Patient Education

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Corticosteroid Injections

Corticosteroid injections have been used for decades to temporarily relieve pain and inflammation in joints and soft tissues, and to relieve systemic inflammatory reactions. The advantage to injecting corticosteroid medication rather than taking it orally is that it is delivered more quickly to the affected area and often has more effective results. Corticosteroid injections are routinely used to reduce the pain and swelling of bursitis, tendonitis and arthritis. In addition, they are helpful in treating lupus, scleroderma and severe allergic reactions. Corticosteroid injections are also very effective in reducing spinal or radiating limb pain (radicular pain) when injected into the epidural space, which is between the dura, the outer layer covering the brain and spinal column, and the spine itself. When used this way, they are referred to as epidurals, which are frequently used for labor pains during childbirth. ...

Degenerated Discs

Degenerated discs are a common back problem. The spinal discs, which are soft, gelatinous cushions that separate the vertebrae, wear down during the aging process. Because the discs function as between-the-bones shock absorbers, allowing the spine to bend and twist, this deterioration can result in serious back pain. As discs are damaged or wear away, the amount of space between the vertebrae gets smaller. As the space narrows, joints are placed under greater stress, resulting in further degeneration. ...

Epidural Steroid Injections

By reducing inflammation, epidural steroid injections (ESIs) are used to temporarily relieve lumbar (lower back), cervical (neck), thoracic (mid-spine) and sciatic-nerve pain. ESIs contain cortisone and an anesthetic, and are delivered directly to the epidural space, which is the area between the spinal cord and the outer membrane that covers the brain and spinal cord (the dura). As a result, they provide more effective and faster pain relief than oral medications. ...

Facet-Joint Injections

Facet-joint injections are both a minimally invasive treatment for back pain caused by inflamed facet joints, and a diagnostic tool for determining whether facet-joint inflammation is a source of pain. Four facet joints connect each vertebra to the vertebra above and below it. A facet-joint injection, administered into either the joint capsule or its surrounding tissue, combines a long-lasting steroid and a local anesthetic. ...

Fibromyalgia

Fibromyalgia is a chronic condition that causes fatigue, as well as widespread pain and tenderness in the muscles, ligaments and tendons. People with fibromyalgia have specific tender points on their bodies that are particularly sensitive when pressure is applied. Fibromyalgia is also associated with sleep problems, headaches and trouble concentrating. Women are more likely than men to develop fibromyalgia, as are people between 40 and 60 years old. ...

Ultrasound-Guided Joint Injections

Joint injections are a minimally invasive treatment for relieving pain caused by inflammatory joint conditions such as rheumatoid arthritis, tendonitis, bursitis and gout. To reduce pain and inflammation from these conditions, medications such as corticosteroids and hyaluronic-acid preparations are sometimes injected into the problem joint. The medications affect only the targeted areas, and usually do not cause side effects. Joint injections are administered under local anesthesia, and cause only brief, mild discomfort. ...

Herniated Disc

A herniated disc (also called a ruptured or slipped disc) is a damaged "cushion" between two bones in the spine (vertebrae). Normally, the gelatinous discs between the vertebrae hold the bones in place and act as shock absorbers, permitting the spine to bend smoothly. When a disc protrudes beyond its normal parameters, and its tough outer layer of cartilage cracks, the disc is considered "herniated." ...

Lumbar Epidural Steroid Injection

A lumbar epidural steroid injection is a minimally invasive procedure for treating leg, buttock and lower back pain originating from the epidural space. The epidural space surrounds the dura, a membrane which protects the spinal cord and its nerves. The primary reasons for pain in this area are herniated or ruptured discs, stenosis, or sciatica all of which result in nerve compression. The pain may originate in any part of the lumbar region of the spine, including the coccyx, or tailbone, where it is referred to as caudal. ...

Lumbar Facet-Joint Injections

Lumbar facet-joint injections are both a minimally invasive treatment for lower-back pain caused by inflamed facet joints, and a diagnostic tool to determine whether facet-joint inflammation is the source of the pain. Facet joints connect each vertebra to the vertebra above and below it. A facet-joint injection, administered either into the joint capsule or its surrounding tissue, combines a long-lasting corticosteroid with a local anesthetic. Although the anesthetic provides only very temporary pain relief, the corticosteroid reduces inflammation and can relieve pain for up to a few years. Enduring pain relief from the injection is diagnostically significant, indicating that the pain originates in the facet joint that received the injection. ...

Lumbar Sympathetic Nerve Block

A lumbar sympathetic nerve block is administered to both diagnose and treat pain in the lumbar (lower) region of the spine. It is used to determine whether the lumbar sympathetic nerves, which carry pain impulses from the lower extremities, are the cause of the pain, and, in some cases, serves to eliminate that pain altogether. During the procedure, medication is injected into or around the lumbar sympathetic nerves on one side of the body. ...

Myofascial Release

Myofascial release is a form of therapy designed to relieve chronic and acute pain through special, targeted massage that aims to reduce tightness within the fascia, a sheet of connective tissue below the surface of the skin. Tightness within the fascia can restrict a patient's range of motion or cause the patient to favor one side of the body. The goal of myofascial release is to relieve pain and allow the patient to regain range of motion. ...

Myofascial Pain

Myofascial pain syndrome is a chronic condition in which trigger points (muscle knots) develop in certain muscles, usually ones that have been injured or overused. Jobs and recreational activities that involve repetitive motions, in which muscles repeatedly contract, are common causes. Trigger points can also be caused by stress and anxiety. Myofascial pain is most common in middle-aged adults, although people of any age may be affected. ...

Neuropathic Pain

Neuropathic pain is a chronic condition caused by damage within the nerve fibers, resulting in the delivery of incorrect signals to the brain. Neuropathic pain, a response to injury to the central nervous or peripheral nervous system, usually causes tissue damage. What makes neuropathic pain so difficult to treat is that it is not only chronic and severe, but unresponsive to simple analgesic relief. ...

Pain Management

An estimated 70 million Americans suffer from chronic pain. Chronic pain is a major medical condition distinctly different from and more complex than acute pain. Whereas acute pain is a normal sensation triggered in the nervous system to alert the body to possible injury, chronic pain is a state in which pain persists, for many months or years, beyond the normal course required by healing. The effects, both economic and personal, associated with chronic pain can be significant. They include loss of income; debt from costly medical treatment; impaired mobility; and anxiety and depression. ...

Platelet-Rich-Plasma Injections

Platelet-rich-plasma (PRP) injections use components of the body's own blood to stimulate healing. Platelets, which are usually associated with coagulation (clotting), are also, according to recent research, able to assist in mending and strengthening damaged tissue by increasing certain growth factors. During the normal healing process, the body uses platelets to promote new-tissue growth and repair injuries. By supplementing platelet content, the healing process is accelerated. There is ongoing research on the efficacy of PRP injections, and some medical professionals remain skeptical about their value. ...

Radiofrequency Neurotomy

Radiofrequency neurotomy is a treatment designed to provide relief from severe pain in the back or neck. It uses the heat generated by radiofrequency waves to interfere with the nerves' ability to send out pain signals. The heat generated by these waves is delivered to targeted nerve areas through special needles that are inserted, just above the spinal area, through the skin. ...

Radiofrequency Rhizotomy

Radiofrequency rhizotomy, also known as neurotomy, is a minimally-invasive procedure for treating nerve pain in the spine. The procedure works by sending pulses of heat energy generated by radio waves to the affected nerves. The goal is to stop these nerves from processing pain signals from injured facet joints, the small joints located between the vertebrae. ...

Sacroiliac-Joint Steroid Injections

Sacroiliac-joint steroid injections help to diagnose and relieve lower-back pain caused by problems with one or both of the sacroiliac joints, which connect the spine's base (sacrum) to the pelvis's ilium bones. If one or both of the sacroiliac joints is inflamed (sacroiliac-joint dysfunction), a patient can experience pain in the buttocks and lower back that worsens when running or standing. Sacroiliac-joint dysfunction can be caused by osteoarthritis, traumatic injury, pregnancy, inflammatory joint disease, or underlying structural abnormalities. ...

Sympathetic-Nerve Blocks

The sympathetic nervous system is responsible for regulating involuntary body functions, including blood flow, heart rate, digestion and perspiration. Sympathetic nerves spread outward from the spine, and, when compromised, can cause pain in various parts of the body. A sympathetic-nerve block is an injection of medication into whichever of these nerves is causing the pain. It works by numbing the nerve, which interrupts the pain signals the nerve is sending to the brain. It is used both to diagnose damage of and treat pain caused by the sympathetic nerves. ...

Tarsal Tunnel Injections

Tarsal tunnel injections are a treatment for tarsal tunnel syndrome, also known as posterior tibial neuralgia, a condition characterized by chronic pain in the foot and ankle. Tarsal tunnel syndrome is caused by abnormal compression on the tibial nerve, a branch of the sciatic nerve that supplies sensation to the foot. Although tarsal tunnel syndrome is not a serious condition, the pain it causes can be acute. Patients may also experience sensations of burning, cramping, tingling or numbness. Fortunately, tarsal tunnel injections can provide welcome relief from these symptoms. ...

Transforaminal Injections

A transforaminal injection is an injection of a long-acting corticosteroid into a foramen of the spine, the place where a nerve root exits. The procedure is performed to relieve back pain and numbness in an attempt to avoid surgical intervention. The injection helps to reduce inflammation and swelling which not only relieves pain, but restores sensation and improves mobility. Transforaminal injections are most successful for patients with radicular back pain, or pain that radiates down the arms or legs. They do not work as effectively on other types of back or neck pain. ...

Trigger-Point Injections

Trigger-point injections treat pain in areas that have developed trigger points, which are knots of muscle that form when muscles contract and but cannot relax. Trigger points are caused by injury to or overuse of the affected muscle; they can also be caused by stress and anxiety. They can irritate the nerves around them, which causes pain in other areas of the body. The chronic pain brought on by trigger points can also decrease the affected muscle's range of motion. ...