503-295-0730 info@apmconline.org

APMC_Logo-Icon2Injection Therapies

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Injections that DO NOT require X-Ray

Botox Injections

Description:
Intramuscular injection of Botulinum toxin

Indication:
Intractable pain associated with cervical dystonia, myofascial trigger points and/or chronic headaches

Joint Injections

Description:
Injection of steroid and/or medication

Indication:
Chronic pain associated with arthritis, synovitis, tendinitis or impingement syndrome

Peripheral Nerve Block

Description:
Block of the peripheral nerve with local anesthetic and/or steroid

Indication:
Diagnosis and/or therapy of peripheral mononeuropathy

Trigger Point Injection

Description:
Injection of painful muscle(s) with local anesthetic and/or steroid.

Indication:
Myofascial pain syndrome associated with appearance of painful points in the muscle(s).

Injections that REQUIRE X-Ray

Celiac plexus/Splanchnic Block

Description:
Block of the sympathetic chain at the level of the lower thoracic spine

Indication:
Visceral upper to mid abdomen pain (chronic pancreatitis, colitis, hepatitis, cholecystitis, etc.)

Celiac plexus/Splanchnic Neurotomy

Description:
Chemical/thermal destruction of the sympathetic chain at the level of the lower thoracic spine

Indication:
Malignant pain of the upper to mid abdomen (pancreatic cancer, etc.)

Cervical/Thoracic Discography

Description:
Diagnostic injection of contrast or saline into the cervical/thoracic intervertebral discs in an attempt to provoke concordant symptoms

Indication:
Precision diagnosis of discogenic pain generator, confirmation of the level of proposed surgical fusion

Cervical/Thoracic Facet Medial Branch Block

Description:
Block of cervical/thoracic facet joint nerve

Indication:
Precision diagnosis of suspected facet syndrome

Cervical/Thoracic Medial Branch Neurotomy

Description:
Thermal destruction of cervical/thoracic facet joint nerve

Indication:
Facet syndrome

Cervical Sympathetic Block

Description:
Block of sympathetic chain at the level of the cervical spine.

Indication:
Neuropathic upper extremity or cranial pain (reflex sympathetic dystrophy, herpes zoster, trigeminal neuralgia, etc.)

Epidural Neurolytic Block

Description:
Chemical/thermal destruction of the spinal  nerve roots

Indication:
Malignant pain of trunk and limbs (most frequently offered to patients with life expectancy of less than six months)

Epidural Port-A-Cath Implantation

Description:
Fluoroscopically guided indwelling epidural catheter implantation with or without subcutaneous port.

Indication:
Intractable malignant pain in patients with a life expectancy of less than three months, acute or subacute pain related to herpes zoster, reflex sympathetic dystrophy or other significant injury.

Epidural Steroid Injection, Cervical/Thoracic Translaminar

Description:
Delivery of steroid into the cervical/thoracic epidural space.

Indication:
Acute and chronic cervical/thoracic radicular pain, lumbar discogenic pain, cervical/thoracic spinal stenosis.

Epidural Steroid Injection, Lumbar/Caudal Translaminar

Description:
Delivery of steroid into the lumbar/caudal epidural space.

Indication:
Acute and chronic lumbar radicular pain, lumbar discogenic pain, lumbar spinal stenosis.

Epidural Steroid Injection, Lumbar/Caudal Transforaminal (Selective nerve root block)

Description:
Delivery of steroid into the lumbar/caudal epidural space.

Indication:
Acute and chronic lumbar/caudal radicular pain, lumbar discogenic pain, lumbar/caudal spinal stenosis, precision diagnosis of discogenic pain generator.

Epidural Steroid Injection, Cervical/Thoracic Transforaminal (Selective nerve root block)

Description:
Delivery of steroid into the cervical/thoracic epidural space.

Indication:
Acute and chronic cervical/thoracic radicular pain, cervical/thoracic discogenic pain, cervical/thoracic spinal stenosis, precision diagnosis of discogenic pain generator.

Intercostal Injection

Description:
Block of the intercostal nerve.

Indication:
Suspected intercostal neuralgia/neuritis, chronic pleuritic pain.

Intercostal Neurotomy

Description:
Chemical or thermal destruction of the intercostal nerve.

Indication:
Malignant or non-malignant chest wall pain unresponsive to conservative therapy (intercostal neuritis/neuralgia, chronic pleuritic pain, chest wall metastasis, etc.)

Kyphoplasty/Vertebroplasty

Description:
Delivery of cement into the fractured vertebral body.

Indication:
Painful vertebral compression fracture(s), metastatic vertebral body lesion, vertebral body hemangioma.

Lumbar Discography

Description:
Diagnostic injection of contrast or saline into the lumbar intervertebral discs in an attempt to provoke concordant symptoms.

Indication:
Precision diagnosis of discogenic pain generator, confirmation of the level of proposed surgical fusion.

Lumbar Facet Medial Branch Block

Description:
Block of lumbar facet joint nerve.

Indication:
Precision diagnosis of suspected facet syndrome.

Lumbar Medial Branch Neurotomy

Description:
Thermal destruction of lumbar facet joint nerve.

Indication:
Facet syndrome.

Lumbar Sympathetic Block

Description:
Block of the sympathetic chain at the level of the upper lumbar spine.

Indication:
Neuropathic pain of the lower extremities (reflex sympathetic dystrophy, ischemic pain, herpes zoster, etc.)

Percutaneous Disc Decompression

Description:
Minimally invasive, designed to reduce intradiscal pressure with resultant alleviation of disc protrusion.

Indication:
Small (less 10mm), focal disc protrusion without associated neurological deficit.

Peripheral Nerve Stimulator Trial

Description:
Placement of external neurostimulator electrode(s) for trial of peripheral nerve stimulation.

Indication:
Chronic pain associated with mononeuropathy.

Peripheral Nerve Stimulator Implantation

Description:
Implantation of peripheral nerve stimulator electrode(s) and generator or receiver.

Indication:
Successful trial of peripheral nerve stimulation.

Sacroiliac Joint Injection

Description:
Intra-articular delivery of steroid.

Indication:
Painful sacroiliac joint arthritis/arthralgia.

Spinal Cord Stimulator Trial

Description:
Placement of external neurostimulator electrode(s) for trial of spinal cord stimulation.

Indication:
Chronic radiculopathy, neuropathy, neuralgia/neuritis of the trunk and limbs, chronic intractable stable angina, chronic intractable ischemic extremity pain, chronic pain associated with interstitial cystitis, chronic pain associated with occipital neuralgia.

Spinal Cord Stimulator Implantation

Description:
Implantation of spinal cord stimulator electrode(s) and receiver or generator.

Indication:
Successful trial of spinal cord stimulation.

Spinal Infusion Trial, Lumbar or Cervical/Thoracic

Description:
Placement of temporary external epidural catheter for trial of spinal infusion therapy.

Indication:
Failure of oral opioid therapy to control intractable pain or intractable side effects of systemic opioid therapy.

Spinal Infusion Drug Delivery Device Implantation

Description:
Spinal catheter and infusion device implantation.

Indication:
Successful trial of spinal infusion therapy.

Subarachnoid Neurolytic Block

Description:
Chemical destruction of the spinal nerve roots.

Indication:
Malignant pain of trunk and limbs (most frequently offered to patients with life expectancy of less than six months).

Superior Hypogastric Plexus Block

Description:
Block of the sympathetic chain at the level of the lower lumbar spine/sacrum.

Indication:
Visceral pain in the lower abdomen (endometriosis, prostatitis, colitis, etc.)

Advanced Pain Management Center
10305 SW Park Way #300, Portland Oregon 97225

Tel:  503-295-0730 |  Fax:  503-295-0731
Monday – Friday: 8AM – 5PM
Note:  We are closed from Noon to 1PM daily

Email: info@apmconline.org

Advance Pain Management Center