How can I relieve lower back pain?
There are many potential causes of low back pain. We understand that the most effective treatment depends on the correct diagnosis of the cause of pain.
Unlike many Interventional Pain Medicine Physicians, Dr. O possesses additional specialities as a board certified Internist and Neurologist. This unique combination and set of skills allows Dr. O to provide the most comprehensive diagnosis in determining the origins of pain and the best solutions for pain relief.
Our process at Prime Pain Specialists is to the first undergo a comprehensive evaluation which includes your medical history and physical examination, followed by imaging studies that may include a magnetic resonance imaging (MRI) or computerized tomography (CT) scan. A correct diagnosis is made, and treatment options tailored to each patient’s pain is offered.
How can I relieve neck pain?
The approach is similar to that mentioned for lower back pain.
What is an epidural injection?
The “dura” is the thick covering of the spinal cord and spinal nerves. Epidural injection is injection of steroid on top (“epi”) of the dura (“epidural”). This can be done in the neck, mid-, and lower back depending on the source of pain. An x-ray machine or “fluoroscopy” is used to safely guide the needle injection.
How is an epidural injection performed?
The patient is positioned face-down. The area to be injected, for example, the lower back, is thoroughly cleaned and the skin and tissues of the area is numbed. After confirmation with a contrast dye, an epidural needle used to deliver the steroid medication into the epidural space with the guidance of x-ray (“fluoroscope”). The point of injection is dressed with Band-Aid.
What are the types of epidural injections?
Epidural injections could be interlaminar or transforaminal in the neck or back. In addition, in the lower back, there could be caudal epidural injection. Your Physician at Prime Pain Specialists will work with you to determine the best approach suitable for your type of pain.
Do epidural injections work?
Yes, most of the time. However, just like many forms of treatment in medicine, it is known that a small fraction patients that do not respond for different reasons. At Prime Pain Specialists, we work through these reasons with our patients and/or provide them with other options to relieve their pains.
Are epidural steroid injections painful?
At Prime Pain Specialists, epidural injections are generally well-tolerated when done under local anesthesia (which means that the skin and tissues of the area is numbed). Occasionally, monitored anesthesia care (MAC) may be used (can we briefly explain this?). We typically do not use general anesthesia or intubation.
I take a blood thinner. Do I need to stop this medication for epidural injections?
To reduce the risk of bleeding, your blood thinner needs to be stopped a few days before the procedure. Your pain physicians will work with you, your family doctor, and other specialists (for example, your cardiologists), to determine for how long the blood thinner should be stopped. Generally, the blood thinner can be resumed within hours of completing the procedure.
Do I need to fast before my procedure?
Epidural injections are usually performed under local anesthesia (which means that the skin and tissues of the area is numbed) and fasting is not necessary. However, if monitored anesthesia care (MAC) (can we briefly explain this?) is used, you may need to avoid food or drink two hours before the procedure. When will i be able to eat/drink after if MAC is used?
Are epidural injections safe?
Epidural injections are generally considered to be safe with very low incidence of serious complications like bleeding, nerve damage, positional headache, or infection. At Prime Pain Specialists, our interventional pain physicians take very careful measures to prevent complications before, during, and after the procedure.
Are there any side effects from epidural injections?
Epidural injections are generally considered to be safe but reported side effects include pain at the site of injection, localized increase in pain, restlessness, anxiety, facial flushing, sleeplessness, elevated blood sugar, transient non-positional headaches, or allergic reactions. Prime Pain Specialists’ interventional pain physicians take very careful measures to prevent or reduce the occurrence of side effects before, during, and after the procedure.
What to expect after an epidural injection?
Generally, epidural injections are safe and well-tolerated. Pain relief from the injection usually starts a few days after the procedure. Immediately after an epidural injection in the lower back for example, there may be transient (short-lived) numbness of the legs, soreness in the back, or facial flushing. Patients with diabetes may experience increase in their blood sugar levels. At Prime Pain Specialists, we work with your primary care physician to carefully monitor your well-being after the procedure.
Do I need to repeat epidural injections?
Epidural injections typically lead to pain relief for 3-12 months and the procedure may need to be repeated periodically as necessary.
How can I get relief from headaches?
There are many causes of headaches and treatment is usually dependent on the cause. The Physicians at Prime Pain Specialists are trained experts who are able to correctly diagnose the cause of headache and tailor treatment accordingly.
What are the small joints of the back called?
The small joints of the back are called the “facet joints.” Each bone of the neck or back (“vertebra”) is connected to its neighbor above by two facet joints and to its neighbor below by 2 facet joints. Each facet joint is supplied by 2 medial branch nerves. Pain arising from these joints is a major cause of back or neck pain.
Are spinal facet injections painful?
Spinal facet injections are generally well-tolerated when done under local anesthesia (which means that the skin and tissues of the area is numbed). Occasionally, monitored anesthesia care (MAC) may be used (can we briefly explain this?).
How long do facet blocks last?
What is a medial branch block?
Medial branch nerves are small sensory nerves that supply a facet joint and send pain signals to the brain. There are 2 medial branch nerves to each facet joint. At appropriate levels in the neck or back and under x-ray guidance, the pain from medial branch nerves can be blocked through injections to diagnose the facet joint as the source of pain.