SERVICES OFFERED

What to Expect On Your First Visit

Individualized Medical Assessment

I analyze your pain history personally and tailor a treatment plan. The plan may involve a diagnostic work-up, such as a back MRI, a short-term trial of medications, or an intervention. Many need physical therapy and exercise, some need a referral to another specialist (such as rheumatology or surgery). In short, a treatment plan will be customized for you.

Diagnostic Work-Up

Your experience is the most important piece, but diagnostic work-up can help to clarify the underlying cause. Examples include lab work, imaging (such as X-ray or MRI), and nerve conduction study. Below are the types of services offered.

Therapeutic Injections

I can deliver therapeutic substances directly to your pain generators, utilizing X-ray and ultrasound to maximize accuracy and safety, and to minimize the dose required to treat your symptoms. Steroids injected directly at the problem site, for example, tend to cause fewer and less intense side effects compared to when it is taken by mouth or intravenously on a daily basis. Below are examples of therapeutic injections:

Epidural Steroid Injection

The most famous of the pain injections. Steroid, which has strong anti-inflammatory properties, and local anesthetic (such as lidocaine) is injected to help alleviate the pain radiating down the arms or the legs (also called sciatica). I perform all of its variations, transforaminal, interlaminar, caudal, etc., and I pick the one that is right for you.

Stellate Ganglion Block and Lumbar Sympathetic Block

These interventions can be useful in treating complex regional pain syndrome (CRPS), type 1 and 2, that can cause intense pain in the arms and the legs. CRPS is sometimes referred as reflex sympathetic dystrophy (RSD), and CRPS type 2 more specifically is also referred to as causalgia. As in real life, one thing can have many names.

Abdominal Pain Blocks (examples: celiac plexus block, splanchnic nerve block, or TAP block)

These blocks can alleviate abdominal pains of different origin. For instance, celiac plexus block can treat pancreatic cancer pain. Some abdominal pain has treatable causes, such as stomach ulcers or Crohn's disease, which can be treated with medication or surgery. Some have no clear etiology or no treatable cause. These blocks can be a useful alternative or adjuncts to medicine.

Pelvic Pain Blocks (examples: hypogastric plexus block or ganglion of impar)

Pelvic pain disproportionately affects female patients. Many undergo surgeries that remove pelvic organs such as uterus or ovaries, but the pain can persist. Pelvic pain blocks can be a helpful way to minimize the pain without taking irreversible actions or to treat pain that remain after these surgeries.

Scalene Muscle Injections

This can be used to treat thoracic outlet syndrome and intractable hiccups.

Botox

When conservative medication treatment fails, Botox injections can be an effective solution for chronic migraines.

Non-Injection Treatments

My treatment options go well beyond injections. I list them here (the list is not exhaustive).

Medications

Sometimes, medication is what you need. There are many kinds of analgesics, neuropathic medicine, muscle relaxers, anti-inflammatories, etc. Needing a pain pill now does not mean needing it forever. If you no longer require one, I will recommend you back off on it.

Ketamine Infusion

Ketamine has pain-relieving properties on its own and can also help some of the commonly used pain medications to work more effectively, by decreasing the tolerance you can build towards them.

Radiofrequency Ablation (aka RFA or Rhizotomy)

RFA is a non-surgical technique that can de-activate specific nerves to treat your pain. Commonly targeted are small nerves that carry painful sensations from your neck, back, and knees.

Vertiflex Procedure

This is a minimally invasive technique that can deliver long-term relief from the leg and back pain associated with lumbar spinal stenosis.

Spinal Cord Stimulator Trial

Under the right circumstances, a spinal cord stimulator may be what you need to treat your pain.

Schedule a consultation today at

310-423-9600