Bedside Pain Management Interventions

Description

This book describes bedside pain management interventions for basic clinical situations commonly encountered during the inpatient care. It aims to provide clinicians with real-world practical information, including patient selection, required equipment, and procedure guidance, that will optimize patient management. Each chapter addresses a particular procedure or a set of procedures, with specialties selected according to the subject matter.  Physicians of any specialty practicing in hospital settings, residents, fellows in training, medical students, physician assistants, nurse practitioners, nurses, psychology, chiropractors, physical therapy and integrative medicine specialists will find this text to be comprehensive and practical. Preface Contents Part I: Challenges of Pain Management and Types of Bedside Interventions Challenges of Pain Management and the Role of Bedside Interventions 1 Overview 2 Historical Aspects 3 Recent Developments 4 Role of Bedside Interventions 5 Challenges of Inpatient Pain Management 6 Conclusion References Clinical Assessment of Pain and Assessment of Outcomes of Bedside Procedures 1 Overview 2 Initial Encounter 3 Detailed History Onset Location Duration Course/Frequency Character Aggravating/Alleviating Factors Related Symptoms Severity 4 Assessment Tools 5 Physical Examination Inspection Palpation Range of Motion Percussion/Auscultation Motor Sensory Provocative Testing 6 Post-procedure Evaluation References Further Reading Pharmacotherapy of Pain in the Hospital: Review of Limitations 1 Background 2 Pain Medications Non-steroidal Anti-inflammatory Drugs (NSAIDs) Acetaminophen Antidepressants and Antiepileptic Drugs Skeletal Muscle Relaxants Opioids 3 Pain Consult/Bedside Procedures 4 Conclusion References Further Reading Sedation and Patient Monitoring for Bedside Pain Management Interventions 1 Overview 2 Historical Aspects, Levels of Sedation 3 Anesthesia for Outpatient Procedures 4 Anesthesia for Inpatient and ICU Procedures 5 Potential Complications 6 Conclusion and Future Directions References Further Reading Bedside Joint, Muscle, and Tendon Injections: Overview 1 Overview 2 Historical Aspects Types of Injections Types of Injection Medications 3 Recent Developments 4 Conclusions and Future Directions References Further Reading Bedside Peripheral Nerve Blockade: Overview 1 Introduction 2 Bedside Peripheral Nerve Blockade: Overview Background Materials, Location, and Supplies Ultrasound Needles and Catheters Local Anesthetics Local Anesthetic Systemic Toxicity Upper Extremity Nerve Blocks Interscalene Block Supraclavicular Nerve Block Infraclavicular Nerve Block Axillary Nerve Block Lower Extremity Nerve Blocks Femoral Nerve Block Adductor Canal Block Popliteal Sciatic Nerve Block Truncal Nerve Blocks Paravertebral Nerve Block Erector Spinae Block Transverse Abdominal Plane Block Rectus Sheath Blocks 3 Conclusion References Further Reading Manual Medicine Interventions for Bedside Pain Management 1 Overview 2 Historical Aspects and Introduction to Osteopathic Manipulative Treatment 3 Osteopathic Manipulative Treatment for the Head and Neck, Low Back, Hip and Sacrum 4 Potential Complications 5 Documentation of Osteopathic Treatment 6 Conclusion and Future Directions References Further Reading Bedside Electro-Acupuncture 1 Overview 2 Background and Mechanism of Action 3 Clinical Application and Presentation of Techniques Intensity Frequency Waveform Continuous Intermittent Dense/Disperse Duration of Treatment Location of Needle Input Craig Percutaneous Electrical Nerve Stimulation (PENS) Osteopuncture Gokavi Transverse Technique (GTT) Systemic Regulatory Points 4 Cautions and Contraindications 5 Conclusion and Future Directions References Further Reading Bedside Pain Psychology, Spiritual and Complementary Medicine Interventions 1 Introduction 2 Benefits, Risks, and Limitations of Behavioral Interventions 3 Patient Evaluation 4 Interventions Patient Education Music and Art Guided Imagery Breathing Exercises Recreation and Journaling Solution-Focused Spiritual Interventions Mindfulness Service Animals Reiki Massage Aromatherapy 5 Summary References Further Reading Patient Safety Considerations for Bedside Interventions 1 Overview 2 Procedure Preparation Informed Consent The Universal Protocol Hand Hygiene Procedure Site Antisepsis 3 Adverse Events During Bedside Procedures Provider Needlestick Infection Peripheral Nerve Injury Pneumothorax Vascular Injection and LAST 4 Conclusion References Further Reading Part II: Technology and Tools for Bedside Interventions Imaging Vs Landmark Techniques for Bedside Interventions: Which Modality to Choose 1 Overview 2 Available Imaging Modalities 3 Which Modality to Choose for Bedside Interventions Shoulder Girdle Injections Hip Injections Sacroiliac Joint Injections Knee Injections Greater Trochanteric Pain/Bursa Injections Piriformis Muscle Injections Lateral Femoral Cutaneous Nerve Block Greater Occipital Nerve Block Ilioinguinal/Iliohypogastric Block Pudendal Nerve Block 4 Conclusion References Further Reading Point-of-Care Ultrasound 1 Overview 2 Historical Aspects and Traditional Approaches 3 Recent Developments 4 Concerns and Drawbacks 5 Conclusion and Future Directions References Further Reading Neuromodulation at the Bedside 1 Bedside Transcutaneous Electrical Nerve Stimulation Overview Indications and Contraindications Equipment and Supplies Technique Potential Complications and Adverse Effects References Further Reading Viscosupplementation for Osteoarthritic Pain 1 Overview 2 Historical Aspects 3 Recent Developments 4 Potential Concerns 5 Conclusion References Further Reading Bedside Physiotherapy: Therapeutic Ultrasound and Other Physical Factors 1 Therapeutic Ultrasound Low-Intensity Therapeutic Ultrasound/Ultrasound Diathermy High-Intensity Focused Ultrasound 2 Other Physical Modalities Transcranial Magnetic Stimulation (TMS) Low Level Laser Therapy (LLLT) Millimeter Waves Therapy (MWT) References Bedside Transcutaneous Drug Delivery 1 Overview 2 Topical Creams 3 Patches 4 Phonophoresis 5 Iontophoresis 6 Patient-Controlled Transcutaneous Fentanyl 7 Conclusion References Kinesio Taping for Bedside Pain Management 1 Overview 2 Historical Aspects 3 Theories 4 Application of Tape Definitions 5 Research 6 Concerns/Drawbacks 7 Conclusion References Further Reading Part III: Bedside Interventions for Special Patient Populations Special Considerations for Bedside Pain Management Interventions for Elderly 1 Overview 2 Historical Aspects and Recent Developments 3 Non Pharmacologic Interventions 4 Pharmacologic Interventions 5 Additional Concerns 6 Conclusion and Future Directions References Further Reading Special Considerations for Bedside Pain Management Interventions for Chronic Pain Patients 1 Background 2 Common Bedside Procedures 3 Special Considerations for Bedside Procedures in Chronic Pain Patients 4 Maximizing Outcomes 5 Summary and Future Directions References Further Reading Special Considerations for Bedside Pain Management Interventions for Morbidly Obese Individuals 1 Overview 2 Specifics of Bedside Interventions for Morbidly Obese Individuals 3 Conclusion References Further Reading Special Considerations for Bedside Pain Management Interventions in the Emergency Department 1 Overview 2 Historical Aspects 3 Bedside Interventional Pain Procedures Peripheral Nerve Blocks Acupuncture Hypnotherapy, and Other Psychological Interventions in the Emergency Department 4 Conclusion References Further Reading Special Considerations for Bedside Pain Management Interventions in the Intensive Care Unit 1 Overview 2 Bedside Pain Management Interventions for Trauma Patients in the Intensive Care Unit 3 Bedside Pain Management Interventions for Patients After Cardiothoracic Surgery 4 Bedside Procedures for Patients After Abdominal Surgery 5 Bedside Procedures for Patients with Pre-existing Chronic Pain Admitted to the Intensive Care Unit 6 Bedside Procedures for Patients Transitioned from Intensive Care to Palliative Care 7 Conclusion References Further Reading Part IV: Bedside Procedures for Head, Neck and Back Pain Peripheral Nerve Blocks for the Management of Headache and Face Pain 1 Overview 2 Supraorbital Nerve Blocks Indications and Contraindications Clinical Anatomy Equipment and Supplies Techniques Landmark Technique, Supraorbital Nerve Block Ultrasound-Guided Technique, Supraorbital Nerve Block 3 Infraorbital Nerve Block Indications and Contraindications Clinical Anatomy Techniques Landmark Technique, Infraorbital Nerve Block Ultrasound-Guided Technique, Infraorbital Nerve Block 4 Mental Nerve Block Indications and Contraindications Clinical Anatomy Technique Extraoral Approach, Mental Nerve Block Intraoral Approach, Mental Nerve Block Ultrasound-Guided Approach, Mental Nerve Block 5 Potential Complications and Adverse Effects References Further Reading Bedside Injections for Temporomandibular Pain 1 Overview and Indications 2 Clinical Anatomy 3 Equipment and Supplies 4 Techniques 5 Potential Complications and Adverse Effects 6 Clinical and Technical Pearls References Further Reading Greater Occipital Nerve Block 1 Overview 2 Lndications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Techniques Anatomic Landmark Technique Ultrasound-Guided Greater Occipital Nerve Block 6 Potential Complications and Adverse Effects References Further Reading Intranasal Block 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Techniques Intranasal Block, Drip Method Intranasal Block, Q-Tip Method 6 Potential Complications and Adverse Effects References Further Reading Botulinum Toxin Injections for Chronic Migraine and Cervical Dystonia 1 OnabotulinumtoxinA Injections for Chronic Migraine and Cervical Dystonia Overview Clinical Presentation and Indications Clinical Anatomy Equipment and Supplies for Chronic Migraine Injections 2 OnabotulinumtoxinA Injections for Chronic Migraine, Landmark Technique Potential Complications and Adverse Events Equipment and Supplies for Cervical Dystonia Injections 3 OnabotulinumtoxinA Injections for Cervical Dystonia, Ultrasound/EMG Guided Technique Potential Complications and Adverse Events References Further Reading Noninvasive Vagus Nerve Stimulation and Electrotherapy for Headaches 1 Noninvasive Vagus Nerve Stimulation and Electrotherapy for Headaches Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Stimulation Technique and Protocol Potential Complications and Adverse Events References Further Reading Superficial Cervical Plexus Nerve Block 1 Superficial Cervical Plexus Block Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Cervical Plexus Block, Landmark Technique Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Cervical Medial Branch Block 1 Ultrasound-Guided Cervical Medial Branch Block Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Cervical Medial Branch Block, Long Axis (Coronal) Technique Cervical Medial Branch Block, Transverse Technique Potential Complications and Adverse Effects References Further Reading Stellate Ganglion Block 1 Stellate Ganglion Block Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Landmark Technique Stellate Ganglion Block, Ultrasound Technique Anterior Approach at C6 Anterior Approach at C7 Response from the Block Potential Complications and Adverse Effects References Further Reading Trigger Point Injections 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Procedure 6 Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Bedside Ligamentous Injections 1 Bedside Ligamentous Injections Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Ligamentous Injections, Landmark, and Ultrasound-Guided Techniques Ultrasound-Guided Interspinous and Supraspinous Injection Ultrasound-Guided Iliolumbar and Sacral Ligament Injections 6 Ligamentous Injections, Various Injectates Corticosteroids Prolotherapy Platelet-Rich Plasma Potential Complications Conclusion References Further Reading Paravertebral Blocks 1 Paravertebral Blocks Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies 2 Paravertebral Block, Landmark Technique 3 Ultrasound Technique 4 Potential Complications and Adverse Effects References Further Reading Interfascial Plane Blocks 1 Overview 2 Erector Spinae Plane Block Anatomy Indications and Contraindications Equipment Technique Potential Complications and Adverse Effects 3 Rhomboid Block (RB) and Rhomboid: Sub Serratus Plane Block (RSS) Anatomy Indications Equipment and Technique 4 Trapezius Muscle Plane Block 5 Serratus Posterior superior Muscle Plane block 6 Thoracolumbar Interfascial Plane Block Equipment and Technique 7 Lumbosacral Interfascial Plane block 8 Future Directions References Further Reading Superior Cluneal Nerve Block 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Superior Cluneal Nerve Block, Landmark Technique 6 Superior Cluneal Nerve Block, Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Middle Cluneal Nerve Injections 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Anatomical Landmark Technique 6 Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Sacroiliac Joint Intraarticular and Periarticular injections 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies (Table 3) 5 [Intraarticular and Periarticular Sacroiliac Joint Local Anaesthetic and Steroid Injection] Landmark Techniques 6 Ultrasound Guided Intraarticular Sacroiliac Joint Injection Technique 7 Potential Complications and Adverse Effects References Further Reading Interventions for Coccygeal Pain 1 Coccygeal Nerve Injection 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Description of the Procedure Landmark Technique Ultrasound-Guided Injection 6 Potential Complications References Further Reading Piriformis Muscle Injection 1 Overview 2 Piriformis Syndrome 3 Indications and Contraindications 4 Clinical Anatomy 5 Equipment and Supplies 6 Piriformis Injection – Ultrasound-Guided Technique 7 Potential Complications and Adverse Effects References Further Reading Part V: Bedside Procedures for Thoracic, Abdominal and Pelvic Pain Intercostal Nerve Blocks 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Intercostal Nerve Blocks, Landmark Technique 6 Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Bedside Injections for Costochondral Pain 1 Overview 2 Costochondral Joint Injection Indications and Contraindications Clinical Anatomy Equipment and Supplies Costochondral Injection—Landmark Technique Costochondral Injection Ultrasound Technique 3 Parasternal Block Indications and Contraindications Clinical Anatomy Equipment and Supplies Parasternal Block Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Transversus Abdominis Plane Blocks 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Landmark Technique 6 Ultrasound Technique 7 Complications and Adverse Effects 8 Subcostal Transversus Abdominis Plane Block Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Ultrasound Technique Complications and Adverse Effects References Further Reading Abdominis Rectus Sheath Block 1 Overview 2 Indications and Contraindications (Table 1) 3 Clinical Anatomy 4 Equipment and Supplies 5 Rectus Sheath Block, Landmark Technique 6 Rectus Sheath Block, Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Ilioinguinal and Iliohypogastric Nerve Block 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies (Table 4) 5 Ilioinguinal and Iliohypogastric Nerve Blocks, Landmark Technique 6 Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Genitofemoral Nerve Block 1 Indications and Contraindications 2 Clinical Anatomy 3 Equipment and Supplies 4 Genitofemoral Nerve Block, Landmark Technique 5 Genitofemoral Nerve Block, Ultrasound Technique Genital Branch Femoral Branch Combined Genitofemoral Block 6 Potential Complications and Adverse Effects References Further Reading Pudendal Nerve Block 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Pudendal Nerve Block, Landmark-Based Technique 6 Pudendal Nerve Block, Ultrasound-Guided Technique 7 Potential Complications and Adverse Effects References Further Reading Part VI: Bedside Procedures for Upper Extremity Pain Shoulder Joint Injections 1 Overview 2 Indications and Contraindications (Tables 1, 2 and 3) 3 Clinical Anatomy 4 Equipment and Supplies 5 Injectates Corticosteroids Local Anesthetics Viscosupplementation (Hyaluronic Acid derivatives) Platelet-Rich Plasma Less Common Agents Botox Morphine Hydrodistention 6 The Glenohumeral Joint Anatomy Technique & Approach Ultrasound-Guidance 7 The Acromioclavicular Joint Anatomy Technique & Approach 8 The Subacromial/Subdeltoid Bursa Anatomy Technique & Approach Blind Techniques Ultrasound Techniques 9 Potential Complications and Adverse Effects 10 Conclusion References Further Reading Periarticular Shoulder Injections 1 Periarticular Shoulder Pain Overview Indications and Contraindications of Periarticular Shoulder Injections Clinical Anatomy Equipment and Supplies Subacromial Bursitis, Landmark Technique Subacromial Bursitis, Ultrasound Technique Biceps Tendinopathy, Landmark Technique Biceps Tendinopathy, Ultrasound Technique Supraspinatus Tendinopathy, Landmark Technique Supraspinatus Tendinopathy, Ultrasound Technique Infraspinatus Tendinopathy, Landmark Technique Infraspinatus Tendinopathy, Ultrasound Technique Subscapularis Tendinopathy, Landmark Technique Subscapularis Tendinopathy, Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Injections for Acromioclavicular Joint Pain 1 Acromioclavicular Joint Injection Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Landmark Technique Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Suprascapular Nerve Block 1 Suprascapular Nerve Block Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Suprascapular Nerve Block, Landmark Technique Ultrasound Technique Potential Complications References Further Reading Brachial Plexus Blocks 1 Brachial Plexus Blocks Overview 2 Common Indications and Contraindications 3 Clinical Anatomy of the Brachial Plexus Roots Trunks Divisions Cords Major Branches Anatomic Variations Peripheral Nerve Ultrasound Imaging 4 Equipment and Supplies 5 Interscalene Block Complications 6 Supraclavicular Block [10] Complications 7 Infraclavicular Block Complications References Further Reading Axillary Nerve Block 1 Axillary Nerve Block Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Axillary Nerve Block Technique Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Bedside Pectoralis Minor and Scalene Muscles Injections 1 Bedside Pectoralis Minor and Scalene Muscles Injections Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Anterior and Middle Scalene Injections 6 Pectoralis Minor Injection 7 Potential Complications and Adverse Effects References Further Reading Elbow Joint, Intra-articular Injections 1 Intra-articular Elbow Injection Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Intra-articular Elbow Injection, Landmark Technique 6 Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Periarticular Elbow Interventions 1 Periarticular Elbow Interventions Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies 2 Periarticular Elbow Interventions, Landmark Technique Lateral Epicondyle Injection Medial Epicondyle Injection Olecranon Bursa Injection 3 Ultrasound Technique Lateral Epicondyle Injection Medial Epicondyle Injection Olecranon Bursa Injection 4 Potential Complications and Adverse Effects Procedure-Related [7] Glucocorticoid-Associated Toxicity [7] References Further Reading Ulnar, Median, Radial, and Antebrachial Cutaneous Nerve Blocks 1 Introduction 2 Common Indications and Contraindications 3 Equipment and Supplies 4 General Approach Ulnar Nerve Block Indications Clinical Anatomy Procedural Technique Elbow/Antecubital Fossa Forearm Median Nerve Block Indications Clinical Anatomy Procedural Technique Antecubital Fossa/Elbow Midforearm Radial Nerve Block Indications Clinical Anatomy Procedural Technique Elbow/Antecubital Fossa Forearm Antebrachial Cutaneous Nerve Block Indications Clinical Anatomy Procedural Technique 5 Potential Adverse Events and Complications References Further Reading Carpal and Cubital Tunnel Injections 1 Carpal Tunnel Injection Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Carpal Tunnel Injection, Landmark Technique Carpal Tunnel Injection, Ultrasound Technique Potential Complications and Adverse Effects 2 Cubital Tunnel Injection Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Carpal Tunnel Injection, Landmark Technique Carpal Tunnel Injection, Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Bedside Injections for Wrist Pain 1 Bedside Injections for De Quervain’s Disease Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Landmark Technique Ultrasound-Guided Technique Potential Complications and Adverse Effects 2 Bedside Radiocarpal Joint Injection Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Ultrasound-Guided Technique Potential Complications and Adverse Effects 3 Bedside Ganglion Cyst Aspirations Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Ultrasound-Guided Technique Potential Complications and Adverse Effects References Further Reading Bedside Injections for Hand Pain: Trigger Finger, Digital Nerve Blocks, Intra-Articular Injections 1 Hand Pain, Overview 2 Injections for Trigger Finger Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Landmark Technique Ultrasound Technique Potential Complications and Adverse Effects Evidence for Trigger Finger Injections 3 Injections for Dupuytren’s Contracture Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Injection Technique Potential Complications and Adverse Effects Evidence for Dupuytren’s Contracture Injections 4 Injections for Digital Nerve Block Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Traditional Technique With and Without Ultrasound Transthecal Technique Subcutaneous Technique Potential Complications and Adverse Effects Choice of Technique and Injectate 5 Intra-articular Injections of the Hand Overview Indications and Contraindications Equipment and Supplies Injection Technique Evidence for Intra-articular Injection Landmark vs. Ultrasound Guidance References Further Reading Botulinum Toxin Injections for Muscle Spasticity 1 Botulinum Toxin Injections for Upper and Lower Limb Overview Indications and Contraindications to Botulinum Toxin Injections Clinical Anatomy Upper Limb Lower Limb Equipment and Supplies Injection of Biceps Brachii, E-stim or EMG Guidance Injection of Biceps Brachii, Ultrasound Guidance Injection of Flexor Pollicis Longus (FPL), E-stim or EMG Guidance Injection of FPL, Ultrasound Guidance Injection of Flexor Carpi Radialis (FCR), E-stim or EMG Guidance Injection of FCR, Ultrasound Guidance Injection of Flexor Carpi Ulnaris (FCU), E-stim or EMG Guidance Injection of FCU, Ultrasound Guidance Injection of Flexor Digitorum Profundus (FDP), E-stim or EMG Guidance Injection of FDP, Ultrasound Guidance Injection of Flexor Digitorum Superficialis (FDS), E-stim or EMG Guidance Injection of FDS, Ultrasound Guidance Injection of Gastrocnemius, E-stim or EMG Guidance Injection of Gastrocnemius, Ultrasound Guidance Injection of Soleus, E-stim or EMG Guidance Injection of Soleus, Ultrasound Guidance Injection of Tibialis Posterior, E-stim or EMG Guidance Injection of Tibialis Posterior, Ultrasound Guidance Injection of Flexor Digitorum Longus (FDL), E-stim or EMG Guidance Injection of FDL, Ultrasound Guidance Injection of Flexor Hallucis Longus (FHL), E-stim or EMG Guidance Injection of FHL, Ultrasound Guidance Potential Complications and Adverse Effects References Further Reading Part VII: Bedside Procedures for Lower Extremity Pain Intra-Articular Hip Injections 1 Intra-Articular Hip Joint Injections Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Landmark Technique The Lateral Approach Landmarks The Anterior Approach Landmarks Ultrasound-Guided Technique Needle Insertion Technique and Injection Potential Complications and Adverse Effects References Further Reading Hip: Periarticular Injections 1 Trochanteric Bursa Injection Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Greater Trochanteric Bursa Injection, Landmark Technique Ultrasound Technique 2 Ischial Tuberosity Injections Indications and Contraindications Clinical Anatomy Equipment and Supplies Ischiogluteal Bursa Injection, Landmark Technique Ultrasound Technique 3 Iliopsoas Bursa Injections Indications and Contraindications Clinical Anatomy Equipment and Supplies Iliopsoas Bursa Injection Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Adductor Canal Block 1 Saphenous Nerve Block in the Adductor Canal Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Adductor Canal Block, Landmark Technique Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Sciatic Nerve Blockade 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Subgluteal Sciatic Nerve Block, Ultrasound Technique 6 Subgluteal Sciatic Nerve Block, Landmark Technique 7 Popliteal Sciatic Nerve Block, Ultrasound Technique 8 Popliteal Sciatic Nerve Block, Landmark Technique 9 Potential Complications and Adverse Effects References Further Reading Lateral Femoral Cutaneous Nerve Block 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 LFCN Block, Landmark Technique 6 LFCN Block, Ultrasound Technique 7 Potential Complications and Adverse Effects References Further Reading Saphenous Nerve Block 1 Overview 2 Indications for Saphenous Nerve Block 3 Contraindications to Saphenous Nerve Block 4 Anatomy 5 Equipment and Supplies 6 Procedure Technique Mid-Thigh/Adductor Canal Distal Thigh/Trans-Sartorial Ankle 7 Potential Complications and Adverse Effects References Further Reading Femoral Nerve Block 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Ultrasound Technique 6 Potential Complications and Adverse Effects References Further Reading Intra-Articular Knee Injections 1 Intraarticular Knee Injections Overview Indications and Contraindications Etiology of Knee Osteoarthritis Intrarticular Knee Injection Candidates, Indications and Contraindications Clinical Anatomy Equipment and Supplies Intraarticular Knee Injection Techniques Superior Approach Lateral Midpatellar Approach Inferior Approach Ultrasound-Guided Approach Suprapatellar Bursa Technique Medial Intraarticular Technique Potential Complications and Adverse Effects References Further Reading Periarticular Knee Injections 1 Pes Anserinus Bursa Injection Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies 2 Pes Anserinus Bursa Injection, Landmark Technique 3 Pes Anserinus Bursa Injection, Ultrasound Technique 4 Potential Complications and Adverse Effects References Further Reading Genicular Nerves Blocks 1 Genicular Nerve Blocks Overview Indications and Contraindications Clinical Anatomy Equipment and Supplies Ultrasound Technique Potential Complications and Adverse Effects References Further Reading Ankle Block 1 Overview 2 Indications and Contraindications Indications Contraindications 3 Equipment and Supplies 4 Ankle Block Tibial Nerve Anatomy Sonoanatomy Block Performance Deep Peroneal Nerve Anatomy Sonoanatomy Block Performance Superficial Peroneal Nerve Anatomy Sonoanatomy Block Performance Sural Nerve Anatomy Sonoanatomy Block Performance Saphenous Nerve Anatomy Sonoanatomy Block Performance Ergonomics Landmark Technique Caution 5 Potential Complications and Adverse Effects References Further Reading Intra-Articular Injections of the Foot and Ankle 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Ankle Joint Injection 6 Subtalar Joint Injection 7 Other Foot Intra-articular Injections 8 Potential Complications and Adverse Effects References Further Reading Soft Tissue Injections of the Foot and Ankle 1 Overview 2 Indications and Contraindications 3 Clinical Anatomy 4 Equipment and Supplies 5 Tarsal Tunnel Injection 6 Plantar Fascia Injection 7 Injection for Morton’s Neuroma 8 Potential Complications and Adverse Effects References Further Reading Index