These are a sample of some of the Interventional Medical Procedures administered at Berkower Pain & Spine Rehabilitation.

Trigger points are focal areas of muscular ischemia, spasm, and inflammation that occur commonly in patients with fibromyalgia. Trigger points break up abnormal muscle fibers.

Greater Occipital Nerve Block: given to patients that have headaches from occipital neuralgia.

Lateral Femoral Cutaneous Nerve Block (Meralgia Paresthetica): This injection helps reduce lateral thigh pain from the lateral femoral cutaneous nerve.

Interlaminar Epidural Steroid Injections: This is commonly used to treat disc herniations and spinal stenosis. When the spine is injured, diseased or degenerated, mechanical and chemical changes can cause inflammation and swelling of the nerve. The injection of a numbing medication (local anesthetic) or saline combined with a steroid in the epidural space can be used to reduce the inflammation and pain. (See Figure 1.)

Transforaminal Epidural Steroid Injections: Steroids and numbing medication given around specific nerve roots to calm irritation and inflammation in the leg or arm. Also commonly used in patients with disc herniations or spinal stenosis. (See Figure 2.)

Sacro-Iliac Joint Injection: Calms pain in the mid-buttocks region. (See Figure 3.)

Facet Injections: Multiple injections of steroids and numbing medication placed in small facet joints of the spine. (See Figure 4.)

Facet Medial Branch Block: Performed with numbing medication on the nerve giving sensation to facet joints. This is not a treatment, but a diagnostic procedure. If these injections result in some pain relief, the indication is that the patient may get 6-12 months of relief by receiving a facet rhizotomy.

Facet Rhizotomy: Procedure that gives the patient 6-12 months of relief from back pain by placing a small wire on the nerve giving sensation to the facet joint.

Lumbar Sympathetic Block: Applied to the lower back to treat CRPS (Complex Regional Pain Syndrome), formerly known as causalgia in the lower legs.

Ganglion of Impar Block: Useful in treatment of sympathetically mediated pain of the perineum, rectum and genitalia.

Caudal Epidurals: Steroid injections in the lowest part of the spinal canal; indicated for leg pain, especially after spinal surgery. (See Figure 5.)

Piriformis Injection: An intramuscular injection of either steroids or Botox® to treat buttocks pain and sciatic nerve impingement. (See Figure 6.)

Subacromial Bursa Injection: This injection is used for conservative treatment for rotator cuff syndrome. It involves injection of a steroid into an inflamed bursa (fluid-filled sac). (See Figure 7.)

Biceps Tendon Injection: This steroid injection is given around the biceps tendon to treat tendonitis.

Glenohumeral Joint Injections: A steroid injection given into the shoulder joint for arthritis. Acromial-clavicular (AC) joint injections: A steroid injection given into the smaller shoulder joint.

Sterno-clavicular (SC) Joint Injections: Steroid injections into the smallest joint where the collar bone meets the sternum (breast bone).

Intercoastal Nerve Block: Helps reduce rib cage and chest wall pain.

Medial and Lateral Epicondyle Injections: Used to calm “golfer’s elbow” and “tennis elbow.”

Carpal Tunnel Injections: Given around the median nerve in the wrist when it is compressed and causing hand, wrist pain and numbness. (See Figure 8.)

Hand and Wrist Joint Injections: Used to decrease inflammation associated with various forms of arthritis.

De Quarivan’s Injections: Applied around the thumb to calm inflammation. (See Figure 9.)

Trigger Finger Injections: Given to calm pain and locking of irritated finger flexor tendons.

Greater Trochanter Injections: Administered into the bursa (fluid sac) overlying the hip. (See Figure 10.)

Intra-Articular Hip Injections: Injections into the hip joint, used for arthritis and, occasionally, labral tears and even avascular necrosis (dead hip bone) to delay the need for hip joint replacement. (See Figure 10.)

Ischial Tuberosity Bursa Injections: Placed in the fluid-filled sac in the buttocks to help resolve localized pain. (See Figure 10.)

Intra-Articular Knee Injections: Used to treat knee arthritis, patella femoral syndrome and meniscus tear (to help decrease pain and help delay surgery until it is absolutely needed. (See Figure 11.)

Pes Anserine Injections: Used to decrease inflammation of the pes bursa, which causes some forms of medial knee pain. (See Figure 11.)

Plantar Fasciitis Injections: Applied to the bottom of the foot to relieve the pain of plantar fasciitis.