Treatments

Spinal Cord Stimulator Trials

Spinal cord stimulation is a safe and effective way to treatment several different types of pain. Spinal cord stimulator trials are conducted to determine if and how a spinal cord stimulator implant may help a patient enjoy long-lasting relief from pain. These trials can last a week or more to allow the patient to understand how the spinal cord stimulation affects them.

When undergoing a trial, the patient will have wires placed in the spine through a small needle insertion and an electrode secured to the skin. Once the patient has had time to evaluate how the spinal cord stimulation affects their pain and functioning, they can have the electrode wires removed from the skin and decide whether to have a more permanent system implanted.

Lumbar/Cervical/Thoracic Epidurals

Epidurals are injections that can be directed into different parts of the spine to relieve pain that is caused by irritation and inflammation in spinal nerves. These epidurals include steroids that provide pain relief by reducing nerve inflammation. Research into the effectiveness of epidural injections have shown that these injections can significantly help improve nerve root pain management.

Lumbar/Cervical/Thoracic Medial Branch Blocks

Medial branch blocks are used to treat back pain. They involve the injection of an anesthetic into the medial nerve of the facet joint. Randomized, double-blind controlled trials have shown that local anesthetic medial branch blocks provides both pain relief and functional improvements when used with or without steroids.

Lumbar/Cervical/Thoracic Radiofrequency Ablations

Radiofrequency ablations, also referred to as radiofrequency neurotomies, have been shown to significantly reduce pain. For people who have undergone medial branch blocks, radiofrequency ablation can help produce more long-lasting, dramatic results. 

This technique involves the insertion of a needle through the skin to deliver radio waves that prevent the neve from transmitting pain signals. 

Genicular Nerve Blocks

Genicular nerve blocks are used in people with chronic knee pain to reduce pain, enhance function, and combat inflammation. Though the results are often significant, they tend to last only a short time. Luckily, for those who respond well to genicular nerve blocks, genicular nerve radiofrequency ablations (described below) are a good option for longer-term impact.

Genicular Nerve Radiofrequency Ablations

Patients with knee pain who have previously enjoyed significant pain relief with a genicular nerve block may be advised to undergo a genicular nerve radiofrequency ablation for longer-lasting effects. Unlike genicular nerve blocks that anesthetize the knee with injections of medications, genicular nerve radiofrequency ablation involves creating a lesion around the genicular nerves to prevent nerve impulses that cause pain.

Genicular nerve radiofrequency ablation often provides relief that lasts several months. The procedure is performed using local anesthesia, and noticeable results can take up to about 6 weeks.

Major Joint Steroid Injections

Major joint steroid injections are used to reverse inflammation that causes joint pain. These injections can be used for several types of pain, including back pain, different forms of arthritis, tendinitis, bursitis, and gout. These injections are relatively simple and quick and can provide pain relief that lasts several months.

Major Joint Viscosupplementation Injections

Major joint viscosupplementation injections are injections of a compound known as hyaluronic acid into joints such as the knee to reduce swelling and pain. In healthy joints, the cartilage surrounding the joint contains hyaluronic acid, which acts as a lubricant to prevent bones from rubbing against one another. However, in certain conditions like osteoarthritis, the cartilage breaks down, decreasing the amount of hyaluronic acid that is available to protect against joint pain.

When hyaluronic levels decrease, hyaluronic acid levels can be replenished with joint viscosupplementation, thereby restoring function and reducing pain. Research has shown viscosupplementation can be helpful in a variety of conditions including hip and knee osteoarthritis.

Lumbar Discographies

Lumbar discography is a diagnostic procedure that helps determine what is causing a patient’s pain and to formulate the most appropriate treatment plan. The procedure involves injecting dye into discs of the spine and evaluating the patient’s pain response as well as the resulting x-ray images. 

Unlike other imaging techniques like magnetic resonance imaging (MRI), which cannot provide insight into which discs cause pain, lumbar discography can help the doctor pinpoint the specific pain-causing disc. It is critical that those who perform lumbar discography have specialized training and the appropriate technical skill to accurately interpret the results.

Occipital Nerve Blocks

Irritation in the occipital nerve can cause pain in different parts of the head and near the eye. To improve this type of pain, including pain associated with chronic headaches and migraines, we can block the occipital nerve by injecting steroids at the back of the head above the neck.

These treatments are especially useful for people with headaches and eye pain that have not been relieved through other conventional approaches, and research shows occipital nerve blocks help people with different headache types including cervicogenic headache, cluster headache, and occipital neuralgia.

Intercostal Nerve Blocks

Intercostal nerves are nerves that lie under the ribs. Irritation and inflammation in these nerves cause pain that can be relieved by anti-inflammatory. We can deliver such medication under the ribs with intercostal nerve blocks that are easily injected while the patient lies on their side. These procedures tend to take less than half an hour, and research shows that they can be quite effective in helping with pain in the ribs and chest.

Platelet-Rich Plasma Joint Injections

Injections of platelet-rich plasma (PRP) – or blood with a higher level of platelets – have become popular for treating pain and dysfunction using a patient’s own blood to help rapidly heal a specific part of the body. 

Plasma is the liquid part of the blood, and platelets are a type of blood cell that contains proteins that can trigger tissue regeneration. To use a patient’s platelet-rich plasma, we take a sample of a patient’s blood and spin in it in a device known as a centrifuge, which separates out the parts of the blood so the PRP can be captured and used for treatment.

PRP joint injections are especially beneficial for improving joint pain and disability in osteoarthritis, musculoskeletal disease, or injuries to tendons, ligaments, or muscles. PRP can also help people heal following surgeries. The best results are usually seen following several weeks of treatment.