Headaches

Mountain Pain & Spine Specialists can help to relieve your chronic headaches and migraines with our wide range of treatment options. We offer a new technique proven to reduce chronic and cluster migraines known as a Sphenoplanatine Ganglion block. Our trained physicians use what is known as a Sphenocath® which is low risk and effective with patients of all ages.

Sphenopalantine Ganglion Block

A sphenopalantine ganglion block is used to provide immediate relief of headache pain and to treat chronic migraine headaches. A revolutionary device called the SphenoCath is used to deliver anesthetic through the nasal cavity, without use of a needle, into the sphenopalantine ganglion. The SphenoCath is placed into the nasal cavity using x-ray guidance in a procedure suite by a physician. Prior to insertion, a local anesthetic is used to reduce nasal irritation during the procedure.

Download The Sphenopalantine Instructions.

Trigger Point Injections

Trigger point injections are used to treat painful areas of the muscle, of areas of the muscle with a “knot”. A knot in the muscle is known to be caused by a tight band of muscle that is unable to relax. Trigger points are often found in the muscle of the back and neck, however they may occur elsewhere in the body. A physician will perform trigger point injections using ultrasonic guidance to deliver a local anesthetic into the belly of the painful muscle. Trigger point injections can be performed with or without use of a corticosteroid. Relief of inflammation and pain may take three to five days, however maximum relief may take up to two weeks.

Download Trigger Point instructions.

Epidural Injections/Nerve Root Injections

The epidural space of a spine is the space between the outermost layer and the bone. The epidural space is outside of the spinal cord and extends from the base of the skull to the tailbone. Nerve roots exit from the spinal cord and then come together to form nerves. Epidural and nerve root injections are performed under x-ray guidance in a procedure suite for precise location. Conscious sedation may be provided upon prior approved request. The physician will then deliver a local anesthetic. Using a spinal needle, the physician then delivers the corticosteroid into the epidural space or selected nerve root. Relief of pain and inflammation may take five to seven days, however maximum relief may take up to two weeks. Epidural and nerve root injections provide long term relief, lasting weeks to months.

Reasons for the Procedure

This injection is performed to relieve spinal pain as well as any radicular pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica and herniated discs.

There are three locations for an epidural:

Download Epidural Procedure Instructions

The Procedure

The patient may be asked to change in a gown for better access during the procedure. Patient will be asked to lie face down on the table. You will be fully awake for the procedure unless you have elected sedation. The procedure will be performed using a special x-ray machine (fluoroscopy). The procedure usually takes 10-15 minutes depending on the approach used to place the steroid.

The area to be injected will be cleansed with a Chloraprep solution. A Sterile draping of a square cloth-like material is placed on your skin, around the area where the procedure will be done. There are several approaches the physician may choose to take Transforaminal (from the side), Interlaminar (straight), or Caudal (below). The area to be injection is numbed with a medication to help make the procedure as comfortable as possible. This local anesthetic helps numb the skin and tissues where the needle will be inserted. You may have some discomfort during the injection. If you experience discomfort, tell your physician. Once the area is numb, a needle will be place alongside the nerve root and a contrast die is injected. After the contrast die is injected a small amount of anesthetic and steroid is injected.

After the Procedure

A band aid will be placed over injection site. You may stay in the recovery area and rest quietly until you feel well enough to leave. For some people, this is 10 minutes; for others, it can be longer.

Cervical Epidural Steriod Injection

This injection is administered to relieve pain in the neck, shoulders, and arms caused by pinched nerve(s) in the cervical spine. Conditions such as herniated discs, spinal stenosis, or radiculopathy can compress nerves, causing inflammation and pain. The medication injected helps decrease swelling of the affected nerve(s). Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.

STEP 1
This procedure is performed with the patient lying down. Intravenous sedation may be given, and an area of neck skin and tissues is numbed with a local anesthetic delivered through a small needle.

STEP 2
Using x-ray guidance (fluoroscopy), the physician guides a larger needle to the painful area of the neck. The needle is inserted into the epidural space, the region through which spinal nerves travel.

STEP 3
Contrast dye is injected into the space to make sure the needle is properly positioned near the area of the irritated nerve(s).

STEP 4
A combination of an anesthetic and cortisone steroid solution is injected into the epidural space. The steroid is an anti-inflammatory medication that is absorbed by the inflamed nerves to decrease swelling and relieve pressure. Lumbar Epidural Steroid Injection This injection procedure is performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions, such as spinal stenosis, radiculopathy, sciatica and herniated discs. In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. However many patients get significant relief from only one or two injections.

Lumbar Epidural Steriod Injection

This injection procedure is performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions, such as spinal stenosis, radiculopathy, sciatica and herniated discs. In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. However many patients get significant relief from only one or two injections.

Positioning the patient
In this procedure, the patient lays face down. A cushion under the stomach area provides comfort and flexes the back. In this position the spine will open, allowing for easier access to the epidural space. A fluoroscope assists the physician in locating the appropriate lumbar vertebra and nerve root.

STEP 1
A local anesthetic numbs the skin and all the tissue, down to the surface of the lamina portion of the lumbar vertebra bone.

STEP 2
The physician then slides a thicker needle through the anesthetized track. Aided by a fluoroscope, the physician guides the needle toward the epidural space between the L-4 and L-5 vertebral space.

STEP 3
A contrast solution is injected so the physician can use the fluoroscope to see the painful areas and to confirm the correct location of the needle tip.

STEP 4
A steroid-anesthetics mix is injected into the foraminal epidural space, bathing the painful nerve root with soothing medication

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