pain-mgt

Pain Injections


If you suffer from chronic back or neck pain, your doctor can refer you to Visconti Imaging & Vein. We offer a variety of pain injections to relieve your suffering and help you get back to not only performing the tasks of day-to-day living, but also doing the things you love.

What do I need to do to prepare for my injections?

  • Get a referral. Your referring doctor will need to fill out an order and specify the type of injection that is recommended for your condition.
  • Bring a driver. After an injection, some patients experience tingling and numbness in their legs which can impact their capability to drive. Because we will be unable to give you your injection without someone to drive you, you will need to bring a driver with you to each appointment.
  • Do not take blood thinners up to one week before your appointment. If you are currently taking blood thinners, including aspirin, heparin, and Coumadin, you will need to ask your referring doctor if it is okay to stop taking them. We will be unable to perform an injection if you are currently taking blood thinners.
  • Retrieve your previous films. If you have had previous diagnostic studies including MRI, CT or x-ray of your spine, please bring the films with you to your appointment.

What types of pain injections does Visconti Imaging offer?

Epidural Spinal Injections (ESI). The nerves of the spine run through the epidural space. Compression of these nerves can cause lower back pain. An epidural injection can be performed to decrease the inflammation, which in turn will relieve the pain. Epidural injections are completed as a series of three, with one shot give every three weeks. It is important that you keep your scheduled appointment whether or not the injection relieved your pain. If it helped, additional medication will be delivered to the same area. If you did not experience any pain relief, a different area of the spine will be targeted. Dr Visconti performs cervical, thoracic, lumbar, and caudal epidural injections.

pain-injectionFacet Injections. The facet joints are found in pairs on each vertebral level. Facet joints provide stability and guide motion of the spine. Pain derived from inflammation of the facet joints can radiate to the leg, buttocks and hip. Depending on what your referring doctor recommends, you may have multiple levels injected at one time.

Medial Branch Blocks. Medial branch block injections are often performed to confirm that your pain is caused by your facet joints. During the injection, a local anesthetic will be placed around the nerves that supply the facet joint. If you experience significant pain relief, it confirms that the joint is the cause of your pain. This relief is only temporary and typically lasts only a few hours. We can provide long-term relief (up to two years) by performing a rhizotomy (Radiofrequency Ablation).

Rhizotomy/Radiofrequency Ablation. Patients with facet joint pain who experience significant relief from medial branch blocks may be candidates for a Radiofrequency Ablation. This minimally invasive procedure applies heat to certain nerves, blocking the transmission of pain signals to the brain. This treatment has been proven to provide significant pain relief for up to two years.

Piriformis (Sciatic) Injections. If the piriformis muscle is inflamed, it can compress the sciatic nerve which can cause tingling and numbness, as well as pain that radiates down the leg. During the procedure, your piriformis muscle will be injected with medication to reduce the amount of swelling. Once the inflammation decreases, the sciatic nerve will no longer be compressed, thus reducing the sensation of pain.

Joint Injections. A steroid injection can help to decrease joint inflammation and could potentially increase range of movement. The most common joint injections completed at Image North include the shoulder, hip, and sacroiliac joints.

Dorsal Column Stimulator. A dorsal column stimulator is an implanted electronic device to help treat chronic pain. The device delivers electric current through wires which are placed near your spinal cord (similar to a pacemaker). Candidates for this procedure typically include patients who have severe and chronic back pain that has been unresponsive to conservative treatments. You will be under mild sedation to ensure your comfort during the procedure. A 50 percent or greater decrease in pain can be expected from this treatment. Dr Visconti works with Boston Scientific to do a “trial” stimulator – under imaging guidance, he will place the stimulator and it will be programmed for you. Then you will go home and try it out for a few days to determine if you are experiencing pain relief. Dr Visconti will then remove the stimulator and, if it was successful, you will see a surgeon to have a permanent implantation to provide you with long-term relief.

How are the procedures performed?

Most spinal injections are performed with the patient lying face down; the joint (hip, shoulder, etc.) injections are normally done with the patient lying face up. The area to be injected will be prepped with a cleansing solution. The procedure itself only takes about 5-10 minutes and a local anesthetic will be used to ease any discomfort that you are feeling. All injections are performed under fluoroscopic guidance, producing live x-ray images, to ensure proper needle placement. Once the needle is in place, a corticosteroid will be injected to medicate the area. This steroid may relieve your symptoms for several weeks up to several months.