We intend to explain your condition in terms anyone may understand. We hope the information provided here, along with information provided by the staff of Eastern Headache and Spine will help you feel more comfortable with the treatment options and better understand how the treatments may help you overcome your pain. Some treatments temporarily alleviate pain to give you time to start physical therapy, enjoy special events and/or give time for the body to heal. Other treatment options may provide more permanent solutions.
Epidural Steroid Injections – When nerve root compression causes pain an epidural steroid injection may provide temporary or sustained relief. The effects of the injection tend to be temporary – providing relief from pain for one week up to one year or more. The injection process is simple. The patient lies down on the imaging table, the doctor sterilizes the injection area, numbs it, introduces the needle into the epidural space with fluoroscopic (X-Ray) guidance and provides the medicine. The procedure usually provokes little pain and is done in less than ten minutes.
Facet Injections – Inflammation, irritation, swelling or arthritis of the facet joint may cause low back pain. If an injection of a small amount of anesthetic or numbing medication at the facet joint reduces or removes the pain, it indicates that the facet joint may be the source of the pain. This is a diagnostic use of the facet joint injection. Once a facet joint is pinpointed as a source of pain, therapeutic injections of anesthetic agents and anti-inflammatory medications may give pain relief for longer periods of time.
Facet joint injections are performed while you are awake, under a local anesthetic. Your physician or an assistant will clean and sterilize the area of the back directly over the affected joint. During the procedure, you will undergo a fluoroscopic X-ray that allows your physician to correctly place the needle onto the joint and provide the injection. The back usually feels better a few days after the injections. It is best to keep activity to a minimum for 2-3 days after the injection.
Sacroiliac Injections – Sacroiliac or SI injections may help hip, low back, leg and groin pain. The procedure is quick and simple. The patient lies down on the imaging table and the staff provides gentle technique fluoroscopic guided injections. We provide a local nerve block with Marcaine or Lidocaine. A small amount of anti-inflammatory Corticosteroid is typically given to reduce inflammation and pain. Maximum relief usually starts 3-5 days later.
Nerve Blocks – Greater and Lesser occipital nerve blocks may help alleviate head, neck, and headache pain. After sterile preparation, a small thin needle is inserted close to the nerve. A local anaesthetic (marcaine) and sometimes anti-inflammatory corticosteroid is given slowly and in the lowest effective amount to reduce any procedure related pain. This procedure often allows the inflamed nerve to stop causing pain and potentially give the nerve time to heal.
Trigger Point Injections (TPI) – Trigger Point injections are performed by inserting a small needle into the muscle or “trigger point” and injecting a local anesthetic and/or steroids. This procedure can be effective in relieving pain in a number of areas of the body including lower back, mid back and neck.
After Your Procedure
We recommend that people take it easy for 2 – 3 days after injections – especially those requiring fluoroscopic (X-Ray) guidance.
By the third day most people feel better, in rare cases the improvement time may take up to two weeks.
If there is local pain after the procedure, using cold (ice in a towel) to decrease inflammation is reasonable. Taking anti-inflammatories, with your doctor’s clearance for safety, may improve local pain for the first few days.
Rarely, infection could occur. This would be identified by local or spreading redness and increased temperature. If suspected, please call us or seek medical attention rapidly.
Occasionally, as with any medicine, local or systemic allergic reactions may occur. If a rash or itching develops discontinue the medication and/or call us or your local health care provider.