Our Services
Pain Services
Consultation:
The Interventional Radiologists offer consultation office visits to review and discuss pain issues. In order to been seen for consultation, a referral from a physician must be given. During the consultation, the physicians review any imaging and review history. Based upon the physicians findings, a treatment plan can be created.
For more information, please contact:
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Riverside Interventional Consultants |
Premier Medical Imaging |
Blocks:
Several blocks are offered for diagnostic and/or therapeutic. An injection of local anesthetic is injected around the nerves giving the patient pain relief. This can be temporary lasting a few hours to therapeutic lasting months.
Discogram:
This is a diagnostic study used to determine the exact level of disc disease. After local anesthesis, the physician will place a needle directly into the disc, and will inject saline and X-ray dye into the disc. The disc is stretched and the patient is assessed for pain. If the pain is reproduced, then the damaged disc can be treated.
Epidural Steroid Injection:
This is a very commonly performed injection. After local anesthetic, a steroid is injected directly around the dura, the sac around the nerve roots that contains cerebrospinal fluid (the fluid that the nerve roots are bathed in). The steroid can markedly decrease inflammation associated with common conditions such as spinal stenosis, disc herniation or degenerative disc disease. By relieving inflammation and swelling around the surrounding nerves, pain can be relieved.
Facet Block Injection:
This injection can be diagnostic or therapeutic. The facet joints are paired joints in the back that have opposing surfaces of cartilage (cushioning tissue between the bones) and surrounding capsule. Twisting injuries can cause damage to one or both facet joints, and degeneration associated with aging may also cause pain. After local anesthesia, a numbing agent and/or a steroid are injected into the facet joint. If the patient's pain is taken away after the injection, it can be inferred that the pain generator is the specific facet joint capsule that has been injected.
IDET™:
IntraDiscal Electro Thermal Therapy or IDET™ is a treatment for patients with painful degenerative disc disease. This is one of the few outpatient treatment options available for pain management of this condition. During the IDET™ procedure thermal energy is delivered directly to the posterior annular wall via a resistive heating coil. Temperature-controlled nerve fiber destruction shrinks collagenous tissue.
Joint Injections (Peripheral):
Peripheral joints are in the arms and legs. The shoulders elbow, wrists, hips, knees and ankles are all peripheral joints. Injections can be done for diagnostic or therapeutic for patients.
Medial Branch Block:
This is a temporary diagnostic procedure. If the nerves are "blocked," they will not be able to carry pain sensation to the spinal cord. It is like temporarily cutting off "wires." Therefore, if the pain is due to facet joint arthritis, you should have relief from pain and stiffness. If this block is successful, the patient is a candidate for a longer lasting procedure called Radiofrequency Lesioning, which could give pain relief lasting months to years.
Myelogram:
A myelogram is a diagnostic study. It uses a special dye and an X-ray (fluoroscopy) to make pictures of the bones and the space (subarachnoid space) between the bones in your spine (spinal canal). A myelogram may be done to find a tumor, an infection, problems with the spine such as a herniated disc, or arthritis.
The spinal canal holds the spinal cord, spinal nerve roots, and a fluid-filled space called the subarachnoid space. A dye is put into the subarachnoid space with a thin needle. The dye moves through the subarachnoid space so the nerve roots and spinal cord can be seen more clearly. Pictures may be taken before and after the dye is used. A myelogram may also be done with a CT scan.
Nucleoplasty:
This is a minimally invasive procedure for patients who have contained herniated discs and radicular pain out of proportion to back pain. Nucleoplasty is a nuclear-reducing procedure that accomplishes disc decompression and decompression of a contained herniation at the disc periphery.
Piriformis Injection:
These injections are performed to decrease spasm of the piriformis muscle and to help the patient make progress in physical therapy. The piriformis muscle is a small muscle in the buttocks that rotates the hip. It runs horizontally while the sciatic nerve runs vertically and directly beneath the muscle. The muscle can become tight and place pressure on the sciatic nerve, resulting in leg pain commonly referred to as sciatica. It may be difficlut to distinguish sciatica from a radiculopathy (nerve pinching in the spine). When the origin of the pain is the pirifomis muscle, the patient's spinal imaging studies do not show any nerve pinching, and motion of the patient's hip will generate the pain.
Radiofrequency Lesioning:
Radiofrequency lesioning can be used to help patients with chronic low-back and neck pain and pain related to the degeneration of joints from arthritis. This procedure sends radio waves (heat) through a needle to damage small sensory nerve endings and interrupt pain signals. Radio frequency is considered quite effective. Some patients have reported pain relief up to 2 years after the procedure. Since nerve endings have a tendency to grow back, the pain will probably return at some time in the future.
Sacroiliac Joint Injection:
The sacroiliac joint is the large connection between the sacrum (the bottom of the spine) and the pelvis. The joint may become inflamed or arthritic. Sacroiliac joint pain can be treated with therapy, heat, ice or direct injections.
Spinal Cord Stimulation:
Spinal cord stimulation is a procedure that uses an electrical current to treat chronic pain. To treat chronic low back pain, a small pulse generator, implanted in the back, transmits electrical pulses to the spinal cord. These pulses interfere with the nerve impulses responsible for leg pain due to nerve damage (sciatica).
Implanting the stimulator is considered to be a simple procedure, typically done using a local anesthetic and a sedative. Your doctor usually will first implant a trial stimulator under the skin (percutaneously) to give the treatment a trial run. (A percutaneous stimulator tends to move from its original location, so it is considered temporary.) After a successful trial, your doctor can implant a more permanent stimulator. The stimulator itself is implanted under the skin of the belly (abdomen), and the small coated wires (leads) are inserted under the skin to the point where they are inserted into the spinal canal. This placement in the abdomen is a more stable, effective location. Most stimulator batteries must be replaced every 2 to 5 years.
After this outpatient procedure is complete, you and your doctor determine the best pulse strength. You are then given instructions for using the stimulator at home. A typical schedule for spinal cord stimulation is to use it for 1 or 2 hours, 3 or 4 times a day.
When in use, the spinal cord stimulator creates a tingling feeling, rather than the pain you have felt in the past.
Trigger Point Injection:
This is a procedure used to relieve the pain and stiffness caused by trigger points in your muscles. Trigger points are like knots in your muscles, and they prevent some muscle groups from relaxing properly. In order to relieve trigger point tenderness, special trigger point injections can be done where local anesthetics and corticosteroids are put directly into each trigger point.
Vertebroplasty:
Vertebroplasty is a treatment procedure performed by interventional radiologists which stabilizes broken bones in the spine caused by osteoporosis. A needle is inserted through the skin, into the crushed vertebrae, where surgical bone cement called poly-methymethacrylate is injected into the bone to stabilize it. More than one crushed vertebrae can be treated in a single procedure. Surgery is not required, because the radiologist is can guide the needle to the exact location via special x-ray equipment. The procedure stops the pain caused by bone rubbing against bone. Most patients experience immediate pain relief.
For more information on vertebroplasty, visit www.vertebroplasty.com
