Helping Relieve Pain
Our goal is to improve your pain and offer support through your treatment and healing process. Your treatment plan is based on your condition and overall health history. We work with your primary care physician, psychologists and pain management consultants to offer you coordinated care.
Conditions We Treat
Causes: Myofascial, neurogenic, post-surgical can cause this pain.
Therapies: Acupuncture, medication, nerve blocks and spinal stimulation implant are possible options.
Causes: There are many types of arthritis that are wide-spread or individual joint pain.
Therapies: We'll coordinate with rheumatology, orthopedics, medication management, physical therapy and nutrition.
Causes: Eighty percent of back pain is acute and pain usually improves in eight weeks. Chronic pain is only in about 20 percent of patients.
Therapies: We'll first rule out infection, tumor and systemic disease, especially if pain gets worse at night. Then, we'll find the source of treatment: if it's disc, nerve root, joint or muscle. Depending on the diagnosis, treatment may include nerve blocks, physical therapy, surgery and other all services.
Therapies: We work closely with oncology and palliative care to provide comfort and improve quality of life. No spinal pumps for medication.
Causes: These headaches are not from blood vessels like migraine or just muscle tension. These are from cervical facet arthritis, exacerbated by poor posture, injury, such as whiplash. You'll experience more pain in the neck than the arms and can't rotate your neck. Looking up makes pain worse.
Therapies: Pain may improve with NSAIDS, physical therapy, traction, osteopathic manipulation therapy or 2-3 injections to see if cervical radiofrequency would work.
Causes: From osteoporosis, trauma or a fracture, these may cause sudden pain in your midline.
Therapies: Your treatment plan may include pain medicine for the short term, epidural steroids, facets treatment, bracing or possible Kyphoplasty (interventional radiology).
Causes: Aging, neck trauma, thoracic or midline lumbar pain worse with certain positions aid in facet arthritis.
Therapies: Pain responds to radiofrequency (RFA), which gives a window to better posture working with physical therapy. (LINK-RFA)
Causes: We'll rule out bad stuff first like tumor or infections. Then, focus on other causes like medication overuse and migraine versus a tension headache.
Therapies: Our treatment is to sort out pain from the neck and coordinate with neurology for migraine. There is a possible overlap with stroke. Our goal is to improve posture, which decreases pain. Additionally, your treatment plan may also include: osteopathic manipulation therapy, acupuncture, BOTOX, psychology for relaxation and nutrition consultation.
Causes: Trauma, aging, poor posture, smoking, obesity, deconditioning, altered weight bearing, which leads to pinched nerves. The discs need to hold the holes open for the nerve roots and may not be able to from degeneration or injury. It takes a year to heal a ruptured disc.
Therapies: While there is no cure, we can help improve your body's alignment to decrease your pain. MRI is used for diagnosis or as a way to visualize the problem. If bowel or bladder is affected, we may need to schedule a surgical consult sooner. Conservative or short term treatment includes medications and injections. You can receive steroids for three or six months maximum.
Causes: Pain in the back of the head from inflamed occipital nerves, at the base of the skull.
Therapies: Rule out vascular, infection, increased intracranial pressure from other sources. Treatment may include steroid blocks, radiofrequency ablation, osteopathic manipulation therapy, medications for neuritis, BOTOX and infusion therapy per neurology.
Causes: Trauma, genetics, mal-alignment or deconditioning can cause osteoarthritis.
Therapies: To help widespread pain, medications, like NSAIDS, strengthening, physical therapy, with neurological re-education may help. We'll work with orthopedics for specific joint issues.
Causes: More common in females. Aging, drinking alcohol, smoking, deconditioning, post menopausal, poor nutrition and low calcium intake are also causes.
Therapies: Specific medications for this given per your primary care physicians. We'll work to reduce risk factors and help general pain.
Causes: Damaged nerves in the periphery from nerve disease, chemotherapy, toxins, alcohol, diabetes and vitamin deficiency. Feels like burning and aching.
Therapies: Work with care team to improve risk factors, prescribe medications specific to nerve pain, acupuncture, physical therapy with stimulation, neurological re-education and nutrition compounds may be suggested to improve pain.
Cause: Sciatic nerve caught in the buttock between the two heads of the piriformis.
Therapies: Diagnosis is done with a back CT or MRI, since this overlaps with true back issues. Physical therapy, injections to the muscle, psychiatric support for relaxation and surgery are possible treatment options.
Post Mastectomy/Thoracotomy Pain
Causes: Frequent burning or sharp pain as a result of surgery for a tumor.
Therapies: Possibly treatments include: medications for neuritis, local injections, stimulation, physical therapy and psychology for neurological re-education. In general, we try to maximize all factors to ensure the best surgical outcome; after the most appropriate plan for the primary care doctor to take over care.
Causes: Resurgence of the chicken-pox virus in one nerve root causes shingles.
Therapies: After the rash appears the pain usually goes away; but people over 55 have an increased risk for permanent pain. Within the first two months, nerve blocks are most effective in preventing permanent pain.
Causes: Inflammation of the joints of the spine.
Therapy: To properly treat we need to diagnosis using X-rays for instability and CT. Other options include physical therapy, NSAIDS, brace and nerve blocks.
Causes: One vertebrae slips onto another. This happens gradually. Frequently, this gets worse with bending forward and presents with intermittent flares.
Therapy: We'll use X-ray to rule out instability. We may need surgical evaluation. Nerve blocks are used for irritated roots. Facet nerve blocks if indicated per exam.
Sympathetically Maintained Pain
Causes: This can happen when an injury overlaps with the nerves that maintain blood vessel tone. Constriction and dilation are accompanied by color changes, temperature changes, pain, decreased range of motion, which leads to increased pain.
Therapies: Initial stages may respond to nerve blocks, physical therapy and spinal cord stimulation (DCS). There may be a series of 10 nerve blocks. Later, DCS and medications become less effective and in the last stage there is no treatment. Luckily, since we are so vigilant about this, we rarely see the last stage.
Causes: Facial pain, three branches for forehead, cheeks, jaw area. A MRI may rule out MS or infection as well.
Therapies: Medications for neuropathy, injections and surgery is possible or spinal cord stimulation.