Patients suffering from migraine headaches, spasticity, myofascial pain, back pain, neck pain, or neuropathy are candidates for Botox injections which typically contain a solution of botulinum toxin and saline solution or local anesthetic. The injections are a minimally invasive treatment option most commonly known for its effect on wrinkles, but also found to be a highly effective form of pain therapy that can provide three to four months of relief.

Discography is a diagnostic procedure in which x-ray dye (x-ray contrast) is injected into the discs of the spine. After the x-ray dye is injected, an x-ray (called a “discogram”) is taken of the discs. The discogram may be normal or may show tears (fissures) in the lining of the disc. The results of discography are used to plan surgery or IDET (intradiscal electrothermal ) treatment.

The epidural steroid injection (ESI) is the placement of cortisone, a powerful anti-inflammatory agent, into the epidural space, which approximates the disc and spinal column. The epidural injection has been used for over 40 years as treatment for back pain. It involves using either steroids or anesthetic agents allowing good benefits with minimal risk factors. The main goal of the epidural injection is to shrink the swelling in bulging or herniated discs, and to decrease any inflammation that surrounds the disc and may be pressing on a spinal nerve. This is a common procedure. Because of the low risk and low incidence of any significant problems or side effects, this is felt to be a reasonable procedure to follow when traditional conservative therapy for disc pain has failed to provide improvement. A large percentage of patients upon whom this procedure is performed will get complete resolution of symptoms; a small percentage may experience no real improvement at all.

If there is improvement from the steroid epidural, it likely will occur over the next several days to two weeks. The improvement should not be expected immediately.

Facet Joint Injection is an injection of long lasting steroid (“cortisone”) in the facet joints – which are located in the back area, as a part of the bony structure.

An Intrathecal Pump (spinal morphine pump) is a specialized device, which delivers concentrated amounts of medication(s) into spinal cord area via a small catheter (tubing).

Patients suffering from degenerative conditions such as rheumatoid arthritis and osteoarthritis often experience pain and inflammation of major joints such as the knee, shoulder, ankle, elbow, and wrist. Small joints in the hands and feet can also be affected. A simple trigger point injection containing anti-inflammatory agents called corticosteroids helps relieve the pain and can last for 6 to 12 months. Trigger point injections are simple and can often be performed in a regular exam room, however some injections in the hip and shoulder pay require ultrasound or x-ray guidance.

Ketamine infusions are a great option for chronic pain suffers who are either looking for an alternative to opioids or who no longer get relief with their current medication regimen. It is also an effective treatment for Refractory Depression and can help when traditional SSRI medications do not work or the patient no longer wants to live with the side effects of said medication (like weight gain, decreased libido, and brain fogginess). Ketamine woks by resetting the NMDA receptors that become less responsive over time with use of narcotics. Ketamine infusions only take about 1.5 hours and can be repeated weekly.

Lidocaine infusions is one of them best alternative pain management treatments to opioids. The infusion only takes about 1.5 hours and can be repeated on a weekly basis with no addiction or dependence potential. The lidocaine, a numbing agent, is infused directly into the blood stream through the use of an infusion pump and can provide lasting relief for up to 12 hours. Although there is still little documentation supporting the claim, it has been said that some patients who try lidocaine infusions before a medial branch block will not need the block or radiofrequency treatment.

Facet joint syndrome, deteriorated or damaged facet joints, compressed medial branch nerves and other conditions that cause pain and inflammation can be relieved through a minimally invasive injection procedure known as a medial branch block. By injecting an anesthetic and steroid medication mixture into the affected area pain and inflammation can be significantly reduced.

One of the most common, safe, and effective chronic pain treatments is the radiofrequency ablation (RFA). RFA uses an electrical current from radio waves to heat and burn the surrounding tissue and nerves to reduce pain signals to affected areas. During the procedure, your Nexus physician will ask specific questions about your sensations to determine if the electrode is in the correct area. The procedure takes about 15-20 minutes to complete.

The sphenopalatine ganglion is a bundle of nerves located in the midface behind the nasal passages. When damage or trauma to the face occurs, it can cause severe pain in the face and head. A minimally invasive procedure known as a sphenopalatine ganglion block can provide relief.

A spinal cord stimulator is a small device with electrodes that is implanted under the skin and uses electrical nerve stimulation to create a tingling feeling which dissipates in moments and simultaneously interrupts the pain signals from being transmitted to the brain. The patient can turn the stimulator on and off or increase and decrease the stimulation as needed. This type of pain therapy is used to improve back pain, complex regional pain syndrome (CRPS), nerve pain, and inflammation of the brain and spinal cord.

Sympathetic nerve blocks are another minimally invasive injection used to relieve a variety of conditions such as sciatica pain which radiates to the lower back and legs, pain caused by regional pain syndrome, shingles, peripheral neuropathy and more. Using contrast dye and x- ray guidance your Nexus physician is able to identify the treatment site and injects a highly- effective and long-lasting steroid medication in the sympathetic nerves to relieve pain. Mild sedation is available for this procedure.

Trigger points are knots in muscle that form because of stress and the inability to relax causing surrounding nerves to become irritated and painful. More than one area can be affected, but multiple trigger point injections can be administered in one session. Trigger point injections are performed by injecting local anesthetic and sometimes corticosteroid into the trigger point for immediate pain relief. Some chronic pain conditions such as fibromyalgia, tension headaches, and myofascial pain syndrome can also by treated with trigger point injections.