Epidural injections utilize anti-inflammatory medications to decrease swelling and inflammation along the nerves and discs in the cervical, thoracic and lumbar spine. By decreasing the inflammation and removing chemical mediators that cause back and sciatic pain symptoms resolve quickly. These are particularly helpful for mild to moderate disc protrusions.
Nerve blocks are frequently used by pain management specialists to diagnose the exact level from which the pain originates. They can also decrease inflammation around the nerve which will then remove the radicular or sciatic pain patients' experience.
Radiofrequency Ablation is done to remove pain caused by facet joints in the cervical or lumbar spine. These small joints allow the spine to flex and extend. They can become inflamed or become arthritic. This causes the pain upon back motion. Radiofrequency is painless and allow the physician to burn the abnormal nerves which carry the painful signal from the damaged facets.
Spinal Cord Stimulation
This technique is for the treatment of chronic low back and sciatic pain. A small implant is placed along the epidural region. Electrical impulses produce a pleasant sensation and the frequency blocks the low back or sciatic pain. This small device is controlled by the patient. In additional a simple trial can be done to ensure the implant will work.
A naturally occurring lubricating substance is injected under ultrasound guidance into the knee joint. This replaced the depleted synovial fluid and stimulates the cells in the knee to produce more lubricating fluid and decrease chemical mediator of pain. This provides six to ten months of relief from arthritic knee pain.
Platelet Rich Plasma (PRP)
Platelet Rich Plasma is a relatively new technique that uses the growth factors in your own blood to accelerate healing od damaged tissue. It is most commonly used for ligament and tendons strains and sprangs. It is also popular to decrease the pain and promote healing of joints with osteoarthritis. A small sample of the patients' blood is drawn and the platter rich component is removed. This component of platelets also contains the body's growth factors used in healing damaged tissue. The concentrated platelet rich plasma (PRP) is then injected into and around the point of injury, jump-starting the healing process. Because your own blood is used, there is no risk of a transmissible infection.
Medtronic infusion devices are used for patients with severe intractable pain that does not respond to conventional techniques. The spinal column contains the receptors which transmit pain from the body to the brain. By placing a small catheter into the spinal fluid and connecting it to a small implantable pump; an extremely small steady infusion can occur. This binds and blocks the pain receptors thus inhibiting a pain signal from reaching the brain. For patients experiencing severe daily pain this outpatient technique allows patients to regain their independence and restore function.
Facet joint injection
These simple injections help confirm if the pain is emanating from the facet joints along the spine. If pain is temporarily alleviated the permanent radiofrequency procedure can then be performed.
Lumbar Sympathetic Block
This simple procedure is done to remove pain in either the right or left leg caused by trauma to muscle and nerves in the affected limb. This is particularly helpful after bone fractures with significant tissue and nerve damage.
Sacroiliac Joint Injection
This large joint supports the weight of the entire torso and upper body. When these ligaments are damaged the pain is sharp and debilitating. A small injection can remove pain and induce the healing process.
Stellate Ganglion Block
This is used when severe tissue bone and nerve damage has occurred to the upper extremities (arms). The pain produced is also known as Reflex Sympathetic Dystrophy or Complex Regional Pain Syndrome. A small injection along the base of the neck will interrupt and inhibit the severe pain from reaching the spinal column and being transmitted to the brain.
A Discogram is done to confirm that the disc in the lumbar or cervical spine is the source of pain. A small amount of radiocontrast is placed in the disc and outlines the shape or disc morphology. By doing this tears and aberrations within the disc can be identified.
San Diego Comprehensive Pain Management Center
3703 Camino Del Rio South, suite 210, San Diego, CA 92108 (619) 640-5555