Conditions & Procedures

A caudal epidural injection involves delivering anti-inflammatory medication into the epidural space to reduce inflammation around nerve roots, which can help alleviate hip, buttock, and leg pain caused by disc damage or bone spurs. The procedure is commonly used to avoid scar tissue in patients who have had previous back surgery. By reducing nerve root inflammation, the injection can provide either long-term relief or temporary pain relief that allows other treatments, like physical therapy, to be more effective.

During the procedure, the physician will numb a small area above the crease between your buttocks and use X-ray guidance to insert a needle into the epidural space through the sacral hiatus. A contrast dye will confirm proper placement of the needle before a combination of numbing medicine and anti-inflammatory steroids is injected.

After the procedure, you'll be monitored for 15-20 minutes before being sent home. Some numbness or weakness in the affected limb may occur temporarily, but repeat injections, up to four sessions, may be recommended for better results.

Discography is a diagnostic procedure used to confirm whether a specific disc is the source of your pain. The discs in your spine act as cushions between vertebrae, but when they bulge, herniate, tear, or degenerate, they can cause pain in the neck, back, arms, or legs. Discography helps identify which disc(s) are contributing to this pain by injecting contrast dye into the disc, which can reveal if the disc is the actual source of discomfort. Unlike MRI and CT scans, which only show anatomical structures, discography is a functional test that directly reproduces symptoms if the disc is the cause of pain. This test is typically considered when pain is significant enough to consider surgery or advanced treatments.

During the procedure, the physician may administer relaxation medication through an IV. You will be positioned based on the area of your spine being tested (on your back for cervical, or on your stomach for thoracic and lumbar). The physician will numb the skin, and then, using X-ray guidance, insert a needle into the disc. The injection of contrast dye will temporarily reproduce your symptoms if the disc is the source of your pain.

Afterward, you may experience some discomfort, but you should avoid driving for eight hours and refrain from applying heat to your back for 24 hours.

An epidural injection is a procedure that delivers anti-inflammatory medication into the epidural space, the area surrounding the spinal nerve roots. This helps reduce nerve inflammation and alleviate pain caused by conditions such as herniated discs or bone spurs. It may provide long-term relief or enhance the effectiveness of other treatments, such as physical therapy. Many patients experience improvement within a few days.

What happens during the procedure?
You'll lie face down on an X-ray table while the injection site is cleaned and numbed. Using X-ray guidance, the physician inserts a small needle into the epidural space, confirms placement with contrast dye, and injects a mix of numbing medication and a steroid. You may feel some pressure.

What happens after?
A dressing may be applied, and you'll be monitored for 15–20 minutes. Temporary numbness or weakness may occur, so avoid walking without assistance.

The hip joint connects the leg to the pelvis and can become painful due to arthritis or other conditions, often causing discomfort in the groin, buttock, or leg. A hip joint injection delivers anti-inflammatory medication directly into the joint to reduce pain and inflammation. It can help diagnose the source of pain, provide relief for hip osteoarthritis, and guide treatment decisions.

During the procedure, a physician uses X-ray guidance to insert a small needle into the joint and injects numbing medicine and cortisone. After the injection, patients may experience temporary numbness or weakness in the leg.

Intercostal nerves run below each rib and can cause pain around the chest if damaged or irritated. A nerve block injects numbing medicine and steroids under the rib to diagnose and relieve pain by reducing inflammation.

During the procedure, a physician uses X-ray guidance to insert a small needle under the rib and injects the medication. Multiple ribs may be treated if needed. After the injection, patients are monitored for shortness of breath or other side effects. A driver is required, and normal activities can resume the next day.

Facet joints are the connections between vertebrae that allow movement and support the spine. When these joints become inflamed due to arthritis or injury, they can cause pain and stiffness. The medial branch nerves supply sensation to the facet joints and carry pain signals to the brain.

A medial branch block is a diagnostic procedure that temporarily numbs these nerves to determine if they are the source of pain. If the block provides relief, it confirms facet joint involvement, and a longer-term treatment, such as radiofrequency neurotomy, may be considered.

During the procedure, you will lie on your stomach while the skin is cleaned and numbed. Using X-ray guidance, the physician will place a small needle near the nerve and inject a local anesthetic.

After the procedure, you may experience temporary numbness or weakness. You will be monitored briefly and given a pain diary to track relief over the next 24 hours.

A nerve root block is a procedure used to diagnose and relieve pain caused by inflamed spinal nerves. Nerve roots exit the spinal cord and form nerves that control movement and sensation in the arms, chest, and legs. When irritated by a damaged disc or bone spur, these nerves can cause significant pain. By injecting numbing medicine near the affected nerve, this procedure helps determine if the nerve is the source of pain and may also provide relief by reducing inflammation.

During the procedure, the doctor numbs a small area of skin before using X-ray guidance to place a thin needle near the nerve root. A contrast dye is injected to confirm proper placement, followed by a steroid medication, with or without an anesthetic, to reduce inflammation and pain.

After the procedure, you may experience temporary numbness or weakness in the affected limb. A short monitoring period follows before you’re discharged with post-care instructions. Most patients can resume normal activities the next day.

Occipital neuralgia causes sharp, throbbing pain in the upper neck, back of the head, and behind the ears due to irritated or injured occipital nerves. An Occipital Nerve Block injects a local anesthetic and steroid to reduce pain and inflammation. The quick, in-office procedure targets the affected nerve, providing relief.

Postherpetic neuralgia (PHN) is lingering nerve pain that occurs after a shingles' outbreak, often causing burning, stabbing, or aching discomfort. To treat PHN, we apply a Qutenza patch in our office, offering up to three months of pain relief from a single one-hour treatment. This can be repeated every three months, with many patients experiencing significant improvement.

A Medial branch radiofrequency neurotomy (rhizotomy) is a non-surgical procedure that targets the nerves responsible for transmitting pain from facet joints in the spine. If diagnostic injections confirm that the facet joints are the source of your pain, but other treatments haven't provided relief, this procedure can offer long-lasting pain management.

During the procedure, the physician uses X-ray guidance to carefully place a needle near the targeted nerve, delivering localized heat to block the pain signals.

While some soreness may occur in the days following the procedure, many patients experience noticeable relief within two to three weeks. Though the nerves may regenerate over time, the pain often does not return for several months or, in some cases, may never return.

The sacroiliac (SI) joint connects the spine to the pelvis and can cause pain in the lower back, buttocks, groin, or leg when inflamed. A sacroiliac joint injection helps diagnose and treat pain by delivering numbing medicine and a steroid to reduce inflammation, providing relief and aiding physical therapy.

Neurostimulation is a pain management technique that uses a small implanted device to disrupt pain signals before they reach the brain. Similar to a pacemaker, it delivers mild electrical pulses to targeted nerves, helping to reduce or replace the sensation of pain. A trial period is conducted to assess its effectiveness before permanent implantation.

A Stellate Ganglion Block is an injection that targets the sympathetic nerves in the neck to reduce pain, swelling, and other symptoms in the upper extremity, head, or face. It is used to treat conditions like Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS), and shingles-related pain. The goal is to calm nerve hyperactivity, leading to partial or full pain relief and improved mobility.

Sympathetic Block is an injection of local anesthetic around a group of nerves in the neck or lower back to reduce pain, inflammation, and other symptoms like swelling or temperature changes. It helps calm down the hyperactivity of the sympathetic nerves, with the goal of providing partial or full pain relief. The procedure is commonly performed for conditions like Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS), or neuropathic pain. During the procedure, you’ll be positioned face down, and the doctor will use X-ray guidance to inject the anesthetic near the targeted nerves. Afterward, you’ll be monitored for a short time to assess pain relief before being discharged with further instructions.