Radiofrequency ablation is a minimally invasive procedure guided for ultrasound or fluoroscopy. After identifying the nerve, radiofrequency ablation uses an electric current to heat up a small area of nerve tissue to stop it from sending pain signals.
Cryoablation uses cold temperatures and is a minimally invasive procedure guided for ultrasound or fluoroscopy. The indications are many and include treatment of chronic low back pain, others spine pain and osteoarthritic joints with severe pain and non-controlled by medication.
Nucleoplasty is an advanced injection procedure guided for fluoroscopy for treating the disc herniation for patients who suffer prolonged and severe back pain that did not respond to conventional treatment. The aim of this procedure is to relieve the pressure inside the disc and on the nerves responsible for causing pain. The procedure should take less than one hour. This procedure is an ambulatory treatment.
Intra-articular Corticosteroids Injection
Corticosteroids medications are used to reduce pain and inflammation and can be taken oral or through an injection. The rationale for injecting steroids is to target more precisely the area of pain and avoid systemic oral medication. This procedure is minimally invasive and is guided generally for ultrasound. Indications include inflammatory arthritis and other musculoskeletal diseases.
After some blood is taken from a patient, it is spun very quickly using a centrifuge. This very fast spinning causes the blood to separate into a range of parts depending upon weight. PRP (platelet rich plasma) is a specific part of the separated blood which will contain 2-5 times the usual number of platelets and have a regenerative effect on the tissues of the body by triggering natural healing processes. Through a minimally invasive procedure guided for ultrasound, the PRP is delivered in the joint, muscle or tendon of pain and degeneration. Most research shows that a series of 3 PRP injections each 1-2 weeks apart gives the best outcome. PRP injections can be used in a lot of diseases, including osteoarthritis knee, epicondylitis of the elbow and muscle tears.
Peripheric Nerve Block
This minimally invasive procedure, as radiofrequency ablation and cryoablation, should be guided for ultrasound or fluoroscopy. Through the injection of local anesthetic, the signal transduction pathway of the selected nerve will be blocked. Corticoid can be added to prolong the duration of the pharmacological effect. The indications are still many, but include especially acute or subacute musculoskeletal diseases.
The frozen shoulder, or adhesive capsulitis, typically will start with severe pain and marked loss of range of motion around the shoulder. This condition is more common in females, in patients with pathologies, like diabetes, and following a traumatic injury. The treatment of this condition includes oral anti-inflammatory medication and physiotherapy. Despite that, the last one is painful and hydrodistension could be performed to reduce the pain and allow stretching and exercises of the shoulder. Hydrodistension is a minimally invasive procedure guided for ultrasound that aims to stretch the tight joint capsule. To do so, local anesthetic and steroid as well as saline is injected into the shoulder under pressure in an attempt to stretch the capsule, allow movement and reduce the pain on the shoulder. Another indication of this procedure is the achilles tendinopathy, but in this case corticosteroids should be avoided.
Calcific tendinitis is a disorder characterized by deposits of hydroxyapatite in any tendon of the body, frequently on tendons of the rotator cuff. Calcification barbotage is a minimally invasive procedure guided for ultrasound used to treat this condition. The aims of this procedure is to dissolve and remove calcium that can build up on tendons. To do so, our specialist doctors will use ultrasound to find the area to be treated and pass a small needle through this area attempting to break up the calcium. After that, they aspirate the contents of the calcific lesion. This also allows the body to reabsorb remaining calcium easier over time. Lastly the doctor injects corticosteroid into the bursal lining around the tendon to alleviate any existing inflammation.
Botulin Toxin Injection
Botulinum toxin is a potent neurotoxin that inhibits release of acetylcholine at the neuromuscular junction. Injection of botulinum toxin into specific overactive muscles causes localized muscle relaxation. This injection preferably is made by ultrasound control. For that reason, the indications of this minimally invasive procedure are spastic muscles secondary to a primary motor neuron lesion, contractures, some overuse tendinosis and aesthetic reasons. The botulinum toxin injection also shows evidence on treatment of other conditions, like knee ostearthritirs and migraine.
Pharmacological Pain Management
Pain is a common symptom and is often associated with significant physical disability and psychosocial problems. This symptom may be present in several conditions and the proper anamnesis and physical examination is crucial to make the right diagnosis and the respective treatment. Pharmacological management pain is commonly part of the treatment and a wide range of drugs can be used to manage pain resulting for tissue damage, inflammation or disorders of the peripheral nervous system or the central nervous system. Due to its complexity, our clinic selected a experienced team of professionals in pain management.
”After the treatment I am only happy to say how I really feel. With some stretch exercises and physiotherapy, I feel great and get on with my life. Thanking you.Carole LeeThe Netherlands
”Before I start with my trip through the Pain Center I would like to say thank you to Dr. Costa and his wonderful team. I feel much better than before.Karola KoenigGermany