Los Angeles Pain Doctor

Avosant


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Diagnosis Model
Pain Diagnosis Model

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Call our offices at:
(310) 274-3481
(800) 964-0404

Beverly Hills
9301 Wilshire Boulevard
Suite 406A
Beverly Hills, California 90210



Insurance
 
INSURANCE & WORKERS' COMPENSATION ACCEPTED!
We accept most types of insurance providers and specialize in the treatment of workers' compensation injuries to the hand and upper extremity.





Pain Management Procedures


Therapeutic Injections
Nerve Blocks

Often times patients suffering from different painful conditions do not respond to conservative treatment and require more aggressive modalities to relieve the chronic pain. Steroid injections and nerve blocks are performed by board certified pain management specialists as a therapeutic and diagnostic tool to help relieve symptoms and provide comfort to patients. Steroid injections are used to reduce nerve and joint inflammation while nerve blocks are used to provide pain relief as well as a diagnostic tool to determine the source of the pain. When an injection is administered as a diagnostic or therapeutic agent, a multidisciplinary approach is used at Avosant Surgical Associates in order to treat the entire spectrum of the pain and the disorder to improve the probability of a successful outcome. Listed below are some common steroid injections and nerve block procedures that are performed.

Pain Management Procedures

Therapeutic Injections


Cervical Epidural Steroid Injection
Cervical Transforaminal Epidural Steroid Injection
Facet Joint Injections
Lumbar Epidural Steroid Injection
Sacroiliac Joint Steroid Injection


Cervical Epidural Steroid Injection

A cervical epidural steroid injection is used as a therapeutic treatment for patients suffering from neck, shoulder, and arm pain caused by a pinched nerve/s in the cervical spine due to conditions such as herniated disc, spinal stenosis (narrowing of the spinal canal), and radiculopathy. A cervical epidural steroid injection is an outpatient procedure in which the patient may receive IV sedation. An x-ray devise known as a fluoroscope, is used to guide the needle into the epidural space. Contrast die is used to confirm the placement of the needle near the irritated nerve/s. An injection of local anesthetic and cortisone is then injected around the irritate nerve/s in the epidural space. The cortisone is a steroidal anti-inflammatory medication used to decrease swelling and alleviate pressure. Some patients may find relief from one injection, however, some may need up to 3 injections administered 2 weeks apart.


Cervical Transforaminal Epidural Steroid Injection

A cervical transforaminal epidural steroid injection is used as a therapeutic treatment for patients suffering from neck, shoulder, and arm pain caused by a compressed nerve root in the cervical spine due to conditions such as herniated discs and spinal stenosis (narrowing of the spinal canal). A local anesthetic is used to numb the skin and tissue all the way down to the vertebrae. An x-ray devised known as a fluoroscope, is used to locate the nerve root and cervical vertebrae as well as to guide the needle into the foraminal space near the compressed nerve root. Contrast die is then injected to confirm the proper placement of the needle. An injection of a steroid and anesthetic solution is then administered in the foraminal epidural space around the compressed nerve root to reduce swelling and inflammation. Once the procedure is finished, most of the patients may return home the same day.


Facet Joint Injections

Facet joint block injections are both a therapeutic and diagnostic technique used to alleviate back and neck pain suspect of being caused by inflammation in the facet joints. Facet joints are located in the rear of the spine on both sides of the vertebrae. These joints connect all the spinal vertebrae to one another. A local anesthetic is used to numb a small area of skin to prepare for injection. An x-ray devised known as a fluoroscope, is used to guide the needle into the facet joint. Contrast die is then injected to confirm the proper placement of the needle. Injection of an anesthetic and anti-inflammatory steroid medication is then administered into the facet joint, one or more joints may be injected at the same time. The steroid medication may take up to 5 to 10 days to reduce inflammation and alleviate pain. Patients may undergo up to 3 injections per year in the affected facet joints.


Lumbar Epidural Steroid Injection

A lumbar epidural steroid injection is used as a therapeutic treatment to relieve lower back and radiating leg pain caused by conditions such as spinal stenosis, sciatica, herniated discs, and radiculopathy. A lumbar epidural steroid injection requires the patient to lie face down with a cushion under the stomach to flex the back in order to allow easier access into the epidural space. A local anesthetic is used to numb the skin.

Lumbar Epidural Steroid Injection Pain
An x-ray devise known as a fluoroscope to guide and locate the proper lumbar vertebrae and nerve root between vertebrates L4 and L5. A contrast die is used to confirm the proper placement of the needle and to see the painful areas. Injection of an anesthetic and anti-inflammatory steroid medication is administered into the foraminal epidural space to reduce swelling and inflammation. Patients may need to repeat the procedure up to 3 times to get full relief.


Sacroiliac Joint Steroid Injection

A sacroiliac joint steroid injection is used as a therapeutic treatment to relieve pain caused by arthritis in the sacroiliac joint, where the spine and hip meet. A sacroiliac joint steroid injection requires the patient to lie face down with a cushion under the stomach to flex the back and allow for easier access into the sacroiliac joint. An x-ray devise known as a fluoroscope, is used to find the sacroiliac joint and to guide the needle into the proper position. Injection of an anesthetic and steroid medication is injected into the joint to relieve swelling, pain, and inflammation.


Nerve Blocks

Cervical Selective Nerve Root Block
Costovertebral Block
Lumbar Sympathetic Block
Stellate Ganglion Block
Femoral Nerve Block
Ankle Nerve Block

Cervical Selective Nerve Root Block

A cervical selective nerve root block is used as a diagnostic and therapeutic treatment for patients suffering from neck, shoulder, and arm pain caused by a pinched nerve in the cervical spine. Cervical selective nerve root block can treat conditions such as herniated disk, spinal stenosis (narrowing of the spinal canal), and radiculopathy. A cervical selective nerve root block is an outpatient procedure in which the patient will be sedated but awake. The area of the neck will be numbed with a local anesthetic. An x-ray devised known as a fluoroscope, is used to guide the needle into the foraminal space of the suspected pinched nerve. A contrast die is used to confirm the needle position. Local anesthetic is injected into the space around the nerve to stop the nerve from firing pain signals. A steroid medication may also be added in order to ease inflammation. If the cervical selective nerve root block relieves the pain, the suspect nerve was the source of the pain. Some patients may need additional injections, if the pain was not relieved, the procedure may be repeated to find the source of the pain.


Costovertebral Block

A costovertebral block is used as a diagnostic and therapeutic treatment for patients suffering from pain caused by damage to one or more of the costovertebral joints. The costovertebral joints connect the ribs to the vertebrae and allows for rib movement during breathing. A costovertebral block is an outpatient procedure. The upper back will be sterilized and numbed. An x-ray devised known as a fluoroscope, is used to guide the needle to the costovertebral joint. A contrast die is used to confirm the needle position. Numbing medication is injected into the costovertebral joint to alleviate pain. A steroid, such as cortisone, is then injected into the costovertebral joint to reduce inflammation and extend the pain relief, this should be felt within 5 days of the injection.


Lumbar Sympathetic Block

A lumbar sympathetic block is an injection of local anesthetic, saline, and anti-inflammatory medication into or around the sympathetic nerve/s, to block pain signals from firing. Patients who receive lumbar sympathetic blocks are suffering from leg pain caused by complex regional pain syndromes due to injury of a joint or limb. Most patients who undergo lumbar sympathetic blocks will need a series of injections to relieve the pain, up to one time per week until the pain goes away. A lumbar sympathetic block is an outpatient procedure. The patient will be numbed with local anesthetic. An x-ray devised known as a fluoroscope, is used to guide the needle to the appropriate sympathetic nerve/s suspect of causing pain. A contrast die is then injected to confirm proper placement of the needle and to identify painful areas. An injection of anesthetic, saline, and anti-inflammatory medication is administered around the sympathetic nerves to block the firing of pain signals to the brain. After the procedure, the patient may feel weakness or numbness in the legs for a few hours.


Stellate Ganglion Block

Stellate ganglion block is used to diagnose and treat pain caused by nerve conditions such as complex regional pain syndrome of the head, face, neck, and arms, phantom limb syndrome, and shingles. The stellate ganglion is a group of sympathetic nerves located at the base of the front of the neck on both sides of the voice box that control involuntary actions such as blood flow, sweating, and pain. A stellate ganglion block is an outpatient procedure. The patient will lie on their back with a support under the neck to tilt the head backward. The patient will receive medication through an IV to help relax. The base of the neck will be sterilized and numbed with a local anesthetic. An x-ray devise known as a fluoroscope, is used to guide the needle to the stellate ganglion nerves. A contrast die is used to confirm proper placement of the needle. Injection around the stellate ganglion nerves with a local anesthetic and anti-inflammatory medication is then administered. Patients that received pain relief from the stellate ganglion block may need additional injections over time. Some patients may experience short term to long term relief, with each additional injection prolonging the pain-free periods. Side effects of stellate ganglion block are nasal congestion, blood-shot, droopy eye on the side of the injection, horse voice, and tingling sensations in the arm and hand, which will dissipate within a few hours.


Femoral Nerve Block

A femoral nerve block is an out patient procedure used as a pre-operative or post-operative technique on the thigh or knee to provide temporary sensory anesthesia to the leg, using a local anesthetic. This anesthetized effect will be felt for several hours, however, pain medication may be needed after the anesthesia wares off.


Ankle Nerve Block

An ankle nerve block is an outpatient procedure used to numb the ankle and foot with local anesthesia, in preparation for surgery on the foot. A series of injections may be needed to block sensation in up to 5 nerves. This anesthetized effect may last for several hours, however, pain medication may be needed after the anesthesia wares off.



Therapeutic Injections Nerve Blocks

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