Dr. Savarese’s Practice Specialties

Epidural Steroid Injections

Epidural Steroid Injections are minimally invasive procedures in which cortisone (steroid) is injected into the layer of fat (epidural space) that surrounds the spine.  These injections have been medically proven to reduce pain due to painful spinal conditions such as a ruptured or slipped disc, degenerative disc disease or spinal stenosis.  The technique reduces the inflammation or swelling, or both, of the nerves in the epidural space. Some patients who have some residual pain after the first injection may receive a second or third epidural steroid injection.  Epidural steroid injections may reduce the llikihood of needing surgery for some painful spinal conditions.  Epidural steroid injections are minimally invasive procedures, where the patient is sent home shortly after completion of the procedure. The patient is awake during the procedure, so risks associated with general anesthesia are avoided.  Dr. Savarese performs all spinal injections under special x-ray guidance to ensure proper needle placement and delivery of mediciation.  He has performed over 5,000 successful epidural injections in the cervical (neck), thoracic (mid-back) and lumbar (low back) regions. 

Spinal Facet Joint Injections

Spinal Facet Joint Injections are minimally invasive procedure in which cortisone (steroid) is injected into the joints of the cervical (neck), thoracic (mid-back) or lumbar (low back) regions of the spine.  These injections are performed for painful spinal conditions such as whiplash or osteoarthritis of the spine. Facet joint injectionsare minimally invasive procedures, where the patient is sent home shortly after completion of the procedure. The patient is awake during the procedure, so risks associated with general anesthesia are avoided.  Dr. Savarese performs all spinal injections under special x-ray guidance to ensure proper needle placement and delivery of mediciation.  He has performed over 2,000 successful injections in the cervical (neck), thoracic (mid-back) and lumbar (low back) regions.

Radio-Frequency Ablation

Radiofrequency ablation (RFA)  sometimes called radiofrequency lesioning (RFL), is used to treat severe chronic pain in the cervical (neck)or lumbar (low back) regions.  Radio frequency waves are used to produce heat on specifically identified nerves surrounding the facet joints on either side of the spine. By generating heat around the nerve, its ability to transmit pain signals to the brain is destroyed, thus ablating the nerve. RFA is a minimally invasive procedure, where the patient is sent home shortly after completion of the procedure. The patient is awake during the procedure, so risks associated with general anesthesia are avoided. The drawback for this procedure is that nerves regenerate over time, so the pain relief achieved lasts for approximately 6–24 month in most patients.  Dr. Savarese has performed over 1,000 RFA’s during his years of practice. 

Electromyography/Nerve Conduction Study (Nerve Testing)

Electromyography (EMG) and Nerve conduction studies (NCS) is also known as nerve testing.  These tests are used mainly for evaluation of weakness or numbness and tingling in the arms and/or legs.  These tests have been shown to be very accurate when diagnosing certain nerve conditions such as Carpel Tunnel Syndrome, Cubital Tunnel Syndrome, Radiculopathy (Pinched nerve in the Spine) and Peripheral Neuropathy.   Dr. Savarese has performed over 10,000 EMG/NCV’s during his years of practice. 

Joint Injections

Dr. Savarese routinely performs various joint injections under x-ray guidence.  Some of these injections are:

Hip Injections

·         Patients with hip joint pain often have pain and stiffness in the groin, leg  and sometimes buttock.  The pain is often described as a sharp ache or a burning sensation.  Occasionally this pain can mimic sciatica or pain from the lumbar spine (low back).  Injections into the hip joint are often used for diagnostic as well as therapeutic purposes.  Once the source of the pain is identified then if the symptoms return more definative treatment can be directed toward the exact cause of the pain. 

Sacroiliac Injections

·         Sacroliitis is a common cause of low back, buttock and thigh pain.  It is due to inflammation of the sacroiliac joint.  Common causes of sacroiliac joint pain include:

o        Persistant low back pain after spinal fustion

o        Trauma from a fall or a motor vehicle accident

o        Ankylosing spondylitis

o        Psoriatic arthritis

o        Arthritis related to Ulcerative Colitis or Crohn’s disease.

·         Injections of anesthetic and cortisone have been shown to be helpful in patient with Sacroiliitis or SI joint dysfunction

Glenohumeral (Shoulder joint) injections

·         Shoulder pain is a very common condition that can typically cause pain anywhere from the neck to the elbow.  Common causes of shoulder pain are:

o        Bursitis

o        Tendinitis

o        Rotator cuff tear

o        Adhesive capsulitis

o        Impingement syndrome

o        Avascular necrosis

o        Glenohumeral osteoarthritis (OA)

o        SLAP lesion or Labral (cartilage) injury.  (http://www.ncbi.nlm.nih.gov/pubmed/16450690).

o        Cervical radiculopathy (Pinched nerve in the neck)

·         Injections into the Glenohumeral joint are often used for diagnostic as well as therapeutic purposes.  Once the source of the pain is identified then if the symptoms return more definative treatment can be directed toward the exact cause of the pain. 

Coccyx injections

o        In patients with coccyx pain or coccydynia, symptoms include tenderness at the tip of the tailbone that is often worsened with sitting.  Often patients have an a sharp increase in pain when going from sit to stand. 

Similar to the injections above, coccyx injections are used for diagnostic as well as therapeutic purposes.  During his residency Dr. Savarese trained with coccydynia expert Dr. Patrick Foye who has advanced training on coccyx injections.