When to Get Neck Injections for Pain [and How to Prepare] Have you been experiencing constant neck pain that radiates from your neck to your arm?  Do simple remedies like stretching, ice/heat therapy or pain medications give you zero relief?  Chronic neck pains are debilitating aches that can hamper your day-to-day activities.  Fortunately, a simple injection may be the answer you’ve been looking for.  What Injections Are Given For Neck Pain?  Neck injections for pain are administered to patients who have been dealing with long-term neck pain.  Cortisone injections for pain in the neck are one of the best alternative treatments before neck surgery is considered. If pain medications or physical therapy hasn’t worked to alleviate your neck pain, you might be the perfect candidate for one of these treatment options:  Epidural steroid injection. A cervical epidural injection places steroids in the epidural space and into the dura (the membrane that covers your spine and nerve root in the neck). This will lower inflammation in the nerve roots, providing pain relief.  Facet joint injections. This injection is recommended if the neck pains are caused by facet joint inflammation. The steroid is injected in the facet joint, a small joint behind your vertebral bones. Nerve root block. If the neck pains are associated with a damaged disk or a bone spur, the nerve root block is considered. This injection is inserted in the area around the spinal nerve root to decrease its inflammation.  What Is A Cervical Epidural Steroid Injection?  The cervical epidural injection is a minimally invasive procedure wherein both a corticosteroid and an anesthetic numbing agent are delivered to the epidural space (the area between the bone and the protective dura sac around the spinal nerves).  This type of corticosteroid injection has been proven as an effective treatment to decrease inflammation and pain in the neck area.  Although this injection is not intended to reduce the size of a cervical herniated disc, it can flush away some of the proteins that cause the swelling in the spinal cord and nerves.  This neck pain injection can bring long-term pain relief, allowing alternative treatments such as physical therapies and exercise programs to improve your spinal condition. When Should You Get A Cervical Epidural Steroid Injection?  Patients who have been suffering from long-term neck and back pain are good candidates for an epidural steroid injection. It may benefit those particularly with the following conditions:  Cervical radiculitis. Pain that radiates from the head or the neck down to the arm due to nerve compression in the cervical spine.  Cervical Herniated Discs. Electric-like pain that’s felt from the neck down to the arms, which may be caused by trauma or neck injury.  Cervical Spondylosis. Pain caused by the aging and normal wear-and-tear of the spinal disc in your neck.  Treatment through the cervical epidural steroid injection has been beneficial to patients with these painful neck inflammatory conditions.  In cases where rehabilitative exercises are required, these epidural injections work well in abating the pain to allow you to continue with physical therapy.  Furthermore, it can also help assess if more invasive treatments, such as surgery, are needed to address the pain. Who Are Not Ideal Candidates For Cervical Epidural Steroid Injection?  A patient with the following conditions is at risk for complications:  Patient with active infections, bleeding problems, high blood pressure, or diabetes If you are taking medications blood-thinners (eg. heparin, coumadin, etc.) If you are allergic to the epidural steroid medication (eg. corticosteroid, anesthetic) You can discuss your conditions with our doctors and we will assess your pain management options.  How To Prepare For Cervical Epidural Steroid Injection?  If you are considering having cervical epidural steroid injections, preparation is key to lessen risks and complications.  Here’s how you can best prepare for your neck injection:  Bring your complete medical data and history at your first appointment.  Be sure to give your doctor a comprehensive list of all your medications so they know which medicines need to be discontinued or avoided before doing the procedure.  What To Expect Before The Procedure?  Before the treatment, your doctor will do a thorough medical examination.  Your medical history will be reviewed and several tests will be done to assess whether you are a good candidate for cervical ESI.  Once cleared, our doctors will list specific instructions on what you should do before the procedure.  For example, a typically required routine preparation is to not eat more than a small meal within a few hours before the injection.  Patients are also typically allowed to take their usual medications, except for those that have anti-inflammatory or blood-thinning effects.  What Happens During The Treatment?  What To Expect: Do Injections In Neck Hurt?  In general, injections can bring some mild discomfort, especially when the medications are delivered in small delicate areas.  Fortunately, local anesthetics (pain relief medication) will be administered before the injection so you can expect to only feel a small amount of pressure rather than pain when your doctor inserts the cervical corticosteroid injection.  If you’re concerned about pain from the neck injection, talk to your doctor to find out your options for pain relief medication.  You may request to be sedated during the procedure, but this is very uncommon as the procedure is not uncomfortable.  Remember to simply relax, stay calm, and take deep breaths during the procedure.  Step 1: Preparing For The Injection Extensive assessments will be done by your doctor to figure out which site to inject. Ideally, they will target the medication as close to the painful nerve as possible.  To do this, x-ray fluoroscopy is used to take live imagery of your neck.  You will lie down on the x-ray table. A local anesthetic will be administered to numb the injection site and minimize pain.  Generally, patients are expected to be awake during the injection to be able to communicate any discomfort to the physician.  Step 2: Inserting The Needle Through the x-ray fluoroscopy, the doctor will be able to see in real-time where to inject the epidural steroid.  A contrast dye will be used to ensure that the medication is flowing in the correct place.  The entry site will be on the side of the neck to access the neural foramen, which sits just above the opening of the nerve root and outside the epidural space.  The needle will go through the skin, between the bony vertebrae, and into the epidural space. Step 3: Injecting The Corticosteroid  Once the local anesthetic takes effect and the needle is correctly positioned, your doctor will inject the epidural steroid injection into the epidural space that surrounds the inflamed nerve roots.  Depending on the pain location, one or several cervical spinal levels may need to be injected.  How To Recover After The Procedure?  After the injection, you will be monitored in a recovery area typically for up to an hour.  Many patients are already able to move and walk around post-injection.  However, for some, temporary weakness and numbness can occur in the legs, which will eventually wear off by the end of the day.  We advise the following to our patients:  Be brought home by a companion  Rest and avoid heavy activities for the rest of the day  Avoid drinking or operating heavy machinery for at least the next 12 hours post-injection  Usually, many patients can resume their regular activities the following day.  However, you may expect soreness at the injection site. This can be alleviated by icing the area and taking mild analgesics that are recommended by your doctor.  What Results Can You Expect?  The medication may not go into full effect right away.  It’s recommended to track the pain levels you feel within the next couple of weeks.  There may be days where the area feels much more painful, numb, or weak. This is normal as the numbing medications eventually wear off before the epidural steroid injections start to take effect within 2-7 days.  For those with mild neck pain, one or two injections may be administered within a 1 to 4-week interval to achieve the full relief.  How Long Do Neck Injections Last?  Depending on the severity of neck pain, patients who undergo cervical epidural steroid injections can expect pain relief that lasts for weeks up to years. To achieve the best results, epidural injections are best done with physical therapy and neck exercise programs.  In Conclusion…  If you’ve been suffering from chronic neck pain, it may be best to consider cervical epidural steroid injections. Get in touch with us and we’ll schedule you for your first appointment!  Epidural steroid injections are a minimally invasive treatment wherein corticosteroids are injected in epidural space within the cervical area of your spine.  This results in decreased inflammation in the nerve and reduces neck pain.  These neck injections a safe, with very low risk associated with the procedure. Not much preparation is needed, but it is important to discuss your medical history and list of medications to your doctor.  Full recovery can be experienced a day after the injection. The epidural steroid injections will take effect in about 2-7 days, but it can bring relief to long-term neck pain. Cervical epidural steroid injections can be a life-changing experience, especially for those that have been dealing with chronic neck pains.  Have you had the procedure already? Share your experience with other people below!  Want to know more about cervical epidural steroid injections? Fill out the form below and ask us a question.

Vein Removal Guide for Patients Are you experiencing discoloration or discomfort in your legs? Varicose veins are the result of faulty valves in the veins that cause the blood to flow in the wrong direction.  A bothersome condition, varicose veins often cause patients to experience swelling in the veins of their legs and feet due to the pooling of blood within them. It can be uncomfortable but is rarely dangerous.  One in four adults in the United States has experienced related symptoms such as painful, achy legs, swollen ankles, and spider veins.  Luckily, there is a varicose vein treatment. Patients can undergo a vein removal procedure, otherwise known as an ambulatory phlebectomy.  To help you in your search for relief, we have put together an easy to follow guide for patients who are candidates for varicose veins treatments.  If you do not find all of your answers in this guide, or you wish to further your research,  please visit our page on managing symptoms.  What Causes Varicose Veins? Veins are the highways used by our blood, which travels through our bodies through one-way valves. If the vein becomes stretched, it loses flexibility, weakening those valves.  When it is stressed, blood can leak backward and flow in the opposite direction, also called venous stasis. When this happens, blood accumulates in the vein or veins, which causes them to become enlarged and swollen. This can also lead to blood clots or superficial venous thrombosis. The most vulnerable veins are those furthest away from the power source; the heart. Legs and feet are most affected because gravity makes for a more difficult and obstructed blood flow.  Who Is Likely to Get Varicose Veins? Weight, gender, hormones, genetics, and lifestyle are all determinants for who will develop varicose veins. People who are overweight tend to have a higher risk. If a person has a condition that causes a heavy pressure on the abdomen, it can cause varicose veins as it would affect the blood flow.  Women are more likely than men to get varicose veins because of hormone factors. Using birth control pills, postmenopausal hormone replacement, or the stages of puberty or menopause can increase your risk. Pregnant women are also likely to acquire this condition as there is a lot of pressure placed on the abdominal region. Pregnancy also increases the amount of blood in the body, which causes increased pressure on the circulatory system.  Changes in hormone levels can also lead to the relaxation of the blood vessels. Typically, they will go away after the pregnancy is over.  Varicose veins can be genetic, causing individuals to be more prone to the condition. Those over the age of fifty are also more likely to get varicose veins, especially if there is a family history.  Also, lifestyle can play a role in causing varicose veins as well, such as working a job that requires a lot of standing, being on your feet, or sitting. Is There a Way to Prevent Varicose Veins? Sometimes, varicose veins are genetic, and there is no proven way to prevent their occurrence completely.  You can decrease your risk by taking measures to improve your circulation. Exercise, eating a high fiber, low-salt diet, elevating your legs, and changing your position from sitting or standing are some daily habits that we recommend.  If there is concern for getting this condition, a varicose vein treatment for prevention could be to wear compression stockings to increase the blood flow in the legs and decrease swelling. What Do I Do If I Have Varicose Veins? Varicose veins are typically not dangerous. They can be unsightly though which leads many patients to feel subconscious and wish to pursue treatment for varicose veins for cosmetic reasons.  If veins become too large, painful or troublesome, there are vein treatment options to reduce their appearance or for complete removal. Keep reading to learn your options for the best vein treatment options available. Laser Vein Removal: Highly Effective, Minimally Invasive Laser vein treatment has been used for over 20 years and is quite safe and effective. The rate of success is 94%.  Preparation: Before your visit to the medical office, you should drink plenty of water. Make sure that you do not shave the treated area on the day of the appointment, or apply makeup or lotion. If prescribed a sedative medication, take it one hour before and make sure that you have someone to drive you to and from the hospital or vein care center.  For your comfort, you should wear loose, comfortable clothing. You should also make sure you’re not wearing your favorite underwear, as the doctor will prep the entire leg, including the groin area.  What to Expect: A laser, or a highly focused beam of light, will be used to heat the affected varicose vein or veins, causing scar tissue to form.  For cautionary reasons, you will be given protective eyewear during treatment. The laser only targets the unwanted varicose vein or veins, leaving the surrounding skin untouched. Healing and Recovery: Recovery is typically short, and you will be able to walk right away following the procedure. You will be told to wear compression stockings for about a week after.  After laser treatment, the veins will gradually change from a dark blue to light red color, and will eventually disappear. This healing process takes anywhere from two to six weeks. Larger veins can sometimes take up to three months. You may need to undergo multiple sessions to obtain your desired results.  Vein Stripping: Traditional Outpatient Procedure Preparation: Before your vein stripping procedure, tell your provider what drugs you are taking. Also inform them if you might be pregnant, or if you have been drinking more than 1 or 2 alcoholic beverages per day. On the day of the procedure, you cannot drink or eat anything for 6-8 hours before the vein stripping. If you have medicine to take, drink only a tiny sip of water.  What to Expect: The vein stripping procedure, also known as an ambulatory phlebectomy, typically takes from 1 to 1 ½ hours.  If you are not allergic to anesthesia, your healthcare professional will administer either a general or spinal anesthesia through injection. With general anesthesia, you will be asleep and unable to feel any pain. With spinal anesthesia, the lower half of your body will go numb. Your doctor may also use a local anesthesia at the site of where the incisions will be made. During the surgery, there will be 2 to 3 small incisions in your leg, near the top, middle, and bottom of the vein. One will be in your groin, the other in the middle, and the last on your calf or ankle.  A wire is tied to the vein and is used to pull it out through the lower cut. The thread is thin and flexible. Your surgeon will close the incisions with stitches.  Healing and Recovery: For a few days (3-5) after the procedure, you will have to wear bandages and compression stockings to control bleeding and swelling.  Sclerotherapy Vein Treatment: a Simple Cosmetic Procedure One of the most common varicose vein treatments for spider veins is sclerotherapy. Since the 1930s, this has been a proven and efficient procedure.  It is not a viable solution for pregnant women. Your eligibility depends on the health of that area of your skin.  Preparation: You should avoid taking certain medications before sclerotherapy. Talk to your doctor about your prescriptions or any herbs or dietary supplements that you are taking.  You should not shave, wear makeup, or put lotion on your legs before the procedure.  What to Expect: This is a quick procedure that lasts from 15 to 30 minutes performed by a dermatologist or a surgeon. The doctor will inject a fine needle full of a salt solution directly into the vein.  You may experience some mild discomfort for a couple of minutes.  Healing and Recovery: After sclerotherapy, walking is encouraged. You will be able to resume your daily activities and even drive yourself home.  You should avoid taking any anti-inflammatory medication for at least 48 hours as well as hot baths, compresses, saunas, or direct sunlight exposure.  You may experience mild itching, raised, red areas, or bruising at the injection site. These side effects should disappear within a few days.  Radiofrequency Vein Ablation: Minimally Invasive and Very Successful Another solution to treat a varicose vein or veins and similar to the laser treatment is the radiofrequency vein ablation. A doctor uses heat to damage the vein, causing scar tissue to form, only using radiofrequency energy. It typically closes off the varicose vein in the leg.  Preparation: There is no special preparation necessary, though, like all procedures, you must let your doctor know if you are allergic to anesthetics. Your skin will be sterilized, and local anesthesia will be administered to the area for numbing.  What to Expect: Radiofrequency energy enters the vein through a catheter that is inserted through a tiny incision in the leg. The cut will be either above or below your knee.  The procedure typically takes place in a medical office setting. You will be administered a local anesthesia or a mild sedative to help you relax.  Healing and Recovery: Most of the time, the recovery from radiofrequency ablation is easy and fast. You may feel a tightening sensation for a couple of days or maybe some bruising or swelling. Veins may take a few months to disappear completely.  Varicose Veins Treatment Cost Are you seeking a vein treatment, but fear that the price tag for relief is just too high? Let us talk about the cost of these various procedures and what considerations to take before choosing the best method for you.  There are a few factors that will impact how much you pay. Do you have an underlying venous disease and/or at risk for blood clots? Is the treatment medically necessary, or is it only cosmetic? If you have venous insufficiency, a known vein disease, treatment will be covered by most insurance companies.  If the procedure is only cosmetic, it may cost over $1000. Home remedies can be useful for reducing the appearance of varicose veins and provide pain relief. Changes in diet, exercise, and taking plant extracts such as horse chestnut can relieve related discomfort. Get the Best Help and Relief from Varicose Veins No matter your reason for pursuing vein treatment, there are options available to you. Speak to your vascular specialist or visit an advanced vein center. Varicose veins affect approximately 35% of the American population, are you considering a vein removal treatment for your varicose veins? We would love to hear from you to know if this guide was helpful for you, or if you have more questions we can answer. Leave a comment or question below.