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Spinal Injections and Pain Management

With the addition of Dr. Aashish Bharara to our team, Perimeter Orthopaedics is proud to announce we now offer our patients pain management and spinal injections.

Dr. Bharara, is a licensed and board-certified interventional Physical Medicine and Spine Management Specialist. Known for his incredible care in spinal injections, he can discuss and treat neck and spinal injuries. With traditional and modern medicine, Dr. Bharara has treated his patients with the upmost care.

Spinal Injections

Spinal injections are used in two ways. First, they can be performed to diagnose the source of back, leg, neck, or arm pain (diagnostic). Second, spinal injections can be used as a treatment to relieve pain (therapeutic).

Most spinal injections are performed as one part of a more comprehensive treatment program. Simultaneous treatment nearly always includes an exercise program to improve or maintain spinal mobility (stretching exercises) and stability (strengthening exercises).

Procedure

Spinal injections are performed under x-ray guidance, called fluoroscopy. This confirms correct placement of the medication and improves safety.

To do this, a liquid contrast dye is injected before the medication. If this contrast does not flow in the correct location, the needle is repositioned and additional dye is injected until the correct flow is obtained. The medication is not injected until the correct contrast flow pattern is achieved making the procedure safe for patients.

Types of Spinal Injections

Epidural Injections:

The overall purpose of an epidural steroid injection is to decrease inflammation and swelling in the spine. In order to accomplish this, Dr. Bharara injects steroids directly into the epidural space in the spine. Depending on the injury and the required medication, the injection may also flush out other fluids. This is one potential avenue of pain management. This is a therapeutic type of injection.

If the pain is completely or nearly completely relieved, then that specific nerve is the primary cause of the pain symptoms. If there is little pain relief, then another source of pain exists.

Facet Joint Injections:

Facet join injections can be done for both diagnostic and therapeutic reasons.

These types of injections are placed into and around the facet joints, which are the small joints located between each vertebra on the back of the spine. Facet joint injections are often used when pain is caused by degenerative/arthritic conditions or injury. They are used to treat neck, middle back, or low back pain. The pain does not have to be exclusively limited to the midline spine, as these problems can cause pain to radiate into the shoulders, buttocks, or upper legs.

For diagnostic purposes, facet joints can be injected in two ways: injecting anesthetic directly into the joint or anesthetizing the nerves carrying the pain signals away from the joint (medial branches of the nerve). If the majority of pain is relieved with anesthetic into the joint, then a therapeutic injection of a steroid may provide lasting neck or low back pain relief.

If anesthetic injections indicate that the nerve is the source of pain, the next step is to block the pain signals more permanently. This is done with radiofrequency ablation, or damaging the nerves that supply the joint with a "burning" technique.

Sacroiliac Joint Injections:

Sacroiliac joint (SI joint) injections are similar to facet joint injections in many ways. The SI joints are located between the sacrum and ilium (pelvic) bones.

Problems in the SI joints have been shown to cause pain in the low back, buttock, and leg. Typically, one joint is painful and causes pain on one side of the lower body. It is less common for both SI joints to be painful at the same time.

This joint can also be injected for both diagnostic and therapeutic purposes. Anesthetizing the SI joint by injection under x-ray guidance is considered the gold standard for diagnosing SI joint pain. A diagnostic injection of the sacroiliac joint with anesthetic should markedly diminish the amount of pain in a specific location of the low back, buttock, or upper leg.

A therapeutic injection will typically include a steroid medication, with the goal of providing longer pain relief.

Pain Management

Cervical radiculopathy, commonly called a "pinched nerve," occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain that radiates into the shoulder and/or arm, as well as muscle weakness and numbness.

Cervical radiculopathy is often caused by "wear and tear" changes that occur in the spine as we age, such as arthritis. In younger people, it is most often caused by a sudden injury that results in a herniated disk. In some cases, however, there is no traumatic episode associated with the onset of symptoms.

Electromyography or EMG:

Electromyography measures the electrical impulses of the muscles at rest and during contractions. Nerve conduction studies are often done along with EMG to determine if a nerve is functioning normally. Together, these tests can help your doctor determine whether your symptoms are caused by pressure on spinal nerve roots and nerve damage or by another condition that causes damage to nerves, such as diabetes.

Treatment

In most cases, cervical radiculopathy responds well to conservative treatment that includes medication, injections and physical therapy. If you are experiencing pain, usually described as burning or sharp, certain neck movements—like extending or straining the neck or turning the head—may increase the pain. Other symptoms include:

If you are experiencing any of the above pain then you should consult your medical provider.

For a full list of injections offered by Dr. Bharara, please call us at 404-255-5595.  

How Long Do Spinal Injections Last?

As far as effects go, the reaction that the body has is largely determined by the individual. Many patients who receive an injection feel the pain relief shortly after the injection. For others, though, the body’s reaction is slightly different. The injection is only effective when the body absorbs the steroids in the appropriate location.

At Perimeter Orthopaedics, we take a proactive approach to pain management. We have helped patients combat their pain for almost 40 years; schedule an appointment to manage your pain today.

 

Read more about Spinal Injections from the American Academy of Orthopaedic Surgeons at OrthoInfo.com.

Author
Lauren Mueller Marketing

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