What fluoroscopy guidance means
Fluoroscopy is live X-ray. During a fluoroscopy-guided injection, the physician watches the needle on a screen as it moves toward the target. For an epidural, a small amount of contrast dye is injected first to confirm where the medication will spread before any steroid is given. Some procedures use ultrasound guidance instead, depending on the area being treated.
Procedures and the guidance used
| Procedure | Guidance |
|---|---|
| Epidural steroid injections | Fluoroscopy (live X-ray). The physician injects a small amount of contrast dye and watches where it spreads to confirm the needle is in the right place before giving the medication. |
| Medial branch blocks and radiofrequency ablation | X-ray guidance, with local anesthetic, for facet joint pain in the neck and back. |
| Genicular nerve blocks and radiofrequency ablation (knee) | Image guidance, with local anesthetic. |
| Spinal cord stimulation trial | Thin leads are placed through a needle under X-ray guidance. |
| Joint injections | Ultrasound or X-ray guidance when needed, to place the medication precisely. |
| Carpal tunnel injections | Ultrasound guidance may be used. |
Your physician explains the guidance used for your procedure before it is scheduled. Results vary from person to person.
Ultrasound guidance
Our physicians use in-office diagnostic musculoskeletal ultrasound to look at muscles, tendons, ligaments and joints, and ultrasound guidance for injections when it suits the area being treated.
What procedure day is like
The skin is numbed first. Most patients feel pressure and a brief pinch. The office explains the arrival time, the image guidance used and whether you need someone to drive you home before anything is scheduled. Afterward, the office explains follow-up timing and activity guidance.
Part of a plan
A procedure is offered only when the evaluation supports it, and it is planned together with physical therapy (Brooklyn and Staten Island). See pain management for the full approach.
Watch and read more
Lumbar spondylosisRead and watch 
Back pain injectionsRead and watch 
Epidural steroid injection recoveryRead and watch 
Facet joint painRead and watch 
Chronic back pain treatmentRead and watch 
How an epidural injection treats back painRead and watch 
Transforaminal epidural for sciatica and leg painRead and watch 
How to fix lower back pain without surgeryRead and watch Fluoroscopy-guided injections near you
Pain procedures are done at all three Precision Care Medical & Sports Performance offices.
Brooklyn: our Brooklyn office on Shell Road serves patients from Gravesend, Sheepshead Bay, Midwood, Coney Island, Brighton Beach and Bensonhurst. Pain management in Brooklyn.
Staten Island: our Staten Island office on Richmond Road serves patients from Dongan Hills, New Dorp, Grant City, Todt Hill, Midland Beach, Great Kills and Eltingville. Pain management in Staten Island.
Manhattan: the Midtown Manhattan office, the Precision Care Spine & Pain Center on East 55th Street, serves patients from Spanish Harlem (East Harlem) and Washington Heights, as well as Midtown, Midtown East, Turtle Bay and UN Plaza, the Financial District, the Upper East Side, the Upper West Side and Harlem.
Questions
What is a fluoroscopy-guided injection?
Fluoroscopy is live X-ray. During a fluoroscopy-guided injection the physician watches the needle on a screen and uses a small amount of contrast dye to confirm it is in the right place before giving any medication.
Which procedures use fluoroscopy or X-ray guidance?
Epidural steroid injections are placed with fluoroscopy (live X-ray). Medial branch blocks, radiofrequency ablation and spinal cord stimulation trials use X-ray guidance. Genicular nerve blocks use image guidance, and joint injections use ultrasound or X-ray guidance when needed.
When is ultrasound used instead?
Ultrasound guidance can be used for joint injections, and may be used for carpal tunnel injections. Our physicians also use diagnostic musculoskeletal ultrasound to look at muscles, tendons, ligaments and joints.
Which offices perform pain procedures?
Pain procedures are done at all three offices: Brooklyn, Staten Island and Midtown Manhattan. The office confirms the date, the preparation and the guidance used for your procedure before anything is scheduled.
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Is a procedure recommended at the first visit?
No. A physician evaluates you first, with a history, hands-on exam and review of any imaging. A procedure is offered only when the evaluation supports it.
What is procedure day like?
The skin is numbed first. Most patients feel pressure and a brief pinch. The office tells you the arrival time and whether you need someone to drive you home before anything is scheduled.
Are procedures combined with physical therapy?
Often, yes. Procedures are planned together with physical therapy, offered at the Brooklyn and Staten Island offices, so the treatment that calms the pain and the work that keeps it from coming back are part of one plan.
Which insurance plans are accepted?
Precision Care Medical & Sports Performance is in network with Aetna, Blue Cross Blue Shield / Empire BCBS, UnitedHealthcare, Oxford, Cigna, EmblemHealth, City of New York Employee PPO, GHI, HIP, Fidelis Care, Healthfirst, MVP, MetroPlus, 1199SEIU, NYSHIP, Medicare, Medicare Advantage and Medicaid, and works with no-fault carriers and the NY Workers' Compensation Board. Call the office with your plan name to confirm before your visit.
How do I make an appointment?
Request an appointment online, or call an office:
An online request is not a confirmed booking until the office contacts you.
General education, not a diagnosis or individual treatment plan. Results vary from person to person. For a medical emergency, call 911.
