Treatments

injections delawareAt Grossinger NeuroPain Specialist we are constantly adding new treatment options for our patients. The doctors enhance their abilities and attend medical conferences for their patients benefit. We have a multitude of options for the patients.

Here is a growing list below of what we offer.

Caudal epidural steroid injections in Delaware and Pennsylvania

This injection is similar to the lumbar epidural steroid injections with the exception of needle entry site.  In the caudal epidural steroid injection the needle is placed through a small opening in the caudal canal at the base of the spinal canal just above the tailbone.  Local anesthetic is given into the skin and the tissues below the skin to reduce the pain of needle entering into the caudal canal.

Celiac Plexus Block

A celiac plexus block is an injection of local anesthetic into or around the celiac plexus of nerves that surrounds the aorta, the main artery in the abdomen. Normally these nerves control basic nerve functions. In certain conditions, these nerves can carry pain information from the gut or abdominal organ tissues back to the spinal cord and brain

Cervical Epidural Steroidal Injection

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the neck, shoulders and arms. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing

Cervical Facet Injections

Cervical facet joints are small pairs of joints where the vertebrae meet on the back side of the neck/cervical spine. These joints provide stability to the spine by interlocking two vertebrae. Facet joints also allow the spine to bend forward (flexion), backward (extension), and twist. Inflammation of facet joints occurs from injuries and arthritis. Microscopic inflammation is often not seen on X-Ray or MRI.

Facet injections serve two purposes, diagnosis and treatment. First, injecting anesthetic (numbing) medication into a joint confirms the diagnosis that the pain comes from this joint if the pain temporarily resolves following the injection. Second, the cortisone reduces inflammation which breaks the pain cycle.

Cervical Selective Nerve Root Block

A cervical selective nerve root block is used to diagnose and in some cases, treat nerve pain in the neck.  A variety of conditions can affect the nerves in the neck, which not only can cause pain in the neck, but pain that spreads to the shoulders and arms.  A cervical selective nerve root block places medication directly around a suspected nerve to help determine if it is the source of pain.  If the selective nerve root block relieves the pain, then the doctor can proceed with treatment.

Lumbar Epidural Steroidal Injection

Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.

Lumbar Epidural Sympathetic Block

[Brings to Sympathetic Blocks and Stellate Ganglion Block

Lumbar Facet Injection

Lumbar facet joints are small joints located in pairs in your lower back. These joints provide stability and guide motion in your spine. If the joints become painful due to arthritis, injury, or mechanical stress, they can cause pain in various areas. The lumbar facet joints can cause pain in your lower back, hip, buttock, or leg.

A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

Lumbar Paravertbral Sympathetic Block

[Brings to Sympathetic Blocks and Stellate Ganglion Block

Lumbar Selective Nerve Root Injection

[Brings to Selective Nerve Blocks (Cervical and Lumbar)

Radiofrequency, Cervical Facet

Cervical facet radiofrequency neurotomy (facet rhizotomy) is used to treat nerve pain in the neck and/or shoulder.  This technique is useful for those patients who experience short term relief following local anesthetic blocks of the nerves supplying the cervical facet joints.  The procedure “turns off” the specific nerve that carries information about pain.  The treatment can provide pain relief for about a year, but can last much longer for some people.

Radiofrequency, Lumbar Facet

Lumbar radiofrequency neurotomy (facet rhizotomy) is used to treat nerve pain that originates in the spine joints of the lower back.  Lumbar radiofrequency neurotomy is useful for people that experienced relief following nerve blocks to the area.  The procedure “turns off” the specific nerve that carries information about pain.  The treatment provides pain relief for about a year, but can last much longer for some people

Radiofrequency, Sacroiliac Joint

branches from transmitting pain signals. Radiofrequency applies a precisely targeted electrical field to create a lesion (change in the body’s tissue) – in this case, in small branches of spinal nerves, rendering them incapable of transmitting pain signals. The applied electrical field can then target these tiny nerves just as they enter the SI joint.

Radiofrequency, Thoracic Facet

Thoracic radiofrequency neurotomy (facet rhizotomy) is used to treat nerve pain that originates in the spine joints of the mid back.  Thoracic radiofrequency neurotomy is useful for people that experienced relief following nerve blocks to the area.  The procedure “turns off” the specific nerve that carries information about pain.  The treatment provides pain relief for about a year, but can last much longer for some people.

Sacro-Iliac Joint Injection

Sacro-Iliac Joint Injection is an injection of long lasting steroid in the Sacro-Iliac joints – which are located in the low back area.  The steroid injected reduces the inflammation and/or swelling of tissue in the joint space. This may in turn reduce pain, and other symptoms caused by inflammation / irritation of the joint and surrounding structures.

Selective Nerve Blocks (Cervical and Lumbar)

Selective nerve root blocks are similar to epidurals. Instead of putting medication in to cover all of the nerve roots, selective blocks are done so as to cover just one or two nerve roots. They involve injecting medication to numb just one or two of the spinal nerves.

There are two types of selective nerve root blocks: diagnostic and therapeutic. When one does a diagnostic block, just enough medication is placed to numb exactly one root. By doing this, the doctor can determine if the nerve root is causing the pain. Therapeutic blocks involve more medication and different medication. The blocks get rid of arm or leg pain about half of the time. They are not used for midline back pain.

Spinal Cord Stimulator Trials

Spinal Cord Stimulator Trial is a reversible procedure that will allow a patient to actually experience the benefits of the Spinal Cord stimulator implant system. The patient uses a temporary, non-implanted (external) system for about 3 to 5 days. If the physician and patient determine that the implant system fits the patient’s pain needs and lifestyle, a surgical procedure is conducted to place the implant.

Stellate Ganglion Block

[Brings to Sympathetic Blocks and Stellate Ganglion Block

Sympathetic Blocks and Stellate Ganglion Block

Sympathetic blocks are performed at the stellate ganglion for upper extremities and lumbar paravertebral ganglions for lower extremities. By diminishing the vicious sympathetic hyperactive feedback, these blocks along with physical therapy and medication help restore normal limb function. Early recognition and intervention are essential for good outcome.

Thoracic Epidural Steroidal Injection

An epidural steroid injection significantly reduces pain for approximately 50% of patients. It works by delivering steroids directly to the painful area to help decrease the inflammation that may be causing the pain. It is thought that there is also a flushing effect from the injection that helps remove or “flush out” inflammatory proteins from around the structures that may cause pain. In addition to relieving pain, the process of natural healing can occur more quickly once the inflammation is reduced.

Thoracic Facet Injection

Thoracic facet joints are small pairs of joints where vertebrae meet on the back side of the middle spine. These joints provide stability to the spine by interlocking two vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist. Inflammation of facet joints occurs from injuries and arthritis. Microscopic inflammation is often not seen on X-Ray or MRI.

Facet injections serve two purposes, diagnosis and treatment. First, injecting anesthetic (numbing) medication into a joint confirms the diagnosis that the pain comes from this joint if the pain temporarily resolves following the injection. Second, the cortisone reduces inflammation which breaks the pain cycle. With pain under control, you can begin a rehabilitative exercise program.

Thoracic Sympathetic Block

[Brings to Sympathetic Blocks and Stellate Ganglion Block

Ultrasound Guided Injection

One of the more exciting advances in interventional sports medicine is the use of Musculoskeletal Ultrasound to help guide injections such as steroid injections, prolotherapy, and PRP. The ultrasound machine is first used to identify the injury, and then the needle is introduced under the guidance of the ultrasound, helping to maximize precision. Ultrasound guidance can make it possible to inject structures that otherwise would not be attempted, and also can improve the effectiveness and safety of many injections by helping pinpoint the injured structure as well as helping to steer clear of adjacent structures that should be avoided (nerves, blood vessels).