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Interventional Procedures

The focus of interventional pain treatment is to first find the cause of your symptoms and then utilize treatment options to manage or alleviate your pain, improve function, and enhance your quality of life.


Almost all injections are performed by musculoskeletal ultrasound guidance of the needle. The use of ultrasound guidance is needed for: avoidance of actual nerve, avoidance of blood vessels (causing hematomas) and for optimal placement of medication leading to a more effective treatment outcome. 


Nerve Block Injections

Nerve block injections are performed on patients for a variety of conditions caused by inflammation of specific nerve roots. The block involves the injection of a local anesthetic with a steroid or herbal anti-inflammatory in proximity to the injured nerve to decrease the conduction of pain signals along the nerve.


Tendon Sheath Injections

Tendon sheath injections are suggested when the tissues around a tendon are painful, swollen or difficult to move.  A tendon is a cord of strong fibrous tissue that connects muscle to bone. Most tendons are surrounded by a sheath or sleeve of synovial tissue. This tissue produces tiny quantities of fluid that lubricate the tendon and allow it to slide smoothly over the joint and work effectively.


In some inflammatory conditions, the synovial tissue becomes thickened and irritable, so that it produces too much fluid and causes pain. Injecting steroid or herbal anti-inflammatory medicine into the fluid within the tendon sheath can treat the inflammation, decreasing the pain and increasing the range of movement in that area.


Intra-articular injections

An intra-articular injection is an injection where the medication is administered directly into the joint space for the purpose of relieving joint pain.  An intra-articular injection is typically given when a joint with localized pain (acute or chronic) has not responded to or stops responding conservative treatment options.


Knee Joint Fluid Therapy Injections

Knee Joint Fluid Therapy (visco supplementation) Injections are approved for the treatment of osteoarthritis of the knee for those patients who have failed to respond to other treatments such as oral medication, exercise, or physical therapy. The Medication is injected directly into the knee joint to restore the cushioning and lubricating properties of normal joint fluid.  Injections are given once a week for 5 weeks.


Trigger Point Injections

Trigger point injections are performed when you have a clinical diagnosis of myofascial pain syndrome, which is a condition characterized by trigger points located within the muscle tissue.  Trigger point injections may help decrease referred pain associated with myofascial pain syndrome.


The physician will begin by localizing the taut band.  Then, the trigger point injection is performed with Lidocaine and a steroid or Sarapin (an herbal anti-inflammatory).  The area is then massaged to distribute the medication into the muscle tissue.


Botulinum toxin Type A (Botox) Injections

Botulinum toxin Type A (Botox) is a protein that causes temporary weakness of the injected muscles.  It may provide relief of a variety of disorders including dystonia, spasticity, and chronic migraine headaches. Botox injections may relieve symptoms for three to six months.  

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