Minimally Invasive Treatments
Bursal Sac Injections
At each location in the body where muscles, bones, and tendons slide over one another, there is a small sac of lubricating fluid which reduces friction. “Bursitis” is a condition where these bursal sacs are inflamed, and is typically caused by overuse of a joint, or arthritis.
Often times, the affected area will have a decreased range of motion due to pain, but a full medical examination is required diagnose bursitis. Conservative treatments such as acupuncture and anti-inflammatories may be prescribed as an initial line of treatment, but in cases of continued pain, a bursal sac injection is recommended. The injection is a combination of corticosteroid and local anesthetic, injected directly into the bursa to relieve pain. The pain relief from one injection lasts anywhere from a few weeks to indefinitely, and it’s proven as a very effective treatment for bursitis.
Carpal Tunnel Injections
The “carpal tunnel” consists of bone and tissue, and connects the forearm to the bottom of the palm. It is a very narrow passageway, and often times swelling of the passing tendons causes compression of the median nerve, in what’s known as carpal tunnel syndrome.
Symptoms of carpal tunnel syndrome include numbness in the fingers, pain in the arm, and weakness in the hands. While not conclusive, it is thought that repetitive hand/wrist motions can cause carpal tunnel syndrome.
A carpal tunnel injection is a corticosteroid injection used to decrease swelling of the passing tendons, which decreases the compression of the median nerve. The corticosteroid is injected directly into the area of inflammation, and typically within a few days patients see a significant decrease in pain, numbness and weakness.
Cubital Tunnel Injections
A close relative of Carpal Tunnel Syndrome, Cubital Tunnel Syndrome is characterized by increased pressure and compression of the ulnar nerve in the elbow. Cubital Tunnel Syndrome is caused by prolonged bending of the elbow and intense physical activity using the elbow (baseball pitchers). Symptoms include weakness and tingling of the elbow, fingers, and hands. A Cubital Tunnel Injection is a corticosteroid injection that’s used to decrease swelling around the ulnar nerve, reducing the compression and decreasing pain. Within a few days patients typically see a significant decrease in pain, numbness and weakness.
Epidural Steroid Injections
An epidural steroid injection is an injection of cortisone and anesthetic, used to treat lumbar, cervical and thoracic back pain. The medicine is injected into the epidural space, between the dura (protective covering of the spinal cord) and the vertebrae.
Conditions that are commonly treated with Epidural Steroid Injections include:
- Lumbar-disc herniation
- Degenerative disc disease
- Lumbar spinal stenosis
- Vertebral compression fractures
- Cysts in a facet joint or nerve root
- Annular tears
Pain relief lasts anywhere from one week to a year, with 1-2 months being the most common duration. Often times, Epidural Steroid Injections are used to decrease pain to the point where patients are able to begin a Physical Therapy program. Together, the treatments have a synergistic effect. Injections may be repeated on a bi weekly or monthly basis, but we recommend a limit of 3-4 in a year.