Pain Management
Pain management therapy is an out-patient treatment that uses imaged guided injections to treat the specific area that is causing pain. Injections may also be used to determine the precise source of pain. These procedures are performed by our experienced radiologists.
Your physician may order pain management at Hastings Imaging Center to help localize the origin of your pain and offer conservative treatment that may prevent the need for surgery.
SACROILIAC (SI) JOINT INJECTIONS
Sacroiliac (SI) joint injections are a minimally invasive procedure commonly used to determine what is causing back or leg pain. A long-lasting corticosteroid and an anesthetic numbing agent are injected into one or both of your SI joints. If the SI joint is injected and the pain goes away for several hours, then it is very likely that the joint is causing your pain. Once you and your doctor know what is causing your pain, you can begin to explore the options for treating the condition.
The Procedure:
- You will be asked to sign a consent form.
- Lying face down on the table, you will receive a local anesthetic to numb the skin before the injection is given.
- CT guidance is used to ensure the safe and proper position of the needle.
- Once the radiologist is sure the needle is correctly placed, the anesthetic and steroid will be injected.
Instructions for the Procedure:
- We will need a list of ALL current medications (including over-the counter medications). Some medications (such as aspirin or Coumadin) will need to be stopped several days ahead of time. The nurse will inform you of the medications that need to be discontinued and the appropriate length of time.
- Please notify the nurse or technologist of allergies to medications, betadine or latex.
- Please inform the technologist if you are pregnant or think you may be pregnant.
- You will be asked to wear a gown during the exam.
After the Procedure:
- Most patients can walk around immediately after the procedure. Some temporary leg numbness or weakness can occur. You will be monitored for up to 30 minutes and allowed to leave. However, you must have someone drive you home.
- You may notice a slight increase in pain as the numbing medicine wears off and before the corticosteroid starts to take effect.
- If the SI joints are the source of your pain, you may begin to notice pain relief starting two to seven days after the injection. If you have no improvement, a second injection may be given.
- You can usually resume full activity the next day. Soreness around the injection site can be relieved with ice and mild analgesics.
FACET INJECTIONS
A facet injection is a minimally invasive procedure that can temporarily relieve pain caused by inflamed facet joints. A long-lasting corticosteroid and an anesthetic numbing agent are injected into one or more of your facet joints. The injection has two purposes. First, by placing numbing medicine into the joint, it can be used as a diagnostic test that will help confirm that the pain is actually coming from your facet joints. Second, by injecting a long lasting steroid, inflammation of the joints can be reduced which can sometimes provide long term pain relief. The goal is to reduce pain so that you may resume normal activities and a physical therapy program.
If you have neck or lower back pain that is a result of inflammation of the facet joints, you may benefit from a facet injection. MRI or X-rays may not show if a facet joint is causing pain. Usually, it is recommended for those who fail to respond to other conservative treatments. Your doctor may wish you to have the injection as a diagnostic test to determine if the facet joint is causing your pain.
The Procedure:
- You will be asked to sign a consent form.
- Lying face down on the table, you will receive a local anesthetic to numb the skin before the injection is given.
- CT guidance is used to ensure the safe and proper position of the needle.
- Once the radiologist is sure the needle is correctly placed, the anesthetic and steroid will be injected.
- One or several joints may be injected depending on the location of your pain.
Instructions for the Procedure:
- We will need a list of ALL current medications (including over-the counter medications). Some medications (such as aspirin or Coumadin) will need to be stopped several days ahead of time. The nurse will inform you of the medications that need to be discontinued and the appropriate length of time.
- Please notify the nurse or technologist of allergies to medications, betadine or latex.
- Please inform the technologist if you are pregnant or think you may be pregnant.
- You will be asked to wear a gown during the exam.
After the Procedure:
- Most patients can walk around immediately after the procedure. Some minor leg numbness can occur temporarily. You will be monitored for up to 30 minutes and allowed to leave. However, you must have someone drive you home.
- You will be given discharge instructions that will include a Pain Diary. It is important to fill this out because recording your levels of pain will help your doctor know how the injection is working.
- You may notice a slight increase in pain as the numbing medicine wears off and before the corticosteroid starts to take effect.
- If the facet joints that were treated are the source of your pain, you may begin to notice pain relief starting two to seven days after the injection. If you have no improvement, a second injection may be given.
- You can usually resume full activity the next day. Soreness around the injection site can be relieved with ice and mild analgesics.
