Discography involves the injection of contrast dye into the center of a disc under direct x-ray control. It is strictly a diagnostic procedure which helps the physician try to locate the source of your pain. Your skin will be injected with a numbing medication such as Lidocaine or Marcaine during the procedure. This may feel like a burning sensation in your back. The physician will tell you when they plan to start the injection(s). You will be asked to report how the injections feel. The most important thing is to report to the physician if the injection reproduces your usual pain.
The epidural space is located outside the lining of the spinal cord. Medications such as corticosteroids and/or local anesthetics are injected in the epidural space by the way of a needle or catheter.
The usage of Botox® (botulinum toxin) is not limited to cosmetic therapies. There are numerous research studies showing the effectiveness of botulinum toxin in managing painful conditions. Low back pain, headaches and neck pain are just a few of the painful conditions that can benefit from botulinum toxin injections.
Facet syndrome cannot be diagnosed by x-ray, CT scan, MRI, Bone scan, or any other radiology process. It is suspected on physical exam by tenderness directly over the facet joint, experiencing pain on extension (bending backwards), and on your history. The diagnosis is made by injecting a local anesthetic and steroid to the painful area or the nerve that goes to this area. If your pain is relieved by this injection you may benefit from another procedure called Radiofrequency Rhizotomy/Neurolysis.
Also called Racz procedure, this procedure is performed to remove excessive scarring in the epidural space. The epidural space is a thin area between the inside of the spine and the protective layer around the spinal cord. Scar tissue may restrict the natural movement of nerves causing inflammation and pain.
A nerve root block is an injection of local anesthetic and sometimes a steroid under the directed vision of an x-ray machine (C-Arm) into the areas where the nerve root exits the spinal column. A nerve root block (injection) follows the path of a single nerve to block pain emitted into an arm, leg or back.
A nerve root block may be used by your Doctor to diagnose (try to determine at which level in your spine the pain is coming from) and provide therapeutic relief at this level with medication.
The sympathetic nerves/ganglions are responsible for pain with burning, shooting and tingling properties. These are specialized nerves that can become “fired-up” even with the smallest injuries or no injuries at all. Most common syndromes related to the sympathetic nerves include RSD(reflex sympathetic dystrophy), facial pain from trigeminal neuralgia, pancreatic cancer pain, etc. Your pain specialist can perform an injection with local anesthetics with or without steroids to disrupt the pain signals from these sympathetic nerves/ganglions.