Services

 


We have had an unwavering commitment to providing the highest level of quality of care to our patients and of quality in our business practices.

The FASTRAC program
Botox/Myobloc
Cryotherapy
Discogram
Epidural Steroid Injections
Facet Joint Injections
Intradiscal Electrothermal Therapy
Intrathecal Spinal Pump Implant
Lumbar Sympathetic Block
Nucleoplasty
Occipital Nerve Block
Radiofrequency Thermocoagulation
Sacroiliac Joint Injections
Spinal Cord Stimulator Implant
Stellate Ganglion Block
Trigger Point Injections


The FASTRAC program

The FASTRAC program allows patients in urgent need of diagnostic or therapeutic injections to be seen within 24-hours, by request from referring physicians.

This system allows patients to be accommodated the same day for procedures without consultations. Procedures Include:
Discogram
Selective Spinal Nerve Root Blocks: cervical, thoracic, lumbar and sacral
Epidural Steroid Injections
Facet Joint Injections
Trigger Point Injections
Nerve Blocks
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Botox/Myobloc

Botox is a therapeutic muscle-relaxing agent that works at nerves that lead to muscles. Botox is given in extremely small therapeutic doses. Botox is injected into the affected muscles. The physician will determine which muscles need to be treated. Botox will normally last for about 3 months. The procedure takes approximately 5-10 minutes to complete. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Cryotherapy

Cryotherapy is a method that freezes nerves to help decrease pain. Cryotherapy is most frequent performed along the occipital nerves located at the base of the skull. During the procedure, a probe inserted close to the affected area. The probe is cooled by a gas called nitrous oxide. Patient may experience some pressure and discomfort during the procedure. The procedure usually takes 30 minutes to complete. After the procedure, the patient can expect soreness at the site where the probe was inserted. Cryotherapy usually produces variable pain relief, which can last two weeks to four months.
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Discogram

A discogram is a diagnostic test in which contrast dye is injected into a disc in the patients spine. Discograms help to pinpoint which disc is causing the patients back or leg pain. It is often done as a pre surgical evaluation to consider what further treatment is needed. As a part of the discogram, a post disco CT scan will be scheduled to show where and how the disc is damaged. During the discogram, you may be given medication to help you relax. The area is numbed with a local anesthetic. The needle is placed into each disc being tested. Then the contrast dye is injected into one of the discs in the patients spine. You may feel increase pain when the contrast dye is injected. The physician will ask if your pain is in the same place as the pain you usually feel. At least two of the patients discs will be tested for comparison. After the discogram, the patient is given pain medication. The procedure takes approximately 30-45 minutes to complete. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Epidural Steroid Injections

Epidural Steroid Injections are used as a non-surgical treatment to treat cervical, thoracic, and lumbar pain. An epidural delivers steroids directly to the affected area to help eliminate inflammation that may be irritating the nerve root. The effects from the epidural may be temporary but may give the patient significant pain relief allowing the patient to start rehabilitation. The epidural steroid injections are given in a series of three. The procedure usually takes 10-15 minutes to complete. Prior to the injection, the patient is given local anesthetic to numb the injected area. Then the physician will locate the appropriate area for the injection using fluoroscopy. An epidural steroid injection to reduce inflammation may take a day or two to work. Following the procedure, the patient is recovered for approximately 15-20 minutes before going home with driver. The patient is asked to do no heavy lifting or strenuous activities on the day of the procedure but may resume their normal activities the next day.
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Facet Joint Injections

Facet joint injection is a steroid injection that reduces the inflammation in the joint space of the spine. The facet joints are located in the back and neck at each vertebral level. The procedure is done outpatient and usually takes 10-15 minutes to complete. During the procedure, the patient is given a local anesthetic to numb the skin. The procedure is performed under fluoroscopy to help the physician to see the spine. Immediately after the injection, you may feel that your pain has subsided or lessen. This is due to the local anesthetic injected. This will last for a few hours. You should start to notice relief from the injection within 48-72 hours. All patients will be recovered for about 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Intradiscal Electrothermal Therapy

The IDET procedure is a non-surgical procedure used to treat chronic back pain. A catheter that uses heat modifies the protein wall of the disc and reduces the amount of disc material that causes nerve irritation. The procedure is done under fluoroscopic guidance where the catheter is guided into the patients disc through a spinal needle and is heated for about 15-20 minutes. IDET can be done in one or multiple disc levels. The patient may experience pressure during the procedure while the needle is placed into the disc. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Intrathecal Spinal Pump Implant

An Intrathecal Pump is a computerized device, which delivers concentrated amounts of medications into spinal cord area through a small catheter to help decrease or eliminate the need of oral medications. The intrathecal pump is offered to patients with chronic and severe pain who have not adequately responded to other treatment modalities. Before the actual implant, the patient must go through a series of steps. The patient will be evaluated by a Medical Psychologist with experience in chronic pain management. After the patient has had a psychological evaluation and has been noted a candidate for the intrathecal pump, then the patient will undergo a intra spinal medication trial. The trial will help to find out if you have any problems with the medications that may be used in the infusion pump and to see if the medication will be effective in providing you with the desired relief of pain. If the trial is successful, you will be referred to a surgeon for implant. Then the permanent device is placed under the skin. During the procedure, tubing is placed in the midline of the lower back and a local anesthetic is injected through it to confirm adequate placement and to obtain anesthesia on the entire surgical field. The intrathecal pump is then placed on the side of the abdomen. The patient should feel that their pain is under control or quite less. The pump will be adjusted electronically to deliver adequate amount of medication. After the procedure, the patient will recover for about four hours and will be allowed to go home with driver.
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Lumbar Sympathetic Block

Lumbar Sympathetic Block is a test that helps the physician find the cause of your symptoms in your lower extremities. The injection blocks the sympathetic nerves in the region where the medication is injected near the spine. You may have symptoms that include burning, pain, or tingling in your legs or feet. If the sympathetic nerves are causing your problem, the temperature in your feet will rise quickly. This treatment may be repeated 1 to 2 weeks apart in a series of three. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Nucleoplasty

Nucleoplasty is a minimally invasive procedure developed to treat patients with contained or mildly herniated disc. Nucleoplasty does not involve any incisions. A special access needle is placed into the disc under fluoroscopy guidance. A wand-like device is then inserted through the needle and into the disc. The device uses heat to remove disc material and seal the channel made by the needle. During the procedure, the patient may feel a sense of pressure or mild discomfort while the needle is inserted into the disc. The procedure takes about 30 to 45 minutes to complete. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver.
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Occipital Nerve Block

An occipital nerve block is useful in diagnosing and treating occipital neuralgia. The occipital nerve block is used to relieve or reduce the pain in the back of the head in the scalp. The block may be done on either left or right side of the back of the head. During the procedure, a local anesthetic in combination with a steroid is injected into the affected area beneath the scalp. Immediately after the injection the patient may notice that their pain has subsided or lessened considerably. This treatment may be repeated 1 to 2 weeks apart in a series of three. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Radiofrequency Thermocoagulation

RFTC is treatment that uses heat to destroy the nerve near a problem joint. This procedure helps to keep some pain messages from traveling to the brain and helps to relieve the patients symptoms. RFTC is performed only after pain relief is obtained after a diagnostic block. RFTC is done under fluoroscopic guidance and a contrast dye may be injected into the affected area to help get a better image. During the procedure, a probe is placed percutaneously and the proper stimulation occurs. Once the probe is placed near the nerve it is heated to 90 degrees C for 60 to 90 seconds. RFTC will not provide a permanent cure as the nerve fiber will regenerate usually within 12 months.
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Sacroiliac Joint Injections

Sacroiliac joint injection is an injection that reduces the inflammation in the joint space. The sacroiliac joints are located in the back where the lumbosacral spine joins the pelvis. The injection consist of steroid and local anesthetic. Prior to the procedure, a small amount of contrast dye is used to confirm proper needle placement. This procedure will be done in an outpatient setting under fluoroscopy. After the injection, you may feel that your pain has subsided or has lessen. This is due to the local anesthetic injected. This will last for a few hours. It is difficult to predict if the injection will help or not. Usually, patients who have recent onset of pain may receive a significant reduction of pain than those who have chronic pain. If the first injection does not relieve your pain in about a week or two weeks, the physician may recommend you have one more injection. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Spinal Cord Stimulator Implant

Spinal Cord Stimulation is a relatively non-invasive surgical procedure that involves stimulation of nerves in the spinal cord by placing electrodes in the space above the epidural space. SCS is used as a treatment for chronic pain of the trunk and/or limbs. SCS is preformed after less invasive treatment options such as medications, physical therapy, epidural steroid injections or nerve blocks have been attempted. A SCS trial is inserted for 7 days to determine a patients response to spinal cord stimulation. If the trial stimulator works well for the patient, a permanent system is placed by a surgeon. The receiver or power source is implanted under the skin on your abdomen or buttocks. The power source is small and can not be seen underneath the patients clothing. After the system is in place, the settings are checked to make sure they are at the right level for the patient. Following the implant you may be ask to stay in the hospital for a 23 hour observation.
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Stellate Ganglion Block

A stellate ganglion block is a block that is performed under fluoroscopy to determine if there is damage to the sympathetic nerve and if it is causing the patients arm pain. It takes approximately 10-15 minutes for the procedure to be completed. A local skin anesthetic is given near the base of the neck on the affected area. Then the physician inserts a needle near the transverse process of the cervical spine and injects a local anesthetic. After the procedure, the patient may notice increased warmth and redness of the painful arm during and after the injection. The patient may experience hoarseness of their voice, redness of the eye and drooping of the eyelid. Pain relief may be noted immediately. This treatment may be repeated 1 to 2 weeks apart in a series of three. Following the procedure, the patient will be recovered for 15-20 minutes before going home with driver. We advise patients to take it easy the day of the procedure and may resume their normal activities the next day.
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Trigger Point Injections

Trigger point injections are given to patients who suffer from muscle pain or spasms located in the neck, headaches, lumbar and other soft tissue problems. Trigger points can help to relax the muscles and also make movement easier. Trigger point injections are not painful, and may be repeated occasionally. After treatment, we ask that you take it easy for the rest of day. The injection sites may be sore for a day or so. Place ice or heat on the treated areas as directed by physician.
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