Learn More About the Conditions we Treat
Are you interested in establishing care with us, but unsure if we can help? Browse the conditions listed below to learn more.
Neck Pain
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Neck pain can be caused by a variety of conditions, one being facet disease, or arthritis of the neck. These are joints that allow you to turn your head left, right, up and down. Just like a knuckle in your hand, they can become arthritic, painful, and enlarge over time. A common symptom is pain that remains primarily in the neck, but may also radiate up towards the base of the skull and out to the shoulder blades.
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Discs in the spine serve as both shock absorbers and spacers that lie between the vertebrae of the spine. They have a fibrous outer ring called the annulus, and a jelly middle called the nucleolus pulposus. The outer ring is constructed like a tire, with alternating fibers that mimic that of a radial tire lying on its side. Over time, these radials can snap, causing the disc to bulge.
The outer portion of the disc has pain fibers, while the inside does not. As the disc degenerates, it starts to expose the outer pain fibers to the inner jelly middle, which is full of inflammatory mediators. Once that occurs, the disc itself can become painful and is now known as discogenic pain. This is one of the more difficult conditions to treat. A combination of epidural steroid injections, physical therapy, and medical management usually manages this condition effectively and will improve over time. Occasionally, the condition is too severe and needs surgical correction. If this is the case for you, we will provide all the supportive care to make sure we help you get the care you need.
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A trigger point is a localized area of muscle damage that remains in spasm and causes localized pain, as well as referred pain. This condition can be treated with a simple injection. Some patients find immediate and long lasting relief, while others have repeated episodes over time. This usually indicates a deeper problem that is causing the repeated cycle of spasm and pain. If this is the case, our providers are committed to discovering the root of the issue to provide long lasting relief.
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Radiculapathy is a term used to describe a pinched nerve as it exits the spine. The nerves pass through an opening called the neural foramen. Patients may have a bulging or collapsing disc, an enlarged facet joint, or both which can narrow this opening. Bone spurs can also form, all of which can put pressure on the nerve.
Common symptoms include neck pain and spasm, as well as pain that radiates down the arm into the hand. This pain is often described as an electrical “shock” down the arm, and can cause a burning sensation and numbness. Severe case will cause weakness as well.
Radiculapathy is diagnosed by history, physical exam, and imaging. EMG and nerve conduction studies may also be performed to provide objective information of potential nerve damage. Minimally invasive treatments such as epidural steroid injections can be very effective and provide long-term relief when used with other treatments. Occasionally, the condition is too severe and requires surgical correction. If this is the case, our providers and staff will support you through obtaining the necessary surgical intervention.
Back Pain
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Back pain can be caused by a variety of factors, including facet disease, or degeneration of the joints of the low back. These joints allow the spine to rotate, flex, and extend. These joints are at risk of early degeneration due to a combination of extensive mobility and heavy loading, along with excessive activity and body weight.
Facet disease is one of the most common causes of back pain. Commonly reported symptoms include pain in the middle of the back that often radiates down the buttocks and into the back of the thighs. This pain is usually worsened with leaning back and rotating, and improved when bending forward.
Anything that can be done to off load the spine will help with this condition. Various treatment options include weight loss, core strengthening, and utilization of a back brace. Advanced disease may require further interventions, such as medial branch blocks and radiofrequency ablation.
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Discs in the spine serve as both shock absorbers and spacers that lie between the vertebrae of the spine. They have a fibrous outer ring called the annulus, and a jelly middle called the nucleolus pulposus. The outer ring is constructed like a tire, with alternating fibers that mimic that of a radial tire lying on its side. Over time, these radials can snap, causing the disc to bulge.
The outer portion of the disc has pain fibers, while the inside does not. As the disc degenerates, it starts to expose the outer pain fibers to the inner jelly middle, which is full of inflammatory mediators. Once that occurs, the disc itself can become painful and is now known as discogenic pain. This is one of the more difficult conditions to treat. A combination of epidural steroid injections, physical therapy, and medical management usually manages this condition effectively and will improve over time. Occasionally, the condition is too severe and needs surgical correction. If this is the case for you, we will provide all the supportive care to make sure we help you get the care you need.
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A trigger point is a localized area of muscle damage that remains in spasm and causes localized pain, as well as referred pain. This condition can be treated with a simple injection. Some patients find immediate and long lasting relief, while others have repeated episodes over time. This usually indicates a deeper problem that is causing the repeated cycle of spasm and pain. If this is the case, our providers are committed to discovering the root of the issue to provide long lasting relief.
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Radiculopathy is a term used to describe an irritated or pinched nerve as it exits the spine. This opening is called the neural foramen. The nerve can be compressed by a bulging disc, an enlarged facet joint, or settling from degenerative disc disease. Bone spurs can also form, all of which can put pressure on the nerve.
Common symptoms include back pain and spasm, as well as pain that radiates through the lower buttock down the leg into the foot. This pain is often described as burning and numb. Severe cases will cause weakness in the leg or foot as well.
Radiculopathy is diagnosed by history, physical exam, and imaging. EMG and nerve conduction studies may also be performed to provide objective information of potential nerve damage. Off loading the spine with weight loss, core strengthening, and utilizing a back brace are all options to treat this condition. Minimally invasive treatments, such as epidural steroid injections, are very effective for mild to moderate conditions. Occasionally, the compression is too severe and requires surgical intervention. If this is the case, our providers and staff will support you through obtaining the necessary surgical intervention.
Other
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A compression fracture is a specific type of fracture that occurs in osteoporotic bone. As we age, the bones of our body can become less dense and become at risk of fracture. The bones of the upper lumbar and lower thoracic area are at particular risk, as this is the point where the rigid rib cage attaches to the mobile lumbar spine. Heavy lifting or a fall can cause one of the bones to break and compress, causing a compression fracture. Typical symptoms include a sudden onset of severe pain in the back that may wrap around the sides of the body. An X-ray is all that is required to identify a compression fracture, however, an MRI adds the advantage of identifying if the fracture is recent, or already healed. This information is vital in order for your provider to know how best to proceed with treatment.
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This is a condition that is characterized by a “slip” of one of the bones of the spine over another. It can be caused later in life due to degenerative changes, or earlier from a defect in the pars interartcularis. Excessive extension, such as back bends that gymnasts perform, can cause this defect. It can also develop over time due to degenerative processes.
Many patients can live with this condition without even knowing it. However, as the slip becomes severe, it can put pressure on the nerves and spinal cord. This is called spinal stenosis, or a narrowing of the spinal canal. This can be treated with conservative techniques, such as physical therapy, core strengthening, and bracing. Epidural steroid injections can be very helpful as well. Occasionally, symptoms are too severe, and may progress over time, requiring surgical intervention. If this is the case, our providers and staff will support you through obtaining the necessary surgical intervention.
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Spinal stenosis is a broad term used to described narrowing of the inside of the spinal canal, which results in pressure on the nerves or spinal cord. This occurs as a result of a bulging disc, enlarging facet joints, bone spurs, and enlargement of the spinal ligaments called the ligamentum flavum. Many elderly patients have a combination of all of these elements, which can lead to profound narrowing and pain. Commonly reported symptoms include back pain and numbness that radiates down the legs or arms, depending on the area affected.
This condition can be effectively treated with epidural steroid injections, core strengthening, and bracing. However, this largely depends on the severity. Ongoing pain and muscle wasting typically requires surgical decompression. If this is the case, our providers and staff will support you through obtaining the necessary surgical intervention.
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Often referred to as Reflex Sympathetic Dystrophy, CRPS is caused by damage to a limb, or damage to the nerves in a limb. As the injury heals, the nerve heals in an abnormal way, causing the limb to be hypersensitive and extremely painful. In the early stages, common symptoms include diffuse pain and burning, as well as redness and warmth. Over time, the disease can progress to cause the extremity to become cool, clammy, and non functional, so early intervention is key to prevent long-term disability.
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These conditions can occur in patients that have had either a laminectomy or a multi level fusion. Normally, the spinal nerves slide through a structure called the neural foramen as we move our limbs, a phenomenon known as “neural flossing”. When a patient needs an operation to take pressure off the nerves or stabilize the spine, scar tissue forms in the area that has been operated on. This can cause the nerves to be tethered in a bed of scar, such that moving the limb causes repeated tugging of the nerve. The nerve reacts by becoming more and more sensitive over time, potentially getting to the point where patients experience continual and intractable back and leg pain.
Early in the process, patients can perform aggressive neural flossing exercises and try a series of medications. Patients in the later stages of this condition will need a more definitive solution, which can be achieved with a spinal cord stimulator.
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Arthritis is a general term used to describe inflammation of the joints. Any joint in the body can be affected by arthritis. We use a variety of modalities to treat this type of pain.
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Diabetes is an extremely common condition that can affect the nerves over time. Common symptoms include burning pain in a “stocking glove” pattern over the feet and lower legs. Skin changes and discoloration as the condition progresses is also common. Initial treatment focuses on glucose control and medications. However, symptoms can worsen over time and require more interventional treatment. Our office offers a topical system called QUTENZA that is specifically designed to treat diabetic neuropathy and post-herpetic neuropathy.
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Postherpetic Neuralgia (PHN) is a long-lasting nerve pain resulting from a shingles outbreak that remains in the same area long after the shingles have cleared. This pain is commonly described as sharp and burning, and can occur anywhere on the body where shingles can appear.
We offer several different treatment options for this condition, including QUTENZA, which is a topical system made with 8% capsaicin that is applied directly to the affected area.
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The shoulder is one of the most complex joints in the body. Unfortunately this complexity can predispose patients to a variety of conditions. Rotator cuff tendinitis, Subacromial impingement (SLAP) lesions, and degenerative changes are all commonly diagnosed conditions. We will diagnose and treat your pain through a detailed history, physical exam, and imaging. Physical therapy and a variety of injections can be employed to treat most conditions. No matter the cause of your pain, we are committed to improving your quality of life and supporting you through whatever treatment is best for you.
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The elbow is a joint that is subject to repetitive use injuries. Demands of work and recreational activities can cause pain in the elbow. We can diagnose your pain with a history, physical exam, and imaging. We employ multiple modalities including physical therapy, medications, and injection therapy. Only in the most severe cases is surgery indicated. We can diagnose and treat all conditions that affect the elbow.
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The wrist is a complex joint that is also subject to a variety of injuries. Carpal tunnel syndrome is the most common condition, which is usually treated with physical therapy, night splints, and injections. Sometimes the condition persists, and an EMG/Nerve conduction study is used to confirm the diagnosis. If nerve damage is present, a carpal tunnel release may be needed.
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The Hip is a large joint that can cause pain. Repetitive use can cause bursitis or inflammation of the joint as well as degenerative arthritis. We will perform and history, physical exam, and imaging to diagnose and treat your condition. Minimally invasive intra articular injections can be used to both diagnose your pain as well as treat it. Sometimes the degeneration is too advanced, and a total hip arthroplasty is needed to surgically correct your problem. No matter what your condition, our providers can treat whatever modality is necessary to restore proper function, and support you through obtaining any necessary surgical interventions.
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The knee is one of the most common areas of pain. Acute injuries like a torn meniscus, cartilage damage, or a torn ligament can cause pain. Chronic conditions, like degenerative arthritis or continued pain after total knee replacement, can also be factors in causing long-term knee pain. The combination of a detailed history, physical exam, and imaging will allow us to find what is causing your pain. We offer several minimally invasive treatments for the knee, including intra articular injections, genicular nerve blocks and radio frequency ablations. If surgical intervention is ultimately required, our providers and staff will support your navigation through this process as much as possible.
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Being involved in a car accident can be very stressful, especially if injuries are sustained. We are very experienced in this field and are confident in our ability to support you through treatment of your pain.