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Definitions

Trigger Point Injections
A trigger point is a knot or tight, ropy band of muscle that forms when muscle fails to relax properly. The trigger point can trap or irritate surrounding nerves and cause pain. The trigger points are injected with local anesthetic and anti-inflammatory.

Epidural Steroid Injections
The epidural space in the back is located using a specially designed needle, under local anesthetic. A solution of local anesthetic and anti-inflammatory are carefully delivered into the epidural space. This acts to dilute a number of chemical factors that may be causing pain and has an anti-inflammatory effect. The technique can be used anywhere in the spine, including cervical, thoracic or lumbar spine.

Radiofrequency Facet Ablations
This is a minimally invasive procedure which can be used for a variety of different nerve blocks including and in place of local anesthetic and anti-inflammatory drugs for a longer lasting nerve block. Radiofrequency can be used to temporarily deactivate minor nerves around the spine and other areas of the body. The pain generating nerves in many patients are often small, unimportant fibers which can cause severe pain. These nerves can be temporarily shut down using radiofrequency energy to heat and deactivate the pain generating nerve fibers. The procedure is performed by locating the affected nerve under x-ray guidance. A special probe is advanced into position, allowing the delivery of radiofrequency energy to the targeted area. Results can last from months to years.

Stellate Ganglion Blocks
The stellate ganglion consists of a collection of nerve fibers in the neck. Over activity in these nerves is implicated in a variety of painful conditions, for example Complex Regional Pain Syndrome and Atypical Facial Pain. A fine needle is located near the stellate ganglion and local anesthetic or radiofrequency is delivered.

Celiac Plexus Blocks
Used in difficult to treat abdominal pain for example chronic pancreatitis. The celiac plexus is a collection of nerves lying around the origin of the celiac artery in the abdomen. For a celiac plexus block, a fine needle is located near the celiac plexus under x-ray or CT guidance and local anesthetic or radiofrequency is carefully delivered.

Facet Injections and Neurolysis
Facet joints are small joints on the back of the spine that allow it to articulate. If they are overused or injured, this can lead to Facet Joint Syndrome, where pain is a prominent feature. Thin needles are inserted near the painful facet joints under x-ray guidance, under local anesthetic. Local anesthetic and anti-inflammatory are then carefully delivered around the facet joints to reduce pain.

Botox Injections for muscular pain
Although generally associated with cosmetic surgery, there is increasing evidence of its therapeutic benefits in painful conditions, Botox injections are used in difficult to treat spinal pain, fibromyalgia (myofacial pain syndrome) and hyperhydrosis.

Vertebroplasty
Vertebroplasty is a procedure whereby bone cement is introduced into a fractured vertebral body via a minimally invasive, percutaneous injection. It was developed with the goals of decreasing pain from symptomatic compressions fractures, strengthening the spine and improving mobility.

Kyphoplasty
Kyphoplasty is a recent technique – first procedure was performed in September 1998. It involves the extra or transpedicular cannulation of the vertebral body, under fluoroscopic guidance, followed by insertion of an inflatable bone tamp. Once inflated, the tamp restores the vertebral body back towards its original height while creating a cavity to be filled with bone cement. This procedure is indicated for progressive, painful osteoporotic or osteolytic vertebral body wedge compression fracture for both acute fractures and chronic fractures.