Precision Image-Guided Injections
Precision image-guided injections is a technique involving the use of an ultrasound scanner or CT scan to guide injections. This method, as opposed to “blind injections,” results in more accurate and effective results, and also reduces the chance of complications.
An ultrasound-guided injection is an outpatient procedure that involves injecting a steroid into the affected area(s) using an ultrasound to guide the needle into place. The benefit of ultrasound-guided injections is precision. Injuries that require these injections are likely to heal better with more accurate and efficient treatment, as opposed to administering the injection blindly.
During this procedure, an ultrasound probe will guide your doctor and is used to ensure a safe and proper position for the needle. Once your doctor is sure the needle is correctly placed, the medicine will be injected.
Fluoroscopic guided injections use an x-ray device called a fluoroscope to allow our doctors to inject numbing and anti-inflammatory medication with maximum accuracy. The use of a fluoroscope gives a continuous video feed onto a monitor that displays plenty of detail inside the body. A dye is used as a contrast for more accurate positioning of the needle. Once the needle is in the correct position, your physician replaces the syringe containing dye with a syringe containing medication.
Visco-Supplement (HA) Injections
For visco-supplement injections, a gel-like fluid called hyaluronic acid is injected into the arthritic joint(s). Hyaluronic acid is a naturally occurring fluid found in the synovial fluid that surrounds the joints. It provides lubrication that allows bones to move smoothly over each other and serves as a shock absorber for joints. It provides a flow of more movement and reduces pain in your arthritic joint(s).
Platelet-rich plasma (PRP) injections involve your physician drawing your own blood, processing it, and then reinjecting it under imaging guidance with the goal of using the healing properties of these cells to support tissue regeneration. Platelet-rich plasma (PRP) describes the end product of a mechanical process through which the blood is extracted and refined to create a serum with a much higher concentration of platelets than that which is found in unprocessed blood.
Medial Branch Nerve Block Injections
Medial branch nerve block injections involve administering medicine near the medial branch nerve, which stops the transmission of pain signals from facet joints. During treatment, a local anesthetic may first be used to numb your skin, and your doctor will then insert a thin needle near the medial branch nerve. Fluoroscopy, a type of x-ray, may be used to ensure the safe and proper position of the needle. A dye may also be injected to make sure the needle is in the correct spot. Once your physician is sure the needle is correctly placed, the medicine will be injected.
You will be monitored for up to 30 minutes after the injection. Before you leave, we will give you discharge instructions as well as a pain diary. Keeping track of your pain helps your doctor know what the next step will be. You may want to check for pain by moving your back in ways that hurt before the injection, but do not overdo it. You may feel immediate pain relief and numbness in your back for up to six hours after the injection. This means the medication has reached the right spot. You should be able to return to work the day after the injection, but always check with your doctor.
How long you can expect pain relief depends on how many areas are injured, and on the amount of inflammation. If your pain goes away for a short time, but then returns, you may be a candidate for radiofrequency ablation (RFA) to the medial branch nerve. This procedure provides a more permanent disruption of pain signals.