Here is just a list of some of the procedures performed at East End Pain Management
caudal/cervical Epidural steroid injection
The goal of the steroids is to reduce inflammation, swelling, and scarring that arise as a consequence of nerve irritation. This nerve irritation may be a result of a disc (herniated or ruptured) , scarring around a nerve root, or a narrowing of the spinal canal (spinal stenosis). Not only mechanical trauma cause nerve irritation but also the disc material itself can cause nerve inflammation (ruptured or “leaking” disc). The steroids also inactivate some of these irritating substances. Medications and physical therapy modalities may be used in conjunction with treatments.
Main indications are herniated disc, spinal stenosis, previous back surgery, a slipped vertebra, and scoliosis. All of these conditions are associated with extremity and/or back pain.
Main indications are herniated disc, spinal stenosis, degenerative changes of the discs, a slipped vertebra, and scoliosis. All of these conditions are associated with extremity and/or neck pain.
diagnostic cervical/lumbar facet nerve block
The goal of this treatment is to definitively determine the origin of persistent neck or lower back pain. With the origin pinpointed it allows more precision in future treatment.
Main indication is to make a diagnosis in patients with neck and/or shoulder pain. This condition is usually associated to arthritis or trauma (whiplash injury /rotation injury). This block can also be used as a predictive tool, prior to denervating the joint (radiofrequency), or before performing a spinal fusion.
Main indication is to make a diagnosis in patients with lower back, buttocks and/or posterior aspect of thigh pain. This condition is usually associated to arthritis or trauma (whiplash injury /rotation injury). This block can also be used as a predictive tool, prior to denervating the joint (radiofrequency), or before performing a spinal fusion.
cervical/lumbar/Thoracic Discography (discogram)
Provocative discography is a diagnostic procedure and has no therapeutic value. The goal is to reproduce the patient’s back and leg pain while increasing the disc pressure. This reproduces the normal increase in pressure that occurs during daily activities (sitting, bending, sneezing, coughing, etc). It also allows us to pinpoint the specific painful level.
Provocative discography remains the "gold standard" for the diagnosis of discogenic pain (pain originating in the intervertebral discs). Normal diagnostic imaging findings do not rule out disc pain. Main indications are degenerative changes of the discs and herniated/bulging disc.
The goal of this procedure is to reduce inflammation of the joint.
Any joint can be a source of pain with secondary limited range of motion. Joint pain may be due to direct injury, degenerative arthritis, occupational activity, or weakening of the muscles/ligaments that support the joint. Physical therapy may be used in conjunction to strengthen the muscles and improve range of motion.
Kyphoplasty is a minimally-invasive, image-guided, procedure used to treat the pain associated with vertebral compression fractures caused by osteoporosis and metastatic tumors. During vertebroplasty, one or two bone needles are inserted into the collapsed vertebra through a small incision in the patient's back; the stylet is removed and a balloon is placed into the vertebra and gradually inflated to reduce the fracture. A specially formulated acrylic bone cement is injected through the cannula to stabilize the fracture. The procedure typically requires a local anesthetic; conscious sedation is sometimes helpful, depending on the patient's condition.
Main indication is pain associated with a vertebral fracture.
Radio-Frequency Denervation cervical/Lumbar Facet Joints
The goal is to numb the joints. This procedure uses heat to “kill” the nerves. In spite of this, the nerves will regenerate after a period of 3-6 months. This “pain improved” period can be used to re-educate the back muscles and strengthen the lower back. Usually if pain returns is of less intensity. This procedure can be repeated at that time. Anti-inflammatories are also used in conjunction with above measures.
Main indication is to treat patients with lower back, buttocks and/or posterior aspect of thigh pain. This condition is usually associated to arthritis, trauma (whiplash injury /rotation injury/ surgery) to the lower back joints (facets). Radio-frequency denervation always follows a series of successful diagnostic lumbar facet blocks.
Sacroiliac Joint Infiltration
The sacroiliac (SI) joint can be a source of lower back, hip and buttocks pain. Sometimes pain in the posterior aspect of the thigh may be experienced. Pain associated with the sacroiliac joint may be due to direct injury, degenerative arthritis, occupational activity, abnormality of gait (the way you walk) and posture.
Spinal Cord Stimulation
Spinal cord stimulation is a medical therapy for people who suffer from certain types of chronic pain. SCS uses a small implanted device to generate tiny electrical pulses that replace the feeling of pain with a tingling or massaging sensation. The objective with this therapy is to reduce your pain to a manageable level. You will not be able to have an MRI while having the stimulator. The unit may be removed later if needed.
Main indication is for people who have had previous had spinal surgeries and pain did not resolve. The second indication is for patients who are not good candidates. spine surgery.
trigger point injection
Trigger point injection is used to reduce muscle spasm.
Muscle spasm can be a source of pain with secondary limited range of motion. Muscle spasm may be due to direct injury, muscular overuse (occupational, sport related), inflammation of a structure below the muscle. Physical therapy may be used in conjunction to relax and strengthen the muscles and improve range of motion. On the physical examination is possible to feel a taught tender muscular band that reproduces the pain and elicits a twitch with deep palpation: the "trigger point."