Non-invasive diagnostic studies that we perform in our practice include anatomical and physiological studies such as Digital X-ray, Electromyography (EMG), Nerve conduction studies (NCV), and Ultrasound. In some cases, minimally invasive diagnostic studies such as diagnostic blocks may be necessary to establish or confirm a medical diagnosis. The goal of these different types of diagnostic studies is to help diagnose your medical condition and help identify the source of your pain. The treatment goal is to restore function, improve strength, range of motion and endurance as well as decrease pain.
This study is performed in order to evaluate injury or disease of muscle tissue, nerve roots and peripheral nerves in patients who complain of pain, weakness, numbness, tingling, or other neuropathic symptoms. Such disorders include Diabetes, Thyroid disorders or other metabolic conditions, Peripheral neuropathies, Entrapment neuropathies, Carpal tunnel syndrome, tarsal tunnel syndrome, Herniated disc, Trauma to nerve or any suspected neuropathy (nerve damage).
Our physicians use state-of-the-art, fully digital and computerized X-ray equipment network system loaded with the latest digital technology that provides the best available image quality and allows your physician to access, read, and diagnose your condition at any time and from any location.
This testing modality allows the visualization of images of vessels, muscles, tendons, ligaments, bursae, joint capsules, peripheral nerves, scar tissue, and the articular cartilage surface of large and small joint. In addition to its diagnostic value, it is also commonly utilized for needle guidance for the aspiration (drainage) or injection of large and small joints to enhance accuracy and outcome.
Physical Therapy treatments include manual therapy using hands-on techniques to address soft tissues and limitations of joint mobility; physical and occupational therapy addressing body mechanics, posture, strengthening, flexibility, stabilization and modalities including heat, cold, electrical stimulation and ultrasound.
Physical Therapy as a component in the patient’s comprehensive treatment plan has the goal and potential of helping patients with their medical condition so patients can get back to their daily activities and their normal life with their family and friends.
TENS (Transcutaneous Electrical Nerve Stimulation)
A small and compact external device is applied to the skin via a special electroconductive garment designed for the specific anatomical area to deliver pain relieving and soothing electrical impulses to nerve endings to stop the pain. Our medical staff will also educate and train you at our clinics on how to use the device at home.
The evaluation and treatment of physical disabilities designed to improve physical strength, range of motion and ability. Physical therapy is used in conjunction and to complement and enhance the pain management treatment plan.
Other Devices & DME
- Cervical Collars & Traction Devices
- Wrist Braces For Carpal Tunnel Syndrome
- Back Braces
- Thoracolumbar Support Brace (TLSO) For Compression Fractures
- Lumbar Support Orthotic (LSO)
- Plantar Fasciitis Night Splint
- Knee Braces
- Ankle Foot Orthotic (AFO) For Dropped Foot
- Tens Units & Garments
- Stimulators & Interferential Stimulators
- Hip braces
- Muscle stimulators
An outpatient/office procedure which involves placement of potent anti-inflammatory agents into the epidural space to reduce disc and nerve inflammation, producing relief.
Transforaminal Epidural Injection
A Transforaminal Epidural Injection is performed to relieve low back and radiating leg pain. The transforaminal approach is a very selective injection around a specific nerve root. The foraminae are small openings between your vertebrae through which the nerve roots exit the spinal canal and enter the body. By injecting medication around a specific nerve root, the doctor can determine if this nerve root is causing the problem. This type of epidural injection is used most often for diagnostic purposes, and it is commonly used in the neck. The medication injected can help reduce swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica and herniated discs. However, many patients get significant relief from only one or two injections. In some cases, it may be necessary to repeat the procedure.
Diagnostic & Therapeutic Nerve Blocks
Are outpatient/office procedures where local anesthetic and anti-inflammatory medication injections are given near a specific nerve or group of nerves to relieve pain:
- Intercoastal Nerve Block
An injection of a local anesthetic and anti-inflammatory medication in the area between two ribs. An intercostal nerve block is performed for pain due to herpes zoster (commonly known as that causes inflammation of the nerves that spread outward from the spine. It may also be performed for pain caused from a surgical incision in the chest area or to help determine the cause of your pain. (Diagnostic nerve block).
- Lumbar Sympathic Block
An injection of local anesthetic around a group of nerves in your lower back. It may be done if you have complex regional pain syndrome (CRPS), a disease involving a disturbance of circulation to the skin or neuropathic pain (pain caused by a disorder of the nervous system).
- Facet Nerve Block
An injection of anti-inflammatory and anesthetic medication in and around the facet joint area to reduce the swelling around the nerve. This is performed if your doctor suspects that your neck or lower back pain may be caused in part by the small facet joints of the spine (Facet joints are located on the side of your spine, away from the spinal cord.).
- Stellate Ganglion Block
An injection of anesthetic medication around the collection of nerves that affect the upper limb. This may be performed to decrease pain and increase the circulation and blood supply to the affected limb. A stellate ganglion may be performed for people who have circulation problems or the following nerve injuries: Complex Regional Pain Syndrome (CRPS), Causalgia, Herpes Zoster and Phantom Limb Pain.
Sacroiliac Joint Injection
The sacroiliac facet joints are a small joint in the area of the low back and buttocks where the pelvis joins with the spine. If the joints become painful they may cause pain in the low back, buttocks, abdomen, groin or legs. A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief experienced will help confirm whether or not the joint is the source of pain. Also, the temporary relief of the numbing medicine may better allow the physician to treat that joint. Also, time release cortisone (steroid) will help to reduce any inflammation that may exist within the joint(s).
Trigger Point Injections
An outpatient/office procedure where small amounts of local anesthetics and anti-inflammatory medications are injected in the area of the muscle where you have pain or tenderness. These areas are called trigger points because they produce pain when stimulated. Trigger Point Injections are performed if you have myofascial pain which is pain in a specific muscle or muscle group.
Botox® (Botulinum Toxin)
Botox® was recently approved by the FDA for use in chronic migraine headaches. Botox® is used for cervical dystonia (painful neck muscle spasm), spasticity (spasms), migraine headache and other pain problems.
An outpatient procedure in which a radiofrequency current is used to heat a small volume of nerve tissue interrupting pain signals from that specific area.
Percutaneous Discectomy Disc Decompression
This option is for patients suffering from low back and leg (radicular) pain due to contained disc herniations. This option is also performed on those who have failed in their conservative treatments and are interested in trying minimally invasive options before considering traditional back surgery. Percutaneous Discectomy is performed in surgery using local anesthetic or conscious sedation to allow patient monitoring in order to pinpoint the pain source. With the help of fluoroscopic guidance (live video X-Ray), the discectomy probe removes disc tissue via a tiny puncture in the skin similar to a simple injection. Removal of disc tissue may relieve painful pressure on the surrounding nerves. The total procedure takes 30-60 minutes.
A minimally invasive outpatient procedure in which a transmitter catheter (Wand) is inserted into the nucleus of the disc via a special cannula inserted through the skin and uses radio waves to dissolve tissue volume. This reduces or eliminates the pressure from the disc on the nerve root and thus the pain.
An outpatient diagnostic X-ray test that attempts to replicate the patient’s pain symptoms in order to pinpoint the pain source in the discs. It has a diagnostic value that X-rays and MRI scans are not able to provide. It also measures the internal intradiscal pressures and assesses the anatomy of the internal components of the intervertebral disc such as internal disc disruptions, tears, etc A medication mixture containing dye is injected into the disc enabling the physician to determine abnormal internal disc fibers, abnormal internal disc pressures, and the source of pain.
Minimally Invasive Lumbar Decompression (MILD)
As its name indicates, this is a minimally invasive surgery done using a very small incision in the low back to remove bone and ligament calcification that produces compression on the lumbar nerves caused by canal stenosis in the lumbar spine.
Neurostimulation / Neuroaugmentation
An outpatient procedure where a special medical device comparable to a heart Pacemaker is surgically inserted under the skin to send mild electrical impulses to the spinal cord (Spinal cord stimulators) or to a peripheral nerve (Peripheral nerve stimulators). These electrical impulses are delivered through special electrodes or leads that are also surgically implanted to specifically cover the area of pain. A trial test is usually performed first to allow you and your physician to assess if this treatment modality will help your condition.
PRP (Platelet Rich Plasma) & Stem-Cell Injections
Platelet rich plasma (PRP) & Stem Cell injections are revolutionary new treatments that help relieving pain and help promote healing and the creation of new cartilage in different musculoskeletal conditions. Packed with growth and healing factors and delivered into different areas of the body via selective injections, these procedures significantly strengthen the body’s natural healing signal.