Treatments

The steroid injections and radiofrequency denervation treatments that I carry out and that are inherently safe. In almost all cases without exception with the indications outweigh the risks, especially if the precise cause of pain has been diagnosed with examination and SPECT CT and MRI.

It must be pointed out however that there always contra-indications and risks involved in these treatments.

Contra-indications

  • Lack of patient consent – if an individual does not want a treatment or is unsure about it despite detailed explanation then it should not be performed
  • Risk of bleeding – injections should not be performed if there is an increased risk of bleeding e.g. with warfarin therapy
  • Infection in the proposed injection area – skin abscesses or pustules for example are in the needle pathway
  • Co-existant neurological diseases e.g. Multiple Sclerosis – this may be exacerbated by the treatment with a relapse being possible
  • Fixed cardiac output e.g. aortic stenosis – only a risk if a spinal block is going to be performed.

Risks

  • Some injections may simply fail to help an individual and then alternative pain relieving procedures or medication will need to be looked at.
  • Occasionally some patients may feel worst for a short while after an injection before there is an improvement or return to the pre-injection level of pain.
  • Injecting into joints can cause infection and the quoted risk is 1:17,000
  • If a spinal tap occurs during an epidural or transforaminal block then a headache can occur and require treatment. This is very rare.

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Nerve Pain

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Treatments

pain treatment