Injections performed in combination by Dr. Dirkx and Dr. Jacques

Dr. Dirkx

Dr. Jacques

  • Cervical interlaminar epidural steroid injections
    A cervical epidural steroid injection is a procedure that involves placing a small amount of strong anti-inflammatory medicine into a fluid space surrounding the spinal nerves to help reduce pain in the neck and arms often caused by a “pinching” or irritation of these nerves.
    Video Link: http://www.spine-health.com/video/cervical-epidural-steroid-injection-video
  • Cervical transforaminal epidural steroid injections
    Cervical transforaminal epidural steroid injections are often for the same reasons as above, except the injections a specially targeted toward a specific pinched nerve or nerves.
  • Lumbar epidural steroid injections
    Similar to the cervical epidural injections described above, a lumbar epidural steroid injection places a steroid medicine around the spinal nerves of the low back. These nerves can often get “pinched” by a bulging disc or other spine problems, and may cause lower back pain and/or leg pain (sciatica).
    Video Link: http://www.spine-health.com/video/epidural-steroid-injections-back-pain-and-leg-pain-video
  • Facet Joint Injections
    Facet joints
    are small joints at the back of the spine that can often become painful due to injury, inflammation, or strain. A facet joint injection places a strong anti-inflammatory medication into the joint itself, which can numb the joints and help reduce the pain. These can be performed in the cervical, thoracic, or lumbar spine.
    Video Link: http://www.spine-health.com/video/facet-joint-injections-back-pain-relief-video
  • Medial Branch Blocks
    Medial branch nerves are tiny nerves that send nerve signals to and from the facet joints in the spine. When the joints are damaged (for example form injury, inflammation, or strain), these nerve signals are often painful. A medial branch nerve block temporarily blocks that pain signal and thus can serve as a useful procedure to help with diagnosis and treatment of the facet pain. These injections can be performed in the cervical, thoracic, or lumbar spine.
    Video Link: http://www.spine-health.com/video/medial-branch-block-video
  • Sacroiliac joint injection
    The sacroiliac joint may be thought of as a very large facet joint. It is the place where the low back meets the “hip bone.” An injection of a strong anti-inflammatory medicine into this joint can help reduce pain caused by inflammation or injury.
  • Myelography
    Myelography (Myelogram) is a diagnostic test of the spine and its nerves. A special x-ray-sensitive dye or “tint” material is injected into the fluid space surrounding the spine and nerves. X-rays and CT scans (“CAT-scans”) following this procedure can help allow your doctor to identify problems within the spine, spinal cord, and spinal nerves.
  • Discography
    Discography
    (also called a discogram) is a diagnostic test used to help your doctor determine if one or more discs are the cause of your back pain. The procedure involves injecting a special x-ray-sensitive dye or “tinted” liquid into the discs to determine which specific disc or discs may be causing your pain. CT scans (“CAT-scans”) following this procedure can further help allow your doctor to identify specific problems within the spine and spinal nerves.
  • Lumbar Sympathetic Block
    A lumbar sympathetic block typically involves either one or a series of injections of anesthetic agent to a group of nerves known as the lumbar sympathetic chain. These injections may help relieve leg pain (sciatica) caused by certain pain conditions, including complex regional pain syndrome, which can occur after an injury to a joint or limb.
  • Trigger Point Injection
    A trigger point injection is an office-based procedure aimed at reducing the back, neck, and shoulder-blade pain caused by “trigger points.” These small knots can form in the muscles or in the surrounding tissue leading to something called myofascial pain syndrome. Some common areas injected can include the muscles in the back of the head and neck, scapular region, low back, and piriformis muscles.

Dr. Pifer

-Steroid Injections-

Steriod injection are used to reduce inflammation in the area of the injections. They are used in two ways. First, they can be performed to diagnose the source pain (diagnostic) and see how the pain responds to treatment. Second,the injections are used as a treatment to relieve pain (therapeutic) in many conditions that pain can be caused by inflammation (tendonitis, bursitis, osteoarthritis, etc).

Dr. Pifer administers steroid injection into the following areas:

  • Shoulder Subacromial Space
  • Shoulder Joint
  • Shoulder AC Joint
  • Tennis Elbow
  • Elbow Bursitis
  • Elbow Joint
  • Tendon conditions around the wrist.
  • Wrist Joint
  • Hip for Bursitis
  • Knee Joint
  • Knee Bursitis
  • Ankle Joint

-Viscosupplementation Injections-

In this procedure, a gel-like fluid called hyaluronic acid is injected into the knee joint. 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. http://orthoinfo.aaos.org/topic.cfm?topic=A00217

-Platelet-rich plasma (PRP) Injections-

PRP is plasma with a higher concentration than what is typically found in blood. For PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood. Laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process. According to the research studies currently reported, PRP is most effective in the treatment of chronic tendon injuries. http://orthoinfo.aaos.org/topic.cfm?topic=A00648

Dr. Pifer administers PRP for chronic tendon injuries for the following areas:

  • Tennis elbow, of the tendons on the outside of the elbow.
  • Chronic Achilles tendonitis
  • Chronic Patellar tendonitis at the knee (jumper's knee)