TREATMENTS

Pain management is not synonymous with opioid management!  Our pain center will treat patients with complicated and chronic medical, surgical and neurological pain.  We believe in a multi-disciplinary approach to provide comprehensive treatment of pain conditions.  We are an intervention-based medical practice that provides:

  • Evaluation of patients suffering from persistent spinal pain, nerve injury pain, headache, joint pain, cancer pain or neuropathic pain.
  • Minimally invasive diagnostic and interventional treatments, including spinal injections, nerve blocks, joint injections, and advanced therapeutic spinal procedures (nerve stimulation therapy and intrathecal drug therapy).

We will use state-of-the-art interventional technologies and advanced minimally invasive procedures to treat pain and achieve our aforementioned goals.  Treatment plan may include interventional, pharmacologic and/or complimentary modalities that are individualized and best suited to address the patient’s pain, restore functions, and hopefully return him/her to a life-style that are more acceptable.

Conditions We Treat:

Cervicogenic headaches
Neck pain
Arthritic pain – osteoporotic, rheumatologic and others
Complex regional pain syndromes (CRPS) and other Sympathetically-mediated pain
Post-traumatic pain
Mid-back and Chest wall pain
Low back pain
Joint and Extremity pain
Cancer pain
Abdominal and Pelvic pain
Perineal and Rectal pain
Post-laminectomy pain
Facial pain
Shingles pain – acute and chronic (postherpetic neuralgia)
Work-related injury pain
Peripheral nerve pain
Myofascial pain
Fibromyalgia pain
Diabetic polyneuropathy
Neuropathic pain
All other chronic pain conditions

Physical Assessments & Treatments

In order to determine which therapies will be most effective, our office will first conduct a thorough, non-invasive physical examination of each patient to pinpoint the origin of the pain.

This evaluation involves a complete neurological and musculoskeletal examination, surveying the spine, nervous system, extremities and various joints.   The results of these initial tests may indicate whether the pain originates from the spinal cord or is contained in a peripheral nerve that acts as a conduit to a specific part of the body.   If necessary, X-rays/MRIs, blood work and additional tests will help the treating physician zero in on the source of pain.

Our Centers have the ability to evaluate and perform procedures on the same visit

Physical Assessments and Treatments (continued)

Mind/Body Connection
Besides the physical burden, chronic pain affects the psychological and spiritual well being of patients and their families.  In addition to a complete physical work-up, we may include a psychological evaluation to help better understand the patient’s perspectives and provide suggestions and support as he/she copes with his/her pain.

 Non-invasive Treatments
Whenever possible, we will first prescribe a conservative course of treatment, such as pain-relieving medications in combination with psychological support.  Some patients benefit from techniques that combine aspects of Eastern medicine with traditional Western approaches.

 State-of-the-Art Techniques
If non-invasive therapies do not address a patient’s needs, he or she, together with a physician, may agree to embark upon more aggressive therapies, such as:

Trigger point injections and Piriformis muscle injection:  Using traditional medications or Botox

 Bursa injections:  Treatment for common inflammatory conditions such as subdeltoid, trochanteric and ischiogluteal bursitis.

Joint injections:  Shoulder, elbow, hip, knee, sacroiliac, and facet joints

 Nerve blocks:  Local anesthesia and/or steroids injected near specific nerves in the spinal column, pelvis, or thoracic cage that affect different parts of the body.  Common techniques include translaminar, transforaminal, or caudal epidurals.

Implantable drug delivery:  A preprogrammed release of opioids, local anesthetics, and/or other medications directly into the spinal cord.  This technique delivers smaller doses of medications at regular intervals and helps reduce systemic side effects.   This is often the best approach for cancer patients, allowing them a greater degree of mobility and symptom relief.

 Radiofrequency Ablation (RFA):  A specialized needle is inserted near a nerve and heated, which renders the nerve incapable of transmitting pain.  This procedure is often effective for alleviating neck, back and disc pain.  Pulsed RFA is a technique employed to treat pain originating from peripheral nerves and most effective in treatment of entrapment neuropathy.

 Spinal cord stimulation:  A small implanted device stimulates the spinal cord with a minute electrical current that interrupts the transmission of pain signals. The indications for this treatment modality are expanding.

Diagnostic procedures:  Medial branch blocks to establish the diagnosis of facet arthropathy; prior to radiofrequency ablation, a specific diagnostic injection is conducted.

 In addition to the traditional fluoroscopy, most of these procedures can now be performed with ultrasound-guided technology.