Our expertise - pain management procedures

Conditions We Treat
  • Atypical facial pain
  • Bursitis
  • Cervicogenic headache
  • Cluster headache
  • Complex Regional Pain Syndrome (RSD, Causalgia)
  • Discogenic pain
  • Facet joint disease
  • Failed back surgery syndrome
  • Fibromyalgia
  • Glossopharyngeal neuralgia
  • Hemicrania continua
  • Herniated disk
  • Meralgia paresthetica
  • Migraine headache
  • Muscle contraction headache
  • Muscle-related low back
  • Muscle-related neck pain
  • Muscle pain and spasm
  • Myofascial pain
  • Nerve entrapment syndromes
  • Occipital neuralgia
  • Osteoarthritis
  • Peripheral neuropathy
  • Phantom limb pain
  • Post-Herpetic neuralgia
  • Post-stroke pain
  • Rheumatoid arthritis
  • Sacroilitis
  • Sciatica
  • Scoliosis
  • Spinal cord injury pain
  • Spinal stenosis
  • Sports-related injuries
  • Temporo-Mandibular pain
  • Tension Type Headache
  • Trigeminal neuralgia
Patients and physicians have always searched for less invasive and risky alternatives to surgical management of pain. With the explosion of technologic advancements in imaging techniques and pain treatment systems, there now exists a host of minimally invasive outpatient procedures that may effectively manage your pain. Now, with advancements in diagnostic interventional pain techniques, our doctors may definitively pinpoint your pain to its exact source by temporarily blocking nerve roots, ligaments, joints, muscles or discs. This allows precise localization of painful structures. We specialized in supplementing exercise, physical therapy, and medication with minimally invasive procedures to effectively diagnose and manage your pain.

Our team will help you manage your pain and maximize your active lifestyle.
  • 90% of all diseases may be associated with pain.
  • 65 million Americans suffer painful disabilities at any given time.
  • $120 billion are spent each year on, or because of pain.​
  • 61% of medical directors of pain centers are anesthesiologists.
  • 75% or more of patients in hospitals hurt and suffer more than they should.

Epidural Injections

An epidural is commonly known as a nerve block to decrease pain and inflammation. Steroids are a powerful anti-inflammatory agent that may shrink swelling around nerve roots from an inflamed, bulging or herniated disc. Because of the low risk and incidence of significant complication, it is generally felt to be a reasonable procedure to follow when disc or nerve root pain which has failed to respond to more conservative measures. A large percentage of patients will get complete resolution of symptoms

Facet Joint Injections

An injection of local anesthetic and steroids into spinal joint(s) to reduce inflammation and pain or to confirm that a suspicious facet joint is the actual pain generator.

Prolotherapy

Prolotherapy is an injection technique used to treat chronic, musculoskeletal pain. It works by stimulating the body's own healing process to repair injured or weakened tissues. New fibrous tissue is created resulting in strengthening of the effected area.

Disc Stimulation Testing

A discogram is a diagnostic test performed to view and assess the internal structure of a disc and determine if it is a source of pain. It is a diagnostic procedure, not a treatment. X-ray dye is injected into the spinal disc(s) and an x-ray (or a "discogram") is taken. The discogram may show tears (fissures) in the lining of the disc. The results of discography can be used to plan treatment options of your back pain including RF Anuloplasty (Disc-trode), IDET, Proliferate therapy, Percutaneous Decompression (Nucleoplasty) or spinal surgery .

Radiofrequency Annuloplasty or Disctrode

Disctrode is a minimally invasive outpatient procedure used in the treatment of discogenic low back pain. It is only offered after diagnostic discography has confirmed disc pain. A spinal wire catheter is guided into a painful torn or fissured disc segment. Thermal energy is then applied to destroy any active pain receptors and modify collagen tissue in the damaged disc. One or multiple disc levels can be treated.

Sacroiliac (SI) Joint Injections

A SI injection is performed with a long acting steroid and local anesthetic. The sacroiliac joints are located in the back where the lumbosacral spine joins the pelvis. They are paired (right and left) and are surrounded by a joint capsule like the finger joints.

Sciatic Nerve Block

The sciatic nerve can be compressed at many sites. The nerve leaves the pelvis through the sciatic notch where it lies under the Piriformis muscle. This is the most frequent site of sciatic nerve entrapment and is called piriformis syndrome. Sciatic nerve entrapment can lead to buttock pain and pain that radiates down the back of the leg to the foot.

Spinal Cord Stimulation

Spinal cord stimulation is an advanced treatment for chronic pain using low-level electrical impulses to stimulate targeted nerves along the spine. The stimulation interferes with the transmission of pain signals to the brain. When successful, painful sensations are replaced with what some patients describe as a more pleasing sensation, called paresthesia.

Trigger Points

A trigger point is a portion of the muscle that has become a source of pain and dysfunction. It usually consists of a nodule or band that can be felt by pressing the skin over the muscle. When the trigger point is pressed, it will feel sore and a cause pain which extends to another body part (for example: a trigger point in the buttocks often refers to leg).

Cervicogenic Headaches

Headache is both a complex and multi-factorial medical problem, which affects millions of people each day. This article will focus specifically on cervicogenic headaches (or those originating from structures of the neck). Common neck pathology lending itself to headache may include but is not limited to, muscular pain (from trauma or overuse syndromes), facet joint arthritis and occipital neuralgia.

Post-Laminectomy Syndrome

It is estimated that approximately 20-40% of the nearly 200,000 Americans who undergo spine surgery each year will have some degree of recurrent spinal o/r leg pain. Despite the immeasurable variability in each of these post-operative pain patients, it is not uncommon for these patients to be categorized in the diagnostic wastebasket known as Post-Laminectomy Syndrome or Failed Back Syndrome.
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Myofascial Pain Syndrome

Individuals with MPS develop either muscular achiness or tightness (due to shortening and contraction of injured muscle fibers) or will often experience referred pain. In the first instance, one might feel "knots" or spasms in the area of muscle injury. Referred pain, however, occurs in areas of the body remote from the origin of the problem. For example, you might feel pain shooting down the leg to the calf from a "trigger point" in the buttocks or low back. Alternatively, a headache may be the result of a trigger point in the neck or upper back. A trigger point is the localized area of muscle irritability that disrupts normal muscle function and is the source of both local and referred pain phenomena. It may feel to you like a "knot" or "band" in the muscle and is often very sensitive to even light pressure.

Radiofrequency Ablation of Facet Joints

Facet RF or neurotomy is a procedure which results in interruption of the nerve supply to a facet joint. Denervation is accomplished by a radiofrequency probe that heats the small nerve branches to each facet joint.

BOTOX® Injections

BOTOX is a therapeutic muscle-relaxing agent that works at motor nerve endings (nerves that lead to muscles). It is in a class of drugs called neurotoxins. When considering neurotoxin therapy, it is important to understand how the product works, the history of its use in patients, its protein content, and possible side effects. This information will help you understand more about BOTOX: what it is, how it works, and how it can help you.

Intravenous Therapy

​About 3 years ago, Dr. Elena Ocher’s clinic started doing intravenous therapy, or heel therapy, using IV injection. Information provided during this period of time gave us an opportunity to formulate a conclusion which we would like to share with you. Our experts concluded that intravenous therapy can provide great results in treating such diseases as: asthma, chronic fatigue, fibromyalgia (system muscle disease), acute muscle spasm, upper respiratory tract infections, chronic sinusitis, seasonal allergic rhinitis, cardiovascular disease, angina, chronic urticaria, hyperthyroidism, dysmenorrheal, and other diseases. After an evaluation, our specialists will put together an individual program, which includes different types of solutions or so called “cocktails.”

Kyphoplasty

A Kyphoplasty is a procedure used to treat painful compression fractures in the bones of the spine. These fractures lead to the collapse or compression of a vertebra, causing the spine to shorten and curve forward. During a Kyphoplasty, the doctor places a needle through the skin and into the spine bone. A balloon is then placed through the needle, into the bone, and then inflated. This restores the height of the vertebrae. Cement is then injected into the space to prevent further collapse.

Platelet-Rich Plasma (PRP) Injections

Platelet-Rich Plasma or PRP is derived from the patient’s blood. Processing the patient’s blood specimen in a centrifuge separates the blood components and concentrates the platelets in the plasma. The concentrated platelets found in PRP are rich in growth factors along with bioactive proteins that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins increase stem cell production to initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels, and stimulate the wound healing process.