Other Treatments

CERVICAL FACET BLOCKS

Cervical facet blocks are useful in the diagnosis and painful conditions involving trauma, arthritis, or any inflammation in the neck. Pathology or trauma of the neck can present as decreased range of motion, pain, spasm and palpable tenderness. Neck pain can be referred to the shoulder, scapula, upper arm, and even precipitate migraine headaches.

STELLATE GANGLION BLOCKS

Stellate ganglion blocks are useful in the treatment of many disorders involving the upper body or upper extremity and head. They may be useful in the treatments of such diseases as acute herpes zoster or shingles and trigeminal neuralgia. They may also be helpful in reducing the symptoms associated with reflex sympathetic dystrophy (RSD) or complex regional pain syndrome (CRPS) of the face, neck, upper extremity, or upper thorax. They are also useful in Reynaud’s Syndrome of the upper extremity and some atypical vascular headaches.

BRACHIAL PLEXIUS BLOCKS

Brachial plexus blocks are useful with pain emergencies associated with acute herpes zoster, brachial plexus neuritis, and shoulder and upper extremity trauma. They may also be used for reflex sympathetic dystrophy and/or complex regional pain syndrome of the shoulder and upper extremity.

MUSCULOSKELETAL BLOCKS

Musculoskeletal blocks of the upper extremity are useful for certain types of nerve entrapment syndromes or inflammation of tendons in the shoulder, elbow, wrist, and fingers.

INTERCOSTAL NERVE BLOCKS

Intercostal nerve blocks are used near the rib cage primarily for the treatment of shingles. As many as 50% of patients who experience the shingles rash will develop a very painful condition called post herpetic neuralgia which is sharp, lancing, burning pain radiating around the rib cage. This technique can be very useful in reducing pain.

CAUDAL EPIDURAL AND LUMBAR FACET JOINT BLOCKS

Caudal epidural and lumbar facet joint blocks are useful in the treatment of chronic low back pain either associated with arthritis, degenerative disc disease, and inflammation of the surfaces of the articulating joints of the vertebral spine.

SI JOINT AND PIRIFORMIS SYNDROME INJECTIONS

Very often, low back pain may be associated with inflammation of the sacroiliac joint which is the joint between the sacrum (bottom part of the spine) and the pelvic bone. There is a left and right joint. This pain can be due to trauma or arthritis of the back. Very often, individuals with other pain conditions of the low back will have imbalances of the musculoskeletal system which will put an unnecessary stress on the SI joint.

PIRIFORMIS SYDROME

The piriformis muscle is a deep muscle under the buttocks which moves the hip joint. What makes the triangular shaped muscle so important is that the sciatic nerve usually passes underneath it and in some individuals, part of it or all of it actually passes through it. When a sciatic nerve is inflamed, it can also cause a severe spasm of the piriformis muscle, and the piriformis muscle when in spasm can affect the sciatic nerve, setting up a self perpetuating pain process. Therefore, injection techniques to this muscle can be very helpful.