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2018-08-16 (1)

The new alternative to for back surgery

If you have lower back pain, trust me, you’re not alone! About 80 percent of adults undergo low back pain at some point in their lifetimes. It is most commonly caused by job-related disability and is a leading contributor of missed work days. In a recent survey held, more than a quarter of adults reported experiencing low back pain during the past 3 months.

Men and women are equally affected by low back pain, which definitely varies in intensity from a dull, constant ache to a sudden, sharp sensation that leaves the person incapacitated. Pain can set in motion unexpectedly as a result of an accident or by lifting something heavy, or it can develop over time due to age-related changes of the spine. Inactive lifestyles also can set the stage for low back pain, especially when a weekday routine of getting too little exercise is punctuated by exhausting weekend workout.

Intradiscal Electrothermal Therapy (IDET) is a minimally invasive treatment for chronic low back pain that results from certain types of painful degenerative disc disease or contained disc herniation. Successful IDET treatment may allow some patients to experience good or excellent pain relief without having to undergo major spinal surgery for disc removal and spinal fusion, or disc replacement.

The IDET treatment was first introduced in 1997 and has been performed extensively since then. The procedure involves inserting a catheter into the disc and heating it up. It takes about an hour and can be readily performed on an outpatient basis (with no overnight hospital stay). Several disc levels may be treated in a single session.

This is a fairly recent technique, FDA approved in 1998, developed for treatment of pain originating from a spinal disc. In the past, severe low back and leg pain caused by a defect in the spinal disc typically required surgery. Surgery frequently can “cure” the problem, but it may not improve the pain. Surgery is also very invasive, not to mention expensive. The IDET procedure was developed and designed with the goal of reducing pain with less invasive techniques, decreasing the risks of complications, and lessening the recovery time and expense.

There are minimal risks associated with IDET when it is performed by an experienced physician. Initially, it was thought that disc space infection, nerve root injury, post treatment disc degeneration or herniation, and post treatment increase in back pain were significant concerns. However, most published studies of IDET therapy have not reported any significant complications and the real risk of complications are now felt to be quite low.

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2018-08-11 p

Relieving Chest Pain just got easier!

It gets hard to describe what to do when you feel pain or discomfort in the chest. Is it a heart attack or another, less serious problem? Since chest pain can be a sign of a heart attack, if the pain is due to heart disease, it is important to seek help and get treatment as quickly as possible.

One of the ways of treating chest pain is to undergo the Intercostal Nerve Block Treatment. Intercostal nerve blocks are popular with physicians treating chronic pain and inflammation in the abdomen or chest for a prolonged period of time. Patients with pain that is resistant to opioid treatments, or who wishes to avoid using them, often find intercostal nerve blocks are a practical and less risky pain management option. Surgeons may also use intercostal nerve blocks as part of analgesia during major thoracic or abdominal procedures.

An intercostal nerve block is an injection of medication that helps relieve pain in the chest area caused by a herpes zoster infection (or “shingles”) or a surgical incision. Intercostal nerves are located under each rib. When one of these nerves or the tissue around it gets irritated or inflamed, it can cause pain. A steroid medication and local anesthetic injected under the rib can help diminish the inflammation and ease the pain. Intercostal nerve blocks also can be used to help identify the source of pain.

Soon after the injection, you may notice that your pain may be gone or considerably less. You will be kept in the recovery room for a short period for observation. The risk of complication from an intercostal nerve block is very low. However, there could be bruising or soreness at the injection site. Very rarely, this injection can result in a complication called a pneumothorax (collapsed lung) so a chest x-ray may be obtained.

Some patients account for pain relief to take place immediately after the injection, but the pain may return a few hours later as the anesthetic wears off. Longer term relief usually begins in two to three days, once the steroid begins to work. The duration of this relief is different for each and every individual patient. For some, the relief lasts several months. If the treatment works for you, you can have periodic injections to stay pain-free.

An intercostal nerve block may be right for you if you have a recent onset of pain in the chest area especially due to shingles or a surgical incision which does not respond to other treatment. Talk to your physician about it. Give a call to Pain Management Institute at 815-464-7212 and schedule your evaluation with Dr. Zaki Anwar. He is very experienced in interventional treatments and a world renowned Pain Medicine Physician who has been practicing ways to cure pain leading to serious problems for the past several years After determining the cause of your pain, he may use a variety of treatments to provide you with pain relief.

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2018-08-04

New innovations are a step towards pain free life

An intrathecal pain pump implantation, or targeted drug delivery, is often considered as an option to relieve chronic pain. This therapy has been recommended as an advanced therapy for patients with cancer and non-cancer pain after systemic medicines have failed. Intrathecal pump therapy for cancer pain reduces pain by delivering medication directly to the area surrounding the spinal cord, thus requiring much smaller doses of medication for relief.

A pump and catheter are surgically implanted beneath the skin by an IPI physician. The pump, implanted in the abdominal area, is connected to the catheter, which is tunneled under the skin to the specific site where the medication is needed. Intrathecal therapy involves the administration of analgesic and antispasmodic medications directly into the spinal fluid for control of pain and spasticity.

When using intrathecal therapy in the management of pain, the physician often uses much lower doses of analgesics to improve pain control, thereby limiting the side effect burden associated with higher doses of systemic analgesics. Pain management with intrathecal therapy has been shown to improve pain control and side effects over systemic analgesics alone.

However, significant side effects and complications can occur with implantation and management of these devices. In addition to routine complications that occur with any surgical procedure, the pumps, catheters, and drugs infused in the pumps all carry their own complications. The pain pump and catheter are implanted under the skin which is why surgical complications are a possibility. The side effects embrace infection, spinal fluid leak, and headache. You should avoid the implant procedure if you have an active infection at the time scheduled for implant.

Once the infusion system is implanted, device complications may occur, which may require surgery to resolve. Drug overdose or underdose can result because of these complications and have serious and even life-threatening adverse effects. Further potential complications include the catheter or pump moving within the body or wearing through the skin. The catheter could leak, tear, kink, or become disconnected.

However, there are a lot more advantages which is why hundreds of people opt for this method to reduce their pain. The following advantages may convince you to think about it;

  • It’s safe and effective when used as directed
  • Does not involve permanent changes to the spinal cord or nerves
  • Can be adjusted to dispense medication according to your activity level and pain patterns
  • Lets you try the therapy for a short period of time before committing to long-term therapy
  • Is reversible—the therapy can be turned off, or if desired, it can be surgically removed

Still feeling confused? Call us at 815-464-7212 and get Dr. Zaki’s expert opinion. Dr. Zaki Anwar, MD an Anesthesiologist and Interventional pain management professional offers its patients a range of exceptionally personalized treatments and services to help facilitate the patients in struggling with severe pain. Hurry up! Before it’s too late!

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2018-07-28

Compressed Spine?! There you go…

Kyphoplasty is useful for treating painful compression fractures in your spine. In a compression fracture, all or part of a spine bone collapses. This procedure is also known as balloon kyphoplasty. A compression fracture or a break in one of your vertebra can be very painful. It gets difficult to move and perform basic functions of life. That’s because a break can result in bone fragments rubbing against each other thus, causing pain.

Surgery can be helpful for treating such fractures. For example, kyphoplasty and vertebroplasty are minimally invasive procedures that are often performed together. Usually, they can be done without a hospital stay. Like vertebroplasty, kyphoplasty injects special cement into your vertebrae, but with the additional step of creating space for the treatment with a balloon-like device. Kyphoplasty can restore a damaged vertebra’s height and may also relieve pain.

As with vertebroplasty, the effectiveness of kyphoplasty is still under debate in the medical community and hence, you should discuss the risks and benefits with your doctor.

At Pain Management Institute, you can achieve expert consultancy for your elbow problems. Dr Zaki Anwar is very experienced in interventional treatments. He is a world renowned Pain Medicine Physician and has been practicing ways to cure pain leading to serious problems for the past several years and has achieved remarkable results. Get his expert opinion by just making a phone call at 815-464-7212.

Doctors might recommend kyphoplasty for cancer-damaged vertebrae or certain spinal fractures. In most cases, a weakening of the bones (osteoporosis) has caused the vertebrae to compress or collapse, causing pain or a hunched posture.

Kyphoplasty Potential Risks

The risks of kyphoplasty include:

  • Infection
  • Bleeding
  • Increased back pain
  • Tingling, numbness or weakness because of nerve damage
  • Allergic reactions to chemicals used with X-rays to help guide the doctor
  • Cement leaking out of position

You may face other risks, depending on your specific medical condition. Make sure to discuss any concerns with your doctor before you undergo the procedure.

Additional Details about the procedure

  1. Before the procedure:

Your doctor will examine you, possibly by taking blood for testing and using X-ray or magnetic resonance imaging (MRI) to locate the fractures.

  1. During the procedure:

Later, the anesthesia would be injected through an IV to either relax you and relieve your pain or put you to sleep. With the help of your X-ray, your doctor will intoduce a needle through your skin and back muscles into the bone, then inflate a balloon to help the vertebra regain its normal shape. He will inject the cement while checking X-rays to ensure it’s going into the right place. At the end, the doctor will remove the needle, with no stitches needed.

The entire procedure will probably take less than an hour, though it may last longer if more vertebrae are treated.

  • After the procedure:

You will spend time in a recovery room. You could go home the same day, but your doctor may want you to stay overnight if required. It’s likely that you can start walking in an hour after the procedure. You may feel some soreness where the needle entered your back, but this lasts no more than a few days. You may quickly notice that you have less pain than you did before the surgery.

Take a constant follow up from your doctor about whether you should avoid any activities after the procedure. He may suggest taking certain vitamins, minerals and medications to help strengthen your bones and prevent additional spinal fractures.

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PainManagement

Can do simple activities anymore?

Painful Shoulder

Whether or not we’re carrying the weight of the world on our shoulders, shoulder pain gets us down in several ways.  Primarily, pain is twinge and never fun.  It frustrates us and get in the way with everything we do. We use our arms for almost every activity and most movements, so if it happens to the arms, it happens to the shoulders, too!

Secondly, when shoulders are unsteady, fragile and painful, they draw our posture out of alignment and this creates a cascade of other effects, such as weakened abdominal muscles, unhappy back muscles and a literal pain in the neck. Severe shoulder arthritis and chronic shoulder pain can formulate the daily-life activities we perform such as, combing hair, reaching for a lamp or putting on clothes gets enormously difficult. If you can’t do the simple things you once did, you may be suffering from a shoulder condition.

Chronic shoulder pain is a common complaint in the pain medicine physician’s office,” says Dr. Zaki. Successful treatment relies upon an precise diagnosis of the more common etiologies: rotator cuff disorders, adhesive capsulitis, acromioclavicular osteoarthritis, glenohumeral osteoarthritis, and instability.

At Pain Management Institute, Dr Zaki Anwar is very experienced in interventional treatments. Dr. Zaki Anwar is a world renowned Pain Medicine Physician. He has been practicing ways to cure pain leading to serious problems for the past several years and has achieved remarkable results. Get his expert opinion by just making a phone call at 815-464-7212.

Shoulder conditions and treatments

  • Rotator Cuff Injury / Shoulder Tendonitis:

It gets better with reduced activity, especially overhead movements, posture adjustments, and changing movements to help the healing, as well as ice, heat and OTC anti-inflammatory drugs. Physical therapy is effective and so is massaging.

  • Shoulder joint instability:

Recovery involves strengthening rotator cuff muscles and scapular muscles to reduce dislocations. Taping is another treatment that is recommended.

  • Shoulder Dislocation:

Treatment is done using ice, rest and anti-inflammatory drugs.

  • Frozen Shoulder:

Treatment includes massage and myofascial release.  The tissue experiencing sticky inflammation needs to be gently coaxed apart. Particular exercises, such as shoulder rolls, scapula rolls and arm stretch are especially therapeutic for this condition.  Acupuncture and electrical micro-current stimulation are also helpful. And, once the shoulder has recovered, keep it warm, supple, strong and stretched with regular movement and exercise.

  • Shoulder Impingement:

Physical therapy is the greatest treatment for this condition, as strengthening the muscles and balancing all the muscles and tissues that affect the position of the shoulder effectively can relieve the impingement. Myofascial release and massage help relax the muscles involved so that they can loosen their grip on the bones and everything can relax back into place giving you quick shoulder pain relief. Exercise is helpful with this condition; pendulum, arm stretch.

  • Bursitis:

This condition gets better with reduced activity, RICE (rest, ice, compression, elevation), and massage and myofascial release of neighboring muscles. Gently, but rapidly vibrating the arm helps to bring relief, and massaging the arms.

  • Osteoarthritis:

Arthritis requires movement, but it must be measured and appropriate, so a physical therapist guides you about using the appropriate exercises that involves stretching, strengthening and supporting the joint. Treatment can also include heat and ice, anti-inflammatory medications and often steroid injections.

  • Thoracic Outlet Syndrome (TOS):

Physical therapy, myofascial release, acupuncture, exercise, and electrical simulation are helpful in relieving the variety of symptoms caused by TOS.

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2018-07-16 01

Wave off to your back pain and say ‘Hi’ to your pain-free life!

Microdiscectomy, also identified as microdecompression, is one of the commonly adapted minimally invasive spine surgery procedures. The major purpose of microdiscectomy is to seize pressure off your nerves to ease your back pain. Microdiscectomy issometimes referred as microdecompression or microdiskectomy. This surgical method is the best option for those who are experiencing herniated lumbar disc.

Conventionally, discectomies are carried out using an open technique. Your general practitioner makes a comparatively large incision, together with cutting some of your back muscles, so that he or she can take a look at your spine. Despite the fact that this technique is helpful, it can become a cause of major muscle damage and recovery from such damage is generally painful and slow. Microdiscectomies have a similar goal as open discectomies. It aims to get rid of the part of your intervertebral disc that’s putting pressure on your nerve and causing you pain.

However, as in other minimally invasive procedures, doctors make use of exceptional tool and visualization equipments that let them make very minute incisions to decrease injury to your back muscles. The results can be a quicker along with less painful recovery.

The achievement rate for microdiscectomy spine surgery is normally high and now you can get expert advice from Dr. Zaki Anwar by just making a phone call at 815-464-7212. He is a world renowned Pain Medicine Physician who has been practicing ways to cure pain leading to serious problems for the past several years and has achieved remarkable results. Dr. Zaki has his interest in discovering every possible treatment option before recommending surgery. “It takes a specialist familiar with treating nervous system conditions to determine which treatment approach is best for each individual patient”, adds Dr. Zaki.

Spinal surgery, in the past meant large incisions, long recovery periods, and painful rehab, but now, providentially, surgical advancements like the microdiscectomy procedure has enhanced the way of living.

A microdiscectomy is characteristically carried out for 2 reasons:

  1. A fragment of your intervertebral disc may have broken away from your disc, and it’s pressing on your spinal nerves or your spinal cord.
  2. Your disc may still be intact, but part of it may be bulging or protruding and pressing on your spinal nerves or your spinal cord.

In addition to the usual risks of surgery which includes infection and blood loss, there are other possible complications for microdiscectomy:

  • Your pain can come back.
  • Your disc can re-herniate.
  • Not all of your disc material may have been removed during your procedure.
  • Your spinal cord, nerves, and blood vessels can be injured.

The good news is that a lot of patients have noteworthy pain relief from a microdiscectomy procedure and they can speedily go back to their regular lives, usually in less than 2 weeks. However, your doctor will counsel you on how quickly you can return to exercise and your other daily activities and what precautions are to be kept in mind. If you are planning to undergo microdiscectomy procedure, I would like to wish you a successful output!

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2018-07-10

Solution for chronic back pain found!

Whether you have been percieving pain for two weeks or two decades,  Pain Management Institute will work with you and your insurance provider to deliver valuable treatment at the source of pain instead of highlighting the symptoms.

Below is an outline of an pioneering measure, how doees it work and the types of patients who may be candidates to make sure you understand the benefits and risks associated with the process of  Racz Epidural Neurolysis.

RACZ caudal neurolysis is an injection method which is frequently used to cure leg and back pain as a consequence of scar tissue as result of a prior surgery. This scar tissue can compress the spinal nerves and send burning pain all the way through the legs and causes unbearable pain in the lower back.

Pain Management Institute specializes in accurately diagnosing and treating the cause of painful conditions to stop them from coming back. It provides adapted treatments and integrative medicine to find the cause of your pain rather than just treating the pain symptoms.

Racz Epidural Neurolysis can evade the necessity for spinal surgery among the patients who are suffering chronic back pain and sciatic pain. This process invloves passing the Racz epidural catheter into the epidural space and injecting medicine directly at the place of nerve injury or adhesion to reduce the pain and break up adhesions generally in patients who have already had surgery.A catheter is positioned in the epidural space through which a solution of medication and local anesthetic can give profound analgesia. It is most favorable to place the epidural catheter close to the patient’s painful dermatome as possible.

The procedure is carried out with the patient lying face down with a cushion placed underneath the stomach. Back pain is intricate and has many causes. Experience of interventional pain therapy for chronic back pain has revealed that the pain is time and again due to a build up of scar tissue either from injury, disc herniation, or previous back surgery. This can be weakening, relentlessly limiting your aptitude to execute physical activity and trims down your aspiration to live your life to its fullest. The objective of the physicians and team at Pain Management Institute is to treat the source of your pain so that you can get back to living!

Prior to the procedure, your pain physician will evaluate your MRI in order to recognize which nerves are likely affected and are accountable for your pain. This injection process has the possiblity to provide instant and considerable long term liberation from chronic pain and discomfort in the lumbar spine. The process normally takes between 30 and 60 minutes. It can be done once, or in a series of up to three injections in a twelve-month period.

Taken as a whole, this method is safe. Nonetheless, with any procedure there are risks, side effects, and the possibility of complications. Luckily, the serious side effects and complications are rare. The immediate effect is generally from the local anesthetic that was injected. This effect will more often wear off in a few hours. The cortisone usually starts working in about 3 to 7 days and the effect can last for several days up to a few months.

 

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2018-07-0555

Is back pain bothering you?

Millions of adults in the United States experience a variety of different types of chronic pain conditions. The pain related to these conditions can be ruthless and can have a damaging impact to an individual’s personal and professional lives. Additionally, chronic pain has a significant impact on the U.S. economy, resulting in improved healthcare utilization, including rehabilitation and decreased worker efficiency.

Patients distressing along chronic pain are time and again treated with a combination of medication, physical therapy, as well as epidural steroid injections and other conservative treatment options. On the other hand, not all patients sense relief from pain through these treatment methods. Radiofrequency lesioning is a minimally invasive procedure that may be used to treat chronic pain that has been unresponsive to conservative measures.

Let’s know what Radiofrequency lesioning is.

Radiofrequency lesioning is a process in which special needles are used to generate lesions along chosen nerves. The needles heat the nerve to 80°C (about the temperature of hot, not boiling, water). When this heat is enforced upon the nerve for about 2-3 minutes, the nerve stops shipping pain signals to the brain. The body aims to re-grow nerves that are blocked in this conduct but that process can take up to a year or longer.

Before advising radiofrequency ablation, diagnostic local anesthetic nerve blocks need to be implemented to make sure that the patient is an ideal applicant. An analytical nerve block involves injecting a local anesthetic into the region of the nerve that is assumed to be causing the patient’s pain. The local anesthetic in effect for the time being numbs the area and should result in reduced pain symptoms. The efficiency of radiofrequency lesioning can be predicted from a patient’s response to the impermanent nerve block procedure.

Radiofrequency lesioning is accessible to patients with certain types of low back or neck pain (predominantly pain from the facet joints). You must have responded well to analytical local anesthetic blocks to be a candidate for Radiofrequency lesioning. The effectiveness of Radiofrequency lesioning will depend on how well you retort to the “temporary” or diagnostic block.

The course of action disrupts nerve conduction (such as conduction of pain signals), and it may in turn into lesser pain than before, and other related symptoms. An estimate of 70-80% patients will achieve a good block of the intended nerve. This should help relieve that part of the pain that the blocked nerve controls. Sometimes after a nerve is blocked, it becomes clear that there is pain from the other areas as well. Based upon the areas to be treated, the process can take from about 30 minutes to an hour.

In view of the fact that nerves cannot be seen on x-ray, the needles are situated using bony landmarks that designate where the nerves usually are. Fluoroscopy (x-ray) is used to identify those bony landmarks. After needle placement, very little voltages are applied to the needle to test for proper placement. After verification of the needle tip position, a small amount of local anesthetic is injected. After the nerve is adequately numbed, higher radiofrequency voltages are applied and the nerve heats to the desired temperature.

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2018-07-04

Are you searching for back pain reliever?

The spinal cord is the foremost collection of nerves carrying nerve impulses to and from the brain to the rest of the body. Rings of bone, called vertebrae, are located around the spinal cord. These bones make up the spinal column or back bones.

Spinal cord injury can be a result by direct trauma to the spinal cord or a consequence of compression, damage from inflammation, infections, bleeds or clots, neoplasms, or spinal arthritis.

Spinal cord damage results in a failure of function, such as mobility or sensation. In majority of the people who have sensitive, traumatic spinal cord injury, the spinal cord is not fully detached but is bruised or torn. Spinal cord injuries may be an outcome of falls, diseases like polio, motor vehicle accidents, sports injuries, industrial accidents, gunshots and physical assaults, among many other causes. If the spine is fragile because of another condition, such as arthritis, slight injuries can cause spinal cord trauma. A lot of pain is suffered by the body when issues related to spinal cord arise.

Spinal cord stimulation is a remedy that masks pain signals before they reach the brain. A small device, similar to a pacemaker, is fixed in the body to transport electrical pulses to the spinal cord. It aids patients towards better management of their chronic pain symptoms and decrease the use of opioid medications. It may be an option if you suffer chronic back, leg or arm pain and have not found relief with other therapies like surgeries. Spinal cord stimulation is recommended when other treatments have not been successful, when surgery is not likely to help, or when surgery has failed. However, the device is not for everyone; consult with your doctor to see if the procedure is right for you.

Spinal cord stimulation does not eradicate the source of pain, it merely interferes with the signal to the brain, and so the amount of pain relief varies for each person. Also, some patients find the tickly sensation obnoxious. For these comprehensions, trial stimulation is carried out before the device is permanently fixed. The objective for spinal cord stimulation is a 50-70% decrease in pain. Nevertheless, even a minute amount of pain diminution can be noteworthy if it helps you to execute your daily activities with less pain and reduces the amount of painkillers you take.

Spinal cord stimulation does not work for everyone. If unsuccessful, the implant can be removed and does not damage the spinal cord or nerves. Some patients may find the sensitivity unpleasant. In other cases it may not cover the entire pain area. With trial stimulation, the experts can sense whether or not, this method is working for the patient. If the procedure proves to be a failure, the trial wires can be detached, causing no damage to the spinal cord or nerves.

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2018-07-01 (1)

Are you going through severe back pain? Now NO more!

Resolving a single structure within the spine as the source of pain can prove to be a diagnostic challenge due to the complexity and complication of the structures involved in the spinal column. Additionally, discrete anatomical structures can clinically present with related symptom patterns and no physical examination finding can be specifically ascribed to any one structure. To further complicate this dilemma, multiple structural abnormalities noted on imaging studies are frequently found to be painless.

Selective nerve root blocks are based on the assumption that delivering a small amount of medication to a specific target can precisely point out  the source of pain and provide information that could affect or predict their surgical outcome.  At the Pain Management Institute,  we offer cervical nerve root blocks under fluoroscopy guidance. Dr. Zaki Anwar is very experienced in these procedures and has a very meticulous approach and safety record.

When a nerve root becomes condensed and swollen, it can cause back and/or leg pain. Occasionally, an imaging study (e.g. MRI) may not clearly illustrate which nerve is causing the pain, therefore selective nerve root block injection is performed to assist in separating the source of pain. Adding more to its diagnostic function, this type of injection for pain management can also be used as a treatment for a far lateral disc herniation (a disc that ruptures outside the spinal canal).

The rate of success differs depending on the primary diagnosis and whether or not the injections are being used primarily for diagnosis. Those who are facing the symptoms of  herniated disc, sciatica or swelling or irritation are the appropriate candidates for selective nerve root block. The following patients should not undergo this treatment:

  • If you have an allergy of any medication which is needed to be injected
  • If you use medication for blood thinning for instance (Coumadin injectable Heparin)
  • If you have an infection currently you are suffering from

During a Selective Nerve Root Block, your doctor will target exact condensed or irritated nerves in your neck, upper back, or lower back, injecting an anesthetic, anti-inflammatory corticosteroid or a mixture of these two medications into the space immediately surrounding the nerve or nerves.

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