- Neurostimulation - Spinal Cord Stimulation: Spinal Cord Stimulation (SCS) is neurostimulation, which is similar to a pacemaker. Neurostimulation is the process of safely delivering light electrical currents to interrupt pain signals
- Neurostimulation - Dorsal Root Ganglion Stimulation: Like SCS, DRG is a type of neurostimulation that helps with pain management. However, DRG is able to focus in on a more specific part of the body
- Regenerative Medicine: Don’t give up what you love because of joint pain. Commonwealth Musculoskeletal Medicine can help you REPAIR, RESTORE and REVITALIZE your joints and cartilage and get you going again.
- Botox for Migraines: Botox injections can offer you relief from Chronic Migraine Pain
- Medication Management: Medication Therapy Management (MTM) is medical care provided by pharmacists whose aim is to optimize drug therapy and improve therapeutic outcomes for patients
- Psychological Assessment for Pain: Psychological evaluation is defined as a way of testing people about their behavior, personality, and capabilities to draw conclusions using combinations of techniques
- Lumbar Discography
- Stellate Ganglion, Thoracic, and Lumber Sympathetic Blocks: The stellate ganglion (or cervicothoracic ganglion) is a sympathetic ganglion formed by the fusion of the inferior cervical ganglion and the firsts thoracic ganglion, which exists in 80% of cases
- Occipital Nerve Blocks: An injection of a steroid or other medication around the greater or lesser occipital nerves that are located in the back of the head, just above the neck area
- Intercostal Nerve Blocks: An injection of medication that helps relieve pain the chest area caused by herpes zoster infection (or "shingles"), or a surgical incision. Intercostal nerves are located under each rib. When one of these nerves or the tissue around it gets irritated or inflamed, it can cause pain
- Trochanteric Bursa Injections: After years of stressing the areas around your joints, these sacs or bursae may become inflamed. This inflammation can cause pain. Greater trochanteric bursitis is the inflammation of the sac that lies over the outside part of your thigh bone (femur), where it joins the hip
- Piriformis Muscle Injections: Piriformis syndrome is an uncommon disorder of a narrow muscle located in the buttocks
- Intra-articular Injections: In medicine, a joint injection (intra-articular injection) is a procedure used in the treatment of inflammatory joint conditions, such as rheumatoid arthritis, gout, tendinitis, bursitis, Carpal Tunnel Syndrome, and occasionally osteoarthritis
- Vertebroplasty: An outpatient procedure for stabilizing compression fractures in the spine. Bone cement is injected into back bones (vertebrae) that have cracked or broken, often because of osteoporosis
YOUR FIRST VISIT WITH US WE DO A COMPREHENSIVE EVALUATION. IT IS HELPFUL FOR US TO RECEIVE INFORMATION AHEAD OF TIME, SUCH AS:
Previous treatments for pain
Recent X-rays, scans, or laboratory studies
Pertinent medical records from other providers
A list of current and previous medicines, their doses, and how they worked
An accurate list of past procedures, surgeries, and medical problems
Common Conditions Treated
- Arthritis: Acute or chronic inflammation of a joint, often accompanied by pain and structural changes and having diverse causes, such as infection, crystal deposition, or injury
- Back and Neck Pain: Back pain is felt in the back. Episodes of back pain may be acute, sub-acute, or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain, or a burning sensation
- Bursitis: Inflammation of a bursa. A bursa is found where there is movement of a joint causing two tissues to rub against each other. For example, behind the elbow or in front of the knee there is a bursa to allow the skin to move without rubbing against the bone
- Cancer Pain: Pain in cancer may arise from a tumor compressing or infiltrating nearby body parts; from treatments and diagnostic procedures; or from skin, nerve, and other changes caused by a hormone imbalance or immune response
- Chronic Whiplash: Whiplash is a non-medical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck associated with extension, although the exact injury mechanisms remain unknown
- Coccydynia: Pain in the region of the coccyx. Also called coccyalgia, coccydynia, coccygodynia
- Degenerative Disc Disease: Degenerative Disc Disease (DDD) is breakdown of an intervertebral disc of the spine. It may cause acute or chronic low back or neck pain. The typical radiographic findings in DDD are black discs, disc space narrowing, vacuum disc, endplate sclerosis, and osteophyte formation
- Diabetic Peripheral Neuropathy: A long-term complication of diabetes. It causes burning, aching, numbness, or pins and needle sensations in the hands, feet, arms, and legs. It is caused by nerve damage.
- Facet Arthropathy: Facet joint arthrosis is an intervertebral joint disorder. The facet joints or zygapophyseal joints are synovial cartilage covered joints that limit the movement of the spine and preserve segmental stability. In the event of hypertrophy of the vertebrae, painful arthrosis can occur.
- Herniated Disc: Occurs when the spongy, soft material that cushions the bones of the spine (vertebrae) slips out of place or becomes damaged
- Ischemic Pain: A type of chest pain caused by reduced blood flow to the heart
- Myofascial Pain: A disorder in which pressure on sensitive points in the muscles causes pain in seemingly unrelated body parts. The syndrome often happens after repeated injury or muscle overuse.
- Neuropathic Pain: A complex, chronic pain state that is usually accompanied by tissue injury. The nerve fibers themselves might be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers.
- Occipital Neuralgia: A condition in which the nerve that run from the top of the spinal cord up through the scalp
- Phantom Limb Pain: PLP refers to ongoing painful sensations that seem to be coming from the part of the limb that is no longer there. The limb is gone, but the pain is real. The onset of this pain most often occurs soon after surgery.
- Piriformis Syndrome: An uncommon disorder of a narrow muscle located in the buttocks
- Post Herpetic Neuralgia: A complication of shingles, which is caused by the chicken pox (herpes zoster) virus. Postherpetic Neuralgia affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear
- Post-Surgical Pain: This type of anesthesia provides the added benefit of pain relief both during and after your surgery. It may reduce your risk of nausea and vomiting after surgery. You, your anesthesiologist, and your doctor will decide before surgery if a nerve block is a suitable pain management or anesthetic option for you
- Radiculopathy: Disease of the spinal nerve roots. Radiculopathy is caused by compression or irritation or a nerve as it exits the spinal column
- RSD/CRPS/Causalgia: Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD), is a long-term condition that often worsens with time. It is characterized by severe pain and sensitivity, swelling, and changes in the skin. It may initially affect one limb and spread throughout the body; 35% of people reported symptoms that affected their whole body
- Sacroiliitis: An inflammation of one or both of your sacroiliac joints - situated where your lower spine and pelvis connect. It can cause pain in your buttocks or lower back, and can extend down one or both legs.
- Sciatica: Usually caused when a herniated disc or bone spur in the spine presses on the nerve
- Shingles: Causes a painful rash that may appear as a stripe of blisters on the trunk of the body. Pain can persist even after the rash is gone (postherpetic neuralgia)
- Spinal Stenosis: Can put pressure on the spinal cord and the nerves within the spine. It commonly occurs in the neck and lower back. The condition is often caused by age-related wear and tear.
Plan of Care
The more information we have, the faster we can develop a plan to treat you. You will be required to sign a routine “Controlled Substance” Agreement. This is a common practice in pain clinics throughout the country. It allows us to provide you with the appropriate pain medicine while limiting potential for abuse or side effects. We encourage you to read it completely and clarify any questions. You will be asked to adhere to its conditions.
Follow-up visits will last for approximately 15 minutes. We make every effort to keep appointments on time for your convenience. Vital signs and an interval history will be collected.
If procedures are appropriate for your treatment, generally they can not be done the same day since most insurance plans require pre-approval. Many procedures are done using light sedation. You will need to bring someone to drive you home. As a rule, most common procedures are completed within 30-45 minutes from start to finish.
You will be expected to pay for any deductibles and co-pays on your insurance before being seen. Please make arrangements ahead of time. Major credit cards are accepted. We make every effort to ensure each visit is efficient and worthwhile.
Cervical Epidural Steroid Injection
This injection relieves pain in the neck, shoulders, and arms caused by a pinched nerve (or nerves) in the cervical spine. Conditions such as herniated discs and spinal stenosis can compress nerves, causing inflammation and pain. The medication injected helps decrease the swelling of nerves.
Lumbar Transforaminal Epidural Steroid Injection
This outpatient procedure is an injection of a steroid-anesthetic medication. The medication can reduce swelling and inflammation of irritated spinal nerves. This procedure is performed to relieve pain in the lower back and pain that radiates from the back to the legs. The injection takes only a few minutes to complete.
Cervical Facet Radiofrequency Neurotomy
This minimally-invasive procedure, also called radiofrequency (or RF) rhizotomy, reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals. This procedure is performed with local anesthetic.
Medial Branch Block
This diagnostic procedure is performed to identify a painful facet joint. The facet joints are the joints between the vertebrae in the spine. They allow the spine to bend, flex and twist.
Lumbar Steroid Injection
This injection procedure is performed to relieve low back and radiating leg pain. Steroid medication can reduce the swelling and inflammation caused by spinal conditions.
Sacroiliac Joint Steroid Injection
This injection procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce swelling and inflammation in the joint.
Lumbar Radiofrequency Neurotomy
This minimally-invasive procedure, also called radiofrequency (RF) rhizotomy, reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals. This procedure is performed with local anesthetic.
Trigger Point Injections
This outpatient procedure is designed to reduce or relieve the pain of trigger points. These small, tender knots can form in muscles or in the fascia (the soft, stretchy connective tissue that surrounds muscles and organs). The trigger point injection procedure takes only a few minutes to complete.