Pain Management

What is an epidural steroidal injection?

One of the most important tools in the practice’s arsenal are spinal injections.  The Pro-Care doctors perform different types of injections in the cervical, thoracic, and lumbar sections of the spine. There is a round sack or lining around the spinal canal. This protective shield is called the dura. The space between the dura and nerves within the spinal canal is called the epidural space. The epidural space is where the steroid injection is performed.

The patient may feel immediate pain relief and numbness in the local area for up to six hours. However, the pain may return after this short pain-free period or may even be a little worse for a day or two. This is normal and is often caused by needle irritation. 

Depending on the amount of inflammation, an injection could offer several months of pain relief.  However, even if this procedure does not have the desired pain relief, it can be used as a diagnostic procedure to narrow further the cause of pain and the type of subsequent treatment needed.

What is a medial branch block?

To understand how a medial branch block works, imagine the facet joints of the spine. Each vertebra has facet joints on both sides of the structure and interfaces with vertebrae above and below. Medial branch nerves, located near facet joints, transmit pain signals from the facet joints to the brain.

The procedure and expectations are very similar to an ESI, including real-time x-ray positioning; however, the injection is given near the medial branch nerve. If the pain goes away for a short time and then returns, the patient may be a candidate for radiofrequency ablation (RFA).  This procedure provides a more permanent disruption of pain signals.

What is a sacroiliac (SI) joint injection?

The SI joint joins the sacrum (tailbone) with the hips (ilium).  This joint moves very little but is very important for proper biomechanics and a dysfunction in the joint can cause significant pain. The procedure and expectations are very similar to an ESI or a medial branch block, including real-time x-ray positioning; however, the injection is given near the SI joint. 

Sometimes an injection can bring several months of pain relief, and then more treatment is needed.  Other times, particularly if there is no underlying bone or joint problem, one injection brings long-term pain relief.  If the pain is caused by injury to more than one area, only some of the symptoms may be helped by one injection.