Spinal Diagnosis – Understanding the Source of the Pain
At Montvale Health Associates, our New Jersey spine specialists utilize a variety of spinal diagnostic tools. Our goal is to treat to source of the pain and not the symptoms which is why a complete diagnosis is so important.
Cervical Medial Branch Block
Cervical medial branch nerves are located in your neck. Cervical medial branch block, a diagnostic injection, is used to diagnose cervical or neck pain. This procedure, performed in our outpatient Surgical Center, is administered either with local anesthesia or conscious sedation. The purpose of this injection is to see how the nerves respond to local anesthetic – whether the pain lessens or completely goes away. The effects can be immediate but may take up to a week before relief is noted.
Some patients will have transient soreness in the injection site and have an increase in pain for a few days. Side effects are very rare but include skin infection and bruising.
Conditions diagnosed with a cervical medial branch block include, but are not limited to:
- Cervical spondylosis
- Cervical facet arthopathy
- Cervical degenerative disc disease
- Cause of headache
- Cause of neck pain
- Cause of shoulder pain
- Cause of facial pain
Lumbar Medial Branch Block
The lumbar nerves are divided into two divisions: posterior and anterior. The medial lumbar nerves are five spinal nerves located in the lumbar vertebrae, in the lower back. A lumbar medial branch block, a diagnostic injection, is used to determine whether injecting a local anesthesia lessens or completely eliminates nerve-related lower back pain.
This procedure, performed in our outpatient Surgical Center, is administered either with local anesthesia or conscious sedation. The effects can be immediate but may take up to a week before relief is noted.
Common conditions diagnosed with a lumbar medial branch block include:
- Lumbar spondylosis
- Lumbar facet arthopathy
- Lumbar spinal stenosis
- Post laminectomy syndrome
- Lumbar degenerative disc disease
- Lumbar discogenic pain
Lumbar Sympathetic Ganglion Block
Our experts at Montvale Health Associates use a lumbar sympathetic ganglion block in evaluating and managing pain in the lower extremities. This procedure may be completed singularly or in a series. During the procedure, we inject a local anesthetic into the sympathetic nerves to determine their response. This will block the nerves that are acting via the sympathetic system, and often pain relief is noted immediately.
In most cases, sedation will be given through your IV once monitoring equipment is in place. Monitoring includes blood pressure, heart rate, oxygen saturation, and ECG tracing (Electrocardiography).
The area will be located using fluoroscopy.
Conditions commonly diagnosed with lumbar sympathetic ganglion block:
- Reflex sympathetic dystrophy
- Peripheral neuropathy
Facet Joint Blocks
Facet joints are located on both sides of each vertebra providing our spine with flexibility and allowing us to bed. Facet joint blocks are used to potentially diagnose arthritis or traumatic injury by injecting an anesthetic. Whether the pain is numbed by the injection and for how long will determine the cause of the pain and the proper procedures to alleviate pain.
Conditions commonly diagnosed with facet joint blocks:
- Traumatic injury
Nerve Root Blocks
A nerve root block is used to determine whether the nerve root is the cause of a patient’s pain. An X-ray guided injection with a local anesthetic is inserted into the targeted area. Whether the anesthetic causes numbness will allow the doctor to know if this is the cause of pain and how to move forward with treatment.
Conditions commonly diagnosed with nerve root blocks:
- Cervical radiculopathy (pinched nerve)
- Lumbar radiculopathy (sciatica)
Soft, jelly-like discs between each vertebrae serve as cushions to prevent the vertebrae from rubbing against each other. A damaged disc can cause inflammation and pressure on nerves. A spinal discography can determine which disc is causing the pain and to which condition the pain is due.
Conditions commonly diagnosed with spinal discography:
- Herniated disc
- Bulging disc
- Torn disc
- Degenerative disc disease