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Patients do best when they understand more about the array of treatment procedures that may be applied to their disorder. To define procedures specific to the Precision Pain Care practice, please see the following descriptions:
Trigger points—To break up abnormal muscle fibers, we employ the following kinds of intramuscular injections:
- Dry needling, with no fluid injected
- Numbing medication
- Physical examination to further evaluate the CAUSE of the trigger points
- Numbing medication with a small amount of steroid or Botox®
This is not a sole treatment, but is used in conjunction with other treatments to address a secondary condition.
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Interlaminar epidural steroid injections—Non-specific injections placed around the spinal nerves, used to reduce irritation involving nerve roots and generally not used to fully relieve back pain. Solution includes steroid, saline and, sometimes, a small amount of numbing medication.
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Transforaminal epidural steroid injections—Steroids and numbing medication given around specific nerve roots to calm irritation in the leg or arm.
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| Sacro-iliac joint injection: -Calms pain in the mid-buttocks region
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Facet injections-Multiple injections of steroids and numbing medication placed in small facet joints of the spine
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Facet medial branch block-Performed only with numbing medication on the nerve giving sensation to facet joints. This is not a treatment, but a diagnostic procedure. If these injections result in some pain relief, the indication is that the patient may get 6 to 12 months of relief by receiving a facet rhizotomy (See below.).
Facet rhizotomy-Procedure that gives the patient 6 to 12 months of relief from back pain by placing a small wire on the nerve giving sensation to facet joint.
Stellate-Used in the neck to block burning pain in the arm and, occasionally, the face. This is a sympathetic nerve block used for complex regional pain syndrome (CRPS), formerly known as causalgia, and herpes zoster infections.
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Celiac plexis/ Splanchnic nerve block-Sympathetic nerve block injections applied to the upper abdomen to treat pain related to pancreatitis or pancreatic cancer
Lumbar sympathetic block-Applied to the lower back to treat CRPS, formerly known as causalgia in the lower legs.
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Hypogastric block-Injections delivered to the lowest part of the back to treat pelvic and anal pain
Ganglion of Impar block-A sympathetic nerve block delivered by injection to treat anal pain
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Caudal epidurals-Steroid injections in the lowest part of the spinal canal; indicated for leg pain, especially after spinal surgery
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Piriformis injection-An intramuscular injection of either steroids or Botox® to treat buttocks pain and sciatic nerve impingement
Navicath-Injections performed with a special catheter to break up scar tissue causing spinal canal narrowing
Peripheral nerve blocks-Indicated before surgery on specific parts of the body or when a nerve is inflamed, these injections are applied to the face, neck, arm, leg, back, or groin to block a specific nerve.
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Subacromial bursa injections-Injection warranted as part of conservative treatment for rotator cuff syndrome; involves injection of steroid into the inflamed bursa (fluid-filled sac).
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Biceps tendon injection-To be used infrequently, this steroid injection is given around the biceps tendon to treat tendonitis.
Glenohumeral joint injections-A steroid injection into the shoulder joint, warranted for shoulder arthritis
Acromial-clavicular (AC) joint injectionsInjection of steroid into the smaller shoulder joint
Sterno-clavicular (SC) joint injections-Steroid injections into the smallest joint where the collar bone meets the sternum (breast bone)
Subscapular bursa injection-An uncommonly applied steroid injection between the shoulder blade and rib cage, warranted for pain under the shoulder joint
Elbow joint injections-Administered to relieve pain of arthritis
Lateral epicondyle injections-Used to calm the inflammation known as "tennis elbow"
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Medial epicondyle injections-Used to calm "golfer's elbow"
Carpal tunnel injections-Given around the medial nerve in the wrist when it is compressed and causing hand and wrist pain and weakness
Hand and wrist joint injections-Used to decrease inflammation associated with various forms of arthritis
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DeQuarivan’s injections-Applied around the thumb to calm inflammation
Trigger finger injections-Given to calm pain and locking of irritated finger flexor tendons
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Greater trochanter injections-IAdministered into the bursa (fluid sac) overlying the hip
Intra-articular hip injections-Injections into the hip joint, used for arthritis and, occasionally, labral tears and even avascular necrosis (dead hip bone) to delay the need for hip joint replacement
Ischial tuberosity bursa injections-Placed in the fluid-filled sac on the buttocks to help resolve localized pain
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Intra-articular knee injections-Used to treat knee arthritis, patella femoral syndrome and meniscus tear (to help decrease pain and help delay surgery until it is absolutely needed
Pes anserine injections-Used to decrease inflammation of the pes bursa, which causes some forms of knee pain
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Plantar fasciattis injections-Applied to the bottom of the foot to relieve the pain of plantar fasciitis
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Morton's neuroma injection-Usually placed between the second and third toe to treat pain caused by nerve overgrowth
Sinus tarsi injections-Placed in a major foot joint to either help heal the Spring ligament or decrease inflammation.
Ankle joint injections-Placed in the ankle joint to decrease inflammation.
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