Obviously Local Anesthetic agent decreases pain on OT table and pain returns back when it’s action is over.

To add to this particulate steroids are injected in small compact joint or spaces around the nerves which are jeopardized(pressure over already inflammed nerve increases and increases pain) till the particulate steroid get dissolved and then steroid action starts to decrease edema of surrounding areas caused by chronic inflammation,which takes 48-72  hours.

If you want your patient to get relief instead of increased pain,read further.

There is a method to decrease the pain after interventional procedure where we inject LA and particulate steroids.

I have never experienced patients saying that pain increased after injection of LA and steroids after 1-3 days as we do treat them with Dry Needling.

Reason behind this pain relief is Hilton’s law.It states that the nerve supplying the joint (synovial membrane) also supplies the skin over the joint and muscles which move the joint.

So understanding this is important.We treat either nerve in Transforaminal epidural steroid injection or caudal epidural steroid injection or nerve supply of joint in facet joint (MBB) or joint in SI joint block.

But we totally neglect that the already irritable nerve also irritates the skin(arrector pili muscle) and muscles supplied by the nerve.

Continuous irritable nerve causes muscle contractions and thus energy crunch by decreasing blood supply(arterial) and also venous return is affected which is not able to drain the waste products including Substance P, which is a Double whammy……

After doing Dry Needling of the area concerned with injection of LA and steroid(dermatome and myotome) patient gets relieved of this pain and myofascial release is done to give more comfort and relaxes the muscles to improve circulation and wash out of Substance P.

Even patient recovers more faster and range of motions of muscle groups improve which were the causing pain as well as disability.

Furthermore Needle Induced Yoga a advanced variant of Dry Needling helps to remove pain not only at physical level but also at mental, intellectual and spiritual  levels.

*Dr Kailas S Waghmare*

MBBS MD ANESTHESIOLOGY

AFIH

Fellowship in Chronic Pain Medicine(MUHS)

*Interventional Spine And Pain Specialist*

*PunePainClinic*

*PatanjaliPainReliefClinic*

*JioPainfreeSmartCity*

+91 956 118 5892