Conditions & Procedures

What Pain Conditions and Injuries are Treated at Pain & Rehabilitation Consultants?

We provide a variety of procedures to treat pain. Our team looks forward to meeting you and discussing your chronic pain needs. Depending on the source and the possible treatment options, we will move forward with a treatment plan designed for you.

Below are a number of videos that go over possible treatment options with a quick summary of how each procedure is performed.

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Pain and Rehabilitation Consultants (PRC) will provide a multidisciplinary approach to the management of chronic pain and medical conditions which may benefit from the expertise of a specialist in physical medicine and rehabilitation.

Cervical Epidural Steroid Injection & Thoracic Epidural Steroid Injection Procedures:

The injection delivers a potent dose of anti-inflammatory medication directly into the epidural space next to the painful and inflamed nerve, treating pain caused by irritation of nerves originating in the neck and upper back as a result of degenerative or herniated discs. For safety and quality purposes, we use fluoroscopic guidance for the procedure.

Cervical Medial Branch Nerve Blocks:

These injections help us determine whether the neck pain originates from painful and arthritic facet joints. These are also known as degenerative joint disease, spondylosis, or arthritis of the spine. These arthritic joints receive pain signals from medial branch nerves. When we use a local anesthetic injection to these nerves, it confirms whether your pain is coming from your facet joints or not. At this point, we may proceed with more definitive treatments such as radiofrequency ablation if these nerve blocks help. We perform these procedures using fluoroscopic guidance.

Cervical and Thoracic Facet Joint Injections:

These injections treat pain due to painful and arthritic facet joints (degenerative joint disease, spondylosis, arthritis). We inject local anesthetics along with an anti-inflammatory medication to treat inflammation and pain in the small facet joints. We use fluoroscopic guidance for these procedures.

Radiofrequency Ablation of the Cervical Facets:

This procedure treats pain due to painful and arthritic facet joints after the origin of the pain has been confirmed by cervical medial branch nerve blocks. The cervical medial branch nerves are small nerves which transmit pain from the facet joints. We advance a special needle to these nerves and a probe, which emits radiofrequency energy, is placed inside the needle to deactivate pain sensation from those nerves. This can provide relief for over a year and the procedure is done using fluoroscopic guidance.

Spinal Cord Stimulator Trial:

For this procedure, we introduce a thin electrode into the epidural space of the spine and advance it to the correct level of the spinal cord. We connect these electrodes to a control unit, which delivers electronic impulses to the spinal cord in an attempt to interrupt the transmission of pain. To start, the electrodes are kept in place for up to a week where we monitor the level of pain. If pain relief is significant, then we implant a more permanent stimulator. All procedures are done with fluoroscopic guidance.

Occipital Nerve Blocks:

Occipital neuralgia is a common type of headache. For this procedure, the injection introduces a dose of local anesthetics along with an anti-inflammatory medication to the inflamed nerves. Depending on the specific nerve involved, this can be done with or without fluoroscopic guidance.

PROCEDURES FOR BACK PAIN/LOWER EXTREMITY PAIN

Lumbar Epidural Steroid Injection:

The injection delivers a dose of anti-inflammatory medication directly into the epidural space next to the painful and inflamed nerves. These injections treat the pain caused by irritation of nerves originating in lower back as a result of degenerative or herniated discs.  We perform these procedures using fluoroscopic guidance.

Lumbar Facet Joint Injections:

We use these injections to treat pain caused by painful and arthritic facet joints (degenerative joint disease, spondylosis, arthritis). This is done by injecting a local anesthetics along with an anti-inflammatory medication into the small facet joints, causing decrease inflammation and pain. This is done with fluoroscopic guidance.

Lumbar Medial Branch Nerve Blocks:

These injections help us determine whether your back pain originates from painful and arthritic facet joints (degenerative joint disease, spondylosis, or arthritis of the spine). These arthritic joints receive pain signals from medial branch nerves. We use a local anesthetic injection to these nerves to confirm if the origin of pain is coming from your facet joints. If these nerve blocks help, we may proceed with more definitive treatments such as radiofrequency ablation. We perform these procedures using fluoroscopic guidance.

Lumbar Facet Radiofrequency Ablation:

This procedure treats pain due to painful and arthritic facet joints after the origin of the pain has been confirmed by Lumbar medial branch nerve blocks. Using fluoroscopic guidance, a special needle is advanced to the Lumbar medial branch nerves (these are small nerves which carry pain from the facet joints). A probe which emits radiofrequency energy is then placed inside the needle to deactivate pain sensation from those nerves. This can provide relief for over a year.

Sacroiliac Joint Injections:

These injections treat inflammation and pain of the sacroiliac joint. This is accomplished by injecting a local anesthetic and an anti-inflammatory medication directly into the joint using fluoroscopic guidance.

Spinal Cord Stimulator Trial:

The electrodes are connected to a control unit to deliver electronic impulses to the spinal cord to interrupt the transmission of pain. The electrodes stay in place for up to a week. If the relief is substantial, then it’s likely a more permanent stimulator can be implanted.

Genicular Nerve Blocks:

These injections help us determine whether knee pain is carried by the genicular nerves. If a local anesthetic injection to the genicular nerves block the pain signals, then we can proceed with more definitive treatments. This is done using fluoroscopic guidance.

Diagnostic Lumbar Discography:

In cases of multiple torn or degenerated discs, this procedure confirms whether pain originates from the disc and identifies the exact disc causing pain. After identification, the patient and the doctor can proceed with more definitive treatments.

Coccyx/Ganglion Impar injections:

These procedures treat cases of tailbone and/or anal pain. A local anesthetics needle with anti-inflammatory medications is introduced either on, in, or slightly through the sacrococcygeal joint above the tailbone to treat the inflamed ligaments, joint, or nerves of the Ganglion Impar. Procedures are done using fluoroscopic guidance.

Sacral Lateral Branch Nerve Blocks:

Using fluoroscopic guidance, these injections help us determine whether pain in the Sacroiliac joint and/or Sacrum are carried by the Lateral branches. If local anesthetic injection to these nerves help your pain, then we’ll move forward with more definitive procedures.

Sacral Radiofrequency Ablation:

This procedure treats pain after we’ve confirmed that pain is originating from the sacroiliac joint and/or sacrum carried by the lateral branches. A special needle is advanced to the lateral sacral branches where a probe that emits radiofrequency energy is then placed inside the needle to deactivate pain sensation from those nerves. Procedures are done using fluoroscopic guidance and can provide relief for over a year.

Genicular Nerve Blocks:

These injections help us determine whether knee pain is carried by the genicular nerves. If a local anesthetic injection to the genicular nerves block the pain signals, then we can proceed with more definitive treatments. This is done using fluoroscopic guidance.

Genicular Radiofrequency Ablation:

After the genicular nerves have been confirmed by genicular nerve blocks to be the nerves transmitting the pain, we use this procedure to treat chronic knee pain. A specialized needle is advanced to the genicular nerves, then a probe is placed inside the needle to deactivate pain sensation from those nerves by emitting radiofrequency energy using fluoroscopic guidance. This provides relief for over a year.

PROCEDURES FOR MUSCULOSKELETAL ULTRASOUND GUIDED INJECTIONS

Trigger Point Injections:

Ultrasound-guidance allows providers to directly see the muscles they’re injecting. This results in better outcomes for trigger point injections, especially for injections done along the chest wall.