joint dysfunction can be caused by osteoarthritis, traumatic injury, pregnancy, inflammatory joint disease, or underlying structural abnormalities.
A sacroiliac-joint steroid injection is used to confirm a diagnosis of sacroiliac-joint dysfunction. If the injection provides pain relief, it establishes the joint as the pain's source, and, at the same time, acts as a treatment. Corticosteroids, along with a local anesthetic and saline solution, are injected directly into the sacroiliac joint, reducing swelling and pain for, possibly, several months.
As with other spinal blocks, a sacroiliac-joint injection can be repeated up to 3 times a year. Spinal injections only provide temporary relief from pain; they are not a cure. For that, surgery may be necessary.
Trigger-point injections treat pain in areas that have developed trigger points, which are knots of muscle that form when muscles contract and but cannot relax. Trigger points are caused by injury to or overuse of the affected muscle; they can also be caused by stress and anxiety. They can irritate the nerves around them, which causes pain in other areas of the body. The chronic pain brought on by trigger points can also decrease the affected muscle's range of motion.
Trigger-point injections are typically used to treat pain in the neck, lower back, arms and legs. They can also be effective for tension headaches, temporomandibular joint (TMJ) pain or fibromyalgia, and for myofascial pain syndrome, a chronic pain condition in which trigger points develop in certain muscles, and cause pain when touched. Patients with this condition often experience deep, aching pain in the affected muscle that worsens over time, as well as muscle and joint stiffness, and difficulty sleeping. Symptoms can significantly affect a person's quality of life, and should be addressed if they do not subside. Over time, patients with untreated myofascial pain syndrome can develop muscle weakness or fibromyalgia.
A needle containing a local anesthetic, and, sometimes, a corticosteroid to reduce inflammation, is inserted into the trigger point to make it inactive and, therefore, alleviate the pain. The procedure typically takes between 15 and 20 minutes, and is done in a doctor's office. If necessary, multiple sites can receive trigger point injections in one appointment.