Cervical Epidural Steroid Injection

A cervical epidural steroid injection may be performed to relieve pain associated with inflammation around the nerves in the neck.

A cervical epidural injection may be used to treat the symptoms from a variety of conditions that may irritate the cervical nerve roots. For example, a cervical herniated disc may impinge on a nerve root, a degenerated disc may cause local inflammation, cervical osteoarthritis or spinal stenosis may reduce the space for the nerves, resulting in inflammation and irritation to the nerves.

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Cervical and Thoracic Facet Joint Injections

A facet joint injection may be done to help diagnose the facet joints as the source of the patient's pain, as well as to provide pain relief.

Facet joints are pairs of small joints in between the vertebrae in the back of the spine. These joints have opposing surfaces of cartilage, which limits friction between the bones. The joint is surrounded by a capsule filled with a small amount of synovial fluid. The synovial fluid acts as an additional lubricant to reduce friction between bones that rub together.

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Cervical Medial Branch Nerve Blocks

A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure.

The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure - called a medial branch radiofrequency neurotomy (or ablation) - for longer-term pain relief.

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Radiofrequency Ablation of the Cervical Facets

This minimally invasive procedure, also known as a Radio Frequency Ablation (RFA), reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals.

To treat neck pain, the RFA procedure is performed on medial branch nerves that carry pain signals from the facet joints. To treat low back pain or posterior pelvic pain from the sacroiliac joint, the RFA procedure is performed on the lateral branch nerves.

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Lumbar Epidural Steroid Injection

Many spinal conditions, including a lumbar herniated disc, can cause inflammation or pressure on the nerve roots leading out of the spine, resulting in pain, tingling, or numbness along those nerves. A lumbar epidural steroid injection may be used to reduce the inflammation around the spinal nerves.

During the procedure, the patient lies down with a cushion underneath their stomach to increase flexion in the lumbar spine, giving more room for the needle to pass through.

First, a local anesthetic is used to numb the skin above the injection site. Using a C-arm, the needle is guided into the epidural space.

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Lumbar Facet Joint Injections

Facet joints are pairs of small joints in-between the vertebrae in the back of the spine. These joints have opposing surfaces of cartilage, which limits friction between the bones. The joint is surrounded by a capsule filled with a small amount of synovial fluid. The synovial fluid acts as an additional lubricant to reduce friction between bones that rub together.

Healthy facet joints support the spine while also allowing a wide range of twisting and bending motion. These joints may become inflamed and painful due to a variety of conditions, such as osteoarthritis, degenerated discs, spinal stenosis, or from a trauma such as a car accident.

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Lumbar Medial Branch Nerve Blocks

A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure.

The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure - called a medial branch radiofrequency neurotomy (or ablation) - for longer-term pain relief.

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Lumbar Facet Radiofrequency Ablation

A radiofrequency neurotomy is a type of injection procedure used to treat facet joint pain. Facet joints are pairs of small joints between the vertebrae in the back of the spine. The facet joints support the spine while also allowing motion in terms of bending, flexing and twisting. Each facet joint is connected to two small medial branch nerves that carry pain signals from the facet joints to the brain.

A number of spinal conditions can lead to facet joint pain, such as osteoarthritis and spinal stenosis, or from a trauma to the back, such as a car accident.

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Sacroiliac Joint Injections

sacroiliac joint injection is designed to diagnose and treat pain and inflammation from sacroiliac joint dysfunction. Either too much or too little movement in one of the sacroiliac joints, which are located at the bottom of the spine on each side of the sacrum, can cause lower back pain and/or leg pain.

An injection in the sacroiliac joint usually has two goals: to confirm the sacroiliac joint as the source of the pain and to alleviate that pain.

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Spinal Cord Stimulator Trial

Spinal cord stimulation for chronic back pain uses electrical pulses to stimulate nerves in the spinal cord, with the goal of interfering with the path of pain signals as they travel to the brain.

 

The first step in the process is a trial period of spinal cord stimulation.

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Trigger Point Injections

A trigger point injection is an outpatient procedure designed to reduce or relieve the back pain caused by trigger points. These small knots can form in muscles or in the fascia tissue leading to myofascial pain.

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