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: leg pain

Doctor for Knee Pain

Orthopedist for Knee Pain

Knee pain is best diagnosed and treated by an orthopedic surgeon, also known as an orthopedist.

Orthopedists have up to 14 years of formal education that includes college, medical school and five years of postgraduate work at a hospital or medical facility. Some orthopedists also choose specialization in orthopedics such as pediatric medicine or choose to concentrate in knee pain
specific part of the body such as the knee.

When to Call a Doctor for Knee Pain

If your symptoms have not gone away after trying 3-7 days with over-the-counter anti-inflammatory pain medications, you should set up an appointment with your doctor. Even if your knee injuries are not disabling, any knee injury that causes pain when you walk should be evaluated by a general doctor or an orthopedist as soon as possible.

How to Find a Doctor for Knee Pain

There are many ways to find an orthopedic surgeon. Family doctor or primary care physician can provide a referral to a doctor who specializes in orthopedic medicine. If you don’t have a general doctor who can give you a referral, visit the American Academy of Orthopedic Surgeons (AAOS) website and search for orthopedic doctors in the NYC area. The site will list the orthopedist

along with the doctor’s information including contact information, education and any specialties and additional training.knee pain

Once you have narrowed a list of potential doctors for knee pain, check with your insurance company to see which doctors are included in your plan. If you do not have insurance, contact the

doctor’s office to see if they offer payment options.

When to Seek Emergency Medical Attention for Knee Pain

Individuals who experience severe pain in their knees and have had a traumatic injury should immediately go to the emergency department or urgent care center. Prompt attention can help a bad knee problem from getting worse. Additionally, many fractures (broken bones) may require immobilization in a specific position to avoid further trauma to the knee. In some emergencies, surgery may be needed as soon as possible. Putting off seeing a doctor may affect healing properly from a knee injury. Other signs and symptoms of knee pain that require immediate evaluation includes:

  • Unable to stand up or walk without severe knee pain

  • Fever

  • knee painDrainage

  • Large or puncture wounds

  • Swelling, if you are taking a blood thinner or have a bleeding disorder

  • Redness and the warm feeling in knee area

Whether you need prompt medical attention for your knee pain or are looking for a new orthopedist, please contact us today to schedule an appointment with the best knee Pain doctor in NYC.

Epidural Steroid Injections for Leg Pain

Epidural Steroid Injections for Leg Pain

Leg pain (also known as radicular pain), numbness and tingling and weakness is most often caused by herniations and bulging in spinal cord discs and bone spurs causing stenosis and nerve impingement. 

Pain management often includes anti-inflammatory medications, postural and exercise education and epidural steroid injections (ESI). Early treatment is essential to prevent further damage and reduce the number of epidural steroid injections. An epidural steroid injection in combination with physical therapy plays an important role in treating patients with leg pain.

Treatment of Leg Pain with Epidural Steroid Injections

Epidural steroid injections (ESI) have been used since the 1950s for treatment of pain. Lumbar epidural steroid injections can help most patients with long-term relief of pain due to nerve root irritation and reduce the chances of needing surgery. epidural injection

Epidural injections are often administered after a trial of conservative medication management, physical therapy and activity modification. Most pain doctors recommend 6 weeks as a reasonable timeframe to try conservative approaches before prescribing epidural steroid injections. This is usually enough time to allow patients to work through a rehabilitation program and improve their level of function and ability to perform daily tasks with little or no pain.

If a patient is suffering from severe leg pain or there are there are neurological signs or symptoms, then starting epidural steroid injections prior to 6 weeks is reasonable and can be helpful in the reduction of leg pain. If the first injection provides partial but significant improvement, then a second injection will be given to help eliminate the remaining leg pain.

Some patient experience substantial response that lasts several days, weeks or months but the pain returns. At that time your leg pain doctor may prescribe another injection.  Two weeks or more between epidural injections is the typical recommendation. Additional injections are made in consultation with your doctor. 

leg painEpidural Steroid Injections and Physical Therapy

The treatment of leg pain involves a combination of medications, therapies and injections to manage pain and allow patients to return to their daily living and work activities.  Physical therapy can also help reduce pain, avoid further injury to the leg and can also reduce time away from work.

Surgical Intervention

If leg pain does not respond to conservative treatment efforts and epidural steroid injections, then surgical intervention may be needed.  If surgery is recommended, it will be scheduled by your doctor dependant on the urgency of the situation. Patients with severe pain or weakness in their leg will receive prompt surgical intervention.

If you or a loved one is experiencing leg pain or have questions about surgery, contact us today at 646-862-5555 to schedule an appointment with the best Pain doctor in NYC.

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.

Contact Us

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

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.

Contact Us

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.