Brachial Plexus Blocks
A brachial plexus injury affects the nerves responsible for communication between the spine and the arms, shoulders and hand. This condition occurs as a result of stretched or torn nerves, which is most commonly associated with contact sports. A brachial plexus injury may also be caused by tumors, falls, congenital defects, inflammation or car accidents. Depending on its severity, the symptoms of a brachial plexus injury may vary. Patients with mild brachial plexus injuries may experience weakness and numbness or a burning sensation in their arm, while patients with severe brachial plexus injuries may experience loss of shoulder and elbow control, inability to use their fingers and inability to move or feel their arm.
A brachial plexus block can be performed with only a local anesthetic, although sedation is an option for anxious patients. Once the local anesthetic has taken effect, the skin surrounding the affected area will be cleaned. With the assistance of x-ray and contrast dye, a needle is inserted. Once the needle is situated properly, the medicine is injected. You will be monitored after the procedure is completed. The pain you have been experiencing should be reduced almost immediately, but the length of time it lasts varies from patient to patient.
Bursa and Joint Injections
The bursae are the small, fluid-filled sacs that lubricate and cushion the bones and allow muscles and tendons to glide smoothly over them. Bursitis is a common condition that involves inflammation of a bursa, causing pain, stiffness, swelling and other troubling symptoms at the affected joint. It can be caused by overuse, stress or direct trauma to the joint and can occur within nearly any joint of the body.
Therapeutic bursa and joint injections are a minimally invasive treatment option used to relieve pain caused by inflammatory joint conditions such as rheumatoid arthritis, tendonitis, bursitis and gout. Corticosteroids, used to reduce inflammation and minimize pain as a result, are injected into the affected joint. This medication only affects the targeted area and does not usually cause side effects. Joint injections are administered under local anesthesia and only cause mild, brief discomfort for patients.
Joint injections can be used to relieve pain in the knee, shoulder, ankle, elbow, wrist, thumb, hip and other locations. Most patients can benefit from bursa and joint injections and are good candidates for treatment, unless they have an infection in the joint or an allergy to one or more of the medications to be used.
Greater and Lesser Occipital Nerve Blocks
Pain outside the spinal area is diagnosed with a peripheral nerve block, which may be inserted in the occipital nerves in the cervical area. The occipital nerves span from the base of the neck to the scalp and they may be damaged by trauma or conditions such as diabetes, neck tumors or gout. Patients may experience tenderness in the scalp, pain when moving their neck, pain radiating from the base of the head to the scalp and sensitivity to light.
Occipital nerve blocks are placed with the help of ultrasound imaging, and injected directly into the affected nerve. This minimally invasive treatment option uses corticosteroids to reduce inflammation and minimize pain. This medication is injected into the occipital nerve and provides immediate pain relief due to the anesthetic. The corticosteroid produces longer-term pain relief that typically begins a few days after the injection. Normal daily activities can usually be resumed the following day. The effectiveness of occipital nerve blocks varies from patient to patient, and pain relief may last anywhere from a few days to a few months.
Other Peripheral Nerve Blocks
A nerve block is a procedure used to treat or diagnose severe pain. The block is placed by injecting an anesthetic into the affected nerve to either numb the pain or determine whether the pain is coming from the nerve. If the pain is relieved when the block is injected, it can be assumed that the pain is caused by the nerve. After a diagnostic nerve block, the procedure may be repeated as a more long-term treatment method.
Nerve blocks are placed with the help of ultrasound imaging, and injected directly into the affected nerve. Pain outside the spinal area is diagnosed with a peripheral nerve block, which may be inserted in the occipital nerves in the cervical area, the ilioinguinal nerve in the pelvic area or other motor nerves. Nerve blocks are not an option for all patients and can cause serious side effects.
The sympathetic nerves are a small group of nerves that carry pain signals from the extremities. A sympathetic block is a minimally-invasive procedure to determine whether the sympathetic nerves are causing your pain. In some cases, it may even provide you with full pain relief.
A sympathetic block injection only takes a few minutes, although you will likely remain in our office for an hour; this includes consulting with your doctor before the procedure, positioning for the procedure and recovery room observation afterwards. Only a local anesthetic is necessary for a sympathetic block, although sedation is an option for anxious patients. Once the local anesthetic has numbed the skin near the targeted site, you will receive the injection.
The effectiveness of a sympathetic block varies. Some patients experience permanent relief, with no further injections necessary. Others may only experience relief for a few weeks or months, requiring additional treatment. The exact effectiveness of a sympathetic block depends on your individual condition.
Trial for Spinal Cord Stimulator
A spinal cord stimulator is an electronic device that is implanted in the body to help relieve chronic pain. Also known as a dorsal column stimulator, the device sends low electrical currents through wires placed near the spinal cord to treat pain. It allows patients to control when pain relief is needed or not.
The device does not cure chronic pain, but usually provides a 50% or greater decrease in pain and allows patients to be more active and have less of a need for pain medication. This procedure is usually considered when other solutions, such as surgery, injections and medications, have failed. Before implantation, patients will often be asked to go through a trial period with an external device. The trial will test patients' pain levels and see if they increase with the help of the device.
During the implantation of the permanent device, wires are fed with a needle and positioned on the spinal cord. The actual device is placed dependent on where the pain is. The device can be removed if necessary. The battery of the device must be replaced every 2 to 5 years. Complications rarely occur as the procedure is very safe and minimally invasive. Proper care following the procedure is required and includes limiting movement and avoiding driving for the first few weeks.
To learn more about our Pain Management Services, please contact us at (215) 725-7600 today to schedule an appointment.