PRM Treatment Options

At Performance & Regenerative Medicine, we perform a range of diagnostic and therapeutic procedures to find and manage the sources of your pain. Procedures include:

Medial Branch Diagnostic Block

Performed in the lumbar, cervical, or thoracic spine, a medial branch diagnostic block is used to determine the source of your pain. A needle is inserted using x-ray guidance so that a pain-killing medication can be delivered to a nerve in your spine. This procedure eliminates pain for a short period; if relief is felt after the procedure, your doctor knows that the block site is where you have damage that can be causing you pain. After a diagnosis is reached, your doctor will be able to craft an effective treatment plan. A therapeutic medial branch block may be ordered. In a clinical study, 84% of patients reported improvement in facet joint pain two years after treatment.

Medial Branch Neurotomy

When people are suffering from facet joint syndrome, they may experience severe pain due to the irritation and compression of medial branch nerves. Also called Facet Rhizotomy, Medial Branch Neurotomy is a procedure that destroys the medial branch nerve that is carrying pain signals to the brain. The goal is to damage the nerve and interrupt the pain signal while preserving other functions such as muscle movement and normal sensation. A large number of patients report a dramatic reduction in pain after this procedure. In some cases, repeat procedures may be necessary to experience relief.

Epidural Steroid Injections (ESI)

This pain relief treatment is used when more conservative measures have failed to provide relief. Epidural steroid injections combine corticosteroids with a local anesthetic. This is the same injection area used to provide pain relief to women during labor. The anesthetic provides immediate pain relief while the steroids work to reduce inflammation and reduce pain long-term. It can be used to treat pain related to herniated or bulging discs, degenerative disc disease, lumbar spinal stenosis, and other conditions that cause back pain.

Sacroiliac Joint Injection

This treatment, also known as a sacroiliac joint block, is used to diagnose or treat lower back pain, including sciatica. The sacroiliac joints connect the sacrum with the hips on each side of your body. Injecting a painkiller into this area can provide relief from lower back pain that involves these joints. During a diagnostic injection, you will be asked to perform movements that normally cause pain; if there is no pain when the anesthetic is active, this is an indication that the sacroiliac joint is the source of your pain. Therapeutic injections include a corticosteroid in addition to the anesthetic to provide long-lasting relief.

Neuromodulation/Spinal Cord Stimulation

Spinal Cord Stimulation (SCS) is used to interrupt the pain signals being sent from nerves to your brain. An electrical impulse is delivered to the spine through a small implanted device. The device, when turned on, provides a small current; the sensation is described as a mild tingling. This can be an effective option for chronic pain if you have not found relief with other therapies.

Lumbar Sympathetic Block

A lumbar sympathetic block is an injection of local anesthetic with the assistance of x-ray guidance. This treatment blocks the sympathetic nerves that run from the lower back into the leg. These nerves are associated with the pain caused by maladies that include complex regional pain syndrome, nerve injuries, and other illnesses or injuries. The block can be performed as a diagnostic tool or treatment. It is often used when other procedures have been ineffective at treating pain.

Stellate Ganglion Block

The stellate ganglions are a group of nerves in the neck, located on each side of the larynx. A stellate ganglion block is an injection into the nerves to relieve pain in the neck, upper chest, arms, and head. Stellate ganglion blocks can be used to treat complex regional pain syndrome, phantom limb pain, shingles, and other maladies. This block can also increase the blood supply to the arm and improve circulation. Stellate ganglion blocks can be performed to diagnose or treat pain. If they are used as a pain treatment, the frequency of the injections will depend on how long relief is felt after each injection is performed.

Ultrasound Guided Intra-articular Joint Injections

Ultrasound guided injections are used to provide pain relief, administer medication, and treat some conditions. This is a relatively new procedure that has been found to provide better results than blind injections. With ultrasound, injections can be targeted more effectively, ensuring that treatment gets to the area where it is needed. These injections can be performed at the wrist, elbow, shoulder, knee, hip and other joints to provide relief. Pain from arthritis, tendonitis and other conditions can be effectively treated in many cases. This treatment can also be valuable for removing fluid or managing pain prior to surgery.