MEDICATIONS The physician may use a variety of different medications based on your particular medical and/or psychological condition, allergies, financial resources and insurance plan formularies. Medications can vary from anti-inflammatory medicines to opioid pain medicines, nerve medications to anti-depressants, anti-seizure medications to muscle relaxants and many others. Each person is different and if medicines are to be used, the treatment will be uniquely tailored to your specific needs. If any controlled substances are used in your treatment plan, you will be required to complete a Prescription Drug Agreement with your doctor.
TRIGGER POINT INJECTION This involves injecting an anesthetic medication into a painful muscle area. This decreases pain and relaxes the muscle. This is a very easy and effective way to treat myofascial (muscle) pain.
TENDON INJECTIONS This involves injecting an anesthetic medication and usually some steroid (cortisone-like) medication into a tendon insertion area. This decreases pain and inflammation. This is a very easy and effective way to treat tendonitis pain.
JOINT INJECTION Since every joint in the body is susceptible to arthritis and chronic pain, sometimes a cortisone and/or anesthetic injection directly into the joint is necessary for relief. Some of these injections are performed under a type of x-ray guidance called fluoroscopy. This lets the doctor see exactly where the medicine is going.
FACET JOINT INJECTION The strength and flexibility of the spine is due in large part to the unique interaction of the disc in the front part of the spinal column with the facet joints in the back of the spinal column. Spinal facet joints have a joint capsule lubricated with fluid and richly innervated by a network of pain-sensitive nerve fibers. Facet joints are numerous and can become vulnerable when the intervertebral disc is injured. Injections of steroids directly into the facet joints may reduce pain and facilitate rehab therapy.
HYALURONATE INJECTION This is a medication that is injected into the knee joint only for osteoarthritis of the knee. It is a protein substance that provided lubrication to the knee and thus pain relief. It is extremely effective. Orthovisc results are variable – usually from about 6 months to upwards of 2 or more years.
EPIDURAL STEROID INJECTIONS An Epidural Steroid Injection is a procedure performed under fluoroscopic guidance (a type of X-ray) where the physician places a needle into the spinal canal and injects a cortisone type medication and local anesthetic. The epidural space is a space inside the spinal canal between the bony canal of the vertebrae and the sac that contains the nerves, spinal cord and spinal fluid. There are several different approaches to this space that the physician may use. This depends on the medical problem being treated. The purpose of this is to try to provide a nerve block and to suppress the inflammation that is affecting the nerves that are carrying the painful nerve signal to the brain. For most spinal conditions, this is a very effective way to decrease pain. The results vary, but usually, the injections last from 3 months to 1 year. Depending on the medical problem, they may totally stop the pain and it may never have to be repeated. They can be repeated if the pain returns and sometimes are performed in a series of two or three injections 2-3 weeks apart. . SI JOINT INJECTIONS The SI Joint is a large joint between the tail bone (Sacrum) and the hip bone (Ilium). Inflammation of this joint is a common cause of Low Back Pain. This is a simple procedure where the physician places a needle into this joint and injects anesthetic and steroid (a cortisone type medication). The purpose is to suppress inflammation and relieve the pain.
DISCOGRAPHY (HOSPITAL-BASED) This is a diagnostic test. The physician inserts a needle into the intervertebral disk. Contrast or dye is injected into the disk. The physician may measure the pressure inside the disk if necessary. During the contrast injection, the patient is asked to report if the additional pressure on the disk reproduces his or her pain. This lets the physician know which particular disks are painful. Once the procedure is completed, the patient is taken to a diagnostic center for a CAT Scan of this area. This test will reveal any disk that is ?disrupted?. This means that there may be tears in the outer ring of the disk that were not seen on an MRI scan or other test. This test is the best way to make an accurate diagnosis of a disk problem in some cases.
DIAGNOSTIC BLOCKS, RADIOFREQUENCY (HOSPITAL-BASED), SYMPATHETIC BLOCKS A Diagnostic nerve block is used to determine sources of pain. These blocks typically contain an anesthetic with a known duration of relief. A sympathetic nerve block is one that is performed to determine if the pain has sympathetic component. This is a network of nerves extending the length of the spine. These nerves control some of the involuntary functions of the body, such as opening and narrowing blood vessels.
PHYSICAL THERAPY AND REHAB Physical Therapy and Rehabilitation Services are available in all three offices of CRO. Our physicians will evaluate your individual rehabilitation for your diagnosis and design a program to strengthen core musculature and promote new neuromuscular patterns.
