The procedures (often injections)  I offer may have  both “diagnostic” (test) and “therapeutic” (treatment) value.  This can be confusing because usually the test and treatment are separate. If you have broken bone, the test is the x-ray, and the treatment is the surgery or cast.  When the problem is pain, a subjective experience (as opposed to a physical finding), however, often only way to confirm if something is causing the pain is to numb up the area that we suspect may be the problem, and see if the pain improves.   If the pain improves, we say that we have found the  “pain generator”–that is, the fundamental source of the pain–and this informs the next steps we have to take.

If we did find the correct target, depending on the type of injection and the exact problem, you may have weeks to months of relief–in which case we can repeat the injection every few months.  This is often the case for epidural steroid injections for pinched nerves, for example, which often provides about 3 months of relief.   Often the pain improves, or the other medications and treatments start working, within those 3 months.   I like to use the analogy of going to the dentist’s office for cleaning–while you can get “tuned up” every 3 months, the daily brushing and flossing is your physical therapy and lifestyle changes (such as weight loss) which will help address the underlying problem.

If you have only temporary relief–depending on the location, we may be able to follow up with a different type of procedure (to “stun” or “burn” the nerves using radiofrequency ablation, for example) , or try a different modality such as physical therapy or medications.