Improving Life Through Pain Management
The spine consists of 26 individual bones that connect to create joints along with supportive tissue like ligaments. All this surrounds nerves that make your body move. It is a complex structure, so several things can go wrong.
Trigger Point Injections
A trigger point injection allows the physician to deliver a local anesthetic to a muscle. Injections may be just an anesthetic or include a steroid.
Trigger point injections can help loosen a tight muscle for those in an active strengthening or stretching program. The physician may repeat the injection to help you perform critical exercises that prevent the need for the treatment in the future.
Some patients experience numbness or muscle weakness for a few hours if the anesthetic reaches a nerve. That may make it difficult for you to walk, in which case, you’ll need to remain in the office until it passes.
Hip Joint Injections
Patients experience hip pain for a variety of reasons, including arthritis, mechanical stress, or labral injury. A hip joint injection delivers numbing medication to the affected joint for immediate pain relief.
The first injection identifies the joint causing pain to your hip, buttock, or leg. Next, the physician delivers time-release cortisone to the same joint to reduce inflammation. That may offer long-term pain relief. It’s important to tell the doctor if you take a blood thinner such as Coumadin, aspirin, Plavix, or Plestal. Also, let them know if you take anti-inflammatories.
About 30 minutes after the procedure, you will move the hip to see if you are experiencing relief. It may take a few hours to get relief, and you may notice numbness or weakness in that leg for a while. As the numbing medication wears off, the pain may return, as well. The cortisone will kick in a few days later for pain relief and improved mobility.
Bursitis Injections
Bursitis injections are for patients with greater trochanteric bursitis or bursa inflammation. Years of wear and tear can cause inflammation in the fluid-filled sacs that sit around joints. The treatment reduces swelling that can lead to a dull ache or stiffness in the hip joint. If conservative treatments like ice and rest don’t relieve the pain, the physician can inject a corticosteroid drug into the bursa to reduce the inflammation and pain. This procedure is not safe for patients with an infection, flu, or who have very high blood pressure. It’s important to let the staff know if you have any of these conditions.
Genicular Nerve Block
The genicular nerve block is both a form of short-term pain relief and a diagnostic tool. The doctor injects a local anesthetic into the knee joint using x-ray guidance. If the patient experiences pain relief, that test indicates the need for a radiofrequency (RF) procedure to cauterize nerves causing the pain.
The pain relief from the injection lasts only a few hours. If the pain returns, then that is a positive result, and the RF is necessary. The doctor conducts that test two times to ensure accuracy before performing the RF.
During the procedure, the doctor uses x-ray guidance to ensure the proper placement of the needle near the genicular nerve. Patients should feel relief within one hour of the treatment.
Suprascapular Injections
Suprascapular injections block nerves using a local anesthetic and steroid medication that affects shoulder pain. The physician uses fluoroscopic x-ray technology or ultrasonic guidance to locate the appropriate nerves.
This procedure provides pain relief but is also a diagnostic tool. Patients that experience less pain after receiving the steroid may be eligible for radiofrequency denervation for long-term relief — typically lasting for six months to one year.
Radiofrequency denervation is an ablation procedure that takes just seconds to complete. It may feel like a cramp in your shoulder. Patients with shoulder pain, a rotator cuff injury, or scapular pain can benefit from this treatment.
Selective Nerve Root Block Injection
A selective nerve root block injection delivers a cocktail consisting of a local anesthetic and a steroid to a nerve root. The goal is to provide pain relief and identify the place in the spine causing the pain.
If the treatment fails to result in pain relief, then the treatment isn’t in the right position. If the pain goes away but comes back in a few hours, it indicates the correct placement of the injection but that this might not be the most effective treatment. If you experience pain relief that lasts over several days, then the treatment is effective.
Facet Joint Injection
Facet joint injections provide pain-relieving medication, typically an anesthetic and steroid cocktail, to a spinal joint. Joints are what connect the vertebrae. The treatment is for patients with chronic inflammation of the facet joint, arthritis in the joints, back or neck pain. It may also be effective for those with pain or neurological symptoms in an arm or leg.
The pain management specialist will numb the area with a local anesthetic and use fluoroscopy to place the injection properly. Once complete, patients experience pain relief for three to six months.
Stellate Ganglion Block
A stellate ganglion block helps to diagnose and treat neuropathic pain in the arm or hand. These patients may experience a burning sensation in the arm or hand and be sensitive to touch. A stellate ganglion block delivers medication to a bundle (ganglion) of nerves in the neck. These are sympathetic nerves that affect the arm or hand.
This treatment is not right for patients with an infection, flu, fever, or very high blood pressure. It’s important to tell the physician if you have any of these problems prior to getting the treatment.
Lumbar Sympathetic Block
A lumbar sympathetic block is an injection of a local anesthetic and possibly a steroid to sympathetic nerves in the spine. These nerves can sometimes cause pain after an injury.
The treatment is both for pain relief and to help with a diagnosis. If the patient experiences pain relief, the physician gets a better understanding of the problem.
A lumbar sympathetic block may be effective for a variety of conditions, including phantom limb pain, complex regional pain syndromes, and shingles in the legs.