Treatments | River Cities

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Treatments

Pain Relieving Treatments in Shreveport, Louisiana

Injections & Nerve Blocks Minimally Invasive Surgical Procedures Diagnostic Procedures Implantable Devices & Ongoing Care Comprehensive Care

Injections and Nerve Blocks

Targeted injections that interrupt pain signals at the source

Genicular Nerve Block

A genicular nerve block is a targeted injection that delivers anesthetic medication to the genicular nerves — the small sensory nerves that supply the knee joint and transmit pain signals to the brain. This procedure serves two important purposes: it can provide immediate, meaningful pain relief for patients with chronic knee pain, and it acts as a diagnostic test to determine whether a patient is a good candidate for the longer-lasting genicular nerve ablation procedure. At River Cities Interventional Pain Specialists, genicular nerve blocks are performed under fluoroscopic guidance for precise, accurate delivery.

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Medial Branch Block

A medial branch block is a targeted injection that delivers local anesthetic to the small nerves — called medial branch nerves — that carry pain signals from the facet joints of the spine to the brain. This procedure is most often used as a diagnostic test: when a medial branch block provides significant pain relief, it confirms that the facet joints are the primary source of a patient's neck or back pain, and identifies them as a strong candidate for the longer-lasting facet radiofrequency neurotomy. At River Cities Interventional Pain Specialists, medial branch blocks are performed under fluoroscopic guidance for precision and accuracy.

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Selective Nerve Root Block

When pain, numbness, or weakness radiates down an arm or leg, it often traces back to a specific irritated or compressed nerve root in the spine. A selective nerve root block (SNRB) is a highly targeted injection that delivers medication directly around a single nerve root as it exits the spinal column — providing both diagnostic information and therapeutic relief. Because this procedure targets one specific nerve rather than the general epidural space, it can help identify exactly which level of the spine is responsible for a patient's symptoms. At River Cities Interventional Pain Specialists, selective nerve root blocks are performed under fluoroscopic guidance to ensure precise, effective delivery.

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Stellate Ganglion Block

The stellate ganglion is a collection of sympathetic nerve cells located at the base of the neck, just in front of the spine. These nerves play a role in regulating pain signals, blood flow, and the body's stress response across the head, neck, arm, and chest. A stellate ganglion block (SGB) delivers local anesthetic directly to this nerve cluster, temporarily disrupting the overactive sympathetic signals that drive certain chronic pain conditions. At River Cities Interventional Pain Specialists, this procedure is performed under ultrasound or fluoroscopic guidance for precision and safety, and it is increasingly recognized not only for pain conditions but also for emerging applications in managing certain autonomic symptoms.

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Sympathetic Block (Lumbar)

The lumbar sympathetic nerves are a chain of nerve fibers running along the front of the lumbar spine that regulate blood flow, sweating, and pain signaling in the lower extremities. When these nerves become overactive — as occurs in Complex Regional Pain Syndrome, vascular insufficiency, and certain other conditions — they can drive intense, burning, and often debilitating leg or foot pain that does not respond to standard pain treatments. A lumbar sympathetic block delivers local anesthetic (and sometimes steroid) directly alongside this nerve chain, interrupting the overactive sympathetic signals and providing relief that can last well beyond the anesthetic's duration. At River Cities Interventional Pain Specialists, this procedure is performed under fluoroscopic guidance for precise, effective placement.

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Transforaminal Epidural Steroid Injection (ESI)

A transforaminal epidural steroid injection (TFESI) is one of the most targeted and effective approaches for delivering anti-inflammatory medication directly to an irritated spinal nerve root. Unlike a standard (interlaminar) epidural injection, which introduces medication into the general epidural space from the midline of the spine, a transforaminal injection approaches from the side — directing medication through the neural foramen, the opening where each nerve exits the spine. This approach allows the medication to reach the anterior (front) epidural space more effectively, bathing the affected nerve root in corticosteroid right at the site of inflammation. At River Cities Interventional Pain Specialists, TFESIs are performed under fluoroscopic guidance for precise, level-specific treatment.

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Trigger Point Injection

If you've ever had a persistent, tender knot in your muscle that seems to radiate pain to surrounding areas when pressed, you may be familiar with a trigger point. Trigger points are hyperirritable spots within tight bands of muscle fiber that fail to relax and can cause both local pain and referred pain patterns throughout the body. When trigger points become a source of chronic pain — a condition called myofascial pain syndrome — trigger point injections can provide fast, targeted relief. At River Cities Interventional Pain Specialists, trigger point injections deliver a small amount of local anesthetic directly into the trigger point, relaxing the muscle knot and interrupting the pain cycle. This quick, in-office procedure often provides relief within minutes.

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Facet Joint Injection

The facet joints are small, paired joints located along the back of the spine that allow for smooth, controlled movement and help stabilize the vertebrae. When these joints become inflamed or arthritic — due to injury, degenerative disc disease, or wear over time — they can be a significant source of back and neck pain. A facet joint injection delivers a combination of anesthetic and corticosteroid directly into the affected joint, reducing inflammation and providing targeted pain relief. At River Cities Interventional Pain Specialists, this procedure is performed under fluoroscopic guidance to ensure pinpoint accuracy.

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Hip Joint Injection

Hip pain can make even the simplest daily activities — walking, climbing stairs, getting in and out of a car — feel challenging and exhausting. When hip pain stems from arthritis, bursitis, labral tears, or other joint-related conditions, a hip joint injection can deliver meaningful, targeted relief directly to the source. This procedure involves the precise delivery of corticosteroid and anesthetic medication into the hip joint capsule, reducing inflammation, calming irritated tissue, and restoring more comfortable movement. At River Cities Interventional Pain Specialists, hip joint injections are performed under fluoroscopic or ultrasound guidance for safe, accurate needle placement.

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Lumbar Intercostal Nerve Block

The intercostal nerves run along the underside of each rib and are responsible for sensation across the chest and upper abdominal wall. When these nerves become irritated, compressed, or damaged — due to injury, surgery, shingles (postherpetic neuralgia), or rib fractures — they can produce sharp, burning, or shooting pain that wraps around the torso and makes breathing, moving, or even lying still genuinely uncomfortable. A lumbar intercostal nerve block delivers targeted local anesthetic and/or steroid medication around the affected nerve(s), interrupting pain signals and providing meaningful relief. At River Cities Interventional Pain Specialists, this procedure is performed with precision imaging to ensure safe, accurate placement.

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Diagnostic Procedures

Pinpointing the true source of pain before treating it.

Discography

When back pain persists despite conservative care and imaging studies haven't pinpointed the exact source, discography can provide the clarity needed to move forward with an effective treatment plan. Discography — also called a discogram — is a diagnostic procedure in which a small amount of contrast dye is injected directly into one or more spinal discs. The response helps our team determine whether a specific disc is the true source of your pain. At River Cities Interventional Pain Specialists, discography is performed only when it will meaningfully change or refine your treatment options — giving you and Dr. Brewer the information you need to make confident decisions about your care.

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Fluoroscopic Guided Injection

Precision is everything when it comes to treating pain at its source. Fluoroscopic guided injection is not a single treatment but rather a technique — using real-time X-ray imaging (fluoroscopy) to guide needle placement with exceptional accuracy during a wide range of spinal and joint injections. At River Cities Interventional Pain Specialists, the majority of our interventional procedures are performed using fluoroscopic guidance to ensure that medication is delivered exactly where it will do the most good. This technology allows Dr. Brewer to confirm needle position in real time, improving both the safety and the effectiveness of each treatment.

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Minimally Invasive Procedures

Longer-lasting relief with surgical precision and outpatient recovery.

Facet Radiofrequency Neurotomy

For patients who have found temporary relief through medial branch blocks or facet joint injections but want a longer-lasting solution, facet radiofrequency neurotomy offers a compelling next step. This minimally invasive procedure uses precisely applied radiofrequency energy (heat) to disrupt the small medial branch nerves responsible for transmitting pain signals from arthritic or injured facet joints. By interrupting that signal pathway, radiofrequency neurotomy can significantly reduce spinal pain — often providing relief that lasts months to over a year. At River Cities Interventional Pain Specialists, this procedure is performed with imaging guidance for maximum precision and safety.

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Genicular Nerve Ablation

For patients with chronic knee pain who aren't ready for or haven't had success with knee replacement surgery, genicular nerve ablation offers a powerful, minimally invasive alternative. This procedure uses radiofrequency energy to disrupt the genicular nerves — the small sensory nerves responsible for transmitting pain signals from the knee joint to the brain. By silencing these pain pathways, genicular nerve ablation can dramatically reduce knee pain and improve mobility, often providing relief that lasts a year or more. At River Cities Interventional Pain Specialists, this procedure is performed under fluoroscopic guidance with meticulous precision.

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Kyphoplasty

A vertebral compression fracture — often caused by osteoporosis, injury, or cancer affecting the spine — can cause sudden, severe back pain and progressive loss of height or spinal curvature. Kyphoplasty is a minimally invasive procedure designed to stabilize the fractured vertebra, restore lost height, and significantly reduce pain — often providing dramatic relief within 24–48 hours. During kyphoplasty, Dr. Brewer uses a small balloon to gently restore the compressed vertebra's shape before filling it with bone cement to lock it in a stable position. This approach combines the precision of a surgical technique with the minimal recovery of an outpatient procedure.

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Implantable Devices & Ongoing Care

Advanced technology for long-term, hard-to-treat pain.

Intrathecal Medication Pump Maintenance

For patients who already have an intrathecal drug delivery system (IDDS) — commonly called a pain pump — in place, proper and consistent maintenance is essential to keeping the device functioning safely and effectively. An intrathecal pump is a small, implanted device that delivers precise doses of pain medication directly into the cerebrospinal fluid surrounding the spinal cord, providing powerful pain relief at a fraction of the oral dose. At River Cities Interventional Pain Specialists, we provide comprehensive pump maintenance care including medication refills, device programming, and long-term monitoring to ensure your pump continues to work the way it should.

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Peripheral Nerve Stimulation

For patients with focal, hard-to-treat nerve pain, peripheral nerve stimulation (PNS) offers a cutting-edge solution that works with your body's own nervous system to interrupt pain signals before they reach the brain. Unlike spinal cord stimulation, which targets the spinal cord itself, PNS delivers gentle electrical pulses directly to a specific peripheral nerve that is the source of your pain. The result is a personalized, highly targeted therapy that can reduce pain from damaged or irritated nerves throughout the body — in the extremities, head, face, or trunk — without the need for daily medications or major surgery. At River Cities Interventional Pain Specialists, we offer both temporary and permanent PNS options depending on your condition and goals.

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Spinal Cord Stimulator

For patients who have tried medications, injections, and physical therapy but continue to live with chronic, debilitating pain, spinal cord stimulation (SCS) represents one of the most powerful breakthroughs in modern pain medicine. A spinal cord stimulator is a small implantable device that delivers precisely controlled electrical pulses to the spinal cord, effectively interrupting pain signals before they reach the brain and replacing them with either a gentle tingling sensation or — with newer waveform technologies — simply less pain without any sensation at all. Approved by the FDA and backed by decades of clinical evidence, SCS can dramatically reduce pain from a wide range of chronic conditions. At River Cities Interventional Pain Specialists, we partner with patients through every step of the SCS process — from initial evaluation through the trial period, implantation, and long-term programming.

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Comprehensive Care

Supporting the whole patient, not just the procedure.

Pain Medication Optimization & Management

Medications play an important role in many chronic pain treatment plans — but effective pain management is never just about writing a prescription. At River Cities Interventional Pain Specialists, pain medication optimization and management is a thoughtful, evidence-based process that ensures every patient is on the right medication at the right dose for their specific condition. Dr. Brewer and our team conduct thorough evaluations, ongoing monitoring, and regular reassessments to help patients achieve the best possible pain control with the fewest side effects — while always pursuing the lowest effective dose and seeking to reduce reliance on medications whenever possible.

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Patient Education

At River Cities Interventional Pain Specialists, we believe that an informed patient is an empowered patient. Understanding your condition — what's causing your pain, how it behaves, and what your treatment options are — is one of the most powerful tools available for improving your outcomes. Patient education isn't a checkbox or an afterthought at RCIPS; it's a core part of every appointment. Our team takes the time to explain your diagnosis in plain language, walk through the evidence behind your treatment options, and equip you with the knowledge and skills to play an active role in your recovery.

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