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: Doctor for epidural injection

What Is an Epidural Steroid Injection?

Epidural Steroid Injection for Back Pain

Best-Epidural-Doctor-NYC-2An epidural steroid injection is commonly used to treat unremitting spinal nerve root irritation (e.g., a “pinched” nerve in the neck or low back). Spinal nerve root irritation most frequently occurs either in the cervical or lumbar spine and is due to compression of the nerve root by a protruding or herniated disc.

Cervical and lumbar disc disease affects millions of Americans each year. Conservative treatment consists of oral nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), stronger painkillers such as opioids and often, physical therapy. When this regimen fails to relieve pain, epidural corticosteroid injections are frequently the next chosen step.

Anatomy of the Spinal Cord

Best-Epidural-Doctor-NYC-1The spinal cord is suspended in cerebrospinal fluid and encased in three membranes. The outermost membrane is the toughest and is called the dura. Each spinal nerve exits the membrane-enclosed sac just below its corresponding vertebra. Thus, an “epi”-dural injection bathes the spinal nerve after it exits the outermost membrane.

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The injection is performed with the aid of fluoroscopy which is a real-time x-ray technique that allows the physician to visualize the placement of the needle. The injection is localized to the spinal level that is clinically suspected to be involved.

Injection of the corticosteroid medication in this way allows the use of a high dose for maximal anti-inflammatory action directed to the affected nerve root. The rest of the body is spared exposure to such a high dose.

Limitations of Epidural Injections

Epidural steroid injections are typically limited to a series of three. Deleterious effects of the hormone on the spinal tissues are thus minimized.

If you suffer from back pain you may be a candidate for an epidural injection. Contact one of NYC’s most experienced pain doctors, Dr. Matthew Grimm, for more information about epidural injections.

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Dr. Grimm answers the question: What is an EMG test?

What Is an EMG?

Best-EMG-Testing-Doctor-NYC-1Electromyography or EMG is a study of the electrical activity of muscles. If you have numbness or weakness your doctor may request an EMG to determine the cause. In cases of neck or low back pain associated with numbness or weakness of an arm or leg, an EMG can help to identify which nerve root is compressed or irritated. This can help guide treatment decisions.

An EMG test is routinely accompanied by a nerve conduction study in order to definitively identify the level of nerve involvement. In other words, your doctor wants to make sure that your leg numbness or weakness is not caused by a problem of your peripheral nerves.

Procedure: How is an EMG done?

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Under sterile conditions, a very fine electrode is inserted into select muscle groups to measure their electrical activity at rest and during contraction. The electrical activity is visualized on a computer monitor and analyzed by the performing physician.

During the nerve conduction portion of the exam, select peripheral nerves are stimulated electrically and responses of the appropriate muscle groups are recorded. This test determines the integrity and function of your peripheral nerves.

Indications for an EMG

Best-EMG-Testing-Doctor-NYC-3An EMG and nerve conduction study is frequently performed in cases of neck or low back pain specifically for the purpose of identifying cervical or lumbar nerve root irritation. Assuming that nerve root irritation has been present for at least three weeks, the test can aid in localizing the level and severity of nerve root involvement. An EMG is a valuable adjunctive test in the evaluation of neck or low back pain when nerve root irritation is suspected.

If you suffer from neck or back pain, contact the best pain doctor in NYC, Dr. Matthew Grimm to schedule an examination.

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