Discography aids in developing an effective treatment plan
We do our best to relieve back pain with non-surgical procedures; however, in some cases we may have to consider surgery. Discography is a tool that your physician may use to identify the root cause of your pain if you do not respond to conservative/non-surgical treatments. Discography will enable our doctors to develop the most effective treatment plan for your condition.
Discography key points:
- Discography is an outpatient procedure that usually takes about 45 minutes, followed by an hour in recovery.
- There may be some discomfort as a hollow needle is inserted into the spine, but all efforts to minimize your pain during the procedure are taken.
- Your general health and other factors are taken into account to reduce the risk of complications or infection.
Epidural Steroid Injections - Interlaminar
An epidural steroid injection is an injection of a long-lasting corticosteroid into the epidural space (or space inside the spinal canal but outside the dural or outermost membrane which covers the nerve roots) to relieve pain and/or diagnose an acute or chronic pain condition. The steroid reduces the inflammation and/or swelling of the nerves which can reduce pain caused by nerve inflammation, irritation, or swelling. Interlaminar refers to the epidural injection technique of injecting into the interlaminar space of the spine (or the space between the layers of adjacent vertebrae). This technique can be performed through paramedian or midline approaches.
Epidural Steroid Injections - Transforaminal
An epidural steroid injection is an injection of a long-lasting corticosteroid into the epidural space (or space inside the spinal canal but outside the dural or outermost membrane which covers the nerve roots) to relieve pain and/or diagnose an acute or chronic pain condition. The steroid reduces the inflammation and/or swelling of the nerves which can reduce pain caused by nerve inflammation, irritation, or swelling. Transforaminal refers to the epidural injection technique of injecting into the openings between the vertebrae through which the nerve roots exit. This technique is performed through an oblique approach.
Facet Joint Injections
A facet joint injection is an injection of a long-lasting steroid (“cortisone”) in the facet joints, located in the back area of the spinal bony structure. These spinal joints are surrounded by a capsule that contains lubricating fluids.
Medial Branch Nerve Blocks
Medial branch nerves are small nerves that feed out from the facet joints in the spine, and therefore carry pain signals from those joints. Facet joint injections are often used to identify a pain source; however, these injections, and other treatments that may be tried.
Occipital Nerve Blocks
An occipital nerve block is essentially the numbing of the greater occipital nerve that runs from the spine and through the back of the head to behind the ears and around the eye area. This is done via an injection, containing a mild local anesthetic to avoid pain from inserting a needle into the vein and surrounding tissues. This local anesthetic may serve to numb the original pain considerably, but it will only do so for a few hours until it wears off. The main substance to be injected, however, is a steroid medication that works over a longer period of time to block the sensitivity of the occipital nerve. It can take up to five days to start working, but once it does the effects can last from one day to a month long period.
Percutaneous epidural and spinal endoscopic adhesiolysis are interventional pain management techniques used to treat patients with refractory low back pain due to epidural scarring.
A percutaneous discectomy is a surgical procedure in which the central portion of an intervertebral disc is accessed and removed through a cannula inserted through the back into the center of the vertebral disc under local anesthetic using a stylet. This procedure reduces the disc height and pressure on the nerves resulting in pain reduction.
Peripheral Nerve Blocks
A peripheral nerve block is accomplished by injecting a local anesthetic near the nerve, or nerves, that control sensation and movement to a specific part of the body. This injection will temporarily numb the area in question, resulting in a number of benefits. The duration of pain relief from peripheral nerve blocks are related both to the choice of medication, as well as to how it is delivered. It can be administered through a single shot injection of local anesthetic or placement of a catheter next to the nerve, which will deliver numbing medication continuously for a period of days.
Peripheral Nerve Stimulation
Peripheral nerve stimulation is a technique in which electrodes are placed along the course of peripheral nerves to control pain. These devices are an extremely safe, efficient, and effective way to ameliorate a variety of severe neuropathic pain conditions. Once the electrodes are in place, they are turned on to administer a weak electrical current to the nerve. The patient experiences this as a pleasant tingling sensation. By stimulating non-painful sensory pathway, the electrical current tricks the brain into turning off (or significantly attenuating) the painful signals, therefore relieving pain.
Prolotherapy is a techniques directed at treating the underlying cause of many pain problems. Althouth that technique has been around for almost 30 years, it has only recently been widely used. Ligaments are like guide wires that hold the bones together. Tendons are the struvtures that attach the muscle to the bone. Both are made of material which is both strong and elastic. This allows you to touch your toes, or carry weights. What is reconstructive therapy/ Prolotherapy? This procedure focuses on trying to get the body to repair itself by stimulating the production of repair cells called Fibroblasts. The injection of irritating medicine around the ligament stimulates the body to lay down more connective tissue. Although many irritants(or prolife rants) have been used, the one we use is D5-which is a highly concentrated sugar solution. The prolife rant is mixed with local anesthetic and is injected onto the base of the ligament where it attaches to the bone. A little dose is placed at each site, the local anesthetic should take virtually all of the pain away for several hours. Then for several days you should expect to be stiff and sore. Tissues may take up to 6 weeks to come to full strength following treatment. Typically we do 3-5 sets of injections, with most people they feel significantly better after 1 or 2 sets of injections.
Radio frequency ablation (RFA) is a medical procedure where part of dysfunctional tissue is ablated using the heat generated from the high frequency alternating current to treat a medical disorder. An important advantage of RF current (over previously used low frequency AC or pulses of DC) is that it does not directly stimulate nerves or heart muscle and can therefore often be used without the need for general anesthetic.