A FEW DIFFERENT TYPES OF INJECTIONS
We now offer this approach through our specialist in this area
Dr. Chundri, M.D. (Anesthesiologist & Pain Management Physician)
1) Epidural steroid injections
2) Selective nerve root block
3) Facet joint injection
Epidural steroid injections can be done in mainly two ways. First of all, what we’re trying to achieve is to place the steroid into the epidural space. Epidural space in itself denotes space that is intimately located above the dura. Dura is the outermost layer covering the spinal cord and the nerves that exit the spinal cord. Most of the inflammation occurs in that area and that is the area that we can place the medications most safely. This can be approached in two ways. One is what’s called “interlaminar” – that means between these lamina. That can be approached from what’s called paramedian – or just off the mid-line – approaching this way. Another approach is called the transforaminal – what that means is “across the foramen.” Foramen being this opening through which the nerve exits. The approach is taken by going into space where the nerve usually doesn’t appear and this is done under the guidance of x-ray or fluoroscopy.
Another type of injection is called selective nerve root block. Selective nerve root block is selectively choosing a specific nerve in order to determine whether that nerve is causing the pain. And in order to that, we approach under the guidance of fluoroscopy, to target a specific nerve then place a small amount of (usually) contrast to outline that we are really concentrating on this nerve root, then place a very small amount of anesthetic. Now, the small amount is important because we don’t want that that anesthetic to spread anywhere else and affect our outcome. If the pain is relieved with this injection, then we know that was the cause of the pain or a pain generator.
Another injection is a facet joint injection. This can be approached in two ways. One is the injection into the joint itself and in order to do that we use fluoroscopy for guidance and we approach the joint itself, going into the joint, and then place the medication into the joint. And the reason to do that is (1) to determine if injecting anesthetic and corticosteroid will relieve the pain – and that is the diagnostic part of this – and (2) the corticosteroid reduces the inflammation.
At Midwest Chiropractic we specialize in PAIN MANAGEMENT – we now offer PAIN INJECTIONS to numb the pain — ask us about this approach
773 229 9600