Pulsed Radiofrequency (PRF)
Pulsed radiofrequency (PRF) is a novel therapeutic modality with many potential applications in pain management. A variation of conventional continuous radiofrequency neurotomy (RFN), without the tissue destruction associated with RFN. This theoretical benefit of PRF is especially alluring in cases of neuropathic pain in which RFN is contraindicated.
Radio frequency neurotomy works by means of radio waves (heat) that are sent through a needle to disrupt small sensory nerve endings of your medial branch nerves and interrupt pain signals from the facet joint(s). This procedure is considered quite effective and typically patients report pain relief between 6-24 months after the procedure. It can take between 1-4 weeks for the results to be fully noticed. The nerve endings do regenerate; therefore the return of familiar pain is likely. Fortunately, the procedure may be repeated if necessary and appropriate. You should recall that you have had the “test injections” called Medial Branch Blocks that determined that the radio frequency neurotomy is an appropriate treatment for this pain complaint.
Spinal Cord Stimulation (SCS)
Spinal Cord Stimulation (SCS) is implantable technology for the treatment of chronic, intractable pain. It works by delivering electrical impulses, and provides relief by altering the pain signals before they reach the brain. Instead of feeling the pain, you feel a tingling sensation. You are able to adjust the strength and area of stimulation using a remote control. When SCS is successful, it should provide significant long term relief, reduce the need for pain medications, and improve function. To determine if the patient is a good candidate for SCS therapy and permanent implantation, a SCS trial will be performed first. The trial is temporary lasting up to a week, where the patient will learn and decide if this is the right treatment for them.
Sacroiliac Joint Injection
The Sacroiliac Joint injection is an injection administered to diagnose and treat low back/buttocks pain caused by injury or disease to the sacroiliac joint (SI joint) which are located in the lower back area and buttocks where the pelvis joins with the spine. If the SI joints are damaged by injury or disease, these joints can cause pain in the lower back, buttocks and sometimes legs. This is due to the inflammation and swelling within the joint space.
Selective Nerve Root Block (SNRB)
A selective nerve root block (SNRB) is an injection that delivers medication into the space around a specific, pre-determined nerve root within the spine. The primary goal of this type of injection is to diagnose the exact nerve(s) that may be the pain generator of back, leg, neck or arm pain. It may also provide therapeutic relief of the irritated nerve.
The Sympathetic Block, or injection, is a diagnostic & potentially therapeutic injection of numbing medicine administered in order to block or decrease a certain type of pain located in the head, neck, chest, arm, or leg- known as sympathetic maintained pain. This type of injection is administered to a group of nerves located in the neck or lower back that are part of the sympathetic nervous system. If an illness or an injury affects the sympathetic nervous system, it may not function optimally and cause pain. This type of injection can often help diagnose, and possibly treat sympathetically maintained pain. One of the conditions considered for this type of procedure is complex regional pain syndrome (CRPS) also called reflex sympathetic dystrophy (RSD).
Trigger Point Injection (TPI)
Trigger Point Injections (TPI) are injections that are given directly into an active trigger point for the management of pain. Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. Trigger points produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders. The goal is to reduce the inflammation and associated pain to allow a patient increased range of motion, and to participate in physical activity.
Ultrasound Guided Injections
A comprehensive medical history, physical exam and routine imaging are the essential foundations for which interventional medicine relies upon to deliver safe and effective injections. For many musculoskeletal pain generators, we are able to provide the addition of ultra sound guidance to accurately deliver medicine under real time visualization allows for the greatest opportunity to provide pain reduction without radiation exposure.
Vertebroplasty is a procedure in which medical grade cement is injected into a fractured vertebra. The main reason a vertebroplasty is performed is to treat a fractured vertebra in the spine that is causing pain and reduced function. Not all fractured vertebra are candidates for vertebroplasty however. This procedure is performed under fluoroscopic guidance (x-ray) to ensure safe, proper placement.