Dr. Charles Nivens, MD Spine Medicine

(843) 705-7471
SCHEDULE AN APPOINTMENT

Treatment Options

Dr. Nivens treats a wide variety of neck, back and joint diagnoses with the latest procedures. The ultimate goal of Dr. Nivens’s various treatments is to minimize inflammation. This, in turn, reduces and/or resolves pain and allows you to return to an active lifestyle. During your evaluation, Dr. Nivens will formulate an individualized comprehensive treatment plan.  A home exercise program to include flexibility and core strengthening is a key component in pain reduction and normal mobility.

To learn more about our treatment options, please call our office at 843-705-7471 to make an appointment today. You can also download our Frequently Asked Questions sheet.

Interventional Pain Management

Spinal injections and radiofrequency nerve ablations are non-operative forms of pain management. Therapeutic injections may be considered an adjunct to medication and physical therapy.  Injection therapy may help control pain from degenerative disc disease, injury, osteoarthritis, and other disorders of the spine/joints. Pain Management strives to relieve and control acute and chronic pain.

Types of Pain

Symptoms/Description
Acute Pain Has been occurring less than 3-6 months
Chronic Pain Ongoing for more than 6 months
Neuropathic Pain Usually a burning type of pain from an inflamed or damaged nerve

Types of Procedures

 

Interlaminar Epidural Steroid Injection
Using X-ray guidance and dye to confirm placement, Dr. Nivens will inject a steroid medication that acts as a powerful anti-inflammatory into the epidural space. This steroid is effective in 80-85% of patients because inflammation is what causes the most pain.
Transforaminal Epidural Steroid Injection
Using X-ray guidance and dye to confirm placement for a steroid injection into the foramen (an opening in the spine for the nerve to exit) at the specific site of inflammation. This procedure is a much more directed approach. This procedure is used to treat patients with knee pain that cannot have knee replacement or have had a knee replacement and are still having pain. Targeting the nerves that supply sensation to the knee, Dr. Nivens will inject a long-lasting local anesthetic into the knee joint. The patient is then given a pain diary and asked to monitor their pain during activities that normally cause the pain. If after 2 results of 50% or more reduction of pain is achieved, then the patient is suggested to have a Genicular Knee Nerve Block (see below).
Medial Branch Nerve Block (MBB)
Targeting the Facet joints, this procedure is used to treat non-radiating pain. Dr. Nivens will focus on the nerves that supply these joints called the Medial Branch Nerves. We inject a long-lasting local anesthetic where the nerve to the joint lies. The patient is then given a pain diary and asked to monitor their pain during activities that normally cause the pain. If after 2 results of 50% or more reduction of pain is achieved, then the patient is suggested to have a Radiofrequency Ablation procedure (see below).
Radiofrequency Ablation (RFA) of the Medical Branch Nerves
Radiofrequency is used to create a scar around the Medial Branch Nerves that supply the Facet Joints.This can significantly reduce pain from the joints for 6-12 months.
Genicular Nerve Block to the Knee
This procedure is used to treat patients with knee pain that cannot have knee replacement or have had knee replacement and are still having pain. Targeting the nerves that supply sensation to the knee, Dr. Nivens will try to block the sensation to the joint and therefore pain is reduced or resolved.
Genicular Nerve Radiofrequency Ablation
Radiofrequency is used to create a scar, which decreases the painful sensations of the knee by targeting the Sensory Nerves to the joint.
Various Joint Injections
We can inject most orthopedic joints with the extremities for synovitis or bursitis. We perform X-ray guided Hip Joint, Sacroiliac (SI) joint, and Greater Trochanteric Bursal injections due to the depth in which these joints are found. We inject Carpal Tunnels for relief of pain and numbness due to Carpal Tunnel Syndrome. We also perform Viscosupplement (i.e. Synvisc, Hyalgan) knee joint injections.
Electromyography (EMG) and Nerve Conduction Studies (NCS)
NCS evaluates the nerves electrically. The only way we can truly evaluate the functioning of our nerves is to apply electricity and evaluate the response. It does not cause significant pain but can be bothersome and tedious for some. The EMG is where we use a very small needle (similar to an acupuncturist’s needle) to directly evaluate the muscle cell of specific muscles and indirectly evaluate the corresponding nerve to that muscle.