Epidural Injections are first line treatment for back pain that radiates into the arms or legs. Upon initial examination, our providers will assess you for back pain and analyze imaging such as X-Rays or MRIs to decide if an epidural is indicated for you. Typically, these injections treat back pain that starts in the spine but can radiate through the extremities. Radiation can include anything from pain, numbness, weakness, or tingling. The anti-inflammatory steroid works to calm down inflammation within the spine that can be irritating to the nerve roots. These can be done in a series of 3 separate injections, but you will be evaluated after each injection for progress and assessed if repeating is beneficial. This can provide relief from the inflammatory component of back pain. These injections pose little risk, but as with any procedure there is slight risk of infection. Patients can usually see pain relief and results within 1-2 weeks of the injection. Patients gain better range of motion, less symptoms into the extremities, ability to perform more activities, and overall pain reduction.

For this procedure you have to option to do this with anesthesia or without. For anesthesia procedures, you will be referred to a surgical center where Dr. Barkow performs injections. You would be put under twilight sedation for the procedure and he will inject steroid into the epidural space. If you choose to do this without anesthesia, you will come to a surgical suite outfitted with fluoroscopic (X-ray) guidance. You are able to drive yourself to and from this procedure as you will not have anesthesia. Dr. Barkow will first injection local anesthetic to numb the location of the injection and then, as he talks you through the procedure, he will inject steroid into the epidural space.

Facet Injections are steroid injections used to treat back pain and pain in the joints of the spine. Patients with facet pain usually have pain localized to the neck or low back that does not radiate. Facets are the paired joints within the spine, one pair at each vertebral level. Just as other joints in the body, these can develop arthritis over time and cause pain. Patients can experience pain with sitting, bending, twisting, standing, or walking. As our patient, you will be assessed for facet pain through a history, examination, and XRay/MRI. If the pain is coming from the facets of the spine, steroid injections can help calm down the inflammation in the affected facets. Patients can usually experience relief 1-2 weeks after the procedure.

For this procedure you have to option to do this with anesthesia or without. For anesthesia procedures, you will be referred to a surgical center where Dr. Barkow performs injections. You would be put under twilight sedation for the procedure and he will inject steroid into the affected facet joints. If you choose to do this without anesthesia, you will come to a surgical suite outfitted with fluoroscopic (X-ray) guidance. You are able to drive yourself to and from this procedure as you will not have anesthesia. Dr. Barkow will first inject local anesthetic to numb the location of the injection and then, as he talks you through the procedure, he will inject steroid into the facet joints.

Hyaluronic Acid Knee Joint Injections (Synvisc, Orthovisc, Hyalgan):

If you are experiencing arthritic knee pain, there is a special injection to alleviate this pain. Patients with arthritis in the knee describe aching pain, difficulty moving the knee, cracking, popping, and difficulty walking or climbing stairs. Upon our assessment we will gather a history of the pain, do a physical exam, and review X-Rays or MRIs. If arthritis is present, we can recommend Hyaluronic Acid injections into the knee. This solution is naturally present in the human body, specifically in the bone and cartilage structures. Our joints, particularly the knees, are surrounded by a membrane called the synovial membrane that provides a capsule around the two connecting bones. The fluid inside this membrane is viscous and thick and provides the elastic shock absorbing properties of the joint. In arthritis, this membrane can erode and cause more irritation to the joint and provide less padding. The Hyaluronic Acid solution can replace this void and provide lubrication and support for the joint.

These injections are FDA approved for osteoarthritis of the knee and done in a series of 3 injections- 1 week apart. The injections will be done in our office with the use of ultrasound guidance and local anesthetic. There are very minimal risks associated with the procedure and the injections can provide more support for the knee and decrease pain from arthritis.