Cervical slipped disc pain for more than 15 years treated with latest minimally invasive technique -

A male 55 years of age, having neck and left arm and chest pain for more than 15years. Feels tightness, and moderate to severe (VAS - 7-8) on lifting some weight, exertion, or working for some time (<10mins)

His multiple MRI were showing disc prolapse at C5-6 and C6-7 levels more on left side.no other abnormality was found.

He was treated with medications, physiotherapy, various manipulation techniques, acupuncture, acupressure and so on. He tried many different methods of treatment but without any success.

He read about pain management on internet and searched for neck pain treatment. He contacted us and came to show Dr. Kailash Kothari, MD, Director PCI.

On examination and reviewing his MRI Dr. Kothari suggested him a novel and minimally invasive technique called PERCUTANEOUS NUCLEOPLASTY for his prolapsed discs. He explained him the nature of the surgery which is without cut and without and bleeding. Even the side effect because of the procedure are very few and very safe.

He took his own time in making the decision (almost 3 months) and he came back to Pain Clinic when there was exacerbation of the pain. He agreed to the treatment.

A minimally invasive surgery called PERCUTANEOUS NUCLEOPLASTY was performed for him at two levels.

The procedure involved an injection from the front of neck and insertion of nucleoplasty wand through it and applied coblation RF current intra discally at 3 points.

The procedure was done under Local anaesthesia and performed in 30 min.

The recovery of patient was fantastic with >80 % pain relief on table.

His first words in table were - Its so pain less, Can I do it again in future if required. He blessed the entire team for his treatment.

MRI showing Disc prolapse 

Ready to give local anesthetic

Under Local anesthesia Needle in the middle of the disc

The patients with neck pain on one or both sides with clinical symptoms suggestive of facet joint as pain generator is very common. Many times it is being referred as spondylosis of the cervical spine. 

One such patient reported to our clinic (Neck pain, On right side, minimal radiation to the upper limb, had severe tender right side of neck - just on the side of mid line, painful neck movement, and had occasional headache.

X-ray was showing straightening of cervical spine and muscle spasm, with mild reduction of C 5-6 disc space.

(Figures showing anatomy of the facet joint and pain areas produced by facet joints in neck)

These patients do respond well to the medial nerve branch (blocking the nerve supplying facet joint).
It is a simple injection performed under X-ray guidance.
0.5 ml of local anesthetic injection is injected under live X-ray to confirm if this nerve block gives you pain relief. If yes & you are totally convinced that it helped you in relieving the pain of your neck, you can undergo a therapeutic procedure called as radio frequency (RF) ablation.
RF current is delivered through a special needle under local anesthesia. To confirm if needle is placed near the affected nerve, sensory & motor stimulation is performed using stimulation mode on the RF generator machine. If you get good sensory & muscle stimulation in the area of your pain, it confirms needle tip is placed in right place.
Than RF energy is delivered, thermal coagulation of the nerve happens over 90 seconds & at 70-80oC.
To block pain of one joint 2 nerves are to be blocked.

THIS PROCEDURE CAN RELIEVE PAIN FOR 6 MONTHS TO 2 YEARS.

PAIN RECURRENCE IS USUALLY DUE TO NERVE REGENERATION. It is required to repeat the procedure after pain returns when nerve regenerates. 

Do you also have neck pain and with such symptoms !! Don't wait and suffer, consult Pain specialist in your area and get medial branch block done to see if it relieves your pain.

   Dr. Kailash Kothari, MD

Trigger point injection is used to treat extremely painful areas of a muscle, which are characterized by the presence of the trigger points. A trigger point is a traumatized area in the muscle, feels like a knot or a tight, taut band of the muscle, and it is tender to deep pressure or palpation.

These trigger points may occur in any area of the body but most commonly they develop in the neck, shoulders and low back.

The trigger point can trap and irritate surrounding nerves and causes a referred pain i.e. pain felt in another part but with close proximity to the original site. Multiple trigger points may have overlapping areas of referred pain.

The presence of trigger points could be the primary muscle problem or could be secondary to trauma, scar tissue formation, fibromyalgia, surgery and many other conditions.

Procedure:

The trigger point injections are a simple procedure performed in the office. The physician examines the patient and the painful involved area to identify the trigger points. After cleansing the skin, a small needle is entered into the trigger point. The injection may cause a twitch or mild pain that lasts from a few seconds to a few minutes.

Aftercare:
Soreness from multiple needle sticks may respond well to an ice pack or massage. Numbness from local anesthetic may last about an hour. We strongly recommend ice, massage and stretching exercises for several days following the procedure.

Complications:
They are remote, but may include but not limited to infection, bleeding, puncture the lung or the pleura (the surrounding membrane of the lungs) if done near the rib cage or at the neck, failure to alleviate the pain, or increase of the pain.

You will be advised to contact our office if any exaggerated swelling, redness, fever or shortness of breath develop following the procedure.