Interventional Spine Procedures

  • Epidural Steroid Injection
    Epidural Steroid Injections are an effective adjunct to treatment for patients with pain of spinal origin. Commonly, nerves in the neck or back are compressed or irritated near the spine by a bulging or herniated disc, a bone spur, or scar tissue. This causes the nerve to become swollen, causing pain, numbness, tingling or weakness in the arms or legs. The purpose of the epidural injection is to decrease inflammation and provide pain relief, thereby facilitating active rehabilitation.
  • Facet Joint Injection
    Facet joint injections are used to treat pain originating from the joints in the spine. The spine is full of joints (called Z-joints or “facet” joints) which allow you to bend forward and back, or nod your head. Like any other joint in the body, these joints have joint fluid and cartilage that can develop arthritis or other painful conditions. Facet joint injections are ways of diagnosing and treating pain coming from these joints.
  • Medial Branch Block (MBB) Injection
    Medial branch block injections are a diagnostic procedure used to help diagnose the source of neck or back pain. The medial branch nerves of the spine are tiny nerves whose primary function is to allow sensation from the facet joints. There is a right and left facet joint at each level of the spine. These joints can become painful in the same ways that knee, hip, shoulder, or finger joints do. It is often very difficult to determine if a particular joint is painful based only on MRI and physical exam, so medial branch blocks (and sometimes facet joint injections) serve as diagnostic procedures to help identify where the pain is coming from.
  • Radiofrequency Ablation
    Radiofrequency ablation is used for long term pain relief of spine and sacroiliac joint pain. Facet joint injections, medial branch blocks, and radiofrequency neurotomy are ways of diagnosing and treating pain coming from joints in the spine.
  • Sacroiliac Joint injection
    A sacroiliac joint injection is a “cortisone shot” for the sacroiliac joint. The sacroiliac joints are two joints (right and left) which connect the lower spine or coccyx to the pelvis. These joints do not move much, but they can become inflamed and painful, especially after trauma. The only way to determine if a sacroiliac joint is causing pain is to fill the joint with anesthetic and see if the pain disappears.

Trigger Point Injections:

  • Trigger point injections are injections of local anesthetic into trigger points in muscles. A trigger point is a palpable band of muscle which is tender to pressure and palpation and may refer pain to a nearby site. These injections are helpful in reducing or resolving persistent muscle spasm and dysfunction.

Joint, Ligament and Bursa injections

  • A variety of joint, bursa, or ligament injections can be performed to assist in the reduction of pain and inflammation. These injections are performed in the office using sterile technique and ultrasound guidance to ensure accurate and safe needle placement. Common injection sites include shoulders, knees, hips, wrists, and hands.

Musculoskeletal Ultrasound

The use of ultrasound has drastically improved the safety and efficacy of injection therapy for the treatment of a broad range of conditions. But that is only the tip of the iceberg. A well-trained and experienced user can differentiate between normal and abnormal nerve, blood vessel, bone, ligament, tendons, bursae, and other soft tissue. This is key in making the correct diagnosis. For example, when trying to determine whether shoulder pain is coming from the rotator cuff which is outside the joint, or from arthritis which is inside the joint, ultrasound can be used to investigate both of these structures for signs of injury and inflammation. It can then be used to guide a needle to exact area that needs treatment