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: Hip Pain

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.

Hip Joint Injections for Chronic Hip Pain –Top Pain Doctor NYC

Hip joint injections are safe and effective means of treating chronic hip pain that does not respond to conventional medical treatment.

Best Pain Doctor NYC for Hip Joint Injections for Chronic Hip Pain 01The hip joint is a large ball-and-socket joint where the thighbone joins the pelvis. The ball (upper end of the femur or thighbone) is held in the socket of the pelvic bone by a group of ligaments that form a capsule around the joint. The cartilage between the two bones allows them to move against each other without friction.

Best Pain Doctor NYC for Hip Joint Injections for Chronic Hip Pain 02The most common disease affecting the hip joint is arthritis, a degenerative, inflammatory condition that results in loss of joint cartilage, erosions of the joint, formation of bone overgrowth (or ‘spurs’), and ultimately leads to chronic pain and instability of the joint. Injury or mechanical stress can also result in inflammation and pain in the hip joint. Aside from the joint, the patient may also experience chronic pain in the buttocks, lower back, and leg, which are commonly known as referred pain from the hip.

Hip joint injections may be considered for patients experiencing these symptoms. These injections can help relieve the pain, as well as help diagnose the cause of pain.

How Hip Joint Injections Work

Hip joint injections involve depositing of medicine, consisting of a mixture of a local anesthetic and a steroid, directly into the joint. These injections can help diagnose the source of pain, because by placing the medicine into the joint, the amount of pain relief experienced will help confirm whether the joint is the source of pain. Complete pain relief in the hip joint confirms that this area is likely to be the source of pain.

Along with the local anesthetic, time-release steroid is also injected into the hip joint to reduce inflammation, which often provides long-term pain 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, 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

Best Pain Doctor NYC for Hip Joint Injections for Chronic Hip Pain 03A hip joint 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 on a lying position and the affected hip is sterilized. After the exact area to be injected is located using live x-ray guidance (fluoroscopy), the skin overlying the hip joint is numbed with a local anesthetic.

A needle is advanced into the hip joint. A small amount of water-soluble dye may be injected to confirm proper needle position. Once this is confirmed, a mixture of anesthetic and anti-inflammatory medication (steroid) is injected into the joint space. The needle is then slowly withdrawn.

After the procedure, the patient is monitored in the recovery area and discharged on the same day. Upon discharge, they will be asked to evaluate their improvement in the succeeding week and report for follow-up. Repeat injections may be performed up to three times, if needed, every two weeks.

Contact Us

A Hip Joint Injection is a minimally invasive, safe, and effective means of treating chronic hip joint pain that is unresponsive to other forms of treatment. If you want more information about treating chronic hip joint 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 hip joint injections are a treatment option for you.