SOLUTIONS / TREATMENT OPTIONS
Lumbar Transforaminal Epidural Injection
This outpatient procedure is an injection of a steroid-anesthetic medication. The medication can reduce swelling and inflammation of irritated spinal nerves. This procedure is performed to relieve pain in the lower back and pain that radiates from the back to the legs. The injection takes only a few minutes to complete.
Facet Radiofrequency Denervation
Radiofrequency facet joint denervation is a safe and effective day case procedure for the treatment of back or neck pain arising from the lumbar or cervical facet joints. It is also known as radiofrequency ablation, neurotomy, lesioning or rhizolysis.
Radiofrequency facet joint denervation is performed as a day procedure at Sparsh Spine in a specialised x-ray facility. All patients are given intravenous sedation to ensure they are as comfortable as possible throughout the procedure.
Facet Joint Injection
Facet joint injections are a procedure whereby a small amount of local anaesthetic and steroid is injected into one or more facet joints in the neck or back. A facet joint injection is a relatively simple, straightforward procedure, and is usually performed in an office based procedure suite or in an ambulatory surgical center.
Cervical Medial Branch Block
Cervical medial branch blocks are a diagnostic test to confirm the cervical facet joints as the cause of your neck pain. If this test confirms that pain is arising from these joints then radiofrequency facet joint denervation may be an effective treatment for your neck pain.
Cervical Epidural Injection
Cervical epidural steroid injection is a non-surgical treatment option for neck pain and upper back pain management. An epidural injection delivers steroids into the epidural space around spinal nerve roots to relieve pain – back pain, leg pain, or other pain – caused by irritated spinal nerves.
Caudal/ Epidural Injection
Epidural steroid injection is used to treat pain associated with irritation and compression of a nerve root by a prolapsed disk or spinal canal stenosis. This pain generally radiates down the arm or leg and is often referred to as sciatica. This procedure is performed under the direction of an x-ray machine so that precise positioning can be obtained. A small volume of steroid (often referred to as cortisone) is then injected immediately adjacent to the affected nerve root and can significantly reduce the pain associated with this condition.
Ganglion Impar Block/ Coccyx Injection
A ganglion impar block is a treatment that is performed to reduce chronic pelvic or rectal pain by blocking nerve impulses. An over-activity of the ganglion impar can result in chronic coccyx pain.
Sacroiliac Joint Injection
A sacroiliac (SI) joint injection—also called a sacroiliac joint block—is primarily used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction. Either too much or too little movement in one of the sacroiliac joints, which are located at the bottom of the spine on each side of the sacrum, can cause lower back pain and/or leg pain.
Percutaneous Vertebroplasty/ Kyphoplasty
Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat vertebral compression fractures (VCF) of the spine. These painful, wedge-shaped fractures can be caused by osteoporosis and injury. Left untreated, they can lead to a humped spine (kyphosis). By restoring the vertebra height with a balloon and injecting cement into the fractured bone, patients can recover faster and reduce the risk of future fractures.
Disc FX
Disc-FX technique is a minimally invasive nucleoplasty for treating this discogenic pain, i.e. pain caused by the disc. It is a combined procedure of endoscopic disc surgery of mechanical treatment with micro-forceps and electrothermic treatment with localised generation of heat.
Ozone Nucleolysis
It is a simple procedure to get pain relief for disc herniation or degenerative disc disease.
It involves insertion of the thin needle in the disc & injection of ozone (produced by specialized ozone generator).
The action of ozone is due to the active oxygen atom liberated from breaking down of ozone molecule.
When ozone is injected into the disc, the active oxygen atom called the singlet oxygen or the free radical attaches with the proteoglycan bridges in the jelly-like material or nucleus pulposus.
Spinal Cord Stimulation
A spinal cord stimulator (SCS) device is surgically placed under the skin and sends a mild electric current to your spinal cord. A small wire carries the current from a pulse generator to the nerve fibers of the spinal cord. When turned on, the SCS stimulates the nerves in the area where your pain is felt.
Endoscopic Dissectomy
A lumbar micro endoscopic discectomy is a minimally invasive procedure performed through a tubular device and designed to relieve pain caused by herniated discs pressing on nerve roots.
NEURALGIA
Radiofrequency Ablation of Trigeminal Ganglion
Radiofrequency ablation is a therapy that uses radio waves to create an electrical current. This current delivers heat to targeted nerve tissues. This is done in an attempt to reduce chronic pain symptoms that are associated with various conditions.
Occipital Nerve RF
Where the occipital neuralgia is refractory in nature, i.e. it does not respond to conservative treatment, then other alternative ways of treating the condition have to be explored.
One option is to treat the condition with a nerve block, where the occipital nerve points are effectively blocked from sending pain signals directly to the brain. This can often provide patients with relatively long lasting pain, but there are occasions where the pain returns or the procedure only awards short-term pain relief.
One option that may be considered at this stage is the use of pulsed radiofrequency which is sometimes abbreviated to PRF.
Stellate Ganglion Block
A stellate ganglion block is an injection of local anesthetic in the sympathetic nerve tissue of the neck. These nerves are a part of the sympathetic nervous system. The nerves are located on either side of the voice box, in the neck.
Ilioinguinal Iliohypogastric Nerve Block
Ilioinguinal and iliohypogastric nerve blocks are a minimally invasive, non-surgical treatment for chronic pain. These nerve blocks can help in the diagnosis of chronic hip, groin, and pelvic pain. In addition, this pain management technique can also provide therapeutic relief by reducing pain signals originating from these nerves.
JOINT RELATED
Suprascapular Nerve Block
A very effective and easy-to-perform technique for the selective, complete anaesthesia of the suprascapular nerve where it emerges through the scapular notch on the floor of the supraspinous fossa. This nerve does not supply its own skin region, but innervates the infraspinatus / supraspinatus muscles and essential portions of the capsule and ligaments in the shoulder joint. This block is thus very well suited for conservative physiotherapeutic management of frozen shoulder syndromes or for analgesia secondary to shoulder surgery. We describe the technique according to Meier, which virtually eliminates the potential complication of pneumothorax.
Suprascapular Nerve Ablation
Chronic shoulder or suprascapular pain is a disabling phenomenon. Chronic headache is also a disabling phenomenon for many patients. Once it was believed that chronic headache that is attributed to the cervical spine originates from the upper cervical nerve roots (C0-C3).
Tennis elbow
Tennis elbow and golfers elbow are considered to be overload tendon injuries, which occur after minor and often unrecognised trauma to the proximal insertion of the extensor (tennis elbow) or flexor (golfers elbow) muscles of the forearm causing pain and tenderness.
Genicular Nerve RF
Radiofrequency ablation for genicular nerves (GNRFA) is a relatively new and lesser-known treatment option that is proving effective for certain patients. A randomized controlled trial demonstrated significant improvement with GNRFA throughout the 12-week follow-up period. At Cleveland Clinic, we consider patients for GNRFA who have failed or are excluded from other treatment modalities. The process begins with a diagnostic genicular nerve block.
PRP therapy/ Regenerative therapy
Platelet rich plasma (PRP) is a regenerative medicine therapy becoming increasingly recognized as a non-steroid alternative to improving tissue healing and rehabilitation. The process for producing PRP is straightforward. After obtaining a blood sample from a patient, the blood is put into a centrifuge, which is a tool that separates the blood into its many components. The PRP can then be collected and delivered to an injured area of bone, joint, or soft tissue. Once the activated platelets are injected into the abnormal tissue, growth factors are released that recruit and increase the proliferation of reparative cells called mesenchymal stem cells.
Plantar Fascia Injection
The plantar fascia (PF) is a thick band of tissue that connects your heel bone to your toes. It helps support the overall shape of your foot, especially when standing, and helps with shock absorption. Irritation and scarring of the plantar fascia, known as plantar fasciitis, is one of the most common causes of heel pain.
HEADACHE
Occipital nerve RF ablation
Currently, it is suggested by some authors that the reason for headache in many patients is attributed to the lower cervical nerve roots in the cervical spine. The suprascapular nerve originates from the C5 and C6 nerve roots and supplies the suprascapular and shoulder region.
Botox Injection
Botox to treat chronic migraines is given at intervals of about 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms
MYOFASCIAL PAIN SYNDROME
Piriformis Injection / Trigger Point Injection
Piriformis syndrome is a common cause of buttock and posterior leg pain. Pain in these areas can begin spontaneously or after an injury. The symptoms are commonly seen in patients with other inflammatory conditions and in patients who sit for most of their work day. The pain usually begins when the piriformis muscle becomes taut, tender, and contracted. This process causes a deep aching sensation in the midgluteal region that is sometimes associated with pain radiating down the posterior leg or up to the lower back.
FIBROMYALGIA
Ketamine Desensitization
Ketamine is a dissociative anaesthetic which also produces intense analgesia, often persisting after the return of consciousness. Total amnesia and a high incidence of hallucinations following ketamine anaesthesia are attributable to the drug being a congener of the hallucinogen phencyclidine (PCP), is a readily synthesized cyclohexamine.
CANCER PAIN
Coeliac Plexus Block
The coeliac plexus is a bundle of nerves in your upper back. These nerves are a certain type, called sympathetic nerves, which control things like digestion, blood pressure and heart rate without you having to think about them. Nerves in the coeliac plexus go between the brain and organs like the pancreas, stomach, liver and kidneys.
In certain conditions, like pancreatic cancer, this group of nerves begins sending signals that cause you to feel pain in your upper abdomen. By injecting the area around the coeliac plexus with local anaesthetic, or sometimes other medicines (such as anti-inflammatory steroids), it may be possible to reduce (or block) this pain for some time.
Superior Hypogastric Block
A superior hypogastric plexus block (also known as a hypogastric block) is an advanced, minimally invasive procedure used to treat pelvic and genital pain that has been so far unresponsive to oral medications and other conventional treatments. This injection is considered to be a sophisticated, and more precise version of a sympathetic block that targets a specific region of the Sympathetic Nervous System (SNS) known as the Superior Hypogastric Plexus.
Intrathecal Pump Implantation
An intrathecal pump works to relieve chronic pain by inserting small amounts of medicine directly into the intrathecal space (area surrounding the spinal cord) to prevent pain signals from being perceived by the brain.