Botox Injections

Botox Injections

Doctors have been using Botox for years to successfully treat wrinkles and creases, But Botox has also brought relief to many people who suffer from chronic medical conditions. Botox is only FDA-approved for chronic migraines, which means headache on 15 or more days a month.

Botox blocks signals from the nerves to the muscles. The injected muscle can’t contract which is why your wrinkles go away when injected. Botox injected around the face and head can prevent muscle contractions that can trigger migraines

How Is a Botox Procedure Done?

Getting Botox takes only a few minutes and doesn’t require anesthesia. Botox is injected with a fine needle into specific muscles with only minor discomfort.

How Long Does a Botox Injection Last?

The effects of Botox typically last 10-12 weeks. As muscle action gradually returns, your migraines will also begin to return. Does insurance cover Botox for Migraines?

Because Botox is FDA approved for chronic migraine, it’s covered by most plans, including Medicare and Medicaid. Before your insurance company will approve Botox for your chronic migraine, you typically must have tried and failed two other preventative treatments. These might include anti-seizure medications, antidepressants, or blood pressure medications that are typically used to prevent migraines.

Orthopedic Injections

Orthopedic Injections

Cortisone injections are used for treating many orthopedic problems, including arthritis, tendonitis, and bursitis. Cortisone is a very powerful anti-inflammatory medication. By reducing inflammation in the affected joint, we can usually reduce the amount of pain the patient is feeling.

Cortisone shots at can be done during a regular office visit with Dr. Anden. She always uses the guidance of an ultrasound machine to ensure accuracy. Cortisone can offer quick relief for your inflamed joint pain and can last several months.

Cortisone injections are very safe to perform. Side effects tend to be rare and minor.

(Please note that cortisone is not the same type of steroid as a performance enhancing drug.)

What to Expect during your shot

  • These injections will be done in Dr. Anden’s office during a regular office visit.
  • The area around the injection site is cleaned.
  • Dr. Anden will use a numbing spray to numb the skin.
  • Using Ultrasound Guidance Dr. Anden will locate the affected area and then insert the needle.
  • You will feel some pain and pressure while the medication is being released.
  • Once finished, Dr. Anden will clean off and bandage the area, if needed.
  • Typically, cortisone shots include a corticosteroid medication and a numbing agent. The numbing agent should give you immediate relief, where the corticosteroid can take 3-5 days to begin helping.
  • Dr. Anden will have you make a follow-up appointment for 2-3 weeks to see how you are improving.

After the cortisone shot

You may return to your normal activity level following the injection. You may use ice if the area is sore. Stretching and at home exercises are always good to do after an injections, as this will keep your muscles from becoming tight.

What are the risks?

As with any injection, there is a risk of infection. Dr. Anden practices safe medical techniques to keep the environment sterile to reduce the chance of infection.

Cortisone can also cause a raise in blood sugars, so please watch this if you are a Diabetic.

Cortisone can also cause facial redness, headaches, and a “wired” or “caffeinated” feeling. If you are unable to sleep following the injection, this is most likely related to the corticosteroid. These side effects should dissipate in 48 hours following the injection.

Trigger Point Injections

Trigger Point Injections

What is a Trigger Point?

A Trigger Point is a tight and painful “knot” of muscle fiber. This knot can form where a muscle is strained or injured and is unable to relax.

A trigger point can feel tight or tense under the skin and is typically very tender to the touch.

Muscles around the neck, upper back, and shoulder blades are prone to trigger points.

Your muscle pain or spasms may be caused by one or more trigger points About Us

Dr. Anden has recommended an in-office injection into your painful spots to help relax the muscle.

Trigger Point Injections are similar to having a deep tissue massage. Rather than massaging the outside of the muscle, Dr. Anden is able to “massage” the inside of the tense muscle using a needle.

Any muscle in the body can have one or more trigger points. Several injections may be needed to best improve your pain. These injections are typically given in sessions a few weeks apart. In some cases you may not notice a change in symptoms until the 2nd or 3rd session.

Trigger Point Injections Trigger Point Injections We will ask you to sit on a chair or lay on the exam table. Dr. Anden will feel and stretch the muscle to find the exact trigger point. Once the trigger point is found, the skin is cleaned and then injected. The injection will contain a numbing agent and a sterile solution.

NO CORTISONE is used during this injection.

Dr. Anden will then move the needle back and fourth in the muscle using a “peppering” technique. You will feel muscle spasms during the injection, as this is the muscle releasing it’s tension.

After the Injection

You will have soreness in the injection site for 2-3 days following the shot. You may use ice on the treated area, as well as rubbing the tender muscle. You may return to work after the injection and have no limitations. You may continue to take your normal medications. Dr. Anden will advise you to make a follow-up for additional sessions if needed.

Spine Interventions

What is a Spinal Injection?

Dr. Anden has recommended a spinal injection to help reduce pain and improve your quality of life.

This is done by injecting Cortisone (a Steroid or strong anti-inflammatory) into the inflamed area to decrease inflammation. This should relieve pain by reducing swelling and irritation.

An injection can also help to identify the source of your pain.

Steroid injections can be done in the Cervical (neck), Thoracic (mid-back) or Lumbar (low back) Spine.

The type of injection you receive is based on your specific symptoms, the findings on your physical exam and the findings on your x-rays, MRI’s or CT Scans.

Spine Anatomy Vertebrae

Spine Anatomy Vertebrae are the blocked shaped bones that form your spinal column. Cervical vertebrae are located in the neck, thoracic vertebrae are located in the mid to upper back and lumbar vertebrae are located in the lower back.


Discs are spongy shock asorbers between each of the vertebrae. A herniated disc or a disc with “wear and tear” may cause inflammation and pain.

Spinal Nerves

Spinal Nerves are branches from the spinal cord exiting the spinal column. They transmit signals that control the movement of your muscles and provide sensation in your arms and legs. These nerves can be irritated or inflamed and cause pain, numbness, tingling or other strange sensations.

Epidural Space

Epidural Space is the space around the sheath (dura) covering the spinal nerves. Placing anti-inflammatory medicine (steroid/cortisone) in the epidural space an help reduce spinal nerve inflammation.

Spinal Injections Facet Joints are small joints in the back of the spine that guide the bending motions of each vertebra. These joints can be irritated or inflamed and cause pain. Sacroiliac Joints (SI Joints) are formed by your lower spine (sacrum) and pelvic bone (ilium). Inflammation in these joints can cause low back, buttocks and other pain. Nerve roots pass through side openings between vertebrae called intervertebral foramina. Irritation or inflammation of the nerve roots can cause pain. Preparing for your Injections

  • A spinal injection is an outpatient procedure done under x-ray guidance.
  • Please bring a driver to drive you home or back to work following the injection
  • You may eat normally prior to your injection.

What to expect during the procedure We will take you into a sterile procedure room and have you lay flat on your stomach with your arms down to your sides. We will clean your skin with a sterile solution and place a drape over your skin.

Once Dr. Anden has located the injection site using a live x-ray, she will numb your skin and guide her needle into place.

The procedure takes approximately 20 minutes. Once finished you will be taken to your waiting room by wheelchair.

Dr. Anden will discuss possible side effects with you as these vary with different injections.

  • Please stop all blood thinners (Coumadin, Aspirin, Plavix) prior to the procedure.
  • We can offer an anti-anxiety medication if you are anxious / nervous about your procedure, but we DO NOT offer sedation for this procedure.