Spine & Joint Injections

interventional procedures

I provide image-guided spine and joint injection procedures as part of the treatment plan for spine and joint-related pain.

These procedures are used to reduce pain, improve mobility, and support rehabilitation when symptoms persist despite appropriate conservative treatments.

Joint Injections

I perform joint injections for pain and inflammation involving the shoulder, hip, knee, and other peripheral joints. These injections may be diagnostic, therapeutic, or both. The injections can help me identify where your pain is coming from, or where it is not.

Joint injections are commonly used for patients with:

  • Osteoarthritis and degenerative joint disease
  • Post-traumatic joint pain
  • Inflammatory joint conditions
  • Capsulitis and restricted joint motion
  • Persistent joint pain following injury or surgery

Depending on the clinical indication, injections may include local anesthetic, anti-inflammatory medication, or biologic therapies such as platelet-rich plasma (PRP). Image guidance may be used to improve accuracy and safety.

Epidural Injections (Cervical, Thoracic, and Lumbar Spine)

I perform epidural injections to deliver medication into the epidural space surrounding spinal nerves. These procedures are commonly used to reduce inflammation, relieve nerve irritation, and improve function in patients with spine-related pain.

Epidural injections may be performed in the:

  • Cervical spine (neck)
  • Thoracic spine (mid-back)
  • Lumbar spine (low back)

Depending on the clinical situation, epidural injections may involve anti-inflammatory medication, anesthetic medication, or biologic therapies such as platelet-rich plasma (PRP). The choice of injectate is individualized based on clinical findings, imaging, and patient goals.

Epidural injections are often considered for patients with:

  • Disc herniation or disc-related pain
  • Spinal stenosis
  • Radicular pain radiating into the arm or leg
  • Inflammatory nerve compression

These injections may help reduce pain and allow patients to participate more fully in physical therapy and rehabilitation.

Lumbar Disc Injections With Biologics (Discogenic Low Back Pain)

I perform lumbar disc injections using biologic therapies such as platelet-rich plasma (PRP) for select patients with discogenic low back pain. These injections are intended to address pain arising from the intervertebral disc itself, rather than nerve compression.

Lumbar disc injections may be considered for patients with:

  • Chronic low back pain felt to be discogenic in origin
  • Disc degeneration without significant instability
  • Persistent axial low back pain that has not responded to conservative care
  • Imaging findings consistent with disc pathology that correlates with symptoms

These procedures are performed under X-ray guidance to ensure accuracy and safety.

Patient selection is critical, and not all disc-related pain is appropriate for intradiscal treatment. The decision to proceed is based on clinical evaluation, imaging review, and discussion of realistic expectations.

Trigger Point Injections

I use trigger point injections to treat focal areas of muscle spasm and myofascial pain that contribute to localized or referred pain patterns.

Trigger point injections are often helpful for patients with:

  • Neck, shoulder, and upper back muscle pain
  • Low back or pelvic muscle pain
  • Overuse or postural muscle dysfunction
  • Myofascial pain syndromes

These injections are commonly combined with stretching, physical therapy, and movement-based rehabilitation to improve durability of results.

Nerve Blocks

I perform nerve blocks to target specific nerves or nerve branches suspected to be contributing to pain. These injections are often used to clarify pain sources and guide treatment planning.

Nerve blocks may be helpful for patients with:

  • Spine-related neck or back pain
  • Nerve-mediated or radicular pain
  • Post-injury or post-surgical pain
  • Certain headache or facial pain conditions

Information gained from nerve blocks can help determine appropriate next steps in care.

Radiofrequency Ablation (RFA)

I perform radiofrequency ablation to reduce pain by interrupting pain signals transmitted by small sensory nerves, most commonly those supplying the facet joints of the spine.

Radiofrequency ablation may be considered when:

  • Pain is chronic and facet-mediated
  • Diagnostic nerve blocks have provided temporary but meaningful relief
  • Conservative treatments have been optimized

The goal of RFA is to improve functional tolerance for daily activities such as standing, walking, and prolonged sitting.

Spinal Cord Stimulation

I evaluate and treat select patients with spinal cord stimulation for chronic pain that has not responded to more conservative therapies.

Spinal cord stimulation may be considered for:

  • Chronic spine-related pain
  • Persistent pain following spine surgery
  • Neuropathic pain syndromes
  • Certain complex or centralized pain conditions

Evaluation includes careful patient selection and typically a temporary trial prior to permanent implantation. I coordinate closely with referring physicians throughout this process.

Sympathetic Nerve Blocks

I perform sympathetic nerve blocks to evaluate and treat certain complex pain conditions involving the autonomic nervous system.

These blocks are most commonly used for patients with:

  • Complex Regional Pain Syndrome (CRPS)
  • Sympathetically mediated pain
  • Pain associated with abnormal temperature or color changes following injury

Sympathetic nerve blocks may provide diagnostic insight and, in some cases, meaningful symptom relief when incorporated into a comprehensive treatment plan.

A Collaborative, Function-Focused Approach

Injection-based procedures are one component of a broader care strategy. I integrate these interventions with rehabilitation, activity modification, and ongoing functional assessment.

My training in both Pain Medicine and Physical Medicine & Rehabilitation allows me to collaborate closely with:

  • Primary care physicians
  • Orthopedic and spine surgeons
  • Rheumatologists
  • Physical therapists and rehabilitation teams

The shared goal is to reduce pain, restore function, and help patients return to meaningful activity whenever possible.

Schedule an Evaluation with Dr. Murakami