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5 Different Injections for Pain

5 Different Injections for Pain

Dr. Patrick McNulty, our double board-certified specialist at McNulty Spine, has dedicated his career to stopping pain and improving the lives of our patients throughout Las Vegas and Henderson, Nevada. 

As an award-winning and highly respected spinal surgeon, Dr. McNulty diagnoses the underlying source of your pain and offers the most advanced treatments. When your pain stems from your spine, including your neck and lower back, it may also affect your arms and legs, so his area of expertise covers most types of pain. Being a board-certified orthopedic surgeon who specializes in spinal disorders, Dr. McNulty is well-versed in sorting out the pain that may be coming from other structures besides your spine, such as your hips, shoulders, elbows, wrists, knees, ankles, or pinched nerves in your upper or lower extremities. 

After identifying the root cause of your symptoms, his first goal is to correct that problem. Sometimes that requires physical therapy and lifestyle changes; other times it calls for surgical intervention. But in many cases, you may find much-needed relief from a simple injection. 

Here’s a closer look at injections Dr. McNulty may recommend. 

1. Sacroiliac joint injections. 

The joint that connects your pelvis to your spine is called the sacroiliac (SI) joint. There is one on each side of the bottom of your spine (the sacrum), connecting to the iliac bones of your pelvis. If the joint becomes irritated and painful, you may feel the symptoms in many different patterns, hence the nickname, “the great imitator”. It can cause back pain,

hip pain, or sciatic pain. 

 

Dr. McNulty would inject marcaine and steroid into your SI joint as a diagnostic and therapeutic tool to determine if your pain is emanating from that joint, as well as treat it. You may experience a whole spectrum of symptom relief from no relief to complete resolution of pain indefinitely. Even if there is no pain relief or temporary pain relief due to the marcaine anesthetic, this is important information to determine future affective treatment.

2. Facet joint injections

Your facet joints come in pairs located on either side of the backside of your spine from head to buttocks at each disc level. When healthy, facet joints stabilize your spine and allow you to bend, twist, and rotate. But degeneration, inflammation, back injuries, and repetitive stress to the spine can damage your facet joints and cause pain. 

Like any other joint, injecting the joint with marcaine anesthetic and steroids may significantly help. The spectrum can be anywhere from no pain relief, to indefinite. Even if there’s no relief, this is important information that directs future treatment. Typically, these injections will be considered if your back pain has persisted for 6-8 weeks, and would also be included with physical therapy. If the injections provide temporary relief, there are typically other options that can be performed on a simple outpatient basis for more extended relief, potentially for years. 

3. Transforaminal epidural steroid injections. 

Sciatica affects about 40% of American adults. Sciatica is the term used to the symptoms that occur when something irritates or damages your sciatic nerve, which runs from your lower spine, through your buttocks, and down each leg. 

Sciatica is typically due to a pinched nerve in your lower lumbar spine, typically a herniated disc or bone spur. Symptoms are most typically pain, but also include tingling, numbness, and potentially weakness. To ease these symptoms, Dr. McNulty uses transforaminal epidural steroid injections. These injections are done carefully under live x-ray, directing the injection around the nerves as the exit the spinal canal in the neuroforamen. (hence transforaminal).  

 

These same injections can also be done in your cervical spine for symptoms in your arm/hands as well.

Transforaminal epidural steroid injection

 

Sciatica affects about 40% of American adults. Sciatica is the term used to the symptoms that occur when something irritates or damages your sciatic nerve, which runs from your lower spine, through your buttocks, and down each leg. 

Sciatica is typically due to a pinched nerve in your lower lumbar spine, typically a herniated disc or bone spur. Symptoms are most typically pain, but also include tingling, numbness, and potential weakness. To ease these symptoms, Dr. McNulty uses transforaminal epidural steroid injections. These injections are done carefully under live x-ray, directing the injection around the nerves as the exit the spinal canal in the neuroforamen. (hence transforaminal).  

These same injections can also be done in your cervical spine for symptoms in your arm/hands as well.

4. Lumbar Analgesic Discograms. 

Low back pain that persists longer than 3 to 4 months after conservative treatment may be due to painful lumbar discs. The prognosis for improvement is poor at this point, and definitive determination of the structural cause of the pain is now important to come up with a definitive treatment plan. An analgesic lumbar discogram involves placing a small needle in the disc under live xray, then injecting the disc with marcaine anesthetic. This should provide at least a 4 hour window to assess how your low back pain changes while the disc is numb. No pain, the disc is the problem. No change, the disc is not the problem. This is very important information to determine the appropriate treatment plan. 

5. Hip joint injections. 

Osteoarthritis often affects the hip joint, causing severe inflammation and pain. You may experience extreme stiffness and pain that makes it difficult to sit down, get in and out of the car, and walk or run. 

But arthritis isn’t the only hip-joint problem. Younger, active people may have other hip joint issues such as torn cartilage and early stages of arthritis. 

If your pain is coming from your hip, Dr. McNulty may recommend a hip joint injection to manage the pain as you heal.

If you’re experiencing pain, call us or request an appointment online to discuss your diagnosis and treatment options with Dr. McNulty.

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