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Non-Spine Pain Procedures

We offer pain relief procedures for conditions that affect areas of your body, including:

Intrathecal Drug Delivery Systems (IDDS)

If you have chronic pain and do not experience adequate pain relief from other approaches, we may recommend the IDDS treatment.

IDDS is a system that sends pain medicine directly to the spinal cord via a pump. Through surgery, we implant the IDDS into the intrathecal space of your spinal canal.

Nerve blocks

Ganglion impar block

We give this injection under x-ray guidance to target nerve fibers that carry pain signals.

This procedure can help reduce painful conditions, such as:

  • Distal urethra
  • Perineal pain
  • Rectal/anal pain
  • Scrotal pain
  • Tailbone (coccydynia)
  • Vagina

Genicular nerve block and radiofrequency ablation

This procedure is a minimally invasive, non-surgical treatment to relieve knee pain. If you suffer from chronic knee pain and other conventional therapies have failed, you may be a candidate for this procedure.

We perform this procedure in two phases: a test procedure followed by a therapeutic procedure.

  1. Diagnostic genicular nerve block
    The purpose of this procedure is to test the percentage of pain relief you receive. We use a local anesthetic and x-ray guidance to target the nerves that supply sensation to your knees.

    We ask you to carry on normal activities that usually aggravate your knee pain. We also ask you to record your pain score for several hours after you have completed the procedure. You feel the effects of the procedure almost immediately, but it wears off after a few hours – this is normal. This procedure is to let your doctor know if the actual ablation procedure will work for your knee pain.
  2. Genicular nerve ablation
    This procedure uses radiofrequency ablation to stun painful nerves and prevent signals from reaching the brain.

    If you achieved significant pain relief from the diagnostic genicular nerve block, then you are a candidate for this procedure. This procedure results in longer-lasting pain relief.

    Soreness at the site of injection is common and can last several days before you start to achieve pain relief.

    The effectiveness of this procedure can last from 6 to 24 months. Slowly, the nerves grow back. If your knee pain returns after six months, you can have this procedure again.

Ilioinguinal nerve block

The ilioinguinal nerve originates from the lower lumbar spinal nerve. This nerve wraps above the iliac crest (the upper ridge of the hip bone) and travels into the groin. It provides sensation to the upper inner thigh and perineum.

Surgery, trauma, or infection can cause damage to the ilioinguinal nerve. Common symptoms include severe pain in the groin, testes (men), labia (women), and inner thigh areas.

If medications fail to provide adequate pain relief, then we perform ultrasound-guided ilioinguinal nerve block. This treatment is both diagnostic and therapeutic. The injection includes both local anesthetic and a steroid, which can provide long-lasting pain relief.

Intercostal nerve block

If you suffer from chest wall or upper abdomen pain that has failed to improve with time or medication, you can be a candidate for this procedure.

Intercostal nerves travel under each of your ribs. With x-ray and ultrasound guidance, we place a small needle to target the intercostal nerve bundle. We inject a small amount of local anesthetic and steroid to provide pain relief.

Common conditions treated with this procedure include:

  • Chronic post-mastectomy pain
  • Post-herpetic neuralgia
  • Post-thoracotomy syndrome (pain after chest surgery)
  • Rib fractures

Lateral femoral cutaneous nerve block

The lateral femoral cutaneous nerve is a branch of the lumbar spinal nerves. These nerves travel under the inguinal ligament and provide sensation to the lateral (outer side) of the thigh. When this nerve becomes pinched, it can result in numbness, tingling, or pain in the lateral thigh.

When pain does not respond to medical management, we may recommend the lateral femoral cutaneous nerve block. This nerve block at the site of the pinched nerve can provide both diagnostic and therapeutic advantages.

We perform the injection with ultrasound guidance. We also use a local anesthetic and steroid around the nerve to provide pain relief.

Piriformis injection

Piriformis injections target the piriformis muscle located in the lower buttocks and above the tailbone. We refer to the straining of this muscle as piriformis syndrome. Tightness in the area can contribute to symptoms of sciatica.

A piriformis injection consists of injecting a local anesthetic and steroid around the sciatic nerve in the piriformis muscle. This procedure helps reduce irritation and inflammation of the nerve caused by the muscle strain.

We can perform this procedure either by ultrasound guidance or x-ray imaging guidance.

Sacroiliac joint injection (SI joint)

We inject a numbing agent and a steroid into one or both of the SI joints. SI joints connect the pelvic bones to the spine. This injection may help pinpoint if your pain is coming from the SI joint and may also ease this pain.

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