As the number of pain
management patients in United States continues to increase, pain Injectables
itself is turning into big business. It is oftentimes helpful for patients to
receive an injection to avoid or delay surgery, or to allow individuals the
ability to participate in physical therapy. Focal injections can also decrease
the need for opiate pain medications.
Let’s look at a few
different types of injections and how well they work. The first type is soft
tissue injections in the extremities. An example of this would be an injection
of steroid medication into the shoulder area that is called the subacromial
bursa. Impingement syndrome is one of the most common diagnoses seen in
medicine today, and a subacromial injection can permit patients increased
function of their shoulder and significant pain relief.
Another type of soft tissue
injection example would be one for tennis elbow. This is a condition around the
elbow that involves inflammation and Injectable pain of the tendon
insertion on the outer part of the elbow. Injections of steroids work very well
for this region, and oftentimes the doctor will place small holes in the bony
region to enhance blood flow and healing of the area.
Another type of injection
performed in the extremities is a nerve block. Let’s use an example of a
supra-scapular nerve block which is a nerve that can become compressed around
the shoulder region. Injecting steroid medication around the area of
compression may allow a patient to participate in physical therapy.
Along with providing excellent Injectables pain relief and
may help the patient avoid surgery
Additional examples of
extremity nerve blocks will include a lateral femoral cutaneous nerve block, an
ankle block, or a carpal tunnel injection. Occipital nerve blocks are utilized
for occipital neuralgia. Occipital neuralgia may be a significant cause of
migraine headaches, and blocking the nerves in this area may provide months of
pain relief. If that works well, the pain doctor may move on to a
radiofrequency ablation which may provide pain relief for over a year.
When it comes to
interventional spinal injections, there are a few different types. These can be
grouped into 3 different categories. The 1st are injections in or around the
facet joint. Pain doctors may inject medication right into the joint or
potentially around the joint which is called a medial branch block. The
evidence for medial branch blocks is strong and can give weeks to months of
pain related along with acting as a diagnostic injection. A subsequent
procedure when that injection wears off called a radiofrequency ablation may
allow patients to receive pain relief for over a year.
The next category of injections
are referred to as epidural steroid injections. Evidence for these injections
is strong, and there are currently three different types used by pain doctors.
The first is known as interlaminar injections, which is the oldest type and has
been done since the 1960s. Transforaminal epidural steroid injections are the
newest type performed and allow the pain doctor to get fairly close to the area
of the pinched nerve with steroid medication. The last type of epidural started
injection is called a caudal injection, and works very well in situations where
steroid is needed to work on multiple areas of compression.
The last category of spinal
injections involves procedures to remove scar tissue. This is called an
adhesiolysis and may be performed under a fiber-optic camera guidance. This is
the least used of the interventional procedures.
Other procedures performed
by pain doctors should be placed into a category termed exotic. These would be
such things as superior hypogastric plexus blocks, sympathetic blocks, and
Botox injections for neuromuscular conditions.
Lastly, one of the more
exciting procedures in pain management is the spinal cord stimulator. These are
permanent implants that can help provide electrical stimulation around the
spinal cord and decreased pain in situations where there is no solution to
caring for the painful problem.
As the years go by in pain
management, technology continues to improve and it is a very exciting field
presently. More research is necessary to keep up with the amount of pain issues
in this country and keep coming up with new solutions to help those in need.