Alumran 4

 

Here is a partial list of the comprehensive pain treatments provided by Alumran Clinic

 

 

pain intervention for head

1- Occipital Nerve Blocks and Radiofrequency

2- Botox injection for headache, migraine and myofascial spasm

3- Sphenopalatine and Gasserian ganglion block

 

pain intervention for backache

1- Transforaminal Epidural

2- Midline Intralaminar Epidural

3- Facet joint injection

4- Median branch block (Radiofrequency ablation)

5- Caudal epidural injection

6- Trigger injections

7- SI Joint Injections and Radiofrequency

 

 

 pain intervention for neck pain

1- Intralaminar midline epidural

2- Cervical facet injection

3- Torticollis

4- Trigger injections

5- Postherpatic Neuralgia

 

Peripheral pain intervention management

1- Nerve blocks e.g Carpal Tunnel block

2- Intraarticular injections

 

pain intervention for cancer  

Regional blocks

Neurolytic procedures

Radiofrequency ablation

Sympathetic blocks

1- Celiac Nerve Block 

2- Ganglion Impar Block

3- Paravertebral Nerve Blok

4- Stellate Ganglion Block

5- Superior Hypogastric Plexus Block

6- Lumbar Sympathetic Block

 

Epidural Steroid (cortisone) Injection

Epidural glucocorticoid injections are commonly given to patients with leg and/or back pain to relieve such pain and improve mobility without surgery. These steroid injections buy time to allow healing to occur and/or as an attempt to avoid surgery after other conservative (non-surgical) treatment approaches have failed.

 

During a transforaminal injection, a thin needle is inserted into the epidural space through the bony opening of the exiting nerve root. This technique allows the cortisone medicine to be placed closer to the irritated nerve root.

 

Indications include disc herniations, Lumbar canal stenosis, vertebral fractures, tumor compressing epidural space, Herpes zoster pain etc.

 


Facet Joint pain syndrome

Facet joints are joints between two vertebral bones. They are arranged in the back part of your spine from the neck all the way down to your low back. They can be painful due to “whiplash” injuries of the neck, arthritis or degeneration in the low back. These joints may cause pain in and around the spine and can markedly limit how you use your neck or back.

When facet joints are painful, it can be difficult to bend the spine backward / sideways.

 

Each facet joint is served by medial branch nerves, and if these nerves are blocked with local anesthetic, the pain from the joints will stop. This is the only test to tell the doctor the pain is coming from facet joint. Once test is positive (i.e. you get more than 50%pain relief), radiofrequency ablation of medial branches will provide your lasting pain relief.

 

 

Radiofrequency Neuroablation

 Radiofrequency ablation or lesioning is a term used when radio waves are used to produce heat to destroy tissue, usually a nerve. It is a non-surgical option to treat your spine pain. In the case of spinal pain, radiofrequency waves are transmitted through a needle placed near the nerve under x-ray guidance. This procedure is also known as RF rhizotomy.

 

It is used in pain coming from facet joint, Trigeminal neuralgia, Sacro-iliac joint, herniated disc, Sympathetic chain etc.

 

Radiofrequency ablation therapy is one of the best procedure available till today to provide long lasting pain relief. It is very safe, done under local anesthesia, & usually requires few hours at the pain clinic.

 

 

Lumbar sympathetic block

A lumbar sympathetic block is an injection of local anesthetic into the back using X-ray guidance or ultrasound. With this procedure, we are blocking the sympathetic nerves to the leg. These nerves typically are not responsible for sensation, but they can be "turned on" in certain pain syndromes.

 

This procedure is typically ordered by your doctor for pain located in the buttocks and/or legs that is caused by sympathetically maintained pain, or complex regional pain syndrome, formerly known as reflex sympathetic dystrophy (RSD). It may also be ordered for nerve injury or post-herpetic neuralgia (herpes zoster, shingles). Lumbar sympathetic blocks are also used with circulation problems (e.g., vascular insufficiency) to see if blood flow can be improved.

 

                                                                    

 

Celiac plexus block

The celiac plexus is a bunch of nerves that supplies the sensation from organs in your abdomen (e.g., pancreas, bowel, etc.). It is used for patients with pain due to abdominal malignancy or chronic pancreatitis.

 

The plexus is located along the side of your spine. Alcohol is injected to destroy the nerves when a neurolytic block is performed, usually for patients with cancer.

 

A diagnostic block is often done prior to a neurolytic block to ensure that pain relief can be achieved by this type of injection. Your doctor will tell you if you are an appropriate candidate for a neurolytic block.

 

 

Stellate ganglion block

 A stellate ganglion block (sympathetic block) is an injection of local anesthetic into the front of the neck. It is typically ordered by your doctor for pain located in the head, neck, chest or arm that is caused by sympathetically maintained pain (complex regional pain syndrome), causalgia (nerve injury), herpes zoster (shingles) or intractable angina. Stellate ganglion blocks are also used with circulation problems, particularly Raynaud's or complex regional pain symdrome (CRPS), to see if blood flow can be improved.

 

Stellate ganglion blocks may be of therapeutic or diagnostic value. One of three things will happen:

The pain does not go away, but there is other evidence of a sympathetic block, meaning the pain is not responsive to sympathetic blocks. This is of diagnostic value.

The pain does not go away and there is no good evidence of a sympathetic block, meaning the block is a technical failure.

The pain goes away after the injection and stays away longer than the life of the local anesthetic, meaning the block was of therapeutic value.

 

The procedure will most likely have to be repeated to achieve a long-lasting benefit. The spacing of injections will be based on how long the pain relief lasts between injections. Usually, you will experience a longer benefit following each subsequent injection.  Left hand CRPS

 Left Stellate ganglion block -

 

Superior hypogastric block

A superior hypogastric block is an injection of local anesthetic and steroid around the sympathetic nerves which supply the organs of the pelvis.

 

These nerves are located on either side of the spine in the lower abdomen. After successful diagnostic injection RF ablation or alcohol neurolysis can be performed to provide long lasting pain relief

 

Gasserian Ganglion RF ablation

The Gasserian Ganglion can be partially ablated as it sits in Meckles Cave either by using Glycerol or by making a radiofrequency lesion.

 

A small thin needle is inserted into the middle of the cheek under local anaesthesia, and gently guided with X-ray assistance through the foramen ovale into Meckles Cave where the Gasserian Ganglion sits.

 

It is important to treat the correct branch of the trigeminal nerve involved in the pain, to avoid excessive numbness post-procedure. With latest RF generators we can stimulate to confirm the branch which is to be ablated. This improves the effectiveness of the therapy

For patients where surgery and anaesthesia is too risky, Injection Techniques may offer pain relief

                                                                      

 

Botox injection

 

Botox ®, also known as Botulinum Toxin Type A, is a protein produced by the bacteria Clostridium botulinum, the same bacteria that causes botulism food poisoning. When injected into muscle in tiny amounts, botulinum A (Botox) can stop or reduce muscle spasm by blocking nerve signals to the muscle. This treatment has been used since the early 1990s to relieve severe muscle spasms around the eyes and in the neck, arms, legs, hands, and feet. Some people with cerebral palsy have gained significant relief from severe muscle contraction with botulinum toxin injections.

 

Botox injections are generally used for people who are experiencing:

Headaches

Myofascial Pain

Fibromyalgia

chronic low back pain.

 

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07801926801  07706774773

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Basra, Iraq

Syed Ali al-Moussawi Street
Near a hospital Musawi