This injection procedure is performed to provide relief of neck, shoulder, and arm pain related to compression of the nerve roots in the relation to the cervical spine.

Many conditions including spinal stenosis or herniated discs can cause inflammation and swelling of the spinal nerves.

The steroid medication from the injection can help reduce the pain and swelling associated with these conditions. Patient should start getting relief around 3-7 days.

This is a minimally invasive procedure called radiofrequency ablation or rhizotomy.

This procedure is performed to reduce or eliminate the pain of damaged facet joints by disrupting the sensory nerves that carry the pain signals.

Similar to facet injections, a special needle is guided under x-ray to the junction where the medial branch nerve is normally located.

The nerve is tested to make sure the needle is in the right position. After testing, the nerve is numbed then heated for 90-120 seconds ensuring the disruption of its pain signaling.

It takes approximately 2-4 weeks for optimal pain relief. This procedure can be performed under local or sedation.

Patients with neck pain that is not nerve related may benefit from facet injections.

Facets are the connections between the above and below vertebra in the spine. They act like the joints in knees, elbows, shoulders etc. When arthritis sets in from age, trauma, or disease, these joints (facets) can start to cause neck pain which can be debilitating.

A facet block can be both diagnostic and therapeutic to confirm that the facets are source of ones pain. Similar to an epidural, a small needle is guided under x-ray into the facet joint. A small amount of local anesthetic is injected either with or without steroid.

If this is the source of pain, patients will feel almost immediate relief within 15-20 minutes. It will take 5-10 days for steroid to help reduce inflammation. Pain relief can be from several days to several months. Up to three-four facet injections are given over a year.

The purpose of this injection is to relieve pain in a patients hip, leg or buttocks pain secondary to osteoarthritis or damage to the joint.

Patients with osteoarthritis, trauma, or other causes of hip pain may benefit from a injection to relieve their pain. Using an x-ray device, a small needle is guided to the joint. A contrast dye is injected to confirm position.

Pain relief usually begins around 1-3 days and in some cases will require 2-3 repeated injections to achieve optimal benefits of treatment.

This injection is performed to relief lower back and radiating leg pain.

Steroid medication is use to coat the nerves in the lower back and relieve/reduce the swelling and inflammation caused by compression of spinal nerves or narrowing the spinal canal. Compression can occur from ligament hypertrophy, bone spurs, herniated discs, and facet or joint hypertrophy.

Patients with back pain that is not nerve related may benefit from facet injections.

Facets are the connections between the above and below vertebra in the spine. They act like the joints in knees, elbows, shoulders etc.

When arthritis sets in from age, trauma, or disease, these joints (facets) can start to cause back pain which can be debilitating. A facet block can be both diagnostic and therapeutic to confirm that the facets are source of ones pain.

Similar to a epidural, a small needle is guided under x-ray into the facet joint. A small amount of local anesthetic is injected either with or without steroid. If this is the source of pain, patients will feel almost immediate relief within 15-20 minutes.

It will take 5-10 days for steroid to help reduce inflammation. Pain relief can be from several days to several months. Up to three-four facet injections are given over a year.

This is a minimally invasive procedure called radiofrequency ablation or rhizotomy.

This procedure is performed to reduce or eliminate the pain of damaged facet joints by disrupting the sensory nerves that carrying the pain signals.

Similar to facet injections, a special needle is guided under x-ray to the junction where the medial branch nerve is normally located. The nerve is tested to make sure the needle is in the right position. After test, the nerve is numbed then heated for 90-120 seconds ensuring the disruption of its pain signaling.

It takes approximately 2-4 weeks for optimal pain relief. iThis procedure can be performed under local or sedation.

A lumbar sympathetic block is performed to relieve leg pain caused by complex regional pain syndrome. This syndrome develops after a injury to ones join or limb.

Similar to a epidural injection, a small needle is placed into a patients back under x-ray guidance. Once the needle is placed in the appropriate position, a contrast dye is injected to confirm accurate and safe placement.

After confirmation, a mixture of local anesthetic, saline, and sometimes steroid is injected into the space surrounding the sympathetic nerves that cause pain in the limbs not related to normal nerve (neuropathic) pain. This block is usually repeated several times to achieve optimal relief. Patients on blood thinners will need to stop their medications if possible to get this treatment.

This is a diagnostic procedure that is performed to identify a painful facet joint that may benefit from a radiofrequency ablation.

The facets allow the spine to bend, twist and flex and can cause pain if they are arthritic or enlarged. Similar to a facet injection, a small needle is placed near the medial branch nerve under x-ray guidance.

A small amount of local anesthetic is given to numb the nerve. Patients will then be asked to go about their regular day and record their pain relief over the next 30 mins to 2 hours after the injection.

If the patient gets good relief, then the patient can be considered for radiofrequency ablation procedure.

Patients suffering from lower back or buttocks pain benefit from sacroiliac joint injections.

The SIJ is the area where the spine and hip join to form a joint space. This can be inflamed and cause pain from arthritis, trauma, or various diseases.

Patient is placed lying on their stomachs under a comfortable pillow. Under fluoroscopic (x-ray) guidance, a small needle is guided into the joint. After confirmation with a contrast dye, a small amount of local anesthetic and steroid are injection in and around the joint.

Patient usually gets relief between 1-3 days and will feel optimal pain relief within 5-14 days.

This is a minimally invasive procedure that is used to relieve chronic pain of the neck, arms, back, and legs when more conservative treatments have failed. It can be used for other issues like muscle pain, chest pain or headaches depending on the circumstances.

Spinal Cord Stimulation uses electrical impulses to relieve pain by interrupting the pain signal pathway effectively telling your brain and body that you are not in pain.

Under local or sedation, a patient is placed on their stomach and two leads (with electrodes) are placed into their epidural space similar to a epidural that is give to women undergoing labor for pregnancy. The leads are then positioned and then connected to a battery. T

his is called the trial period which will last approximately 1 week. If the trial is successful, we can move forward for potential implantation. A successful trial is one where patients get anywhere from 50-100% relief and/or significant improvement in daily activities.

An implant will require placing the same leads in the epidural space and then placing a battery in the back under the skin. This is all done under local or sedation and patients do very well with post procedure recovery.

This injection is performed to treat pain from over active sympathetic nerves in the neck that track to the upper extremities.

Most common patients are those suffering from shingles and complex regional pain syndrome which can affect the head, face, neck, and/or arms.

A small needle is inserted into the neck under x-ray guidance and local/sedation down to the ganglion nerves. A mixture of anesthetic, saline, and anti-inflammatory medication is injected around the nerves to block pain signals from reaching the brain.

Common side effects are nasal congestion, droopy eye, hoarse voice and warmth which indicate a successful block. These symptoms disappear over time and pain relief follows. This injection is usually repeated and more pain relief follows with every injection.

This injection is performed to relief pain associated with the upper back, ribs, and abdomen caused by a pinched nerve or nerves in the thoracic spine. Pain can be radiating to ribs and sides of one’s back and torso.

This is a outpatient procedure that is designed to reduce or relieve pain caused by small tender knots that occur in the muscles in patients neck and back.

It is done under local and only takes a few minutes. A small needle in introduced into the knots and injected with local anesthetic and steroid.

This is designed to give almost instant relief and can last from several hours to weeks depending on use of steroid or not. This can give patient time to exercise and stretch in order to relieve those knots in their muscles.