Millennium Pain Center Leaders in Pain Control, Research, Education and Advocacy.
  • Procedures


    • Epidural Steroid Injections
    • Epidural Steroid Injections


      Steroids are potent anti-inflammatory medications. The goal of an epidural steroid injection is to place this medication near the area of injury or pathology within the spine. The steroid medication reverses the effect of pain-producing inflammatory compounds produced by the body, thereby easing pain and allowing for improved function. A local anesthetic is usually injected with the steroid, which may provide immediate short-term pain relief.   By combining a local anesthetic and steroid, diagnostic information …Read More

    • Sacroiliac Joint Injection
    • Sacroiliac Joint Injection


      The sacroiliac joints, or SI joints, exist on both sides of the lower back, joining the spine to the pelvis. These joints are susceptible to injury, either by chronic stress or acute injury. This type of pain may occur with other spine problems and the diagnosis of sacroiliac arthropathy is frequently overlooked. The joint is injected with local anesthetic and steroid under X-ray guidance. Typically, this is a difficult joint to inject and requires precision …Read More

    • Facet Joint Injections
    • Facet Joint Injections


      It is not uncommon for specific joints to cause debilitating pain, either due to acute injuries or chronic arthritis. As a pain-alleviating treatment to delay eventual surgery or to augment physical therapy, injections of local anesthetic and steroid may be performed into or around specific joints. Common joints include the shoulder, knee and hip. These injections are performed in the office under fluoroscopy for accuracy and safety purpose.   Read More

    • Disc Stimulation (Discography)
    • Disc Stimulation (Discography)


      This technique is used to diagnose discogenic pain, pain generated from the intervertebral disc. This technique is properly termed provocation or discography as the disc is stimulated in an attempt to reproduce clinical pain. This study attempts to reproduce internal disc pressures, similar to pressures generated in painful activities, in order to diagnose disc pain. A normal disc accepts the injection of contrast without pain, usually maintains a high internal pressure with the injection, and …Read More

    • Intradiscal Interventions
    • Intradiscal Interventions


      Percutaneous disc decompression refers to nonsurgical procedures designed to reduce disc volume, thereby decreasing the pressure exerted on pain generators either within the disc or at the spinal nerve. Only certain patients are candidates for this procedure. Appropriate candidates have a positive disc stimulation procedure. The positive disc must demonstrate contained intradiscal contrast spread, well-maintained height and no evidence of spondylolisthetic vertebral segment. While initially developed for contained disc herniations, these techniques have been used …Read More

    • Spinal Cord Stimulation
    • Spinal Cord Stimulation


      In this procedure, one or two wires (leads) are placed into the epidural space to provide electrical stimulation of the spinal cord, acting to interfere with the transmission of pain. This technique is very effective in arm and leg pain caused by nerve injuries and can also be useful in some types of low back pain. It has also been used to treat pain from vascular insufficiency and chest pain. The stimulation can be adjusted …Read More

    • Vertebral Augmentation
    • Vertebral Augmentation


      The patient is positioned horizontally (prone) on the operating table. Percutaneous vertebroplasty can be performed under sedation and local anesthesia. Fluoroscopy, a special type of x-ray used during some spine procedures, is implemented to identify the vertebral pedicles and is used for needle guidance. A special bone needle is inserted through the skin (percutaneous) and positioned. The cement is mixed to the consistency of thin paste and prepared for syringe injection through the needle. Fluoroscopy …Read More

    • Peripheral Nerve Stimulation
    • Peripheral Nerve Stimulation


      Some headaches occur from stimulation of the greater and/or lesser occipital nerves, either directly or secondary to pathology in the upper cervical spine. If occipital nerve mediated pain is diagnosed by precision injection techniques, then the electrical stimulation of these nerves may represent a long-term nonpharmacologic approach to pain treatment. Unlike spinal cord stimulation, the leads are placed under the skin in the upper neck. Like spinal cord stimulation, electrical energy is used to block …Read More

    • Other Peripheral Injections
    • Other Peripheral Injections


      Certain conditions such as tennis elbow (lateral epicondylitis), golfer’s elbow (medial epidcondylitis), carpal tunnel syndrome and other tendonopathies may benefit from localized injection of anesthetic and steroid. Also, certain peripheral neuropathies may respond to injections around the involved nerves. These injections are only performed if more conservative treatments fail and judicious amounts of medication are used. Typically, these procedures are performed in the office. Read More

    • Peripheral Joint Injections
    • Peripheral Joint Injections


      Occasionally, a specific muscle may generate pain due to sustained contraction and subsequent localized ischemia. While this type of pain is usually secondary to another problem, it can occur primarily. These areas of muscle pain are called trigger points and can be treated with injection of small amounts of local anesthetic solution with or without steroid, usually in concert with specific physical therapy treatments. If the primary source of the muscle pain, such as an …Read More

    • Visceral Pain Procedures
    • Visceral Pain Procedures


      Abdominal and pelvic pain is mediated by nerves that coalesce with specific ganglia in near the lumbar spine. The well-defined location of these ganglia allow for interventions designed to alleviate chronic abdominal or pelvic pain. Abdominal pain may be treated with a celiac plexus axis intervention. The celiac plexus is located just anterior to the aorta at the L1 vertebral level. For malignant pain such as pancreatic, stomach or liver cancer, this intervention may consist …Read More

    • Intraspinal Drug Delivery Systems
    • Intraspinal Drug Delivery Systems


      Many medications that are normally given orally or intravenously can be delivered directly into the spinal canal. The advantage of this delivery is that a much smaller dosages of medication can be used, thereby minimizing many side effects associated with other oral or intravenous use. Typically, the intraspinal administration is 300 times more effective than the oral dose. Morphine (and other opioids or narcotics) interacts with opioid receptors in the spinal cord to decrease pain …Read More

    • Sympathetic Nerve Interventions
    • Sympathetic Nerve Interventions


      The sympathetic nervous system may be involved in specific pain syndromes. These include complex regional pain syndrome (formerly called reflex sympathetic dystrophy or RSD), atypical facial pain and microvascular ischemia. Local anesthetic injected around the sympathetic ganglia in the cervical or lumbar spine may diagnose sympathetic involvement in painful conditions of the head/neck/upper extremities and the lower extremities, respectively. These procedures require the use of X-ray in order to provide accurate needle placement and treatment …Read More