Long Island Specialists
Who Help End Your Pain
In addition to tried-and-true traditional approaches, we offer a wide range of treatment protocols that are evidence-based and have proven very successful in the past. So, we’re confident that we can plan a treatment regimen for your unique needs.
This innovative and sophisticated treatment uses water-cooled radiofrequency ablation to treat the disc-related and discogenic discomfort commonly associated with a bulging or herniated disc in the mid-back area. Biacuplasty is a good alternative to spinal fusion surgery in many cases, since immobilizing the disc through fusion surgery or repairing the damage from the inside are the only two ways to treat this type of pain. The gentle energy burst not only eases the discomfort, but also assists in healing the damaged collagen. Most patients begin feeling relief just a few days after the procedure.
These injections into the celiac plexus (a nerve group surrounding the aorta) relieve abdominal pain due to pancreatitis, cancer, and other conditions. A doctor injects gentle medication right onto the nerve block that inhibits pain transmissions to the brain, so the procedure is quite effective if done early enough. This procedure usually takes less than thirty minutes and typically does not require general anesthetic. After a brief series of injections, many patients experience little or no abdominal pain for several years thereafter.
A pinched or inflamed nerve in the cervical spine, which is usually caused by stenosis, arthritis, or some other condition, generally triggers intense pain in the patient’s neck, arms, and shoulders. A pain relief specialist can inject a specialized substance directly onto the affected area which not only decreases pain, but also reduces the inflammation and swelling that causes this pain. Injections into the epidural matter that surrounds the spine are particularly effective in cases involving more generalized pain.
This diagnostic procedure often pinpoints the source of pain and thus helps put patients on the path towards optimal relief. The doctor focuses on the small facet joints in various parts of the spine; these joints are very easily injured due to whiplash, sports injuries, and other mild to moderate trauma. A branch block is the only way to identify the precise nerve that’s been damaged and is therefore causing pain. The minimally-invasive procedure usually only requires a local anesthetic and perhaps a mile analgesic. If pain relief is incomplete, radiofrequency ablation is often the next step
Once our pain relief specialist injects a small dose of a mild analgesic directly onto the neck’s stellate ganglion (cervicothoracic ganglion), patients who have endured chronic pain in their hands, shoulders, or arms often experience nearly instant relief that’s usually also very long lasting. The technique was pioneered about a hundred years ago and has been continually refined since then. Ganglion blocks are well-known in the industry as a treatment of choice when some other methods do not show very much promise.
Genicular Neurotomy is a good option for those who either want to avoid knee surgery or have undergone this procedure and not been pleased with the results. This nonsurgical procedure involves no steroids or other medicine. Instead, the doctor uses a series of radio waves to relieve pain due to chronic knee osteoarthritis and some other conditions. Since the pain relief is near instantaneous, patients are free to resume normal activities, and even extensive physical therapy, with greatly increased mobility and practically no discomfort.
The intercostal nerves send pain signals from the abdomen and upper chest to the brain, so after pain signals are blocked and the inflammation in the area is reduced, even rather severe discomfort begins to dissipate almost immediately. This treatment is diagnostic as well, because if the patient feels better, the doctor has a better idea of the next treatment method to use. This procedure is especially ideal for postsurgical patients and those struggling with cancer pain, fractured ribs, and neuropathic pain.
Instead of taking vast amounts of pain medication by mouth, a doctor can use a pump to deliver medication directly to the intrathecal space which surrounds the patient’s spinal cord and achieve the same results, or even better results, with a much lower dose. As an added bonus, the patient also experiences far fewer medication side effects. If a temporary pump is successful, the doctor usually proceeds with a permanent pump. The outpatient procedure is completely reversible and gives the patient control over medication levels through use of a specialized programmer.
These injections often have tremendous diagnostic, therapeutic, and analytical value, making them an important part of many treatment regimens. A Board Certified specialist from PIOLI can inject a fluid or dye to assess the damage to joints or nerves, send corticosteroids to the affected area that help reduce inflammation, or inject another specialized fluid to determine the extent of nerve healing, the precise range of motion, and other variables. Most patients are viable candidates for joint injections, because they have been proven effective and involve few or no side effects.
Patients who are suffering from disc herniation, stenosis or spondylolysis and therefore have arm, neck, leg, or back pain are usually good candidates for this minimally-invasive procedure. Each LEI usually contains both a numbing agent that acts as an anesthetic and a corticosteroid to reduce inflammation. Even though these injections do not shrink the herniated disc, many patients experience long term pain relief without surgery or opioid medications, because the injected fluid washes away the proteins which trigger inflammation.
If chronic pain in your legs, buttocks, feet, or legs has not responded to some other treatments, you may be a good candidate for this innovative nonsurgical therapy. A tiny amount of anesthetic applied directly to a particular area of the lumbar spine impedes pain signals, making the affected area feel significantly better. This medicine also improves blood flow. Since the pain dissipates so quickly, most patients can go back to physical therapy within a few days. LSBs are particularly effective in dealing with complex regional pain syndrome, neuropathic pain, and cancer pain.
Chronic and severe headaches, especially if the pain is in basically the same location, may be indicative of damage to the occipital nerve, which is located in the back of the head just underneath the scalp. These headaches are difficult to treat, mostly because many patients also have issues with the facet joints and/or spondylosis. Following this minimally-invasive procedure that inhibits transmissions from the lesser and greater occipital nerves, a majority of patients reported that the duration, frequency, and severity of their headaches, along with vomiting, light sensitivity, and other symptoms, decreased significantly for a rather long period of time.
Rhizotomy uses just the right amount of heat to ablate (burn) inflamed nerve endings to stop pain transmission signals, making this nonsurgical treatment ideal for patients with arthritic spines and nerve-related leg or back pain. The doctor uses a fluoroscope to place tiny electrodes to the proper location, where they gently apply soothing energy directly to the affected location. After about a half-hour procedure, about 75 percent of patients experience dramatic pain relief for over a year.
This therapy is used to diagnose and treat sciatica; in particularly complex cases, the doctor may use two separate injections. The diagnostic portion usually involves lidocaine or another local anesthetic along with a specialized dye; in the treatment portion, the doctor uses a corticosteroid to reduce inflammation and thereby decrease pain. This procedure may be repeated up to three or four times a year, if necessary. The pain relief from each administration generally lasts between three and twelve months.
This simple, nonsurgical procedure often speeds relief to affected joints and other pain centers. For a variety of reasons -- often due to mild trauma -- small and tender knots often develop in the muscles or in the surrounding tissue. Just one anesthetic injection is usually enough to relax the muscle. Afterwards, some mild stretching or movement is usually enough to take care of any lingering discomfort. Typically, our pain relief specialist performs this procedure in an examining room-type setting and it can be repeated as needed.
Hyaluronan injections are useful tools when treating knee pain due to osteoarthritis. Most healthy joints have plenty of hyaluronic acid, but osteoarthritic joints usually lack this valuable fluid. Studies show that viscosupplementation increases range of motion, reduces pain, and may even retard the progress of this degenerative disease. As little as 2ml of this viscous fluid is usually sufficient to strengthen the cartilage and provide an extra cushion during weight-bearing activity. Just one injection usually provides at least three months of pain relief in most patients.