In-Office Treatments

During your visit, your neurologist will first gather a very thorough history of your symptoms, prior treatments and testing, and of your general health. He or she will then perform a complete neurological examination. This initial step in determining a diagnosis is often the most important one.  Information on in-office treatments are below, and information on neurological testing that might be done can be found here.

The following treatments can be performed during an office visit:

Trigger point injection (TPI) is used to treat extremely painful areas of muscle. Normal muscle contracts and relaxes when it is active. A trigger point is a knot or tight, ropy band of muscle that forms when muscle fails to relax. For the TPI, a small needle is inserted into the trigger point and a local anesthetic (e.g., lidocaine, procaine) with or without a corticosteroid is injected. Injection of medication inactivates the trigger point and thus alleviates pain.

The procedure takes only 5-10 minutes and no prep on the part of the patient is needed. Sustained relief usually is achieved with a brief course of treatment. The injection may cause a twitch or pain that lasts a few seconds to a few minutes.

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This procedure is most commonly used to treat occipital neuralgia, but has also been shown to help in some cases with migraines and tension type headaches.

An occipital nerve block is an injection of a steroid and local anesthetic around the greater and lesser occipital nerves that are located on the back of the head just above the neck area. The steroid injected reduces the inflammation and swelling of tissue around the occipital nerves. This may in turn reduce pain, and other symptoms caused by inflammation or irritation of the nerves and surrounding structures.

The procedure takes only a few minutes. No prep on the part of the patient is required.

Botox is used to treat several types of neurologic diseases which involve chronic spasticity of muscles (tightness and increased muscle tone such as that seen after a stroke or head/spinal cord injury), and movements disorders which cause episodic and repeated involuntary contraction of muscles (such as dystonia, torticollis, and blepharospasm).

Botox is a neurotoxin which, when injected into muscles in a very small dose, acts to partially and temporarily weaken the muscle. The procedure involves injection of Botox using a very thin needle into the affected muscles and generally takes anywhere from 20-60 minutes, depending on the number of muscles to be injected.

The goal of therapy is to reduce muscle spasm and/or pain. See the following link for more details: