Physiatry Evaluation and Electro-Diagnostic Testing (EMG)
As musculoskeletal and spine care specialists, we conduct a comprehensive physical examination utilizing the diagnostic tools necessary to identify the symptom/pain generator. Each patient benefits from our detailed understanding of pain physiology, functional anatomy and restorative rehabilitation.
Cervical, Lumbar and Thoracic Transforaminal Epidural Steroid Injections
Description: This is the direct application of medication to an injured/inflamed region of the spine.
Indication: Best used for neck or back pain that radiates into the arm or leg.
Facet and Facet Nerve Block: Cervical, Thoracic and Lumbar
Description: An injection technique delivering medication into the facet joint capsule or onto the facet nerve.
Indication: Localized neck or back pain aggravated by walking and spine extension (bending backwards).
Sacroiliac Joint Injection
Description: Intra-Articular injection for sacroiliac joint dysfunction.
Indication: Diagnostic affirmation and therapeutic benefit when SI joint is suspected as a primary pain source (i.e. trauma to buttock).
Radio Frequency Facet Nerve Denervation: Cervical, Thoracic and Lumbar
Description: Use of RF signal (applied by an electrode) to block the nerve to the Facet and posterior spine elements.
Indication: Chronic posterior element pain (i.e. pain with spine extension) that is unresponsive to more conservative measures.
Percutaneous Disc Decompression (Nucleoplasty)
Description: Minimally invasive technique utilizing radio-frequency energy to dissolve material from the center of the disc. Percutaneous nucleoplasty achieve significant reduction in intradiscal pressure, thereby reducing back and/or leg pain in appropriate patients.
Indication: The ideal patient has persistent low back and/or leg pain not associated with a large disc herniation. Candidates may have MRI or CT scan showing smaller disc protrusions. The patient should have undergone conservative treatment, including physical therapy, medications, epidural injections.
Lumbar, Cervical, and Thoracic Discography
Description: Intradiskal placement of contrast/dye for the purpose of visualizing and diagnosing internal disk disruption.
Indication: Low back pain unexplained by other diagnostic tests including MRI. Often used to determine the number of levels to include in an annuloplasty or spine fusion.
Cervicothoracic and Lumbar Sympathetic Blockade w/wo Radio Frequency
Description: Pain anesthesia administered to components of the sympathetic nervous system i.e. Stellate Ganglion (Cervicothoracic); Lumbar Sympathetic chain.
Indication: Sympathetically maintain pain disorders most commonly causalgia (peripheral nerve injury) and reflex sympathetic dystrophy (RSD).
Lysis of Adhesions
Description: The application of a Steroid/Saline/Enzyme solution to reduce and eliminate scar tissue, often formed after surgery.
Indication: Extremity or spine pain following spine surgery, with evidence of persistent pain, inflammation or scar tissue.
Pain Blocks for Pelvic Pain Syndromes
Description: Various types of anesthetic blocks can be used for chronic or persistent pelvic pain syndromes.
Indication: Failure to improve with conservative treatment of various conditions, such as intractable testicular or pelvic pain syndromes.
Spinal Cord Stimulator
Description: Electrical stimulator implanted percutaneously (within the spine) by which electrical impulses are applied to block pain transmission.
Indication: Patients that have failed all reasonable care. General indications include: Failed back surgery syndrome, neuropathic pain (RSD) and peripheral vascular disease.
Indications for our Services:
Pain in any location may be helped by our techniques. Frequently, we see patients with:
•Painful spine conditions including acute and chronic low back pain
•Pain associated with degenerative spine conditions (i.e. spinal stenosis)
•Headache, neck, thoracic and shoulder pain
•Back, neck and pain following spine surgery
•Pain secondary to reflex sympathetic dystrophy of the arms or legs