Fluoroscopically guided injections allow precise placement of the medication at the suspected source of the pain. This allows for a more efficient procedure and a more pleasant and comfortable experience for the patient. Fluoroscopic injection of medication can be used for both diagnostic and therapeutic purposes. Having in-office fluoroscopy allows patients to be treated in a more timely fashion and provides cost savings for the patient and the insurance carrier.

Epidural steroid injections are used to treat spinal nerve root inflammation or “sciatica.” This is often caused by a herniated disc, a disc bulge, or protrusion. It is also utilized in treatment of spinal stenosis or “narrowing” of the spinal canal. Epidural steroid injections are also highly effective in the treatment of shingles. A small amount of steroid is injected on the inflamed nerve root, thereby reducing inflammation and swelling, resulting in decreased pressure on the nerve(s).

Facet joints are located at each vertebra of the spine and inflammation of these joints is a frequent source of pain, especially in elderly patients or individuals with degenerative spine conditions, such as scoliosis.

Under direct fluoroscopic visualization, a small amount of steroid is injected into these joints. Pain relief typically occurs in 2-5 days. Facet joint injection is a safe and effective procedure, often providing patients with long-term pain relief. 

Approved by Medicare in 1976 for treatment of chronic pain, spinal cord stimulation has a long and successful history of relieving refractory nerve pain resulting from injury or surgery. It continues to be an excellent option for patients when conservative treatments (medications, physical therapy, nerve blocks) have failed. Patients who have recurrent extremity pain following back surgery, due to scar tissue formation or nerve damage, can benefit from spinal cord stimulation.

The initial step of implantation involves placement of a “trial” electrode for 5-7 days. After the “trial period”, if significant pain relief is achieved (>50%), the electrode is implanted in a specific location near the spinal cord. It is connected to a rechargeable battery – powered generator, which is implanted under the skin in the abdomen, or upper buttock region.

A lumbar transforaminal epidural steroid injection (TFESI) is an injection of local anesthetic (numbing medicine) and steroid medication into the bony opening (the foramen) between the lumbar vertebrae. The lumbar root exits the spine at the foramen and travels down to the leg. The nerve root can become compressed between the disc and the bony wall of the foramen causing inflammation and pain. Steroids are powerful anti-inflammatory agents that work best when injected directly into the area where the inflammation is occurring. The goal of the lumbar TFESI is to reduce inflammation of the lumbar nerve root at the area of compression thereby relieving pain in the lower back or legs. It is important to understand that a lumbar transforaminal epidural steroid injection will not correct the preexisting medical condition, but it may significantly decrease your level of pain

A sacroiliac joint injection is an injection of local anesthetic (numbing medicine) and steroid medication into the sacroiliac joint (SI joint). SI joints connect to the bottom of the spine, the sacrum, to the outer part of the hip bone, the ilium. Each person has two SI joints, one on either side of the sacrum. Inflammation of the sacroiliac joint can cause severe pain. Steroids are powerful anti-inflammatory agents that work best when injected directly into the area where the inflammation is occurring. The goal of an SI joint injection is to decrease inflammation of the SI joint, thereby relieving pain associated with that inflammation. A sacroiliac joint injection may be used to diagnose or treat low back or buttock pain. Depending on the source of pain, your doctor may choose to inject one or both or your SI joints. When both sacroiliac joints are injected, it is called a bilateral SI joint injection.