Interventional Pain Management

What are these injections?

Patients presenting with tendon inflammation, degeneration and tears, often present to the doctor with significant, pain and loss of movement of the injured limb. This leads to lack of sleep, and the inability to function normally, which in turn leads to anxiety, which further exacerbates the pain.

Injection of Corticosteroids (a chronic anti-inflammatory agent), has been found to decrease symptoms dramatically, and if used in conjunction with rest and physiotherapy, could lead to significant improvement in long term outcomes in this group of patients.

Another group of injections involves injecting the patient’s blood into the injured tendon (autologous blood injection), or injecting the patients platelets, which have been concentrated by spinning these down to concentrations above 1000 (normal platelet levels in autologous blood is 250). The growth factors in the platelets then result in restoration and healing of the existing tendon tissues.

Corticosteroids and blood products may also be injected directly into a joint to provide relief (i.e. the knee, shoulder and spine).

How are these injections performed?

You will be ushered into an ultrasound or CT room. Following which, the Radiologist will ask you a few questions and may examine your painful limb or area of pain. The area to be injected will then be cleaned with an antiseptic skin solution, following which, a small needle containing local anaesthetic and the substance to be injected, will slowly and carefully be guided into the area that is being injected. Ultrasound or CT may be used to guide the needle, and to ensure precise positioning of the needle tip. The injection itself normally takes less than a minute, and the only part of the procedure felt by the patient is the needle going through the skin.

Injections like hydrodilataion of the shoulder, normally takes longer, and maybe associated with mild discomfort as we stretch the shoulder capsule.

What are the side effects of these injections?

Pain may be worse in the 24-48 hours following the injection. This is normal, and oral pain tablets are indicated to help relieve symptoms in this period. Ice packs may also be useful in the acute stage, especially following autologous blood injections or platelet rich plasma injections. Corticosteroids usually take 3-5 days to take effect.

Any injection can potentially cause infection. The incidence of infection in joint injections is about 1 in 4000, and the incidence of infection in tendon injections is even less likely. If pain worsens over the few days following the injection than you are advised to contact us at 9337 8288 and consult your referring doctor as soon as possible.

Very rarely, bleeding may occur, following the injection, this may present with a lump or bruise in the area injected. Please contact us if you notice this.

How do I prepare for an injection?

If you are on Warfarin or any blood thinners, please notify our staff on booking your injection. We may need to speak with your doctor about suspending these for a few days. It is best practice to suspend all Non-steroidal anti-inflammatories (Aspirin, Neurofen, Voltarin and Mobic) for 4 days before the injection (for 7days before a Platelet Rich Plasma PRP injection).

If you have any overlying skin infections in the area to be injected, please notify us.

If you are allergic to local anaesthetic or corticosteroid (extremely rare), please notify us.

Besides this, no specific preparation is required.

How long should I expect the injection to last?

This varies considerably, depending on the area being injected, the severity of the injury, and the compliance of the patient and their willingness to use physiotherapy and other aids such as orthotics for plantar fasciitis, to prolong the effects of the injections. Some patients require only one injection, and some patients require ongoing injections for relief. Relief obtained from autologous blood injections and PRP injections is more long lasting than that from corticosteroid injections.

Spine Injections

Our Service

At DiagnostiCare we have considerable experience in interventional back and neck pain injections. Dr Stephen Fasulakis has been performing these procedures in New South Wales as well as at the Epworth Hospital in Richmond. He a member of the International Spinal Intervention Society, ISIS, as well as an accredited endovascular interventional radiologist with the Royal Australian and New Zealand College of Radiologists.

What we offer

Selective foraminal nerve root injection Performed in the lumbar and cervical spine to confirm the site of origin of a patients discomfort Epidural injections of analgaesia Injection of the epidural space in order to relieve symptoms of nerve root irritation or symptoms of spinal canal stenosis Facet Joint Injection The joints between vertebral bodies are injected in patients presenting with mechanical back or neck pain Other Sacroiliac joint inection, transfacetal drainage of synovial cyst are also offered.

The Procedure

Spinal injections are performed on the CT scanner using small, low dose volume scans to track the position of the needle. Under sterile conditions, some local anaesthetic is administered at the site of injection, following which a needle is gently advanced into the epidural space/neural exit foramen/facet joint. A mixture of corticosteroid and local anaesthetic are then injected into the required area The injection takes about 15 to 20 minutes from start to finish, and the patient is observed for 30 minutes following the procedure.

Checklist before the injection

Please bring any recent scans that you may have had for review. We may need to cancel the injection and order updated scans, if no recent baseline study is available. Please notify us if you are taking any blood thinners or anticoagulants such as Warfarin, Plavix and Nonsteroidal anti inflammatories such as Ibuprofen, Aspirin or Voltarin. These will have to be stopped a few days before the study.

Complications

Generally safe with very few serious complications reported. As with any injection, there is a small risk of infection and bleeding. Headache, if the the CSF spaces are inadvertently punctured. This is exceedingly rare. Transient numbness in the legs or arms. Severe side effect such as paralysis have been reported in the literature, but are extremely rare and largely avoidable by using good and meticulous techniques.

Frequently asked questions

How much am I out of pocket for a spinal injection? Ans: Health care card holders and pensioners are bulk billed. All others are charged an out of pocket fee. Worksafe is billed directly for Worksafe patients. How effective are spinal and nerve root injections? Ans: About three quarters of patients have a significant improvement in symptoms. The improvement may last from a week to several months. More than one injection may be required.

Safe and Targeted Spine Injections in Melbourne

At DiagnostiCare, we have specialists with the training and expertise to provide a range of targeted spine injections. Our team, including Dr Stephen Fasulakis (a member of the International Spinal Intervention Society), are all highly experienced in this specialised field of medicine.

Our spine injection treatments can provide relief for a range of conditions, including spinal stenosis, herniated discs, and sciatica. These treatments are performed using state-of-the-art imaging technology, which ensures that the injection is accurately delivered to the precise location required.

Every patient is unique, and at DiagnostiCare, we take this into account with individualised treatments catered to each patient’s specific condition and degree of pain. This personalised approach extends to patient examination, correlatio  with previous studies  and consultations where we take the time to explain the process thoroughly, addressing any concerns or fears the patients may have.

Access Spine Injections in Melbourne

DiagnostiCare knows that the thought of getting a spine injection can cause unease for patients in Melbourne. Our medical professionals are committed to making your experience as comfortable as possible. The injections are performed using a local anaesthetic to minimise pain and discomfort during the procedure.

The needle’s positioning is carefully guided with ultrasound or CT to ensure precise delivery, and the procedure typically takes no more than a minute, minimising any discomfort for our patients. The focus is always on providing world-class service that places your wellbeing and comfort first.

Our dedication goes beyond the procedure itself. At DiagnostiCare, we understand that the real measure of success is how much your life is improved after the treatment. Therefore, we also provide advice on managing the recovery process and maintaining a pain-free lifestyle.

Why Choose DiagnostiCare for Spine Injections in Melbourne?

• Expert Medical Team: Our team of medical professionals, including spinal intervention specialists, ensures that you are in the most capable and experienced hands for your spine injections.
• State-of-the-Art Technology: We use advanced imaging technology to guide our procedures, ensuring precision and accuracy.
• Patient-centric Approach: Your comfort and wellbeing are our top priority. We make sure that the procedure is explained thoroughly to ease any apprehensions and provide post-treatment guidance to aid in recovery.
• Strict Safety Standards: At DiagnostiCare, we strictly adhere to all safety precautions, minimising potential complications such as infection or bleeding.
• Convenient Locations: Our Keilor East facility serves residents from all over Melbourne and is easily accessible from nearby locations such as Moonee Ponds, Ascot Vale, and Essendon.

Allow us to help you manage your spine and back pain efficiently. contact us at (03) 9337 8288 for more information or to schedule your appointment.

Understanding the Safety Measures of Spine Injections

Spine injections involve the administration of medication into the affected regions of the spinal cord to alleviate pain. Though the term “spine injection” might be daunting for many Melbourne patients, the entire procedure is carried out under highly sterile conditions and careful guidance to ensure maximum safety.

Patients might feel some pain or discomfort for the first 24-48 hours following the procedure, but this is normal and expected. For this, oral pain medication, along with ice packs, can relieve the discomfort. It typically takes around 3-5 days for the corticosteroids used in the injection to work, and patients usually start feeling substantial relief.

The incidence of infection is extremely low, but if pain worsens over the course of a few days, you should seek medical attention immediately. These procedures are safe with very few serious complications observed. They are carried out meticulously with world-class protocols in place at DiagnostiCare.

Should you have any additional queries or concerns, feel free to reach us at (03) 9337 8288 or email info@diagnosticare.com.au.