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Pain Management Procedures

The Institute offers a range of minimally invasive pain therapies that are performed by the pain management and physiatry specialists. This may include:

Epidural Steroid Injections (ESI) - An ESI works by delivering steroids directly to the painful area to help decrease the inflammation that may be causing the pain. An epidural injection is typically used to alleviate chronic low back and/or leg pain. While the effects of the injection tend to be temporary. While the effects of the injection tend to be temporary, providing relief from pain for one week up to one year can be very beneficial for patients during an episode of severe back pain. It also provides sufficient pain relief to allow the patient to progress with their rehabilitation program.

Trigger Point Injections - Trigger point injections (TPI) are used to treat extremely painful areas of muscle by injecting an anesthetic directly into the muscle. A trigger point is a knot or tight band of muscle that forms when muscle fails to relax. The knot often can be felt under the skin and may twitch involuntarily when touched. The trigger point can trap or irritate surrounding nerves and cause referred pain (pain felt in another part of the body). Because of this "referred pain," trigger points can mimic pinched nerves.

Facet Joint Injections - Lumbar facet joints are small joints located in pairs on the back of the spine. They provide stability and guide motion in the low back. If the joints become painful they may cause pain in the low back, abdomen, buttocks, groin or legs.

A facet joint injection provides temporary pain relief allowing a chiropractor or physical therapist to treat the joint. Also, the time release cortisone (steroid) that is injected will help to reduce any inflammation that may exist within the joint(s).

Sacroiliac Joint Injections
- The sacroiliac joint is the part of your lower back made up of the sacrum (the bony structure above your tailbone and below your lower vertebrae) and the top part (iliac) of your pelvis. It is the part of the low back just behind your waist. You have right and left sacroiliac joints. Symptoms of sacroiliac joint pain can include pain in the sacroiliac area, difficulty bending or twisting your low back, pain after sitting for a long time, stiffness in the low back, hip, or leg, or a feeling of being "out of alignment."

A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief experienced will help confirm or deny the joint as a source of pain. Additionally, the temporary relief of the numbing medicine may better allow a chiropractor or physical therapist to treat that joint. Also, cortisone (steroid) will help to reduce any inflammation that may exist within the joint(s).

For more information, or to schedule an appointment with our Pain Management Physicians, call


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