Specialists in Image-Guided Procedures

Nerves transmit all pain signals in our bodies. No other tissues send any pain signals. Not bones. Not muscles. The only tissues that can send signals or electrical impulses of pain from joints or muscles are the nerve branches that plug into these painful tissues. Without those signals being sent, patients don’t have to feel pain. For example, if an Interventional Pain Specialist stops a nerve from firing, patients don’t have to feel their arthritic knee, shoulder, neck, or back pain, among other pains.

Radiofrequency Ablation (RFA) is a procedure during which small nerve endings are heated and melted down so that there is a loss of feeling to the painful area. This is a long-lasting and safe therapy.

These procedures should always be performed with X-ray guidance (fluoroscopy) or ultrasound-guidance in a specially-built procedure suite in a clinic, or an operating room, like those at Bloor Pain Specialists. The x-ray or ultrasound machine is used to take pictures as the radiofrequency needle is moved into each correct position to target each nerve branch. Each nerve branch is then heated using radiofrequency energy and the heat causes the inner lining of the nerve to break down, separating the connection from the painful joint or tissue from the signal being sent to the patient through the patient’s nerves.

Yes. All procedures are covered by OHIP. Only a few clinics/hospitals are approved to perform these procedures, with Bloor Pain Specialists being one of them. Check with your GP, neurologist, chronic pain doctor, or other specialist. You will need a referral from your Family Doctor or specialist before scheduling an appointment. Please bring all MRI/CT/X-ray/EMG reports when you go for your consultation.

The epidural space is a location that surrounds the nerves of the spine. “Epi” means outside and “dura” is the name of the membrane that holds the spinal fluid and the nerves. Hence, the epidural space is by definition the space outside the nerves of the spine.
The epidural space can have a number of different things injected or inserted into it. In labour, women often get an epidural catheter (tube) placed, but this cannot be done with x-ray guidance because x-rays can be bad for developing fetuses and babies.
In the outpatient setting, for management of pain, corticosteroids are sometimes put into the epidural space with x-ray guidance. This x-ray guidance allows for more precise placement of the needle and magnification of the needle, which allows for a smaller needle to be used.
These injected corticosteroids are medications that act as antidotes to inflammation, very potently improving any inflammation around a nerve root or herniated disc for conditions like sciatica.
Unless the patient is pregnant, these procedures should always be performed with a mobile C-Arm X-ray machine (fluoroscopy) in a specially-built procedure suite in a clinic, or an operating room, as a standard of care, to watch the needle go accurately to the correct layer of the spine. The x-ray is used to take pictures as the needle is moved into the correct position to target each nerve root or herniated disc. Bloor Pain Specialists has 4 of these procedure suites and C-Arm machines.

Yes. All procedures are covered by OHIP. Only a few clinics/hospitals are approved to perform these procedures, with Bloor Pain Specialists being one of them. Check with your GP, neurologist, chronic pain doctor, or another specialist. You will need a referral from your Family Doctor or specialist before scheduling an appointment. Please bring all MRI/CT/X-ray/EMG reports when you go for your consultation.

Our specialists are trained to inject every joint and all types of nerve blocks. Some procedures are done with x-ray (fluoroscopic C-Arm) guidance, while others are performed with ultrasound guidance. Our anesthesiologists also perform ketamine and/or lidocaine infusions.