I live and ski in Sun Valley approximately 60 days/season. I have developed knee pain and I am wondering if I am a candidate for PRP (Platelet-Rich Plasma)?

You may be a good candidate for Regenerative Medicine, either PRP or Stem Cell.  Stem Cell is done primarily for osteoarthritis of the larger joints-knee, hips, shoulder.  Whereas PRP is more typically done for a partial tear or sprain of tendons/ligaments.  However, PRP can also be done for osteoarthritis (and degenerative discs of the spine).  Call Pain Care Boise at 208-342-8200 to set up an evaluation.

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Do nerve blocks with steroids cure the problem for which they are used in chronic pain conditions?

Nerve blocks for chronic pain generally do not "cure" the problem but rather decrease the inflammation. We typically see a more manageable pain level and, therefore, improved function. This will allow the body time to heal itself. There are numerous examples of clinical conditions that can be treated with nerve blocks. For examples, when treating a herniated disc with epidural steroids, we decrease the inflammation of the nerve roots. Whether...

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Why would a celiac plexus block be done for a patient with pancreatic cancer?

The celiac plexus innervates the lower esophagus, stomach, small intestines, most of the large intestines, liver, pancreas, spleen, adrenal glands, and kidneys. Therefore, by blocking the celiac plexus, you can interrupt the pain fibers from these abdominal organs. The celiac plexus is actually a series of ganglia just in front of the aorta and the 1st and 2nd lumbar vertebrae. A diagnostic block is done first with local anesthetic only....

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What is piriformis syndrome?

The piriformis muscle lies in the lower buttocks area between the sacrum and hip. The sciatic nerve runs below or through the piriformis muscle. Piriformis syndrome will mimic sciatica. With piriformis syndrome, there is no weakness or numbness. Piriformis syndrome is typically caused by an injury to the piriformis muscle and often does result in irritation of the sciatic nerve that runs near it. It is typically treated with anti-inflammatories,...

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What is interventional pain management?

Interventional pain management refers to a group of minimally invasive surgical procedures typically done as an outpatient to alleviate acute, chronic, or cancer- related pain conditions. These include, but are not limited to; trigger points injections, epidural steroids, facet injections, peripheral nerve blocks, sympathetic blocks, intravenous infusions, neurolytic procedures (radiofrequency lesioning, cryotherapy, chemical neurolysis), Botulinum Toxin injections, intradiscal treatments (IDET, Loblation/Nucleoplasty, LASE), intraspinal analgesics, and spinal cord stimulation techniques. Specific...

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When is spinal cord stimulation utilized in pain management?

Spinal cord stimulation is considered for neuropathic pain or pain due to a nerve injury when other more conservative modalities have failed. It is most commonly used when one has a difficult to treat extremity pain, arm or leg pain. Examples of arm or leg pain can be after spine surgery due to continued scar tissue about the nerve roots, with reflex sympathetic dystrophy problems, following injuries to peripheral nerves,...

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Is a nerve root injection different than an epidural steroid injection?

A nerve root injection is a transformational epidural steroid injection. An epidural steroid injection is usually an interlaminar (between two vertebrae) approach. With an interlaminar steroid injection the needle is placed to the epidural space typically near the middle of the spinal canal. With an interlaminar approach, a high volume technique is utilized to bathe several nerve roots at several levels. With a nerve root injection, a needle is placed...

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What is and when is a neurolytic block used in pain medicine?

Neurolysis can be achieved through injection of chemicals (Phenol, Glycerol, or Alcohol), the use of cryotherapy (cold), or the use of radiofrequency lesioning (heat). All of these therapies are typically used as an end of the road type of treatment. Cryotherapy can be used for some peripheral neuropathies of nerves that are a sensory nerve only. Radiofrequency lesioning is most commonly used to denervate facet joints. These two types of...

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If my herniated disc is not pressing on a nerve root, could it still cause my low back pain and leg pain?

Although controversial, it is possible. A herniated disc is felt to cause lower extremity or radicular pain by potentially two different mechanisms. The most obvious is by physical or mechanical pressure on the nerve root. The second is by a chemical irritant and/or acid \ base changes due to the contents of the inner part of a disc reaching the nerve root through a herniation or even a simple fissure...

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Is sciatica only caused by a herniated disc?

No. First, sciatica is a bit of a misnomer. Strictly, sciatica means pain in the distribution of the sciatic nerve. In medicine, sciatica commonly is used to describe lower extremity pain caused by the irritation of the nerve roots that form the sciatic nerve. This can be caused by a herniated disc or anything that puts pressure on the nerve root; such as spinal stenosis, severe facet arthritis, bone spurs,...

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