Service types: Pain management injections.

Patients with sciatic pain (leg pain) after a prolapsed disc with abutment or compression of a nerve root may get significant relief from injections into the site of bupivacaine and a steroid. These injections are only given under x-ray guidance for safety reasons and usually after the patient has had an MRI.

Service types: Pain management injections.

Any joint in the upper or lower limbs may be a source of pain, and intra-articular injection may be the best treatment option.  Often these can be done as an office procedure but the more complex ones may require x-ray guidance such as the hip joint, sacrococcygeal joint etc.  The advantage is that joint entry can be confirmed with contrast, thus maximising the treatment effect.

Service types: Pain management injections.

Peripheral nerve blocks are interventions which involve injections of local anaesthetic and/or steroids around peripheral nerves in order to influence pain phenomena.  These can include injections under the flexor retinaculum at the wrist for carpal tunnel syndrome, injections around the suprascapular nerve for varieties of shoulder and periscapular pain, occipital nerve blocks for occipitalgia and headaches, ilio-inguinal nerve blocks, intercostal nerve blocks, lateral femoral cutaneous nerve blocks, genitofemoral nerve blocks, and diagnostic cervical and lumbar medial branch blocks for the diagnosis of chronic pain in those regions.

Service types: Pain management injections.

Spinal facet joint injections can be done for non-radicular back pain, and can be done precisely under x-ray guidance.  In the office a peri-facet injection can be performed without x-ray and may be the first approach used.

Service types: Pain management injections.

Sacroiliac joint pain can be disabling and often occurs after a direct blow to the sacral region, such as slipping and falling onto one's bottom.  Typically pain is felt over the lower sacral area and may extend in a somatic fashion down the back of the thigh.  Often pain is felt in the lateral hip region and a small percentage of patients experience ipsilateral groin pain. 

The injection is performed with x-ray guidance, and intra-articular positioning is validated by an arthrogram with contrast medium.  The effectiveness rate is 40-70%.

Service types: Pain management injections.

Occipital nerve blocks can be performed as an office procedure without imaging guidance.  They are done for occipital pain and headaches of various types.

Service types: Pain management injections.

Most muscles in the body can produce ongoing pain and disability.  Sometimes this is associated with the presence of trigger points which sometimes resolve with injections of local anaesthetic and/or steroid injection.

Service types: Management of acute or chronic pain problems and syndromes.

Rarely, post-surgical scars may be associated with a special burning pain and some of these may respond to steroid injection therapy.

Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older.

You can get it at any age and are more likely to if you have previously injured a joint, or are overweight.

The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well.

The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience.

Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see www.arthritis.org.nz