The Following Treatments Are Available Below
Trigger point injections are injections to the muscle belly. Injections are aimed at taut bands or areas of spasm within the muscle belly. Taut bands can be painful and the underlying cause of pain generation. Trigger point injections are diagnostic and therapeutic. If there is significant relief after trigger point injections, certainly one can consider that the muscle spasm is a pain generator. The injection consists of anesthetic as well as antiinflammatory medication.
Epidural steroid injections are a procedure to place medication both antiinflammatory as well as anesthetic in the epidural space. The epidural space is located within the spine around the spinal cord and nerve roots. The goal of epidural injections is diagnostic and therapeutic. Epidural injections can relieve pain that is generating from disc herniations as well as irritated or pinched nerve roots. These procedures are performed under fluoroscopic guidance.
Facet blocks are performed under fluoroscopic guidance and can be diagnostic and therapeutic. Injections are performed at the facet joint or the medial branch nerve. Improvement after this type of injection would be diagnostic for facet joint related pain.
Facet Rhizotomy is a long acting facet block done chemically to burn the nerve. This procedure is indicated if the patient does not receive benefits from a facet block, which does not offer prolonged relief.
This procedure is done in the neck, anesthetic blockade is performed at the stellate ganglion. The goal of this procedure is for blockade of the sympathetic chain. This is diagnostic and therapeutic for evaluation and treatment of RSD.
Lumbar sympathetic block is performed about the lumbar area. The goal of this procedure is for blockade of the sympathetic chain. This would be diagnostic and therapeutic for evaluation and treatment of RSD.
Botox is a long acting treatment for muscular pain. Botox acts locally at the injection site to relieve muscle spasm and to relieve pain. Benefits of this can last up to three to six months. This is also used for intractable headaches that do not respond to more conservative measures.
Occipital nerve is located in the back of the neck at the junction of the head. Occipital entrapments can occur with underlying spasm commonly causing occipital headaches. This can subsequently produce symptoms radiating to the top of the head as well as in back of the eyes. Occipital blocks can be diagnostic and therapeutic for occipital neuralgia/occipital headaches.
Electrodiagnostic studies are a diagnostic procedure to assess underlying neuropathic problems. EMG/NCS can be diagnostic for cervical or lumbar radiculopathy/pinched nerve, neuropathy or distal nerve entrapment such as carpal tunnel syndrome. EMG/NCS can be helpful in determining acute versus chronic conditions and identify neuropathic recovery. EMG/NCS are commonly used in conjunction with MRIs to correlate anatomical findings and neuropathic function.
Future care needs and life care planning are based on physical impairments as well as functional disabilities. This plan can outline what a patient will need in the future in terms of active and passive treatments, durable medical equipments, medical care medication as well as interventional injections and surgery. Costs can be included in a life care plan.
A physiatrist/physical medicine rehabilitation specialist is a specialty of identifying physical impairments and how those physical impairments result in physical disabilities and subsequent handicap. A physical medicine rehabilitation specialist specializes in the neuromuscular and skeletal system to identify physical impairments and functional disabilities. A disability evaluation may lead to conclusions of physical restrictions as well as compensatory strategies to maximize functional independence.
A sphenopalatine ganglion block (SPG) is performed with a cotton tip probe with saturation of anesthetic at the SPG ganglion, which is located in the posterior aspect of the nose. This procedure is commonly used in relieving headaches as well as an adjuvant for pain management.
Epidural lysis of adhesions indicated typically in a postoperative patient who has epidural scarring formation. Epidural scarring can cause irritation, inflammation and swelling around the nerve roots. Epidural lysis of adhesions are performed to breakup scar tissue and relieve irritative focus of nerve roots.