Facet Nerve Block
Diagnostic blocks are done to ascertain if facet joints are the source of pain and inflammation.
Lumbar Epidural Steroid Injection
Done to relieve shooting, burning leg pain that is radiating in character and also for chronic low back pain due to degenerative disc disease or spinal stenosis.
Lumbar Facet Nerve Radio Frequency Neurotomy
This is a state of the art procedure to deaden nerves. Radio waves are used to heat the tip of the needle (cannula). It is a minimally invasive procedure and it is done for longer lasting relief of lower back pain. Nerves can regrow and pain can return usually after several months. The procedure can be repeated again.
Lumbar Sympathetic Block
Done to relieve leg pain due to complex regional pain syndromes. These syndromes are seen after an injury to the joint or limb.
Cervical Epidural Steroid Injection
Done to relieve neck pain with or without radiation to upper arms and shoulders. This could be due to conditions such as herniated discs, spinal stenosis, degenerative disc disease, etc which can cause inflammation and pain from the nerves. The injected medication helps to calm down the affected nerve.
Transforminal Epidural Steroid Injection
Performed to relieve chronic lower back and leg pain that is radiating in character. The nerve root can become inflammed due to conditions like spinalstenosis, sciatica, herniated discs and radiculopathy. In certain cases, it is important to repeat the procedure 2-3 times over a period of weeks some patients may get good relief with 1-2 injections.
Stellate Ganglion Block
This nerve block is done both diagnostically and therapeutically to manage the pain coming from painful sympathetic nerves. It is given in conditions like reflex sympathetic dystrophy, complex regional pain syndromes affecting the neck, arms and face. Several injections may be needed to calm down the irritated nerves.
Caudal Epidural Steroid Injection
Done to relieve chronic low back pain which radiates to the lower leg which may be caused by spinal stenosis, sciatica, herniated discs, degenerative disc disease, etc. The medication given will reduce the inflammation and swelling in the involved nerve roots.
Sacroiliac Joint Injection
Done to relieve chronic pain in the buttocks with our without radiation to the legs due to arthritis in the joint. This is a joint in the buttocks region where the spinal column and hip bone meet. An anesthetic agent and steroid are injected to calm down the inflammed joint. If the diagnostic block proves helpful, then radio frequency rhizotomy/neurotomy (killing the small nerves) is done for longer lasting pain relief.
Discography / Discogram
This is a diagnostic procedure to determine if the low back pain is due to the involvement of one or more discs. The results help the surgeon to make a decision whether surgery is needed or not. This procedure involves injecting a small amount of dye (contrast) into the disc and determines if pressurizing the discs can recreate the pain. Mild I.V. sedation may be given as it is important for the patient to be awake enough to tell the doctor about the intensity of pain recreated by the injection. The patient may be sent for CT scan to confirm the diagnosis.
Epiduralysis / Racz Adhesiolysis
This is a procedure done for patients who are suffering from chronic intractable low back pain after surgery (laminectomy) with radiation down the legs and failed back surgery syndrome. Post surgical patients develop epidural space adhesions that are like webs that envelope the nerve roots and create intense pain. By introducing a small gauge catheter under fluroscopic (x-ray) guidance this catheter can deliver various medications, dye and hypertonic saline to breakup the adhesions and decrease the pain in the nerve roots and epidural space.