Interventional Pain Procedures Under X-Ray Guidance
A variety of interventional procedures can be used to treat a range of pain conditions, from chronic low back pain to migraine headaches. Many of these techniques are performed under X-Ray guidance, which helps the physician deliver the therapy—whether it's a steroid injection or heat-based remedy—to the exact source of the pain. Mount Sinai's pain management specialists are skilled in determining the most appropriate interventional procedure for each patient, and administering that procedure to achieve the greatest possible pain relief.
Our Pain Management and Integrative Medicine practice is pleased to provide a range of interventional treatment options, including the following.
Epidural Steroid Injections
An Epidural Steroid Injection is a minimally invasive procedure performed under live X-Ray guidance that is used to treat pain in the neck, shoulders, arms, upper and lower back, buttocks, and legs that results from irritation of spinal nerve roots. A variety of conditions such as herniated disc, degenerative disc disease, and arthritis can cause a stenosis (narrowing) of the openings through which nerves exit the spine, which can be irritating to the nerves. By injecting low doses of long-lasting corticosteroids (potent anti-inflammatory pain medications) targeted directly to the source of the pain (instead of much larger oral or intravenous doses) this inflammation can be decreased, providing pain relief.
These office-based procedures take approximately five minutes to perform and may be done under either local anesthesia or comfortable sedation.
Medial Branch Blocks / Facet Joint Injections
Medial Branch Blocks and Facet Joint Injections are minimally invasive procedures performed under live X-Ray guidance that are used to diagnose and treat pain arising from the small joints of the spine (facet joints). Diseases of these joints can produce pain in the neck, upper and lower back, and buttocks. Just like any other joint in the body (such as the knee or elbow) these joints may be acutely injured or produce chronic pain due to conditions such as arthritis. Medial Branch Blocks and Facet Joint Injections deliver low doses of long-lasting corticosteroids and local anesthetics directly to the source of the pain to alleviate discomfort.
These office-based procedures take approximately five minutes to perform and may be done either under local anesthesia or comfortable sedation.
Radiofrequency Nerve Ablations
Radiofrequency Nerve Ablation is a minimally invasive procedure performed under live X-Ray guidance to treat back and neck pain by using precisely controlled heat to temporarily and selectively disable nerves responsible for pain. The procedure involves inserting a specialized needle with a heated tip near the problematic nerve, where the heat interrupts the nerve's ability to send pain signals.
This office-based procedure takes approximately 20 minutes to perform and may be done either under local anesthesia or comfortable sedation.
Major Joint Injections (Knee, Hip, Shoulder)
Joint injections are minimally invasive procedures performed either under live X-Ray or ultrasound guidance to treat pain resulting from various causes, including osteoarthritis. Medications such as corticosteroids, local anesthetics, or hyaluronan (i.e. Synvisc, Hyalgan, etc.) are injected directly into the source of the pain to provide relief from mild to moderate osteoarthritis. This office-based procedure takes about 10 minutes to perform.
Occipital Nerve Blocks
Occipital Nerve Blocks are safe, office-based procedures used to treat various types of headaches, including migraines. Local anesthetic with or without a small dose of corticosteroid is used in this injection, which is administered to the back of the head near the greater and lesser occipital nerves. This procedure takes about 30 seconds to complete.
Kyphoplasty (Balloon kyphoplasty)
Balloon kyphoplasty is a minimally invasive procedure for the treatment of painful fractures of the spine (vertebral compression fracture) resulting from trauma in patients with osteoporosis or tumors. In kyphoplasty, a small balloon is threaded through an incision in the back to the site of the injury, where it is inflated to gently push any damaged bone back into place. Cement is then inserted into the site to hold the bone in proper position. This procedure is performed in an operating room under a combination of local anesthesia and sedation.