A discogram is a diagnostic procedure used to precisely locate which spinal discs are injured and causing back pain. The discs in your spine are a soft cushion that sits between each vertebra, the bones that make up the spinal column. The disc is a cartilage-like material made up of an outer portion called the annulus which surrounds an inner portion called the nucleus. The nucleus pulposus is a soft jelly like substance that acts like a shock absorber.
Epidural injections contain a strong anti-inflammatory agent called corticosteroid and an anesthetic for pain relief. It is not the same as an epidural anesthesia given before birth to decrease labor pain. Epidural injections are given to relieve pain in the neck, back, arm and leg due to inflammation of spinal nerves from conditions such as spinal stenosis, spondylolysis, herniated disc, degenerative disc and sciatica. Epidural injections are administered into the epidural space of the spine. The epidural space is the space between the outermost covering of the spinal cord (dura mater) and the wall of the spinal canal.
Facet joint injections contain a strong anti-inflammatory agent called corticosteroid and an anesthetic for pain relief. They are given to relieve pain in the back, neck, arm and leg and even headaches caused from inflammation of the facet joints. Facet joint injections are administered into the inflamed painful facet joints. These are the joints connecting each vertebra of the spine to the vertebra below it and above it. Each vertebra has four facet joints, one pair connects to the vertebra above and the second pair connects to the vertebra below. Thus they are present on both sides of the spine from the neck to the lower back providing flexibility and smooth movement to both the neck and the spine.
Medical branch block is an injection of a local anaesthetic near the medial branch nerves to temporarily block the pain signal carried from the facet joints of the spine to the brain. It is used to assist your physician in diagnosing the cause of your back pain. Facet joints are the joints connecting the different vertebrae of the spine to each other. Medial branch nerves are small nerves that supply the facet joints of the spine.
A sympathetic nerve block is an injection of an anesthetic near the affected sympathetic nerves to block pain. It is performed to determine if damage to the sympathetic nerves is the cause of the patients pain. If the block provides temporary pain relief, your physician may recommend a series of blocks to provide longer pain relief. Sympathetic nerves originate from the front of the spine and are part of the autonomous nervous system that controls several involuntary body functions including blood pressure, heart rate and digestion, and sweating. Sometime the nerves can continue to transmit pain even after an injury is healed.
Physical Medicine and Rehabilitation (PM&R) physicians, also known as physiatrists, treat a wide variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. PM&R physicians evaluate and treat injuries, illnesses, and disability, and are experts in designing comprehensive, patient-centered treatment plans.
Physiatrists utilize cutting‐edge as well as time‐tested treatments to maximize function and quality of life.
PM&R physicians diagnose and treat medical conditions associated with disabilities.
PM&R physicians work collaboratively with neurologists, orthopedists, neurosurgeons, physical therapists, occupational therapists, and speech therapists, and primary care physicians to look at the “big picture” of improving