Interventional Pain Management

The medications injected will depend on what is causing your pain and where it is located. For example:

• Corticosteroids are used for pain caused by inflammation, and often used for joint pain
• Hyaluronate (used in a procedure called Viscosupplementation) lubricates knees with osteoarthritis

Other injections – usually delivered at the spine or at joints located throughout the body – are classified by the area of the body treated:

• Epidural injection – an anti-inflammatory steroidal medication administered into the epidural space surrounding the spinal cord. Epidural injections may be delivered at different areas of the spine to address pain originating in the neck, upper-back, or low-back.
• Facet joint injections – used to treat pain stemming from facet joints, which are the small bones covered in cartilage that connect the vertebrae of the spine. Facet joint injections are considered either cervical (delivered at the neck), thoracic (delivered at the upper back), or lumbar (delivered in the low back region).
• Sacroiliac joint injections – steroid injections administered at the sacroiliac (SI) joint, which connects the spine with the pelvis. This is used to treat low back or hip pain associated with the SI joint.
• Dr. Giordano uses in-office fluoroscopy (a type of real-time X-ray) or ultrasound to guide these injections for precise application and the most effective results possible.

Another type of guided injection, nerve block delivers an anesthetic near problematic nerves. This essentially blocks the nerves from sending pain signals that otherwise would travel to the brain, where the signals are perceived as pain. Nerve blocks we offer at Central Florida Spine & Pain include:

• Intercostal Nerve Blocks – injections delivered to the intercostal nerves, located under the ribs. These nerve blocks relieve chest pain associated with shingles or inflammation and irritation that is sometimes associated with a surgical incision.
• Medial Branch Blocks – used to treat the nerves that run through the facet joints of the spine.
• Occipital Nerve Blocks – injections delivered at the back of the head close to the occipital nerves that run from the top of the spine to the scalp. These nerve blocks are used to treat headaches.
• Selective Nerve Root Block – a combination diagnostic and therapeutic injection that is used to identify and treat the source of spinal nerve pain, such as a herniated disc or spinal stenosis.
• Sympathetic Blocks – to calm pain associated with sympathetic nerves along your spine that control autonomous functions, such as circulation or digestion.

Platelet-rich plasma (PRP) therapy is a revolutionary procedure in which a patient’s own blood is used to supercharge healing in an area of the body. During PRP therapy, we will draw your blood, process it in a centrifuge to concentrate the growth-factor-rich platelets, then reinject the concentrated solution at a target site in the body. Ultrasound guidance allows precise application of PRP. This therapy signals to your body to use all of its natural healing powers at the target site. As cellular turnover occurs in the weeks to come, and damaged cells are repaired and replaced by your body, you should experience a gradual lessening of symptoms associated with the condition.

Radiofrequency ablation (RFA) – also called rhizotomy or radiofrequency neurotomy – uses radio waves to heat and destroy the ends of nerves associated with your pain. Special needles deliver the electromagnetic current to the area being treated. When nerve endings are destroyed, this prevents pain signals from being generated and sent to the brain. RFA can be used to treat neck, back, and hip pain.

When you have tight knots (trigger points) in your muscles that are causing pain elsewhere in your body, trigger point injections into the muscle can help it to relax, relieving your symptoms.