Injections and Procedures

Joint, Tendon and Nerve Injections

Injections into various joints, tendons, and nerves at the site of pain can provide additional relief when other treatments, such as medication and physical therapy, have failed to provide adequate relief on their own. This option is used to treat a multitude of pain complaints including:

Joint pain
Nerve Pain
Tendon-related pain

Injection therapies, in combination with a focused post-treatment physical therapy rehabilitation program, give patients a better chance of pain reduction and improved function. There is good evidence to support the use of injections in decreasing pain due to joint pain, nerve pain, and tendinosis. The goal of injection therapy is to postpone and, in some cases, eliminate the need for surgery.

Joint Injections

Intra-articular (inside the joint capsule) injections are used to address joint pain in the axial (spine) and appendicular (all joints outside of the spinal column) skeleton. These injections can be both diagnostic (confirmation that the pain is coming from the joint) and therapeutic (provides a period of pain relief).

The most common intra-articular joint injections in the axial skeleton are:

The sacroiliac (SI) joint – where the sacrum meets the bones of the pelvis
Facet joints – more technically called zygapophyseal joints, these are small joints between the vertebrae that provide structure and stability for the spine
The atlanto-axial joint – The joint between the 1^st and 2^nd vertebrae in the neck, or C1-2 joint

Some common appendicular injections include:

Nerve Injections

There are innumerable nerves in your body, and pain may stem from any one of them. We can use injection of an anesthetic (numbing) agent to eliminate pain sensation in the affected area. These numbing medications can be used on any part of the nervous system and on any nerve fiber type. The block affects the area of injection but also spreads along the nerve. The benefit of such an injection is that it gives good diagnostic information (ie if the pain decreases, we can be confident that your pain was generated from the targeted nerve).

The main types of nerve injections are:

Axial nerve injections – target the nerves exiting the spinal column in the neck and low back. In addition to epidural steroid injections and medial branch blocks, some common nerve injections include:
- Sympathetic blocks – targets the sympathetic nerves that come off the larger nerve roots. These are useful in treating CRPS and PTSD
- Selective nerve root blocks – targets the nerve roots as they exit the spine. These are very similar to ESIs but typically only use numbing medication to yield the highest possible diagnostic benefit.
Peripheral nerve injections – target various nerves anywhere outside of the spinal area
- Genicular nerve injections – target nerves that go to your knee
- Lateral Femoral Cutaneous nerve injections – targets the nerve that runs along the front of your upper thigh and pelvis

Tendon Injections

Tendons attach muscle to bone, and any inflammation or injury of the tendon can cause tendinosis, which can cause pain. The goal with injections into a tendon is to reduce pain and promote healing. This entails removal of the scar tissue found around the injured tendon, and then injecting a regenerative medicine agent such as platelet rich plasma (PRP) or stem cells.

What to expect during your injection

Depending on your anatomy, sedation preference and provider recommendation, joint, nerve and tendon injections are done at our surgery center. Your provider may utilize fluoroscopic (x-ray) or ultrasound guidance. This allows us to be sure that we not only accurately inject into our intended target but also that we get good spread of the medication throughout the joint capsule, along the path of the nerve or the damaged and painful part of the tendon.

You may opt for sedation during your injection. It is usually recommended if you have a fear of needles, or if you feel that you may not be able to lay still during the injection. Many patients do not utilize sedation and do very well.

Exceptional Pain Management Treatment

At the Denver Spine and Pain Institute, we’ve witnessed firsthand how debilitating pain can derail your quality of life. Our team is committed to providing you with the relief necessary to enjoy your favorite activities and perform routine daily activities with ease. Our goal is to help you live life to the fullest once again.

Our exclusive Connected Care Approach™ has been designed with your needs in mind, and it will get you back to enjoying life without the frustration and challenges that often come along with chronic pain. As part of this approach, you’ll receive:

A full spectrum of care options, including physician treatments, physical therapy, massage, diet and lifestyle coaching, behavioral health services and other state-of-the-art treatments
Individualized care plans to address your specific pain needs
Caring and therapeutic relationships with our team to ensure the best possible treatment
A detailed discussion of all your treatment options so that you can make an informed decision

We’ll work closely with you to identify and deliver the treatments necessary to achieve the pain relief you’re seeking.

Schedule an Appointment

Please contact us today to schedule an appointment. The Denver Spine and Pain Institute serves patients in Denver and the surrounding areas of Colorado.

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