Injections

Injections

Cervical Facet

For Neck Pain and Headaches

A cervical facet joint injection is an outpatient procedure for diagnosing and treating neck, shoulder, upper back pain, and headache pain.

Cervical facet joints are small joints located in pairs on the back/side of your neck. These joints provide stability and guide motion in your spine.

You may feel pain if a cervical facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected. Cervical facet pain can occur in an area from your head down to your lower shoulder blade. Why are facet joint injections helpful?

A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an x-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, the physician numbs a small area of skin with numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use x-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected.

20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone  becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

Cervical Interlaminar Epidural Injection

For Neck, Shoulder, Upper Back and Arm Pain

A interlaminar epidural injection is an outpatient procedure for diagnosing and treating neck, shoulder, upper back, and arm pain.

The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the back and into the arms and legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc, injured soft tissue or from contact in some way with the bony structure of the spine.

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots and other soft tissue, hopefully reducing the pain in the back or arms. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

An IV is started so that relaxation medication can be given. The patient is placed lying on their side on the x-ray table and positioned in such a way that the physician can best visualize the spine using x-ray guidance. The skin on the lower neck or back is scrubbed using 2 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a small needle, using x-ray guidance into the epidural space. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. A mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected.

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet (“pain diary”). This will be available online.

A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. The neck, upper back or arms may feel weak or numb for a few hours. This is to be expected, however it does not always happen. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, another treatment may be indicated. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working. Patients are generally asked to be at the appropriate facility one hour prior to the procedure and can expect to be at that facility approximately 2-3 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work.

Lumbar Facet Injection

For Low Back Pain

A lumbar facet joint injection is an outpatient procedure for diagnosing and treating low back pain, buttock, hip or groin pain.

Lumbar facet joints are small joints located in pairs in your lower back. These joints provide stability and guide motion in your spine.

You may feel pain if a lumbar facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected. Facet joint pain can refer to other areas of the lower body.

The lumbar facet joints can cause pain in your lower back, hip, buttock, or leg. A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an x-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, he physician numbs a small area of skin with numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use x-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected.

20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical, chiropractic treatment, or massage therapy after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

When can I resume activity? On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

Lumbar Interlaminar Epidural Injection

For Low Back and Leg Pain

A lumbar interlaminar epidural injection is an outpatient procedure for diagnosing and treating low back and leg pain.

The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the back and into the legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or from contract in some way with the bony structure of the spine.

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

An IV is started so that relaxation medication can be given. The patient is placed lying on their side on the x-ray table and positioned in such a way that the physician can best visualize the low back using x-ray guidance. The skin on the back is scrubbed using 2 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a small needle, using x-ray guidance into the epidural space. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. A mixture of numbing medicine (anesthetic) and anti- inflammatory (cortisone/steroid) is injected.

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet (“pain diary”). This will be available online.

A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. The back or legs may feel weak or numb for a few hours. This is to be expected, however it does not always happen. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, another treatment may be indicated. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working. Patients are generally asked to be at the appropriate facility one hour prior to the procedure and can expect to be at that facility approximately 2-3 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work.

Lumbar Transforaminal Epidural Injection

For Low Back and Leg Pain

A lumbar transforaminal epidural injection is an outpatient procedure for diagnosing and treating low back and leg pain.

The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the back and into the legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or from contract in some way with the bony structure of the spine.

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

An IV is started so that relaxation medication can be given. The patient is placed lying on their side on the x-ray table and positioned in such a way that the physician can best visualize the low back using x-ray guidance. The skin on the back is scrubbed using 2 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a small needle, using x-ray guidance into the epidural space through the bony opening of the exiting nerve root. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. A mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected.

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet (“pain diary”). This will be
available online.

A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. The back or legs may feel weak or numb for a few hours. This is to be expected, however it does not always happen. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, another treatment may be indicated. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical therapy, chiropractic care or massage after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working. Patients are generally asked to be at the appropriate facility one hour prior to the procedure and can expect to be at that facility approximately 2-3 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work.

Sacroiliac Joint Injection

For Low Back and Buttocks Pan

A sacroiliac joint injection is an outpatient procedure diagnosing and treating low back and buttocks pain.

The sacroiliac joint is a large joint in your lower back and buttocks region. When the joint becomes painful, it can cause pain in its immediate region or it can refer pain into your groin, abdomen, hip, buttock or leg. (see image at left.) A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the joint is numb it means this joint is more likely than not your pain source. Furthermore, time-release cortisone will be injected into the joint to reduce any presumed inflammation, which on many occasions can provide long-term pain relief.

If needed, an IV will be started so that adequate relaxation medication can be given. After lying on an x-ray table, the skin over your lower back/buttock will be well cleansed. Next, the physician will numb a small area of skin with medicine (anesthetic) which stings for a few seconds. The physician then will use x-ray guidance to direct a very small needle into the joint. He will then inject several drops of contrast dye to confirm that the medication only goes into the joint. A small mixture of numbing medication (anesthetic) and anti-inflammatory cortisone will then be slowly injected.

20-30 minutes after the procedure, you will move your back to try to provoke your usual pain. You will report your remaining pain, (if any) and also record the relief you experience during the next week, on a “pain diary” we will provide. You may or may not obtain improvement in the first few hours after the injection, depending on if the sacroiliac joint is your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned.

On occasion, the part of your treated spine may feel slightly weak or have an odd feeling in your leg for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical, chiropractic treatment, or massage therapy after the injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

Thoracic Facet Injection

For Back Pain

A thoracic facet joint injection is an outpatient procedure for diagnosing and treating back pain.

Thoracic facet joints are small joints located in pairs along the spine in your back. These joints provide stability and guide motion in your spine.

You may feel pain if a thoracic facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are  injured. Facet pain also depends on which facet joint is affected. Facet joint pain can refer to other areas of the body.

The thoracic facet joints can cause pain in your back and other areas. A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of Immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.

An IV will be started so that adequate relaxation medicine can be given, if needed. After lying on an x-ray table, the skin over the area of the spine to be treated will be well cleansed. Next, the physician numbs a small area of skin with  numbing medicine (anesthetic), which stings for a few seconds. Next, the physician will use x-ray guidance to direct a very small needle into the joint. He then injects several drops of contrast dye to confirm that the medicine only goes into the joint. A small mixture of numbing medicine (anesthetic) and anti-inflammatory cortisone is then slowly injected.

On the day of the injection you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities.

20-30 minutes after the procedure, you move your area of usual discomfort to try to provoke your usual pain. You report your remaining pain (if any) and record the relief you experience during the next week in a “pain diary” we provide*. You may or may not feel improvement during the first few hours after the injection. This depends on if the joints injected are your main pain source. The pain diary is an important component of your care. It helps your treating physician to be informed of your results so future tests and/or needed treatment can be planned. How will I feel after the procedure? On occasion, the part of your treated spine may feel slightly weak or odd for a few hours after the injection. You may notice a slight increase in your pain lasting for several days, as the numbing medicine wears off before the cortisone becomes effective. Ice is typically more helpful that heat during the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. If you do not notice improvement within 10 days after the injection, it is unlikely to occur. You may take your regular medications after the procedure, but try to limit any pain medications for the first 4-6 hours after the procedure. This will ensure that the diagnostic information obtained from the procedure is accurate. You may be referred for physical, chiropractic treatment, or massage therapy after the  injection while the numbing medicine is effective and/or over the several weeks while the cortisone is working.

Thoracic Transforaminal Injection

Content Coming Soon

Trigger Point Injections

For Neck, Shoulder, Upper Back and Headache Pain

A trigger point injection is an outpatient procedure for diagnosing and treating head, neck, shoulder, upper back, and arm pain.

Myofascial trigger points are felt to be hyperirritable foci in muscles and fascia associated with taut muscle bands. Trigger points are diagnosed by palpation and produce a local twitch response and a referred pain pattern distal to the site of muscle irritability. Trigger points cannot be properly diagnosed in the acute stages of neck or back pain when muscle spasm and inflammation are present. Initially, trigger points generally respond to a program of stretching and correction of poor postural mechanics with or without other modalities, such as superficial heat or cold. Trigger point injections should be reserved for patients who have not responded in the first four to six weeks to a properly directed rehabilitation program and appropriate pharmacologic intervention.

The trigger point injection into the trigger point of the injured muscle. This allows for relaxation of the muscle and improved healing. These injections are an adjunct treatment, which facilitates participation in an active exercise program and may assist in avoiding the need for surgical intervention.

A small needle is inserted into the trigger point and a local anesthetic (e.g., lidocaine, procaine) with or without a corticosteroid is injected. Saline solution can also be injected. Injection of medication inactivates the trigger point and thus alleviates pain. Sustained relief usually is achieved with a brief course of treatment. The injection may cause a twitch or pain that lasts a few seconds to a few minutes.

Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet. Numbness from the anesthetic may last about an hour and a bruise may form at the injection site. Pain can be relieved by alternately applying moist heat followed by ice for a day or two. In most cases, stretching exercises and physical therapy are performed following TPI. A follow-up appointment will be made for a repeat block if indicated.

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8:30AM – 12:00PM &
2:00PM – 6:00PM


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Closed

Locations

Murray

32 West 6400 South
(Winchester St.) Ste. 200
Murray, Utah 84107

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Phone

(801) 466-7246

Fax

(801) 327-9339