Pain Management Procedures
 

Pain Management Procedures

Therapeutic Joint Injection

A therapeutic pain management joint injection is a procedure to relieve pain caused by arthritis in all joints. Joints we most commonly inject are shoulders and hips. A long acting anti-inflammatory medication (steroid) is mixed with a local anesthetic (numbing agent) and injected into the affected joint.

Hardware

This injection procedure is performed on patients who have undergone a fusion and have hardware in place. This procedure will determine if pain is originating from the hardware. Steroid medication can reduce swelling and inflammation near the hardware. If the injection relieves the patient’s pain, the surgeon may decide to remove the hardware.

Most people experience back pain at some point in a lifetime. The source may be injury or deterioration of muscles, bone, discs, nerves or a combination of these.

When conservative therapies such as rest, analgesics, and exercise fail to relieve pain, a number of minimally invasive treatments are available to help avoid major surgery.

At CRL Imaging, Radiologists perform diagnostic and therapeutic spinal injections and minimally invasive pain procedures to help people heal with greater comfort, fewer complications, less risk and better results. A physician’s referral is required.

About the Procedures

Joint Injections – Facet, Musculoskeletal, Bursa, Sacroiliac

Joint injections can result in a reduction of inflammation within a specific joint affected by degeneration or arthritis. Steroids are used to decrease the inflammation.

Facet Joint Injection
A facet joint injection introduces a local anesthetic (numbing agent) and a steroid (anti-inflammatory) into the facet joint(s) to help relieve pain. Each bone in the spine is connected by 4 facet joints, two on each side. The facet joints allow the spine to bend, flex, and rotate. When these joints deteriorate and become inflamed, an injection into the joint may be helpful.

Musculoskeletal (MSK) Injection – hip, knee, ankle, foot, shoulder, elbow, wrist, hand
A musculoskeletal injection is a procedure used to treat inflammatory joint conditions, commonly caused by arthritis. A long acting anti-inflammatory medication (steroid) is mixed with a local anesthetic (numbing agent) and injected into the affected joint.

Bursa Injection

A bursa injection introduces a local anesthetic (numbing agent) and a steroid (anti-inflammatory) into the bursa sac to help relieve pain. Our bodies have many of these fluid filled sacs, which help the skin, muscles and tendons to glide over bones. Sometimes these deteriorate and/or become inflamed (bursitis).

Sacroiliac Injection
A sacroiliac (SI) joint injection is a procedure to help relieve pain in the SI joints caused by conditions such as arthritis. The SI joints are located in the back where the spine and hip bone meet. A long acting anti-inflammatory medication (steroid) is mixed with a local anesthetic (numbing agent) and injected into the affected SI joint.

Epidural Steroid Injections – Cervical, Thoracic, Lumbar

Epidural steroid injections reduce inflammation in the spinal column due to disc herniation or bulge, reducing painful symptoms and facilitating healing. This procedure can help relieve pain that originates in the back or neck. A long acting anti-inflammatory medication (steroid) is mixed with a local anesthetic and injected into the neck or back.

The medication decreases the inflammation of the nerves and may provide pain relief for a period of several weeks to several months. It does not change the condition of the discs or other structures in any way.

Intercostal Nerve Block

The goal of an intercostal nerve block is to “interrupt” a pain signal that originates from the nerves surrounding the ribs by injecting a local anesthetic (numbing agent) in the area between two ribs.

The most common types of pain responding to intercostal nerve blocks are from the after effects of shingles (herpes zoster), an acute viral infection that causes inflammation of the nerves that spread outward from the spine, or a surgical incision in the chest. In some cases, this procedure may also be used to help determine the cause of pain (called a diagnostic nerve block).

Trigger Point Injections (TPI)

Trigger Point Injections (TPI) are sometimes given for neck pain, headaches, and low back pain to treat muscle spasm and other soft tissue problems. Typically a low dose of anesthetic medication, with or without steroid, is injected into one or more trigger points (tender areas within the muscle tissue) to relieve persistent muscular pain.

Preparation

No special preparation is needed prior to the procedure. Please inform the scheduler or nurse of any blood thinning medication you may be taking.

Injection

The steroid medicine used decreases the joint inflammation while the local anesthetic numbs the injection site. Immediate pain relief may be experienced after the injection while the local anesthetic is in place. The long-term relief provided by the steroid is NOT immediate. The steroid is time-released and it may take 1-14 days before the benefits of the injection are felt.

After the Procedure

On the day of the procedure, patients should arrange for a ride home, take it easy for the rest of the day, and resume normal activities (as tolerated) the following day.

Follow-up

More than one injection is often needed for pain relief. A follow-up visit should be made with the physician that ordered the injection. The physician can determine if another injection is warranted and they can contact CRL Imaging to set up any additional appointments.