Neck and back problems are commonly due to problems with the intervertebral disc, or narrowing of certain structures of the spine that cause stenosis (narrowing) and increase pressure on nerves. Epidural steroid injections work to relieve pain by injecting an antiinflammatory medication which decreases inflammation and pressure on these structures, and generates pain relief.
Medial branch blocks are injections performed to determine whether the source of someone’s pain is due to joint pain from small joints in between adjacent vertebrae, called facet joints. Local anesthetic is placed on the medial branch nerves which numbs sensation to the joints. If a medial branch block is helpful, it can be followed by a radiofrequency ablation: a longer lasting version of the procedure.
Trigger points are painful areas of tight spasming muscle, or knots in muscle, which remain even after trying to stretch or massage them away. These can occur with stress, injury, or overexertion. These areas of increased muscle tension can be targeted with an injection of anesthetic which can provide relief within minutes.
Vertebral compression fractures are painful fractures that can occur due to trauma or due to bone density problems like osteoporosis. These can be diagnosed by MRI or CT imaging, and can be treated with kyphoplasty. In this procedure, a needle is inserted into the damaged vertebra, and cement is used to strengthen the bone and restore its normal height.
Certain pain conditions involve the sympathetic nervous system. When the sympathetic nervous system is overactive, this can lead to hypersensitivity to pain, and chronic pain even after the tissue has healed from an injury. By guiding a needle the sympathetic nerves in the spine and injecting an anesthetic, this painful cycle can be interrupted and can produce pain relief.