Injections of medications to decrease pain and inflammation have long been used in pain medicine as additional, adjunctive treatment to medications. Traditionally, it has always been a combination of a steroid and a local anesthetic agent. The steroid acts to interrupt the inflammatory cascade that leads to pain and swelling. The local anesthetic provides immediate pain relief to provide diagnostic confirmation of the pain generator as well as to break the pain cycle in certain chronic pain syndromes like Complex Regional Pain Syndrome (CRPS) and trigger points.
Botulinum toxin injections have been shown to be safe and well tolerated in many clinical settings. In a pain management setting, these injections are usually considered after more traditional measures have failed. The exception to this is in the treatment of cervical dystonia, in which botulinum toxin injections are considered a first line treatment.LEARN MORE
Diagnostic injections are injections designed to better understand your pain generator. This typically is an anesthetic agent like lidocaine injected to block pain-sensing nerves in a specific structure guided by imaging (x-ray and/or ultrasound). Other diagnostic injections use contrast, a special dye, used to assess the integrity of different structures and if they are pain generators.LEARN MORE
The purpose of all epidural injections is to place a mixture of steroid and local anesthetic at the source of the problem to decrease inflammation causing pain, and to promote healing and clinical improvement. This treatment option has the potential to completely resolve pain and ultimately may prevent operative treatment.
Spinal injections are commonly used to localize and treat painful tissues in the cervical, thoracic and lumbosacral spine. Treatment with spinal injections and the type of injections differ among individual patients. The spinal specialists at Virginia Spine Institute rely on a thorough patient history combined with a physical exam and appropriate imaging studies and diagnostic tests in order to determine if an injection is warranted.LEARN MORE
Dr. Thomas Schuler
Founder of Virginia Spine Institute
Chief Executive Officer