Image-guided injections and PRT

At OrthoCoast, we provide PRT treatments in the cervical and lumbar spine. They may be suitable for selected symptoms when their course, the medical examination and imaging findings suggest nerve root irritation as the cause of pain. Pain travelling from the neck into an arm is called cervicobrachialgia; pain radiating from the lower back into a leg is called lumboischialgia. These descriptions alone, or tingling in a hand or leg, do not establish an indication for this type of injection. We check whether the symptoms, examination and imaging findings fit together, which treatments have already been tried and whether there is a clear goal. An injection may provide relief for suitable patients. Whether relief occurs and how long it lasts vary from person to person; lasting improvement cannot be promised. The scientific evidence for individual procedures in the cervical spine is limited. In the cervical spine, nerves, the spinal cord and important blood vessels lie close together. We therefore explain the particular risks of the specific procedure planned and possible alternatives. New or increasing paralysis, unsteady walking or other signs that nerve or spinal cord function is at risk require urgent assessment. An injection must not delay that assessment or any other necessary treatment.

An injection may be considered to relieve certain symptoms temporarily and make further treatment steps possible. Which medicine is suitable and whether the expected benefit justifies the risks depend on your situation. It helps the assessment if you can name a specific limitation: does radiating pain mean you can barely sit, can walk only short distances or cannot get enough sleep at night? We also discuss what change would matter to you. A short-term response and a longer-lasting improvement are different observations.

An injection is not appropriate for every case of back pain. For many symptoms, the main approaches are information and advice, adapted activity, exercise therapy and a carefully limited medication plan. Depending on the cause, other non-surgical measures or an assessment by another specialist may be appropriate. If a nerve’s function is at risk or the findings require another treatment, an injection must not delay the necessary care. We therefore explain not only the proposed procedure but also the reasons for or against other approaches.

Please bring recent medical letters and any MRI, CT or X-ray reports together with the corresponding images. Access via a QR code or a CD may be helpful. An up-to-date list of diagnoses and medicines is also part of preparation. In particular, tell us about blood-thinning medicines, known allergies, infections and previous unwanted reactions to injections. Diabetes and a possible pregnancy may also be relevant to planning. Please do not stop medicines on your own. A doctor must decide whether and how treatment should be adjusted.