Our Services

Our Services

Our comprehensive and state-of-the-art interventional pain management techniques help treat painful symptoms and help you regain your normal life. The treatment techniques are catered to individual patients' needs. At Optimum Pain and Regenerative Medicine we specialize in creating treatment plans that help you regain your normal lifestyle-free of pain. We invite you to learn more about some of the conditions and treatments at Optimum Pain and Regenerative Medicine on this page.

Epidural injections
Epidural injections can be performed to the cervical, thoracic, and lumbar regions of the spinal column. They can be administered to alleviate pain due to a herniated disc, spinal stenosis, or radiculopathy which can compress the nerves causing inflammation and pain. An injection will be given into the epidural space of the affected region of the spine. A combination of local anesthetic and steroid medication will be injected to decrease swelling to the affected nerves and thus reduce the pain. Although some patients may require only one injection, typically a series of three injections will be ordered. The injection may provide permanent relief or a period of pain relief for several months.
Sacroiliac Joint Injections
Sacroiliac Joint injections can help to alleviate pain to the low back, buttocks, hips, abdomen, groin or legs. This pain can be caused by arthritis. The sacroiliac joint is a large joint at the low back where the pelvis joins with the spine. An injection to this site includes the injection of local anesthetic and steroid medication to help reduce any inflammation that may exist in the joint. You may require a series of three injections. Depending upon the amount of relief that you receive the doctor may discuss a more permanent procedure to alleviate your pain called a radiofrequency.
Facet Injections
Facet Injections can be performed to the cervical, thoracic, and lumbar regions of the spine. This area can be injected if there is history of trauma, arthritis, or inflammation of the facet joint. These injuries can occur after a sudden forceful twisting of the spine while lifting heavy objects. The pain can be associated with decreased range of motion and spasms. During the procedure you will be injected with a local anesthetic and steroid medication. Depending upon the origin of the pain you may receive several injections at different levels of the spine. You may require a series of three injections. Depending upon the amount of relief that you receive the doctor may discuss a more permanent procedure to alleviate your pain called a radiofrequency.
Radiofrequency
A radiofrequency is performed to the facet joints or sacroiliac joints by creating a lesion or burn in the painful nerve endings to these areas. The purpose is to decrease pain to these areas and improve function for a longer period of time. The procedure is only done after there has been temporary relief from facet injections or sacroiliac joint injections. A special needle is used to provide a controlled heat lesion to the affected nerve endings. The procedure can be performed at different levels of the spinal column at the same visit.
Caudal epidural Steroid Injection with or without Lysis of Adhesions
Caudal epidural Steroid Injection with or without Lysis of Adhesions can be used to alleviate low back pain and radiating leg pain. It can be used to treat lumbar radiculopathy, low back pain, spinal stenosis, sciatica, post laminectomy pain syndrome, phantom limb pain, and pelvic pain syndromes. The injection includes administration of local anesthetic and steroid medication which help to alleviate swelling and inflammation. Many patients can have significant relief after one injection. However, the procedure can be repeated if needed.
Transforaminal injections
Transforaminal injections can be performed to the cervical, thoracic, or lumbar regions of the spine. The injections can help alleviate pain associated with radiculopathy, displaced intervertebral disc, or sciatica. The needle is injected into the foraminal space near the nerve root. A local anesthetic and steroid medication is injected into the foraminal space to help alleviate swelling and inflammation of the affected region of the spine. There is a possibility of numbness to the affected extremity following the procedure. This numbness is temporary and should be relieved within hours after the procedure. Many patients receive this injection as a series of three.
Stellate Ganglion Nerve Block
The Stellate Ganglion Nerve Block is an injection used to treat pain associated with shingles, frostbite, reflex sympathetic dystrophy, Reynaud’s disease, acute vascular insufficiency and vascular headaches. It can also be used for complex regional pain syndromes affecting the head, face, neck or arms. The injection includes the administration of local anesthetic and steroid medication around the ganglion nerves to block the pain signals. Common reactions following this procedure include nasal congestion, blood shot droopy eye on the side that the injection was given as well as a hoarse voice and a warm tingling sensation in the arm and hand which usually decreases after a few hours. If the first injection alleviates pain, then more injections will be ordered over time.
Discography
A Discography can be performed to the cervical, thoracic, or lumbar regions of the spine. It is considered a diagnostic procedure that helps to confirm or rule out the discs as a source of pain. It will help to diagnose what a CT scan and MRI cannot diagnose. It is done to identify the painful discs and help the doctor plan the correct interventional pain procedures. It utilizes the placement of a needle into the disc while injecting contrast dye to provoke the pain. The patient is awake during the procedure to discuss with the physician the intensity and location of pain. Following the procedure, the patient will be sent for a CT scan to confirm what the procedure has already diagnosed. The patient will be brought in for a follow up appointment following the procedure to discuss the results of the discography.
Intrathecal Pump Therapy
Intrathecal Pump Therapy is an alternative method of medication delivery. It can be used in patients that suffer from chronic pain related to cancer, post laminectomy syndrome, failed back syndrome, and osteoporosis. It can also be used in patients that suffer from cerebral palsy, strokes, multiple sclerosis, or paraplegia. It works by delivering small dosages of analgesic medication to pain receptors in the spinal cord. Due to the small dosages and the direct delivery to pain receptors the entire body does not suffer from negative side effects such as grogginess, confusion and over sedation. The medication enters the intrathecal space around the spinal cord via a catheter that is placed by the physician. Prior to permanent placement of an intrathecal pump, a trial study will be performed at the doctor’s clinic. If there is proven positive effects after the trial then the patient will be sent to a surgeon for permanent placement of a pump. Once a permanent pump is placed the patient will have to have regular appointments with their physician to ensure that the pump is working properly and to refill the medication as needed.
Spinal cord stimulation
Spinal cord stimulation is used to relieve chronic low back pain and sciatic pain. It uses electrical impulses to block pain signals from being perceived in the brain. It is used on patients that have failed to get relief from conservative therapies or surgery. Instead of sensing the pain, the patient may feel a tingling sensation to their previous pain site. Prior to implantation of a permanent stimulator, the patient undergoes a trial period with an external stimulator. The device might stay in place for a few days to see how the patient will respond to the tingling sensation. Every patient responds differently to the sensation of the stimulation. The degree of stimulation can be adjusted or turned off at any time by the patient depending upon the severity of the pain. Having a spinal cord stimulator can alter certain activities in your life. Make sure to fully discuss the procedure with your physician prior to participating in a trial stimulation.
Trigger Point Injections
Trigger Point Injections can be used to treat local areas of muscle pain and spasms. They are commonly injected to areas defined as tight muscle bands or knots of the muscle which are painful. These painful muscle knots are often found in the shoulders, neck, low back, buttocks and thighs. These trigger points can often mimic pain that people feel from pinched nerves in the neck or back. Medications used during an injection into these painful muscles include local anesthetics with steroids. Many times more than one injection is given at one time to the various sites of painful muscles. Trigger point injections are sometimes repeated in a series depending upon the amount of relief that is achieved from the injection.
Botox injections
Botox injections (Botulisum Toxin Type A) can force tight muscles to relax. These painful muscle knots are often found in the shoulders, neck, low back, buttocks and thighs. When standard trigger point injections fail to relax the muscle, Botox injections can often be used. Typically the medication does not actually work for one to two weeks following the injection but many patients experience relief within days of the injection. The effect of the Botox typically wears off within three to four months. If used frequently, a patient can develop antibodies to the medication and it will begin to lose its effectiveness. The patient will follow the series of injections with a consultation with the doctor to assess the effectiveness of the injections.
Percutaneous Vertebroplasty
Percutaneous Vertebroplasty is a minimally invasive procedure used to strengthen a broken vertebrae (spinal bone) that has been weakened or fractured by osteoporosis or cancer. It can also be used in patients with traumatic vertebral crush fractures. The procedure can help improve patient’s functional abilities and can often prevent further vertebral fracture. A needle is advanced into the area of the fracture and an orthopedic cement mixture is injected into the fractured bone. The cement will harden and it will stabilize the fractured vertebrae. Patients are able to sit and stand later the same day. They are brought in for consultation within days after the procedure. Patients that experience one fracture can often experience others and it is important to monitor patients for other fractures in the vertebrae on a regular basis.
Occipital Nerve Blocks
Occipital nerve blocks are used to treat severe pain along the nerves in the head and neck. Many patients suffering from headaches due to this nerve pain receive this type of injection. The injection involves the administration of local anesthetic and steroid medication to the area of the scalp where thee occipital nerves are located. The patient may have more than one injection to the occipital nerves depending upon the amount of relief that the patient received from the first injection. The doctor will meet with the patient weeks after the procedure to determine the amount of relief the patient received and to determine if another injection is needed.
Ganglion Impar Block
A Ganglion Impar Block can be useful in managing pain to the rectum, genitalia, and perineum. This technique is often used in patients that have history of cancer or have undergone radiation treatment. The procedure involves the advancement of a needle into the tailbone region to inject the ganglion impar. Medications used during this injection typically include a local anesthetic and a steroid medication. The relief of the pain is temporary but the area can be injected with longer lasting medication if there has been positive effects following the first injection.
Intercostal Nerve Block
An Intercostal Nerve Block is useful in managing pain to the chest wall and the upper abdominal wall. Patients that suffer from rib fractures, shingles, cancer pain or those that have had chest surgery and experience pain after the surgery may be a candidate for this type of injection. The needle is advanced in between the ribs to the affected nerve and a combination of local anesthetic and steroid medication is injected. The patient may receive varying degrees of relief following this procedure. If the patient does receive relief following the injection, then a cryotherapy procedure can be performed to provide more permanent relief. This procedure can be discussed in detail with the doctor to determine if the patient is a candidate for cryotherapy.
Cryotherapy
Cryotherapy is a treatment used to freeze or deaden a nerve that is irritated and causing pain. It can be used to block pain from several different nerves including the intercostal nerve. During the procedure a needle or probe is inserted into the affected area and the temperature is dropped down to freezing. The freezing temperatures inactivate the nerve and the irritation is relieved. The area injected might feel numb or tingling after the procedure but these sensations are usually only temporary. This procedure is not repeated frequently since the nerve pain should be relieved. The patient will follow up with the doctor after the procedure to determine the degree of effectiveness.
Joint injections
Joint injections can be performed on most major joints in the body including the shoulders, elbows, wrists, hips, knees, and ankles. Many patients with history of osteoarthritis or injury to the joint can receive these injections to help alleviate the pain. A needle is advanced into the joint and a local anesthetic along with a steroid medication is injected. Following a joint steroid injection, the doctor may choose to start a different series of injections to the joint. Hyaluronic acid is a viscous, injectable gel that is often used to help lubricate the joint. It improves the viscosity of the joint fluid that is already there and prevents further damage to the joint surfaces. Typically injections of hyaluronic acid are performed in a series of five injections at least a week apart from each other.

When you are experiencing pain, it can interrupt your daily schedule. At Optimum Pain and Regenerative Medicine we work with you to create a customized treatment plan to help you regain your lifestyle. With many treatments available, please find important information about pain and treatments offered below.

Understanding Pain

At some point in our lives, many of us have experienced pain to some degree. While we might understand what pain feels like, it may still be difficult to define. By understanding pain, you can take a stand against chronic pain. Learn More...

Types of Pain

Not all pain is created equal. There are three different types of pain that encompass different areas of the pain you might be feeling. Depending on the type of pain you are experiencing, your pain specialist will be able to create an appropriate treatment plan. Learn More...

Nerve Blocks

When your pain does not respond to conservative treatment options, your pain specialist can provide a second line of therapy. A nerve block can be performed to lessen the painful signals transmitted by nerves with relief ranging anywhere from a few hours to several months.

Regenerative Medicine

 

Spinal Cord Stimulation (SCS)

Your pain specialist may recommend more complex treatment options, such as Spinal Cord Stimulation (SCS). SCS is widely used by pain specialists and is FDA approved for treatment of trunk and limb pain. Learn More...