Medical Center MEDICA 2005


Affiliates Sofia, Vidin and
MC Academica 2008 - Pleven
Medica 2005 Medical Center
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Interventional treatment for chronic pain

Interventional treatment for chronic pain

Interventional treatment for chronic pain (injections) can relieve pain and spasm and break the cycle of pain and immobility.

Spinal Injections

We offer a few spinal injections at branches in Sofia and Pleven. These injections include epidurals, caudal epidurals, nerve root blocks, facet joint injections, trigger point injections.

Conditions treated with Spinal Injections

Spinal injections are for pain in the low back, neck or middle of the back (lumbar, cervical or thoracic) and for prolapsed discs (slipped discs), sciatica and leg or foot pain caused by inflammation or compression of the nerves in the back. This may be as a result of injury, arthritis, disc compression or nerve root irritation caused by narrowing of the spinal canal (spinal stenosis).

What is the procedure?

You will have a thorough assessment to see which treatment is appropriate. The doctor can use ultrasound equipment for guidance in placing the needle. You will be explained what is happening throughout the procedure. You will need to arrange a lift home as we do not recommend that you drive home straight after a spinal injection.

Is it painful?

In most cases spinal injections are not painful procedures. You may experience some feelings of pressure as the fluid is pushed in. The doctor can administer extra pain relief if you do feel pain and will ask you throughout the procedure if you are ok and coping with the treatment. You will be always monitored closely and will rest for at least 20 minutes before going home.

Will I need more than one injection?

This depends on what course of treatment is appropriate for your condition.

Who does Spinal Injections at our medical center?

Our neurosugeons, orthopedic surgeons and rheumatologists are experienced in these injections. See on our webpage for Doctors who offer these procedures.

Nerve Root Block Injections

These injections are given to various areas of the spinal nerves at the point at which they leave the spine at their root. You can have lumbar (low back) or cervical (neck) nerve root block injections. The injection is a mix of anaesthetic and steroid which work together to numb the root for immediate relief and to reduce inflammation over the next few weeks. If the pain reduces during the procedure this helps confirm the accuracy of the diagnosis.

Conditions treated by Nerve Root Block Injections

This type of injection is given to diagnose and treat pain that travels down the leg usually caused by a prolapsed (slipped) disc where the disc bulge presses on the nerve root. Another condition this is used for is spinal stenosis which is when the opening for the root is restricted by bony narrowing due to arthritis and the root becomes irritated. The pressure on the nerve root causes inflammation and swelling which then causes pain to be referred down the leg.

Arm pain from a slipped disc in the neck is also treated by nerve block injections.

What is the procedure?

You will have a thorough assessment to see if this treatment is appropriate and the treatment will be explained to you. You will have a thorough assessment to see which treatment is appropriate and the treatment will be explained to you. The doctor can use ultrasound equipment for guidance in placing the needle. You will be explained what is happening throughout the procedure and you will be closely monitored. You will have to lie on your front for the procedure and stay lying down for a short while afterwards. Your leg may feel weak and a bit numb for a while and you should not drive for the rest of the day.

Is it painful?

Local anaesthetic is used so it is not an excessively painful procedure. The doctor can administer extra pain relief if you do feel pain and will ask you throughout the procedure if you are ok and coping with the treatment.

Will I need more than one injection?

You will be booked in for a follow up and progress report and the doctor will decide then on any further treatment if appropriate. It is important to book in with one of our practitioners so they can guide you in a programme of gradual return to full fitness.

How long will it take to work?

You may not feel any benefit for the first day or two and may even feel slightly worse for a couple of days. This does not mean the outcome will be negative and if you have any concerns, you can ring branches and you will always have a follow up to discuss your progress and any further treatment with the doctor.

Steroid Injections

Steroid (corticosteroid) injections are given to provide pain relief and reduce inflammation in the joints and soft tissues of the body. Cortisone is used which is a powerful anti-inflammatory medicine that works to break the cycle of pain and swelling in the joint. Once pain is reduced a graduated return to normal exercise can be supervised by one of our physiotherapists.

Conditions treated by Steroid Injections

Steroid injections are effective in treatment of inflammatory conditions such as osteoarthritis (wear and tear, arthritis), rheumatoid arthritis and sudden painful attacks caused by gout. Sports injuries, ankle sprains, Achilles tendonitis, knee ligament sprains and bursitis can all be treated by steroid injections.

It is most important to have an accurate diagnosis of the injury or condition and our clinicians are experts in diagnosis. They will examine you thoroughly and the doctors may use x-ray or ultrasound to assist the diagnosis. If necessary, you will be referred for an MRI or to a surgeon if surgery is indicated.

Do cortisone injections only have a temporary effect?

The cortisone injected only lasts in the body for around 2 weeks after which, occasionally the pain can return. This occurs when the underlying cause of the pain has not been addressed. Our medical centre we always address the underlying cause of the pain so that the pain is unlikely to return after an injection.

Are cortisone injections painful?

In the past, cortisone injections were done without anaesthetic in a doctor’s surgery without image guidance.

At our medical centre most of the injections include an anaesthetic to the skin and the cortisone is mixed with local anaesthetic which can result in an almost pain free injection.

In some parts of the body there are more sensory nerves, and some discomfort is inevitable.

Can I only have three injections of cortisone?

If repeatedly injected into the same place there have been reports of degradation of collagen and other soft tissues. The very fact that repeated injections were used in these case studies suggest that the injection was not working, in which case there should not be a need to repeat the injections. At our medical centre we limit the injections to a maximum of three in the same part of the body in a short period of time. One of alternatives is PRP.

How long does it take to work?

Most pain relief occurs during the first 2-4 weeks, and you should contact the clinic for advice to see if you need a second injection for the best outcome after a couple of weeks. Once you are in less pain it is important that you book in to see physios so they can monitor your progress and give you a graduated exercise programme to increase strength and mobility.

Soft Tissue Injections

Steroid injections are given to provide pain relief and reduce inflammation in soft tissues such as muscles and tendons. Cortisone is used which is a powerful anti-inflammatory medicine that works to break the cycle of pain and swelling in the affected part of the body. Once pain is reduced a graduated return to normal

Conditions treated by Soft Tissue Injections

Soft tissue injections are for any tissue that is not a bone or a joint. This means ligaments, muscles and tendons which support the structure of the joints in the body. The injections may be appropriate for knee and ankle sprains affecting the ligaments of these joints, muscle injuries, shoulder rotator cuff injuries, groin strain, pubic pain etc.

What is the procedure?

You will have a thorough assessment to see if this treatment is appropriate and the treatment will be explained to you. The doctor can use the ultrasound equipment for guidance in placing the needle. You will be explained what is happening throughout the procedure.

Is it painful?

Local anaesthetic is used so it is not an excessively painful procedure. The doctor can administer extra pain relief if you do feel pain.

Will I need more than one injection?

We routinely perform one injection initially and occasionally a second injection is required 2-3 weeks later.

How long does it take to work?

Most pain relief occurs during the first 2-4 weeks, and you should contact the clinic for advice to see if you need a second injection for the best outcome after a couple of weeks. Once you are in less pain it is important that you book in to see physios so they can monitor your progress and give you a graduated exercise programme to increase strength and mobility.