We provide a variety of services to treat pain and weakness. Services to help you get your life back.
Often, when people come to see us with pain, they believe that their only options are surgery or to take pills for pain for the rest of their lives. We at Comprehensive Rehabilitation and Pain Specialists want you to know that you have other options.
Epidural Injections with Fluoroscopic Guidance
Lumbar epidural injections are used to treat sciatica (leg pain coming from the back) as well as low back pain coming from the lumbar discs. When the discs bulge or herniate they release some inflammatory chemicals inside of them. When these get on the nerves and ligaments of the low back, they cause a lot of irritation and pain. It’s kind of like a very hot pepper. So what do you normally do when your mouth is burning from a hot pepper? Some people try to rinse their mouth out by drinking water. Some savvy people know to neutralize the chemicals in the pepper, they can drink some milk. Well, we spine specialists do the same thing in epidural injections. We give a volume of fluid injected near the area of inflammation to wash away some of those chemicals and we mix it with a steroid to decrease the inflammation for the chemicals that are not washed away.
Facet Injection
Facet Injections are given to those suffering with low back pain from arthritis of the spine. The vertebral bones meet together with each other and with the bones above in the thoracic spine and below in the sacrum at joints called the facet joints. These are major weight-bearing joints that support about 60% of your upper body weight. They are also shockingly small – about the size of your thumb joint. Facet joints can develop arthritis just like a knee or hip. In a facet joint injection, anti-inflammatory medication is injected into the arthritic facet joints while using fluoroscopic guidance to improve low back pain. Sometimes this procedure works for many months. If, however, the procedure helps significantly, but for only a brief period of time, a radiofrequency ablation can be considered (see below).
Rhizotomy/Radiofrequency Ablation
Rhizotomy or Radiofrequency Ablation is a treatment to offer lasting pain relief to those suffering from low back pain from arthritis. It does not involve the usage of steroids for treatment. For the rhizotomy procedure, the small nerves that supply the facet joints in the back are actually blocked for a long period of time by performing a selective burn to the nerve. Relief from this procedure can be long-term lasting 9-12 months. When the procedure wears off, it may be repeated.
Sacroiliac Joint Injections/Rhizotomy
The sacroiliac joints are joints on the left and right side of the body between the sacrum (part of the spine) and the pelvis. People with pain here will complain of pain in the back, groin or hip. Injection to these joints with fluoroscopic guidance can be performed to improve pain. If the injection helps, but does not last, a rhizotomy or radiofrequency ablation can be performed for this joint. This procedure is used to give 9-12 months of relief at a time. When it wears off, the procedure may be repeated.
Horizontal Therapy (HT)
Horizontal Therapy is an integrative health treatment that helps those suffering from a wide variety of pain conditions including fibromyalgia, arthritis, neck, or back pain, pain after an injury, as well as diabetic neuropathy. It is FDA approved to treat pain and studies have shown that Horizontal Therapy is an effective treatment. Our brain talks to our nerves with electricity and our nerves talk to our muscles with electricity. Horizontal Therapy takes advantage of this by stimulating the site of injury with electrical potentials to increase chemical reactions and possibly stimulate healing reactions that have slowed. It is a pleasurable experience for most people as you sit in a comfortable chair for 45 minutes while the stimulation proceeds with electrode pads. You may read, listen to music, sleep or just relax while receiving the therapy. Many patients see a reduction in their pain and improved range of motion over several treatments.
Electrodiagnostic Testing/EMG/NCS
Electrodiagnostic Testing is a test performed by a certified physician or provider to more accurately diagnose nerve diseases and ensure that the best treatment is provided. We offer this service at our practice.
Consultations
One of the strengths of our practice is our dedication to listening to each person that entrusts us with their care. We pride ourselves on taking a comprehensive history, performing a thorough physical examination, and personally reviewing and/or ordering appropriate testing and records to accurately diagnose and therefore treat you. Our consultations are never double booked and during your visit, you are our only concern.
Medication Management
Sometimes physical therapy, braces, injections, and other best practices are unable to treat pain completely. In cases such as these, our providers may recommend a trial of medication. There are a wide variety of medications that are available to treat pain. Please schedule an appointment with one of our providers to discuss these options with you.
Brace Fitting/Orthotic Evaluation and Prescriptions
Orthotic Fitting is prescribing properly fitted braces to knees, hands, or low back to improve pain and function. The purpose of these braces is to improve pain as well as restore function, for instance a back brace along with other appropriate treatments may allow you to stand and walk longer.
Joint Injections
These treatments are indicated for pain in joints such as knee, shoulder, hip, wrist, elbow, foot, as well as others. Our board certified physicians and providers are experienced to properly diagnose and treat the source of your pain. All injections are not the same. Proper selection of type of injection and placement are crucial. Our providers utilize fluoroscopic guidance when indicated to ensure you receive the injected medication with proper placement each time.
Joint Injections can be performed with either viscosupplementation (a treatment that restores a key component of natural knee joint fluid and reduce inflammation) or with a steroid anti-inflammatory.
Viscosupplementation
Currently only indicated for knee pain, this is the injection of a naturally occurring substance called hyaluronic acid. Hyaluronic acid is a gel-like substance that the cartilage cells make in the knee and other joints. This medication decreases knee pain by blocking some chemicals that cause pain and inflammation. Hyaluronic acid also provides some cushioning and lubrication due to its thick viscosity. These injections are like an oil change for the knee.
Independent Medical Examinations
Our providers are experienced at taking extensive histories, reviewing prior records and performing thorough physical examinations to arrive at the proper diagnosis and treatment for each person who entrusts us with their care.
Trigger Point Injections
Trigger Point Injections are used to treat pain from muscle tightness and sometimes from fibromyalgia. Trigger points are tight tender muscles that cause pain at the area and sometimes will refer pain to other areas. This source of pain has to be treated by loosening the tight muscle. Trigger point injections accomplish this by the injection of sterile fluid, usually lidocaine, along with the movement of a very small needle to loosen up the muscle. They are the injection equivalent of a super deep tissue massage and are covered by most insurances.
Impairment Ratings
We are available to provide this service upon requesting individuals after a work related injury.