Many therapeutic spine injection procedures provide a two-fold benefit to patients.  The injection provides immediate and long-term potential relief.  Most injections contain a local anesthetic providing immediate relief and for maximum benefit, a long acting medication is also injected that typically takes affect two to three days following the injection for long-term relief. 

IOC pain management services provide treatment for neuropathic pain syndromes, as well as, diagnostic and therapeutic spine injection procedures including:

An ESI is a common injection given to provide relief from certain types of low back (lumbar) and neck (cervical) pain. The "epidural space" is the space located between the covering of the spinal cord and the inside of the spinal canal. This space extends the entire length of the spine.  When medication is injected into the epidural space it can move freely up and down the area of the spine that is injected.  During an ESI, a steroid is usually injected into the epidural area, coating the nerve roots, as well as, the outside lining of the facet joints near the injection site.  If the injection is given in any area of the spine, it affects that entire section.  As an example, if the injection is given into the lumbar region of the spine, it will affect the entire lower portion of the back; similarly, if injected into the cervical area, it will affect the entire upper area of the cervical spine area. 

Selective nerve root blocks are similar to epidurals, but instead of injecting medication to cover all of the nerve roots, selective blocks are done specifically to cover just one or two nerve roots. Medication is injected targeted directly to provide relief to just one or two affected spinal nerves.

There are two types of selective nerve root blocks: diagnostic and therapeutic. A diagnostic nerve block, injects just enough medication to numb exactly one root. If the patients symptoms are relieved, the physician then knows that this is the nerve root that is causing symptoms.  Therapeutic nerve blocks involve injecting different types of medication.

Patients that have been shown to have pain originating from the facet joints are candidates for this procedure.  Generally, candidates for radiofrequency lesioning should have had at least two facet injections that gave significant relief of pain.

Radiofrequency lesioning also known as Neurotomy and nerve ablation is performed using mild sedation and local anesthetics. Fluoroscopic x-ray guidance allows the physician to accurately position the radiofrequency probe adjacent to the medial branch nerves at the site the pain is originating from. The nerve is then heated to 80° C using a radiofrequency generator.  The heat will be sufficient to either destroy the tissue surrounding the affected nerve, or deactivate the nerve.

These are local anesthetic injections given near a specific nerve or group of nerves to relieve pain.

A lumbar sympathetic block is an injection of local anesthetic around a group of nerves in your lower back. This may be recommended for patients who have been diagnosed with reflex sympathetic dystrophy (RSD), or other neuropathic pain.

Intradiscal therapy is a minimally invasive treatment for chronic pain originating from the intervertebral discs.  Controlled levels of heat are applied to an area of the affected disc wall.  As the heat contracts and thickens the collagen of the disc wall this raises the temperature of the nerve endings. This may result in contraction or closure of the disc wall fissures, or a reduction in the bulge of the inner disc material and a desensitization of the pain sensors within the disc.

This procedure may be recommended if your neck or lower back pain may be caused by the small facet joints of the spine.  Symptoms of facet joint arthritis can frequently be helped by these types of injections.

Spinal Cord Stimulator Implants

For some patients suffering from chronic back pain or post-surgical pain, placement of a spinal cord stimulator may be recommended.  The spinal cord stimulator implants microscopic leads that deliver low levels of electrical currents to the lower portion of the spinal cord effectively blocking the sensation of pain. Placement of a spinal cord stimulator implant is usually considered after nonsurgical options have failed and patients are not considered a candidate for surgery.  Patients must have a thorough clinical evaluation to determine if they meet the clinical selection criteria for the implant.

You don’t have to struggle daily with pain.  Our pain management team of healthcare professionals treats each patient individually, using innovative state-of-the-art diagnostic and therapeutic procedures to diagnose pain and determine a pain management treatment plan that’s right for you.  Our interdisciplinary approach to pain management allows IOC to offer you the full spectrum of treatment options. Let our team of experts work with you to help you return to your life.  Whatever the source of your pain, you can benefit from visiting the pain management experts at Iowa Orthopaedic Center, P.C.   Call IOC today at 515-247-8400, or toll free 800-642-6381, we’re here to help you!