Treat your pain and live a better life…

best-pain-doctor-nycWelcome to my blog about pain. Unfortunately, many people suffer from chronic pain. As a board certified physician in physical medicine and rehabilitation, my specialty is treating these people with both acute and chronic pain.

A majority of my practice is working with patients that are experiencing back and neck pain.

My goal with this blog is to help patients who are experiencing any type of back or neck pain to understand what is causing their pain and discuss options that are available to end their pain. I hope to be able to provide readers with a portal that they can can use to educate themselves and facilitate treatment.

My specialty is my Interventional Spine Skills including cervical and lumbar epidural steroid injections, facet injections, medial branch blocks, Radiofrequency ablation, sympathetic ganglion blocks, spinal cord stimulator trials, sacroiliac joint injection, piriformis muscle block and musculoskeletal joint injection. I also perform many other procedures to alleviate acute and chronic pain.

I hope you enjoy reading my blog as much as I enjoy writing it and observing people from all over the world reading it.

– Matthew Grimm, M.D.

Category Archives: Back Pain

How Do Spinal Cord Stimulators Aid In Pain Relief?

For those people who are suffering from significant pain, finding a treatment option can be difficult to do. Oral medications tend to be the first line of care. Doctors may also use nerve blocks to help minimize the pain and control the function of the nerves that are sending pain signals to the brain. In some cases, these are also ineffective. When that occurs, more advanced treatment options become necessary. The use of implantable systems can be helpful to some people in these chronic pain conditions.

What is Spinal Cord Stimulation?Spinal-Cord-Stimulator

In some situations, the goal of these systems is to interrupt the transmission to the brain. When a nerve feels pain, such as in the fingertips, the nerve sends an electrical impulse to the brain. These tools work to interruption that flow of messages from the spinal cord to the brain. In doing so, it may work to reduce the amount of information the brain has about the pain, thus helping the individual to feel better.
Spinal cord stimulation is a type of pain control method like this. In this method, the device works to provide low levels of electrical current. This current is applied to the dorsal portion of the spinal cord. In doing this, it creates a block to the pain. The pain slows and stops while the stimulation is occurring and the individual feels significant relief.

The spinal cord stimulation device is implanted under the skin during a surgical procedure. This device can sometimes have an internal or external power source, depending on the model selected by the doctor. It is often used in conditions in which the pain is severe and other treatment options are not effective. There are some risks to using this type of device, but for those that receive some level of improvement from pain, it can be well worth it.

Could This Be a Treatment for You?

LowBackPiainEvery individual’s pain is different. The best course of treatment for you is one that is going to help you to find relief and it may take trying a variety of methods to get to that point.

 

Call us at 646-862-5555 and schedule a consultation to meet with Mathew Grimm the best New York pain doctor in the area. Take a few minutes to learn more about your options.

Epidural Injections for Back Pain: Good or Bad?

Epidural Steroid Injections (ESIs) are commonly used for treating pain in lower back and sciatica. They have been used since the 1950s and have become an important part of non-surgical pain management for back pain and sciatica. For many patients, the injections are enough to relieve the pain. But as in any pain management treatment, there are pros and cons to epidural injections.

How epidural injectionsLong Does an Epidural Injection Last?

The effect of an epidural injection can range from temporary or can last from a week to even a year. For patient with an acute episode of back pain or leg pain, an epidural injection can provide immediate pain relief. Typically, three injections are used on a patient who finds relief with the first shot. Most pain doctors require 4-6 months between each injection.

Epidural Injections Focus on the Pain

With painkillers and steroids, the relief is not easily focused. With Epidural Steroid Injections, the exact area is targeted. Patients know right away if the injection is working.

Epidural Injections Flush out Chemicals

Back pain is mostly caused by chemical inflammation, which also leads to swelling in the affected area. Epidural Steroid Injections flush out the harmful chemicals like inflammatory proteins,, while significantly relieving the pain and swelling.

What Is the Success Rate of Epidural Steroid Injections?

The success rates of the epidural injections are always dependent on a patient’s condition and the level of pain they have. The benefits provided by Epidural Steroid Injections are substantial. When properly done using x-ray or fluoroscopic guidance, over 50% of patients suffering from back pain reported pain relief.

Risks Associated With Epidural Steroid Injections

There is a certain amount of risk involved with all medical procedures and lumbar epidural is no exception. But, the risks associated with ESIs are uncommon, but they must be mentioned so individuals are aware of them before and after an Epidural Steroid Injectionprocedure:

  • Nerve Damagepain doctor epidural injections for back pain 4
  • Bleeding
  • Infection
  • Dural Puncture

What Are The Side Effects Associated With Epidural Steroid Injections?

As in any medical procedures, there can be side effects dependent on the patient’s age, health and other medical conditions. Side effects from Epidural Steroid Injections are rare, but they can include:

  • Increase in localized pain.
  • Headaches that go away after 24 hours.
  • Flushing of the face.
  • Sleep problems.
  • Fever on the night the injection
  • Anxiety.
  • A high level of blood sugar.
  • Stomach ulcers.

In the end, only a patient can decide if Epidural Steroid Injections are the best option for relieving back pain. Contact us today at 646-862-5555 to learn more about ESIs and to schedule an appointment with the best back pain doctor in NYC.

Spinal Pain Doctor

Spinal Pain Doctor

There are many types of pain doctors that care for patients experiencing pain due to spinal conditions. Choosing the most appropriate type of health care provider greatly depends on the patient’s symptoms, such as the duration and severity of the spinal pain. Most patients first discuss their spinal pain symptoms with a primary care provider such as a medical doctor, chiropractor or doctor of osteopathic medicine, but if the patient’s spinal or back pain does not respond to initial treatment, the services of a spine specialist may be the best option.pain doctor

Spinal Disc Problems

Spinal disc problems can lead to symptoms of back pain and/or sciatica. Back pain with sciatica is a common back pain complaint. Most patients have a “simple” back pain where serious underlying issues are unlikely. However, a skilled spinal pain doctor will always be aware of warning signs which may justify investigation or even an emergency admission to further diagnose and treat the spinal pain. Spinal disc problems can include:

  • Disc herniation

  • Degenerative disc disease

  • Infection

pain doctor

Three Groups of Health Providers Who Treat Back Pain

For many people with back pain, the first contact for most back pain sufferers is the general doctor. The first group includes primary care physician, family practice doctor, internist, pediatrician, chiropractor and Doctor of Osteopathy. They are also the medical practitioners that usually diagnose a spinal problem and refer their patients to spine specialists.

The second group of health care providers is composed of spine specialists have a specific area of expertise in diagnoses and treatments for spinal and back pain. These specialists are surgeons, physiatrists, anesthesiologists, neurologists and rheumatologists.

For patients with chronic spinal problems or back pain, the third group includes therapists for back pain or psychological help:

  • Physical Therapist

  • Occupational Therapist

  • Clinical Psychologist

The first step in finding the best spinal pain doctor is to have an examination so a proper diagnosis for care and treatment can be made. Contact us today to schedule an appointment with the best spinal pain doctor in NYC.

When to See a Doctor for Back Pain

back painSometimes a little back pain comes into every person’s life. Milder backaches can generally be successfully managed by simple back pain treatments such as rest, medicines, therapeutic massage, physical therapy, exercise and weight loss. But when back pain is persistent and affects the quality of your life, it indicates the need for an evaluation and possibly surgery. Avoiding a visit to a back pain doctor might allow the underlying condition of your back pain to worsen. If you are experiencing back pain that has any of the following symptoms, it’s time to see a doctor for back pain:

  • Back pain that follows an accident, such as a car collision or a slip and fall.

  • The pain is constant and getting worse.

  • Back pain that continues for more than 4 weeks.

  • The pain is severe and does not improve after a few days of rest and ice.

  • Does not respond to common pain relievers (ibuprofen or acetaminophen).

  • The pain worsens at night, as opposed to alleviating the pain after resting.

  • Severe pain that wakes one up from deep sleep.

  • Numbness or altered sensation in the upper inner thighs, groin area, buttock or genital area.

  • Neurological problems, such as weakness, numbness or tingling in one or both legs or arms.

If you are facing any of the following serious scenarios along with moderate to severe back pain, immediate medical attention is usually needed:

  • back painPersistent back pain in cancer patients.

  • Back pain in a younger people (under 20).

  • Individuals who have osteoporosis.

  • Steroid users.

  • Individuals who have HIV.

  • Any obvious deformity of the spine that shows up suddenly or over time.

  • Blood in the urine, possibly burning during urination with (or without) one-sided back pain

  • Major, unexplained weight loss with back pain and neurological impairment

Finally, these symptoms along with back pain should never be ignored and do warrant going to the emergency room and immediately being evaluated by a pain doctor:

  • Abdominal pain

  • Progressive leg weakness

  • Uncontrolled bladder and bowels

While the above described symptoms and possible conditions may seem unnerving, it is important to remember that most causes of back pain are not life threatening and will usually get better in several weeks with proper diagnosis and treatment.

If you or a family member is experiencing acute or chronic back pain, contact us today to schedule an appointment with the best pain doctor in NYC.

How to avoid the need for disc surgery. Alternatives to neck or low back surgery:

What are my alternative options to disc surgery?

 

Treatment options for neck or low back pain

When a patient presents with a herniated cervical or lumbar disc with clinical evidence of nerve root irritation (cervical or lumbar radiculopathy), he or she has several choices: no surgery, traditional open surgery, microscopic surgery or micro-endoscopic surgery. If he or she chooses no surgery, evidence shows that the herniated disc may decrease in size or disappear within a few weeks or months. Epidural injections may also prevent the need for neck or back surgery.

Types of surgical treatment: open discectomy vs. micro-discectomy

Surgery is generally reserved for patients who fail to respond to conservative treatment or have significant or progressive weakness or loss of sensation due to irritation of a nerve root by a herniated disc.

Traditional Open Discectomy

A traditional open discectomy causes considerably more disruption of spinal tissues than a microsurgical procedure usually resulting in a longer recovery time.

Microsurgical Discectomy

A microsurgical discectomy is minimally invasive and is less disruptive of spinal tissues usually resulting in a shorter recovery time.

The goal of surgery is the removal of any material (usually disc material) pressing on the spinal nerve. At the least, the portion of the disc which protrudes into the spinal canal is removed. More aggressive surgery involves exploring the ruptured disc for any loose fragments. The aim of the more aggressive approach is the prevention of recurrent disc herniation.

Micro-endoscopic discectomy

An even less invasive form of cervical or lumbar disc surgery involves the use of endoscopes. An endoscope is a long thin tube which contains a light and a video camera allowing the surgeon to visualize the spinal structures on a monitor. The surgery is performed using very fine instruments through the same tube (also called a cannula).

How to avoid the need for disc surgery

Dr. Grimm often will prevent the need for disc surgery by performing epidural injections and/or prescribing physical therapy.

Contact us today to schedule an appointment with best back pain doctor in NYC, and hopefully avoid the need for disc surgery.

Trigger Point Injections

 

Best Pain Management Doctor NYC3Trigger point injections are used to treat chronic pain in discrete, focal muscle groups in the neck, arms, legs, and lower back. These multiple muscle groups have trigger points, which are hyperirritable knots of muscle that are taut and which fail to relax. These cause local pain, which may also radiate or spread to other parts of the body. Although trigger points may be treated using nonsteroidal anti-inflammatory drugs, antidepressants, physical therapy and acupuncture, their effects are often short lasting compared to trigger point injections.

Trigger point injections may also be used to treat a variety of conditions, including fibromyalgia, tension headaches, temporomandibular joint pain, and myofascial pain syndrome.

How Trigger Point Injections WorkBest Pain Management Doctor NYC2

Trigger-point injection is a minimally invasive, safe, and effective way to inactivate trigger points and provide prompt, symptomatic pain relief. The procedure involves inserting a small needle into the patient’s trigger points, which are located in muscle groups in the neck, arms, legs and lower back. The injection contains a local anesthetic and may include a corticosteroid to reduce inflammation. Usually, a brief course of treatment that is given in a doctor’s office will result in sustained relief. Since the treatment uses locally administered medications, it does not have a widespread effect on the body; rather, only painful areas are targeted, and no systemic side effects are expected.

Patients benefit from this procedure because after the injection, trigger points are inactivated and inflammation and pain are reduced for several months, allowing the patient to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.

Best Pain Management Doctor NYC4General Procedure

A trigger point injection is an outpatient procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. The patient is initially briefed about the procedure and prepared beforehand so that he is relaxed.

The patient is placed in a comfortable recumbent position (either prone or supine) to allow muscle relaxation. Trigger points are located by palpating the muscles and finding knots under the skin. Once a trigger point is located the overlying skin is cleansed. The doctor isolates the point with a pinch between the thumb and index finger to stabilize it and inserts a needle directed to the point. The doctor warns the patient of the possibility of a sharp pain, muscle twitching, or unpleasant sensation when the needle touches the tight muscular band.

A small amount of local anesthetic is injected into the trigger point. The doctor then withdraws the needle a little and redirects it in different directions under the skin, injecting small amounts of anesthetic in each direction. This is done until the local twitch response is no longer elicited or muscle tautness is no longer felt. Pressure is applied on the skin after the needle is completely withdrawn to stop any bleeding. A simple bandage is applied to cover the area.

Post-injection soreness may be experienced, but this is expected to resolve in a few days. Patients are encouraged to remain active, using a full range of motion in the muscles, but are advised to avoid strenuous activity a few days after injection.

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Trigger Point Injection is a minimally invasive, safe, and effective means of treating muscle pain that is unresponsive to other forms of treatment. If you want more information about treating painful trigger points, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your pain.  Make an appointment with the NYC’s top board-certified interventional pain management physician to know if trigger point injections are a treatment option for you.

Best Pain Management Doctor NYC5

Treatment of Acute and Chronic Pain

Treatment of acute and chronic pain p02Pain is an unpleasant symptom that sends a signal that something may be wrong or that damaging stimuli may be present in the body. This uncomfortable feeling may range from mild to severe, and may last for a short moment, come and go, or persist for a long time.

A variety of conditions can cause pain, including injury, degenerative processes, and disease. Its treatment depends on many factors, and while some types of pain respond to single treatments, others may need a combination of treatment modalities.

Treatment of Acute Pain

Treatment of acute and chronic pain p01Acute pain often occurs suddenly and is usually localized and sharp in quality. It warns an individual of a disease or a threat to the body, or it may be caused by injury, surgery, or natural processes like childbirth. Acute pain may be mild and short lasting, or it may be severe and long lasting. In most cases, however, it disappears when the underlying cause has resolved. If unrelieved, acute pain may lead to chronic pain.

Treatment of acute and chronic pain p03The treatment of acute pain often involves identifying an underlying cause and treating it. Options for symptomatic treatment of pain may include the use of:

· Hot compress

· Ice packs

· Oral medications like Acetaminophen (ex. Tylenol®)

· Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen

· Local anesthetic injection (ex. lidocaine)

· Nerve blocks (epidural anesthesia)

· Physical therapy, including massage and exercise

· Surgery

Depending on the type and cause of acute pain, symptoms may be managed by general practitioner, an internist, a surgeon, or a pain management specialist.

Treatment of Chronic Pain

Pain that persists despite healing of an injury or disease may be considered as chronic pain because pain signals in the nervous system remain active for several weeks, months, or even years. The pain may lead to other symptoms like muscle tension, limited mobility, depression, lack of energy, anxiety, sleep disturbances, and changes in appetite. These symptoms may also affect an individual’s daily activities and relationship with others. Common complaints include low back pain, chronic headaches, arthritis, cancer pain, neurogenic pain, and psychogenic pain.

Although chronic pain may originate from an injury or disease process, some people suffer from long lasting pain in the absence of physical injury or damage. The cause of chronic pain may be unknown or undiagnosed; however, treatments may be given to relieve the individual’s symptoms and to improve the quality of their life. Usually, a combination of treatments is needed, and these are often given to suit individual needs. These may include:

· Oral pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs), although its use may be limited because of potential side effects from chronic use

· Narcotics (such as morphine or codeine), although its use is limited by its potential for abuse and side effects

· Other medications, such as anticonvulsants, antidepressants, and anxiolytic drugs

· Localized anesthetic injections, like trigger point injections and hip joint injections

· Nerve blocks, like stellate ganglion block and epidural block

· Electrical stimulation, like spinal cord stimulation

· Radiofrequency ablation

· Physical therapy

· Psychotherapy

· Relaxation techniques such as deep breathing

· Biofeedback

· Behavior modification

Because of the complexity of the character of chronic pain, its treatment has evolved into a specialty. The management of chronic pain in most cases involves a multidisciplinary approach. This means that a team of specialists may be needed to evaluate, diagnose, and treat one’s condition, including internists, surgeons, anesthesiologists, psychiatrists, and physical therapists. Most patients who suffer from persistent pain that does not respond to conventional treatments are referred to a Chronic Pain Clinic, which is managed by a Chronic Pain Specialist, a highly trained physician to diagnose and treat difficult cases of pain syndromes.Tallahassee pain doctor

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If you need more information about pain and its associated symptoms, make an appointment with NYC’s top Pain Management Specialist who will help improve your symptoms, increase your mobility, and take control of your life.

Piriformis Injections

Severe buttock and leg pain.

Leg and buttock pain doctor nyc 01Piriformis injections are indicated for patients who experience severe buttock and posterior leg pain characteristic of Piriformis Syndrome, a chronic condition that involves the lower sacral muscle. Piriformis syndrome may constitute up to 6-8% of low back pain conditions associated with sciatica, which refers to pain, weakness, numbness, or tingling in the leg. Tightness of the piriformis muscle may cause nerve and vessel entrapment because of its proximity to the large sciatic nerve and blood vessels, causing a deep aching sensation in the mid-gluteal region (buttock) that is associated with pain radiating down the back of the leg.

How Piriformis Injections Work

A piriformis injection involves deposition of a mixture of local anesthetic and steroid medication into the muscle, which will helps reduce pain and inflammation around the nerves that pass near the piriformis muscle. This will also reduce other symptoms such as numbness, tingling or swelling. Since the treatment uses locally administered medications, it does not have a widespread effect on the body; rather, only painful areas are targeted, and no systemic side effects are expected.

Patients benefit from this procedure because after the injection, inflammation and pain are reduced for several months, allowing the patient to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.

General Procedure Piriformis Injection

buttock and leg pain doctor nyc 02A piriformis injection is an outpatient procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. The patient is initially briefed about the procedure and prepared beforehand so that he is relaxed.

The patient is asked to lie prone (on their abdomen) on the table. The skin on the affected buttock is sterilized. Next, a small area of skin is injected with numbing medicine (local anesthesia). When ready, the physician directs a small needle into the piriformis muscle, using x-ray guidance. Other imaging techniquesbuttock and leg pain doctor nyc 03 may be used, such as ultrasound, or electromyography to identify the muscle and the sciatic nerve. A small amount of dye is injected to insure proper needle position. The physician asks the patient to move their leg during the procedure. This consists of rotating the leg outward and moving it straight to the side away from the other leg. A mixture of local anesthetic and anti-inflammatory (steroid) is injected into the muscle. The needle is then slowly withdrawn.

Patients are then monitored in the recovery area and discharged on the same day. Numbness or weakness in the leg are temporary and will disappear in a few hours. After discharge, patients are asked to evaluate the relief they experience during the next week and report for follow-up. It may take at least 72 hours before the full effect of the steroid is observed. Repeat injections may be performed up to three times, if needed, every two weeks.

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A Piriformis Injection is a minimally invasive, safe, and effective means of treating buttock and leg pain that is unresponsive to other forms of treatment. If you want more information about treating chronic low back pain, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your pain.  Make an appointment with the NYC’s top board-certified interventional pain management physician to know if piriformis injections are a treatment option for you.

Implantable Spinal Cord Stimulator Doctor NYC

Spinal cord stimulator doctor nyc 01

Spinal cord stimulator implantation NYC for Chronic Pain.

Spinal cord stimulation is a safe and effective method of blocking chronic spinal pain that uses low voltage electrical currents to stimulate the spinal nerves. It helps patients to better manage their pain and decrease the use of pain medication. It is an option for patients who have chronic leg or arm pain, failed back surgery syndrome, complex regional pain syndrome, and other severe nerve-related pain or numbness.

Spinal cord stimulator doctor nyc 02

How Spinal Cord Stimulation Works

A small battery-powered spinal cord stimulator is implanted in the body to transmit an electrical current to the spinal cord. A trial stimulator used percutaneously (through the skin) may be done to give the treatment a trial run. If patient response is successful, a ‘permanent’ stimulator may be implanted under the skin of the abdomen, with the small, coated wires (leads) inserted under the skin to the point where they are placed into the spinal canal.

After the procedure, the patient and the doctor determine the best pulse strength to be applied. The patient is instructed on how to use the stimulator at home, which usually consists of stimulation for 1 to 2 hours, 3 to 4 times a day. Spinal cord stimulation creates a tingling feeling, which blocks the pain signals to the brain. The goal of treatment is a 50-70% reduction in pain. Patients benefit even with incomplete removal of pain, which allow them to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.

General Procedure – Spinal Cord Stimulator Implant Procedure

Implantation of a spinal cord stimulator is an outpatient procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. The patient is initially briefed about the procedure and prepared beforehand so that he is relaxed. He may be lightly sedated or placed under general anesthesia during the procedure.

The patient is placed lying on his side or on his stomach on the operative table. The areas of your back and abdomen where the leads and the generator are to be placed are shaved and sterilized. Local anesthetic is injected where incisions are to be made to numb the area.

The placement of surgical leads is performed with x-ray guidance (fluoroscopy). A small skin incision is made in the middle of the back and the leads are inserted in the epidural space above the spinal cord using a small needle or through a small incision. The generator is usually implanted in the abdomen.Spinal cord stimulator doctor nyc 03

The patient is monitored in the recovery area after the procedure. Most patients are discharged on the same day, but some physicians request an overnight stay in the hospital. The pulse generator will be programmed before the patient leaves. He will receive instructions on how to care for the incision area and how to program and regulate the device.

Contact Us to schedule a consultation for a spinal cord stimulator  implant.

Spinal Cord Stimulation is a safe and effective means of treating chronic spinal pain that is unresponsive to other forms of treatment. If you want more information about treating chronic spinal pain, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your pain.  Make an appointment with the NYC’s top board-certified interventional pain management physician to know if Spinal Cord Stimulation is a treatment option for you.

Radiofrequency Ablation of the Medial Branch Nerves

Radiofrequency Ablation of the Medial Branch Nerves 01

Radiofrequency Ablation of the Medial Branch Nerves

is a safe and effective way to relieve chronic lumbar (lower back) pain using radio waves to create heat. These radiofrequency waves are electromagnetic waves that travel at the speed of light and Radiofrequency Ablation of the Medial Branch Nerves 03blocks nerve tissue from transmitting pain signals to the brain. The medial branch nerves are sensory nerves that carry pain signals from injured facet joints to the brain. Facet joints are parts of the spinal bones (vertebrae) that allow one to do a wide range of motions. Injury or degenerative changes in these joints, particularly in the lower back, can cause inflammation and severe pain, which may not respond to conservative medical therapy. (click picture to enlarge)

How Radiofrequency Ablation Works

Radiofrequency ablation provides long-term pain relief that exceeds the effects of a nerve block or other types of injections. Various types of chronic pain conditions respond well to radiofrequency ablation including pain from previous spinal surgery, whiplash injury, complex regional pain syndrome and spondylitis (arthritis of the spine).

The procedure involves the placement of insulated needles with a tiny electrode next to the medial nerve branch. A small radiofrequency current is directed to the medial branch nerve of the facet joint for 60-90 seconds, which generates heat (60-80 degrees Celsius) that destroys the nerve tissue. The result is blockage of pain signals to the brain.

Radiofrequency Ablation of the Medial Branch Nerves 05Radiofrequency ablation is a relatively safe and common technique that can provide dramatic and long-lasting pain relief without systemic side effects. Patients benefit from this procedure because pain is reduced for several months, allowing the patient to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.

Radio Frequency Ablation for Back Pain: General Procedure

Radiofrequency ablation is an outpatient procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. The patient is initially briefed about the procedure and prepared beforehand so that he is relaxed.

The patient needs to be relaxed but alert during the procedure to help the doctor correctly place the electrode used during nerve ablation. The procedure will take 20-45 minutes, with the patient lying on their stomach (prone). After the skin is properly sterilized, local anesthesia is injected to numb the area.

Radiofrequency Ablation of the Medial Branch Nerves 02Using x-ray guidance, insulated needles are directed next to the targeted medial nerves. The doctor will use X-rays to guide twin, insulated needles with an electrode are placed next to the nerve. During the procedure, the doctor asks the patient if he feels a tingling sensation or a muscle twitching. These signs will help ensure the electrode isRadiofrequency Ablation of the Medial Branch Nerves 04 properly positioned. Once the needle and electrode are placed correctly, the nerve is heated with radio waves until pain signals to the brain are blocked.

Post Operative Recovery after Radiofrequency Ablation Procedure for Back Pain:

After the procedure, the patient is monitored in a recovery area and discharged when stable. The patient may feel some local pain for several days after the procedure, which may be relieved by oral medications. Some swelling or bruising may occur where the needle was inserted and this may be reduced by applying a cold pack. It may take weeks for the full effects of radiofrequency ablation to be felt, but the pain relief may last for six months or even longer. Some nerves grow back, and radiofrequency ablation may need to be repeated.

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Radiofrequency Ablation of the Medial Branch Nerves is a minimally invasive, safe, and effective means of treating low back pain that is unresponsive to other forms of treatment. If you want more information about treating chronic low back pain, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your back pain.  Make an appointment with the NYC’s top board-certified interventional pain management physician to know if radiofrequency ablation is a treatment option for you.