Botox is used medically to treat certain muscular conditions, and manage pain, however, it is most commonly known for its cosmetic application in temporarily paralyzing muscles to remove wrinkles. It is made from a neurotoxin called botulinum toxin that is produced by the bacterium Clostridium botulinum. It acts as a temporary paralytic and can be effective in the treatment of migraines, muscular disorders, and some bladder and bowel disorders. Botox is administered by diluting the powder in saline and injecting it directly into neuromuscular tissue.

Neurogenx Treatment is a highly advanced treatment for neuropathy. This treatment safely uses cutting-edge, patented, high-frequency electronic waves to gently reach deep down through muscle and tissue to relieve neuropathy symptoms and severe neuromuscular pain. The treatment creates changes at the body’s cellular level that reduce swelling, remove excess fluids and waste products, alter Ph levels and increase cellular metabolism. These changes relieve pain and help healing begin. 

A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure.

If the patient experiences marked pain relief immediately after the injection, then the facet joint is determined to be the source of the patient’s pain.

The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure – called a medial branch radiofrequency neurotomy (or ablation) – for long term pain relief.

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back. Both facet joint injections and medial branch blocks are used to diagnose and treat pain stemming from facet joints. While treating pain, typically steroids or steroids mixed with anesthetics are used.

The mechanism of pain control is different for facet joint injections and medial branch blocks.

A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anesthetic (numbing agent) and/or steroid medication, which can anesthetize the facet joints and block the pain. The pain relief from a facet joint injection is intended to help a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition.

Facet joint injections usually have two goals: to help diagnose the cause and location of pain and also to provide pain relief:

• Diagnostic goals: By placing numbing medicine into the facet joint, the amount of immediate pain relief experienced by the patient will help determine if the facet joint is a source of pain. If complete pain relief is achieved while the facet joint is numb, it means that joint is likely a source of pain.
• Pain relief goals: Along with the numbing medication, a facet joint injection also includes injecting time-release steroid (cortisone) into the facet joint to reduce inflammation, which can sometimes provide longer-term pain relief.

The injection procedure may also be called a facet block, as its purpose is to block the pain.

Dysfunction in the sacroiliac joint, also called the SI joint, can sometimes cause lower back and/or leg pain. Leg pain from sacroiliac joint dysfunction can be particularly difficult to differentiate from radiating leg pain caused by a lumbar disc herniation (sciatica) as they can feel quite similar. For decades, the sacroiliac joint was suspected as a common cause of low back and/or leg pain, although difficulty in accurate diagnostic testing left many in the medical profession skeptical. Today it is estimated that the sacroiliac joint is responsible for 15% to 30% of lower back pain cases. The sacroiliac joint connects the hip bones (iliac crests) to the sacrum, the triangular bone between the lumbar spine, and the tailbone (coccyx). The primary function of the sacroiliac joints is to absorb shock between the upper body and the pelvis and legs.

The sacroiliac joint typically has little motion. Small movements at the joint help with shock absorption and forward/backward bending. The joint is reinforced by strong ligaments surrounding it, some of which extend across the joint in the back of the pelvis. This network of soft tissues provides support, limits movement at the joint, and assists with absorbing pressure.

Other muscles that support sacroiliac joint function include the gluteus maximus and the piriformis muscle.

Joint injections are used to deliver steroids directly into a joint, such as a knee, ankle, hip or wrist. Sometimes fluid is removed from the joint before the steroid is injected.

Steroid joint injections can help with pain and swelling by treating the underlying joint inflammation – improvement is often with a several days.

Joint injections are performed in an office or hospital setting, often with a cold spray or other local anesthesia. After the skin surface is thoroughly cleaned, a needle in injected directly into a joint. At this point steroids can be injected into the joint. The steroid treats the inflammation inside the joint, leading to decreased swelling and pain.

Commonly injected joints include the knee, shoulder, ankle, elbow, wrist, base of the thumb, and small joints of the hands and feet. Hip joint injection may require the aid of an ultrasound or X-ray called fluoroscopy for guidance. Some small joints may also be more easily aspirated or injected with aid of ultrasound.

Osteoarthritis of the knee is one of the leading causes of disability in the United States. It develops slowly and the pain it causes worsens over time. Although there is no cure for osteoarthritis, there are many treatment options available to help people manage pain and stay active.

A treatment option is a procedure called viscosupplementation. If you have tried all other nonsurgical treatment methods and your pain continues to limit your activities, viscosupplementation may be an option.

In this procedure, a gel-like fluid called hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. People with osteoarthritis have a lower-than-normal concentration of hyaluronic acid in their joints. The theory is that adding hyaluronic acid to the arthritic joint will facilitate movement and reduce pain.