
TREATMENTS
Injections
These can be performed in the area of pain. They can be done with Xray or Ultrasound. They can be done in the injection room or theatre. The injections can be done awake or with sedation.
X-Ray guided procedures
Facet joint injections (cervical, thoracic and lumbar spine)
Selective nerve root injections
Epidural injections
Sacroiliac joint injections
Hip joint injections
Knee joint injections
Sympathetic plexus blocks
Pudendal nerve block
Piriformis muscle injection
Ultrasound guided procedures
Trigger point injections
Botox injections to muscular structures and soft tissues
Peripheral nerve blocks
Shoulder joint injections
Occipital nerve blocks
Genicular nerve injections for knee pain
Advanced procedures (Xray)
Pulsed radiofrequency treatment of facet joints medial branch nerves, peripheral nerves and nerve roots
Radiofrequency thermal lesioning denervation treatment (Rhizotomy) of facet joints medial branch nerves
Sacroiliac joint denervation
Joint injections
+ PRP injections
Regenerative Medicine uses the body’s own ability to heal a damaged area, rather than steroids to reduce inflammation. Platelet Rich Plasma injection is a type of regenerative treatment that I offer.
+ Platelet Rich Plasma/PRP
A patient's own blood (10mls) is drawn into a syringe while an IV cannula is inserted. The blood separated in a centrifuge into Red Blood Cells, White Blood Cells and Plasma, which contain the platelets. The plasma and platelets contain high concentrations of the body's own anti-inflammatory chemicals and growth factors. The PRP is injected into the area of pain.
+ Back Pain
Animal research and clinical research in patients have shown some benefits for low back pain (Facet Joint, Sacroiliac Joint, Disc Injections).
+ Joint Pain
PRP Injection in the major joints (knees/hips/shoulders) has also been studied. Of 12 randomized controlled trials for knee arthritis comparing PRP with either steroid, hyaluronic acid, or placebo, PRP was superior in 10 of the 12 studies.
+ Is it safe?
PRP is your own bodies Plasma and Platelet Cells. There is a small risk (1 in 10,000) of infection/bleeding/nerve injury with any spinal injection, this is minimized with sterile technique.
+ Is it painful?
When a patient has a steroid injection, the steroid is usually mixed with local anaesthetic so it is not painful. With PRP, local anaesthetic cannot be used for injection because local anaesthetic decreases the effect of the PRP. Some patients may have pain for a few days following injection.
+ Are there any other side effects?
There are usually no systemic side effects e.g. the hormonal effects that occur with steroids such as facial flushing, menstrual cycle change, osteoporosis with multiple injections etc. Some patients do experience an immune response which can cause feelings like having a flu.
+ Does it have to be repeated?
It is recommended to have 2 PRP Injections for full effect each approximately one month apart. Whether the PRP works is difficult to predict. How long it will last for is also difficult to predict nut it can last longer than a steroid injection.
SPINAL CORD STIMULATOR
NEUROMODULATION IS THE ALTERATION OF NERVE ACTIVITY USING A TARGETED STIMULUS.
SPINAL CORD STIMULATION IS A TYPE OF NEUROMODULATION. SCS ALTERS NERVE FUNCTION AND ACTIVITY BY DELIVERING A MILD ELECTRICAL CURRENT DIRECTLY ONTO THE SPINAL CORD OR TO NERVE CELLS BESIDE IT. IT IS USED FOR PATIENTS WITH CHRONIC PAIN WHO ARE RESISTANT TO CONVENTIONAL TREATMENT. SCS WORKS BEST IN PATIENTS WHO HAVE NERVE DAMAGE PAIN OR CHRONIC DISEASES OF THE NERVOUS SYSTEM. THE ELECTRICAL CURRENT CHANGES THE STRENGTH AND VOLUME OF PAIN SIGNALS THAT GO UP THE SPINAL CORD TO THE BRAIN, REDUCING THE AMOUNT OF PAIN THE PATIENT FEELS.
SPINAL INJECTION
YOUR SPINE IS MADE OF A NUMBER OF BONES CALLED VERTEBRAE. THEY ARE CONNECTED TO ONE ANOTHER ALLOWING YOUR SPINE TO MOVE AND ALSO PROTECTS THE SPINAL CORD AND NERVES. THESE STRONG INTERCONNECTIONS ARE MADE UP OF INTERVERTEBRAL DISCS (WHICH ACT AS YOUR SPINE’S SHOCK ABSORBING SYSTEM) AND FACET JOINTS (WHICH CONNECT THE VERTEBRAE TO ONE ANOTHER). THESE STRUCTURES CAN WEAR DOWN AND, WITH TIME, AND CAUSE PAIN.