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Evaluation / Consultation

We will review your prior records, take thorough history from you about your pain and evaluate you to decide treatment plan.

Interventional Procedures

A Lumbar Facet Joint Block / Medial Brach Block is a minimally invasive injection of local anesthetic and steroid in the small joints of the spine or over the nerve to the joint in the neck or lower back. Multiple injections are performed depending upon pain. It is done under x-ray guidance to ensure precise placement of the needle. Facet joint blocks are requested for patients who have pain in their neck or back as a result of arthritis in the face.

An Epidural Steroid Injection is an injection of steroid medication into the epidural space of the spine under x-ray guidance.  Nerves travel through the epidural space to the back and into the legs. Nerve roots may cause pain in leg due to pinching from a disc or arthritic bony structures of the spine. Epidural steroid injection provides pain relief by reducing the inflammation of the nerve roots. It is not unusual for a patient to require more than one injection to receive long term benefit. The injections are done in a series of three.

A Selective Nerve Root Block is an injection of local anesthetic and steroid over the nerve exits the spine. A nerve root block may be diagnostic or therapeutic. If you get a period of sustained pain relief from the injection, the block may be repeated.

A Sacro-iliac Joint Injection is an injection of local anesthetic and a steroid medication into the sacroiliac joint. SI joint is the joint between spine and pelvis. Injection is done under x-ray guidance. It is done for buttock pain due to arthritis in the SI joint.

Rhizotomy or Radio-Frequency Ablation is a procedure to deaden the sensory nerves going to joint to give longer lasting relief from joint pain. It is usually done for facet joint pain (neck or back), also for Sacro-iliac joint pain. Once the needle is in place under x-ray guidance, a mild electrical current stimulates the nerve and confirms its exact location. Then the electrode is heated to deaden the sensory nerve. Pain relief may last longer than a block.

Joint Injections for Hip, Knee, and Shoulder are done with steroid and an anesthetic medicine. It is done under x-ray guidance for hip joint. It is usually done for arthritic pain from the joint.

Trigger Point Injections are injections into muscle for myofascial pain. It is anesthetic and steroid injection.

Botox Injections are done for severe muscle spasms and for headaches. It paralyzes the part of muscle for a few months to give the relief, its effect may last 4-6 months.

EMG / NCV (Nerve Conduction Studies)

This is a nerve test done for diagnosing nerve pinching like carpal tunnel syndrome, pinched nerve in neck or back, peripheral neuropathy from diabetes etc.

Other modalities we may use

  • Physical therapy, TENS unit
  • Cognitive Behavioral Therapies (CBT) under the direction of a pain psychologist
  • Other specialists consultations – Spine surgeon, Orthopedic surgeon, Neurologist, Rheumatologist, Psychiatrist etc.
  • Urine Toxicology is done randomly in office
  • Imaging tests – X-Ray / MRI / CT Scans etc.