We believe in treating the whole patient – not just the symptoms – so that you have the best chance of being pain-free for a long time to come. Our state-of-the-art pain management procedures are highly effective in eliminating and relieving pain. Dr. Silberberg and our staff believe that pain management can be even more successful by coordinating pain care approaches for the best treatment outcomes.
Epidural Injections in Austin and Surrounding Areas
Epidural injections are a non-surgical option for intense back pain. The procedure involves delivering pain relieving medications directly to or near the source of the pain in the spine during a short outpatient procedure. Epidural injections can be very effective for some people and may be repeated over time. For some, physical rehabilitation is possible once the pain has been relieved. These injections are used to treat pain from the following causes:
Epidural injections administer local anesthetic and/or steroids into the epidural space. Steroid medication is used to reduce swelling and inflammation. The epidural injection is a short outpatient procedure that can be performed at many surgery centers, hospitals, or medical clinics. Before receiving the epidural injection, your lower back area will be sterilized and numbed with an anesthetic.
Your doctor will use a live X-ray image (fluoroscopy) to carefully insert and guide the needle to the epidural space. A contrast dye is used to confirm the needle placement. Then, the medication solution is delivered to the epidural space, and the needle is removed. You will be monitored for several minutes before you can return home. Your doctor will instruct you on how to relieve temporary, mild pain at the injection site. Most people can resume their regular activities the next day.
There are three physical areas of epidural treatment:
The neck is a vulnerable part of the spine and is susceptible to injury and degeneration. A variety of conditions can cause pinched nerves in the neck, which not only can cause pain in the neck, but pain that spreads to the shoulders and arms. Epidural injections are delivered to the cervical spine to treat pain in the neck, shoulders, and upper extremities.
Your thoracic spine is comprised of 12 vertebrae in your chest area. Twelve bones (vertebrae) make up the thoracic spine. Spinal nerves extending from the spinal cord travel out of the thoracic spine to exchange nerve signals with your brain about specific parts of your body, especially the internal organs and muscles that move the ribs when you breathe. For pain in the upper back, thoracic epidural injections are sought out.
The lumbar area of your spine is made up of five large vertebrae in your lower back, forming the curve below your waist. Nerves extending from the spinal cord travel from the lumbar spine to the lower back, buttocks, legs, and feet, regulating sensation and movement in the lower body. Lower back pain that radiates into the legs can be treated with lumbar epidural injections.
Trigger Point Injections
A trigger point is a small area in a muscle that is very sensitive to touch, often causing intense pain. Injury, overexertion, muscle tension, and muscle spasms are common causes of these trigger points. They most frequently occur in the neck, back, and shoulders. Injections can relax muscles and relieve pain by delivering medications directly to the trigger point.
While therapeutic modalities like ultrasound and manipulative therapy can be beneficial for some, trigger point injections are considered the most effective way to thwart a trigger point for prompt symptom relief. The injected medication usually consists of an anesthetic to relax the area and relieve pain. A steroid medication is sometimes included in the injection. Injections are usually followed by physical therapy aimed at pain relief and muscle flexibility.
BOTOX® is useful for more than smoothing out wrinkles. In fact, it is used for treating painful muscle spasms and contractions in the neck (cervical dystonia), tension headaches, migraine headaches, back pain, and myofascial pain. BOTOX injections block the nerve signals that trigger muscle hyperactivity and uncomfortable spasms. In many cases, the effects of BOTOX are greater and longer lasting than traditional steroid injections. You can receive BOTOX injections for pain relief as an outpatient in your doctor’s office. Each treatment lasts for about three months, and injections may be repeated if they are successful.
Viscosupplementation therapy is a treatment for osteoarthritis of the knee. When bones begin to degenerate and synovial fluid (a natural shock absorber and lubricant) starts to dissipate, painful arthritic symptoms can follow. You may begin to notice knee pain, stiffness, and problems with walking or stair climbing.
Viscosupplementation therapy is appropriate for people with moderate to moderately severe knee osteoarthritis that has failed to respond to traditional treatments. For those who are trying to delay knee replacement surgery, or for those who are not suitable candidates for surgery, it is especially useful.
Viscosupplementation uses a product called hyaluronic acid (HA) to supplement the synovial fluid. Your doctor can administer viscosupplementation therapy in his or her office. They will inject HA into your knee joint three to five times, once per week. The time it takes for beneficial effects to be felt is variable, as is the extent of pain relief from patient to patient. Good results can be sustained for 6-12 months.
Further Solutions for Austin Pain Management
In addition to local injections, Greater Austin Pain Center is also qualified for many other procedures and treatments.
Facet Joint / Medial Branch Nerve Blocks
Facet joints are small joints at each segment of the spine that provides stability and guide motion. A cervical, thoracic, or lumbar facet joint injection can anesthetize the facet joints and block pain. Facet joint injections can help diagnose the cause and location of pain as well as provide pain relief.
Joint Injections: Knee, Elbow, Hip, Shoulder, Sacroiliac
Corticosteroid, platelet rich plasma, and other medications can be injected into the site of joint pain to provide relief to osteoarthritis and pain symptoms. The corticosteroid or PRP can help reduce inflammation of the joints and relieve pain in that area. Relief can typically last for several months.
Sympathetic Ganglion Blocks (Stelle, Impar, Lumbar)
Stellate Ganglion Block – the stellate ganglion is a group of nerves at the base of the front of the neck, on both sides of the voice box. The stellate ganglion regulates involuntary sympathetic nervous functions like sweating, blood flow, pain in the head/neck/upper chest/upper arms.
Greater and Lesser Occipital Nerve Blocks
Occipital nerve blocks inject steroid or other medication around the greater/lesser occipital nerves located on the back of the head, above the neck area. Occipital nerve blocks can help treat occipital neuralgia and chronic headaches that arise from the neck.
Radiofrequency Neurolysis / Thermal Ablation
Radiofrequency ablation is a procedure where an electrical current is used to heat up a small area of nerve tissue thereby decreasing the pain signals from that area. Radiofrequency ablation is used to treat pain in the lower back or the sacroiliac joints. Medial branch or facet joint injections are usually done prior to a radiofrequency ablation.
Kyphoplasty / Vertebroplasty
Kyphoplasty is a procedure that helps treat a spinal/compression fracture. During the kyphoplasty, a special balloon is inserted using fluoroscopy guidance. The balloon is inflated, which allows the fracture to be elevated and compacts the inner bone to create a cavity inside the vertebrae.
Discography is a procedure that helps to identify the source of a patient’s lower back, groin, hip, and/or leg pain. If prior treatments have been unsuccessful, discography may be done prior to a back surgery to determine the exact disc creating the problem.
Spinal Cord Stimulators
Spinal cord stimulation uses mild electrical pulses to interfere with pain signals reaching the brain. A small device is implanted near the spine and generates these pulses. A patient that is considered a good candidate for spinal cord stimulation is scheduled for a trial run.
Platelet Rich Plasma (PRP) injections – Platelet Rich Plasma (PRP) is a non-operative therapy that takes advantage of platelets’ wound healing properties. Blood consists of liquid (plasma) and solid (platelets, red blood cells, white blood cells) components.
Start Living Again
Getting to the root of your pain can feel like a confusing journey, but Dr. Silberberg and his staff are here to help. Armed with knowledge and cutting-edge technology, we can help you take your life back. Contact us today and speak with our pain specialists!
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation/examination or replace the advice of your health care professional. This information should NOT be relied upon to determine diagnosis or course of treatment. Information used on this website does not constitute or establish a patient-physician relationship.