All of the injections below are done under ultrasound or fluoroscopy/x-ray guidance to ensure proper placement of the needle under direct visualization. Almost all of the fluoroscopic injections are done at Fellowship Surgical Center. We pride ourselves in our cleanliness, attention to detail, commitment to quality, patient comfort, and patient safety. The ultrasound injection can be done in the office.
Epidural Steroid Injection
A minimally invasive procedure used to treat spinal nerve inflammation to help alleviate neck, arm, back, and leg pain. Spinal nerve inflammation may be caused by several factors, the most common being spinal stenosis or a disc herniation. The goal of the injection is to decrease pain in order to allow you to participate in physical therapy and return to normal daily activity in hopes to avoid surgery.
Selective Nerve Root Blocks
The spine is made up of a spinal cord that has several nerve roots that branch off of it in order to help your muscles and organs function. Each nerve root is in charge of different muscles and organs. A selective nerve root block is a minimally invasive procedure used to help diagnose and/or treat the exact nerve root that is causing pain. Once the exact level of pathology is found, the next steps may be determined.
Facet Joint Injections
Facet joint connects each vertebra to the one above and below. The joints are well spine to twist and bend. A facet joint injection is a minimally invasive procedure used to treat inflamed facet joints caused by arthritis, injury, or disc degeneration to help alleviate neck or back pain.
Diagnostic Facet Block/Medial Branch Blocks
A minimally invasive procedure used to help diagnose the source of neck or back pain. This procedure blocks the nerves that innervate each facet joint, thereby inhibiting the signals of pain back to the brain. The major function of these nerves that innervate the facet joints, is to provide feedback of facet joint injury or arthritis. A small amount of anesthetic is used to numb the nerve and help determine which facet joint the pain is coming from. This pain relief lasts for a short period of time, usually about a day. Once the correct location is diagnosed, a radiofrequency ablation can be done.
Sacroiliac Joint Injection
Sacroiliac (SI) joint located between the iliac bones and the sacrum which connects the spine to the hips. This joint tubes much of the impact when walking and lifting. Pain in this area can mimic that of low back or hip problems. This joint has a very small amount of movement. SI joint pain may be caused by apparent leg length discrepancy, advanced age, inflammatory arthritis, pregnancy, trauma, prior surgeries, or ankylosing spondylitis. A SI joint injection is a minimally invasive procedure where a small amount of steroid and anesthetic is injected into the joint capsule.
The coccyx or tailbone, located at the end of the spine, is the insertion site for multiple muscles, ligaments, tendons, and provides weight-bearing support while seated. A coccyx injection is a minimally invasive procedure is used to inject small amount of steroid and anesthetic into a very small joint in hopes to reduce inflammation.
Cervical Stellate Ganglion Blocks
The stellate ganglion is a collection of sympathetic nerves that control sympathetically mediated pain in the head, neck, and upper extremities. Sympathetic nerves can transmit pain after injury. A cervical stellate ganglion block can be used to treat complex regional pain syndrome (CRPS), post-herpetic neuralgia, chronic postsurgical pain, hyperhidrosis, phantom limb pain, and more. Small amount of anesthetic is injected around the stellate ganglion in order to decrease sympathetic activity.
Lumbar Synthetic Plexus Blocks
Lumbar sympathetic plexus block is a collection of sympathetic nerves are control mediated pain in the back and legs. Sympathetic nerves can transmit pain after injury. Sympathetic plexus block can be used to treat complex regional pain syndrome, reflex synthetic dystrophy, shingles, peripheral neuropathy, and more. Small amount of anesthetic is injected around the lumbar sympathetic plexus nerve decrease in pathetic activity.
Occipital Nerve Blocks
Occipital nerves located at the base of the skull, when inflamed can cause symptoms of a headache. This pain involves the top of the head, the temple, forehead, and/or the eyes. Area around the occipital nerve is injected with local anesthetic and steroids.
Regenerative medicine, allows your body’s natural growth factors to heal tissues. Platelet rich plasma (PRP), is one such form of regenerative medicine. Platelets or thrombocytes ourselves that cause blood clots and assist in healing functions. PRP injection concentrates platelets from the patient’s own blood to allow healing for tendon, ligament, muscle, or joint injuries. Concntrated platelets release growth factors to increase localized healing. The key benefits of using PRP is that it is the patient’s own blood that is being injected, thereby eliminating rejection of the injected substance. The patient’s blood is drawn and spun down to separate the platelets from the red and white blood cells. Once spun down, the platelets are injected into the site of injury.
Stem Cell Therapy
Stem Cell Injections are one of the treatment modalities under the umbrella of regenerative medicine, or biologics. This approach taps into the ability of one’s own stem cells and natural growth factors. Stem cells, is one such form of regenerative medicine. Stem cells are cells that do not have any specific role yet and in theory can be used for various purposes. The stem cells that are used in the injections are obtained from the patient’s own body. When stem cells are taken from an adult body they are usually taken from fat or bone marrow. These cells are called mesenchymal stem cells. These cells are able to form into new bone, muscles, ligaments, tendons, and cartilage at the site that they are injected into.
A bursa is a fluid-filled sac that helps decrease the friction between moving muscles and tendons. This injection is used for hip, knee, ankle, shoulder, elbow and wrist joints. A joint is a hinge between two bones. If inflamed or injured, this can be a source of significant pain. A small amount of steroid and anesthetic is injected into the joint or bursa in order to decrease inflammation thereby reducing pain.
Peripheral Nerve Blocks
If peripheral nerves, nerves that are located in your extremities, are compressed or inflamed this may be another source of significant pain, numbness, and weakness. These nerves may be blocked and uncompressed with local anesthetic, giving the nerve more space to freely relay the appropriate messages from the spinal cord to the muscles.
Trigger Point And Muscle Injections
When muscles become tight after an injury a trigger point or knot may form. Many times these knots can be felt under the skin. Trigger point is may also irritate nerves that cause referred pain or pain that is felt in another location in the body separate from where the trigger point is located. A small needle is inserted into the trigger point either with no medication, with local anesthetic or saline, or with steroid. This needle insertion allows for the not breakdown, thereby alleviating the pain. These can be used to treat fibromyalgia, headaches, myofascial pain syndrome, among many others.