PROCEDURES | Lynn Fraser, MD

Epidural Steroid Injection

This procedure utilizes medication to reduce inflammation around the nerves that lie in the epidural space. It is commonly performed in the neck and low back and can help pain radiating to the arms and legs. Intermittent x-ray guidance is used for safety and to verify the injection is going to the area of interest.

Selective Nerve Root Block

This procedure utilizes medication to reduce inflammation at the level of the spinal nerve root. This is performed in the low back to treat and diagnose pain radiating down the leg. Intermittent x-ray guidance is used for safety and to verify the injection is going to the area of interest.

Sacroiliac Joint Injection

This procedure utilizes medication to reduce inflammation in the sacroiliac joint, the area where the pelvis meets the spine. The joint space can become irritated, most commonly due to arthritis. Intermittent x-ray guidance is used for safety and to verify the injection is going to the area of interest.

Trigger Point Injection

This procedure utilizes a numbing medication and sometimes an additional anti-inflammatory medication to relieve painful muscle spasms. It can be performed in several different areas of the body that are affected by myofascial pain.

Piriformis Injection

This procedure utilizes medication to reduce inflammation around the sciatic nerve as it courses behind the piriformis muscle. This injection is used for sciatica at the level of the peripheral nerve, or after it exits the spine. Intermittent x-ray guidance is used for safety and to verify the injection is going to the area of interest.

Greater Trochanteric Bursa Injection

This procedure utilizes medication to reduce inflammation in the bursa, which is lateral to the hip joint. This is used for patients with hip pain that presents while lying on their side or while applying pressure to the exterior hip. Intermittent x-ray guidance is used for safety and to verify the injection is going to the area of interest.

Genicular Nerve Block

This procedure utilizes medication to reduce inflammation around the nerves that send pain signals from the knee. This is an ideal option for patients that have persistent knee pain after knee replacement, since they are no longer a candidate for injections into the knee joint. Intermittent x-ray guidance is used for safety and to verify the injection is going to the area of interest.

Radiofrequency Ablation

This procedure involves denervation of the sensation to the facet joints, which are just off the side of the spine. The process leading to a radiofrequency ablation includes first performing a diagnostic or test block that targets the nerves around the facet joints. If short-term relief is obtained from the diagnostic block, then a radiofrequency ablation is performed that can provide a year or more of relief of pain caused by the facet joints.

FAQs

How do I prepare for the procedure?

You may eat and drink as usual prior to the injection. If you are taking an antibiotic for an active infection, including urinary tract infection, or if you have a fever, please notify the office. If you are taking a blood thinner, please notify the office. Certain blood thinners will need to be discontinued prior to the procedure, but please call the office for specific instructions; do not discontinue your blood thinner without being directed to do so. I ask that you bring a driver to a procedure appointment.

Will the procedure be painful?

You will feel the numbing injection, which will be a stick, following by a burning sensation that lasts for a few seconds. After the initial numbing, you should only feel pressure. If you feel a sharp sensation after I have given the numbing, then let me know, and I will give additional numbing medication. Once the targeted structure is injected, you may feel an aching sensation or discomfort as the steroid medication is administered. This should only last a few seconds and will pass. Most procedures take approximately 10 minutes, with the exception of a radiofrequency ablation that takes about 30 minutes.

What should I expect after the procedure?

You will be monitored in recovery for 10 to 15 minutes following the procedure. If you were on a blood thinner prior to the procedure that was stopped, you will be given instructions on restarting your blood thinner. You may have soreness at the injection site, similar to receiving the flu vaccine. You can use ice at the injection site for up to 15 minutes at a time. I ask that you rest and do not participate in strenuous activity for 24 hours following the injection. The steroid medication can take 1 to 2 weeks to take effect. You will be given instructions on very rare but concerning signs/symptoms to watch out for following the procedure. I ask that you have someone drive you home following the procedure.