Facet joints are small stabilizing joints located between and behind adjacent vertebrae. Occasionally, these become inflamed due to spinal stenosis, spondylolysis, sciatica, herniated disc, or post operative degenerative changes, causing neck and back pain. A facet injection delivers a combination of long-lasting corticosteroid and anesthetic to the facet joints, relieving pain.

Cervical epidural steroid injections are done to alleviate inflammation in the cervical, or neck area, by delivering steroid with or without an anesthetic to the epidural space within the spine. This decreases inflammation of the nerve roots, thus healing an injury. This type of injection can cause relief for up to several months. The procedure takes up to thirty minutes plus approximately forty-five minutes recovery time.

A trigger point forms when a muscle becomes tight and fails to relax. The knot can often be felt under the skin and may twitch involuntarily when touched. A trigger point can irritate surrounding nerves as well as cause referred pain (pain felt in another part of the body). A small needle is inserted into the trigger point and a local anesthetic (e.g., lidocaine, bupivacaine) with or without a corticosteroid is injected. Injection of medication inactivates the trigger point and thus alleviates pain. Sustained relief usually is achieved with a brief course of treatment. The injection may cause a twitch or pain that lasts a few seconds to a few minutes.

A spinal cord stimulator (SCS), is an implantable medical device used to treat chronic neurological pain. Implanted into the epidural space in the spine, this device sends an electric impulse, altering the body’s perception of pain. This device helps relieve chronic pain disorders such as failed back surgery syndrome, complex regional pain syndrome, and peripheral neuropathy.

The sacroiliac joint is the large joint between the sacrum at the base of the spine and the ilium of the pelvis. There are 2 (right and left) and when one becomes painful, it can cause pain in its immediate region or it can refer pain into your groin, abdomen, hip, buttock or leg.

A sacroiliac joint injection may reduce inflammation and provide long term relief. It can also help determine the source of pain, if pain decreases after injection.

We administer selective nerve root block (SNRB) to diagnose the specific source of nerve root pain and for therapeutic relief of low back pain and/or leg pain. We use fluoroscopy as a rapid and effective means of guiding needle placement when performing selective lumbar nerve root blocks. Fluoroscopic guidance increases the accuracy of needle placement, and thus the specificity of the examination.

These injections can be done at various sites, and the needle is visualized in real time as it enters the body by using an ultrasound machine. This allows more precise injections to the intended location.

Lumbar epidural steroid injections are done to alleviate inflammation in the lumbar area of the back, by delivering an anesthetic and steroid to the epidural space within the spine. This decreases inflammation of the nerve roots, thus healing an injury. This type of injection can cause relief for up to several months. The procedure takes up to thirty minutes plus approximately forty-five minutes recovery time.

Thoracic epidural steroid injections are done to alleviate inflammation in the thoracic area of the back, by delivering an anesthetic and steroid to the epidural space within the spine. This decreases inflammation of the nerve roots, thus healing an injury. This type of injection can cause relief for up to several months. The procedure takes up to thirty minutes plus approximately forty-five minutes recovery time

Bursa injections can help diagnose the source of pain and provide relief by delivering local anesthetic and anti-inflammatory steroid medications into specific synovial fluid filled fibrous sacs (bursa), which are adjacent to joints in the body. This procedure may reduce inflammation, resulting in long-term pain relief..

This type of injection is both diagnostic and therapeutic. The piriformis muscle begins in the pelvis and connects to the sacrum. Because it sits on top of the sciatic nerve, pain in the piriformis muscle can cause symptoms of sciatica. Piriformis injections can help pinpoint the source of pain and can relieve back pain if the piriformis is the culprit.

A medial branch block can relieve pain primarily in the neck or back, caused by arthritic changes in the facet joints for mechanical low back pain. These blocks consist of injecting medication outside the joint space near the nerve that supplies the joint called the medial branch (steroid may or may not be used). Multiple injections may be required, depending upon how many joints are involved. A block may be therapeutic and/ or diagnostic.

A Costochondral joint injection is used to treat refractory cases of costochondritis, which causes severe pain. Lidocaine, or a combination of corticosteroid and lidocaine, is injected.