Areas of Expertise
Each of our physicians are medical doctors (M.D.'s), board certified in the specialty of physical medicine and rehabilitation (PM&R). We are experts at diagnosing and treating painful and disabling conditions stemming from nerve, muscle, and bone/joint disorders. In an effort to further enhance their ability to diagnose and treat complex conditions, each of our doctors have pursued additional training and achieved board certification in either pain medicine or electrodiagnostic medicine.
- Pain Medicine
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Medical discipline focusing on the diagnosis and treatment of a wide variety of pain disorders. It is a multi-disciplinary specialty recognized by the American Board of Psychiatry and Neurology, American Board of Physical Medicine and Rehabilitation, and American Board of Anesthesiology.
Medicine discipline which focuses on the physiologic evaluation of nerve and muscle function. Credentialing and oversight done by the American Board of Electrodiagnostic Medicine (ABEM).
- Diagnostic Testing
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In order to identify the precise anatomic or physiologic etiology of the patient’s symptoms, diagnostic testing is frequently an essential part of the evaluation process. Such tests can be used not only to confirm a suspected diagnosis, but also to exclude potentially more serious causes of these same symptoms. Commonly ordered studies include blood work which can screen for infections, metabolic disorders, hormonal abnormalities, vitamin or mineral deficiencies, and rheumatologic diseases. Imaging studies such as x-ray, CT scans, MRIs, and bone scans are effective at providing a static picture of the part of the anatomy in question. Although some imaging, MRI in particular, is very good at picking up structural abnormalities, whether or not these abnormalities are responsible for the presenting symptoms is frequently unclear and can even be misleading. These findings must correlate clinically – meaning that they must coincide with the history and physical examination findings, otherwise the symptom generator remains in question.
- Musculoskeletal Ultrasound
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Recently, musculoskeletal ultrasound has become more popular and frequently utilized as an imaging modality. Unlike x-ray or CT, it does not expose the patient to radiation and it is substantially less expensive than MRI. It is a useful tool when evaluating soft tissue inflammatory conditions such as bursitis and tendonitis. Furthermore, it can be used to help guide injections into such structures when necessary.
- Electrodiagnostic Evaluation
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An electrodiagnostic examination is a physiologic test which is very helpful in assessing nerve and muscle function when symptoms include pain, weakness, and/or sensory abnormalities such as numbness or tingling. This study is frequently used to confirm a clinically suspected diagnosis. A condition such as low back pain with associated lower limb sciatica is a typical scenario where such a study would be warranted.
- Diagnostic Blocks
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In cases where no other means of diagnosing or confirming the source of pain are efficacious or reliable, diagnostic blocks can be very helpful and are usually considered the gold standard diagnostic study. Pain stemming from a nerve or joint may be diagnosed in this manner. Anesthetizing or “blocking” sensory transmission from the painful structure should result in complete or near complete analgesia. Spinal facet joints, sacroiliac joints, and spinal nerve roots.
- Therapeutic Interventions
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We provide a unique combination of therapeutic option to treat the wide range of chronic and complex conditions frequently found in our patient population. Such conditions are oftentimes unresponsive to other forms of treatment. These interventions include:
- Trigger point injections
- Prolotherapy
- Platelet-rich plasma (PRP)
- Visco supplementation for arthritis
- Knee
- Hip
- IV Lidocaine infusion
- Radiofrequency ablation
- Spinal cord stimulator
Above bulleted items (trigger point injections, prolotherapy, PRP,etc.) will or may already be included in the articles.