Injections of steroids or nerve blocks can be an effective form of pain management. The injections are typically administered by a healthcare professional. Injections can be made directly into the body part or area suffering pain including the spine, other joints of the body, and muscles. Common injections include:
Facet joint injections involve either a anesthetic or steroid and are administered for either diagnostic or therapeutic purposes. Facet joints are the small joints of the spine which provide stability and guide motion. Arthritis, injury, or mechanical stress can cause inflammation and pain. The injection will be administered in a hospital or doctor’s office with x-ray guidance. The patient will wear a gown and lie face down on a treatment table. A local anesthetic will be applied to the area to be injected and the patient may opt for a mild sedative. The needle will be guided into the medial branch nerve and the anesthetic and anti-inflammatory solution will be injected. The procedure takes between 15 and 30 minutes. Following the injection, the patient will rest in a recovery area for approximately a half hour. There may be some lingering effects from the sedation, so the patient should take care for at least 24 hours following the treatment and have someone drive him or her home.
An epidural steroid injection is typically used to provide anesthesia during surgery, analgesia following surgery, or for diagnosis and treatment of inflammation in the epidural space. This is the area around the outer covering of the spinal cord, extending from the skull to the tailbone. It contains the fat, blood vessels and nerves that pass through the spinal cord. As with the facet joint injections, the patient will wear a gown and the injection will be made directly into the patient’s spine, after a local anesthetic and sedative have been applied.
Botox® injections have been FDA approved to help prevent and relieve chronic migraines. Botox® works by blocking chemical changes on nerve endings. The injections are made into the muscles of the forehead, the side and back of the head, and the neck and shoulders to create a partial and temporary denervation of the muscle. This means that the muscles will be too weak to contract and create the tension associated with headaches and migraines.
Botox® treatment is FDA approved to be administered for migraines at 12 week intervals over a 15-month period to manage chronic migraine pain. Chronic migraine pain is classified as 15 or more headaches each month, lasting for four hours or more. The injections are given in a specific order, in specific locations on the face and head. The treatment should dull the pain over time. Patients should commit to a series of treatments for best chances of success. Clinical trials have shown Botox® treatments to prevent up to nine potential headache days in a month.
Dr. Badday may suggest that any patients suffering from migraines should keep a journal of their symptoms and pain. This log should include information on food and drink, the time of the menstrual cycle for women, and other details about the day when the migraine strikes. When you meet with the doctor regarding your headaches, take the journal with you as it may reveal triggers which can then be avoided. You will need to tell your doctor all medications you take regularly, including vitamins and supplements, medications, or combinations of the two, these can trigger migraines and headaches. Dr. Badday may suggest stress reduction techniques as migraines can be stress related as well. There are a variety of common triggers for migraines including:
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