Integrated Pain and Rehabilitation CenterBack to homepage

220 E Evergreen St., Sherman, TX 75090
P (903)957-0470 | F (903)957-0469


Epidural Steroid Injections (cervical, thoracic and lumbar)

The epidural space covers the spinal cord and runs the entire length of the spine. For multiple reasons you can get narrowing in this space, which can put pressure on the spinal cord and/or nerves. When this occurs, it can lead to pain in the back and extremities.

An epidural injection can help reduce, and possibly eliminate this pain. A steroid is placed into the epidural space at the level of damage which then decreases the inflammation in that area. Sometimes these injections may require a series in order to get prolonged pain relief but is dependent on the patients anatomy and response to the medication.

Trigger Point Injections

Muscle spasm is a common contributor to pain. Prolonged muscle spasming can lead to "knots" in the muscles. This can then aggravate the nerves and cause pain in that area. Trigger point injections are injections into the muscles that contain a local anesthetic and sometimes a corticosteroid. These injections only take a few minutes but can allow for a sustained relief of pain due to muscle spasms.

Facet Injections

The facet joints allow the spine to twist and turn from the neck all the way down to the low back. The joints are also helpful in supporting the body’s weight. Aging, normal wear and tear, athletics, and arthritis all cause problems with the facet joints. Facet joint pain most commonly occurs near the spine and possibly in the shoulders or in the hips and buttocks in the low back region.

There are at least two reasons to perform facet joint injections. The first is that the injections are therapeutic in that they place steroids into the facet joints , which can decrease the joints’ inflammation and reduce pain. The second is that the injections can help determine the specific source of a patient’s pain. If a patient’s usual pain is eliminated by the injections, this verifies that the pain is coming from an injected joint. When the injections are combined with local anesthesia, the injected joint is usually pain-free for two to four hours.


For patient's who benefit from the Facet Injections, but the pain relief is short-lived, a Rhizotomy/Radiofrequency Ablation may be a great option. This procedure is performed just like the facet injections, but an electrode is attached to the needles. This electrode is then heated, which will then deaden, or "turn off" the nerves that carry pain signals to the brain.

Joint Injections

Our bodies have multiple joints, including the knee, hip, shoulder, sacroiliac joint. These joints can be prone to pain for a multiple of reasons, such as arthritis. Joint injections allow numbing medicine and steroid to be directly placed into the painful joint, resulting in a reduction in pain and inflammation.

Spinal Cord Stimulation

Electrical stimulation for the treatment of pain has been around for years. In 1989, the FDA approved the use of Spinal Cord Stimulation (SCS) as a treatment for chronic pain. This intervention helps with neuropathic chronic back, neck and limb pain. The neurostimulation interferes with the transmission of pain signals. With this therapy, a small implanted system is used to replace pain with different feeling. Some people describe this feeling as a gentle massaging sensation or, in some cases, simply the absence of pain.

Intrathecal Spinal Pumps

This is a surgical procedure where a pump is implanted under the skin in the abdomen and then a catheter is ran into the spine where the pain is located. The medication is then pumped directly into the spinal fluid, allowing for a much stronger effect. This allows for a less doseage of medication and fewer side effects. Several medications can be administered this way, or even a combination of medications. This pump is refilled every 3 to 6 months, and the patient is able to be fully active while having this.

Botox Injections for Treatment of Migraines

Chronic migraines are defined as 15 or more headache days a month with each headache lasting 4 or more hours. Botox is a prescription medication that is injected into several different areas on the head, depending on the location of the headache, to prevent chronic migraines. This procedure is FDA approved.

Medication Management

Oral medications are the first line of treatment and are the most common non-surgical treatment for back and neck pain. If over-the-counter medications are not able to appropriately control your pain, prescription medications may be a great option. There are several different types of pain medications available and the doctor will work closely with the patient to determine the best treatment plan.

EMG/Nerve Conduction Tests

Electromyography and Nerve Conduction Tests are ordered to get more information about the health of the peripheral nerves. It helps give the provider better knowledge on which nerve is pinched and exactly where it is being pinched at. The EMG measures the electrical activity of the muscles while the Nerve Conduction portion assesses the conduction rate of an impulse that is produced by a specific nerve. This procedure helps the provider identify the problematic nerve and develop further treatment plans.