Discogram

  • A Discogram is a test used to determine which disc or discs, if any, are related to your pain. Many people have discs that look abnormal on an MRI, and the DISCOGRAM  is the best study to determine if that disc is the pain source.

    Discogram or Intradiscal Injection. An intradiscal injection may be performed by injecting the disc with cortisone and anesthetic medication. The discogram is a procedure in which a contrast solution (dye) is injected into the intervertebral disc to show its form and structure. It will show the presence of tears in the disc, and offer an explanation for your pain whether it is related to the disc. An intradiscal steroid injection is done to relieve pain. The discogram is done for diagnostic purposes to aid in the evaluation of your pain, as to where the source is ordered to identify painful discs in the spine. This procedure is purely diagnostic in that it will only help your physician to determine if one of the discs in your spine is responsible for your typical pain symptoms. 

 

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A discogram has two parts. First, a needle is inserted into the problem disc, and saline is injected into the disc to create pressure inside the disc. The human vertebral disc is a unique structure in the spine that bears weight and allows motion. It is made of a central portion (the nucleus pulposus) which is surrounded by layers of tissue (the annulus fibrosis). The disc helps the spine support the body and allows movement between the vertebra. In a normal disc, there are nerves only in the outermost layers of the annulus fibrosis. The layers of the annulus may tear as a result of overloading the spine or lifting in an awkward position. These tears may trigger a series of events that can cause pain. As the disc tries to heal (which is a slow process), new nerve endings may form in the injured area. The nucleus pulposus of the disc contains a lot of water, which lets it bear weight and transfer load much like pressing on a water balloon. The contents of the nucleus of an injured disc may leak out into the outer layers or all the way through those layers to the nearby nerve roots exiting from the cauda equina (the lower end of the spinal cord). The nucleus contains chemicals that are very irritating to nerve tissue. As this fluid leaks, it may come in contact with the sensitive nerve endings in the outer disc and cause pain. These chemicals may also make the nerve endings more sensitive, so movement that was not painful in a normal disc may cause pain in an injured disc. The irritating fluid from the nucleus may leak out of the disc and onto the nerve roots, producing pain. These events in the disc may also trigger disc degeneration.

Although magnetic resonance imaging (MRI) is a very good tool for showing disc abnormalities, it does not allow your health care provider to directly determine if the abnormalities are causing your pain. Studies in which MRI was performed in people without back pain show that 35% to 52% of these patients had one or more abnormal discs. In a study of people without back pain but who were of the same age and occupation as a group of back pain patients, 76% had abnormal MRIs. These studies raise the question: If MRI shows that a back pain patient has an abnormal disc, is that abnormality related to the pain or just an abnormality similar to that seen in people without pain.

 

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Post-herpetic Neuralgia or Pain after Shingles: A common procedure known as Selective Transforaminal Nerve Block works powerfully to reduce inflammation and control pain

  • Every year, nearly 1 million Americans get shingles
  • Nearly 1 and 3 people over the age of 60 will get shingles in her lifetime
  • Pain after 3 months of shingles is considered post herpetic neuralgia or pain after shingles.
  • More than 5% of elderly patients have post-herpetic neuralgia 1 year after acute herpes zoster
  • Selective Transforaminal Nerve Root Blocks under Fluoroscopy Guided-Image Technology is a quick, safe, effective alternative solution for treating pain associated with postherpetic neuralgia.

 

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Pain after shingles, or Postherpetic neuralgia (PHN), is a common complication of shingles. Shingles is a disease caused by the varicella zoster virus. The same virus that causes chickenpox. If you have shingles, the virus has probably been in your body since you were a child, but has remained dormant. It may seem strange that a virus could lay dormant in your body for decades. But that’s just what this virus does. And it is pretty common. Nearly 1 in 3 people over the age of 60 will get shingles in their lifetime. More than 5% of elderly patients have post-herpetic neuralgia 1 year after acute herpes zoster.  The overall incidence of HZ is approximately 3/1000 of the population per year rising to 10/1000 per year by 80 years of age. Approximately 50% of individuals reaching 90 years of age will have had HZ. In approximately 6%, a second attack may occur (usually several decades after the first). Patients with HZ can transmit the virus to a non-immune individual causing varicella. HZ is not contracted from individuals with varicella or HZ. Reduced cell-mediated immunity to HZ occurs with aging, explaining the increased incidence in the elderly and from other causes such as tumors, HIV and immunosuppressant drugs.
What many people don’t know is that shingles can actually cause long-lasting pain. Shingles symptoms start with a painful, blistering rash that usually forms on a person’s chest or back. However, the shingles rash will go away in time. But once it is gone, you may still experience burning, stabbing, shooting symptoms of nerve pain caused by shingles. When you have shingles, nerves can often be damaged because of your shingles rash.
This can cause a specific type of pain—nerve pain from shingles. The site of your shingles rash usually determines where you are most likely to feel nerve pain.
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An intra-articular infiltration or injection  is a form of treatment that involves injecting powerful anti-inflammatory corticosteroids and analgesic into a joint under Fluoroscopy Guided-Image Technology . This type of injection is routinely performed on patients suffering from a variety of conditions that cause inflammation in the joints of the body. Intraarticular steroid injections have been used on patients since 1951. Since then, they have been the subject of numerous medical studies that have revealed their benefits in treating pain and inflammation.

SHOUDER

 

  • Approximately 7.5 million people go to the doctor’s office every year for shoulder injuries, including shoulder and upper arm sprains and strains. 
  • About 2/3 of patients with shoulder pain don’t need surgery. Conservative treatment options like rotator cuff exercises and Infiltration under fluoroscopy guided image  technology reduce shoulder inflammation and improve functionality.
  • Shoulder pain can make activities such as throwing a ball, lifting a heavy dish from a high cupboard, or even steering a car difficult. The shoulder is engaged in almost all arm movements, so painful movement of the shoulder joint affects many everyday activities. Add a comment

    Read more: Intra-articular Infiltration or Injection

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