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: Shoulder Pain

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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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.

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PRP Injection for shoulder pain – Case Study

Today I would like to share with you a case study in which a series of three PRP injections helped one of my patients with shoulder pain. The pain was debilitating and prevented her from working (She works as a server in a restaurant and could not carry trays).

imageThis patient is a 41 year old female that came to my office with a chief complaint of right shoulder pain for 10 weeks. She states she was working out on a machine at the gym more than she usually does and woke up the next day with significant pain in her right shoulder. She is right dominant. She reported severe pain with any range of motion of her shoulder.

She had been taking prescription anti-inflammatories prescribed by her internist. She had been out of work, avoiding the gym and resting. She had applied ice as well. None of these relieved the pain and it was not getting better at all.

Physical examination revealed pain and stiffness with range of motion. There was weakness and guarding. There was localized swelling and imagetenderness to touch.

MRI of the right shoulder revealed bursitis and a tear of the rotator cuff.

A steroid injection into the right shoulder failed to relieve the symptoms. After the steroid injection I performed a series of 3 PRP injections into the shoulder joint.

She got progressively better after each PRP injection and after the third injection she reported that she was pain free and back to the gym and work.