Interventional Pain Management

Interlaminar epidural steroid injections are a common, long-term treatment for herniated discs, spinal stenosis and irritated nerves. The injections contain cortisone/steroid, a powerful anti-inflammatory medication, and effectively reduce pain, inflammation and numbness with the results lasting weeks to months.

During the procedure, your Long Island pain management specialist, Dr. Choi, uses fluoroscopic guidance (real-time x-ray imaging) to inject the steroid into the area between the bone and spinal canal, whis is called the epidural space. The injection causes minimal discomfort because the needle is inserted into the back side of the spine away from the spinal nerve roots.

Transforaminal epidural steroid injections are used to target spinal nerves more directly. The injection has therapeutic benefits, such as reducing the swelling of irritated spinal nerves and alleviating pain, inflammation, numbness and tingling. It’s also diagnostic and helps determine the cause of your back pain.

Using fluoroscopic guidance, Dr. Choi injects steroids directly into the opening of the spine where the nerve root is located, called the foramen. As the medication takes effect, swelling and inflammation of the spinal nerve roots decrease.

Your sacroiliac joints, sometimes referred to as SI joints, are located on both the right and left side of your lower back and buttocks and connect your pelvis to your sacrum. Dysfunction in the joints can lead to lower back and/or leg pain.

Sacroiliac joint injections are used as a diagnostic test to confirm the source of your pain, while also temporarily reducing inflammation and discomfort. Dr. Choi uses fluoroscopic guidance to inject a local anesthetic into the area.

If your pain and inflammation decreases after the injection, Dr. Choi is able to confirm that your sacroiliac joint is causing your discomfort and other symptoms. He can then help you decide on further treatment to treat the issue.

The facet joints connect the bones of the spine. Since they’re innervated with many spinal nerves, they’re susceptible to pain, which often presents as back pain and/or sciatica.

Dr. Choi can use facet joint injections, which are chemical sensory nerve blocks, as a diagnostic test and a way to reduce pain from irritated or inflamed joints. If you respond to the injections, Dr. Choi can confirm that your facet joints are the source of your pain and then create a personalized, long-term treatment plan.

The medial branch nerves carry pain messages from the facet joints to the brain. If you experienced good but only temporary relief from facet joint injections, a medial branch block may be the next step. The diagnostic tests confirms whether the facet joints are the cause of your symptoms. The results help us create a treatment plan.

During the procedure, your Long Island pain management specialist, Dr. Choi, uses fluoroscopic guidance to inject the area with a local anesthetic. This temporarily blocks the nerves from carrying pain signals to the brain. If it’s effective and you experience pain relief, you could be a candidate for a radiofrequency neurotomy, which is a long-term solution.

Radiofrequency neurotomy is a therapeutic treatment that provides long-term relief from pain that originates in the facet joints. If a medial branch block is effective for you, you’ll be a candidate for this procedure.

During a radiofrequency neurotomy, Dr. Choi ablates, or deadens, the nerves that supply the facet joint. This blocks pain signals from being sent to the brain.

If there are multiple possible lumbar sources of your chronic lower back, hip, groin and/or leg pain and the discomfort hasn’t responded to other treatments, Dr. Choi may recommend discography.

Discography, sometimes called a discogram, is an imaging test that is used to determine which disc is causing your pain. Dr. Choi injects a contrast dye into certain discs. The dye moves into cracks in the discs’ exterior, revealing damaged areas on an x-ray. Once Dr. Choi pinpoints the abnormal disc(s), he can develop an appropriate plan to treat them.

If you have symptoms that are associated with a neuromuscular abnormality, such as numbness, tingling, pain and muscle weakness, Dr. Choi may recommend electromyography (EMG). An EMG is a type of test performed to evaluate the health of the nerve cells and muscles that surround your spine. It’s used to diagnose conditions, such as nerve disorders, motor neuron disorders and disc herniation.

During the diagnostic procedure, Dr. Choi places surface electrodes on your skin and tiny electrode needles, about the size of an acupuncture needle, at different sites beneath the surface. The electrodes pick up electrical activity in response to a nerve’s stimulation in the muscle.

Platelets circulate in the bloodstream and cause blood clotting, as well as play a key role in activating the body’s natural healing response after an acute injury. If an acute injury doesn’t heal properly, it can result in a loss of function and chronic pain.

Platelet rich plasma (PRP) therapy harnesses the power of platelets to accelerate the healing process and relieve pain. First, we take your blood and run it through a special device that concentrates the platelets. Then, Dr. Choi injects your own platelets into the site of the injury under the guidance of ultrasound or fluoroscopy.

The procedure, which is performed in our office and doesn’t require downtime, helps to initiate healing and rebuild damaged tendons and/or cartilage. PRP can be successful in reducing pain and improving function.