Therapeutic Injections for Pain

Options for Therapeutic Injections in Los Angeles

Injections are a therapeutic and deliberate method to block pain signals from reaching the brain and thus alleviating the perception of pain. Therapeutic blocks include: Chemodenervation (Botox®)Selective Nerve Root Block (SNRB) and Sympathetic Nerve Block. Therapeutic injections are a medical procedure used to treat pain, as a diagnostic tool to identify its source, to predict the outcomes of a given treatment and to avoid invasive surgery. The injections may be anesthetic or anti-inflammatory in nature and are targeted toward a specific nerve or a group of nerves to treat pain.

Therapeutic injections are often used to treat persistent severe pain that is not easily managed by pain medications, lifestyle modifications or physical therapy. They are often used in place of major surgery to avoid or reduce the use of prescription painkillers.

Read on to learn more about Los Angeles Botox pain treatments and selective nerve blocks, or schedule a consult today.

What is Chemodenervation with Botox?

Chemodenervation is a non-surgical minimally invasive pain management procedure that is used to eliminate or reduce the pain produced from a variety of neurological disorders by paralyzing a group of muscles with a pharmacological compound called Botulinum.

Botulinum, sometimes referred to as Botox, which is a brand name for one form of the bacteria botulinum toxin-A. It is one of the most poisonous substances known to man. If left untreated, high doses of botulism can result in respiratory failure and even death. However, Botulinum has been proven to be successful therapeutically in extremely small doses to prevent signals from nerve cells from reaching muscles. Once the muscle, or muscle group, is injected with Botulinum  it can become temporarily released which can significantly reduce chronic pain from muscle spasms and contracted or stiff muscles.

Botulinum in Pain Management

Botulinum was first approved to cosmetically reduce wrinkles, but is now used to treat a large number of health conditions and new uses are being regularly discovered. Today it is used therapeutically to treat chronic pain conditions and a variety of other neurological disorders. that include:

How is Chemodenervation with Botulinum Typical Given?

In most cases chemodenervation with Botox takes just a few minutes to treat muscle spasms or other neurological disorders. The procedure typically begins with the injection of a local anesthetic followed by a Botox injection directly into the muscles that are overactive active or painful. In the majority of procedures ultrasound or electromyography (EMG) imaging is used to guide the placement of Botox injections. Utilizing these imaging tools allows for the more precise and accurate injection of the targeted muscle or muscle group and minimizes injury to adjacent nerves or blood vessels.

Once the Botox injection is completed pain or spasms may decrease immediately with the most evident effect 7-14  days after treatment. The relief provided by the injections typically lasts up to four months before the irregular muscle activity returns. – Some patients may require injections more often than others depending on the severity of the pain or spasms.

Side Effects of Botulinum Injections

The side effect from a typical Botulinum procedure includes, soreness, redness or bruising around the injection area. Applying iced compacts or taking over the counter pain medication(s) to counter or relieve pain are often recommended. Rarely do more serious side effects occur. Our specialists will review the potential risks of botulinum injections during your consultation. Schedule a visit today to learn more about Botox for pain in Los Angeles.

After a Botulinum Injection

Botox injections can be an effective and ongoing treatment for the relief of chronic pain or muscle spasms, but it is not a cure. Depending on the condition treated and the patient’s response each patient will have a varying degree of pain relief. Their results may last anywhere from 3 to 12 months, with the majority lasting 4 months, depending on the condition that is treated.

What is a Selective Nerve Root Block Injection?

Selective nerve root block (SNRB) injections are designed to deliver relief from pain due to compression and inflammation of nerves in the spinal cord. When compared to other techniques the target-specific administration of chemicals and/or medications involved in a selective nerve injection delivers a more precise administration of drugs directly to the nerves.

Pain originating from the lower back and the leg are the common sites for selective nerve injections. It is used therapeutically to relieve pain and as a diagnostic tool, where it is used to identify if a certain nerve is the cause of the patient’s pain and symptoms.

How Does a Selective Nerve Root Block Work?

A selective nerve root block works by directly administering a drug to either irritate or numb a specific nerve. First, a numbing agent (local anesthesia) is applied to the skin where the needle will be pierced. With the help of an x-ray device (fluoroscope), a needle is inserted directly into the nerve where the painful area is located. A contrast dye is then injected to confirm the correct needle placement. Afterward, a corticosteroid and is injected into the never to reduce inflammation and pain.

What Conditions are Selective Nerve Root Blocks Used For?

Selective nerve blocks can be effective for conditions where a localized ‘block’ is required to reduce and stop pain from being felt. In general, these are the conditions when there is an increased pressure within the bone cavity where a nerve traverses. Some common conditions with selective nerve injections are:

  • Herniated discs
  • Spinal stenosis
  • Cervical radiculopathy
  • Lumbar radiculopathy
  • Failed back surgery syndrome
  • Sciatica

What to Expect During the Selective Nerve Block Treatment

Patients typically receive selective nerve block injections in an outpatient setting and generally do not need to be admitted to a hospital. Provided that there are no observed complications or adverse reactions, patients usually leave shortly after the procedure is performed.

The use of a corticosteroid in selective nerve injections may deliver immediate pain relief after the injection, but the drugs injected into the nerve may take anywhere from 3 to 7 days to provide significant pain relief. If successful, therapeutic injections may provide several days or many months of pain relief.

Candidates for a Selective Nerve Block Injection

Candidates for selective nerve block are patients who fail to receive adequate pain relief with the use of conventional oral drugs, muscle injections, physical therapy and other pain-relieving techniques. Often, these patients suffer from prolonged pain exposure and restriction of body movement. Selective nerve root block injections can provide an instant and target-specific pain relief if successful. Schedule a consultation with one of our specialists to learn if Selective Nerve Block Injection can help.

What Are The Benefits of Selective Nerve Injections?

When successful, selective nerve block injections may provide almost rapid relief of pain from chronic long term conditions, as well as those that occur during the healing process of conditions like herniated discs. Aside from pain relief selective nerve block injections are also used as a diagnostic tool to determine if a specific nerve is the potential source of pain. The result of the procedure may help to guide further treatment that may result in longer pain relief for patients.

What are the Risks for Selective Nerve Root Block Injections?

Selective nerve block injections are generally perceived as a safe medical procedure. However, some side effects and complications might occur. Pain and tenderness at the injection site after the procedure are common.

Tell your doctor if you have bleeding problems, and if you are taking any blood-thinning medications. As this procedure will utilize a contrast media for guided visualization of the needle, you should notify your physician if you have any known allergies to seafood, iodine, or to any other substance in order to avoid fatal anaphylactic reactions. Although uncommon, damage to the nerve and nearby tissues may occur.

Meet With Our Specialists

Our highly experienced doctors, state of the art technology, world-renowned personalized care, and numerous clinical trials allow us to provide our patients with the highest standard of neurological treatments in the world. We invite you to schedule a consultation with our experts today!

neurological associates's dr. marisa chang and dr. sheldon jordan

What is Sympathetic Nerve Block?

A Sympathetic Nerve Block is a non-surgical procedure that targets a specific network of nerves in the sympathetic nervous system which lies outside the spine. The sympathetic nervous system is primarily responsible for involuntary responses of the body, or simple actions that the body cannot control such as heartbeat, blood flow, blood pressure, digestion, and sweating. Sometimes, an injury near certain areas under involuntary control, even after the injury has healed, may continue to send pain signals to the brain which can lead to chronic pain. When this occurs a sympathetic nerve block may be used to temporarily block pain sensations that are carried from the peripheral tissues to the spinal cord.

Sympathetic nerve blocks are used therapeutically and diagnostically.  They may be used to block pain in the lumbar sympathetic blockade and the sympathetic or ganglion blockade. If the procedure is successful, they may reduce pain caused by inflammation or irritation and offer a long term solution for chronic pain or confirm a nerve’s contribution to the pain.

What Conditions are Sympathetic Nerve Blocks Used For?

Sympathetic nerve blocks have been proven effective in treating certain conditions that would usually bring a chronic, recurrent or prolonged state of pain. Some of these conditions include:

Who Can Be a Candidate for a Sympathetic Nerve Block for Pain Management?

Patients who fail to control pain using more conservative therapies (oral medications or physical therapy), may benefit from a sympathetic nerve block.

During Sympathetic Nerve Block Treatment

Sympathetic nerve blocks use chemicals, often anesthetics (numbing agents) that are combined with steroids, and injected directly into the nerve under imaging guidance to guide placement of the needle and administer the drug. Most patients are sedated during the procedure while the neurologist evaluates the spread of the injection through X-rays. When a sufficient area is covered, the injections and procedure will be over. Following the procedure, the needle is removed and a small band-aid is applied. If the sympathetic nerve block is successful, pain relief may be felt almost immediately.

Benefits of Sympathetic Nerve Block

The most significant benefits of sympathetic nerve blocks are the rapid relief of chronic pain, which can be immediate and occur over the course of a few days. Other benefits include improvements in movement, which allow patients to regain the ability to resume normal daily activities, which increase the quality of life.

What are the Typical Risks of Sympathetic Nerve Blocks?

Patients might find soreness and pain at the injection site, which is temporary and can be relieved by applying ice or anti-inflammatories.  In some cases, an infection may occur at the injection site.

Sympathetic nerve blocks injections do pose a risk for bleeding. Patients who are taking blood-thinning medications, such as aspirin and warfarin should notify their physician before the procedure.

If the nerve block was done in the upper part of the body, patients might experience difficulty in swallowing and voice changes, thus increasing the risk for aspiration. Exercise caution when sipping liquids and avoid biting large chunks of food.

To learn more about sympathetic nerve blocks in Los Angeles and Santa Monica, schedule an appointment with our specialists.