SERVICES

For musculoskeletal pain (knees, ankles, shoulders, wrists, etc.), healing starts with appropriate diagnosis! Musculoskeletal ultrasound is a non-invasive, radiation-free radiological examination used to generate images for diagnosis. Linked to a powerful computer, a probe produces images of the human body’s anatomical structures. It is among the best examinations to diagnose certain musculoskeletal disorders affecting tendons, muscles, ligaments, bursae, fascias and nerves. 

This examination helps individuals afflicted by pain or joint limitations and for which X-ray examinations are non-specific.

Musculoskeletal ultrasound is an accurate and dynamic examination, during which several musculoskeletal structures likely to be the source of a patient’s pain are examined. 

The ultrasound does not involve any X-rays; instead, ultrasounds are emitted by a probe in the form of short impulses. They help in making or confirming a diagnosis and, more precisely, identifying the type and extent of a lesion. When required, high-precision injections can also be performed during such examination by directly observing the lesion and the injection needle used to inject medication right where the problem is located.

Discal stimulation is a diagnostic procedure performed to determine if a patient’s symptoms are the result of a disc affliction (disc tear, herniated disc). To do so, a needle is inserted in the intervertebral disc under fluoroscopic guidance. Then a contrast medium is injected to increase pressure inside the disc.

The purpose of this procedure is to confirm that a disc is the source (discogenic) of pain by recreating the patient’s usual symptoms. A scan can then be performed to ensure a better discal disease diagnosis. This procedure is indicated when an intra-discal percutaneous (thermal annuloplasty, PRP injection) procedure or surgery is considered after conservative treatment failed on a patient.

Info on the way!

BOTOX is a purified neurotoxin complex protein produced from the bacterium Clostridium botulinum.

BOTOX is used in adults who have 15 or more migraine headaches per month lasting 4 or more hours per day.

Chronic Migraine is defined as:

• 15 or more headache days per month over 3 months, with 8 headache days meeting criteria for migraine with or without aura.
• To meet criteria for migraine, the patient experiences two of the following symptoms:
  • Headache on one side of the head only
  • Headache throbs or pulses
  • Headache is moderate to severe in pain intensity
  • Headache is aggravated by, or causes avoidance of, physical activity and is accompanied by either nausea and/or vomiting or sensitivity to light or sound.
  • Additionally, the migraine sufferer will have treated their headache with migraine medication prior to the expected development of the symptoms listed above.

BOTOX is injected by needle into several head and neck muscles that may be causing or contributing to your headaches. The radiologist determines the number of injections and the sites required to treat your specific condition.

It is recommended that you get your BOTOX injections every 12 weeks. You may continue this therapy, if deemed effective, after discussing with your practitioner.

Your practitioner will decide whether or not you are eligible for treatment if you are already receiving BOTOX for other conditions. It is very important that you inform your practitioner.

Many patients with chronic headache report that their pain typically arises from the neck or, more specifically, the base of the skull. Often that pain arises on one side or the other and extends forward to involve the top of the head, the temple, the forehead, the eye or some combination thereof. These are termed cervicogenic (ie, “born of the neck”) headaches.

Residing in those areas of the skull base are the occipital nerves. Irritation/inflammation of those nerves may cause a specific type of “neuralgiform” pain: occipital neuralgia. More commonly, however, those nerves serve as major “on-ramps” to the “superhighway” upon which travel the pain signals that produce migraine and other types of headache. If one can block traffic on these busy on-ramps, then it may be possible to halt the flow of pain signal on the superhighway and thus—at least temporarily—halt head pain.

Such is the logic of occipital nerve blocks (ONBs) for suppression of chronic headache. The blocks themselves are relatively simple to perform. Your physician will use a small needle to inject a solution into the area around the nerves; the composition of that solution differs according to physician experience and preference but most often contains a long-acting local anesthetic and a steroid anti-inflammatory drug. Insertion of the needle is not especially painful, but infusion of the solution may cause temporary discomfort.

Occipital nerve blocks are not for everyone, but for selected patients they can prove a more effective means of suppressing chronic headache than any oral medication.

Available July 2020