Book an Appintment with Dr. Mikhail Kogan

Specialties: Pain Management, Anesthesiology.

Dr. Sekhar Upadhyayula, MD and Dr. Mikhail Kogan MD

Dr. Sekhar and Dr. Mikhail Kogan are member of American Society of Anesthesiologists.

Pain Solutions New York - NYpainsolutions.com

Call on 718-544-1171 or visit www.nypainsolutions.com for Appointment.

Epidural Steroid Injection

The Epidural Steroid Injection is a procedure where numbing medicine (anesthetic) and anti- inflammatory medicine (steroid) is injected into the epidural space to treat pain caused by irritation of the spinal nerves.

Cervical Facet Joint Injection

The Cervical Facet Joint Injection is a procedure used to block or decrease pain caused by problems in the upper (neck area) spine.

Showing posts with label Knee injection. Show all posts
Showing posts with label Knee injection. Show all posts

Epidural steroid injection- A standard treatment option for several varieties of low back pain

Epidural steroid injections (ESIs) are a standard treatment option for several varieties of low back pain particularly when in the course of radicular leg pain, a condition normally called sciatica.
An Epidural steroid injection reduces pain as a result of it contains corticosteroids that mimic the consequences of the naturally occurring hormones cortisone and hydrocortisone that serves to reduce inflammation around irritated nerves. The result of the steroid is temporary and therefore the cause of the nerve irritation, normally the chronic changes of the disc resulting in a bulge or rupture nevertheless remains. Worse, there is a likelihood these hormones in such unnaturally high concentrations would possibly truly weaken the spinal bones, ligaments, and therefore the tendons of close muscles combining the problem. ESI's are sometimes restricted to only some a year as a result of steroid injections additionally suppress the body's natural secretion balance and might result in adrenal insufficiency, a significant medical condition. Delaying repeat injections is likely to permit your body an opportunity to come back to its normal balance though there's very little proof to support this notion. the chance of those facet effects might increase with the number of steroid injections received and the dose given in every injection.

Risks factors-
>>Death of nearby bone (osteonecrosis)
>>Joint infection
>>Nerve injury
>>Skin and soft tissue thinning around injection web site
>>Temporary flare of pain and inflammation within the joint
>>Tendon weakening or rupture
>>Thinning of nearby bone (osteoporosis)
>>Whitening or lightening of the skin around injection web site


Alternative-
Modern medical science has finally developed an efficient alternative to endless injections or just living with the pain - Spinal Decompression medical aid. Performed on a special, computer controlled table similar in some ways in which to a normal traction table one disc level is isolated and by utilizing specific traction and relaxation cycles throughout the treatment, along side proper positioning, negative pressure will truly be created inside the disc.
It works by gently separating the sinning disc five to seven millimeters making negative pressure (or a vacuum) within the disc promoting the retraction of the bulging disc tissue. This negative pressure also pulls water, oxygen, and nutrients into the disc, thereby re-hydrating a degenerated disc and transfer within the nutrients required to start the healing method. because the disc retracts the pressure comes off the nerve eliminating the irritation that triggered the inflammatory method.

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Epidural Steroid Injections


Epidural injections are administered for relieving the pain suffered by the patients in their spine. Epidural injections are used for treating low back pain for quite sixty years. These injections contain steroids, anesthetics and anti inflammatory medications.
They perform the task of decreasing the inflammation and swelling that is inflicting the back and leg pain. The epidural injections deliver the medication contained in them into the epidural space of the spine.

What are the major indicators for having Epidural Injections?

Epidural injections are sometimes indicated for people who are affected by chronic back pain or sciatica and haven't been able to find relief from the never ending pain through the use of typical treatment ways. Patients with a bulging or slipped disc are perfect candidates for receiving epidural injections.
In addition to the present, spinal stenosis is another medical condition that an epidural injection will sway be terribly helpful. Victims of a car accident who have suffered a spinal injury or individuals convalescent from failed back surgery syndrome will realize epidural injections terribly effective for assuaging their back pain.

What does Epidural Injections entail?

Epidural injections involve these of a hypodermic needle to deliver corticosteroids into the epidural space of the spine that alleviates the pain and inflammation that the patient has been suffering from. The medicine nature of the corticosteroids decreases the inflammation within the spinal discs and within the process relives the pressure on the spinal nerves.
In some cases, the epidural injections are used to deliver an anesthetic to the spinal nerves that stops them from sending pain signals to the brain and therefore curb the pain being felt by the patient. the utilization of radiology improves the accuracy and effectualness of the epidural injections.

How will Epidural Injections facilitate the doctor offer treatment?

Epidural injections will provide instant relief from the never ending back and leg pain. Their ability to right away decrease the chronic pain within the spine is extremely useful for seattle pain doctors in managing the pain symptoms of patients. With the pain taken care of, the doctors will direct their attention towards solving the other symptoms of the patient.   

What to expect when having Epidural Injections?

The epidural injections are administered using a hypodermic needle. you'll be asked to lie down on your stomach. The doctor goes to apply anti-septic solution and a local anesthetic on the skin of the area above the epidural space wherever the injection is to be inserted.
The anti-septic goes to clear the bacteria whereas the anesthetic can numb the area so you are doing not feel any kind of pain once the injection is inserted into the epidural space. once ensuring that the needle is placed at the proper spot victimization X-ray steering, the seattle pain management doctor goes to inject the contents of the injection into the epidural space. A band-aid goes to be applied over the injection web site once the procedure has been completed.

There are three varieties of epidural injections:

Interlaminar injection – oldest technique – injection of steroid between the “lamina” bones.

Transforaminal Epidural – the latest technique, interjects medication specifically wherever the nerve root is being pinched.

Caudal Epidural – places the steroid medication very low within the spine then it migrates to alleviate pain at multiple levels.

What are the risks of having Epidural Injections?

Infection remains the most risk of epidural injections. There's additionally a chance of a reaction happening to the medication that's delivered within the injection. However, the risks and complications related to epidural injections are uncommon.
What are the benefits of having Epidural Injections?

The most necessary benefit of epidural injections is fast relief from acute or chronic back or leg pain. Dozens of studies are looking at epidural injections and have shown that in over seventy fifth of individuals, excellent pain relief is achieved. This might last from days to months.

Sciatica Nerve Pain Symptoms - Part2

Symptoms of a Herniated Disc/Pinched Nerve:
Usually, a person’s main complaint is back pain. In some cases, there is also a previous history of episodes of localized lower back pain, that is present within the back and continues down the leg that's served by the affected nerve. This pain is typically described as a deep and sharp pain, that gets worse because it moves down the affected leg. The onset of pain with a herniated disc might occur out of the blue or it should be proclaimed by a tearing or snapping sensation within the spine that's thought to be the results of a unexpected tear of a part of the annulus fibrosis.

A person with a herniated disc can usually complain of lower back pain that will or might not radiate into totally different components of the body. they're going to typically have restricted vary of motion once asked to bend forward or lean backward, and that they might lean to at least one side as they try to bend forward. Sometimes, they walk with a painful gait, flexing the affected leg thus as to not place too much weight on the facet of the body that hurts.

Diagnosis of Herniated Disc/Pinched Nerve:
A neurologic history and examination performed by a trained physician can provide the foremost objective proof of a rupture and pinched nerve. There are not any laboratory tests which will sight the presence or absence of a rupture, however they'll be useful in diagnosis uncommon causes of nerve root pain and irritation. EMG (electromyographic test) could facilitate to work out that nerve root specifically is being pinched or isn't operating ordinarily within the scenario wherever many nerve roots is also concerned. MRI is that the take a look at of alternative for diagnosis a herniated disc.

Treatment for Herniated Disc/Pinched Nerve:

The treatment for the vast majority of individuals with a herniated disc doesn't commonly embody surgery. several patients can respond to non-surgical treatments. the first component of non-surgical treatment is controlled physical activity. Usually, treatment can begin with avoidance of intensifying activities followed by a gradual come to traditional activities. Sitting is dangerous for this condition as a result of the sitting posture puts a large quantity of stress and pressure on the lumbar spine, which can increase the pressure on the affected nerve root. the suitable use of medicines is a very important a part of non-surgical treatment. this will embody anti-inflammatory drug medicine, analgesics, muscle relaxants, or tranquilizers. in addition, the proper doses of acetylsalicylic acid are tried to assist herniated discs. physiotherapy is additionally necessary.

Surgical treatment and chronic pain therapies are reserved for people that haven't had success with non-surgical treatment choices and a enough amount of your time has passed to point that they'll ought to have surgery so as to assist them to induce higher.

Back Pain Treatment - NYpainsolutions


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Given the prevalence of back pain, you would think we'd have treatment for it down pat. Not even close. "The challenge is that you can't see injuries to tendons, ligaments, and muscles the way you can bone fractures and herniated disks," Despite diagnostic advances, doctors can't pinpoint an exact cause for as many as 85 percent of back problems, which makes them tricky to treat. Spinal manipulation, for example, is controversial -- some docs say it does more harm than good -- but it's the only remedy that got me off the couch and back on my bike. "Chiropractic care is not without concerns; then again, neither is traditional medicine, particularly when you're dealing with a problem like back pain, which has no easy, one-size-fits-all fix,"

Even exercise, which a majority of experts agree is one of the best ways to maintain a healthy back and chase away aches and pains, can be problematic. "When you're sedentary, the muscles supporting the spine get weaker, and you're more prone to injury," Dr. says. But "exercising with improper form -- rounding the back when doing dead lifts or arching it during ab work -- can place unwanted stress on the spine".

If you fall into the 80 percent of the population that regularly suffers from back pain, take heart: One-third of aches due to a strain or a sprain improve in a week without medical intervention (the remainder may take up to eight weeks). But unless you do some spine tuning -- strengthening your back through exercise and fostering healthier habits with our advice here -- your odds of a recurrence within six months are about one in three, Dr. says. Keep your back in tip-top shape by avoiding these seven spinal sins.
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Common Back Pain Causes

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It began as a twinge. Then the pain began to radiate down my back when I biked. teasing became dangerous once it hurt to show my head; don't attempt cycling with impaired neck quality. however I saw no reason to switch my fitness routine. I pedaled. I kickboxed. I raised weights. And once regarding 3 weeks, I paid the value. One sleepless night, pain that felt sort of a knife in my back stapled me to the couch.

Whether you are a week­end human, an elite athlete, or somewhere in between, there is a sturdy probability that eventually you will take care of back pain, too. Here's why: Everyday activities that you simply do stupidly, slithering on a try of shoes, crawl into bed in the dead of night -- will build or break your spine health. Most aches square measure caused by strains (injured muscles or tendons) or sprains (damage to the robust animal tissue, or ligaments, situated wherever your vertebrae connect with joints). These injuries square measure usually brought on by over­use, a replacement activity, excessive lifting, or an accident. different times, a compressed (aka pinched) nerve, like in a very herniated disk, is guilty for the ache.

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Back Pain Solutions in New York Queens


The back is an complex structure of bones, muscles, and different tissues that form the posterior a part of the body’s trunk, from the neck to the pelvis. The centerpiece is that the spinal column, that not only supports the higher body’s weight however homes and protects the spinal cord — the delicate systema nervosum structure that carries signals that management the body’s movements and convey its sensations. Stacked on high of 1 another are quite thirty bones — the vertebrae — that kind the back, conjointly referred to as the spine. every of those bones contains a circular hole that, once stacked in register with all the others, creates a channel that surrounds the spinal cord. The spinal cord descends from the bottom of the brain and extends within the adult to merely below the skeletal structure. little nerves ("roots") enter and emerge from the spinal column through spaces between the vertebrae. as a result of the bones of the spinal column continue growing long when the spinal column reaches its full length in babyhood, the nerve roots to the lower back and legs extend several inches down the back before exiting. this large bundle of nerve roots was dubbed by early anatomists because the complex body part equina, or horse’s tail. The areas between the vertebrae are maintained by spherical, spongy pads of animal tissue referred to as bone discs that afford flexibility within the lower back and act very similar to shock absorbers throughout the back to cushion the bones because the body moves. Bands of tissue referred to as ligaments and tendons hold the vertebrae in place and fix the muscles to the spinal column.

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Symptoms of Back Pain

Symptoms of Back Pain include:
  •     Muscle ache
  •     Shooting or stabbing pain
  •     Pain that radiates down your leg
  •     limited flexibility or range of motion of the back
  •     Inability to stand up straight

When to see a doctor

Most back pain step by step improves with home treatment and self-care. though the pain may take many weeks to disappear fully, you must notice some improvement within the primary seventy two hours of self-care. If not, see your doctor.

In rare cases, back pain will signal a serious medical problem. request immediate care if your back pain:
  •     Causes new bowel or bladder problems
  •     Is related to pain or throbbing (pulsation) within the abdomen, or fever
  •     Follows a fall, blow to your back or different injury

Contact a doctor if your back pain:
  •     Is constant or intense, especially at night or when you lie down
  •     Spreads down one or both legs, especially if the pain extends below the knee
  •     Causes weakness, numbness or tingling in one or both legs
  •     Is accompanied by unexplained weight loss
  •     Occurs with swelling or redness on your back

Also, see your doctor if you start having back pain for the primary time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or drug or alcohol abuse.

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Endoscopic-Discectomy Treatment in Queens New York



Many patients who are suffering with serious discomfort related to the spine and back, for all such patients, specialists have many new treatments and Endoscopic Discectomy is one within the list. it's true that this treatment uses the whole technology to its advantage, however sadly, it's not the answer to all or any the conditions that cause back pain, say specialists.

In easier language, we can say that it primarily depends upon the interaction of malady with the surrounding structures and the type of complaint that's bothering the patient's health, that more determines if he's the candidate for this advance procedure or no.

During the endoscopic laser Spine Treatment, the medical experts remove the herniated material and try to achieve back the earlier access to the damaged disc. Moreover, they conjointly cauterize the disc so no any leakage of disc material happens within the body. wherever the normal discectomy needed the surgeons to form a large size incision (5-6 inch) to achieve access to the broken disc, the new to make discectomy is performed with latest technology and the incision that's currently created by the surgeons is concerning the scale of a token. it's through this gap that the sawbones insert a operating tube within the patient's body to simply insert and manipulate the special tools and perform the desired operation. This surgery is performed with associate degree medical instrument, a little video camera that displays the live video on a screen through that the sawbones is ready to find the broken disc and treat it.