Diagnosis & Treatment

We use a variety of diagnostic tests and methods to determine an appropriate treatment plan for each patient. Treatments available at The Pain Management Center at Montefiore Nyack Hospital include:

• Medial branch block. Medial branches are nerves that connect the spinal joints to the rest of the nervous system. The injection of a local anesthetic blocks those nerves and helps the doctor determine if the pain is originating from the joints and what further treatments may be required.
• Selective nerve block. Mostly used for disc herniation or “slipped discs,” this procedure includes the injection of a local anesthetic and therapeutic steroid to help the doctor determine the exact nerve that’s causing pain.
• Trigger point injections. This outpatient procedure is designed to reduce or relieve the pain of trigger points. These small, tender knots can form in muscles or in the fascia (the soft, stretchy connective tissue that surrounds muscles and organs). The trigger point injection procedure takes only a few minutes to complete.
• Joint injection—hip. This outpatient injection procedure relieves hip, leg or buttock pain caused by arthritis or other damage to the hip joint.
• Cervical facet radiofrequency neurotomy. This minimally invasive procedure, also called radiofrequency (or RF) rhizotomy, reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals. This procedure is performed with local anesthetic.
• Thoracic epidural steroid injection. This outpatient procedure is an injection performed to reduce inflammation and reduce pain in the upper back.
• Caudal steroid injection. This outpatient procedure is an injection of a steroid-anesthetic medication through an opening in the sacrum (a triangular bone at the base of the spine). The medication can reduce swelling and inflammation of irritated spinal nerves. The injection takes only a few minutes to complete
• Cervical epidural steroid injection. This injection relieves pain in the neck, shoulders and arms caused by a pinched nerve (or nerves) in the cervical spine. Conditions such as herniated discs and spinal stenosis can compress nerves, causing inflammation and pain. The medication injected helps decrease the swelling of nerves.
• Sacroiliac joint steroid injection. This procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce swelling and inflammation in the joint.
• Lumbar transforaminal epidural steroid injection. This outpatient procedure is an injection of a steroid-anesthetic medication. The medication can reduce swelling and inflammation of irritated spinal nerves. This procedure is performed to relieve pain in the lower back and pain that radiates from the back to the legs. The injection takes only a few minutes to complete.
• Lumbar sympathetic block. This procedure is performed to relieve leg pain caused by complex regional pain syndromes, which may develop after an injury to a joint or limb. Usually, a series of injections is needed to treat the problem.
• Celiac plexus block. This procedure is performed to diagnose and reduce abdominal pain caused by conditions such as cancer or pancreatitis. An injection is used to block the nerves serving the abdomen. An intravenous (IV) line may be used to administer medication to relax the patient.
• Stellate ganglion block. This injection can both diagnose and treat pain coming from the sympathetic nerves. It’s a common treatment for shingles and complex regional pain syndromes affecting the head, face, neck or arms. Usually, a series of these injections is needed to treat the problem.
• Intrathecal pump implant. An intrathecal pump relieves chronic pain. It uses small amounts of medicine applied directly to the intrathecal space (the area surrounding the spinal cord) to prevent pain signals from being perceived by the brain. Pump candidates include people for whom conservative treatments have failed and surgery is not likely to help.
• Kyphoplasty. This minimally invasive procedure treats spine fractures caused by osteoporosis. It’s designed to provide rapid back pain relief and help straighten the spine.
• Spinal cord stimulator implant. Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, arms and legs. It’s believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.