Treatments


 
 

BACK PAIN

Epidural Steroid Injection

An epidural steroid injection, or ESI, is a minimally invasive procedure that injects a steroid into the epidural space of the spine to relieve pain originating from the neck or back area. This is a common treatment option for pain caused by disc herniation/bulge or spinal stenosis.

Selective Nerve Root Block

A selective nerve root block is a procedure similar to an ESI that involves injecting a steroid at a specific nerve root exiting the spine resulting in decreased inflammation and thus, pain relief. This procedure can also be used for diagnostic purposes to determine which nerve root is the culprit of pain if the MRI/CT is inconclusive.

Facet Joint Injection

The vertebrae of your spine are connected to each other by facet joints. These joints can become inflamed and be a source of neck and back pain. A facet injection is performed to alleviate this pain by injecting a steroid into the joint space.

Medial Branch Nerve Block

A medial branch nerve block is generally a diagnostic procedure used to determine if the medial nerves on a specific facet joint are a patient’s source of pain. These nerves provide sensation to the facet joint. To perform this procedure, an anesthetic is injected over these small medial nerves. The facet joint is determined to be the source of the patient’s pain if the patient experiences relief soon after the injection. Should the patient gain relief, they may be a candidate for a radiofrequency ablation.

Radiofrequency Ablation

Radiofrequency ablation, also known as RFA, is a procedure used to decrease facet joint pain by actually thermally lesioning the medial branch nerve instead of just blocking it. The results are the same as the block but much longer lasting. The nerves can regenerate in 6-12 months, but the procedure can be repeated at that time.

Spinal Cord Stimulation

Spinal cord stimulation, or SCS, is a treatment used for patients with chronic pain who have not responded to other forms of conservative treatment. SCS interferes with chronic pain fiber signals and thus decreases the sensation of pain reaching the brain. Obtaining a spinal cord stimulator is a two-step process. First, a SCS trial is performed in which a temporary device is placed in a patient. The patient is able to experience SCS for about a week to determine what type of pain relief is achieved. If the patient displays at least 60-70% improvement, they will be a candidate for a permanent stimulator which is implanted under the skin.

Discogram

A discogram is a diagnostic imaging test used to determine whether a specific intervertebral disc is the source of back pain. It is often used prior to surgery or when other radiology testing (i.e. MRI) has shown to be inconclusive or inconsistent given the patient’s symptoms. A discogram is performed by injecting a contrast dye into the disc space. During the procedure, the patient is closely observed to see if the provocative dye is producing their pain. Following the procedure, the patient is sent for a CT scan. If the dye remains localized in the center of the disc, the disc is normal. If the dye spreads and leaks out of the disc, this signifies a damaged, torn disc.

Kyphoplasty

Kyphoplasty is used to treat a spinal compression fracture. Typically, these fractures occur in spinal vertebrae secondary to osteoporosis, cancer metastasis and trauma. These fractures can be very painful and debilitating but are successfully treated with a kyphoplasty procedure. When the vertebral body fractures, the bone collapses and causes it to become compressed. To repair this, a balloon is inserted through a needle into the compressed bone to hopefully restore some of the height lost from the fracture. After the balloon is let down, cement is injected into the cavity created and the pain is relieved.

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NECK PAIN

Epidural Steroid Injection

An epidural steroid injection, or ESI, is a minimally invasive procedure that injects a steroid into the epidural space of the spine to relieve pain originating from the neck or back area. This is a common treatment option for pain caused by disc herniation/bulge or spinal stenosis.

Selective Nerve Root Blocks

A selective nerve root block is a procedure similar to an ESI that involves injecting a steroid at a specific nerve root exiting the spine resulting in decreased inflammation and thus, pain relief. This procedure can also be used for diagnostic purposes to determine which nerve root is the culprit of pain if the MRI/CT is inconclusive.

Facet Joint Injection

The vertebrae of your spine are connected to each other by facet joints. These joints can become inflamed and be a source of neck and back pain. A facet injection is performed to alleviate this pain by injecting a steroid into the joint space.

Medial Branch Nerve Block

A medial branch nerve block is generally a diagnostic procedure used to determine if the medial nerves on a specific facet joint are a patient’s source of pain. These nerves provide sensation to the facet joint. To perform this procedure, an anesthetic is injected over these small medial nerves. The facet joint is determined to be the source of the patient’s pain if the patient experiences relief soon after the injection. Should the patient gain relief, they may be a candidate for a radiofrequency ablation.

Radiofrequency Ablation

Radiofrequency ablation, also known as RFA, is a procedure used to decrease facet joint pain by actually thermally lesioning the medial branch nerve instead of just blocking it. The results are the same as the block but much longer lasting. The nerves can regenerate in 6-12 months, but the procedure can be repeated at that time.

Spinal Cord Stimulation

Spinal cord stimulation, or SCS, is a treatment used for patients with chronic pain who have not responded to other forms of conservative treatment. SCS interferes with chronic pain fiber signals and thus decreases the sensation of pain reaching the brain. Obtaining a spinal cord stimulator is a two-step process. First, a SCS trial is performed in which a temporary device is placed in a patient. The patient is able to experience SCS for about a week to determine what type of pain relief is achieved. If the patient displays at least 60-70% improvement, they will be a candidate for a permanent stimulator which is implanted under the skin.

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JOINT PAIN

Joint Injections

Pain to the ankle, knee, hip, shoulder, elbow, wrist, and hand caused by inflammation or arthritis is commonly treated with a joint injection. This procedure is performed by injecting a steroid into the joint space with or without fluoroscopy/x-ray guidance.

Sacroiliac Joint Injection

The sacroiliac joint is the joint that connects the sacrum to the pelvis – basically the upper body to the lower body. It typically becomes inflamed due to arthritis if walking mechanics are altered. A sacroiliac joint injection can be performed by injecting a steroid into the small joint space to decrease inflammation and eliminate pain.

Viscosupplemenation

This procedure consists of injecting lubricating fluid into a joint and is most commonly used to treat patients with symptoms of knee osteoarthritis that have failed to get long term benefit from steroid injections. Examples include Supartz or Synvisc.

Platelet Rich Plasmapheresis Therapy (PRP)

Platelet Rich Plasmapheresis (PRP) is a concentration of platelet rich plasma protein derived from the patient’s own small blood sample. The sample is centrifuged and split into different layers with one layer consisting of a great concentration of growth factors. This is used to encourage a brisk healing response in soft tissues and joints. We use it most notably in acute muscle strains, tendon and ligament injuries, and osteoarthritic joints

Stem Cell Treatments

Regenerative therapies, like PRP therapy and stem cell treatments, can help to promote your body’s natural healing processes. They help promote healing in arthritic or degenerative joints and can prevent further degeneration from occurring. Stem cell therapy has the capacity to help relieve joint pain and inflammation without requiring surgery to repair the affected joint.

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OTHER PAIN

Trigger Point Injection

A trigger point injection is administered by injecting an anesthetic/steroid mixture into a muscle that is a source of pain. A trigger point forms as a small knot in an area of muscle or fascia (tissue surrounding the muscle) and is often characterized by tightness and tenderness to touch.

Blood Patch

An epidural blood patch is a procedure used to treat spinal headaches. Spinal headaches fortunately are rare but can occur after a lumbar puncture, such as a spinal tap.

Carpal Tunnel Injection

Carpal tunnel injections are given to relieve inflammation caused by carpal tunnel syndrome. Although these injections often provide temporary relief (for several weeks or more), they do not usually provide permanent relief from carpal tunnel symptoms.

Sympathetic Block

A sympathetic block is an injection of local anesthetic in the sympathetic nerve tissue. This block is performed for diagnostic and therapeutic purposes to treat damaged sympathetic nerves – such as in Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS)

Occipital Nerve Block

An occipital nerve block is an injection of steroid/local anesthetic mixture around the occipital nerves, which are located on the back of the head (above the neck area). For those with chronic headaches originating from the back of the head, an occipital nerve block can potentially relieve this pain.

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INFUSIONS

Infusions are one of the cutting-edge treatments available at Permian Basin Pain Management. The interventional pain management practice aims to help its patients live their best life. In addition to providing innovative pain-relieving treatments, the practice offers an array of infusions. To learn more about the types of infusions available, please call the office.

Location
Permian Basin Pain Management
1802 W Wall St
Midland, TX 79701
Phone: 432-200-8767
Fax: 432-685-3135
Office Hours

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432-200-8767