ELECTROMYOGRAM (EMG)

An electromyogram, or EMG, measures the electrical activity produced by muscles. This technique is used to assess the health of muscles and their motor neurons, which are the nerve cells that control them. An EMG is done using a medical instrument called an electromyography, which detects the electrical signals generated by muscles when they are stimulated. These signals are translated into graphs, sounds, or numerical values, which are interpreted by your doctor.

During an EMG, a needle electrode is put to a muscle and also attached to a recording machine. Once the electrodes are in place, the electrical activity in that muscle is recorded while the muscle is at rest. Your doctor will ask you to contract the muscle slowly, and that electrical activity is recorded as well. Throughout the test, the electrode may be moved a number of times to assess the activity in different parts of the muscle or in different muscles altogether.

EMGs are helpful in diagnosing a number of neurological disorders. Your doctor may order an EMG if you have signs or symptoms of a nerve or muscle disorder, which may include tingling, numbness, muscle weakness, muscle pain, or cramping.

EPIDURAL STEROID INJECTIONS

An epidural steroid injection is a non-surgical procedure that can help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves due to a spine condition like spinal stenosis or a herniated disc. During this procedure, a corticosteroid (anti-inflammatory medicine) is injected into the epidural space, which is the area between the bone and the protective sac of the spinal nerve. There are two methods your doctor may use to inject the medication: interlaminar, in which the doctor will inject the epidural space from behind, and transforaminal, when the injection goes in from the side.

Fluoroscopy is used to direct the needle into its proper position, which allows your doctor to watch the needle in real time on the x-ray monitor. A dye is injected first to ensure the needle is in the right place, and the medicine will follow. The injection works to relieve pain by reducing inflammation around the spinal nerves; while the treatment can provide pain relief, it will not make a herniated disc smaller or fix whatever spine condition is causing the pain.

Pain relief is usually felt two to three days after injection, but can take up to a week to take effect depending on the patient. The amount and duration of pain relief can also vary from weeks to years, and is dependent on many factors. It is important to discuss with your doctor your response to epidural steroid injections in order to plan future treatments.

PAIN MANAGEMENT SPECIALISTS

Pain management specialists are experts in evaluating, diagnosing, and treating different types of pain, whether that’s chronic pain, pain that stems from an injury, or a combination.

Many medical practices will automatically offer surgery to a patient in pain. At the Interventional Spine & Surgery Group, we understand that most patients can actually get better with conservative treatment, which is why this type of treatment is done first by the best pain management specialists and the best non-surgical techniques.

Our team of the best pain management specialists utilize a variety of non-surgical treatments, including:

Our practice philosophy is to get you better with the least amount of treatment necessary, which is why we start patients with consultations with the best pain management specialists. If conservative treatment doesn’t quite do the trick, our pain management specialist and the rest of our team of experts, including orthopedic and spine surgeons, neurologists, neurosurgeons, and physiatrists, work very closely, evaluating and treating patients at the same time, coordinating care and putting more than one expert mind to the best options for treatment.

Your best choice for treating pain is a practice like the Interventional Spine & Surgery Group, where six specialties within pain management exist under one roof. The patient benefits by being under the care of not just one doctor, but having access to an entire team of specialists with training, support, and experience, including neurosurgeons, neurologists, orthopedic surgeons, physiatrists, and the best pain management specialists. We treat patients across northern New Jersey, with locations in North Bergen, South Orange, Englewood, Clifton, Succasunna, and Totowa. Contact our office today to learn more about how the best pain management specialists at the Interventional Spine & Surgery Group can treat your pain without surgery.

MAJOR JOINT INJECTIONS

Major joint injections are done to relieve pain caused by an inflamed joint. Causes of joint pain can include arthritis, injury, or degeneration. The goal of this injection is two-fold:

To determine which joint is causing pain
To treat the affected joint, relieving inflammation and pain

During this procedure, your doctor will inject a local anesthetic into the affected joint under fluoroscopic guidance. If that injection relieves the pain, the diagnosis is confirmed, and a corticosteroid injection will follow, which is a more robust and long-acting medication that reduces inflammation and provides pain relief over an extended period of time.

The Interventional Spine and Surgery Group offers injections for all major joint pain, including the shoulder, elbow, wrist, hip, knee, ankle, hand, and foot. Pain relief from injections can last days to years and is often paired with other conservative treatments like physical therapy or an exercise program to allow your condition to improve subsequently.

RHIZOTOMY

A rhizotomy is a procedure that essentially “turns off” the pain signals from inflamed facet joints to the brain. This rhizotomy procedure is an option when there are facet joint issues in the spine. Each facet joint, which is located at each intervertebral segment of the spine, contains a medial nerve, which is the source of sensation in the joint, including pain. When the medial nerve is impacted, pain can develop.

This is why rhizotomy procedures and rhizotomy surgery are performed: to decrease lumbar and back pain, which can be debilitating. A rhizotomy procedure for back pain is a safe and effective method of dealing with the suffering, lack of movement, impaired activity and lower standard of life that comes from the very real effects of impact nerves.

Your rhizotomy surgeon will begin the procedure by guiding the placement of an electrode using fluoroscopy. Once that needle is in place, a mild electrical current stimulates the nerve to confirm its exact location. Then, the electrode is heated to deaden the sensory nerves, which is what stops the pain signals from traveling to the brain.

A rhizotomy is one of the least invasive procedures offered at the Interventional Spine & Surgery Group to relieve back pain but is still an option only after conservative treatments have failed to bring relief to patients suffering from facet joint issues, like facet syndrome. Patients often benefit from a rhizotomy procedure when their pain is limited to one spot or region in the spine, and aren’t experiencing additional symptoms.

WHAT CONDITIONS CAN BE TREATED WITH RHIZOTOMY?

Rhizotomy has a number of uses, and is a common medical procedure due to the fact that it is minimally invasive and an easier surgery than most back surgeries. It is also effective at treating the following conditions:

Back and neck pain that is associated with arthritis, herniated discs, and degenerative spine conditions. In these rhizotomy procedures, called fact rhizotomy, the surgery works on the nerves that travel through the joints of the spine.
Trigeminal neuralgia, facial pain caused by irritation of the trigeminal nerve, can be treated through a rhizotomy procedure and can relieve debilitating pain.
Pain in joints, including the knees and the hips, which are caused by arthritis are also prime candidates for rhizotomy.
There are several more, rarer conditions that can be treated through rhizotomy surgery, including pain affecting the peripheral nerves and spasticity caused by cerebral palsy. These procedures are much less common, though positive results have been seen.

WHAT IS RECOVERY LIKE AFTER A RHIZOTOMY?

The rhizotomy procedure is very quick, often lasting only a few minutes. Because of the anesthesia involved you will spend several hours in the surgical center’s recovery room. But you should be up on your feet in a very short period of time; depending on how you react to the anesthesia, you could be back to full activity, including driving and going to work, in as little as one to two days.
However, it’s not uncommon to have pain and swelling, or bruising, at the surgical site.

WHAT IS THE SUCCESS RATE FOR RHIZOTOMY?

Like most procedures, rhizotomy can’t guarantee a 100% effectiveness rate. A portion of patients who undergo the surgery will receive little-to-no pain relief. And in others who are relieved of their pain, the pain may return in coming years as the nerve regrows. However, these are a small percentage of the cases. When you consult with a rhizotomy surgeon, they can give you all of the information you need to know to make an educated choice about your surgery. The vast majority of patients who undergo the rhizotomy procedure experience pain relief that lasts.