Transforaminal epidural steroid injection
A more effective epidural where the medication is targeted at the nerve roots that are affected by disc disease. This treatment is used in the lumbar and thoracic spine for treatment of radiculopathy, sciatica or herniated disc disease.
Intralaminar epidural steroid injection
Used in the cervical spine for pain in the neck that radiates into the shoulders or arms. This treatment involves injecting medication into the epidural space to decrease swelling around a herniated disc.
Sacroiliac joint injection
The medication is injected into the sacroiliac joint which joins the sacrum and ilium. Usually the pain is localized over the sacroiliac joint in the buttock.
Facet joint injection
A diagnostic injection, used prior to radiofrequency ablation, that helps determine if the pain comes from the facet joints in the cervical, thoracic, or lumbar spine. This pain starts in the spine and may radiate to the side, but does not affect the arms or legs.
Spinal cord stimulation
A pacemaker for the spine that sits in the epidural space. This implanted device is used for patients who previously have had surgery and still have pain. Prior to advancing to stimulator placement the device is tested to confirm adequate pain control. Also effective in intractable pain of diabetic neuropathy.
Discography
A diagnostic technique to determine if a disc is the cause of a patient’s pain. This procedure can be used pre-surgery to help the surgeon identify the painful disc or prior to a discectomy to make sure there is no tear in the disc.
Percutaneous lumbar fusion
An injection where a bone plug is placed into the facet joints to offer lumbar stabilization. This outpatient procedure is used for patients with facet medicated pain who failed radiofrequency ablation. It is used as an alternative to surgical lumbar fusion.
Radiofrequency ablation
A long-term solution to lumbar facet arthropathy. A needle with an electrical tip is utilized to “burn” the medial branch nerves that supply the facet joints. Usually patients who suffer from lumbar facet arthropathy have pain isolated to their spine. This can also be utilized in sacroiliac joint pain.
Brachial plexus block
A diagnostic injection to determine if the pain is starting in the brachial plexus. This procedure can also be used pre-surgery to help with pain control.
Stellate ganglion block
A block of the sympathetic(fight or flight) nervous system in the neck. This treatment is used to treat CRPS (RSD) of the upper extremity. It has been demonstrated to help post-herpetic neuralgia and facial pain as well.
Celiac plexus block
Another sympathetic nervous system injection that is used for patients with abdominal pain who are suffering from cancer.
Lumbar sympathetic block
Another block of the sympathetic nervous system used for CRPS of the legs and feet. Usually part of a series of injections that helps the patient tolerate the pain to participate in physical therapy.
Ganglion of impar injection
The final sympathetic block that is used for pelvic pain or cancer pain from the rectum.
Intrathecal pump
A pump that places medication directly into the fluid around the spinal cord. The permanent pump is placed after a test dose of medication to confirm that the medication is more affective when placed into the spinal fluid. This device is used to treat cancer pain or spasticity from Multiple Sclerosis. When medication is placed into the fluid around the spinal cord the side effects are usually diminished and the efficacy is increased.
Trigger point injection
An injection into the tender point in the muscle to reduce the pain associated with myofascial pain. This treatment is used to help decrease symptoms associated with many different pain states.
Joint injections
Injections into the ankle, knee, hip, wrist, elbow or shoulder joints that reduce swelling associated with arthritis.
Ligament/Tendon injection
Injection around a swollen ligament or tendon to reduce pain.
Lateral A-A block
An injection at the base of the skull used to help determine to cause of headaches. This injection can be both diagnostic and therapeutic.
Caudal injection
An alternate approach to the epidural space used after the patient has had back surgery. This injection is used when the symptoms do not point to specific nerves causing the pain.
Racz procedure
A catheter is placed in the epidural space and advanced to the nerve root where the pain starts. The catheter and medication are used to break up the scar tissue and free the nerve root, therefore reducing the pain.
Ilioinguinal nerve block
Used to treat lower abdominal or pelvic pain. This treatment helps decrease the pain from ilioinginal entrapment after hernia surgery.
Coccygeal nerve block
An injection used to treat coccydynia. Other treatments for coccydynia include caudal injection and ganglion of impar injection.
Supracluneal nerve block
An injection of the nerves as they cross the top of the hip. Patients are suffering from hip, abdominal or pelvic pain and have tenderness when the top of the hip is pressed.
Cryoneurolysis
A more permanent destruction of sensory nerves or a neuroma that is similar to radiofrequency ablation. Rather than using heat, cold is used to stop transmission of the electrical signal along the nerve.
