Epidural Steroid Therapy

• Interlaminar
• Transforaminal
• Caudal

The epidural steroid injection is an injection of steroid-anesthetic into the spine to treat pain in the back or neck. Conditions such as herniated discs and spinal stenosis can compress nerves, causing inflammation and pain. The medication injected helps decrease the swelling of nerves.

Facet Joint Therapy

• Medial Branch Nerve Blocks

Facet joints are found on both sides of the spine. Each vertebra connects at these joints. The process of inflammation of facet joints is also called spondylosis of the neck or the lumbar spine. The injection of numbing medicine bathes the medial branch nerves, which attach to the facet joints, and helps to diagnose the source of the pain.

Sacroiliac Joint Therapy

The sacroiliac joint is the largest joint between the sacrum and the pelvic bone. Pain in the buttock area at the side of the tailbone may be due to sacroiliac inflammation or damage. This injection procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce swelling and inflammation in the joint.

Radiofrequency Neurotomy Procedures

Radiofrequency neurotomy uses heat to target specific nerves and temporarily impair their ability to send pain signals. If the patient obtains excellent pain relief from the diagnostic blocks, then radiofrequency neurotomy is indicated for long-term pain relief. This minimally invasive procedure is most commonly used for pain in the back, neck and buttocks (sacroiliac joint). It may also be helpful for knee joint pain.

Nerve Blocks

• Occipital Nerve Blocks
• Peripheral Nerve Blocks
• Selective Nerve Root Blocks
• Sympathetic Nerve Blocks – Lumbar, Ganglion Impar
• Stellate Ganglion Nerve Blocks

Interrupting the nerves, which carry the painful information to the brain, can give temporary or long-term relief from pain. Long-term disruption of nerves using powerful medication can be appropriate in cancer pain syndromes.
Nerve blocks for various syndromes are commonly performed and are tailored to the specific patient and diagnosis. Sometimes, nerve blocks can assist in understanding where a pain is coming from when it is unknown.
This procedure is an injection that numbs branches of nerves in the neck or lower back. Usually, a series of injections is needed to treat a problem.

Spinal Cord Stimulation

Spinal cord stimulation (also called SCS) is a therapy most commonly done to patients when conservative treatments have failed. It is believed that passing an electrical current through nerves along the painful pathway can generate a soothing feeling which blocks the pain.
A trial of spinal cord stimulation is performed in order to see if a positive response is achieved. If so, a separate procedure is performed to implant a small rechargeable battery pacemaker and electrical leads underneath the skin. The patient uses a remote control to change the stimulation as needed.

Trigger Point Injection Therapy

Small, tender knots can form in muscles or the fascia. Muscles may become damaged and painful. The injection of local anesthetic into the area is designed to reduce or relieve the pain and tenderness (trigger point) can relax the muscle and allow it to heal. The trigger point injection procedure takes only a few minutes to complete.

Peripheral Joint Injections – shoulder, hip, knee