Epidural steroid injection
An injection into the epidural space. This space extends from the neck to the low back region. All nerves that provide coverage to the arm, legs and trunk pass through this space. With this procedure, a small amount of steroid is injected with either a local anesthetic or a salt solution (saline) into the epidural space.
Selective nerve root injection
This technique involves injecting only select nerves using x-ray guidance to confirm the origin of a patient's pain. Nerves that are often injected are those associated with the upper and lower extremities. Thus the nerves of the neck and low back are typically injected with a combination of local anesthetic and steroid or just local anesthetic.
Facet joint injection
The facet joints are vertebral joints that interconnect one vertebra to another and extend down from the neck to the low back region and are often involved in neck and low back pain syndromes. These joints are often injected with local anesthetic as a diagnostic procedure. If the pain improves, patients may undergo radiofrequency ablation (RF), which uses heat to destroy the small nerves that supply the joints.
Freezing of peripheral nerves for long-term nerve blockade (6-9 months). This treatment may be utilized for intercostal nerves (after rib fractures), occipital nerves (headache/head trauma patients), and other superficial nerves.
Discogram (disc stimulation)
A test that determines where discs are to be injected under x-ray guidance with dye. Specific patterns of dye spread and a patient's response to the injection help to determine the pain diagnosis and the best treatment option.