As a skilled and experienced Pain Medicine Interventionalist, Dr. Levin evaluates each patient very thoroughly and carefully to help determine appropriate treatment options in order to provide the most effective individualized care. These treatment options may include: Lumbar, Thoracic and Cervical Epidural Steroid Injections utilizing targeted transforaminal techniques, Lumbar and Cervical Sympathetic Blocks, Sphenopalatine, Facial and Head and Neck Procedures, Discography, Percutaneuos Discectomy or Disc Decompression procedures, precision joint and nerve injections, Radiofrequency Neuroablative procedures, Peripheral or Spinal Cord Stimulator trials and implants, Foraminoplasties and several patented and patent pending advanced interventional procedures.
Primarily talk to us about it before choosing a treatment for your CTS. Try to find out as much as possible about the injection to which you reacted. These injections contain different steroids, varying or no local anaesthetic and other chemicals such as stabilisers and preservatives. For example, the commercial preparation 'Kenalog' used in this area contains not only the steroid (Triamcinolone acetate), but also sodium chloride, benzyl alcohol, carboxymethylcellulose sodium, polysorbate 80 and either sodium hydroxide or hydrochloric acid used to balance the pH (acidity). You may have had an allergic reaction to one of the other components of the injection or you may have reacted to one of the synthetic steroids which are not native to the human body. It does not necessarily follow that you would also react to a different preparation so knowing exactly which preparation you have had a reaction to is a vital piece of information.
Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back ( lumbar radiculopathy ), such as from lumbar spinal stenosis , cervical spinal stenosis, herniated disc , and foraminal encroachment, causes back pain that goes down the leg. Epidural injection is also used as a minimally invasive procedure to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy , which causes pain.