Interventional Pain Management

Pain management often takes a multidisciplinary approach to minimize or eliminate pain without using surgical techniques. The goals include increasing physical activity, eliminating unsafe medication use, and learning lifestyle behaviors that work toward wellness.

Epidural Steroid Injection is the most commonly performed procedure used to relieve pain. This injection delivers a powerful anti-inflammatory steroid into the area of the pain generator. The technique involves using x-ray fluoroscopy to guide the needle directly into the area where the pain generator is located. The majority of patients who receive this type of injection will experience a beneficial effect, lasting for a number of weeks or months allowing for continual participation in their activities or rehab program. These injections can be repeated if episodic flare-ups occur.

Facet Joint Injections involve the injection of steroid medication into the affected spinal facet joint to reduce inflammation and pain. Injections into these joints or blocks of the nerves that feed the facet joints can often be very helpful to relieve pain. This injection also requires the use of x-ray fluoroscopy.

Sacroiliac Joint Injections are used for the treatment of sacroilitis or sacroiliac dysfunction. This is a problem in the joint where the sacrum (tailbone) and the pelvis meet. An irritation in this joint can cause low back and leg pain. This procedure is also performed with the use of x-ray fluoroscopy to allow for the proper placement of the steroid injection.

Trigger Point Injections are muscle blocks. Muscles chronically tense or in spasm become tender and painful. The pain triggers more spasm that can develop into a vicious cycle. Injections into the muscle can help to break the cycle and allow for pain relief.

Medial Branch Blocks is a method of injecting local anesthetic with or without steroids near the nerve supplying the specific facet joint. These blocks are usually indicated in patients with back pain originating from arthritic changes in the facet joints or from mechanical stress to the back. A medial branch block can be performed for the diagnosis or treatment of pain arising from the facet joints.

Spinal Cord Stimulation can be an effective alternative or adjunct treatment to other therapies that have failed to manage pain on their own. An implantable system delivers electrical pulses via a lead to nerves in the dorsal aspect of the spinal cord. Pain signals are inhibited before they reach the brain and replaced with a tingling sensation that covers the specific area where the pain was felt.

Interventional therapy can alleviate chronic pain by blocking the transmission of pain signals to the brain. Interventional pain management involves special procedures such as an injection of local anesthetic, steroid, or narcotic around nerves, tendons, joints or muscles, nerve blocks and spinal cord stimulation to treat and manage pain. In some cases of extreme pain, drugs are often given in smaller doses through the catheter directly into the spinal cord. Even though interventional procedures for treating pain seem simple, extreme care should be taken when conducting these procedures. These procedures should be performed by well-trained and experienced Specialists. Dr. Carlson is fellowship trained in Interventional Pain procedures.

Cervical Epidural Steroid Injection: Acervical epidural steroid injection places powerful anti-inflammatory medication directly into the epidural space of the spine in the neck region.

Discography: Discography is performed under X-ray guidance, the needle is placed inside the suspected disc and a contrast dye is injected. This test is used to determine whether the disc is the source of pain in patients with neck or back pain.

Lumbar Epidural Steroid Injection: A lumbar epidural steroid injection places powerful anti-inflammatory medication directly into the epidural space of the spine in the lower back region.

Radiofrequency lesioning: This technique uses electrical impulses to interrupt nerve conduction and the transfer of pain signals for 6 to 12 months. During the procedure, a special needle is directed into the involved nerve tissue with the guidance of an X-ray. The needle tip is then heated for 90-120 seconds so that the nerve gets cauterized and destroyed thereby reducing the pain.